Case study: Correction of angular deformity post-trans-tibial amputation to improve prosthesis fit and comfort

2014 ◽  
Vol 39 (2) ◽  
pp. 157-160 ◽  
Author(s):  
Beth Lineham ◽  
Paul Harwood ◽  
Peter Giannoudis
Keyword(s):  
Soft Tissues ◽  
Wedge Osteotomy ◽  
Angular Deformity ◽  
Amputation Level ◽  
Soft Tissue Problems ◽  
Surgical Options ◽  
Case Basis ◽  
Insight Into

Background:This case report describes the revision of a trans-tibial amputation complicated by a proximal malunited fracture. It demonstrates the complexity of decisions involved in revisions of this nature.Case description and methods:The patient presented has a painful stump due to breakdown of soft tissues. She had been suffering for over a year with pressure sores and inability to use a prosthesis resulting from this, decreasing her quality of life. Malunion of a tibial fracture proximal to the amputation complicated her condition.Findings and outcomes:Initially it was feared that the amputation level would be converted to a through-knee amputation, but wedge osteotomy of the tibia allowed coverage of the stump, increasing functionality for the patient, while still maintaining a below-knee stump.Conclusion:This report highlights the importance of addressing the cause of soft tissue problems in an amputation revision, which must be addressed on a case-by-case basis.Clinical relevanceThis case offers an insight into the decision-making process in limb reconstruction and suggests a solution for similar cases. It is important that all surgical options are considered before amputation length is sacrificed.

Change in residual limb size over time in the NU-FlexSIV socket: A case study

2018 ◽  
Vol 42 (6) ◽  
pp. 620-625
Author(s):  
Stefania Fatone ◽  
Jessica Yohay ◽  
Ryan Caldwell
Keyword(s):  
Soft Tissues ◽  
Internal Surface ◽  
Residual Limb ◽  
Long Term Effect ◽  
Long Time ◽  
The Subject ◽  
Insight Into ◽  
Over Time

Background: This case study represented a unique opportunity wherein a long-time user of sub-ischial sockets had kept nearly every socket he wore for a decade. This individual let us borrow these sockets so we could digitize them and indirectly assess change in residual limb size over time by calculating changes in socket volume and circumferences over time. Case Description and Methods: Over a decade, the subject maintained a relatively stable body weight of 84–88 kg and received nine sub-ischial sockets. The internal surface of each socket was scanned using a mechanical digitizer and volume and circumferences calculated. Findings and Outcomes: Socket volume increased 31.3%, from a low of 2659.2 cm3 for the oldest socket to a high of 3490.6 cm3 for the most recent socket. Proximal circumferences increased more than distal circumferences with a 15.9% total increase proximally versus 8.9% total increase distally. Discussion and Conclusion: The results suggest that this individual’s residual limb increased in size over time despite the compressive effect of the socket and liner. In addition, the increase in circumference was greater proximally than distally, which is where the remaining muscle bellies are located. Clinical relevance This case study provides insight into the long-term effect of the sub-ischial socket on residual limb volume given compression of the soft tissues by the socket system.

scholarly journals Text Messaging Vs Academic Writing - A Case Study

2015 ◽  
Vol 21 (2) ◽  
pp. 545-550
Author(s):  
Simona Boştină-Bratu
Keyword(s):  
Young People ◽  
Academic Writing ◽  
Text Messaging ◽  
Future Career ◽  
Controversial Topic ◽  
The Relationship ◽  
Insight Into

Abstract The paper aims to bring into discussion the relationship between informal e-communication and formal writing, focusing on the use of SMS language, which is in a constant evolution, particularly among the young generations. SMS language is also a controversial topic today: some linguists and teachers are concerned that this abbreviated language, with its carefree spelling, its poor punctuation and grammar and its paucity of vocabulary is a real menace to students’ quality of writing; others, on the contrary, consider it inspiring and useful as students with a good command of texting also possess a broader facility for language. But what do students have to say about the topic? In order to gain insight into how they view the role and impact of texting on their writing, a questionnaire was distributed to a group of army cadets. The answers show that although text messaging is widely used and is an important tool of communication among young people, students consider that it has a negligible impact on their overall writing abilities and they strongly appreciate the value of writing for their future career.

scholarly journals Quality in Software Development: a pragmatic approach using metrics

2014 ◽  
Vol 52 ◽  
Author(s):  
Daniel Acton ◽  
Derrick Kourie ◽  
Bruce Watson
Keyword(s):  
Software Development ◽  
Software Quality ◽  
Software Projects ◽  
New Approach ◽  
Software Products ◽  
Main Disadvantage ◽  
Insight Into ◽  
Gaining Insight

As long as software has been produced, there have been efforts to strive for quality in software products. In order to understand quality in software products, researchers have built models of software quality that rely on metrics in an attempt to provide a quantitative view of software quality. The aim of these models is to provide software producers with the capability to define and evaluate metrics related to quality and use these metrics to improve the quality of the software they produce over time. The main disadvantage of these models is that they require effort and resources to define and evaluate metrics from software projects. This article briefly describes some prominent models of software quality in the literature and continues to describe a new approach to gaining insight into quality in software development projects. A case study based on this new approach is described and results from the case study are discussed.

Occupational therapy in older people with stroke

2020 ◽  
pp. 249-268
Author(s):  
Rowena Padamsey ◽  
Avril Drummond
Keyword(s):  
Occupational Therapy ◽  
Older People ◽  
Occupational Therapists ◽  
Therapeutic Interventions ◽  
Younger Adults ◽  
Person Following ◽  
Key Aspects ◽  
Insight Into

‘Occupational therapy in older people with stroke’ examines how occupational therapists (OTs) increase people’s independence, quality of life, and satisfaction in all aspects of daily life. A fundamental philosophy of OT is to treat everyone as an individual, taking into account their personal roles, beliefs, attitudes, function, and environment. Consequently, the approaches to rehabilitation described in this chapter may be applied to both older and younger adults. A case study has been used for illustration. Key aspects of functioning affected by stroke are explored, focusing in particular on cognition and perception. The OT will work with the patient and their family to identify areas of function which are particularly important to them, and will aim to enable people to complete these activities as independently as possible. This chapter gives an insight into key fundamental therapeutic interventions with the older person following a stroke.

scholarly journals Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: a realist evaluation case study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028169 ◽  
Author(s):  
Marleen Hermien Lovink ◽  
Miranda GH Laurant ◽  
Anneke JAH van Vught ◽  
Irma Maassen ◽  
Lisette Schoonhoven ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Data Collection ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Quality Of Healthcare ◽  
Realist Evaluation ◽  
Optimal Model ◽  
Insight Into

ObjectivesThis study aimed to gain insight into how substitution of elderly care physicians (ECPs) by nurse practitioners (NPs), physician assistants (PAs) or registered nurses (RNs) in nursing homes is modelled in different contexts and what model in what context contributes to perceived quality of healthcare. Second, this study aimed to provide insight into elements that contribute to an optimal model of substitution of ECPs by NPs, PAs or RNs.DesignA multiple-case study was conducted that draws on realist evaluation principles.SettingSeven nursing homes in the NetherlandsParticipantsThe primary participants were NPs (n=3), PAs (n=2) and RNs (n=2), working in seven different nursing homes and secondary participants were included; ECPs (n=15), medical doctors (MDs) (n=2), managing directors/managers/supervisors (n=11), nursing team members (n=33) and residents/relatives (n=78).Data collectionData collection consisted of: (1) observations of the NP/PA/RN and an ECP/MD, (2) interviews with all participants, (3) questionnaires filled out by the NP/PA/RN, ECPs/MDs and managing directors/managers and (4) collecting internal policy documents.ResultsAn optimal model of substitution of ECPs seems to be one in which the professional substitutes for the ECP largely autonomously, well-balanced collaboration occurs between the ECP and the substitute, and quality of healthcare is maintained. This model was seen in two NP cases and one PA case. Elements that enabled NPs and PAs to work according to this optimal model were among others: collaborating with the ECP based on trust; being proactive, decisive and communicative and being empowered by organisational leaders to work as an independent professional.ConclusionsCollaboration based on trust between the ECP and the NP or PA is a key element of successful substitution of ECPs. NPs, PAs and RNs in nursing homes may all be valuable in their own unique way, matching their profession, education and competences.

scholarly journals An Insight into Members' Satisfaction with their Union: A Comparative Case Study of Malaysian and American Unions

2020 ◽  
Author(s):  
Husna Johari
Keyword(s):  
Comparative Case Study ◽  
Quality Work ◽  
Quality Of Work ◽  
Union Leaders ◽  
Union Representation ◽  
The Usa ◽  
Perceived Outcomes ◽  
Insight Into

This study examines the importance of the various facets of satisfaction with union representation in determining overall satisfaction with the union. samples of union members from Malaysia and the USA are used in this study. generally, overall union satisfaction is specified as function of union members ' expectation concerning union efforts and the perceived outcomes of union performance on (1) 'bread and butter' issues (such as wages and benefits), (2) quality of work issues (such as job interest and workers' voice in the employing organization), and (3) member-union relations (such as the quality of communication between union leaders and members). the results indicate that all the faces are important determinants of overall satisfaction with union representation. however, in the case of WMUPU (Malaysia) the results showed a greater emphasis on aspects like bread and butter, and member-union relations while the OPE1U(USA) findings relate more to issues on quality work life.  

scholarly journals An Insight into the Interrelation between the Mosques’ Architectural Codes and the Quality of Worshipers’ Presence of the Heart: A Case Study of the Safavid Mosques in Isfahan

2020 ◽  
Vol 5 (2) ◽  
pp. 51-74
Author(s):  
Mahdieh Ahmadi ◽  
Hero Farkisch ◽  
Vahid Ahmadi ◽  
Ahmad Mirza Kouchak Khoshnevis ◽  
◽  
...  
Keyword(s):  
Insight Into

scholarly journals Nitrogen Storage in Crops: Case Study of Zeins in Maize

2021 ◽  
Author(s):  
Marija Duvnjak ◽  
Kristina Kljak ◽  
Darko Grbeša
Keyword(s):  
Nutritional Value ◽  
Food Source ◽  
Storage Proteins ◽  
Protein Bodies ◽  
Alpha Beta ◽  
Maize Grain ◽  
Growing Conditions ◽  
Insight Into

Crop grains accumulate significant amounts of nitrogen in the form of storage proteins. Grain storage proteins are not only important in the aspects of germination but also, storage proteins are a valuable food source in human and animal nutrition. This chapter will give insight into genotype and growing conditions influencing the quantity and quality of storage proteins, primarily maize storage proteins the leading cereal by world production. Main storage proteins in cereals are prolamins, and in maize prolamins are called zeins located within the endosperm in protein agglomerations called protein bodies. Four main classes of zein proteins are: alpha, beta, gamma and delta zein. Each of four zein classes has a distinctive position and role within protein bodies. Prolamin proteins define nutritional value of maize grain not only via amino acid quality but also via starch availability. Starch, the most important energy component of maize grain, is located within starch-protein matrix. Within this matrix, starch granules are surrounded by protein bodies that limit starch availability. In this chapter, we will describe how zein proteins influence characteristics of maize grain and nutritional value of maize.

Misophonia: An Evidence-Based Case Report

2020 ◽  
Vol 29 (4) ◽  
pp. 685-690
Author(s):  
C. S. Vanaja ◽  
Miriam Soni Abigail
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Case History ◽  
Pure Tone ◽  
Physiological Responses ◽  
Evidence Based ◽  
Management Option ◽  
Pure Tone Audiogram

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

Chronic Refractory Cough: A Case Study

2017 ◽  
Vol 2 (3) ◽  
pp. 57-62
Author(s):  
Anna Maria Siciliano
Keyword(s):  
Quality Of Life ◽  
Adult Female ◽  
Chronic Cough ◽  
Treatment Regime ◽  
Speech Language Pathology ◽  
Old Adult ◽  
Language Pathology

This paper presents a successful behavioral case study in treatment of chronic refractory cough in a 60-year-old adult female. The efficacy for speech-language pathology treating chronic cough is discussed along with description of treatment regime. Discussion focuses on therapy approaches used and the patient's report of changes in quality of life and frequency, duration, and severity reduction of her cough after treatment.

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