Abstract This paper explains that prosthetic devices were needed the minute the first human was born with a missing or deformed limb, or the first person lost a limb in battle or even during the course of daily life. The author points out that the ancient principles on which prosthetics continue to rely are still amazingly efficient. It explains that in the past 25 years, there have been advances in prosthetic limb technology, such as lightweight plastics, composites and electronic systems; but there will be more, which will continue to open new directions for prosthetics. The paper relates that prostheses for amputations through the hip joint consist of a laminated hip basket, hip joint, knee joint, SACH foot, pipe connectors and external cosmetic finish; an active carbon fiber foot and multi-axis hydraulic and mechanical knee joint may also be used. Charts and illustrations.
Table of Contents
Overview Section
History of Lower Limb Prosthetics
Advancements and the Future
Aetiology and Incidence of Lower Limb Amputation Pre- and Post-Operative Considerations in Lower Limb Amputation Types of Surgery
Syme's Amputation Below Knee Amputation Above Knee Amputation Hip Disarticulation
Pain Management
Types of Lower Limb Prosthetic Hardware
Literature Review Section
From the Paper "Sometimes, especially after recorded history began, the reasons for needed prosthetic devices sounded eerily like some of the major 'hero' stories of today; the young man who cut off his own arm to escape entrapment in a crevice on a lonely mountain is one recent example. A few years ago, a man cut off his own lower leg when he caught it in a bear trap far from home or help. However, in Herodotus' The Histories, dating to 484 BCE, there is a story of a Persian named Hegestratus. Hegistratus was captured by the enemy and imprisoned with a leg iron. To escape, he cut off part of his own foot; later, he is said to have worn a wooden replacement, a prosthesis (University of Iowa Health Care Web site). Another account, however, notes that he used a 'wooden filler' to escape, traveling 30 miles before he was captured and "had his head amputated" (Northwestern University Prosthetics-Orthotics Web site). Not only was there no prosthetic head, Hegistratus did not live long enough to investigate what was available in foot prostheses at the time. While much of this knowledge is based on the verbal record, there was physical evidence of early prostheses. A tomb in Capua, Italy, offered an artificial leg made from copper and wood and dating to 200 BCE. Bombing in World War II destroyed it, however."
Abstract This paper looks at the symptoms and mental state of those who suffer from apotemnophilia, a rare disorder, experienced by mentally competent people that want healthy limbs and/or digits removed from their bodies. It considers several factors such as: What apotemnophilia is, if amputation may be an effective way to treat the disorder, possible psychological causes and why amputation may be actually be necessary. It also discusses the ethical aspects of amputating healthy limbs and why this disorder is not yet included in the "Diagnostic and Statistical Manual of Psychological Disorders" (DSM).
From the Paper "Apotemnophiles are often confused with acrotomophiles. The difference between the two is that acrotomophiles gain sexual gratification by being with or fantasizing about a person who has a disability or amputation. John Money (1977) originally coined the term "apotemnophilia" while looking at case studies of two men who became sexually aroused by the thought of being with a person who had an amputation or having one themselves (Money, 1977, p.117). It is likely that these two men were acrotomophiles, however the term apotemnophilia (note the suffix) has stood the test of time. Apotemnophiles simply wish to have their amputation(s) performed in an effort to become "whole". Apotemnophilia is not a problem of sexual desire, but a problem of body image (Elliot, p.73). "
Abstract The paper shows how in the first wars fought by American soldiers, medical science and the government were both completely unprepared in coping with the problems of veterans after war. The paper discusses soldiers' opium addiction, the over-use of amputation and the lack of resources to overcome the physical and mental injuries of war.
Outline:
Objective
Introduction
Drug Addiction-Soldiers Disease Ignored
Quick to Amputate and Failure to Assist
Mental Disabilities of Veterans Post-War
Summary and Conclusion
From the Paper "The facts are that more Civil War veterans died from soldier's disease than were killed by war wounds. Immediately following the Civil War there were absolutely no reports whatsoever of addiction however, "there were 63,000 soldiers whose chronic diarrhea carried on after the war" (Adams, 1889 as cited in Mandel, 2008) Furthermore, there were more than 20,000 survivors of amputations that the Union doctors had reported. (US Surgeon General, 1883; as cited in Mandel, 2008) The work of Horatio Day entitled "The Opium Habit" which was published in 1868 relates information to the 'Soldier's Disease' stating: "The events of the last few years [Civil War] have unquestionably added greatly to their [confirmed opium eaters'] number."
This paper reviews an article by R.A. Sherman, in "Diabetes Care" (Feb. 2003), about the use of maggot therapy for treating diabetic foot ulcers unresponsive to conventional therapy.
Abstract This paper explains that the problem of foot and leg ulcers on diabetic patients is significant because of its prevalence and the tens of thousands of amputations that occur due to unresolved ulcers. The author points out that the data collection procedure of tracing and photographing the wounds for eight weeks could be replicated; however, the measurement instruments or tools are not clearly described and the reliability and validity of the measurements were not addressed. The paper concludes that this research presents some interesting findings on a small scale; further research needs to be done to ensure that these results are replicated in other patient demographics, including female patients.
Table of Contents
Introduction
Statement of Problem
Literature Review
Theoretical Framework or Concepts
Research Design
Data Collection and Statistics
Discussion
Summary
From the Paper "Healing rate concepts, previously studied, were utilized in this research. The concept of healing rate "was defined as the change in surface area divided by the mean circumference over time". This concept was meaningful to the study, as it allowed the researcher to determine the effectiveness of the maggot treatment, in relation to conventional treatment. Although they do not provide rationale for the question, hypotheses or purpose of the investigation, they are integral to the determination of the success of the research. This concept of healing rate is based on previous research."
Abstract This paper discusses the film "Dances With Wolves" in relation to man's inhumanity to man, culture, our attitudes towards other cultures, and the media's portrayal of other cultures through the medium of film.
From the paper:
"The film "Dances With Wolves" (Costner) looks in detail at the way strangers get to know each other. It is seen from the point of view of John Dunbar, a lieutenant fighting during the American Civil War. We meet the wounded hero in a field hospital just as he is about to have his leg amputated. However, when the doctors leave, he decides to rejoin his regiment, and invites death by riding his horse in a suicidal charge at the enemy lines."
Abstract This paper addresses the basics of appropriate and potentially successful nursing in wound care and the promotion of healing. The first section provides some introductory information on the problem of wound care. This is followed by a discussion of the relevant literature and an explanation of the research methodology used within the thesis. The paper then provides the results of the thesis, offering a framework that can be used for insuring that the essential basics in wound care are provided by nurses. Finally the study includes a section on the conclusions drawn from the thesis. The paper makes reference to a number of specific wound types, caused by diseases such as diabetes, old-age and physical impairment among others.
Contents:
Introduction
Theoretical Framework
Inflammatory Phase
Proliferative Phase
Remodeling Phase
Background
Statement of Purpose
Significance to Nursing
Integrated Review of the Literature
Method
Results
Optimization of Wound Healing
Conclusions
References
From the Paper "Recent estimates suggest that 1 percent of the total health care dollar is spent on wound care in the US (Lane, 1995). While this figure seems relatively small and inconsequential, many of individual costs associated with wound care are massive. Approximately $1.36 billion is spent on pressure ulcer treatment (US Department of Health and Human Services [USDHHS], 1994). Similar estimates have also suggested that the average cost to heal a single pressure ulcer ranges from $1,951 for a leg ulcer to $29,373 for a diabetic ulcer (Bolton, Van Rijswijk, & Shaffer, 1996). Foot ulcers are the number one reason for hospitalization of diabetic patients and are the major cause of non-traumatic amputations."
Tags: hospital, health, care, nurse, diabetes, hmo, amputate
Abstract This paper presents an historical account of Clara Barton's heroic service as a Civil War nurse, her active involvement in the suffragist movement, her nursing and social services work in Europe, and her successful involvement in forming the American Red Cross.
From the Paper "When picturing the atrocities of war today, one usually envisions the ungodly sight of a soldier being shot or blown up. The pain and anguish of a person's face as well as the assailed and bloody body hitting the ground readily come to mind. In the Civil War, however, much of the death and gore did not occur on the battlefields but in the so-called hospitals. Because most people believed the war was going to last only a few months or weeks there was no real effort to recruit doctors. At the beginning of the Civil War, there were 36 doctors in the whole United States and 12 of these surgeons went to the South to serve. Surgeons had no formal training in the art of medicine."
Tags:amputation, cedar, mountain, angel, of, the, battlefield, union, nurses, missing, in, action, treaty, of, geneva, united, states
Abstract The body of knowledge regarding phantom limb syndrome and the associated complications has been a topic of interest for over a century. Phantom limb syndrome occurs when a patient, who has had a part of their body amputated, still experiences vivid sensations of feeling from the missing part. Since this subject has been such a mysterious part of medical lore for over a century, the paper reviews the most current state of research regarding these phenomena, by utilizing a literature review of twelve contemporary articles on the subject.
Paper Outline:
Abstract
Introduction
Literature Review
Conclusion
References
From the Paper "Siddle (2004) concludes that the management of phantom limb pain is critical in a ensuring a patient's recovery from amputation. With this pain there could be adverse psychological implications for the patient, which could hinder their recovery. For this reason, when a patient is non-responsive to a traditional analgesic regimen, Siddle recommends the introduction of non-analgesic drugs, such as those that are typically used in epilepsy or depression."
Abstract This research examines the diabetes epidemic among African- Americans; the broad range of risk and structural factors that contribute to the disease onset in this population group. The paper focuses on the African-American population, disproportionately affected by diabetes. This study effort emphasizes the necessity for equal application and implementation of health care interventions in the context of disease populations, disease management of the most common, costly and complex treatable diseases, as well as, chronic conditions with the greatest disparities in care.
Outline:
Abstract
I. Diabetes in People of Color
i) Understanding
ii) Aims and Objectives
iii) One Voice Counts
II. Review of Relevant and/or Related References
From the Paper "On an average, African Americans are 1.8 times more likely to have diabetes than whites of similar age. For every six whites with diabetes, 10 African Americans have diabetes, accompanied with a 27 percent higher mortality rate. Nearly 3.2 million (13.3 %) of all African Americans have been diagnosed with diabetes and suffer from higher rates of serious complications, which include heart disease, stroke, high blood pressure, blindness, kidney disease, nervous system disease, amputations, neuropathy, dental disease, and complication of pregnancy. Diabetes, one of the most common and costly health problems, is also among the most preventable diseases."
Abstract The paper defines bionics as a cutting-edge joining of biology and electronics. The paper describes how organic structures or functions are replaced with electronic or mechanical ones. The paper demonstrates how bionic prosthetics have emerged in numerous real-world applications and practical examples.
From the Paper "Prosthetic technology has advanced enough in recent years that it can be legitimately referred to as bionics. Bionics can be best thought of as a cutting-edge joining of biology and electronics. Organic structures or functions are replaced or substituted with electronic or mechanical ones (Rockets, 2006). This can be done in order to compensate for a physical deficiency--such as an amputation--or even to augment existing abilities--such as providing enhanced strength. By and large, however, research into the practical applications of bionics has been limited to hospitals and universities where the focus is compensation for physical maladies."
Abstract The paper explores how quality of life in patients with diabetes is a large concern for nurses. The paper discusses how complications associated with diabetes are the main contributors to disability and death rather than the disease itself. The paper explains that one type of intervention that can greatly decrease the likelihood of complications is preventive self-care activities.
Outline:
Statement of Issue
Concern to Professional Nursing
Intervention
Implementation
Conclusion
From the Paper "Quality of life in patients with chronic illnesses such as diabetes is a large concern for nurses. Unlike acute disease processes, chronic disease in patients, while therapeutic relations between nurse and patient can strengthen over time, they must also be evaluated to determine the effectivity of treatment. Interventions to improve the quality of life of these patients have significant value. DeSouza and Nairy (2003) reported a significant improvement in quality of life parameters with nurse-directed intervention. Some of these interventions involve patient empowerment through teaching of self-care activities that not only aid both health care provider and patient to jointly participate in managing diabetes, but also impart to both patient and family a sense of control over this chronic disease."
