Custom Made Finger Prosthesis Study

Custom Made Finger Prosthesis Study ABSTRACT: AIMS AND OBJECTIVES Maxillofacial Prosthodontics is an art and science which provides life-like appearance to the missing structures of an individual. The complete or partial loss of a finger results in significant functional deficiencies. In addition to immediate loss of grasp, strength and security, the absence of a finger may cause marked psychological trauma. CASE DESCRIPTION A case report has been presented where a custom made finger prosthesis; comfortable in use and esthetically acceptable to the patient was fabricated; using silicone material. CONCLUSION The retention for this patient was obtained by reducing the stump and using a ring of suitable size. Introduction: Finger and partial-finger amputations are some of the most frequently encountered forms of partial-hand losses.1 Although the most common causes of these amputations are traumatic injuries, congenital absences or malformations may present similar clinical challenges.2 Prosthesis refers to artificial replacement of an absent part of the human body. These artificial substitutes serve primarily to improve the patient’s appearance and to support them psychologically. They play an immense role in making the patient more socially acceptable.3 Reconstructive surgery cannot restore esthetics as much as prosthesis can and thus has limited role in case of lost body parts. The major role in rehabilitating the patient is thus played by the maxillofacial prosthodontist and the anaplastologist. The ideally constructed finger prosthesis must meet the following preconditions: the prosthesis must assist in grip and absorbing and transferring forces to the hand; the prosthesis should look natural, allowing expression of gestures.4,5 This article presents a case of rehabilitation of a finger defect with a silicone prosthesis and describes a method of retention for the same. CLINICAL REPORT: A 22-year-old female patient reported to the Department of Prosthodontics, with a chief complaint of a partially missing index finger on her right hand. A complete hand examination was carried out that revealed a residual stump on the index finger of the right hand measuring 1.5 cm in height. A solitary healed wound/scar was seen on the base of the residual stump. The surrounding area appeared to be normal with no signs of any infection or inflammation. Informed consent was obtained before beginning the treatment procedure. Making Impressions The index finger of the patient’s left and right hand were lubricated with a thin layer of petroleum jelly, to prevent the hydrocolloid impression material from adhering to it. Impressions of the stump and of the index finger of the contralateral hand which correspond to the lost digit were taken using irreversible hydrocolloid. A plastic disposable cup of sufficient length and diameter was chosen to confine the impression material. The containers were tried on the patient’s fingers to provide adequate clearance of at least 5 mm around for the impression material. Regular setting alginate was mixed using cold water to increase the working time and poured into the containers. The patient was asked to dip her finger and stump vertically into the container without touching the sides or the bottom of the container. Both the impressions were made with the digits in the semiflexed and relaxed position. The material was allowed to set and the fingers were removed quickly in a jerking motion after the material was set. The impression of the stump was poured in Type-III dental stone. The impression of the middle finger was poured with molten modeling wax. Upon cooling, the wax pattern was retrieved from alginate mold by partially incising the alginate mold with sharp instrument. The wax pattern was then adjusted by sculpting and adapted on the working cast. Approximate length and angulations were determined on working cast and later confirmed during trial of wax pattern. The wax pattern was tried on the patients affected right hand little finger. Necessary adjustments regarding the length, contour and angulations of the finger were done at this stage of prosthetic fabrication. Stump preparation A reduction of 1-1.5 mm was done on the stone casts to produce prosthesis with a smaller diameter which can be stretched over the stump to provide retention. The pattern and the cast were then invested in a large size Hanau flask. The mold was first poured only upto half of the pattern. Tin foil substitute was applied and then the other half was poured, wax was eliminated in the conventional way. Color matching and incorporation of nail The most critical step was to match the color of the prostheses to the patient’s skin color. The basic skin color was observed. The colors were mixed with the silicone to obtain the base color. Maximum efforts were made to achieve the appropriate characterization for the palmer and dorsal surfaces of the prostheses. The shade matching was done using natural daylight. Artificial nail was properly shaped and trimmed to the required size. Around 1 mm of nail bed was carved in the wax pattern and the nail was incorporated in that space. The mould created by the elimination of the wax was packed with silicone rubber. The material was allowed to bench cure overnight and for the final polymerization, it was placed in hot water, for one hour, at 45 degrees Celsius. Once the final prosthesis was retrieved, the flash was trimmed using a sharp blade and the final finishing was accomplished using fine sand paper. The retention for this patient was by using a ring of suitable size. DISCUSSION: Individuals who desire finger replacement usually have high expectations for the appearance of the prosthesis.6 The polyvinyl chloride material generally used is easily and permanently stained by such common materials as ballpoint pen and newspaper ink and has not proven durable enough for active use. The acceptance rate has been much higher when individually sculpted custom restoration using silicone elastomer is provided.7 The overall durability and stain resistance of silicone is far superior to any other material currently available for finger restorations. Almost all stains can be removed easily with water and soap.8 Silicone finger restorations may have additional functional benefits. Many traumatic amputees experience painful hypersensitivity at the termination of finger remnants. The gentle, constant pressure of an elastomer prosthesis can help desensitize and protect the injured tip. Over time, scar tissue contained within a silicone prosthesis seems to become more pliant an d comfortable. Recent literature speculates that silicone gel improves the hydration of the stratum corneum of immature hypertrophic scars. Placing a decorative ring over the margin of a finger prosthesis ending at the metacarpal-phalangeal joint will make the changing color of the hand less noticeable although the distal joint functions will be slightly restricted. Conclusion The custom-made finger prosthesis is esthetically acceptable and comfortable for use in patients with amputated fingers, resulting in psychological improvement and personality. An esthetic and retentive prosthesis are the primary determinant factors in the successful prosthetic restoration of a finger. The retention for this patient was obtained by reducing the stump and using a ring of suitable size.

12 Hours Without Technology Essay

Those who identify themselves as technological determinists believe we as humans have remarkably little control over technology and the effect it has on the world. Just two months ago, I passionately denied this point of view and identified myself as a social constructivist. Perhaps it is the idea of not being in complete control of my decisions that I did not want to accept. However, after completing the challenge of going twelve hours without technology, I quickly learned that my thoughts on technological determinism were not in line with my experiences. The fact is technology has become an integral part of day-to-day life. Truly understanding the effects and dare I say, control, that technology has on life, twelve hours without it will certainly enlighten each one of us. In the following pages, I will attempt to describe the challenges of my day without technology. Furthermore, I will attempt to interpret how my experiences relate to my relationship with technology and society. Ultimately, my purpose is to identify events which support or defy the view of technological determinism and understand the driving factors behind them. See more:  First Poem for You Essay With a career that heavily relies on technology, I reasonably challenged myself to refrain from using technology on a Sunday. What I learned was quite surprising and honestly, quite stressful. First, to appreciate the challenges I endured on this Sunday, it is crucial to know a little bit about my professional background. As a licensed mortgage loan originator, I have a fiduciary duty to all of my clients that are purchasing a home. While my career requires a large set of professional requirements, the most valuable aspect to being successful is to be available nearly 24 hours a day every day of the week. Going into this project, I knew that refraining from using technology, specifically my phone and the computer, would prove to be challenging but at the same time I figured everyone deserves a day off every now and then†¦I soon learned that this would come with a cost. My Sunday morning started off much the same as any other. I woke up early to tend to my e-mails that had made their way to my inbox from potential homeowners throughout the evening. Responsibly, I made sure to reply to every e-mail, voicemail and, text message prior to 9:00AM. Completely disconnecting from the internet and shutting down my phone was just as nerve racking as I had anticipated it to be. Knowing that this day would be a challenge for me, I had previously arranged a few things to do to keep my mind and attention away from my business. Depending on how one would define technology, someone could argue that I instantly failed to avoid the use of technology within just an hour of starting my project. My wife and I left the house in the technological wonder of a Chevy Tahoe Hybrid around 9:30AM to attend regular church services. I recognized right away that avoiding technology entirely for twelve hours would be impossible for me to accomplish. Instead, I switched my focus to avoiding my phone, internet or computer use for the remainder of the day. My wife and I proceeded to attend church and then went to lunch. When we returned home, I decided to take each of the three dogs for a run. Normally, I opt to take one of them each day on a rotation, but it was a beautiful day and the small blinking light on my phone begging me to check my text messages, e-mails and voicemails were not within reach. This was my first insight into a day without technology. Almost immediately I was able to find more time to do things that are more valuable to me. While I was enjoying the extra time with my beloved pets, I also recognized that as the day progressed, I was growing more and more anxious from not being able to use my phone. Little did I know that by the time I had finished taking the last four-legged child for a run, I was not the only anxious person affected by vacation from technology. There was a storm brewing that would hinder my goal. When I returned home, my wife frantically met me at the door with her phone in hand. My managing sales supervisor had called her because he had received a few phone calls from upset potential clients. Notably, this was just five hours into my twelve hour challenge on a Sunday afternoon. Reluctantly, I took the phone from my wife and proceeded to field the onslaught of exploratory questions as to my whereabouts and reasoning for not answering my phone or promptly replying to my e-mails. It is crucial to remember that I’m essentially self-employed, so I had no obligation to answer to a supervisor for an issue such as this but the fact that I had chosen not to use an ordinary technology such as my phone, I found myself in an awkward and rather challenging position. After taking some time to put out some proverbial fires with my sales manager and a few clients, I put my phone down and resumed my challenge of avoiding technology. Before doing so, I noticed that I had received several text messages throughout the day from friends and family. Reflecting upon the nature of the texts as I read through them, I noticed one general recurring theme. Many of the initial text conversations had begun with an unassuming â€Å"hello† and â€Å"how are you. † Just five or six hours after not receiving a response from me, many of the one-sided conversations had progressed to worry about my safety. At this point, I dismissed the idea that I had control when it came to technology. As I reflected on these events, I could not help but be reminded of Neil Postman. We need to proceed with our eyes wide open so that we may use technology rather than be used by it (Postman, 1998, p. 6). Suddenly, I realized that I have been interacting with technological development in a way where technology was using me more than I was using it. By definition, social constructivism â€Å"presumes that social and cultural forces determine technical change† (Johnson & Wetmore, 2009, p. 143). On the flip side, technological determinism â€Å"is the claim that the introduction of new technologies produces direct and unalterable social changes† (Johnson & Wetmore, 2009, p. 93). I acknowledge that refraining from technological use for twelve hours was an extremely small scale task in terms of the technology available at hand. Despite that, it was surprising how disturbed my friends, family, co-workers and clients alike had become by my avoidance of a phone. â€Å"Technological change creates winners and losers† (Harris, 2012). These disturbances certainly support this idea, and I would argue that this is at the foundation of the technological determinism theory. The introduction of the smartphone into my personal and professional life has set an expectation which has had a direct and unalterable affect. While this reliance on the phone may put me on the loser side of this equation, my clients are certainly on the winning side. My choice of career has brought new technology into my life that may have not been necessary with different decisions on my part. In closing, I should repeat that the main point of this paper and this experiment was to describe the challenges of a day without technology while interpreting my experiences in terms of the relationship between technology and society at a personal level. My experience with this project may have been more extreme than others given the expectations of my profession. However, by the end of my unsuccessful day without technology, it was clear that the technologies I have brought into my own life on a personal and professional level unmistakably dictates how I interact with the world and more importantly, how the outside world expects me to interact with it.

Prejudice, Stereotype, and Discrimination Essay

Have you ever gone a day without judging someone? Probably not. It is so easy to judge others without even meaning to do it. In the textbook Education Psychology, Anita Woolfolk describes prejudice as â€Å"prejudgment or irrational generalization about an entire category of people† (Woolfolk, 2008). Prejudice is a major problem in everyday lives. It is happening all around us. Prejudice can be a positive or negative thing. It is usually negative, brings people down, and not all the way true. Discrimination is â€Å"treating or acting unfairly toward particular categories of people†. (Woolfolk, 2008) Conflict Research Consortium says â€Å"Prejudice and discrimination are negative manifestations of integrative power. Instead of bringing or holding people together, prejudice and discrimination push them apart†. (Prejudice and Discrimination, 1998) Prejudices can be judged by race, appearance, gender, values, location, and religion. By about the age of four, children are aware of differences among people, like appearance, language and names. Later they become aware of religious and cultural distinctions. â€Å"Young children will not develop biases unless their parents teach them to be prejudiced. Even without direct coaching from their parents, many young children develop racial prejudice†. (Woolfolk, 2008) It is sad that children are learning about racial prejudice at such a young age. Young children may or may not be aware of the special treatment boys tend to receive from their teachers over girls. They are very much aware that their feelings, opinions and beliefs receive less consideration because of their youth. When children approach adolescence, they become more alert of the subtle prejudices about the differences in social class and religion. Stereotyping is a â€Å"schema that organizes knowledge or perceptions about a category†. (Woolfolk, 2008) It is so hard not to stereotype others. Stereotyping organizes what you know or believe about people into groups. People use stereotypes to make sense of the world. Stereotypes distort information to fit your thinking better. â€Å"Prejudice creates social and emotional tension, can lead to fear and anxiety and occasionally hostility and violence, and can ruin the self-esteem and self-confidence of those being ridiculed and make them feel terrible, unaccepted, and unworthy. Children’s school performance suffers, they may become depressed and socially withdrawn. † (Prejudice, 2007) Prejudice, stereotypes, and discrimination have been going on for a long time. African Americans were considered worthless a long time ago. They were used as slaves. There were segregated schools, buses, and stores. In 1963, Martin Luther King, Jr. gave his speech about whites and blacks should be treated equally. The laws started to change after that point in time. I do not think prejudice, stereotyping, and discrimination has gone down. I think it is still a big factor in society. This parenting website I looked at said this â€Å"children are also being exposed to different cultures through the media. They are learning and forming opinions about people and events all over the country and the world. As a result, there is more of a need and opportunity to help children learn to understand and value diversity. † (Prejudice, 2007) Children need to know why people are different and do things differently. Media is still a big part of prejudice, stereotyping, and discrimination. Children see what actors and actresses wear and how they act in movies. They see the commercials about food (if I eat this, I will look like that). I think as teachers and parents we need be good examples for children today. They should not say bad things about people in front of children. Teachers and parents need to tell children that it is okay to be friends with a person who is different. I found an article on this website that parents have asked some questions about prejudice. Some of the questions are â€Å"Is there prejudice in public schools? Yes. Do educators hold different expectations for minority children? Yes. Are children denied access to advanced or gifted placement classed based on racial biases? Yes. Can the battle against prejudice in public education be successfully fought and won? Yes†. (Prejudice and Discrimination In Public Schools, 2001) I really like the last question, prejudice can be fought and won. It all starts at home, parents are their child’s first teacher. Children see what their parents say and how they act. One example of stereotyping that I thought of was that I did an internship my senior year of high school. I helped a second grade teacher. After a couple of times going into the class, the teacher would always whisper to me about this little girl. She says she never gets anything right, she always has messy hair, she is always talking, and the list went on and on. One Sunday I was at church and I saw that girl. I told my mom what the teacher had told me about that girl. My mom said that she has had a hard couple of months. She told me that the little girl’s mom had left her and her family. I felt really bad for the girl. After that day, I started to recognize the girl. I would say hi to her when I would see her. I did not care what she looked liked. To this day, the girl always comes up to me in church and gives me a hug. â€Å"Stereotyping often results from and leads to prejudice. Prejudice leads to discrimination. Prejudice can be spread by the use of propaganda. Language, particularly slang, is often used to dehumanize members of certain groups of people†. (Grobman, 1990) All three of these judgments go together. It is hard to do one without doing the other two. It is really bad that people rather make judgments about people than getting to know them. People really need to take the time to know the person or group of people before they start making judgments. It is sad that young children are making judgments about people. Parents and teachers need to turn prejudice, stereotyping, and discrimination around. It can be fought and won. Works Cited Grobman, G. M. (1990). The Holocaust–A Guide for Teachers. Retrieved November 29, 2009, from A Guide for Teachers Web site: http://remember. org/guide/History. root. stereotypes. html Prejudice. (2007, June). Retrieved November 29, 2009, from American Academy of Pediatrics: http://www. aap. org/publiced/BK5_Prejudice. htm Prejudice and Discrimination. (1998). Retrieved November 29, 2009, from Conflict Research Consortium: http://www. colorado. edu/conflict/peace/problem/prejdisc. htm Prejudice and Discrimination In Public Schools. (2001). Retrieved November 29, 2009, from The Public School Parent’s Network: http://www. psparents. net/Prejudice%20&%20Discrimination. htm Woolfolk, A. (2008). Education Psychology: Active Learning Edition. Boston: Pearson Education, Inc.

Inhumanity in Flannery O’Connor’s A Good Man is Hard to...

In Flannery O’Connor’s, â€Å"A Good Man is Hard to Find,† and Shirley Jacksons, â€Å"The Lottery,† both short stories deal with man’s inhumanity in different situations, and ending with a similar consequence. Jackson and OConnor both use two characters to depict man having the power to manipulate truth and objection into something people accept. In O’Connor’s’ A Good Man is Hard to Find, the Misfit is a character in need of desired assistance, troubled and confused he wanders savagely murdering strangers. On the opposite side of the ring, you have a seemingly traditional early 1900’s Caucasian senior citizen traveling with her family. Hasting to waste time, the grandmother drives her family all through the Southeastern states. The two meet†¦show more content†¦Ã¢â‚¬Å"The feelings of uneasiness caused by executions being performed in an arbitrary manner reverberates on several levels. First, we see the character s within the story itself begin to question the necessity of the ritual† (Shields 412-413). There has to be a point where someone could have spoken to reveal the inhumanity of this pugnacious tradition that has plagued the community for more than seventy-seven years. Then again, no, there are no words said about the inhumanity of the violence, until Tessie Hutchinsons’ family gets chosen. She defends her family stating, â€Å"You didnt give him time enough to take any paper he wanted. I saw you. It wasnt fair!†(Jackson). She then is attacked by her fellow friends, Be a good sport, Tessie. Mrs. Delacroix called, and Mrs. Graves said, All of us took the same chance. Mrs. Hutchinson at this point is being very hypocritical; the lottery was fair for all the citizens, so why doesn’t she just go along with the tradition? Would her outbursts have been the same if Mrs. Hutchinsons’ family wasn’t chosen? The final words of Mrs. Hutchinson were It is nt fair, it isnt right.† Both O’Connor’s and Jacksons’ short stories display crucial argumentative points about tradition, and inhumanity. They both can relate of the theme that life is a gamble. From the grandmother trying to use her faith to save her desperate life, to even the most relative example of all, the lottery. The grandmother