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Carpal luxations
Published in Peter Houpt, Hand Injuries in the Emergency Department, 2023
In a perilunate fracture-dislocation, the severity of the injury is often not visible externally. Patients experience diffuse swelling and pain, with a painful limited motion of the wrist. The sensibility in the median nerve and ulnar nerve distribution is disturbed. On palpation, the dorsal dislocation of the os capitatum can be felt.
Case 1.7
Published in Monica Fawzy, Plastic Surgery Vivas for the FRCS(Plast), 2023
Apart from the viability of the replant, I will assess for subjective and objective measures, as well as patient reported outcome measures.Subjective measures include:the patient’s ability to resume work andpainObjective measures include:the resultant range of motion relative to normal,sensibility using two-point discrimination testing, andthe measure of grip strengths.Patient reported outcome measures, which are hand specific, include:the functional impact on the patient’s hand function using the DASH and MHQ scoring system andpatient reported psychological sequelae and quality of life, e.g., using the HADS scoring system.
Sensory Examination
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Testing is begun with monofilament 2.83 (green colour), which is considered normal light-touch sensibility. Gradually the other coloured filaments are used to test the sensation. The results are noted in the areas of sensory loss and interpreted with the clinical findings. In cases of inconclusiveness, the examiner performs the test three times to get a reliable test. The examiner should apply the filaments holding them for about 1.5 seconds and uniformly removing them. Care must be taken not to touch the skin before pressing to bend the filament, bouncing the filament against the skin and removing the filaments too quickly, giving additional stimulus clues to the patient and misleading results. If a response is not obtained with the thickest filament (6.65 – red lined) in a particular hand area, the pinprick test is used as a final test of sensibility [1–8] (Figure 5.2).
Sensibility and measurement properties of the Tampa Scale of Kinesiophobia to measure fear of movement in children and adults in surgical settings
Published in Disability and Rehabilitation, 2023
Giulia Mesaroli, Kyle Vader, Brittany N. Rosenbloom, Kathryn A. Birnie, Jennifer Stinson
Sensibility in the context of measurement tools refers to the “common sense” aspects of the tool including face and content validity [21]. Content validity refers to the degree to which the content of the tool reflects the construct (kinesiophobia), and face validity refers to the degree to which the items in the tool look at face value to adequately reflect the construct [22]. To critically appraise the sensibility of the TSK, Bombardier’s Sensibility Assessment worksheet was used (Supplementary File 2) [23]. This worksheet is based on prior work published by Feinstein (1983) and Rowe and Oxman (1993) and includes 14 items divided into 4 categories: (1) purpose, population, setting, (2) content validity, (3) face validity and (4) feasibility. Data was collected pertaining to each of the 14 items from relevant studies.
Adverse effects of orthodontic forces on dental pulp. Appearance and character. A systematic review
Published in Acta Odontologica Scandinavica, 2023
Jukka Huokuna, Vuokko Loimaranta, Merja A. Laine, Anna-Liisa Svedström-Oristo
The pulpal blood flow is an indicator of pulpal health. A decreased pulpal blood flow or transient ischaemia may cause a decrease in pulpal sensory responses and the sensibility of teeth. Since the pulp tissue is encased in calcified tissues, only indirect tests can be used to assess pulp vitality. Vitality tests assess pulpal circulation, which can be evaluated by using Laser Doppler Flowmetry (LDF). LDF is a non-invasive method of measurement that utilises the frequency change (Doppler shift) of light reflecting back from moving red blood cells [3]. Pulp sensibility tests in turn extrapolate pulpal health from responses to electric current (electric pulp testing, EPT) and thermal changes (cold and heat). Higher response thresholds or failure to respond to EPT or thermal tests are indications of reduced sensibility. Sensibility tests can also be used to reproduce the symptoms reported by the patient. However, a positive reaction to sensibility tests indicates only that pulpal nerves are functioning but does not give any direct information about the pulpal blood flow [4].
Mental Health Nurses’ Self-Care at Work, Searching for Equilibrium: An Interpretative Phenomenological Analysis
Published in Issues in Mental Health Nursing, 2023
Maria O’Malley, Brenda Happell, James O’Mahony
The Self-Tuning Model of Self-Care (Vinje & Mittelmark, 2008) addresses the processes involved for nurses to maintain their vitality as they engage with their work. Whilst predominantly concerned with job engagement, the model offers insights into self-discoveries made by nurses’ relating to their self-care (Vinje & Mittelmark, 2008). An ability to engage in introspection, or self-observation, becomes the cornerstone of self-care. This introspection ideally leads to self-sensibility and reflection. Originally, sensibility was constructed as the nurses’ awareness, receptiveness and understanding of their clients’ needs and situations, assisting the nurse to empathise with their experience (Vinje & Mittelmark, 2008). Self-sensibility is simply turning this sensitivity and awareness towards the self (Vinje & Mittelmark, 2008). These three processes (introspection, sensibility, reflection) create an internal adjustment in response to experiences such as work overload, stress, or achievement, that shape the sense of coherence (comprehensibility, manageability, meaningfulness) (Mittelmark et al., 2022). Sense of coherence will either promote or threaten health and well-being (Bauer et al., 2020). Self-care strategies facilitate positive adjustment, shaping the health-promoting sense of coherence.