We performed a prospective study to determine whether the walking pattern of children with flatfoot can be influenced by using shoes and custom-modeled insoles. One hundred and thirty-two children (mean age ; 4.20±2.53) who had been referred by a physiatrist, and who were diagnosed with flatfoot at the brace clinic in our institute, were assigned to three groups : The first group was asked to walk barefoot, the second one to walk with shoes without insoles and the last one to walk with shoes with insoles. We measured walking speed, cadence, step length, step width, the duration of right and left stance phases, both double-limb stance phases, both swing phases, walking angle, and toe angle using a 2.4 m sheet-type Gait Analyzer, the Walk Way MW-1000 ^TM, at the individual's self-selected speed. Compared with the barefoot group, a significant increase was observed in the group using shoes with custom-modeled insoles in both walking speed and step length on both sides, and there were reductions in swing phase and walking angle on both sides (paired t-test ; p<0.002).

Bacterial infection associated with the use of medical or dental devices is a serious concern. Although devices made of ethylene vinyl acetate (EVA) are often used in the oral cavity, there are no established standards for their storage. We investigated bacterial survival on EVA sheets under various storage conditions to establish a standard for hygienic storage of such dental devices. Bacterial counts were evaluated, which showed a significant decrease after washing with sterilized water, mechanical brushing and rinsing, and using Mouthguard Cleaner as compared to untreated samples. In addition, no bacteria were detected on samples stored 2 days or longer in a ventilated environment, whereas they were detected for up to 14 days on samples without any cleaning stored in a closed environment. Bacterial counts for the untreated samples gradually declined, while surviving bacteria on samples treated with sterilized water and mechanical brushing showed a rapid decrease. Additionally, bacterial identification using polymerase chain reaction (PCR) revealed that Streptococcus oralis was dominantly detected on salivary samples after 14 days of storage among both two subjects. For effective hygienic storage of dental devices made of EVA, washing with sterilized water is important to remove absorbed salivary compounds along with storage in a ventilated environment.
Adult ; Colony Count, Microbial ; Decontamination ; methods ; Dental Equipment ; microbiology ; Equipment Contamination ; Humans ; Microbial Viability ; Molecular Typing ; Polyvinyls ; Saliva ; microbiology ; Streptococcus ; physiology ; Time Factors ; Water ; Young Adult

Objective: To examine how doctors who work in outpatient clinics in depopulated areas in Hokkaido contribute to the provision of primary care to residents.Methods: The study adopted a qualitative research design. Six doctors, all of whom were men and in charge of medical clinics located in depopulated areas in Hokkaido, participated in a semi-structured interview. The interviews were recorded using a digital voice recorder. The data were transcribed and classified into codes, subcategories, and categories, and analyzed.Results: A qualitative analysis yielded the following five superordinate categories: (1) clinical praxis in accordance with residents’ lifestyles and life stages; (2) innovative care provision based on residents’ conditions; (3) provision of routine care in partnership with other healthcare providers and associated stakeholders; (4) beliefs and feelings of pride associated with working as doctors in clinics in depopulated areas; and (5) difficulties in guaranteeing reliable and continuous operation of clinics in depopulated areas.Conclusion: This study successfully identified the specific contributions of doctors working in outpatient clinics in depopulated areas to primary care, as well as the related challenges that they face. Moving forward, researchers should continue to examine how the issues faced by clinics in depopulated areas can be addressed using regional medical care plans.