Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.
Animals ; Congenital Abnormalities ; Foot ; Foot Orthoses ; Gait ; Hallux ; Hallux Limitus ; Hallux Rigidus ; Hallux Valgus ; Hammer Toe Syndrome ; Head ; Hoof and Claw ; Humans ; Joints ; Metatarsal Bones ; Metatarsalgia ; Metatarsophalangeal Joint ; Neuroma ; Orthotic Devices ; Quality of Life ; Shoes ; Splints ; Toes

BACKGROUND: Traditionally, conservative management with an offloading orthosis, such as total contact cast (TCC), has been the standard of care for midfoot Charcot arthropathy. Considering complications of TCC and surgery, we treated midfoot Charcot arthropathy without TCC in our patients. The purpose of this study was to report clinical and radiological outcomes of conservative management of midfoot Charcot arthropathy. METHODS: A total of 34 patients (38 feet) who were diagnosed as having midfoot Charcot arthropathy between 2006 and 2014 were included. Patients started full weight bearing ambulation in a hard-soled shoe immediately after diagnosis. Outcomes such as progression of arch collapse, bony prominence, ulcer occurrence, limb amputation, and changes in Charcot stage were evaluated. RESULTS: Of 38 feet, arch collapse was observed in four while progression of bottom bump of the midfoot was observed in five feet. Foot ulcers related to bony bumps were found in two feet. CONCLUSIONS: Conservative treatment without restriction of ambulation is recommended for midfoot Charcot arthropathy because it is rarely progressive, unlike hindfoot-ankle arthropathy. In some cases, simple bumpectomy can be required to prevent catastrophic infection.
Amputation ; Arthropathy, Neurogenic ; Diagnosis ; Extremities ; Foot ; Foot Ulcer ; Humans ; Orthotic Devices ; Shoes ; Standard of Care ; Ulcer ; Walking ; Weight-Bearing

BACKGROUND: This study aimed to investigate the effects of critical thinking and good communication skills on the problem-solving abilities of dental hygiene students. METHODS: A total of 508 dental hygiene students were convenience-sampled from 3 universities. RESULTS: The results revealed that critical thinking had the highest intellectual fairness score of 3.60, and systematicity was the lowest at 3.19. The values for communication skills were high in reaction, social adequacy, and concentration, with an average of 3.65. Problem-solving abilities were in the following order: clarification of the problem, seeking solutions, and decision making. According to general characteristics, more extroverted personalities possessed higher levels of critical thinking, communication skills, and problem-solving abilities (p<0.01). Critical thinking scores were high (p=0.016) in students who responded that peer relationship was difficult; however, their communication skills were the lowest (p<0.001). Additionally, problem-solving abilities were highest among students who reported a difficult peer relationship (p=0.001). The higher the satisfaction with dental hygiene academics, the higher the critical thinking, communication skill, and problem-solving ability (p<0.001). Critical thinking showed a high positive correlation with variables in the following order: clarification of the problem, performing the solutions, seeking solutions, decision making, and evaluation and reflection. The communication skills were also related to these variables listed above (p<0.01). With critical thinking, confidence, watchfulness, intellectual passion/curiosity, sound skepticism, objectivity, and systematicity all influenced the problem-solving ability. CONCLUSION: Communication skills were influenced by noise control, putting on the other's shoe, social tensions, and efficiency, which affected the problem-solving ability. Dental clinics require dental hygienists to have critical thinking to make analytical judgments and effective communication skills to solve human relation problems with patients and care-givers. Therefore, these skills should be developed in dental hygiene students to improve their problem-solving abilities.
Decision Making ; Dental Clinics ; Dental Hygienists ; Humans ; Judgment ; Noise ; Oral Hygiene ; Shoes ; Thinking

Skin diseases associated with athletic activities can be classified as skin infections, inflammatory reactions, trauma, and abnormal proliferation, depending on the cause of the condition. Athlete's nodule is a generic term for reactive nodules that occur in athletes. It is particularly common in the foot due to tight sneakers, repetitive pressure or friction, and inappropriate choice of shoes or other sports equipment. The diagnosis of black heel (calcaneal petechiae) should be considered when numerous black spots occur on the soles in patients who frequently engage in abrupt movements, such as starts, stops, or leaps. Palmoplantar eccrine hidradenitis may occur in athletes who play baseball, dance, and climb, activities in which repetitive and strong stimuli are applied to the floor of the hands and feet. Painful fat herniation should be suspected in cases of painful skin-colored firm nodules on the feet of athletes who place a large amount of weight on their feet when moving. Itching, urticaria, angioedema, chest tightness, and syncope occurring within 5 minutes after starting exercise should be suspected to be exercise-induced angioedema/anaphylaxis. Excessive force can cause deformation of nails, as in tennis toe and jogger's toenail. For the diagnosis and treatment of sports-related skin diseases, it is essential to pay attention to patients' hobbies and exercise habits, including sports, and to consider the relationship of those habits with the presumed mechanisms of the skin disease. In addition, thorough pre-exercise warm-ups, increasing strength gradually, and wearing proper equipment will help prevent the occurrence of sports-related skin diseases.
Angioedema ; Athletes ; Baseball ; Dancing ; Diagnosis ; Foot ; Friction ; Hand ; Heel ; Hidradenitis ; Hobbies ; Humans ; Nails ; Pruritus ; Shoes ; Skin Diseases ; Skin ; Sports ; Sports Equipment ; Syncope ; Tennis ; Thorax ; Toes ; Urticaria

BACKGROUND: Increasing the slip resistance of floor surfaces would be desirable, but there is a lack of evidence on whether traction properties are linearly correlated with the topographic features of the floor surfaces or what scales of surface roughness are required to effectively control the slipperiness of floors. OBJECTIVE: This study expands on earlier findings on the effects of floor surface finishes against slip resistance performance and determines the operative ranges of floor surface roughness for optimal slip resistance controls under different risk levels of walking environments. METHODS: Dynamic friction tests were conducted among three shoes and nine floor specimens under wet and oily environments and compared with a soapy environment. RESULTS: The test results showed the significant effects of floor surface roughness on slip resistance performance against all the lubricated environments. Compared with the floor-type effect, the shoe-type effect on slip resistance performance was insignificant against the highly polluted environments. The study outcomes also indicated that the oily environment required rougher surface finishes than the wet and soapy ones in their lower boundary ranges of floor surface roughness. CONCLUSION: The results of this study with previous findings confirm that floor surface finishes require different levels of surface coarseness for different types of environmental conditions to effectively manage slippery walking environments. Collected data on operative ranges of floor surface roughness seem to be a valuable tool to develop practical design information and standards for floor surface finishes to efficiently prevent pedestrian fall incidents.
Friction ; Shoes ; Traction ; Walking ; Weights and Measures

As the aging of the foot progresses, the stiffness of the soft tissues, the reduction of the range of motion, the decrease of the muscle strength, and the flattening of foot are manifested. These changes increase the risk of foot pain, the problem of weight distribution and transmission, and the risk of falls, resulting in secondary complications and lowering quality of life. The most common deformities and diseases of the elderly foot are hallux valgus, hammertoes, hallux rigidus, Achilles tendinitis, plantar fasciitis, metatarsalgia, hyperkeratosis, and other deformities of the feet caused by chronic conditions. Systemic diseases that promote these foot problems include diabetes, peripheral nerve damage, repetitive ankle ligament injuries, deformities due to fractures, and obesity. Understanding the mechanisms of aging and the processing of biomechanics in the elderly will enable them to reach a healthy life through appropriate rehabilitation, exercise and educations during aging. In addition, it is necessary to promote the healthy life in elderly by customized exercise, training, and shoes.
Accidental Falls ; Aged ; Aging ; Ankle ; Congenital Abnormalities ; Fasciitis, Plantar ; Flatfoot ; Foot Diseases ; Foot ; Hallux Rigidus ; Hallux Valgus ; Humans ; Ligaments ; Metatarsalgia ; Muscle Strength ; Obesity ; Peripheral Nerves ; Quality of Life ; Range of Motion, Articular ; Rehabilitation ; Shoes ; Tendinopathy

The present study was performed to reveal the current status and risk factors of Strongyloides stercoralis infections in the villages of Kenethao district, Xayaburi Province, Lao PDR. Fecal specimens were collected and examined for S. stercoralis using Koga-agar plate culture technique. Among 516 individuals, the prevalence of S. stercoralis and hookworm infection was 44.2% and 17.1%, respectively. Co-infection was detected in 13.2% of the cases. The prevalence did not significantly differ between males and females (P=0.193). However, the prevalence of S. stercoralis infection increased significantly with age (P=0.041). Of the risk factors examined, both performing farming activities (P=0.001) and walking barefoot when going outside of the house (P=0.003) showed significant correlations with S. stercoralis infections. Our results suggest that S. stercoralis is highly endemic in this area. The National Helminth Control Program of Lao PDR should take actions to control S. stercoralis infection. In addition, provision of health education about the benefits of wearing shoes would be important for reducing infection in the study area. Moreover, the application of high-sensitivity diagnostic approaches is needed to obtain the true impact of S. stercoralis infections in all rural communities in order to provide surveillance activities in Lao PDR.
Agriculture ; Coinfection ; Culture Techniques ; Female ; Health Education ; Helminths ; Hookworm Infections ; Humans ; Male ; Prevalence ; Risk Factors* ; Rural Population* ; Shoes ; Strongyloides stercoralis* ; Strongyloides* ; Walking

The purpose of this study was to identity the probability of cross-contamination from the environment. For this, we examined foodservices at 20 universities/colleges for microbiological analysis of their working facilities and environment as well as their preventive equipment against cross-contamination. Seventy percent of the 20 foodservices were found to maintain one unified working area, which suggests high probability of contamination of food/utensils/equipment in the cooking area by pre-preparation or dish washing. According to the microbiological analysis, the hygiene acceptance ratio of working facilities in the clean zone was 70%, which was higher than the average 45% hygiene acceptance ratio of working facilities in the contamination operating zone. There was a significant difference in the total plate count (P<0.001) and coliform count (P <0.01), which demonstrates that work tables in the clean zone were in a good state compared to those in the contamination operating zone. In the contamination operating zone, refrigerator shelves had a high probability of cross-contamination. Regarding the floor surface and airborne microbes, cooking areas which should be maintained as clean zones had higher cross-contamination probability than those in the contamination operating zone. So corrective actions such as cleaning and sanitizing, keeping dry floors, lowered temperature and humidity, shoe disinfecting facilities, and checking concentrations, are necessary to manage floor surfaces and airborne microbes in the cooking area.
Cooking ; Humidity ; Hygiene ; Shoes

PURPOSE: The purpose of this study was to explore the predictors of turnover intention among nurses working in small and medium-sized hospitals in South Korea. METHODS: Data were obtained from a survey conducted in 2016 on welfare policy and system improvement. The participants were nurses of the Korean Nurses Association who worked in small and medium-sized hospitals. The responses of 2,011 nurses were analyzed using hierarchical multiple regression analysis, which was performed to explore the predictors of nurses' turnover intentions. RESULTS: The findings of this study showed that the predictors significantly reducing nurses' desire to leave their hospitals were a 40-hour workweek, satisfaction with the salary, and six out of the 40 fringe benefits provided by their hospitals: the provision of uniforms and work shoes, paid menstrual leave, operational costs for the department, job-related educational costs, and in-house nurse training program. CONCLUSION: These findings suggest that hospitals should provide proper work hours and reasonable rewards for nurses' work in order to reduce turnover intention among their nurses.
Education ; Intention* ; Korea ; Personnel Turnover ; Reward ; Salaries and Fringe Benefits ; Shoes

In this work, we develop a device, called ‘Walk-Even’, that can provide real-time feedback to correct gait asymmetry commonly exhibited in post-stroke survivors and persons with certain neurological disorders. The device computes gait parameters, including gait time, swing time, and stance time of each leg, to detect gait asymmetry and provide corresponding real-time biofeedback by means of auditory and electrotactile stimulation to actively correct the user's gait. The system consists of customized force-sensor-embedded insoles adjustable to fit any shoe size, electrotactile and auditory feedback circuits, microcontroller, and wireless XBee transceivers. The device also offers data saving capability. To validate its accuracy and reliability, we compared the gait measurements from our device with a commercial gait and balance assessment device, Zeno Walkway. The results show good correlation and agreement in a validity study with six healthy subjects and reliability study with seventeen healthy subjects. In addition, preliminary testing on six post-stroke patients after an 8-week training shows that the Walk-Even device helps to improve gait symmetry, foot pressure and forefoot loading of the affected side. Thus, initial testing indicates that the device is accurate in measuring the gait parameters and effective in improving gait symmetry using real-time feedback. The device is portable and low cost and has the potential for use in a non-clinical setting for patients that can walk independently without assistance. A more extensive testing with stroke patients is still ongoing.
Biofeedback, Psychology* ; Foot ; Gait* ; Healthy Volunteers ; Humans ; Leg ; Nervous System Diseases ; Rehabilitation* ; Shoes ; Stroke ; Survivors