Rocker outsole shoes and margin of stability during walking: a preliminary study

Rocker outsole shoes are commonly prescribed to diabetic patients to redistribute peak plantar pressures at high risk areas such as forefoot thereby decreasing risks of plantar ulceration. However, there are evidences of postural destabilizing effect of the rocker outsole shoes. Patients with diabetes, particularly those suffering from neuropathy, are at a higher risk of falling. Then, beside primary role of rocker outsole in offloading, it is essential to explore the effect of the rocker outsole on postural stability of these patients. The smaller base of support (BOS) of the rocker outsoles due to their specific geometry has been previously mentioned as a threat to postural stability. Margin of stability (MOS) appeared to be an appropriate method for measuring postural stability during walking by considering the dynamicity of BOS in its equation. MOS is defined as the distance between the velocity adjusted position of the centre of mass (COM) and the boundaries of the BOS which constantly changes during walking. Then, this study proposes how we can use MOS concept to investigate the impact of the rocker outsoles on dynamic stability. In this study the kinematic data from a single subject with diabetic neuropathy was used to explain the efficiency of the methodology. Conclusive results are expected after carrying out systematic tests using a statistically representative sample size.This project is funded by Iran University of Medical Sciences (IR.IUMS.REC. 1395.9211503202).info:eu-repo/semantics/publishedVersio

Rocker outsole shoe is not a threat to postural stability in patients with diabetic neuropathy

Background: Rocker outsole shoes are commonly prescribed to patients with diabetic neuropathy to offload a particular area of the foot sole, thereby decreasing the risk of foot ulceration. Contrary to this, some evidence has reported a postural destabilising effect of these shoes in healthy adults. Objective: To explore the postural stability of patients with diabetic neuropathy who wear a rocker outsole shoe. Study design: Quasi-experimental. Method: In total, 17 patients with diabetic neuropathy (aged 49.29 ± 7.48 years; 7 female, 10 males) participated in this study. A Motor Control Test measuring centre of force displacement, response strength scale and response latency in medium and large perturbations was conducted using the EquiTest system to evaluate postural stability while wearing a baseline shoe (without a rocker outsole) or a rocker outsole shoe (with a toe-only rocker sole). Results: No significant difference was observed between the shoe conditions in centre of force displacement and response latency of the participants (p > 0.05). The results indicated a significant increase in the response strength scale of participants by the rocker outsole, for medium forward and backward and large forward perturbations (p = 0.014, p = 0.001 and p = 0.027, respectively). Conclusion: When the immediate effect is a concern, the rocker outsole shoe did not negatively affect postural stability in patients with diabetic neuropathy. Clinical relevance This article will provide objective evidence about the effect of rocker outsole on postural balance in diabetic patients. In prescription of rocker outsole to prevent plantar ulceration of diabetic foot, immediate postural destabilising is not a concern

Time Management Behaviors and Emotional Intelligence in Head Nurses in Emergency and Intensive Care Units

Background: Time management is of particular importance in nursing. One of the most effective variables associated with time management is emotional intelligence (EI). This study assessed the relationship between time management and EI and the level of EI and time management skills in head nurses in emergency and intensive care units. Methods: A cross-sectional study was conducted on all head nurses in the emergency and intensive care units of nine educational hospitals at Isfahan University of Medical Sciences in Iran in 2015 using Bradberry-Greaves’ EI and Macan’s Time Management Questionnaires. Results: Participants’ total time management score was (104.15 ± 6.98); total EI score was (128 ± 15.80). There was no significant relationship between overall EI and time management skills. There was a significant relationship between age and the emotional self-awareness dimension of EI (p =.027) and the mechanics dimension of time management (p =.037), and between work experience and overall time management skills (p =.049) and the mechanics dimension of time management (p =.038). Conclusions: Specific EI and time management skills may help head nurses to cope with the challenges they face, which may improve the quality of nursing care. Nursing leaders should consider the importance of time management and EI in increasing motivation and satisfaction of nursing staff and improving quality of care. © Copyright 2022 Creative Health Care Management

Energy Harvesters for Wearable Electronics and Biomedical Devices

Energy harvesters (EHs) are widely used to transform ambient energy sources into electrical energy, and have tremendous potential to power wearables electronics and biomedical devices by eliminating, or at least increasing, the battery life. Nevertheless, the use of EHs for a specific application depends on various aspects including the form of energy source, the structural configuration of the device, and the properties of materials. This paper presents a comprehensive review of the classification of EHs, notably thermoelectric generators (TEGs), triboelectric nanogenerators (TENGs), and piezoelectric generators (PEGs) that allows a wide variety of devices to be operated. The EHs are discussed in terms of their operating principles, optimization factors, state-of-the-art materials, and device structure, that directly influence their operational efficiency. Besides, the breakthrough performance of each of the EHs listed above is highlighted. From the review and analysis, the maximum output power density of 9.2 mW cm-2, 50 mW cm-2, and 64.9 µW cm-2, respectively, are obtained from the TEG, TENG, and PEG, respectively. Furthermore, recent applications relevant to a specific EH and their output performance, are also enlightened. Eventually, the essential outcomes and future direction from this review are discussed and encapsulated