Patients' Experience of therapeutic footwear whilst living at risk of neuropathic diabetic foot ulceration: an interpretative phenomenological analysis (IPA).

BACKGROUND: Previous work has found that people with diabetes do not wear their therapeutic footwear as directed, but the thinking behind this behaviour is unclear. Adherence to therapeutic footwear advice must improve in order to reduce foot ulceration and amputation risk in people with diabetes and neuropathy. Therefore this study aimed to explore the psychological influences and personal experiences behind the daily footwear selection of individuals with diabetes and neuropathy. METHODS: An interpretative phenomenological analysis (IPA) approach was used to explore the understanding and experience of therapeutic footwear use in people living at risk of diabetic neuropathic foot ulceration. This study benefited from the purposive selection of a small sample of four people and used in-depth semi structured interviews because it facilitated the deep and detailed examination of personal thoughts and feelings behind footwear selection. FINDINGS: Four overlapping themes that interact to regulate footwear choice emerged from the analyses: a) Self-perception dilemma; resolving the balance of risk experienced by people with diabetes and neuropathy day to day, between choosing to wear footwear to look and feel normal and choosing footwear to protect their feet from foot ulceration; b) Reflective adaption; The modification and individualisation of a set of values about footwear usage created in the minds of people with diabetes and neuropathy; c) Adherence response; The realignment of footwear choice with personal values, to reinforce the decision not to change behaviour or bring about increased footwear adherence, with or without appearance management; d) Reality appraisal; A here and now appraisal of the personal benefit of footwear choice on emotional and physical wellbeing, with additional consideration to the preservation of therapeutic footwear. CONCLUSION: For some people living at risk of diabetic neuropathic foot ulceration, the decision whether or not to wear therapeutic footwear is driven by the individual 'here and now', risks and benefits, of footwear choice on emotional and physical well-being for a given social context

Normal-to-abnormal rearrangement and nhc activation in three-coordinate iron(ii) carbene complexes

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Synthesis, Structural, Spectroscopic, and Magnetic Characterization of Two-coordinate Cobalt (II) Aryloxides with Bent or Linear Coordination

Treatment of the cobalt(II) amide, [Co{N(SiMe3)2}2]2, with four equivalents of the sterically crowded terphenyl phenols, HOArMe6 (ArMe6 = C6H3-2,6(C6H2-2,4,6-Me3)2) or HOAriPr4 (AriPr4 = C6H3-2,6(C6H3-2,6-Pri2)2), produced the first well-characterized, monomeric two-coordinate cobalt(II) bisaryloxides, Co(OArMe6)2 (1) and Co(OAriPr4)2 (2a and 2b), as red solids in good yields with elimination of HN(SiMe3)2. The compounds were characterized by electronic spectroscopy, X-ray crystallography, and direct current magnetization measurements. The O–Co–O interligand angles in 2a and 2b are 180°, whereas the O–Co–O angle in 1 is bent at 130.12(8)° and its cobalt(II) ion has a highly distorted pseudotetrahedral geometry with close interactions to the ipso-carbons of the two flanking aryl rings. The Co–O distances in 1, 2a, and 2b are 1.858(2), 1.841(1), and 1.836(2) Å respectively. Structural refinement revealed that 1, 2a, and 2b have different fractional occupations of the cobalt site in their crystal structures: 1, 95.0%, 2a, 93.5%, and 2b, 84.6%. Correction of the magnetic data for the different cobalt(II) occupancies showed that the magnetization of 2a and 2b was virtually identical. The effective magnetic moments for 1, 2a, and 2b, 5.646(5), 5.754(5), and 5.636(3) B respectively, were indicative of significant spin–orbit coupling. The differences in magnetic properties between 1 and 2a/2b are attributed to their different cobalt coordination geometries