RESUMEN
BACKGROUND: High levels of occupational stress have been reported in podiatrists practising in Australia. One possible stressor is the predominance of the treatment of aged patients with chronic disease in Podiatry practice. METHODS:Forty (40) Podiatrists attending a regional podiatry conference were invited to participate in the research using a convenience sampling method. Podiatrists were asked to complete a survey examining occupational stress in general and specifically in relation to practice with older adults (defined as those over the age of sixty five). RESULTS:The survey of sources of occupational stress among podiatrists has identified that patient demands and expectations are the most significant stressor both in general and in geriatric practice for the Podiatrist. The perceived limited clinical gains and chronic nature of their conditions in older patients was also ranked highly as a stressor. CONCLUSIONS:Working with the elderly is a significant part of podiatry practice and as such needs to be seen with more positive attitude by many practitioners. The development of geriatric practice as a speciality within the profession may help to raise the value of working with the elderly. This has implications for preparing podiatrists for practice with the geriatric population along with the need for strategies to avoid or minimise these work stressors.
RESUMEN
BACKGROUND: There has been limited literature indicating that podiatrists' health may be at risk from exposure to human nail dust. Previous studies carried out in the UK have shown that large amounts of dust become airborne during the human nail drilling procedure and are present in the air up to 10 hours after a clinical session. This increases the risk of Respiratory Tract (RT) infection for the practitioner. METHODS: This study used a nasal swabbing technique and fungal culture to determine whether podiatrists (n = 50) had the same microbes present in their nasal cavities as non-podiatry health professional control group (n = 45). All swabs were cultured, counted and identified for each subject. Survey data of use and type of nail drill, type of mask used and frequency of change over a two week period. RESULTS: The results showed podiatrists had a greater range of microbes in their nasal cavities although the controls had greater overall numbers of organisms. The known pathogen and common mould, Aspergillus fumigatus was ost commonly found fungus within the podiatric group with 44% of the group having the fungus present. All nail drills used by the podiatrists had some form of dust extraction (except one). Of concern was 17% (n = 8) of the podiatrists did not use a mask at all whilst drilling and seemed unaware of any infection control issues. Simple disposable masks were the most frequently worn with only half being changed after each patient further increasing the cross infection risk CONCLUSION: The high levels of Aspergilus contamination is a significant finding in the podiatry group as this fungus is small enough to enter the tissue of the nasal cavity and as a small particle will stay airborne in the room for up to 16 hours. Aspergilus has been shown to cause brain and soft tissue tumours in extreme cases. The high levels of upper respiratory track problems reported in the literature may well be caused by this fungal agent. The non use and use of inappropriate masks by podiatrists is clearly an occupational hazard to their health and well being.
RESUMEN
BACKGROUND: Idiopathic toe-walking (ITW) in children has been associated with ankle equinus. Although equinus has been linked to foot deformity in adults, there has been limited investigation of the impact of equinus on structural foot change in children. We used the weightbearing lunge test and the six-item version of the Foot Posture Index (FPI-6) to evaluate the weightbearing foot and ankle measures of children with an ITW gait and to compare these with their age-matched peers. METHODS: Sixty 4-to 6-year-old children were grouped into ITW (n = 30) and non-toe-walking (n = 30) cohorts using a validated ITW tool. Ankle range of motion was determined with weightbearing lunge tests. The FPI-6 was calculated during weightbearing stance. RESULTS: There was a highly significant difference in the weightbearing lunge test measures between the ITW cohort and the non-toe-walking cohort. The FPI-6 comparison was not significant. The straight-leg lunge test had a statistically significant relationship with the FPI-6 in the ITW cohort. CONCLUSION: Children with an ITW gait demonstrated reduced flexibility at the ankle joint but similar weightbearing foot posture compared with non-toe-walking children, showing that for children 4 to 8 years old, an ITW gait affects the available ankle dorsiflexion but seems to have a limited effect on weightbearing foot posture as measured by the FPI-6.
