The Use of Patient Simulations to Teach and Assess Clinical Competencies in Colleges of Podiatric Medicine: A Survey of US Podiatric Medical Schools.

Human and mechanical simulations are used to teach and assess clinical competencies in medical education. In 2014, the National Board of Podiatric Medical Examiners implemented the Clinical Skills Patient Encounter, an examination using standardized patients. Similar clinical skills examinations already existed as part of medical and osteopathic licensure examinations. The purpose of this study was to assess the use of simulation-based education in the nine colleges of podiatric medicine in the United States to inform podiatric clinical faculty and other stakeholders about current trends within the podiatric education system. In 2019, the Clinical Skills Patient Encounter committee of the National Board of Podiatric Medical Examiners developed a survey and contacted each podiatric school to voluntarily participate. The mailed survey instrument gathered information on patient simulation modalities, years used, clinical content application, simulation program administration, facilities and equipment available, and the role of simulation educators. All nine schools participated anonymously. The survey showed that simulation modalities were used in all of the schools during the first 3 years, although there was considerable variance in their use.

Association between knowledge and adherence to foot self-care practices performed by diabetics.

OBJECTIVES: to verify the association between knowledge and adherence to foot self-care practices performed by patients with diabetes mellitus type 2. METHODS: cross-sectional, descriptive study carried out with 197 patients in basic health units located in the Northeast region of Brazil. For data collection, we used a semi-structured questionnaire that addressed issues inherent to knowledge and Diabetes Self-Care Activities. RESULTS: we observed that patients with moderate knowledge about self-care practices were more likely to perform foot self-examination, dry the interdigital spaces, moisturize their feet with creams and oils, observe the presence of mycosis and ingrown toenail when compared to patients with insufficient knowledge. CONCLUSIONS: the patients' level of knowledge was closely related to the self-care activities carried out, which reinforces the importance of nurses working on training those on essential health care.

Association between knowledge and adherence to foot self-care practices performed by diabetics / Asociación entre conocimiento y adherencia a las prácticas de autocuidado con los pies realizadas por diabéticos / Associação entre conhecimento e adesão às práticas de autocuidado com os pés realizadas por diabéticos

ABSTRACT Objectives: to verify the association between knowledge and adherence to foot self-care practices performed by patients with diabetes mellitus type 2. Methods: cross-sectional, descriptive study carried out with 197 patients in basic health units located in the Northeast region of Brazil. For data collection, we used a semi-structured questionnaire that addressed issues inherent to knowledge and Diabetes Self-Care Activities. Results: we observed that patients with moderate knowledge about self-care practices were more likely to perform foot self-examination, dry the interdigital spaces, moisturize their feet with creams and oils, observe the presence of mycosis and ingrown toenail when compared to patients with insufficient knowledge. Conclusions: the patients' level of knowledge was closely related to the self-care activities carried out, which reinforces the importance of nurses working on training those on essential health care.

RESUMEN Objetivos: verificar la asociación entre conocimiento y adherencia a las prácticas de autocuidado de pacientes con diabetes mellitus tipo 2. Métodos: estudio descriptivo, transversal, realizado con 197 pacientes en unidades básicas de salud ubicadas en el Noreste de Brasil. Para la recopilación de datos, fue utilizado un cuestionario semiestructurado que aborda temas relacionados con el conocimiento y las actividades de autocuidado, como la diabetes. Resultados: ha observado que los pacientes con control moderado sobre las prácticas de autocuidado han tenido más probabilidades de realizar autoexamen de los pies, secar los espacios interdigitales, hidratar los pies con cremas y aceites, observar la presencia de micras y uña encarnada, en comparación a los pacientes con conocimiento insuficiente. Conclusiones: el nivel de conocimiento de los pacientes estaba estrechamente relacionado con las actividades de autocuidado realizadas, lo que refuerza la importancia del enfermero actuar en la capacitación de aquellos acerca de los cuidados esenciales con su salud.

RESUMO Objetivos: verificar a associação entre o conhecimento e a adesão às práticas de autocuidado com os pés realizadas por pacientes com diabetes mellitus tipo 2. Métodos: estudo transversal, descritivo, realizado com 197 pacientes em unidades básicas de saúde localizadas na região Nordeste do Brasil. Para a coleta de dados, foi utilizado um questionário semiestruturado que abordava questões inerentes ao conhecimento e às Atividades de Autocuidado com o Diabetes. Resultados: observou-se que os pacientes com conhecimento moderado sobre as práticas de autocuidado tiveram mais chances de realizar autoexame dos pés, secar os espaços interdigitais, hidratar os pés com cremes e óleos, observar a presença de micose e unha encravada, quando comparados aos pacientes com conhecimento insuficiente. Conclusões: o nível de conhecimento dos pacientes apresentou estreita relação com as atividades de autocuidado realizadas, o que reforça a importância de o enfermeiro atuar na capacitação daqueles sobre os cuidados essenciais com sua saúde.

Adquisición de competencias para el diagnóstico de onicomicosis mediante entrenamiento práctico podológico preclínico y clínico / Competence acquisition for the diagnosis of onychomycosis by preclinical and clinical podiatric practical training

Introducción: Para el correcto diagnóstico de la onicomicosis es fundamental realizar una adecuada toma de muestra. Objetivo: Evaluar la competencia de los alumnos del grado en Podología en la realización de la toma de muestra ungueal como experiencia preclínica y clínica. Métodos: Estudio observacional, descriptivo y transversal, realizado sobre una muestra de 75 alumnos, pertenecientes a segundo (n = 45) y cuarto curso (n = 30) del grado en Podología. Los alumnos de segundo curso no contaron con experiencia previa, mientras que los de cuarto ya habían realizado prácticas preclínicas y clínicas. Se evaluó el procedimiento de toma de muestras ungueales mediante el grado de seguimiento de cada alumno del protocolo preestablecido y explicado. Además, se obtuvo el porcentaje de cultivos contaminados tras el período de incubación de las muestras. Resultados: Los alumnos de cuarto curso siguieron más fielmente el protocolo de toma de muestras ungueales y las contaminaron significativamente menos que los alumnos de segundo curso (23,3 por ciento frente al 51,1 por ciento; p-valor = 0,017). La experiencia previa en toma de muestras ungueales (p-valor = 0,027) y en la realización de quiropodias (p-valor = 0,016) redujo significativamente el porcentaje de cultivos contaminados. Conclusiones: Una sola práctica preclínica no es suficiente para que la mayoría de los alumnos de segundo curso adquieran la competencia de toma de muestra. Las experiencias preclínica y clínica de los alumnos de cuarto curso constituyen un factor determinante para la correcta realización de la toma de muestra ungueal(AU)

Introduction: For the correct diagnosis of onychomycosis, it is essential to take an adequate sample. Objective: To assess the competence of students of the degree in Podiatry in the realization of nail sampling as a preclinical and clinical experience. Methods: Observational, descriptive and cross-sectional study carried out on a sample of 75 students, belonging to the second (n=45) and fourth academic years (n=30) of the degree in Podiatry. The second-year students did not have previous experience, while the fourth-year students had already done preclinical and clinical practices. The nail sampling procedure was assessed by the degree of follow-up of each student of the pre-established and explained protocol. In addition, the percentage of contaminated cultures was obtained after the incubation period of the samples. Results: The fourth-year students followed the nail sampling protocol more faithfully and contaminated them significantly less than second-year students (23.3 percent versus 51.1 percent; p value=0.017). Previous experience in nail sampling (p value=0.027) and in performing podiatry (p value=0.016) significantly reduced the percentage of contaminated cultures. Conclusions: A single preclinical practice is not enough for most second-year students to acquire the competence of sampling. The preclinical and clinical experiences of fourth-year students constitute a determining factor for the correct realization of the nail sampling(AU)

Differences in mineral concentrations on hooves of horses, mules and donkeys / Diferenças nas concentrações de minerais nos cascos de equinos, muares e asininos

This study aimed to measure the concentrations of minerals in different regions and pigmentation of horses' hooves, mules and donkeys. A total of 20 Crioulo horses, 20 mules and 20 Pega donkeys were used. They formed two groups: pigmented (dark) or non-pigmented (bright) hooves. All animals were unshod and with adequate foot conformation. Females were non-pregnant and without foal and no animals were in training. Samples were collected from the hooves of all limbs in the regions of wall, sole and frog. The concentrations of calcium, magnesium, copper, iron and zinc were determined by atomic absorption spectrophotometry; sodium and potassium concentrations were determined by atomic emission spectrophotometry. Among the groups it was observed that the wall, sole and frog of donkeys' hooves presented higher concentrations of sodium and calcium and with the exception of the frog that also obtained higher levels of copper in this species. Mules had lower concentrations of zinc in the wall and the horses had higher concentrations of potassium and zinc in the sole and higher magnesium in the frog and wall. There was no difference (P>0.05) in concentrations regarding the pigmentation of the hooves. The different regions of the hooves in each group presented similar concentrations of minerals and it was regardless of the pigmentation. The mineral concentrations may be related to desirable functional properties of the donkeys' hooves. Pigmented and non-pigmented hooves have similar concentrations of minerals.

O objetivo desse trabalho foi mensurar os teores de minerais nas diferentes regiões e pigmentações dos cascos de equinos, muares e asininos. Utilizaram-se 20 equinos da raça Crioula, 20 muares e 20 asininos da raça Pêga. Formaram-se dois grupos conforme os cascos pigmentados (escuros) e não pigmentados (claros). Todos os animais estavam desferrados e com adequada conformação podal e as fêmeas estavam não gestantes e sem potro ao pé e nenhum animal estava em treinamento. Amostras foram coletadas dos cascos de todos os membros nas regiões de parede, sola e ranilha. As concentrações de cálcio, magnésio, cobre, ferro e zinco foram determinadas por espectrofotometria de absorção atômica e as concentrações de sódio e potássio foram determinadas por espectrofotometria de emissão atômica. Entre os grupos observou-se que a parede, sola e ranilha nos asininos apresentaram maiores valores de sódio e cálcio e, exceto para a ranilha, também obteve-se maiores teores de cobre nesta espécie. Os muares apresentaram menores teores de zinco na parede e, os equinos, maiores teores de potássio e zinco na sola e ranilha e de magnésio na ranilha e parede. Não houve diferença (P>0,05) nos teores dos minerais quanto à pigmentação dos cascos. As diferentes regiões dos cascos em cada grupo apresentaram teores similares de minerais e este independeu da pigmentação. As variações dos teores de minerais entre os grupos podem estar relacionados a propriedades funcionais desejáveis dos cascos dos asininos. Cascos pigmentados e não pigmentados apresentam teores similares dos minerais.

Changes to the feet of institutionalized elderly persons / Alterações dos pés de idosos institucionalizados

Abstract Objective: The present study aimed to identify the most frequent changes to the feet of institutionalized elderly persons. Method: A descriptive study was conducted with elderly persons living in long-term care facilities in the city of Passo Fundo, Rio Grande do Sul, Brazil. A total of 174 people aged 60 years and over of both genders were surveyed regardless of health conditions. Those with amputations, burns or who were undergoing surgery of the lower limbs were excluded. Data were collected through the application of a structured questionnaire containing sociodemographic variables (age, gender, ethnicity, marital status, schooling, main occupation) and variables related to alterations of the feet (nail, dermatological and bone deformities). The Manchester Scale was subsequently applied to evaluate the degree of hallux deformity. Results: The most frequent nail deformities were onychomycosis, onychogryphosis, onycholysis, onychosclerosis; the dermatological findings were callosities, especially interdigital and bromhidrosis; the most prevalent bone deformities were pes cavus and transverse arches. In the assessment of hallux valgus, according to the Manchester Scale, painful feet (38.5%), mild deformities (35.6%) and no deformities (25.3%) were identified. Conclusion: The results suggest signs of neglect of the health of the feet of institutionalized elderly persons. There should be more investment in the training of teams responsible for care.

Resumo Objetivo: Identificar as alterações mais frequentes dos pés de idosos institucionalizados. Método: Trata-se de um estudo descritivo realizado com idosos residentes em Instituições de Longa Permanência para Idosos, no município de Passo Fundo, RS, Brasil. Participaram 174 pessoas com 60 anos ou mais, de ambos os sexos. Foram excluídos aqueles com amputação, queimaduras ou submetidosà cirurgia de membros inferiores. Os dados foram coletados por meio da aplicação de um questionário estruturado contendo variáveis sociodemográficos (idade, sexo, raça, estado civil, escolaridade, principal ocupação) e referentes às alterações podológicas (ungueais, dermatológicas e deformidades ósseas). Na sequência foi aplicada a Escala Manchester para avaliação do grau de deformidade do hálux. Resultados: As alterações ungueais mais frequentes foram a onicomicose, onicogrifose, onicólise, onicosclerose; as dermatológicas encontradas foram calosidades, especialmente a interdigital e bromidrose; as deformidades ósseas mais prevalentes foram pé cavo e arco transverso. Na avaliação do hálux valgo, segundo a Escala Manchester, identificaram-se pés dolorosos (38,5%), deformidade leve (35,6%) e sem deformidades (25,3%). Conclusão: Os resultados sugerem indícios de negligência acerca da saúde dos pés dos idosos, no âmbito da institucionalização. Faz-se necessário maior investimento na qualificação das equipes responsáveis pelo cuidado.

Are the U.S. territories lagging behind in diabetes care practices?

AIMS: Although U.S. territories fall within the mandate outlined by Healthy People 2020, they remain neglected in diabetes care research. We compared the prevalence and secular trends of four recommended diabetes care practices in the U.S. territories of Guam, Puerto Rico, and the U.S. Virgin Islands to the 50 United States and D.C. ("U.S. States") in 2001-2015. METHODS: Data were from 390,268 adult participants with self-reported physician diagnosed diabetes in the Behavioral Risk Factor Surveillance System. Diabetes care practices included biannual HbA1c tests, attendance of diabetes education classes, daily self-monitoring of blood glucose, and receipt of annual foot examination. Practices were compared by U.S. territory and between territories and U.S. states. Multivariable models accounted for age, sex, education, and year. RESULTS: Of adults with diagnosed diabetes, 7% to 11% in the U.S. territories engaged in all four recommended diabetes care practices compared with 25% for those, on average, in U.S. states. Relative to the U.S. states, on average, the proportion achieving biannual HbA1c testing was lower in Guam and the U.S. Virgin Islands (45.6% and 44.9% vs. 62.2%), while annual foot examinations were lower in Puerto Rico (45.9% vs 66.1% in the U.S. states). Diabetes education and daily glucose self-monitoring were lower in all three territories. CONCLUSIONS: U.S. territories lag behind U.S. states in diabetes care practices. Policies aimed at improving diabetes care practices are needed in the U.S. territories to achieve Healthy People 2020 goals and attain parity with U.S. states.

Biossegurança em salões de beleza: avaliação da estrutura e dispositivos / Bioseguridad los salones: estructura de la evaluación y dispositivos / Biosafety in beauty salons: structure and devices evaluation

Objetivo: avaliar a estrutura física, os dispositivos presentes em salões beleza e a dinâmica da limpeza/desinfecção de superfícies e mobiliários nesses estabelecimentos. Método: Trata-se de um estudo transversal, envolvendo 235 salões de beleza. Foram entrevistadas manicures/pedicures e observados a estrutura física dos salões e métodos de esterilização. Resultados: O tamanho médio dos salões foi de 67 m2, sendo que 49% dispunham de sala exclusiva para manicures/pedicures; 2% não possuíam banheiro; 30% dispunham de uma única pia e, em 43% deles, havia um local próprio destinado à limpeza de artigos. O método de esterilização utilizado, predominantemente, foi o calor seco (61,7%), sendo que, em 35,3% dos casos havia autoclave e, em 33,2%, foi realizada a validação da esterilização pelo uso do indicador biológico. A limpeza de superfícies entre clientes foi referida por 2% dos estabelecimentos. Conclusão: A estrutura dos salões precisa ser revista, os espaços parecem não atender a demandas mínimas para as atividades desenvolvidas, com condições adequadas de funcionamento, o que aumenta o risco biológico, como a ausência de sanitários ou o compartilhamento de uma única pia para atividades distintas. Ações educativas e orientações seguras de funcionamento visando à segurança da saúde de profissionais e clientes são necessárias e emergenciais.

Objectives: to evaluate the physical structure, devices present in beauty salons and the dynamics of surfaces and furniture cleaning/disinfection in these establishments. Method: This was a cross-sectional study, involving 235 beauty salons. We interviewed manicurists/pedicurists, observing the physical structure of the salons and sterilization methods. Results: The average size of the salons was 67 m2, 49% had an exclusive room for manicurists/pedicurists; 2% did not have a bathroom; 30% had a single sink for all types of use, and in 43% of them, there was a separate space for cleaning items. Dry heat was the predominant method of sterilization (61.7%), in 35.3% of the cases, there was an autoclave, and in 33.2%, the sterilization was validated using the biological indicator. Cleaning of surfaces between customers was reported by 2% of the establishments. Conclusion: The structure of the salons needs to be reviewed, the spaces do not seem to meet the minimum demands for the developed activities, with adequate operating conditions, which increases the biological risk, such as the absence of toilets or sharing a single sink for different activities. Educational actions and safe guidance for operation aiming at the health safety of professionals and clients are necessary and emergency.

Objetivo: evaluar la estructura física, los equipamientos utilizados en los salones de belleza y la dinámica de la limpieza/desinfección de superficies y mobiliario en estos establecimientos. Método: Se realizó un estudio transversal con 235 salones. Manicuristas y pedicuristas fueron entrevistados, observando la estructura física de las salas y métodos de esterilización. Resultados: Las áreas de trabajo promedio fueron de 67 m2, de los cuales el 49% tenían áreas exclusivas para manicuristas/pedicuristas; 2% no tenían baño; 30% tenían solamente un fregadero, y en el 43% de ellos, había un sitio propio para la limpieza de los elementos. El método más utilizado de esterilización es por calor seco (61,7%), y había el método autoclave (35,3%), y en el 33,2%, la validación de la esterilización fue utilizada por medio del indicador biológico. La limpieza de superficies entre los clientes fue informada en el 2% de los establecimientos. Conclusión: La estructura de los salones necesita ser revisada, los espacios parecen no cumplir los requisitos mínimos para desarrollar las actividades en óptimas condiciones, aumentando el riesgo biológico, como la falta de baños o la utilización del único fregadero para diferentes actividades. Acciones educativas y orientaciones seguras de funcionamiento visando a la salud de los profesionales y clientes son necesarias y de urgencia.

A 5-Year Review of Clinical Outcome Measures Published in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery®.

This investigation presents a review of all of the clinical outcome measures used by authors and published in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery® from January 1, 2011, to December 31, 2015. Of 1,336 articles published during this time frame, 655 (49.0%) were classified as original research and included in this analysis. Of these 655 articles, 151 (23.1%) included at least one clinical outcome measure. Thirty-seven unique clinical outcome scales were used by authors and published during this period. The most frequently reported scales in the 151 included articles were the American Orthopaedic Foot and Ankle Society scales (54.3%; n = 82), visual analog scale (35.8%; n = 54), Medical Outcomes Study Short Form Health Survey (any version) (10.6%; n = 16), Foot Function Index (5.3%; n = 8), Maryland Foot Score (4.0%; n = 6), and Olerud and Molander scoring system (4.0%; n = 6). Twenty-four (15.9%) articles used some form of original/subjective measure of patient satisfaction/expectation. The results of this investigation detail the considerable variety of clinical outcome measurement tools used by authors in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery® and might support the need for a shift toward the consistent use of a smaller number of valid, reliable, and clinically useful scales in the podiatric medical literature.

Conscientious objection in spanish podiatrists students: a questionnaire survey / Objeción de conciencia en estudiantes españoles de podología: estudio mediante cuestionario / Objeção de consciência em estudantes de podologia na Espanha: um questionário de sondagem

Objective: To explore attitudes towards conscientious objections among podiatrists students in Spain. Methods: Podiatrists students at University of A Coruña, King Rey Juan Carlos University, University of Sevilla and Complutense University of Madrid were emailed a link to complete an anonymous online questionnaire, hosted by an online survey company. A total of 432 podiatrists students responded. Results: Nearly half of the students in this survey stated that they believed in the right of podiatrist to conscientiously object to any procedure. Demand for the right to conscientiously object is greater in Roman Catholic podiatrists students when compared with other groups of religious podiatrists students. Discussion: Examining patients and podiatric treatments continues to be controversy issues among podiatrists students and this may contribute to the looming crisis in podiatry services over next years. This project sheds some light on how future podiatrist view some of their ethical rights and obligations. Using empirical evidence, it reveals that conscientious objection is an issue in the Spain podiatrists student body today. These data could help anticipate problems that may arise when these podiatrists students qualify and practice podiatry in the community. Conclusion: Clearer guidance is needed for podiatrists students about the issue of conscientious objection at podiatry school.

Objetivo: Explorar actitudes hacia la objeción de conciencia entre estudiantes de podología en España. Métodos: Se realizó un cuestionario anónimo online vía email a estudiantes de podología de la Universidad del Rey Juan Carlos de la Coruña, la Universidad de Sevilla y la Universidad Complutense de Madrid, organizado por una empresa de encuestas online. Respondieron un total de 432 estudiantes de podología. Resultados: Casi la mitad de los estudiantes afirmaron en la encuesta que creían en el derecho del podólogo a la objeción de conciencia en cualquier procedimiento. La exigencia del derecho a objeción de conciencia fue mayor en estudiantes de podología católicos que en otros grupos de otras religiones. Discusión: Examinar a pacientes y los tratamientos de podología continúan siendo temas controversiales entre los estudiantes de podología y esto puede que contribuya a la inminente crisis en servicios de pedicura en los próximos años. Este proyecto derrama algo de luz sobre como futuros podólogos ven algunos de sus derechos y obligaciones éticas. Usando evidencia científica, revela que la objeción de conciencia es un tema para los estudiantes de podología en España hoy día. Estos datos pueden ayudar a anticipar problemas que puedan surgir cuando estos estudiantes de podología califiquen y practiquen podología en la comunidad. Conclusión: Se necesitan pautas más claras para estudiantes de podología sobre el tema de objeción de conciencia en la Escuela de Podología.

Objetivo: Explorar atitudes com relação à objeção de consciência entre os estudantes de podologia na Espanha. Método: Aos estudantes de podologia da Universidade Universidade Rei Juan Carlos, de Corunha, da Universidade de Sevilla e da Universidade Complutense de Madri foram enviados por email um link para completar um questionário online anônimo, hospedado por uma empresa de pesquisa on-line. Um total de 432 alunos de podologia responderam. Resultados: Quase metade dos alunos nesta pesquisa afirmaram que acreditavam no direito de podólogo se opor conscientemente a qualquer procedimento. A demanda para o direito de se opor conscientemente é maior em estudantes católicos romanos, quando comparado com outros grupos religiosos de estudantes. Discussão: O exame de pacientes e tratamentos podiátricos continuam a ser problema de controvérsia entre os alunos de podologia e isso pode contribuir para a crise iminente nos serviços de podologia para os próximos anos. Este projeto lança alguma luz sobre a forma de o futuro podólogo conhecer alguns dos seus direitos e obrigações éticas. Usando a evidência empírica, revela que a objeção de consciência é um problema no corpo discente de podologia da Espanha, hoje. Estes dados poderiam ajudar a antecipar problemas que podem surgir quando esses estudantes de podología se qualificarem e praticarem a podologia na comunidade. Conclusão: Orientação mais esclarecida é necessária para alunos de podologia sobre a questão da objeção de consciência no curso de graduação.

Podiatric Resident Performance on a Basic Competency Examination in Musculoskeletal Medicine.

A basic competency examination in musculoskeletal medicine has previously been administered to residents across a variety of medical specialties and has demonstrated that medical school preparation in musculoskeletal medicine might be inadequate. The objectives of the present study were to assess podiatric surgical resident performance on this examination and to assess podiatric surgical residency director opinions of the level of importance of the test subject areas. A total of 117 podiatric surgical residents from 15 residency programs completed the 25-question examination. The residents scored a mean ± standard deviation of 60.32% ± 12.60% (range 22.00% to 92.00%). On the 7 questions rated by podiatric residency directors as ≥8 on a 10-point scale of relative importance, this score improved to 84.92% ± 11.93% (range 39.29% to 100.0%). Senior level residents did not outperform junior level residents (60.76% versus 60.44%; p = .898), and those who had completed a general orthopedics rotation at some point in their education did not outperform those who had not (61.12% versus 58.64%; p = .370). The podiatric residency directors assigned a mean ± standard deviation importance score of 6.97 ± 2.07 out of 10 for the 25 questions and suggested a mean ± standard deviation passing score of 69.14% ± 9.03% for the examination. The results of the present investigation provide original data on podiatric surgical resident performance on a basic competency examination in musculoskeletal medicine. Although the residents scored well for some specific test areas, the overall performance was similar to that of previous iterations of the examination given to general surgery and internal medicine residents. The lower scores compared with those from the orthopedic and physical therapy specialties might indicate a need for improved general musculoskeletal medicine education within the podiatric curriculum.

Baropodometric analyses of patients before and after bariatric surgery.

OBJECTIVE: The aim of this study was to evaluate the vertical component of the ground reaction force, plantar pressure, contact area of the feet and double-support time using static and dynamic (gait) baropodometry before and after bariatric surgery. METHODS: Sixteen individuals with a body mass index of between 35 and 55 were evaluated before and after bariatric surgery. Thirteen patients (81.3%) were female and three (18.8%) male and their average age was 46±10 (21-60) years. An FSCAN system (version 3848) was used for baropodometric analyses (1 km/h and 3 km/h). The peak plantar pressure and ground reaction force were measured for the rear foot and forefoot. The double-support time and foot contact area were measured during gait. RESULTS: There were reductions in the ground reaction force in the forefoot and rear foot and in the foot contact area in all evaluations and of the double-support time at 3 km/h, as well as a significant reduction in the body mass index at six months post-surgery. The peak pressure did not vary at 1 km/h and at 3 km/h, reductions in peak pressure were observed in the left and right rear feet and left forefoot. CONCLUSIONS: Weight loss after bariatric surgery resulted in decreases in the ground reaction force and contact area of the foot. Plantar pressure was decreased at 3 km/h, especially in the forefoot. There was an increase in rhythm because of a reduction in the double-support time at 3 km/h.

Baropodometric analyses of patients before and after bariatric surgery

OBJECTIVE: The aim of this study was to evaluate the vertical component of the ground reaction force, plantar pressure, contact area of the feet and double-support time using static and dynamic (gait) baropodometry before and after bariatric surgery. METHODS: Sixteen individuals with a body mass index of between 35 and 55 were evaluated before and after bariatric surgery. Thirteen patients (81.3%) were female and three (18.8%) male and their average age was 46±10 (21-60) years. An FSCAN system (version 3848) was used for baropodometric analyses (1 km/h and 3 km/h). The peak plantar pressure and ground reaction force were measured for the rear foot and forefoot. The double-support time and foot contact area were measured during gait. RESULTS: There were reductions in the ground reaction force in the forefoot and rear foot and in the foot contact area in all evaluations and of the double-support time at 3 km/h, as well as a significant reduction in the body mass index at six months post-surgery. The peak pressure did not vary at 1 km/h and at 3 km/h, reductions in peak pressure were observed in the left and right rear feet and left forefoot. CONCLUSIONS: Weight loss after bariatric surgery resulted in decreases in the ground reaction force and contact area of the foot. Plantar pressure was decreased at 3 km/h, especially in the forefoot. There was an increase in rhythm because of a reduction in the double-support time at 3 km/h.

Comparação morfológica dos cascos dos membros torácicos de equinos submetidos à tenotomia do flexor digital superficial ou à desmotomia de seu ligamento acessório / Morfological forelimb hoof comparison of horses underwent to superficial digital flexor tenotomy or its accessories desmotomy

A tenotomia do flexor digital superficial e a desmotomia de seu acessório são rotineiramente empregadas na correção cirúrgica de deformidades flexoras metacarpofalângicas. Objetivando-se avaliar os efeitos de tais práticas cirúrgicas sobre a morfologia dos cascos de equinos, realizou-se a tenotomia do flexor digital superficial e a desmotomia de seu acessório respectivamente nos membros torácicos direito e esquerdo de nove equinos. No pré-operatório, aos 15, 30 e 60 dias após a cirurgia foram tomadas as medidas da pinça, talão lateral, comprimento e largura do casco visto pela sola, além da angulação dos mesmos nos membros operados. O casco deformou-se em resposta a ambos os procedimentos cirúrgicos, aumentando o comprimento do talão, diminuindo o comprimento e aumentando a largura do casco visto pela sola. A tenotomia promoveu ainda elevação do ângulo do casco. Os procedimentos cirúrgicos estudados alteraram significativamente o formato do casco.

The superficial digital flexor tenotomy and desmotomy of its accessories are routinely used in surgical correction of flexural metacarpophalangeal deformities. Aiming to assess the effects of these surgical procedures on hooves morphology, the superficial digital flexor tenotomy and desmotomy of its acessories was proceeded respectively in the right and left forelimbs of nine horses. Preoperatively, 15, 30 and 60 days after surgery, the measurements of the toe, lateral heel, length and width of the sole and the angulation of the same were taken. The hoof deformed in response to both surgical procedures, increasing the length of the toe, decreasing length and increasing the width of the hoof seen from the sole. The tenotomy also promoted the hoof angle elevation. The studied surgical procedures significantly altered the hoove shape by reducing its length and increasing its width, as well as increasing the height of heels.

Comparação morfológica dos cascos dos membros torácicos de equinos submetidos à tenotomia do flexor digital superficial ou à desmotomia de seu ligamento acessório / Morfological forelimb hoof comparison of horses underwent to superficial digital flexor tenotomy or its accessories desmotomy

A tenotomia do flexor digital superficial e a desmotomia de seu acessório são rotineiramente empregadas na correção cirúrgica de deformidades flexoras metacarpofalângicas. Objetivando-se avaliar os efeitos de tais práticas cirúrgicas sobre a morfologia dos cascos de equinos, realizou-se a tenotomia do flexor digital superficial e a desmotomia de seu acessório respectivamente nos membros torácicos direito e esquerdo de nove equinos. No pré-operatório, aos 15, 30 e 60 dias após a cirurgia foram tomadas as medidas da pinça, talão lateral, comprimento e largura do casco visto pela sola, além da angulação dos mesmos nos membros operados. O casco deformou-se em resposta a ambos os procedimentos cirúrgicos, aumentando o comprimento do talão, diminuindo o comprimento e aumentando a largura do casco visto pela sola. A tenotomia promoveu ainda elevação do ângulo do casco. Os procedimentos cirúrgicos estudados alteraram significativamente o formato do casco. (AU)

The superficial digital flexor tenotomy and desmotomy of its accessories are routinely used in surgical correction of flexural metacarpophalangeal deformities. Aiming to assess the effects of these surgical procedures on hooves morphology, the superficial digital flexor tenotomy and desmotomy of its acessories was proceeded respectively in the right and left forelimbs of nine horses. Preoperatively, 15, 30 and 60 days after surgery, the measurements of the toe, lateral heel, length and width of the sole and the angulation of the same were taken. The hoof deformed in response to both surgical procedures, increasing the length of the toe, decreasing length and increasing the width of the hoof seen from the sole. The tenotomy also promoted the hoof angle elevation. The studied surgical procedures significantly altered the hoove shape by reducing its length and increasing its width, as well as increasing the height of heels.(AU)

Enfoque multidimensional de la percepción de la salud del pie en una población adulta / Multidimensional approach to perceived foot health in an adult sample

Como parte de un estudio más amplio sobre representaciones sociales de la salud del pie en la población adulta de la comunidad autónoma de Galicia (España), el objetivo de este trabajo consiste en conocer cómo se construyen los significados acerca de la salud del pie y su relación con la calidad de vida. Un total de 282 personas de un centro ambulatorio de salud perteneciente a la ciudad de La Coruña (España) –de los cuales 80 eran hombres (28.4%) y 202 mujeres (71.6%), con una edad promedio de 39.67± 15.75– fue incluido en el estudio; todos ellos completaron su curso. Mediante el escalamiento multidimensional se analizó cómo las personas representan cognitivamente la salud del pie en su contexto inmediato y cómo clasifican espontáneamente dichas percepciones. Los datos obtenidos muestran que los participantes utilizan al menos dos dimensiones y se puede sugerir que la percepción de la salud del pie está relacionada con la existencia de un facultativo y del mantenimiento del cuidado de los pies, que se integra en la vida o la actividad personal, y se conceptualiza como parte de un estilo de vida más saludable en la búsqueda de mejorar la calidad de vida y el bienestar...

Can foot and ankle surgeons accurately estimate patient body mass index?

The body mass index (BMI) is an objective patient finding that has been established to have a negative effect on the development and outcomes of podiatric pathologic entities and interventions. The objective of the present investigation was to assess the ability of podiatric physicians to estimate the patient BMI from clinical and radiographic observation. For the clinical estimation of the patient BMI, podiatric specialists across 3 levels of experience (i.e., students, residents, and practicing clinicians) performed 294 estimations on 72 patients in 3 clinical situations (standing, sitting in a treatment chair, and lying in a hospital bed). It was more common to inaccurately estimate the patient BMI (77.9%) than it was to correctly estimate it (22.1%), with underestimations being the most common error (48.3%). The estimations were particularly inaccurate when the patients were in the common clinical situation of sitting in a treatment chair or lying in a hospital bed and with patients actually classified as obese. For the radiographic estimation of patient BMI, 150 consecutive lateral ankle radiographs were analyzed, with the ratio of the overlying soft tissue diameter to the underlying bone diameter calculated and compared. Positive, but weak, relationships were observed with these ratios. From these data, we have concluded that podiatric practitioners should perform an actual calculation of the patient BMI during the patient examination and medical decision-making process to fully appreciate the potential risks inherent to the treatment of obese patients.

O risco oculto no segmento de estética e beleza: uma avaliação do conhecimento dos profissionais e das práticas de biossegurança nos salões de beleza / Hidden in the risk segment of aesthetic and beauty: an assessment of the knowledge of professional and practices in salons biosafety / El riesgo oculto en el segmento de estética y belleza: una evaluación de los conocimientos de los profisionales y la práctica de la bioseguridad en las peluquerías

O risco da transmissão microbiana pontencializa-se quando manicures e pedicures desconhecem e não utilizam medidas de biossegurança. Esta pesquisa teve como objetivo avaliar o conhecimento e a adesão às recomendações de biossegurança por manicures/pedicures que trabalham em salões de beleza. Tratou-se de uma pesquisa transversal, do tipo survey, em salões de beleza e em uma escola técnica de podologia em Minas Gerais, considerando adesão e conhecimento adequados quando houve acerto mínimo nas questões de 75%. Foram entrevistadas 84 mulheres manicures/pedicures. Houve baixa adesão aos equipamentos de proteção individual (45%) e aos métodos de reprocessamento de artigos, com deficiência na limpeza destes. Uma parcela significativa não utilizava avental/uniforme nem sapatos fechados no trabalho. O fator dificultador principal para não adesão às medidas foi a falta de informação. Os resultados deste estudo reforçam a necessidade de maior assistência dos órgãos públicos aos profissionais deste segmento acerca das medidas de biossegurança.

The risk of microbial transmission potentially increases when manicurists and pedicurists are unaware of or do not use biosecurity procedures. This study aimed to evaluate the knowledge and adherence to biosecurity procedures for manicurists/pedicurists who work in beauty salons. This was a cross-sectional survey with manicurists in beauty salons and in a technical school of podiatry, which evaluated the adherence to and knowledge of biosecurity procedures, with 75% of correct answers taken as the minimum for adequate adherence and knowledge. A total of 84 manicurists/pedicurists were interviewed, all female. There was poor adherence to the use of personal protection equipment (45%) and to methods of reprocessing equipment. The oven was the most widely used method of sterilizing, insufficient for cleaning and decontamination of material. A significant portion did not use an apron/uniform or closed shoes at work. The intervening factor most cited for non-adherence to the measures was the lack of information. The results reinforce the need for increased assistance regarding biosecurity procedures for professionals in this sector.

El riesgo de transmisión microbiana se convierte en potencial cuando manicuras/pedicuras desconocen y no utilizan las medidas de bioseguridad. Este estudio tuvo como objetivo evaluar el conocimiento y la adhesión a las recomendaciones de bioseguridad para manicuras/pedicuras. Esta fue una investigación transversal, Survey, en peluquerías de belleza y escuela técnica de podología, teniendo en cuenta la adhesión y conocimiento apropiado cuando se produjo precisión adecuada de al menos 75%. Se entrevistó 84 mujeres manicura y tuvo una baja adhesión a los equipos de protección personal (45%), métodos de reprocesamiento de artículos, con deficiencia de limpieza de los mismos. Una parte importante no usaba delantal/uniforme, ni zapatos cerrados en el trabajo. El factor de intervención a la no adhesión a las medidas fue la falta de información. Los resultados de este estudio refuerzan la necesidad de una asistencia para los profesionales de este segmento sobre las medidas de bioseguridad.