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Diabetes mellitus is one of the most common diseases around the world, and mainly affects the foot among the human body parts. The main causes of the diabetic foot are neuropathy, peripheral arterial disease and foot deformities; it leads to foot ulceration. Generally, sensory loss, high plantar pressure, foot deformities, inappropriate footwear, blindness, and age are the causing risk factors for developing foot ulceration in diabetic patients. Foot ulceration will result in prolonged hospitalization, high medical expenses, and serious complications with lower extremity amputation. For a long time, appropriate footwear has been recommended by physicians for reducing plantar pressure to prevent foot ulceration, the risk of amputation, and re-ulceration. A review is provided in this article towards the existing literature on the causes and prevalence of the diabetic foot, foot ulceration, off-loading pressure, footwear modification for different types of diabetic foot deformities, and types of footwear and textile materials used in footwear insoles for healing purposes.

The purpose of this paper is to develop a prototype of a wearable medical device in the form of a bandage with a real-time data monitoring platform, which can be used domestically for diabetic patients to identify the possibility of foot ulceration at the early stage.

The prototype can measure blood volumetric change and temperature variation in the forefoot area simultaneously. The waveform extracted using a pulsatile-blood-flow signal was used to assess blood perfusion-related information, and hence, predict ischemic ulcers. The temperature difference between ulcerated and the reference was used to predict neuropathic ulcers. The medical device can be used as a bandage during the application wherein the sensory module is placed inside the hollow pocket of the bandage. A platform was developed through a mobile application where doctors can extract real-time information, and hence, determine the possibility of ulceration.

The height of the peaks in the pulsatile-blood-flow signal measured from the subject with foot ischemic ulcers is significantly less than that of the subject without ischemic ulcers. In the presence of ischemic ulcers, the captured waveform flattens. Therefore, the blood perfusion from arteries to the tissue of the forefoot is considerably low for the subject with ischemic ulcers. According to the temperature difference data measured over 25 consecutive days, the temperature difference of the subject with neuropathic ulcers occasionally exceeded the 4 °F range but mostly had higher values closer to the 4 °F range. However, the temperature difference of the subject who had no complications of neuropathic ulcers did not exceed the 4 °F range, and the majority of the measurements occupy a narrow range from −2°F to 2 °F.

The proposed prototype of wearable medical apparatus can monitor both temperature variation and pulsatile-blood-flow signal on the forefoot simultaneously and thereby predict both ischemic and neuropathic diabetes using a single device. Most importantly, the wearable medical device can be used domestically without clinical assistance with a real-time data monitoring platform to predict the possibility of ulceration and the course of action thereof.

Diabetic foot ulcers are associated with considerable morbidity, mortality and costs to the NHS. This paper describes a review of publications reporting randomised controlled trials examining the clinical effectiveness of interventions for diabetic foot ulcers for 1986–1996. Only 23 studies were identified that described randomised controlled trials and, of these, only 4 fulfilled three criteria shown to influence reliability of results: adequate description of randomisation, double blinding and description of withdrawals and drop‐outs. No cost‐effectiveness studies conducted alongside trials were identified from the searches. This shortage of rigorous trials highlights the need for more well designed research in the prevention and treatment of diabetic foot ulcers to determine clinical effectiveness as well as relative cost‐effectiveness.

Ankle–foot orthoses (AFOs) are assistive devices prescribed for a number of physical and neurological disorders affecting the mobility of the lower limbs. Additive manufacturing has been explored as an alternative process; however, it has proved to be inefficient cost-wise. This work aims to explore the possibilities of generating modular AFO elements, namely, calf, shank and footplate, with the localized composite reinforcement that aids in the optimization of the device in terms of functionality, aesthetics, rigidity and cost.

The conventional lower leg–foot orthosis configuration depends on thermoforming a polymer sheet around a mortar cast with a trademark firmness relying upon the trim-line with the inalienable plan restrictions. In manufacturing of AFO the expert, i.e. orthotist's, guidance is used. Polypropylene and polyethylene material is used in fabrication of AFO to complete all-round reported points of interest over the ordinary outlines, yet their mechanical conduct under administration conditions cannot be effectively anticipated.

AFOs made of polypropylene and polyethylene material are available in the market, which are used by children of age 3-5 years. With the existing AFO design, patients are facing excessive heating and sweating problems during long-term usage. After feedback from patients and orthotists (who prescribed AFO to patients), an attempt has been made to solve the problem with a new and improved AFO design of AFO by using finite element modelling and stress analysis. Also, the results indicate that the new design is similar to the actual product design.

This work introduces the low-cost 3D printing with reinforcement approach as an alternative route for the designing and manufacturing of orthotic devices with complex shapes. It is expected that new applications add-up to increase the body of knowledge about the behaviour of such products which will mix both areas, composite theory and additive manufacturing. This study investigated the fields related to 3D scanning, 3D printing and computer-aided designing for the manufacturing of a customized AFO.

The first part ofthis series discussed current research on yam hairiness testing [Wang 1998]. In this part of the series, the importance of yam hairiness is outlined first. This is followed by a description of recent research on several novel ways of reducing yam hairiness.

The purpose of this paper is to disclose the author’s personal experiences regarding the war on drugs, specifically detailing cannabis encounters.

This work is autobiographical, with notes of science-based fact.

Cannabis could be the gateway to the end of the war on drugs.

The hope for this publication is to explain some of the author’s hope is that by sharing the author’s personal story, people will rally behind the cause of cannabis legalisation and legitimisation; resources are included at the bottom of the document.

It is the author’s story, so hopefully it is original.

Reports on a study that focuses on the specific roles of the nurse within the interdisciplinary team as an example of how nursing contributes to developing clinical effectiveness in wound healing. The multidisciplinary team approach used here builds on recommendations by Edmonds as the most effective method of delivering care to patients with diabetic foot ulceration. In particular, monitors the evolution of the service provided and patient outcomes by measuring the number of ulcers treated, the level of service provided, record keeping and patient outcome. The contribution of the wound care nurse includes the assessment of the status and progress of ulcers presented at the clinic. Argues that, as research in wound care has evolved, so the contribution of the nurse has grown (in line with NHS recommendations) with a broader range of wound features assessed and documented. In evaluating improvements in recording information, three indicators were used. Ulcer size and type were recorded in 1993 on 2.2 per cent and 17.8 per cent of occasions respectively. By 1999 these had progressed to being recorded on 100 per cent of occasions. Assessments of ulcer edge also showed an improvement, being recorded on 11.1 per cent of occasions in 1993 and 50.6 per cent of occasions in 1999. The detail of record keeping allowed the data collection.

We review the conceptualization of quality of life (QOL) past and present, providing a new definition that transcends the traditional approach. We discuss the importance of QOL as a mandatory assessment in patient care and clinical trials, concurring with the need for disease-specific tools and focusing on a nerve fiber-specific tool for assessing impacts of diabetic neuropathies on QOL and activities of daily living (ADLs) used in multi-center clinical trials and translated into different languages. By relating neuropathic disabilities to different nerve fibers, the Norfolk Quality of Life – Diabetic Neuropathy (QOL-DN) is able to measure impacts of nerve-fiber-specific neurotrophic therapies, providing pertinent endpoints to changes in health status and QOL.

Refugees and asylum seekers often present complex health needs, including chronic pain, related to traumatic experiences. To help them manage their pain, the Wellbeing and Self-Care Service provides health advice, pain education, soft tissue manual therapies and training in self-help techniques. The paper aims to discuss these issues.

A 0-10 pain scale (0= no pain, 10= very severe pain) is used to record reported intensity of pain before and after treatment. Change is analysed by comparing the position of a tick on the scale before and after therapy. In follow-up appointments, attendees were asked whether they were practicing self-help techniques; if they experienced improvement, and if so, how long it lasted; and whether they had reduced the use of painkillers.

From April 2014 to March 2015, 192 people were seen in 524 therapeutic encounters (63 per cent females, 37 per cent males). In total, 173 (90 per cent) were asylum seekers and refugees. Of the refugees and asylum seekers, 40 per cent were torture survivors. After treatment, 53 per cent of the 192 people treated showed a major reduction of pain, and 39 per cent a moderate reduction. In follow-up encounters, 87 per cent reported improvement (⩾2 weeks, 46 per cent), 70 per cent reported a reduction in the use of painkillers and 83 per cent reported that they practiced self-help techniques to different degrees.

Soft tissue manual therapies combined with education and training that emphasise communication and active patient participation in the healing process are non-invasive therapeutic approaches that can confer temporary relief to refugees and asylum seekers suffering chronic pain.

The purpose of this paper is to analyze the context of the emergence of a skin infection outbreak in the aftermath of Hurricane Matthew in Haiti and detail the role of community-based participatory research in mobilizing local action in a country with low state capacity.

While implementing a post-disaster study that combined a survey of 984 households and 69 community leaders with 23 focus groups, 60 ethnographic interviews and community mapping, a skin infection outbreak was detected. Using study results, the research team in partnership with different stakeholders responded to the outbreak with a health intervention.

The findings illustrate how pre-existing conditions shape local communities' vulnerability to health crises in the aftermath of disasters and the critical role research can play in informing the recovery processes. Community-based approaches to emergency health reinforced by multi-stakeholder partnerships with local government can strengthen post-disaster response and governance structures setting the groundwork for the development of local resilience.

The health intervention was implemented as a result of the study. Patients served were not derived from the study sample but were self-selected based on their need for skin-related medical treatment.

This article highlights the integral role research can play in identifying the health impacts of disaster events in vulnerable, hard-to-reach communities and strengthening government involvement in disaster governance.