Background Several footwear design characteristics are known to have detrimental effects on the foot. However, one characteristic that has received relatively little attention is the point where the sole flexes in the sagittal plane. Several footwear assessment forms assume that this should ideally be located directly under the metarsophalangeal joints (MTPJs), but this has not been directly evaluated. The aim of this study was therefore to assess the influence on plantar loading of different locations of the shoe sole flexion point. Method Twenty-one asymptomatic females with normal foot posture participated. Standardised shoes were incised directly underneath the metatarsophalangeal joints, proximal to the MTPJs or underneath the midfoot. The participants walked in a randomised sequence of the three shoes whilst plantar loading patterns were obtained using the Pedar® in-shoe pressure measurement system. The foot was divided into nine anatomically important masks, and peak pressure (PP), contact time (CT) and pressure time integral (PTI) were determined. A ratio of PP and PTI between MTPJ2-3/MTPJ1 was also calculated. Results Wearing the shoe with the sole flexion point located proximal to the MTPJs resulted in increased PP under MTPJ 4–5 (6.2%) and decreased PP under the medial midfoot compared to the sub-MTPJ flexion point (−8.4%). Wearing the shoe with the sole flexion point located under the midfoot resulted in decreased PP, CT and PTI in the medial and lateral hindfoot (PP: −4.2% and −5.1%, CT: −3.4% and −6.6%, PTI: −6.9% and −5.7%) and medial midfoot (PP: −5.9% CT: −2.9% PTI: −12.2%) compared to the other two shoes. Conclusion The findings of this study indicate that the location of the sole flexion point of the shoe influences plantar loading patterns during gait. Specifically, shoes with a sole flexion point located under the midfoot significantly decrease the magnitude and duration of loading under the midfoot and hindfoot, which may be indicative of an earlier heel lift.
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Background. Barefoot plantar pressure measurements are routinely used in the risk evaluation for ulceration in diabetic patients with neuropathy. The aim was to compare three step-protocols commonly used for pressure assessment in these patients. Methods. Dynamic barefoot plantar pressures were measured in 14 diabetic neuropathic patients (vibration perception threshold >35 V) contacting a pressure platform on the first, second or third step after gait initiation. Ten repeated trials per step-protocol were collected. The 3-step protocol was regarded the reference protocol. Peak pressure, pressure-time integral and contact time were calculated for each of six anatomical foot regions. Intraclass correlation coefficients (ICC) were calculated to assess reliability in each protocol. Findings. Regional peak pressures and pressure-time integrals were not significantly different between protocols. Contact time was significantly different in the heel region between the 1-step and 3-step protocol only (P < 0.05). Intraclass correlation coefficients for the maximum 10 repeated trials were high (>0.87) and similar between protocols. Reliable estimates (ICC > 0.85) of peak pressure were achieved with three repeated trials in the 2-step protocol, and four in the other two; for pressure-time integral these numbers were 7 (1-step), 4 (2-step), and 5 trials (3-step). Interpretation. Barefoot plantar pressures in the diabetic neuropathic foot can be assessed in a reproducible manner with any of the step-protocols used. For this purpose, the 1-step and 2-step protocols prove to be valid methods. A 2-step protocol requires the least amount of repeated trials for obtaining reliable pressure data and may be recommended for assessment of these patients.
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Introduction: Pressure ulcers are a high cost, high volume issue for health and medical care providers, affecting patients’ recovery and psychological wellbeing. The current research of support surfaces on pressure as a risk factor in the development of pressure ulcers is not relevant to the specialised, controlled environment of the radiological setting. Method: 38 healthy participants aged 19-51 were placed supine on two different imaging surfaces. The XSENSOR pressure mapping system was used to measure the interface pressure. Data was acquired over a time of 20 minutes preceded by 6 minutes settling time to reduce measurement error. Qualitative information regarding participants’ opinion on pain and comfort was recorded using a questionnaire. Data analysis was performed using SPSS 22. Results: Data was collected from 30 participants aged 19 to 51 (mean 25.77, SD 7.72), BMI from 18.7 to 33.6 (mean 24.12, SD 3.29), for two surfaces, following eight participant exclusions due to technical faults. Total average pressure, average pressure for jeopardy areas (head, sacrum & heels) and peak pressure for jeopardy areas were calculated as interface pressure in mmHg. Qualitative data showed that a significant difference in experiences of comfort and pain was found in the jeopardy areas (P<0.05) between the two surfaces. Conclusion: A significant difference is seen in average pressure between the two surfaces. Pain and comfort data also show a significant difference between the surfaces, both findings support the proposal for further investigation into the effects of radiological surfaces as a risk factor for the formation of pressure ulcers.
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Nature areas in North-West Europe (NWE) face an increasing number of visitors (intensified by COVID-19) resulting in an increased pressure on nature, negative environmental impacts, higher management costs, and nuisance for local residents and visitors. The high share of car use exaggerates these impacts, including peak pressures. Furthermore, the almost exclusive access by car excludes disadvantaged people, specifically those without access to a car. At the same time, the urbanised character of NWE, its dense public transport network, well-developed tourism & recreation sector, and presence of shared mobility providers offers ample opportunities for more sustainable tourism. Thus, MONA will stimulate sustainable tourism in and around nature areas in NWE which benefits nature, the environment, visitors, and the local economy. MONA will do so by encouraging a modal shift through facilitating sustainableThe pan-European Innovation Action, funded under the Horizon Europe Framework Programme, aims to promote innovative governance processes ,and help public authorities in shaping their climate mitigation and adaptation policies. To achieve this aim, the GREENGAGE project will leverage citizens’ participation and equip them with innovative digital solutions that will transform citizen’s engagement and cities’ effectiveness in delivering the European Green Deal objectives for carbon neutral cities.Focusing on mobility, air quality and healthy living, citizens will be inspired to observe and co-create their cities by sensing their urban environments. The aim to complement, validate, and enrich information in authoritative data held by the public administrations and public agencies. This will be facilitated by engaging with citizens to co-create green initiatives and to develop Citizen Observatories. In GREENGAGE, Citizen Observatories will be a place where pilot cities will co-examine environmental issues integrating novel bottom-up process with top-down perspectives. This will provide the basis to co-create and co-design innovative solutions to monitor environmental problems at ground level with the help of citizens.With two interrelated project dimensions, the project aims to enhance intelligence applied to city decision-making processes and governance by engaging with citizen observations integrated with Copernicus, GEOSS, in-situ, and socio-economic intelligence, and by delivering innovative governance models based on novel toolboxes of decision-making methodologies and technologies. The envisioned citizens observatory campaigns will be deployed and fully demonstrated in 5 pilot engagements in selected European cities and regions including: Bristol (the United Kingdom), Copenhagen (Denmark), Turano / Gerace (Italy) and the region of Noord Brabant (the Netherlands). These innovation pilots aim to highlight the need for smart city governance by promoting citizen engagement, co-creation, gathering new data which will complement existing datasets and evidence-based decision and policymaking.
The capacity on the Northern ring road in Breda is approaching its limits. Due to planned spatial developments the ring road might even be under further pressure. Therefore the municipality of Breda is working on an action plan to deal with this task. This requires insight into the functioning of the Northern ring road, which has been achieved by combining the following data sources: • Meetweken Breda 1st edition (GPS)• Meetweken Breda 2nd edition (GPS)• OViN• License plate cameras (NRW)• Counting data (NRW)• Bluetooth data (NRW)• Weather data (KNMI)The results show that in comparison with other strongly urbanized cities, Breda is more oriented towards the car and less use is made of public transport and the bicycle. Particularly on short distances there is still potential to further increase bicycle usage. In depth results can be found in the presentation, including information about: peak hours, the number of trips per person per day, the percentage of multimodal trips and the effect of rain on route choice. By combining the insights from the different forms of data, additional insights and an overarching mobility picture emerge. In other words, the overall picture is more than the sum of the parts.
Nature areas in North-West Europe (NWE) face an increasing number of visitors (intensified by COVID-19) resulting in an increased pressure on nature, negative environmental impacts, higher management costs, and nuisance for local residents and visitors. The high share of car use exaggerates these impacts, including peak pressures. Furthermore, the almost exclusive access by car excludes disadvantaged people, specifically those without access to a car. At the same time, the urbanised character of NWE, its dense public transport network, well-developed tourism & recreation sector, and presence of shared mobility providers offers ample opportunities for more sustainable tourism. Thus, MONA will stimulate sustainable tourism in and around nature areas in NWE which benefits nature, the environment, visitors, and the local economy. MONA will do so by encouraging a modal shift through facilitating sustainable transport modes, providing inclusive routing to and within nature areas, and nudging visitors and stakeholders towards more sustainable behaviour. These are the key solutions to manage visitor flows, reduce negative impacts, and stimulate inclusive access. 8 nature areas and 3 knowledge & dissemination partners work together to:> Assess the impact of visitors & mobility on nature areas and develop strategies to reduce this impact>Jointly pilot solutions on the modal shift, routing and nudging > Provide capacity building for stakeholders across NWENature areas, destination marketing organisations, tourism & mobility service providers, local and regional authorities and (potential) visitors of nature areas all benefit from the strategies and solutions for, and revenues of, sustainable tourism. MONA develops and promotes a mindset around sustainable tourism which is balanced, inclusive, and socially and environmentally sustainable. This is made possible by the projects’ multidisciplinary approach, for which the transnational partnership and expertise is essential.
