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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Emotions are a key component of tourism experiences, as emotions make experiences more valued and more memorable. Peak-and-end-theory states that overall experience evaluations are best predicted by the emotions at the most intense and final moments of an experience. Peak-and-end-theory has mostly been studied for relatively simple experiences. Recent insights suggest that peak-and-end-theory does not necessarily hold for tourism experiences, which tend to be more heterogeneous and multi-episodic in nature. Through the novel approach of using electrophysiological measures in combination with experience reconstruction, the applicability of the peak-and-end-theory to the field of tourism is addressed by studying a musical theatre show in a theme park resort. Findings indicate that for a multi-episodic tourism experience, hypotheses from the peak-and-end-theory are rejected for the experience as a whole, but supported for individual episodes within the experience. Furthermore, it is shown that electrophysiology sheds a new light on the temporal dynamics of experience
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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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Stage fright among musicians and music students is a severe problem, and a problem moreover that is not easily talked about. This researchreport is a reflection of the project Peak Performance & Reducing Stage Fright, in which six students of the Prince Claus Conservatoire got the opportunity to take the HeartMath training. A training developed by de GGZ Heerenveen. The research, which is described in this report, was aimed at the usefulness of this training for professional music students.
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With the rise of the number of electric vehicles, the installment of public charging infrastructure is becoming more prominent. In urban areas in which EV users rely on on-street parking facilities, the demand for public charging stations is high. Cities take on the role of implementing public charging infrastructure and are looking for efficient roll-out strategies. Municipalities generally reserve the parking spots next to charging stations to ensure their availability. Underutilization of these charging stations leads to increased parking pressure, especially during peak hours. The city of The Hague has therefore implemented daytime reservation of parking spots next to charging stations. These parking spots are exclusively available between 10:00 and 19:00 for electric vehicles and are accessible for other vehicles beyond these times. This paper uses a large dataset with information on nearly 40.000 charging sessions to analyze the implementation of the abovementioned scheme. An unique natural experiment was created in which charging stations within areas of similar parking pressure did or did not have this scheme implemented. Results show that implemented daytime charging 10-19 can restrict EV owners in using the charging station at times when they need it. An extension of daytime charging to 10:00-22:00 proves to reduce the hurdle for EV drivers as only 3% of charging sessions take place beyond this time. The policy still has the potential to relieve parking pressure. The paper contributes to the knowledge of innovative measures to stimulate the optimized rollout and usage of charging infrastructure.
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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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Music performance anxiety (MPA) is one of the most reported psychological problems among musicians, posing a significant threat to the optimal performance, health, and psychological wellbeing of musicians. Most research on MPA treatment has focused on reducing symptoms of performance anxiety, but complete “cures” are uncommon. A promising addition or alternative that may help musicians enhance their performance under pressure, despite their anxiety, is pressure training (PT). In other high-pressure domains, such as sports and police work, pressure training has been proven effective in reducing choking and enhancing performance quality under pressure. Therefore, the aim of this narrative review is to explore the potential of pressure training in music settings. Specifically, we first provide a theoretical overview of current models explaining performance declines due to anxiety. Second, we discuss the current state of research on the effectiveness and application of pressure training in sports and police work as well as recent developments in pressure training interventions for music settings. While there is a limited number of studies investigating the effectiveness of pressure training on musicians' performance quality, research focusing on musicians' experiences has shown that pressure training can be particularly beneficial for enhancing performance skills, preparing for performances, and managing performance anxiety. Based on the reviewed literature, the final section points out suggestions for future research as well as recommendations for musicians, teachers, and music institutions for practical applications.
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The massive die-off of the herbivorous sea urchin Diadema antillarum in 1983 and 1984 resulted in phase shifts on Caribbean coral reefs, where macroalgae replaced coral as the most dominant benthic group. Since then, D. antillarum recovery has been slow to non-existent on most reefs. Studying settlement rates can provide insight into the mechanisms constraining the recovery of D. antillarum, while efficient settlement collectors can be used to identify locations with high settlement rates and to collect settlers for restoration practices. The aim of this study was to compare pre and post die-off settlement rates and to determine possible settlement peaks in the Eastern Caribbean island of St. Eustatius. Additionally, we aimed to determine the effectiveness and reproducibility of five different settlement collectors for D. antillarum. D. antillarum settlement around St. Eustatius was highest in May, June and August and low during the rest of the study. Before the die-off, settlement recorded for Curaçao was high throughout the year and was characterized by multiple settlement peaks. Even though peak settlement rates in this study were in the same order of magnitude as in Curaçao before the die-off, overall yearly settlement rates around St. Eustatius were still lower. As no juvenile or adult D. antillarum were observed on the reefs around the settlement collectors, it is likely that other factors are hindering the recovery of the island's D. antillarum populations. Of all five materials tested, bio ball collectors were the most effective and reproducible method to monitor D. antillarum settlement. Panels yielded the least numbers of settlers, which can partly be explained by their position close to the seabed. Settler collection was higher in mid-water layers compared to close to the bottom and maximized when strings of bio balls were used instead of clumps. We recommend research into the feasibility of aiding D. antillarum recovery by providing suitable settlement substrate during the peak of the settlement season and adequate shelter to increase post-settlement survival of settlers. The bio ball collectors could serve as a suitable settlement substrate for this new approach of assisted natural recovery.
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Elevated plantar foot pressures during gait in diabetic patients with neuropathy have been suggested to result, among other factors, from the distal displacement of sub-metatarsal head (MTH) fat-pad cushions caused by to claw/hammer toe deformity. The purpose of this study was to quantitatively assess these associations. Thirteen neuropathic diabetic subjects with claw/hammer toe deformity, and 13 age- and gender-matched neuropathic diabetic controls without deformity, were examined. Dynamic barefoot plantar pressures were measured with an EMED pressure platform. Peak pressure and force-time integral for each of 11 foot regions were calculated. Degree of toe deformity and the ratio of sub-MTH to sub-phalangeal fat-pad thickness (indicating fat-pad displacement) were measured from sagittal plane magnetic resonance images of the foot. Peak pressures at the MTHs were significantly higher in the patients with toe deformity (mean 626 (SD 260) kPa) when compared with controls (mean 363 (SD 115) kPa, Po0.005). MTH peak pressure was significantly correlated with degree of toe deformity (r= 0.74) and with fat-pad displacement (r= 0.71) (Po0.001). The ratio of force-time integral in the toes and the MTHs (toe-loading index) was significantly lower in the group with deformity. These results show that claw/hammer toe deformity is associated with a distal-to-proximal transfer of load in the forefoot and elevated plantar pressures at the MTHs in neuropathic diabetic patients. Distal displacement of the plantar fat pad is suggested to be the underlying mechanism in this association. These conditions increase the risk for plantar ulceration in these patients.
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In wheelchair rugby (WR) athletes with tetraplegia, wheelchair performance may be impaired due to (partial) loss of innervation of upper extremity and trunk muscles, and low blood pressure (BP). The objective was to assess the effects of electrical stimulation (ES)-induced co-contraction of trunk muscles on trunk stability, arm force/power, BP, and WR performance.
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