Excessive pressure and shear stress while walking cause a risk of callus formation, which eventually causes foot ulcers in patients with diabetes mellitus. Callus under the second metatarsal head (MTH) has been associated with increased shear stress/pressure ratios (SPR). Callus under the fifth MTH has been associated with increased peak shear stress (PSS). The purpose of this study is to examine whether the effect of the suitable size and width of shoes prevents diabetic foot ulcers under the second and fifth MTH. We measured the pressure and shear stress by testing three kinds of sizes and two types of width of shoes. Significant difference was not observed in the SPR under the second MTH among different sizes of shoes. However, the pressure and shear stress were significantly lower when putting on shoes of fit size compared with larger sizes. The PSS under the fifth MTH was significantly smaller when putting on shoes of fit width compared with those of narrow width. Wearing shoes of fit size and width has the potential to prevent callus formation by reducing the pressure and shear stress constituting SPR under the second MTH and PSS under the fifth MTH.

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Objective: Dehydration has a risk of reducing cognitive function, which can lead to misjudgment by nurses. Nurses are required to be in optimal physical and mental conditions since their misjudgments affect the lives of patients. Therefore, it is desirable to prevent dehydration in nurses; however, the prevalence and factors of dehydration in nurses have not been clarified. This study aimed to clarify dehydration prevalence in nurses and examine dehydration factors before and after their shift. Methods: Data were collected during the day shift of 115 registered nurses in 19 wards of 2 hospitals in Japan. Urine specific gravity (USG) and body weight were measured before and after the shift to determine dehydration. Questionnaires, including demographic characteristics and fluid intake, were recorded before and after their shift. Multivariate analysis was performed based on the fluid intake, number of steps, and years of experience as dehydration factors. Results: Overall, 59 (51.3%) and 82 (71.3%) nurses were dehydrated before and after their shift, respectively. USG before the shift (odds ratio [OR]: 2.328, 95% confidence interval [CI]: 1.424-3.807) and years of experience (OR: 0.946, 95% CI: 0.899-0.996) were factors related to dehydration at the end of the shift. USG before the shift (OR: 2.573, 95% CI: 1.347-4.914) was also a factor related to dehydration factors after the shift for beginner nurses. Conclusions: Over 70% of nurses were dehydrated after their shift. USG before the shift and years of experience were related to dehydration after the shift. To prevent dehydration, it is desirable for managers to encourage beginner nurses to drink water.