BACKGROUND: In this podcast, we present the result of the 2023 scheduled update of the 2019 guidelines of the International Working Group of the Diabetic Foot (IWGDF) addressing the use of systems to classify foot ulcers in people with diabetes in routine clinical practice.
METHODS: These guidelines were based on a systematic review of the available literature that identified 28 classifications addressed in 149 articles and, subsequently, expert opinion using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology. We first assessed the value of each system independently and, in the second stage, chose the best one or two to be used in each clinical scenario.
RESULTS: We recommend (1) for communication among healthcare professionals to use the Site, Ischaemia, Neuropathy, Bacterial infection, Area, Depth (SINBAD) classification (first option) or consider using Wound, Ischaemia, foot Infection (WIfI) system (alternative option, when the required equipment and level of expertise are available and it is considered feasible) and in each case the individual variables that compose the systems should be described rather than a total score; (2) for predicting the outcome of an ulcer in a specific individual: no existing system could be recommended; (3) for characterising a person with an infected ulcer: the use of the IDSA (Infection Diseases Society of America)/IWGDF (first option) classification or consider using the WIfI system (alternative option, when the required equipment and level of expertise are available and it is considered as feasible); (4) for characterising a person with peripheral artery disease: consider using the WIfI system as a means to stratify healing likelihood and amputation risk; (5) for the audit of outcome(s) of populations: the use of the SINBAD score.
CONCLUSIONS: Although there is no classification that fits all purposes, it is crucial that healthcare professionals standardize the way they characterise diabetes-related foot ulcers and guide their decision-making process by using validated classification systems.

OBJECTIVE: To explore the factors that affect the quality of interactions between nursing personnel and the informal caregivers of people with memory disorders.
METHODS: Systematic review and metasummary of qualitative empirical research.
METHODS: The literature search targeted studies concerning the professional care interactions between nursing personnel and the informal caregivers of people with progressive memory disorders. The search in PubMed, CINAHL, PsycINFO and Scopus covered records from the earliest possible date up to December 2020. The data were summarised using a qualitative metasummary method. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist was used to validate the reporting process.
RESULTS: Ten articles were included. As presented in 33 statements, the factors affecting the quality of interactions were related to (1) expectations, (2) memory disorders, (3) interaction strategies, (4) time and place of interactions and (5) organisational aspects. Meeting the individual interactional needs of informal caregivers is recommended. The results provide guidance for improving the quality of interactions between nursing personnel and informal caregivers.

BACKGROUND: This publication represents a scheduled update of the 2019 guidelines of the International Working Group of the Diabetic Foot (IWGDF) addressing the use of systems to classify foot ulcers in people with diabetes in routine clinical practice. The guidelines are based on a systematic review of the available literature that identified 28 classifications addressed in 149 articles and, subsequently, expert opinion using the GRADE methodology.
METHODS: First, we have developed a list of classification systems considered as being potentially adequate for use in a clinical setting, through the summary of judgements for diagnostic tests, focussing on the usability, accuracy and reliability of each system to predict ulcer-related complications as well as use of resources. Second, we have determined, following group debate and consensus, which of them should be used in specific clinical scenarios. Following this process, in a person with diabetes and a foot ulcer we recommend: (a) for communication among healthcare professionals: to use the SINBAD (Site, Ischaemia, Bacterial infection, Area and Depth) system (first option) or consider using WIfI (Wound, Ischaemia, foot Infection) system (alternative option, when the required equipment and level of expertise is available and it is considered feasible) and in each case the individual variables that compose the systems should be described rather than a total score; (b) for predicting the outcome of an ulcer in a specific individual: no existing system could be recommended; (c) for characterising a person with an infected ulcer: the use of the IDSA/IWGDF classification (first option) or consider using the WIfI system (alternative option, when the required equipment and level of expertise is available and it is considered as feasible); (d) for characterising a person with peripheral artery disease: consider using the WIfI system as a means to stratify healing likelihood and amputation risk; (e) for the audit of outcome(s) of populations: the use of the SINBAD score.
CONCLUSIONS: For all recommendations made using GRADE, the certainty of evidence was judged, at best, as being low. Nevertheless, based on the rational application of current data this approach allowed the proposal of recommendations, which are likely to have clinical utility.

BACKGROUND: Classification and scoring systems can help both clinical management and audit the outcomes of routine care.
OBJECTIVE: This study aimed to assess published systems used to characterise ulcers in people with diabetes to determine which should be recommended to (a) aid communication between health professionals, (b) predict clinical outcome of individual ulcers, (c) characterise people with infection and/or peripheral arterial disease, and (d) audit to compare outcomes in different populations. This systematic review is part of the process of developing the 2023 guidelines to classify foot ulcers from the International Working Group on Diabetic Foot.
METHODS: We searched PubMed, Scopus and Web of Science for articles published up to December 2021 which evaluated the association, accuracy or reliability of systems used to classify ulcers in people with diabetes. Published classifications had to have been validated in populations of >80% of people with diabetes and a foot ulcer.
RESULTS: We found 28 systems addressed in 149 studies. Overall, the certainty of the evidence for each classification was low or very low, with 19 (68%) of the classifications being assessed by ≤ 3 studies. The most frequently validated system was the one from Meggitt-Wagner, but the articles validating this system focused mainly on the association between the different grades and amputation. Clinical outcomes were not standardized but included ulcer-free survival, ulcer healing, hospitalisation, limb amputation, mortality, and cost.
CONCLUSIONS: Despite the limitations, this systematic review provided sufficient evidence to support recommendations on the use of six particular systems in specific clinical scenarios.

Introduction One of the most fundamental aspects of medicine is the doctor-patient relationship. Many factors influenced this link, including socio-cultural patterns, economic levels, political systems, and health systems. In India, there is an increase in violence toward physicians. Almost every now and then, the newspaper comes with headlines about a doctor being abused by patients or their families. Concerns regarding the absence of good doctor-patient communication among Indian doctors prompted an assessment of the current situation. The major purpose of this study is to assess the confidence of tertiary care hospital interns and post-graduates in their communication skills. Materials and methods In May and June 2021, a cross-sectional survey was conducted among all interns and post-graduates from various departments at a tertiary care hospital and research center in Trichy, Tamil Nadu, India. The questions were designed to measure the confidence of physicians\' communication with patients. The Likert scale was used to rate the \"confidence in using\" and \"actual use\" of communication skills with patients, which constitute two sections in our questionnaire. Google forms were used to collect data. The information was then exported to a Microsoft Excel spreadsheet. SPSS software version 22.0 was used to analyze the data. Results For confidence in their communication skills, the participants obtained a mean score of 2.98 (S.D. = 0.44). Participants obtained an average score of 2.28 (S.D. = 0.89) for practicing confident communication with patients. It was found that persons who had higher confidence levels had a negative correlation (ρ = -0.318) with that during their communication with patients and this was statistically significant (p-value = < 0.001) Conclusion Despite having confident communication skills, medical practitioners in India hardly ever practice them with their patients. This gap must be explored by conducting qualitative studies to address effective communication skills among health professionals.

The COVID-19 pandemic brought with it many hardships to the world as a whole. Mass infection and casualties due to disease state were rampant, which affected many families. Lockdown drove up the incidence of depression and isolated people from their loved ones. The toll on the general population was high, as was the toll on the medical community, a subset of the general population. It was a time of death and devastation, with supply chain issues creating personal protective equipment shortages and staffing being affected by illness, fear, age, and expertise. Despite the constraints, many places were able to rally staff together to provide adequate staffing for healthcare delivery purposes to serve our communities. Cross-specialty collaboration in the outpatient and inpatient setting as well as the use of technology aided our service to our community to help persevere through the many surges of the pandemic and come out with lessons learned as well as reflections.

Nursing handovers represent an important and complex form of communication in healthcare organizations that involve the exchange of patient-related information between nurses. This qualitative descriptive study aimed to identify the intershift handover experiences among nurses working in small and medium-sized hospitals. Focus-group interviews were conducted with 30 nurses who directly participated in patient care in such hospitals in South Korea. The reporting of the study findings adhered to the Consolidated Criteria for Reporting Qualitative Research checklist. The data were analyzed using content analysis. Under the main theme of \"baton touch in a relay,\" 6 categories, 17 subcategories, and 45 codes (concepts) were derived. The six categories were \"procedural rituals for shifts,\" \"nonstandardized handover training,\" \"inconsistent handover style,\" \"stress due to handovers,\" \"coping strategies for handovers,\" and \"interruptions of handovers.\" Nurses in small and medium-sized hospitals strive to improve the quality of handovers by preparing individual-level coping strategies under difficult conditions. This indicates that standardized handover education strategies need to be developed for nurses that are suitable for the personnel systems of small and medium-sized hospitals.

OBJECTIVE: Professional communication and professional values are two basic concepts in operating rooms and should be studied more closely in view of the nature of work and the high circulation of patients in operating rooms.
METHODS: The present work is a descriptive-analytic study with a cross-sectional design. The sample was 603 operating room physicians and personnel selected from the public hospitals of Shiraz. The data collection instruments were the 41-item professional communication questionnaire and the 26-item professional values scale.
RESULTS: The results showed that the operating room nurses and physicians perceived the status of professional communication and professional values to be satisfactory. As for professional communication, the participants\' perception of the domains of mutual respect and trust (p ≤ 0.001), teamwork (p ≤ 0.001), ethical competence (p ≤ 0.017), and workplace conflicts (p ≤ 0.001) was significant. As for professional values, only the dimension of care (p ≤ 0.016) was perceived to be significant. Moreover, a significant positive relationship was found to exist between professional communication and professional values (p ≤ 0.001).
CONCLUSIONS: Considering the significance of the concept of professional communication and its connection with professional values, it is recommended that operating room personnel and physicians receive systematic education about professional communication and the harms of destructive attitudes as part of their academic education and afterwards.

Early provision of interprofessional education (IPE) is imperative to ensure effective communication between healthcare professionals. However, there are several barriers to offering adequate IPE, including space restrictions and lack of human resources, prompting exploration of alternative modalities. In 2019, an IPE activity was offered in person with 213 pharmacy and 45 physician assistant (PA) students participating in one-on-one team huddles focusing on managing an acutely ill patient. In 2020, the same IPE activity, including 194 pharmacy and 45 PA students, was offered virtually. Peer evaluations, an attitudes survey, and confidence surveys were administered to evaluate the impact of the IPE activity. A student t-test and descriptive statistics were utilized to analyze the data. On average, PA students in the virtual group rated their peers higher than PA students in the in-person group, with little difference in the pharmacy peer evaluation of their PA partner. Ninety percent of pharmacy students and 91% of PA students in the virtual group felt that \"they learned something new regarding therapeutic management\" from their partner versus 84% of pharmacy and 81% of PA students in the in-person group. In conclusion, using a virtual modality for a communications-focused IPE was not detrimental to student attitudes and did not adversely affect peer perceptions.

The paper introduces organizational psycholinguistics as an approach to professional communication i.e., the communication in organizations. The author systematizes a number of theories and concepts as a methodological basis of organizational psycholinguistics. The organizational psycholinguistics methodology is based on Theory of Speech Activity. Organizational psycholinguistics analyzes the communication aimed at a joint activity organization. At the same time, speech activity itself is an activity towards an independent goal to modify a partner\'s psychic state to involve him/her in a joint activity. The article describes goals, objects, subjects, tasks of the organizational psycholinguistics. The author indicates the methods used in the organizational psycholinguistic research and outlines prospects for further research in this field.