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- Author or Editor: Hylton B. Menz x
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A survey of podiatric medical students in Australia was undertaken prior to and following the completion of a compulsory geriatrics course to evaluate the effect of geriatrics education on knowledge of aging, attitudes toward older people, perceptions of treatment efficacy, and desire to specialize in geriatrics. Students had a reasonable knowledge of aging and favorable attitudes toward older people prior to undertaking the course, but few wanted to specialize in geriatrics. General knowledge of aging and attitudes toward older people improved after completion of the course, but career aspirations remained unchanged. Students generally considered geriatrics to be a low-profile specialty, and less than half stated that they would be interested in pursuing continuing education in geriatrics. These results provide further evidence that students’ lack of desire to specialize in geriatrics may be primarily due to limited recognition within the profession, rather than unfavorable attitudes toward older people or lack of interest in geriatrics during their undergraduate education. (J Am Podiatr Med Assoc 93(2): 124-130, 2003)
Despite the wide range of publication opportunities in podiatric medicine, little is known about how podiatric authors select journals in which to publish or their perceptions of journals currently available. To investigate these issues, a survey of publication patterns and perceptions of full- and part-time academic staff members at podiatric medical schools in Australia was undertaken. Most of the papers by Australian podiatric medical faculty members have been published in “local” journals, such as the Australasian Journal of Podiatric Medicine (38%) and the British Journal of Podiatry (17%). However, an increasing number of papers are being published in JAPMA (14%). In addition, a large proportion of papers have been published in a variety of journals that are not specific to podiatric medicine, particularly in the areas of biomechanics and diabetic medicine. The number of publications per faculty member was associated with the highest qualification obtained, academic rank, and the number of years of employment in higher education. The most important factors in selecting the journal in which to publish were the journal’s inclusion in MEDLINE, the perceived prestige of the journal, and the quality of the journal’s peer-review panel and editor. (J Am Podiatr Med Assoc 91(4): 210-218, 2001)
A retrospective analysis of 878 articles published in JAPMA from 1991 to 2000 was conducted to investigate changing patterns of publication activity in podiatric medicine. Most of the articles published in JAPMA were case reports (37%), followed by literature reviews (33%) and original research (30%). The Journal has covered a wide range of topic areas, with the most common being foot surgery (14%). A breakdown of the proportion of original research versus review articles and case reports for each topic area revealed that while orthotic therapy and biomechanics attract considerable attention from researchers, other important specialty areas such as foot surgery, dermatology, pediatrics, and rheumatology continue to be represented primarily by literature reviews and case reports. Two significant trends were observed: a gradual increase in the proportion of original research articles and a steady increase in the number of articles by authors outside the United States. These findings provide valuable insight into patterns of publication in podiatric medicine and raise a number of issues regarding the ongoing development of the profession. (J Am Podiatr Med Assoc 92(5): 308-313, 2002)
Foot Health Service Provision by the Australian Department of Veterans’ Affairs
Do Major Podiatric Medical Interventions Reduce the Number of Maintenance Treatments?
Background: In Australia, the Department of Veterans’ Affairs provides podiatric medical services, including nail surgery and the provision of footwear and orthoses, for war veterans and their dependents. We sought to evaluate whether the provision of these interventions reduces the number of ongoing maintenance treatments.
Methods: We used the database of the Department of Veterans’ Affairs to document the number of major podiatric medical interventions (footwear, foot orthoses, nail surgery, and combinations of these interventions) for 1996–1997. The number of maintenance podiatric medical treatments provided in the 2 years before (1994–1996) and 2 years after (1997–1999) these interventions was then compared with a control group that did not receive any major interventions.
Results: Compared with the number of treatments in the 2 years before the interventions, in the subsequent 2 years there was a significant increase in the mean ± SD number of maintenance treatments after receiving footwear only (10.4 ± 5.8 versus 12.3 ± 5.0), foot orthoses only (9.4 ± 5.3 versus 12.2 ± 4.6), nail surgery only (10.2 ± 5.8 versus 13.2 ± 4.4), and footwear plus foot orthoses (9.3 ± 6.1 versus 13.3 ± 5.5). In the control group, the mean number of treatments in 1994–1996 and 1997–1999 was 10.8 and 11.8, respectively.
Conclusions: Provision of major podiatric medical interventions did not reduce the number of ongoing maintenance treatments received by veterans. However, owing to the inherent limitations of claims data, it is difficult to determine whether this finding is due to the limited efficacy of the interventions or to the policy structure of podiatric medical service provision in the Department of Veterans’ Affairs. (J Am Podiatr Med Assoc 97(6): 469–474, 2007)
Postural stability is an important component of skilled athletic activity. However, the effects of foot orthoses on stability have not been adequately addressed. This study measured postural sway in 30 asymptomatic professional soccer players in three standing positions and four underfoot conditions. The results revealed that the underfoot condition had no significant effect on sway in the mediolateral or anteroposterior planes; however, there was a trend toward less mediolateral sway when subjects stood in a unipedal position with prefabricated orthoses. These results suggest that insoles and foot orthoses have no significant beneficial or detrimental effects on postural stability in asymptomatic subjects. Clinically, this suggests that no improvements in balance performance could be expected with prophylactic use of insoles or orthoses but that clinicians may prescribe insoles and foot orthoses without fear of impairing postural performance in elite athletes. (J Am Podiatr Med Assoc 91(4): 194-202, 2001)
Foot problem assessments were performed on 135 community-dwelling older people in conjunction with clinical tests of balance and functional ability. Eighty-seven percent of the sample had at least one foot problem, and women had a higher prevalence than men of foot pain, hallux valgus, plantar hyperkeratosis, lesser digital deformity, and digital lesions. Postural sway did not differ between older people with and without each of these foot conditions. However, the presence of specific foot conditions impaired performance in a more challenging balance test and in some functional tests. In particular, older people with foot pain performed worse in a leaning balance test, stair ascent and descent, an alternate step-up test, and a timed six-meter walk. Furthermore, multiple regression analyses revealed that foot pain was a significant independent predictor of performance in each of these tests. These results show that the presence of foot problems, particularly foot pain, impairs balance and functional ability. As foot pain is amenable to treatment, podiatric intervention has the potential to improve mobility and independence in older people. (J Am Podiatr Med Assoc 91(5): 222-229, 2001)
