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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)
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)
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)
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)
Background: Falls in older people are a major public health problem, and there is increasing evidence that foot problems and inappropriate footwear increase the risk of falls. Several multidisciplinary prevention clinics have been established to address the problem of falls; however, the role of podiatry in these clinics has not been clearly defined. The aims of this study were to determine the level of podiatric involvement in multidisciplinary falls clinics in Australia and to describe the assessments undertaken and interventions provided by podiatrists in these settings.
Methods: A database of falls clinics was developed through consultation with departments of health in each state and territory. Clinic managers were contacted and surveyed as to whether the clinic incorporated podiatry services. If so, the podiatrists were contacted and asked to complete a brief questionnaire regarding their level of involvement and the assessment procedures and interventions offered.
Results: Of the 36 clinics contacted, 25 completed the survey. Only four of these clinics reported direct podiatric involvement. Despite the limited involvement of podiatry in these clinics, all of the clinic managers stated that they considered podiatry to have an important role to play in falls prevention. Podiatry service provision in falls clinics varied considerably in relation to eligibility criteria, assessments undertaken, and interventions provided.
Conclusions: Despite the recognition that foot problems and inappropriate footwear are risk factors for falls, podiatry currently has a relatively minor and poorly defined role in multidisciplinary falls-prevention clinics in Australia. (J Am Podiatr Med Assoc 97(5): 377–384, 2007)
Use of Laterally Wedged Custom Foot Orthoses to Reduce Pain Associated with Medial Knee Osteoarthritis
A Preliminary Investigation
Osteoarthritis of the knee is a common condition that can cause considerable pain and disability. Various forms of lateral wedging may be effective in the treatment of medial compartment osteoarthritis, but it is not known whether incorporating a lateral wedge into a custom-molded foot orthosis will achieve similar results. Therefore, 30 subjects (21 men and 9 women) aged 29 to 77 years (mean ± SD, 58.1 ± 11.6 years) with radiographically confirmed medial compartment knee osteoarthritis were issued custom-molded foot orthoses with a 5° lateral heel wedge. Pain levels were recorded using a 100-mm visual analog pain scale on the date of issue of the orthoses (baseline) and again 3 and 6 weeks later. Mean ± SD pain levels were significantly reduced at 3 weeks (34 ± 22 mm) and 6 weeks (23 ± 22 mm) versus baseline (69 ± 19 mm) (F2 = 39.57). The degree of pain reduction was greater in patients with less severe osteoarthritis. At 6 weeks, all subjects had achieved at least some reduction in pain, and 28 reported that their orthoses were comfortable. This preliminary study indicates that laterally wedged foot orthoses may be beneficial in the treatment of mild-to-moderate osteoarthritis of the medial compartment of the knee. Further investigations using a larger sample, longer follow-up, and a no-treatment control group seem warranted. (J Am Podiatr Med Assoc 95(4): 347–352, 2005)
