Professor Keith Rome, editor-in-chief (Australia) of the Journal of Foot and Ankle Research shares his reflections over the past year, as it draws to a close. In Professor Rome’s final editorial for STRIDE, as he prepares to step down from his role, he touches on the many highlights that have taken place.
Of note, the Journal of Foot and Ankle Research is now ranked as a Q1 quartile; an incredible achievement for a journal that started from scratch around 15 years ago. This milestone is a credit to everyone who has had a role to play in the journal’s evolution over the years.
A very warm welcome to everyone from the Journal of Foot and Ankle Research editor-in-chief. This will be my final editorial for STRIDE, as I am stepping down as editor-in-chief (Australia) at the end of 2024. I have been in post since August 2018, and I believe it is time for a new editor to take the journal forward. There have been many changes since my last report. The commence of our new publishers from BMC Springer to Wiley from 1st January 2024, has been fully implemented. We have been working closely with Wiley and the new web-site is progressing well.
There have been many changes to the management of the journal in 2023/24. The Editors in Chief include Professor Sarah Curran (UK), who was appointed in November 2023 and myself (Australia) supported by Dr Andrew Buldt (Deputy editor Australia) and Dr Stewart Morrison (Deputy Editor UK). The editors are further supported by associate editors Dr Gordon Hendry and recently appointed Professor Mattew Carroll (from New Zealand). The continue work of Professor Cylie Williams should be highlighted. We have appointed a new JFAR social editor, Dr Prue Molyneux (AUT University, New Zealand).
A significant indicator of JFAR quality is being a Q1 journal. Q1 journals, also known as “top quartile” journals, are the highest-ranking journals in the category of orthopaedic and sports medicine. They represent the top 25% of journals based on their citation impact factor. The citation impact factor is a measure of how often articles in a particular journal are cited by other researchers. To be classified as Q1, a journal’s impact factor must be in the highest quartile (the top 25%) among journals publishing in the same field of science.
For the year 2023, 266 decisions on manuscripts were received. This was a significant increase of 9% compared to 2022 submissions. Submissions from China contributed significantly to this increase, and resulted in China being the largest source of submissions to the journal at the country level (18%). The journal accepted 90 articles in 2023, a slight increase from 88 in 2022. The 2023 Impact Factor of 2.9, which is an increase from 2.03 in 2021. Manuscript turnaround times remained fairly constant in 2023 despite the consequent workforce challenges. The average time from submission to first decision was 30 days, and the mean time from submission to acceptance was 133 days. This year (2024 up to 7th October 2024) there have been 11 articles published from members of the Australian Podiatry Association (APodA).
I have highlighted four articles from this year that illustrates the diversity of research being conducted in Australia, some of which has been highlighted in previous issues of STRIDE.
The overarching aim of this study was to identify motivators and barriers for studying podiatry in Australia and New Zealand. This study used a mixed methods design. Students enrolled in (i) podiatry and (ii) relevant non-podiatry health, sport or science programs at nine Australian and one New Zealand university, were invited to participate in an online survey. Quantitative data were analysed using descriptive statistics and linear/logistic regression models. Three independent assessors used inductive thematic analysis for the qualitative data. Overall, 278 podiatry students and 553 non-podiatry students from physiotherapy and 29% from occupational therapy responded to the survey. Interest in a health-related career, wanting to make a difference to people’s health, and opportunity to care for people from different backgrounds/age groups were key motivating factors among podiatry students. Barriers to studying podiatry were encountered by 28.1% of podiatry students. Thematic analysis identified seven themes concerning career choice, which are as follows: (i) awareness of profession and scope of practice; (ii) stereotypes and negative perceptions of the profession; (iii) awareness of career pathways; (iv) job prospects and earning potential; (v) working with people and building relationships; (vi) podiatry is not the first preference; and (vii) barriers which limit student enrolment. In conclusion, the authors reported a variety of factors that motivate and influence students to study podiatry, however, altruistic reasons are most highly rated. Allied health students have limited understanding of the scope of practice and career opportunities in podiatry. Additionally, the podiatry profession often faces negative stereotypes.
The objective of this systematic review is to determine the benefits and harms of heel lifts to any comparator for lower limb musculoskeletal conditions. A number of databases were searched. Randomised, quasi-randomised or non-randomised trials comparing heel lifts to any other intervention or no-treatment were eligible for inclusion. Data was extracted for the outcomes of pain, disability/function, participation, participant rating of overall condition, quality of life, composite measures and adverse events. Two authors independently assessed risk of bias and certainty of evidence using the GRADE approach at the primary time point 12 weeks (or next closest). The results demonstrated eight trials (n=903), investigating mid-portion Achilles tendinopathy, calcaneal apophysitis and plantar heel pain were included. Heel lifts were compared to exercise, ultrasound, cryotherapy orthotics, stretching, footwear, activity modification, felt pads and analgesic medication. No outcome was at low risk of bias and few effects (2 out of 47) were clinically important. Low-certainty evidence (1 trial, n = 199) indicates improved pain relief (56 points on a 100 mm visual analogue scale) with custom orthotics compared to heel lifts at 12 weeks for calcaneal apophysitis. Very low-certainty evidence (1 trial, n = 62) indicates improved pain and function with heel lifts over indomethacin (36, Foot Function Index) at 12 months for plantar heel pain. In conclusions the authors reported few trials have assessed the benefits and harms of heel lifts for lower limb musculoskeletal conditions. Only two outcomes out of 47 showed clinically meaningful between group differences. However, due to very low to low certainty evidence we are unable to be confident in the results and the true effect may be substantially different.
Diabetes-related foot disease (DFD) is a leading cause of the Australian and global disease burdens and requires proportionate volumes of research to address. Bibliometric analyses are rigorous methods for exploring total research publications in a field to help identify volume trends, gaps and emerging areas of need. This bibliometric review aimed to explore the volume, authors, institutions, journals, collaborating countries, research types and funding sources of Australian publications investigating DFD over 50 years. The results found 332 eligible publications were included. Publication volume increased steadily over time, with largest volumes (78%) and a 7-fold increase over the last decade. Mean co-authors per publication was 5.6, mean journal impact factor was 2.9 and median citation was 9 (IQR2-24). Most frequent authors were Peter Lazzarini (14%), Vivienne Chuter (8%) and Jonathon Golledge (7%). Most frequent institutions affiliated were Queensland University Technology (33%), University Sydney (30%) and James Cook University (25%). Most frequent journals published in were Journal Foot and Ankle Research (17%), Diabetic Medicine (7%), Journal Diabetes and its Complications (4%) and International Wound Journal (4%). Most frequent collaborating countries were the United Kingdom (9%), the Netherlands (6%) and the United States (5%). Leading research types were aetiology (38%), treatment evaluation (25%) and health services research (13%). Leading funding sources were no funding (60%), internal institution (16%) and industry/philanthropic/international (10%). In conclusion, Australian DFD research increased steadily until more dramatic increases were seen over the past decade. Most research received no funding and mainly investigated aetiology, existing treatments or health services. Australian DFD researchers appear to be very productive, particularly in recent times, despite minimal funding indicating their resilience. However, if the field is to continue to rapidly grow and address the very large national DFD burden, much more research funding is needed in Australia, especially targeting prevention and clinical trials of new treatments in DFD.
Burnout is highly prevalent among health practitioners. It negatively impacts job performance, patient care, career retention and psychological well-being. This study aimed to identify factors associated with burnout among Australian podiatrists. Data were collected from registered podiatrists via four online surveys administered annually from 2017 to 2020 as part of the Podiatrists in Australia: Investigating Graduate Employment (PAIGE) study. Information was collected about work history, job preferences, personal characteristics, health, personality, life experiences and risk-taking behaviours. Multiple logistic regression analyses were used to determine if (i) individual characteristics, (ii) workplace factors and (iii) job satisfaction measures were associated with burnout (based on the abbreviated Maslach Burnout Inventory). A total of 848 responses were included, with 268 podiatrists (31.6%) experiencing burnout. Participants experiencing burnout were slightly younger, more recent to practice, had poorer health, greater mental distress, lower scores for resilience, extraversion, agreeableness, conscientiousness, emotional stability and openness to experiences. They were less likely to have financial and clinical risk-taking behaviour and more likely to have career risk-taking behaviour. Prediction accuracy of these individual characteristic variables for burnout was 72%. Participants experiencing burnout were also more likely to work in private practice, have more work locations, work more hours, more direct patient hours, see more patients, have shorter consultation times, more likely to bulk bill chronic disease management plans, have less access to sick leave and professional development and be more likely to intend to leave patient care and the profession within five years than participants not experiencing burnout. Prediction accuracy of these workplace-related variables for burnout was 67%. Participants experiencing burnout were less satisfied with their job. Prediction accuracy of these variables for burnout was 79%. In conclusion, many of the factors associated with burnout in Australian podiatrists are modifiable, providing opportunities to implement targeted prevention strategies. The strength of association of these factors indicates high potential for strategies to be successful.
In summary, 2024 has again illustrated the wealth and depth of research being published by APodA members that have significant ramifications to clinical practice. I encourage members to review the articles published in the journal, which is an open access journal, free of charge.
It has been an honour and privilege working for the membership of APodA over the last six years. Finally, I would like to thank APodA for their full support of the journal and I wish the new editor-in-chief good luck.
Best regards
Professor Keith Rome (editor-in-chief Australia)
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