Magazine Issue

STRIDE: August 2021

The Australian Podiatry Association reserves the right to edit material for space and clarity and to withhold material from publication. Individual views expressed in this publication are not necessarily those of the Association and inclusion of product or service information does not imply Association endorsement unless specifically stated. STRIDE for podiatry is the official monthly publication of the Australian Podiatry Association Limited. STRIDE for podiatry is copyright and no part may be reproduced without written permission from the Australian Podiatry Association. ©2019 AUSTRALIAN PODIATRY ASSOCIATION, 89 Nicholson St, East Brunswick, VIC 3159, P (03) 9416 3111 W podiatry.org.au The Australian Podiatry Association would like to acknowledge the traditional custodians of the land. To pay respects to the past, present and future traditional Custodians and Elders of this nation and the continuation of cultural, spiritual and educational practices of aboriginal and Torres Strait islander peoples. We acknowledge the contribution of First Nations people to knowledge on health and appreciate the role feet play in connection to land and mobility between meeting places.

In this issue

From the CEO & President

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Nello Marino, CEO

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Katrina Richards, President

Note from the editor

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Nello Marino, CEO

APODA update

Our paediatric symposium is nearly here!

By Annette Harris

National CPD | State Manager QLD

Are you going to the Paediatric Podiatry Symposium? Read on to see why you should!

 

This one day event is for any podiatrist keen to learn more about podiatric conditions in children under 18. The day is being led by a range of inspiring presenters and moderators. It is completely online and all sessions are recorded if you can’t make it on the day. The program is packed with a range of topics that you can see in full here. It really will be a day of useful, ‘take back to practice and implement’ CPD.

 

Topics to be covered include: 

  • Developmental Coordination Disorder
  • Possible links between flat feet and chronic disease
  • Diagnosis of apophyseal injuries
  • And more!

 

When: Saturday 21 August, 2021. 10:00am to 5:30pm AEST

Where: Online

 

Register now at this link and we look forward to seeing you online!

JFAR update

Australian podiatrists have been running a COVID-19 marathon

By Dr Andrew Buldt

The study

Experiences of Australian podiatrists working through the 2020 coronavirus (COVID-19) pandemic: an online survey. Williams, C.M., Couch, A., Haines, T., Menz, H.B.  J Foot Ankle Res 14:11 (2021)

 

Background

On 19 January 2020, the Chief Medical Officer of Australia issued a statement about the appearance of a concerning novel coronavirus. Since that date, there have been a variety of responses by federal and state governments to mitigate the impact of the virus, while many international recommendations for podiatry triage and risk identification were made in the first three months of the pandemic. 

 

Australian government policies focused on the provision of essential podiatry services only. Further, most of the research about SARS-CoV-2 focused on the epidemiology and treatment of COVID-19, while workforce research concentrated on ‘frontline’ workers, such as nurses and paramedics. 

 

Process

A cross-sectional survey of Australian podiatrists and podiatric surgeons was conducted over a four year period. As part of the final wave of the survey, specific questions were asked relating to the impact of the COVID-19 pandemic on PPE and consumables, business decisions related to closures and working situations, the access of information for business decision making and the general impact of the pandemic on individual and practice circumstances. The primary aim of this study was to describe the impact of the SARS-CoV-2 pandemic on Australian podiatry settings.

 

 

Results

A total of 465 podiatrists and podiatric surgeons provided responses. Of these respondents, up to 25% reported using telehealth during the pandemic. The results indicated there were minimal issues with the procurement of PPE (49% of respondents reported no issues), and ‘business as usual’ was the most common response (67% of respondents) to employment and business conditions. 

 

Participants also reported mostly using state and territory Department of Health websites (75% of respondents) and the Australian Podiatry Association website (72% of respondents) to access information to make decisions about their health and businesses.

 

The qualitative responses further described the feelings of podiatrists throughout the pandemic. Podiatrists reported positive experiences in playing a leading role as public health advocates. However, many were frustrated by the government’s attitude to the podiatry profession as being not as important as others. 

 

Participants also described challenges akin to running a marathon. This included the need to prepare, educate and plan to keep themselves and their patients safe, but also having to navigate various roadblocks imposed by government settings. 

 

Some podiatrists described the experience of navigating speed bumps and generally rebounding from challenges. While others described ‘hitting the wall’, reporting negative impacts to mental health. Podiatrists also reported a generally optimistic outlook, seeing an end in sight to the pandemic, and also reported learning more about their practice behaviors and enhancements during the pandemic, as they made plans to move forward.

 

This study provided a fascinating and important reflection into the lives of podiatrists during the COVID-19 pandemic.

 

More information

To read the study in full, head here. N.B. We will publish a different high-impact study summary each month over the next three months. All studies are clinically relevant for Australian podiatrists.

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JFAR UPDATE

Impact factor increases for Journal of Foot and Ankle Research

By Professor Keith Rome

Editor-in-Chief (Australia) Journal of Foot and Ankle Research

By Professor Cathy Bowen

Editor-in-Chief (UK) Journal of Foot and Ankle Research
Professor Keith Rome and Professor Cathy Bowen share the good news of JFAR’s increased impact factor, alongside charting this visual journey.

The Journal of Foot and Ankle Research (JFAR) was launched in July 2008 as the endorsed research publication of the Australian Podiatry Association and the Royal College of Podiatry (UK). JFAR was developed to meet the growing need for an international platform for the publication of foot and ankle research that had reach and significance across the podiatry profession. The timing of its launch coincided with the rise of open access publishing: an innovative publication model which enables free full-text access to anyone with an internet connection. Since its inception, JFAR has been published by BMC Springer, one of the pioneers of scholarly open access in our opinion.

 

Since July 2008, over 600 papers have been published in JFAR, with authors from over 40 different countries. JFAR has also published conference proceedings, including the biennial Australian Podiatry Conference; annual Royal College of Podiatry conference; the International Foot and Ankle Biomechanics Community (i-FAB) conference, and six article collections: Diabetic Foot (2012), Rheumatoid Foot (2013); Cross-journal Collection (2014); Paediatric Foot (2015); The Science and Sociology of Footwear (2017) and Neurological and Degenerative Conditions (2020).

  

Journal of Foot and Ankle Research 2020 Metrics

It is with great pleasure that we announce that the Journal of Foot and Ankle Research has achieved an increased impact factor. The impact factor is an objective measurement of a journal’s quality, expressed in terms of numerical figures. The impact factor is a parameter for highlighting the relative significance of a journal within its specific field. It indicates the frequency with which an article appears in the Journal Citation Reports. The impact factor acts as a measuring medium for the number of citations received by articles in a particular journal.

 

According to Journal Citation Reports®, published by Clarivate Analytics, the new Impact Factor is 2.30, a substantial increase from the previous 1.59 (Table 1). Further metrics include in 2020, 68,000 article downloads and 1,584 social media mentions. Table 2 illustrates a comparison to impact journals publishing foot and ankle/podiatry research.

 

Table 1. Illustrates impact score trends of JFAR over the past seven years

 

 

Table 2. Comparison of Impact Factors for Journals commonly publishing foot and ankle/podiatry related research.

 

Journal Impact Factor
Arthritis Care and Research 4.79
Journal of Diabetes 4.00
Gait and Posture 2.84
Foot and Ankle International 2.83
Journal of Foot and Ankle Research 2.30
Clinical Biomechanics 2.06
Journal of the American Podiatric Medical Association 0.68
The Foot No IF

 

We would like to thank our readers, reviewers, authors and editors for their contributions to this major achievement.

 

What we learned at the conference

Section editor James Gerrard summarises the Indigenous conference stream’s highlights from this year’s Australian Podiatry Conference.

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Queensland Orthotic Lab is a place where art meets science.

The role of the foot and ankle in knee OA

Let’s first recap on what osteoarthritis is. Osteoarthritis (OA) is a disease of the entire joint complex. It is a result of alterations to joint cartilage, subchondral bone, synovium, the joint capsule, and ligaments. The development of OA is complex, involving a combination of metabolic, mechanical, and inflammatory factors, which lead to damage of the synovial joint and impede its ability to function adequately. It is now known that OA results from an imbalance between joint destruction and joint repair, and is not solely a degenerative disease process1.

How to protect your business brand

Podiatrist and technologist Andrew Schox explains how you can protect your business name and online identity, given tech increasingly changes the rules in this brand ballpark.

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Generalised joint hypermobility amongst children and teens

Fully understanding the musculoskeletal impact that lower limb joint hypermobility and treatment complications have upon individual children and their families has long been a challenge for podiatrists. As clinicians, it is important to be able to thoroughly recognise the signs and symptoms for children that may present to clinics with excessive joint range of motion. 

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DolorClast® Radial Shock Waves

Meet your researchers

Dr Fiona Hawke talks with Dr Caleb Wegener, Head of Product Management Footwear at UVEX Safety Australia and New Zealand.

APERF

Podiatric surgery and research – what’s missing?

By Dr Dean Samaras

Dr Dean Samaras is a fellow of the Australasian College of Podiatric Surgeons (ACPS) and a trustee of APERF. He is a registered specialist, podiatric surgeon, with Ahpra (PBA) and endorsed to prescribe scheduled medicines. Dean is an adjunct lecturer at LaTrobe University and has published research in prominent peer reviewed foot and ankle journals. His main research topics have included minimal incision foot surgery, hallux rigidus and soft tissue pathology.
Dr Dean Samaras explains why there is further to go in supporting the link between podiatric surgery and research.

Since the establishment of the Australian Podiatry Education & Research Fund (APERF) in 1990, research methods and standards have evolved over this time and so too, has the clinical scope and impact of the podiatry profession on the healthcare system.

 

Where we are at

Amongst the many fields of podiatric medicine, APERF has strategically funded a wide variety of musculoskeletal and surgical related projects and the results of published research funded by APERF continues to be incorporated into daily practice by podiatric surgeons, both locally and abroad.

 

Podiatric surgeons are registered specialists within the profession and have pioneered the implementation and development of many foot surgical techniques. The indications, safety and short to medium-term outcomes of many foot and ankle surgical interventions have been established, however there is certainly room for further research.

 

Areas to explore

Cost effectiveness of podiatric surgeon techniques and services compared to other providers has been demonstrated and this should be evaluated further. It is also important for podiatric surgeons to continue to investigate surgical outcomes with an emphasis on patient reported outcome measures (PROMs) and over a longer period of follow up. These methods are required as part of the ongoing assessment of the delivery and impact of podiatric surgery on patient health and quality of life in Australia.

 

How to make a difference

APERF, as a priority, supports research that has the potential for the greatest impact on improving outcomes for patients. I would therefore encourage aspiring and experienced podiatric researchers to collaborate with industry partners, podiatrists, podiatric surgeons and surgical registrars (trainees) on future surgical projects. 

 

If you have a research idea or wish to express interest in leading a surgery related research project, contact the Australasian College of Podiatric Surgeons (ACPS) and/or the Podiatric Surgery Department at the University of Western Australia (UWA).

 

More information 

For more information about the annual APERF grant program, application process and different ways to contribute to the Foundation can be found here.

 

The Australian Podiatry Education and Research Foundation (APERF) was established in 1991 and exists to advance research into the causes, prevention, and treatment of foot problems. APERF is a charitable trust that is currently overseen by seven trustees. Since its establishment, APERF has supported 81 research projects and has awarded $495,000 in research grants. For more information about APERF or to make a donation, please visit the website and follow on Twitter @_aperf

Part 2: The history of podiatric surgery in Australia

In the first part of this series which we ran in April 2021, we provided a brief outline of how the Australasian College of Podiatric Surgeons (ACPSV), aided by our American colleagues, fostered the beginnings of podiatric surgery in Australia. This process of genesis occurred over 15 years, from 1975 to 1990. In this instalment we describe how podiatric surgery developed over the next 20 years. It was a period of great change!

Charity Focus: Footscape

How collaboration can improve thousands of lives

By Anthony Lewis

CEO Footscape

Since completing his Bachelor of Podiatry at La Trobe University in 2000 Anthony Lewis has worked in a range of Australian healthcare settings serving marginalised population groups predisposed to foot pathology. Observing the startling implications of debilitating foot pathology upon the most vulnerable has motivated Anthony to establish Footscape. Anthony has completed further post graduate studies extending to a Master of Public Health at Flinders University and Graduate Certificate in Wound Care at Monash University.
Anthony Lewis, CEO of Footscape, explains why collaboration is so critical to their purpose, and for anyone with a personal or professional goal in sight.

Collaboration is a process described by Taylor et al (2021), through which organisations who have different perspectives about an issue or who can address different aspects of it, can constructively search for solutions together. Importantly, the solutions will go beyond one partner’s own limited vision of what is possible and intervene across more than their own scope of practice.

 

Why is this relevant to Footscape? As a podiatry charity with finite resources, Footscape recognises the importance of collaboration in our strategic plan. 

 

 

Collaboration is everything

To date, collaboration with like-minded health and welfare organisations has given the opportunity for Footscape to reach and assist thousands of people across Australia who are experiencing disadvantage and encountering foot pathology. 

 

Indeed, Footscape has proudly distributed over 40,000 items of podiatry material aid. This includes footwear, socks, foot care kits and orthotic devices to identified people who are experiencing homelessness, asylum seekers, Aboriginal persons, financially disadvantaged children and people who have experienced domestic violence.

 

An example up close

How have we been able to do this? By collaborating with over fifty affiliate organisations. The end result is that people who need help can get it. Podiatrist Rebecca Mannix shares some insights into what this can translate to.

 

People that experience homelessness use their feet as their primary mode of transport – to get food, attend appointments, for exercise to reduce stress or even to keep warm when it’s cold. It’s not uncommon for clients to report walking 10 to 15 kilometres every day, which can put stress on their bodies, especially if they are carrying all of their possessions.  

 

Often our clients report their shoes getting stolen when they are asleep, which means that many wear their shoes all night, and this can lead to bacterial infections – particularly if feet are wet.  

 

Footscape’s generous provision of high-quality second-hand shoes has greatly improved our ability to support these clients as they work to achieve their goals. For many clients this reduces their pain levels greatly and they are able to get back into walking. Others join our football team (Cohealth Kangaroos) and use the runners for training. This in turn improves their health, self-esteem, and builds healthy friendships alongside learning skills such as anger management and working as a team.  

 

Without Footscape this would be impossible and we are extremely grateful, as are our clients.

 

This affects us all

Baum (2016) articulates that if public health is to be effective in the future, then an essential skill for practitioners is to be able to collaborate with people, organisations and sectors. This applies to all of us, no matter what our role. 

 

The required skills appear to be flexibility, willingness to question current practice, an entrepreneurial approach to problem-solving and a willingness to take risks and step around bureaucratic blocks. 

 

Accordingly, podiatrists working with disadvantaged communities in the far corners of the country are strongly encouraged to reach out to Footscape and benefit from prompt access to material aid items to help their clients.

Idea to Impact: An innovator’s roadmap

Work out what podiatrists or patients really want in a product

By Ben Lindsay

Biomedical engineer, software developer, technologist and futurist.

Ben Lindsay is the inventor of the Solushin medical device and Program Manager of INCUBATE. Please contact him via ben@solushin.com or on LinkedIn.
Biomedical engineer and technologist explains why the number 37 can make all the difference if you are planning on inventing a product to help fellow podiatrists or patients.

When you design a product, you’re looking to try to solve a problem for potential users. 

 

Yet have you ever noticed that if you ask a bunch of people, whether patients or fellow podiatrists, what problem they need to be solved by a product, then you get a multitude of answers? 

 

For example, with podiatrists, you might hear responses like these: Shorter days! Less administration! More money per consult! The list goes on. The reality is that everyone wants different things.

 

So, if you want to design a solution for a large number of people… how can you ensure you’re designing something that the group, and not each individual, wants? It is surprisingly simple. 

 

 

I’m not here to pull out a corny, overused quote, like Henry Fords’;

“If I’d asked customers what they wanted, they would have told me, ‘A faster horse!’”.

Nope, instead I will give you a key takeaway to help you navigate through the confusing amount of responses you get. 

 

And I am sorry if you hate them, but it involves numbers. Well, one number to be exact, and that number is 37. 

 

The power of 37

While you will hear lots of different responses when it comes to what your patients (or fellow podiatrists) want, your job is to narrow down to the four, five or six most common answers. 

 

 

From now on, all your remaining research doesn’t involve the question, ‘What is your biggest problem?’ Instead, it is: ‘From these four to six options, I want you to allocate a total of 37 points. Give more points to the options that are bigger problems you want to be solved.’

 

The individual can then methodically allocate points according to what is most important to them across the various options. 

 

But, why 37? Why can’t we do 40? This is a simple and vital trick. 

 

The secret in the number

After I engaged people myself with a number like 40, I kept seeing responses like eight, ten and 12 across four options. It became apparent they’d divide 40 by 4 and centre their responses of the number 10. 

 

However, when I gave them 37-points, they could no longer divide. They took longer to allocate points because they’d total up to 36, 38 or 39; they really had to think about their responses. 

 

What does all of this give you? Well, after you talk to everyone, you now have a quantitative analysis of what people want. Sum up all the responses to each problem and let the numbers tell you the story. 

 

Now you know which problem affects more podiatrists (or patients) and by how much. So go ahead and solve that one!

 

Good luck.

How to reduce stress during work

Managing stress and staying mentally healthy when you are working is critical to overall health and wellbeing. This article provides some practical tips to limit stress and better protect everyone’s mental health during work.

Thank you!

…And that wraps up STRIDE’s first digital issue! The roll out of STRIDE as a digital entity is an iterative process and our editorial team and external contributors are learning as we go. A lot of passion and hard work has been poured into every single article, and we hope you enjoyed STRIDE’s leap into this digital space. As always, please feedback any comments to our editor Siobhan Doran at siobhan.doran@podiatry.org.au

 

Have a great month (and don’t forget to search back on any of these articles whenever you need to!)

Editor, STRIDE

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