join_the_dark_side_for_free_by_astronokOnce upon a time academics considered working with companies tantamount to dancing with the devil, selling their soul, and a path toward exploitation of their ideas for cold hard cash. To some, working with some companies that produce foot care products or services is still not palatable.

After more than a decade working with companies of all sizes and shapes, and through some turbulent times (take overs, private equity investments, and going into administration), it is something I enjoy and I am proud of. I now consider it essential to academic life. We have benefited from over £4 million in research income from industry, it created jobs, supported PhD’s, created careers, produced research publications, and supported learning at all levels.

Made possible with industrial funding: Nurse Dr Ciaran Wright and Podiatrist Susie Kirkham worked on blister and callus research.  Dr Daniel Parker studied plantar soft tissue properties and is now a member of the Salford research team. 

Working with industry grounds academics in real world foot problems, just as working with clinicians does too (just at different stages of the foot health journey).  The vast majority of feet are subject to choices we make as consumers, not patients,  and many foot health issues relate to consumer choices – socks, footwear, diet, and physical activity.  Indeed, my last foot health problem was due to playing in a charity football match.

But the most contentious area is where health professional and consumer practices overlap.  Should people with diabetes ever use over the counter foot health products for example?  Podiatrists don’t own “feet” and people will always seek self-management first (a good thing) so quality consumer solutions should be good for individuals and their feet.

By way of an example, that orthoses and insoles are available in pharmacy stores and online is a reality. Does a health professional need to consider this an ‘issue’, is it something to bang on the table about ? and insist it’s “all rubbish”? Perhaps we should, but I would argue we can only do this with credibility if we are willing to ask similar questions of ourselves. Some retail products are exactly the same products used by health professionals for example.

When the opportunity for collaboration with industry arises, I consider it a professional duty to help ensure that consumer foot care products are safe and mirror health professional beliefs and practice. Also, it’s a great opportunity to educate others, ensure industry employees from all sorts of backgrounds (regulatory, marketing, and scientists) learn about feet and foot health, and are better informed about feet in their own commercial professional roles.

It is also an opportunity to shape product claims, trying to ensure they remain proportional to the public understanding of health and the product features, and consistent with the behaviours and beliefs of health professionals.  We have been party to specific issues related to claims of back pain relief from orthoses for example, and likewise advised our partners to avoid making claims concerning “toning shoes”. Other companies lost out to the tune of $25-40 million.

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Remember these, not one of our partners. (see here for legal outcomes)

 

We should also remember the things that business is good for: creating employment, development of people, spending money with other businesses, paying taxes.  Industry may also set new standards. We are currently advising on a commercially funded investigation of the biomechanical effects of foot orthoses: the rigour in research governance, data management and maintaining independence would put most academic research teams to shame.  The people we work with often have PhD’s, are scientists and committed to integrity in the products they help commercialise.

Furthermore, industry can achieve things that health professionals and academics cannot. Companies are excellent at educating the public through well organised and resourced marketing and advertising campaigns. To me these are unique opportunities to shape the public health conversation about foot health.

For Universities, working with industry is as essential as having undergraduates. They are the users of our research, knowledge and ideas, and employers for our graduates, so they are customers (if we must use these terms).  My experience it that working with industry, like many relationships, is about “partnership”, not “projects”, about long terms values and strategy, not immediate needs and quick wins. Good commercial partners value what academia offers rather than preying upon it, or trying to massage it to do something that the industry partner ‘needs’ (yesterday). Symbiotic would be the biological equivalent.

This is not to say that every company we have the opportunity to work with show the qualities that make for good partnerships, or show their true colours initially.  But that’s life. There are plenty of “foot product peddlers” out there. I know of some whose “product development” is to source products cheap, try them out amongst office staff and in the absence of issues (and after confirming commercial viability) take products to market. This is a real contrast to the months or years that research and development with any rigour requires. We don’t work with these companies.

Some of our recent and current commercial relationships include with Clark’s footwear, Toffeln footwear, Scholl foot care, Salfordinsole, and Otivio wound care. Long may it continue.

 

Toffeln Wearer Innovation Loop, click here for more details.

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Publications with our commercial partners:

 

1: Anderson J, Williams AE, Nester C. An explorative qualitative study to determine the footwear needs of workers in standing environments. J Foot Ankle Res. 2017 Aug 30;10:41. 

2: Preece SJ, Chapman JD, Braunstein B, Brüggemann GP, Nester CJ. Optimisation of rocker sole footwear for prevention of first plantar ulcer: comparison of group-optimised and individually-selected footwear designs. J Foot Ankle Res. 2017 Jul 6;10:27. 

3: Hashmi F, Nester CJ, Wright CR, Lam S. The evaluation of three treatments for plantar callus: a three-armed randomised, comparative trial using biophysical outcome  measures. Trials. 2016 May 17;17(1):251. 

4: Hashmi F, Kirkham S, Nester C, Lam S. The effect of topical anti blister products on the risk of friction blister formation on the foot. J Tissue Viability. 2016 Aug;25(3):167-74. 

5: Harrison-Blount M, Cullen M, Nester CJ, Williams AE. An action research approach to facilitating the adoption of a foot health assessment tool in India.  J Foot Ankle Res. 2015 Sep 16;8:52. 

6: Parker D, Cooper G, Pearson S, Crofts G, Howard D, Busby P, Nester C. A device for characterising the mechanical properties of the plantar soft tissue of the foot. Med Eng Phys. 2015 Nov;37(11):1098-104. 

7: Hashmi F, Nester C, Wright C, Newton V, Lam S. Characterising the biophysical properties of normal and hyperkeratotic foot skin. J Foot Ankle Res. 2015 Aug
12;8:35. 

8: Hashmi F, Wright C, Nester C, Lam S. The reliability of non-invasive biophysical outcome measures for evaluating normal and hyperkeratotic foot skin.  J Foot Ankle Res. 2015 Jul 9;8:28. 

9: Melvin JM, Preece S, Nester CJ, Howard D. An investigation into plantar pressure measurement protocols for footwear research. Gait Posture. 2014 Sep;40(4):682-7. 

10: Harrison-Blount M, Cullen M, Nester CJ, Williams AE. The assessment and management of diabetes related lower limb problems in India-an action research
approach to integrating best practice. J Foot Ankle Res. 2014 May 18;7:30. 

11: Majumdar R, Laxton P, Thuesen A, Richards B, Liu A, Arán-Ais F, Parreño EM, Nester CJ. Development and evaluation of prefabricated antipronation foot orthosis. J Rehabil Res Dev. 2013;50(10):1331-42. 

12: Kirkham S, Lam S, Nester C, Hashmi F. The effect of hydration on the risk of  friction blister formation on the heel of the foot. Skin Res Technol. 2014 May;20(2):246-53. 

13: Forghany S, Nester CJ, Richards B, Hatton AL, Liu A. Rollover footwear affects lower limb biomechanics during walking. Gait Posture. 2014 Jan;39(1):205-12.

14: Forghany S, Nester CJ, Richards B. The effect of rollover footwear on the rollover function of walking. J Foot Ankle Res. 2013 Jul 9;6(1):24. 

15: Chapman JD, Preece S, Braunstein B, Höhne A, Nester CJ, Brueggemann P, Hutchins S. Effect of rocker shoe design features on forefoot plantar pressures in people with and without diabetes. Clin Biomech (Bristol, Avon). 2013 Jul;28(6):679-85.

16: Hashmi F, Richards BS, Forghany S, Hatton AL, Nester CJ. The formation of friction blisters on the foot: the development of a laboratory-based blister creation model. Skin Res Technol. 2013 Feb;19(1):e479-89.