Professional Doctorates: Grasping A New Way

It is one thing to write a curriculum for a professional doctorate with a graduate profile that talks of practice-change and leadership development. Our experience of initiating the Doctor of Health Science in 2002 was that it was all too easy to fall back on the PhD mindset. It took inspiration from the literature, and pioneering candidates, to show us how this programme could be distinctively different from a PhD. We tell our story to reveal both challenges and possibilities. We see that all our candidates have a focus on bringing change to practice. Some do this through research ‘on’ practice, others by research ‘in’ practice, and then there are those caught up in the research/practice nexus. We believe a professional doctorate programme has potential to significantly grow the candidate into a leader of practice-change

Loneliness in men 60 years and over : the association with purpose in life

Loneliness as a consequence of getting older negatively impacts on the health and well-being of men as they age. Having a purpose in life may mitigate loneliness and therefore positively impact on health and well-being. Limited research into loneliness and purpose in life has been undertaken in older men. This study seeks to understand the relationship between loneliness and purpose in life in a group of older men. Using data from a cross-sectional survey of 614 men aged 60 years and over living in New Zealand, bivariate and multivariate analyses were undertaken to examine the relationship between loneliness and purpose in life using a range of demographic, health, and social connection variables. Bivariate analysis revealed that being unpartnered and having low socioeconomic status, limited social networks, low levels of participation, and mental health issues were associated with loneliness. Multivariate analysis showed that having poor mental health and lower purpose in life were indicators of loneliness. Consequently, improving mental health and purpose in life are likely to reduce loneliness in at-risk older men. As older men are a heterogeneous group from a variety of sociocultural and ethnic backgrounds, a multidimensional approach to any intervention initiatives needs to occur

Ankle sprains: an investigation into patient perceptions and performance of physical tasks following acute ankle sprains using a mixed methods approach

Introduction: Ankle injuries are among the most prevalent acute musculoskeletal injuries, and are a significant burden on any health system. The interaction of the physiotherapist with the patient and their mutual understanding of impairments, function and recovery are important to achieving a satisfactory return to work and leisure activities. To date, little attention has focused on this interaction. There is a need for further exploration of differences and associations between outcome questionnaires that investigate similar domains of pain and function, and whether scores from such outcome measures are related to the patient’s perception of function and recovery. Of further interest is whether there are relationships between impairment measures and perceived function, and how actual performance of tasks might influence the patients understanding of their capabilities. To provide a more complete picture of these relationships, a ‘mixed methods’ approach using qualitative research methods within a quantitative study was thought to be most appropriate. The overall aim of this thesis was to utilise this research approach to investigate patients’ perceptions of their recovery and elucidate factors important to both therapists and patients that ultimately might enhance their understanding of recovery from an ankle injury. Literature reviews: Three literature reviews were undertaken. Firstly a review of systematic reviews investigating ankle sprains identified a wide variety of management strategies. There was a lack of strong evidence to support any particular management strategy. Hence clinicians are likely to have difficulty setting appropriate rehabilitation plans. Secondly a critical review identified a number of different outcome questionnaires that were utilised to gauge recovery level; however, justification for their selection was often lacking. This review also identified that little emphasis was placed on understanding the patients’ perception of their injury and the rehabilitation process. A final critical review investigated impairment and performance measures and identified four specific areas that were focused upon by clinicians during the treatment of ankle sprains: joint position sense, postural control, strength and performance during function. However, only weak evidence was found for there being a deficit in joint position sense, postural control and strength in the injured limb following an ankle sprain, and inconclusive evidence of deficits in physical performance of tasks related to function. Methods: Forty participants with an acute sprained ankle were recruited along with their treating physiotherapist. The participants completed a Global questionnaire, the Lower Limb Task Questionnaire (LLTQ) and the Short Form -36 (SF-36) Questionnaire at the initial visit, at discharge and at a six week follow up visit where they also undertook impairment testing involving, joint position sense, postural control and strength along with a functional performance test and selected functional activities. Ten participants were purposefully selected to undertake semi-structured interviews. The treating physiotherapists completed global questionnaires at the initial visit and at time of discharge. An interpretive hermeneutic approach was undertaken to examine the participants’ perceptions. Results: There were equal numbers of males and female participants and the average age of participants was 30.5 years. The relationship between questionnaires for the domains of pain and function varied between low and high degrees of association. The global limitations scores between the participants and physiotherapists were similar at the initial visit, whereas on discharge the participants had a significantly lower score (p0.05). There was no association between questionnaire scores and impairment measures (p>0.05). Additionally there were no significant associations between previous injury and questionnaire scores and impairment measures. Finally in relation to the performance of specific functional tests there was a significant difference (p<0.05) between the six week follow up LLTQ score and the score following actual performance of the test. The findings of the participants’ interviews identified three key concerns. Firstly, that participants have a limited understanding of questionnaires, and secondly, that there is a difference in understanding of ‘recovery’ between the therapist and the patient at time of discharge. Thirdly, there was dissociation between outcome measures and the patient’s perception of their own recovery. Conclusions: This study revealed a lack of understanding and effective communication concerning physiotherapy practice in relation to ankle sprains. It was apparent that questionnaires purporting to measure similar constructs are at times dissimilar in scores and are not related strongly. Care needs to be taken in selecting and interpreting outcome measures particularly in relation to questionnaires. It was also apparent that caution should be exercised when considering the influence of impairment measures upon function. Physiotherapists should be aware that patients may perceive a lack of confidence in their level of function at the time of discharge. As a result physiotherapists need to incorporate strategies to improve patient confidence in their management plan

Promoting age-friendly communities : an integrative review of inclusion for older immigrants

Immigration patterns of older people are transforming the ethnic composition of Western societies (Torres 2012). In 2015, immigrants aged 65 years and over made up 13% of the total number of immigrants worldwide, almost double the percentage of people aged 65 years and over globally (United Nations, Department of Economic and Social Affairs,, and Population Division 2016). While immigration in older adulthood can provide new opportunities, evidence indicates migrants of all ages can experience discrimination, difficulty speaking the language and a lack of community support in their host country (Shishehgar et al. 2015; Schunck et al. 2015). Research on immigration has focused predominantly on younger people and older immigrants have largely been ignored (Torres-Gil and Treas 2008, 2009)

Part of the Disease Or Part of the Cure&quest; Chinese Investments in the Zambian Mining and Construction Sectors

China's role in African development is much debated among academics as well as among private sector organisations, trade unions and politicians. Notwithstanding the recent upsurge of interest, the lion's share of the current studies on ‘China in Africa’ is still based on a combination of aggregate figures and sporadic information from news agencies. Although much of the hysteria surrounding the ‘China in Africa’ debate has now evaporated – at least from the scholarly debate – the local debate is highly politicised and of a very dichotomous nature: China is either seen as benign or malign to African development efforts. This paper seeks to go beyond this dichotomous view by examining the multifaceted nature of Chinese investments in two sectors of the Zambian economy. It argues that these investments to a large extent resemble other foreign investments but the sheer size and growth of the investments trigger local reactions.Le rôle de la Chine dans le développement en Afrique fait objet d’un débat ardent, non seulement aux Etats Unis et en Europe mais également prend de l’ampleur en Afrique. Ce débat ne se limite pas aux écrits universitaires mais concerne aussi des organisations du secteur privé, des syndicats et des hommes politiques. En dépit de cet intérêt croissant, la plupart des études actuelles sur ‘la Chine en Afrique’ sont encore basées sur de statistiques agrégées et d’informations sporadiques en provenance des agences de presse. De plus, le débat est dichotomique: les activités de la Chine sont perçues comme ayant des effets soit positives, soit négatifs sur les pays africains. Cet article cherche à dépasser cette vision en examinant les multiples aspects des investissements chinois dans deux secteurs de l’économie zambienne. Il cherche ainsi à contribuer à notre compréhension des conséquences domestiques de la présence de plus en plus importante de la Chine en Afrique.European Journal of Development Research (2009) 21, 644–661. doi:10.1057/ejdr.2009.23