Jan Ritchie

Using qualitative research to enhance the evidence-based practice of health care providers

The physiotherapy profession has increasingly sought to demonstrate that its practice is based on sound scientific principles validated by rigorous research, in other words that its practice is evidence-based. This paper will assert that evidence-based practice requires not only carefully evaluated interventions judged through objective criteria but also input from patients in a systematic way that provides a foundation for patient-centred care. Consideration of both is essential if the best outcomes of physiotherapy intervention are to ensue. The merits of qualitative research are appraised as a means of adding the humanistic mission to result in best practice in physiotherapy.

The Almajiri Heritage and the Threat of Non-State Terrorism in Northern Nigeria--Lessons from Central Asia and Pakistan

The Almajiri heritage is, like the madrassahs in Central Asia, a system of Muslim education that dates back several centuries. With the imposition of British colonial rule between 1902 and 1960 on parts of the Sokoto Empire that currently constitute northern Nigeria, the Norths amalgamation with Southern Nigerian British protectorates in 1914, and the formal abolition of slavery in northern Nigeria in 1936, this heritage underwent major structural and functional transformations. Given the lessons from the 1980 Maitatsine terrorist insurgence in Kano, Nigeria, and the rise of Islamic fundamentalism in northern Nigeria since 1999, a potential exists that the heritage may evolve into an apparatus for perpetuating non-state terrorism. Drawing on the trajectory of similar educational systems in Central Asia prior to, during, and following Russian communist rule, this article outlines reasons for the growing terrorist potential of the Almajiri heritage, and suggests measures for avoiding such trajectories.

Factors Influencing Food Choice in an Australian Aboriginal Community

We explored with Aboriginal adults living in a remote Australian community the social context of food choice and factors perceived to shape food choice. An ethnographic approach of prolonged community engagement over 3 years was augmented by interviews. Our findings revealed that knowledge, health, and resources supporting food choice were considered “out of balance,” and this imbalance was seen to manifest in a Western-imposed diet lacking variety and overrelying on familiar staples. Participants felt ill-equipped to emulate the traditional pattern of knowledge transfer through passing food-related wisdom to younger generations. The traditional food system was considered key to providing the framework for learning about the contemporary food environment. Practitioners seeking to improve diet and health outcomes for this population should attend to past and present contexts of food in nutrition education, support the educative role of caregivers, address the high cost of food, and support access to traditional foods.

Insider–outsider positions in health-development research: reflections for practice

Recognising that the stance of investigators could make a major impact on the quality and/or interpretation of development-study findings, a small investigation to explore researcher positions and roles was implemented. This was a subsidiary component of a larger health-development study which aimed to explore the evidence base for psychosocial and mental-health policy formulation and implementation in two conflict-affected, low-resourced countries. Five of the research team were interviewed by a sixth member in an open, semi-structured interview format, and the data were analysed thematically. The primary learning for the team, with wider implications for others in development research and practice, is that if the aim is to produce credible findings from investigations of this nature, it is important to exhibit a high degree of transparency regarding the role and position of each researcher, and an explicit attempt to be reflexive in relation to the associated challenges.

It looks after me: how older patients make decisions about analgesics for osteoarthritis.

To explore the key motivators behind selection of analgesics (nonsteroidal antiinflammatory drugs [NSAIDs], acetaminophen, and complementary medications [CMs]) by patients with osteoarthritis (OA).

Reflections on prevention in dieting-induced disorders

OBJECTIVE The purpose of this article is to reflect on current approaches to the prevention of anorexia nervosa and bulimia nervosa. METHOD The literature on preventing those disorders was examined within the context of the published literatures concerned with preventive interventions for adolescent drug-taking and alcohol-related behaviors. RESULTS Our review revealed that those involved in preventing eating disorders maintain the traditional distinction between primary and secondary prevention, although the fruitfulness of that categorization is now uncertain. DISCUSSION It is argued that interventions for dieting-induced disorders ought to be generic, and target the gamut of transitional risk behaviors among adolescents. Programs for dieting, cigarette smoking, alcohol use, and safe sex within the health and social development curricula in schools must be sustained by comprehensive efforts within the broader context of societal and systemic change.

Doing good qualitative research in public health: not as easy as it looks.

In this paper, we discuss qualitative research for public health professionals. Quality matters in qualitative research, but the principles by which it is judged are critically different from those used to judge epidemiology. Compared to quantitative research, good quality qualitative studies serve different aims, answer distinct research questions and have their own logic for sampling, data collection and analysis. There is, however, no need for antagonism between qualitative research and epidemiology; the two are complementary. With theoretical and methodological guidance from experienced qualitative researchers, public health professionals can learn how to make the most of qualitative research for themselves.

Health Promoting Schools: Issues and Future Directions for Australia and the Asia Pacific Region

This paper sets out to trace the development of health promoting schools in Australia and the Asia Pacific Region. An overview of conceptual frameworks pertinent to promoting health in school is presented, together with a justification for a focus on schools as settings for health. The challenge ahead for school communities is to move from the simple classroom-based topic focused old style health education, to the whole settings approach and the broad-ranging, comprehensive collection of actions that make up this wider view.

Prevention of dieting-induced disorders: Findings and implications of a pilot study

Abstract This article outlines selected findings from a preliminary evaluation of an intervention aimed at improving the food- and body-related attitudes of young girls. Our principal purpose in presenting these data is to illustrate the difficulties that confront us in assessing the efficacy of preventive interventions for the dieting-induced disorders anorexia nervosa and bulimia nervosa, especially within the context of current approaches to prevention.

Case series research: a case for qualitative method in assembling evidence

Evidence-based practice is in vogue in the health care disciplines generally, and no less in physiotherapy specifically. Although the hierarchy of evidence favours quantitative methods, there is a place for rigorous, systematically undertaken qualitative research methods in the assembling of evidence. It is becoming increasingly acceptable to seek to enhance knowledge development by using mixed research approaches, where the qualitative method of the social sciences is called on to illuminate findings derived from quantitative studies. This article acknowledges the value of qualitative method used in this manner and argues further that there is a particular instance where this method can do more, in that it can stand alone in the gathering of evidence. This instance comes under the banner of case series research. Inductively derived findings from a series of carefully and systematically undertaken case studies have an important role in the assembling of evidence for more effective practice, especially in a discipline such as physiotherapy where interventions are more often context-dependent and complex.