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Purpose: To explore patients’ experiences with rehabilitation, with a particular focus on outcomes that are perceived to be of value. Materials and methods: Semi structured interviews were conducted with adults who recently had rehabilitation for a chronic health condition in a hospital or community setting. Banja’s definition of rehabilitation (personally fulfilling, socially meaningful and functionally effective) informed the enquiry and interpretation of the findings. Thematic analysis was used to categorise the data into codes and themes. Results: 16 people (40–84 years, 69% male, n = 11) participated in individual telephone-interviews, describing their perspectives on what mattered to them about rehabilitation. The themes generated from the data suggested that participants focused on important social, functional and personal outcomes, but also required two fundamental features in their rehabilitation, namely a personalised and relational experience and a clear understanding of their own progress delivered in a way that is meaningful to them. Conclusions: People who undertake rehabilitation express diverse expectations when assessing their outcomes and progress, although common elements could be identified. Participants valued a number of key features about the delivery and evaluation of their rehabilitation. These features revolved around the personalisation of the process and having clarity about progress.Implications for rehabilitation Rehabilitation therapists should encourage ongoing personalised discussions about progress to promote clear and shared understanding of what clients and therapists expect, alongside the use of current available measures. Rehabilitation therapists should consider providing opportunities for participants to self-reflect about their experiences and modify their goals based on personal progress and deeper understanding of their circumstances. Rehabilitation therapists should consider assessing the extent to which the individual

Aim The increasing prevalence of chronic conditions and impairments in the population is putting new demands on health and rehabilitation services. Research on self-help groups suggest that participation in these groups might have a positive impact on people who are struggling with chronic illnesses or disabilities. In this study, we explore person-centred support in which participants in self-help groups are undergoing rehabilitation to develop their knowledge, skills and confidence necessary to handle life's challenges. Method The design is exploratory, analysing data from informant interviews and focus groups (a total of 32 participants) using a Grounded Theory inspired approach to analyse. The participants were rehabilitation clients aged between 20 and 60 years; eight were men and twenty-six were women. Results Three main categories emerged as being important self-help processes that were likely to promote positive rehabilitation outcomes: (1) Learning and practicing safely, (2) A refuge from expectations, (3) Internal processes that accentuate the positives. Conclusion Peer support delivered through the structured self-help environment can facilitate the development of new self-awareness, promote acceptance and adjustment, facilitate the establishment of new skills and enable transfer of learning to new environments, including the workplace.

This learning module, one of a series of 127 performance-based teacher education learning packages focusing on specific professional competencies of vocational teachers, deals with the task of assisting students in achieving basic reading skills. Addressed in the individual learning experiences included in the module are the following topics: the role of the vocational instructor in developing students' reading skills; creation of an appropriate environment; assessment of students' reading needs and abilities to handle instructional materials using such techniques as the cloze procedure; and techniques and strategies to use in helping students improve reading skills (teaching technical vocabulary, providing practical reading knowledge and tips, using reading games, supplementing reading assignments, individualizing reading help, and providing practice and reinforcement). Each learning experience contains an objective, one or more learning activities, and a feedback activity. The module provides student teachers with an opportunity to examine case studies, develop their own instructional materials, and assist students in developing reading skills in an actual teaching situation. (MN)

Full Text, Thesis (PhD Doctorate), Doctor of Philosophy (PhD), School of Human Serv & Soc Wrk, Griffith Health, Despite the prevalence of First Australian deaths by suicide there is a lack of services developed and delivered by First Australians and limited evidence for the effectiveness of mainstream programs. This dissertation is focused on developing a better understanding of First Australian suicidal ideation and suicide-related behaviours in order to inform effective responses to suicide in our communities. As a First Australian researcher I subscribed to a research model based on an Indigenist paradigm. The Indigenist paradigm entails a cultural alliance with the First Australian community and participants in this research. My enculturation as a First Australian obliges me to work with the First Australian community to pursue emancipation by challenging structures and societal issues that oppress First Australians. My established professional, family and personal relationships within the First Australian community in the regional city of Mackay (Queensland, Australia) facilitated my engagement with the community in this research. My engagement with this research began at the time of a cluster of deaths by suicide of First Australian youth within Mackay’s First Australian community. I participated in an initial investigation of this suicide cluster to strengthen the community’s knowledge about deaths by suicide. My work has been overseen by an Indigenous Critical Reference Group consisting of highly respected community representatives. Given deaths by suicide continued to affect Mackay’s First Australian community, the Indigenous Critical Reference Group requested a deeper understanding of the issues that needed to be addressed and proposed my involvement in continued research. Their request led to this thesis, ensuring that this dissertation represents true community-driven research. To respond to the request of the Indigenous Critical Reference Group, I revisited the initial investigation. During the initial interviews, some participants shared their own personal exper

Full Text, Thesis (PhD Doctorate), Doctor of Philosophy (PhD), School of Human Serv & Soc Wrk, Griffith Health, Facilitating individual engagement in the rehabilitation process is vital if our investment in interventions is to achieve the desired outcomes. Studies of engagement in the cardiac rehabilitation (CR) context are limited, in that they lack a comprehensive and detailed basis for understanding and monitoring the whole process of engagement. The Model of Therapeutic Engagement (MTE) (Lequerica & Kortte, 2010) is the most comprehensive theoretical framework yet proposed to explain CR engagement, however, in the ten years since its first proposal, no research has investigated this multi-layered model empirically to determine its utility in the context of CR. The MTE defines the process of engagement by theorising a series of sub-models that focus on: 1) individual intention to engage in CR programs; 2) initiation of CR (i.e. actual attendance); and 3) maintenance of participation in CR programs over time (i.e. completion). Although the MTE is likely to be useful in understanding engagement in CR, it has been derived from a psychological orientation. Consequently, it gives little consideration to the role of socio-environmental factors which are considered vital in the fields of rehabilitation and health promotion. The overall aim of this empirical study was to evaluate the way in which the components of the MTE contribute to engagement outcomes and interact with each other, and also to examine the role of socio-environmental barriers in the MTE. This empirical study aims to evaluate the theory underlying the MTE by implementing it empirically, and thus develop a better understanding of the process of CR engagement. Through this approach, useful predictors that may act as management ‘levers’ can be identified, which if manipulated, can lead to better engagement. In turn, this could inform planning and design of future programs. The research began with a synthesis of the existing evidence for each of the proposed relationships among variables at each of the three stages o

Background: Social networks are known to have a major influence on the recovery journey of people with severe mental illness (SMI). Aims: To understand the role of bonding and bridging social capital in the recovery process following SMI and to identify the barriers that prevent social networks from being mobilized. Method: A review of major electronic databases for qualitative studies from 2006 to 2015 (41 papers) was undertaken for thematic synthesis. Result: The main themes for bonding social capital included: a buffer for isolation and loneliness, variations depending on illness stages, balance in relationships and connections as a source of self-management. Main themes for bridging social capital comprised: feeling powerless and excluded from community/health care, social care beyond the illness, social care barriers and social inclusion through community groups. Conclusion: All those involved in the management of SMI must be aware of how social support networks hinder or contribute to recovery. People with SMI need opportunities to form reciprocal relationships and sustain supportive networks that can assist them to endure the challenges presented by SMI.

Full Text, Thesis (PhD Doctorate), Doctor of Philosophy (PhD), School of Human Service & Social Work, Griffith Health, Accumulating research evidence recognises the interaction between people and place, and demonstrates the potential for the built environment to provide a supportive influence on a person’s health status and recovery journey following illness or injury. However, the nature of the supportive influence of the healthcare built environment is not well understood, particularly within inpatient neurorehabilitation settings, where people experience prolonged admissions and due to the functional, cognitive and social challenges often resulting from serious injury, may be particularly dependent on the environment to support rehabilitation and recovery. Despite the relevance of the built environment during this critical stage in the rehabilitation process, there are no clear guidelines for the design of supportive neurorehabilitation settings. Design of these settings has often focused on functional and safety requirements as dictated by building codes and industry standards. This is not commensurate with the current healthcare focus on patient-centred approaches to practice, which has broadened the focus from safety, clinical efficiencies and cost-effectiveness, toward supporting user activity and experiences of care (Bate & Robert, 2007a; Gesler, Bell, Curtis, Hubbard & Francis, 2004). Further, the lack of research specific to neurorehabilitation populations and in-depth examination of user experiences limits the development of supportive settings that contribute positively to recovery and rehabilitation experiences following serious spinal cord and brain injury. The current study employed a multi-method, multiple-case study approach to explore how patients and staff interact with and experience the neurorehabilitation built environment at two sites, a spinal injury unit (SIU) and a brain injury unit (BIU). It aimed to address the central research question, how does the built environment support the inpatient neurorehabilitation experience? Each case (neurorehabilitation uni

Ligand-receptor interactions mitigate intracellular responses, with abnormal signaling corresponding to different disease states. G-protein coupled receptors currently compose 50% of drug targets, signifying their importance in the pharmaceutical industry. Therefore, monitoring the binding events of ligands to receptors within the cell membrane is highly important for drug development. One key limitation of accurately monitoring ligand binding to a transmembrane protein is the reconstitution of the protein. Many platforms lack conformational freedom for reconstituted membrane proteins, affecting ligand binding measurements. This work developed a new liposome shell microparticle platform to tether lipid vesicles, which provide conformational freedom for the protein. These particles can be used in a pull-down assay for identification of ligand-receptor binding pairs. CHO-K1 cell membranes containing 5-HT1A receptors were tethered to sulfonate modified particles. NAN-190, a fluorescent 5-HT1A antagonist, binding to 5-HT1A receptors was monitored using flow cytometry. Liposome shell microparticles may also be used in packed bed membrane-based liquid chromatography. To retain the particles a frit is needed within the column. In this work a new thermal polymerization method for fabrication of on-column frits was developed. This method has advantages including a short polymerization time, ease of frit placement within the capillary, minimal and inexpensive equipment and retention of the polyimide capillary coating. Thermal frits were synthesized within a packed bed column and allowed for separation of phenolic acids and aliphatic amines. Frit stability and reproducible retention times demonstrate the utility of this new method for frit synthesis. Lipid vesicle heterogeneity may also affect ligand binding. Lipid membranes can be doped with fluorescent lipids and/or fluorophores can be encapsulated within sensors. However, liposome composition measurements are currently limi

Full Text, Thesis (PhD Doctorate), Doctor of Philosophy (PhD), School of Human Serv & Soc Wrk, Griffith Health, The World Health Organization (1946/2006) recognises that everyone has the right to enjoy the highest possible standard of physical, mental and social wellbeing (high level wellness, health and happiness), regardless of their socioeconomic circumstances, ethnicity or beliefs. Decades of research have provided a good understanding of the factors that facilitate high level wellness, including healthy food, physical activity, supportive relationships and equitable access to money, power and resources (Commission on Social Determinants of Health, 2008; Donaldson, Dollwet, & Rao, 2015; World Health Organization, 2015b, 2017a). However, relatively few people appear to be flourishing (Huppert & So, 2013; Keyes & Simoes, 2012), suggesting that this growing body of knowledge on wellness determinants has not translated into ‘high level wellness for all’. Qualitative research on the lived experience of high level wellness could complement existing initiatives, by providing new perspectives on what this way of being is, and how people attain and maintain it. This information could benefit a range of audiences, including people who have not experienced high level wellness first hand, or known anyone who has. This study aimed to provide a new understanding of high level wellness, based on interviews with 25 Australian adults. It focused on two research questions: (1) ‘What is high level wellness?’, and (2) ‘How do people attain and maintain this way of being?’ Participants were recruited via traditional and social media (i.e., newspapers, radio, television, Facebook, Linked In, Twitter and email). These people were over the age of 18, lived in South East Queensland (Australia), and reported a high (or very high) level of ‘wellness’, ‘health’ and ‘happiness’. The 20 female participants ranged from 25 to 65 years of age (M=43.6), whereas the five males were aged between 41 and 60 (M=53.4). Participants lived in Brisbane (n=14), Gold Coast (n=7), Logan (n=2), Ipswich (n=1) and the S