Identity and sense of self: the significance of personhood in rehabilitation

Recovery from conditions leading to illness/disability is often defined in terms of physical improvement; however, people themselves describe their own recovery as more than this alone: it is a returning to the life they led before their illness. These two approaches highlight a potential mismatch between the way we as health care professionals perceive our world (the observable) and the way the people we are caring for perceive their world (often hidden from us). In this presentation I will explore how we can access the subjective world of those who use our services by exploring the role of life narratives within rehabilitation. I will share ideas from research linked to life changes, sense of self, and agency which we can use to inform our practice and support people in their recovery and rehabilitation

Fostering Hope Through Palliative Rehabilitation

Cancer patients’ need for rehabilitation is growing, as more and more people live with the long-term consequences of disease and its treatment due to early detection and improved treatment regimens. There are a number of people living with incurable cancer who have symptoms that need to be managed for many years, paralleling long-term conditions. Beyond clinical management, a sense of hope is vital in enhancing their quality of life

Exploring positive adjustment in people with spinal cord injury.

This study explored adjustment in people with spinal cord injury; data from four focus groups are presented. Thematic analysis revealed four themes, managing goals and expectations, comparison with others, feeling useful and acceptance, showing participants positively engaged in life, positively interpreted social comparison information and set realistic goals and expectations. These positive strategies show support for adjustment theories, such as the Cognitive Adaptation Theory, the Control Process Theory and Response Shift Theory. These results also provide insight into the adjustment process of a person with spinal cord injury and may be useful in tailoring support during rehabilitation

How do you exercise with epilepsy? Insights into the barriers and adaptations to successfully exercise with epilepsy.

Exercise has been shown to be a physiological and psychological benefit for people with epilepsy (PWE). However, barriers prevent many PWE from exercising safely and confidently. This research explored current perceived barriers to exercise and adaptation techniques used by PWE in order to maintain physical activity levels. Three focus groups (2-3 participants per group) and three semi-structured interviews were conducted (11 participants total). Constructive grounded theory was used to frame the study and analyse the findings, presenting new insight into the motivation, perceived barriers, and adaptation techniques used to exercise. The main motivator to maintain physical activity levels was the benefit of exercise on physical and mental health. This was shown in an increase in mood, higher social interaction, and perceived improvement in overall physical health as a result of exercise. Current barriers to exercise included a fear of injury, lack of social support, and exercise-induced seizures (e.g., through overheating and/or high exercise intensity level). Adaptation techniques used were self-monitoring through the use of technology, reducing exercise frequency and intensity level, and exercising at certain times of the day. The importance of social support was shown to provide increased confidence and positive encouragement to exercise, contrasting with family and friends worrying for his/her safety and medical professionals requesting termination of some physical activities. These findings provide new insight into current adaptation techniques that are used and developed by PWE to overcome common barriers to exercise. These new additions to the literature can lead to further development of such techniques as well as examine current medical professionals' knowledge of the benefits of exercise for PWE

Incidence and prevalence of falls in adults living with an intellectual disability living in the community: A systematic review

Review question/objective: The objective of this review is to synthesize the best available evidence to determine the incidence and prevalence of falls in adults with intellectual disability living in the community

Can a web-based community of practice be established and operated to lead falls prevention activity in residential care?

The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted using the web, but frequency of engagement by any participant was low. Participatory barriers, including competing demands from other tasks and low levels of knowledge about information communication technology (ICT) applications, were identified by CoP members. A web-based CoP can be established and operated across multiple RAC sites if RAC management support dedicated time for web-based participation and staff are given web-based training

DNA Authentication of St John’s Wort (Hypericum perforatum L.) Commercial Products Targeting the ITS Region

open access articleThere is considerable potential for the use of DNA barcoding methods to authenticate raw medicinal plant materials, but their application to testing commercial products has been controversial. A simple PCR test targeting species-specific sequences within the nuclear ribosomal internal transcribed spacer (ITS) region was adapted to screen commercial products for the presence of Hypericum perforatum L. material. DNA differing widely in amount and extent of fragmentation was detected in a number of product types. Two assays were designed to further analyse this DNA using a curated database of selected Hypericum ITS sequences: A qPCR assay based on a species-specific primer pair spanning the ITS1 and ITS2 regions, using synthetic DNA reference standards for DNA quantitation and a Next Generation Sequencing (NGS) assay separately targeting the ITS1 and ITS2 regions. The ability of the assays to detect H. perforatum DNA sequences in processed medicines was investigated. Out of twenty different matrices tested, both assays detected H. perforatum DNA in five samples with more than 103 ITS copies µL−1 DNA extract, whilst the qPCR assay was also able to detect lower levels of DNA in two further samples. The NGS assay confirmed that H. perforatum was the major species in all five positive samples, though trace contaminants were also detected

A principal components approach to parent-to-newborn body composition associations in South India

Background: size at birth is influenced by environmental factors, like maternal nutrition and parity, and by genes. Birth weight is a composite measure, encompassing bone, fat and lean mass. These may have different determinants. The main purpose of this paper was to use anthropometry and principal components analysis (PCA) to describe maternal and newborn body composition, and associations between them, in an Indian population. We also compared maternal and paternal measurements (body mass index (BMI) and height) as predictors of newborn body composition.Methods: weight, height, head and mid-arm circumferences, skinfold thicknesses and external pelvic diameters were measured at 30 ± 2 weeks gestation in 571 pregnant women attending the antenatal clinic of the Holdsworth Memorial Hospital, Mysore, India. Paternal height and weight were also measured. At birth, detailed neonatal anthropometry was performed. Unrotated and varimax rotated PCA was applied to the maternal and neonatal measurements.Results: rotated PCA reduced maternal measurements to 4 independent components (fat, pelvis, height and muscle) and neonatal measurements to 3 components (trunk+head, fat, and leg length). An SD increase in maternal fat was associated with a 0.16 SD increase (?) in neonatal fat (p < 0.001, adjusted for gestation, maternal parity, newborn sex and socio-economic status). Maternal pelvis, height and (for male babies) muscle predicted neonatal trunk+head (? = 0. 09 SD; p = 0.017, ? = 0.12 SD; p = 0.006 and ? = 0.27 SD; p < 0.001). In the mother-baby and father-baby comparison, maternal BMI predicted neonatal fat (? = 0.20 SD; p < 0.001) and neonatal trunk+head (? = 0.15 SD; p = 0.001). Both maternal (? = 0.12 SD; p = 0.002) and paternal height (? = 0.09 SD; p = 0.030) predicted neonatal trunk+head but the associations became weak and statistically non-significant in multivariate analysis. Only paternal height predicted neonatal leg length (? = 0.15 SD; p = 0.003).Conclusion: principal components analysis is a useful method to describe neonatal body composition and its determinants. Newborn adiposity is related to maternal nutritional status and parity, while newborn length is genetically determined. Further research is needed to understand mechanisms linking maternal pelvic size to fetal growth and the determinants and implications of the components (trunk v leg length) of fetal skeletal growt

How older adults would like falls prevention information delivered: Fresh insights from a world cafe forum

Translation of falls prevention evidence into practice is problematic. Understanding older adults’ views about falls prevention information could enhance delivery of falls prevention, resulting in better engagement and uptake of recommended activities. The aim of this study was to examine the views and preferences of community-dwelling older adults about seeking and receiving falls prevention information. A community forum using a modified World Café approach was conducted. Participants discussed five topic areas in small groups, under the guidance of table facilitators. Perspectives were captured on paper. Thematic analysis was conducted to identify factors that influence participants’ engagement and uptake of information. Seventy-three older adults participated in the forum covering wide-ranging preferences around falls prevention information. Personal experience was considered the key influence on an older adult’s decision to initiate seeking information. While health professionals were often approached, alternative sources such as public libraries, peer educators and seniors’ organisations were also favoured as credible sources of information. Older adults proposed falls prevention information should be delivered with a positive tone, coupled with highly valued qualities of respect, empathy and time to listen to foster motivation to engage in recommended activities. Consumer-focused practical strategies were proposed to potentially improve future design, communication and dissemination of falls prevention information. This improvement could enhance engagement of messages and subsequent uptake of falls prevention recommended strategies