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PubMed2004

Recovery from aphasia: a longitudinal study on language recovery, lateralization patterns, and attentional resources.

Despite the large body of evidence on the neural basis of the recovery from aphasia, the role of either cerebral hemisphere remains controversial. This paper reports the results of a longitudinal single-case study on the patterns of lateralization for lexical semantic processing during the recovery from aphasia. The experimental protocol included a lateralized lexical decision task (LDT), an attentional task and a language test. There was no presentation site effect on the LDT, and the performance was jointly influences by attentional and language factors. These findings suggest that the recovery of lexical semantic processing may be sustained by both cerebral hemispheres, and highlights the importance of experimental protocols that allow examining both language and attentional factors modulating factors modulating the recovery from aphasia.

Analysis of Variance↗

PubMed2005

Self-administered instrument to measure the patient's experience of recovery after first-episode psychosis: development and validation of the Psychosis Recovery Inventory.

OBJECTIVE: Patients who are recovering from a first-episode psychosis face specific and complex issues that are related to their illness and treatment experiences, such as the appraisal of the extent of their recovery and the risk of relapse. Currently, no instrument provides a comprehensive assessment of these related attitudes. A novel self-administered rating scale for the measurement of key perceptions during the recovery stage after a first-episode psychosis is presented. The Psychosis Recovery Inventory (PRI) is designed to specifically address a number of closely related issues that are faced by patients who are recovering from a first-episode psychosis. METHOD: The process of development of the PRI involved the generation of items from qualitative interviews, the construction and refinement of these items and a validation study. The longitudinal stability of the PRI items was assessed in a test-retest reliability study in which 20 patients completed the retest within 4 weeks. The internal consistency and convergent validity of the PRI were evaluated by a comparison of the PRI subscale scores and the Scale to Assess Unawareness of Mental Disorder and Drug Attitude Inventory scores in a sample of 48 first-episode psychosis patients. RESULTS: The validation study shows that the PRI is an instrument with a good test-retest reliability, internal consistency and convergent validity. CONCLUSIONS: This pragmatic, low burden, self-administered scale can be applied in clinical and research settings to obtain reliable information on the attitudes of patients on a range of interrelated issues in the recovery stage that follows a first-episode psychosis.

Adult↗

PubMed2006

Moving toward recovery within clients' personal narratives: directions for a recovery-focused therapy.

Recent literature emphasizes that recovery from schizophrenia involves recovery within one's own narrative of an integral sense of identity, agency, social connection, and worth. While this is intuitively appealing and consistent with a wide range of literature, it raises the issue of how to best help people do this in individual psychotherapy. In this article, we explore how psychotherapy might help people construct new narratives or storied understandings of their lives and thereby promote recovery from schizophrenia. Exemplified with two individual examples, we first discuss the barriers that challenge and the techniques that help psychotherapists seeking to enter into dialogue with people with severe mental illness. We also offer a theoretical model of how the revitalization of dialogues within therapy can be conceptualized as a process that promotes recovery and discuss the objective measurement of such outcomes.

Adaptation, Psychological↗

PubMed1990

Late recovery of auditory comprehension in global aphasia. Improved recovery observed with subcortical temporal isthmus lesion vs Wernicke's cortical area lesion.

This study examined the relationship between recovery of auditory comprehension in global aphasia patients after 1 year post onset, and temporal lobe lesion in Wernicke's cortical area vs temporal lobe lesion in the subcortical temporal isthmus area. Computed tomographic scans and language behavior were examined in 14 right-handed globally aphasic stroke patients with lesion in the left hemisphere. Nine patients had large cortical/subcortical frontal, parietal, and temporal lobe lesion that included more than half of Wernicke's cortical area (FPT cases). Five patients had large cortical/subcortical frontal and parietal lobe lesion, but only subcortical temporal lobe lesion, including the temporal isthmus (FPTi cases). All patients were tested acutely at 1 to 4 months post onset and again at 1 to 2 years post onset. There was a significantly greater increase in the amount of recovery that had taken place after 1 to 2 years post onset for the FPTi group vs the FPT group in the overall Boston Diagnostic Aphasia Examination (BDAE) Auditory Comprehension Z score. In four of the five FPTi cases, the late BDAE Auditory Comprehension Z scores were above -0.5 (mild-to-moderate comprehension deficits). Most recovery was in single-word comprehension. In eight of the nine FPT cases, the late BDAE Auditory Comprehension Z-scores were below -0.5 (moderate-to-severe comprehension deficits). There was no significant difference between the two groups in recovery of spontaneous speech, repetition, or naming, where severe deficits remained in most cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1996

Dichloroacetate enhanced myocardial functional recovery post-ischemia : ATP and NADH recovery.

This study was undertaken to determine the effect of dichloroacetate (DCA) on myocardial functional and metabolic recovery following global ischemia. Isolated rabbit hearts were subjected to 120 min of mildly hypothermic (34 degrees C), cardioplegic arrest with multidose, modified St. Thomas' cardioplegia. Hearts were reperfused with either physiologic salt solution (PSS) as controls, (CON, n = 10) or PSS containing DCA (DCA, n = 6) at a concentration of 1 mM. Functional and metabolic indices were determined at baseline and at 15, 30, and 45 min of reperfusion. In four DCA and four CON hearts, myocardial biopsies were taken at baseline, end-ischemia, 15 and 45 min for nucleotide levels. Functional recovery was significantly better in hearts reperfused with DCA as demonstrated by recovery of baseline developed pressure (DCA = 69 +/- 5%, CON = 45 +/- 9%) and dP/dt (DCA = 64% +/- 10% versus CON = 48% +/- 10%). Coronary blood flow was not different between groups either at baseline or during reperfusion, but myocardial oxygen consumption (MVO2) was increased in the DCA versus CON hearts (79% +/- 20% of baseline vs 50% +/- 18%). Recovery of myocardial adenylate energy status was improved in the DCA versus CON hearts (ATP recovered to 45% +/- 20% versus 8% +/- 6% of baseline). Coronary sinus lactate concentration was decreased in DCA perfused hearts at 45 min of reperfusion. Percent of baseline NADH values was similar at 15 min of reperfusion, but at 45 min, DCA hearts showed a decrease in NADH levels, while CON hearts showed an increase (DCA = 48%; CON = 121%). The enhanced myocardial function and improved metabolic status noted with DCA may result from increased oxidative phosphorylation due to altered pyruvate dehydrogenase (PDH) activity.

Adenine Nucleotides↗

PubMed1994

Recovery of olfactory behavior. II. Neonatal olfactory bulb transplants enhance the rate of behavioral recovery.

Previous experiments in this laboratory have shown that transplants of a fetal olfactory bulb into a neonatal rat are viable and that they establish connections with the olfactory peduncle and olfactory cortex. The focus of this experiment was to investigate the anatomical correlates of any behavioral recovery seen in rats that had one olfactory bulb removed along with an immediate transplant of a fetal olfactory bulb. Anatomical details, such as transplant organization and olfactory nerve repenetration patterns were analyzed using a variety of histological and immunohistochemical techniques. The rats in this experiment showed behavioral recovery of olfactory ability. The recovery rates observed in these animals were compared to two other groups of rats that this laboratory has shown to be behaviorally competent: normal rats and rats with neonatal ablations of the olfactory bulb but no transplant. Although the animals with transplants did not recover to completely normal levels of olfactory ability, they did start behavioral testing in a more behaviorally competent condition than rats with simple neonatal lesions. Anatomical analysis revealed that the transplanted olfactory bulb was heavily penetrated by incoming olfactory nerve fibers but olfactory nerve penetration was not limited to the transplanted olfactory bulb. The extra-bulbar host regions that were penetrated included the orbital frontal cortex and three olfaction-related areas; olfactory cortex, olfactory peduncle and the subependymal cell layer. The olfactory nerve penetration patterns observed beyond the transplant were essentially the same as those observed in rats with only neonatal lesions of the olfactory bulb. Thus, multiple pathways may have contributed to the recovery observed in the rats with olfactory bulb transplants.

Animals↗

PubMed1976

Isolation of lymphocyte subpopulations from rabbit peripheral blood. Comparison of methods based on recovery of rosette-forming cells and on recovery of Ig-bearing cells from a digestible immunoadsorbent.

Two methods to obtain lymphocyte subpopulations, defined by specific surface receptors, from rabbit peripheral blood cells were compared as to cell recovery, yield and purity of the obtained fractions: a) the formation of rosettes between lymphocytes and SRBC or SRBC coated with an antigen--antibody--complement complex (D-SRBC), followed by isolation of the rosettes and recovery of the RFC, b) retention of surface-Ig bearing cells on an immunoadsorbent to which antibody to rabbit Ig was covalently attached via a digestible gelatin bridge, with subsequent recovery of the retained cells by the enzymatic digestion of the bridge. Purity of the isolated cell fractions was assessed in all cases by the percentage of cells staining with FITC-labeled goat anti-rabbit Ig. Using the rosette method, all of the RFC could be recovered from rosettes and a very pure, surface-Ig negative, sub-population of cells was obtained: however, the overall number of rosettes formed (SRBC and D-SRBC) was low (8-9% of the nucleated PBC). Very good recoveries and highly enriched cell populations were obtained with the digestible immunoadsorbent, provided certain precautions to minimize cell losses were taken. Thus, 47% of the input cells, representing 90% of the lymphocytes could be recovered; separated cell populations were 96% Ig-positive or, in another experiment, 96% Ig-negative.

Adsorption↗

PubMed1996

Recovery of function after brain damage: differential effects of blocking calcium uptake during the recovery of a learned behavior and the performance of the recovered behavior following neocortical brain injury.

The recovery of a learned behavior following brain damage is typically considered to have occurred when the brain-injured individual reattains the performance criterion that defined original preoperative learning. While this is obviously correct from an operational point of view, it does not necessarily mean that the consequences of the brain injury have been reversed, particularly with regard to the sustained performance of the supposedly recovered behavior. The present research attempted a more comprehensive evaluation of the behavioral effects of localized neocortical injury by investigating how a calcium channel blocker would effect (a) the original preoperative acquisition, (b) the initial postoperative recovery, and (c) the subsequent long-term performance of a brightness discrimination learned by rats subjected to injuries of their visual neocortex. The results demonstrated that notwithstanding the brain-injured rat's ability to reattain the performance criterion used to define preoperative learning, its long-term performance of this recovered behavior was significantly inferior to that of a normal rat. More importantly, the present data suggest that there are important differences between the initial postoperative recovery of a behavior and its long-term performance since the same drug that will facilitate initial recovery has just the opposite effect with respect to the animals long-term postoperative performance of the behavior.

Analysis of Variance↗

PubMed2006

Practicing recovery from a simulated trip improves recovery kinematics after an actual trip.

The goal of this study was to determine if practicing recovery from a simulated trip improved the ability of older adults to recover from an actual trip. Twelve healthy older adults ranging in age from 63 to 83 years were randomly assigned to either a control or an experimental group. Each group performed one trip before and one trip after an intervention. The experimental group received trip recovery training on a modified treadmill while the control group walked on a treadmill for 15 min. Compared to the control group, the experimental group showed greater reduction in maximum trunk angle (p=0.027) and time to maximum trunk angle (p=0.043), as well as increased minimum hip height (p=0.020). Although the results showed beneficial effects of trip recovery training on actual trip recovery, future studies should explore the ability to retain improvements over extended periods.

Accidental Falls↗

PubMed2001

Experiencing recovery: a dimensional analysis of recovery narratives.

This paper applies the technique of dimensional analysis to recovery narratives in order to examine the uniqueness of the recovery process. It finds that there are four central dimensions involved in recovery: self, others, the system, and the problem. The recovery process is made up of component processes that correspond to these dimensions: recognizing the problem, transforming the self, reconciling the system, and reaching out to others. The paper concludes by suggesting how understanding these dimensions and processes may aid practice and policy.

Convalescence↗

PubMedDate not supplied

Cocaine recovery support groups and the language of recovery.

The authors have attempted to make clear that recovery is a lifelong process. In its early phases, clients are working primarily to achieve relief from guilt and pain created by their addiction. As recovery progresses, however, there is a movement from a relief mentality to a true experience of delight (Enright 1980). The goals of treatment have been achieved when this shift is evident: when one is living comfortably, responsibly and joyfully without cocaine or other drugs. The authors' experience indicates that treating cocaine addicts in cocaine-specific groups is useful in that the homogeneity facilitates group identification and the educational component of treatment. However, the content of the groups and nature of the recovery process are not drug specific or unique. The emergence of C.A., which is based on the same 12 steps as A.A., also illustrates this. What is being treated is addictive disease, not alcoholism or cocaine addiction. Regardless of the chemical, the essentials of treatment are the same: The language of recovery is universal.

Adaptation, Psychological↗

PubMed1977

Split-dose and liquid-holding recovery after X-irradiation in diploid yeast Saccharomyces cerevisiae. II. Dependence of the recovery process on cellular protein metabolism.

In diploid yeast, split-dose recovery (SDR) after X-irradiation was affected, if incubation between split doses was performed in the presence of the protein-synthesis inhibitor, cycloheximide. In exponentially-growing cell-cultures, early SDR was undisturbed but complete recovery was not achieved. Concomitantly the cells show a decresing ability to perform subsequent liquid-holding recovery (LHR). In stationary-phase cell-cultures, SDR was completely suppressed. The cells show, however, recovery from potentially lethal damage in the presence of cycloheximide during incubation between the dose-fractions. The experimental results suggest that in diploid yeast SDR after X-irradiation is an enzymatic process dependent on a functioning protein metabolism.

Cell Survival↗

PubMedDate not supplied

Ensuring the chain of recovery for stroke in your community. Chain of Recovery Writing Group.

Until recently, the prehospital and emergency department management of nonhemorrhagic stroke was largely supportive care. Studies now have demonstrated the potential of certain therapeutic interventions to reverse the debilitating consequences of such strokes. But despite the potential benefit, there exists a clear time dependency for such interventions, not only to ensure therapeutic efficacy, but also to diminish the likelihood of significant therapeutic complications. In turn, to optimize the chances of a better outcome for the patient with stroke, each community must establish and continue to refine a chain of recovery for stroke patients. The chain of recovery is a metaphor that describes a series of sequential actions that must take place in a timely fashion to optimize the chances of recovery from stroke. Each of these sequential actions forms an individual link in the chain, and each link must be intact. The links include: identification of the onset of stroke symptoms by the patient or bystanders; dispatch life support services, which preferably include enhanced 9-1-1 and medically supervised and trained dispatchers who can rapidly deploy the closest responders and transport units; emergency medical services (EMS) personnel who can rapidly assess and transport the stroke patient to the closest appropriate center capable of providing advanced stroke diagnostics and interventions; en route notification of the receiving facility so that appropriate personnel can be readied for rapid diagnosis and intervention; and receiving facilities capable of providing rapid diagnosis and advanced treatment of stroke, including the availability of specialists who can evaluate underlying etiologies as well as plan future therapies and rehabilitation. To ensure that the chain of recovery is in place, aggressive public education campaigns should be implemented to increase the probability that stroke symptoms and signs will be recognized as soon as possible by patients and bystanders. In addition, because most of the current training programs for EMS dispatchers and prehospital care personnel are lacking with regard to stroke, it is recommended that such personnel and their EMS system managers be updated on current management and treatment strategies for stroke.

Cerebrovascular Disorders↗

PubMed1999

Pharmacodynamics and the plasma concentration of mivacurium during spontaneous recovery and neostigmine-facilitated recovery.

BACKGROUND: The authors examined the plasma concentrations of the isomers of mivacurium and its pharmacodynamics during spontaeous and neostigmine-facilitated recovery after a mivacurium infusion. METHODS: Sixteen patients receiving nitrous oxide-opioid anesthesia received 0.25 mg/kg mivacurium. Patient response to neuromuscular stimulation was determined using a mechanomyograph Once T1 had recovered to 25% of its baseline height, a mivacurium infusion was begun and adjusted to maintain 95-99% neuromuscular block. The infusion was discontinued after 90 min and muscle strength allowed to recover either spontaneously or after neostigmine/glycopyrrolate (0.05/0.01 mg/kg). Plasma concentrations of the isomers of mivacurium after discontinuation of the infusion were determined using an HPLC assay. Differences between the groups were determined using a one-way analysis of variance with a Bonferroni-corrected t test or Student t test as appropriate. P < or = 0.05 was considered significant. RESULTS: Differences in the times for recovery to a train-of-four ratio of 70% did not achieve statistical significance (mean+/-SD, 13.3+/-6.0 vs. 16.3+/-2.5 min for the neostigmine and spontaneous groups, respectively). Plasma cholinesterase activity decreased significantly from baseline values after administration of neostigmine (5.88+/-0.21 vs. 0.43+/-0.04 U/ml plasma). Plasma concentrations of the trans-trans isomer were significantly greater in the neostigmine group than in the spontaneous recovery group 5, 6, 8, and 10 min after discontinuation of the infusion. Differences in the plasma concentration of the cis-trans isomer did not achieve statistical significance. CONCLUSIONS: Although administration of neostigmine decreased plasma cholinesterase activity and caused the trans-trans isomer to remain in the plasma at higher concentration, it did not delay recovery from mivacurium-induced block.

Adult↗

PubMed2003

Comparison of recovery of blood culture isolates from two BacT/ALERT FAN aerobic blood culture bottles with recovery from one FAN aerobic bottle and one FAN anaerobic bottle.

Traditionally, a routine blood culture for adult patients consisted of paired aerobic and anaerobic bottles, but the routine use of an anaerobic blood culture bottle has been challenged in recent years. In this study, we compared the recovery of two FAN aerobic bottles with one FAN aerobic and one FAN anaerobic bottle. Each pair of bottles was collected by a separate collection procedure, and each bottle held a recommended 8- to 12-ml draw. A total of 704 clinically significant isolates were recovered from 8,620 sets (17,240 pairs), with 487 (69.2%) isolates recovered from one or both bottles in each pair of bottles, 86 isolates (12.2%) recovered only from the FAN aerobic-FAN aerobic pair, and 131 isolates (18.6%) recovered only from the FAN aerobic-FAN anaerobic pair. Significantly more total organisms (P = 0.002), gram-positive cocci (P = 0.03), Staphylococcus aureus (P = 0.05), Enterobacteriaceae other than Escherichia coli (P = 0.02), and anaerobes (P = 0.01) were recovered from the FAN aerobic-FAN anaerobic pair than from the FAN aerobic-FAN aerobic pair. A separate analysis was performed on the 618 isolates that were recovered from the FAN aerobic-FAN anaerobic pair to compare recovery by bottle type. Significantly more S. aureus (P = 0.005) and anaerobes (P < 0.001) were recovered from the FAN anaerobic bottle, while significantly more coagulase-negative staphylococci (P = 0.01), Streptococcus pneumoniae (P = 0.03), and other gram-negative bacilli (P = 0.004) were recovered from the FAN aerobic bottle. These results support the routine use of a FAN anaerobic bottle for use in the culture of blood with the BacT/ALERT system in our institution. These results also suggest that the decision of whether to routinely utilize an anaerobic blood culture bottle should be influenced by the overall recovery of bacteria and yeast, the recovery of specific types of bacteria or yeast, the medium type, and the blood culture system utilized by the laboratory.

Anaerobiosis↗

PubMed1992

Measuring visual neglect in acute stroke and predicting its recovery: the visual neglect recovery index.

An overall measure of the recovery of visual neglect in patients with an acute stroke is described: The "Visual Neglect Recovery Inde" (VNRI) expresses the amount of visual neglect on a battery of visual neglect tests as a percentage of complete recovery from the maximal visual neglect measurable. The principles underlying the development of the index are similar to those involved in the development of the Motricity Index for hemiplegia. A population of 68 survivors of stroke who presented with visual neglect at two to three days were followed for up to six months. The VNRI showed that neglect was greater in those with right hemisphere stroke than in those with left hemisphere stroke and that recovery was most rapid over the first 10 days and reached a plateau at three months. Most patients, including many with severe initial visual neglect, showed little visual neglect at three months. Stepwise regression analysis showed that the severity of visual neglect at three months and at six months post-stroke could be predicted by the severity of visual neglect and the presence of anosognosia at two to three days. A regression equation was produced which may enable clinicians to select patients for intensive treatment of visual neglect.

Acute Disease↗

PubMed2006

Effectiveness of a collaborative recovery training program in Australia in promoting positive views about recovery.

OBJECTIVE: This study examined the impact of a two-day, recovery-based training program for mental health workers on knowledge, attitudes, and hopefulness related to the recovery prospects of people with enduring mental illness. METHODS: A self-report pre-post training repeated-measures design was used with 248 mental health workers from the community-based government health sector (N=147) and nongovernment organizations (N= 101) in eastern Australia. RESULTS: Staff attitudes and hopefulness improved after training. Trainees significantly increased their knowledge regarding principles of recovery and belief in the effectiveness of collaboration and consumer autonomy support, motivation enhancement, needs assessment, goal striving, and homework use. CONCLUSIONS: This preliminary evidence indicates that staff recovery orientation can improve with minimal training.

Adult↗

PubMed1996

Cognitive therapy and recovery from acute psychosis: a controlled trial. II. Impact on recovery time.

BACKGROUND: A trial of CT in acute psychosis conducted by the authors has shown a significant impact on the rate and degree of recovery of positive symptoms, the focus of the intervention. This paper seeks to determine whether these effects generalise to other features of acute psychosis including dysphoria, insight and "low level' psychotic thinking which were not directly targeted. METHOD: Measures of dysphoria, insight and psychotic thinking were taken over a six-month period following presentation for acute psychosis. Using survival analysis, time to recovery from psychosis using three definitions of increasing stringency was compared between the CT and control group. RESULTS: CT was associated with a 25-50% reduction in recovery time depending on the definition used. CONCLUSION: The impact of the CT intervention extended beyond positive symptoms to include insight, dysphoria and "low level' psychotic thinking. Nevertheless this kind of "clinical' recovery required a median of 20 weeks to complete. Implications for clinical models of acute care are discussed.

Acute Disease↗