Comparison of functional outcomes and treatment cost between a computer-based cognitive rehabilitation teletherapy program and a face-to-face rehabilitation program.

The authors compared outcomes of 19 participants who received computer-based cognitive teletherapy rehabilitation with 20 participants who received face-to-face speech-language rehabilitation. The study compared outcomes from 2 "real-word" treatment programs provided by an outpatient rehabilitation center. A total of 39 participants with moderate to severe closed head traumatic brain injuries and a minimum of 1 year following injury were analyzed. Outcome measures included clinical indicators of independent living status, return to work or school, and independent driving. Cost measures included the total cost of the treatment and a measure of service costs per hour. Time since injury was a covariate, and an analysis of covariance revealed no differences between groups in independent living, driving status, return to work or school, or total treatment costs. The computer-based teletherapy cognitive rehabilitation program provided similar functional outcomes as face-to-face speech-language therapy at a similar total cost. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral approaches to neuropsychological rehabilitation.

Behavioral approaches have been applied to a wide variety of behavioral and cognitive disturbances resulting from brain damage or disease. This article provides a comprehensive and critical review of the literature concerned with behavioral interventions in neuropsychological rehabilitation. The article examines 6 categories of target behavior: inappropriate social behavior, attention and motivation, unawareness of deficits, memory, language and speech, and motor disturbance. The efficacy of behavioral approaches for treatment of the neurologically impaired and implications for the future role of behavioral approaches in neuropsychological rehabilitation are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Outcome evaluation findings of a Hawaiian culture-based adolescent substance abuse treatment program.

As part of efforts to identify effective culturally appropriate treatment for Hawaiian and Asian and Pacific Islander adolescents with substance abuse and co-occurring disorders, this evaluation research sought to assess the efficacy of the I Mua Mau Ohana program. This long-term residential program combined culturally based experiential learning/therapy, education, spirituality, counseling, and family involvement. Participants were interviewed at intake and followed up at 3, 6, and 12 months using the Government Performance and Results Act (GPRA) Tool and the Global Appraisal of Individual Needs (GAIN) instruments. Results showed long-term improvement in substance use and related problems, decreased criminal justice involvement, and improved mental health and social functioning, while showing positive trends in education and employment. However, unexpected findings were revealed in family functioning. Although promising, further research is needed to substantiate the program's effectiveness and possibility of being considered an "evidence-based program." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An approach to large-scale outpatient neuropsychological rehabilitation.

Presents the Rusk Institute of Rehabilitation Medicine Adult Outpatient Neuropsychology Section's approach to providing multifaceted neuropsychological treatment to large numbers of patients within a major, urban, general rehabilitation facility. Discussed are techniques for circumventing the obstacles posed by limited financial resources and social and institutional restrictions and techniques for providing cognitive remediation, psychotherapy, and family and coordination services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Natural reinforcement in a psychiatric rehabilitation program

A case of sustained hypertension produced by unilateral section of the glossopharyngeal nerve is reported. Special tests revealed baroreceptor dysfunction. The hypertension was responsive to propranolol therapy. Review of the literature revealed no other documented cases of sustained hypertension although transient hypertension is common.     

Outcome measurement in pulmonary rehabilitation

The measurement of outcomes of therapy is becoming ever more important as part of the overall management of an individual patient. This is particularly true when considering pulmonary rehabilitation for a patient with chronic lung disease. Health, clinical, and behavioral domains should be assessed when evaluating the effectiveness of pulmonary rehabilitation. This assessment of outcomes can be easily made using currently available tools.     

The development of a rehabilitation psychology program for persons with schizophrenia: Changes in the treatment environment.

Reports the changes that occurred over a 4-yr period at a therapeutic community for persons with schizophrenia when a rehabilitation psychology program was added to the traditional inpatient treatment and eventually replaced it. Data collected (from patients and staff members over the 4 yrs) using the Community Oriented Programs Environment Scale revealed several significant and desirable changes in the quality of the perceived treatment environment, including increases in practical orientation and autonomy. Specific interventions that accounted for improvement in the rehabilitation potential of the treatment environment are described. Conceptual differences between the traditional inpatient psychiatric model and the rehabilitation psychology model are outlined. Value differences between these 2 models are presented as an explanation for the failure of rehabilitation services offered adjunctively with traditional psychiatric services. The treatment environment changed only when rehabilitation became a central part of the treatment philosophy. The fundamental differences between these 2 treatment approaches are related to reports of improved outcome from programs using psychosocial models. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sociological and cultural aspects in postacute neuropsychological rehabilitation

Various forms of postacute brain injury rehabilitation programs exist. Comprehensive day treatment programs are the most holistic, being neuropsychological in orientation. The importance of developing a trusting relationship and the use of inventive techniques in the individualization of treatment within a holistic rehabilitation program will be described via a case presentation, stressing the sociocultural aspects of the individual as central to treatment.     

The effect of cognitive rehabilitation on the neuropsychological status of patients in drug abuse treatment who display neurocognitive impairment.

72 patients engaged in residential drug abuse treatment who also had cognitive impairment were randomly assigned to 1 of 4 groups. One group of patients received 2 hrs of computer-assisted cognitive rehabilitation per week over a 6-mo period; a 2nd group received 2 hrs of progressive muscle relaxation per week over a 6-mo period; a 3rd group was taught typing on a computer; and a 4th group received no treatment beyond that provided by the program. All patients were tested with a neuropsychological test battery at admission and at monthly intervals thereafter for 6 mo. Results show that Ss in the cognitive rehabilitation group demonstrated a faster rate of cognitive recovery during the first 2 mo of treatment and had more efficient cognitive functioning over the first 4 mo of residence. These patients were also rated as more "appropriately participatory" in the treatment program by the clinical staff. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining a multidimensional framework of racial identity across different biracial groups.

The term multiracial is complex. Recent research has adopted a multidimensional view initially proposed by Rockquemore and colleagues (2002, 2009) for examining racial identity among Black/White biracial people. This approach has acknowledged the social construction of race and broadened the range of racial identity options beyond the two “traditional” options of being “Black” or “biracial.” This study was designed to further assess this framework by examining a more diverse multiracial sample from Canada and the U.S. (N = 122). Both the Black/White biracials (n = 38) and Asian/White biracials (n = 40) showed great variability in their selection of Rockquemore's multiracial identity categories, but the pattern of responses differed across the two groups. In addition to revealing different patterns of identity selection between Asian/White and Black/White biracial persons, findings demonstrated the importance of identity validation by others and its relation to conceptions of the self. Having a multiracial identity that is validated by others (as opposed to invalidated or contextually dependent identities) was associated with higher levels of identity integration and self-concept clarity. Theoretical implications for extending a multidimensional model to other biracial groups are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The relationships among rehabilitation staff members' reports of cognitive dysfunction and neuropsychological assessment in an acute rehabilitation population.

Purpose/Objective: To examine the relationships among rehabilitation staff members' observations of the extent to which attention and memory functioning interfered with participants' rehabilitation progress and the relationship between these observations and neuropsychological testing. Research Method/Design: Participants were 39 adults admitted to a Commission on Accreditation of Rehabilitation Facilities-accredited, acute physical medicine rehabilitation unit who were referred for neuropsychological assessment. For study purposes, participants were administered the Mental Control subtest of the Wechsler Memory Scale-Third Edition (D. Wechsler, 1997) and the Neuropsychological Assessment Battery (R. A. Stern & T. White, 2003). Occupational therapists, physical therapists, and nurses were asked to rate the extent to which participants' attention/concentration and memory interfered with their progress in rehabilitation. Results: Staff ratings of participants' attention or memory functioning interfering with rehabilitation progress were strongly and most closely related to their own ratings of the other cognitive domain. Objective attention and memory test performance were weakly and nonsignificantly correlated with each other. Relationships between staff observations and test data were also weak. Conclusions/Implications: Rehabilitation staff members may be viewing cognition as a unitary construct rather than identifying the independent contributions of different cognitive domains as they apply to rehabilitation performance and progress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison between an outpatient hospital-based pulmonary rehabilitation program and a home-care pulmonary rehabilitation program in patients with COPD. A follow-up of 18 months

AIM: In this study, the effects of a 12-week hospital-based outpatient pulmonary rehabilitation program (HRP) are compared with those of a 12-week home-care rehabilitation program (HCRP) in COPD patients. A control group received no rehabilitation therapy. METHODS: After randomization and stratification, effects on lung function, exercise performance (4-min walking test and cycle ergometer test), dyspnea, and leg effort during exercise, and well-being were assessed in 45 COPD patients with moderate to severe airflow limitation (mean [SD] FEV1 percent predicted, 42.8 [8.4]). RESULTS: After HRP and HCRP, at 3 to 6 months after the start of the study, equal improvements were detected in exercise capacity and in Borg dyspnea and leg effort scores at similar work levels during the cycle test. However, whereas after HRP at longer term values tended to return to baseline outcome, after HCRP a further ongoing significant improvement in exercise capacity was observed, while Borg dyspnea scores remained significantly improved over 18 months. Improvements in cycle workload and dyspnea score were significantly better maintained after HCRP as compared with HRP. Lung function, arterial oxygen saturation, and heart frequency during exercise did not change. A significant improvement in well-being was maintained over 18 months in both rehabilitation groups. CONCLUSION: Beneficial effects are achieved both after a HRP and a HCRP in COPD patients with moderate to severe airflow limitation. Yet we recommend to initiate HCRPs as improvements are maintained longer and are even further strengthened in this setting.     

Outcome of subacute stroke rehabilitation: a randomized controlled trial

We compared the biological activity of a new group of keto-C-glycosides to that of a narrow spectrum of unsaturated ketonucleosides in a panel of non-small-cell lung cancer (NSCLC) cells with various levels of intrinsic resistance to standard chemotherapy drugs. Unlike cisplatin, etoposide, adriamycin, or taxol, for which a significant difference in the cytotoxic effect was observed between sensitive cell lines (H460, H125, and MGH4) and drug-resistant cell lines (H661, MGH7, and FADU), nucleoside analogs were equally cytotoxic in NSCLC cell lines, with compound 92 being 10-fold more active than compound 43, 44, 81, or 161, while compound 3 was the least active. Apoptotic measurements with flow cytometric analysis of terminal uridine deoxynucleotide nick end-labeled cells revealed that the cytotoxic activity of these nucleosides correlated with their potency to induce apoptosis. Compound 92 triggered death in cells with wild-type p53, mutated p53, or p53 gene deletion. Our findings suggest that keto-C-glycosides may be promising alternative anticancer agents which merit further studies in in vivo cancer models refractory to standard chemotherapy drugs.     

Experience-dependent neuropsychological recovery and the treatment of alcoholism.

Accumulating research has shown that some cognitive deficits in recently abstinent alcoholics (e.g., cognitive flexibility, acquisition of novel skills) improve only with remediation in contrast to the spontaneous, time-dependent rebound seen for other tasks. In principle, this facilitated or experience-dependent recovery should enhance acquisition of the content of alcoholism treatment programs, but this relationship has yet to be tested empirically; previous research assessed recovery using only neuropsychological tasks presented by an experimenter. The current investigation focused on treatment-relevant remediation (acquisition of the content of a relapse-prevention [RP] program) using tasks administered by self-guided workbooks. Four groups of male alcoholics received pre- and posttesting. Between the 2 testing sessions, the groups received neuropsychological remediation tasks (n?=?15), ecologically relevant tasks (n?=?15), attention-placebo tasks (n?=?16), or no intervention (n?=?15). Results showed that exposure to both types of remediation produced significant cognitive recovery, with skills transferring to posttest neuropsychological measures and RP acquisition. Hence, cognitive remediation may facilitate alcoholism treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)