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ObjectiveThe purpose of this paper is to construct a conceptual framework for investigating the reconstruction of narrative identity in mental health recovery from a complexity perspective. This conceptual framework provides the foundation for developing a health boardgame to facilitate narrative identity reconstruction.MethodsA selective integrative review of the theoretical and empirical literature relevant to narrative identity reconstruction in recovery was conducted. Sources included books, dissertations, internet resources, and professional journals.FindingsThe reviewed material provides a conceptual framework that offers an enriched understanding of narrative identity reconstruction in recovery as a process of adaptive growth. It identifies the Hero’s Journey, the life story model of identity (LSMI), and intentional change theory (ITC) as particularly relevant in informing strategies for narrative identity reconstruction. The conceptual framework can be operationalized in a narrative coaching treatment approach using a boardgame.Conclusion and Implications for PracticeIn practice, mental health professionals could use the narrative coaching boardgame to facilitate people’s adaptive change with a focus on building skills to reconstruct their preferred narrative identity and foster hope. Future research should explore what aspects of narrative identity and non-linear dynamic processes of change are most important in people’s recovery narratives and in particular these processes can be assessed in response to the use of the boardgame.

The c-fos immunohistochemical method of activity-dependent labeling was used to localize locomotor-activated neurons in the adult cat spinal cord. In decerebrate cats, treadmill locomotion was evoked by electrical stimulation of the mesencephalic locomotor region (MLR). Spontaneous or MLR-evoked fictive locomotion was produced in decerebrate animals paralyzed with a neuromuscular blocking agent. After bouts of locomotion during a 7- to 9-h time period, the animals were perfused and the L3-S1 spinal cord segments removed for immunohistochemistry. Control animals were subjected to the same surgical procedures but no locomotor task. Labeled cells were concentrated in Rexed's laminae III and IV of the dorsal horn and laminae VII, VIII, and X of the intermediate zone/ventral horn after treadmill locomotion. Cells in laminae VII, VIII, and X were labeled after fictive locomotion, but labeling in the dorsal horn was much reduced. In control animals, c-fos labeling was a small fraction of that observed in the locomotor animals. The results suggest that labeled cells in laminae VII, VIII, and X are premotor interneurons involved in the production of locomotion, whereas the laminae III and IV cells are those activated during locomotion due to afferent feedback from the moving limb. c-fos-labeled cells were most numerous in the L5-L7 segments, consistent with the distribution of locomotor activated neurons detected through the use of MLR-evoked field potentials.

Development of pharmacological strategies for the control of locomotion in patients with spinal cord injury or disease requires an understanding of the neuroactive substances involved in the activation of the spinal cord neural systems for the control of locomotion. Studies using the in vitro preparations of the lamprey, frog embryo, and newborn rat indicate that excitatory amino acids (EAAs) are involved in the initiation of locomotion. The present study determines whether spinal EAA receptors play a role in locomotion in an in vivo, adult mammalian preparation. Experiments were performed on precollicular, postmammillary decerebrate cats, some of which were spinalized at the 13th thoracic segment. Cannulas for drug infusions were positioned intrathecally in the lumbar region of the spinal cord. A ligature around the spinal cord at the level of the 13th thoracic segment prevented rostral diffusion of the drugs. Locomotion was monitored with electromyograms in treadmill locomotion experiments and electroneurograms in fictive locomotion experiments. Intrathecal infusion of either the NMDA receptor antagonist 2-amino-5-phosphonovaleric acid or the non-NMDA receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione blocked hindlimb treadmill and fictive locomotion induced by electrical stimulation of the mesencephalic locomotor region (MLR) of the midbrain. Intrathecal administration of NMDA elicited hindlimb fictive locomotion in resting animals similar to that evoked by electrical stimulation of the MLR. At lower concentrations, NMDA evoked either independent bursting activity in the various nerves or loosely organized rhythmicity showing little reciprocity between antagonists. In contrast, administration of the EAA uptake blocker dihydrokainic acid (DHK) evoked intermittent periods of bursting activity characterized by a variable duration and a high degree of reciprocity between flexors and extensors. Given together at low concentrations, NMDA and DHK produced a well-coordinated locomotor pattern. Kainate and quisqualate were ineffective in producing fictive locomotion. These results are consistent with the suggestion that EAAs play a role in the initiation of mammalian locomotion. Furthermore, the results are consistent with those obtained from the neonatal rat in vitro preparations.

One hundred and twenty-three total colonoscopies were performed on 115 children with ages ranging from 3 months to 16 years. The major indications were suspected inflammatory bowel disease and unexplained rectal bleeding. Ninety-seven per cent of all procedures were carried out with sedation only. Adult colonoscopes were used in most of the patients but in babies and small children paediatric instruments were preferable. Total colonoscopy was possible in all patients with a patent colon. The terminal ileum was examined in 63 patients. Endoscopic snare polypectomy was successfully carried out in 8 children and multiple haemangiomas were electrocoagulated in one. Total colonoscopy in this paediatric series proved to be at least as easy, rapid, well-tolerated, and safe as in adults. In selected patients as single colonoscopy can give an accurate diagnosis with biopsy proof and sometimes the opportunity for definitive treatment.

In newborn English Infants, the predominant faecal bacteria were coliforms and bacteroides, as shown by Gram film, culture, and gas-liquid chromatography, whether they were bottle fed or exclusively breast fed. This contrasted with bifidobacterial predominance in faeces from breast-fed Nigerian infants. Presumably environmental factors other than exclusive breast feeding are also important for establishing the flora. No differences were detected between the flora of infants of atopic and non-atopic controls.