Subcutaneous granulocyte colony-stimulating factor administration for subacute traumatic spinal cord injuries, report of neurological and functional outcomes: A double-blind randomized controlled clinical trial

OBJECTIVE Granulocyte-colony stimulating factor (G-CSF) is a major cytokine that has already been clinically verified for chronic traumatic spinal cord injuries (TSCIs). In this study, the authors set out to determine the safety and efficacy of G-CSF administration for neurological and functional improvement in subacute, incomplete TSCI. METHODS This phase II/III, prospective, double-blind, placebo-controlled, parallel randomized clinical trial was performed in 60 eligible patients (30 treatment, 30 placebo). Patients with incomplete subacute TSCIs with American Spinal Injury Association Impairment Scale (AIS) grades B, C, and D were enrolled. Patients were assessed using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) scale, Spinal Cord Independence Measure (SCIM-III) and International Association of Neurorestoratology Spinal Cord Injury Functional Rating Scale (IANR-SCIFRS), just before intervention and at 1, 3, and 6 months, after 7 daily subcutaneous administrations of 300 μg/ day of G-CSF in the treatment group and placebo in the control group. RESULTS Among 60 participants, 28 patients (93.3) in the G-CSF group and 26 patients (86.6) in the placebo group completed the study protocol. After 6 months of follow-up, the AIS grade remained unchanged in the placebo group, while in the G-CSF group 5 patients (45.5) improved from AIS grade B to C, 5 (45.5) improved from AIS grade C to grade D, and 1 patient (16.7) improved from AIS grade D to E. The mean ± SEM change in ISNCSCI motor score in the G-CSF group was 14.9 ± 2.6 points, which was significantly greater than in the placebo group (1.4 ± 0.34 points, p < 0.001). The mean ± SEM light-touch and pinprick sensory scores improved by 8.8 ± 1.9 and 10.7 ± 2.6 points in the G-CSF group, while those in the placebo group improved by 2.5 ± 0.60 and 1.2 ± 0.40 points, (p = 0.005 and 0.002, respectively). Evaluation of functional improvement according to the IANR-SCIFRS instrument revealed significantly more functional improvement in the G-CSF group (10.3 ± 1.3 points than in the placebo group (3.0 ± 0.81 points; p < 0.001). A significant difference was also observed between the 2 groups as measured by the SCIM-III instrument (29.6 ± 4.1 vs 10.3 ± 2.2, p < 0.001). CONCLUSIONS Incomplete subacute TSCI is associated with significant motor, sensory, and functional improvement after administration of G-CSF. ©AANS 2019

Investigating the Relationship between Locus of Control, Emotional Intelligence, and Resilience among Young Male Opium Abusers in Shiraz

Background: Addiction destroys lifestyles and affects individuals, family,and society. The present study aimed to investigate the relationship between resilience, locus of control, and emotional intelligence in opium addicts.Recognizing the weaknesses of this group helps them to recover and can provide preventive strategies for society.Methods: A total of 40 male opium addicts were selected by convenience sampling from Ibn-e-Sina Center in Shiraz. Rotter, Shrink, Connor-Davidson,and demographic questionnaires were used in this cross-sectional study, and Pearson’s test was used to obtain the correlation coefficient.Results: Less resilient people reported more relapses after quitting (r=-0.424,P=0.006). People with higher social awareness used psychological therapies to liberate themselves from addiction (r=0.337, P=0.033). Longer addiction was reported among people who consumed opium more frequently during the day (r=0.433, P=0.005). Greater frequency of daily consumption and more years of consumption had a positive relationship with increasing the number of quits and relapses (r=0.323, P=0.042; r=0.362, P=0.022).Conclusion: Addiction treatment centers should evaluate and improve the levels of resilience, emotional intelligence, and type of locus of control in addicts. Most of the participants started their addiction out of curiosity between the ages of 20 and 25 years. The media and policymakers are recommended to play a vital role in raising social awareness and clarifying the devastating consequences of opium addiction. Most of the participants were unemployed and needed money for more treatments. Therefore, it is advisable that rehabilitation centers use occupational therapists for pre-vocational and vocational rehabilitation programs in the treatment process

A Cognitive Neurodynamic Approach to Prediction of Students’ Adaptation to College: An Ex-Post Facto Study

Introduction: Campus life tends to make social and academic demands on college students. To cope with these demands, students are required to use their neurocognitive skills of problem- solving and planning intentional actions that target towards adaptation to college. This paper presents an illuminating perspective that would inform understanding of a new approach to cognitive neuroscience. The linkage between cognition and adaptation was sought in the context of a cognitive neurodynamic approach proposed by the Intention, Meaning, and Perception (IMP) model of neuro-occupation. Methods: An ex post facto study was conducted on a convenience sample of 187 college students in Shiraz, Iran. A brief questionnaire was developed to screen participants for diversity of cognitive neurodynamic processing capacity and three standardized questionnaires were used to gather data about college adaptation manifestations. The partial correlation, 1-way, and 2-way ANOVA tests were used to analyze the data. Results: The partial correlation test showed large, positive correlation (r&ge;0.7, P<0.001) between elements of the cognitive neurodynamic process, denoting that the interrelated connections among intention, meaning, and perception were governed by feedback loops. One-way ANOVA test revealed that students with diverse cognitive neurodynamic processing capacity had a variety of college adaptation manifestations. Two-way ANOVA showed a statistically significant main effect for neurodynamic processing capacity (F2, 178=8.1, P<0.001). Conclusion: College adaptation could have been established by the cognitive neurodynamic process proposed by the IMP model. Therefore, it is advisable for faculty, mental health practitioners, and counselors who work with students at universities to understand this process and address students maladaptation to campus life

The Neuro-Occupation Model for Occupational Therapy: A Correlation Study

Objectives: The Neuro-occupation model has been referenced as the single occupational therapy conceptual framework that considers the interaction of three underpinning variables of Intention, Meaning, and Perception that explains how occupational performance is shaped. To date, studies have focused on the qualitative relationships between the variables. Quantitative studies that focus on the relationships among variables are lacking, begging the question as to whether the model is well-conceptualized. Extending prior work on the Neuro-occupation model, the aim of this quantitative study is to test the model by investigating correlations among the key variables of the model. Methods: This is a correlational study by a convenience sample of 25 cognitively-oriented patients with strokes recruited from three rehabilitation facilities in Shiraz, Iran. The participants were evaluated using three standardized instruments to measure the variables: 1. Adapted Achievement Motivation Questionnaire, 2. Connor-Davidson Resilience Scale, and 3. Canadian Occupational Performance Measure. To control the effects of months post-stroke and cognitive functioning, the partial correlation test was used to explore relationships among the variables. Results: The correlational analysis indicated significant positive relationships among the variables of intention, meaning, and perception. The partial correlations showed acceptable correlation coefficients (r&ge;0.45, P<0.05). Discussion: The Neuro-occupation model is a well-conceptualized framework, which can assist occupational therapists in understanding the design of occupational performance.&nbsp

Making lighting adjustments to establish new behavioral patterns in a child with autism: A follow-up study

The behavioral patterns of children with autism are thought to be comprised of interconnected parameters. Acknowledging the value of lighting parameter, a less-studied aspect of the physical environment, this study illustrates how such parameter could contribute to increasing attention to visual stimuli. This paper outlines the establishment of new behavioral patterns following a novel approach using blacklight conditions, which highlighted objects in the foreground of the blackened environment, to modify the visual environment surrounding a child with autism. The child was first attracted to objects in the environment under blacklight conditions. This paper offers healthcare practitioners a useful perspective that has the potential to address a very important aspect of how a child with autism developed interaction with the objects following an environmental modification

Predictive Value of Braden Risk Factors in Pressure Ulcers of Outpatients With Spinal Cord Injury

Pressure Ulcers (PUs) remain among the most common complications after traumatic spinal cord Injuries (SCIs). The main goal of risk factor assessment with different tools has been to provisionally estimate the chance of developing pressure ulcers in patients with Spinal Cord Injury (SCI). Braden tool has been of good predictive value and most commonly employed in hospital communities for risk assessment of pressure sore development. The objective of this study was to determine the Braden risk factors as well as the prevalence of pressure injuries in SCI patients. This cross-sectional study was performed from June 2013 to December 2015 on 163 consecutive referred outpatients with chronic traumatic SCI in our tertiary SCI rehabilitation clinic. We assessed pressure induced skin injuries as well as their Braden risk factors and analyzed their association with stage and location of Pressure Ulcer (PU) and calculated prevalence of PU. One hundred and sixty-three patients out of 580 were found to have active pressure sores, with a prevalence of 28.1%. In the multiple models, only the Braden scale had significant association with the presence of active pressure sore. Patients with severe and moderate Braden scores were 2.36 and 1.82 times, more at risk of pressure sore development, as compared with those having mild scores (P≤0.01). It may be deduced that in various stages of SCI rehabilitation, the Braden scale may be calculated, and patients with moderate and severe risks (according to Braden sale) may need more attention and/or inpatient care for PU prevention.