Effects of peer mentoring on self-efficacy and hospital readmission following inpatient rehabilitation of individuals with spinal cord injury: a randomized controlled trial

Publication date: Available online 23 March 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Julie Gassaway, Michael L. Jones, W. Mark Sweatman, Minna Hong, Peter Anziano, Karen DeVault
ObjectiveInvestigate the effect of intensive peer mentoring on patient reported outcomes of self-efficacy and unplanned hospital readmissions for persons with spinal cord injury/disease (SCI/D) within the first 6 months after discharge from inpatient rehabilitationDesignRandomized controlled trial;SettingNon-profit inpatient rehabilitation hospital specializing in care of persons with SCI/D and brain injuryParticipants158 patients admitted to the SCI rehabilitation program whose discharge location was a community setting. Participants (51% paraplegia and 49% tetraplegia) were 73% Caucasian and 77% male with a mean age of 38.InterventionsParticipants in the experimental group received initial consult/introduction with a peer support program liaison and were assigned a peer mentor, who met with the participant weekly throughout the inpatient stay and made weekly contact by phone, email or in person for 90 days post-discharge. Participants also were encouraged to participate in regularly scheduled peer support activities. Control group participants were introduced to peer support and provided services only upon request.Main Outcome Measure(s)General Self-efficacy Scale (adapted to SCI/D), project-developed community integration self-efficacy scale, and patient-reported unplanned rehospitalizations.ResultsGrowth rate for self-efficacy in the first 6 months post-discharge was significantly higher for experimental group participants compared to control group participants. Experimental group participants also had significantly fewer unplanned hospital days.ConclusionThis study provides evidence that individuals receiving intensive peer mentoring during and following rehabilitation for SCI/D demonstrate greater gains in self-efficacy over time and have fewer days of unplanned rehospitalization in the first 180 days post-discharge. More research is needed to examine the long-term effects of this intervention on healthcare utilization and the relationship between improved health and patient-reported quality of life outcomes.



http://ift.tt/2mZC0NT

“Resistance training for muscle weakness in multiple sclerosis: direct versus contralateral approach in individuals with ankle dorsiflexors’ disparity in strength.”

Publication date: Available online 23 March 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Andrea Manca, Maria Paola Cabboi, Daniele Dragone, Francesca Ginatempo, Enzo Ortu, Edoardo Rosario De Natale, Beniamina Mercante, Giovanni Mureddu, Guido Bua, Franca Deriu
ObjectiveTo compare effects of contralateral strength training (CST) versus direct strength training (DST) of the more-affected ankle dorsiflexors on muscle performance and clinical-functional outcomes in people with multiple sclerosis (MS) exhibiting inter-limb strength asymmetry.DesignRandomized controlled trialParticipantsIndividuals with relapsing-remitting MS and mild-to-moderate disability (EDSS≤6) presenting with ankle dorsiflexors' strength disparity.InterventionParticipants were randomly assigned to a CST (n=15) or DST (n=15) group performing a 6-week maximal-intensity strength training of the less- or more-affected dorsiflexors, respectively.Main Outcome MeasuresMaximal strength, endurance to fatigue and mobility outcomes were assessed before (PRE), at the intervention end (POST) and at 12-week follow-up. Strength and fatigue parameters were measured after 3 weeks of training (mid-intervention).ResultsIn the more-affected limb of both groups, PRE-to-POST significant increases in maximal strength (p≤0.006) and fatigue endurance (p≤0.04) were detected along with consistent retention of these improvements at follow-up (p≤0.04). At mid-intervention the DST group showed significant improvements (p≤0.002), with no further increase at the POST, despite training continuation. Conversely, the CST group showed non-significant strength gains, increasing to significance at the POST (p≤0.003). In both groups, significant PRE-to-POST improvements in mobility outcomes (p≤0.03), not retained at follow-up, were observed.ConclusionsAfter 6 weeks of training, CST proved as effective as DST in enhancing performance of the more-affected limb with a different time-course, which may have practical implications in management of severely weakened limbs where DST is not initially possible.



http://ift.tt/2mxBV7O

Hippocampal BDNF overexpression or microR124a silencing reduces anxiety- and autism-like behaviors in rats

Publication date: 30 May 2017
Source:Behavioural Brain Research, Volume 326
Author(s): Amine Bahi
MicroRNA124a (miR124a) has emerged recently as a key player for multiple neuropsychiatric disorders including depression, anxiety, alcoholism, and cocaine addiction. Although we have previously reported that miR124a and its target the brain-derived neutrophic factor (BDNF) play an important role in autism-like behaviors, the molecular and behavioral dysfunctions remain unknown. The aim of this study was to understand the effects of sustained decreases in miR124a and increases of BDNF in the dentate gyrus (DG) on neonatal isolation-induced anxiety-and autism like behaviors in rats. Here we report that lentiviral-mediated silencing of miR124a in the adult DG attenuated neonatal isolation-induced anxiety-like behavior in the elevated plus maze (EPM) and open-field (OF) tests. Also, miR124a silencing decreased autism-like phenotype in the marble burying test (MBT), self-grooming (SG), and social interaction tests. Pearson's correlations demonstrated that high levels of BDNF, a direct target of miR124a, were negatively correlated with miR124a expression. Interestingly, viral-mediated BDNF overexpression in the DG also reversed the neonatal isolation-induced anxiety-and autism like phenotypes. Collectively, these findings suggest that miR124a, through its target BDNF, may influence neonatal isolation-induced anxiety-and autism like behaviors. In conclusion, these results do support the hypothesis that miR124a in discrete hippocampal areas contributes to anxiety- and autism-like behaviors and may be involved in the neuroadaptations underlying the development of autism spectrum disorders as a persistent and lasting condition, and therefore provide a clearer mechanistic framework for understanding the physiopathology of such psychiatric illnesses.



http://ift.tt/2nt9AyY

Study of trace metal imbalances in the blood, scalp hair and nails of oral cancer patients from Pakistan

Publication date: 1 September 2017
Source:Science of The Total Environment, Volumes 593–594
Author(s): Muhammad Abdul Qayyum, Munir H. Shah
Oral cancer is an important cause of cancer morbidity and mortality globally and exposure to trace metals alongside tobacco, alcohol and HPV are the important etiological factors in its development. Selected essential and toxic trace metals (Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn) were measured in the blood, scalp hair and nails of oral cancer patients and counterpart controls by atomic absorption spectrometry. Mean concentrations of Cd, Ni and Pb were found to be significantly higher (p<0.05) and those of Cu, Fe and Zn were considerably lower in the blood, scalp hair and nails of the patients than the controls. Most of the metal concentrations exhibited higher dispersion and asymmetry in the blood, scalp hair and nails of the patients compared with the controls. The correlation study revealed significantly diverse relationships among the metals in blood, scalp hair and nails of both donor groups. Variations in the metal levels were also noted for various stages (I, II, III & IV) as well as the types (adenocarcinoma and squamous cell carcinoma) of oral cancer. Multivariate cluster analysis of the metal levels in the patients were also significantly dissimilar than the controls. The study evidenced considerably divergent variations in the metal levels in oral cancer patients in comparison with the controls.

Graphical abstract

http://ift.tt/2mVZdzq

FGFR a promising druggable target in cancer: molecular biology and new drugs

Publication date: Available online 23 March 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Rut Porta, Roberto Borea, Andreia Coelho, Shahnavaj Khan, Antonio Araujo, Pablo Reclusa, Tindara Franchina, Nele Van Der Steen, Peter Van Dam, Jose Ferri, Rafael Sirera, Aung Naing, David Hong, Christian Rolfo
IntroductionThe Fibroblast Growth Factor Receptor (FGFR) family consists of Tyrosine Kinase Receptors (TKR) involved in several biological functions. Recently, alterations of FGFR have been reported to be important for progression and development of several cancers. In this setting, different studies are trying to evaluate the efficacy of different therapies targeting FGFR.Areas CoveredThis review summarizes the current status of treatments targeting FGFR, focusing on the trials that are evaluating the FGFR profile as inclusion criteria: Multi-Target, Pan-FGFR Inhibitors and anti-FGF (Fibroblast Growth Factor)/FGFR Monoclonal Antibodies.Expert opinionMost of the TKR share intracellular signaling pathways; therefore, cancer cells tend to overcome the inhibition of one tyrosine kinase receptor by activating another. The future of TKI (Tyrosine Kinase Inhibitor) therapy will potentially come from multi-targeted TKIs that target different TKR simultaneously.It is crucial to understand the interaction of the FGF-FGFR axis with other known driver TKRs. Based on this,it is possible to develop therapeutic strategies targeting multiple connected TKRs at once. One correct step in this direction is the reassessment of multi target inhibitors considering the FGFR status of the tumor. Another opportunity arises from assessing the use of FGFR TKI on patients harboring FGFR alterations.



http://ift.tt/2ncxz2U

Academic Remediation

Publication date: Available online 23 March 2017
Source:Academic Radiology
Author(s): Carol M. Rumack, Jeannette Guerrasio, Alicia Christensen, Eva M. Aagaard
At our institution, we have developed a remediation team of strong, focused experts who help us with struggling learners in making the diagnosis and then coaching on their milestone deficits. It is key for all program directors to recognize struggling residents because early recognition and intervention gives the resident the best chance of success.



http://ift.tt/2mxwcig

A Tribute to Mark Richard Robbin, MD

Publication date: Available online 23 March 2017
Source:Academic Radiology
Author(s): Mark E. Mullins, Pablo R. Ros




http://ift.tt/2mxAhmC