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Relationships between gross motor skills and cardiovascular fitness with visuospatial working memory (VSWM) in children are hypothesized to be mediated by underlying functional brain mechanisms. Because there is little experimental evidence to support this mechanism, the present study was designed to investigate the relationships of gross motor skills and cardiovascular fitness with VSWM-related brain activation in 8- to 10-year-old children. Functional magnetic resonance imaging data obtained during a VSWM-task were analyzed for 80 children from grades 3 (47.5%) and 4 of 21 primary schools in the Netherlands (51.3% girls). Gross motor skills (Korper Koordinationstest für Kinder and Bruininks-Oseretsky Test of Motor Proficiency - 2nd Edition) and cardiovascular fitness (20-meter Shuttle Run Test) were assessed. VSWM-related brain activation was found in a network involving the angular gyrus, the superior parietal cortex, and the thalamus; deactivation was found in the inferior and middle temporal gyri. Although behavioral results showed significant relations of gross motor skills and cardiovascular fitness with VSWM performance, gross motor skills and cardiovascular fitness were not related to VSWM-related brain activation. Therefore, we could not confirm the hypothesis that brain activation underlies the relationship of gross motor skills and cardiovascular fitness with VSWM performance. Our results suggest that either the effects of physical activity on cognition do not necessarily go via changes in gross motor skills and/or cardiovascular fitness, or that brain activation patterns as measured with the blood-oxygen-level dependent (BOLD) signal may not be the mechanism underlying the relationships of gross motor skills and cardiovascular fitness with VSWM. [ABSTRACT FROM AUTHOR]

Disability measures in multiple sclerosis (MS) rely heavily on ambulatory function, and current metrics fail to capture potentially important variability in walking behavior. We sought to determine whether remote step count monitoring using a consumer-friendly accelerometer (Fitbit Flex) can enhance MS disability assessment. 99 adults with relapsing or progressive MS able to walk ≥2-min were prospectively recruited. At 4 weeks, study retention was 97% and median Fitbit use was 97% of days. Substudy validation resulted in high interclass correlations between Fitbit, ActiGraph and manual step count tally during a 2-minute walk test, and between Fitbit and ActiGraph (ICC = 0.76) during 7-day home monitoring. Over 4 weeks of continuous monitoring, daily steps were lower in progressive versus relapsing MS (mean difference 2546 steps, p < 0.01). Lower average daily step count was associated with greater disability on the Expanded Disability Status Scale (EDSS) ( p < 0.001). Within each EDSS category, substantial variability in step count was apparent (i.e., EDSS = 6.0 range 1097-7152). Step count demonstrated moderate-strong correlations with other walking measures. Lower average daily step count is associated with greater MS disability and captures important variability in real-world walking activity otherwise masked by standard disability scales, including the EDSS. These results support remote step count monitoring as an exploratory outcome in MS trials. [ABSTRACT FROM AUTHOR]

Hemangiomas and vascular malformations (VM) in functional areas can be treated by a variety of methods. Because of the natural involution of hemangiomas, a non-agressive approach is recommended. Active therapy is necessary only in cases where a function is affected such as vision, respiration, hearing, and feeding. Psychological problems can be an indication for early excision, and psychological/cosmetic reasons in the presence of fibrofatty tissue residues when the hemangioma has been involuted for late excision. In contrast to hemangiomas, no involution is to be expected for VMs, so that therapy depends mainly on the occurrence of functional problems and/or serious complications. Surgical excision still has a place, however, the indications are limited. [ABSTRACT FROM AUTHOR]

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The goal of this study was to assess the effectiveness of the selective use of prophylactic antibiotics after preoperative microbiological analysis of the oral and nasal cavity. In a retrospective study of wound infections after palatal surgery, 124 patients were included (134 procedures) who underwent all types of corrections of the palate. Standardized cultures from nasal and oropharyngeal mucosa were routinely obtained from all patients admitted for palatal surgery in the week prior to operation. According to existing protocol, every patient revealing group A Streptococcus from the nose or the throat received intravenous amoxicillin-clavulanate perioperatively. The postoperative finding of the combination of partial or complete wound dehiscence, pus, and fever was considered evidence of infection. Cultures from dehisced wounds were subsequently analyzed. Out of 134 procedures performed with this selective use of antibiotics, an infection rate of 6.0% (eight procedures) was noted. None of the patients receiving the amoxicillin-clavulanate prophylaxis showed infection. Patients showing infection revealed preoperative cultures with a diverse flora. Postoperative cultures of these patients showed group A Streptococcus and Staphylococcus aureus as the main pathogens. Despite the retrospective design and limited number of infected patients, cautious conclusions are warranted. When routine cultures from the nasal and oropharyngeal mucosa are obtained preoperatively, infection rate may be reduced by selective use of antibiotics against group A Streptococcus and Staphylococcus aureus. [ABSTRACT FROM AUTHOR]

Pharyngeal reconstruction can be accomplished in a variety of ways, from pedicled to free revascularized tissue transfers. The use of an extra skin paddle combined with a buried radial forearm flap, which permits long-term postoperative monitoring under direct vision, has been described before. In this study, we monitored nine patients who had undergone pharyngeal reconstruction with a buried reversed radial forearm flap. Our modified technique gave better coverage of the large vessels and a better postoperative neck contour, prevented esophageal leakage and facilitated continuous postoperative patient monitoring, without any significant additional donor site morbidity. [ABSTRACT FROM AUTHOR]

Treatment of neuromas of the large nerves in the hand with or without post-traumatic dystrophy remains difficult. As a hypothesis, sufficient cover of the painful area should decrease the influence of pressure on neuromas, cope with the dystrophic condition and therefore improve function and quality of life. In ten consecutive patients suffering from incapacitating complaints after one or more interventions for treatment of painful neuromas a reverse fasciocutaneous flap was transposed to the area involved. Over all, patients considered the operation to be a breakthrough in their chronic pain situation. A positive benefit was obtained with respect to dystrophic symptoms, use of the hand and quality of life. The procedure can be an important step in the rehabilitation process. [ABSTRACT FROM AUTHOR]

This project points to the complexities involved in understanding mental health management. Some hypotheses were supported: intention to leave the work organization and organization commitment were the best predictors of turnover, the rural manager more of a generalist compared to urban counterpart. Many hypotheses were not supported. The annual turnover rate has fallen, burnout seems a myth for this group, many rural-urban differences were not significant, job satisfaction was good. Nonwork variables affect turnover but not as strongly as predicted while reward systems came forward as a crucial area for predicting and understanding turnover. More work, of course, needs to be done. An understanding of state differences, career paths and turnover (why has it fallen), and reward systems as utilized in public sector organizations are needed. Continued research of rural and urban systems and managers using objectively defined taxonomies and systematic data collection is desirable. Finally managers' responses to the problems and changes this decade will bring would be fascinating to follow. [ABSTRACT FROM AUTHOR]

To determine issues in mental health administration in this decade 314 public sector, community level, mental health administrators and 200 professionals in mental health from across the country were sampled. The 670 responses from 253 respondents were analyzed and placed into 15 categories. Impact of decreased funding and personnel related issues were paramount. Implications of the data for administration in mental health are discussed. [ABSTRACT FROM AUTHOR]

Cardiac myxomas are rarely diagnosed in children, and biatrial tumors are an unusual presentation in any age group. An 8-year-old boy with massive biatrial cardiac myxomas, who presented in acute cardiogenic shock with no preceding cardiac symptomatology, is reported. [ABSTRACT FROM AUTHOR]