Achondroplasia and cervical laminoplasty.

Achondroplasia is associated with short pedicles that predispose individuals with this trait to develop symptomatic spinal canal stenosis. Laminoplasty is an excellent means of treating cervical myelopathy due to stenosis in selected individuals. Laminoplasty preserves segmental motion and stability, both of which are of benefit to all individuals.

Thinning of sensorimotor cortices in children with Tourette syndrome.

The basal ganglia portions of cortico-striato-thalamo-cortical (CSTC) circuits have consistently been implicated in the pathogenesis of Tourette syndrome, whereas motor and sensorimotor cortices in these circuits have been relatively overlooked. Using magnetic resonance imaging, we detected cortical thinning in frontal and parietal lobes in groups of Tourette syndrome children relative to controls. This thinning was most prominent in ventral portions of the sensory and motor homunculi that control the facial, orolingual and laryngeal musculature that is commonly involved in tic symptoms.

Sex differences in cortical thickness mapped in 176 healthy individuals between 7 and 87 years of age.

Findings from previous magnetic resonance imaging studies of sex differences in gray matter have been inconsistent, with some showing proportionally increased gray matter in women and some showing no differences between the sexes. Regional sex differences in gray matter thickness have not yet been mapped over the entire cortical surface in a large sample of subjects spanning the age range from early childhood to old age. We applied algorithms for cortical pattern matching and techniques for measuring cortical thickness to the structural magnetic resonance images of 176 healthy individuals between the ages of 7 and 87 years.

Age-related changes in prefrontal white matter volume across adolescence.

Past research has suggested that white matter volume increases from childhood to adulthood; however, during adolescence, there is somewhat limited data to support this finding. In the present study, 65 typically developing adolescents underwent structural magnetic resonance imaging. Using magnetic resonance imaging, prefrontal white matter volumes were examined in relation to adolescent age and sex.

Mapping cerebellar vermal morphology and cognitive correlates in prenatal alcohol exposure.

Prenatal exposure to alcohol can result in neuroanatomical and neurocognitive deficits. High-resolution magnetic resonance imaging, surface-based image analytic methods, and neuropsychological measures were used to characterize the cerebellar vermis and to evaluate potential cognitive correlates of vermal morphology in 21 children and adolescents with prenatal alcohol exposure and 21 normally developing individuals. Alcohol-exposed individuals showed statistically significant reductions in the midline sagittal areas of the anterior vermis and posterior-inferior vermis, and significant displacement of the anterior and posterior-inferior vermal regions.

The Minimum Data Set bedfast quality indicator: differences among nursing homes.

Background: Excessive time in bed has negative effects on both physical conditioning and functioning. There are no data or practice guidelines relevant to how nurses should manage the in-bed times of nursing home residents, although all nursing homes receive a bedfast prevalence quality indicator report generated from the Minimum Data Set.

Objectives: To compare nursing homes that score in the upper and lower quartiles on the Minimum Data Set bedfast prevalence quality indicator for proportion of bedfast residents, activity and mobility nursing care, and amount of time all residents spend in bed, and to evaluate whether residents who spend more time in bed are different from those who spend less time in bed according to functional measures.

The minimum data set prevalence of restraint quality indicator: does it reflect differences in care?

Purpose: This study investigated whether the use of restraining devices and related measures of care quality are different in nursing homes that score in the upper and lower quartiles on the Minimum Data Set (MDS) "prevalence of restraint" quality indicator, which assesses daily use of restraining devices when residents are out of bed.

Design And Methods: The study was a cross-sectional study, with 413 residents in 14 nursing facilities. Eight homes scored in the lower quartile (25th percentile; low prevalence, 0-5%) on the MDS restraint prevalence quality indicator, and six homes scored in the upper quartile (75th percentile; high prevalence, 28-48%).

A standardized quality assessment system to evaluate incontinence care in the nursing home.

Objectives: To demonstrate the reliability and feasibility of a standardized protocol to assess and score urinary incontinence care in nursing homes.

Design: Descriptive.

Setting: Eighteen nursing homes (NHs).

The minimum data set urinary incontinence quality indicators: do they reflect differences in care processes related to incontinence?

Purpose: To determine if nursing homes that score in the lower 25th percentile (low prevalence) versus the upper 75th percentile (high prevalence) on each of two Minimum Data Set (MDS) incontinence quality indicators provide different incontinence care processes

Design: Cross-sectional.

Subjects: 347 long-term residents in 14 skilled nursing facilities for the MDS "prevalence of incontinence" indicator and 432 residents in 16 skilled nursing facilities for the MDS "prevalence of incontinence without a toileting plan" indicator.

Measures: Nine care processes related to incontinence were defined and operationalized into clinical indicators.