Effects of running exercises on reaction time and working memory in individuals with intellectual disability.

BACKGROUND: This study explored the effect of running exercises at low [30% heart rate reserve (HRR)] and moderate (60%HRR) intensities on cognitive performances in individuals with intellectual disability (ID). METHODS: Participants performed randomly reaction time (RT) tests: visual RT [simple RT (SRT) and choice RT (CRT)], auditory SRT (ASRT) and working memory (WM) (Corsi test) before and after the exercises. RESULTS: The results showed that after both exercises, SRT decreased significantly (P < 0.001) in both groups with higher extent (P < 0.05) at 60%HRR compared with 30%HRR. CRT decreased (P < 0.01), similarly, after the both exercises in both groups with higher (P < 0.001) extent in the intellectual disability group (IDG). ASRT decreased significantly, at 30%HRR, in IDG (P < 0.001) and in control group (CG) (P < 0.01) with greater extent in IDG (P < 0.001). At 60%HRR, ASRT decreased significantly in both groups (P < 0.001) with greater extent in IDG (P < 0.001). The ΔASRT% was significantly (P < 0.05) higher at 30%HRR compared with 60%HRR in IDG. In CG, no significant (P = 0.21) difference was reported between intensities. The Corsi forward and the Corsi backward scores increased significantly (P < 0.01) in both groups after both intensities with higher extent in IDG (P < 0.01). CONCLUSIONS: Our results suggest that low and moderate running exercises improve similarly simple and choice visual RT as well as WM in individuals with ID. Furthermore, low-intensity exercise could be more appropriate to enhance ASRT compared the moderate one in these individuals. Therefore, low-intensity exercise seems to be an efficient strategy to improve cognitive performances in individuals with ID.

Designed game situations enhance fundamental movement skills in children with Down syndrome.

BACKGROUND: This study aimed to compare the effects of a designed program based on games situations with those of a conventional one, the Adapted Physical Education (APE) program, on the fundamental movement skills (FMS) in children with Down Syndrome (DS), aged 6 to 10. METHODS: Twenty-eight children (13 girls and 15 boys; age 8.84 ± 1.06) with DS participated in this study. The participants were divided into two groups as the experimental group (EG) with 13 children (3 girls and 10 boys) and the control group (CG) composed with 15 children (10 girls and 5 boys). The EG participated in a conceived training program based on games situations along 10 weeks, while the CG took part in an APE conventional program based on football, long Jump and sprint adapted exercises. The FMS (locomotor and object control skills) were evaluated using the Gross Motor Development-2 Test at pretraining and posttraining for both groups. RESULTS: The results revealed that both programs improve significantly locomotor skills with significantly better improvement in the EG. However, a significant object control skills improvement was observed only among the EG. CONCLUSIONS: In light of our findings, a training program based on adapted games situations during 10 weeks may be recommended for FMS improvement, specifically object control skills.

Neuromuscular characteristics in trained vs. sedentary male adults with intellectual disability.

BACKGROUND: This study aimed to explore muscle strength production and its underlying neuromuscular characteristics in sedentary and trained individuals with intellectual disability (ID) compared with healthy sedentary individuals. METHODS: Three adult groups (age: 25.07 ± 0.70) consisting of sedentary individuals with ID (IDSG), trained individuals with ID (IDTG) and a control group (CONT) participated in the present study. Peak torque (PT) during maximal voluntary isometric contraction, voluntary activation level (VAL), surface electromyography (sEMG) recordings, electrophysiological (Mmax ) and potentiated twitch torque (PTT responses) of the knee extensor muscles and thigh muscle volume were assessed. RESULTS: Compared with CONT and IDTG, respectively, IDSG presented significantly lower PT (-48% and -42%), VAL (-24% and -9%), sEMG (-49% and -29%), Mmax (-41% and -39%) and PTT (-32% and -28%) values. These deficits were reduced between IDTG compared with CONT (i.e. PT: -10%; VAL: -16%; and sEMG: -28%) or did not differ anymore (PTT and Mmax ). Normalising PT to thigh muscle volume and/or computing theoretical PT value overwhelm strength production differences between IDTG and CONT. Training background influences the outcomes with IDTG exhibiting greater PT, VAL, sEMG, Mmax and PTT than IDSG. CONCLUSIONS: Strength production deficit in IDSG was related to both muscular and neural characteristics compared with healthy controls whereas this deficit mainly arises from neural characteristics for IDTG.

Ovarian masses in pediatric patients: a multicenter study of 98 surgical cases in Tunisia.

Ovarian masses requiring surgical intervention are uncommon in the pediatric population. Our aim is to report results of a multicentric Tunisian study concerning the clinical practice and the management of pediatric ovarian masses and to identify the factors that are associated with ovarian preservation. Between January 2000 and December 2015, 98 pediatric patients (<14 years) were surgically treated for ovarian masses at the five pediatric surgery departments in Tunisia. Ninety-eight patients were included in this study. The mean age of the patients at time of surgery was 8.46 ± 4.87 years. Sixty-three ovarian masses (64.3%) were non-neoplastic lesions, 24 (24.5%) were benign tumors, and 11 (11.2%) were malignant neoplasms. Conservative surgery (ovarian-preserving surgery) was successfully performed in 72.4% of the benign lesions, whereas only three patients (27.3%) with malignant tumors underwent ovary-sparing tumor resection (p < .001). The mean diameter of the tumors in the patients who underwent oophorectomy was significantly larger than that in the patients who underwent conservative surgery (7.8 ± 3.9 cm vs. 5.7 ± 2.9 cm, respectively, p = .001). In our study, the risk factors for oophorectomy were a malignant pathology and large tumor size. In accordance with the Gynecologic Cancer Intergroup consensus, we recommend that surgical management of ovarian masses in children should be based on ovarian-preserving surgery.

Electrostimulation Training Effects on diurnal Fluctuations of Neuromuscular Performance.

This study examined the effects of electrostimulation (ES) strength training at the same time-of-day on the diurnal fluctuations of maximal voluntary isometric contractions (MVIC) and surface electromyography (EMG). 20 male performed 3 MVICs of knee extension coupled with surface EMG before and after 5 weeks of 3 ES training sessions per week. Each ES training session consisted in 45 isometric contractions. The participants were randomly assigned to either a morning (MTG, 07:00-08:00 h) or an evening (ETG, 17:00-18:00 h) training group. Both groups performed the evaluation tests at 07:00 and 17:00 h. Before ES training, MVIC was significantly higher in the evening compared to the morning for all groups, but there was no significant difference between groups for all EMG parameters. After the ES training, the diurnal variations in MVIC were blunted in the MTG and persisted in the ETG. Significant time-of-day effect was noticed for all EMG parameters but there was no group effect. The elimination of the diurnal fluctuations of MVIC and the appearance of EMG variations by training in the morning hours suggest that neural adaptations are the main source of temporal specificity of neuromuscular performance after ES strength training.

Effects of Ramadan Gasting on Postural Balance and Attentional Capacities in Elderly People.

OBJECTIVE: To evaluate the effects of Ramadan fasting on postural balance and attentional capacities in older adults. SETTING: the Neurophysiology department of a University Hospital. PARTICIPANTS: Fifteen males aged between 65 and 80 years were asked to perform a postural balance protocol and a simple reaction time (SRT) test in four testing phases: one week before Ramadan (BR), during the second (SWR) and the fourth week of Ramadan (FWR) and 3 weeks after Ramadan (AR). MEASUREMENTS: Postural balance measurements were recorded in the bipedal stance in four different conditions: firm surface/eyes open (EO), firm surface/eyes closed (EC), foam surface/EO and foam surface/EC using a force platform. RESULTS: Results of the present study demonstrated that center of pressure (CoP) mean velocity (CoPVm), medio-lateral length (CoPLX) and antero-posterior length (CoPLY) were significantly higher during the SWR than BR. Likewise, values of CoPVm and CoPLX increased significantly during the FWR compared to BR. The CoPLX decreased significantly in the FWR compared to the SWR. Values of CoPVm and CoPLX were significantly higher AR in comparison with BR. In addition, SRT values increased significantly during the SWR and the FWR than BR. CONCLUSION: Ramadan fasting affects postural balance and attentional capacities in the elderly mainly in the SWR and it may, therefore, increase the risk of fall and fall-related injuries. More than three weeks are needed for older adults to recover postural balance impairment due to Ramadan fasting.

Iatrogenic esophageal perforation in the neonate.

BACKGROUND: Esophageal perforation is uncommon and often iatrogenic. AIM: To report a neonatal case of esophageal perforation. CASE: A premature newborn boy was admitted with a diagnosis of oesophageal atresia after several unsuccessful attempts to insert an orogastric tube. A chest x-ray showed a "high pouch" with a gasless intestine. At operation, no atresia was found and a large traumatic perforation of the lower cervical segment was identified, requiring cervicotomy and primary closure. Oral feeding was started after 3 weeks. As a result, nosocomial sepsis occurred, causing death in the third month after surgical treatment. CONCLUSION: Oesophageal perforation in the neonate is often iatrogenic and may mimic oesophageal atresia. The authors highlight the importance of early diagnosis and management.

[Two cases of juvenile primary mediastinal hydatidosis]. / Hydatidose médiastinale primitive chez l'enfant: à propos de deux cas.

Hydatid cyst disease is still a significant clinical problem in endemic regions. The lungs and the liver are most often involved in the child. A mediastinal localisation is rare and represents 0.1 to 4% of all cases of hydatidosis. The authors reports on two cases and provides a review of the literature. In a retrospective review of the last 12 years, the authors treated two cases with a mediastinal localisation out of total of 235 intrathoracic hydatid cysts arising in 222 patients (0.85%). Two girls, one 12 and the other 13 years old, were admitted with a previous history of chest pain. The chest x-ray revealed an homogenous opacity of 150 mm in the first case and 50 mm in the second. Computed tomography in the second case revealed a cyst in the posterior mediastinum. The abdominal ultrasound was normal in both cases. The patients were approached through a posterolateral thoracotomy and the diagnosis was confirmed macroscopically. The cysts were intact and located on the left side of the posterior mediastinum. The operative field was isolated and protected with hypertonic saline solution. Hydatid fluid was aspirated, followed by the extraction of the hydatid membrane and subtotal excision of the residual cavity in both cases. The postoperative course was uneventful without any relapse or other organ involvement during four and three years, respectively. The authors notes that hydatidosis should be considered in the differential diagnosis of a mediastinal cyst mass. Because of the benign nature of the disease, they emphasize that surgical treatment must be conservative.

[Nasal angiocentric T cell-natural killer cell lymphoma with pancreatic localisation in a child]. / Lymphome N.K./T. nasal angiocentrique avec localisation pancréatique chez un enfant.

The nasal angiocentric T-cell-natural killer cell lymphoma is an aggressive tumor, exceptional in Tunisia, which is observed especially in Asia, Mexico and South America. We report the case of an 11-year-old boy, presenting with an exuberant and ulcerative tumor of the right nasal pit. Radiological investigation evidenced a right ethmoïdo-frontal tumor. Evolution was characterized by the installation of abdominal pain and fever, the evidenciation of a mass within the head of the pancreas that compressed the extra hepatic biliary duct and Wirsung's canal and was associated to hyperamylasemia. Biopsy under ultrasound revealed a histiocytic nature. Nasal biopsy found histiocytic and lymphocytic cells and led to a diagnosis of rhinoscleroma. The absence of improvement under antibiotic treatment and the development of fever with leuconeutropenia oriented towards the diagnosis of a non-Hodgkinian malignant lymphoma. Medullary biopsy and immunohistochimic study confirmed a T/NK cells lymphoma, with medullary invasion. The child died from acute respiratory distress syndrome. The authors insist on the rarity of this bipolar location, in particular in children, emphasize the difficulty of the diagnosis and review the literature.

[Medico-social prevention, fertility, and development]. / Prevention medico-sociale, fecondite et developpement.

PIP: The author reports on a sample survey of 738 Tunisians, conducted to investigate the impact of preventive and social medicine on health and fertility. The sample population, drawn from the 1975 census, is described. Attention is given to the role played by information sources, particularly mass media, in preventive medicine, alcoholism and the prevention of traffic accidents, and public opinion concerning preventive medicine. Attitudes toward family planning are mentioned in the final section, and a copy of the questionnaire used is included.^ieng

[The couple between union and breakup]. / Le couple entre l'union et la rupture

PIP: A general review of marriage patterns in Tunisia in the period since independence in 1956 is presented. Information is included on age at marriage and proportions married. An analysis of divorce trends by sex, rural or urban area, duration of marriage, and age at marriage is also provided.^ieng

[The Maghrib family between the economy and procreation]. / La famille maghrebine entre l'economie et la procreation

PIP: The author examines factors affecting fertility and family size in the North African context. Particular attention is given to the microeconomic factors affecting family size^ieng

[Demographic policy, education, and employment]. / Politique demographique, enseignement et emploi

PIP: This article examines whether fertility limitation in Tunisia would help to solve the problems of providing education and employment opportunities for the country's population. Recent economic and social tendencies in Tunisia suggest that rapid demographic growth does not necessarily impede socioeconomic development, particularly in education and employment. Calculations about future educational and employment needs do not take into consideration the effects of income generation and consumption changes spurred by demographic growth. The "rationing" of children to change the age structure envisioned by population planners would be faced with the need to consider all the different social groups in Tunisia and their complex motivations. Measures to discourage fertility disregard hundreds of years of Tunisian tradition. Tunisia's crude birth rate has decreased from 45.7/1000 in 1960 to 33.9/1000 in 1978, and its net reproduction rate had declined from 2.52 in 1960 to 2.34 in 1971. The rise in the median age at marriage between 1966 and 1974 resulted in some 23% fewer births. It is estimated that 313,240 births were averted through contraception from 1967-79, and by the year 2000 some half million births will have been averted. The structure of education in Tunisia may not be well suited to the development or employment needs of the country, and unemployment among school dropouts is high. It is obvious that decreasing the number of children in primary school will result in savings for the country, just as decreasing the number of people searching for work will help solve the unemployment problem. In the long run, however, such means by themselves do not attack the roots of the problem, for which a global policy of modernization is required.^ieng

[Demo-economic theory in Tunisia]. / La pensee demo-economique tunisienne

PIP: This is a brief overview of the population theory of Tunisia's 1st leader after independence, H. Bourguiba. Bourguiba believed in the Malthusian theory of economic development linked to an appropriate population growth; he was convinced of the power of the human will in changing the traditional sexual behavior of the Tunisian population, and in changing the traditional Tunisian institutions with the purpose of reaching a development in economic production and of limiting population growth. Economics and demography have their basis in political economy; the government has the right to intervene into the private lives of the citizens, through persuasion and not coercion, since birth regulation does not simply concern the welfare of the individual but of the whole country. Toward this goal not only birth control is permitted, but also abortion in certain cases and sexual sterilization. The ideal number of children for the Tunisian family would be 4 at most, and annual population growth should not exceed 3%. Social justice and redistribution of wealth would not be possible without first achieving such goals.^ieng

[Paramedics' attitudes towards family planning]. / Le corps paramedical face au planning familial.

PIP: Recognizing that paramedics are the key interface between national family planning objectives and a potential acceptor population, this article examines the importance and impact of ideas and attitudes which such personnel may transmit to potential users. The study interviewed a total of 394 family planning personnel, including midwives, male and female nurses, as well as paramedics, involved in a family planning program conducted by the Ministry of Public Health in Tunisia. The actual interviewing process was conducted in regional hospitals, centers and dispensaries, the majority of which were located in urban rather than rural environments. The interview questionnaire included 10 closed-ended questions, 12 open-ended inquiries and 13 multiple-choice questions. The investigation provided the following: with regard to knowledge of formal government regulations and laws, the paramedic body was greatly misinformed or ignorant of the existence of many regulations. Responses often indicated a refusal to investigate the availability of certain legal contraceptive measures. This attitude was perceived as counterproductive to the aims of making such personnel available to a population for a counseling function. A thorough understanding of the relationship between population growth and development was not expressed. Though 75% of the paramedic population interviewed practiced contraceptive methods, 25% openly stated they were not motivated to use contraceptives themselves. The IUD and abortion were chosen as the most widely accepted forms of contraception, vasectomy and contraceptive pills being the least popular. Although 83% of those interviewed perceived that family planning efforts could, in the course of 15 years, have an effect on ameliorating the standard of living and aiding national development, their attitudes are assessed as unfavorable and counterproductive. The article calls for better training and attitude formation for family planning personnel.^ieng