Colour opponency is widespread across the mouse subcortical visual system and differentially targets GABAergic and non-GABAergic neurons.

Colour vision plays many important roles in animal behaviour but the brain pathways processing colour remain surprisingly poorly understood, including in the most commonly used laboratory mammal, mice. Indeed, particular features of mouse retinal organisation present challenges in defining the mechanisms underlying colour vision in mice and have led to suggestions that this may substantially rely on 'non-classical' rod-cone opponency. By contrast, studies using mice with altered cone spectral sensitivity, to facilitate application of photoreceptor-selective stimuli, have revealed widespread cone-opponency across the subcortical visual system. To determine the extent to which such findings are truly reflective of wildtype mouse colour vision, and facilitate neural circuit mapping of colour-processing pathways using intersectional genetic approaches, we here establish and validate stimuli for selectively manipulating excitation of the native mouse S- and M-cone opsin classes. We then use these to confirm the widespread appearance of cone-opponency (> 25% of neurons) across the mouse visual thalamus and pretectum. We further extend these approaches to map the occurrence of colour-opponency across optogenetically identified GABAergic (GAD2-expressing) cells in key non-image forming visual centres (pretectum and intergeniculate leaflet/ventral lateral geniculate; IGL/vLGN). Strikingly, throughout, we find S-ON/M-OFF opponency is specifically enriched in non-GABAergic cells, with identified GABAergic cells in the IGL/VLGN entirely lacking this property. Collectively, therefore, we establish an important new approach for studying cone function in mice, confirming a surprisingly extensive appearance of cone-opponent processing in the mouse visual system and providing new insight into functional specialisation of the pathways processing such signals.

Caregivers' perspectives on health-related quality of life in young children with TB and respiratory illnesses.

BACKGROUND: There is a lack of holistic health-related quality of life (HRQoL) measures for young children with respiratory disease, especially in low- and middle-income countries (LMICs). We aimed to understand caregivers' perceptions of the relevance of common HRQoL domains for children with respiratory diseases, including TB. METHODS: This study was nested in a prospective observational cohort of children presenting with respiratory symptoms presumptive of pulmonary TB. We conducted 10 semi-structured interviews to explore caregivers' perceptions of the five commonly measured HRQoL domains: physical health, social support, emotional and psychological wellbeing, and schooling. We used case descriptive analysis and thematic coding. RESULTS: Caregivers considered all five domains to be relevant. The socio-economic context framed their responses, with QoL requiring sufficient basic resources for children. HRQoL experiences varied according to the severity of the child's symptoms, but not between TB and non-TB illnesses. Manifestations in the psychological domain were difficult to distinguish from the emotional domain. Social support included broad support for family members, indirectly benefiting the children. Caregivers were concerned about their children's early developmental milestones and future schooling. CONCLUSION: This exploratory study shows that HRQoL domains are relevant but require adaptation to be applicable for young children affected by respiratory illnesses living in LMICs.

CONTEXTE: Il existe un manque de mesures holistiques de la qualité de vie liée à la santé (HRQoL) pour les jeunes enfants atteints de maladies respiratoires, en particulier dans les pays à revenu faible ou intermédiaire (LMIC). Nous avons cherché à comprendre la perception qu'ont les soignants de la pertinence des domaines communs de la HRQoL pour les enfants atteints de maladies respiratoires, dont la TB. MÉTHODES: Cette étude était imbriquée dans une cohorte observationnelle prospective d'enfants présentant des symptômes respiratoires présomptifs de TB pulmonaire. Nous avons mené 10 entretiens semi-structurés pour explorer les perceptions des soignants sur les cinq domaines de la HRQoL communément mesurés : santé physique, soutien social, bien-être émotionnel et psychologique, et scolarité. Nous avons utilisé une analyse descriptive des cas et un codage thématique. RÉSULTATS: Les soignants considèrent que les cinq domaines sont pertinents. Le contexte socio-économique encadrait leurs réponses, la QoL nécessitant des ressources de base suffisantes pour les enfants. Les expériences de QoL variaient en fonction de la gravité des symptômes de l'enfant, mais pas entre les maladies TB et non TB. Les manifestations dans le domaine psychologique étaient difficiles à distinguer du domaine émotionnel. Le soutien social comprenait un large soutien aux membres de la famille, ce qui profitait indirectement aux enfants. Les soignants étaient préoccupés par les premiers stades de développement de leurs enfants et par leur future scolarité. CONCLUSION: Cette étude exploratoire montre que les domaines de la QoL sont pertinents mais nécessitent une adaptation pour être applicables aux jeunes enfants atteints de maladies respiratoires vivant dans les LMIC.

Commissural communication allows mouse intergeniculate leaflet and ventral lateral geniculate neurons to encode interocular differences in irradiance.

KEY POINTS: Unlike other visual thalamic regions, the intergeniculate leaflet and ventral lateral geniculate nucleus (IGL/vLGN) possess extensive reciprocal commissural connections, the functions of which are unknown. Using electrophysiological approaches, it is shown that commissural projecting IGL/vLGN cells are primarily activated by light increments to the contralateral eye while cells receiving commissural input typically exhibit antagonistic binocular responses. Across antagonistic cells, the nature of the commissural input (excitatory or inhibitory) corresponds to the presence of ipsilateral ON or OFF visual responses and in both cases antagonistic responses disappear following inactivation of the contralateral thalamus. The steady state firing rates of antagonistic cells uniquely encode interocular differences in irradiance. There is a pivotal role for IGL/vLGN commissural signalling in generating new sensory properties that are potentially useful for the proposed contributions of these nuclei to visuomotor/vestibular and circadian control. ABSTRACT: The intergeniculate leaflet and ventral lateral geniculate nucleus (IGL/vLGN) are portions of the visual thalamus implicated in circadian and visuomotor/vestibular control. A defining feature of IGL/vLGN organisation is the presence of extensive reciprocal commissural connections, the functions of which are at present unknown. Here we use a combination of multielectrode recording, electrical microstimulation, thalamic inactivation and a range of visual stimuli in mice to address this deficit. Our data indicate that, like most IGL/vLGN cells, those that project commissurally primarily convey contralateral ON visual signals while most IGL/vLGN neurons that receive this input exhibit antagonistic binocular responses (i.e. excitatory responses driven by one eye and inhibitory responses driven by the other), enabling them to encode interocular differences in irradiance. We also confirm that this property derives from commissural input since, following inactivation of the contralateral visual thalamus, these cells instead display monocular contralateral-driven ON responses. Our data thereby reveal a fundamental role for commissural signalling in generating new visual response properties at the level of the visual thalamus.

PROFICIENCY AT OBJECT CONTROL SKILLS BY NINE- TO TEN-YEAR-OLD CHILDREN IN SOUTH AFRICA: THE NW-CHILD STUDY.

Adequate proficiency at object control skills, which is influenced by biological and environmental constraints, underlies the development of more complex sport-specific skills. This study describes proficiency at six object control skills and demographic correlates associated with each skill and each skill criteria in 9- to 10-year-old children who were randomly selected from 20 schools (N=826) and tested with the Test of Gross Motor Development-2. Cross-tabulation and hierarchical linear models were used to analyze the effects of sex (433 boys, 393 girls), ethnicity (619 Black, 207 White), and high (n=312) and low (n= 514) socioeconomic school environments. Twenty-three percent of the sample showed below average proficiency. Significant sex and socioeconomic school environment differences were found favoring boys and children from higher socioeconomic environments, although kicking showed significant interaction effects. It is concluded that environmental opportunities are the primary cause of differences across skills and the rates at which the skills are learned.

Relationships between academic performance, SES school type and perceptual-motor skills in first grade South African learners: NW-CHILD study.

BACKGROUND: Perceptual-motor skills contribute to a variety of basic learning skills associated with normal academic success. This study aimed to determine the relationship between academic performance and perceptual-motor skills in first grade South African learners and whether low SES (socio-economic status) school type plays a role in such a relationship. METHODS: This cross-sectional study of the baseline measurements of the NW-CHILD longitudinal study included a stratified random sample of first grade learners (n = 812; 418 boys and 394 boys), with a mean age of 6.78 years ± 0.49 living in the North West Province (NW) of South Africa. The Beery-Buktenica Developmental Test of Visual-Motor Integration-4 (VMI) was used to assess visual-motor integration, visual perception and hand control while the Bruininks Oseretsky Test of Motor Proficiency, short form (BOT2-SF) assessed overall motor proficiency. Academic performance in math, reading and writing was assessed with the Mastery of Basic Learning Areas Questionnaire. Linear mixed models analysis was performed with spss to determine possible differences between the different VMI and BOT2-SF standard scores in different math, reading and writing mastery categories ranging from no mastery to outstanding mastery. A multinomial multilevel logistic regression analysis was performed to assess the relationship between a clustered score of academic performance and the different determinants. RESULTS: A strong relationship was established between academic performance and VMI, visual perception, hand control and motor proficiency with a significant relationship between a clustered academic performance score, visual-motor integration and visual perception. A negative association was established between low SES school types on academic performance, with a common perceptual motor foundation shared by all basic learning areas. CONCLUSION: Visual-motor integration, visual perception, hand control and motor proficiency are closely related to basic academic skills required in the first formal school year, especially among learners in low SES type schools.

Relationship between the body composition and motor and physical competence of Grade 1 learners in South Africa.

AIM: The objective of this study was to determine relationships between body composition and motor and physical competence of Grade 1 learners living in the North West Province of South Africa. METHODS: Data were collected by means of a stratified random sampling procedure from 816 Grade 1 learners (419 boys, 397 girls) with a mean age of 6.84 years (+ 0.39 SD), in the NW-CHILD-study. Height, weight, skinfolds (subscapular, triceps, calf) and waist circumference were measured. International cut-off values were used to classify the subjects in normal, overweight or obese categories. Motor and physical competence was measured by using the Bruiniks-Oseretsky Test of Motor Proficiency-2 SF and the Test of Gross Motor Development 2. RESULTS: One out of 10 learners were overweight or obese. Fine motor precision, balance, running speed and agility and strength correlated significantly with BMI with no clear relationships with object control skills and upper limb-coordination. CONCLUSION: A clear relationship was found between body composition and most of the motor and physical fitness competencies of Grade 1 learners. Intervention strategies to improve the body composition of overweight children and accompanying motor proficiency back logs and physical fitness deficiencies are recommended.

The effect of a multidisciplinary physical activity intervention on the body composition and physical fitness of obese children.

AIM: The aim was to determine the effect of a physical activity, diet, and behaviour modification intervention of 13 weeks, 3x per week for 60 minutes on the body composition and physical fitness of overweight and obese children. METHODS: A convenience sample of 37 subjects with a mean age of 11 years (±0.99) was used, where 20 subjects (13 girls; seven boys) took part in the intervention and 17 (11 girls; six boys) formed part of the control group. Body composition (height, body mass, skinfolds, circumferences, body fat percentage, and body mass index) and health-promoting physical fitness (cardiorespiratory endurance, flexibility, muscular strength, and muscular endurance) were analysed using the Fitnessgram and the Bruininks-Oseretsky Test of Motor Proficiency-II during baseline, after the intervention programme, and after a follow-up period of three months. RESULTS: The results showed statistical (P<0.05) and practical significant (d>0.2) improvement in the body composition of the group, after participation in the intervention, with a sustainable effect, three months later on body fat percentage and the subscapular skinfold. Muscular strength and flexibility improved significantly after the intervention, but with no sustainable effect. CONCLUSION: It is concluded that a multi-disciplinary obesity intervention can improve the body composition profile and the health-related physical fitness of young obese children, although the effect will not be sustainable without ongoing, controlled intervention.

The inhibition of monoamine oxidase by esomeprazole.

Virtual screening of a library of drugs has suggested that esomeprazole, the S-enantiomer of omeprazole, may possess binding affinities for the active sites of the monoamine oxidase (MAO) A and B enzymes. Based on this finding, the current study examines the MAO inhibitory properties of esomeprazole. Using recombinant human MAO-A and MAO-B, IC50 values for the inhibition of these enzymes by esomeprazole were experimentally determined. To examine the reversibility of MAO inhibition by esomeprazole, the recoveries of the enzymatic activities after dilution of the enzyme-inhibitor complexes were evaluated. In addition, reversibility of inhibition was also examined by measuring the recoveries of enzyme activities after dialysis of enzyme-inhibitor mixtures. Lineweaver-Burk plots were constructed to evaluate the mode of MAO inhibition and to measure Ki values. The results document that esomeprazole inhibits both MAO-A and MAO-B with IC50 values of 23 µM and 48 µM, respectively. The interactions of esomeprazole with MAO-A and MAO-B are reversible and most likely competitive with Ki values for the inhibition of the respective enzymes of 8.99 µM and 31.7 µM. Considering the available pharmacokinetic data and typical therapeutic doses of esomeprazole, these inhibitory potencies are unlikely to be of pharmacological relevance in humans. The MAO inhibitory effects of esomeprazole should however be taken into consideration when using this drug in animal experiments where higher doses are often administered.

Change over three years in adolescents' physical activity levels and patterns after a physical activity intervention: play study.

AIM: This study aimed to determine over a three-year period what the PA levels and patterns of adolescents will be after participating in a physical activity (PA) intervention. METHODS: African adolescents (158 boys, 211 girls, N.=309) from a disadvantaged environment in South Africa with a mean age of 14.9±1.4, boys and 14.3±1.4 girls) participated in the study as a PA intervention group (N.=282) and a control group (N.=87). Multi-level modelling (repeated measures analysis of covariance (ANCOVA) adjusted for attendance percentage and gender to compare the intervention and control groups and repeated measures analysis of variance (ANOVA) over time, with a Bonferroni post hoc test were used to determine how the variables differ across the various testing opportunities. Week and weekend PA levels and patterns were analysed separately. RESULTS: Similar mean PA levels were found among the boys during week and weekend baseline measurements, with a significantly higher mean PA-level after three years in the intervention group. Baseline measurements for girls indicated statistically significant mean differences during the week and the weekend, although these mean differences were not significant during the end measurements. Boys and girls (excluding the intervention group of boys), showed a tendency of declining mean PA over the three years. The PA intervention showed a stabilising effect on PA levels and contributed to more active choices among the intervention group of boys, especially during weekends. CONCLUSION: Participation in similar PA interventions is recommended for adolescent boys, with adaptation to the content for girls.

A qualitative Exploration of Resilience in Pre-Adolescent AIDS Orphans Living in a Residential Care Facility

This article presents the findings of a study among a small group of South African AIDS orphans living in a residential care facility; Lebone Land. The research was conducted between June and September 2006. A qualitative; exploratory study consisting of in-depth; semistructured interviews with eight children and seven key informants aimed to identify and investigate developmental assets operating in the children's lives to help them cope amid exposure to adversities. The findings indicate that the developmental assets that facilitate coping and foster resilience in these children relate to four main components: external stressors and challenges; external supports; inner strengths and interpersonal and problem-solving skills. Emerging key themes relate to the experience of illness; death; poverty and violence; as well as the important roles of morality; social values; resistance skills; religion and faith in assisting these children in defining their purpose in life. To this end; constructive use of time; commitment to learning; goal-setting; problem-solving ability and self-efficacy are fundamental in the children's attainment of their future projections. Therefore; qualities such as optimism; perseverance and hope seem to permeate the children's process of recovery. Strong networks of support; particularly friendships with other children; also seem to contribute to developing and sustaining resilience

Physical Activity Levels and Energy Expenditure of 9-Year-Old - 12-Year-Old Overweight and Obese Children

The high occurrence of overweight and obesity amongst children is a disturbing health problem worldwide. Possible causes of increasing childhood obesity are inactivity and energy imbalances. The aim of this study was to analyse the total energy expenditure (TEE) and physical activity levels in 9-year-old - 12-year-old overweight and obese children during a weekday and a weekend day; as well as during a weekday morning and afternoon. Twenty-four 9-year-old - 12-year-old children (seven boys and 17 girls); of whom nine were overweight and 15 were obese; were selected from seven public primary schools for this study. Body mass index (BMI) cut-off points were used to distinguish between overweight and obese. Each participant wore an ACTICALT monitor to determine their physical activity levels and TEE. It was found that the TEE of the children did not differ between a week day and a weekend day; although the TEE of the week day afternoon differed significantly from that of the weekday morning. Unlike the overweight children; none of the obese children met the requirements of 60 minutes of moderate-intensity physical activity per day. Strategies should be found to increase the activity levels of overweight and; especially; obese children; specifically during the mornings and over weekends

Comparing two tensioning suture sizes for 360 degrees viscocanalostomy (canaloplasty): a randomised controlled trial.

PURPOSE: To compare the safety and efficacy of two polypropylene (Prolene) sutures for tensioning of the inner wall of Schlemm's canal (SC) in black African patients with primary open-angle glaucoma (POAG) undergoing canaloplasty. METHODS: In a prospective randomised trial of 90 patients, canaloplasty was performed with a flexible microcatheter (iTrack-250A) and sodium hyaluronidate 1.4% (Healon GV). After complete circumferential dilatation of the SC, a Prolene suture, either 6-0 Prolene (group 1) or 10-0 Prolene (group 2), was retracted through the SC and tightened leaving tension on the canal and trabecular meshwork. Nd:YAG laser goniopuncture was not performed postoperatively. RESULTS: The mean preoperative intraocular pressure (IOP) was 42.7 mm Hg+/-12.5 (SD) in group 1 and 45.0 mm Hg+/-12.1 (SD) in group 2 (P=0.70). The mean postoperative IOP without medications was 18.4 mm Hg+/-7.1 (SD) in group 1 and 16.4 mm Hg+/-6.6 (SD) in group 2 at 1 month (P=0.10), 19.2 mm Hg+/-6.4 (SD) in group 1 and 16.4 mm Hg+/-4.9 (SD) at 15 months (P=0.04). Pressures equal or less than 21, 18, and 16 mm Hg without medications (complete success) at 12 months were 51.0% (95% confidence interval (CI) 0.35-0.73), 34.1% (95% CI 0.21-0.56), and 21.2% (95% CI 0.11-0.42) in group 1, and 76.9% (95% CI 0.62-0.96), 68.8% (95% CI 0.54-0.89), and 53.6% (95% CI 0.38-0.76) in group 2, respectively. In the Cox regression analysis, IOP<18 mm Hg without medications depended significantly on the type of Prolene (hazard ratio (HR) 2.60, 95% CI 1.24-5.46, P=0.01) and age (HR 1.3, 95% CI 1.03-1.86, P=0.03), but not on preoperative IOP (HR 1.01, 95% CI 0.99-1.04, P=0.16) and gender (HR 0.67, 95% CI 0.34-1.33, P=0.26). No filtering bleb was observed. Intra- and postoperative complications were similarly rare in the two groups and included partial 'cheese-wiring' (2), Descemet's rupture (2), and hyphaema (3). CONCLUSIONS: In this clinical trial, IOP reduction was substantial in canaloplasty and slightly greater in combination with 10-0 Prolene than 6-0 Prolene sutures at an equally low complication rate. Younger age, but not the level of IOP at surgery, had a positive effect on the amount of IOP reduction, thus suggesting that an early surgical intervention to re-establish physiological outflow offers the best prognosis.

Relationships between Overweight; Obesity and Physical Fitness of Nine- 12-Year-Old South African Children

Background: South African children show the same tendencies in overweight and obesity as children in developed countries a decade ago. Childhood overweight is associated with chronic diseases; early mortality in adulthood and psycho-social effects with lifelong consequences. This study aimed to determine relationships between overweight; obesity and physical fitness of nine- to twelve-year-old South African children. Methods: Anthropometric (body-mass index [BMI]; fat percentage) and physical fitness (cardiovascular endurance; body composition; muscle strength; muscle endurance; flexibility) measurements were obtained from 280 children aged nine to twelve years (128 boys; 152 girls) using the Fitnessgram and Bruininks-Oseretsky Test of Motor Proficiency II. International cut-off points were used to categorise children into normal-weight; overweight or obese categories. Data were analysed using descriptive statistics; Spearman rank order correlation and variance of analysis. Results: One in five children was overweight or obese; while girls were twice as likely as boys to be obese. Aerobic capacity and muscle strength; especially leg strength; decreased progressively with an increase in BMI. A progressive but nonsignificant decline was found in muscle endurance with increasing BMI; while flexibility showed the poorest relationships with various degrees of weight. Variance of analysis indicated significant relationships between BMI; cardiovascular endurance and strength (p 0.05); while different relationships were found when gender was taken into consideration. Conclusions: Health-enhancing physical fitness of young children is negatively affected by overweight and obesity; and intervention strategies are recommended to improve the quality of life of such childre;n but also to prevent early mortality during adulthood

Channelography: imaging of the aqueous outflow pathway with flexible microcatheter and fluorescein in canaloplasty.

BACKGROUND: The aim of this study is to present a new approach to visualize the aqueous outflow system during glaucoma surgery using a flexible microcatheter and fluorescein, called channelography. PATIENTS AND METHODS: Schlemm's canal was unroofed in a standard non-penetrating dissection technique in patients undergoing canaloplasty. A flexible microcatheter (iTrack 250A) was introduced into the canal and advanced 360 degrees . Fluorescein sodium tracer was injected through the microcatheter during cannulation and the aqueous outflow pathway was video-recorded and evaluated. RESULTS: In the early phases, episcleral veins which were thinner, branched and fairly straight originating from the limbus could clearly be distinguished from ciliary veins which were thicker, tortuous vessels leaving posterior to the limbus. The filling quality of the episcleral veins varied among glaucoma patients. The permeability of the trabecular meshwork/inner wall of Schlemm's canal determined by fluorescein diffusion into the anterior chamber differed in this regard as well. In the late phases, the sclera stained with fluorescein, and no details were detectable. CONCLUSIONS: This qualitative in-vivo method was simple, safe, and enabled us to visualize the details of the aqueous outflow system during canaloplasty. Filling characteristics of episcleral venous network as well as trans-trabecular diffusion may reflect the clinical status of the outflow pathway in glaucoma patients, and may be helpful in the prediction of the surgical outcome in canaloplasty.

Capsular opacification after vitreous-sparing cataract surgery in children.

BACKGROUND: The aim of this study was to evaluate different methods of intraocular lens (IOL) implantation and posterior capsule management in the absence of vitrectomy with respect to visual axis opacification (VAO) in children. PATIENTS AND METHODS: Seventy-three eyes of African children undergoing cataract extraction and IOL implantation between 1998 and 2001 were evaluated. In all eyes, the IOL haptics were placed in the bag and the vitreous was preserved. The IOL optic and posterior capsule were managed in the following 3 ways: The IOL optic was captured behind the posterior capsule in conjunction with posterior capsulotomy (PC) in 47 eyes (group 1). The IOL optic was implanted in the bag with PC in 14 eyes (group 2) and without PC in 12 eyes (group 3). Cox proportional hazard analysis and Kaplan-Meier survival curves were performed to evaluate the incidence of Elschnig pearls (EP) and VAO. RESULTS: Elschnig pearls developed in 14.9 % of the patients in group 1, in 56.8 % in group 2 and in 91.7 % in group 3. The occurrence of EP depended significantly on optic capture (p < 0.001) and child's age (p < 0.05), but not on PC (p = 0.084) and eye side (p = 0.1). The persistence of visual axis clarity depended significantly on optic capture (p < 0.001) but not on PC. CONCLUSIONS: In vitreous-sparing cataract surgery, posterior capsule opening does not effectively prevent VAO unless it is in conjunction with IOL optic capture.

The effect of different intervention programmes on the self-concept and motor proficiency of 7- to 9-year-old children with DCD.

BACKGROUND: The self-concept of children is influenced by developmental co-ordination disorder (DCD). The aim was to determine the most effective method in enhancing motor proficiency and self-concept of 7- to 9-year-old children with DCD. METHODS: Teachers at nine different schools identified 201 possible DCD candidates. The Movement Assessment Battery for Children identified 58 with DCD (36 boys and 22 girls). Self-concept and anxiety were determined by the Tennessee Self-Concept Scale (Child Form) and Child Anxiety Scale respectively. The children were randomly grouped into four experimental groups [motor intervention (MI), self-concept (SC) enhancing intervention, psycho-motor intervention (P-MI) and a control group (CG)]. A two-way analysis of variance (anova) with a group factor and a repeated measures over time followed by a Bonferroni post hoc analysis and separate one-way anovas followed by a Tukey post hoc analysis were conducted to determine between-group and within-group differences at the pre-, post- and re-tests. Effect sizes (d) were calculated to determine the practical significance of statistical differences (P < 0.05). RESULTS: After completion of the intervention programmes, no significant improvement in motor proficiency was found in the SC group, while the MI, P-MI and CG groups improved significantly (P < 0.01). No further improvements were found after the retention period in all the groups. From the pre-test to retest 2, the MI, P-MI and CG improved (P < 0.01), while the SC showed lower (P > 0.05) motor proficiency. A tendency of lower anxiety (P > 0.05) was found in the SC, while the total self-concept of the P-MI showed the biggest improvement (P < 0.05). CONCLUSION: Motor proficiency and self-concept of children with DCD benefit from intervention, but both should be addressed for optimal benefits.

Habitual physical activity and body composition of black township adolescents residing in the North West Province, South Africa.

OBJECTIVE: It is known that stunting and obesity affect a large proportion of children in the world, and these can be affected by the physical activity levels of the children. In the present study, we evaluated the association between physical activity, physical development and body composition in black adolescent children. DESIGN: Cross-sectional study. SETTING: Black township schools in the North West Province, South Africa. METHODS: Three-hundred and thirteen grade 8 children were included in the Physical Activity in Youth study. Anthropometric measurements, body composition measures and maturity level as assessed by Tanner stages were determined in these children. In addition, Previous Day Physical Activity Recall questionnaires were administered on the children to record the various activities they undertake daily. RESULTS: The demographic characteristics of the children showed a high level of homogeneity. A high prevalence of stunting (16.3%) was observed in the children, which was higher in boys than in girls (21.6 vs. 12.3%). Also prevalent was overweight/obesity (8.6%), but this was higher in girls than in boys (13.4 vs. 1.6%). The children also showed a reduction in levels of physical activity with advancement in maturity; furthermore, boys showed a more central form of fat deposition whilst girls showed more gynoid deposition. CONCLUSIONS: The study revealed that physical activity plays a role in determining body composition, and further indicated that physical activity is associated with favourable body composition measures. Children who were more active were likely to have less fat deposits.

Ovarian torsion in a premenarcheal girl: MRI findings.

Adnexal torsion is an uncommon cause of severe lower abdominal pain in women and is often difficult to distinguish from other acute abdominal conditions. However, adnexal torsion should be considered in premenarcheal girls admitted with acute abdominal pain and evidence of an ovarian mass. Accurate and early radiological diagnosis is mandatory immediately after onset of clinical symptoms in order to preserve the viability of the ovary. Ultrasound (US) is usually the first line examination performed in an emergency setting, but computed tomography (CT) and magnetic resonance imaging (MRI) can be useful in case of ambiguous US findings, especially in patients with sub-acute symptoms and a suspected adnexal mass. This case report describes the additional value of MRI in a premenarcheal girl with sub-acute right fossa pain.

Body composition and physical fitness of undernourished South African rural primary school children.

OBJECTIVE: The purpose of this study was to determine the relationships between the body composition characteristics, body mass index (BMI), sum of skinfolds (SSF), % body fat (%BF), fat-free mass (FFM) and waist-to-hip ratio (WHR), and nine physical fitness items in undernourished rural primary school children in Ellisras, South Africa. DESIGN: A cross-sectional study. SETTING: The study consisted of 462 boys and 393 girls who were aged 7-14 y. MEASUREMENTS: Five body composition measures were assessed: BMI, SSF, %BF, FFM and WHR. Nine physical fitness test items were assessed: standing long jump, bent arm hang, sit-ups, 10 x 5 m shuttle run, 50 m sprint, 1600 m run, flamingo balance, sit and reach, plate tapping. RESULTS: BMI was highly correlated with FFM (r = 0.7, P < 0.001). In line with findings from Western countries, regression coefficients (B) showed that children with higher BMI or SSF performed worse in bent arm hang (girls, B = -0.84, P < 0.001, and B = -0.06, P = 0.02, respectively) and in 1600m run (B = 6.68, P < 0.001). BMI was significantly associated with flamingo balance (B = 0.26, P = 0.04). WHR was positively associated with bent arm hang (B = 9.37, P = 0.03), and inversely with sit and reach (B = -7.48, P = 0.01). In contrast, significant relationships were found between BMI and standing long jump (B = 0.74, P = 0.04), sit and reach (B = 0.51, P < 0.001), flamingo balance (B = 0.26, P = 0.04) and plate tapping (B = -19, P = 0.01). SSF was significantly associated with sit and reach (B = 0.04, P = 0.03). Significant inverse associations were found between FFM and bent arm hang (girls, B = -0.06, P = 0.05), 1600 m run (girls, B = -2.33, P = 0.003) and 50 m run (boys, B = -0.11, P = 0.006). FFM was significantly associated with standing long jump (boys, B = 0.99, P < 0.001; girls, B = 0.73, P < 0.001), flamingo balance (B = 0.17, P < 0.001), and with sit and reach (boys, B = 0.59, P = 0.03). CONCLUSION: In the present study in undernourished children, body composition was significantly related to physical fitness, but not always in the expected direction. It is therefore important to note that in this population, BMI should not be interpreted as a measure of fatness/overweight, but rather as an indicator of muscle mass.

Viscocanalostomy for open-angle glaucoma in black African patients.

PURPOSE: To study the clinical effectiveness of viscocanalostomy in a population of black African patients with open-angle glaucoma that was uncontrolled on medical treatment. SETTING: Department of Ophthalmology, Medical University of Southern Africa, Medunsa, South Africa. METHODS: In this prospective study viscocanalostomy was performed in 214 eyes of 157 black African patients with open-angle glaucoma that was poorly controlled by medical therapy. The procedure involves the production of superficial and deep scleral flaps. The deep flap is disserted to the plane of Schlemm's canal. From this plane, an intact window in Descemet's membrane is created by gentle pressure at the level of Schwalbe's line using a cellulose sponge. Aqueous humor diffuses through this window into a subscleral space (lake). Reflection of the inner flap unroofs Schlemm's canal, creating a trough leading to 2 entrances into Schlemm's canal (surgical ostia). A delicate cannula is introduced into the entrance of Schlemm's canal left and right and high-viscosity sodium hyaluronate is gently injected into the canal for 4 to 6 mm. The deeper scleral flap is excised (deep sclerectomy) and the superficial flap is sutured securely using 5, 11-0 polyester fiber (Mersilene) sutures. High-viscosity sodium hyaluronate is then injected into the subscleral lake to act as a physical barrier to fibrinogen migration postoperatively. RESULTS: Postoperative intraocular pressure (IOP) of 22 mm Hg or less was achieved without medical therapy in 82.7% of eyes. If a beta blocker was added to the cases not achieving 22 mm Hg or less postoperatively, the success rate increased to 89.0%. The average follow-up was 35 months (range 6 to 64 months). CONCLUSION: Viscocanalostomy produced an encouraging long-term reduction in the IOP of black African patients with glaucoma who would otherwise have had a poor prognosis.