Motor coordination among Greek children: from assessment to intervention

A Thesis submitted in partial fulfilment of the requirements of the University of Wolverhampton for the degree of Doctor of PhilosophyBackground: Developmental Coordination Disorder (DCD) describes children with a difficulty to acquire age-specific motor skills. Although there is a significant body of literature addressing developmental and cognitive issues in children with DCD, few studies have actually examined the associations between DCD, physical activity and physical fitness. Therefore, the aim of the present research work was to assess these associations in a series of four successive studies which were set: a) (study 1) to estimate DCD prevalence rates in Greek children and investigate whether these children exhibit different obesity and cardiorespiratory fitness levels than an overseas sample, b) (study 2) to provide evidence on the association between DCD and physical fitness levels, c) (study 3) examine whether a motor skills and exercise training intervention programme affects motor proficiency in a cohort of elementary school children with and without DCD, and d) (study 4) to test the hypothesis that DCD is associated with CVD risk, identify modes of physical activity that mediate such an association and to evaluate the CSAPPA scale as a potential tool for identifying Greek children for DCD. Methods: The total of 574 Greek (Age: 11.46 ± 1.54 years; BMI: 19.96 ± 3.53) children were assessed for anthropometry, physical fitness (flexibility, hand strength, leg explosive power, speed and cardiorespiratory fitness), motor competence (i.e., short form of the Bruininks-Oseretsky Test of Motor Profiency- BOTMP-sf) and subjected to two self assessments for: i) perception of adequacy for physical activity (CSAPPA scale), and ii) children’s participation in physical activity (Participation Questionnaire - PQ). Results: Study 1: Greek children demonstrated significantly higher DCD prevalence rates (p<0.05), higher body fat (p<0.05) and were inferior in both cardiorespiratory fitness (p<0.05) and motor competence (p<0.05) compared to an overseas sample. Study 2: Greek children with DCD demonstrated significantly higher BMI values (p<0.01) and lower leg explosive power (p<0.01), speed (p<0.01) and hand strength (p<0.01) than those without DCD. Study 3: Results showed a significant main effect of time [F(14, 115) = 3.79, p< 0.001; η2 = 0.32] for motor competence (p<0.001) between children with and without DCD. Significant main effects of group (i.e intervention and control groups) [F(42, 351) = 4.01, p< 0.001; η2 = 0.33] were observed for BMI (p<0.01), motor competence (p<0.01), cardiorespiratory fitness (p<0.01), hand strength (p<0.05), leg explosive power (p<0.05), speed (p<0.01), and free time play activities (p<0.05). Study 4: Chi-square comparisons and ANOVA, revealed significantly increased body mass (p<0.05), BMI (p<0.05) and inactivity (p<0.05), as well as significantly decreased cardiorespiratory fitness (p<0.05), motor competence (p<0.05), CSAPPA indices, and participation in free play (p<0.05) in children with DCD. Furthermore, BMI and cardiorespiratory fitness were significantly associated with motor competence (p<0.05) with inactivity as the mediating factor (p<0.05). ROC curve analyses for CSAPPA indicated an optimal cut-off at 62 points. Conclusions: 1) the relatively high DCD and obesity prevalence rates together with the low cardiorespiratory fitness suggest greater health risk for Greek children with the studied condition, 2) children with DCD tend to perform worse in selected physical fitness parameters compared to their normal peers, 3) motor skills and exercise training interventions for children with DCD may improve health and skills related fitness, and 4) inactivity mediates the relationship between DCD and CVD risk in children with DCD. Finally, the CSAPPA scale may serve as a practical and a cost-effective proxy assessment for identifying Greek children with DCD, however as this is not a standardised test for use with children, its use should be treated with caution until further validation work

Peripheral Mononuclear Cell Resistin mRNA Expression Is Increased in Type 2 Diabetic Women

Resistin has been shown to cause insulin resistance and to impair glucose tolerance in rodents, but in humans its physiological role still remains elusive. The aim of this study was to examine whether resistin mRNA expression in human peripheral mononuclear cells (PBMCs) and its corresponding plasma levels are altered in type 2 diabetes. Resistin mRNA levels were easily detectable in human PBMC, and found to be higher in DM2 compared to healthy women (P = .05). Similarly, mononuclear mRNA levels of the proinflammatory cytokines IL-1β, TNF-α, and IL-6 were all significantly higher in DM2 compared to control women (P < .001). The corresponding plasma resistin levels were slightly, but not significantly, increased in DM2 women (P = .051), and overall, they correlated significantly with BMI (r = 0.406, P = .010) and waist circumference (r = 0.516, P = .003), but not with fasting insulin levels or HOMA-IR. Resistin mRNA expression is increased in PBMC from DM2 women, together with increased expression of the inflammatory cytokines IL-1β, TNF-α, and IL-6, independent of obesity. These results suggest that resistin and cytokines might contribute to the low-grade inflammation and the increased atherogenic risk observed in these patients

Motor coordination among Greek children : from assessment to intervention

Background: Developmental Coordination Disorder (DCD) describes children with a difficulty to acquire age-specific motor skills. Although there is a significant body of literature addressing developmental and cognitive issues in children with DCD, few studies have actually examined the associations between DCD, physical activity and physical fitness. Therefore, the aim of the present research work was to assess these associations in a series of four successive studies which were set: a) (study 1) to estimate DCD prevalence rates in Greek children and investigate whether these children exhibit different obesity and cardiorespiratory fitness levels than an overseas sample, b) (study 2) to provide evidence on the association between DCD and physical fitness levels, c) (study 3) examine whether a motor skills and exercise training intervention programme affects motor proficiency in a cohort of elementary school children with and without DCD, and d) (study 4) to test the hypothesis that DCD is associated with CVD risk, identify modes of physical activity that mediate such an association and to evaluate the CSAPPA scale as a potential tool for identifying Greek children for DCD. Methods: The total of 574 Greek (Age: 11.46 ± 1.54 years; BMI: 19.96 ± 3.53) children were assessed for anthropometry, physical fitness (flexibility, hand strength, leg explosive power, speed and cardiorespiratory fitness), motor competence (i.e., short form of the Bruininks-Oseretsky Test of Motor Profiency- BOTMP-sf) and subjected to two self assessments for: i) perception of adequacy for physical activity (CSAPPA scale), and ii) children’s participation in physical activity (Participation Questionnaire - PQ). Results: Study 1: Greek children demonstrated significantly higher DCD prevalence rates (p<0.05), higher body fat (p<0.05) and were inferior in both cardiorespiratory fitness (p<0.05) and motor competence (p<0.05) compared to an overseas sample. Study 2: Greek children with DCD demonstrated significantly higher BMI values (p<0.01) and lower leg explosive power (p<0.01), speed (p<0.01) and hand strength (p<0.01) than those without DCD. Study 3: Results showed a significant main effect of time [F(14, 115) = 3.79, p< 0.001; η2 = 0.32] for motor competence (p<0.001) between children with and without DCD. Significant main effects of group (i.e intervention and control groups) [F(42, 351) = 4.01, p< 0.001; η2 = 0.33] were observed for BMI (p<0.01), motor competence (p<0.01), cardiorespiratory fitness (p<0.01), hand strength (p<0.05), leg explosive power (p<0.05), speed (p<0.01), and free time play activities (p<0.05). Study 4: Chi-square comparisons and ANOVA, revealed significantly increased body mass (p<0.05), BMI (p<0.05) and inactivity (p<0.05), as well as significantly decreased cardiorespiratory fitness (p<0.05), motor competence (p<0.05), CSAPPA indices, and participation in free play (p<0.05) in children with DCD. Furthermore, BMI and cardiorespiratory fitness were significantly associated with motor competence (p<0.05) with inactivity as the mediating factor (p<0.05). ROC curve analyses for CSAPPA indicated an optimal cut-off at 62 points. Conclusions: 1) the relatively high DCD and obesity prevalence rates together with the low cardiorespiratory fitness suggest greater health risk for Greek children with the studied condition, 2) children with DCD tend to perform worse in selected physical fitness parameters compared to their normal peers, 3) motor skills and exercise training interventions for children with DCD may improve health and skills related fitness, and 4) inactivity mediates the relationship between DCD and CVD risk in children with DCD. Finally, the CSAPPA scale may serve as a practical and a cost-effective proxy assessment for identifying Greek children with DCD, however as this is not a standardised test for use with children, its use should be treated with caution until further validation work.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Adiponectin levels and expression of adiponectin receptors in isolated monocytes from overweight patients with coronary artery disease

Abstract Background Adiponectin has insulin-sensitizing and anti-atherosclerotic effects, partly mediated through its action on monocytes. We aimed to determine adiponectin levels and expression of its receptors (AdipoR1 and AdipoR2) in peripheral monocytes from overweight and obese patients with coronary artery disease (CAD). Methods Fifty-five overweight/obese patients, suspected for CAD, underwent coronary angiography: 31 were classified as CAD patients (stenosis ≥ 50% in at least one main vessel) and 24 as nonCAD. Quantitative RT-PCR and flow cytometry were used for determining mRNA and protein surface expression of adiponectin receptors in peripheral monocytes. A high sensitivity multiplex assay (xMAP technology) was used for the determination of plasma adiponectin and interleukin-10 (IL-10) secreted levels. Results Plasma adiponectin levels were decreased in CAD compared to nonCAD patients (10.9 ± 3.1 vs. 13.8 ± 5.8 μg/ml respectively, p = 0.033). In multivariable analysis, Matsuda index was the sole independent determinant of adiponectin levels. AdipoR1 and AdipoR2 protein levels were decreased in monocytes from CAD compared to nonCAD patients (59.5 ± 24.9 vs. 80 ± 46 and 70.7 ± 39 vs. 95.6 ± 47.8 Mean Fluorescence Intensity Arbitrary Units respectively, p &lt; 0.05). No significant differences were observed concerning the mRNA levels of the adiponectin receptors between CAD and nonCAD patients. AdipoR2 protein levels were positively correlated with plasma adiponectin and Matsuda index (r = 0.36 and 0.31 respectively, p &lt; 0.05 for both). Furthermore, basal as well as adiponectin-induced IL-10 release was reduced in monocyte-derived macrophages from CAD compared to nonCAD subjects. Conclusions Overweight patients with CAD compared to those without CAD, had decreased plasma adiponectin levels, as well as decreased surface expression of adiponectin receptors in peripheral monocytes. This fact together with the reduced adiponectin-induced IL-10 secretion from CAD macrophages could explain to a certain extent, an impaired atheroprotective action of adiponectin. </jats:sec

Photodynamic Therapy for Juxtapapillary Retinal Capillary Hemangioma

Various treatment modalities have been described for retinal capillary hemangioma. Our purpose is to present a case of juxtapapillary retinal capillary hemangioma treated with photodynamic therapy. A 69-year-old woman with no previous ocular history presented with blurred vision and photopsias in the right eye three months ago. At presentation, her best corrected visual acuity was 6/9 in the right eye and 6/6 in the left eye. The anterior segment was totally normal and IOP was normal in both eyes as well. Dilated fundoscopy revealed a yellowish, well-circumscribed, elevated area with blood vessels, on the inferior margin of the right optic disc, as optic disc edema. Fluorescein angiography and angiogram with indocyanine green confirmed the diagnosis of juxtapapillary retinal capillary hemangioma. The patient was treated with photodynamic therapy with verteporfin and three months later her visual acuity was 6/7.5 in the right eye, while the lesion was slightly smaller. These findings remained stable at the one-year follow-up. In conclusion, photodynamic therapy offers promising anatomical and functional results for juxtapapillary retinal capillary hemangioma, providing visual acuity improvement or even stabilization and restriction of enlargement of the lesion

Integrated analysis environment for the Movement Assessment Battery for Children

Developmental Coordination Disorder (DCD), a chronic and usually permanent condition found in children, is characterized by motor impairment that interferes with a child's activities of daily living and with academic achievement. One of the most popular tests for the quantitative diagnosis of DCD is the Movement Assessment Battery for Children (MABC). Based on the Battery's standardized scores, it is possible to identify children with typical development, children at risk of developing DCD, and children with DCD. This article describes a computational system we developed to assist with the analysis of results obtained in the MABC test. The tool was developed for the web environment and its database provides integration of MABC data. Thus, researchers around the world can share data and develop collaborative work in the DCD field. In order to help analysis processes, our system provides services for filtering data to show more specific sets of information and present the results in textual, table, and graphic formats, allowing easier and more comprehensive evaluation of the results.O Transtorno do Desenvolvimento da Coordenação (TDC), uma condição crônica e, geralmente, encontrada em crianças, é caracterizado por comprometimento motor que interfere nas atividades de vida diária de uma criança e em seu desempenho acadêmico. Um dos testes mais populares para o diagnóstico quantitativo do TDC é a bateria Movement Assessment Battery for Children (MABC). Com base em escores padronizados da bateria, é possível identificar as crianças com desenvolvimento típico, crianças com risco de desenvolver o TDC e crianças com TDC. Este artigo descreve um sistema computacional que desenvolvemos para ajudar com a análise dos resultados obtidos na bateria MABC. A ferramenta foi desenvolvida para o ambiente web e sua base de dados fornece integração dos dados da MABC. Assim, pesquisadores de todo o mundo podem compartilhar dados e desenvolver trabalho colaborativo na área do TDC. A fim de ajudar os processos de análise, nosso sistema fornece serviços de filtragem de dados para mostrar conjuntos mais específicos de informação e apresentar os resultados em formato de texto, tabela e gráficos, permitindo a avaliação mais fácil e mais abrangente dos resultados.Sao Paulo State Univ Rio Claro, Rio Claro, SP, BrazilSao Paulo State Univ Rio Claro, Rio Claro, SP, Brazi

Oxytocin and Psychological Factors Affecting Type 2 Diabetes Mellitus

Background. The aim of this study was to investigate the association of oxytocin with trait and state psychological factors in type 2 diabetic patients.Methods. OXT and psychological variables were analyzed from 86 controlled diabetic patients (glycosylated haemoglobin A1c (HbA1c) &lt; 7%) from 45 uncontrolled diabetic patients (HbA1c ≥ 7). Psychological characteristics were assessed with the Eysenck Personality Questionnaire (EPQ), while state psychological characteristics were measured with the Symptom Checklist 90-R (SCL 90-R). Blood samples were taken for measuring oxytocin in both subgroups during the initial phase of the study. One year later, the uncontrolled diabetic patients were reevaluated with the use of the same psychometric instruments.Results. During the first evaluation of the uncontrolled diabetic patients, a statistically significant positive relationship between the levels of OXT and psychoticism in EPQ rating scale (P&lt;0.013) was observed. For controlled diabetic patients, a statistically significant negative relationship between oxytocin and somatization (P&lt;0.030), as well as obsessive-compulsive scores (P&lt;0.047) in SCL-90 rating scale, was observed. During the second assessment, the values of OXT decreased when the patients managed to control their metabolic profile.Conclusions. The OXT is in association with psychoticism, somatization, and obsessionality may be implicated in T2DM.</jats:p

Connection between Telomerase Activity in PBMC and Markers of Inflammation and Endothelial Dysfunction in Patients with Metabolic Syndrome

Metabolic syndrome (MS) is a constellation of metabolic derangements associated with vascular endothelial dysfunction and oxidative stress and is widely regarded as an inflammatory condition, accompanied by an increased risk for cardiovascular disease. The present study tried to investigate the implications of telomerase activity with inflammation and impaired endothelial function in patients with metabolic syndrome. Telomerase activity in circulating peripheral blood mononuclear cells (PBMC), TNF-α, IL-6 and ADMA were monitored in 39 patients with MS and 20 age and sex-matched healthy volunteers. Telomerase activity in PBMC, TNF-α, IL-6 and ADMA were all significantly elevated in patients with MS compared to healthy volunteers. PBMC telomerase was negatively correlated with HDL and positively correlated with ADMA, while no association between TNF-α and IL-6 was observed. IL-6 was increasing with increasing systolic pressure both in the patients with MS and in the healthy volunteers, while smoking and diabetes were positively correlated with IL-6 only in the patients' group. In conclusion, in patients with MS characterised by a strong dyslipidemic profile and low diabetes prevalence, significant telomerase activity was detected in circulating PBMC, along with elevated markers of inflammation and endothelial dysfunction. These findings suggest a prolonged activity of inflammatory cells in the studied state of this metabolic disorder that could represent a contributory pathway in the pathogenesis of atherosclerosis