An evaluation of trauma focused cognitive behavioral therapy for children in Zambia

To monitor and evaluate the feasibility of implementing Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) to address trauma and stress-related symptoms in orphans and vulnerable children (OVC) in Zambia as part of ongoing programming within a non-governmental organization (NGO). As part of ongoing programming, voluntary care-workers administered locally validated assessments to identify children who met criteria for moderate to severe trauma symptomatology. Local lay counselors implemented TF-CBT with identified families, while participating in ongoing supervision. Fifty-eight children and adolescents aged 5–18 completed the TF-CBT treatment, with pre- and post-assessments. The mean number of traumas reported by the treatment completers (N = 58) was 4.11. Post assessments showed significant reductions in severity of trauma symptoms (p < 0.0001), and severity of shame symptoms (p < 0.0001). Our results suggest that TF-CBT is a feasible treatment option in Zambia for OVC. A decrease in symptoms suggests that a controlled trial is warranted. Implementation factors monitored suggest that it is feasible to integrate and evaluate evidence-based mental health assessments and intervention into programmatic services run by an NGO in low/middle resource countries. Results also support the effectiveness of implementation strategies such as task shifting, and the Apprenticeship Model of training and supervision.     

‘No Outsiders’: Moving beyond a discourse of tolerance to challenge heteronormativity in primary schools

In this paper we describe a UK‐based participatory action research project that looks beyond the discourse of tolerance to investigate and challenge heteronormative processes in primary schools through reflective action research. This 28‐month ESRC‐funded project supports 15 primary teachers working in schools in three regions of the UK to develop action research projects that address lesbian, gay, bisexual and transgender equality in their own schools and classrooms. In this paper we will examine how the original principles on which the project design was based have manifested themselves throughout the course of the project, drawing upon examples of classroom practice and reflective discussions among project team members. We will explore how designing intentionally for collective participation has produced spaces for people to do and think in ways that have not only gone beyond what we imagined but have also challenged and sometimes contradicted our own ways of thinking.     

Developmental Changes in Attention and Comprehension Among Children With Attention Deficit Hyperactivity Disorder

Changes in visual attention and story comprehension for children (N = 132) with attention deficit hyperactivity disorder (ADHD) and comparison peers were examined. Between the ages of 7 and 9 (Phase 1) and approximately 21 months later (Phase 2), children viewed 2 televised stories: 1 in the presence of toys and 1 in their absence. Both groups of children showed developmental increases in visual attention and stable group differences over time. Deficits in comprehension among children with ADHD, however, increased over time. Whereas comparison children’s recall of factual and causal information increased over time in both viewing conditions, children with ADHD showed no developmental improvement in recall of factual information in the toys‐present condition and no improvement in recall of causal relations in either viewing condition.     

Body mass changes during training in elite rugby union: Is a single test of hydration indices reliable?

There is limited research studying fluid and electrolyte balance in rugby union players, and a paucity of information regarding the test–retest reliability. This study describes the fluid balance of elite rugby union players across multiple squads and the reliability of fluid balance measures between two equivalent training sessions. Sixty-one elite rugby players completed a single fluid balance testing session during a game simulation training session. A subsample of 21 players completed a second fluid balance testing session during an equivalent training session. Players were weighed in minimal clothing before and after each training session. Each player was provided with their own drinks which were weighed before and after each training session. More players gained body weight (9 (14.8%)) during training than lost greater than 2% of their initial body mass (1 (1.6%)). Pre-training body mass and rate of fluid loss were significantly associated (r?=?0.318, p?=?.013). There was a significant correlation between rate of fluid loss in sessions 1 (1.74?±?0.32?L?h^?1) and 2 (1.10?±?0.31?L.?h^?1), (r?=?0.470, p?=?.032). This could be useful for nutritionists working with rugby squads to identify players with high sweat losses.     

Lower extremity joint loads in habitual rearfoot and mid/forefoot strike runners with normal and shortened stride lengths

Our purpose was to compare joint loads between habitual rearfoot (hRF) and habitual mid/forefoot strikers (hFF), rearfoot (RFS) and mid/forefoot strike (FFS) patterns, and shorter stride lengths (SLs). Thirty-eight hRF and hFF ran at their normal SL, 5% and 10% shorter, as well as with the opposite foot strike. Three-dimensional ankle, knee, patellofemoral (PF) and hip contact forces were calculated. Nearly all contact forces decreased with a shorter SL (1.2–14.9% relative to preferred SL). In general, hRF had higher PF (hRF-RFS: 10.8 ± 1.4, hFF-FFS: 9.9 ± 2.0 BWs) and hip loads (axial hRF-RFS: ?9.9 ± 0.9, hFF-FFS: ?9.6 ± 1.0 BWs) than hFF. Many loads were similar between foot strike styles for the two groups, including axial and lateral hip, PF, posterior knee and shear ankle contact forces. Lateral knee and posterior hip contact forces were greater for RFS, and axial ankle and knee contact forces were greater for FFS. The tibia may be under greater loading with a FFS because of these greater axial forces. Summarising, a particular foot strike style does not universally decrease joint contact forces. However, shortening one’s SL 10% decreased nearly all lower extremity contact forces, so it may hold potential to decrease overuse injuries associated with excessive joint loads.     

Recovery Responses to Maximal Exercise in Healthy-Weight Children and Children With Obesity

Purpose: The purpose of this study was to examine differences in heart rate recovery (HRRec) and oxygen consumption recovery (VO₂ recovery) between young healthy-weight children and children with obesity following a maximal volitional graded exercise test (GXTmax). Method: Twenty healthy-weight children and 13 children with obesity completed body composition testing and performed a GXTmax. Immediately after the GXTmax, HRRec and VO₂ recovery were measured each minute for 5 consecutive minutes. Results: There were no statistically significant group differences in HRRec for the 5 min following maximal exercise, Wilks’s Lambda = .885, F(4, 28) = 0.911, p = .471, between the healthy-weight children and children with obesity despite statistically significant differences in body fat percentage (BF%; healthy-weight children, 18.5 ± 6.1%; children with obesity, 41.1 ± 6.9%, p < .001) and aerobic capacity relative to body mass (VO₂ peak; healthy-weight children, 46.8 ± 8.2 mL/kg/min; children with obesity, 31.9 ± 4.7 mL/kg/min, p < .001). There were statistically significant differences in VO₂ recovery for the 5 min following exercise, Wilks’s Lambda = .676, F(4, 26) = 3.117, p = .032. There were no statistically significant correlations between HRRec and body mass index (BMI), BF%, VO₂peak, or physical activity. Conclusions: In a healthy pediatric population, obesity alone does not seem to significantly impact HRRec, and because HRRec was not related to obesity status, BMI, or BF%, it should not be used as the sole indicator of aerobic capacity or health status in children. Using more than one recovery variable (i.e., HRRec and VO₂ recovery) may provide greater insight into cardiorespiratory fitness in this population.