Specificity of a Maximal Step Exercise Test

To adhere to the principle of “exercise specificity” exercise testing should be completed using the same physical activity that is performed during exercise training. The present study was designed to assess whether aerobic step exercisers have a greater maximal oxygen consumption (max VO₂) when tested using an activity specific, maximal step exercise test (SET; arms and legs) versus a maximal running test (legs only). Female aerobic step exercisers (N=18; 20.7 ± 1.5 years) performed three maximal graded exercise tests (GXTs): 2 SETs; 1 treadmill test (TMT). The SET consisted of six 3-min progressive stages of alternate lead, basic step, basic step with biceps curls, knee raise with pull-down, repeater knee with pull-down, lateral lunge with pull-down, and side squat with shoulder presses. Stepping rate was 32 steps· min^?1 on an 8-in (20.32 cm) step for stages 1–3, and a 10-in (25.4 cm) step for stages 4–6. Submaximal and maximal heart rate (HR) and oxygen consumption (VO₂) were recorded at the end of each stage. Test–retest reliability for the first five stages of the SET ranged from .91 to .97 for HR, and from .84 to .96 for VO₂. Maximal HR was significantly greater (p =.0001) for the SET (200 ± 6.2 beats·min^?1) as compared to the TMT (193 ± 7.9 beats·min^?1). No significant difference was found for max VO₂ (42.9 ± 8.5, 41.2 ± 5.9 ml·kg^?1·min^?1, p =.14). The SET was a valid and reliable protocol for assessing responses of these aerobic step exercisers; however, max VO₂ from a TMT did not differ significantly from the SET. Conversely, max HR obtained from the criterion TMT was 7 beats·min^?1 lower than from the SET. If a training HR for step exercise (arms and legs exercise) is prescribed based on the max HR from treadmill exercise (legs only), then the training HR should be calculated from a TMT max HR that has been increased by 7 beats·min^?1 to obtain an intensity of step exercise comparable to that of running.     

Strategies in assessing the need for updating evidence-based guidelines for six clinical topics: an exploration of two search methodologies

BACKGROUND: Because of the expense of updating practice guidelines, recent attention has focused on approaches that can reliably assess any updating required. Shekelle et al. (Journal of the American Medical Association 2001, 286, 1461-7) proposed using limited literature searches with expert involvement to reduce resources used in assessing whether a guideline needs updating. OBJECTIVES: This study compared Shekelle's method and the traditional systematic review method regarding comprehensiveness and effort. METHODS: Two research teams translated critical key questions on screening test treatments and outcomes to Medical Subjects Headings (MeSH) and search strategies. They refined Shekelle's method over three iterations, seeking greater efficiency. Using both methods independently, teams assessed the need to update six topics from the 1996 Guide to Clinical Preventive Services (US Preventive Services Task Force). Outcomes included completeness of study identification, importance of missed studies and effort involved. RESULTS: The revised review approach produced fewer citations than the traditional approach and saved time, identifying fewer eligible studies than the traditional approach. None of the studies missed was rated important by the experts consulted. CONCLUSIONS: The revised review approach provides an acceptable method for judging whether a guideline requires updating. Librarians were an integral part of the research process that streamlined the searches.     

Treatment practices for childhood posttraumatic stress disorder

OBJECTIVE: This study surveyed practices in treating childhood PTSD among child psychiatrists and non-M.D. therapists with self-identified interest in treating traumatized children. METHOD: An anonymous survey was mailed to 207 child psychiatrists ("medical") and 460 nonphysician ("non-medical") therapists inquiring about current interventions used to treat children with PTSD. RESULTS: Two hundred and forty-seven responses were received: of 77 medical and 82 nonmedical respondents who currently treat children with PTSD, a wide variety of modalities are used. Most preferred modalities among medical responders were pharmacotherapy, psychodynamic, and cognitive-behavioral therapy. Most preferred modalities among nonmedical respondents were cognitive-behavioral, family, and nondirective play therapy. Ninety-five percent of medical respondents used pharmacotherapy for this disorder; most preferred medications to treat childhood PTSD were selective serotonin reuptake inhibitors and alpha-adrenergic agonists. Several significant differences between medical and nonmedical practices were identified. CONCLUSIONS: There is little clinical consensus regarding the effectiveness of the many modalities used to treat traumatized children who have PTSD symptoms; empirical research is particularly needed to evaluate the efficacy of pharmacotherapy and EMDR.     

Mission to Planet Markle: Problem-Based Learning for Teaching Elementary Students Difficult Content and Practices

Research in Science Education - Young children can struggle to learn difficult disciplinary content and important skills for practicing science. Problem-based learning (PBL) may be useful for...     

Security,Extremism and Education: Safeguarding or Surveillance?

This article analyses how education is positioned in the current concerns about security and extremism. This means firstly examining the different meanings of security (national, human and societal) and who provides security for whom. Initially, a central dilemma is acknowledged: that schooling appears to be simultaneously irrelevant to the huge global questions of security and yet central to the learning of alternative ways to conduct human relations. With regard to extremism, two aspects of importance in ideological compliance or challenge are firstly the attempted securitisation of education, and secondly the role of education in young people joining or supporting extremist movements. The UK’s ‘Prevent’ strategy is examined here. The issue of how to safeguard young people without securitising institutions suggests four key features: inclusivity, encounters with difference, networking and active citizenship. Critiquing sacred texts and the use of humour and satire also act to foster resilience. Educational approaches within transitional justice underline the importance of tackling violence in schools and promoting a human rights culture that promotes both human security and ultimately national security.     

Defining the Difference: Comparing Integrated and Traditional Single-Subject Lessons

Early childhood curricula should be authentic and child-centered, however, many teachers still rely on direct instruction lessons. To better define how an integrated curriculum meets the needs of students, this study examined teacher talk and actions during instructional activities with first and second graders under two conditions: (1) subject-integrated social studies lessons of an integrated curriculum unit (experimental condition); and (2) single subject-focused mathematics lessons of a traditional separate subject curriculum (control condition). The mixed-methods study sought to define and compare characteristics of both curriculum approaches. Fourteen hours of observations were collected in each setting. In the integrated curriculum setting, the teacher was a facilitator of teamwork, offering choices, and giving praise; students made choices, decisions, and worked collaboratively. In the traditional setting, the teacher delivered direct instruction and controlled behavior; students followed directions, recalled knowledge, and worked individually. Less teacher energy was expended for behavior management in the integrated curriculum setting, indicating intrinsic motivation of students. Implementation of integrated curricula is recommended because of the student-centered focus that results in greater motivation, ownership, and teamwork, along with deeper knowledge connections. Because many factors hinder implementation, teachers need support when first teaching with this approach.