QUALIDADE DE VIDA E STRESS DE CRIANÇAS E ADOLESCENTES COM CÂNCER EM ESTÁGIO DE REMISSÃO E RECIDIVA

O câncer em crianças até cerca de duas décadas, era considerado uma doença crônica, com prognóstico desfavorável, resultando na maioria dos casos, em morte. Atualmente, tem-se apresentado como uma doença com melhores perspectivas, onde 70% das crianças acometidas por essa doença podem ser curadas, quando diagnosticadas precocemente, e tratadas em centros especializados¹. Este estudo teve como objetivo, avaliar a qualidade de vida e o stress de crianças e adolescentes com câncer, em remissão e recidiva. Trata-se de um estudo correlacional, quali-quantitativo, transversal. Foi desenvolvido no ambulatório de oncologia pediátrica da Faculdade de Medicina do ABC, e na enfermaria do Hospital Mário Covas. Contou com a colaboração de 40 sujeitos, com idades entre 06 a 14 anos, de ambos os sexos. Como instrumento para medir a qualidade de vida, foi utilizado o Child Health Questionnaire (CHQ-PF50), que possui 15 conceitos em saúde, abrangendo aspectos físicos e psicossociais e para medir o stress, a Escala de Stress Infantil (ESI), que tem como objetivo, avaliar o stress da criança, através de reações físicas e psicológicas. Os resultados indicaram que no domínio físico (PhS), as crianças em situação clínica de recidiva e remissão não apresentam diferenças significativas em relação às variáveis: qualidade de vida e stress, porém, no domínio psicossocial (PsS), houve diferença estatisticamente significante, indicando que os meninos apresentam melhor qualidade de vida e menor stress, se comparados com as meninas, mostrando que o emocional interfere nesse resultado.(AU)

QUALIDADE DE VIDA DE PARTICIPANTES DE PROGRAMAS DE ECONOMIA SOLIDÁRIA

Este estudo buscou estudar qualidade de vida em indivíduos que trabalhavam em cooperativas com a filosofia da Economia Solidária. Mais especificamente procurou: levantar o perfil sócio econômico cultural e demográfico de indivíduos adultos integrantes de programas de Economia Solidária; avaliar a qualidade de vida desses indivíduos integrantes de programas; descrever a compreensão desses trabalhadores sobre o conceito de qualidade de vida. Participaram desse estudo 69 pessoas, trabalhadores de três cooperativas distintas de catadores de lixo reciclável. Foi aplicado um questionário elaborado especialmente para esse estudo contendo dados de identificação dos participantes, com o propósito de fazer um levantamento relativo aos dados sócioeconômicos, culturais e demográficos e, nesse questionário foi agregado o critério de classificação de renda e classe social da Associação Brasileira dos Institutos de Pesquisa - ABIPEME e utilizou-se a Escala de Qualidade de vida Whoqol Bref . Verificou-se, que os trabalhadores apresentaram um bom nível de qualidade de vida. Em relação aos dados sócio-econômicos culturais, observou-se um predomínio da presença de mulheres, solteiras ou com parceiros, mas com filhos. Com relação aos domínios que compõem Qualidade de Vida, houve uma correlação significativa entre os domínios físico e psicológico e também uma correlação entre os domínios: psicológico e de relações sociais. Por outro lado, o domínio meio ambiente foi o que apresentou um índice menor de qualidade de vida em relação aos demais. Levanta-se a hipótese de que o fato dos cooperados estarem insatisfeitos com seus ganhos, por os considerarem insuficientes, acrescido de suas condições de moradia serem precárias, além da maioria ser oriunda de um sistema econômico competitivo e individualista e não terem ainda a devida adaptação que esse novo sistema exige, interferiram no domínio meio ambiente de forma negativa..(AU)

QUALIDADE DE VIDA E EFICÁCIA ADAPTATIVA DE PESSOAS COM OBESIDADE

A obesidade é uma doença crônica que vem acometendo, progressivamente, cada vez mais pessoas no mundo. Por ser uma patologia de difícil controle que favorece a eclosão de outros agravos à saúde, é premente a necessidade de realização de pesquisas que possam contribuir para o aperfeiçoamento dos tratamentos, bem como para a melhoria da qualidade de vida e eficácia adaptativa. Sendo assim, a presente pesquisa visou avaliar a percepção da qualidade de vida (QV), a eficácia adaptativa (EDAO) e o funcionamento global (AGF) de pessoas com obesidade, relacionando os resultados obtidos na avaliação da percepção da QV com os da eficácia adaptativa, bem como aos do funcionamento global (AGF). Para tanto, utilizou-se o questionário WHOQOL-100 versão em português para avaliação da percepção de qualidade de vida, a Entrevista Diagnóstica Preventiva Escala Diagnóstica Adaptativa Operacionalizada (EDAO) para a eficácia adaptativa e a Escala de Avaliação do Funcionamento Global (AGF) para o funcionamento global. Este estudo contou com a participação de trinta mulheres obesas (Índice de Massa Corporal IMC >=30 kg/m2), com idade média de 52,33 anos, que utilizavam os serviços de um ambulatório situado na região do Grande ABC, estado de SP. A maioria das participantes se encontrava no grau I de obesidade - 46,70%, situava-se no grau II 33,30% e 20,00% no grau III. O aumento de peso da maioria teve início nas gestações (43,30%), o segundo período onde ocorreu o início do descontrole do peso corporal foi entre os 40 aos 50 anos (20,00%). Na avaliação geral da QV, observou-se que no domínio VI Aspectos Espirituais/Religião/Crenças Pessoais foi encontrado o maior escore médio (16,17 - DP=2,95 [equivalente a 80,83% do escore máximo que poderia ser obtido]), comparando-o com os demais domínios avaliados. Em oposição, o domínio I Físico foi o que apresentou o menor escore médio (11,77 - DP=2,78 - 58,83%). Todas as participantes se encontravam em ineficácia adaptativa: Grupo 2 Ineficaz Leve (26,7%), no Grupo 3 Ineficaz Moderada (33,3%) e no Grupo 4 Ineficaz Severa (30,0%). Quanto à avaliação do funcionamento global (AGF), notou-se que 36,67% se situavam no intervalo entre 51-60 pontos. 23,33% das participantes no intervalo entre 31-50 pontos. Apenas 23,33% tiveram pontuação acima de 70 pontos. Relacionando os resultados das avaliações, foram encontradas correlações fortes, positivas e significativas entre a avaliação da percepção de qualidade de vida, da eficácia adaptativa e do funcionamento Global.

Sanctioning pregnancy:a psychological perspective on the paradoxes and culture of research

Pregnancy provides a very public, visual confirmation of femininity. It is a time of rapid physical and psychological adjustment for women and is surrounded by stereotyping, taboos and social expectations. This book seeks to examine these popular attitudes towards pregnancy and to consider how they influence women’s experiences of being pregnant. Sanctioning Pregnancy offers a unique critique of sociocultural constructions of pregnancy and the ways in which it is represented in contemporary culture, and examines the common myths which exist about diet, exercise and work in pregnancy, alongside notions of risk and media portrayals of pregnant women. Topics covered include: •Do pregnant women change their diet and why? •Is memory really impaired in pregnancy? •How risky behaviour is defined from exercise to employment •The biomedical domination of pregnancy research. Different theoretical standpoints are critically examined, including a medico-scientific model, feminist perspectives and bio-psychosocial and psychodynamic approaches. Table of Contents: Introduction. Cognition and Cognitive Dysfunction. Working and Employment. Dietary Change and Eating. Exercise and Activity. Pregnancy and Risk. Pregnancy Under Surveillance. Concluding Remarks. References/Bibliography. Index.

Leadership and the negotiation of order in small groups

This thesis is focussed on the role differentiationhypothesis as it relates to small groups (Bales, 1958). The hypothesis is systematically examined, both conceptually and empirically, in the light of the Equilibrium Hypothesis (Bales, 1953) and the Negotiated Order Theory of leadership (e.g. Hosking, 1988). Chapter 1 sketches in a context for the research,which was stimulated by attempts during the 60s and 70s to organise small groups without leaders (the leaderless group, based on isocratic principles). Chapter 2 gives a conceptual and developmental overview of Bales' work, concentrating on the Equilibrium Hypothesis. It is argued that Bales' conceptual approach, if developed, can potentially integrate the disparate small groups and leadership literatures. Chapters 3 and 4 examine the concepts `group', `leader' and `leadership' in terms of the Negotiated Order perspective. In chapter 3 it is argued that two aspects of the concept group need to be taken separately into account; physical attributes and social psychological aspects (the metaphysical glue). It is further argued that a collection of people becomes a group only when they begin to establish a shared sense of social order. In chapter 4 it is argued that leadership is best viewed as a process of negotiation between those who influence and those who are influenced, in the context of shared values about means and ends. It is further argued that leadership is the process by which a shared sense of social order is established and maintained, thus linking the concepts `leadership' and `group' in a single formulation. The correspondences with Bales' approach are discussed at the end of the chapter. Chapters 5 to 8 present a detailed critical description and evaluation of the empirical work which claims to show role differentiation or test the hypothesis, both Bales original work and subsequent studies. It is argued here, that the measurement and analytical procedures adopted by Bales and others, in particular the use of simple means as summaries of group structures, are fundamentally flawed, and that role differentiation in relation to particular identifiable groups has not been demonstrated clearly anywhere in the literature. Chapters 9 to 13 present the empirical work conducted for the thesis. 18 small groups are examined systematically for evidence of role differentiation using an approach based on early sociometry (Moreno, 1934). The results suggest that role differentiation, as described by Bales, does not occur as often as is implied in the literature, and not equivocally in any case. In particular structures derived from Liking are typically distributed or weak. This suggests that one of Bales' principal findings, that Liking varies independently of his other main dimensions, is the product of statistical artifact. Chapter 14 presents a general summary of results and presents some considerations about future research.

Semantic linking through spaces for cyber-physical-socio intelligence:a methodology

Humans consciously and subconsciously establish various links, emerge semantic images and reason in mind, learn linking effect and rules, select linked individuals to interact, and form closed loops through links while co-experiencing in multiple spaces in lifetime. Machines are limited in these abilities although various graph-based models have been used to link resources in the cyber space. The following are fundamental limitations of machine intelligence: (1) machines know few links and rules in the physical space, physiological space, psychological space, socio space and mental space, so it is not realistic to expect machines to discover laws and solve problems in these spaces; and, (2) machines can only process pre-designed algorithms and data structures in the cyber space. They are limited in ability to go beyond the cyber space, to learn linking rules, to know the effect of linking, and to explain computing results according to physical, physiological, psychological and socio laws. Linking various spaces will create a complex space — the Cyber-Physical-Physiological-Psychological-Socio-Mental Environment CP3SME. Diverse spaces will emerge, evolve, compete and cooperate with each other to extend machine intelligence and human intelligence. From multi-disciplinary perspective, this paper reviews previous ideas on various links, introduces the concept of cyber-physical society, proposes the ideal of the CP3SME including its definition, characteristics, and multi-disciplinary revolution, and explores the methodology of linking through spaces for cyber-physical-socio intelligence. The methodology includes new models, principles, mechanisms, scientific issues, and philosophical explanation. The CP3SME aims at an ideal environment for humans to live and work. Exploration will go beyond previous ideals on intelligence and computing.

Health related quality of life and perception of stigmatisation in adolescents living with sickle cell disease in Nigeria:a cross sectional study

Background: Sickle cell disease impacts the physical, emotional and psychological aspects of life of the affected persons, often times exposing them to disease associated stigma from the society and alters the health related quality of life (HRQoL). This study compared the HRQoL of adolescents with sickle cell disease with their healthy peers, identified socio-demographic and clinical factors impacting HRQoL, and determined the extent and effects of SCD related stigma on quality of life. Procedure: We conducted a cross-sectional survey among 160 adolescents, 80 with SCD and 80 adolescents without SCD. Socio-demographic and clinical data were collected using a pre-tested questionnaire. HRQoL was investigated using the Short Form (SF-36v2) Health Survey. SCD perceived stigma was measured using an adaptation of a perceived stigma questionnaire. Results: Adolescents with SCD have significantly worse HRQoL than their peers in all of the most important dimensions of HRQoL (physical functioning, physical roles limitation, emotional roles limitation, social functioning, bodily pain, vitality and general health perception) except mental health. Recent hospital admission and SCD related complication further lowered HRQoL scores. Over seventy percent of adolescents with SCD have moderate to high level of perception of stigmatisation. Hospitalisation, SCD complication, SCD stigma were inversely, and significantly associated with HRQoL. Conclusions: Adolescents living with SCD in Nigeria have lower health related quality of life compared to their healthy peers. They also experience stigma that impacts their HRQoL. Complications of SCD and hospital admissions contribute significantly to this impairment. Pediatr Blood Cancer 2015;62:1245-1251.

The effectiveness of a conceptually-based health and wellness course in developing health related factors, exercise self-efficacy and knowledge of health issues and exercise performance among diverse college students

The purpose of the study was to investigate the physiological and psychological benefits provided by a self-selected health and wellness course on a racially and ethnically diverse student population. It was designed to determine if students from a 2-year Hispanic serving institution (HIS) from a large metropolitan area would enhance their capacity to perform physical activities, increase their knowledge of health topics and raise their exercise self-efficacy after completing a course that included educational and activity components for a period of 16 weeks. A total of 185 students voluntarily agreed to participate in the study. An experimental group was selected from six sections of a health and wellness course, and a comparison group from students in a student life skills course. All participants were given anthropometric tests of physical fitness, a knowledge test, and an exercise self-efficacy scale was given at the beginning and at the conclusion of the semester. An ANCOVA analyses with the pretest scores being the covariate and the dependent variable being the difference score, indicated a significant improvement of the experimental group in five of the seven anthropometric tests over the comparison group. In addition, the experimental group increased in two of the three sections of the exercise self-efficacy scale indicating greater confidence to participate in physical activities in spite of barriers over the comparison group. The experimental group also increased in knowledge of health related topics over the comparison group at the .05 significance level. Results indicated beneficial outcomes gained by students enrolled in a 16-week health and wellness course. The study has several implications for practitioners, faculty members, educational policy makers and researchers in terms of implementation of strategies to promote healthy behaviors in college students and, to encourage them to engage in regular physical activities throughout their college years.

História oral de vida de pessoas com úlcera venosa nos serviços de atenção primária à saúde

The Chronic Venous insufficiency is characterized as a set of physical changes including how most serious complication of venous ulcers, characterized by irregular and progressive loss of continuity of the skin. The occurrence of venous ulcers in people with chronic venous insufficiency generates dependence on them with health services, with long-term treatments that cause limitations and high-impact changes, affecting their quality of life, affecting the physical, psychological, social, cultural and spiritual as an important public health problem. This study aimed to describe the experience of having a venous ulcer, in the scenario of primary health care services to Health, which includes Primary Care Units and Family Health Strategy in the city of Natal / RN, based on the life histories of users. This is a qualitative study, exploratory and descriptive, with the Oral History of Life as a methodological framework. From the ponto zero was the recruitment of participants who formed the network, totaling six employees, of both sexes and aged between 57 and 79 years. After approval by the Research Ethics Committee - UFRN under the Protocol 653 788/2014 and CAAE 30408014.0.0000.5537 was held data collection, between the months of July and August, through interviews, using identification and characterization of the instrument employees and open questions. Interviews were recorded, transcribed, transcriadas and returned to employees for a conference. The narratives were subjected to Content thematic analysis technique, according to Bardin, allowing the construction of three themes that encompass categories, namely: Axis I - Perspectives on the changes: the impact wound in social relations (changes with ulcer venous, venous ulcer and social and family relationships); Axis II - Brands in body and soul: the story of being hurt (conceptions of the body injured; therapeutic itinerary in primary care services); and Axis III - Reconstruction of being hurt: coping mechanisms (redefinition of the wounded body, resilience to chronic wound). The impact of having a chronic venous ulcer generates impact of physical, psychological and social order. As aspects related to changes after the appearance of venous ulcers, survey participants reported the presence of pain, physical limitations, psychological distress, social and emotional isolation, incapacity, aesthetic discomfort and dependency on health services; the family was the aspect thatshowed no significant change after the occurrence of wound for most participants, an ally in the therapeutic process as a support network. The redefinition of the body and the wound are the main coping mechanism of chronic condition. The services in the Primary Care Network play a fundamental role in the rehabilitation of patients with venous ulcers, although there are difficulties in accessing appropriate treatment and need for expanded services, with permanent professional training of health teams and providing the resources managers to strengthen the comprehensive care of people with venous ulcers in Health Primary Care.

Características psicológicas do paciente obeso grave e suas implicações pós-operatórias na cirurgia bariátrica

Obesity is a chronic disease that has multi-factorial aetiology, characterized by high degree of body fat; the degree of obesity will vary according to the Body Mass Index (BMI=m2 /kg). The severe degree of obesity is characterized by BMI>40 and it is regularly associated to endocrine-metabolic or mechanic clinical alterations, and to psychological disorders. Binge Eating (BE) results were overly high for this population. The Bariatric Surgery has been the treatment chosen by those diagnosed with severe obesity as this intervention provides prompt outcomes for loss of weight and clinical improvement conditions. However, recent research has acquiesced that after two years between 20% and 30% of people subject to this intervention gained weight. The main objective of this research is to assess the psychological and behavioral characteristics of those diagnosed with severe obesity that have been subject to Gastric Bypass Surgery in the past 24 months. Specific aspects were investigated: (1) characteristics of different personalities and diagnose of clinic and personality disorders; (2) BE and its relation with loss of weight; (2) the difference between the groups regarding post-surgery care, e.g. physical activity, psychological and dietician input. Method: 40 adults (women and men) aged 23 and 60 year-old who went through a bariatric surgery in the past 24 months, in the city of Natal-RN (Brazil); they were assembled in two groups n=20, Gain group displaying loss of < 50% of their initial surplus of weight, and the Loss group displaying loss of >50%. The research protocol is made of a socio-demographic questionnaire and 3 psychometric instruments: Rorschach – Comprehensive System; Millon Personality Inventory (MCMI-III); and the Binge Eating Scale (Escala de Compulsão Alimentar Periódica (ECAP). Through Rorschach significant differences between these groups were verified according to the kind of personality (EB) - more EB Extratensivo in Gain group and Intratensivo in Loss group – and the lack of control to express affect, increasing the answer for Color Pure at Group I. Concerning the people standardization, the sample as a whole tends to show psychic pain, denigrated selfperception, high levels of self-criticism, distorted perceptions, vulnerability to develop mood disorders and high scores regarding Suicide. MCMI-III results showed more clinic and personality disorders in Group I: Depressive Disorder and Schizotypal, Anxiety, Dysthymia, Major Depressive Disorder; Thought Disorder, Bipolar- Manic and Posttraumatic Stress Disorder. In relation to ECAP, the results indicated significant differences, showing increased BE results in Gain group. There were found significant differences between BE severity and the presence of clinic and personality disorders. Concerning the post-surgery care, the observed differences are statistically significant regarding physical activities with median-increased differences in Loss group. There is a difference between the initial weight and the time post-surgery, indicating that the higher the initial weight and the time after the surgery the higher the re-gain of weight post-surgery. Finally, the results show that the participants with more than 3 years of surgery will have Clinic and Major Depressive Disorders; Somatoform Disorder; Dysthymia. These results confirm prior studies related to BE post-surgery and re-gain of weight as well as the proneness of clinic disorders in severe obesity people. That means the results reinforce that the surgery process is a facet of the severe obesity treatment. The post-surgery process needs to be the main focus of attention and have a long-term input to sustain the care of the surgery results and the quality of life of the patients.

PERSONALIDADE, ESTILOS PARENTAIS E COGNIÇÃO EM MENINOS VÍTIMAS DE ABUSO SEXUAL

Há um consenso na literatura de que a vivência do abuso sexual na infância ocasiona uma série de consequências, tanto físicas quanto psicológicas, às vítimas. O cenário de violência contra crianças e adolescentes está cada vez mais frequente na sociedade contemporânea, tornando-se um problema de saúde pública, de modo a ser necessário um olhar mais atento dos profissionais e elaboração de políticas públicas tanto para a prevenção dos casos como para o tratamento dos problemas deles decorrentes. Nas crianças, há uma associação do aumento de problemas comportamentais e psicológicos, que podem se estender até o período da idade adulta. Outros estudos enfatizam alterações em áreas cerebrais e as relacionam com o surgimento de transtornos mentais na população de crianças vítimas de violência sexual, dentre outros tipos de violência. O objetivo deste trabalho foi verificar a presença de traços de personalidade, os estilos parentais desenvolvidos e o desempenho cognitivo, especificamente as funções executivas, em meninos com histórico de abuso sexual. Foram avaliadas 62 crianças e adolescentes (32 com histórico de abuso sexual e 30 sem), sendo que no grupo de abuso a idade média dos integrantes é de 11,7 anos de idade e seus genitores majoritariamente divorciados, diferentemente do grupo controle, no qual os genitores são, na maior parte, casados. O método constou de questionário sociodemográfico, testes neuropsicológicos que avaliam as funções executivas (Wisconsin Card Sortint Test, Figuras de Ray e Escala de Inteligência Wechsler para Crianças - Terceira Edição (WISC-III)- Semelhanças, Arranjo de Figuras, Compreensão, Cubos, Dígitos e Vocabulário), Questionário de Personalidade para Crianças e Adolescentes (EPQ-J) e Inventário de Estilos Parentais (IEP). Não houve resultados significativos entre o abuso e as funções executivas, tanto nos subtestes dos Escala de Inteligência Wechsler para Crianças - Terceira Edição (WISC-III) quanto no do Wisconsin; porém o grupo apresentou dados significativamente menores na memória do Figuras Complexas de Rey. Com relação ao EPQ-J, os resultados demonstraram maiores índices de neuroticismo, os quais podem ser associados com sintomas de depressão, e apresentaram menores índices em extroversão, trazendo possíveis dificuldades nas relações sociais. Com relação aos estilos parentais, o grupo apresentou dificuldades e prejuízos nas percepções sobre os genitores, especialmente com relação ao genitor, que é o maior abusador estatisticamente. Os dados mostraram uma correlação entre neuroticismo e vocabulário, estilos parentais e vocabulário, e neuroticismo e estilos parentais. Observou-se a importância de maiores estudos com o público masculino, para que possam ser elucidadas, de forma mais abrangente, as questões de abuso sexual e suas interferências nos aspectos neuropsicológicos, estilos parentais e traços de personalidade, visto que a maior parte dos estudos é relacionada ao público feminino. É necessário o desenvolvimento de políticas públicas para o atendimento específico do público masculino que sofre abuso, e que o profissional da saúde esteja preparado para ajudar, fortalecendo os aspectos psíquicos e emocionais.

(New School) Adult physical education class

General note: Title and date provided by Bettye Lane.

Structured Sports and Physical Activities: Their Critical Role

Even though one recognizes the physical and psychological kindness of h more and more involvement of the children to the physical and sporty activities, these programs seem more and more inaccessible to some. This article underlines the importance school déprogrammes centered on structured physical and sporty activities. In the setting of a recent survey, one asked youngsters to 5th year to take in note all their activities (as diary calendar) during two days of consecutive week. L·s children that participated in structured physical and sporty activities before and after the hours class sembkient to pull a lot more phisir of their day that those that didn't participate in these activities. Besides, seuk the young that took to structured physical and sporty activities reached the rates recommended of daily physical activity. The article proposes to the school administrators, to the parents, to the children and to the collectivities various measures encouraging the adoption of additional programs centered on the physical and sporty activities in school environment.

COPING STRATEGIES AND PSYCHOLOGICAL WELL-BEING AMONG BHUTANESE REFUGEES RESETTLED IN OTTAWA, CANADA

Since 2008, more than 6000 Bhutanese refugees have been resettled in over 21 communities across Canada, with nearly 300 individuals residing in Ottawa. This resettling process is associated with physical and psychological stress, as individuals acclimatize to a new country. A lack of understanding of the impact of this transition exists. This study assessed the relationship between coping strategies and psychological well-being of Bhutanese refugees resettled in Ottawa. A cross sectional survey of a representative sample of Bhutanese adults (n = 110) was conducted between November and December 2015. Coping strategies and psychological well-being were measured using the Brief COPE and General Well-being (GWB) scales. The total GWB mean score of 69.04 ± 12.09 suggests that respondents were in moderate distress. GWB did not significantly differ by sex, marital status, religion, employment, part time or full time job, or length of stay in Canada. Using multiple linear regression, significant independent variables from univariate analysis with GWB (age, education, positive reframing, self-blame and venting) were modeled to determine the best predictors of general well-being (GWB, F (11, 96) = 3.61, p < .001, R² = 21.2%). Higher levels of education and positive reframing were associated with greater GWB scores while self-blame and ages 41-50 were inversely associated with general well-being. It was found that above 66% of the unemployed participants were from age groups 41 and above. This finding suggests that career guidance services and vocational training to address unemployment may benefit this community. Nurses can provide support and counselling to assist refugees to minimize the use of negative coping strategies like self-blame and venting and promote positive coping strategies. Further, collaboration between nurses, other interdisciplinary professionals and community organizations is necessary to address social determinants of health and enhance refugee psychological well-being.

Evaluating a School Community Linked Physical Activity Intervention Programme: a Multi-level Analysis.

Previous research has highlighted the importance of positive physical activity (PA) behaviors during childhood to promote sustained active lifestyles throughout the lifespan (Telama et al. 2005; 2014). It is in this context that the role of schools and teachers in facilitating PA education is promoted. Research suggests that teachers play an important role in the attitudes of children towards PA (Figley 1985) and schools may be an efficient vehicle for PA provision and promotion (McGinnis, Kanner and DeGraw, 1991; Wechsler, Deveraux, Davis and Collins, 2000). Yet despite consensus that schools represent an ideal setting from which to ‘reach’ young people (Department of Health and Human Services, UK, 2012) there remains conceptual (e.g. multi-component intervention) and methodological (e.g. duration, intensity, family involvement) ambiguity regarding the mechanisms of change claimed by PA intervention programmes. This may, in part, contribute to research findings that suggest that PA interventions have had limited impact on children’s overall activity levels and thereby limited impact in reducing children’s metabolic health (Metcalf, Henley & Wilkin, 2012). A marked criticism of the health promotion field has been the focus on behavioural change while failing to acknowledge the impact of context in influencing health outcomes (Golden & Earp, 2011). For years, the trans-theoretical model of behaviour change has been ‘the dominant model for health behaviour change’ (Armitage, 2009); this model focusses primarily on the individual and the psychology of the change process. Arguably, this model is limited by the individual’s decision-making ability and degree of self-efficacy in order to achieve sustained behavioural change and does not take account of external factors that may hinder their ability to realise change. Similar to the trans-theoretical model, socio-ecological models identify the individual at the focal point of change but also emphasises the importance of connecting multiple impacting variables, in particular, the connections between the social environment, the physical environment and public policy in facilitating behavioural change (REF). In this research, a social-ecological framework was used to connect the ways a PA intervention programme had an impact (or not) on participants, and to make explicit the foundational features of the programme that facilitated positive change. In this study, we examined the evaluation of a multi-agency approach to a PA intervention programme which aimed to increase physical activity, and awareness of the importance of physical activity to key stage 2 (age 7-12) pupils in three UK primary schools. The agencies involved were the local health authority, a community based charitable organisation, a local health administrative agency, and the city school district. In examining the impact of the intervention, we adopted a process evaluation model in order to better understand the mechanisms and context that facilitated change. Therefore, the aim of this evaluation was to describe the provision, process and impact of the intervention by 1) assessing changes in physical activity levels 2) assessing changes in the student’s attitudes towards physical activity, 3) examining student’s perceptions of the child size fitness equipment in school and their likelihood of using the equipment outside of school and 4) exploring staff perceptions, specifically the challenges and benefits, of facilitating equipment based exercise sessions in the school environment. Methodology, Methods, Research Instruments or Sources Used Evaluation of the intervention was designed as a matched-control study and was undertaken over a seven-month period. The school-based intervention involved 3 intervention schools (n =436; 224 boys) and one control school (n=123; 70 boys) in a low socioeconomic and multicultural urban setting. The PA intervention was separated into two phases: a motivation DVD and 10 days of circuit based exercise sessions (Phase 1) followed by a maintenance phase (Phase 2) that incorporated a PA reward program and the use of specialist kid’s gym equipment located at each school for a period of 4 wk. Outcome measures were measured at baseline (January) and endpoint (July; end of academic school year) using reliable and valid self-report measures. The children’s attitudes towards PA were assessed using the Children’s Attitudes towards Physical Activity (CATPA) questionnaire. The Physical Activity Questionnaire for Children (PAQ-C), a 7-day recall questionnaire, was used to assess PA levels over a school week. A standardised test battery (Fitnessgram®) was used to assess cardiovascular fitness, body composition, muscular strength and endurance, and flexibility. After the 4 wk period, similar kid’s equipment was available for general access at local community facilities. The control school did not receive any of the interventions. All physical fitness tests and PA questionnaires were administered and collected prior to the start of the intervention (January) and following the intervention period (July) by an independent evaluation team. Evaluation testing took place at the individual schools over 2-3 consecutive days (depending on the number of children to be tested at the school). Staff (n=19) and student perceptions (n = 436) of the child sized fitness equipment were assessed via questionnaires post-intervention. Students completed a questionnaire to assess enjoyment, usage, ease of use and equipment assess and usage in the community. A questionnaire assessed staff perceptions on the delivery of the exercise sessions, classroom engagement and student perceptions. Conclusions, Expected Outcomes or Findings Findings showed that both the intervention (16.4%) and control groups increased their PAQ-C score by post-intervention (p < 0.05); with the intervention (17.8%) and control (21.3%) boys showing the greatest increase in physical activity levels. At post-intervention, there was a 5.5% decline in the intervention girls’ attitudes toward PA in the aesthetic subdomains (p = 0.009); whereas the control boys had an increase in positive attitudes in the health domain (p = 0.003). No significant differences in attitudes towards physical activity were observed in any other domain for either group at post-intervention (p > 0.05). The results of the equipment questionnaire, 96% of the children stated they enjoyed using the equipment and would like to use the equipment again in the future; however at post-intervention only 27% reported using the equipment outside of school in the last 7 days. Students identified the ski walker (34%) and cycle (32%) as their favorite pieces of equipment; with the single joint exercises such as leg extension and bicep/tricep machine (<3%) as their least favorite. Key themes from staff were that the equipment sessions were enjoyable, a novel activity, children felt very grown-up, and the activity was linked to a real fitness experience. They also expressed the need for more support to deliver the sessions and more time required for each session. Findings from this study suggest that a more integrated approach within the various agencies is required, particularly more support to increase teachers pedagogical content knowledge in physical activity instruction which is age appropriate. Future recommendations for successful implementation include sufficient time period for all students to access and engage with the equipment; increased access and marketing of facilities to parents within the local community, and professional teacher support strategies to facilitate the exercise sessions.