Attitudes toward physical activity as a treatment component for adolescents with anorexia nervosa: An exploratory qualitative study of patient perceptions.

OBJECTIVE: Anorexia nervosa (AN) with compulsive exercise is associated with poor treatment outcomes. This study sought to understand the attitudes of adolescents with AN from various stages of treatment, toward physical activity research practices and physical activity as a component of treatment. METHOD: Seventeen adolescents 12-18 years old (15 female) with AN (10 with acknowledged history of compulsive exercise) were recruited from a Canadian Tertiary Care Hospital's Eating Disorder Program. Six inpatients, 5-day program patients, and six outpatients treated by either the inpatient and/or day treatment program in the past 2 years completed individual, semi-structured interviews that were audio-recorded and transcribed. Results were analyzed deductively using qualitative techniques. RESULTS: Participants recognized both benefits (psychological, sociological, and physiological) and risks (trigger negative thoughts, increase competitive behavior) of implementing physical activity into acute AN treatment. Patient characteristics, such as stage of treatment and exercise history, had an impact on participants' perceptions toward physical activity in AN. Participants suggested that the ideal physical activity program would be focused on fun, individualized and progressively integrated, group-based, and directly supported by staff. Although the majority of participants stated that they would wear an activity monitor for research purposes, concerns were voiced regarding compliance and the potential impact on eating disorder symptomatology. DISCUSSION: Participants overwhelmingly supported the careful implementation of structured physical activity and physical activity psychoeducation into the acute treatment of adolescents with AN. This study allows for the inclusion of patient voices in the conversation surrounding the role of physical activity in AN treatment.

Building capacity for protected area management in Lao PDR.

Declining biodiversity in protected areas in Laos is attributed to unsustainable exploitation of natural resources. At a basic level, an important need is to develop capacity in academic and professional training institutions to provide relevant training to conservation professionals. The paper (a) describes the capacity building approach undertaken to achieve this goal, (b) evaluates the effectiveness of the approach in building capacity for implementing conservation and (c) reviews implementation outcomes. Strong linkages between organizations implementing field conservation, professional training institutions, and relevant Government agencies are central to enhancing effectiveness of capacity building initiatives aimed at improving the practice of conservation. Protected area management technical capacity needs will need to directly influence curriculum design to insure both relevance and effectiveness of training in improving protected area management. Sustainability of capacity building initiatives is largely dependent on the level of interest and commitment by host-country institutions within a supportive Government policy framework in addition to engagement of organizations implementing conservation.