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Exposure to war, conflict and forced migration puts children at risk of mental health problems. The present study examined the levels of psychological distress and resilience factors among 106 Palestinian refugee children aged 11 to 17 in the West Bank. In a cross-sectional, mixed method design along with qualitative interviews, three questionnaires were administered: the Strength and Difficulties Questionnaire and Patient Health Questionnaire-15, assessed the risk of mental health disorders and psychosomatic complaints, and the Child and Youth Resilience Measure assessed the availability of resilience-enhancing factors. Palestinian refugee children were found to be at greater risk for mental disorders and psychosomatic complaints than were children living in non-conflict affected settings. In addition, resilience-enhancing resources were significantly reduced and were negatively correlated with both symptom outcomes. Risk factors identified included poverty, violence and marginalisation. Key protective factors were youth education, supportive relationships and social participation. Our findings support interventions that address the identified protective factors, which may promote the mental health of this vulnerable population.

Background Studies on the impacts of child maltreatment (CM) have been conducted in diverse areas. Mechanistic understanding of the complex interplay between factors is lacking. Hallmarking is an approach which identifies common factors across studies and highlights the most robust findings. Objectives In a review of systematic reviews and meta-analyses, we addressed the following questions: 1) What are the hallmarks associated with exposure to CM across the bio-ecological spectrum? 2) What is the strength of evidence to support each hallmark? 3) What are the gaps that future research should address? Methods A comprehensive literature search was carried out to find relevant systematic reviews or meta-analyses. 269 articles were read in full and 178 articles, encompassing more than 6000 original papers, were included in the final synthesis. All reviews were independently rated for quality by at least 2 reviewers using AMSTAR-2. Results Of 178 review articles, 6 were rated as high quality (all meta-analyses) and 46 were rated as medium quality. Most were from high income countries. Conclusions Based on the most commonly reported high-quality research findings we propose that the hallmarks of exposure to child maltreatment are: Increased risk of psychopathology; Increased risk of obesity; Increased risk of high- risk sexual behaviours, Increased risk of smoking; and Increased risk of child maltreatment in children with disabilities. Research gaps include a lack of focus on complexity and resilience. Little can be concluded about directions of causality or mechanisms. Adequately powered prospective studies are required to move the field forward.

This study compares the physiological responses and rating of perceived exertion (RPE) of subjects exercising on two different treadmills. Eleven physically active subjects, all familiar with treadmill running, were tested on both a Woodway and a Powerjog treadmill in a submaximal test. Although the Powerjog ran at actual speeds slightly higher (P < 0.05) than the Woodway at each of two target speeds, paired comparisons in terms of V O 2 , heart rate and RPE were adjusted by regressing the differences of each of these response variables in turn on the actual difference in treadmill speed for the particular individual. At a target speed of 4.00 m s A1 , the Woodway produced signi®cantly higher average V O 2 , heart rate and RPE. A similar trend existed at the lower target speed of 3.11 m s A1 , but did not quite achieve statistical signi®cance (P < 0.05). These physiological differences are attributed to the structural design of the treadmills, the key feature most likely being the stiffness of the running surface. Measurements of the de¯ection of the running surface, under static loads up to three times human bodyweight, showed that the Woodway was signi®cantly stiffer than the Powerjog. The results do not, of course, imply that one treadmill is`better' overall than the other, but they are signi®cant for manufacturers and athletes since comparisons of performance measured on different treadmills in different laboratories may be spurious.

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