When Backbone Organizations Become the Funder: The Use of Fiscal Intermediaries in the Context of Collective Impact

Intermediary organizations are increasingly being engaged to work with grantees in the context of collective impact and similar collaborative approaches that aim to solve significant societal problems. At times the backbone organization – the group providing support to the collective effort – takes on the work of a fiscal intermediary. This dual role has two distinct functions: engagement of collaborative partners to advance a shared agenda, and distributing funds while holding those partners accountable. This article explores the complexities of the dual relationship by using examples from the Social Innovation Fund, a White House initiative, and Got Your 6, a collective-impact campaign that seeks to bridge the civilian-military divide. Given that the intersection of fiscal intermediaries and backbones is a relatively new phenomenon, there is a gap in the literature about the challenges organizations playing this dual role may face. But the benefits may outweigh the challenges if the dual role is deployed effectively; participants in the case studies offer insights into this. The foundation community would be well served to explore the alternative approaches to integrating funding with backbone roles as they work with their collective-impact partners. Collectively, a field of practice can be built if funders continue to experiment with how to better integrate the disparate roles and share the results of those experiments

The Effects of Playing Surface on Plant Leg Knee Kinematics of Men and Women Collegiate Soccer Players

The majority of anterior cruciate ligament (ACL) injuries for soccer players are non-contact. Women have a higher incidence of non-contact ACL injury than men. One of the five most important factors associated with these non-contact injuries is when the plant leg knee flexes to less than 30°. Women soccer players have also been reported to flex the knee less than men when planting to take a shot. While soccer is mainly played on natural grass (NG) fields, playing on artificial turf (AT) surfaces is becoming increasingly popular because of the many benefits including low maintenance. Recently some data has suggested that knee injury incidence rates are higher on artificial turf than natural grass. Purpose: To determine if playing surface has an effect on men and women soccer players’ plant leg knee angle when performing maximal effort power (PS) and finesse (FS) shots. Methods: Sixteen collegiate soccer players (8 female, 8 male, age = 20.17± yrs, mass = 73.67± kg, height = 162.41± cm) performed four different shooting conditions (3 PS on artificial turf, 3 PS on natural grass, 3 FS on artificial turf, 3 FS natural grass). Participants performed a 15 yd maximal effort dribble into a 5yd x 5yd cone box to complete the shot. A wireless electrogoniometer and accelerometer were attached to each participant in order to collect plant leg knee angle kinematics as well as tibial acceleration at 200 Hz. Separate 2x2 (field surface x gender) Repeated Measures ANOVAs were used to analyze data collected from each shot type. Results: The mean (sd) knee angle (degrees) for men, on grass and turf fields during the power shot were 29.3 °(11.4°) and, 28.6°(8.1°), respectively. The knee angle for women on grass and turf fields for the power shot were 26.8°(3.8°), and 31.9° (18.7°), respectively. The mean (sd) knee angle (degrees) for men on grass and turf fields during the finesse shot were 30.8° (13.1°) and 28.7° (8.6°), respectively. The knee angle for women on grass and turf fields for the finesse shot were 24.0° (6.5°), and 24.3° (6.3°), respectively. Field surface had no significant effect on knee angle of the plant leg during the power (F(1,14) = 0.251, p = 0.624) or finesse (F(1,14) = 0.082, p = 0.779) shots. Furthermore, plant leg knee angle were similar between genders during the power (F(1,14) = 0.012, p = 0.913) and finesse (F(1,14) = 3.128, p = 0.099) shots. Lastly, there was no significant interaction between field condition and sex on the plant leg knee angle during the power (F(1,14) = 0.431, p = 0.522) and finesse (F(1,14) = 0.141, p = 0.713) shots. Conclusion: A more extended knee on the plant leg has been shown to be one factor that is associated with knee injuries in soccer. Data from this study suggests that playing surface had no effect on plant leg knee kinematics for either men or women suggesting that either surface is acceptable for play with respect to plant leg knee kinematics

Identifying behavioural determinants to uptake and adherence to a whey protein supplement for the management of type 2 diabetes: A qualitative interview study

Interventions targeting diet and physical activity have demonstrated to be effective for improving glycaemic control in adults with type 2 diabetes. However, initiating and sustaining these changes remains a challenge. Ingestion of whey protein has shown to be effective for improving glycaemic control by increasing insulin and incretin secretion, and influencing appetite regulation; however, little is known about what influences uptake and adherence. We conducted a qualitative interview study to explore behavioural determinants of uptake and adherence to a commercially made whey protein supplementation. In total, 16/18 adults with type 2 diabetes who participated in an RCT took part in a semi-structured interview. Seven themes were generated from the data following thematic analyses. The most frequently reported determinant of uptake was the expectation that the supplement would improve health status (e.g., type 2 diabetes management), as a consequence of appetite suppression and weight loss. Determinants of adherence included palatability; the belief that the supplement was an appetite suppressant; and receiving positive reinforcement on the effects of the supplement. Frequency of consumption led to reduced adherence with some participants. Findings support that the whey protein supplement is a viable management option for adults with type 2 diabetes; however, uptake will be driven by conveying information on the positive effects of the supplement on appetite suppression and glycaemic control. Adherence will be determined by palatability, behavioural prompting, and positive reinforcement

Generated randomly and selected functionally? The nature of enterovirus recombination

FA was supported by a PhD studentship from the Ministry of Education, Government of Saudi Arabia and KB was supported by Biological Sciences Research Council award BB/M009343/1to D.J.E and an ISSF award from The Wellcome Trust to the BSRC, University of St Andrews.Genetic recombination in RNA viruses is an important evolutionary mechanism. It con-tributes to population diversity, host/tissue adaptation and compromises vaccine efficacy. Both the molecular mechanism and initial products of recombination are relatively poorly understood. We used an established poliovirus-based in vitro recombination assay to investigate the roles of se-quence identity and RNA structure, both implicated or inferred from analysis of circulating recom-binant viruses, in the process. In addition, we used next generation sequencing to investigate the early products of recombination after cellular co-infection with different poliovirus serotypes. In independent studies we find no evidence for a role for RNA identity or structure in determining recombination junctions location. Instead, genome function and fitness are of greater importance in determining the identity of recombinant progeny. These studies provide further insights into this important evolutionary mechanism and emphasise the critical nature of the selection process on a mixed virus population.Publisher PDFPeer reviewe

3D visualization of bioerosion in archaeological bone

Palaeoradiology is increasingly being used in archaeological and forensic sciences as a minimally invasive alternative to traditional histological methods for investigating bone microanatomy and its destruction by diagenetic processes. To better understand ancient mortuary practices, taphonomic studies using microCT scanning methods are gaining an ever more important role. Recently it was demonstrated that 2D virtual sections obtained by microCT scanning of intact samples are comparable to physical sections for the rating and diagnosis of bioerosion in archaeological bone. Importantly, volume image data obtained from tomographic methods also allow the rendering and analysis of 3D models. Building on these methods we provide (1) detailed descriptions of bioerosion in 3D volume renderings, virtual sections, and traditional micrographs, and (2) accessible techniques for the visualization of bioerosion in skeletal samples. The dataset is based on twenty-eight cortical bone samples, including twenty femora (of which five are cremated), two ribs, two parietals, one mandibular ramus, one humerus, and two faunal long bones from five archaeological sites in Lower Austria dating from the Early Neolithic to the Late Iron Age. Notably, we reduce the need for time-consuming image segmentation by sequentially applying two noise-reducing, edge-preserving filters, and using an image-display transfer function that visualizes bioerosion, as well as Haversian and Volkmann canal structure and density in 3D. In doing so we are also able to visualize in 3D the invasion of canals by microbiota, which has previously only been reported in 2D sections. Unlike conventional thin sections, the 3D volume images shown here are easy to create and interpret, even for archaeologists inexperienced in histology, and readily facilitate the illustration and communication of microtaphonomic effects

In children, the microbiota of the nasopharynx and bronchoalveolar lavage fluid are both similar and different

RATIONALE: Sputum and bronchoalveolar lavage fluid (BALF) are often obtained to elucidate the lower airway microbiota in adults. Acquiring sputum samples from children is difficult and obtaining samples via bronchoscopy in children proves challenging due to the need for anesthesia and specialized procedural expertise; therefore nasopharyngeal (NP) swabs are often used as surrogates when investigating the pediatric airway microbiota. In adults, the airway microbiota differs significantly between NP and BALF samples however, minimal data exist in children. OBJECTIVES: To compare NP and BALF samples in children undergoing clinically indicated bronchoscopy. METHODS: NP and BALF samples were collected during clinically indicated bronchoscopy. Bacterial DNA was extracted from 72 samples (36 NP/BALF pairs); the bacterial V1-V3 region of the 16S rRNA gene was amplified and sequenced on the Illumina Miseq platform. Analysis was performed using mothur software. RESULTS: Compared to NP samples, BALF had increased richness and diversity. Similarity between paired NP and BALF (intra-subject) samples was greater than inter-subject samples (P = 0.0006). NP samples contained more Actinobacteria (2.2% vs 21%; adjusted P = 1.4 × 10-6 ), while BALF contained more Bacteroidetes (29.5% vs 3.2%; adjusted P = 1.2 × 10-9 ). At the genus level several differences existed, however Streptococcus abundance was similar in both sample types (NP 37.3% vs BAL 36.1%; adjusted P = 0.8). CONCLUSION: Our results provide evidence that NP samples can be used to distinguish differences between children, but the relative abundance of organisms may differ between the nasopharynx and lower airway in pediatric patients. Studies utilizing NP samples as surrogates for the lower airway should be interpreted with caution

Addressing Health Literacy in Patient Decision Aids:An Update from the International Patient Decision Aid Standards

BACKGROUND: There is increasing recognition of the importance of addressing health literacy in patient decision aid (PtDA) development. PURPOSE: An updated review as part of IPDAS 2.0 examined the extent to which PtDAs are designed to meet the needs of low health literacy/disadvantaged populations. DATA SOURCES: Reference list of Cochrane review of randomised controlled trials (RCTs) of PtDAs (2014, 2017 and upcoming 2021 versions). STUDY SELECTION: RCTs that assessed the impact of PtDAs on low health literacy or other disadvantaged groups (i.e. ≥50% participants from disadvantaged groups and/or subgroup analysis in disadvantaged group/s). DATA EXTRACTION: Two researchers independently extracted data into a standardized form including PtDA development and evaluation details. We searched online repositories and emailed authors to access PtDAs to verify reading level, understandability and actionability. DATA SYNTHESIS: Twenty-five out of 213 RCTs met inclusion criteria illustrating that only 12% of studies addressed the needs of low health literacy or other disadvantaged groups. Reading age was calculated in 8/25 studies (33%), which is recommended in previous IPDAS guidelines. We accessed and independently assessed 11 PtDAs. None were written at 6(th) grade level or below. Ten PtDAs met the recommended threshold for understandability, but only 5 met the recommended threshold for actionability. We also conducted a post-hoc subgroup meta-analysis and found that knowledge improvements after receiving a PtDA were greater in studies that reported using strategies to reduce cognitive demand in PtDA development compared to studies that did not (Chi(2)=14.11, p=0.0002, I(2)=92.9%). LIMITATIONS: We were unable to access 13 out of 24 PtDAs. CONCLUSIONS: Greater attention to health literacy and disadvantaged populations is needed in the field of PtDAs to ensure equity in decision support