Physically fit or physically literate? Children with special educational needs understanding of physical education

The role of physical literacy within physical education (PE) has become a widely debated topic in recent years. Its role in educating children about physicality through embodiment, skill acquisition and reading the environment is argued to be of great benefit to children. However, whether children understand the role of PE in the development of these competencies is not clear, and this is even truer for children who have special educational needs (SEN). Drawing on qualitative phenomenological data from 30 children in key stages 2 and three (7 to 14 years of age) who have SEN, this paper explores notions of physical fitness and physical literacy as understood by children in PE lessons. It aims to gain insight into the ways that children understand the purpose of PE, and places these perceptions within a physical literacy framework, using the National Curriculum for PE (NCPE) as a foundation. Findings demonstrate that children with SEN perceive PE as a means for improving physical fitness, whereas concepts surrounding physical literacy appear to be lost. The paper concludes by making recommendations for factoring physical literacy components more forcibly into the PE curriculum, and through initial teacher training and continued professional development

The pirate in the pump: children's views of objects as imaginary friends at the start of school

The main aim of this paper is to use a phenomenological approach (Merleau-Ponty, 1962. Phenomenology of Perception. Evanston: Northwestern University Press; Merleau-Ponty. 1968. The Visible and the Invisible: Followed by Working Notes. Evanston: Northern University Press) to contribute a new theoretical understanding of what imaginary friends mean for children in the context of starting school. The paper addresses the specific area of ‘object-friends’ and draws on examples from an empirical and consultative study of a small sample of five and six-year-old children’s everyday experiences of friendship in school. The paper argues that if practitioners consider embodiment approaches and listen attentively to the knowledge and information that children share about their imaginary friends, this could be used to nurture children’s early learnin

Visual methodologies, sand and psychoanalysis: employing creative participatory techniques to explore the educational experiences of mature students and children in care

Social science research has witnessed an increasing move towards visual methods of data production. However, some visual techniques remain pariah sites because of their association with psychoanalysis; and a reluctance to engage with psychoanalytically informed approaches outside of therapy based settings. This paper introduces the method of ‘sandboxing’, which was developed from the psychoanalytical approach of the ‘world technique’. ‘Sandboxing’ provides an opportunity for participants to create three-dimensional scenes in sand-trays, employing miniature figures and everyday objects. Data is presented from two studies conducted in Wales, UK. The first, exploring mature students’ accounts of higher education, and the second, exploring the educational experiences of children and young people in public care. The paper argues that psychoanalytical work can be adapted to enable a distinctive, valuable and ethical tool of qualitative inquiry; and illustrates how ‘sandboxing’ engendered opportunities to fight familiarity, enabled participatory frameworks, and contributed to informed policy and practice

Simvastatin for patients with Acute Respiratory Distress Syndrome: long term outcomes and cost-effectiveness from a randomised controlled trial

Background: Simvastatin therapy for patients with ARDS has been shown to be safe and associated with minimal adverse effects, but it does not improve clinical outcomes. The aim of this research was to report on mortality and cost-effectiveness of simvastatin in patients with ARDS at 12 months. Methods: A cost-utility analysis alongside a multicentre, double-blind, randomised controlled trial carried out in the UK and Ireland. Five hundred and forty intubated and mechanically ventilated patients with acute respiratory distress syndrome were randomly assigned (1:1) to receive once-daily simvastatin (at a dose of 80 mg) or identical placebo tablets enterally for up to 28 days. Results: Mortality was lower in the simvastatin group (31.8%; 95% CI 26.1, 37.5) compared to the placebo group (37.3%; 95% CI 31.6, 43.0) at 12 months although this was not significant. Simvastatin was associated with statistically significant QALY gain (incremental QALYs 0.064, 95% CI 0.002, 0.127) compared to placebo. Simvastatin was also less costly (incremental total costs –£3601, 95% CI –8061, 859). At a willingness-to-pay threshold of £20,000 per QALY the probability of simvastatin being cost-effective was 99%. Sensitivity analyses indicated that the results were robust to changes in methodological assumptions with the probability of cost-effectiveness never dropping below 90%. Conclusion: Simvastatin was found to be cost-effective for the treatment of ARDS, being associated with both a significant QALY gain and a cost saving. There was no significant reduction in mortality at 12 months

An ecological method for the sampling of nonverbal signalling behaviours of young children with profound and multiple learning disabilities (PMLD)

- Background: Profound and multiple learning disabilities (PMLD) are a complex range of disabilities that affect the general health and wellbeing of the individual and their capacity to interact and learn. - Method: We developed a new methodology to capture the nonsymbolic signalling behaviours of children with PMLD within the context of a face-to-face interaction with a caregiver to provide analysis at a micro-level of descriptive detail incorporating the use of the ELAN digital video software. - Conclusion: The signalling behaviours of participants in a natural, everyday interaction can be better understood with the use of this innovation in methodology, which is predicated on the ecology of communication. Recognition of the developmental ability of the participants is an integral factor within that ecology. The method presented establishes an advanced account of the modalities through which a child affected by PMLD is able to communicate

Prescriptive variability of drugs by general practitioners

<div><p>Prescription drug spending is growing faster than any other sector of healthcare. However, very little is known about patterns of prescribing and cost of prescribing between general practices. In this study, we examined variation in prescription rates and prescription costs through time for 55 GP surgeries in Northern Ireland Western Health and Social Care Trust. Temporal changes in variability of prescribing rates and costs were assessed using the Mann–Kendall test. Outlier practices contributing to between practice variation in prescribing rates were identified with the interquartile range outlier detection method. The relationship between rates and cost of prescribing was explored with Spearman's statistics. The differences in variability and mean number of prescribing rates associated with the practice setting and socioeconomic deprivation were tested using t-test and <i>F</i>-test respectively. The largest between-practice difference in prescribing rates was observed for Apr-Jun 2015, with the number of prescriptions ranging from 3.34 to 8.36 per patient. We showed that practices with outlier prescribing rates greatly contributed to between-practice variability. The largest difference in prescribing costs was reported for Apr-Jun 2014, with the prescription cost per patient ranging from £26.4 to £64.5. In addition, the temporal changes in variability of prescribing rates and costs were shown to undergo an upward trend. We demonstrated that practice setting and socio-economic deprivation accounted for some of the between-practice variation in prescribing. Rural practices had higher between practice variability than urban practices at all time points. Practices situated in more deprived areas had higher prescribing rates but lower variability than those located in less deprived areas. Further analysis is recommended to assess if variation in prescribing can be explained by demographic characteristics of patient population and practice features. Identification of other factors contributing to prescribing variability can help us better address potential inappropriateness of prescribing.</p></div