Transforming Philanthropic Transactions

Evaluates the approach and effectiveness of SVP's first five years working to inspire philanthropy and volunteerism and build organizational capacity among nonprofits. Describes SVP's model that fuses donor education and capacity building activities

Fundamental movement skills and their assessment in primary schools from the perspective of teachers

Evidence suggests that children struggle to acquire age-appropriate fundamental movement skills (FMS), despite their importance for facilitating physical activity. This has led to calls for routine school-based screening of children’s FMS. However, there is limited research exploring schools’ capacity to conduct such assessments. This study investigated what factors might affect the adoption and implementation of FMS assessments in primary schools. School staff (n = 853) completed an online questionnaire developed using the Capability, Opportunity, Motivation and Behavior (COM-B) model. A majority reported that knowledge of pupils’ FMS ability would be beneficial (65.3%), and 71.8% would assess FMS if support was provided. Barriers included: Capability–few possessed knowledge of FMS (15%); Opportunity–teachers reported 30–60 minutes as acceptable for assessing a class, a substantially shorter period than current assessments require; Motivation–57.2% stated FMS assessments would increase workload stress. Solutions to these issues are discussed using the COM-B theoretical framework.</p

The validity and reliability of school-based fundamental movement skills screening to identify children with motor difficulties

Aim Assess whether school-based teacher-led screening is effective at identifying children with motor difficulties. Methods Teachers tested 217 children aged between 5 and 11 years old, after a one hour training session, using a freely available tool (FUNMOVES). Four classes (n = 91) were scored by both researchers and teachers to evaluate inter-rater reliability. Researchers assessed 22 children using the Movement Assessment Battery for Children (MABC-2; considered to be the ‘gold standard’ in Europe for use as part of the diagnostic process for Developmental Coordination Disorder) to assess concurrent and predictive validity. Results Inter-rater reliability for all individual activities within FUNMOVES ranged from 0.85–0.97 (unweighted Kappa; with 95%CI ranging from 0.77–1). For total score this was lower (κ = 0.76, 95%CI = 0.68–0.84), however when incorporating linear weighting, this improved (κ = 0.94, 95%CI = 0.89–0.99). When evaluating FUNMOVES total score against the MABC-2 total score, the specificity (1, 95%CI = 0.63–1) and positive predictive value (1; 95%CI = 0.68–1) of FUNMOVES were high, whereas sensitivity (0.57, 95%CI = 0.29–0.82) and negative predictive values (0.57, 95%CI = 0.42–0.71) were moderate. Evaluating only MABC-2 subscales which are directly related to fundamental movement skills (Aiming &amp; Catching, and Balance) improved these values to 0.89 (95%CI = 0.52–1) and 0.93 (95%CI = 0.67– 0.99) respectively. Interpretation Teacher-led screening of fundamental movement skills (via FUNMOVES) is an effective method of identifying children with motor difficulties. Such universal screening in schools has the potential to identify movement difficulties and enable earlier intervention than the current norm.</p

Managing the coagulopathy of postpartum hemorrhage: an evolving role for viscoelastic hemostatic assays

Postpartum hemorrhage (PPH) is usually caused by obstetrical complications but may be exacerbated by hemostatic impairment. Standard laboratory tests of coagulation often take too long to become available to inform treatment in a rapidly changing clinical situation. The role of point-of-care viscoelastic hemostatic assays (VHAs) in monitoring hemostatic impairment and guiding procoagulant blood product replacement during PPH is evolving, although these technologies are not available in most maternity units. We have used VHAs during PPH in our institution for the last 8 years and have developed a simple algorithm to direct blood component replacement. VHAs are useful for reassuring clinicians that hemostasis is adequate and that procoagulant blood products are not required and an obstetrical cause for bleeding needs to be sought. VHAs can be used to detect hypofibrinogenemia due to dilution or acute obstetrical coagulopathy and to guide fibrinogen replacement. The role of VHAs in guiding fresh frozen plasma infusion is less clear, but normal results suggest that fresh frozen plasma is not required. In this review, we describe 3 cases of postpartum hemorrhage to illustrate different hemostatic scenarios and discuss the controversies and evidence gaps related to each case

Developing and validating a school-based screening tool of Fundamental Movement Skills (FUNMOVES) using Rasch analysis

Background A large proportion of children are not able to perform age-appropriate fundamental movement skills (FMS). Thus, it is important to assess FMS so that children needing additional support can be identified in a timely fashion. There is great potential for universal screening of FMS in schools, but research has established that current assessment tools are not fit for purpose. Objective To develop and validate the psychometric properties of a FMS assessment tool designed specifically to meet the demands of universal screening in schools. Methods A working group consisting of academics from developmental psychology, public health and behavioural epidemiology developed an assessment tool (FUNMOVES) based on theory and prior evidence. Over three studies, 814 children aged 4 to 11 years were assessed in school using FUNMOVES. Rasch analysis was used to evaluate structural validity and modifications were then made to FUNMOVES activities after each study based on Rasch results and implementation fidelity. Results The initial Rasch analysis found numerous psychometric problems including multidimensionality, disordered thresholds, local dependency, and misfitting items. Study 2 showed a unidimensional measure, with acceptable internal consistency and no local dependency, but that did not fit the Rasch model. Performance on a jumping task was misfitting, and there were issues with disordered thresholds (for jumping, hopping and balance tasks). Study 3 revealed a unidimensional assessment tool with good fit to the Rasch model, and no further issues, once jumping and hopping scoring were modified.Implications The finalised version of FUNMOVES (after three iterations) meets standards for accurate measurement, is free and able to assess a whole class in under an hour using resources available in schools. Thus FUNMOVES has the potential to allow schools to efficiently screen FMS to ensure that targeted support can be provided and disability barriers removed.</p

Bonding with bump : Interoceptive sensibility moderates the relationship between pregnancy body satisfaction and antenatal attachment

PROBLEM: There is limited understanding and contradictory results regarding the contribution of the pregnant bodily experience to antenatal attachment. BACKGROUND: Antenatal attachment is an important aspect of pregnancy, which has been linked with positive maternal and infant outcomes. Given the profound physical process of pregnancy, it is likely that bodily experience is implicated in antenatal attachment, with research supporting the involvement of pregnancy body (dis)satisfaction. However, previous research reveals conflicting results and has only focused on exteroceptive bodily experience (appearance) rather than internal physiological sensations (interoception). AIM: To examine the relative contributions of both external and internal bodily experience in antenatal attachment. METHODS: This cross-sectional study collected online survey data from 159 pregnant participants with measures capturing interoceptive sensibility (subjective experience of interoception), pregnancy body dissatisfaction and antenatal attachment. FINDINGS: We replicated previous findings that pregnancy body dissatisfaction is related to antenatal attachment. However, the relationship between pregnancy body dissatisfaction and antenatal attachment was moderated by worry about interoceptive signals. The interoceptive construct of body trust was most strongly associated with antenatal attachment. DISCUSSION: The results suggest that interoception is important for antenatal attachment, particularly feelings of body trust. Moreover, for individuals who were less worried about bodily sensations, high levels of body dissatisfaction were associated with low attachment scores, whilst for those who were more concerned about these sensations, the relationship between body dissatisfaction and antenatal attachment was mitigated. CONCLUSION: The results suggest that focusing on internal sensations may be a protective strategy against pregnancy body dissatisfaction to strengthen maternal bonds

Biomarker-guided duration of Antibiotic Treatment in Children Hospitalised with confirmed or suspected bacterial infection (BATCH): Protocol for a randomised controlled trial

Introduction Procalcitonin (PCT) is a biomarker more specific for bacterial infection and responds quicker than other commonly used biomarkers such as C reactive protein, but is not routinely used in the National Health Service (NHS). Studies mainly in adults show that using PCT to guide clinicians may reduce antibiotic use, reduce hospital stay, with no associated adverse effects such as increased rates of hospital re-admission, incomplete treatment of infections, relapse or death. A review conducted for National Institute for Health and Care Excellence recommends further research on PCT testing to guide antibiotic use in children.Methods and analysis Biomarker-guided duration of Antibiotic Treatment in Children Hospitalised with confirmed or suspected bacterial infection is a multi-centre, prospective, two-arm, individually Randomised Controlled Trial (RCT) with a 28-day follow-up and internal pilot. The intervention is a PCT-guided algorithm used in conjunction with best practice. The control arm is best practice alone. We plan to recruit 1942 children, aged between 72 hours and up to 18 years old, who are admitted to the hospital and being treated with intravenous antibiotics for suspected or confirmed bacterial infection. Coprimary outcomes are duration of antibiotic use and a composite safety measure. Secondary outcomes include time to switch from broad to narrow spectrum antibiotics, time to discharge, adverse drug reactions, health utility and cost-effectiveness. We will also perform a qualitative process evaluation. Recruitment commenced in June 2018 and paused briefly between March and May 2020 due to the COVID-19 pandemic

Fundamental Movement Skills and Their Assessment in Primary Schools from the Perspective of Teachers

YesEvidence suggests that children struggle to acquire age-appropriate fundamental movement skills (FMS), despite their importance for facilitating physical activity. This has led to calls for routine school-based screening of children’s FMS. However, there is limited research exploring schools’ capacity to conduct such assessments. This study investigated what factors might affect the adoption and implementation of FMS assessments in primary schools. School staff (n = 853) completed an online questionnaire developed using the Capability, Opportunity, Motivation and Behavior (COM-B) model. A majority reported that knowledge of pupils’ FMS ability would be beneficial (65.3%), and 71.8% would assess FMS if support was provided. Barriers included: Capability–few possessed knowledge of FMS (15%); Opportunity–teachers reported 30–60 minutes as acceptable for assessing a class, a substantially shorter period than current assessments require; Motivation–57.2% stated FMS assessments would increase workload stress. Solutions to these issues are discussed using the COM-B theoretical framework.Economic and Social Research Council White Rose Doctoral Training Partnership Pathway Award [ES/P000745/1], ActEarly: a City Collaboratory approach to early promotion of good health and wellbeing funded by the Medical Research Council [MR/S037527/], National Institute for Health Research Yorkshire and Humber ARC [NIHR20016