Investigation into the relationship between adolescents’ perceived and actual fundamental movement skills and physical activity

Abstract Objectives: To explore the relationship between fundamental movement skill (FMS) competence, perceived FMS competence and physical activity (PA) in adolescents. Methods: The Test of Gross Motor Development (TGMD), the TGMD-2 and the Victorian Skills manual were used to assess FMS competence (locomotor, object control and stability). The Physical Self Confidence scale was used to assess perceived FMS competence (locomotor, object control and stability). Moderate to vigorous intensity PA (MVPA) was measured via accelerometry. Multi-level modelling analyses was used to examine: (i) actual FMS as the predictor and perceived FMS as the outcome, (ii) perceived FMS as the predictor and MVPA as the outcome, and (iii) actual FMS as the predictor and MVPA as the outcome. All analyses were completed for each subtest of FMS (locomotor, object control and stability). Results: A total of 584 adolescents (boys n = 278) aged 12.82 – 15.25 years (M 13.78, SD .42) participated in this study. Actual stability was associated with perceived stability (p<.01) and MVPA (p<.05) in boys. This was not found true for girls, however actual locomotor skills were associated with MVPA (p≤.05). Boys scored significantly higher than girls for FMS proficiency, perceived FMS and MVPA (p<.05). Discussion: Gender differences may exist due to cultural gender differences in sport participation norms. Considering the magnitude of physical and psychological changes occurring during adolescence, it is recommended to track young people over time to better understand the relationship between perceived and actual FMS, as well as PA participation. Keywords: physical activity, motor competence, adolescent

The Youth-Physical Activity Towards Health (Y-PATH) intervention: Results of a 24 month cluster randomised controlled trial

Low levels of physical activity in youth are an issue internationally, with the age related decline in levels over the adolescent period of particular concern. This study evaluated a multi-component school-based intervention (Y-PATH: Youth-Physical Activity Towards Health), focused on halting the age-related decline in physical activity of youth in early adolescence. A cluster randomized controlled trial in 20 post primary schools (10 control, 10 intervention) was conducted. Data were collected from all 20 schools at baseline (2013), and 12 months (2014), and from 10 of these schools (5 intervention) at 24 months (2015). The setting was mixed gender post primary schools residing in the greater area of Dublin, Ireland. Principals from each school were asked to nominate one first year class group attending their school in September 2013 to participate in the study (N = 564). Intervention schools implemented the Y-PATH whole school intervention, comprising teacher component, parent component, and PE component; while control schools continued with usual care. The main outcome measure was accelerometer derived average minutes of daily moderate to vigorous physical activity (MVPA). Data were analysed from October 2015 -November 2017. At baseline 490 participants were assessed (mean age 12.78y ± .42). Results of the multilevel regression analysis confirmed that there was a significant time intervention effect, and this was predominantly contributed by the difference between control and intervention groups within females. Findings support the case for national dissemination of the Y-PATH intervention so that the knowledge learned can be translated to routine practice in schools

Reducing delays in the diagnosis and treatment of muscle-invasive bladder cancer using simulation modelling

This is the author accepted manuscript. The final version is available from SAGE Publications via the DOI in this record Objective: To develop a simulation model to identify key bottlenecks in the bladder cancer pathway at Royal Cornwall Hospital and predict the impact of potential changes to reduce these delays. Materials and methods: The diagnosis and treatment of muscle-invasive bladder cancer can suffer numerous delays, which can significantly affect patient outcomes. We developed a discrete event computer simulation model of the flow of patients through the bladder cancer pathway at the hospital, using anonymised patient records from 2014 and 2015. The changes tested in the model were for patients suspected to have muscle-invasive disease on flexible cystoscopy. Those patients were ‘fast-tracked’ to receive their transurethral resection of bladder tumour (TURBT) treatment using operating slots kept free for these patients. A staging computed tomography scan was booked in the haematuria clinic. Pathology requests were marked as 48 hour turnaround. The nurse specialist would then speak to the patient whilst they were on the ward following their TURBT to give information about their ongoing treatment and provide support. Results: The model predicted that if the changes were implemented, delays in the system could be reduced by around 5 weeks. The changes were implemented, and analysis of 3 months of the data post-implementation shows that the average time in the system was reduced by 5 weeks. The environment created by the changes in the pathway improved referral to treatment times in both muscle-invasive and non-muscle-invasive groups. Conclusion: The simulation model proved an invaluable tool for facilitating the implementation of changes. Simple changes to the pathway led to significant reductions in delays for bladder cancer patients at Royal Cornwall Hospital. Level of evidence: Not applicable for this cohort study.National Institute for Health Research (NIHR

Engaging stakeholders in research to address water-energy-food (WEF) nexus challenges

The water–energy–food (WEF) nexus has become a popular, and potentially powerful, frame through which to analyse interactions and interdependencies between these three systems. Though the case for transdisciplinary research in this space has been made, the extent of stakeholder engagement in research remains limited with stakeholders most commonly incorporated in research as end-users. Yet, stakeholders interact with nexus issues in a variety of ways, consequently there is much that collaboration might offer to develop nexus research and enhance its application. This paper outlines four aspects of nexus research and considers the value and potential challenges for transdisciplinary research in each. We focus on assessing and visualising nexus systems; understanding governance and capacity building; the importance of scale; and the implications of future change. The paper then proceeds to describe a novel mixed-method study that deeply integrates stakeholder knowledge with insights from multiple disciplines. We argue that mixed-method research designs—in this case orientated around a number of cases studies—are best suited to understanding and addressing real-world nexus challenges, with their inevitable complex, non-linear system characteristics. Moreover, integrating multiple forms of knowledge in the manner described in this paper enables research to assess the potential for, and processes of, scaling-up innovations in the nexus space, to contribute insights to policy and decision making

Lack of confidence among trainee doctors in the management of diabetes: the Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study

Background: There is an increased prevalence of diabetes. Doctors in training, irrespective of specialty, will have patients with diabetes under their care

Predicting microbial water quality with models: Over-arching questions for managing risk in agricultural catchments

The application of models to predict concentrations of faecal indicator organisms (FIOs) in environmental systems plays an important role for guiding decision-making associated with the management of microbial water quality. In recent years there has been an increasing demand by policy-makers for models to help inform FIO dynamics in order to prioritise efforts for environmental and human-health protection. However, given the limited evidence-base on which FIO models are built relative to other agricultural pollutants (e.g. nutrients) it is imperative that the end-user expectations of FIO models are appropriately managed. In response, this commentary highlights four over-arching questions associated with: (i) model purpose; (ii) modelling approach; (iii) data availability; and (iv) model application, that must be considered as part of good practice prior to the deployment of any modelling approach to predict FIO behaviour in catchment systems. A series of short and longer-term research priorities are proposed in response to these questions in order to promote better model deployment in the field of catchment microbial dynamics

Real world, multicentre patterns of treatment and survival in metastatic renal cell carcinoma with the UK Renal Oncology Collaborative (UK ROC): Is it time to look favourably on first-line immunotherapy containing combinations in all IMDC groups?

\ua9 2024 The Author(s). Cancer Medicine published by John Wiley &amp; Sons Ltd.Introduction: Clinical trials show improved progression-free survival (PFS) and overall survival (OS) in first-line metastatic renal cell carcinoma (mRCC) patients with immunotherapy containing systemic anti-cancer therapies (SACT). However, in the favourable international metastatic renal cell cancer database consortium (IMDC) group there is no trial evidence for OS benefit despite clear PFS improvement when comparing anti-VEGF tyrosine kinase inhibitor (TKI) monotherapy and (immunotherapy and TKI) IO/TKI combinations. Objective: To assess the impact of first-line SACT choice on the clinical outcomes of PFS and OS in mRCC. To evaluate this impact of initial SACT for allcomers and the favourable IMDC group. Methods: A multicentre retrospective review of patients who started SACT for mRCC (01/01/2018–30/06/2021) at 17 UK NHS trusts. Patient demographics and IMDC group were analysed. Survival data were compared using Kaplan–Meier curves, and the statistical significance of differences in outcome between the groups was assessed with the log-rank test. Univariable and multivariable Cox proportional hazard modelling estimate the hazard ratios (HRs) for survival outcomes associated with IMDC and treatment subtype. Results: One thousand three hundred and nineteen patients were identified with a median age of 64. 294 (22.3%), 695 (52.7%) and 321 (24.3%) were IMDC group favourable, intermediate and poor, respectively. 311 (23.6%), 197 (14.9%) and 778 (59%) patients received checkpoint inhibitor and anti-CTLA4 monoclonal antibody (IO/IO), IO/TKI and TKI first-line SACT across all IMDC groups. Significant PFS improvement favouring IO/TKI versus TKI was demonstrated in allcomers HR = 0.61. In the favourable risk group, Log rank testing demonstrated a significant benefit for IO/TKI over TKI for PFS (HR = 0.60, 95% CI [0.39, 0.91]) and OS (HR = 0.42, 95% CI [0.18, 0.99]). Conclusion: In this real-world evidence cohort, we have shown OS and PFS benefit with IO/TKI versus TKI in the favourable IMDC risk group. This has not been previously reported from trial outcomes and would support use of front-line IO/TKI in mRCC favourable risk patients

Permanent Campaigning: A Meta-Analysis and Framework for Measurement

Permanent campaigning emerged as a concept in the 1970s in studies of US politics but is now recognized as a universal phenomenon. Despite its long history, there has been no attempt to build a holistic picture of the elements that constitute a permanent campaign. Generally, researchers focus on tactical elements, situating their use within an overall strategy, but there is a lack of a broader methodological framework for holistically measuring adherence to the permanent campaigning. This article presents results of a meta-analysis of relevant research to provide a framework to understand how permanent campaigning is practiced. Our study showed there were three reasonably discrete forms of campaigning activities that had been identified: those in which permanent campaign strategies are related to capacity building and strategy; a second, in which permanent campaigning relates to paid and owned media; and a third in which earned media is the main focus. In mapping these studies, we identify the common features of permanent campaigning, identifying strong and weak indicators and the extent these are employed by the government, parties, or elected representatives and within which political systems: parliamentarism or presidentialism. Our framework can be applied in future comparative research to understand trends in political communication