Global levels of fundamental motor skills in children: A systematic review.

Competence in fundamental motor skills (FMS) facilitates physical activity participation and is important for children's holistic development. This study aimed to systematically review the FMS levels of children worldwide, using the Test of Gross Motor Development-2 (TGMD-2). In accordance with PRISMA guidelines, studies were identified from searches across 7 databases. Studies were required to: (i) include typically developing children (3-10 years), (ii) be published in English, (iii) have been published between 2004 and 2019 and, (iv) report ≥1 TGMD-2 outcome scores. Extracted data were evaluated based on importance of determinants, strength of evidence, and methodological quality. Data from 64 articles were included. Weighted mean (and standard deviation) scores were calculated for each FMS outcome score. Analyses revealed FMS competence increases across age during childhood, with greater proficiency in locomotor skills than object control skills. Additionally, boys exhibit higher object control skill proficiency than girls. Compared to TGMD-2 normative data, children demonstrate "below average" to "average" FMS levels. This review highlights the scope for FMS development among children worldwide. These findings reinforce the necessity for FMS interventions in early educational settings, as FMS competence is positively associated with physical activity and other health outcomes.

The Acute Effects From the Use of Weighted Implements on Skill Enhancement in Sport: A Systematic Review.

ABSTRACT: Jermyn, S, Neill, CO, and Coughlan, EK. The acute effects from the use of weighted implements on skill enhancement in sport: A systematic review. J Strength Cond Res 35(10): 2922-2935, 2021-Weighted implements are used before competitive performance with the aim of enhancing motor skill execution on return to the standard implement. The purpose of this review was to analyze the existing literature pertaining to the acute effects of weighted implements on respective sporting performance. Following a systematic screening process, 25 studies were identified. This review highlighted the effects of (a) weighted balls and bats on throwing and batting performance and (b) indoor weight throw implements on indoor weight throw performance. Studies reported conflicting effects on immediate performance post-warm-up with the respective implements. Notably, although overweighted bats and overweight attachments are a prominent preparatory tool in baseball, this review found consistent and repeated evidence of degraded batting performance in striking-based studies. Decreased bat velocity, altered swing patterns, subjective-objective mismatches of bat speed and weight, temporal accuracy errors, and inadequate recalibration to the standard bat were identified as acute effects. This review identified an obvious dearth of research into the acute effects of weighted implements on motor skills in other sports with equally complex perceptual motor patterns, such as football (soccer), golf, rugby, basketball, and American football. Future weighted implement research should investigate the acute effects of respective implements on motor skill performance in other sports, such as those aforementioned, with the purpose of exploring relevant implications for preparatory strategies and immediate performance on return to the standard implement.

Lessons From the Experts: The Effect of a Cognitive Processing Intervention During Deliberate Practice of a Complex Task.

Deliberate practice is defined as an activity that is highly relevant to improving performance. It is effortful, challenging, not inherently enjoyable, or immediately rewarding and underpinned by advanced cognitive processing. The authors examine the effect of increasing cognitive processing during deliberate practice on skill learning in intermediate-level performers using a novel approach and quasi-experimental design. Two matched groups of intermediate-level Gaelic football players practiced a kick they identified as being most relevant to improving performance during an acquisition phase and pre-, post-, and retention tests. During acquisition, participants rated practice for cognitive effort and enjoyment. An intervention group engaged in structured cognitive processing before, during, and after the kicking practice sessions, whereas a control group did not. Both groups improved kicking accuracy across pre-, post-, and retention tests; however, the intervention group improved accuracy significantly more than the control group. The intervention group rated practice greater for mental effort compared with the control group, while both groups rated practice low for enjoyment. The intervention group increased reflection and evaluation to a greater degree following practice compared with the control group. Findings highlight the value of applying the principles of deliberate practice and increasing cognitive processing to expedite learning in intermediate-level performers, with implications for skill learning across many professional domains.

Mycoplasma genitalium Macrolide and Fluoroquinolone Resistance Detection and Clinical Implications in a Selected Cohort in New Zealand.

Mycoplasma genitalium has been associated with infections of the genitourinary tract, and prevalence is secondary to Chlamydia trachomatis The clinical observation of increasing treatment failure indicating antibiotic resistance, especially in cases of recurrent urethritis, has been confirmed by molecular testing. Mutations in the 23S rRNA gene can cause macrolide resistance, and topoisomerase/gyrase mutations can cause fluoroquinolone resistance. In this study, 115 M. genitalium DNA-positive samples were analyzed. Eighty-nine (77.4%) samples had a 23S rRNA mutation present, and 26 (22.6%) were wild type (no resistance mutation). Fluoroquinolone mutation screening was performed on 86 (74.8%) of the 115 samples, of which 20 (23.3%) samples had a mutation or mutations associated with increased resistance. This study shows the increasing antibiotic resistance in New Zealand and the need for appropriate guidelines to treat at-risk patients.

Evaluating the Perceived Health-Related Effectiveness of 'The Daily Mile' Initiative in Irish Primary Schools.

Many Irish primary school children do not meet recommended physical activity (PA) guidelines. The Daily Mile (TDM) is a primary school initiative designed to increase children's PA output. This study evaluates TDM's perceived effect on Irish primary school children's health-related metrics. A mixed-methods study, comprising two data collection phases, used the RE-AIM framework to evaluate TDM. Phase One involved teachers, principals and classroom assistants (n = 191) from TDM-registered schools completing a questionnaire. Two TDM-registered schools participated in Phase Two, where (i) interviews were conducted with each principal, (ii) a teacher sub-sample (n = 4) participated in a focus group, and (iii) a child sub-sample (n = 14) participated in separate focus groups. TDM was perceived to positively impact the markers of children's health, including their PA behaviour, physical fitness and social well-being. Inclement weather (66.5%) and a lack of time (56.5%) were reported as the top-ranked implementation barriers. Moreover, TDM's repetitive nature often left children feeling disinterested and resulted in some teachers modifying the initiative to maintain engagement levels. Maintaining the long-term implementation of TDM and its health benefits in primary schools may require bespoke amendments to the original format to preserve children's engagement.

A Systematic Review of the Implementation and Effectiveness of 'The Daily Mile' on Markers of Children's Health.

Currently, a high percentage of children globally fail to meet the World Health Organisation's (WHO) recommended daily physical activity (PA) guidelines. The Daily Mile (TDM) is a school-based PA initiative, designed to improve primary school children's PA behaviour. The purpose of this review was to evaluate the extant TDM implementation process and identify its impact on health-related metrics. Three databases were used to search for articles from the time TDM originated in 2012 until February 2022. The identification and screening process of articles for their ability to meet this review's eligibility criteria were facilitated by use of PRISMA and Rayyan. Sixteen articles from the initial search (n = 202) were deemed eligible for inclusion. An analysis of these articles identified five common outcome categories that permeated throughout the research articles: (1) cardiorespiratory fitness (CRF); (2) anthropometry and body composition; (3) PA; (4) cognition; and (5) process evaluation. Results presented from the included articles suggests TDM positively impacts markers of a variety of health-related metrics, namely CRF and PA. However, implementation barriers including TDM's repetitive nature, time constraints associated with competing curriculum demands and inadequate facilities regularly necessitate the adaptation and development of the original TDM format by schools and teachers.

Factors affecting decision-making in Gaelic Football: a focus group approach.

Objectives: Research examining decision-making in sports has predominantly used experimental approaches that fail to provide a holistic understanding of the various factors that impact the decision-making process. The current study aimed to explore the decision-making processes of Senior (expert) and Academy (near-expert) Gaelic Football players using a focus group approach. Methods: Four focus groups were conducted; two with Senior players (n = 5; n = 6) and two with U17 Academy players (n = 5; n = 6). In each focus group, short video clips of Senior Gaelic football games were played, and the action was paused at key moments. The group then discussed the options available to the player in possession, the decision they would make in that situation, and importantly, what factors influenced the final decision. Thematic analysis was used to identify themes that emerged from the focus groups. Results and discussion: Four primary themes emerged that affected the decision-making process. Three themes were related to information sources, namely, pre-match context (coach tactics and instructions, match importance, and opposition status), current match context (score and time remaining), and visual information (player positioning and field space, and visual search strategy), and the fourth theme related to individual differences (self-efficacy, risk propensity, perceived pressure, physical characteristics, action capabilities, fatigue) that moderated the decision-making process. Compared to the near-expert Academy players, the expert Senior players displayed a more sophisticated understanding of the various sources of information and were able to integrate them in a more complex manner to make projections regarding future scenarios. For both groups, the decision-making process was moderated by individual differences. A schematic has been developed based on the study findings in an attempt to illustrate the hypothesized decision-making process.

Chlamydia trachomatis testing sensitivity in midstream compared with first-void urine specimens.

PURPOSE: Traditionally first-void urine specimens are used to test for Chlamydia trachomatis. In contrast, midstream urine specimens are traditionally recommended for microscopy and culture of presumptive bacterial urinary tract infections. The ability to test for both C trachomatis and urinary tract infection on a single midstream urine specimen would greatly aid clinical practice, as an urinary tract infection is an extremely common complaint in primary care. This study set out to determine how well positive C trachomatis results obtained on first-void specimens would correlate with positive findings in matched midstream specimens. METHODS: One hundred women with a first-void urine specimen positive for C trachomatis also provided midstream specimens for comparison. All specimens had C trachomatis testing performed using a DNA detection method. RESULTS: Of the 100 eligible participants with a first-void specimen positive for C trachomatis, 96 (96%) also had a positive midstream specimen (95% exact confidence limits, 90.1%, 98.9%). CONCLUSIONS: These results suggest that by using newer nucleic acid amplification techniques (NAATs), timing of specimen collection is not so important in testing for C trachomatis as previously thought. The sensitivity of NAAT testing on midstream urine specimens in women is sufficiently equivalent to testing on first-void specimens to consider in clinical practice and research settings where first-void specimens have formerly been collected.

The Effects of a Weighted Football Intervention on Ball Velocity of a Standard Football Place-Kick among Elite Gaelic Football Goalkeepers: A Single-Subject Designed Study.

Weighted football place-kicking acutely enhances the ball velocity (BV) of subsequent standard football place-kicks. However, there is a dearth of research examining the long-term effects of such interventions, with less evidence in existence among elite athlete cohorts. Therefore, the purpose of this study was to investigate the individual effects of a 4 week, eight-session weighted Gaelic football intervention on BV of standard Gaelic football place-kicks among six elite male Gaelic football goalkeepers. This research design was based on a pre-, mid-, post-, and retention-test design. A linear mixed model analysis was employed, with time and participants as fixed effects, and the number of place-kicks per testing session as a random effect. Post hoc tests revealed significant changes in BV for five of the six participants (p < 0.05), with three participants experiencing significant BV increases from pre-test to post-test (p < 0.05), while no significant differences were found between post-test and retention-test. The remaining three participants experienced no significant BV differences from pre-test to post-test and retention-test. These findings suggest that a weighted football place-kicking intervention can be a time-efficient means of maintaining and enhancing BV and, thus, kick distance, among elite goalkeepers during pre-season and in-season phases.

Fundamental Movement Skill Proficiency and Health Among a Cohort of Irish Primary School Children.

PURPOSE: This study aimed to investigate the relationship between fundamental movement skills (FMS) and markers of health among a cohort of Irish primary school children. METHODS: Participants (N = 296, mean age: 7.99 ± 2.02 years) were senior infant (n = 149, mean age: 6.02 ± 0.39 years) and 4th class (n = 147, mean age: 9.97 ± 0.40 years) students from three primary schools in Cork, Ireland. FMS proficiency (TGMD-2) and markers of health (BMI percentile, waist circumference percentile, blood pressure percentiles, resting heart rate, cardiorespiratory fitness, objectively measured physical activity; PA) measurements were recorded. Correlation and hierarchical stepwise multiple linear regression analyses were conducted to investigate the relationship between FMS and markers of health. RESULTS: A small, positive relationship was found between FMS (Gross Motor Quotient; GMQ) and cardiorespiratory fitness with small negative correlations between GMQ and 550 m time SDS among 6-year-olds (r(129) = -.286, p < .05) and 10-year-olds (r(132) = -.340, p < .05). A moderate, positive correlation was found between GMQ and light PA (r(71) = .400, p < .05). Small positive correlations were revealed between GMQ and moderate PA (r(71) = .259, p < .05) and between GMQ and total PA (r(71) = .355, p < .05). After adjusting for age, sex, the interaction effect of age and sex, and school attended, FMS explained 15.9% and 24.8% of the variance in 550 m time SDS among 6- and 10-year-olds, respectively, and 6% and 6.5% of the variance in light PA and moderate PA, respectively. After adjusting for age and sex, FMS explained 11.6% of the variance in total PA. CONCLUSION: A wide range of FMS is important for children's cardiorespiratory fitness and PA.

Accuracy of Children's Perceived Skill Competence and its Association With Physical Activity.

BACKGROUND: Perceived movement competence is important in the relationship between actual competence and physical activity (PA). This study examines the accuracy of children's perceptions and investigates the relationship between perceived competence (PC) and PA. METHODS: Data collected were part of Project Spraoi, a PA and nutrition-based intervention. Participants (N = 419) were senior infant/first class (n = 202, mean age: 6.5 [0.6] y) and fourth/fifth class (n = 217, mean age: 10.4 [0.6] y) children from 3 schools in Cork, Ireland. The Test of Gross Motor Development-2 and Pictorial Scale of Perceived Movement Skill Competence for Young Children assessed actual and PC in 6 locomotor and 6 object-control fundamental movement skills. Moderate to vigorous PA levels were measured by accelerometry. Wilcoxon signed-rank tests assessed the accuracy of PC. Hierarchical regression analysis investigated relationships between PC and both actual competence and moderate to vigorous PA. RESULTS: Children had greater perceived overall and object-control competence than actual. Among younger children, there was no difference between perceived locomotor and actual, while older children had lower perceived locomotor competence than actual. PC did not predict actual competence. Perceived object-control and total PC were significant predictors of moderate to vigorous PA. CONCLUSIONS: Children have inflated perceptions of their overall and object-control movement skill competency. Perceived object-control and total FMS is associated with PA and thus, interventions aimed at increasing PA among children should target PC.

Implementing HIV pre-exposure prophylaxis (PrEP): let's not get caught with our pants down.

HIV pre-exposure prophylaxis (PrEP) is a daily pill that prevents HIV acquisition. In March 2018, New Zealand became one of the first countries in the world to publicly fund PrEP for individuals at high risk. PrEP promises significantly improved HIV control but is unfamiliar to most health practitioners here, compromising its potential. In this article we review the rationale for PrEP and identify barriers to rapid implementation. The latter include: consumer and health practitioner awareness; acceptability; scale-up targets; prescribing and pharmacy bottlenecks; service capacity to manage follow-up; primary care training; monitoring systems for uptake and quality; equity; eligibility; risk compensation and policy. Many of these areas are ripe for research and innovation. By addressing these obstacles we can realise the potential of PrEP and move closer to ending HIV in Aotearoa/New Zealand.

Sex, Bugs, and Rock 'n' Roll: A Service-Learning Innovation to Enhance Medical Student Knowledge and Comfort With Sexual Health.

INTRODUCTION: Sexual health is an intrinsic element of overall health; however, opportunities to enhance medical student comfort and knowledge about sexual health vary substantially and receive limited curricular time. Sex, Bugs, and Rock 'n' Roll is a novel service-learning initiative designed to enhance undergraduate medical student knowledge and comfort with sexual health. A total of 80 fifth-year undergraduate medical students researched, designed, and delivered a short sexual health promotion initiative for a population that experiences inequity. METHODS: This initiative employed active learning tasks including performing a literature review, participating in team learning, facilitating small-group sessions, and providing peer feedback. Ongoing formative feedback from the program leaders, tutors, and members of the target audience contributed to student development. A summative assessment rubric was used by program leaders to evaluate student performance at the end of the module. Anonymized pre- and posttest knowledge questions and module evaluations were used to evaluate the module. RESULTS: All 80 (100%) students completed randomized pre- and posttest knowledge questions and module evaluations. Student knowledge scores about sexuality and sexual health improved by 17% between pre- and posttest. All students reported increased comfort with and understanding of the clinical relevance of sexual health in the module evaluations. DISCUSSION: Sex, Bugs, and Rock 'n' Roll is a promising initiative for improving medical student knowledge and comfort with sexual health. This module also offers a novel way for students to experience sexual health, public health, and social accountability in an active and engaging fashion.

A novel response to an outbreak of infectious syphilis in Christchurch, New Zealand.

During 2012, Christchurch experienced a dramatic increase in cases of infectious syphilis among men who have sex with men. This was accompanied by some novel trends; notably, the acquisition of infection in a younger age group, with local sexual contacts, commonly via the use of social media. This study is a report on an approach to case identification and public health communication as a component of a multifaceted outbreak response. Enhanced syphilis surveillance data on public health responses to outbreaks of sexually transmissible infections was collated and reviewed, alongside clinical records and literature. Reported outbreak response methods were adapted for the Christchurch cohort. A Facebook page was created to raise awareness of infectious syphilis, the importance of screening and where to get tested. Twenty-six males were diagnosed with infectious syphilis in 2012, an increase from previous years, of which 22 reported only male sexual contact. High use of social media used to find potential sexual contacts was reported. Enhanced syphilis surveillance characterised in detail an infectious syphilis outbreak in Christchurch. Index cases were identified, contact tracing mapping was used to identify transmission networks and social media was also used to educate the risk group. There was a decrease in infectious syphilis presentations, with no cases in the last 3 months of 2012.

How experts practice: a novel test of deliberate practice theory.

Performance improvement is thought to occur through engagement in deliberate practice. Deliberate practice is predicted to be challenging, effortful, and not inherently enjoyable. Expert and intermediate level Gaelic football players executed two types of kicks during an acquisition phase and pre-, post-, and retention tests. During acquisition, participants self-selected how they practiced and rated the characteristics of deliberate practice for effort and enjoyment. The expert group predominantly practiced the skill they were weaker at and improved its performance across pre-, post- and retention tests. Participants in the expert group also rated their practice as more effortful and less enjoyable compared to those in the intermediate group. In contrast, participants in the intermediate group predominantly practiced the skill they were stronger at and improved their performance from pretest to posttest but not on the retention test. Findings provide support for deliberate practice theory and give some insight into how experts practice and improve their performance beyond its current level.

Enhanced surveillance of infectious syphilis in New Zealand sexual health clinics.

Following a rise in cases of infectious syphilis in New Zealand, national enhanced surveillance at sexual health clinics was initiated. All public sexual health clinics reported monthly on the number of cases seen, and completed a coded questionnaire on each case. Monthly reports to routine surveillance were compared and discrepancies reconciled. During 2011, 72 cases of infectious syphilis were reported. The majority (83%) were among men who have sex with men who were mainly infected in New Zealand and had an ethnic profile similar to all New Zealanders. Most heterosexual infections occurred overseas, among people of non-European non-Maori ethnicity. About half the cases had symptoms on presentation. Overall, 18% of men who have sex with men were HIV positive. Resurgent syphilis in New Zealand disproportionally affects men who have sex with men, amongst whom HIV is prevalent. Men who have sex with men should be aware of the risks and symptoms of syphilis and encouraged to have regular sexual health checks including serology testing. Control of syphilis should be included in the strategy to check HIV spread. Syphilis serology should continue to be part of routine immigration and antenatal screening, and where clinically indicated. Enhanced surveillance was easily initiated for an uncommon condition seen at sexual health clinics, and provided valuable information.

Human papilloma virus vaccines and their role in cancer prevention.

The introduction of the human papilloma virus (HPV) vaccine is the single most important advance in the prevention of cervical cancer since the introduction of cervical cytology half a century ago. Vaccination should ideally occur prior to a female's first sexual experience. This article suggests that the HPV vaccine should be publicly funded in New Zealand.

Chlamydia trachomatis prevalence and sexual behaviour in Christchurch high school students.

AIMS: To estimate the prevalence of Chlamydia trachomatis among young people in Year 12 and Year 13 in Christchurch secondary schools. METHODS: A cross-sectional survey on sexual behaviour was carried out in conjunction with the collection of urine samples, which were tested for C. trachomatis. RESULTS: 1582 young people were invited to take part in the study. 72% of these students answered the questionnaire of whom 49% had experienced sexual intercourse. The mean age of the sample was 16.7 years. The prevalence of C. trachomatis among the sexually active participants who provided a urine sample was 2.0% (1.8% of males and 2.3% of females). 39% of sexually active participants had had one partner in their lifetime and 13% had had more than five partners. 51% of males and 39% of females indicated that they always used condoms and 69% of males and 57% of females reported using a condom on the last occasion of sexual intercourse. CONCLUSIONS: Our study shows that 2.0% of sexually active senior high school students have asymptomatic C. trachomatis infections. Opportunistic screening for C. trachomatis should be offered to all sexually active males and females at risk.