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In the past decade, teachers and researchers have recognized the vital role school climate plays in the public school setting in the United States (Thapa, Cohen, Guffey & Higgins-D'Alessandro, 2013). One of the greatest indicators of achievement is the relationship between school and student socioeconomic status (Sirin, 2005). According to Bryk and Schneider (2003), if schools create positive learning environments, students will achieve at a higher level than what their socioeconomic background would otherwise predict. The purpose of this quantitative study was to identify the relationship between school climate and student academic achievement in reading at the elementary level in public schools in Virginia, USA. The researcher examined extant data from the 2018-2019 school year, which included Grade 5 Reading Virginia Standards of Learning (SOL) pass rates and school climate surveys from two school divisions in the Commonwealth of Virginia. The findings indicated that the school climate dimension had the strongest correlation to the Reading SOL pass rates in both school districts. School leaders and building-level principals could use these findings to better understand the importance of school climate and its impact on student achievement.

BACKGROUND: Contemporary surgical practices for traumatic brain injury (TBI) remain unclear. We describe the clinical profile of an 18-centre US TBI cohort with cranial surgery. METHODS: The prospective, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (2014-2018; ClinicalTrials.gov #NCT02119182) enrolled subjects who presented to trauma centre and received head computed tomography within 24-h (h) post-TBI. We performed a secondary data analysis in subjects aged ≥17-years with hospitalisation. Clinical characteristics, surgery type/timing, hospital and six-month outcomes were reported. FINDINGS: Of 2032 subjects (age: mean = 41.4-years, range = 17-89-years; male = 71% female = 29%), 260 underwent cranial surgery, comprising 65% decompressive craniectomy, 23% craniotomy, 12% other surgery. Subjects with surgery (vs. without surgery) presented with worse neurological injury (median Glasgow Coma Scale = 6 vs. 15; midline shift ≥5 mm: 48% vs. 2%; cisternal effacement: 61% vs. 4%; p

Although there is a plethora of tools available to assess children's movement competence (MC), the literature suggests that many have significant limitations (e.g. not being practical for use in many 'real-world' settings). The FMS[superscript 2] assessment tool has recently been developed as a targeted solution to many of the existing barriers preventing practitioners from utilising MC assessments. The aim of this study was to investigate the structural and convergent validity of this new tool among 8- to 12-year-old Irish primary school children. As part of this study, 102 children (56.8% female, mean = 9.8 years) were assessed using the FMS[superscript 2], the Test of Gross Motor Development (3rd edition) (TGMD-3) (short version) and the Functional Movement Screen™ (FMS™). Structural validity was assessed using confirmatory factor analysis (CFA). The convergent validity between the FMS[superscript 2], the TGMD-3 (short version) and the FMS™ was investigated using the Pearson product-moment correlation coefficient. Results of CFA for the FMS[superscript 2] indicate a good fit model, supporting a three-factor structure (locomotor, object manipulation, and stability). Additional findings indicate a moderate, positive correlation between the FMS[superscript 2] and the TGMD-3 (short version) (r = 0.66), with a low, positive correlation between the FMS[superscript 2] and the FMS™ (r = 0.48). This study presents the first preliminary findings to suggest that the FMS[superscript 2] may be a versatile, time-efficient, and ecologically valid tool to measure children's MC in multiple settings (e.g. research, education, sport, athletic therapy, and physiotherapy). Future research should also seek to continue to implement this solution, consolidate the existing validity findings with a larger and more diverse sample, and further explore the feasibility of the tool in 'real-world' settings.

We examine and compare the relationship between minimum wage increases and youth homicide rates in three groups: all youth, White youth only, and Black youth only. Using 2001-2019 mortality data from the National Vital Statistics System (NVSS) for all 50 states and Washington DC, we apply a difference in differences (DD) design to compare the change in youth homicides across states with varying changes in the state-specific minimum wage. With the inclusion of state-specific linear time trends, we find that a $1 increase in minimum wage leads to a significant 4% reduction (RR = 0.96, 95%CI [0.92, 0.99]) in homicides among White youth, but no significant reduction among Black youth (RR = 0.98, 95%CI [0.91, 1.04]). Findings are consistent with research on marginalization-related diminished returns for Black youth. While minimum wage increases are a promising step to reduce youth homicides overall, reducing homicide disparities experienced by Black youth requires additional components. Future research should examine policies with the specific intention to dismantle structural racism.

Purpose: Competence in fundamental movement skills (FMS) is purported to be linked with increased physical activity participation. Yet, recent research suggests a low level of FMS proficiency in children. The aim of this study was to evaluate the efficacy, impact on gender, and influence of teacher fidelity on the Moving Well-Being Well intervention. Method: The intervention was delivered in 18 primary schools (n = 925, M[subscript age] = 7.55 years). Data were gathered on six FMS and two balance skills pre- and postintervention using the Test of Gross Motor Development--Third Edition and Bruininks--Oseretsky Test of Motor Proficiency 2. Results: The mean postintervention FMS score was higher than preintervention, with a mean increase of 7.85 (23%). A two-way analysis of covariance found gender was not statistically significant (p = 0.74), but teacher fidelity was statistically significant (p = 0.000; moderate effect size). Conclusions: The intervention significantly improved children's FMS, having a similar effect on boys and girls. Teacher fidelity of implementation had a significant impact on FMS improvement.

OBJECTIVE: The International Mission on Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) and Corticosteroid Randomization After Significant Head Injury (CRASH) prognostic models for mortality and outcome after traumatic brain injury (TBI) were developed using data from 1984 to 2004. This study examined IMPACT and CRASH model performances in a contemporary cohort of US patients. METHODS: The prospective 18-center Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study (enrollment years 2014-2018) enrolled subjects aged ≥ 17 years who presented to level I trauma centers and received head CT within 24 hours of TBI. Data were extracted from the subjects who met the model criteria (for IMPACT, Glasgow Coma Scale [GCS] score 3-12 with 6-month Glasgow Outcome Scale-Extended [GOSE] data [n = 441]; for CRASH, GCS score 3-14 with 2-week mortality data and 6-month GOSE data [n = 831]). Analyses were conducted in the overall cohort and stratified on the basis of TBI severity (severe/moderate/mild TBI defined as GCS score 3-8/9-12/13-14), age (17-64 years or ≥ 65 years), and the 5 top enrolling sites. Unfavorable outcome was defined as GOSE score 1-4. Original IMPACT and CRASH model coefficients were applied, and model performances were assessed by calibration (intercept [< 0 indicated overprediction; > 0 indicated underprediction] and slope) and discrimination (c-statistic). RESULTS: Overall, the IMPACT models overpredicted mortality (intercept -0.79 [95% CI -1.05 to -0.53], slope 1.37 [1.05-1.69]) and acceptably predicted unfavorable outcome (intercept 0.07 [-0.14 to 0.29], slope 1.19 [0.96-1.42]), with good discrimination (c-statistics 0.84 and 0.83, respectively). The CRASH models overpredicted mortality (intercept -1.06 [-1.36 to -0.75], slope 0.96 [0.79-1.14]) and unfavorable outcome (intercept -0.60 [-0.78 to -0.41], slope 1.20 [1.03-1.37]), with good discrimination (c-statistics 0.92 and 0.88, respectively). IMPACT overpredicted mortality and acceptably predicted unfavorable outcome in the severe and moderate TBI subgroups, with good discrimination (c-statistic ≥ 0.81). CRASH overpredicted mortality in the severe and moderate TBI subgroups and acceptably predicted mortality in the mild TBI subgroup, with good discrimination (c-statistic ≥ 0.86); unfavorable outcome was overpredicted in the severe and mild TBI subgroups with adequate discrimination (c-statistic ≥ 0.78), whereas calibration was nonlinear in the moderate TBI subgroup. In subjects ≥ 65 years of age, the models performed variably (IMPACT-mortality, intercept 0.28, slope 0.68, and c-statistic 0.68; CRASH-unfavorable outcome, intercept -0.97, slope 1.32, and c-statistic 0.88; nonlinear calibration for IMPACT-unfavorable outcome and CRASH-mortality). Model performance differences were observed across the top enrolling sites for mortality and unfavorable outcome. CONCLUSIONS: The IMPACT and CRASH models adequately discriminated mortality and unfavorable outcome. Observed overestimations of mortality and unfavorable outcome underscore the need to update prognostic models to incorporate contemporary changes in TBI management and case-mix. Investigations to elucidate the relationships between increased survival, outcome, treatment intensity, and site-specific practices will be relevant to improve models in specific TBI subpopulations (e.g., older adults), which may benefit from the inclusion of blood-based biomarkers, neuroimaging features, and treatment data.

OBJECTIVES: An estimated 14-23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort. METHODS: Data from hospitalized subjects with Glasgow Coma Scale score of 3-12 were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (enrollment period: 2014-2019). Prior TBI with amnesia or alteration of consciousness was assessed using the Ohio State University TBI Identification Method. Competing risk regressions adjusting for age, sex, psychiatric history, cranial injury and extracranial injury severity examined the associations between prior TBI and in-hospital mortality, with hospital discharged alive as the competing risk. Adjusted HRs (aHR (95% CI)) were reported. Multivariable logistic regressions assessed the associations between prior TBI, mortality, and unfavorable outcome (Glasgow Outcome Scale-Extended score 1-3 (vs. 4-8)) at 3, 6, and 12 months after injury. RESULTS: Of 405 acute msTBI subjects, 21.5% had prior TBI, which was associated with male sex (87.4% vs. 77.0%, p=0.037) and psychiatric history (34.5% vs. 20.7%, p=0.010). In-hospital mortality was 10.1% (prior TBI: 17.2%, no prior TBI: 8.2%, p=0.025). Competing risk regressions indicated that prior TBI was associated with likelihood of in-hospital mortality (aHR=2.06 (1.01-4.22)), but not with hospital discharged alive. Prior TBI was not associated with mortality or unfavorable outcomes at 3, 6, and 12 months. CONCLUSIONS: After acute msTBI, prior TBI history is independently associated with in-hospital mortality but not with mortality or unfavorable outcomes within 12 months after injury. This selective association underscores the importance of collecting standardized prior TBI history data early after acute hospitalization to inform risk stratification. Prospective validation studies are needed. LEVEL OF EVIDENCE: IV. TRIAL REGISTRATION NUMBER: NCT02119182.

Research has shown that childhood physical activity participation has a positive relationship with markers of wellbeing, such as self-esteem and quality of life, and physical activity participation may serve as protective mechanism against some mental illnesses including depression. The aim of the current study was to examine the relationship between gender, physical activity, screen time, body mass index and wellbeing in Irish school children (N = 705; mean age: 8.74 ± 0.52 years) from social disadvantage. In Northern Ireland, schools included in the 2010 Multiple Deprivation Measure (NIMDM) were invited to participate. Schools included for participation in the Republic of Ireland were from the Delivering Equality of Opportunity in Schools (DEIS) index. Data gathered included accelerometry (physical activity), self-report (screen time and wellbeing), and anthropometric measurements. Physical activity was objectively measured during eight consecutive days using Actigraph GT1M and GT3X devices, using stringent accelerometer protocol. Screen time activities were derived using questions adapted from the Health Promotion Agencies National Children's Survey in Northern Ireland. The KIDSCREEN-27 is a health-related quality of life measurement, and this tool was used by participants to self-report their health and wellbeing. Results suggest that boys accumulated more minutes of daily screen time than girls, however, boys were more physically active when compared to girls. Wellbeing scores for gender showed inverse associations with daily screen time. Standard multiple regression revealed that gender, physical activity, screen time and body mass index (combined) explained little variance in the prediction of wellbeing. Results indicate the importance of gender-based considerations for physical activity and screen time with children from social disadvantage. The inverse relationship found between overall screen time and wellbeing will help guide future healthy lifestyle interventions for Irish children of low-income communities.

Ignoring technology in teaching English language in EFL contexts persuaded the researchers to do this study. In fact, this research looked at how Saudi Arabian EFL learners' academic achievement (AA), creativity, and academic buoyancy (AB) were affected by vocabulary acquisition with and without the use of technology. Fifty intermediate EFL students were chosen based on the convenience sampling method to accomplish this goal, and they were split into two groups: control and experimental. Subsequently, the three questionnaires were given out to evaluate the participants' AB, AA, and creativity before the treatment. Next, utilizing the WhatsApp application to teach new words to the experimental group (EG) and the control group using the conventional technique, the research completed a 16-session treatment. At the end of the course, the post-tests for the AB, AA, and creativity for both groups were administered. The results of this research revealed that on three post-tests, the EG outperformed the control group. In other words, the technology-based treatment helped the EG to develop their AA, AB, and creativity. There are implications for English teachers, students, researchers, and other stakeholders from the current study. The implications of this research can encourage EFL teachers to incorporate technology into their English classes.

We empirically examined the effectiveness of how the Analysis of Competing Hypotheses (ACH) technique structures task information to help reduce confirmation bias (Study 1) and the portrayal of intelligence analysts as suffering from such bias (Study 2). Study 1 (N = 161) showed that individuals presented with hypotheses in rows and evidence items in columns were significantly less likely to demonstrate confirmation bias, whereas those presented with the ACH-style matrix (with hypotheses in columns and evidence items in rows) or a paragraph of text (listing the evidence for each hypothesis) were not less likely to demonstrate bias. The ACH-style matrix also did not confer any benefits regarding increasing sensitivity to evidence credibility. Study 2 showed that the majority of 62 Dutch military analysts did not suffer from confirmation bias and were sensitive to evidence credibility. Finally, neither judgmental coherence nor cognitive reflection differentiated between better or worse performers in the hypotheses evaluation tasks.

An analysis by the probability shows the criterion that an analysis method has to satisfy to allow the authentication of a product. There are two distinct ways of achieving this criterion. It defines two groups for the classification of authenticatication methods: those in which information is concentrated into few data points and those in which information is spread across many data points.The reason for requiring authenticity testing allows to choose between these two groups. The nature of the sample will then specify the appropriate method.

IntroductionNeuroworsening may be a sign of progressive brain injury and is a factor for treatment of traumatic brain injury (TBI) in intensive care settings. The implications of neuroworsening for clinical management and long-term sequelae of TBI in the emergency department (ED) require characterization.MethodsAdult TBI subjects from the prospective Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot Study with ED admission and disposition Glasgow Coma Scale (GCS) scores were extracted. All patients received head computed tomography (CT) scan

Physical literacy (PL) is highlighted as a construct that can positively impact physical activity (PA). Measurement methods and definitions for PL exist, but vary between research groups. This variation affects the ability to compare research findings. The purpose of this study was to assess the construct validity of PL in children. PL was operationalised according to Whitehead's (2001) definition, comprising confidence, motivation, physical competence, and knowledge and understanding. Participants (n = 1073; mean age 10.86 ± 1.20 years: 53% male) were measured on: (i) confidence (Physical Activity Self-Efficacy Scale; Bartholomew et al., 2006), (ii) motivation (Behavioural Regulation in Exercise-Adapted; Sebire et al., 2013), (iii) physical competence (health-related fitness: 20 m shuttle run, back-saver sit-and-reach, handgrip strength, plank); balance (Bruininks-Oseretsky Test of Motor Proficiency 2; Bruininks, 2005); object-control and locomotor skills (Test of Gross Motor Development-3rd edition (TGMD-3); Ulrich, 2016); and (iv) knowledge and understanding (PA and sedentary guidelines). Confirmatory factor analysis (CFA) was conducted to analyse the factor structure of PL. The best-fitting model (X[superscript 2] = 209.8, df = 99, p < 0.001; comparative fit index = 0.95, normed fit index = 0.91, Tucker-Lewis index = 0.93, root mean square error of approximation = 0.032, 95% confidence interval: 0.026-0.038) was a three-component model containing the domains of motivation, confidence, and physical competence. The knowledge and understanding domain did not fit the model well. Factor loadings were highest for confidence and motivation. Findings support the adoption of a pragmatic approach to PL measurement. CFA results indicated a similar factor structure as has been identified in other studies which have used different tools to measure PL domains.

As part of developing and researching a virtual reality (VR) game intended to increase access to and broaden participation in STEM learning, designers and researchers from EdGE at TERC and interns from Landmark College, a post-secondary institute for learners with ADHD, autism, dyslexia, and other learning differences, have been immersed in an intensive co-design process. Co-design embraces the ‘nothing about us without us’ movement by ensuring stakeholder voices, in this case neurodiverse learners, have a prominent role throughout the design process. We present our co-design process, key lessons learned, important game-design decisions, and the experiences and perspectives of individual co-design participants. And recommendations are provided to help guide others who are interested in implementing a co-design process of their own.

Many different elements have a significant impact on the effectiveness of both teaching and assessment. The ever-expanding body of research on assessment has provided an overview of several cognitive, social, and emotional aspects that impact the academic accomplishment of learners in either a direct or indirect manner. In spite of the promising literature on assessment, no research has been done to investigate the probable interactions between self-assessment (SA), test-taking skills (TTS), student evaluation apprehension (SEA), self-esteem (S-E), and language achievement (LA). The purpose of this research was to offer a model that would illuminate the connection among SA, TTS, SEA, S-E, and LA in online classes. Therefore, 417 Turkish EFL students were given the Core of Self-assessment Questionnaire (CSAQ), the Test-Taking Skills Scale (TTSS), the Student Evaluation Apprehension Scale (SEAS), and the Foreign Language Learning Self-esteem Scale (FLLSE). Structural equation modeling (SEM) and confirmatory factor analysis (CFA) both found that SA and TTS are related to SEA, S-E, and LA. Based on the data analysis, EFL students' SA and TTS can predict the level of SEA, S-E, and LA in online classes. This has important implications for the development of EFL students' feeling of effectiveness and their ability to define and achieve goals. Consequences and potential future directions are also examined.

Background: Musculoskeletal injuries are common in adolescents, and recently schools have been suggested as an opportune location for injury prevention strategies. This study aimed to identify the current practices and perceptions of post-primary PE teachers in Ireland on injury prevention exercise programs (IPEP), which are key to informing potential implementation strategies. Methods: Post-primary PE teachers (n = 287) completed an online anonymous survey. Outcome measures included current IPEP practices in PE class, teachers' attitudes toward IPEPs, willingness to implement, and perceived ability to implement an IPEP in PE class. Descriptive statistics were calculated, and Mann-Whitney "U" tests were used to compare differences between groups. Results Results: indicated that only 1 in 5 PE teachers currently used an IPEP in class. Of these, no teacher used an existing IPEP exactly as intended, while most teachers were willing to implement an IPEP (80.5%). Those who previously received formal IPEP education or were aware of an existing IPEP had significantly higher perceived ability to implement an IPEP in class (p < 0.001). Conclusions: This study demonstrates that despite a willingness among PE teachers to implement IPEPs in class, few currently do. Thus, post-primary PE class may be an under-utilized setting for adolescent injury prevention and warrants further investigation.

Background: The world experienced challenges due to the COVID-19 pandemic which resulted in school closures across the globe in early 2020. Schools pivoted to remote delivery of learning using a variety of online and offline resources. PE is vital in providing motor development opportunities for children and it is essential to ensure that the provision of quality PE experiences is continued, even in the context of a pandemic. It was in this context that the "PE at Home" lessons were developed. Purpose: This study examined teachers' and parents' experiences of using the "PE at Home" resource and contributes to documenting the PE home-learning experience and can inform how the education system might respond and incorporate remote teaching into the future. Methods: A mixed-methods study utilising online surveys with 29 teachers and 173 parents/guardians and online interviews with five teachers, five parents and seven resource developers was undertaken. Quantitative data were descriptively analysed while qualitative data were analysed using a thematic approach (Braun, V., and V. Clarke. 2006. "Using Thematic Analysis in Psychology." "Qualitative Research in Psychology" 3 (2): 77-101). Findings: The "PE at Home" lessons had excellent viewership with over 27,000 Facebook and 937 website views. Three themes (i) ensuring the 'E' remained in PE; (ii) home-schooling and physical education; (ii) and context and relatability were developed from the data. While some parents demonstrated that their knowledge of PE was that it consisted of physical activity, other parents along with teachers and developers reflected on the educative component of the lessons. The "PE at Home" lessons provided teachers with a resource to share with parents to support parents home-school during COVID-19 school closures. An Irish resource featuring Irish children and aligned with the Irish curriculum was seen as a strength by both parents and teachers. Conclusion: The "PE at Home" lessons address the teaching and learning of PE in multiple contexts, particularly in an online environment, and they can be used in multiple ways to promote learning.

Background: The meaningful assessment of motor competence is well positioned for school-based curricular emphasis, through the integration of motor skills and movement patterns in both primary, and second level school physical education. Aligned with the growing interest in holistic motor competence assessment in physical education, the aim of this study was to assess the convergent validity between fundamental movement skills and functional movement assessments in a large cohort of adolescent youth. Method: A sample of 583 adolescents, aged between 12 and 16 years old participated in the study. Ten fundamental movement skills were assessed in line with the behavioural components from the Test of Gross Motor Development, and the Get Skilled Get Active resource. Seven specific functional movements were also assessed, using the existing protocol from the widely established Functional Movement Screen. All data were analysed using Bayesian procedures, in which the Bayes factors provided information about the probability of a hypothesis being true. Findings: The results indicate that it is very probable (BF10 > 10,000:1) that boys show higher actual motor competence levels in the object control subset of fundamental movement skills, when compared to girls. Moreover, a positive association between the total scores of the Functional Movement Screen and the locomotion subset of fundamental movement skills was found to be very probable (BF10 = 7.737). BF10 10 BF10 10 Discussion: This study provides evidence of convergent validity between functional movement and fundamental movement skill assessments in adolescence. This study presents an evidence-informed rationale for physical education pedagogues to move beyond traditional perceptions of movement as being exclusively pertaining to physical skills, to a more holistic concept of motor competence comprising of both movement skills and movement patterns. Conclusion: The current study broadens the assessment perspectives of motor competence within physical education, by specifically heightening physical education teachers' awareness towards the possible complementarity of both locomotion and movement patterns in the psychomotor domain of adolescent learning in physical education.

Background: Many Irish children are failing to meet the recommended guidelines for physical activity. Research shows that children are failing to develop the necessary physical literacy skills to reverse this trend. Early childhood has been identified as a critical period to intervene, with the school environment identified as a key environment to do so. Qualitative research is increasingly included in intervention studies to aid the development of acceptable, attractive, effective and sustainable interventions. The aim of this study was to evaluate the implementation process of the MWBW intervention (Exploratory trial) in the primary school setting, allowing the research team to assess the quality of the intervention's implementation. Objectives included assessing whether the intervention is suitable for the primary school environment, and to inform for future, mainstream implementation through a comprehensive process evaluation. Methods: The intervention is underpinned by both the theory of constraints and self-determination theory, and is designed using the comprehensive framework outlined by the behaviour change wheel. The intervention was delivered in 18 primary schools (22% DEIS) to 925 participants (age range 6-10 years, mean 7.55). The intervention was co-delivered by trained coaches and class teachers who were being upskilled (by trained coaches) whilst the intervention was being delivered. Qualitative data were gathered in the form of child focus groups (N = 32, 62% Male), teacher (N = 31) and principal (N = 5) questionnaires (open-ended questions), coach focus groups (N = 16, 81% Male) and weekly reflections. Data were analysed thematically following Braun and Clarke guidelines on using thematic analysis. Results: Five key themes, with subsequent sub-themes, were identified: (1) Implementation of the Moving Well-Being Well model, (2) Outcomes from the intervention, (3) Fidelity of implementation, (4) Key components of favourite games and (5) Challenges faced and areas to develop. Conclusions: Findings would suggest that the MWBW intervention is suited to the Irish primary school environment and its model of implementation can provide benefits to both children participants and teachers. Findings also show that the intervention has largely been delivered as intended showing potentially significant increases in participants overall FMS. Future research should examine the contextual impacts on the overall FMS improvement and how it varies from site to site. Evidence from this study also suggests that in order to produce similar or improved results in the future as part of a wider-scale roll-out of the intervention in schools, researchers should look to further assist teachers (possibly through added resources and/or training) to assist fidelity of implementation as well as looking at other factors that may influence intervention outcomes such as weather, seasonality, access to indoor facilities and environmental factors.

BACKGROUND: Disparities in adherence to health maintenance recommendations have been well-documented in patients with IBO. Solutions to address these issues remain under-described or evaluated. We sought to engage at-risk patients with IBO for a qualitative assessment of their barriers to health maintenance targets. The goal of this endeavor is to inform the design of interventions to address these disparities in practice.

Assessing children's movement competence (MC) offers numerous benefits for academics, practitioners, clinicians and children, allowing individuals to meet children's developmental needs and improve their MC. Yet, there is concern that currently available assessment tools only provide a single plane (fundamental movement skills) perspective of a child's MC. The aim of this study was to elicit the expert opinion of a mixture of academics and practitioners from a variety of fields (research, education, sport, physiotherapy, athletic therapy) to design a tool to measure both the fundamental and functional movement skills of children aged 8-12. A three-round Delphi poll with an international panel of 17 academics (n = 8) and practitioners (n = 9) was conducted. The consensus was that the assessment should assess (a) object manipulation, (b) locomotor, and (c) stability MC and the assessment layout should be dynamic, incorporating a hybrid model of stations and a circuit. Expert consensus was that most skills were to be performed using the dominant and non-dominant side, with object manipulation skills assessed using process and product criteria. The consensus was also that the assessment should have varied 'layers' of marking criteria to cater for varying assessor expertise and have a series of 'add-on" elements to provide a more detailed evaluation should it be needed. These findings present the foundation and content validity of an assessment which takes a dualistic view of children's movement skills, that could be used across several environments (schools, sports clubs, clinical settings, etc.) and could be suitable for use with a large group of children.