To assess the association between the maternal continuum of healthcare and child immunisation in East Africa using propensity score matching (PSM).

Cross-sectional study using Demographic and Health Survey data.

This study was conducted in East African countries.

This study included a weighted sample of 13 488 women with children aged 12–23 months.

Child immunisation was the outcome variable of this study.

The PSM estimates indicate that the average treatment effect on the treated for complete child immunisation was 0.0583, meaning that children of mothers who received a complete maternal continuum of care had a 5.83% higher probability of being fully immunised compared with children of mothers with incomplete care. Expressed relative to the treated group’s mean, this corresponds to a 7.48% increase. Additionally, our results indicated that the population average treatment effect was 0.0629. This means that, on average, a complete continuum of maternal healthcare increases the probability of full child immunisation by approximately 6.29% across the entire population.

The study highlights that children whose mothers receive comprehensive maternal healthcare are more likely to complete their childhood immunisations. This finding underscores the need to integrate immunisation services into maternal healthcare programmes to enhance vaccination coverage and promote better child health. To maximise this connection, improving access to maternal healthcare, especially in underserved regions, is crucial, along with ensuring that immunisation is a regular part of maternal care.

Sodium-glucose cotransporter-2 inhibitors have demonstrated cardiorenal protective effects in adults with chronic kidney disease (CKD), but their efficacy and safety in paediatric CKD remain uncertain. Treatment for hereditary kidney disease in children is limited. This DAPA-PedHKD study aims to evaluate the effectiveness and safety of combining renin-angiotensin-aldosterone system inhibitors (RAASi) with dapagliflozin compare to RAASi alone in children with hereditary kidney disease accompanied by proteinuria.

DAPA-PedHKD is a multicentre, randomised, crossover, open-label clinical trial. Patients aged 6–18 years with hereditary kidney disease will be eligible. All patients must have received stable RAASi therapy for at least 4 weeks, with a baseline estimated glomerular filtration rate (eGFR) of ≥60 mL/min/1.73 m², and either a 24-hour urinary protein level of >0.2 g or a urinary protein-to-creatinine ratio (UPCR) of >0.2 mg/mg. Participants will be randomised in a 1:1 ratio to receive either dapagliflozin in addition to standard RAASi therapy or RAASi therapy alone for 12 weeks. After a 4-week washout period with continued RAASi therapy, participants will crossover to the other treatment for another 12 weeks. Outcome assessments will be conducted at baseline and at weeks 2, 6, 12, 16, 18, 22 and 28. The primary outcome is the change in 24-hour urinary protein excretion from baseline to week 12. Secondary outcomes include changes in the UPCR, urinary albumin-to-creatinine ratio, serum albumin, eGFR, blood pressure and body weight from baseline to week 12. Neither participants nor investigators are blinded to treatment allocation, and placebo control is not used.

This study has been approved by the Ethics Committee of the Children’s Hospital of Fudan University and 11 local ethics committees. We will publish results in peer-reviewed journals and present at international conferences.

NCT06890143.

To analyse the impact of selected neonatal care interventions on regional care capacity.

Design

Discrete event simulation modelling based on clinical data.

Neonatal care in the southwest of the Netherlands, consisting of one tertiary-level neonatal intensive care unit (NICU), four hospitals with high-care neonatal (HCN) wards and six with medium-care neonatal (MCN) wards.

44 461 neonates admitted to at least one hospital within the specified region or admitted outside of the region but with a residential address inside the region between 2016 and 2021.

The impact of three interventions was simulated: (1) home-based phototherapy for hyperbilirubinaemia, (2) oral antibiotic switch for culture-negative early onset infection and (3) changing tertiary-level NICU admission guidelines.

Regional neonatal capacity defined as: (1) occupancy per ward level, (2) required operational beds per ward level to provide care to all inside region patients at maximum 85% occupancy, (3) proportion rejected, defined as outside region transfers due to no capacity to provide local care and (4) the weekly rejections in relation to occupancy to provide a combined analysis.

In the current situation, with many operational beds closed due to nurse shortages, occupancy was extremely high at the NICU and HCNs (respectively 91.7% (95% CI 91.4 to 92.0) and 98.1% (95% CI 98.0 to 98.2)). The number of required beds exceeded available beds, resulting in >20% rejections for both NICU and HCN patients. Although the three interventions individually demonstrated effect on capacity, clinical impact was marginal. In combination, NICU occupancy was reduced below the 85% government recommendation at the cost of an increased burden for HCNs, highlighting the need for redistribution to MCNs.

Our model confirmed the severity of current neonatal capacity strain and demonstrated the potential impact of three interventions on regional capacity. The model showed to be a low-cost and easy-to-use method for regional capacity impact assessment and could provide the basis for making informed decisions for other interventions and future scenarios, supporting data-driven neonatal capacity planning and policy development.

Pneumonia remains a leading cause of under-5 mortality in sub-Saharan Africa, accounting for approximately 14% of deaths in this age group. In Malawi, pneumonia accounts for 12% of under-5 deaths, with recent data revealing a concerning trend of over 110 000 new cases reported in 6 months. The Malawi government has made significant strides in reducing childhood mortality through the Integrated Community Case Management (iCCM) strategy, resulting in an 11% reduction in under-5 mortality over a 5-year period. However, the current iCCM strategy does not include the management of chest indrawing pneumonia in children aged 2–59 months and fast-breathing pneumonia in infants aged up to 2 months. This implementation research aims to increase pneumonia treatment coverage for under-5 year-old children in Kasungu District, Malawi, by expanding the community-based management of pneumonia by the iCCM-trained Health Surveillance Assistants (HSAs).

The current implementation research using both qualitative and quantitative data collection methods will assess the feasibility and acceptability of iCCM-trained HSAs managing chest indrawing pneumonia and fast-breathing pneumonia in children under 5 with oral amoxicillin at the community level in district Kasungu using the existing district health system. The study will employ a district health system model, leveraging existing trained iCCM HSAs to enrol and manage infants aged 7–59 days with fast-breathing pneumonia and 2–59-month-old children with chest indrawing pneumonia in the community with 7-day and 5-day oral amoxicillin, respectively. HSAs will also use pulse oximetry to identify hypoxaemic children for prompt referral to a hospital for further care. Sociodemographic features of enrolled children will be documented. Enrolled children will be followed up on treatment compliance using follow-up forms. The pneumonia treatment coverage will be assessed using baseline, midline and end-line surveys using both qualitative and quantitative data collection methods.

Ethical approval was obtained from the National Health Research Sciences Committee and the WHO Ethics Committee. The implementation research findings will be disseminated to national-level stakeholders and specifically targeted at District Health Offices, which are responsible for implementing the interventions.

To identify the assessments, diagnostic criteria and outcome measures reported in peer-reviewed literature for children with growing pains and persistent lower limb pain in the presence of restless leg syndrome (RLS).

Scoping review completed in line with Joanna Briggs Institute methodological guidance

Five online databases were searched—MEDLINE, Embase, CINAHL, PsycINFO and AMED—for records up to 14 October 2024.

Records reporting on the use of assessments, diagnostic criteria or outcome measures in children (aged 0–18 years) with growing pains or persistent lower limb pain in the presence of RLS. Articles were required to have a sample size of ≥10 and be available in English language.

Data were extracted by two independent reviewers and analysed using descriptive statistics.

Following review of 19 806 records, 61 unique records were included. Most were observational cross-sectional or case–control designs. Assessments were varied and primarily focused on body functions and pain characteristics rather than activities and participation. There were 15 unique diagnostic criteria reported for growing pains with limited consistency and sometimes conflict between included items. Outcomes measures were only reported in eight records and typically measured pain presence and intensity.

Assessment and subsequent diagnosis of growing pains and persistent pain in the presence of RLS lack consistency. Outcome measures were seldom used as most records were not designed to measure change over time. Standardised practices for assessment and management of these conditions may benefit clinicians and optimise patient care.

Cerebral palsy (CP) is the most common motor disability in children, with higher prevalence in low-income and middle-income countries (LMICs) compared with high-income countries (HICs). Children with CP (CwCP) often face significant challenges in achieving toileting independence due to motor, sensory and cognitive impairments. Parents play a pivotal role in managing these challenges, often encountering significant emotional, physical and social burdens. Despite the importance of toileting for autonomy and dignity, limited evidence exists on tailored toilet training programmes for CwCP, especially in LMICs. Understanding parental perspectives is essential to addressing these gaps and informing family-centred interventions.

This scoping review aims to explore parents’ perspectives on toileting management for CwCP, focusing on strategies, challenges and unmet needs, to inform future research and the development of supportive interventions. This scoping review will be conducted in accordance with the guidelines of the Joanna Briggs Institute and summarised using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews framework. The English language full-text articles, published between January 2014 and December 2024, addressing the parental perspectives, challenges and strategies related to the task of toileting in CwCP below 18 years of age will be included. Systematic searches will be conducted through PubMed, EMBASE, CINAHL, Scopus, Web of Science and grey literature. The data will be extracted and analysed thematically using Microsoft Excel.

The present protocol has been registered in the Open Science Framework (DOI: https://doi.org/10.17605/OSF.IO/73YQZ). Ethical approval is not required, as this review uses secondary data from published studies and does not involve direct participant recruitment. The findings will synthesise themes related to parents’ strategies, challenges and expectations in toileting management for CwCP. They will help address existing literature gaps and inform the development of practical, evidence-informed toileting education programmes for parents.

Early-onset chronic liver disease (CLD) and its subsequent clinical progression have systemic impact. Its trajectory coincides with critical periods of brain development. In this study, we will test the hypothesis that early-onset CLD is associated with neurodevelopmental and psychiatric symptoms and delineate their neurobiological underpinnings through multimodal neuroimaging.

This study will recruit 100 patients with biliary atresia and 50 patients with other types of early-onset CLD, aged between 6 and 30 years, under the primary care of Paediatric Liver Services at King’s College Hospital, London, UK. Cognitive performance and autism-related behaviours will be evaluated with neurodevelopmental assessments. Participants and their parents will complete questionnaires addressing neurodevelopmental and psychiatric outcomes in everyday life, and quality of life. Multimodal neuroimaging will be conducted using electroencephalography (EEG); eye-tracking; structural, functional and diffusion MRI; and magnetic resonance spectroscopy (MRS). Clinical information will be collected from patients’ medical records and bio samples. Data of 222 neurotypical controls and 307 neurodivergent controls without CLD will be pooled from the Longitudinal European Autism Project with a similar study protocol. Neurodevelopmental and psychiatric outcomes will be compared with normative values and between groups. Associations with clinical risk factors will be explored using multivariable regression. Neuroimaging markers will be compared between groups and associations with neurodevelopmental outcomes and clinical risk factors will be tested using multivariable regression. Individual deviation from normal brain development will be quantified using Bayesian modelling and will be associated with neurodevelopmental outcomes.

This study was approved by the National Health Service Health Research Authority’s ethical committee (REC reference: 22/PR/1587). Findings from this study will be published in peer-reviewed journals, presented at national and international conferences and shared with patients and their families for widespread dissemination of the results.

Individuals with Down syndrome (DS) are predisposed to obstructive sleep apnoea (OSA) due to craniofacial features (eg, midface hypoplasia, glossoptosis) and studies have shown that the prevalence of OSA in this population is markedly increased compared with that of typically developing children. Adenotonsillectomy is considered the first-line treatment for childhood OSA. However, persistent OSA is common, thus many children with DS are referred for positive airway pressure (PAP) therapy initiation; PAP appears to be an important aspect of living with DS. PAP has been shown to be highly effective in the general population for treating OSA and improving OSA-associated neurobehavioural symptoms, such as quality of life, behaviour, mood, daytime sleepiness and school performance. However, PAP as a treatment for OSA has not been well-studied in children with DS. Therefore, we designed a multicentre randomised controlled trial recruiting children with DS and OSA at three academic institutions, aged 6–18 years, referred for PAP initiation to treat OSA.

86 participants will be randomised to a 6-month intensive behavioural intervention (INT) to improve PAP adherence versus standard clinical care and underwent standardised evaluations of quality of life, behaviour, attention, PAP adherence and healthcare utilisation at baseline, 6 months and 12 months.

This study has been approved by the institutional review board at Children’s Hospital of Philadelphia (IRB of record, IRB # 20–0 17 512). Cincinnati Children’s Medical Center and University of Miami delegated IRB review and approval responsibility to Children’s Hospital of Philadelphia through reliance agreements as mandated by National Institutes of Health (NIH). All participants will be minors; consent will be obtained from parents and assent from participants will be obtained when possible. The intervention tested in this trial is considered not greater than minimal risk, and no identifiable data will be reported. As required by the NIH, a data safety monitoring board (DSMB) has been formed, who will review and approve the protocol and any protocol changes prior to implementation. The study team will send biannual reports and hold a biannual meeting with the DSMB to review any safety and protocol concerns. Findings will be presented at national conferences pertinent to this topic and published in peer-reviewed medical journals. In addition, findings will be shared in the lay format with DS associations around the world and used for training of healthcare providers and trainees (R25HD118212). Further, data collected will be deposited in a repository (National Sleep Research Resource; sleepdata.org) after completion of the study to maximise use by scientific community.

NCT04132999.

Adolescent idiopathic scoliosis (AIS) is a common paediatric spinal deformity with large curves surgically managed through spinal fusion. However, postoperative rehabilitation remains inconsistent and varies depending on clinician, hospital or location. Our international e-Delphi consensus established a broad range of statements from preoperative care until 12 months postoperatively. However, rehabilitation and graded return to sport between 3 and 12 months remains vague and further consensus work is needed. This study aims to understand the intermediate and late stages of rehabilitation in order to guide return to sport, exercise and physical activity. The primary objective is to explore content of rehabilitation and milestones between 3 and 12 months postoperatively. This understanding of postoperative care will form the basis for future postoperative guidance.

This protocol for a nominal group technique (NGT) study is written in accordance with the Accurate Consensus Reporting Document guidelines. A national sample of expert surgeons, physiotherapists and nurses in AIS will be recruited. The NGT will take place virtually and will consist of six stages: stage 1: idea generation; stage 2: round robin idea sharing; stage 3: discussion and clarification; stage 4: anonymous voting; stage 5: results feedback; and stage 6: discussion and final voting. This NGT will be preceded by a scoping review which will be disseminated a priori to inform stage 1 idea generation. The population, concept, context framework will be used to explore postoperative rehabilitation towards sports, exercise or physical activities following any kind of spinal surgery. The study steering group and patient and public involvement representative have been involved from conceptualisation and will continue to be involved until final dissemination.

The University of Birmingham has provided ethical approval: ERN_4201-Jun2025. Dissemination will take place through conference presentation and peer-reviewed publications.

Detecting chronic kidney disease (CKD) early can provide opportunities to optimise native kidney function, prevent further decline and plan for timely kidney transplantation if required. Understanding how children are found to have kidney disease and present to specialist kidney care may help tailor interventions to support a timelier diagnosis. The aim of this study was to examine the pathway to specialist care for UK children who present late to nephrology with advanced CKD (requiring kidney replacement therapy within 90 days of first nephrology review) to determine whether there are modifiable aspects to presentation and diagnosis.

Semi-structured, in-depth qualitative study. A topic guide based on the theoretical framework of health behaviour by Scott et al, The Model of Pathways to Treatment, was developed to capture differences in symptom appraisal and help-seeking before reaching nephrology care.

UK paediatric nephrology units (n=4) between December 2017 and December 2020.

Children and young people who experienced a late presentation of CKD and their parents/carers.

Twenty-two participants participated across 19 interviews: seven children (two male, median age 16, IQR 13–17.5 years) and 15 parents. A typology of presentation to healthcare was identified: commonly, families reported repeated cycles of primary care help-seeking before onward referral to specialist care, although long appraisal intervals were also noted. In all cases, secondary care referral led to onward nephrology care involvement. Narratives highlighted that not all cases of late presentation could be avoided.

A typology of symptom appraisal and help-seeking can inform interventions to improve CKD detection. Interventions that support symptom appraisal and consideration of targeted CKD testing in children may help reduce appraisal and help-seeking intervals, respectively.

To assess the relationship of infant growth, feeding practices and tummy time to their motor development at 12 months, with a special focus on how maternal physical activity during late pregnancy relates to infants’ motor skills.

Longitudinal study.

Rural city in the Mid-Southern USA.

16 singleton pregnant women in the third trimester and their term infants were recruited, excluding mother–infant pairs with health issues that impact infants’ motor development and restrict mothers’ physical activity.

Maternal physical activity and sedentary time during the third trimester were measured using Actigraph activity monitors. Labour nurses measured neonatal birth weight and length using standard procedures. Infants’ motor percentiles at 4 and 12 months were measured respectively using the Alberta Infant Motor Scale and Peabody Developmental Motor Scales II test by a licensed paediatric physical therapist. Feeding practices, infants’ time spent in different positions and family composition were evaluated separately at 4 and 12 months using a study-specific survey.

Infant motor percentiles at 4 months were positively associated with their 12-month motor percentiles (r=0.649, p=0.009). For each additional percentile at 4 months, the mean 12-month percentile increased by 0.4. Motor percentiles at 12 months were also positively associated with infants’ birth weight (r=0.553, p=0.026) and length (r=0.637, p=0.008), but not significantly associated with tummy time (r=–0.069, p=0.840). Infant motor percentiles at 12 months were not associated with time spent sedentary (r=–0.134, p=0.634), light activity (r=0.213, p=0.447) or moderate activity (r=–0.050, p=0.858) during the third trimester. At 12 months, breastfeeding status (p=0.576) and having siblings (p=0.230) were not related to motor scores.

Motor percentiles at 4 months, birth weight and length correlated with motor skills at 12 months, whereas tummy time, siblings, and breastfeeding were not significant predictors. Physical activity during pregnancy did not significantly correlate to motor skills at 12 months.

Physical activity improves physical and psychosocial outcomes in healthy children and in children with a range of chronic health conditions. Unfortunately, children with chronic health conditions have lower levels of physical activity compared to their healthy peers due to multiple restrictions in physical activities and therefore tend to have lower levels of physical activity compared with their peers. This paper describes the protocol for Move to Improve, a pragmatic trial of an individualised physical activity intervention for children with chronic health conditions.

Using the RE-AIM framework, this study aims to test the feasibility of Move to Improve, an 8-week hospital-based individualised physical activity intervention. We will recruit 100 children aged 5–17 years who are diagnosed with type 1 diabetes, cancer, postburn injuries and cerebral palsy to a single-arm, pragmatic feasibility trial. The primary outcomes (objective moderate to vigorous physical activity, quality of life and goal attainment) and secondary outcomes (including aerobic capacity, body composition, motor function, grip strength and psychosocial outcomes) will be assessed at baseline, post intervention and at 6-month and 12-month follow-ups. We will conduct semistructured interviews with participants and their primary caregiver at a 2-month follow-up to capture aspects of feasibility. Quantitative data will be reported descriptively, and qualitative data will be analysed using thematic analysis. Data gathered from this study will inform service decision-making and future trials.

The study has received ethics approval from the Government of Western Australia Child and Adolescent Health Service Human Research Ethics Committee (RGS6677). Findings of this research will be communicated to the public through peer-reviewed publications, conference presentations, reports, infographics and information sheets. Modifications to the protocol will be outlined in the trial registry and journal publications. Authorship will be in accordance with the International Committee of Medical Journal Editors.

Australian and New Zealand Clinical Trials Registry Number: ACTRN12624000836538.

Infant-centred and family-centred developmental care (IFCDC) within the frame of special intensive care prioritises a holistic approach to caring for infants by addressing their developmental and emotional needs. A key principle of IFCDC is the active involvement of parents in care, which promotes better long-term outcomes for both the infant and their caregivers. This scoping review aims to examine parental satisfaction and the challenges associated with their involvement in infant care by assessing the global implementation of the IFCDC principle of parental involvement in specialised intensive care settings.

The scoping review will follow the methodological framework outlined by Khalil et al and the Joanna Briggs Institute methodology. Literature from 2014 to 2025 will be searched for relevant papers across PubMed (MEDLINE). Two reviewers will independently screen titles, abstracts and full texts, with a third reviewer resolving conflicts. Key findings and results from eligible papers will be analysed and summarised in line with the scoping review’s objectives.

No ethical approval is needed. We intend to submit the paper for publication and thus to present the results in a peer-reviewed journal. This scoping review is registered at OSFREGISTRIES (https://osf.io/h94qr/?view_only=a08b30a5eb3a4a3d97aeda7c6d7e157d).

Improving the quality of life for preterm children is a global health priority, given their vulnerability to neurocognitive impairments and adverse health consequences. Lack of posthospital care further exacerbates these risks, necessitating effective interventions during the neonatal period. This protocol for a pilot study aims to investigate the effects of touch interventions, including physiotherapy and osteopathic manipulative treatment, on brain activity in moderately preterm infants using brain functional MRI (fMRI), computerised EEG and metabolomics.

A 3-arm randomised sham-controlled trial will be conducted with 15 infants per experimental group. The study will include stable preterm infants born between 32.0 and 33.6 weeks of gestational age who do not require any intensive care treatments.

The study aims to assess the impact of touch interventions on brain activity and metabolic sequelae. Using fMRI will primarily examine the pre-post changes between groups in blood oxygenation level dependent levels among different brain areas, specifically the anterior insula and the medial prefrontal cortex. Secondarily, we will explore the preterm brain’s neural effects on EEG slow delta wave band. Metabolomics will provide data on the effects among the three groups on metabolic changes associated with touch interventions.

Ethical approval has been obtained from the Ethics Committee of the local health agency in Milan (CET 449-2024). Understanding the effects of touch interventions on brain activity in moderately preterm infants, without needs of intensive care, can contribute to improving their clinical outcomes and promoting their growth, development and social behaviour. Findings from this pilot study will pave the way for future research, enabling the development of evidence-based interventions to enhance preterm infants’ well-being and long-term outcomes.

NCT05853991.

Programmes based on early childhood development (ECD) services play a vital role in improving child health and developmental outcomes. Across many countries, these programmes target children under 5 years of age—including those who are healthy, at risk or with developmental disorders—and are implemented in governmental and non-governmental organisations in both the health and non-health sectors globally. This protocol outlines a scoping review designed to systematically map and synthesise existing evidence on the components, implementation strategies and delivery mechanisms of ECD services worldwide. The review aims to inform the development of optimised and comprehensive interventions that support holistic child development.

This review will be conducted by Arksey and O’Malley’s framework and its recent advances. Several databases, including PubMed/MEDLINE, Scopus, Science Direct and Web of Science, Scientific Information Database, Magiran, IranMedex and Barakat knowledge network system, will be initially searched for studies up to December 2024. All searches will be done for published or unpublished articles/reports without time and language restrictions. Two researchers will independently carry out screening of the included studies and extraction of data. Any discrepancies will be resolved by consensus. In case no initial consensus is reached, a third researcher will be consulted to make a decision. The findings will be synthesised through the content-analysis method.

The findings of this review may offer a novel perspective for developing a comprehensive package of ECD services within the Iranian health system. Furthermore, it provides a detailed roadmap for researchers and stakeholders aiming to enhance child health and prevent developmental disorders. This study received ethical approval from Tabriz University of Medical Sciences (ID: IR.TBZMED.REC.1404.139), with no ethical concerns as it involves no patient participation or interventions.

To assess the prevalence of primary teeth extraction and associated factors among children under 5 years old living in Adea Berga Woreda, West Shewa, Oromia, Ethiopia.

A community-based cross-sectional study using interviewer-administered questionnaire.

A total of 542 caregivers of under-five children participated in the study, which was conducted in Adea Berga Woreda, West Shewa, Oromia, Ethiopia, from 1 to 30 July 2024.

Prevalence of primary teeth extraction among under-five children.

Of the 550 study participants, 542 responded, yielding a response rate of 98.5%. The prevalence of primary teeth extraction was 14.02%. Factors significantly associated with primary tooth extraction included residence (adjusted OR (AOR) 2.33; 95% CI 1.27 to 4.28), having information about scientific solutions for teething symptoms (AOR 2.10; 95% CI 1.16 to 3.79), a history of traditional medicine use (AOR 5.68; 95% CI 3.06 to 10.55), and the primary teeth extraction is traditional practice in the community (AOR 3.79; 95% CI 2.06 to 6.97).

Primary teeth extraction is a significant public health issue in the study area. Living in rural areas, lacking information about scientific treatments for teething symptoms, the traditional practice of primary teeth extraction and a history of using traditional medicines were identified as predictors of primary tooth extraction.

The transition from hospital to home can be challenging for parents of premature infants due to a lack of education on specific care. This may lead to both higher readmission rates and healthcare costs. Telehealth interventions can improve the quality of care specific to premature and critically ill newborns. This protocol outlines the WELCOME study and evaluates its feasibility and effectiveness of this approach.

This two-centre randomised control trial (RCT) will assign 240 families with premature and critically ill newborns to an intervention or control group. The study has a parallel group design and an exploratory framework. The control group will receive standard postdischarge care. The intervention group will additionally receive scheduled video consultations, digital assessments and 24/7 access to educational resources. Primary outcomes will focus on 30-day readmission and emergency care use. Secondary outcomes will include child development and parental health. The intervention is expected to be feasible, with high acceptance and minimal drop-out. It will aim to improve parents’ self-efficacy and health literacy. If successful, insights from this multimethod telehealth study will inform standard care.

Results will be published in anonymised and summarised form in international and national journals and symposia. The study received ethical approval from the Ethics Committee of the Ludwig-Maximilians-University Munich (No. 25-0028) and was registered in the German Clinical Trials Register on 6 March 2025 (DRKS00034422).

DRKS00034422.

Mother-infant skin-to-skin contact (SSC) improves developmental and cognitive outcomes in preterm infants. However, the effects of SSC on healthy term infants remain unclear. We aim to investigate the short-term and long-term impacts of SSC in full-term infants to provide supporting data emphasising the importance of mother-infant SSC in South Korea.

This study is a prospective, double-blind, randomised controlled trial. A total of 130 mothers and their healthy term infants will be recruited after birth. Participants will be randomised to the intervention (SSC) or control groups. Participants in both groups will be instructed on general newborn care guidance and requested to record the same in a mobile diary app daily for 2 weeks after hospital discharge. The intervention group will be educated on the importance and clinical advantages of mother-infant SSC and provided with practical guidance, along with an informational pamphlet. They will also be informed to engage in a minimum of 6 hours of SSC per day with the infant’s and mother’s chests exposed and in contact for at least 15 min per session and to keep a record of the contact time. Breastfeeding rate, time spent on SSC and holding clothed infant, maternal depression, anxiety and bonding scores will be measured. Infants’ growth, temperament and neurodevelopmental outcomes will be assessed. In addition, artificial intelligence algorithms will be developed to analyse infant movements captured in videos.

This study was approved by the institutional review board of the Korea University Anam Hospital (2024AN0613), and the results will be disseminated through scientific conferences and publications.

NCT06777524, registered on 14 January 2025.

In Tanzania, the problem of early sexual initiation among adolescent girls and adolescent girls and young women has remained a persistent public health and human rights challenge that continues to draw the attention of policymakers. Evidence suggests that in some parts of the country, as much as 70% of women had their sexual debut as minors, underscoring the urgency to understand all drivers of early sexual debut among this population. While scholars have pointed to addressing a range of factors that work to expose adolescent girls and young women to early sexual initiation, the role of coercion at first sex has been less explored.

We used cross-sectional data from the 2022 Tanzania Demographic and Health Survey.

A total sample of 1242 sexually active unmarried adolescent girls and young women aged 15–24.

Our study relied on logistic regression models to examine the role of coerced sex on early sexual initiation among sexually active unmarried adolescent girls and young women aged 15–24 years in Tanzania.

We found that 31% and 14% of sexually active unmarried adolescent girls and young women experienced early sexual initiation and coerced first sex, respectively. At the bivariate level, we discovered that those who indicated that they willingly wanted to have their first sex were less likely to initiate sex early (OR=0.44, 95% CI 0.27 to 0.72). At the multivariate level, the significance of these relationships largely holds, even after sequentially accounting for sociodemographic (OR=0.50, 95% CI 0.30 to 0.82) and HIV-related characteristics (OR=0.50, 95% CI to 0.30 to 0.83).

We recommend re-examination of policy addressing early sexual initiation in Tanzania by incorporating coerced sex as one of the major determinants needing urgent attention. Intensifying awareness creation on the risk of early sexual initiation through coerced sex, especially among adolescent girls and boys, will go a long way to help reduce the incidence of early sexual initiation.

Visual perception and visual-motor integration skills are key predictors of handwriting. Children with cerebral palsy often experience difficulties in these areas, which can negatively affect handwriting. Interventions targeting these skills may improve handwriting outcomes in this population.

This single-blind (data analyst blinded), three-arm randomised controlled trial will include 30 children with spastic cerebral palsy. Participants will be randomly allocated to one of three groups: (1) a computerised visual-motor integration training group, (2) a computerised visual perception training group or (3) a control group. Randomisation will be performed using a stratified permuted block design based on cerebral palsy subtype (hemiplegia, diplegia and quadriplegia). Each intervention group will receive 20 individual sessions (two times per week for 10 weeks) using validated computerised games. The primary outcome is handwriting performance, assessed by the Persian Handwriting Assessment Tool. Secondary outcomes include visual-motor integration, assessed by the Beery–Buktenica Developmental Test of Visual–Motor Integration, and visual perception, assessed by the Test of Visual–Perceptual Skills–Revised.

This study was approved by the Ethics Committee of Tehran University of Medical Sciences. Written informed consent will be obtained from parents. Participation is voluntary, free and confidential. Control group participants may receive the intervention after the trial. Results will be published in peer-reviewed journals and shared with relevant stakeholders.

IRCT20230219057447N1.