AbstractMany low‐ and middle‐income countries are faced with a double burden of malnutrition characterized by a stagnating burden of undernutrition and an increasing prevalence of overweight and obesity often observed both at population and household levels. We used data from the 2017 National Integrated Child Health and Nutrition Survey in the Republic of the Marshall Islands to explore the prevalence of overweight mother‐stunted child pairs (mother–child double burden, MCDB). We used bivariate analysis, multivariate logistic regression, and multinomial logistic regression analysis to explore associations between child‐, maternal‐, and household‐level variables and both stunting and MCDB and other types of maternal–child pairs. Our results indicate that nearly three out of four mothers were overweight or obese and one in four households is home to an overweight mother with a stunted child. The risk of child stunting and of MCDB were largely associated with maternal characteristics of lower maternal height, maternal age at birth, years of education, and marital status and household economic status as measured by wealth index and number of household members. These findings support the growing body of evidence showing that the coexistence of high maternal overweight and child stunting (MCDB) has linked root causes to early life undernutrition that are exacerbated by the nutrition transition.
Jessica L. Blankenship, Stanley Gwavuya, Uma Palaniappan et al.
Introduction The Missing Piece Surveillance study was a school-based surveillance study documenting group A Streptococcus (Strep A) infection in children in two towns of the Kimberley region of Western Australia (Broome and Derby). The Kimberley experiences higher rates of the serious immune-mediated conditions acute rheumatic fever (ARF) and rheumatic heart disease (RHD), which can result from Strep A infection. The clinical epidemiological study aimed to document the prevalence and features of superficial Strep A infections, particularly impetigo (skin sores) and pharyngitis (sore throat) in children aged 5-15. Surveillance required several years of collaboration with participants, their families, their teachers and their schools to support primary data collection. Methods Following the completion of surveillance, the research team aimed to find a way to share their findings with the communities they worked with, particularly with the children who has provided their time and biological samples. In this study, we describe the use and value of participatory action research methods to co-create two storybooks telling the stories of the Missing Piece study. Results Through consultation, focus groups and reflection, we explored how the design, content and use of storybooks could create meaning for participants. Discussion Resultingly, children's voices and preferences were incorporated into the communication tool, producing an outcome that reflected participatory action methodology and co-creation.
Kassandra Fernando, Ann Grand, Heather J. Bray et al.
Abstract Genomic medicine has profoundly transformed Nephrology—a specialty uniquely positioned to take advantage of the mechanistic insights provided by genomics that can guide precision care. Genetic kidney diseases account for a substantial proportion of chronic kidney disease in both children and adults, and the integration of genomic testing has redefined diagnosis, management, and even the conceptual architecture of kidney disorders. Contemporary Nephrology is increasingly guided by genomic understandings that clarify pathogenesis, refine clinical classification, and enable precision interventions. As genomic sequencing becomes embedded in clinical workflows, the focus is shifting from single-timepoint analysis to iterative genomic reanalysis. The reinterpretation of genomic data in light of new knowledge, improved annotation, and evolving classification criteria substantially increases diagnostic yield and optimises patient care. Reanalysis represents not only a technical evolution but also a philosophical shift- viewing genomic data as a living, longitudinal resource that requires continual stewardship. This review explores the foundational role of genomics and genetic kidney disease in Nephrology, the state of genomic integration in clinical practice, and the transformative potential of genomic reanalysis. It also considers imminent frontiers, including multi-omics, artificial intelligence, and the foundational importance of equity in genomic care. Together, these advances signal a reimagining of Nephrology—from a phenotype-based discipline to one rooted in molecular precision and iterative discovery.
Jacqueline Soraru, Erik Biroš, Aron Chakera et al.
Background The likelihood of a childhood additional need is elevated among high-risk infants and the likelihood of incontinence is elevated among children with additional needs. Although successful toilet training may reduce the prevalence of incontinence among children with additional needs who were identified as a high-risk infant, there is very little research regarding incontinence and toilet training among this group of children. Aims The aim of this study is to determine how many 5- and 6-year-old children with additional needs who previously participated in a service for high-risk infants experience incontinence, and to describe the caregiver experience of toilet training this group of children. Methods In this exploratory study, participating caregivers completed an online questionnaire which included quantitative and qualitative questions. Results Drawing from data provided by 17 caregivers, we found that 13 out of the 18 children we investigated experienced incontinence, and we identified five themes relating to the toilet training experience among caregivers: caregiver expertise, emotions, determining the leader, taking action, and evaluating progress. Conclusion In this exploratory study, we found the majority of 5- and 6-year-old children with additional needs who previously participated in a service for high-risk infants experienced incontinence. Our results also described the challenges caregivers experienced when toilet training this group of children. Findings from this study support further research into the barriers and facilitators of continence attainment for children with additional needs who were identified as a high-risk infant.
Isobel June Walker, Mascha Friderichs, Anna Urbanowicz
INTRODUCTION: The right to build a family is central to decision-making around reproductive health, social inclusion and citizenship. Yet, in societies that privilege cis-heteronormative ways of reproducing, individuals whose bodies, identities, and relationships exist outside of these norms may be susceptible to reproductive injustice during their fertility journeys. This is arguably the case for transgender and non-binary (trans) people involved in decision-making about their reproductive futures. METHODS: This article investigates barriers to the fertility preservation journeys of trans individuals making decisions about gamete freezing for gender transition-related reasons. The discussion draws primarily on data collected from an interview study with 13 trans people in Aotearoa New Zealand, aged between 19 and 30 years. Analyses of YouTube video blog and survey data support the discussion. FINDINGS: Study findings indicate a need for more information in a range of healthcare and educative settings about reproductive options for trans people; the presence of a generational shift in reproductive orientations for some participants toward the option of biogenetic parenthood as well as non-consanguineous forms of doing family; and relational decisionmaking about gamete freezing that is interactively negotiated with family and discussed with others, rather than purely agentic. CONCLUSION: To address the study findings, we call for healthcare professionals and social work practitioners to actively include the voices of trans and queer (LGBTQIA+) youth in education programming, policy, and decision-making as a step towards reimagining and securing equitable access to sexual and reproductive health, fertility care, and diverse reproductive paths for all people.
BACKGROUND: Many jurisdictions internationally continue to permit parents to use physical force against children under defences variously termed 'reasonable force', 'lawful correction', or 'domestic discipline'. In Queensland, Australia, this is codified under section 280 of the Criminal Code Act 1899 (Qld). The appropriateness of such defences is increasingly contested, with child and youth advocates arguing that they effectively decriminalise child abuse, yet little is known about whether community attitudes align with their continued availability. OBJECTIVE: This study aimed to understand how situational factors and community member characteristics shape attitudes towards the legal defence of domestic discipline and what community members believe constitutes a fair outcome, when a parent is charged with assaulting a child. PARTICIPANTS AND SETTING: A quota-sampled survey of 1662 adults and qualitative focus groups with 58 community members, all residing in Queensland, Australia. METHODS: Participants were presented with a vignette describing a parent's use of physical force against an 11-year-old child, with the severity of force, use of an implement, and the child's diagnosis with ADHD experimentally varied. Survey data were analysed using binary logistic regression; focus group data were analysed thematically. RESULTS: After controlling for participant sociodemographics (e.g., age and gender), the predicted probability of a guilty finding rose sharply with the severity of force used, increasing from 7.2% (grabbed hand tightly) to 36.9% (slapped thigh with wooden spoon), and 56.9% (slapped face). Many participants, including several who supported a guilty finding, did not endorse criminal justice intervention, instead favouring parenting support and education. Qualitative findings revealed widespread uncertainty about the threshold between discipline and abuse. CONCLUSIONS: Findings reveal a gap between current legal tests and community reasoning, and support reform towards non-punitive, education-focused responses to low-level parental discipline, with implications for jurisdictions internationally that retain similar defences.
Hayley Boxall, Kate Fitz-Gibbon, Clementine Froomes-Houseman et al.
Lesbian, bisexual and queer (LBQ) women are under increasing threat. The combined nature of patriarchal misogyny, femmephobia and queerphobia contributes to high levels of sexual violence and harassment. Current literature focuses on biomedical health – STIs and pregnancy – and interventions targeting youth behaviour. Sociocultural factors are often treated as secondary. Here, we focus on Contextual Safety (CS) – the relationships, discourses, and interpersonal behaviours of others that afford risk, harm, or safety. Through a critical feminist lens, we explored LBQ femme-women’s retrospective accounts of CS. A Reflexive Thematic Analysis of repeated interviews with 10 femme- and LBQ-identified Australians provided insight into experiences and what can be done to protect young people. Pervasive masculine entitlement, with the media’s sexualisation of LBQ femininity, were key contributors to harm. Left with little choice, subject to feminine devaluation, participants often self-sabotaged in response to sexual threats through feigning and fawning. Participants’ experiences displayed stereotype incompatibility and confusion, leading to behaviours which validate either queer identity or a feigned cis-het identity in equally risky ways. Participants urged families and schools to minimise risk through community education. We must continue to push against the status quo to afford more safety in sexual exploration.
