BMJ Paediatrics Open最新文献

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Eco-anxiety, knowledge and action in primary school-aged children in East London. 东伦敦小学学龄儿童的生态焦虑、知识和行动。
IF 2 4区 医学
BMJ Paediatrics Open Pub Date : 2025-06-26 DOI: 10.1136/bmjpo-2025-003324
Imogen I Hensler, Khushi Patel, Julia Michalek, Callum Ritchie, Francois van Loggerenberg, Dennis Ougrin, Jennifer Y F Lau
{"title":"Eco-anxiety, knowledge and action in primary school-aged children in East London.","authors":"Imogen I Hensler, Khushi Patel, Julia Michalek, Callum Ritchie, Francois van Loggerenberg, Dennis Ougrin, Jennifer Y F Lau","doi":"10.1136/bmjpo-2025-003324","DOIUrl":"10.1136/bmjpo-2025-003324","url":null,"abstract":"<p><p>Eco-anxiety refers to negative feelings around climate change, associated with distress and concern about the future. As there are minimal data on eco-anxiety in pre-adolescent children, here, we measured worries, knowledge and commitment to action in primary school-aged children in East London, an area characterised by high child poverty levels and ethnic diversity. Approximately half of the children worry about and are aware of global warming. We also found a correlation between worries and knowledge, and between worries and taking action. While these data are limited by a cross-sectional design and by the use of single-item self-reports of these constructs, nonetheless, greater engagement of pre-adolescent children in discussions around climate change is called for.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of parental beliefs and practices leading to excessive screen time in early childhood. 分析父母的信念和做法导致儿童早期过多的屏幕时间。
IF 2 4区 医学
BMJ Paediatrics Open Pub Date : 2025-06-25 DOI: 10.1136/bmjpo-2025-003488
Priyank Bhutani, Litna A Varghese, Gagan Bajaj, Charul Bhutani, Firoz Khan, Geetha R Menon, Ramesh Chandra Deka, Suvendra Kumar Ray, Siddhartha Sankar Satapathy
{"title":"Analysis of parental beliefs and practices leading to excessive screen time in early childhood.","authors":"Priyank Bhutani, Litna A Varghese, Gagan Bajaj, Charul Bhutani, Firoz Khan, Geetha R Menon, Ramesh Chandra Deka, Suvendra Kumar Ray, Siddhartha Sankar Satapathy","doi":"10.1136/bmjpo-2025-003488","DOIUrl":"10.1136/bmjpo-2025-003488","url":null,"abstract":"<p><strong>Background: </strong>Excessive screen time in young children is a growing concern in the digital age. It is important to explore parental beliefs and practices that could shape children's screen time routines.</p><p><strong>Methods: </strong>This cross-sectional study surveyed 3624 parents of children aged 2-5 years from five northern Indian states between July and October 2024. The participants completed a validated questionnaire assessing sociodemographic factors, children's screen time duration, parental beliefs and practices related to screen time regulation (guidelines and enforcement), screen use purposes (eg, feeding, chores) and perceived impacts on child development (eg, social skills, attention, speech/language). Data analysis included χ<sup>2</sup> tests and multinomial logistic regression to identify associations between variables.</p><p><strong>Results: </strong>Over 60% of the children spent 2-4 hours daily on screens, with no significant associations between weekday-weekend screen time patterns and sociodemographic factors. Multinomial logistic regression revealed that the odds of excessive screen use were greater among children whose parents were unsure of whether restrictions should be set (AOR=3.03 for 4-6 hours), those whose parents did not set screen time limits (AOR=1.64 for 4-6 hours and AOR=2.07 for >8 hours), those whose parents used screens during feeding (AOR=1.82 for 2-4 hours; AOR=2.66 for 4-6 hours, AOR=2.79 for 4-8 hours and 3.54 for >8 hours) and those whose parents did not believe that screen time hindered speech and language development (AOR=1.77 for 2-4 hours and AOR=2.11 for 4-6 hours).</p><p><strong>Conclusion: </strong>Parental factors, including the absence of screen time limits and the cultural use of screens during mealtimes, contribute to excessive screen time. Interventions in India should focus on practical programmes that support parents in managing screen time, tailored to regional and cultural contexts.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advancing early childhood development for children with disabilities and the Global Disability Summit 2025. 促进残疾儿童早期发展和2025年全球残疾问题首脑会议。
IF 2 4区 医学
BMJ Paediatrics Open Pub Date : 2025-06-24 DOI: 10.1136/bmjpo-2025-003595
Bolajoko O Olusanya, Olaf Kraus de Camargo, Sheffali Gulati, Shanti Raman
{"title":"Advancing early childhood development for children with disabilities and the Global Disability Summit 2025.","authors":"Bolajoko O Olusanya, Olaf Kraus de Camargo, Sheffali Gulati, Shanti Raman","doi":"10.1136/bmjpo-2025-003595","DOIUrl":"10.1136/bmjpo-2025-003595","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Systematic literature review and meta-analysis on therapeutic management of faecal impaction in the paediatric population. 对儿科人群粪便嵌塞治疗管理的系统文献回顾和荟萃分析。
IF 2 4区 医学
BMJ Paediatrics Open Pub Date : 2025-06-22 DOI: 10.1136/bmjpo-2025-003483
Morris Gordon, Svetlana Lakunina, Anna de Geus, Aderonke Ajiboye, Ahmer Khan Amran, Merit Tabbers, Marc A Benninga, Amber Balda, Vassiliki Sinopoulou
{"title":"Systematic literature review and meta-analysis on therapeutic management of faecal impaction in the paediatric population.","authors":"Morris Gordon, Svetlana Lakunina, Anna de Geus, Aderonke Ajiboye, Ahmer Khan Amran, Merit Tabbers, Marc A Benninga, Amber Balda, Vassiliki Sinopoulou","doi":"10.1136/bmjpo-2025-003483","DOIUrl":"10.1136/bmjpo-2025-003483","url":null,"abstract":"<p><strong>Background: </strong>To date, there is no universally accepted or standardised protocol for management of faecal impaction (FI) in paediatric population. If left untreated, it can lead to serious consequences for the health and well-being of the child. We set out to determine the effectiveness and safety of existing therapeutic interventions for FI in children and identify any gaps occurring in current research.</p><p><strong>Methods: </strong>We have performed a systematic literature review on treatment of FI in paediatric population in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We have included randomised controlled trials (RCTs) on all interventions for children (0-18 years old) with FI on background of functional constipation and excluded children with organic causes of FI. Our primary outcomes were treatment success, defecation frequency and withdrawals due to adverse events. We have performed a meta-analysis of the data.</p><p><strong>Results: </strong>Out of 13 341 records identified, only eight RCTs met our inclusion criteria with a total of 513 participants randomised. The diagnosis of functional constipation was mainly made using ROME III criteria. The diagnosis of FI varied from study to study. We identified several intervention groups based on our search. Our analysis has shown that there is no difference probably between PEG (Polyethylene Glycol).and PEG with sodium picosulphate, and there may be no difference between PEG and rectal enema for treatment success, but enema may lead to greater stool frequency. No other studies produced anything other than very low certainty evidence.</p><p><strong>Conclusions: </strong>No therapeutic approach was superior to others, with evidence limited by significant clinical heterogeneity related to varying patient and clinical factors, different outcome measures and limited study numbers. More high-quality research is needed to determine effective strategies for FI. Moreover, a consensus should be reached regarding the definition and diagnosis of FI as based on that a standardised approach to patient's care can be determined.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of primary healthcare worker training to screen children under 5 years of age with a low-cost alternative to the direct ophthalmoscope, the 'Arclight', as part of the Integrated Management of Newborn and Childhood Illness (IMNCI) programme in Tanzania. 作为坦桑尼亚新生儿和儿童疾病综合管理(IMNCI)方案的一部分,对初级卫生保健工作者在使用低成本替代直接检眼镜的“Arclight”筛检5岁以下儿童方面的培训进行评估。
IF 2 4区 医学
BMJ Paediatrics Open Pub Date : 2025-06-18 DOI: 10.1136/bmjpo-2025-003520
A N J Malik, Godfrey Furhini Mnedeme, Nemes Iriya, Philip Bahati, Henry Marealle, Andrew Blaikie, Mlika Mafwiri
{"title":"Evaluation of primary healthcare worker training to screen children under 5 years of age with a low-cost alternative to the direct ophthalmoscope, the 'Arclight', as part of the Integrated Management of Newborn and Childhood Illness (IMNCI) programme in Tanzania.","authors":"A N J Malik, Godfrey Furhini Mnedeme, Nemes Iriya, Philip Bahati, Henry Marealle, Andrew Blaikie, Mlika Mafwiri","doi":"10.1136/bmjpo-2025-003520","DOIUrl":"10.1136/bmjpo-2025-003520","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the integration of childhood eye screening with the Arclight direct ophthalmoscope into an already existing WHO/UNICEF Integrated Management of Newborn and Childhood Illness (IMNCI) programme in Tanzania.</p><p><strong>Design: </strong>Prospective interventional study.</p><p><strong>Setting: </strong>Primary healthcare facilities in a semirural district, central Tanzania.</p><p><strong>Participants: </strong>Two IMNCI (Integrated Management of Newborn and Childhood Illness) facilitators received training enhanced with four newly developed videos on using the Arclight. These facilitators then trained 378 primary healthcare workers (PHCWs) who were already familiar with the IMNCI 'Eye Module'. The training covered how to perform red reflex testing with the Arclight device, interpret the results and appropriately refer children who failed the screening.</p><p><strong>Intervention: </strong>'Arclight' direct ophthalmoscope and training of primary healthcare workers.</p><p><strong>Main outcome measures: </strong>Number of children screened and diagnosed with eye conditions.</p><p><strong>Results: </strong>Over 4 months, 2 trained IMNCI facilitators trained 378 PHCWs on how to use the Arclight direct ophthalmoscope to screen children's eyes. Over a 6-month period, 36 000 children were screened in primary care settings with 136 seen at district level facilities and 105 referred to regional and tertiary facilities. The most common diagnoses of children referred were allergic conjunctivitis (37.4%), bacterial conjunctivitis (31.2%) and cataract (7.1%). There were six cases of ophthalmia neonatorum (3.9%) and two cases of retinoblastoma (1.3%). The incidence rate per 10 000 children of cataract was 3.05, ophthalmia neonatorum 1.67 and retinoblastoma 0.55.</p><p><strong>Conclusion: </strong>Primary healthcare workers in Tanzania can be trained to screen for eye disease in babies and children using the Arclight direct ophthalmoscope as part of an ongoing child health programme leading to the detection of treatable and serious eye diseases. Training all PHCWs would allow every child under 5 years old to be screened for eye disease, detecting serious eye conditions such as cataract and retinoblastoma earlier preventing avoidable childhood blindness and mortality.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring hygiene practices, prenatal recommendations and parental attitudes towards congenital cytomegalovirus prevention and screening in Sweden. 探索卫生习惯,产前建议和父母对先天性巨细胞病毒预防和筛查的态度在瑞典。
IF 2 4区 医学
BMJ Paediatrics Open Pub Date : 2025-06-17 DOI: 10.1136/bmjpo-2025-003524
Allison Mackey, Ulrika Löfkvist
{"title":"Exploring hygiene practices, prenatal recommendations and parental attitudes towards congenital cytomegalovirus prevention and screening in Sweden.","authors":"Allison Mackey, Ulrika Löfkvist","doi":"10.1136/bmjpo-2025-003524","DOIUrl":"10.1136/bmjpo-2025-003524","url":null,"abstract":"<p><strong>Objective: </strong>The aims of the study were to explore the attitudes of parents of young children towards prevention and screening for congenital cytomegalovirus infection, and to map the practices and recommendations in prenatal care regarding the prevention of fetal infection.</p><p><strong>Methods: </strong>A survey was distributed across Sweden to parents of children under 2 years. Information about congenital cytomegalovirus infection was provided. Questions followed, pertaining to attitudes towards screening and prevention, hygiene behaviours during pregnancy, and recommendations from midwives.</p><p><strong>Results: </strong>4405 parents completed the survey; 4263 were pregnant less than 2 years prior. Parents were positive towards screening, with 85% agreeing that screening should be offered. A predicted increase in stress was positively associated with positive attitudes towards screening. Attitudes towards prevention were positive (90%). Most did not regularly perform hygiene measures to prevent cytomegalovirus infection during pregnancy, though behaviours preventing other infections were common. Recommendations by midwives rarely included cytomegalovirus prevention.</p><p><strong>Conclusion: </strong>Parents have positive attitudes toward screening and prevention of congenital cytomegalovirus infection, despite a predicted increase in stress. Information is not being conveyed by prenatal providers about how to protect oneself against cytomegalovirus infection, which reflects a lack of hygiene routines during pregnancy related to its prevention.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preventive practices and parental attitudes towards snakebites in children in snakebite hotspots of rural Sri Lanka. 斯里兰卡农村蛇咬伤热点地区儿童蛇咬伤的预防措施和家长态度。
IF 2 4区 医学
BMJ Paediatrics Open Pub Date : 2025-06-13 DOI: 10.1136/bmjpo-2025-003543
Kavinda Dayasiri, Gihan Gunarathna, Indika Gawarammana, Shaluka Jayamanne
{"title":"Preventive practices and parental attitudes towards snakebites in children in snakebite hotspots of rural Sri Lanka.","authors":"Kavinda Dayasiri, Gihan Gunarathna, Indika Gawarammana, Shaluka Jayamanne","doi":"10.1136/bmjpo-2025-003543","DOIUrl":"https://doi.org/10.1136/bmjpo-2025-003543","url":null,"abstract":"<p><strong>Background: </strong>Snakebites remain a major public health issue in rural Sri Lanka, particularly among children under 5. Parental attitudes, knowledge and preventive practices significantly influence the risk of snakebites and the effectiveness of first aid responses. This study aimed to assess parental attitudes, knowledge sources and preventive practices related to snakebite prevention and management in children living in snakebite-endemic rural regions of Sri Lanka.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted in the Ampara and Polonnaruwa Districts, two snakebite-endemic regions in Sri Lanka. The study targeted parents with at least one child under 5 years old, who were selected through cluster sampling facilitated by Public Health Midwives. A structured, self-administered questionnaire was used to collect data on demographic characteristics, parental attitudes towards snakes and snakebites, knowledge sources and preventive practices.</p><p><strong>Results: </strong>A total of 518 parents participated, with the majority being mothers (94.2%). Extreme fear of snakes was reported by 92.7% of participants. Parental beliefs varied, with 23.7% believing that a snake should always be killed after biting a person and 18.0% holding the belief that snakes take revenge. Significant associations were found between extreme fear of snakes and the absence of prior training in snakebite first aid (p=0.035) as well as being a mother (p=0.001). Major challenges in snakebite care included transportation difficulties (90.5%), lack of proximity to hospitals with emergency treatment (81.5%) and reliance on traditional healing practices (32.6%). Traditional healing practices (32.6%) were significantly associated with low socioeconomic status (p=0.001) and low parental education (p=0.001). Social media (42.1%) was the most common source of knowledge on snakebite care. Storing paddy at home was significantly associated with a family history of snakebites (p=0.004) CONCLUSIONS: Parental fear, cultural beliefs and limited access to training programmes significantly influence snakebite prevention and management practices. Enhancing community-based education, improving healthcare accessibility and incorporating snakebite first-aid training into public health programmes could mitigate the risks and improve outcomes for paediatric snakebite cases in rural Sri Lanka.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Environment and admission preferences of 16-17 year olds. 16-17岁学生的环境和入学偏好。
IF 2.3 4区 医学
BMJ Paediatrics Open Pub Date : 2025-06-13 DOI: 10.1136/bmjpo-2023-002451
Hannah Siu-Yu Ha, Samantha Jones, Damian Roland
{"title":"Environment and admission preferences of 16-17 year olds.","authors":"Hannah Siu-Yu Ha, Samantha Jones, Damian Roland","doi":"10.1136/bmjpo-2023-002451","DOIUrl":"10.1136/bmjpo-2023-002451","url":null,"abstract":"<p><p>This is a short letter highlighting findings from a service evaluation of 16-17 year olds' preferences of location of care following presentation to an Emergency Department. 95 young people were interviewed; 54.7% (52/95) of participants preferred to be seen in the Paediatric Emergency Department, with 16 year olds showing a higher preference (62.2%) compared with 17 year olds (48.0%). Additionally, 58.9% (56/95) desired a choice in treatment location, and 67.4% (64/95) expressed a preference for age-specific wards during admissions. Our findings highlight the importance of recognising the individual needs and preferences of young people within healthcare.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Caught between fear and tradition: parental knowledge, beliefs and emergency responses to paediatric snakebites in rural Sri Lanka. 陷入恐惧与传统之间:斯里兰卡农村儿童蛇咬伤的父母知识、信仰和应急反应。
IF 2 4区 医学
BMJ Paediatrics Open Pub Date : 2025-06-13 DOI: 10.1136/bmjpo-2025-003658
Kavinda Dayasiri, Tharuka Perera, Indika Gawarammana, Shaluka Jayamanne
{"title":"Caught between fear and tradition: parental knowledge, beliefs and emergency responses to paediatric snakebites in rural Sri Lanka.","authors":"Kavinda Dayasiri, Tharuka Perera, Indika Gawarammana, Shaluka Jayamanne","doi":"10.1136/bmjpo-2025-003658","DOIUrl":"https://doi.org/10.1136/bmjpo-2025-003658","url":null,"abstract":"<p><strong>Background: </strong>Paediatric snakebite remains a critical yet underexplored public health issue in rural Sri Lanka, where children are particularly vulnerable due to ecological exposure, limited access to timely care and entrenched traditional beliefs. While biomedical advancements exist, parental knowledge, cultural practices and systemic barriers significantly shape prehospital responses and outcomes.</p><p><strong>Methods: </strong>This qualitative exploratory study employed 10 focus group discussions with 70 parents (45 mothers, 25 fathers) from snakebite-endemic rural communities in the Ampara and Polonnaruwa Districts. Participants were purposively selected, including those with direct or indirect exposure to snakebite incidents. Data were collected using a semistructured guide and analysed thematically, following Braun and Clarke's six-phase framework. Themes were validated through member checking and intercoder agreement.</p><p><strong>Results: </strong>Five interrelated themes emerged: (1) pervasive fear and psychological burden associated with snakebite risk, (2) fragmented and inconsistent knowledge of envenomation symptoms and first-aid, (3) environmental and structural vulnerabilities such as unsafe housing and proximity to snake habitats, (4) strong adherence to traditional beliefs and ritual practices and (5) a high demand for culturally tailored education and systemic support. Many parents employed harmful first-aid methods due to inherited practices and a lack of formal training. Despite challenges, participants expressed strong willingness to learn and adopt evidence-based strategies.</p><p><strong>Conclusions: </strong>Effective paediatric snakebite prevention and management require context-specific, culturally sensitive interventions that address both knowledge gaps and structural barriers. Engaging with local belief systems and improving healthcare accessibility are essential for reducing snakebite-related morbidity and mortality among children in rural Sri Lanka.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Environmental factors and clinical markers of stress during neonatal transport: a systematic literature review . 新生儿运输过程中应激的环境因素和临床标志:系统文献综述 。
IF 2 4区 医学
BMJ Paediatrics Open Pub Date : 2025-06-12 DOI: 10.1136/bmjpo-2025-003568
Tone Solvik-Olsen, Marit Bekkevold, Fridtjof Heyerdahl, Astri Maria Lang, Jostein S Hagemo, Marius Rehn
{"title":"Environmental factors and clinical markers of stress during neonatal transport: a systematic literature review .","authors":"Tone Solvik-Olsen, Marit Bekkevold, Fridtjof Heyerdahl, Astri Maria Lang, Jostein S Hagemo, Marius Rehn","doi":"10.1136/bmjpo-2025-003568","DOIUrl":"10.1136/bmjpo-2025-003568","url":null,"abstract":"<p><strong>Background: </strong>Neonatal transport is an essential component of modern neonatal intensive care globally, providing access to advanced treatment while exposing vulnerable neonates to environmental conditions that may increase the risk of physiological instability.</p><p><strong>Objective: </strong>To systematically review studies measuring environmental exposures, specifically vibration, sound and temperature fluctuations during neonatal transport and to evaluate their impact on clinical parameters in neonates.</p><p><strong>Methods: </strong>A systematic literature review identified studies reporting environmental factors or clinical data during transport via ground, rotor or fixed-wing air ambulances. The medical databases searched included MEDLINE/PubMed, Embase, the Cochrane database of systematic reviews, Nursing Reference Center Plus, UpToDate and SveMed covering the period from November 2020 to January 2025.</p><p><strong>Results: </strong>15 observational studies, 13 prospective and 2 retrospective covering publications from 1992 to 2025 were included. The studies included data on vibration, sound, ambient temperature and a wide range of clinical parameters such as heart rate and heart rate variability, change in clinical behaviour scales and cortisol in saliva reflecting the neonatal condition. Only four articles reported the effect of environmental factors on neonatal physiology.</p><p><strong>Conclusions: </strong>This review highlights the presence of environmental factors, particularly noise and vibration, during transport and raises concerns about their impact on neonates. Although diverse clinical parameters were documented, the small sample sizes and variability in measurement methods across studies limit the ability to draw definitive conclusions. These observations emphasise the need for standardised monitoring protocols and further research to optimise neonatal transport practices.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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