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Kangaroo Care is an effective practice recommended by WHO for newborns, especially preterm infants, to reduce mortality and morbidity and improve health outcomes. Understanding parents' experiences with Kangaroo Care is vital as it can significantly influence uptake and sustained practice; however, experiences may vary across healthcare systems.
To explore parents' experiences of Kangaroo Care in neonatal units and to examine differences across international health systems.
A qualitative meta-synthesis.
A systematic search of the literature was carried out over seven databases, including CINAHL, MEDLINE ALL, EMBASE, PsycINFO, Maternity & Infant Care, Scopus and Cochrane Library. Qualitative studies published in English from 2010 to January 2024 were included. Data extraction and quality appraisal, using the CASP Qualitative Checklist, were undertaken. Meta-synthesis of the included qualitative findings was carried out. The findings were reported following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guideline. The protocol was registered on PROSPERO (CRD42023483347).
Twenty-five studies were included and four themes were identified: parental fulfilment from Kangaroo Care, Hardship in Kangaroo Care practice, Roadblocks and difficulties in adopting and Building bridges to encourage and support Kangaroo Care.
This review underscores the multifaceted nature of parental experiences, including positive and challenging aspects, as well as significant barriers and facilitators that influenced Kangaroo Care implementation. By understanding these experiences and factors that hinder and enable, healthcare systems and professionals can better support and empower parents to improve the effectiveness of Kangaroo Care.
Kangaroo Care is lifesaving, particularly in low-income countries, but can be a challenge for parents providing it. By addressing deficiencies in infrastructure and resources, barriers can be minimised, thereby encouraging the practice of Kangaroo Care. This is especially important in lower-middle- and low-income countries where the practice is most effective and the practice is lowest.
This project is a meta-synthesis; therefore, no patient or public contribution was deemed necessary.
Meperidine, once viewed as relatively safe, is now discouraged in clinical settings due to its associated risks. Previous studies have identified a significant decrease in meperidine distribution across the USA from 2000 to 2021. Regional disparities accompanied this decline. The goal of this study was to investigate if the decrease in meperidine distribution has continued in recent years, 2019–2023, and if regional variations persist. This investigation also aimed to identify correlates of meperidine distribution, including adult obesity prevalence and annual income, to provide insight into the regional variation.
Retrospective observational study using data from the Automation of Reports and Consolidated Orders System Drug Retail Summary Reports by the Drug Enforcement Administration (DEA), the Centers for Disease Control and Prevention (CDC) and the US Census Bureau.
USA, including Puerto Rico.
US population.
The primary outcome was the meperidine distribution across the US between 2019 and 2023. Secondary outcomes included associations between meperidine distribution and adult obesity prevalence and median household income.
Total meperidine distribution across the USA dropped by 57.8% from 2019 to 2023. A substantial geographic variation was found with southern states accounting for the second, third and fourth highest in meperidine use per capita in 2023, only behind Puerto Rico. In contrast, northeastern states accounted for four of the five lowest states. A significant relationship was found between annual income and meperidine distribution in 2022 (r(49) = –0.38, p
Our study revealed a continued decrease in meperidine distribution and sustained presence of geographical variation from 2019 to 2023. Furthermore, novel relationships were identified between meperidine distribution, annual income and adult obesity prevalence.
Sexual and gender-based violence can have long-term impacts on the physical and mental health of survivors, with demonstrated impairments to immune, endocrine and nervous systems, and increased risk of chronic conditions such as cardiovascular disease, depression and post-traumatic stress. Moreover, survivors commonly experience low self-efficacy and lack of perceived control over their lives. Creating space for survivors to feel empowered through a multidimensional approach to health promotion, considering both physical and psychological influences on health, is necessary to reduce chronic disease.
In this type II hybrid effectiveness-implementation cluster randomised controlled trial, we evaluate a novel peer-led intervention that combines expressive writing and trauma-informed boxing, Left Write Hook, against trauma-informed boxing alone—an intervention approach that is currently accessible in the community and has been shown to improve both mental and physical health. 20 clusters of 8–10 adults (n=150) with a self-reported history of child sexual abuse or other gender-based violence will be recruited in Melbourne, Australia, through health services and the community. Clusters will be randomly assigned to complete either 8x weekly group sessions of Left Write Hook (intervention) involving both expressive writing and trauma-informed boxing led by a trained peer facilitator, or 8x weekly group boxing sessions led by a trauma-informed boxing facilitator (control). Implementation will be evaluated against the PRISM Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. The primary effectiveness outcome is change in self-efficacy from preintervention to postintervention (8 weeks). Secondary effectiveness outcomes are changes in symptoms of complex post-traumatic stress disorder, trauma-related cognition and indicators of physical fitness (strength, flexibility, aerobic fitness and balance). Assessment will be completed online or over the phone with a member of the research team at preintervention (0 weeks), postintervention (8 weeks) and at 1 month following completion of the intervention (12 weeks). The primary implementation outcome is the fidelity of the train-the-champion implementation strategy for intervention training and delivery, and the secondary implementation outcome is adoption of the intervention and training delivery.
Ethical approval was received from the Human Research Ethics Committee of The University of Melbourne (2024-28998-60131-11) and the Alfred Hospital Ethics Committee (110810). Results will be disseminated via publication in a peer-reviewed journal, and data will be made available via Open Science Framework at the conclusion of the trial.
ACTRN12624000862549.
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