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Abstract We construct the canonical constitutive relations for a fluid description of a system with a spin current, valid in an arbitrary number of dimensions in the absence of parity breaking or time reversal breaking terms. Our study encompasses the hydrostatic partition function, the entropy current, Kubo formula, conformal invariance, and the effect of charge. At some stages of the computation we turn on a background torsion tensor which naturally couples to the spin current.

Abstract Non-Riemannian gravitational theories suggest alternative avenues to understand properties of quantum gravity and provide a concrete setting to study condensed matter systems with non-relativistic symmetry. Derivation of an action principle for these theories generally proved challenging for various reasons. In this technical note, we employ the formulation of double field theory to construct actions for a variety of such theories. This formulation helps removing ambiguities in the corresponding equations of motion. In particular, we embed Torsional Newton-Cartan gravity, Carrollian gravity and String Newton-Cartan gravity in double field theory, derive their actions and compare with the previously obtained results in literature.

Abstract Anomalous transport coefficients are known to be universal in the absence of dynamical gauge fields. We calculate the corrections to these universal values due to dynamical gluon fields at strong coupling, at finite temperature and finite density, using the holographic duality. We show that the consistent chiral magnetic and chiral vortical currents receive no corrections, while we derive a semi-analytic formula for the chiral separation conductivity. We determine these corrections in the large color, large flavor limit, in terms of a series expansion in the anomalous dimension Δ of the axial current in terms of physical parameters Δ, temperature, electric and chiral chemical potentials and the flavor to color ratio N f N c $$ \frac{N_f}{N_c} $$ . Our results are applicable to a generic class of chiral gauge theories that allow for a holographic description in the gravity approximation. We also determine the dynamical gluon corrections to the chiral vortical separation current in a particular example in the absence of external axial fields.

Background: Experiences of household food insecurity are associated with a wide range of deleterious nutritional, developmental, psychological and social consequences for children. Children's distinct experiences of food insecurity, compared to adults, have been identified in diverse economic and cultural contexts. Yet historically, measurement of food insecurity in children has been predominantly reported by adult respondents on behalf of children, potentially underestimating prevalence and neglecting their unique perspectives. In response to this, child-report measures have been developed to assess food security status at both the individual and household level., Objectives: To identify and characterise child self-report food insecurity assessment tools used globally, with particular interest in how children's perspectives have been included in measure development processes., Methods: A scoping systematic literature review was conducted using PRISMA-ScR. Searches were conducted in four databases in January 2024 using keywords and MeSH terms. Data were extracted and synthesised relating to population and measure characteristics, validity and reliability metrics, and child involvement in measure development., Results: A total of 169 papers employing child-report measures were included after screening. Most papers originated in North America, used a single-item and included children aged >12 years. Of the child-report measures identified (n = 33), most were not specifically validated in the population of use. Only a small number of included papers (n = 13) had the aim to specifically evaluate measure validity. The Child Food Insecurity Experiences Scale and Child Food Assessment Scale emerged as child-centred measures with comprehensive validity evidence., Conclusions: Further child-centred validity testing, particularly with younger children (<12 years) is necessary to ensure validity of measures across age-groups and contexts. Ethical considerations when employing child-report measures, including how to best use tools across different child settings also warrant further exploration., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Coeliac Disease (CD) affects up to 1.4% of children worldwide, with a rising global incidence. A less typical clinical presentation and the need for a life-long gluten exclusion diet raise challenges for diagnosis, management, and healthcare delivery with considerable impacts for CD patients and families as well as clinical services., Aims: To explore the lived experiences of caregivers of children with CD to identify barriers and enablers to diagnosis, referral, and treatment to inform a more streamlined service delivery model., Methods: Semi-structured interviews with caregivers of children with CD diagnosed for at least one month with no significant co-morbidities. Interviews were thematically analyzed., Results: Sixteen participants representing 12 family units were interviewed. Children with CD ranged in age from 3 to 18 years. Time from symptom onset to diagnosis varied from one month to > 10 years and symptoms were mainly atypical and non-specific. Six key themes were identified: the iterative diagnosis journey, restricted choices, child responsibility and autonomy, mental load (encompassing foodwork, emotional rollercoaster, and lack of trust), Google™ reigns for information, and where to from here?, Conclusion: There is a need to decentralize CD diagnosis and management to meet the increasing demand created by rising incidence. Participants highlighted the need for a more streamlined diagnosis pathway, increased training of health professionals, and access to age-appropriate resources. Efforts need to be made to advocate for increased community awareness. These insights will be used to reimagine and co-design a decentralized model of care for pediatric CD diagnosis and management in Queensland, Australia., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests., (© 2025. The Author(s).)

Responsive feeding practices are crucial for developing healthy eating behaviours in children. However, chaotic households and financial stress may disrupt these practices. This cross-sectional study aimed to characterise feeding practices among Australian parents experiencing financial hardship. Parents of children aged 5-35 months, who identified as experiencing financial hardship, completed an online questionnaire from October 2021 to June 2022. Validated tools gathered data on feeding practices, mealtime structure and environment, household chaos (HC), household food insecurity (HFI) and sociodemographic characteristics. Bivariate correlations and hierarchical regression assessed relationships between these variables, adjusted for parent age, education and number of children. Data from 213 parent-child dyads were analysed (97% mothers, median age = 31 years, IQR 28-36; 50% boys, median age = 12 months, IQR 8-17). Median HC score was 4 (IQR 2-7). Seventy-six percent of families reported experiencing HFI (median = 6, IQR 3-9). Over 80% of parents often or always ate meals as a family and never or rarely engaged in 'parent-led' feeding (median = 1.75, IQR 1.00-2.50), or used '(non)-food as reward' (median = 1.33, IQR 1.00-2.00). '(Non)-food as reward' was positively correlated with HC (p = 0.016), and 'food to calm' was positively associated with HC (p = 0.004). 'Feeding on demand' was negatively associated with HC and HFI (p = 0.002). 'Persuasive feeding' was not associated with either. Findings suggest that HC had more influence than HFI on some nonresponsive feeding practices. Increasing levels of HC and HFI may result in less structured mealtimes. Interventions must consider how financial hardship, HFI and HC can impact parents' ability to engage in responsive feeding practices. This cross-sectional study examined feeding practices among Australian parents facing financial hardship. Over 75% were food insecure. While the meal environment supported responsive feeding, increasing household chaos and food insecurity led to fewer structured mealtimes and household chaos increased coercive practices such as using (non)-food rewards and food to calm., (© 2024 The Author(s). Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Little is known about how discrimination contributes to health behaviors in childhood. We examined the association between children's exposure to discrimination and their snacking behavior in a sample of youth of color (N = 164, M age  = 11.5 years, 49% female, 60% Black, 40% Hispanic/Latinx). We also explored whether children's body mass index (BMI) or sleepiness moderated the association between discrimination and calorie consumption. The significant link between discrimination and calorie consumption was moderated by children's BMI, such that discrimination was associated with calorie consumption for children with BMI percentiles above 79%. Children's sleepiness did not serve as an additional moderator. Efforts to promote health should consider children's broader socio-contextual experiences, including discrimination, as factors that may shape eating patterns., (© 2024 The Author(s). Child Development published by Wiley Periodicals LLC on behalf of Society for Research in Child Development.)

Tinea incognito (TI) is a dermatophyte infection that often presents atypically due to the inappropriate use of corticosteroids or other immunosuppressive treatments, complicating its diagnosis and management. This case report describes a 29-year-old American Indian (Maya) female from Yucatán, Mexico, initially diagnosed with inverse psoriasis and treated with topical corticosteroids. Over several months, her condition deteriorated, with lesions spreading and worsening, ultimately revealing TI. The misdiagnosis was attributed to the masking effects of corticosteroids, which suppressed the immune response and facilitated fungal dissemination. The case underscores the diagnostic difficulties of TI, particularly when treatments exacerbate rather than alleviate the condition. Key to diagnosis is the combination of patient history, mycological testing, and clinical examination. The study also highlights the role of chronic glucocorticoid use in impairing antifungal immunity by reducing crucial cytokines like IL-17 and IFN-γ, leading to persistent fungal infections. Furthermore, addressing underlying conditions such as obesity, insulin resistance, and diabetes is essential for effective management. Timely and accurate identification of TI, coupled with appropriate treatment, is critical to prevent complications and improve patient outcomes., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gallegos Espadas et al.)

Background: Responsive feeding is a reciprocal process between caregiver and child that is primarily child-led. It is linked to the development of positive eating behaviors and food preferences. There is evidence that household chaos, family dynamics, the quality of mealtime routines, financial hardship, and food insecurity can impact the feeding relationship., Objective: This study explored factors influencing feeding experiences among Australian parents with young children experiencing financial hardship, including household chaos and food insecurity., Design: This qualitative semi-structured interview study was conducted as a component of a larger research program to design and evaluate a parent program to support responsive feeding practices in Australian families experiencing financial hardship and food insecurity., Participants/setting: Participants were caregivers of a child aged 6 months to 3 years (n = 29), living in Australia, who self-identified as experiencing financial hardship. Interviews were conducted in person and via telephone between August 2021 and January 2022., Analysis: Transcripts were analyzed using the Framework Method of thematic analysis., Results: Five key themes were generated: family tensions heightened through hardship, making tradeoffs and sacrifices, the unseen mental load, the inescapable impact of COVID-19, and resiliency and being creative. Despite facing multiple hardships and challenges with feeding the family, parents demonstrated resilience and capabilities through creative food resource management and organizational skills. Parents experienced a high mental load through the cognitive and emotional work of planning, adapting, anticipating, and caring for the family's needs through meals and child feeding., Conclusions: Programs to support child feeding need to consider the high mental load families with food insecurity experience and how this can impact parents' capacity. Program content should be contextually sensitive to the experience of food insecurity and consider the constraints inherent in families and communities while building on capabilities and strengths., (Copyright © 2024 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objective: Schools are identified as a setting for food and nutrition education (FNE) in childhood. FNE is a key strategy to optimise child growth and development and impart life-long food skills. There is limited synthesis of the literature to understand the socio-ecological determinants of teachers and schools engaging in FNE., Design: For this scoping review, five databases (APA PsycInfo, ERIC, Medline, CINAHL and Scopus) were searched using the terms (and synonyms for) primary school teacher, self-efficacy and food and nutrition. A quality assessment using relevant Johanna Briggs tools was carried out for the included papers. Data were extracted using a modified socio-ecological model, and narrative themes were identified., Setting: Primary (elementary) schools in high-income countries., Participants: Primary-school teachers., Results: Forty-one papers were included in this review from ten countries (predominantly the USA). The narrative synthesis identified five themes that interact with teacher delivery of FNE. These were (i) perceived food and nutrition responsibilities of teachers, (ii) teacher beliefs and self-efficacy, (iii) opportunities to build teacher nutrition knowledge and self-efficacy, (iv) interpersonal contributors and (v) broader environmental, structural and policy contributors., Conclusions: Multiple strategies are needed to build the capacity of teachers to undertake FNE within primary school settings. These strategies include a focus on learner-centred education that will build teacher agency, school leadership, ensuring the health and well-being of teachers and providing initial teacher education as well as innovative professional development for cross-curriculum integration. Strategies drawing from each level of the socio-ecological framework will increase opportunities for capacity building.

Background: The way in which children interact with food has a profound impact on their health and wellbeing. However, most research, strategy and policy where food is the focus are derived from adult perspectives. There is limited understanding of children's perspectives of the nature of their everyday food practices, and their level of involvement and influence. This work garnered children's (8-12 years old) descriptions of, and involvement in, their everyday food practices., Methods: Forty-two children from 28 families from across Brisbane (Australia) participated in qualitative creative draw-and-tell interviews and 20 of these children (from 15 families) also completed Photovoice data collection. Data were abductively analysed through a social practice theory lens., Results: Children reported engaging in food planning, acquisition, preparation, consumption and tidy-up practices, to varying degrees of 'less involved', 'in partnership with adults or other children' or 'independently'. This was influenced largely by the willingness of adults to relinquish control and children's desire to participate, as well as other contextual factors. Children were more independent in consumption practices, as well as packing lunchboxes and preparing food spaces (as preparation practices). Partnerships were established more so within food acquisition and preparation practices, with less involvement described within planning and tidy-up practices., Conclusions: The findings add new knowledge and depth and breadth to that already obtained from parents, teachers and adult researchers, highlighting the importance of privileging children's voices when investigating their food experiences. This work may be used to guide adults to invite and support children to be involved in food practices that they report being less involved in, as well as inform how best to work with and include children in future research and food and nutrition strategies and policies., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: In high-income countries, significant diet-related health inequalities exist between people of different socioeconomic backgrounds. Individuals who face socioeconomic challenges are less likely to meet dietary guidelines, leading to increased incidence and prevalence of morbidity and mortality associated with dietary risk factors. To promote healthy eating, strategies may focus on individual-level factors (e.g., knowledge, skills, and behavior) along with broader societal factors (e.g., social determinants of health). The concept of food literacy is considered an individual-level factor and has been framed as a skill set that individuals must possess to effectively navigate the complexities of the modern food system. Food literacy interventions can be a complementary but effective tool for encouraging healthy eating behavior among diverse populations, including those facing socioeconomic disadvantage. However, there is limited evidence to guide the design of food literacy intervention for vulnerable population groups. In the process of developing an ideal portfolio of solutions and strategies to promote food literacy and healthy eating for people experiencing socioeconomic disadvantage, this systematic scoping review aims to comprehensively examine the effects of food literacy interventions on promoting food literacy behavior and healthy eating in adults (18 years and above) from various socioeconomic groups (SEGs) in high-income countries., Methods: The review includes both qualitative and quantitative papers obtained from academic databases, including MEDLINE (via EBSCOhost), Embase, Web of Science, and Google Scholar. In addition to the electronic search, manual forward and backward citation searching will be conducted to identify additional relevant papers. Food literacy interventions will be evaluated across four domains: planning and management, selection, preparation, and consumption. Papers included in the review will be analyzed for process, impact, and outcome evaluation. The main outcome of a food literacy intervention is the modification in eating behavior, while the mechanism for this action will be through impact measure of food literacy behaviors. Implementation factors will be extracted for process evaluation. This review will also include a range of dietary behavior measures, such as diet quality index and dietary intake indicator. The screening process for all citations, full-text articles, and abstract data will be carried out by two reviewers independently. In case of any potential conflicts, they will be resolved through discussion. The quality of quantitative studies will be reviewed using the JBI critical appraisal checklist for analytical cross-sectional studies. The "Consolidated Criteria for Reporting Qualitative Studies (COREQ)" will be used to report on the quality of qualitative papers., Systematic Review Registration: https://doi.org/10.17605/OSF.IO/TPNKU., (© 2024. The Author(s).)

Introduction: Intrinsic sphincter deficiency (ISD) is associated with a patient history of urethral injury or childbirth. Suburethral sling placement for ISD has been found to be beneficial in patients with this diagnosis. ISD in the pediatric population is rare and surgical management may prove difficult. ISD requires intensive counseling on available treatment options for this unique population., Case Presentation: This report is on the use of the single-incision mini-sling for complete ISD in an adolescent patient. The patient was a 15-year-old nulligravid female who was found to have idiopathic complete intrinsic deficiency based on a multi-channel urodynamic study. Despite conservative management, the patient opted for a surgical option instead. The patient underwent a single-incision mini-sling placement. At 3- and 6-month postoperative follow-up visits, the patient reported a subjective cure of stress urinary incontinence., Conclusion: Single-incision mini-sling is a minimally invasive surgical technique that may be a feasible treatment option to reduce urinary incontinence in pediatric patients with a diagnosis of ISD., Competing Interests: Conflicts of Interest: The authors declare they have no conflicts of interest., (© 2024 HCA Physician Services, Inc. d/b/a Emerald Medical Education.)

Background: The need for addition of external electron donors such as ethanol or lactate impairs the economic viability of chain elongation (CE) processes for the production of medium-chain carboxylates (MCC). However, using feedstocks with inherent electron donors such as silages of waste biomass can improve the economics. Moreover, the use of an appropriate inoculum is critical to the overall efficiency of the CE process, as the production of a desired MCC can significantly be influenced by the presence or absence of specific microorganisms and their metabolic interactions. Beyond, it is necessary to generate data that can be used for reactor design, simulation and optimization of a given CE process. Such data can be obtained using appropriate mathematical models to predict the dynamics of the CE process., Results: In batch experiments using silages of sugar beet leaves, cassava leaves, and Elodea/wheat straw as substrates, caproate was the only MCC produced with maximum yields of 1.97, 3.48, and 0.88 g/kgVS, respectively. The MCC concentrations were accurately predicted with the modified Gompertz model. In a semi-continuous fermentation with ensiled sugar beet leaves as substrate and digestate from a biogas reactor as the sole inoculum, a prolonged lag phase of 7 days was observed for the production of MCC (C6-C8). The lag phase was significantly shortened by at least 4 days when an enriched inoculum was added to the system. With the enriched inoculum, an MCC yield of 93.67 g/kgVS and a productivity of 2.05 gMCC/L/d were achieved. Without the enriched inoculum, MCC yield and productivity were 43.30 g/kgVS and 0.95 gMCC/L/d, respectively. The higher MCC production was accompanied by higher relative abundances of Lachnospiraceae and Eubacteriaceae., Conclusions: Ensiled waste biomass is a suitable substrate for MCC production using CE. For an enhanced production of MCC from ensiled sugar beet leaves, the use of an enriched inoculum is recommended for a fast process start and high production performance., (© 2024. The Author(s).)

Background: Fathers play a pivotal role in parenting and child feeding, but they remain underrepresented in intervention studies, especially those focused on disadvantaged populations. A better understanding of fathers' experiences and needs regarding support access and child nutrition information in the context of disadvantage can inform future interventions engaging fathers., Objective: This study aims to explore fathers' experiences; perceived enablers; and barriers to accessing support and information related to parenting, child feeding, and nutrition and to co-design principles for tailoring child nutrition interventions to engage fathers., Methods: Australian fathers of children aged 6 months to 5 years with lived experience of disadvantage participated in semistructured interviews and co-design workshops, primarily conducted via videoconference. Creative analogies were used to guide the ideation process in the workshops., Results: A total of 25 interviews and 3 workshops (n=10 participants) were conducted, with data analyzed using reflexive thematic analysis and the Capability, Opportunity, and Motivation-Behavior model. The interview data illuminated factors influencing fathers' initiation in seeking support for parenting, child feeding, and nutrition, including their experiences. It highlighted fathers' diverse information needs and the importance of an inclusive environment and encouragement. Enablers and barriers in accessing support related to parenting and child nutrition were identified at the individual (eg, personal goals and resource constraints), interpersonal (family support and false beliefs about men's caregiving role), organizational (inadequate fathering support), and systemic levels (father-inclusive practice and policy). Digital data collection methods enabled Australia-wide participation, overcoming work and capacity barriers. Videoconferencing technology was effectively used to engage fathers creatively. Key principles for engaging fathers were co-designed from the workshop data. Interventions and resources need to be father specific, child centered, and culturally appropriate; promote empowerment and collaboration; and provide actionable and accessible strategies on the what and how of child feeding. Fathers preferred multiformat implementation, which harnesses technology-based design (eg, websites and mobile apps) and gamification. It should be tailored to the child's age and targeted at fathers using comprehensive promotion strategies., Conclusions: Fathers faced barriers to accessing support and information related to parenting and feeding that may not adequately address their needs. Future interventions could integrate the co-designed principles to engage fathers effectively. These findings have implications for health service delivery and policy development, promoting father-inclusive practice., (©Jeffrey Tsz Hei So, Smita Nambiar, Rebecca Byrne, Danielle Gallegos, Kimberley A Baxter. Originally published in JMIR Pediatrics and Parenting (https://pediatrics.jmir.org), 30.05.2024.)

Household food insecurity has significant negative implications across the lifespan. While routine screening is recommended, particularly in healthcare, guidelines are lacking on selection of screening tools and best-practice implementation across different contexts in non-stigmatizing ways. The objective of this scoping review was to synthesize evidence on household food insecurity screening tools, including psychometrics, implementation in a range of settings, and experiences of carrying out screening or being screened. Four electronic databases were searched for studies in English published from 1990 until June 2023. A total of 58 papers were included, 21 of which focused on tool development and validation, and 37 papers described implementation and perceptions of screening. Most papers were from the USA and described screening in healthcare settings. There was a lack of evidence regarding screening in settings utilized by Indigenous people. The two-item Hunger Vital Sign emerged as the most used and most valid tool across settings. While there is minimal discomfort associated with screening, screening rates in practice are still low. Barriers and facilitators of screening were identified at the setting, system, provider, and recipient level and were mapped onto the COM-B model of behavior change. This review identifies practical strategies to optimize screening and disclosure.

Seborrheic pemphigus (SP) represents a localized and superficial form of pemphigus foliaceus (PF) often mistaken for other dermatological conditions such as seborrheic dermatitis (SD) due to clinical similarities. Additionally, SP may be conceptually confused with pemphigus erythematosus (PE) due to historical terminology and overlapping clinical features. We present a case study of a 38-year-old female initially diagnosed with SD but later identified as SP through detailed clinical and histopathological analysis. We discuss the challenges in accurately diagnosing SP, emphasizing the importance of distinguishing it from PE and other acantholytic dermatoses. Furthermore, we highlight the effectiveness of topical treatment in managing SP, contrary to the systemic therapy often required for PE. Our findings underscore the necessity for further research to optimize management strategies for SP and emphasize the significance of precise terminology in clinical practice and research., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Gallegos Espadas et al.)

Household food insecurity (HFI) and poorer prenatal diet quality are both associated with adverse perinatal outcomes. However, research assessing the relationship between HFI and diet quality in pregnancy is limited. A cross-sectional online survey was conducted to examine the relationship between HFI and diet quality among 1540 pregnant women in Australia. Multiple linear regression models were used to examine the associations between HFI severity (marginal, low, and very low food security compared to high food security) and diet quality and variety, adjusting for age, education, equivalised household income, and relationship status. Logistic regression models were used to assess the associations between HFI and the odds of meeting fruit and vegetable recommendations, adjusting for education. Marginal, low, and very low food security were associated with poorer prenatal diet quality (adj β = -1.9, -3.6, and -5.3, respectively; p < 0.05), and very low food security was associated with a lower dietary variety (adj β = -0.5, p < 0.001). An association was also observed between HFI and lower odds of meeting fruit (adjusted odds ratio [AOR]: 0.61, 95% CI: 0.49-0.76, p < 0.001) and vegetable (AOR: 0.40, 95% CI: 0.19-0.84, p = 0.016) recommendations. Future research should seek to understand what policy and service system changes are required to reduce diet-related disparities in pregnancy.

Background: Design thinking is an iterative process that innovates solutions through a person-centric approach and is increasingly used across health contexts. The person-centric approach lends itself to working with groups with complex needs. One such group is families experiencing economic hardship, who are vulnerable to food insecurity and face challenges with child feeding., Objective: This study describes the application of a design thinking framework, utilizing mixed methods, including co-design, to develop a responsive child-feeding intervention for Australian families-'Eat, Learn, Grow'., Methods: Guided by the five stages of design thinking, which comprises empathizing, defining, ideating, prototyping, and testing. We engaged with parents/caregivers of a child aged 6 months to 3 years through co-design workshops (n = 13), direct observation of mealtimes (n = 10), a cross-sectional survey (n = 213) and semistructured interviews (n = 29). Findings across these methods were synthesized using affinity mapping to clarify the intervention parameters. Parent user testing (n = 12) was conducted online with intervention prototypes to determine acceptability and accessibility. A co-design workshop with child health experts (n = 9) was then undertaken to review and co-design content for the final intervention., Results: Through the design thinking process, an innovative digital child-feeding intervention was created. This intervention utilized a mobile-first design and consisted of a series of short and interactive modules that used a learning technology tool. The design is based on the concept of microlearning and responds to participants' preferences for visual, brief and plain language information accessed via a mobile phone. User testing sessions with parents and the expert co-design workshop indicated that the intervention was highly acceptable., Conclusions: Design thinking encourages researchers to approach problems creatively and to design health interventions that align with participant needs. Applying mixed methods-including co-design- within this framework allows for a better understanding of user contexts, preferences and priorities, ensuring solutions are more acceptable and likely to be engaged., (© 2024 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Introduction: Resolution of underlying urinary tract anomalies prior to kidney transplantation in patients with end stage renal disease (ESRD) secondary to uropathy, has been historically supported under the argument that this would help prevent infectious complications and graft loss. We propose to perform earlier kidney transplantation with a transient vesicostomy, deferring resolution of the uropathy to the post-transplantation period. The aim of this study was to evaluate the outcomes of kidney transplantation in children with a vesicostomy., Material and Methods: A retrospective, multicenter study was performed including all patients under 18 years of age who underwent kidney transplantation with a vesicostomy, between January 2005 and December 2020 and had at least one year of follow up. Data related with the indication and timing of vesicostomy, time until transplantation, post-transplantation complications, urinary tract infections (UTI) and graft survival rate were collected., Results: Of the 758 transplantations performed in the study period, 16 patients met the inclusion criteria. Mean age at transplantation was 58 months (range 20-151), and mean weight was 13.5 Kg (range 8.4-20). Mean time from vesicostomy to kidney transplantation was 30 months (range 0-70). There were 2 (12.5%) ureteral complications that required reoperation. Eighteen episodes of UTI were identified in 8 patients (50%), accounting for 0.4 UTIs per patient-year of follow-up. UTIs did not lead to graft loss in any of the cases. Urinary tract reconstruction was performed in 5 patients (31.3%) at an interval of 1-91 months post-transplantation. After a mean follow-up of 44.8 months (range 13-200) from transplantation, patients with vesicostomy had a mean creatinine clearance of 86.6 ml/min/1.73 m 2 , with a mean serum creatinine level of 0.6 mg/dl. Graft survival rate was 100%., Discussion: Early kidney transplantation into a vesicostomy permits a resolution of the ESRD, avoiding deleterious effects related to dialysis. With a low rate of UTIs, we found no graft loss due to infectious complications. This strategy permits careful planning and better timing for the urinary tract reconstruction without delaying kidney transplantation., Conclusion: Kidney transplantation in pediatric patients with vesicostomy seems to be a safe and effective strategy. UTI rate was similar to that reported in the literature of patients with corrected urinary anomalies undergoing kidney transplantation without urinary diversion., Competing Interests: Conflict of interest None., (Copyright © 2023 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)