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The use of disposable nappies has increased worldwide while cloth nappies usage dropped significantly. However, rural communities often dump nappy waste indiscriminately without considering the outcomes. This study first identified methods used by the community to dispose nappy waste in order to assess the social and environmental impacts posed by disposable nappy waste in Collins Chabane Local Municipality, Limpopo Province, South Africa. The study employed a mixed-method research design where quantitative and qualitative data were collected. A snowball sampling method was used to identify 163 households with infants using disposable nappies, and purposive sampling method was used to select 7 early childhood development (ECD) centres which cared for infants. Data collected using closed-ended questionnaires, semi-structured interviews, and field observation checklist were analysed using Statistical Package for the Social Sciences (SPSS) version 29.0 for quantitative data, and Atlas.ti version 24.0 for qualitative data. Results indicated that disposable nappy waste was dumped indiscriminately in areas such as roadsides, nearby streams, open spaces, pit latrines, in a mountain, as well as in termite’s mounds. It was also found that improper disposal of nappy waste causes social and environmental impacts, with (65%) of respondents indicated that it reflects bad culture and/or behaviour in society. This study suggested that cultural norms and values within communities should be improved. It was further recommended that different stakeholders should implement measures such as incentivised nappy waste take back schemes, establishment of nappy waste drop off centres, designation of environmental management champions, and encourage the use of biodegradable nappies.

The objective of this study is to examine the effect of discontinuing wearing protective garments (absorbent pyjama pants — APP) in children with severe childhood nocturnal enuresis (NE). The study employs a multicenter, parallel, randomized controlled trial. Following a 4-week run-in period, participants were randomly allocated in a 2:1 group allocation to discontinue or continue using APP. The research was conducted across seven European pediatric incontinence centers. The study included treatment-naïve children aged 4–8 years with severe (7/7 wet nights per week) mono-symptomatic NE, who had used nighttime protection for at least 6 months prior to the study. The study consisted of a 4-week run-in period (± 7 days), where all children slept wearing APP (DryNites ® ). At week 4 (± 7 days), if meeting randomization criteria (7/7 wet nights during the last week of run-in), participants were randomized to continue to sleep in APP or to discontinue their use for a further 4 weeks, with the option of another 4 weeks in the extension period. The primary outcome was the difference between groups of wet nights during the last week of intervention. Quality of life (QoL) and sleep were secondary endpoints. In total, 105 children (43 girls and 62 boys, mean age 5.6 years [SD 1.13]) were randomized (no-pants group n  = 70, pants group n  = 35). Fifteen children (21%) in the no-pants group discontinued early due to stress related to the intervention. Children in the no-pants group experienced fewer wet nights compared to the pants group during the last week (difference 2.3 nights, 95% CI 1.54–3.08; p  < 0.0001). In the no-pants group, 20% responded to the intervention, of whom 13% had a full response. Clinical improvement was detected within 2 weeks. Sleep and QoL were reported as negatively affected by APP discontinuation in the extension period but not in the core period.     Conclusion : A ~ 10% complete resolution rate was associated with discontinuing APP. While statistically significant, the clinical relevance is debatable, and the intervention should be tried only if the family is motivated. Response was detectable within 2 weeks. Discontinuing APP for 4–8 weeks was reported to negatively affect QoL and sleep quality. No severe side effects were seen. Trial registration : Clinicaltrials.gov Identifier: NCT04620356; date registered: September 23, 2020. Registered under the name: “Effect of Use of DryNites Absorbent Pyjama Pants on the Rate of Spontaneous Resolution of Paediatric Nocturnal Enuresis (NE).” What is Known? • APP has been hypothesized to delay time until spontaneous resolution of bedwetting, but no prospective randomized evidence is available regarding if APP use sustains symptoms. • No evidence whether discontinuation of APP can lead to dryness or impact sleep quality and QoL. What is New? • Thirteen percent became dry after removing APP for up to 8 weeks and initial response was detectable within 2 weeks. • Even though  prolonged discontinuation was reported to lead to sleep disturbances and rediced QoL, still our results suggest trying 2 weeks of the intervention if the family is motivated, prior to engaging established treatments for nocturnal enuresis.

Mismanaged disposable diaper (DD) waste is widespread in many urban African cities. Proposed policy responses range from free DD provision to outright bans. However, African studies examining DD consumption, disposal, and benefits are scarce. This cross-sectional study aimed to assess socio-economic variation in DD consumption, inappropriate DD disposal, and perceived benefits for children's carers. A survey interviewing 440 carers of children aged 0–36 months attending health facilities in Greater Accra, Ghana and Kisumu, Kenya found 95.0 and 94.2% used DD, respectively. Median DD consumption in a child's first 36 months was significantly higher in the wealthiest households, respectively, compared to the poorest households (4,099 versus 2,800 DD and 2,876 versus 1,714 DD, p ¼ 0.015 and 0.001 in Greater Accra and Kisumu, respectively). In Greater Accra, 10.2% of households reported burning, burying, or dumping used DD in latrines or elsewhere, compared to 30.5% in Kisumu. Carers in all wealth quintiles consistently cited DD's convenience and hygiene benefits. This confirms widespread DD consumption among rich and poor households, posing disposal challenges for those lacking waste collection services. Given DD's likely time-saving and reported convenience benefits for children's carers, we recommend waste management programmes that separate DDs for safe disposal as opposed to outright bans.

In developing countries, there is currently no established waste management plan that includes resource recovery from used disposable diapers (DDs) apart from incineration and landfilling. In low-income areas with limited storage space, the complex composition and odour of used DDs make it impossible to manage properly if not supported by effective waste management systems. In the absence of effective waste management, DDs are dumped in open spaces, burned or buried. These actions pose threats to the safety and health of humans, animals and the environment. Separation and collection of DDs are critical preliminary steps to landfilling, recycling or beneficiation. In this article, we describe a case study of two pilot collection projects in Langa township in Cape Town, South Africa, to determine whether and how a source-separated collection system can work in low-income, resource-constrained areas. The lessons learned highlighted the following: The eagerness of parents to participate for the benefit of their own and their children’s health; the complementarity of the two pilot collection models to serve the needs of the community; the important role non-government organisations play in the implementation of waste management projects; the significance of the possible job creation opportunities and the unintended benefits of enhancing social cohesion. The financial sustainability of these projects needs further exploration.

New data show that the bacteria on nappy skin is very site-specific, which has important implications for cleansing. Adapted from the source document.

Used disposable nappies constitute a waste stream that has no established treatment method. The purpose of this study was the assessment of the dark fermentation of used disposable nappies and expired food products under different pH values. The biodegradable part of the used disposable nappies was recovered and co-fermented with expired food products originating from supermarkets. The recoverable economic potential of the process was examined for different volatile fatty acids exploitation schemes and process pH values. The process pH strongly affected the products, with optimum hydrogen production at pH 6 (4.05 NLH2/Lreactor), while the amount of produced volatile fatty acids was maximized at pH 7 (13.44 g/L). Hydrogen production was observed at pH as low as pH 4.5 (2.66 NLH2/Lreactor). The recoverable economic potential was maximized at two different pH values, with the first being pH 4.5 with minimum NaOH addition requirements (181, 138, and 296 EUR/ton VS of substrate for valorization of volatile fatty acids through microbial fuel cell, biodiesel production, and anaerobic digestion, respectively) and the second being pH 6, where the hydrogen production was maximized with the simultaneous production of high amounts of volatile fatty acids (191, 142, and 339 EUR/ton VS of substrate respectively).

Up to fifty per cent of babies will suffer from the irritant dermatitis in the nappy area, or inflammatory eruption of the skin, known as nappy rash. This article discusses the condition's causes and recommended treatments. Adapted from the source document.

Disposable diapers contribute to the generation of plastic waste globally, with more than 8 million tonnes of diapers ending up in landfills or incinerated each year. One strategy for reducing this waste while maintaining child and parent health and well-being is to increase reusable diaper use and reduce delays in toilet training. We outline a protocol for applying behavioural science to understand the factors influencing these behaviours and to generate intervention recommendations. The research will be conducted in two stages. Stage 1 involves semi-structured interviews and surveys, guided by the Capability, Opportunity, Motivation-Behaviour (COM-B) model, to explore factors influencing reusable diaper use and toilet training at 18–30 months. Data will be analyzed using quantitative (regression and ANOVA) and qualitative (deductive and inductive) methods. Stage 2 involves triangulating findings to identify key barriers and enablers. Intervention frameworks (Behaviour Change Wheel and BCT Taxonomy) will help identify potential behaviour change intervention strategies to target key barriers and enablers identified within COM-B domains. Interventions will be presented to multidisciplinary stakeholders and nominal group technique process will be used to agree on the most promising, feasible, and acceptable options for development and piloting. The findings will help generate recommendations for supporting UK government policy and practice change in this area.

•Release of spermatozoa from absorbent sanitary towels and nappies/diapers.•Simple, rapid method to break down superabsorbent polymers to release spermatozoa•A range of different sample types and storage conditions were evaluated.•DNA profiles obtained from spermatozoa released from superabsorbent polymers. This work presents a rapid and reliable method to recover spermatozoa from Super Absorbent Polymers (SAPs) commonly found in sanitary protection products such as nappies and sanitary towels. The use of salt solutions was investigated and a protocol was developed using a calcium chloride (CaCl2) solution to release semen deposited onto a selected SAP containing product. The method was tested on ultra-sanitary towel samples treated with a known amount of semen. A range of treatments were examined; some samples were prepared and immediately frozen for storage and others were allowed to air dry overnight to replicate the condition of similar items recovered for examination in sexual offence cases. The method allowed the collection of low yields of spermatozoa, but these were still sufficient for microscopic identification of intact heads and to obtain ESI17 DNA profiles from all the samples. This report presents the method, the results obtained and discusses prospective adaptations to the method for validation to implement the method into forensic casework.

Diaper dermatitis is a common type of irritant contact dermatitis occurring in infants and toddlers. Its occurrence is triggered by an unfavorable environment under the diaper, damage to skin integrity by fecal enzyme degradation, overhydration and disruption of the lipid bilayer structure facilitating the entry of irritants and microorganisms. In diaper dermatitis development, the central proinflammatory cytokines are IL-1α, IL-8 and TNF-α. The initial release of IL-1α and TNF-α starts a further cascade of pro-inflammatory chemo- and cytokines, resulting in inflammation and erythema of the skin. A recently recognized factor in diaper dermatitis is the composition of the skin microbiome; common pathogenic strains Candida albicans and Staphylococcus aureus are associated with skin irritation. The resulting impaired microbiome composition produces a local inflammatory response and may thus worsen the initial dermatitis clinical presentation and subsequent healing. Introduction of probiotics is an attractive treatment for microbiome modulation, which has shown success in other skin conditions in adults and children. Probiotics are thought to work as a protective shield against irritants, maintain low skin pH, secrete beneficial metabolites, and block pathogen invasion. There is preliminary evidence that certain probiotics given orally or topically could be used as a gentle intervention in diaper dermatitis.