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Moral injury in clinical and academic medicine—it is time to act

When doctors working within healthcare systems under pressure perpetrate, witness, or fail to prevent acts that contradict their own moral or ethical values and expectations, it can lead to moral distress or moral injury. This can result from active behaviour and from purposeful inactive behaviour. It is a growing and critical concern, representing significant distress that extends far beyond traditional concepts such as burnout. This article discusses moral injury in clinical and academic medicine and actively gives suggestions to prevent and address moral injury. 

Working together for perioperative excellence in pediatric perioperative research

Pediatric perioperative care can be described as a journey, starting when surgery is first contemplated, all the way through to a patient’s full recovery. For the child and their family, this journey spans from the time at home pre-operatively through a hospital stay and finishes with at-home recovery.

Evaluating Type 1 Diabetes Resources to Improve Awareness and Knowledge of Type 1 Diabetes Within Community Sport Settings

A main challenge identified by youth during exercise and sport is the lack of knowledge and awareness around type 1 diabetes (T1D) particularly in community sport settings. Working with youth living with T1D, parents and community sport coaches, our team has developed resources for the T1D and sporting community. This study was to evaluate the acceptability and usability of the resources.

Hand Involvement and Its Association with Burn Characteristics, Surgical Management, and Length of Stay in Paediatric Inpatients: A 10-Year Cross-Sectional Study from Western Australia

Hand burns are a key criterion for immediate referral to tertiary burn centres in Australia, New Zealand, and internationally, yet few studies have examined how paediatric burn epidemiology, surgical management, and length of stay differ according to the extent of hand involvement. 

How Vaccine Mandates Emerged Without a Mandate: Testing Stream Independence in Vietnam's COVID-19 Response

This study adapts the Multiple Streams Framework (MSF) to explore why COVID-19 vaccine mandates were applied at sectoral and subnational levels in Vietnam while the central government maintained that vaccination was voluntary. Document analysis reveals that these mandates arose from the effective coupling of the three streams—problem, policy, and politics—in a setting of authoritarian rule, where the streams function differently (and more uniformly) compared to democratic contexts.

Population-specific heterogeneity in ontogeny of the broadly-conserved blood transcriptional program during the first week of life

Previous research has shown that immune development during the first week of life, i.e. ontogeny, is progressive, consistent and robust, involving large numbers of differentially expressed genes at each sampled time point.

Association between village coverage of 13-valent pneumococcal conjugate vaccine and vaccine-type pneumococcal carriage among children aged 0–59 months with pneumonia in Papua New Guinea

Pneumococcal conjugate vaccine (PCV) prevents pneumococcal disease and pneumonia, but indirect effects are poorly understood in low-coverage, high-burden settings like Papua New Guinea (PNG). PNG introduced 13-valent PCV (PCV13) in 2014. We aimed to assess direct and indirect effectiveness of PCV13 against vaccine-type pneumococcal carriage among children with pneumonia or suspected meningitis in PNG

Global, regional, and national burden of tuberculosis and multidrug-resistant tuberculosis by HIV status, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Tuberculosis (TB) is the leading global cause of death from a single infectious agent. Recent reductions in global health funding have threatened TB control, making comprehensive assessment of TB, HIV-related TB, and drug-resistant TB burdens before these disruptions essential for shaping effective responses.

FeBRILe3: Caregiver Satisfaction With Early Discharge of Febrile Infants Under 3 Months Old

Although evidence supports clinicians to "safely do less" for febrile infants assessed as low risk of serious bacterial infection (SBI), early discharge may increase caregiver concern and reduce satisfaction with care. We captured the self-reported satisfaction and concerns for families enrolled in the study of fever, blood cultures and readiness for discharge in infants less than 3 months old (FeBRILe3), a prospective safety assessment of early discharge of low-risk febrile infants, to aid evaluation of this practice. 

“The Other One Was Half and Half, Half-Caste”: A Qualitative Exploration of Colonial Narratives Used to Represent Aboriginal Children by Non-Indigenous Foster Carers in Australia

Since colonisation in Australia, dominant western narratives have continually undermined the identity of Aboriginal and Torres Strait Islander peoples. Through a lens of subaltern theory, this article explores how Aboriginal children, their families, and their communities are spoken for and about as members of subaltern communities by non-Indigenous foster carers.