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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.

The role of positive appraisal style and positive expectations in student emotional resilience

Emotional resilience is an individual difference dimension, reflecting variation in the degree to which people show better or worse emotional well-being relative to what is predicted based on stressor exposure. Given that young adults commencing university studies commonly encounter a broad range of potential stressors, understanding the mechanisms that underpin emotional resilience could inform strategies for optimising student emotional well-being.

What Parents, Teachers and Clinicians Know About the Features of Developmental Dyslexia and Its Intervention: A Scoping Review

Despite decades of research, misconceptions about developmental dyslexia remain widespread among those responsible for identifying and supporting affected children. Identifying the nature and persistence of these beliefs is essential to improving practice and policy. We conducted a scoping review to map the understanding of developmental dyslexia among teachers, parents and clinicians by identifying their beliefs about its features and interventions.

Co-designing a new clinical pathway to support families with children identified as having early-stage type 1 diabetes in Western Australia

Children with early-stage (pre-symptomatic) type 1 diabetes are currently identified primarily via research-based screening programmes in Australia. Once identified, families live with the knowledge that their child has an increased chance of developing symptomatic, lifelong, insulin-requiring type 1 diabetes but have no specific clinical pathway available to them in Western Australia for accessing tailored support or education. This project aimed to co-design a new clinical pathway to address this unmet need.

Implementing Cultural Safety in Research Methodology: The Co-Design Process of a Brief Therapeutic Intervention for Aboriginal and Torres Strait Islander Young People Who Engage in Self-Harm

Aboriginal and Torres Strait Islander Peoples share rich cultural traditions unrivalled across the world; however, the continued impact of colonisation led to sustained, profound trauma that has spanned generations. With Aboriginal and Torres Strait Islander people presenting to hospital emergency departments for self-harm and suicidal behaviours at a rate 2.9 times higher than non-Indigenous people, there is a need to develop culturally appropriate interventions to address this growing problem.

Etiology of Severe Microcephaly in Infants: A Multinational Surveillance Study

Severe microcephaly, or head circumference at least 3 standard deviations below the mean for age and sex, is a rare condition with diverse etiology, making diagnosis challenging. Following the 2015 to 2016 Zika virus outbreak, surveillance studies in Australia, Canada, New Zealand, and the United Kingdom and Ireland were conducted to monitor severe microcephaly. We describe the etiology, clinical features, and diagnostic investigations of severe microcephaly among children aged younger than 1 year.

Clinical and cognitive profile of nigral iron content in children with ADHD

ADHD has been associated with impaired central nervous dopaminergic pathways. Brain iron is an essential cofactor for the synthesis of dopamine and the substantia nigra (SN) is a significant pool of dopaminergic neurons playing a central role in the activity of the nigrostriatal pathway. The present study investigated SN iron content in children with ADHD, its relationship with ADHD symptom severity and cognitive performance.

Seasonal variation in BMI outcomes at 6 months: secondary analyses of a multidisciplinary healthy lifestyle programme for children and adolescents with obesity

While international evidence suggests seasonal variations may influence outcomes of interventions for pediatric obesity, data for Aotearoa New Zealand are limited. We examined seasonal variations in changes in body mass index standard deviation score (BMI SDS) in young people with obesity enrolled in an intervention programme. 

Skeletal muscle health in childhood cancer survivors: a systematic review and meta-analysis

Childhood cancer survivors (CCS) are at risk of long-term skeletal muscle deficits following intensive therapies during critical periods of growth. This review aimed to synthesize approaches for assessing muscle quantity, quality, and function in CCS and to quantify deficits relative to healthy peers.