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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. 

Targeting intolerance of uncertainty in young children diagnosed with autism: A randomized controlled trial of a parent-mediated group intervention

Young children diagnosed with autism experience high rates of co-occurring anxiety, with uncertainty-related concerns commonly reported. This randomized controlled trial investigated an 8-week parent-mediated group anxiety intervention, “Coping with Uncertainty in Everyday Situations” (CUES-Junior©).

Acceptability, feasibility, and program outcomes of an equity-focused, adapted community-based healthy lifestyle program for children, young people, and their families

International guidelines recommend multidisciplinary intervention programs for addressing childhood obesity. In Western Australia, community-based healthy lifestyle programs for children and young people are insufficient for demand, especially for those over-represented in obesity statistics relating to prevalence. This protocol outlines the implementation and evaluation of an adapted, evidenced, community-based program in Perth, Western Australia.

Atopy-related immune profiles are subject to genetic influence as evaluated using school-aged twin pairs

The interaction of genetic and environmental contributions to immunological traits and their association with atopic disease remain unclear. Flow cytometry and in vitro cytokine responses were used to characterize immune profiles from 93 school-aged twin pairs. Using an established twin pair analytical strategy, the genetic and environmental influences on immunological traits were evaluated, along with their association with atopy. Our findings suggest strong genetic influence on several traits, particularly B cell abundance. In contrast, cytokine responses from in vitro stimulations appeared mainly shaped by environmental exposures.

Caregivers' Perceptions of Clinical Symptoms, Disease Management, and Quality of Life Impact in Cases of Cyclin-Dependent Kinase-Like 5 Deficiency Disorder: Cross-Sectional Online Survey

Cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder (CDD) is an ultrarare genetic condition causing developmental epileptic encephalopathy characterized by seizures and motor and intellectual disabilities. No disease-modifying therapies are available, and treatments focus mainly on symptom management to improve quality of life.

Plasma testosterone concentration is correlated with circulating immune cell abundance in transgender young people on gender-affirming hormone treatment

Sex hormones, such as oestrogen and testosterone, display significant immune modulatory properties. This is highly relevant for transgender (trans) people who undergo gender-affirming hormone (GAH) treatment. However, only a limited number of studies have evaluated the immunological impact of GAH treatments, and almost none have assessed the impact in trans young people.

Clinical Predictors of Longitudinal Respiratory Exacerbation Outcomes in Young Hospitalised Children

Respiratory infection and wheezing illness are leading causes of hospitalisation in childhood, placing a significant burden on families and healthcare systems. However, reliably distinguishing children at risk of developing persistent disease from those likely to outgrow their symptoms remains a clinical challenge. Earlier identification would allow clinicians to focus care and resources on those most likely to benefit from long-term management, while reducing anxiety and uncertainty about the future for families.

Children arriving hungry in the first year of school: population trends in Australia from 2009 to 2021

Access to adequate nutrition is a human right. In 2023, 23% of Australian households were severely food insecure, reducing food intake, skipping meals or days of eating. Food insecurity in early childhood is linked to poor health and development. Specifically, breakfast provides children with the necessary nutrients required for sustained attention, memory, and cognitive growth. Australian research has reported that one in three children aged 8–18 years regularly skip breakfast. However, there is little understanding of the prevalence of food insecurity among young children in Australia.

The effect of moderate-to-late preterm birth on lung function over the first 5 years of life in a South African birth cohort

Preterm birth is associated with increased mortality and morbidity, particularly due to lung disease. Low- and middle-income countries (LMIC) have the highest rates of preterm birth. Infants born extremely preterm rarely survive, so the largest burden is amongst moderate-to-late preterm (MLP) infants. The long-term health impact on MLP children in LMIC is poorly understood. The aim of this study was to assess the effect of MLP birth on lung function trajectories from birth to 5 years in the Drakenstein Child Health Study.

Study of tranexamic acid on post-tonsillectomy haemorrhage (STOP) pilot trial

Matt Cooper BCA Marketing, BSc Statistics and Applied Statistics, PhD Manager, Biostatistics 08 6319 1723 matt.cooper@thekids.org.au Manager,