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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. 

Shame as a mediator of the association of childhood emotional abuse with aversive cognitive perseveration in adults

Childhood emotional abuse (CEA) has been linked to response-focused emotion regulation in adulthood. However, the underlying mechanisms remain unexplored. This pre-registered study examined whether shame mediates the association between CEA history and aversive cognitive perseveration (ACP), including brooding rumination, experiential avoidance and emotional non-acceptance, in adulthood. 

An infant nasal microbial gene atlas uncovers intervention-driven microbiome shifts and salt-resistant pathogen expansion

Functional studies of how early-life interventions shape the airway microbiome remain scarce. Here, we performed metagenomic sequencing of 704 longitudinal nasal swabs from infants with and without cystic fibrosis (CF) to construct and characterize a non-redundant gene atlas of the infant nasal microbiome. We aimed to determine how the nasal microbiome is perturbed by early therapies, as CF is commonly treated with inhaled hypertonic saline to improve mucociliary clearance.

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. 

Neonatal sepsis and cardiovascular dysfunction II: assessment

Neonatal sepsis-induced cardiovascular dysfunction includes impaired myocardial function (which may be systolic and/or diastolic) and vasoregulatory failure (which may lead to vasodilation or vasoconstriction). The haemodynamic response in neonatal sepsis may therefore be hyperdynamic or hypodynamic, and the underlying pathophysiological mechanisms are heterogenous.

Low-plastic diet and urinary levels of plastic-associated phthalates and bisphenols: the randomized controlled PERTH Trial

The everyday use of plastic products exposes us to plastic-associated chemicals (PACs), which have been associated with risks to human health. We present the results of the Plastic Exposure Reduction Transforms Health Trial, with an observational cohort of 211 Australian participants and a 7-day pilot randomized controlled trial in 60 participants. Intervention groups received combinations of plastic-free kitchenware, low-plastic personal-care products and food sourced from more than 100 producers that minimized all plastic touchpoints from paddock to plate, while the control group received no intervention.

Move to Improve: Co-Designing a Hospital-Based Physical Activity Program for Children With Chronic Health Conditions

Physical activity can support physical and mental health among children living with chronic health conditions; however, programmes must be tailored to their specific needs to support participation.

Distinct Enterovirus Antigen Landscape in Children With Islet Autoimmunity

Enteroviruses (EVs) have long been implicated in the development of islet autoimmunity (IA) and type 1 diabetes. However, given the ubiquity of EV infections in children, disease susceptibility is likely driven by host-specific immune responses rather than viral exposure alone.

Psychosocial aspects of early detection in type 1 diabetes: Language matters, decision making and support needs

The potential implementation of early type 1 diabetes (T1D) detection pathways, encompassing autoantibody screening and longitudinal monitoring, raises important psychosocial considerations for ethical, person-centred care. This review summarises evidence on the psychosocial impact of early T1D detection, identifying key evidence gaps and recommendations for integrating psychosocial support. 

Speech and language therapists’ training and service delivery with children and adults with neurogenic communication disorders from culturally and linguistically diverse backgrounds

Speech and language therapists' (SLT) practice with cultural and linguistic diverse (CALD) populations with acquired and congenital neurogenic communication disorders in Denmark and Sweden is becoming more urgent due to demographic changes.