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Rishi S. Kotecha MB ChB (Hons) MRCPCH FRACP PhD Co-Head, Leukaemia Translational Research rishi.kotecha@health.wa.gov.au Co-Head, Leukaemia
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.
The authors' international collaboration of researchers and clinicians was established to develop core outcome sets for infants, children, and adolescents. Here, the authors report on a qualitative mixed methods study with semistructured interviews of parents/guardians and their children undergoing anesthesia for surgery along with perioperative healthcare providers.
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.
Allergic diseases are rising worldwide, especially in childhood, and their clinical diversity increasingly exposes the limits of traditional phenotype-based classifications. Genetic susceptibility, environmental exposures, epithelial barrier biology, and immune pathways interact to shape highly variable disease trajectories and treatment responses. In this context, precision medicine is no longer only an aspirational concept, but a practical effort to define meaningful endotypes, identify clinically useful biomarkers, and connect biological insight to prevention and care.
The prevalence of allergic diseases across the Australian population, in all regions and age groups, is not well documented. This study aimed to describe the prevalence and distribution of five allergic diseases (allergic rhinitis, asthma, drug allergy, eczema, and food allergy) and examine differences by sociodemographic factors.
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.
Protection of newborns from infection can be achieved through maternal or vaccine-induced antibodies, but the factors influencing vaccine protection (correlate of protection) and subsequent infant immunity remain insufficiently understood. Further investigation is essential to optimize early-life vaccination strategies.
To summarize recent evidence in pediatric total intravenous anesthesia (TIVA), highlighting advances in pharmacokinetics-pharmacodynamics, target-controlled infusion (TCI), electroencephalography (EEG)-guided titration, emerging agents, safety, and sustainability, and to provide clinicians with an updated, practical framework for pediatric TIVA practice.
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.