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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. 

AI succeeds in diagnosing rare diseases

Timo Lassmann BSc (Hons) MSc PhD Feilman Fellow; Head, Precision Health Research and Head, Translational Intelligence timo.lassmann@thekids.org.au

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.

Cost-Effectiveness of Oral Immunotherapy Treatments vs No Treatment for Peanut Allergy in Children

The first peanut oral immunotherapy (OIT) for children was approved by the US Food and Drug Administration (FDA) in 2020. While clinical efficacy is established, evidence on cost-effectiveness-whether the benefits outweigh the costs and adverse effects-remains limited. A variant of OIT, known as probiotic and peanut OIT (PPOIT), has shown similar efficacy in trials.

Implementation Fidelity of a Smartphone Application for Population-Based General Movement Assessment: The Early Moves Study

To describe the infant and maternal characteristics of the Early Moves cohort and to assess representativeness to the general population, and to evaluate the implementation fidelity of an application-based collection of General Movement Assessment (GMA) videos at writhing and fidgety age.

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.

Routine Emollient Therapy with Coconut Oil in Preterm Infants and Allergic Sensitization at 1-Year Corrected Age

Skin care for very and extremely preterm infant is an important and previously underappreciated topic. Coconut oil skin care for preterm infants is a promising option, but several important questions remain including the theoretical potential for allergic sensitization.

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,

The Cold Atmospheric Plasma Inhibits Cancer Proliferation Through Reducing Glutathione Synthesis

Cold atmospheric plasma (CAP) is a safe and effective alternative to radiotherapy for cancer treatment. Its anticancer effects are attributed to increased intracellular reactive oxygen species (ROS). Glutathione, a key antioxidant derived from glutamine, is critical for cell proliferation. This study investigated whether CAP-induced ROS elevation results from reduced glutamine-glutathione conversion and elucidates the underlying mechanisms.