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Vaccine hesitancy and suboptimal vaccine uptake pose significant threats to public health, but modifiable psychological factors underpinning them are under-investigated. We examined the prevalence of spontaneous emotional mental imagery relating to infectious diseases and perinatal vaccines and its unique associations with vaccine hesitancy and uptake behaviour.
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.
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.
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.
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.
Observable signs of clinical deterioration may present differently in children with dark-coloured skin, leading to potential missed or delayed recognition. It is unknown how health professionals approach assessment in children with dark-coloured skin.
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.
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.
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.
B-cell acute lymphoblastic leukemia (B-ALL) is the most common pediatric cancer. Current therapeutic regimens have improved 5-year event-free survival rates to 90%, however clinical outcomes for high-risk subgroups, such as BCR-ABL1+ B-ALL and relapsed ALL, remain poor. In addition, 16% of newly diagnosed children with ALL present with vertebral compression fractures. Moreover, 16% of children with ALL undergoing glucocorticoid therapy also experience a high incidence of vertebral fractures, indicating that bone health may be compromised by both leukemia progression and osteotoxicity of chemotherapy.