Abstract: Background: The Paediatric Palliative Care Service (PPCS) of the Royal Children's Hospital (RCH) in Brisbane was established in 2009. This service has evolved from the hospital's paediatric oncology palliative care service and works collaboratively with primary health care teams in a consultative model. Aims: With the expanded scope of caring for all children diagnosed with life-threatening conditions in mind, a forum was held in late 2009 to identify barriers and gaps and to plan for the future of the PPCS. Design: Stakeholders, including medical staff specialists (24%), nurses (32%), allied health (24%), community support group representatives (16%), corporate policy representatives (2%) and bereaved parents (2%) from South East Queensland (SEQ) were invited to attend. Results: A number of barriers were highlighted including: equity in access to services; awareness, understanding and fear associated with this work; experience of health professionals; funding and resources. A lack of respite options, the need for further education, improved collaboration and improved communication between services were identified as existing gaps. Conclusion: The forum provided an opportunity to gather expert and experienced health professionals in paediatric palliative care to discuss the issues and assist in the planning for the future direction of the PPCS. This report may provide a valuable insight for other services.

Abstract: The aims of this pilot study were twofold: (1) to establish the relevance of the Family Management Measure (FaMM) when used in Australia, including its conceptual equivalence using the literature and empirical data and to (2) describe family management of children with chronic conditions. The FaMM, which was recently developed in the United States, is used to explore family management of childhood chronic conditions in an Australian setting. The FaMM was found to be a relevant measure of family management based on the themes derived from pertinent studies conducted in Australia and also for the six Australian mothers who participated in 'think-aloud' interviews, using items from the FaMM. The scales and items of the FaMM yielded rich and varying accounts of managing childhood chronic conditions within family life which need consideration by health professionals.

Abstract: Background: This study presents findings on the characteristics of women who used antidepressants in pregnancy and how such mothers compare to depressed and non-depressed mothers in terms of their demographics and health across pregnancy. We also present findings on the birth outcomes for these three groups of women. Methods: Data were drawn from the first wave of the Longitudinal Study of Australian Children (LSAC). This study examined n=5,107 infants, who were assessed in their first year. Mothers reported antidepressants as a prescribed medicine over their pregnancy. Results: In this nationally representative study, the 2.1% of Australian women who indicated that they took antidepressants during their pregnancy also took more general medications, were more likely to smoke and drink alcohol during pregnancy, and also reported higher depression scores at wave one and more infant sleep problems than the non-depressed control group. Infants exposed to antidepressants showed reduced length at birth. Conclusions: Antidepressant use during pregnancy in Australian women is reasonably prevalent. Caution in prescription is needed given that adverse child developmental outcomes have not been ruled out by existing studies. The current findings point to the complexity of multiple in utero exposures from smoking, alcohol, depression and antidepressants impacting on child developmental outcomes. Clinical guidelines are needed to provide optimal clinical care for infants who were exposed in utero to antidepressants.

Abstract: Objective: Risks associated with maternal-infant bed-sharing are widely documented and promoted. This study aims to examine sleep patterns and strategies including bed-sharing. Methods: Women aged over 18 who have infants aged up to 24 months were eligible to participate in an anonymous online questionnaire in March 2010. A representative sample of 1,000 respondents was randomly selected from a total sample of 2000. Results: The challenge of facilitating infant sleeping was highlighted, with 92% of respondents having difficulties at some point. Almost all (97%) felt sleep-deprived at some time, with almost half reporting that they were always or regularly deprived of sleep. Sleep deprivation exacerbated exhaustion or feeling run down (75%), irritability (70%), made mothers less patient with their infants (63%) and put additional strain on their relationship with their partner (37%). Strategies to facilitate infant sleeping included rocking and patting (50%), giving a dummy/comforter (46%) and allowing the baby to fall asleep in their arms (47%) or after feeding (45%). Just under half (41%) utilised bed-sharing as a sleep strategy at night. Bed-sharing was more likely to be used if babies experienced frequent waking at night and unstable sleep patterns. Conclusions: Maternal-infant bed-sharing continues to be an infant sleep strategy used by mothers, despite the risks involved. Implications This study highlights that mothers still continue to bed-share despite preventative health campaigns and the known risks. Thus, health promotion should be modified to include a stronger emphasis on risk minimisation strategies.

Abstract: Background: Ngala is an early parenting, not-for-profit organisation in Western Australia. Research academics from three universities in Perth had been involved in separate research activities over recent years at Ngala. During 2007, a strategic decision was made to forge formal links and articulate an interdisciplinary research framework to promote a research culture amongst Ngala practitioners. Aim: to describe an organisational case study of the development of an interdisciplinary research agenda within Ngala. Methods: Collaborative methods were used to achieve this. An action learning project was undertaken over a two year period with involvement of researchers, managers and practitioners across the five disciplines of nursing, midwifery, early childhood, psychology and social work. This project focused on the development of a research framework to guide future planning within the organisation. Findings: The development process enabled practitioners, managers and researchers to have conversations about the nominated theories and approaches that inform their work in early childhood and parenting settings, thereby improving the communications between the various disciplines represented. As a part of this process, a small action research project was undertaken with practitioners which focused on understanding the barriers staff experienced to approaching research activities and to arrive at potential solutions for these barriers. Conclusion: It was anticipated that with leadership evolving at all levels of the organisation, the resultant research framework would be sustainable into the future, and grow the evidence-base necessary for a strong platform for practice and research.

Abstract: Aim: To explore the understanding of mental health consultation and its utilisation from the perspective of primary care workers working with children and young people who experience mental health issues. Background: Recognition of mental health consultation is respected and advocated as a way forward to support those professionals who may not necessarily have the training or understanding of child mental health issues, yet come across them frequently as part of their daily practice. Little is known, however, about how primary care professionals understand or utilise mental health consultation. Design: A qualitative research design informed by phenomenology. Methods: School nurses (n=6) were purposively sampled. Semi-structured interviews were undertaken, facilitated by the use of open-ended questions. All interviews were audio-recorded and transcribed, followed by vigorous thematic analysis. Results: Five overarching themes were identified from the data. These included: communication; crisis identification; hindrances; resources; and expectations. Each main theme consisted of several sub-themes relating to issues of professional identity; blurring of professional boundaries; constraints such as time management and workload; and the participant's own needs, including self-confidence and educational needs. Conclusions and implications for clinical practice: When utilised, mental health consultation proved effective in supporting the participants to address the mental health needs of children and young people; however, there are several factors such as lack of resources, differing perceptions of mental health consultation and personal challenges that prevent full engagement. This research contributes to existing knowledge by advocating that all individuals participating in mental health consultation should be encouraged to embrace the practice and understand what it actually means within the context of their own discipline.