Editorial: An ecological context of Childhood
Professor Steve Campbell

Developmentally supportive care for twins and higher-order multiples in the NICU: a review of existing evidence
Melanie R Jarvis and Melissah Burnett

It is widely acknowledged that the neonatal intensive care unit (NICU) can be an extremely stressful and demanding environment for term and preterm neonates. Researchers have explored many developmental care strategies that aim to reduce neonates' exposure to stressful stimuli in the NICU and enhance their ability to adapt and develop in an artificial environment. However, delayed childbearing and recent advances in obstetric medicine have contributed to a dramatic increase in the number of preterm and low birthweight, multiple-gestation neonates occupying our NICUs. This discussion paper explores the multiple birth phenomenon in Australia, the impact that this trend will have on our NICUs and the importance of implementing specialised developmental care strategies that support the unique needs of our multiple-gestation neonates.
Keywords: Developmental care, neonate, multiple gestation, twins, co-bedding.

Drug prescribing in childhood obesity: a case study conundrum
Victoria Cullens, Linda King and Louise Mc Dermott

This case study discusses the implications of drug prescribing for an obese child admitted to hospital following an accident at home. Paracetamol and morphine are specifically examined, as serious consequences could result from inappropriate prescribing of these two drugs. Guidelines for prescribing for overweight or obese children and young people are presented, along with a formula for calculating an adjusted dosing weight for those children with a weight greater than 120% of their expected lean body weight.
Key words: obesity, children, prescribing, paracetamol, morphine.

Caring for ventilated children at home – the child’s perspective
Jon Darvill, Dr Ann Harrington and Jenny Donovan

This study described the experiences of two Australian ventilator-dependent children who are cared for at home. A primary objective was to capture the voices of the children themselves. The study is constructivist and uses case study as the method. Data were generated with the children themselves, who drew pictures and told stories of children just like them.

The technology-dependent children’s lifestyles could be classed as normal in that, within the confines of their conditions, they did usual things. They found positive aspects of hospitalisation, such as getting good news, celebrating birthdays and receiving presents. However, they also suffered in that, when it came to hospitalisation, they were uncertain and anxious, particularly when exposed to needles, anaesthetic masks and operations. The presence of their tracheostomies restricted their activities and may have engendered feelings of self-consciousness or embarrassment. It was clear that they understood how their technology functioned. In this study, despite their circumstances, the children found positive and happy aspects of their lives. The study confirmed that children can meaningfully contribute to research. Listening to the child’s voice and their participation in their care is now an acceptable practice.

Conference report
Dr Margo A Pritchard

Paediatric oncology nursing: working and coping when kids have cancer – a thematic review
Melissa Zander and Dr Alison Hutton

It is well established that nursing can be a stressful occupation. In particular, paediatric oncology, as a setting, is perceived as both personally and professionally demanding, due to additional stressors that are unique to its speciality. This thematic review examines 18 articles to identify effective internal mechanisms for dealing with stressors associated with working in paediatric oncology and methods for managers and colleagues to enhance paediatric oncology nurses’ coping strategies. Following an analysis of the literature, a theoretical model of effective coping was conceptualised. Implications for nursing practice and recommendations for further research into the resilience of paediatric oncology nurses are also addressed.
Keywords: paediatric oncology, coping, nursing stressors