Editorial: Reflections from the INANE Conference Coolum 11–13 August 2010
Alison Hutton and Denise Harrison

Online learning: anywhere anytime education for specialist nursing
Patricia Bromley Contemporary nurses are required to be professionally accountable, to update knowledge, education and skills, and deliver care that is evidence-based and best practice. However, the pressure of combining shift work with family life often excludes continuing education. For nurses to embrace lifelong learning, education needs to be accessible, affordable and flexible. To accommodate this, new methods and models of education are developing with broader use of available resources, including greater access to academic programmes through online learning. The integration of educational technology into nursing education involves a paradigm change in traditional views of learning. Evaluation of contemporary literature into online learning suggests that learning outcomes can be as good as, or even better than, traditional didactic learning models. This paper will explore the issues around online learning, discussing the potential advantages and disadvantages for contemporary postgraduate nurse education. It concludes that the difficulties associated with online learning can be minimised with quick and easy access to electronic learning resources and technical support and adequate facilitation both online and in the clinical area.
Keywords: online learning, web-based learning, e-learning, nurse education.

Costs of meals and parking for parents of hospitalised children in an Australian paediatric hospital
Joanne Siffleet, Ailsa Munns and Linda Shields 

Costs to parents of hospitalised children have been extensively explored, from financial costs to psychological, social and emotional costs. No matter what perspective is taken an admission to hospital of a child means added cost to any family’s budget. For those whose income is dependent on a low wage, or welfare, costs of such an event take up a larger proportion of an income than for families from well-to-do backgrounds. In this paper, we explore the potential impact on a family budget of costs of parking and meals incurred during a child’s admission to hospital. To determine costs, a survey was conducted at food outlets to examine types and availability of meals, opening times, proximity to wards and the cost of average types of meals on offer at different facilities. Costs of parking were determined. We took income figures for a family from the website of the Australian Bureau of Statistics (ABS). An estimate of the costs of food and parking to support one parent to remain with the child was at least 30% of the average weekly family disposable income. For one-parent families, their income is significantly proportionally depleted by covering costs of food and parking for an accompanying parent. We recommend that parents be provided with meals whilst staying with their hospitalised child; that provision be made to allow families to eat together and that free parking be made available to all parents.

Predicting the growth percentile of extremely low birthweight infants
Alice Hill 

Nearly one in ten low birthweight infants are considered extremely low birthweight (ELBW), weighing less that 1000 grams at birth and 27 weeks or less gestational age. Survival rates and morbidity often vary within countries1 and while the survival rate for these infants has increased, there has been very little decrease in the proportion of infants with severe sequelae, for example, bronchopulmonary dysplasia, neurosensory disorders, or cerebral palsy. Compounding these morbidities is the role socio-economic status, race and gender are thought to contribute to the health issues. Because of the morbidities that occur with premature birth it is imperative for healthcare professionals to know the influence that major medical complications and associated social factors have on the growth of ELBW infants. Understanding the influence of these factors on growth will assist healthcare professionals in discussing developmental issues and growth expectations with parents of ELBW infants. Therefore, a secondary data analysis was conducted to help identify the growth percentile and those factors that may influence the growth of ELBW infants. The purposes of the study are to determine whether at six and 12 months: (1) bronchopulmonary dysplasia (BPD), gender, race, and socio-economic status (private insurance versus Medicaid) predict ELBW infants’ (750–1000 grams) growth percentiles (weight, height, and head circumference); (2) hospital length of stay and gestational age predict growth percentiles; and (3) prenatal care, maternal age and parity predict growth percentiles.
Keywords: extremely low birthweight infants, percentile, bronchopulmonary dysplasia and socio-economic status.

Improving parent–infant relationships: An innovative group approach to working with families to improve parent–infant relationships within a community setting
Lynn Priddis and Gail Wells

Aim: Regulatory disturbances in infants such as sleeping, feeding and excessive crying are frequently symptoms of a disturbed mother–infant relationship. This paper builds on previous research to describe a group intervention: Tuned In Parenting (TIP) for dyads where mothers have presented and received traditional assistance.
Method: The design was a pre-test, post-test qualitative design with a control group. Sample: Mothers of infants aged 6–18 months who self-referred to a community health organisation in Perth, Western Australia and received traditional treatment for feeding, crying, sleeping disturbances in their infants and where problems in the mother–child relationship were identified. Outcome measures: Filmed interactions of mother and child, content analysis of parent interview pre- and post-intervention and focus groups with agency staff.
Results: The intervention programme was completed by 17 mothers. Fourteen mothers acted as a control. There were observable changes in the film of parent–child interactions for all but two of the intervention group dyads and no such changes observed in the control group participants. Interview themes and subthemes identified in interview transcripts pre- and post-test reveal substantial differences between the groups.
Conclusions: Mother–child interaction problems were observed in all dyads who presented. Substantial changes were observed in those who participated in the intervention. Practical outcomes for the organisation were identified.
Keywords: Video interaction, parenting group, maternal sensitivity, parent-infant interactions.

Commentary to Lancet paper - Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial
Denise Harrison