Catherine M. Olsson

To explore how those with a physical illness in childhood are managing in relationships across childhood to young adulthood. On transition to primary school parents were asked about their child's physical health (n = 1895). Childhood health problems were classified using the Global Burden of Disease (GBD) framework. Relational health was assessed using parent and self-reported measures. A total of 1347 parents reported their child had any physical illness between 5-8 years of age, with 143 reporting their child had been so ill they thought they might die. Having a childhood illness was associated with lower Self-control and Cooperation in both late childhood (|β| = -0.15 and -0.1, respectively) and adolescence (|β| = -0.14 and -0.12, respectively). For those reporting a health-related life-threatening experience, there was some evidence of higher disengagement across all age groups (|β|_range = 0.20-0.24), and more pronounced problems with peers (|β|_range = 0.31-0.41) and social skills (|β|_range = 0.27-0.35) in late childhood. Children were generally faring well, however, there was elevated risk of a range of compromised relational difficulties for those with 'life-threatening' medical experiences. Risks mostly extended to late childhood; however, disengagement from parents extended into adolescence and young adulthood.

Background: We examine precursors of child emotional distress during the COVID‐19 pandemic in a prospective intergenerational Australian cohort study. Methods: Parents ( N = 549, 60% mothers) of 934 1–9‐year‐old children completed a COVID‐19 specific module in 2020 and/or 2021. Decades prior, a broad range of individual, relational and contextual factors were assessed during parents' own childhood, adolescence and young adulthood (7–8 to 27–28 years old; 1990–2010) and again when their children were 1 year old (2012–2019). Results: After controlling for pre‐pandemic socio‐emotional behaviour problems, COVID‐19 child emotional distress was associated with a range of pre‐pandemic parental life course factors including internalising difficulties, lower conscientiousness, social skills problems, poorer relational health and lower trust and tolerance. Additionally, in the postpartum period, pre‐pandemic parental internalising difficulties, lower parental warmth, lower cooperation and fewer behavioural competencies predicted child COVID‐19 emotional distress. Conclusions: Findings highlight the importance of taking a larger, intergenerational perspective to better equip young populations for future adversities. This involves not only investing in child, adolescent, and young adult emotional and relational health, but also in parents raising young families.

Objective: Childhood physical illnesses have been associated with heightened risk for mental health problems in adolescence and young adulthood; however, little is known about the natural history of this relationship. Here, we examine the nature of mental health adjustment to illness from diagnosis in childhood into adolescence and young adult life. Methods: Data were drawn from a large population-based cohort. Parents reported whether their child had a physical illness at 5–6 and 7–8 years and whether they believed their child was so sick it was thought they might die. Depression and anxiety symptoms were reported by parents (for children 7–10 years) and self-reports (11–28 years). Results: A total of 1,001 (56%) parents reported their child had a physical illness. Of these parents, 143 (8%) believed their child might die. Findings indicated there was some evidence of higher levels of depressive and anxious symptoms across late childhood and into early adolescence for those reporting a physical illness in childhood. A similar pattern was observed for those who were so sick it was thought they might die, although symptoms were elevated to a greater extent. Conclusion: Although physical illness in middle childhood is associated with higher levels of depressive and anxious symptoms, by early adolescence, these differences diminish, indicating a process of adaptation that persists into young adulthood. This suggests a potentially sensitive period of adjustment to illness for some, especially for children who it was feared might die. Additional psychosocial assessment and support may be warranted across the “acute” illness period.

Objective: To reflect on the experiences of loss and grief during the COVID-19 pandemic. The world is united in grief with COVID-19 now the leading cause of death globally (close to 4 million by mid-2021), with public health approaches to containment having widespread social and economic impacts. COVID-19 has not only changed how we live but also how we die; complicating the dying process for those with the disease, as well as those dying from other causes and complicating the grieving process for those left behind. It is essential that we invest in approaches to supporting a good death for the dying and approaches to healthy grieving. In Australia, lockdowns have prevented or significantly restricted access to hospitals and aged care facilities. As of mid-2021, 910 deaths have occurred, mostly in these settings, and with high risk for complicated grief. With the disease mostly under control within Australia, vaccine roll out underway and better preparation for responding to outbreaks, it is timely to reflect on the experiences of loss and grief during the pandemic with the aim of improving approaches to care for both the dying and bereaved in the context of COVID and future natural disasters.

Background: Support for family caregivers, including bereavement follow-up, is a core function of palliative care. Many caregivers acknowledge positive aspects associated with the role; however a considerable proportion will experience poor psychological, social, financial, spiritual, and physical well-being and some will suffer from complicated grief. Many family caregivers have unmet needs and would like more information, preparation, and support to assist them in the caregiving role. There is a shortage of evidence-based strategies to guide health professionals in providing optimal support while the caregiver is providing care and after the patient's death. Purpose: To develop clinical practice guidelines for the psychosocial and bereavement support of family caregivers of palliative care patients. Methods: (1) Literature review; (2) focus groups and structured interviews with key stakeholders within Australia; (3) national and international expert opinion to further develop and refine the guidelines using a modified Delphi process; and (4) endorsement of the guidelines from key palliative care, caregiver, and bereavement organizations (national and international). Results: The guidelines were developed for multidisciplinary health care professionals and clinical services commonly involved in caring for adult patients receiving palliative care in a variety of care sites throughout Australia. These consensus-based guidelines have been endorsed key Australian and international organizations. Conclusions: The guidelines may prove valuable for the international palliative care community and for generalist health care providers who occasionally care for palliative care patients. Research is recommended to explore the uptake, implementation, and effectiveness of the guidelines.

Background: The purpose of the study was to investigate smoking, alcohol use, illicit drug use and sexual risk taking among adolescent survivors of childhood cancer treated in Australia.Procedure: A comparison study selecting on exposure (cancer vs. healthy) and administering a branched computerised questionnaire assessing health‐risk behaviour, predominately by telephone interview. One hundred fifty‐three adolescent survivors of childhood cancer were compared with age matched healthy adolescents drawn from one of two Australian population based surveys of adolescent health. Behaviours assessed were tobacco use, alcohol use, binge drinking, cannabis use, pain reliever use, other illicit drug use and unprotected sex.Results: Compared to their healthy peers, younger survivors (13‐ to 17‐years) were at an increased risk of reporting pain reliever use (OR = 2.1) for non‐medical purposes, but lower risk of binge drinking (OR = 0.20), cannabis use (OR = 0.25), other illicit drug use (OR = 0.31), tobacco use (OR = 0.38) and alcohol use (OR = 0.44). Older survivors (18‐ to 24‐years) were at an increased risk of reporting alcohol use (OR 1.5), but at lower risk of reporting cannabis use (OR = 0.27), other illicit drug use (OR = 0.44) and tobacco use (OR = 0.47). Survival analysis using the full adolescent survivor cohort (13‐ to 24‐years) showed that the age of onset of tobacco use was later for cancer survivors (hazard ratio HR = 0.65).Conclusion: Adolescent cancer survivors show reduced involvement in most health‐risk behaviours, with the exception of pain reliever use among younger survivors and alcohol use among the older survivors. Although risks were reduced a substantial proportion of survivors engage in these behaviours. Pediatr Blood Cancer