Studies have shown that admission to the hospital of a child can induce feelings of fear and helplessness in parents, challenging usual patterns of coping and parenting competence. Stress has been associated with parents' need to establish effective communication with staff and their need for information, ready access to their children, and participation in decision making relating to their child's care. This study of coping and adjustment was undertaken with the parents, including mothers and fathers, of children under 18 years of age diagnosed with a brain tumor, presenting at Royal Children's Hospital, Melbourne, between 2001 and 2002 (N=53). It was a prospective study using repeated measures over time. Participants in the study were involved in a questionnaire interview at 4 different points: at the time of diagnosis, 6 months postdiagnosis, 1 year postdiagnosis, and 2 years postdiagnosis, in which they were asked, among other things, about their experience of the hospital. The point of diagnosis was marked by a high level of dependence, with parents coping with rapid decision making and shock, and the surrender of care of their child. Parents identified high levels of information need but noted that they were often too stressed to take in information early on, and that this information need persisted up to the 2-year postdiagnosis point. More parents expressed dissatisfaction with the hospital and particularly with their interactions with the health care team at the 6-month post-diagnosis period, reflecting a possible reduction in attention given to families once they had settled into the treatment routine and the crisis of diagnosis had passed.

ADOLESCENCE IS A TIME of great change, when young people take on new roles and responsibilities, renegotiate relationships with adults, peers, and the community, and experiment with things symbolic of adult life. These developmental tasks are often accompanied by the adoption of risk-taking behaviours that compromise health. Healthy risk-taking is a positive tool in an adolescent's life for discovering, developing, and consolidating his or her identity. 1 It is the extent to which an adolescent engages in health-risk behaviours, and the overall impact of these behaviours on personal health and development, that are of increasing public health concern. The research suggests that young people who participate in multiple risk-taking behaviours increase the chance of damaging their health.We review the prevalence of a range of health-risk behaviours and discuss challenges faced by general practitioners in assessing and treating those at risk. We also discuss a useful framework for identifying risk and protective factors, and present a psychosocial screening device. Health-risk behaviour and outcomesRisk behaviour has been defined as "behaviours that increase the likelihood of adverse physical, social, or psychological consequences" (M D Resnick, Professor of Pediatrics, School of Medicine, and Professor of Public Health, University of Minnesota, personal communication). The first comprehensive survey of Australian women's health, the Australian Longitudinal Study on Women's Health, provides a snapshot of young women's health-risk behaviours. The survey investigated three age cohorts (young, mid-age and older), with women aged 18-23 years making up the young cohort. 2 A summary of findings from this and other studies on a range of health-risk behaviours is presented below.ABSTRACT ■ Healthy risk-taking is a normal part of adolescence.■ Young people who participate in multiple risk-taking increase the chance of damaging their health.■ There appears to be a growing range and prevalence of health-risk behaviours among young women, notably in their use of alcohol and marijuana. ■ Research suggests that such health-risk behaviours may be related to psychological factors such as stress and depression. ■ General practitioners have a central role in identifying and preventing health-risk behaviours and associated mental health problems in young people. ■ Comprehensive assessment includes a series of screening questions about home, education (or employment), activities, drugs, sexuality and suicide for young people, MJA 2003; 178: 601-604 known as the HEADSS technique. Kew, VIC.

Previous studies suggest that support from social networks is a protective factor buffering the negative effects of stressful events, such as having a child with a chronic illness. The literature highlights the need for more systematic examination of parents' social support networks across the disease trajectory, to obtain a more complete understanding of how a family's support system affects adjustment over time. This was attempted in this study of 88 parents of children with brain tumors, recruited from hospitals in Australia, Singapore, and New Zealand. It employed a longitudinal design, tracking families for 2 years postdiagnosis to examine the relationship between social support and coping. As in previous research this study showed that different types of support are needed at different stages in the illness trajectory. The study also identified the use of various coping strategies by families, directed at the maintenance and enhancement of existing supports and the securing of new supports. The study failed to establish a statistically significant relationship between level of coping and social support, however, suggesting that parents were using primarily "internal" familial modes of coping, including preexisting patterns of coping, with external social support being an adjunct to their coping rather than being a major contributor.