Five of Victoria's most talented health and medical researchers in the early stages of their careers have been recognised for their pioneering breakthroughs that are improving care and changing lives.

Minister for Health, Jenny Mikakos MP presented the prestigious 2019 Premier's Awards for Health and Medical Research which is celebrating its 25th year.

The awards honour the outstanding work and discoveries of up-and-coming health and medical researchers in the early stages of their career.

The Premier's Awards include categories in the research areas of clinical, public health, basic science, health services and for the first time a category to recognise Aboriginal researchers.

Dr Kate McArthur, the winner of the Premier’s Excellence Award 2019, was recognised for her research at the University of Melbourne and Walter and Eliza Hall Institute of Medical Research into ‘How dying cells hide from our immune system’. 

This research was recognised for her world-first discovery of how dying cells hide from our immune system and prevent an anti-viral response. 

This work will have real implications for the treatment of a range of diseases such as lupus and rheumatoid arthritis. 

Also winning awards were Dr Mary Ann Anderson from the University of Melbourne and Walter and Eliza Hall Institute of Medical Research, Dr Vincent Cornelisse from Monash University, Melbourne Sexual Health Centre and The Alfred Hospital, Dr Kylie Dyson from Monash University and Dr Mishel McMahon from La Trobe University.

Winner of the Excellence Award 2019 and Winner of the Basic Science Award

Dr Kate McArthur from the University of Melbourne and Walter and Eliza Hall Institute of Medical Research.

Clinical Researcher Award

Dr Mary Ann Anderson from the University of Melbourne and Walter and Eliza Hall Institute of Medical Research.

Public Health Researcher Award

Dr Vincent Cornelisse from Monash University, Melbourne Sexual Health Centre and The Alfred Hospital.

Health Services Researcher Award

Dr Kylie Dyson from Monash University.

Aboriginal Researcher Award

Dr Mishel McMahon from La Trobe University.

Shortlisted Entries

A total of 24 finalists were shortlisted for the award categories in the areas of clinical, public health, basic science, health services research and a category recognising an Aboriginal researcher in any category of health and medical research. Find out more about each finalist's project in the Nominees section.


  • Dr Amy Baxter (La Trobe Institute for Molecular Science, La Trobe University)

    Understanding how innate immunity peptides from plants interact with membranes and how this can be exploited for therapeutic developments

    Dr Amy BaxterThe immune system of all living organisms is armed with protective cationic antimicrobial peptides (CAPs), a class of proteins that form a ‘first line of defense’ against invading microbes. Defensins are an important family of these CAPs. 

    Dr Baxter’s research examines the anticancer properties of two plant defensins, NaD1 from ornamental tobacco, and TPP3 from tomato. 

    Dr Baxter found that NaD1 was able to efficiently kill human tumour cells without harming healthy, non-cancerous cells. 

    TPP3 was shown to have comparable anticancer activity, suggesting these defensins share an evolutionarily conserved mechanism of membrane targeting. 

    Dr Baxter’s research has led to a paradigm-shift in our understanding of the dynamics in innate immunity and also identifies defensins of the Solanaceae plant family as a promising new class of anticancer agents for future clinical development.

  • Dr Anselm Wong (Monash University, Austin Health and Monash Health)

    Management and risk prediction of paracetamol overdose

    Paracetamol overdose is the world’s most common drug overdose and the majority of cases involve young females. Paracetamol overdose can lead to acute liver failure and death.

    Dr Wong’s research helped to decrease the severe adverse effects associated with the antidote (acetylcysteine) for paracetamol overdose and to develop a shorter 12 hour treatment regimen compared to the standard 20 hour treatment for paracetamol overdose.

    Decreasing treatment time by eight hours for low risk patients means shorter hospital stays freeing up treatment capacities in the health system.

    Dr Wong’s research has helped change over 40 years of clinical practice and the new practice is being adopted throughout Australia and internationally.

  • Dr Danielle Ingle (University of Melbourne and Peter Doherty Institute for Infection and Immunity

    Understanding the emergence of bacteria that cause gastro-intestinal disease

    Dr Danielle IngleDr Ingle’s research into the emergence of bacteria that causes serious diarrhoeal disease in humans, particularly in children under the age of five, has had global academic and public health impact. The findings have been published internationally.

    Dr Ingle worked with a dataset of nearly 200 bacterial strains collected from children, as part of the Global Enteric Multicenter study based in South Asia and Sub-Saharan Africa.

    To better understand the specific group of bacteria, atypical enteropathogenic Escherichia coli (aEPEC), Dr Ingle combined traditional microbiology laboratory methods with cutting-edge genomic technologies and advanced computational analysis of the bacterial DNA.

    Dr Ingle’s research resulted in tools being implemented in public health laboratories, including in Victoria.

    Dr Ingle’s research also provides data on antimicrobial resistance (AMR) that will be critical as the threat posed by AMR bacteria increases.

  • Dr Emma Ridley (Monash University and Australian and New Zealand Intensive Care Research Centre)

    Understanding the impact of nutrition during critical illness

    Approximately 100,000 Australians are admitted to an intensive care unit (ICU) annually. Vital nutrients are often provided via a tube (gastric nutrition) or the vein (intravenous nutrition). Although the majority of critically ill patients receive nutrition, the exact effect on recovery is unclear. 

    Dr Ridley’s research identifies vital evidence and practice gaps to inform future research and the practice of nutrition provision in critical illness. 

    Dr Ridley found that the literature informing knowledge of energy in critical illness is of low quality, and international research showed nutrition intake often remains inadequate after transfer to the hospital ward. 

    The research confirmed that only 50-60 per cent of the intended nutrition is provided to critically ill patients and is leaving patients consistently underfed. The research demonstrated that combining gastric tube nutrition and intravenous nutrition can increase energy delivery to 80-100 per cent of a patient’s need. 

    Dr Ridley’s work has led to the development and funding of a world first industry collaboration, to further investigate the role of nutrition on patient recovery following critical illness.

  • Dr Erin Hoare (Global Obesity Centre, Deakin University)

    Preventing depression through modifying nutrition and physical activity systems in Australian secondary schools

    Dr Hoare’s research evaluates the potential for nutrition and physical activity to improve and prevent symptoms of depression among Australian students.

    Deakin University's, Global Obesity Centre (GLOBE) developed a method for school and community leaders to identify major drivers of unhealthy behaviours among students and conducted workshops to identify the best interventions to improve such behaviours.

    Dr Hoare and colleagues found that implementing healthier nutrition and physical activity improved wellbeing, and this was associated with a decrease in depressive symptoms (26 per cent to 17 per cent) over the two-year study.

    This finding is unique because mental health problems are known to increase over this age period and is the first intervention of this kind to find improvements in mental health.

    Dr Hoare’s research holds great public health potential, already informing 12 publications, national and international conference presentations and media interest. The methodology developed by GLOBE has been utilised across Victoria.

  • Dr Hamish Graham (University of Melbourne and Murdoch Children’s Research Institute)

    Improving oxygen therapy for children and newborns in Nigerian hospitals

    Oxygen is an essential medical therapy that has been saving lives for more than 100 years. 

    A lack of pulse oximeters (small devices to test blood oxygen levels) and oxygen in hospitals globally results in more than 150,000 preventable deaths annually, from child pneumonia alone. 

    Dr Graham’s doctoral research evaluated the introduction of pulse oximeters and improved oxygen systems to 12 small-medium sized hospitals in Nigeria. Prior to his intervention, less than 20 per cent of children who needed oxygen received it. After his intervention, more than 90 per cent of children who needed oxygen received it. 

    Dr Graham’s research has resulted in the establishment of a Nigerian NGO dedicated to scaling up pulse oximetry and oxygen. It has also resulted in an international collaboration to: design and test better oxygen delivery devices and; extend pulse oximetry and oxygen to primary care facilities.

    Dr Graham’s research has been referenced in Nigerian oxygen policies and by global research and advocacy bodies including the World Health Organization.

  • Dr Hannah Pitt (Centre for Population Health Research, Deakin University)

    The impact of sports betting advertising on children's gambling attitudes and behaviours

    The impact of gambling advertising on children has been a significant concern of governments and the community. 

    Dr Pitt’s world-first research, which focused on 8-16-year olds in Victoria and New South Wales, demonstrated the increasing impact of gambling advertising on the normalisation of sports betting for young people, including that young people were aware of gambling advertising in their everyday environments, and had significant brand recall. Importantly the research found 75 per cent of young people perceived sports betting had become a normal or common part of sport. 

    Dr Pitt’s research generated evidence which supported policies implemented by the Victorian and federal governments that aimed to limit young people’s exposure to gambling advertising. 

    Findings from this research have also been influential in the development of a media and education campaign and used as evidence internationally to advocate against the legalisation of sports betting in New Jersey. 

    Dr Pitt’s research has also developed new theoretical and methodological foundations for studying the impact of gambling advertising on young people, which are being replicated in Australia and internationally.

  • Dr Karyn Alexander (Monash University)

    Preventive healthcare for young children in general practice

    Early identification of child health problems could significantly improve the health trajectories of Australian children. 

    Despite high rates of overweight and developmental delay, apart from immunisations, preventive health services are not routinely offered to young children. 

    Low uptake of health assessments in Victoria, despite Medicare funding for general practice-delivered child health, overweight rates and development delay, compelled Dr Alexander to discover why. 

    Dr Alexander’s research found parents are more likely to seek preventive healthcare with first-born children. Increased parenting-confidence, cultural health beliefs, personal health practices, relationships with health providers and cost, all impact the uptake of health assessments. Families also seek information for developmental concerns through social contacts. 

    Discussions with general practitioners and nurses reveal some practitioners avoid child health assessments, while others are inspired to provide high-quality services. 

    Further research and testing in three general practices demonstrated teamwork and better practice systems improved delivery of high-quality assessments. 
    Dr Alexander’s research provides a roadmap to increase preventive healthcare for young children and improve child health trajectories and economic outcomes for society.

  • Dr Kate McArthur (University of Melbourne and Walter and Eliza Hall Institute of Medical Research)

    How dying cells hide from our immune system

    Dr Kate McArthurThe human body eliminates billions of functionally-exhausted or damaged cells through a ‘cell suicide’ program. This continuing process is essential to the development and day-to-day health of tissue and organs. It occurs “silently” as not to trigger any immune system ‘alarms’.

    Dr McArthur’s research demonstrates that ‘caspase’ proteins are required for this stealthy form of death. Without caspases, dying cells generate danger signals triggering anti-viral responses, even if no virus is present.

    Dr McArthur’s research suggests these danger signals emanate from the cell’s energy-producing organelles, the mitochondria. 

    In a world first, Dr McArthur observed DNA from inside mitochondria (mtDNA) escaping into the cell’s cytoplasm. Released-mtDNA then triggers the anti-viral response. 

    Dr McArthur’s research documents the first “mitochondrial herniation” mechanism by which mtDNA escapes the mitochondria. mtDNA is a potent pro-inflammatory danger signal and implicated in the development of a wide range of human pathologies, including inflammatory and autoimmune diseases such as lupus and rheumatoid arthritis.

  • Dr Kathryn Field (University of Melbourne and Royal Melbourne Hospital)

    Working to improve care for patients with malignant brain tumours: Outcomes from an Australian clinical trial

    Glioblastoma is the most common type of malignant brain tumour in adult Australians. It has a devastating impact on a person’s health, and is almost always fatal.

    Dr Field’s research explored the development, conduct and reporting of results from a clinical trial for Australian patients with recurrent glioblastoma.

    The trial – the largest of its kind in Australia – used a ‘targeted therapy’ drug, bevacizumab, by itself or combined with chemotherapy.

    Results from the trial and Dr Field’s research has had substantial impact on the way clinicians manage current and future patients with glioblastoma.

    The research has been presented at national and international conferences and published in international journals.

  • Dr Kylie Dyson (Monash University)

    Paramedic exposure to cardiac arrest and patient survival: does practice make perfect?

    Approximately 30,000 Australians suffer an out-of-hospital cardiac arrest each year, which fewer than 10 per cent survive.

    Early defibrillation and high-quality chest compressions are known to improve patient survival and it is likely that experienced paramedics perform better at these vital interventions.

    Using the Victorian Ambulance Cardiac Arrest Registry, Dr Dyson measured paramedic exposure to cardiac arrest cases and complex resuscitation procedures.

    Dr Dyson’s research reveals Victorian paramedics treat fewer than two cardiac arrests each year, and paramedics receive little refresher training to maintain their resuscitation competency.

    The research showed patients treated by paramedics with the highest exposure to cardiac arrest are 50 per cent more likely to survive. Patients intubated by paramedics with more exposure to this skill were also more likely to be intubated more successfully. 

    The findings suggest monitoring paramedic exposure to cardiac arrest and resuscitation procedures and strategies such as simulation training.

  • Dr Mardee Greenham (University of Melbourne and Murdoch Children’s Research Institute)

    Social and psychological outcomes after stroke in children

    Stroke affects 1.3 to 1.6 per 100,000 children and is one of the top 10 causes of death in children. 

    A high proportion of children suffering stroke experience long-term disabilities, including motor, cognitive and language problems. While social and psychological (‘psychosocial’) problems are also very common and have a major influence on child and family well-being, relatively little is known about these. 

    Dr Greenham’s research investigated psychosocial function in children after stroke and explored factors that impact outcome. 

    Dr Greenham’s research confirmed that child stroke presents a high risk of social and psychosocial impairment. Older age at stroke predicted poorer psychosocial outcome. 

    Surprisingly, the size and location of stroke were not important, but family environment and having a chronic illness were crucial influences. 

    Factors within the child, such as pre-stroke functioning, and stroke-related disability, were also important predictors. 

    Dr Greenham’s findings indicate the need for a focus on psychosocial function in rehabilitation services and routine screening.

  • Dr Marliese Alexander (Monash University and Peter MacCallum Cancer Centre)

    Personalised risk assessment to predict outcomes and direct preventive therapies for patients with lung cancer

    Lung cancer is among the most commonly diagnosed cancers and is responsible for more deaths than any other cancer. 

    Blood clots are a leading cause of morbidity and death, but effective preventive medicines are not recommended routinely in outpatient settings. 

    Dr Alexander’s research demonstrates blood clot events can be predicted using a two-step risk assessment, considering blood biomarkers before and in the early phase of commencing cancer treatment. 

    The new model identifies patients and time periods of ‘high clot risk’ to allow targeted delivery of preventive medications. 

    With potential application for all cancers, this research has attracted competitive funding and is currently being tested in a phase 3 multi-centre randomised trial. 

    In separate research, a ‘lung cancer prognostic index’ was developed to more accurately predict survival following the diagnosis of lung cancer. Developed and then validated on two independent Australian lung cancer cohorts, the index has since been validated in a large (>46,000) US lung cancer cohort. It is currently being utilised to conduct ‘big data’ studies relating to the clinical and economic value of companion diagnostic testing (tests used as a companion to a therapeutic drug to determine its applicability to a specific person).

  • Dr Mary Ann Anderson (University of Melbourne and Walter and Eliza Hall Institute of Medical Research)

    The use of a new drug to treat lymphoma and leukemia

    Dr Anderson’s research has been pivotal in the clinical development of Venetoclax, a new drug treating patients with certain types of leukemia and lymphoma, including chronic lymphocytic leukemia (CLL). 

    Dr Anderson’s research spanned clinical and laboratory work, translating basic discoveries made in Melbourne into an approved drug for use in patients in Australia today. 

    Dr Anderson dosed the world’s first patient with Venetoclax and managed the first-in-human clinical trial, with patients whose CLL was no longer responding to standard treatments. 

    As well as clinical findings, Dr Anderson demonstrated the first evidence in key laboratory testing and helped design the safest way to use this new drug in patients at high risk of developing side effects.

  • Dr Mishel McMahon (La Trobe University)

    Principles of First Nation childrearing

    Aboriginal childrearing dates back thousands of years.

    Dr McMahon’s research shows the status of First Nation Australian principles of childrearing is different, yet equal, to Western childrearing theories.

    Ten articles written by First Nation Australian authors were analysed using an Aboriginal Relational methodology Dr McMahon formulated for the study.

    First Nation community leaders reviewed Dr McMahon’s findings to re-frame how childrearing principles could be articulated and implemented.

    Four key concepts of First Nation Australian childrearing were identified as: Lifespan; Relatedness; Relational Parenting; Strong Kids; and Our Story. By revealing First Nation Australian approaches to child rearing, Dr McMahon’s study has the potential to improve understanding of Aboriginal childrearing within policy and practice and deliver beneficial outcomes for both Aboriginal and Non-Aboriginal families and children.

  • Dr Michelle Yong (Monash University)

    Use of a novel immune based test to characterise immune-related outcomes in transplant recipients and HIV-infected individuals

    This research characterises the viral related outcomes of cytomegalovirus (CMV) and HIV using a novel approach in patients with lowered immune systems such as stem cell transplant recipients, patients with blood cancers or HIV infection. 

    CMV infections can lead to substantial issues such as invasive infection of the lungs and gastrointestinal system. 

    Dr Yong’s cross-disciplinary research assessed a simple, rapid immune diagnostic assay in stem cell transplant recipients and HIV-infected individuals. Dr Yong was able to accurately identify and predict CMV infection and death in stem cell transplant recipients by monitoring the immune system. 

    Dr Yong showed that decreased function of CMV -specific T cells is related to risk of infection. Dr Yong also determined CMV infection can lead to other infectious consequences such as a four times increased risk of invasive fungal infection. 

    This internationally recognised research has led to significant changes in identifying and managing viral infections in patients with lowered immune systems.

  • Dr Peter Savas (University of Melbourne and Peter MacCallum Cancer Centre)

    A more precise understanding of breast cancer

    Breast cancer affects one in eight women in Australia and up to one third of patients have disease at the incurable stage. Better strategies for treating this common condition are needed.

    Advances in technology allow for rapid profiling of cancer DNA and the design of personalised and precise treatment therapies for patients.

    Dr Savas’ research established an Australian first, precision oncology program for patients with advanced breast cancer, providing sophisticated DNA testing to 180 patients.

    Following testing, some patients were enrolled onto clinical trials tailored to their testing profile, showing that precision oncology is possible for Australian breast cancer patients.

    To better understand the immune cells that infiltrate some breast cancers, Dr Savas’ research also employed cutting-edge techniques allowing simultaneous profiling of many thousands of cells.

    The research proved that specialised immune cells are found in breast cancers and is a first step towards harnessing these cells to fight and even prevent breast and other cancers.

  • Ms Philippa Karoly (University of Melbourne)

    Forecasting epileptic seizures

    People living with epilepsy face the daily uncertainty of not knowing whether they will have a seizure. Many factors, such as sleep quality, blood-sugar levels, medication and stress affect an individual’s risk of having a seizure. 

    These everyday risks limit their ability to work, drive, exercise and do routine activities. A daily seizure forecast would therefore be life-changing for people living with epilepsy. 

    Ms Karoly investigates the drivers and underlying patterns of seizures and develops an innovative, patient- specific approach to seizure forecasting. 

    Using sophisticated computational techniques, long-term data from brain recordings, environmental, behavioural and physiological factors can be combined and converted into useful seizure likelihood forecast models. 

    Future devices using forecast models, paired with advanced wearable data recording technology, creates potential for seizure forecasting to be a viable clinical management tool that will empower people to have more control over their lives.

  • Dr Rebecca Delconte (University of Melbourne and Walter and Eliza Hall Institute of Medical Research)

    Targeting Natural Killer cells in cancer immunotherapy

    Dr Rebecca DelconteOver the last decade, the ability to harness the immune system to fight cancer has come to the forefront of cancer treatment. However, while these immunotherapies are rapidly showing promise in the clinic, they also come with limitations and side effects. 

    Dr Delconte’s research sheds light on effectively using Natural Killer (NK) cells, an alternate immune cell, as a form of cancer immunotherapy. 

    Dr Delconte’s project found the protein CIS (cytokine induced SH2-domain) is a potent intracellular checkpoint in NK cell tumour immunity and suggests the possibility for novel cancer immunotherapy approaches. 

    This research will inform the design of medical approaches to increase NK cell anti-metastatic function and prevent metastases spread and be instrumental for designing new strategies to boost the anti-tumour function of NK cells in cancer patients.

  • Dr Rebecca Leech (Institute for Physical Activity and Nutrition, Deakin University)

    Understanding adults' eating patterns

    A healthy diet is essential for prevention of cardiovascular disease, but very few Australian adults meet national recommendations for intakes of five nutritious food group foods. 

    Dr Leech’s research takes a novel approach of examining how foods are consumed together at meals and snacks to advance the understanding of adults’ eating patterns and their role in dietary intakes and cardio-metabolic health. 

    By examining how eating patterns are associated with obesity and hypertension in a nationally-representative sample of Australian adults, this research contributes to evidence that can be translated into practical, healthy eating messages. 

    Dr Leech’s findings have directly informed international recommendations for eating patterns research. Finally, this research includes the development of a research tool for analysing the timing of eating, which has since been adopted by an international research group.

  • Dr Sandeep Prabhu (Alfred Health, University of Melbourne, Baker Heart and Diabetes Research Institute and Royal Melbourne Hospital)

    Atrial fibrillation and heart failure: The role of cardiac scarring and its influence on catheter ablation

    Atrial fibrillation (irregular heart rhythm) and heart failure are emerging epidemics in the developed world. Both conditions are associated with significantly worsened health outcomes, and death, and both share mechanisms that may promote the progression of the other. 

    Catheter ablation, a procedure in which the heart is electrically modified by catheters, has emerged as a new effective treatment for atrial fibrillation with superior outcomes compared to standard medical treatment, however its role in heart failure patients is unclear. 

    Dr Prabhu‘s research focussed on a randomised clinical trial using cardiac MRI to identify patients whose heart failure was driven primarily by atrial fibrillation, and who would benefit most from restoring normal rhythm with catheter ablation. 

    The research found that the majority of patients who received catheter ablation showed dramatic improvements in their heart function including complete reversal to normal heart function. The findings, now published, have since been incorporated into national and several international practice guidelines. 

    Dr Prabhu‘s research also provided a systematic exploration of changes to the atrial tissue and its electrical properties from both conditions, improving the understanding of how they affect the heart.

  • Dr Vanesa Stojanovska (Victoria University)

    Intestinal nerve damage caused by chemotherapy

    Dr Vanesa StojanovskaThe anti-cancer chemotherapy drug oxaliplatin is used in the first-line treatment for colorectal cancer.

    Despite its efficacy, oxaliplatin induces nervous system toxicities leading to numbness, tingling and burning sensations and gastrointestinal side-effects such as nausea, vomiting, constipation and diarrhea. These side-effects can result in life-threatening complications.

    Dr Stojanovska’s research used pioneering synchrotron technology to track the chemotherapy drug in the intestinal nerves, to show oxaliplatin induces cell damage and death.

    By determining the mechanisms of intestinal nerve injury following oxaliplatin treatment, Dr Stojanovska’s research paved the way for novel and protective therapeutic strategies to treat and minimise side-effects and improve anti-cancer treatment.

  • Dr Vincent Cornelisse (Monash University, Melbourne Sexual Health Centre and The Alfred Hospital)

    Prevention of HIV and other sexually transmitted infections

    Populations affected by HIV are the same populations affected by bacterial sexually transmitted infections (STIs), including chlamydia, gonorrhoea and syphilis. 

    Dr Cornelisse’s research seeks to find and evaluate new strategies to prevent the transmission of HIV and STIs.

    In this research, Dr Cornelisse validated the use of HIV pre-exposure prophylaxis (PrEP) eligibility criteria, which provided important information for the Australian PrEP clinical guidelines.

    Working with Melbourne Sexual Health Centre, Dr Cornelisse investigated the epidemiology of gonorrhoea and chlamydia, to clarify the role of throat gonorrhoea in transmission to sexual partners. His research indicated that gonorrhoea is commonly transmitted by tongue kissing, and hence that we need new gonorrhoea prevention strategies, as condoms cannot prevent transmission by kissing. He then showed that antiseptic throat gargle is an acceptable and useable intervention to prevent gonorrhoea of the throat. 

    The research team is now conducting a large trial to assess whether the use of antiseptic throat gargle is effective at preventing throat gonorrhoea. If this proves to be effective, it may provide a new strategy to prevent the transmission of throat gonorrhoea, which is increasingly common.

  • Dr Wendy Bunston (La Trobe University)

    Infant experiences in women’s refuges after leaving family violence

    Infants make up the highest number of children to enter women’s refuges with their mothers escaping family violence. 

    Dr Bunston’s qualitative research conducted in eight refuges in three countries (Australia, Scotland and England) found infants largely remain unseen, despite them being the reason mothers sought refuge. 

    Dr Bunston’s research found the refuge focuses on the mother and expects her to tend to her child. 

    However, highly traumatised mothers are often unavailable to their infants. This leaves the exceedingly dependent, rapidly developing infant in a vulnerable state. 

    Infants are often only attended to when they show obvious distress or failure to thrive. Where specialist help is sought this can be difficult to access due to waiting lists or unavailability. 

    Fathers are rarely spoken of, or with derision, leaving the infant alone to make sense of their complex attachment to their fathers. 

    The research also shows the reluctance of staff to think about and respond to the relational needs of infants, not from a lack of compassion but as a defense against the distressing nature of this work. The research makes recommendations to address this gap in service delivery.