Asthma is one of the most common reasons for children's consultations with the general Background -Children with parents who smoke are often exposed to high levels of practitioner, 10 admissions to hospital, 11 and issuing of prescriptions. 6 It is estimated that environmental tobacco smoke, and children with asthma are particularly susceptible to approximately 50% of children under 10 years in this country have at least one parent who the detrimental effects of passive smoking. Data were collected from parents who smokes.2 In addition, one paediatric respiratory outpatient clinic recently reported that 42% of smoke and from their asthmatic children. The families are currently taking part in a children attending were regularly exposed to parental tobacco smoke in their own homes randomised controlled trial to test an intervention designed to reduce passive smoking (Clark RA et al, unpublished data, 1996).Families that include a child with asthma in children with asthma. This paper reports on the baseline data. Questionnaire data and at least one parent who smokes are currently taking part in a randomised clinical trial and cotinine levels were compared in an attempt to assess exposure and to identify to test an intervention designed to reduce exposure of children with asthma to tobacco factors which influence exposure of the children. The aim of the study was to identify smoke. This paper reports on the extent of passive smoking, assessed by salivary cotinine the scope for a reduction in passive smoking by these children. levels, of the children at baseline and identifies factors that influence exposure. Factors inMethods -A sample of 501 families with an asthmatic child aged 2-12 years was vestigated relate to the child, the index parent, other smokers in contact with the child, and obtained. Factors influencing passive smoking were assessed by interviewing the socioeconomic environment. The aim is to determine the scope for a possible reduction parents. Cotinine levels were measured from saliva samples using gas liquid in passive smoking by the children. chromatography with nitrogen phosphorous detection. Results -Cotinine levels in children were Methods strongly associated with the age of the Criteria for admission were a documented diaConclusions -Many children are exposed gnosis of asthma in the GP case records and at at home. Families were identified by GP pracCentre, Lyon Street, (Thorax 1997;52:766-769) tice staff. The index child was the youngest Dundee DD4 6RB, UK family member with asthma. Where both par-P W Slane
Objective To investigate whether parents of asthmatic children would stop smoking or alter their smoking habits to protect their children from environmental tobacco smoke. Design Randomised controlled trial. Setting Tayside and Fife, Scotland. Participants 501 families with an asthmatic child aged 2-12 years living with a parent who smoked. Intervention Parents were told about the impact of passive smoking on asthma and were advised to stop smoking or change their smoking habits to protect their child's health. Main outcome measures Salivary cotinine concentrations in children, and changes in reported smoking habits of the parents 1 year after the intervention. Results At the second visit, about 1 year after the baseline visit, a small decrease in salivary cotinine concentrations was found in both groups of children: the mean decrease in the intervention group (0.70 ng/ml) was slightly smaller than that of the control group (0.88 ng/ml), but the net difference of 0.19 ng/ml had a wide 95% confidence interval ( − 0
SUMMARY A new type of test used to examine medical students' clinical skills in paediatrics is described. Each student has to circulate round a number of timed stations. At each one he performs a specified clinical procedure-such as history taking, physical examination, urine analysis, and radiological interpretation-and is marked according to his performance. This type of test is objective and can be extended to cover different aspects of clinical methods; it readily informs the student about his progress, and enables the teacher to look critically at his own technique.
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