SummaryBackground Environmental, cultural and health care differences may account for variation among countries in the prevalence of asthma and respiratory symptoms in teenagers. Objective To examine the prevalence of respiratory symptoms and the level of diagnosis, and to compare determinants of asthma and severe wheeze in two countries. Methods Self-completion questionnaires based on the International Study of Asthma and Allergies in Childhood (ISAAC) protocol were provided to school children in Ireland (Republic and Northern Ireland). In the Republic of Ireland, all children in classes largely aged 13±14 years from 30 postprimary schools were selected by random sampling stratified by school size, composition and Health Board in Spring 1995. In Northern Ireland, all children largely aged 13±14 years of age from 26 postprimary schools were selected by random sampling stratified by school type, composition and Education and Library Board in Spring 1996. Results Questionnaires were completed by 2364 children from Northern Ireland and 2671 from the Republic, about 90% of those eligible to participate. The prevalences of wheeze at various levels of severity, of diagnosed asthma and of treated wheeze were very similar in Northern Ireland and the Republic of Ireland. A significant proportion of those reporting more severe symptomatology (four or more attacks of wheeze in the past 12 months and/or one or more nights disturbed and/or moderate or greater disruption of daily activities and/or speech restriction due to wheeze) had been neither diagnosed nor treated for asthma (20±37%). To investigate the determinants of the more severe symptomatology of asthma or treated wheeze a series of stepwise multiple regression analyses was performed. A history of atopy, cigarette smoking, the possession of a furry pet other than a dog or cat and age were each independently associated with severe wheeze, whilst atopy, a furry pet (as above) and gender were each independently associated with asthma or treated wheeze. Conclusions Cigarette smoking is closely associated with the reporting of significant respiratory symptoms together with atopy and exposure to furry pets. Some 20±37% of severe symptoms were neither diagnosed nor treated as asthma.

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The relationship between a history of respiratory infections (and associated variables) The model selected for FEVo.751 accounted for 800 of the variation in FEVo.75I and no interaction terms were necessary. For FVC I it was necessary to include interactions between sex and "area of residence" and between sex and "history of chronic respiratory disease" and this model accounted for 15 % of the variation. No interaction was needed for FEVo.75/FVC ratio and 10 % of the variation was explained.The number of subjects included in the regression 847

Objective To evaluate the level of understanding and the practice of community development among Health and Social Service professionals in Northern Ireland and to assess the potential need for formal training in community development. Design A survey using questionnaires among a representative sample of health and social service professionals in Northern Ireland. Qualitative data was obtained from separate focus groups. Setting Questionnaires were self-completed by subjects contacted at their place of work. Focus groups were carried out by experienced interviewers in workplace settings. Method Ten Health and Social Services Community Trusts were selected to be representative of Trusts in Northern Ireland. Questionnaires were distributed to all 502 Health and Social Service professionals working in these Trusts. A focus group session was carried out in each of four Health and Social Services Community Trusts across the Province. Results The overall response rate was 57 per cent. Two hundred and eighty-seven questionnaires were returned from a total of 502. High response rates were obtained among health visitors, community psychiatric nurses, and social workers for disability, but groups such as community midwives may have been less well represented in our study sample (response rate 21 per cent). Over 28 per cent of subjects, particularly social workers, said they were unfamiliar with the concept of community development. Thirty- nine per cent described their knowledge as adequate and 4 per cent as good. Almost 40 per cent of the subjects said that they never used a document which had been widely distributed in Northern Ireland on a strategy for community development. Seventy-two per cent of subjects had not used the Voluntary Activity Unit's Handbook for Practitioners which had also been widely distributed in the Province. Questions on training required by professionals suggested that the majority of professionals required training in methods and techniques, values and principles, definition and clarification of professional roles, and knowledge of practice elsewhere. Focus groups reported that a high level of commitment and out- of-hours involvement was required to further enhance community development. Conclusions The majority of professional groups were positive about community development, but were unable to find or provide examples. Training needs were identified among all professional groups in this study.

The present study tests the suggestion that the respiratory morbidity of children resident in South Wales is substantially higher than that among children resident in some were matched for population density (with the assistance of the 1971 Census County Reports), socioeconomic index, and size with five schools in the Vale of Glamorgan (two small schools in the Vale were matched with one in Avon). In total 21 schools were selected. SUBJECTS Almost all the schools had mixed ability classes. In such schools where the normal practice is to allocate pupils alternately by successive birthdays, one class was taken to be representative of one year's intake of children. In schools where "streaming" was practised representative samples were chosen from all the year's intake. In two large schools each with a small designated "special" class of low ability children from all age groups these classes were not considered for inclusion in the final sample. Where possible approximately 100 pupils were chosen from each school. The sizes of the schools ranged from 72 to 469 pupils (7-11 years only). QUESTION NAIRESA questionnaire (copies of which may be obtained from the authors) was given to each parent or guardian of a child eligible for inclusion in the study. These questionnaires were distributed by the form teachers from each school. In addition to demographic and medical information the questionnaire included a number of standard questions derived 842 on 10 May 2018 by guest. Protected by copyright.

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