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Interpretation of the East Anglian trends is made more difficult by the change in England in 1987 of the system for the collection of hospital admission data. The fact that the rates for the East Anglian region seem to decline before this change and other considerations suggest that the observed trends, although partly reflecting the disruption of the coding during the changeover in systems, may not be entirely artefactual. The possible roles of diagnostic transfer and changes in the delivery of care, asthma treatment, admission and readmission policies, and the severity and prevalence of asthma in changing admission rates are considered. The changing trends in admission rates for East Anglia and Wales reflect recently published trends for mortality from asthma in England.

This paper discusses findings from a recently completed study of adolescent foster care, which included a detailed assessment of the parenting approaches and strategies used by the foster carers of adolescents in long‐term placements. Sixty‐eight foster carers were interviewed at two points in time. The first interview was conducted two months after the start of a new adolescent placement and the second after the placement had been continuing for a year, or at the point of disruption if this occurred earlier. The interview schedules were designed specifically for this study and were based upon well‐established techniques developed in other studies of parenting. They enabled the researchers to make summary ratings for each carer on established dimensions of parenting such as control and discipline, responsiveness and the level of engagement with the child. The researchers assessed how these strategies changed and developed in relation to the young person's behaviour and whether these approaches influenced either the likelihood of placement disruption or the quality of the placement for the child. This paper describes the parenting strategies used by the foster carers, highlighting the areas of parenting that significantly affected the placement outcomes and the corresponding implications for policy and practice.

Background Menstruation has been shown to be problematic for many women with intellectual disabilities. There has been a greater focus on menstrual suppression or elimination than on help and training to manage menstrual care successfully. Method A cross-sectional questionnaire survey was conducted in England to investigate the help and training currently given to women with intellectual disabilities. Results Twenty-nine percent of the women had never been given the opportunity to learn how to manage their own menstrual care. Where someone had tried to teach the woman, this was most often her mother. Carers were giving considerable amounts of assistance with menstrual care, although some of the women with more profound disabilities were able to manage menstrual care independently.Conclusions The authors argue that all women with intellectual disabilities should have the chance to manage or assist with their own menstrual care, backed by a strategic approach to menstrual education and support.

Background Menstruation appears to be problematic for women with learning disabilities, yet there has been little quantitative research on their experiences, or comparisons with other groups of women. This paper considers the nature and extent of menstrual problems experienced by women with learning disabilities. Methods The data reported here come from a cross-sectional postal questionnaire survey conducted with carers of 452 women, aged 14-55 years, who had learning disabilities.Results Women with learning disabilities appear to be as likely to experience menstrual problems as other women. However, such problems may be experienced differently and more negatively and may not always be recognized appropriately. Conclusions More attention needs to be given to menstrual problems experienced by women with learning disabilities, both in research and in practice. It is particularly important that women with learning disabilities be supported to play a central role in recognizing and defining the problems they experience.