Search

Objective: To assess whether a physical activity intervention reduces body mass index in young children., Design: Cluster randomised controlled single blinded trial over 12 months., Setting: Thirty six nurseries in Glasgow, Scotland., Participants: 545 children in their preschool year, mean age 4.2 years (SD 0.2) at baseline., Intervention: Enhanced physical activity programme in nursery (three 30 minute sessions a week over 24 weeks) plus home based health education aimed at increasing physical activity through play and reducing sedentary behaviour., Main Outcome Measure: Body mass index, expressed as a standard deviation score relative to UK 1990 reference data. Secondary measures were objectively measured physical activity and sedentary behaviour; fundamental movement skills; and evaluation of the process., Results: Group allocation had no significant effect on the primary outcome measure at six and 12 months or on measures of physical activity and sedentary behaviour by accelerometry. Children in the intervention group had significantly higher performance in movement skills tests than control children at six month follow-up (P=0.0027; 95% confidence interval 0.3 to 1.3) after adjustment for sex and baseline performance., Conclusions: Physical activity can significantly improve motor skills but did not reduce body mass index in young children in this trial., Trial Registration: Current Controlled Trials ISRCTN36363490.

Objectives: To identify the number and current location of children, aged 0 to 16 years, requiring long term ventilation in the United Kingdom, and to establish their underlying diagnoses and ventilatory needs., Design: Postal questionnaires sent to consultant respiratory paediatricians and all lead clinicians of intensive care and special care baby units in the United Kingdom., Subjects: All children in the United Kingdom who, when medically stable, continue to need a mechanical aid for breathing., Results: 141 children requiring long term ventilation were identified from the initial questionnaire. Detailed information was then obtained on 136 children from 30 units. Thirty three children (24%) required continuous positive pressure ventilation by tracheostomy over 24 hours, and 103 received ventilation when asleep by a non-invasive mask (n=62; 46%), tracheostomy (n=32; 24%), or negative pressure ventilation (n=9; 7%). Underlying conditions included neuromuscular disease (n=62; 46%), congenital central hypoventilation syndrome (n=18; 13%), spinal injury (n=16; 12%), craniofacial syndromes (n=9; 7%), bronchopulmonary dysplasia (n=6; 4%), and others (n=25; 18%). 93 children were cared for at home. 43 children remained in hospital because of home circumstances, inadequate funding, or lack of provision of home carers. 96 children were of school age and 43 were attending mainstream school., Conclusions: A significant increase in the number of children requiring long term ventilation in the United Kingdom has occurred over the past decade. Contributing factors include improved technology, developments in paediatric non-invasive ventilatory support, and a change in attitude towards home care. Successful discharge home and return to school is occurring even for severely disabled patients. Funding and home carers are common obstacles to discharge.

Objective: To investigate how parents use bronchodilator treatment for relief of symptoms when treating their asthmatic preschool children., Design: A commercial electromechanical timer device was attached to a large volume spacer to record the time and date of each use of inhaled bronchodilator over two months. The recorded time and dates were compared with symptoms noted in an asthma diary card., Setting: Large paediatric teaching hospital in Glasgow., Subjects: 29 preschool children with moderately severe asthma attending a specialist paediatric asthma clinic., Main Outcome Measures: Inhaler use measured by the timer device; symptoms and inhaler use recorded by parents in a daily asthma diary., Results: Satisfactory data were obtained in 22 of the 29 children; the median number of study days was 53 (range 18-77). Asthmatic symptoms were recorded on a median of 30 (3-77) days. Bronchodilator was used on a median of 19 (2-73) days, or on 63% (7-100%) of days when symptoms occurred. The median number of puffs used in a day was 1 (range 0-100) and was significantly related to symptom severity in only 14 of the 22 children. In only two of the 22 children was bronchodilator given more frequently than four hourly, and only five children ever used more than 12 puffs a day., Conclusions: The frequency of parental administration of bronchodilator treatment was variable and not closely related to the parent's record of symptom severity. Parents often recorded symptoms in their children but did not treat them.