Systematic review of worldwide variations of the prevalence of wheezing symptoms in children

Background: Considerable variation in the prevalence of childhood asthma and its symptoms (wheezing) has been observed in previous studies and there is evidence that the prevalence has been increasing over time. Methods: We have systematically reviewed the reported prevalence and time trends of wheezing symptoms among children, worldwide and within the same country over time. All studies comprising more than 1000 persons and meeting certain other quality criteria published over a 16-year period, between January 1990 and December 2005, are reported and a comparison of ISAAC (International Study of Asthma and Allergies in Childhood) and non-ISAAC studies is made, in part as a way of expanding the power to examine time trends (the older studies tend to be non-ISAAC), but also to examine possible methodological differences between ISAAC and non-ISAAC questions. Results: A wide range of current prevalence of wheeze was observed between and within countries over time. The UK had the highest recorded prevalence of 32.2% in children aged 13–14 in 1994–5 and Ethiopia had the lowest prevalence, 1.7% in children aged 10–19 in 1996. All studies in Australia and the UK were compared using multiple logistic regression. ISAAC phase I and III studies reported significantly higher prevalence of current wheeze (OR = 1.638) compared with non-ISAAC studies, after adjusting for various other factors (country, survey year, age of child, parental vs child response to the survey). Australia showed a significantly higher prevalence of current wheezing (OR = 1.343) compared with the UK, there was a significant increase in the prevalence odds ratio per survey year (2.5% per year), a significant decrease per age of child (0.7% per year), and a significantly higher response in current wheezing if the response was self-completed by the child (OR = 1.290). These factors, when explored separately for ISAAC and non-ISAAC studies, showed very different results. In ISAAC studies, or non-ISAAC studies using ISAAC questions, there was a significant decrease in current wheezing prevalence over time (2.5% per year). In non-ISAAC studies, which tend to cover an earlier period, there was a significant increase (2.6% per year) in current wheezing prevalence over time. This is very likely to be a result of prevalence of wheezing increasing from the 1970s up to the early 1990s, but decreasing since then. Conclusion: The UK has the highest recorded prevalence of wheezing and Ethiopia the lowest. Prevalence of wheezing in Australia and the UK has increased from the 1970s up to the early 1990s, but decreased since then and ISAAC studies report significantly higher prevalences than non-ISAAC studies.

Part-time and fractional staff in the learning and skills sector

This Universities and College Union Launch Event presentation reported on the findings of Learning and Skills Research Network (LSRN) London and South East (LSE) Regional Research Project. The presentation reflected on research carried out during 2002-06 on the development and deployment of part-time staff in the Learning and Skills Sector. Although the lifelong learning sector is the largest UK education sector, little attention has as yet been paid to the role of LSC sector part-time staff. Worrying trends of an increasing casualisation of staffing have been reported. The role of part-timers as highly committed (philanthropic) but generally underpaid and exploited staff (ragged-trousered) emerged from the data collected by this investigation, which examined the role of part-timers in several colleges and adult education institutions in London and the South East. The metaphor of the 'ragged-trousered philanthropist' was consciously selected to investigate the interactivity between philantrophy, employment practices for PT staff, and education as social action, in addressing the need for good practice to achieve quality outcomes in learning and teaching. The results are to some extent transferable to other education and training sectors employing part-time staff, e.g. higher education institutions and work-based training organisations.