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To identify the clinical conditions associated with substantial time spent in hospital by children aged 1-14 years, records of children admitted to hospital in 1975, 1979, and 1984 were studied. Analysis was by linkage of abstracts of routine records of hospital inpatient care in six districts in southern England covered by the Oxford record linkage study. The total time spend in hospital in the acute specialties each year was calculated by summing the lengths of stay of all episodes of care for each child in each year. First, admissions with long median times in hospital per child admitted were identified. These included, notably, fracture of femur and, in the later years, leukaemia, other malignant neoplasms, and congenital disorders of metabolism. Second conditions were identified which accounted for large numbers of children with lengths of stay of five days or more. These included, in particular, congenital anomalies, asthma, and appendicitis. Third, conditions were identified which accounted for the largest numbers of bed days used. These included congenital anomalies, hypertrophy of tonsils and adenoids, asthma, otitis media, appendicitis, and head injury. Median time spent in hospital per child admitted declined for most conditions but increased for leukaemia, other malignant neoplasms, and congenital disorders of metabolism. Admission rates for children who spent five days or more in hospital each year declined for all common conditions except asthma which increased. Total numbers of beds used increased for asthma and otitis media but declined for all other common conditions. [ABSTRACT FROM AUTHOR]

Focuses on medical issues in Great Britain. Issue on the molar dosage of calcium chloride solutions; Effect of using oral contraceptives on older women; Association between Madelung's deformity and Huntington's chorea.

Appeal of Professor Sir Roy Meadow against the GMC finding him guilty of professional misconduct. [ABSTRACT FROM AUTHOR]

It may be that this poignant article is published after those of us in the UK have heard the result of a current appeal to the High Court involving the legality or otherwise of the advice given to doctors by the General MEdical Council on withdrawing life prolonging treatments.¹ Paediatricians in this country are encouraged to follow a framework devised by the Royal College of Paediatrics and Child Health (RCPCH).² The latter document states: "Feeding is a particularly emotive area for parents and staff and opinions vary regarding withholding and withdrawal of feeding. The role of assisted feeding for an infant or child by nasogastric tube or gastrostomy should be considered very carefully and discussed fully with the family. It may be entirely appropriate, for example, in a child with a swallowing disorder due to a slowly progressive neurodegenerative disease..." The family is this case were clearly at odds with their doctors over what was best for their child and grandchild and felt dictated to rather than being invited to share decision making. We were not in a position to ask the doctors whether their perception of the situation was different. Did they see themselves as threatening the family with court proceedings or as simply explaining how the law required them to act if they could not reach agreement as to the child's best interests? Would the clinicians concur with the family's view that they did not tell them the disadvantages of artificial feeding? Whatever the facts of the matter, surely none of us would disagree with the contention that an intervention is not right just because it is possible; that doctors should be open in their discussions with parents; and that professionals should either provide palliative care themselves to the end or show some humility in the face of having to hand it over to another team. 1 General medical council. Withholding and withdrawing life-prolonging treatments: good practice in decision-making. London: GMC, 2002 (www.gmc-uk.org). 2 Royal College of paediatrics and Child Health. Witholding or withdrawing life sustaining treatment in children: a framework for practice, 2nd edn. London: RCPCH, 2004 (www.rcpch.ac.uk). [ABSTRACT FROM AUTHOR]

The article focuses on the estimate of marginal cost of giving access to the electronic edition of the periodical "Archives of Disease in Childhood." Access to the electronic edition of ADC will be provided free automatically to those from countries which are defined as poor under the human development index by the United Nations. The income that ADC get from resource poor countries is minimal and facilitating information supply should encourage development, improvement in healthcare and eventually create a market. It is easy for donors to invest money and reap the rewards of short term success.