Behavioural difficulty, chronic disability, and learning problems represent a significant part of the workload of community-based general paediatricians. Appropriate exposure during paediatric training should be given to these issues along with more sophisticated training in the medical, social and psychological complications of chronic illness and its effect on clients and families.

Ongoing training and upgrading in acute paediatric diagnostic and procedural skills, rationalization of resuscitation expertise, training in management and administrative skills and models of care for the chronically ill should become part of the training of community-based general paediatricians.

Children with asthma are substantially more likely to suffer anxiety than children without asthma. Future studies are required to determine the sequence of events that leads to this comorbidity, and to test strategies to prevent and treat anxiety among children with asthma.

No abstract

There has been a substantial absolute and per capita increase in paediatric ED presentations and hospital admissions since the 1990s. These trends place an increasing burden on the public hospital system, and strategies are required to promote paediatric acute care in the ambulatory setting.