Previous studies have shown that the regular administration of short acting beta-agonists can be associated with adverse effects on airway caliber and bronchial hyperresponsiveness (BHR) and that this may occur through a proinflammatory mechanism. The aim was to explore possible adverse effects of high-dose beta-agonist therapy and to assess any adverse interaction with corticosteroids. We undertook a randomized, crossover study to investigate the effects of 6 wk of treatment with regular terbutaline (1 mg four times a day), regular budesonide (400 microg twice a day), combined treatment, and placebo in subjects with mild to moderate asthma. Major endpoints were PD(15) saline, PD(20) methacholine, and induced sputum differential cell counts. Thirty-four subjects were randomized and 28 completed the study. PD(15) saline decreased on terbutaline alone compared with placebo treatment and on combined treatment compared with budesonide alone (mean fold decrease of 0.57 [95% CI = 0.36, 0.90] and 0.65 [95% CI = 0.43, 0.97], respectively). PD(20) methacholine was not affected by the use of terbutaline either alone or in combination with budesonide. The percentage of eosinophils in induced sputum increased during terbutaline treatment alone compared with placebo (median 8.3% versus 4.4%, p = 0.049). The addition of terbutaline to budesonide did not affect the percentage of eosinophils compared with budesonide treatment alone. These findings support the hypothesis that short-acting beta-agonists have a permissive effect on airway inflammation and that when used in high dose there may be an unfavorable interaction with inhaled corticosteroids.

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Introduction: In extending work on early life antecedents of parenting, we investigate associations between childhood family history of disadvantage, adolescent socioemotional wellbeing, and age at irst parenthood and subsequent parenting behaviour. Methods: Parent-child interactions were recorded when participants in the longitudinal Dunedin Multidisciplinary Health and Development Study (New Zealand) had a three-year-old child. Data were available for 358 mothers and 321 fathers, aged between 17.7 and 41.5 at the time of their child's birth. Associations between parenting and antecedent data on socioeconomic disadvantage, adolescent wellbeing and mental health, as well as current adult mental health and age at parenting, were tested for using structural equation modelling. Results: Family disadvantage in childhood and lower adolescent wellbeing was associated with less positive future parenting, but only adult (not adolescent) anxiety/depression symptoms were directly associated with parenting behaviour. Childhood family disadvantage was associated with further disadvantage across the life course that included less positive parenting of the next generation. In contrast, socioemotional wellbeing during adolescence and later age of onset of parenting were associated with more positive parenting. Conclusions: Reducing childhood disadvantage and improving socioemotional wellbeing during childhood and adolescence is likely to have intergenerational beneits through better parenting of the next generation.

The living arrangements of young people in New Zealand are diverse and often complex. In this article we report the range of care and living arrangements of 209 15-year-old New Zealanders, 47 of whom identified as Māori. These young people were participants in the second generation of a cohort study. Data were collected from their parents via a life history calendar and analysed for variety and consistency of care arrangements, household membership and transitions. Few participants had a consistent pattern of parental care arrangements and most had experienced multiple changes in household composition and frequent changes of address. We conclude that the whānau/family lives of many young New Zealanders are complex and dynamic. These observations contrast with the conventional notions of family life that form the basis for New Zealand's family policies. We argue that social policies and services impacting on young people need to reflect the lived reality of young people if they are to meet young people's needs.

This paper describes the development of a method of data collection, which captures the complexity of living situations, family dynamics and key life events of teenagers. This 'Life History Calendar' was adapted from earlier life history calendar methods for a multidisciplinary intergenerational study. The new calendar is able to record details of 15 years of teenage participants' lives and can be administered to teenagers and their parents to show changes over individual lives and difference between individuals in a cohort. Referring to some preliminary data, we show that the calendar is a practical and effective method of data collection, which will be useful to researchers and practitioners working with young people and their families.