The consequences of irregular treatment and poor inhalation technique for children with asthma are linked to more hospitalisations and increased morbidity. The 'Funhaler'™™ is a novel spacer device for asthma, devised by Watt et al. (2003) which aims to improve adherence.

Mark scheme

Marking points from the official mark scheme (Oct/Nov 2021). The mark or mark type is shown in brackets.

1. [1] 1 mark basic answer, 2 marks for elaboration/example.
2. Note: 0 marks 'it is for children'
3. This device incorporates a number of features to distract the attention of children from the drug delivery event itself and to provide a means of self-reinforcing the use of effective technique.
4. it isolates incentive toys (spinner and whistle) in a separate branch to the standard inhalation
5. the design of the toys themselves ensures sufficient inspiratory resistance to minimise entrainment of inspired air through the toy circuit.
6. the design attempts to link the optimal function of the toys to deep tidal breathing pattern conducive to effective medication.
7. [1] 1 mark for basic statement up to 4 marks for detail and quality of elaboration/example
8. Funhaler is a 'toy' with spinner and whistle and the harder blown the louder the whistle and the more the toy spins
9. This is fun for a child and is positive reinforcement.
10. Positive reinforcement should lead to repetition of the action i.e. taking medication
11. Answers may include reference to Skinner
12. [1] 1 mark for identification and 1 mark for outline x2
13. ignorance,
14. fear,
15. boredom,
16. forgetfulness, and
17. apathy.
18. [1] 1 mark for each advantage/disadvantage (however basic/detailed) which is related to the question (max 4 marks).
19. [1] 1 mark for conclusion.
20. Note: If three (or more) arguments for one side, best two credited. If one side only, max 2 marks.
21. children are young and naïve and so are more likely to behave naturally, even in laboratory experiments.
22. children will not question what is happening.
23. children are not adhering so studies involving children are as appropriate as adults as participants.
24. children may not understand complex instructions and if they do...
25. they may not be able to explain what they are thinking or how they feel.
26. children may not exercise the right to withdraw; they may not understand a debriefing.
27. children may be psychologically harmed by a study which may not be evident for many years.
28. Conclusion: any appropriate conclusion drawn from the discussion that has been presented. 1 mark if appropriate. A conclusion is a 'decision reached by reasoning' and so a summary of points already made scores 0 marks.