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Purpose There is minimal evidence showing that beta-2-agonist bronchodilators (BDs) improve outcomes in bronchiolitis. The use of these agents in ambulatory settings for children with bronchiolitis has not been well studied. Methods Data from emergency department and physician office visits were obtained from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 1995-2003. Visits surveyed included those of children less than or equal to 2 years old who were seen by a physician and given the primary, secondary, or tertiary diagnosis of bronchiolitis. We excluded children with concomitant diagnoses that would otherwise justify the use of BDs (eg, asthma). BDs included albuterol, albuterol sulfate, levalbuterol, or salmeterol. Results 491 visits met study criteria. BDs were prescribed in 311 (63%) visits. Children seen in the emergency department were more likely to receive BDs compared to children seen in office settings; 66% versus 57% (OR = 1.51 [95% CI = 1.03-2.23]). BD use did not vary with other factors, such as patient race, insurance status, hospital teaching status, or physician level of training. There was no significant trend over time toward decreasing beta-2-agonist bronchodilator use (p = .7447). Conclusion Despite lack of efficacy, nearly 2/3 of children with bronchiolitis are treated with BDs in ambulatory settings—especially in emergency rooms.

Background Despite the benefits of physical activity, overall engagement time in physical activity is low among American youth, even among preschool-aged children. Parental perceptions and attitudes may be influential in promoting physical activity in children. Objective To assess parental receipt of physical activity health promotion counseling for their children and associations with perceptions and attitudes regarding physical activity and television viewing in their preschool children. Study Design As part of an intervention to increase physical activity in a group of inner city, Title I, preschool children, a questionnaire regarding physical activity was completed by the preschooler9s parent (or guardian). Questions assessed frequency of parental counseling by school or health provider, parental perception of activity level, time engaged in television viewing and eating dinner while watching television. Frequencies of responses were obtained for each question and chi-square analysis was used to assess the relationship between variables of interest. Results 1,178 parents were surveyed. 1,100 (93%) completed part or all of the questionnaire. Overall 88% of respondents felt their child got about the right amount or too much physical activity. Children9s TV/computer/video time was reported as $ 2 hours/day for 38% on weekdays and 57% on weekends while 62% of children ate dinner at least 2 times a week while watching television. Overall, only 22% of parents felt their child9s TV/computer/video time was too much. The association between perceptions of the right amount of TV viewing and the hours of television viewed was significant (p Conclusion Many preschool parents do not receive counseling about the importance of physical activity and decreasing sedentary behaviors at their child9s school or by health providers. Parental receipt of counseling at their child9s health clinic but not school was related to their child9s physical activity time. It was not related to children9s sedentary behaviors or parent9s perceptions about these behaviors.