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BACKGROUND Clinical presentations of coronavirus disease 2019 (COVID-19) among children with asthma have rarely been investigated. This study aimed to assess clinical manifestations and outcome of COVID-19 among children with asthma, and whether the use of asthma medications was associated with outcomes of interest. METHODS The Global Asthma Network (GAN) conducted a global survey among GAN centres. Data collection was between November 2020 and April 2021. RESULTS Fourteen GAN centres from 10 countries provided data on 169 children with asthma infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 was asymptomatic in 58 (34.3%), mild in 93 (55.0%), moderate in 14 (8.3%) and severe/critical in 4 (2.4%). Thirty-eight (22.5%) patients had exacerbation of asthma and 21 (12.4%) were hospitalized for a median of 7 days (interquartile range 3-16). Those who had moderate or more severe COVID-19 were significantly more likely to have exacerbation of asthma as compared to those who were asymptomatic or had mild COVID-19 (adjusted odds ratio (adjOR) 3.97, 95% CI 1.23-12.84). Those who used inhaled bronchodilators were significantly more likely to have a change of asthma medications (adjOR 2.39, 95% CI 1.02-5.63) compared to those who did not. Children who used inhaled corticosteroids (ICS) did not differ from those who did not use ICS with regards to being symptomatic, severity of COVID-19, asthma exacerbation and hospitalization. CONCLUSIONS Over dependence on inhaled bronchodilator may be inappropriate. Use of ICS may be safe and should be continued in children with asthma during the pandemic of COVID-19.

The temporal evolution of the prevalence of asthma described in the ISAAC (International Study of Asthma and Allergies in Childhood) in 2002 is unknown, or if the geographical or age differences are maintained in Spain.To describe the prevalence of asthma symptoms in different Spanish geographic areas and compare it with that of those centers that participated in the ISAAC.Cross-sectional study of asthma prevalence, carried out in 2016-2019 with 19,943 adolescents aged 13-14 years and 17,215 schoolchildren aged 6-7 years from 6 Spanish geographical areas (Cartagena, Bilbao, Cantabria, La Coruña, Pamplona and Salamanca). Asthma symptoms were collected using a written questionnaire and video questionnaire according to the Global Asthma Network (GAN) protocol.The prevalence of recent wheezing (last 12 months) was 15.3% at 13-14 years and 10.4% at 6-7 years, with variations in adolescents, from 19% in Bilbao to 10.2% in Cartagena; and in schoolchildren, from 11.7% in Cartagena to 7% in Pamplona. These prevalences were higher than those of the ISAAC (10.6% in adolescents and 9.9% in schoolchildren). 21.3% of adolescents and 12.4% of schoolchildren reported asthma at some time.There is a high prevalence of asthmatic symptoms with an increase in adolescents and a stabilization in Spanish schoolchildren with respect to the ISAAC. Geographic variations in asthma prevalence are not so clearly appreciated, but areas with high prevalences maintain high numbers.

Introducción: durante la pandemia de COVID-19, el uso de equipos y dispositivos de protección por parte de los profesionales es fundamental para evitar la transmisión de la infección en el colectivo de sanitarios. Material y métodos: el Grupo Laboral-Profesional de la Asociación Española de Pediatría de Atención Primaria (AEPap) ha realizado una encuesta a los vocales autonómicos de la AEPap para conocer la disponibilidad que han tenido los pediatras de Atención Primaria (PAP) de sistemas de protección frente a la enfermedad, y las pruebas diagnósticas realizadas para el diagnóstico de los contagios de los PAP. Resultados: en marzo de 2020, solo en el 32% de las comunidades autónomas (CC. AA.), los pediatras tenían sistemas de protección adecuados. En abril ascendió al 70%. En todas las CC. AA. se han registrado casos de PAP enfermos, aunque es difícil cuantificar el número de afectados. De las que tenemos datos, sumando el número de pediatras enfermos conocido, más test de reacción en cadena de la polimerasa (PCR) positivo, los que han estado en aislamiento y los ingresados, la cifra asciende al 7,65% de la cifra total de PAP. Los test rápidos serológicos o PCR o ambos se han realizado en seis comunidades los últimos días de abril y en otras seis los primeros días de mayo. Entre las CC. AA. de las que hay información, Aragón es la única comunidad en la que no se ha realizado test. Se ha correlacionado la disponibilidad de los sistemas de protección y el gasto sanitario. Conclusiones: los sistemas de protección han sido insuficientes. Las CC. AA. con mayor gasto sanitario han contado más precozmente con sistemas de protección adecuados. Han resultado infectados PAP en todas las comunidades autónomas, especialmente en Madrid, Castilla y León y Comunidad Valenciana. La detección de profesionales afectos por la infección ha sido tardía.

The aim of the present study was to estimate the associations between the prevalence of asthma symptoms in schoolchildren and meteorological variables in west European countries that participated in the International Study of Asthma and Allergies in Children (ISAAC), Phase III 1997-2003. An ecologic study was carried out. The prevalence of asthma was obtained from this study from 48 centers in 14 countries, and meteorological variables from those stations closest to ISAAC centers, together with other socioeconomic and health care variables. Multilevel mixed-effects linear regression models were used. For schoolchildren aged 6-7 years, the prevalence rate of asthma decreased with an increase in mean annual sunshine hours, showed a positive association with rainy weather, and warm temperature, and a negative one with relative humidity and physician density (PD). Current wheeze prevalence was stronger in autumn/winter seasons and decreased with increasing PD. Severe current wheeze decreased with PD. For schoolchildren aged 13-14 years, the prevalence rates of asthma and current wheeze increased with rainy weather, and these rates decreased with increased PD. Current wheeze, as measured by a video questionnaire, was inversely associated with sunny weather, and nurse density. Severe current wheeze prevalence was stronger during autumn/winter seasons, decreased with PD, and indoor chlorinated public swimming pool density, and increased with rainy weather. Meteorological factors, including sunny and rainy weather, and PD may have some effect on the prevalence rates of asthma symptoms in children from west European countries.

The objective of this study was to estimate the relationship between the prevalence of asthma in schoolchildren aged 6-7 years and 13-14 years and the mean annual sunny hours (MASH) in Spain, and to explore predictive models for asthma prevalence. The prevalence of asthma was obtained from the International Study of Asthma and Allergies (ISAAC) Phase III 2002-2003, and climate and socio-economic variables from official sources. Nine centres were studied and a further four centres, two of which are in ISAAC, to test the predictive models. Logistic regression was used to estimate adjusted prevalence rates of asthma for each centre, and multiple regression models to study the effects of MASH and other meteorological and socio-economic variables. The adjusted prevalence rate of asthma decreased 0.6% [95% confidence interval (CI) 0.4-0.8%] for the 6-7 years group and 1.1% (95% CI 0.8-1.3%) for the 13-14 years group with an increase in the MASH of 100 h. Relative humidity was negatively associated with asthma in the older age group, and gross province product per capita (GPP) was positively associated with asthma in the younger age group. The predictive models, which included MASH, gender, relative humidity, and GPP, anticipated prevalence rates of asthma without significant differences between the levels observed and those expected in 9 of the 11 measurements carried out. The results indicate that sunny hours have a protective effect on the prevalence of asthma in schoolchildren.

Social and family factors may influence the probability of achieving asthma control in children. Parents' quality of life has been insufficiently explored as a predictive factor linked to the probability of achieving disease control in asthmatic children.Determine whether the parents' quality of life predicts medium-term asthma control in children.Longitudinal study of children between 4 and 14 years of age, with active asthma. The parents' quality of life was evaluated using the specific IFABI-R instrument, in which scores were higher for poorer quality of life. Its association with asthma control measures in the child 16 weeks later was analyzed using multivariate methods, adjusting the effect for disease, child and family factors.The data from 452 children were analyzed (median age 9.6 years, 63.3% males). The parents' quality of life was predictive for asthma control; each point increase on the initial IFABI-R score was associated with an adjusted odds ratio (95% confidence interval) of 0.56 (0.37-0.86) for good control of asthma on the second visit, 2.58 (1.62-4.12) for asthma exacerbation, 2.12 (1.33-3.38) for an unscheduled visit to the doctor, and 2.46 (1.18-5.13) for going to the emergency room. The highest quartile for the IFABI-R score had a sensitivity of 34.5% and a specificity of 82.2% to predict poorly controlled asthma.Parents' poorer quality of life is related to poor, medium-term asthma control in children. Assessing the parents' quality of life could aid disease management decisions. Pediatr Pulmonol. 2016;51:670-677. © 2015 Wiley Periodicals, Inc.

Background Parents’/caregivers’ quality of life is an important aspect to consider when handling paediatric asthma, but there is a paucity of valid and reliable instruments to measure it. The Family Impact of Childhood Bronchial Asthma (IFABI-R) is a recently developed questionnaire to facilitate the assessment of asthma-related parents’/caregivers’ quality of life. This study researches the psychometric properties of IFABI-R. Methods Parents/main caregivers of 462 children between 4 and 14 years of age with active asthma were included in the sample. IFABI-R was administered on two different occasions and a number of other variables related to the parents’/caregivers’ quality of life were measured: child's asthma control, family functioning, and parents’/caregivers’ perception of asthma symptoms in the child. IFABI-R evaluative and discriminative properties were analysed, and the minimal important change in the IFABI-R score was identified. Results IFABI-R showed high internal consistency (Cronbach's alpha = 0.941), cross-sectional construct validity (correlation with the degree of child's asthma control, family functioning and parent/caregiver perception of the child's asthma symptoms), longitudinal construct validity (correlation of changes in the IFABI-R with changes in asthma control and changes in the perception of symptoms), sensitivity to change and test–retest reliability. An absolute change of 0.3 units in IFABI-R related to a minimal significant change in the parents’/caregivers’ quality of life. Conclusions IFABI-R is a reliable and valid instrument to study the quality of life of parents/caregivers of children with asthma.

Objetivos: Describir la utilización de distintos medios de comunicación en los adolescentes (televisión, móvil, ordenador, internet y videojuegos) y analizar la influencia en su salud y desarrollo. Material y métodos: Estudio transversal realizado mediante la cumplimentación de una encuesta por parte de 884 adolescentes de 14 a 18 años de Cantabria, que cursaban 3.° y 4.° de ESO en los institutos pertenecientes a seis poblaciones de Cantabria en junio de 2003. El análisis estadístico consistió en una estadística descriptiva univariable y bivariable. Resultados: Todos los adolescentes tenían televisor en su domicilio, y el 24 % de las familias, cuatro o más. La presencia de los distintos medios de comunicación en la habitación del adolescente fue del 52,5 % para la TV, el 57,8 % para el ordenador, el 52 % para el internet y el 38,7 % para la videoconsola. El radiocasete y el reproductor de CD son los más presentes en el dormitorio, con el 76,8 y el 67,4 %, respectivamente. Los adolescentes ven una media de 3 h/día de televisión entre semana y 3,2 h/día el fin de semana; usan la videoconsola entre semana una media de 0,69 h/día (41 min), y una media de 1,09 h/día (65 min) el fin de semana. En el caso de internet entre semana, lo utilizan una media de 0,83 h/día (49 min), y una media de 1,15 h/día (69 min) el fin de semana. El 87,2 % de los adolescentes tienen móvil, y son las mujeres adolescents las que más disponen del mismo (91,6 % frente al 82,4 %; p

To determine the prevalence of wheezing during the first year of life in Cantabria, Spain and its associated risk factors.A cross-sectional, multicentre, descriptive epidemiological study was carried out in a representative sample of 958 infants in the first year of life, born in Cantabria. A previously validated and standardised written questionnaire was completed by the parents of infants seen between 12 and 15 months of age in the Primary Care Centres.The prevalence of wheezing was 32.7%. A relationship was found with male gender (OR 1.38, 95%CI [1.05-1.81]), the presence of a sibling (OR 2.43 [1.38-3.98]), attending nursery school (OR 2.40 [1.71-3.35]), exclusive breastfeeding for3 months (OR 1.47 [1.12-1.93]), a first cold at ≤3 months (OR 2.07 [1.56-2.74]), asthma in siblings (OR 2.17 [1.25-3.77]), parental allergic rhinitis (OR 1.62 [1.10-2.37]) and paracetamol use1 a week (OR 2.49 [1.31-4.73]), and maternal smoking during pregnancy (OR 2.18 [1.51-3.15]). The prevalence of recurrent wheezing (≥3 episodes) was 14.3%. Significant associations were observed with the male gender (OR 1.79 [1.23-2.60]), attending nursery school (OR 2.92 [1.96-4.35]), first cold at ≤3 months (OR 2.11 [1.46-3.04]), eczema (OR 1.92 [1.21-3.04]), maternal asthma (OR 1.77 [1.00-3.14]), exclusive breastfeeding for3 months (OR 1.53 [1.06-2.22]), and maternal smoking during pregnancy (OR 1.53 [1.05-2.22]).One third of the infants experienced wheezing during the first year of life; those who were less exclusively breastfed, attended nursery school, presented eczema, family asthma or allergic rhinitis, and maternal smoking during pregnancy.

Describe the association between parents' quality of life and the two components of asthma control in children: impairment and risk.Cross-sectional study with children between 4 and 14 years of age with active asthma recruited at primary care centers in Spain. Asthma control was assessed according to the Third National Asthma Expert Panel Report, classifying "impairment" in three levels (well-controlled asthma, partially controlled, and poorly controlled), and "risk" as high or low. The parents' quality of life was evaluated using the specific Family Impact of Childhood Bronchial Asthma Questionnaire instrument (IFABI-R). The association between asthma control and the parents' quality of life was analyzed using multivariate regression models adjusted for other social and family variables.Data from 408 children were analyzed. The parents' quality of life was affected in the partially controlled asthma group when compared with well-controlled asthma, as showed by an increase in IFABI-R scores in all dimensions: functional 17.2% (p 0.001), emotional 10.4% (p = 0.021), and socio-occupational 6.8% (p = 0.056). The differences were higher in poorly controlled asthma compared with well-controlled asthma: functional 24.3% (p = 0.001), emotional 18.9% (p = 0.008), and socio-occupational 11.5% (p = 0.036). The "risk" component was independently associated with the parents' quality of life. Of all the elements used to assess the control, the only one independently associated with the parents' quality of life was recurrent asthma crisis.In asthma control, both "impairment" and "risk" in children are gradually associated with the parents' quality of life. The global assessment of the control surpasses the importance of each individual element used in this assessment.

Objetivos: Conocer los hábitos televisivos de los niños de Cantabria y valorar la influencia en su salud y desarrollo. Material y métodos: Estudio transversal realizado mediante la cumplimentación de una encuesta por parte de los padres de 796 niños de 2 a 13 años de edad de Cantabria, en la que participaron 47 pediatras de atención primaria. Se han utilizado para el análisis estadístico las pruebas de x2, Mann-Whitney, Kruskal-Wallis y regresión múltiple. Resultados: Los niños y niñas pequeños (2-5 años) ven una mediana de 9 h/semanales de televisión, los medianos (6-9 años) 12,5 h/semanales, y los mayores (10-13 años) 14,6 h/semana. El 19 % de las familias tienen tres o más televisores en su casa. La presencia de televisor, ordenador o videoconsola en la habitación del niño aumenta con la edad, siendo de forma general de un 15, 9 y 10 %, respectivamente. Las niñas mayores son las que tienen más ordenador en su habitación (20 % frente al 9% en los niños de la misma edad), al contrario de lo que ocurre con la videoconsola en la que más niños (22 %) que niñas (12 %) la tienen. El 27 % de los niños ven la televisión solos y el 29% la ven mientras desayunan, el 36 % mientras comen y cenan. El 58 % de los niños nunca come golosinas viendo la televisión, y sólo un 1% las come habitualmente. Los niños obesos y los que presentan una enfermedad crónica ven 4,5 y 3 h/semana más de televisión, respectivamente, que los que están sanos. Asimismo, se observó un mayor consumo televisivo (2,85 h/semana más) en los niños con peor rendimiento escolar (p, 0,001). Conclusiones: Los pediatras deben realizar educación sanitaria respecto al consumo televisivo, aconsejando que éste se limite a menos de 2 h/día (lo ideal menos de 1 h/día). Los padres deben ver la televisión con sus hijos, comentando los programas y enseñándoles a ser críticos. Hay que evitar la presencia de televisión en la habitación de los niños y ésta no debe utilizarse como canguro. : Objective: To determine television-viewing habits in Cantabrian children and the influence of these habits on their health and development. Material and methods: A transversal survey was carried out in the parents of 796 children aged 2-13 years old with the help of 47 primary care pediatricians. The chi-square, Mann-Whitney and Kruskal-Wallis tests as well as multiple regression analysis were used for the statistical analysis. Results: Children aged 2-5 years old watched television for 9 hours/week, those aged 6-9 years watched 12.5 hours/ week and those aged 10-13 years watched 14.6 hours/week. Nineteen percent of the families had three or more televisions in their homes. The presence of a television, com-puter or video games in the child's room increased with age and was 15 %, 9% and 10 %, respectively. Girls aged 10-13 years were more likely to have computers in their rooms (20 % versus 9% of boys of the same age), while boys aged 10-13 were more likely to have video games than girls (22 % versus 12 %, respectively). Twenty-seven percent of the children watched television alone, 29 % watched it while having breakfast and 36% while having lunch or dinner. Fifty-eight percent of the children never ate sweets while watching television and only 1% habitually did so. Obese children and those with a chronic illness watched television more (4.5 and 3 hours/week, respectively) than healthy children. Children with lower school performance watched more television (2.85 hours/week) (p, 0.001). Conclusions: Pediatricians should carry out health education on the number of hours children should spend in front of the television, advising a limit of less than 2 hours/day (the ideal time would be less than 1 hour/day). Parents should watch television with their children, discuss the programs with them and teach them to be critical. The presence of television sets in children's rooms should be avoided and television should not be used as a nanny.

Antecedentes: El pediatra de atención primaria debe ser capaz de detectar las alteraciones de conducta en los niños, ya que estos problemas se hallan presentes en aproximadamente un 50% de las consultas pediátricas. Para ello es necesario disponer de un instrumento útil y de fácil cumplimentación como es el cuestionario de Eyberg sobre la conducta infantil. Objetivos: Conocer la prevalencia de alteraciones de la conducta infantil mediante la utilización del cuestionario de Eyberg y su posible influencia por determinadas variables (edad, sexo, estudios de los padres, televisión, lectura y rendimiento escolar). Material y métodos: Estudio transversal realizado en junio de 1998 mediante cumplimentación por parte de los padres de 796 niños de 2-13 años, de la versión española del cuestionario de Eyberg para el cribado de las alteraciones de conducta en los niños. Todos los niños incluidos procedían de las consultas pediátricas ubicadas en los centros de salud de Cantabria, colaborando 47 pediatras de atención primaria. Resultados: Un 17,2% de los niños de Cantabria de 2-13 años presenta anomalías de conducta, siendo similar por grupos de edad y sexo, excepto en las niñas mayores (10-13 años), que son las que menos trastornos de conducta manifiestan (p < 0,011). La conducta más frecuentemente referida fue ''le cuesta estar quieto un momento'' (25,6%) y la que menos, ''pega a los padres'' (0,4%). Se asoció una menor frecuencia de alteraciones de conducta a tener menos edad, ser niña, nivel de formación mayor de los padres y haber comenzado a ver la televisión más tardíamente, mientras que se asoció con mayor frecuencia de conductas alteradas el hecho de un mayor número de horas dedicadas a ver televisión. Hasta 2,84 horas más a la semana ven la televisión los niños con alteraciones de la conducta en comparación con los demás niños, siendo esta diferencia de 4,99 horas más a la semana en los niños de 10-13 años. Conclusiones: La prevalencia de alteraciones de la conducta encontrada en nuestra población hace necesaria la utilización del cuestionario de Eyberg en los controles de salud que realiza el pediatra de atención primaria. : Ambulatory care pediatricians must be able to detect changes in children's behavior since these problems occur in approximately 50% of pediatric consultations. For this reason, useful and easy evaluation methods, such as the Eyberg questionnaire on child behavior are needed. Objective: To determine the prevalence of behavior disorders in Cantabrian children by using the Eyberg inventory and to evaluate the possible influence of certain variables (age, sex, parents' education, television, reading and school performance) on children's behaviour. Patients and methods: A transversal study was carried out in June 1998 with the help of the parents of 796 children, aged from 2 to 13 years, who filled in the Spanish version of the Eyberg questionnaire for the screening of changes in children's behavior. All the children taking part in this survey were recruited from pediatric consultations in Cantabrian health centers. Fortyseven ambulatory care pediatricians took part in this study. Results: Behavior disorders were detected in 17.2% of the Cantabrian children aged from 2 to 13 years. This percentage was similar in groups of age and sex, except in the girls aged from 10-13 years, who showed fewer behavior disorders (p < 0.011). The most common behaviours reported were: ''he/she can't keep still'' (25.6%) and less frequently ''he/she hits the parents'' (0.4%). Lower frequency of behavior disorders was associated with younger age, female sex, greater parent education and later commencement of television viewing. Higher frequency of behavior disorders was associated with longer hours spent in television viewing. The children with behavior disorders spent up to 2.84 hours/week more watching television than other children. This difference rose to 4.99 more hours/week in children aged 10 to 13 years. Conclusions: In view of the prevalence of behavior disorders observed in the population studied, ambulatory care pediatricians should use the Eyberg questionnaire as a matter of routine.

To describe mass media use in teenagers (television, mobile phones, computers, Internet and video games) and to analyze its influence on teenagers' health and development.We performed a cross sectional study by means of a survey of 884 teenagers aged between 14 and 18 years old who were in the third and fourth years of high school in six towns in Cantabria (Spain) in June 2003. The statistical analysis consisted of uni- and bivariable descriptive statistics.All the teenagers had a television set at home and 24 % of families had four or more television sets. The presence of distinct mass media in teenagers' rooms was 52.5 % for televisions, 57.8 % for computers, 52 % for the Internet and 38.7 % for games consoles. The most frequently found media in teenagers' bedrooms were radio/cassette players and compact disks with 76.8 % and 67.4 %, respectively. Teenagers watched television for an average of 3 hours per day on weekdays and 3.2 hours per day at weekends. They played games consoles for an average of 0.69 hours per day on weekdays (41 min) and an average of 1.09 hours per day (65 min) at weekends and used the Internet on weekdays for an average of 0.83 hours per day (49 min) and an average of 1.15 hours per day (69 min) at weekends. A total of 87.2 % of the teenagers, especially girls, had a mobile phone (91.6 % of girls versus 82.4 % of boys; p0.001). The average age at which teenagers had the first mobile phone was 13 years old. Expenditure on mobile phones amounted to 15 3 a month in girls and 10 3 a month in boys, and mobiles were mainly used for sending messages. Nearly half the teenagers (46.4 %) took their mobile phones to high school and reported they had an average of three mobile phones at home. Most (82.1 %) surfed the net but boys preferred surfing and downloading games and girls preferred chatting and sending e-mails. Sixty-two percent of teenagers had been to a cybercafé and 40.8 % has visited a pornographic web site, especially boys (33.1 % of boys versus 7.7 % of girls; p0.001). Nearly two-thirds of teenagers (71.5 %) had a video console, especially boys (87 % of boys versus 57.2 % of girls; p0.001) and they started playing with them at an average age of 8.8 years. Boys preferred video games with shooting, fights, sports and driving, while girls preferred adventure video games. Nearly a quarter (22.2 %) spent money on video games and cybercafés (an average of 27.06 3 a month in boys and 16.81 3 a month in girls) with no significant differences between sexes.Society as a whole and especially health professionals should increase health education on mass media consumption, by stimulating reasonable use of mass media and teaching teenagers to be critical. Parents should set a limit of less than 2 hours/day to the use of mass media and should avoid their presence in teenagers' bedrooms. Prepay mobile phone should be used and switched off in inappropriate places. Parents should supervise and educate teenagers about video games, Internet access and e-mail usage in adolescence.

To determine television viewing habits in Cantabrian children and the influence of these habits on their health and development.A transversal survey was carried out in the parents of 796 children aged 2-13 years old with the help of 47 primary care pediatricians. The chi-square, Mann-Whitney and Kruskal-Wallis tests as well as multiple regression analysis were used for the statistical analysis.Children aged 2-5 years old watched television for 9 hours/week, those aged 6-9 years watched 12.5 hours/ week and those aged 10-13 years watched 14.6 hours/week. Nineteen percent of the families had three or more televisions in their homes. The presence of a television, computer or video games in the child's room increased with age and was 15%, 9% and 10%, respectively. Girls aged 10-13 years were more likely to have computers in their rooms (20% versus 9% of boys of the same age),while boys aged 10-13 were more likely to have video games than girls (22% versus 12%, respectively). Twenty-seven percent of the children watched television alone, 29% watched it while having breakfast and 36% while having lunch or dinner. Fifty-eight percent of the children never ate sweets while watching television and only 1% habitually did so. Obese children and those with a chronic illness watched television more (4.5 and 3 hours/week, respectively) than healthy children. Children with lower school performance watched more television (2.85 hours/week) p0.001).Pediatricians should carry out health education on the number of hours children should spend in front of the television, advising a limit of less than 2 hours/day (the ideal time would be less than 1 hour/day). Parents should watch television with their children, discuss the programs with them and teach them to be critical. The presence of television sets in children's rooms should be avoided and television should not be used as a nanny.

Ambulatory care pediatricians must be able to detect changes in children's behavior since these problems occur in approximately 50% of pediatric consultations. for this reason, useful and easy evaluation methods, such as the Eyberg questionnaire on child behavior are needed.To determine the prevalence of behavior disorders in Cantabrian children by using the Eyberg inventory and to evaluate the possible influence of certain variables (age, sex, parents' education, television, reading and school performance) on children's behaviour.A transversal study was carried out in June 1998 with the help of the parents of 796 children, aged from 2 to 13 years, who filled in the Spanish version of the Eyberg questionnaire for the screening of changes in children's behavior. All the children taking part in this survey were recruited from pediatric consultations in Cantabrian health centers. Forty-seven ambulatory care pediatricians took part in this study."he/she can't keep still" (25.6%) and less frequently "he/she hits the parents" (0.4%). Lower frequency of behavior disorders was associated with younger age, female sex, greater parent education and later commencement of television viewing. Higher frequency of behavior disorders was associated with longer hours spent in television viewing. The children with behavior disorders spent up to 2.84 hours/week more watching television than other children. This difference rose to 4.99 more hours/week in children aged 10 to 13 years.In view of the prevalence of behavior disorders observed in the population studied, ambulatory care pediatricians should use the Eyberg questionnaire as a matter of routine.