Quality of life in caregivers of children with asthma: Validity and reliability of the IFABI-R questionnaire.

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.

Wheezing and risk factors in the first year of life in Cantabria, Spain. The EISL study.

OBJECTIVES: To determine the prevalence of wheezing during the first year of life in Cantabria, Spain and its associated risk factors. METHODOLOGY: 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. RESULTS: 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 for <3 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 use >1 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 for <3 months (OR 1.53 [1.06-2.22]), and maternal smoking during pregnancy (OR 1.53 [1.05-2.22]). CONCLUSIONS: 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.

[Mass media consumption in adolescence]. / Consumo de los medios de comunicación en la adolescencia.

OBJECTIVES: 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. MATERIAL AND METHODS: 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. RESULTS: 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; p < 0.001). 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; p < 0.001). Nearly two-thirds of teenagers (71.5 %) had a video console, especially boys (87 % of boys versus 57.2 % of girls; p < 0.001) 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. CONCLUSIONS: 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.

[Television watching habits in children in Cantabria]. / Hábito televisivo en los niños de Cantabria.

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, 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) 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.

[Association between lipid profile and Apo E genotype in Spanish children (8-15 years old)]. / Asociación entre el perfil lipídico y genotipo de la apoproteína E en niños españoles (8-15 años).

OBJECTIVE: Different studies conclude that apoprotein E (Apo E) is a genetic determinant of lipid levels and cardiovascular risk, although these studies have been carried out principally in adults, with scarce and variable results available in children. The aim of our study was to analyze the association between lipid profile and the different Apo E isoforms (E2, E3 and E4) in a group of Spanish children. PATIENTS AND METHODS: In a transversal study, apo E genotypes and the lipid profile [total cholesterol (TC), LDL-c, HDL-c, triglycerides (TG), Apo A1, apo B and Lp(a)] were determined in 191 children (110 boys and 81 girls) between 8 and 15 years of age. Apo E genotyping was performed by means of polymerase chain reaction and subsequent digestion with the restriction enzyme HhaI. RESULTS: The relative frequency for the E3, E4 and E2 alleles were 0.87, 0.09 and 0.04, respectively. Total cholesterol, LDL-c and Apo B serum levels were highest in the group of individual with the genotypes E3/E4 and lowest in the group E2/E3, while E3/E3 individuals had intermediate levels. When analyzed according to gender, we only found statistical significance in the group of girls (p < 0.004). CONCLUSIONS: The apo E genotype was significantly associated with lipid differences observed in the childhood population and this is modulated by gender.