Influence of a multidisciplinary paediatric allergy clinic on parental knowledge and rate of subsequent allergic reactions

BACKGROUND: Studies have demonstrated that families of children with food allergy have significant deficiencies in their knowledge of how to avoid allergen exposure and how to manage allergic reactions. This study aims to assess the impact of a multidisciplinary paediatric allergy clinic consultation on parental knowledge of food allergy and to determine the rate of subsequent allergic reactions. METHODS: Sixty-two subjects (<17 years) referred with food allergy were prospectively enrolled. Parental knowledge was assessed by questionnaire and EpiPen trainer. Families saw a paediatric allergist, clinical nurse specialist and dietician. Knowledge was reassessed after 3 months and rate of allergic reactions after 1 year. RESULTS: After one visit to the paediatric allergy clinic, there was a significant improvement in parental knowledge of allergen avoidance (26.9%, P < 0.001), managing allergic reactions (185.4%, P < 0.0001) and EpiPen usage (83.3%, P < 0.001). Additionally, there was a significant reduction in allergic reactions (P < 0.001). Children with egg, milk or multiple food allergies were more likely to suffer subsequent reactions. CONCLUSIONS: A single visit to a multidisciplinary allergy clinic considerably improves families' abilities to manage allergic reactions to foods with an accompanying reduction in allergic reactions. Young children with egg, milk or multiple food allergies were at greatest risk of further reactions.     

A coprological survey of parasites of wild carnivores in Ireland

The increasing movement of people to wilderness areas, shrinking of wildlife habitats and the resulting urbanisation of wildlife has led to growing concerns about the transfer of parasitic diseases, particularly from contaminated faeces. Faecal samples from wild carnivores in Ireland were examined for the presence of protozoan and nematode parasites. Red fox (Vulpes vulpes) samples (n?=?91) were positive for Uncinaria stenocephala (38 %), Eucoleus aerophilus (26 %), Toxocara canis (20 %), Trichuris vulpis (4 %) and Isospora-like oocysts (9 %). Badger (Meles meles) samples (n?=?50) were positive for Uncinaria criniformis (40 %), E. aerophilus (6 %) and Isospora-like oocysts (16 %). No parasites were observed in pine marten (n?=?48; Martes martes) faeces. Approximately 5 % of American mink (Mustela vison) samples were positive for Cryptosporidium by polymerase chain reaction (identified as Cryptosporidium andersoni (n?=?3) and ‘mink’ genotype (n?=?1)). The results suggest that wild carnivores in Ireland have a range of parasites, although it is unclear from the present study to what extent these infections are associated with morbidity. While it can be expected that, via their faeces, wild carnivores contribute to the spread of these parasites, they are unlikely the primary source of environmental contamination. Therefore, they should not always be the principal target of control measures.     

Public Health Genomics knowledge and attitudes: A survey of public health educators in the United States

PurposeThis study assessed U.S. public health educators' attitudes toward genomic competencies, their awareness of efforts in the health promotion field to promote/incorporate genomics, and their basic & applied genomic knowledge.MethodsA total of 1607 public health educators, nationwide, responded to a web-based survey.ResultsThe sample comprised predominantly white (76.8%) female (83.9%) participants, with an average age of 40.1 years and 11.2 years of practice in public health education/promotion. Generally, participants had negative attitudes toward genomic competencies, low awareness, and deficient genomic knowledge. Although various socioeconomic characteristics (e.g., ethnicity, gender, and educational level) correlated with participants' attitudes, awareness, and genomic knowledge, training in genetics/genomics or public health genomics also exhibited a positive association. After we controlled for socioeconomic factors, awareness, training, and genomic knowledge remained significantly associated with respondents' attitudes toward genomic competencies.ConclusionAlthough this sample of public health educators had unfavorable attitudes and limited genomic knowledge, training seems to affect these variables. Thus, relevant training for this group of health professionals should be developed and advocated. Continuing education tools, focusing on public health genomics content, might be a venue for delivery of information and the development of favorable professional attitudes.     

南京某大学低年级学生性态度、行为和性健康知识的调查分析

目的了解低年级大学生性态度、行为和性健康知识状况,为高校开展生殖健康教育与服务提供参考。方法参考以往同类型调查和项目自行设计问卷,调查内容包括性态度、性行为、生殖健康知识、性病知识的知晓率和对性健康知识和服务需求状况。结果低年级大学生性态度性别差异大,男生性态度较开放,有性经历的男生（13.9%）明显多于女生（6.4%）,差异有统计学意义（χ2=11.532,P〈0.01）;对于人流危害的认识女生优于男生（P〈0.05）;对AIDS知识的知晓情况男生优于女生（P〈0.05）,但两者对避孕知识及性健康知识掌握均有所不足;男女生性健康知识的获取途径主要为互联网、媒体和同伴;男女生希望提供的服务均依次为知识教育、生殖健康咨询及性病/艾滋病防治知识、避孕方法。结论对大学生进行性健康咨询、性知识教育、性病/艾滋病防治知识及避孕方法知识的教育非常迫切。     

Baseline survey of oral health of primary and secondary school pupils in Uganda

Background

Among the issues that determine the performance of a child at school is health. In recognition of this, the Uganda government has embarked on a school health program for the success of universal primary education. Although dental health is an important component of school health there is little information on it.

Objective

This study aimed at collecting information on dental health of pupils in school for evaluation and planning.

Design

A cross-sectional study using a multistage cluster sampling technique was used to select 685 children attending schools in 5 districts. Children were clinically examined for common illnesses/conditions. The oral examinations were done using simplified versions of Decayed, Missing, and Filled teeth (DMFT) index and Community Periodontal Index (CPI). Oral examinations also assessed presence of fluorosis.

Results

The pupils attending school were aged from 5 to 22 years. Sixty six percent (456) were found to be caries free with a group DMFT of 0.7. The D-component (decay) accounted for approximately 70% of the cases. Fifty nine percent of the pupils were found to have a healthy periodontium. Sixteen percent of the pupils were found to have some degree of fluorosis of whom the majority were from the highland districts of Kabale and Mbale. Urban school pupils were more likely to have caries (OR 1,69; 95% CI 1.21–2.37) than the rural.

Conclusion

There is an upward trend in the caries prevalence when compared to studies done earlier. This study revealed a need to develop preventive programs alongside improvement of dental health services.     

Attitude,knowledge and habits of high school pupils in Israel regarding oral health

The purpose of this project was to study the habits, knowledge and attitudes of 132 high school students in regards to their teeth and oral health. An inflated amount of consumption of snack food and sweet beverages between meals was reported. Seventy-two point seven percent claimed to brush their teeth at least twice daily. Forty-nine point three percent claimed to visit their dentist annually. The results also demonstrated a poor general knowledge and misconceptions concerning teeth, food and oral health throughout the years of high school studies. Knowledge levels correlated with with age. More than half of the pupils attributed esthetical importance to the teeth appearance. The students' knowledge concerning prevention stemmed mainly from their dentist, parents, and the media and only 2.6% learned anything from formal school teaching. In the light of the students' poor knowledge, it would appear that resources should be invested in schools at the elementary and high school level for oral hygiene and caries prevention education in the hope of improving bad habits and perpetuating improved oral health and hygiene.     

Social capital and self-rated health in the Republic of Ireland: evidence from the European Social survey

This paper analyses the determinants of self-reported health in Ireland, conditioning self-reported health on a set of socio-economic, labour market and social capital variables. Ireland has the highest self-reported health rate in Europe, a finding backed-up by other studies. Data were derived from the 2002 and 2005 European Social survey. The full 87,915 observations from both rounds were pooled and used to estimate mean self-rated health across Europe. The Irish data were isolated, totalling 2,049 individuals for 2002 and 2,286 individuals for 2005. The 2002 data were used to analyse the determinants of subjective health state, as it had a richer array of social capital variables. The results demonstrate statistically significant effects of income on self-reported health that are robust to different statistical specifications and statistically significant though modest effects of social capital variables such as associational membership and frequency of social meeting and labour market variables such as being on a limited as opposed to permanent contract.     

Ethics and Society: A survey of parental attitudes toward oocyte donation

A questionnaire was sent to couples who had successfully completedoocyte donation cycles to survey their experiences and makesuggestions to others considering this option. A majority ofcouples were successful in their first cycle, despite advancedmaternal age or length of time attempting conception. A preferencefor non-anonymous arrangements was highlighted, despite theunknown long-term impact, and the importance of finding supportwas stressed. Respondents indicated no confusion about theirrole as parents of children conceived through oocyte donation.     

Social and health capital in Northern Ireland

This paper will discuss findings from Department of Health, Northern Ireland, (DHSSNI) funded ethnographic research which looked at health and the assessment of related need in two small rural towns in Northern Ireland (one Catholic and one Protestant). The initial study conducted in 1996-7 addressed a series of interrelated issues which influenced health and health status. This included detailing local resources, perceived needs, local cultural practices, health beliefs (lay and professional) and health behaviours. A primary reading of the data suggested that, in terms of major health concerns, health perceptions and health problems, the similarities in both communities were more striking than observed differences. This discussion presents findings from a closer analysis of the data. It suggests that over and above structural and environmental considerations, there was a complex interaction of influences on health and social well-being for both communities and it suggests important differences.     

An inter-laboratory survey of paediatric bilirubin analyses.

A regional quality control trial of paediatric bilirubin analyses is described. The overall performance of the group was unsatisfactory with an unacceptably high inter-laboratory variation. The use of a common standard produced improvement in performance but it is concluded that the poor performance was also due to methodological problems. This lack of agreement between laboratories is a major problem when patients are transferred between hospitals.     

A follow-up survey of family physicians' interest in and knowledge of nutrition

Forty-two practicing family physicians completed a questionnaire about 33 nutrition topic areas. They were among 71 physicians who, over an eight-year period (1980-1988), completed an identical questionnaire upon entry to their first postgraduate year in the family practice residency program at Brown University/Memorial Hospital of Rhode Island. Specific topic areas were grouped into five scales. Perceived knowledge of these topics significantly increased (p less than .0001) in all areas except nutritional biochemistry. There was significantly less (p less than .0001) interest in learning more about nutrition. One major exception was that the physicians wanted to learn more about nutrition counseling. Another exception was that nutrition in the life cycle remained an area about which they wanted to learn more. The physicians rated nutritional skills as less relevant on the second questionnaire than on the first. The authors conclude that more emphasis on nutrition counseling skills and nutrition in the life cycle may be appropriate in medical education.     

A survey of antibiotic prescribing and knowledge of penicillin allergy.

BACKGROUND: Cephalosporins can cause allergic reactions in patients with penicillin (PCN) allergy. Physicians' prescribing habits for patients with PCN allergy can vary. OBJECTIVES: 1) Survey community and academic physicians, students, residents, and allergists on their tendencies to prescribe cephalosporins and/or perform PCN skin testing in patients with different histories of PCN allergy. 2) Evaluate PCN allergy knowledge in these groups. METHODS: A questionnaire consisting of four case scenarios and five true/false questions on PCN allergy was distributed at various conferences and by mailings. RESULTS:Three hundred seventy-eight completed surveys were analyzed. Given a patient with a history of rash with PCN, an equal number of allergists and nonallergists (36%) prescribed cephalosporins, although there was a difference between pediatricians (56%) and internists (22%). Given a history of PCN anaphylaxis, no allergists but 11% of nonallergists prescribed a cephalosporin. Skin testing was infrequently requested by nonallergists. The correct response rate for the true/false questions was 89% for allergists, community (63%) and academic (67%) physicians, pediatricians (61%), internists (67%), residents (68%), and students (68%). Pediatric residents had the highest (74%) and community pediatricians the lowest (59%) correct response rate. CONCLUSIONS: There is marked variation in prescribing cephalosporins and in requesting PCN skin testing in patients with varied histories of PCN allergy. The survey results indicate a need for increased PCN allergy education.