IgE-mediated cow's milk protein allergy (CMPA) is managed in Ireland using a milk ladder, a method of gradual baked milk introduction. A recent review explored the introduction of baked milk as a treatment for IgE-mediated CMPA and demonstrated that the number of patients who became tolerant to unheated milk during the study periods was greater in the gradual milk introduction group (range 54%–88.1%, mean 62.5%) compared to those who underwent complete avoidance of milk (range 0%–66.7%, mean 21.42%)
Tessa Ah Heng, Caoimhe Cronin, Laura E. Flores et al.
Children with paediatric rheumatic diseases (PRDs) are at increased risk of vaccine-preventable disease. Safe and effective vaccination is central to preventive care in PRD patients; however, uncertainty surrounding immunogenicity and safety has contributed to suboptimal vaccination. The aim of this study was to evaluate treatment effect on immunogenicity to vaccination in PRD patients and assess vaccine safety, specifically adverse events following immunisation (AEFI) and disease flare. Scoping review. In this scoping review, a systematic search of PubMed, CINAHL and Embase databases was conducted from 2014 to 23 August 2022 to identify observational studies evaluating the immunogenicity and safety of commonly used vaccinations in PRD patients. The primary outcome was immunogenicity (defined as seroprotection and protective antibody concentrations), with secondary outcomes describing AEFI and disease flare also extracted. Due to extensive heterogeneity related to diagnostic and vaccination variability, narrative synthesis was used to describe the findings of each study. Study quality was assessed via the Mixed Methods Appraisal Tool. The review was prospectively registered with PROSPERO (CRD42022307212). The search yielded 19 studies evaluating immunogenicity to vaccination and incidence of AEFI and disease flares in this population, which were of acceptable quality. Corticosteroids did not have deleterious effects on vaccine response. Treatment with conventional disease-modifying antirheumatic drugs (DMARDs) and biologic DMARDs generally had no effect immunogenicity in PRD patients. While patients exhibited adequate seroprotection, protective antibody levels were lower in patients on some immunosuppressant agents. Varicella infections were recorded post vaccination in several patients with low protective antibody levels undergoing treatment with DMARDs and corticosteroids. Most vaccines appear safe and effective in PRD patients, despite immunosuppressant treatment. Booster vaccinations should be considered with some studies highlighting inadequate seroprotection following primary course of vaccinations with acceleration of antibody decline over time. There was limited evidence to support avoiding live vaccines in PRD patients.
Jacqueline Cunninghame, Sophie Chien-Hui Wen, Mitchell Dufficy et al.
Online Sexual Exploitation of Children (OSEC) is a rising form of child abuse in the Philippines with significant social, health and wellbeing consequences for survivors. In response, this scoping review was undertaken to advance understanding of the current empirical evidence on OSEC in the Philippines and to identify its characteristics, key drivers and leading intervention and prevention approaches in order to develop improved policy and practice responses. The authors undertook systematic and manual searches of international academic databases and websites to identify empirical peer reviewed research and grey literature studies conducted from 2005 onwards that investigate OSEC in the Philippines. The search located 121 records, of which 19 met all inclusion criteria. The studies identified provide insights into the dominant forms of OSEC and the characteristics of demand-side offenders and survivors, as well as the specific mediums of exploitation and contexts in which OSEC takes place. Key risk factors for OSEC in the Philippines include the vulnerabilities arising from poverty and weak social protection, limited overall understanding of the harms of OSEC, as well as facilitative technology, social media and financial transaction systems. The findings outline that existing evidence on OSEC is insufficient and recommends further research into OSEC prevalence, the socio-cultural contexts that facilitate OSEC, and establishing the efficacy of intervention approaches, suggesting policy responses focus on community-based child safety initiatives.
Abstract Nutrition is of vital importance in the physical, emotional, and intellectual development of children, for retarded academic performance is not the only risk of lack of good food; various health risks that may deform the body system or result in sickness or death are also, not unconnected to consumption of foods devoid of quality and safety. This article aims to assess the food quality and safety among Nigerian school children. A review of related online free-full articles written in the English language published from 2018 to 2022 was done. A consequent title and abstract review of articles published on food quality and safety, and over 1056 published studies identified, they were visualized, profiled, cleansed, prepared, analyzed, and summarized, of which 36 most relevant articles met the inclusion criteria and were utilized for the review. This study found that providing high-quality and safe foods to children is key to achieving sustainable development goals by 2030, and it is in this quest that tremendous educational and health benefits. We also found that the foods served or sold to children in schools are sometimes of low quality and unsafe to satisfy learners’ esthetic or nutritional needs, which have grave consequences for their physical growth, health status, and academic development. In conclusion, there is a need to train and monitor food handlers on food quality and safety in schools in Nigeria.
With the rise of adolescent smartphone use, concerns about teen online safety are also on the rise. A number of parental control apps are available for mobile devices, but adoption of these apps has been markedly low. To better understand these apps, their users, and design opportunities in the space of mobile online safety for adolescents, we have conducted four studies informed by the principles of Value Sensitive Design (VSD). In Study 1 (Chapter 2), we conducted a web-based survey of 215 parents and their teens (ages 13-17) using two separate logistic regression models (parent and teen) to examine the factors that predicted parental use of technical monitoring apps on their teens' mobile devices. Both parent and teen models confirmed that low autonomy granting (e.g., authoritarian) parents were the most likely to use parental control apps. The teen model revealed additional nuances, indicating that teens who were victimized online and had peer problems were more likely to be monitored by their parents. Overall, increased parental control was associated with more (not fewer) online risks. In Study 2 (Chapter 3), we conducted a structured, qualitative feature analysis of 75 Android mobile apps designed for promoting adolescent online safety. We found that the available apps overwhelmingly supported parental control through restriction and monitoring over teen self-regulation or parental active mediation. In Study 3 (Chapter 4), we conducted a qualitative analysis of 736 reviews of 37 mobile online safety apps from Google Play that were publicly posted and written by teens. Our results indicate that teen ratings were significantly lower than that of parents with 76% of the teen reviews giving apps a single star. Teens felt that the apps were overly restrictive and invasive of their personal privacy, negatively impacting their relationships with their parents. For our final study (Chapter 5), we developed a mobile app prototype suggesting alternative designs for keeping teens safe online and conducted a user study which showed that parents and children (ages 10-17) both significantly preferred our new app design over existing parental control apps. Both parents and children reported that our VSD informed design is less privacy-invasive for children and would improve communication and trust relationship between them. Yet, more work needs to be done to improve approaches for risk detection and mediation that support online safety. In summary, this research will enable researchers and designers to create more effective solutions for teen online safety that will help promote more positive parent-teen relationships.
Background In response to a national mpox (formerly known as monkeypox) outbreak in England, children exposed to a confirmed mpox case were offered modified vaccinia Ankara–Bavaria Nordic (MVA-BN), a third-generation smallpox vaccine, for post-exposure prophylaxis. We aimed to assess the safety and reactogenicity and humoral and cellular immune response, following the first reported use of MVA–BN in children. Methods This is an assessment of children receiving MVA–BN for post-exposure prophylaxis in response to a national mpox outbreak in England. All children receiving MVA–BN were asked to complete a post-vaccination questionnaire online and provide a blood sample 1 month and 3 months after vaccination. Outcome measures for the questionnaire included reactogenicity and adverse events after vaccination. Blood samples were tested for humoural, cellular, and cytokine responses and compared with unvaccinated paediatric controls who had never been exposed to mpox. Findings Between June 1 and Nov 30, 2022, 87 children had one MVA–BN dose and none developed any serious adverse events or developed mpox disease after vaccination. Post-vaccination reactogenicity questionnaires were completed by 45 (52%) of 87 children. Their median age was 5 years (IQR 5–9), 25 (56%) of 45 were male, and 22 (49%) of 45 were White. 16 (36%) reported no symptoms, 18 (40%) reported local reaction only, and 11 (24%) reported systemic symptoms with or without local reactions. Seven (8%) of 87 children provided a first blood sample a median of 6 weeks (IQR 6·0–6·5) after vaccination and five (6%) provided a second blood sample at a median of 15 weeks (14–15). All children had poxvirus IgG antibodies with titres well above the assay cutoff of OD 450nm 0·1926 with mean absorbances of 1·380 at six weeks and 0·9826 at 15 weeks post-vaccination. Assessment of reactivity to 27 recombinant vaccina virus and monkeypox virus proteins showed humoral antigen recognition, primarily to monkeypox virus antigens B6, B2, and vaccina virus antigen B5, with waning of humoral responses observed between the two timepoints. All children had a robust T-cell response to whole modified vaccinia Ankara virus and a select pool of conserved pan-Poxviridae peptides. A balanced CD4 + and CD8 + T-cell response was evident at 6 weeks, which was retained at 15 weeks after vaccination. Interpretation A single dose of MVA–BN for post-exposure prophylaxis was well-tolerated in children and induced robust antibody and cellular immune responses up to 15 weeks after vaccination. Larger studies are needed to fully assess the safety, immunogenicity, and effectiveness of MVA–BN in children. Our findings, however, support its on-going use to prevent mpox in children as part of an emergency public health response. Funding UK Health Security Agency.
Shamez N Ladhani, Alexander C. Dowell, Scott Jones et al.
Objective Autism Spectrum Disorder is a neurodevelopmental disorder, with a rapid increase in recognition over the past decade. Interest in alternative therapies is growing annually, such as dietary therapies including gluten-free and/or casein-free diet, and the ketogenic diet. However, there is no consensus on the efficacy and safety of dietary therapy in children with ASD up to now. This study aimed to assess the efficacy and safety of these diet interventions for children with ASD based on a meta-analysis of global data. Methods Seven databases (Cochrane Library, PubMed, EMBASE, Web of Science, VIP, CNKI, and Wanfang) were searched according to the established inclusion criteria, from the inception of the databases to August 18, 2021. The Cochrane Bias risk assessment tool was intended to assess the quality of the included studies. Review Manager 5.4 software was used as an efficacy analysis tool of the included studies, taking the core autistic symptoms and scales of ASD as therapeutic efficacy evaluations. Results In total, 7 RCTs with 338 participants were finally obtained. All studies assessed the association between core autistic symptoms and therapeutic diet, showing a statistically significant effect (standard mean difference (SMD) of −0.51, 95% confidence interval (Cl): −0.81 to −0.21), in which two studies which followed the GFD diet reported significant reductions in social behaviors (SMD of−0.41, 95% Cl: −0.75 to −0.06), showing no correlation with the length of the interventions ( P < 0.05). Two studies were performed in KD diet suggested a significant effect in core symptoms (SMD of −0.67, 95% Cl: −1.04 to −0.31). No statistically significant changes were observed in the GFCF diet, GFD diet, cognition, communication, and stereotypical behaviors subgroups (all P > 0.05). Conclusion The results of a meta-analysis suggest that diet therapies can significantly ameliorate core symptoms of ASD, and GFD diets are conducive to improving social behaviors. Although the results suggest the effectiveness of dietary therapy for ASD, limited by the small sample size of RCTs, more well-designed, and high-quality clinical trials are needed to validate the above conclusions. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/ , identifier: CRD42021277565.
The article is devoted to the analysis of the author’s research: focus groups with parents of children gadget users with access to the Internet (n = 6), the questionnaire survey among adolescents (n = 303) and parents (n = 326) about media consumption, and information security legislation. The new trends and risks in the development of modern child-parent relationships: gadget and Internet addiction, conflicts, decreasing parental control and authority, alternative interaction forms, dangerous content and the consequences of its consumption were identified. The research objectives are to identify the main areas and problems of interaction between parents and children with IT-technology products, zones and consequences of media influence on the parent-child relations and classification of strategies for the Internet safety of children. As a result, the main types of strategies for prevention and liquidation online risks: external (institutional) and internal (intrafamily, intrapersonal), restricting, training and replacing are typologized and presented.
Nose and mouth covering (NMC) has been made compulsory for children in many countries during the Covid-19 pandemic. We wanted to determine the average CO2 levels in inhaled air with NMC in children between age 6 and 17. We used short term measurements under surgical masks and FFP2 masks according to European norm EN 149, compared to baseline in an experimental, intra-individually controlled study over 25 min. CO2 content was measured every 15 s using an automated dual-wavelength infrared CO2 measurement device (G100, Geotech, Leamington Spa, UK) over 25 min in a short-term experimental setting, with children seated. After baseline measurement children were provided with two types of commonly worn NMC: surgical masks and FFP2--masks in randomized sequence for 3 min each. We kept ambient CO2-levels below 1000 parts per million (ppm) through frequent ventilation. We measured breathing frequency and pulse as potential physiological moderator variables. Forty-five children, 25 boys, 20 girls, with a mean age of 10.7 years (standard deviation 2.6) were measured. We measured 13,100 ppm (SD 380) under surgical mask and 13,900 ppm (SD 370) under FFP2 mask in inhaled air. A linear model with age as a covariate showed a highly significant effect of the condition (p < 1*10−9). We measured 2,700 ppm (SD 100) CO2 at pre-baseline and 2,800 ppm (SD 100) at post-baseline, a non-significant small difference. Appropriate contrasts revealed that the change was due to the masks only and the difference between the two types of masks was small and not significant. Wearing of NMC (surgical masks or FFP2- -masks) raises CO2 content in inhaled air quickly to a very high level in healthy children in a seated resting position that might be hazardous to children's health.
Harald Walach, Helmut Traindl, Juliane Prentice et al.
Objectives: Ensuring child online safety is a shared responsibility among parents, children, and educators. This article underscores the collaborative nature of the solution, exploring how parents and teachers can intervene in children’s online safety to ensure responsible digital citizenship among children. Prior work: Despite extensive research (Wright, 2011; Tapscott, 2009), there remains a gap in understanding the effectiveness of parental and teacher involvement across different contexts, particularly in Zimbabwe. Approach: A quantitative research approach was adopted. Two thousand seven hundred eighty children aged 8 to 18 were interviewed, constituting 55% girls and 45% boys across all ten provinces in Zimbabwe. Data was collected using questionnaires. Both descriptive and inferential statistics were used to analyse data. Results: The main finding from the study was that children are more likely to receive help from parents than teachers when faced with online difficulties, explaining good versus bad websites, suggesting safe internet use, guiding online behaviour, and dealing with past online issues. Implications: The results underscore the important role parents play in ensuring children’s online safety in internet use. Value: The findings of this study will be used to develop educational programs and policies that will empower parents and teachers to create a safe digital environment for the younger generation.
Maxwell Sandada, Gift Kalisto Machengete, Rumbidzai Panavanhu et al.
