Food allergy in children: accidental exposure and management in school
Bibliographic record
Abstract
BackgroundFood allergy management relies mainly on avoidance and appropriate treatment of severe reactions (anaphylaxis) with epinephrine. Accidental exposure remains a concern, and may occur in school, where allergic children must rely on school personnel to recognize and treat their reaction with an epinephrine auto-injector such as the EpiPen®. Methods used to solicit participation in a study to assess the ability of school personnel to use the EpiPen® may introduce selection bias. Objectives 1) To determine the annual incidence, characterize the severity and management, and identify predictors of accidental exposure among a cohort of children with peanut allergy. 2) To determine if the consent process introduces selection bias by comparing 2 methods of soliciting the participation of Quebec school personnel in a study evaluating their ability to use the EpiPen® and identify anaphylaxis. Methods 1) Parents of Canadian children with peanut allergy completed questionnaires about accidental exposures over the preceding year. 2) School personnel from randomly selected schools in Quebec were approached using 1) a partial disclosure or 2) a full disclosure approach, and were assessed on their ability to use the EpiPen® and to identify anaphylaxis. Results 1) 1411 children participated in the 1st study: an annual incidence rate of accidental exposure of 12.5% was found. Age ≥13 years at study entry and a severe previous reaction to peanut were associated with an increased risk of accidental exposure, and increasing disease duration with a decreased risk. 2) 343 school personnel participated in the 2nd study. The participation rate was higher in schools with a partial disclosure approach. Participants from the full disclosure group were more likely to have a perfect score, and were more able to identify 3 signs of anaphylaxis. Discussion The annual incidence rate of accidental exposure for children with peanut allergy is 12.5%. Children with a recent diagnosis and adolescents being at higher risk, education of allergic children and their families is crucial immediately after diagnosis and during adolescence. Accidental exposures occur in school; adequate treatment of anaphylactic reactions by school personnel is important. Despite training, school personnel perform poorly when asked to demonstrate the EpiPen® technique. The quality and frequency of anaphylaxis training programs have to be re-examined. As the process of consent can influence participation and bias outcomes, researchers and Ethics Boards may need to consider conditions under which studies can proceed without full consent.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".