The social vulnerability that is associated with food allergy (FA) might predispose children with FA to bullying and harassment. This study sought to quantify the extent, methods, and correlates of bullying in a cohort of food-allergic children.
Patient and parent (83.6% mothers) pairs were consecutively recruited during allergy clinic visits to independently answer questionnaires. Bullying due to FA or for any cause, quality of life (QoL), and distress in both the child and parent were evaluated via questionnaires.
Of 251 families who completed the surveys, 45.4% of the children and 36.3% of their parents indicated that the child had been bullied or harassed for any reason, and 31.5% of the children and 24.7% of the parents reported bullying specifically due to FA, frequently including threats with foods, primarily by classmates. Bullying was significantly associated with decreased QoL and increased distress in parents and children, independent of the reported severity of the allergy. A greater frequency of bullying was related to poorer QoL. Parents knew about the child-reported bullying in only 52.1% of the cases. Parental knowledge of bullying was associated with better QoL and less distress in the bullied children.
Bullying is common in food-allergic children. It is associated with lower QoL and distress in children and their parents. Half of the bullying cases remain unknown to parents. When parents are aware of the bullying, the child's QoL is better. It is important to proactively identify and address cases in this population.
"The guidelines concur about prevention of anaphylaxis recurrences by avoidance of confirmed allergens, including hidden or cross-reacting allergens [2-4,13-15,22,53,64,99,104,105],[107-111]. Vigilant avoidance prevents anaphylaxis recurrence from culprit allergens [107,108]; however, it can be time-consuming, frustrating, difficult to sustain in daily life, and associated with impaired quality-of-life; including bullying of food-allergic children [109-111]. "
[Show abstract][Hide abstract] ABSTRACT: ICON: Anaphylaxis provides a unique perspective on the principal evidence-based anaphylaxis guidelines developed and published independently from 2010 through 2014 by four allergy/immunology organizations. These guidelines concur with regard to the clinical features that indicate a likely diagnosis of anaphylaxis -- a life-threatening generalized or systemic allergic or hypersensitivity reaction.
They also concur about prompt initial treatment with intramuscular injection of epinephrine (adrenaline) in the mid-outer thigh, positioning the patient supine (semi-reclining if dyspneic or vomiting), calling for help, and when indicated, providing supplemental oxygen, intravenous fluid resuscitation and cardiopulmonary resuscitation, along with concomitant monitoring of vital signs and oxygenation. Additionally, they concur that H1-antihistamines, H2-antihistamines, and glucocorticoids are not initial medications of choice.
For self-management of patients at risk of anaphylaxis in community settings, they recommend carrying epinephrine auto-injectors and personalized emergency action plans, as well as follow-up with a physician (ideally an allergy/immunology specialist) to help prevent anaphylaxis recurrences.
ICON: Anaphylaxis describes unmet needs in anaphylaxis, noting that although epinephrine in 1 mg/mL ampules is available worldwide, other essentials, including supplemental oxygen, intravenous fluid resuscitation, and epinephrine auto-injectors are not universally available.
ICON: Anaphylaxis proposes a comprehensive international research agenda that calls for additional prospective studies of anaphylaxis epidemiology, patient risk factors and co-factors, triggers, clinical criteria for diagnosis, randomized controlled trials of therapeutic interventions, and measures to prevent anaphylaxis recurrences. It also calls for facilitation of global collaborations in anaphylaxis research.
In addition to confirming the alignment of major anaphylaxis guidelines, ICON: Anaphylaxis adds value by including summary tables and citing 130 key references. It is published as an information resource about anaphylaxis for worldwide use by healthcare professionals, academics, policy-makers, patients, caregivers, and the public.
World Allergy Organization Journal 05/2014; 7(1):9. DOI:10.1186/1939-4551-7-9
"An in-depth survey of 250 families seen at the Jaffe Institute was completed and initial results published.  One finding was that bullying of food-allergic children is common and is associated with significant decrease in quality of life. Therefore, bullying, along with other salient topics, were later incorporated into a question on the screening questionnaire. "
[Show abstract][Hide abstract] ABSTRACT: The EMPOWER program was launched to provide patient and family-centered care, which includes emotional support and consultation to children who suffer from food allergy and their parents. It resides within the Jaffe Food Allergy Institute in the Department of Pediatrics at the Icahn School of Medicine at Mount Sinai in New York, USA. Patients' perspectives are central to program development. Patient and family feedback has been incorporated into all operational and developmental aspects of the emerging program. This approach is frequently recommended but rarely practiced. [1,2] This manuscript presents the original aims of the program, the way those aims were approached, and the progress to date. Research results, as well as information about programmatic processes, are presented, with the intent of providing useful information to readers who might be interested in creating similar person-centered programs.
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