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1. 10 practical priorities to prevent and manage serious allergic reactions: GA2LEN ANACare and EFA Anaphylaxis Manifesto

Author: Antonella Muraro, Debra de Silva, Marcia Podesta, Aikaterini Anagnostou, Victoria Cardona, Susanne Halken, Pete Smith, Luciana Kase Tanno, Paul Turner, Margitta Worm, Montserrat Alvaro‐Lozano, Stefania Arasi, Anna Asarnoj, Simona Barni, Kirsten Beyer, Lucy A. Bilaver, Andrew Bird, Roberta Bonaguro, Helen A. Brough, R. Sharon Chinthrajah, Emma E. Cook, Céline Demoulin, Antoine Deschildre, Timothy E. Dribin, Motohiro Ebisawa, Montserrat Fernandez‐Rivas, Alessandro Fiocchi, David M. Fleischer, Eleanor Garrow, Jennifer Gerdts, Mattia Giovannini, Kirsi M. Järvinen, Mary Kelly, Edward F. Knol, Gideon Lack, Francesca Lazzarotto, Thuy‐My Le, Stephanie Leonard, Jay Lieberman, Michael Makris, Lianne Mandelbaum, Mary Jane Marchisotto, Gustavo Andres Marino, Francesca Mori, Caroline Nilsson, Anna Nowak‐Wegrzyn, Mikaela Odemyr, H. N. G. Oude Elberink, Kati Palosuo, Nandinee Patel, Jennifer Pier, Sung Poblete, Rima Rachid, Pablo Rodríguez del Río, Maria Said, Hugh A. Sampson, Angel Sánchez Sanz, Sabine Schnadt, Fallon Schultz, Alice Toniolo, Julia E. M. Upton, Carina Venter, Brian P. Vickery, Berber Vlieg‐Boerstra, Julie Wang, Graham Roberts, Torsten Zuberbier, and GA2LEN ANACare Centres and EFA
Subjects: adrenaline, allergy, anaphylaxis, hypersensitivity, Immunologic diseases. Allergy, RC581-607
Abstract: Abstract This Anaphylaxis Manifesto calls on communities to prioritise 10 practical actions to improve the lives of people at risk of serious allergic reactions. The Global Allergy and Asthma European Network and the European Federation of Allergy and Airways Diseases Patients' Associations (EFA) compiled patient‐centric priorities. We used qualitative consensus methods, research evidence and feedback from over 200 patient groups, stakeholder organisations and healthcare professionals. We encourage healthcare, education and food organisations to collaborate with people at risk of serious allergic reactions to tackle safety, anxiety and financial burdens for individuals and societies. Key priorities for prevention include awareness‐raising campaigns for the public and professionals, school and workplace initiatives and mandatory precautionary allergen labels on food. Priorities for improving immediate and long‐term management include educating healthcare professionals, patients and schools about when and how to use adrenaline, funding two approved adrenaline devices for everyone at risk, and facilitating access to allergy specialists. Integrated care pathways should include clinical and non‐clinical management options such as individualised risk assessment and quality of life assessment, self‐management plans, dietetic and psychosocial support and peer support. Organisations around the world are committing to work together towards these priorities.
Published: 2024
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2. Parents’ practices, feelings, and support needs surrounding the development of food allergy literacy (FAL) in children before their transition to school

Author: Prathyusha Sanagavarapu, Ann Dadich, and Maria Said
Subjects: Children's food allergy, Parent/Family, Chronic diseases, Food allergy literacy, Early childhood/early intervention, Child health, Science (General), Q1-390, Social sciences (General), H1-99
Abstract: Children's knowledge of food allergy and risk prevention, coined as food allergy literacy (FAL), can bolster their safety in schools. Addressing research gaps on this topic, especially, parents' role, the aim of this study was to investigate Australian parents' practices, feelings, and support needs relating to building children's FAL before their transition to school. Questionnaire data from 159 parents were analysed statistically to characterise the sample and explore the association between children's FAL, parent anxiety, and parent confidence in their child's ability to stay safe at school. Results indicated that parents supported children's knowledge of food allergy and risk prevention using age and developmentally appropriate pedagogies. However, they focused less on building children's skills to read food labels, communicate symptoms, and seek help. Furthermore, the association between children's FAL and parents' feelings about children's safety in school was weak. However, the association between the child's FAL and parents' confidence in the child's ability to stay safe at school was moderate-to-strong. The implications of these findings for educators are discussed.
Published: 2024
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3. Investigating health care pathways for anaphylaxis: Seeing the bigger picture through linked data

Author: Samantha L. Stiles, MPH, Frank M. Sanfilippo, PhD, Kevin Murray, PhD, Richard Loh, FRACP, Maria Said, RN, Rhonda M. Clifford, PhD, Sandra L. Vale, PhD, and Sandra M. Salter, PhD
Subjects: Anaphylaxis, linked data, care pathway, Australia, Immunologic diseases. Allergy, RC581-607
Abstract: Background: Anaphylaxis is increasing in Australia involving all levels of the health care system. Although guidelines recommend calling an ambulance and 4-hour observation, knowledge gaps exist regarding where people experiencing anaphylaxis receive care. Objective: We sought to examine care pathways for anaphylaxis in Western Australia and factors associated with seeking care from ambulance versus the emergency department (ED), and subsequent hospital admission. Methods: A cross-sectional study was undertaken using linked ambulance, ED, hospital, and mortality data. The proportion of anaphylaxis events following each care pathway from 2010 to 2017 was examined. Multivariable logistic regression was used to determine factors associated with ambulance versus ED as the first point of care, with additional models to determine risk of admission. Results: Most of the 16,456 anaphylaxis events followed 6 distinct care pathways. ED was first point of care in 9,713 (59.0%) events; ambulance in 5,926 (36.0%); and hospital in 817 (5.0%). Factors associated with ambulance attendance compared with ED were metropolitan region (odds ratio [OR], 3.00; 95% CI, 2.70-3.34), age more than 65 years (OR, 2.98; 95% CI, 2.54-3.50), and anaphylaxis occurring during the day (OR, 1.31; 95% CI, 1.21-1.42). Risk of subsequent hospitalization was associated with food trigger in ED (OR, 1.52; 95% CI, 1.11-2.07), age more than 65 years (OR, 1.48; 95% CI, 1.24-1.77), children younger than 5 years (OR, 1.24; 95% CI, 1.08-1.41), and history of cancer (OR, 1.36; 95% CI, 1.18-1.56). Conclusions: Most people experiencing anaphylaxis present directly to ED; however, ambulance care is still substantial and around half the events involved observation in the hospital. Discrepancies in recording of anaphylaxis across linked data sets highlight gaps in current burden data, supporting the need for improved reporting.
Published: 2025
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4. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines update – XVI - Nutritional management of cow's milk allergy

Author: Carina Venter, Rosan Meyer, Marion Groetch, Anna Nowak-Wegrzyn, Maurizio Mennini, Ruby Pawankar, Rose Kamenwa, Amal Assa'ad, Shriya Amara, Alessandro Fiocchi, Antonio Bognanni, Ignacio Ansotegui, Stefania Arasi, Sami L. Bahna, Roberto Berni Canani, Martin Bozzola, Jan Brozek, Derek Chu, Lamia Dahdah, Christophe Dupont, Motohiro Ebisawa, Ramon T. Firmino, Elena Galli, Gideon Lack, Haiqi Li, Alberto Martelli, Nikolas G. Papadopoulos, Maria Said, Mario Sánchez-Borges, Holger Schunemann, Raanan Shamir, Jonathan Spergel, Hania Szajewska, Luigi Terracciano, Yvan Vandenplas, Susan Waserman, Amena Warner, and Gary W.K. Wong
Subjects: Cow's milk allergy, Nutrition, Baked milk, Hypoallergenic formulas, Plant based alternatives, Immunologic diseases. Allergy, RC581-607
Abstract: Cow's milk allergy (CMA) is one of the most common presentations of food allergy in early childhood. Management of CMA involves individualized avoidance of cow's milk and other mammalian milk and foods containing these. Optimal elimination of cow's milk avoidance includes: label reading; information about safe and nutritious substitute foods; appropriate choice of infant formula or a plant-based food; establishing tolerance to baked milk and monitoring nutritional intake and growth. Substitute formulas are divided into soy formula (not hydrolyzed), milk-based extensively hydrolyzed formulas, rice based extensive, and partially hydrolyzed formulas and amino acid-based formulas. The use of other mammalian milks is not recommended for the management of cow's milk allergy due to a high level of cross-reactivity and nutritional concerns. For toddlers who are eating well, children, and adults, a suitable plant-based beverage may be a suitable alternative to a specialized formula, following careful nutritional considerations. Families need to be instructed on finding suitable nutritious foods and how to prepare suitable meals at home. Individuals with CMA also need to know how to identify and treat acute severe reactions.
Published: 2024
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5. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guideline update – XII – Recommendations on milk formula supplements with and without probiotics for infants and toddlers with CMA

Author: Antonio Bognanni, MD, PhD (c), Alessandro Fiocchi, MD, Stefania Arasi, MD, MSc, PhD, Derek K. Chu, MD, PhD, Ignacio Ansotegui, MD, PhD, Amal H. Assa'ad, MD, Sami L. Bahna, MD, DrPH, Roberto Berni Canani, MD, PhD, Martin Bozzola, MD, Lamia Dahdah, MD, Christophe Dupont, MD, PhD, Piotr Dziechciarz, MD, PhD, Motohiro Ebisawa, MD, PhD, Ramon T. Firmino, MD, Alexandro Chu, BHSc(Hons), Elena Galli, MD, PhD, Andrea Horvath, MD, PhD, Rose Kamenwa, MD, Gideon Lack, MBBCh, Haiqi Li, MD, Alberto Martelli, MD, Anna Nowak-Węgrzyn, MD, PhD, Nikolaos G. Papadopoulos, MD, PhD, Ruby Pawankar, MD, PhD, Yetiani Roldan, MD, Maria Said, RN, Mario Sánchez-Borges, MD, Raanan Shamir, MD, PhD, Jonathan M. Spergel, MD, PhD, Hania Szajewska, MD, Luigi Terracciano, MD, Yvan Vandenplas, MD, PhD, Carina Venter, PhD, RD, Siw Waffenschmidt, PhD, Susan Waserman, MD, MSc, Amena Warner, RN, SN (PG Dip), Gary W.K. Wong, MD, Holger J. Schünemann, MD, MSc, PhD, and Jan L. Brozek, MD, PhD
Subjects: Milk allergy, Milk replacement formulas, Probiotics, Clinical practice guidelines, GRADE, Immunologic diseases. Allergy, RC581-607
Abstract: Background: Cow's milk allergy (CMA) is the most common food allergy in infants. The replacement with specialized formulas is an established clinical approach to ensure adequate growth and minimize the risk of severe allergic reactions when breastfeeding is not possible. Still, given the availability of multiple options, such as extensively hydrolyzed cow's milk protein formula (eHF-CM), amino acid formula (AAF), hydrolyzed rice formula (HRF) and soy formulas (SF), there is some uncertainty as to the most suitable choice with respect to health outcomes. Furthermore, the addition of probiotics to a formula has been proposed as a potential approach to maximize benefit. Objective: These evidence-based guidelines from the World Allergy Organization (WAO) intend to support patients, clinicians, and others in decisions about the use of milk specialized formulas, with and without probiotics, for individuals with CMA. Methods: WAO formed a multidisciplinary guideline panel balanced to include the views of all stakeholders and to minimize potential biases from competing interests. The McMaster University GRADE Centre supported the guideline-development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used, including GRADE Evidence-to-Decision frameworks, which were subject to review by stakeholders. Results: After reviewing the summarized evidence and thoroughly discussing the different management options, the WAO guideline panel suggests: a) using an extensively hydrolyzed (cow's milk) formula or a hydrolyzed rice formula as the first option for managing infants with immunoglobulin E (IgE) and non-IgE-mediated CMA who are not being breastfed. An amino-acid formula or a soy formula could be regarded as second and third options respectively; b) using either a formula without a probiotic or a casein-based extensively hydrolyzed formula containing Lacticaseibacillus rhamnosus GG (LGG) for infants with either IgE or non-IgE-mediated CMA.The issued recommendations are labeled as “conditional” following the GRADE approach due to the very low certainty about the health effects based on the available evidence. Conclusions: If breastfeeding is not available, clinicians, patients, and their family members might want to discuss all the potential desirable and undesirable consequences of each formula in infants with CMA, integrating them with the patients' and caregivers’ values and preferences, local availability, and cost, before deciding on a treatment option. We also suggest what research is needed to determine with greater certainty which formulas are likely to be the most beneficial, cost-effective, and equitable.
Published: 2024
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6. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines update – X – Breastfeeding a baby with cow's milk allergy

Author: Vicki McWilliam, PhD, AdvAPD, Merryn J. Netting, PhD, BSc, BND, Evelyn Volders, PhD, AdvAPD, Debra J. Palmer, PhD, BSc, BND, Ignacio Ansotegui, Stefania Arasi, Amal H. Assa'ad, Sami L. Bahna, Roberto Berni Canani, Antonio Bognanni, Martin Bozzola, Jan Brozek, Derek Chu, Lamia Dahdah, Christophe Dupont, Piotr Dziechciarz, Motohiro Ebisawa, Ramon T. Firmino, Alessandro Fiocchi, Elena Galli, Rose Kamenwa, Gideon Lack, Haiqi Li, Alberto Martelli, Anna Nowak-Węgrzyn, Nikolas G. Papadopoulos, Ruby Pawankar, Maria Said, Mario Sánchez-Borges, Holger Schunemann, Raanan Shamir, Jonathan Spergel, Hania Szajewska, Luigi Terracciano, Yvan Vandenplas, Susan Waserman, Carina Venter, Amena Warner, and Gary W.K. Wong
Subjects: Breastfeeding, Infant, IgE-mediated cow's milk allergy, Non-IgE-mediated cow's milk allergy, Maternal nutrition, Immunologic diseases. Allergy, RC581-607
Abstract: Cow's milk allergy is rare in exclusively breastfed infants. To support the continuation of breastfeeding an infant after diagnosis with a cow's milk allergy, it is critical to examine the evidence for and against any form of cow's milk elimination diet for lactating mothers. In this narrative review, we highlight the lack of high-quality evidence, hence subsequent controversy, regarding whether the minuscule quantities of cow's milk proteins detectable in human milk cause infant cow's milk allergy symptoms. Current clinical practice recommendations advise a 2–4 week trial of maternal cow's milk dietary elimination for: a) IgE-mediated cow's milk allergy only if the infant is symptomatic on breastfeeding alone; b) non-IgE-mediated associated symptoms only if the history and examination strongly suggest cow's milk allergy; and c) infants with moderate to severe eczema/atopic dermatitis, unresponsive to topical steroids and sensitized to cow's milk protein. There should be a clear plan for home reintroduction of cow's milk into the maternal diet for a period of 1 week to determine that the cow's milk elimination is responsible for resolution of symptoms, and then subsequent reoccurrence of infant symptoms upon maternal cow's milk reintroduction. The evidence base to support the use of maternal cow's milk avoidance for the treatment of a breastfed infant with cow's milk allergy is of limited strength due to a lack of high-quality, adequately powered, randomised controlled trials. It is important to consider the consequences of maternal cow's milk avoidance on reducing immune enhancing factors in breast milk, as well as the potential nutritional and quality of life impacts on the mother. Referral to a dietitian is advised for dietary education, along with calcium and vitamin D supplementation according to local recommendations, and a maternal substitute milk should be advised. However, for most breastfed infants with cow's milk allergy maternal cow's milk dietary elimination will not be required, and active support of the mother to continue breastfeeding is essential.
Published: 2023
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7. Contemporary trends in anaphylaxis burden and healthcare utilisation in Western Australia: A linked data study

Author: Samantha L. Stiles, BSc, MID, MPH, PhD Candidate, Frank M. Sanfilippo, BSc, BPharm, PGradDipPharm PhD, Richard Loh, KS., MBBS, FRACP, Maria Said, RN, Rhonda M. Clifford, BPharm, GradDipHospPharm, PhD, and Sandra M. Salter, BPharm, PGradDipPharm, PhD
Subjects: Anaphylaxis, Epidemiology, Linked data, Trends, Australia, Immunologic diseases. Allergy, RC581-607
Abstract: Background: Anaphylaxis is a growing public health problem in Australia. To determine the extent of the problem, we linked multiple health datasets to examine temporal trends in anaphylaxis events across the health system in Western Australia (WA). Methods: We identified an anaphylaxis cohort from 1980 to 2020 using linked datasets from ambulance, emergency departments, hospital inpatients and deaths. Age-standardised anaphylaxis event rates were calculated from 2010 to 2020. Dataset-specific rates for anaphylaxis were also examined, to show differences in health care utilisation. Annual percent change in rates (2010–2019) were estimated using age-adjusted Poisson regression models. Results: A total of 19 140 individuals (mean age 31 years; 51% female) experienced 24 239 anaphylaxis events between 2010 and 2020. From 2010 to 2019, the average annual percent increase (95% CI) in rates was 5.3% (4.8–5.8%), from 70.3 to 113.9, with rates reducing to 76.5/100 000 population in 2020. Adolescents and young adults aged 5–14 years and 15–24 years had the greatest increase of 6.9% (5.6–8.1%) and 6.8% (5.6–8.0) respectively, with those over 25 years increasing by approximately 5% per year and children 1–4 years showing the lowest annual increase of 2.6% (1.1–4.2%). The highest absolute rates were seen in under 1 year (269.7/100 000; 2019). There has been an acceleration of trends from 2015 to 2019, underpinned by large increases in 15–24 and 25–34 years. All databases, show similar increasing trends, with ambulance attendance (33.7 per 100 000), emergency presentation (89.8 per 100 000) and hospital admissions (46.2 per 100 000), for anaphylaxis highest in 2019. However, whilst ambulance and emergency presentations have grown by 8.9% (95%CI 7.9–9.8%) and 6.6% per year (95%CI 6.0–7.2%), respectively, hospitalisations appear to be steadying with only a 0.9% (95%CI 0.2–1.6%) yearly rise. Conclusion: Rates of anaphylaxis continue to increase, with WA having higher rates than previous estimates for Australia. Whilst rates are still high in infants, lower trends in children compared to older ages may indicate better prevention of allergy. Results show more people experiencing anaphylaxis now receive care in emergency and ambulance, rather than hospital. Further exploration of the patient care journey through prehospital and inpatient care is required, to understand the changing health demands of people who experience anaphylaxis.
Published: 2023
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8. Nip allergies in the Bub: a qualitative study for a public health approach to infant feeding for allergy prevention

Author: Sandra L. Vale, Ingrid Roche, Merryn Netting, Maria Said, Preeti Joshi, Rhonda Clifford, Dianne E. Campbell, and Sandra M. Salter
Subjects: focus groups, infant feeding, food allergy prevention, Public aspects of medicine, RA1-1270
Abstract: Abstract Objective: To identify a brand, key messages and resources to underpin a public health approach to food allergy prevention. Methods: A focus group design was used to explore perceptions and opinions of potential brands, infant feeding messages and resources for providing standardised food allergy prevention information. Focus groups were conducted in February 2018 using interview guides and were transcribed verbatim. A content analysis of the transcripts was undertaken using thematic analysis software. The University of Western Australia provided ethics approval: RA/4/20/4280. Results: Seven focus groups with 39 participants were conducted. Four slogans and styles of imagery were considered. ‘Nip Allergies in the Bub’ was the most favoured slogan and images of babies with food were most favoured. Participant feedback was sought regarding messages and supporting messages were considered important. Participants were consulted about useful resources and a website was identified. Conclusions: Conducting focus groups assisted the selection of a brand, messages and resources to underpin a public health approach to implementing allergy prevention guidelines. Implications for public health: This is the first focus group research undertaken for food allergy prevention. Identification of a meaningful brand, key messages and resources will support a public health approach to implementing allergy prevention guidelines.
Published: 2022
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9. WAO consensus on DEfinition of Food Allergy SEverity (DEFASE)

Author: Stefania Arasi, MD, PhD, MSc, Ulugbek Nurmatov, MD, Audrey Dunn-Galvin, PhD, Graham Roberts, DM, Paul J. Turner, FRCPCH, PhD, Sayantani B. Shinder, MD, PhD, Ruchi Gupta, MD, MPh, Philippe Eigenmann, MD, Anna Nowak-Wegrzyn, MD, PhD, Ignacio J. Ansotegui, MD, PhD, Montserrat Fernandez Rivas, MD, Stavros Petrou, PhD, Luciana K. Tanno, MD, PhD, Marta Vazquez-Ortiz, MD, PhD, Brian Vickery, MD, PhD, Gary Wong, MD, FRCPC, Montserrat Alvaro-Lozano, MD, PhD, Miqdad Asaria, PhD, Philippe Begin, MD, MSc, Martin Bozzola, MD, Robert Boyle, MD, Helen Brough, MD, PhD, Victoria Cardona, MD, PhD, R. Sharon Chinthrajah, MD, PhD, Antonella Cianferoni, MD, Antoine Deschildre, MD, David Fleischer, MD, Flavio Gazzani, PhD, Jennifer Gerdts, Marilena Giannetti, PhD, Matthew Greenhawt, MD, MBA, MSc, Maria Antonieta Guzmán, MD, Elham Hossny, MD, PhD, FAAAAI, Paula Kauppi, MD, Carla Jones, Francesco Lucidi, PhD, Olga Patricia Monge Ortega, MD, PhD, Daniel Munblit, MD, PhD, Antonella Muraro, MD, Giovanni Pajno, MD, Marcia Podestà, Pablo Rodriguez del Rio, MD, PhD, Maria Said, Alexandra Santos, MD, MSc, MRCPCH, PGCAP, FHEA, PhD, Marcus Shaker, MD, Hania Szajewska, MD, PhD, Carina Venter, PhD, Cristopher Warren, PhD, Tonya Winders, Motohiro Ebisawa, MD, PhD, and Alessandro Fiocchi, MD
Subjects: Consensus, Definition, Food allergy, Severity, e-Delphi study, Immunologic diseases. Allergy, RC581-607
Abstract: Background: While several scoring systems for the severity of anaphylactic reactions have been developed, there is a lack of consensus on definition and categorisation of severity of food allergy disease as a whole. Aim: To develop an international consensus on the severity of food allergy (DEfinition of Food Allergy Severity, DEFASE) scoring system, to be used globally. Methods: Phase 1: We conducted a mixed-method systematic review (SR) of 11 databases for published and unpublished literature on severity of food allergy management and set up a panel of international experts. Phase 2: Based on our findings in Phase 1, we drafted statements for a two-round modified electronic Delphi (e-Delphi) survey. A purposefully selected multidisciplinary international expert panel on food allergy (n = 60) was identified and sent a structured questionnaire, including a set of statements on different domains of food allergy severity related to symptoms, health-related quality of life, and economic impact. Participants were asked to score their agreement on each statement on a 5-point Likert scale ranging from “strongly agree” to “strongly disagree”. Median scores and percentage agreements were calculated. Consensus was defined a priori as being achieved if 70% or more of panel members rated a statement as “strongly agree” to “agree” after the second round. Based on feedback, 2 additional online voting rounds were conducted. Results: We received responses from 92% of Delphi panel members in round 1 and 85% in round 2. Consensus was achieved on the overall score and in all of the 5 specific key domains as essential components of the DEFASE score. Conclusions: The DEFASE score is the first comprehensive grading of food allergy severity that considers not only the severity of a single reaction, but the whole disease spectrum. An international consensus has been achieved regarding a scoring system for food allergy disease. It offers an evaluation grid, which may help to rate the severity of food allergy. Phase 3 will involve validating the scoring system in research settings, and implementing it in clinical practice.
Published: 2023
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10. Welcome back Kotter–Developing a National Allergy strategy for Australia

Author: Sandra L. Vale, BSc, Maria Said, RN, Jill Smith, BSc, Preeti Joshi, PhD, and Richard KS. Loh, FRACP
Subjects: National Allergy Strategy, Funding, Kotter's Change Model, Allergy, Strategy, Advocacy, Immunologic diseases. Allergy, RC581-607
Abstract: Background: Allergic diseases have become an increasing health issue worldwide, being one of the fastest growing chronic diseases in Australia and other westernized countries. In 2013, allergic diseases were reported to affect 20% of the Australian population. Despite the high prevalence there was no national strategy to address these complex health issues, to enable the health system to manage the increasing number of patients. This project aimed to develop and implement a national strategy to improve allergy management in Australia, with a view of improving the quality of life of people living with or caring for someone with allergic diseases. Methods: The need for a national strategy to improve allergy management was identified. The Australasian Society of Clinical Immunology and Allergy (ASCIA) and Allergy & Anaphylaxis Australia (A&AA) worked together as partners to progress a national strategy using a theoretical model to underpin its development. Unrestricted education grants were sought to fund engagement with stakeholder organizations for both development and implementation summits. Several stages of advocacy were undertaken. Results: The National Allergy Strategy was developed as a partnership between ASCIA and A&AA. The Kotter's Change Management Model provided the basis for the steps undertaken to develop and implement the National Allergy Strategy. Two Allergy Summits, one for development and the other for implementation, were held. Several events were held to advocate for federal government funding. Five individual funding grants were achieved to implement National Allergy Strategy projects addressing the most urgent issues. Conclusion: The development of the National Allergy Strategy, a partnership between ASCIA and A&AA, was important in enabling successful advocacy for funding and implementation of important Australia-wide projects. The partnership has also helped facilitate engagement with key stakeholders to help advocate for funding and provide guidance and expertise in project implementation and resource development. The National Allergy Strategy has been successful in attracting funding to implement projects and develop resources urgently needed. The National Allergy Strategy has also provided a framework and a collaborative approach, for advocacy for further funding and future work to be undertaken.
Published: 2022
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11. Managing food allergy: GA2LEN guideline 2022

Author: Antonella Muraro, MD, Debra de Silva, PhD, Susanne Halken, DM DMSc, Margitta Worm, MD∗, Ekaterina Khaleva, MD MSc, Stefania Arasi, MD PhD, Audrey Dunn-Galvin, PhD, Bright I. Nwaru, PhD, Nicolette W. De Jong, PhD, Pablo Rodríguez Del Río, MD PhD, Paul J. Turner, FRCPCH PhD, Pete Smith, FRACP PhD, Philippe Begin, MD MSc, Elizabeth Angier, MSc, Hasan Arshad, DM, Barbara Ballmer-Weber, PhD, Kirsten Beyer, MD, Carsten Bindslev-Jensen, MD PhD DSc, Antonella Cianferoni, MD PhD, Céline Demoulin, Antoine Deschildre, MD, Motohiro Ebisawa, MD PhD, Maria Montserrat Fernandez-Rivas, DM PhD, Alessandro Fiocchi, MD, Bertine Flokstra-de Blok, PhD, Jennifer Gerdts, Josefine Gradman, MD, Kate Grimshaw, PhD, Carla Jones, Susanne Lau, MD, Richard Loh, FRACP, Montserrat Alvaro Lozano, MD, Mika Makela, MD PhD, Mary Jane Marchisotto, Rosan Meyer, PhD, Clare Mills, PhD, Caroline Nilsson, MD PhD, Anna Nowak-Wegrzyn, MD PhD, Ulugbek Nurmatov, PhD, Giovanni Pajno, MD, Marcia Podestà, Lars K. Poulsen, PhD, Hugh A. Sampson, MD, Angel Sanchez, Sabine Schnadt, Hania Szajewska, MD, Ronald Van Ree, PhD, Carina Venter, PhD, Berber Vlieg-Boerstra, PhD, Amena Warner, Gary Wong, MD FRCPC, Robert Wood, MD, Torsten Zuberbier, MD, Graham Roberts, DM, Priya Bansal, Roberto Berni–Canani, Katharina Blumchen, Andreas Bonertz, Melisande Bourgoin-Heck, Ozlem Ceylon, Amandine Divaret-Chauveau, David Fleischer, Maximiliano Gomez, Marion Groetch, Domingo Barber Hernandez, Betina Hjorth, Lydia Collins Hussey, André C. Knulst, Agnes Leung, Douglas Mack, Vera Mahler, Francesca Mori, Leyla Namazova-Baranova, Kati Palosuo, Claudio Alberto Salvador Parisi, Antonio Carlos Pastorino, Odilija Rudzeviciene, Maria Said, Piotr Sawiec, Scott Sicherer, Sakura Sato, and Svitlana Zubchenko
Subjects: Food allergy, Food hypersensitivity, Children, Adolescent, Adults, Immunologic diseases. Allergy, RC581-607
Abstract: Food allergy affects approximately 2–4% of children and adults. This guideline provides recommendations for managing food allergy from the Global Allergy and Asthma European Network (GA2LEN). A multidisciplinary international Task Force developed the guideline using the Appraisal of Guidelines for Research and Evaluation (AGREE) II framework and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. We reviewed the latest available evidence as of April 2021 (161 studies) and created recommendations by balancing benefits, harms, feasibility, and patient and clinician experiences. We suggest that people diagnosed with food allergy avoid triggering allergens (low certainty evidence). We suggest that infants with cow's milk allergy who need a breastmilk alternative use either hypoallergenic extensively hydrolyzed cow's milk formula or an amino acid-based formula (moderate certainty). For selected children with peanut allergy, we recommend oral immunotherapy (high certainty), though epicutaneous immunotherapy might be considered depending on individual preferences and availability (moderate certainty). We suggest considering oral immunotherapy for children with persistent severe hen's egg or cow's milk allergy (moderate certainty). There are significant gaps in evidence about safety and effectiveness of the various strategies. Research is needed to determine the best approaches to education, how to predict the risk of severe reactions, whether immunotherapy is cost-effective and whether biological therapies are effective alone or combined with allergen immunotherapy.
Published: 2022
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12. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guideline update – XIII – Oral immunotherapy for CMA – Systematic review

Author: Antonio Bognanni, MD, Derek K. Chu, MD, Ramon T. Firmino, DDS, PhD, Stefania Arasi, PhD, MSc, Siw Waffenschmidt, Arnav Agarwal, MD, Piotr Dziechciarz, MD, PhD, Andrea Horvath, MD, PhD, Rime Jebai, MSc, MPH, Hanako Mihara, MD, MPH, Yetiani Roldan, MD, Maria Said, RN, Raanan Shamir, MD, PhD, Martin Bozzola, MD, Sami Bahna, MD, DrPH, Alessandro Fiocchi, MD, Susan Waserman, MD, MSc, Holger J. Schünemann, MD, MSc, PhD, Jan L. Brożek, MD, PhD, Ignacio J. Ansotegui, MD, PhD, Stefania Arasi, MD, PhD, Amal H. Assa'ad, MD, Sami L. Bahna, MD, DrPH, Roberto Berni Canani, MD, PhD, Jan Brozek, MD, PhD, Derek K. Chu, MD, PhD, Lamia Dahdah, MD, Christophe Dupont, MD, PhD, Motohiro Ebisawa, MD, PhD, Ramon Targino Firmino, MD, Elena Galli, MD, PhD, Rose Kamenwa, MD, Gideon Lack, MBBCh, Haiqi Li, MD, Alberto Martelli, MD, Anna H. Nowak-Wegrzyn, MD, PhD, Nikolaos G. Papadopoulos, MD, PhD, Ruby Pawankar, MD, PhD, Mario Sánchez-Borges, MD, Jonathan M. Spergel, MD, PhD, Hania Szajewska, MD, Luigi Terracciano, MD, Yvan Vandenplas, MD, PhD, Carina Venter, PhD, RD, Amena Warner, RN, SN (PG Dip), and GaryW.K. Wong, MD
Subjects: Milk allergy, Oral immunotherapy, Systematic review, Meta-analysis, GRADE, Immunologic diseases. Allergy, RC581-607
Abstract: Background: Allergy to cow's milk is the most common food allergy in infants and it is usually outgrown by 5 years of age. In some individuals it persists beyond early childhood. Oral immunotherapy (OIT, oral desensitization, specific oral tolerance induction) has been proposed as a promising therapeutic strategy for persistent IgE-mediated cow's milk allergy. We previously published the systematic review of OIT for cow's milk allergy (CMA) in 2010 as part of the World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines. Objective: To systematically synthesize the currently available evidence about OIT for IgE-mediated CMA and to inform the updated 2022 WAO guidelines. Methods: We searched the electronic databases including PubMed, Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and the websites of selected allergy organizations. We included all studies irrespective of the language of the original publication. The last search was conducted in February 2021. We registered the protocol on Open Science Framework (10.17605/OSF.IO/AH2DT). Results: We identified 2147 unique records published between 2010 and 2021, including 13 randomized trials and 109 observational studies addressing cow's milk OIT. We found low-certainty evidence that OIT with unheated cow's milk, compared to elimination diet alone, increased the likelihood of being able to consume ≥150 ml of cow's milk in controlled settings (risk ratio (RR): 12.3, 95% CI: 5.9 to 26.0; risk difference (RD): 25 more per 100, 95% CI 11 to 56) as well as accidently ingest a small amount (≥5 ml) of cow's milk (RR: 8.7, 95% CI: 4.7 to 16.1; RD: 25 more per 100, 95% CI 12 to 50). However, 2–8 weeks after discontinuation of a successful OIT, tolerance of cow's milk persisted in only 36% (range: 20%–91%) of patients. OIT increased the frequency of anaphylaxis (rate ratio: 60.0, 95% CI 15 to 244; rate difference 5 more anaphylactic reactions per 1 person per year, 95% CI: 4 to 6; moderate evidence) and the frequency of epinephrine use (rate ratio: 35.2, 95% CI: 9 to 136.5; rate difference 268 more events per 100 person-years, 95% CI: 203 to 333; high certainty). OIT also increased the risk of gastrointestinal symptoms (RR 6.9, 95% CI 1.6–30.9; RD 28 more per 100, CI 3 to 100) and respiratory symptoms (RR 49.0, 95% CI 3.12–770.6; RD 77 more per 100, CI 62 to 92), compared with avoidance diet alone. Single-arm observational studies showed that on average 6.9% of OIT patients (95% CI: 3.8%–10%) developed eosinophilic esophagitis (very low certainty evidence). We found 1 trial and 2 small case series of OIT with baked milk. Conclusions: Moderate certainty evidence shows that OIT with unheated cow's milk in patients with IgE-mediated CMA is associated with an increased probability of being able to drink milk and, at the same time, an increased risk of serious adverse effects.
Published: 2022
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13. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guideline update – XIV – Recommendations on CMA immunotherapy

Author: Jan L. Brozek, Ramon T. Firmino, Antonio Bognanni, Stefania Arasi, Ignacio Ansotegui, Amal H. Assa'ad, Sami L. Bahna, Roberto Berni Canani, Martin Bozzola, Derek K. Chu, Lamia Dahdah, Christophe Dupont, Piotr Dziechciarz, Motohiro Ebisawa, Elena Galli, Andrea Horvath, Rose Kamenwa, Gideon Lack, Haiqi Li, Alberto Martelli, Anna Nowak-Węgrzyn, Nikolaos G. Papadopoulos, Ruby Pawankar, Yetiani Roldan, Maria Said, Mario Sánchez-Borges, Raanan Shamir, Jonathan M. Spergel, Hania Szajewska, Luigi Terracciano, Yvan Vandenplas, Carina Venter, Siw Waffenschmidt, Susan Waserman, Amena Warner, Gary W.K. Wong, Alessandro Fiocchi, and Holger J. Schünemann
Subjects: Milk allergy, Immunotherapy, Practice guidelines, GRADE, Immunologic diseases. Allergy, RC581-607
Abstract: Background: The prevalence of cow's milk allergy (CMA) is approximately 2–4.5% in infants and less than 0.5% in adults. Most children outgrow cow's milk allergy in early childhood, particularly that to the baked milk products. Immunotherapy with unheated cow's milk has been used as a treatment option for those who have not yet outgrown CMA, but the benefits must be balanced with the adverse effects. Objective: These evidence-based guidelines from the World Allergy Organization (WAO) intend to support patients, clinicians, and others in decisions about the use of oral and epicutaneous immunotherapy for the treatment of IgE-mediated CMA. Methods: WAO formed a multidisciplinary guideline panel balanced to include the views of all stakeholders and to minimize potential biases from competing interests. The McMaster University GRADE Centre supported the guideline-development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used, including GRADE Evidence-to-Decision frameworks, which were subject to public comment. Results: After a careful review of the summarized evidence and thorough discussions the WAO guideline panel suggests: a) using oral immunotherapy with unheated cow's milk in those individuals with confirmed IgE-mediated CMA who value the ability to consume controlled quantities of milk more than avoiding the large adverse effects of therapy, b) not using oral immunotherapy with unheated cow's milk in those who value avoiding large adverse effects of therapy more than the ability to consume controlled quantities of milk, c) using omalizumab in those starting oral immunotherapy with unheated cow's milk, d) not using oral immunotherapy with baked cow's milk in those who do not tolerate both unheated and baked milk, and e) not using epicutaneous immunotherapy outside of a research setting. The recommendations are labeled “conditional” due to the low certainty about the health effects based on the available evidence. Conclusions: Clinicians, patients, and their family members might want to discuss all the potential desirable and undesirable effects of oral immunotherapy for IgE-mediated CMA and integrate them with the patients' values and preferences before deciding on a treatment option. More robust research is needed to determine with greater certainty which interventions are likely to be the most beneficial with the least harms, and to develop safer, low-cost, and equitable treatments.
Published: 2022
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14. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update – I – Plan and definitions

Author: Alessandro Fiocchi, MD, Antonio Bognanni, MD, Jan Brożek, MD, PhD, Motohiro Ebisawa, MD, PhD, Holger Schünemann, MD, Ignacio J. Ansotegui, MD, PhD, Stefania Arasi, MD, Amal H. Assa'ad, MD, Sami L. Bahna, MD, DrPH, Roberto Berni Canani, MD, PhD, Martin Bozzola, MD, Derek Chu, Lamia Dahdah, MD, Christophe Dupont, MD, PhD, Ramon Targino Firmino, Elena Galli, MD, PhD, Rose Kamenwa, MD, Gideon Lack, MD, Haiqi Li, MD, Alberto Martelli, MD, Anna Nowak-Węgrzyn, MD, Nikolas G. Papadopoulos, MD, PhD, Ruby Pawankar, MD, PhD, Maria Said, RN, Mario Sánchez-Borges, Raanan Shamir, PhD, Jonathan M. Spergel, MD, PhD, Hania Szajewska, MD, Luigi Terracciano, MD, Yvan Vandenplas, MD, PhD, Carina Venter, PhD, RD, Amena Warner, Susan Waserman, MD, MSc, and Gary W.K. Wong, MD
Subjects: Food allergy, Cow's milk allergy, Oral immunotherapy, GRADE, Immunologic diseases. Allergy, RC581-607
Abstract: Since the World Allergy Organization (WAO) Diagnosis and Rationale against Cow's Milk Allergy (DRACMA) Guidelines were published 10 years ago, new evidence has accumulated about the diagnosis, therapy, and specific immunotherapy for cow's milk allergy (CMA). For this reason, WAO has felt the need to update the guidelines.We introduce here this update. The new DRACMA guidelines aim to comprehensively address the guidance on diagnosis and therapy of both IgE non-IgE-mediated forms of cow's milk allergy in children and adults. They will be divided into 18 chapters, each of which will be dedicated to an aspect. The focus will be on the meta-analyzes and recommendations that will be expressed for the 3 most relevant clinical aspects: (a) the diagnostic identification of the condition; (b) the choice of the replacement formula in case of CMA in infancy when the mother is not able to breastfeed, and (c) the use of specific immunotherapy for cow's milk protein allergy.
Published: 2022
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15. Potential Association of Legionnaires’ Disease with Hot Spring Water, Hot Springs National Park and Hot Springs, Arkansas, USA, 2018–2019

Author: Allison E, James, Kurt, Kesteloot, J Terry, Paul, Richard L, McMullen, Shirley, Louie, Catherine, Waters, Jennifer, Dillaha, Joel, Tumlison, Dirk T, Haselow, Jessica C, Smith, Sooji, Lee, Troy, Ritter, Claressa, Lucas, Jasen, Kunz, Laura A, Miller, and Maria, Said
Subjects: Microbiology (medical), Arkansas, Legionellosis, Potential Association of Legionnaires’ Disease with Hot Spring Water, Hot Springs National Park and Hot Springs, Arkansas, USA, 2018–2019, Hot Springs National Park, Epidemiology, Parks, Recreational, Water, Legionella, environmental health, hot springs, Infectious and parasitic diseases, RC109-216, United States, Legionella pneumophila, Infectious Diseases, Water Supply, Synopsis, Humans, Medicine, Legionnaires' Disease, Water Microbiology, bacteria, Legionnaires’ disease
Abstract: Legionella pneumophila is the cause of Legionnaires’ disease, a life-threatening pneumonia that occurs after inhalation of aerosolized water containing the bacteria. Legionella growth occurs in stagnant, warm-to-hot water (77°F–113°F) that is inadequately disinfected. Piped hot spring water in Hot Springs National Park, Arkansas, USA, has naturally high temperatures (>135°F) that prevent Legionella growth, and Legionnaires’ disease has not previously been associated with the park or other hot springs in the United States. During 2018–2019, Legionnaires’ disease occurred in 5 persons after they visited the park; 3 of these persons were potentially exposed in spa facilities that used untreated hot spring water. Environmental testing revealed Legionella bacteria in piped spring water, including 134°F stagnant pipe water. These findings underscore the importance of water management programs to reduce Legionella growth in plumbing through control activities such as maintaining hot water temperatures, reducing stored water age, and ensuring adequate water flow.
Published: 2022

16. Acute management of anaphylaxis in pregnancy

Author: Elina Tan, Michael O'Sullivan, Tim Crozier, Helen Kolawole, Stav Mantas, Maria Said, Kristina Rueter, Katie Frith, and Sara Barnes
Subjects: Epinephrine, Pregnancy, Infant, Newborn, Humans, Female, Family Practice, Anaphylaxis
Abstract: Anaphylaxis in pregnancy is rare but can potentially be associated with significant morbidity and mortality for the mother, fetus and neonate. With appropriate and timely management, even severe anaphylaxis can be managed with excellent maternal and fetal outcomes.The aim of this article is to provide an illustrative case and highlight current recommendations for diagnosis and management of acute maternal anaphylaxis, which have recently been reviewed and developed into a guideline by the Australasian Society of Clinical Immunology and Allergy.An understanding of management of anaphylaxis in pregnancy is essential knowledge in the general practice setting. The recommended dosage and administration of adrenaline (epinephrine) for anaphylaxis is the same in pregnant and non-pregnant patients: 0.5 mg adrenaline intramuscularly in the mid-outer thigh (or dose of 0.01 mg/kg if50 kg). The use of adrenaline in maternal anaphylaxis is supported by various international guidelines.
Published: 2022

17. Overview of registries for anaphylaxis: a scoping review protocol

Author: Ingrid Roche, Sandra Salter, Frank M Sanfilippo, Samantha L. Stiles, Maria Said, Rhonda Clifford, and Richard Loh
Subjects: Protocol (science), 050402 sociology, Scope (project management), business.industry, 05 social sciences, Scopus, MEDLINE, CINAHL, Grey literature, medicine.disease, Review Literature as Topic, 03 medical and health sciences, 0302 clinical medicine, 0504 sociology, Index (publishing), Humans, Medicine, Registries, 030212 general & internal medicine, Medical emergency, business, Anaphylaxis, General Nursing, Public health policy
Abstract: Objective This review aims to describe the scope and operational features of global registries for anaphylaxis and assess their contribution to improving knowledge and care of anaphylaxis by measuring their research output. Introduction The incidence of anaphylaxis is increasing around the world. Structured reporting systems, such as patient registries, are needed to better understand the burden of anaphylaxis and protect the growing number of allergic patients. Inclusion criteria The concept to be mapped is registries across the world that enroll patients who have experienced anaphylaxis. Published and gray literature sources will be considered if they describe the scope and operational features of anaphylaxis registries. Only full-text studies published in English will be included. There will be no date restriction. Methods The JBI methodology for scoping reviews will be followed. Embase, MEDLINE, Scopus, and CINAHL will be searched from inception date for relevant articles. Identified keyword and index terms will be adapted for searches of gray literature sources, using Google advanced search functions. The authors and developers of identified registries will be contacted, where possible, to obtain additional information about the development and structure of systems. Data will be extracted by two independent reviewers. Any discrepancies will be resolved by a third reviewer. Tables and a narrative summary will be used to describe and compare the scope and features of anaphylaxis registries and outline their output to assess their contribution to research, clinical practice, and public health policy for anaphylaxis.
Published: 2020
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18. Peanut Can Be Used as a Reference Allergen for Hazard Characterization in Food Allergen Risk Management: A Rapid Evidence Assessment and Meta-Analysis

Author: M. Hazel Gowland, Natasha Purington, Nandinee Patel, Dianne E. Campbell, Arnon Elizur, María Cristina López, Sebastien La Vieille, Hugh A. Sampson, Anthony E.J. Dubois, Eva Södergren, Motohiro Ebisawa, Benjamin C. Remington, Sabine Schnadt, E. N. Clare Mills, Barbara Ballmer-Weber, Helen A. Brough, R. Sharon Chinthrajah, Geert F. Houben, André C. Knulst, W. Marty Blom, Gustavo Alberto Polenta, Paul Turner, Jonathan Hourihane, Stephen L Taylor, Simon Brooke-Taylor, Jennifer Gerdts, Maria Said, René W.R. Crevel, Joseph L. Baumert, Hongbing Chen, Groningen Research Institute for Asthma and COPD (GRIAC), Medical Research Council (MRC), National Institute for Health Research, University of Zurich, and Turner, Paul J
Subjects: ORAL TOLERANCE INDUCTION, CLINICAL REACTIVITY, Arachis, IGE ANTIBODIES, PFAS, Pollen food allergy syndrome, WHEAT ALLERGY, medicine.disease_cause, DOUBLE-BLIND, Allergen, Dosis de Referencia, Food Labeling, immune system diseases, Alérgenos, COWS MILK ALLERGY, Immunology and Allergy, Risk management, Randomized Controlled Trials as Topic, ED, Eliciting dose, Threshold, 10177 Dermatology Clinic, Hazard, humanities, Eliciting Dose, Dosis Provocadora, Meta-analysis, CROSS-REACTIVITY, ED01, Amount of allergen expected to cause objective symptoms in 1% of the population with that allergy, 2723 Immunology and Allergy, ED05, Amount of allergen expected to cause objective symptoms in 5% of the population with that allergy, Alergia Alimentaria, THRESHOLD DOSE DISTRIBUTIONS, Eliciting dose, Food Hypersensitivity, Precautionary allergen labeling, Food Allergies, 610 Medicine & health, Legislation, Cacahuete, Maní, PAL, Precautionary allergen labeling, Risk Assessment, WHO, World Health Organization, Reference Dose, Food allergy, Environmental health, FC, Food challenge, medicine, Humans, Precautionary Allergen Labeling, Review and Feature Article, Reacciones Anafilácticas, Anaphylaxis, HENS EGG, EIA, Exercise-induced anaphylaxis, Reference dose, CI, Confidence interval, business.industry, CHALLENGE-PROVEN, Evidence-based medicine, Allergens, medicine.disease, Etiquetado Preventivo de Alérgenos, Umbral, Groundnuts, Metanálisis, respiratory tract diseases, Peanut, FAO, Food and Agriculture Organization, business, DBPCFC, Double-blind, placebo-controlled food challenge, Anaphylactic Reactions, Meta-Analysis
Abstract: Regional and national legislation mandates the disclosure of “priority” allergens when present as an ingredient in foods, but this does not extend to the unintended presence of allergens due to shared production facilities. This has resulted in a proliferation of precautionary allergen (“may contain”) labels (PAL) that are frequently ignored by food-allergic consumers. Attempts have been made to improve allergen risk management to better inform the use of PAL, but a lack of consensus has led to variety of regulatory approaches and nonuniformity in the use of PAL by food businesses. One potential solution would be to establish internationally agreed “reference doses,” below which no PAL would be needed. However, if reference doses are to be used to inform the need for PAL, then it is essential to characterize the hazard associated with these low-level exposures. For peanut, there are now published data relating to over 3000 double-blind, placebo-controlled challenges in allergic individuals, but a similar level of evidence is lacking for other priority allergens. We present the results of a rapid evidence assessment and meta-analysis for the risk of anaphylaxis to a low-level allergen exposure for priority allergens. On the basis of this analysis, we propose that peanut can and should be considered an exemplar allergen for the hazard characterization at a low-level allergen exposure. Resumen: La legislación regional y nacional exige la divulgación de alérgenos "prioritarios" cuando están presentes como ingrediente en los alimentos, pero esto no se extiende a la presencia involuntaria de alérgenos debido a instalaciones de producción compartidas. Esto ha dado lugar a una proliferación de etiquetas de precaución para alérgenos ("pueden contener") (PAL) que los consumidores alérgicos a los alimentos suelen ignorar. Se han hecho intentos para mejorar la gestión del riesgo de alérgenos para informar mejor el uso de PAL, pero la falta de consenso ha llevado a una variedad de enfoques regulatorios y a la falta de uniformidad en el uso de PAL por parte de las empresas alimentarias. Una posible solución sería establecer “dosis de referencia” acordadas internacionalmente, por debajo de las cuales no se necesitaría PAL. Sin embargo, si se van a utilizar dosis de referencia para informar la necesidad de PAL, entonces es esencial caracterizar el peligro asociado con estas exposiciones de bajo nivel. Para el maní, ahora hay datos publicados relacionados con más de 3000 desafíos doble ciego controlados por placebo en individuos alérgicos, pero falta un nivel similar de evidencia para otros alérgenos prioritarios. Presentamos los resultados de una evaluación rápida de la evidencia y un metanálisis del riesgo deanafilaxia a una exposición a alérgenos de bajo nivel para alérgenos prioritarios. Sobre la base de este análisis, proponemos que el cacahuete puede y debe considerarse un alérgeno ejemplar para la caracterización del peligro en una exposición a un alérgeno de bajo nivel. Instituto de Investigación de Tecnología de Alimentos Fil: Turner, Paul J. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Patel, Nandinee. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Ballmer-Weber, Barbara K. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Ballmer-Weber, Barbara K. Clínica de Dermatología y Alergología. Kantonsspital; Suiza. Fil: Baumert, Joe L. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Blom, W. Marty. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Brooke-Taylor, Simon. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Brough, Helen. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Brough, Helen. King's College London. Departamento de Alergia Pediátrica; Reino Unido. Fil: Campbell, Dianne E. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Campbell, Dianne E. Tecnologías DBV. Montrouge; Francia. Fil: Chen, Hongbing. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Chinthrajah, R. Sharon. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Crevel, René W.R. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Dubois, Anthony E.J. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Ebisawa, Motohiro. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Elizur, Arnon. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Elizur, Arnon. Universidad de Tel Aviv. Facultad de Medicina Sackler. Departamento de Pediatría; Israel. Fil: Gerdts, Jennifer D. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Gowland, M. Hazel. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Houben, Geert F. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Hourihane, Jonathan O.B. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Knulst, André C. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: La Vieille, Sébastien. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: López, María Cristina. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Mills, E.N. Clare. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Polenta, Gustavo Alberto. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Tecnología de Alimentos; Argentina. Fil: Polenta, Gustavo Alberto. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Purington, Natasha. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Said, María. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Sampson, Hugh A. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Sampson, Hugh A. Escuela de Medicina Icahn. División de Alergia e Inmunología Pediátricasen. Nueva York. Estados Unidos de América. Fil: Schnadt, Sabine. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Södergren, Eva. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Södergren, Eva. ThermoFisher Scientific; Suecia. Fil: Taylor, Stephen L. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Remington, Benjamin C. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido. Fil: Remington, Benjamin C. Grupo BV. Consultoría Remington; Holanda.
Published: 2022

19. A multi-disciplinary approach to the diagnosis and management of allergic diseases: An EAACI Task Force

Author: Isabel Skypala, Gavriela Feketea, Dermot Ryan, Radosław Gawlik, Maria Said, Emilia Vassilopoulou, Berber Vlieg-Boerstra, Rosan Meyer, Constantinos Pitsios, Raluca Maria Pop, Inger Kull, Audrey Dunn Galvin, and Sophie Schiere
Subjects: Quality of life, medicine.medical_specialty, Health Personnel, Immunology, education, CINAHL, Disease, Care, Cochrane Library, Quality of life (healthcare), Food allergy, Hypersensitivity, Added value, Humans, Immunology and Allergy, Medicine, Children, Multi disciplinary, Questionnaire, Task force, business.industry, Oral allergy, Chronic spontaneous urticaria, European guidelines, Asthma, Family medicine, Pediatrics, Perinatology and Child Health, Quality of Life, Eczema atopic dermatitis, business, Inclusion (education)
Abstract: Background: Guidelines for management of patients with allergic conditions are available, but the added value of nurses, allied health care professionals (AHPs) and general practitioners (GPs), in the management of allergic disease has not been fully clarified. The European Academy of Allergy and Clinical Immunology (EAACI) appointed a task force to explore this issue. Aim: To investigate the added value of nurses, AHPs and GPs in management of allergic diseases, in an integrated model of care. Methods: A search was made of peer-reviewed literature published between 2010 and December 2020 (Cochrane Library, PubMed, and CINAHL) on the involvement of the various specific health care providers (HCPs) in the management of allergic diseases. Results: Facilitative models of care for patients with allergies can be achieved if HCP collaborate in the diagnosis and management. Working in multidisciplinary teams (MDT) can increase patients’ understanding of the disease, adherence to treatment, self-care capabilities, and ultimately improve quality of life. The MDT competencies and procedures can be improved and enhanced in a climate of mutual respect and shared values, and with inclusion of patients in the planning of care. Patient-centered communication among HCPs and emphasis on the added value of each profession can create an effective integrated model of care for patients with allergic diseases. Conclusion: Nurses, AHPs, and GPs, both individually and in collaboration, can contribute to the improvement of the management of patients with allergic disease. The interaction between the HCPs and the patients themselves can ensure maximum support for people with allergies.
Published: 2021
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20. Anaphylaxis after vaccination reported to the Vaccine Adverse Event Reporting System, 1990-2016

Author: Pedro L. Moro, Maria Cano, John R. Su, Maria Said, Carmen Ng, and Paige Lewis
Subjects: Adult, Male, Allergy, Pediatrics, medicine.medical_specialty, Adolescent, MedDRA, Immunology, Article, Young Adult, 03 medical and health sciences, Adverse Event Reporting System, 0302 clinical medicine, medicine, Humans, Immunology and Allergy, 030212 general & internal medicine, Child, Adverse effect, Anaphylaxis, Aged, Aged, 80 and over, business.industry, Medical record, Vaccination, Infant, Middle Aged, medicine.disease, United States, Hypersensitivity reaction, 030228 respiratory system, Child, Preschool, Female, business
Abstract: BACKGROUND: Anaphylaxis, a rare and potentially life-threatening hypersensitivity reaction, can occur after vaccination. OBJECTIVE: We sought to describe reports of anaphylaxis after vaccination made to the Vaccine Adverse Event Reporting System (VAERS) during 1990–2016. METHODS: We identified domestic reports of anaphylaxis within VAERS using a combination of Medical Dictionary for Regulatory Activity queries and Preferred Terms. We performed a descriptive analysis, including history of hypersensitivity (anaphylaxis, respiratory allergies, and drug allergies) and vaccines given. We reviewed all serious reports and all nonserious reports with available medical records to determine if they met the Brighton Collaboration case definition for anaphylaxis or received a physician’s diagnosis. RESULTS: During the analytic period, VAERS received 467,960 total reports; 828 met the Brighton Collaboration case definition or received a physician’s diagnosis of anaphylaxis: 654 (79%) were classified as serious, and 669 (81%) had medical records available. Of 478 reports in children aged less than 19 years, 65% were male; childhood vaccines were most commonly reported. Of 350 reports in persons aged 19 years or greater, 80% were female, and influenza vaccines were most frequently reported. Overall, 41% of reports described persons with no history of hypersensitivity. We identified 8 deaths, 4 among persons with no history of hypersensitivity. CONCLUSION: Anaphylaxis after vaccination is rare in the United States and can occur among persons with no history of hypersensitivity. Most persons recover fully with treatment, but serious complications, including death, can occur. (J Allergy Clin Immunol 2019;143:1465–73.)
Published: 2019
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21. European Regulations for Labeling Requirements for Food Allergens and Substances Causing Intolerances: History and Future

Author: Pieter Scheelings, Martina Koeberl, Maria Said, N. Alice Lee, Fiona Fleming, Robin Sherlock, Katrina J. Allen, D. Clarke, Lisa Katzer, Neil Shepherd, Andreas L. Lopata, and James H. Roberts
Subjects: Allergy, Food industry, medicine.disease_cause, 01 natural sciences, Analytical Chemistry, 0404 agricultural biotechnology, Allergen, Environmental health, medicine, Environmental Chemistry, Risk management, Pharmacology, Government, business.industry, digestive, oral, and skin physiology, 010401 analytical chemistry, Stakeholder, 04 agricultural and veterinary sciences, Consumer protection, medicine.disease, Food safety, 040401 food science, respiratory tract diseases, 0104 chemical sciences, business, Agronomy and Crop Science, Food Science
Abstract: Food allergies are increasing globally, including numbers of allergens, the sensitization rate, and the prevalence rate. To protect food-allergic individuals in the community, food allergies need to be appropriately managed. This paper describes current Australian food allergen management practices. In Australia, the prevalence of food allergies, the anaphylaxis rate, and the fatal anaphylaxis rate are among the highest in the world. Interagency and stakeholder collaboration is facilitated and enhanced as Australia moves through past, current, and ongoing food allergen challenges. As a result, Australia has been a global leader in regulating the labeling of common allergens in packaged foods and their disclosure in foods not required to bear a label. Moreover, the food industry in Australia and New Zealand has developed a unique food allergen risk management tool, the Voluntary Incidental Trace Allergen Labelling program, which is managed by the Allergen Bureau. This paper summarizes insights and information provided by the major stakeholders involved to protect food-allergic consumers from any allergic reaction. Stakeholders include government; consumer protection, regulation, and enforcement agencies; the food industry; and food allergen testing and food allergen/allergy research bodies in Australia. The ongoing goal of all stakeholders in food allergen management in Australia is to promote best practice food allergen management procedures and provide a wide choice of foods, while enabling allergic consumers to manage their food allergies and reduce the risk of an allergic reaction.
Published: 2018
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22. CRISE ORGANICA E LUTA DE CLASSES HOJE

Author: Ana Maria Said
Subjects: Automotive Engineering
Abstract: Para compreendermos o momento de crise orgânica que nos envolve nos dias atuais, partamos do que Marx irá definir, no Manifesto do Partido Comunista, como crise de superprodução que, posteriormente, Gramsci irá definir como crise orgânica do sistema. Recebido em 12 de agosto de 2016Aprovado em 13 de setembro de 2016Editado em 15 de dezembro de 2016
Published: 2016
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23. A PUBLIC HEALTH APPROACH TO FOOD ALLERGY PREVENTION – PILOT RESULTS

Author: Richard Loh, Merryn J. Netting, Sandra Salter, Sandra Vale, Preeti Joshi, Kevin Murray, Rhonda Clifford, Dianne E. Campbell, and Maria Said
Subjects: medicine.medical_specialty, business.industry, Food allergy, Environmental health, Public health, Immunology, Immunology and Allergy, Medicine, business, medicine.disease
Published: 2020
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24. Retrospective Study of Expert Examination Performed by the Brazilian Federal Police in Investigations of Wildlife Crimes, 2013-2014

Author: Licia Maria Said De Lavor, Luciana Vargas Sant’Ana, Tália Missen Tremori, Paula Brügger, Víctor Antonio Toledo Gonzalez, and Sérvio Túlio Jacinto Reis
Subjects: Community and Home Care, medicine.medical_specialty, lcsh:R, Wildlife, lcsh:Law, lcsh:Medicine, Retrospective cohort study, Mistreatment, Legal veterinary medicine, Geography, Family medicine, medicine, Forensic science, Crime, lcsh:K
Abstract: One of the main demands for veterinary medical experts is the forensic investigation of crimes against wildlife. In Brazil, most of these crimes are related to the trafficking of wild animals, whose conducts involve the capture, transport and illegal trade of specimens. All these activities also involve various forms of animal mistreatment. This article aims to present the main types of expert examinations used in investigations of wildlife crimes through a retrospective study of records kept by the Criminalistic System of the Brazilian Federal Police in the years 2013 and 2014. The increase in the number of examinations performed in 2014, compared to the year 2013 (86.15%), was mainly focused on identification, mistreatment and investigation of bird ring forgery, reaffirming the importance of these tests in the casuistry of the Federal Police.
Published: 2016
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25. ASCIA guidelines for prevention of anaphylaxis in schools, pre-schools and childcare: 2015 update

Author: Richard Loh, Maria Said, Raymond J Mullins, Jill Smith, and Sandra Vale
Subjects: medicine.medical_specialty, business.industry, Family medicine, Pediatrics, Perinatology and Child Health, medicine, medicine.disease, business, Anaphylaxis
Published: 2015
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26. The global impact of the DRACMA guidelines cow's milk allergy clinical practice

Author: Holger J. Schünemann, Arabella Martelli, Jonathan M. Spergel, Lamia Dahdah, Ignacio J. Ansotegui, Sami L. Bahna, Raanan Shamir, Martin Bozzola, Yvan Vandenplas, Jan Brozek, Alessandro Fiocchi, Rose Kamenwa, Maria Said, Amal Assa'ad, Hugh A. Sampson, Mario Sánchez-Borges, Carina Venter, Roberto Berni Canani, Luigi Terracciano, Gary Wong, Haiqi Li, Susan Waserman, Ruby Pawankar, Gideon Lack, Motohiro Ebisawa, Christophe Dupont, Elena Galli, Clinical sciences, Growth and Development, Pediatrics, Fiocchi, Alessandro, Schunemann, Holger, Ansotegui, Ignacio, Assa'Ad, Amal, Bahna, Sami, Canani, Roberto Berni, Bozzola, Martin, Dahdah, Lamia, Dupont, Christophe, Ebisawa, Motohiro, Galli, Elena, Li, Haiqi, Kamenwa, Rose, Lack, Gideon, Martelli, Alberto, Pawankar, Ruby, Said, Maria, Sánchez-Borges, Mario, Sampson, Hugh, Shamir, Raanan, Spergel, Jonathan, Terracciano, Luigi, Vandenplas, Yvan, Venter, Carina, Waserman, Susan, Wong, Gary, and Brozek, Jan
Subjects: Pulmonary and Respiratory Medicine, 030201 allergy, medicine.medical_specialty, Oral food challenge, business.industry, Immunology, Scopus, MEDLINE, Public policy, Milk allergy, Review, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Food allergy, Family medicine, medicine, Immunology and Allergy, Overdiagnosis, Grading (education), business, health care economics and organizations
Abstract: Background: The 2010 Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines are the only Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines for cow's milk allergy (CMA). They indicate oral food challenge (OFC) as the reference test for diagnosis, and suggest the choice of specific alternative formula in different clinical conditions. Their recommendations are flexible, both in diagnosis and in treatment. Objectives & methods: Using the Scopus citation records, we evaluated the influence of the DRACMA guidelines on milk allergy literature. We also reviewed their impact on successive food allergy and CMA guidelines at national and international level. We describe some economic consequences of their application. Results: DRACMA are the most cited CMA guidelines, and the second cited guidelines on food allergy. Many subsequent guidelines took stock of DRACMA's metanalyses adapting recommendations to the local context. Some of these chose not to consider OFC as an absolute requirement for the diagnosis of CMA. Studies on their implementation show that in this case, the treatment costs may increase and there is a risk of overdiagnosis. Interestingly, we observed a reduction in the cost of alternative formulas following the publication of the DRACMA guidelines. Conclusions: DRACMA reconciled international differences in the diagnosis and management of CMA. They promoted a cultural debate, improved clinician's knowledge of CMA, improved the quality of diagnosis and care, reduced inappropriate practices, fostered the efficient use of resources, empowered patients, and influenced some public policies. The accruing evidence on diagnosis and treatment of CMA necessitates their update in the near future.
Published: 2018

27. Teatro de Arena de São Paulo:: reflexões sobre política, arte e formação

Author: Ana Maria Said
Subjects: Educação, Arte, Política
Abstract: [1] Parte deste texto foi publicado no livro eletrônico dos anais do XVII Taller Internacional Nueva Ciência Política, na Universidad de la Habana, em Cuba, em 2014. Teatro de Arena de São Paulo: reflexões sobre política, arte e formação Resumo: Pretendemos neste texto analisar o projeto político-pedagógico do Teatro de Arena de São Paulo (1955 – 1972) que nos incita a refletir sobre a relação entre política, arte e formação humana. Nesse sentido analisaremos o alcance de sua obra e de suas críticas político-sociais dentro do contexto histórico e ideológico em que se formou e atuou o Teatro de Arena de São Paulo. Estudaremos a obra do Arena, dentro do quadro de efervescência cultural e política de final dos anos 1950 e década de 1960, e da resistência ao período obscuro da ditadura militar no Brasil. Para que possamos fazê-lo, a análise da influência isebiana com a questão da conscientização, incluindo a obra de Paulo Freire, torna-se fundamental.Palavras-chave: Arte; Política; Educação. The Arena Theatre of São Paulo: reflections about politics art and formation Abstract: In this text, the intention is to analyse the political-pedagogic project of the Arena Theatre of São Paulo (1955-1972), which incites us to reflect about the relationship between the politics, arts and human formation. We will analyse the reach of its work and social- political criticism inside the historical and ideological contest that has formed and acted the Arena Theatre of São Paulo. We will study the work of the Arena, inside the cultural and political effervescence picture in the end of the 1950’s and the decade of 1960’s, including the resistance of the obscure time of the military dictatorship in Brazil. In order to do this, the analysis of the Isebian influence on the question of awereness, including the work of Paulo Freire, has become essential.Keywords: Art; Politics; Education. Teatro di Arena di San Paolo: riflessioni su politica, arte e formazione Lo scopo di questo testo, è l’intenzione di analizzare il progetto politico-pedagogico del Teatro di Arena di San Paolo (1955-1972), che ci incita a riflettere sul rapporto tra la politica, le arti e la formazione umana. Analizzeremo la portata del suo lavoro e di critica politico-sociale all’interno del contesto storico e ideologico in cui si è formato e in che abbia agito il Teatro di Arena di San Paolo. Studieremo il lavoro dell’Arena, all’interno del quadro dell’ effervescenza culturale e politica dalla finedel 1950 e nel decennio del 1960, come resistenza al tempo oscuro della ditatura militare in Brasile. Per poter farlo, l’analisi dell’influenza del ISEB sulla questione della consapevolezza, compreso il lavoro di Paulo Freire, è diventato essenziale. Parole chiave: Arte; Politica; Educazione. Data de registro: 08/09/2015 Data de aceite: 20/04/2016
Published: 2017

28. HEGEMONIA E QUESTÃO FEMININA EM ANTONIO GRAMSCI

Author: Ana Maria Said
Subjects: General Medicine, General Chemistry
Abstract: No contexto de crise de autoridade, como definia Antonio Gramsci, em que há um avanço da extrema direita em muitos e importantes países do mundo, se instala a questão das minorias, dos preconceitos e das discriminações, da violência sobre elas, como manifestação do comportamento retrógrado e conservador da sociedade individualista e de massas. Para Gramsci, a luta política pela hegemonia no capitalismo contemporâneo é empreendida nasociedade civil, como base para as lutas contra a opressão. É no terreno político-econômico que a superação da condição de subalternidade das minorias se coloca. E a questão feminina está incluída nesse contexto. A reforma intelectual e moral seria a estratégia para que essa superação fosse possível. As mudanças na vida material contemporâneas impulsionam as conquistas femininas e sua afirmação como sujeito histórico, possibilitando uma inserção social e econômica. Mas, como todas as minorias, suas lutas específicas devem estar embasadas pela organização de classes. Gramsci nunca se ocupou especificamente sobre a “questão feminina”. É provável que se possa entender o papel da mulher na sociedade, para Gramsci, ao pensá-la a partir do conceito de “hegemonia” e sua definição de subalternidade e de sua superação. É a análise que pretendemos desenvolver nesse texto.
Published: 2019
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29. ASCIA guidelines for prevention of anaphylaxis in schools, pre-schools and childcare: 2012 update

Author: Sandra Vale, Jill Smith, Maria Said, Geraldine Dunne, Raymond Mullins, and Richard Loh
Subjects: First episode, Allergy, medicine.medical_specialty, Pediatrics, business.industry, Professional development, Environmental exposure, Guideline, medicine.disease, Food allergy, Family medicine, Pediatrics, Perinatology and Child Health, Medicine, Health education, business, Anaphylaxis
Abstract: The aim of these guidelines is to assist staff in school and childcare settings to plan and implement appropriate risk minimisation strategies, taking into consideration the needs of the allergic child, the likely effectiveness of measures and the practicality of implementation. Although these guidelines include risk minimisation strategies for allergic reactions to insect stings or bites, latex and medication, the major focus relates to food allergy. This is due to the higher relative prevalence of food allergy in childhood (compared with other allergic triggers) and the higher likelihood of accidental exposure in these settings. Care of the allergic child in the school, pre-school or childcare settings requires accurate information obtained from parents and carers, staff training in the recognition and management of acute allergic reactions, planning for unexpected reactions (including in those not previously identified as being at risk), age appropriate education of children with severe allergies and their peers, and implementation of practical strategies to reduce the risk of accidental exposure to known allergic triggers. Strategy development also needs to take into account local or regional established legislative or procedural guidelines and the possibility that the first episode of anaphylaxis may occur outside the home. Food bans are not recommended as the primary risk minimisation strategy due to difficulties in implementation and lack of proven effectiveness.
Published: 2013
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30. Third sector and education : the Good Student Program

Author: Fabiane Maria Said, Krawczyk, Nora Rut, 1958, Zan, Dirce Djanira Pacheco e, Cabral, Fatima Aparecida, Universidade Estadual de Campinas. Faculdade de Educação, Programa de Pós-Graduação em Educação, and UNIVERSIDADE ESTADUAL DE CAMPINAS
Subjects: Política e educação, Programas sociais, Social mobility, Politics and education, Empresários, Mobilidade social, Social program, Entrepreneurs
Abstract: Orientador: Nora Rut Krawczyk Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Resumo: Esta pesquisa tem como objetivo compreender, explicar e descrever o interesse de setores empresariais na área da educação. Adotou-se uma abordagem empírica-analítica com a condução de um Estudo de Caso do Programa Bom Aluno, instituição sem fins lucrativos e de direito privado. Buscou-se entender a dinâmica do Programa: a retirada de alunos com bom desempenho escolar das escolas públicas e a viabilização da migração desses às escolas privadas de excelência acadêmica. Verificou-se no decorrer da pesquisa tanto os efeitos positivos na mudança da trajetória escolar familiar dos participantes do Programa, como uma descrença na possiblidade da resolução dos problemas da escola pública por via da administração pública direta. Por conseguinte, verificou-se que os idealizadores do Programa nutrem a crença de que a solução para os problemas atuais da educação brasileira possa estar na parceria público-privado, isto é, no chamado terceiro setor, vinculado tanto à responsabilidade social quanto ao voluntariado empresarial. Entende-se que esse formato de programa social idealizado pelos setores empresariais na área de educação se intensificou no movimento neoliberal no país e não estaria desvinculado de demandas mercadológicas, uma vez que seu ideário se respalda em noções de eficiência e meritocracia, inerentes à lógica da concorrência e da competição entre alunos e famílias, fato que limitaria a construção de justiça social dentro do sistema educacional brasileiro Abstract: This research aims to understand, explain and describe the interest of business sectors in the area of education. An empirical-analytical approach was adopted with the conduction of a Good Student Case Study, a private non-profit institution. The aim was to understand the dynamics of the Program, the withdrawal of students with good academic performance from public schools and the viability of migration to private schools of academic excellence. In the course of the research, both the positive effects on the change in the family school trajectory of the Program participants and the disbelief in the possibility of solving the problems of the public school through direct public administration were verified during the course of the research. In this sense, the ideals of the Program nourish the belief that the solution to the current problems of Brazilian education may be in the partnership relationship between public and private, that is, the so-called third sector linked to social responsibility and corporate volunteering. It is understood on the one hand that this format of social program idealized by the business sectors in the area of education intensified in the neoliberal movement in the country and would not be dissociated from meeting the own logic of market supported in the efficiency and meritocracy, in turn, would not be dissociated from the logic of competition, competition between students and families, which would limit the construction of social justice within the Brazilian educational system. On the other hand, it can be observed to what extent social programs with this format can be transformed into educational public policies, having as justification to save the young talents Mestrado Ciências Sociais na Educação Mestra em Educação
Published: 2017

31. Global perceptions of food allergy thresholds in 16 countries

Author: Lucy A. Bilaver, Yanne Boloh, Katrina J. Allen, Scott H. Sicherer, Susan Waserman, Antonella Muraro, Ruchi Gupta, Mary Jane Marchisotto, Sabine Schnadt, Jesse Blumenstock, Lynne Regent, Steve L. Taylor, Laurie Harada, and Maria Said
Subjects: business.industry, Immunology, 04 agricultural and veterinary sciences, Food purchasing, medicine.disease, 040401 food science, Food hypersensitivity, Food labeling, 03 medical and health sciences, 0404 agricultural biotechnology, 0302 clinical medicine, 030228 respiratory system, Food allergy, Labelling, Environmental health, Global health, medicine, Immunology and Allergy, Food science, Food allergens, business
Published: 2016
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32. Educar para a vida: a formação filosófica na perspectiva da Filosofia da práxis

Author: Gigliola Mendes and Ana Maria Said
Abstract: Proposta de um modelo de formação filosófica de jovens do Ensino Médio inspirado na Filosofia da práxis de Gramsci. Formá-los na práxis teria como objetivo a sua elevação cultural, dando-lhes acesso aos códigos dominantes da sociedade em que vivem, o que os faria conhecer seus direitos e deveres e desenvolver a capacidade de exigi-los. Em tal perspectiva, o professor tem como desafios oferecer formação teórica aos seus alunos e educá-los politicamente para a transformação da sociedade.
Published: 2012
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33. In Liberia, the end of the Ebola epidemic will be the beginning

Author: Maria Said
Subjects: Face shield, medicine.medical_specialty, Ebola virus, business.product_category, Ecology, business.industry, Health, Toxicology and Mutagenesis, Public health, Hemorrhagic Fever, Ebola, medicine.disease_cause, medicine.disease, Global Health, Liberia, Virology, Test (assessment), Sierra leone, Animal ecology, Health care, Communicable Disease Control, medicine, Humans, Medical emergency, business, Epidemics, Personal protective equipment
Abstract: We were ready. When the vehicle arrived at the gate of the Monrovia Medical Unit (known as the MMU) in the late hours of the afternoon, we were already gathered in the donning area. A phone call from the Ministry of Health had alerted us to the new patient’s symptoms and background—fever, headache, malaise, nausea, vomiting, and diarrhea in a woman who lived and worked in a neighborhood thought to have a high transmission of the Ebola virus. We had been trained to move slowly, deliberately, and carefully in our preparation, and it took about 20 min before the first pair of nurses was fully dressed in their Personal Protective Equipment, including a gown, boots, two sets of gloves, mask, hood, apron, and face shield that would help protect them from the virus. In the hour before the patient’s arrival, we had moved more quickly, slipping in and out through zippered flaps in the olive-colored tents that make up the 25-bed Ebola Treatment Unit (ETU) staffed by Officers of the U.S. Public Health Service Commissioned Corps in Margibi County, Liberia. The pharmacists gathered the IV fluids and medications that we would likely give. The safety team filled buckets with chlorinated water: 0.05% for skin and 0.5% for everything else. The laboratory team checked that they had the purple tube to collect the blood to test for the virus. When it was time, we lifted the bright orange fencing that separated the donning area from the high-risk area and moved slowly down the short hallway to the Suspect Ward. We washed our gloved hands in chlorinated water from a bucket outside the ward, and then stepped in. She looked sick. She had vomited in the ambulance on the way over. Her face was flushed and sweaty, and the whites of her eyes were injected with red. An Ebola survivor who worked with us had warned us about patients with red eyes—‘‘a bad sign, a bad sign,’’ he had said. The test results came the next morning. She had run a high fever throughout the night, and we were ready for the confirmation of our suspicions. But our Ebola patient did not have Ebola. Instead, she had malaria. In August and September, according to the World Health Organization, at the peak of the epidemic in Liberia, there were over 300 new confirmed Ebola cases per week. Since it began, over 8300 people had been infected, and over 3500 had died (1). Health care workers have been disproportionately affected, with over 800 infections and almost 500 deaths in Liberia, Sierra Leone, and Guinea (1). In response to this crisis, the MMU was set up with the mission of providing hope through care to health care workers and responders in Liberia who may be infected with Ebola Virus Disease. Since it opened on November 7, 2014 until the time of writing in mid-January, it has provided care for 36 health care workers, 17 of whom tested positive for Ebola. The MMU is one part of a large international effort to stop the epidemic. The results of this hard Published online: February 18, 2015
Published: 2015

34. P53: ADDRESSING FOOD ALLERGY IN FOOD SERVICE: THE NATIONAL ALLERGY STRATEGY FOOD SERVICE PROJECT

Author: S Voukelatos, J Aiken, Jill Smith, K Grinter, Sandra Vale, and Maria Said
Subjects: Allergy, business.industry, Food allergy, Environmental health, Internal Medicine, medicine, Food service, Food safety, business, medicine.disease
Published: 2017
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35. P5: ADRENALINE AUTOINJECTOR CARRIAGE AND STORAGE IN THE AUSTRALIAN ANAPHYLAXIS POPULATION

Author: Sandra Salter, Sandra Vale, Rhonda Clifford, Maria Said, and H Charsley
Subjects: education.field_of_study, Carriage, business.industry, Autoinjector, Anesthesia, Population, Internal Medicine, medicine, medicine.disease, education, business, Anaphylaxis
Published: 2017
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36. P54: PREVENTING THE DEVELOPMENT OF FOOD ALLERGY: IMPLEMENTING NEW ASCIA GUIDELINES FOR INFANT FEEDING

Author: Richard Loh, Jill Smith, Preeti Joshi, Maria Said, Katrina J. Allen, and Sandra Vale
Subjects: business.industry, Food allergy, Environmental health, Internal Medicine, Medicine, business, medicine.disease, Infant feeding
Published: 2017
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37. P52: 250 K: A YOUTH ALLERGY AWARENESS PROJECT BY THE NATIONAL ALLERGY STRATEGY

Author: J Aiken, Maria Said, Sandra Salter, Jill Smith, Richard Loh, and Sandra Vale
Subjects: Allergy, Pediatrics, medicine.medical_specialty, business.industry, Family medicine, Internal Medicine, medicine, medicine.disease, business
Published: 2017
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38. Estado: sociedade civil e luta hegemônica

Author: Ana Maria Said
Subjects: Sociedade civil, Consenso, Coerção, Hegemonia, Estado
Abstract: * Doutora em Educacao, na area Educacao, Sociedade, Politica e Cultura pela Universidade Estadual de Campinas - UNICAMP. Professora do Instituto de Filosofia da Universidade Federal de Uberlândia. Email : anasaid@ufu.br Resumo Procuraremos nesse artigo enfocar a complexa analise de Gramsci ao conceito de “Estado integral”, que Christine Buci Gluksmann denomina de “Estado ampliado”: sociedade politica + sociedade civil, encouracada de coercao. Para isso, nao perderemos de vista a relacao dialetica entre Estado e sociedade que permeia a obra gramsciana. Na verdade, ao refletirmos sobre o alcance da obra gramsciana na compreensao do Estado e da luta pelo poder na sociedade contemporânea, nao poderemos deixar de pensar o conceito de hegemonia neste pensador que se defronta e confronta com o fascismo e com as tendencias autoritarias que incidem sobre a democracia nos tempos atuais. Palavras-chave : Estado. Sociedade civil. Hegemonia. Consenso. Coercao. Abstract We seek in this article to focus on the complex analysis of Gramsci’s concept of the “Integral State”, which Christine Buci-Gluksmann calls “Extended State”: political society + civil society, armored of coercion. For that, we must keep in mind the dialectical relationship between State and society that permeates Gramsci’s work. In fact, when we reflect about the scope of Gramsci’s work on the understanding of State and the fight of the contemporary society for power, we can’t leave behind the concept of hegemony of this thinker, which faces and confronts the fascism and the authoritarian tendencies that affect democracy in current times. Keyword : State. Civil society. Hegemony. Consensus. Coercion. Referencias BUCI-GLUCKSMANN, C. Gramsci e lo Stato: per una teoria materialistica della filosofia. Roma: Editori Riuniti, 1976. CROCE, B. Cultura e vita morale. Napoli: Bibliopolis, 1993. FERRI, F.(Org.). Politica e storia in Gramsci. Roma: Ed. Riuniti & Istituto Gramci, 1977. GRAMSCI, A. Quaderni del carcere: A cura di Valentino Gueratana. 2. ed.,. Edizione Critica dell’Istituto Gramsci. Torino: Ed. Einaudi, 1975.v. 1, 2, 3 e 4. ______. Cartas do carcere. Organizacao de Antonio A. Santucci. Palermo: Ed. Sellerio, 1996. IZZO, F. Democrazia e cosmopolitismo in Antonio Gramsci. Roma: Carocci Ed., 2009. LIGUORI, G. Roteiros para Gramsci. Rio de Janeiro: Editora UFRJ, 2007. MUSCATELLO, B. (Ed.). Gramsci e il marxismo contemporaneo. Traducao de Roberto Della Seta. Roma: Ed. Riuniti, 1990. NARDONE, G. Il pensiero di Gramsci. Bari: De Donato, 1984. VACCA, G. Vida e pensamento de Antonio Gramsci (1926-1937). Brasilia: Fundacao Astrojildo Pereira; Rio de Janeiro: Contraponto, 2012. Data de registro: 10/03/2014 Data de aceite: 23/04/2014
Published: 2014

39. The Importance of Research in the MEPI Program

Author: Myat Htoo Razak, Roger I. Glass, and Maria Said
Subjects: Biomedical Research, International Cooperation, Schools, Nursing, Human immunodeficiency virus (HIV), MEDLINE, Nurses, HIV Infections, medicine.disease_cause, Article, Education, Critical mass (sociodynamics), Nursing, Acquired immunodeficiency syndrome (AIDS), Physicians, medicine, Humans, Education, Nursing, Curriculum, Africa South of the Sahara, Schools, Medical, Academic Medical Centers, Education, Medical, Health professionals, business.industry, General Medicine, Public relations, medicine.disease, United States, Work (electrical), General partnership, Diffusion of Innovation, business, Delivery of Health Care
Abstract: The Medical Education Partnership Initiative (MEPI), which aims to strengthen and transform education in medicine and the health sciences in Africa, has placed special emphasis on including research as part of new curricula. The great progress achieved against HIV/AIDS globally has been based in part on major research conducted by African investigators working in African institutions at African field sites in collaboration with international partners. This experience demonstrates the key role of academic institutions in generating knowledge while training the next generation of health professionals. Research is a key driver of innovation in the health sciences, and it can spur global collaborations, build substantial financial support, empower scientific leadership, and promote economic development. Through MEPI, young investigators are becoming engaged in research training early in their careers with projects that develop research skills to help them better understand how to evaluate and integrate new evidence into policy and practice, advance the science of health within their countries, and strengthen the academic institutions in which they work. Research training is an essential component of MEPI and should endure long after the program ends. It may help build a critical mass of researchers as well as a cadre of health professionals, teachers, and leaders who will be better equipped to embrace the continually changing panorama of advances in the health sciences.
Published: 2014
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40. A estrategia e o conceito de democracia em Gramsci e o PCB

Author: Ana Maria Said, Piozzi, Patrizia, 1949-2015, Saviani, Dermeval, Goergen, Pedro L., Graciolli, Edilson Jose, Marques Neto, José Castilho, Universidade Estadual de Campinas. Faculdade de Educação, and UNIVERSIDADE ESTADUAL DE CAMPINAS
Subjects: Democracia, Politics, Political parties, Strategy, Estratégia, Democracy, Education
Abstract: Orientador: Patrizia Piozzi Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação Doutorado Educação, Sociedade e Cultura Doutor em Educação
Published: 2006

41. O projeto politico-pedagogico do Teatro de Arena de São Paulo

Author: Ana Maria Said, Vieira, Evaldo, 1942, Universidade Estadual de Campinas. Faculdade de Educação, and UNIVERSIDADE ESTADUAL DE CAMPINAS
Subjects: Teatro de arena - São Paulo (Estado), Teatro na educação
Abstract: Orientador: Evaldo A. Vieira Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Mestrado
Published: 1989

42. Retrospective Study Of Expert Examination Performed By The Brazilian Federal Police In Investigations Of Wildlife Crimes, 2013-2014.

Author: Sérvio Túlio Jacinto Reis, Licia Maria Said De Lavor, Luciana Vargas Sant’Ana, Tália Missen Tremori, Víctor Antonio Toledo Gonzalez, and Paula Brügger
Subjects: Forensic science, Legal veterinary medicine, Wildlife, Crime, Mistreatment, Law, Medicine
Abstract: One of the main demands for veterinary medical experts is the forensic investigation of crimes against wildlife. In Brazil, most of these crimes are related to the trafficking of wild animals, whose conducts involve the capture, transport and illegal trade of specimens. All these activities also involve various forms of animal mistreatment. This article aims to present the main types of expert examinations used in investigations of wildlife crimes through a retrospective study of records kept by the Criminalistic System of the Brazilian Federal Police in the years 2013 and 2014. The increase in the number of examinations performed in 2014, compared to the year 2013 (86.15%), was mainly focused on identification, mistreatment and investigation of bird ring forgery, reaffirming the importance of these tests in the casuistry of the Federal Police.
Published: 2016

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