Laura Polloni

What do school personnel know, think and feel about food allergies?

BackgroundThe incidence of food allergy is such that most schools will be attended by at least one food allergic child, obliging school personnel to cope with cases at risk of severe allergic reactions. Schools need to know about food allergy and anaphylaxis management to ensure the personal safety of an increasing number of students. The aim of this study was to investigate Italian school teachers and principals’ knowledge, perceptions and feelings concerning food allergy and anaphylaxis, to deeply understand how to effectively support schools to manage a severely allergic child. In addition a further assessment of the impact of multidisciplinary courses on participants was undertaken.Methods1184 school teachers and principals attended courses on food allergy and anaphylaxis management at school were questioned before and after their course. Descriptive and inferential statistics were used to analyze the resulting data.ResultsParticipants tended to overestimate the prevalence of food allergy; 79.3% were able to identify the foods most likely involved and 90.8% knew the most frequent symptoms. 81.9% were familiar with the typical symptoms of anaphylaxis but, while the majority (65.4%) knew that “adrenaline” is the best medication for anaphylaxis, only 34.5% knew indications of using adrenaline in children. 48.5% thoroughly understood dietary exclusion. School personnel considered that food allergic students could have social difficulties (10.2%) and/or emotional consequences (37.2%) because of their condition. “Concern” was the emotion that most respondents (66.9%) associated with food allergy. At the end of the course, the number of correct answers to the test increased significantly.ConclusionsHaving adequately trained and cooperative school personnel is crucial to significantly reduce emergencies and fatal reactions. The results emphasize the need for specific educational interventions and improvements in school health policies to support schools to deal with allergic students ensuring their safety and psychological well-being.

Psychological care of food-allergic children and their families: an exploratory analysis.

inflammation, AR, and asthma. Thus, this study might suggest that a FeNO value >34 p.p.b., such as pathological, may predict future asthma onset with good reliability in AR children. Therefore, all these previous studies were consistent with the present report, confirming the role of FeNO as marker of bronchial impairment. On the contrary, lung function assessment was not able to predict asthma onset in all children, also those with high FeNO values. This fact highlights the possible capability of FeNO as potential candidate of predictive marker for asthma onset in AR patients. However, this study has a main limitation, such as the restricted number of children, who were enrolled. In conclusion, this study provides a preliminary evidence that FeNO may predict with fair capability the risk of asthma onset in children with AR alone. Therefore, a simple FeNO measurement could suggest relevant information about possible bronchial involvement in AR.

School personnel's self‐efficacy in managing food allergy and anaphylaxis

Food allergy affects up to 4–7% European schoolchildren. Studies identified important shortcomings on food allergy and anaphylaxis management in schools. In social cognitive theory, personal beliefs in own capabilities influence choices, effort levels, perseverance and performance accomplishments. This study aimed to investigate school personnels self‐efficacy in managing food allergy and anaphylaxis, providing a valid instrument to deeply understand how to support schools to effectively manage students at risk of food reactions.

Multidimensional analysis of food-allergic children and adolescents’ self-concept: A comparison with a healthy matched sample:

The study investigated self-concept in food-allergic youths and matched healthy controls. Global and domain-specific self-concepts were assessed in 154 participants (9–19 years) using the Multidimensional Self-Concept Scale. Statistical analysis assessed differences between the two samples and effects of asthma, dermatitis, age, and gender among patients. Significant differences were found for Total Scale score and for Competence and Physical scores. Patients showed clinically problematic self-concepts in Global, Competence, and Family domains. Age was found to be associated with the Total score. Health professionals should consider food-allergic patients’ personality development. Further studies could examine disease-specific consequences and interventions.

Bullying risk in students with food allergy: schoolteachers' awareness

Bullying is demonstrated to be a critical issue related to food allergy (FA) in children and adolescents. We recently investigated bullying victimization in a sample of food-allergic Italian students matched to healthy controls, finding that food-allergic schoolchildren have a probability of being bullied approximately 2 times higher than healthy peers. 60% of them reported they were victims of some form of bullying at least once in the last 2 months, demonstrating that food-allergic patients should be included in the category of students at high risk of bullying. This article is protected by copyright. All rights reserved. Language: en

Perinatal stress and food allergy: a preliminary study on maternal reports.

Maternal stress in fetal and early life has been associated with the development of respiratory allergies, but no studies exist about food allergy. Stressful events and the quality of caregiving provided, as they affect the emotional and physiologic regulation of the infant, could alter the hypothalamic–pituitary–adrenal and immune system, facilitating an increased allergic response. This study aimed to investigate the influence of perinatal stress, as perceived by mothers, on developing food allergy in childhood. A survey on pregnancy and the first three months after giving birth was submitted to 59 Italian mothers of at least one child suffering from severe food allergy and one completely healthy child, for a total of 118 children examined. The presence of stressful events and the quality of perinatal period for each child were assessed retrospectively. The food allergic children’s data were compared to siblings’ data through inferential statistics. The results showed a significantly higher number of stressful events occurred during patients’ perinatal period, compared to siblings, in particular bereavements in pregnancy and parenting difficulties in postpartum. Mothers reported harder pregnancies and more stressful, harder, and, in general, worse postpartum when referring to their food-allergic children, in comparison with their siblings (p < .05). Psychological aspects are demonstrated to be involved in the development of allergic diseases. This study constitutes the first step to examine the role of early stress and perinatal psychosocial factors in the pathogenesis of food allergy; further studies are necessary to understand individual psychological impact and its relations with genetic and biological factors.

Food allergy and attitudes to close interpersonal relationships: an exploratory study on attachment

Food allergy is a common immunologic disease that includes potentially fatal reactions. It impacts considerably on patients’ social life including close interpersonal relationships. Attachment theory provides a theoretic framework to evaluate the quality of close interpersonal relationships in chronic disorders. Attachment insecurity, mainly characterized by attachment avoidance, has been found in a variety of health conditions, but still needs to be investigated in food allergy. The study aimed to investigate attachment, as attitude to close interpersonal relationships, among food‐allergic young patients, compared to healthy controls.

Alexithymia in food-allergic versus healthy children and young adults

Alexithymia is a multifaceted personality construct associated with several medical illnesses. However, no studies have focused on food allergy. We investigated alexithymia among food-allergic youths, compared to a matched healthy sample. A total of 220 participants aged 9–25 years were assessed using the Toronto Alexithymia Scale and the Alexithymia Questionnaire for Children. Food-allergic patients reported higher levels of alexithymia compared to a matched healthy sample. Furthermore, an association between alexithymia and a clinical history of anaphylaxis was found among patients. Some possible hypotheses have been discussed considering physiological, psychological, developmental, and cognitive/behavioral factors.

Assessment of children's nutritional attitudes before oral food challenges to identify patients at risk of food reintroduction failure: a prospective study

Inappropriate dietary eliminations may impair quality of life, affect childrens growth and unnecessarily impact on healthcare costs. Previous retrospective studies reported that around 25% of children continue a food‐avoidance diet despite a negative oral food challenge (OFC). A definite pattern has not been found yet for patients not reintroducing the food. This study aimed to examine the role of childs nutritional attitudes and maternal anxiety in reintroducing food after a negative OFC.

Nutritional behaviour and attitudes in food allergic children

The results showed school-aged children are significantly less interested in tasting new foods (p<.01) than younger children. Most of the children (76;71%) claimed to have a “monotonous” diet; in a rising rating scale from 1 to 5 they reported a mean score of 3.3. No differences were found between the two groups of age. When asked about causes of repetitive diet, the participants answered: strict avoidance (36), difficulties in making traditional recipes (23), a limited choice of food industry safe products (21) and low curiosity about food (23). Regarding participation to social events involving food, 17.5% of older children reported they never attend parties. Those who participate always (22;62.5%), or sometimes (7;20%) eat only “safe foods” (45%), or bring foods from home (24%), or take on both solutions. Younger children answered “sometimes” for the majority (39; 54%), a few “always” (27;37.5%) and only some “never” (6;8.5%). Conclusion The results underline the impact of food allergy in reducing interest about food and in influencing patients’ approach to social life. It is important to support families in arousing curiosity in children, suggesting recipes for a varied and stimulating diet.