Probiotics for preventing acute otitis media in children

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: to assess the effects of probiotics to prevent the occurrence and reduce the severity of acute otitis media in children.</p

The point prevalence of respiratory syncytial virus in hospital and community-based studies in children from Northern Australia:studies in a 'high-risk' population

Introduction: Respiratory syncytial virus (RSV) is the leading viral cause of acute lower respiratory infections globally, accounting for high morbidity and mortality burden among children aged less than 5 years. As candidate RSV vaccine trials in pregnant women and infants are underway a greater understanding of RSV epidemiology is now needed, especially in paediatric populations with high rates of acute and chronic respiratory disease. The objective was to identify RSV prevalence in children living in northern Australia, a region with a high respiratory disease burden. Methods: Data were sourced from 11 prospective studies (four hospital and seven community-based) of infants and children with acute and chronic respiratory illnesses, as well as otitis media, conducted between 1996 and 2017 inclusive. The data from northern Australian children in these trials were extracted and, where available and consented, their nasopharyngeal swabs (biobanked at -80°C) were tested by polymerase chain reaction assays for RSV-A and B, 16 other viruses and atypical respiratory bacterial pathogens. Results: Overall, 1127 children were included. Their median age was 1.8 years (interquartile range 0.5-4.9); 58% were male and 90% Indigenous, with 81% from remote communities. After human rhinoviruses (HRV), RSV was the second most prevalent virus (15%, 95% confidence interval (CI) 13-18). RSV prevalence was greatest amongst children aged less than 2 years hospitalised with bronchiolitis (47%, 95%CI 41.4-52.4), with more than two-thirds with RSV aged less than 6 months. In contrast, the prevalence of RSV was only 1-3.5% in other age groups and settings. In onethird of RSV cases, another respiratory virus was also detected. Individual viruses other than RSV and HRV were uncommon (0-9%). Conclusion: Combined data from 11 hospital and communitybased studies of children aged less than 18 years who lived in communities with a high burden of acute and chronic respiratory illness showed that RSV was second only to HRV as the most prevalent virus detected across all settings. RSV was the most frequently detected virus in infants hospitalised with bronchiolitis, including those aged less than 6 months. In contrast, RSV was uncommonly detected in children in community settings. In northern Australia, effective maternal and infant RSV vaccines could substantially reduce RSV bronchiolitis-related hospitalisations, including admissions of Indigenous infants from remote communities.</p

Human Bocavirus in Infants, New Zealand

In 2005, a parvovirus, subsequently named human bocavirus (HBoV), was discovered in respiratory samples taken from infants and children hospitalized at Karolinksa University Hospital, Sweden, with lower respiratory tract infection. HBoV has since been identified in infants and children with respiratory illness in >17 countries, at frequencies ranging from 1.5% to >18.0%. This study reaffirms previous reports of finding HBoV in a subset of infants with bronchiolitis. It is also, to our knowledge, the first study of its kind in New Zealand infants, confirming wide distribution of HBoV. In the northern hemisphere, HBoV circulates primarily during the winter months, although it continues circulating until early summer, later than most other seasonal respiratory viruses. Therefore, this study may underestimate the percentage of New Zealand infants with bronchiolitis whose HBoV test results were positive because sample collection ceased in October (southern hemisphere spring) at the end of the bronchiolitis epidemic. The small number of HBoV-positive infants prevents conclusions concerning ethnicity, coinfection, and bronchiolitis severity

Antibiotics in childhood pneumonia: how long is long enough?

Improved access to healthcare, vaccines and treatment with antibiotics has reduced global mortality from childhood community-acquired pneumonia. However, as respiratory viruses are responsible for most episodes of pneumonia, important questions remain over who should receive these agents and the length of each treatment course. Worldwide concerns with increasing antibiotic resistance in respiratory pathogens and appeals for more prudent antibiotic prescribing provide further urgency to these clinical questions. Unfortunately, guidelines for treatment duration in particular are based upon limited (and often weak) evidence, resulting in national and international guidelines recommending treatment courses for uncomplicated pneumonia ranging from 3 to 10 days. The advantages of shortcourse therapy include a lower risk of developing antibiotic resistance, improved adherence, fewer adverse drug effects, and reduced costs. The risks include treatment failure, leading to increased short- or long-term morbidity, or even death. The initial challenge is how to distinguish between bacterial and non-bacterial causes of pneumonia and then to undertake adequately powered randomised-controlled trials of varying antibiotic treatment durations in children who are most likely to have bacterial pneumonia. Meanwhile, healthcare workers should recognise the limitations of current pneumonia treatment guidelines and remember that antibiotic course duration is also determined by the child’s response to therapy

The menopausal experience among indigenous women of Sarawak, Malaysia

Objectives To document the common menopausal symptoms and quality of life in indigenous women of Sarawak in Malaysia. Methods A face-to-face interview using the Menopause-specific Quality of Life questionnaire was conducted with 276 indigenous Sarawakian women aged 40–65 years to determine the mean age of menopause and common symptoms (divided into vasomotor, psychosocial, physical and sexual domains) associated with menopause. Results The mean age at menopause of postmenopausal women was 50.78+2.47 years (range 47.3–58.2 years). The most common symptoms reported were aching in muscles and joints (82.6%), lack of energy (77.5%) and low backache (77.2%). The typical menopausal symptoms of hot flushes, night sweats, sweating and vaginal dryness were experienced by 42.4%, 34.8%, 29.7% and 49.3%, respectively of the women studied. Perimenopausal women (n¼114) experienced the most physical and psychosocial symptoms, while postmenopausal women (n¼102) experienced most sexual symptoms. Perimenopausal and postmenopausal women were reported to suffer more than premenopausal women (p50.001) within the four domains of symptoms (vasomotor, psychosocial, physical and sexual). Conclusions The menopausal symptoms in this study correspond to those in other studies on Asian women but the prevalence of typical and classical menopausal symptoms was lower compared to studies on Caucasian women. The perimenopausal women had the most significant decrease in quality of life, followed by postmenopausal women and premenopausal women. Vasomotor symptoms had a predominant influence on the quality of life

On the Role of Intrinsic Value in Terms of Environmental Education

AbstractAn understanding of instrumentally valuable nature resulted from anthropocentrism is incapable of producing long-term, real solutions to deal with environmental problems. It is obvious that these problems cannot be handled staying within the current understanding of nature-human relationship and without broaden the extent of ethics in a way to involve non-human entities. Human beings are prone to protect what they consider as intrinsically valuable. Further, they have a tendency to value the things around them and it can be improved. Thus, a big part of this can be succeeded through environmental education. Therefore, in this paper, I discuss the role of intrinsic value in terms of environmental education to handle the environmental problems, and investigate a new account of subjective intrinsic value about nature