ABSTRACT
Identifying the "essential" components of an undergraduate immunology lecture course can be daunting because of the varying postgraduate pathways students take. The American Association of Immunologists Education Committee commissioned an Ad Hoc Committee, representing undergraduate, graduate, and medical institutions as well as the biotechnology community, to develop core curricular recommendations for teaching immunology to undergraduates. In a reiterative process involving the American Association of Immunologists teaching community, 14 key topics were identified and expanded to include foundational concepts, subtopics and examples, and advanced subtopics, providing a flexible list for curriculum development and avenues for higher-level learning. Recommendations for inclusive and antiracist teaching that outline opportunities to meet the needs of diverse student populations were also developed. The consensus recommendations can be used to accommodate various course settings and will bridge undergraduate and graduate teaching and prepare diverse students for subsequent careers in the biomedical field.
Subject(s)
Allergy and Immunology/education , Curriculum/standards , Societies, Medical/standards , Allergy and Immunology/organization & administration , Allergy and Immunology/standards , Humans , Students , Teaching/standards , United StatesABSTRACT
BACKGROUND: The coronavirus disease 2019 pandemic imposed multiple restrictions on health care services. OBJECTIVE: To investigate the impact of the pandemic on Allergy & Immunology (A&I) services in the United Kingdom. METHODS: A national survey of all A&I services registered with the Royal College of Physicians and/or the British Society for Allergy and Clinical Immunology was carried out. The survey covered staffing, facilities, personal protective equipment, appointments & patient review, investigations, treatments, and research activity. Weeks commencing February 3, 2020 (pre-coronavirus disease), April 6, 2020, and May 8, 2020, were used as reference points for the data set. RESULTS: A total of 99 services participated. There was a reduction in nursing, medical, administrative, and allied health professional staff during the pandemic; 86% and 92% of A&I services continued to accept nonurgent and urgent referrals, respectively, during the pandemic. There were changes in immunoglobulin dose and infusion regimen in 67% and 14% of adult and pediatric services, respectively; 30% discontinued immunoglobulin replacement in some patients. There was a significant (all variables, P ≤ .0001) reduction in the following: face-to-face consultations (increase in telephone consultations), initiation of venom immunotherapy, sublingual and subcutaneous injection immunotherapy, anesthetic allergy testing, and hospital procedures (food challenges, immunoglobulin and omalizumab administration); and a significant increase (P ≤ .0001) in home therapy for immunoglobulin and omalizumab. Adverse clinical outcomes were reported, but none were serious. CONCLUSIONS: The pandemic had a significant impact on A&I services, leading to multiple unplanned pragmatic amendments in service delivery. There is an urgent need for prospective audits and strategic planning in the medium and long-term to achieve equitable, safe, and standardized health care.
Subject(s)
Allergy and Immunology/organization & administration , COVID-19/epidemiology , Delivery of Health Care , Pandemics , Pediatrics/organization & administration , SARS-CoV-2 , Adult , COVID-19/diagnosis , Child , Humans , Hypersensitivity/diagnosis , Hypersensitivity/therapy , State Medicine , Surveys and Questionnaires , United KingdomABSTRACT
An exemplar outcome of an immunology-based intervention is vaccine development; the current COVID-19 pandemic is a case in point. Can we build an immunology research ecosystem in Africa that nurtures discovery and enables translation? We see African immunologists as key agents of change and discuss obstacles and opportunities.
Subject(s)
Allergy and Immunology , Developing Countries , Africa , Allergy and Immunology/education , Allergy and Immunology/organization & administration , Allergy and Immunology/trends , COVID-19 Vaccines , Humans , SARS-CoV-2Subject(s)
Allergy and Immunology/organization & administration , Societies, Medical/organization & administration , Allergy and Immunology/history , Biomedical Research/history , Biomedical Research/organization & administration , History, 21st Century , International Cooperation/history , Societies, Medical/historySubject(s)
Allergy and Immunology/organization & administration , Anniversaries and Special Events , Societies, Medical/organization & administration , Allergy and Immunology/history , Biomedical Research/history , Biomedical Research/organization & administration , History, 21st Century , International Cooperation/history , Societies, Medical/historyABSTRACT
OBJECTIVES: To understand parent preferences for NHS paediatric allergy services. DESIGN: A stated preference study (discrete choice experiment). SETTING: West Midlands, UK. PARTICIPANTS: A sample of parents of children aged 16 years or younger recruited from the general population through a third party company approved by the University of Birmingham. INTERVENTION: An online questionnaire with 18 choice questions describing two hypothetical paediatric allergy specialist clinics described in terms of the clinician, information provision, additional facilities, waiting times and out of pocket expenses. Main outcome measures Preference and willingness to pay estimates for each of the specified attributes. RESULTS: Parents strongly preferred that their children be reviewed by consultants or specialist nurses formally trained in allergy compared with consultants with no formal allergy training [Willingness to pay (WTP) estimates for nurse specialist £150.9 (138.8-163.2), trained allergy consultants £218.7 (205.7-231.9), compared with consultants without formal training]. They were willing to wait longer to see trained practitioners. Parents also expressed a strong preference for improving online information regarding allergies [WTP for written information £18.4 (6.1-30.6) and £72.6 for improved online information (59.9-85.3), compared with verbal information]. Specialist clinics with additional dietician and eczema support were also preferred [WTP £29.9 (19.8-40.1), compared with no additional support]. CONCLUSIONS: Parents showed strong preference for formally trained practitioners in specialist allergy clinics. Access to improved online allergy information and additional facilities within allergy clinics were also preferred. These findings have implications for future commissioning of paediatric allergy services in the UK.
Subject(s)
Allergy and Immunology , Choice Behavior , Delivery of Health Care, Integrated , Health Knowledge, Attitudes, Practice , Hypersensitivity/therapy , Parents/psychology , State Medicine , Access to Information , Adolescent , Adult , Allergy and Immunology/economics , Allergy and Immunology/organization & administration , Child , Child, Preschool , Delivery of Health Care, Integrated/economics , Delivery of Health Care, Integrated/organization & administration , England , Female , Health Care Costs , Health Care Surveys , Health Expenditures , Humans , Hypersensitivity/diagnosis , Hypersensitivity/immunology , Infant , Infant, Newborn , Male , Middle Aged , Referral and Consultation , Specialization , State Medicine/economics , State Medicine/organization & administration , Time Factors , Waiting Lists , Young AdultABSTRACT
Telemedicine adoption has rapidly accelerated since the onset of the COVID-19 pandemic. Telemedicine provides increased access to medical care and helps to mitigate risk by conserving personal protective equipment and providing for social/physical distancing to continue to treat patients with a variety of allergic and immunologic conditions. During this time, many allergy and immunology clinicians have needed to adopt telemedicine expeditiously in their practices while studying the complex and variable issues surrounding its regulation and reimbursement. Some concerns have been temporarily alleviated since March 2020 to aid with patient care in the setting of COVID-19. Other changes are ongoing at the time of this publication. Members of the Telemedicine Work Group in the American Academy of Allergy, Asthma & Immunology (AAAAI) completed a telemedicine literature review of online and Pub Med resources through May 9, 2020, to detail Pre-COVID-19 telemedicine knowledge and outline up-to-date telemedicine material. This work group report was developed to provide guidance to allergy/immunology clinicians as they navigate the swiftly evolving telemedicine landscape.
Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Telemedicine/organization & administration , Allergy and Immunology/organization & administration , Betacoronavirus , COVID-19 , Clinical Coding , Computer Security , Health Services Accessibility/organization & administration , Humans , Hypersensitivity/therapy , Infection Control/organization & administration , Insurance, Health, Reimbursement , Pandemics , SARS-CoV-2 , Societies, Medical , Telemedicine/economicsSubject(s)
Allergy and Immunology/standards , Eosinophilic Esophagitis/therapy , Gastroenterology/standards , Advisory Committees/standards , Allergy and Immunology/organization & administration , Eosinophilic Esophagitis/immunology , Gastroenterology/methods , Gastroenterology/organization & administration , Humans , Societies, Medical/organization & administration , Societies, Medical/standards , United StatesABSTRACT
Eosinophilic esophagitis (EoE) is a chronic inflammatory condition of the esophagus. Many new studies have been reported recently that describe EoE management. An expert panel was convened by the American Gastroenterological Association Institute and the Joint Task Force on Allergy-Immunology Practice Parameters to provide a technical review to be used as the basis for an updated clinical guideline. This technical review was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Eighteen focused EoE management questions were considered, with 15 answered using the GRADE framework and 3 with a narrative summary. There is moderate certainty in the evidence that topical glucocorticosteroids effectively reduce esophageal eosinophil counts to <15 per high-power field over a short-term treatment period of 4-12 weeks, but very low certainty about the effects of using topical glucocorticosteroids as maintenance therapy. Multiple dietary strategies may be effective in reducing esophageal eosinophil counts to <15 per high-power field over a short-term treatment period, with moderate certainty for elemental diets, low certainty for empiric 2-, 4-, and 6-food elimination diets, and very low certainty that allergy-based testing dietary eliminations have a higher failure rate compared to empiric diet elimination. There is very low certainty for the effect of proton pump inhibitors in patients with esophageal eosinophilia. Although esophageal dilation appears to be relatively safe, there is no evidence that it reduces esophageal eosinophil counts. There is very low certainty in the effects of multiple other medical treatments for EoE: anti-interleukin-5 therapy, anti-interleukin-13 therapy, anti-IgE therapy, montelukast, cromolyn, and anti-TNF therapy.
Subject(s)
Eosinophilic Esophagitis/therapy , Evidence-Based Medicine/standards , Food Hypersensitivity/diagnosis , Administration, Topical , Adult , Advisory Committees/standards , Age Factors , Allergy and Immunology/organization & administration , Allergy and Immunology/standards , Child , Dilatation/adverse effects , Dilatation/standards , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/immunology , Eosinophils/drug effects , Eosinophils/immunology , Esophagoscopy/adverse effects , Esophagoscopy/standards , Evidence-Based Medicine/methods , Food Hypersensitivity/complications , Food Hypersensitivity/diet therapy , Food Hypersensitivity/immunology , Food, Formulated , Gastroenterology/methods , Gastroenterology/organization & administration , Gastroenterology/standards , Glucocorticoids/administration & dosage , Humans , Proton Pump Inhibitors/therapeutic use , Societies, Medical/organization & administration , Societies, Medical/standards , Treatment Outcome , United StatesSubject(s)
Allergy and Immunology/organization & administration , Allergy and Immunology/statistics & numerical data , Appointments and Schedules , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Age Factors , Betacoronavirus , COVID-19 , Humans , Pandemics , SARS-CoV-2 , Sex Factors , Telemedicine/organization & administration , TelephoneSubject(s)
Clinical Decision-Making/methods , Eosinophilic Esophagitis/therapy , Evidence-Based Medicine/standards , Food Hypersensitivity/diagnosis , Administration, Topical , Advisory Committees/standards , Allergy and Immunology/organization & administration , Allergy and Immunology/standards , Dilatation/standards , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/immunology , Evidence-Based Medicine/methods , Food Hypersensitivity/complications , Food Hypersensitivity/diet therapy , Food Hypersensitivity/immunology , Food, Formulated , Gastroenterology/methods , Gastroenterology/organization & administration , Gastroenterology/standards , Glucocorticoids/administration & dosage , Humans , Proton Pump Inhibitors/therapeutic use , Societies, Medical/organization & administration , Societies, Medical/standards , Treatment Outcome , United StatesSubject(s)
Clinical Decision-Making/methods , Eosinophilic Esophagitis/therapy , Food Hypersensitivity/diagnosis , Administration, Topical , Advisory Committees/standards , Allergy and Immunology/organization & administration , Allergy and Immunology/standards , Dilatation/standards , Eosinophilic Esophagitis/diagnosis , Eosinophilic Esophagitis/immunology , Esophagoscopy/standards , Food Hypersensitivity/complications , Food Hypersensitivity/diet therapy , Food Hypersensitivity/immunology , Food, Formulated , Gastroenterology/methods , Gastroenterology/organization & administration , Gastroenterology/standards , Glucocorticoids/administration & dosage , Humans , Immunologic Factors/therapeutic use , Proton Pump Inhibitors/therapeutic use , Societies, Medical/organization & administration , Societies, Medical/standards , Treatment Outcome , United StatesSubject(s)
Allergy and Immunology/organization & administration , Latent Tuberculosis/immunology , Mycobacterium tuberculosis/immunology , Societies, Medical/organization & administration , Tuberculosis, Pulmonary/immunology , Allergy and Immunology/history , Animals , Congresses as Topic , Disease Models, Animal , Female , History, 20th Century , History, 21st Century , Humans , Latent Tuberculosis/diagnosis , Latent Tuberculosis/drug therapy , Latent Tuberculosis/microbiology , Lung/diagnostic imaging , Lung/immunology , Positron Emission Tomography Computed Tomography , Societies, Medical/history , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/microbiologyABSTRACT
BACKGROUND: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the sinonasal mucosa and with strong associations to other immune-mediated comorbidities. Patients often require referral to both an otolaryngologist and an allergist/immunologist. This study is the first in the literature to describe a multidisciplinary clinic that offers patient care by subspecialists in rhinology and in allergy/immunology. METHODS: One hundred twenty-nine patients were seen in the Comprehensive Sinus and Allergy Clinic (CSAC) between January 2016 and June 2017 and 43 selected patients were seen in both the standalone allergy and rhinology clinics over the same time period. Patient satisfaction was retrospectively assessed using a modified Press-Ganey satisfaction survey. Time to evaluation and time to follow up appointment were compared between the CSAC and both the standalone rhinology and allergy/immunology clinics. RESULTS: Patients seen in the CSAC reported high satisfaction with the amount of time spent with the physicians (98.3%), quality of medical care (9.3 ± 1.0), and most importantly, the convenience of seeing two physicians in one day (9.5 ± 1.2). Time from referral placement to clinic evaluation (P ≤ .02) and time to follow up appointment (P ≤ .002) was significantly shorter for the CSAC than for the standalone Rhinology or Allergy clinics. CONCLUSION: Patients reported high satisfaction with the medical care provided and were also seen much faster in our multidisciplinary clinic as compared to standalone rhinology or allergy/immunology clinics. Overall, a multidisciplinary approach may be beneficial to patients presenting to tertiary referral centers with CRS and atopic conditions.