The Infant Microbiome and Its Impact on Development of Food Allergy.

The prevalence of food allergy (FA) has been increasing over the past few decades; recent statistics suggest that FA has an impact on up to 10% of the population and 8% of children. Although the pathogenesis of FA is unclear, studies suggest gut microbiome plays a role in the development of FA. The gut microbiome is influenced by infant feeding method, infant diet, and maternal diet during lactation. Breastfeeding, Mediterranean diet, and probiotics are associated with commensal gut microbiota that protect against FA. This area of research is essential to discovering potential preventive methods or therapeutic targets against FA.

House dust microbiota and atopic dermatitis; effect of urbanization.

BACKGROUND: Previous studies have shown that a child's risk of developing atopic disease is impacted by both genetic and environmental factors. Because small children spend the majority of their time in their homes, exposure to microbial factors in their home environment may be protective or risk factors for development of atopic diseases, such as atopic dermatitis. METHODS: Dust samples from the homes of 86 Black South African children 12 to 36 months old were collected for analysis of the bacterial microbiome. This case-control study design included children with and without atopic dermatitis from rural and urban environments. RESULTS: Significant differences in bacterial composition and diversity were found when comparing children with and without atopic dermatitis. Furthermore, house dust microbiota was significantly different in rural and urban areas. Differences were best accounted for by higher relative abundance of Ruminococcaceae, Lachnospiraceae, and Bacteroidaceae families in rural compared with urban houses. Levels of Ruminococcaceae were also found to be significantly depleted in the house dust of rural children with atopic dermatitis as compared to control children. CONCLUSIONS: House dust composition may be an important risk factor for the development of atopic disease, and this association may be driven in part by the gut microbiome. Low levels of the Ruminococcaceae family from Clostridia class in particular may explain the association between urban living and atopy. However, further research is needed to elucidate these links.

Take-up and profile of individuals accessing a web-based bipolar self-test screening measure.

BACKGROUND: Early detection of bipolar disorder is associated with improved long term outcome. In this study, we profile individuals accessing a web-based self-report screening tool for bipolar disorder. METHOD: Participants accessing the self-screening tool for bipolar disorder (the Mood Swings Questionnaire; MSQ) via the Black Dog Institute website were asked to indicate whether they were willing to participate in a research study evaluating the tool. Demographic details, mood disorder history, previous treatments and the impact of mood problems were assessed, followed by completion of the MSQ to determine the likelihood of a bipolar disorder diagnosis. RESULTS: During the first year of the study, the bipolar self-screening test web-page was viewed 278,279 times. A total of 5803 were eligible to provide baseline data, and 4829 completed the MSQ. Of these, 65% were assigned a preliminary bipolar disorder diagnosis based on MSQ cut-off scores, with the majority (89%) expecting such a result, feeling reassured (64%) by the result, and viewing the self-test as helpful (94%). Encouragingly, over 70% indicated they would follow-up this suggested diagnosis with a health professional. Personal, social and relationship 'costs' were rated as more severe than financial costs in relation to the bipolar condition, highlighting the burden of illness across differing domains. LIMITATIONS: Results may not be generalizable to a community sample of individuals diagnosed with bipolar disorder. CONCLUSION: This web-based (E-health) screening strategy has proven to be extremely successful. Firstly, participants viewed the self-screening tool as useful, supporting the need for easily accessible mental health screening tools to assist with early detection and diagnosis. Secondly, this method has provided quantitative data on help-seeking behaviors, strategies employed to assist with mood problems, response to diagnosis, and the impact of a bipolar condition, which has previously been explored predominantly through qualitative means. The success of this strategy will next be assessed encouraging participants to have any bipolar disorder confirmed and more condition-specific management implemented to determine impact in illness course.

Evaluating the utility of a bipolar self-test screening measure.

OBJECTIVE: To detail the methodology of an online study designed to test the utility of a bipolar self-test screening measure. METHOD: We describe the current technical success of an online methodology in recruiting a large sample with minimal cost. RESULTS: Over some six months, more than 120 000 people accessed the Black Dog Institute Bipolar Self-Test, with screening criteria allowing a cohort to be recruited. CONCLUSION: This paper details the overall study strategy that will be reported on after a large finite sample has been derived.

Next generation of self-management education: Web-based bipolar disorder program.

OBJECTIVE: Education and self-management training assist patients with bipolar disorder to take control of their condition and to reduce disability, but the timeliness and availability of the education are important. A free Web-based bipolar education program has been recently developed to provide accessible evidence-based information for patients, carers and health professionals. The present paper describes the nine-module program, reports usage data and user profiles, and overviews the aims and methodology of a randomized controlled trial to measure its impact. METHODS: Customized Web reports were developed to measure usage of the Web-based program, and to profile its users on a month-by-month basis. Data on the percentage of completers of each module were also collected. A randomized controlled trial evaluating the program in people with newly diagnosed bipolar disorder was also commenced. RESULTS: More than 8,000 visitors used the online program in its first 6 months. Users were predominantly female, of a broad cross-section of ages, 43.5% with bipolar disorder, and with the remainder describing themselves as health professionals, carers/family/friends of a person with bipolar disorder or members of the general public. The majority (76%) completed the sessions they commenced. CONCLUSIONS: The Web-based education program is attracting a steady stream of users and is exhibiting good completion rates. This preliminary support for the program's utility requires validation from our randomized controlled trial before definite conclusions can be drawn.