Exposures to several outdoor fungal spore taxa, including some not reported in previous research, are associated with the risk of child and adolescent asthma hospitalization, particularly in individuals sensitized to Cladosporium. We need further studies to examine cross-reactivity causing asthma exacerbations. Identifying sensitization to multiple fungal allergens in children with asthma could support the design and implementation of more effective strategies to prevent asthma exacerbations.

The composition and relative abundance of airborne pollen in urban areas of Australia and New Zealand are strongly influenced by geographical location, climate and land use. There is mounting evidence that the diversity and quality of airborne pollen is substantially modified by climate change and land-use yet there are insufficient data to project the future nature of these changes. Our study highlights the need for long-term aerobiological monitoring in Australian and New Zealand urban areas in a systematic, standardised, and sustained way, and provides a framework for targeting the most clinically significant taxa in terms of abundance, allergenic effects and public health burden.

Summary Background Asian infants born in Australia are three times more likely to develop nut allergy than non‐Asian infants, and rates of challenge‐proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate the risk factors for nut allergy, we assessed the whole‐of‐state prevalence distribution of parent‐reported nut allergy in 5‐year‐old children entering school. Methods Using the 2010 School Entrant Health Questionnaire administered to all 5‐year‐old children in Victoria, Australia, we assessed the prevalence of parent‐reported nut allergy (tree nut and peanut) and whether this was altered by region of residence, socio‐economic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders. Results Parent‐reported nut allergy prevalence was 3.1% (95% CI 2.9–3.2) amongst a cohort of nearly 60 000 children. It was more common amongst children of mothers with higher education and socio‐economic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian‐born mothers (aOR 2.67, 95% CI 2.28–3.27) were more likely to have nut allergy than non‐Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of nut allergy (aOR 0.1, 95% CI 0.03–0.31). Conclusion Migration from Asia after the early infant period appears protective for the development of nut allergy. Additionally, rural regions have lower rates of nut allergy than urban areas.

Introduction The development of bedside methods to assess muscularity is an essential critical care nutrition research priority. We aimed to compare ultrasound‐derived muscle thickness at 5 landmarks with computed tomography (CT) muscle area at intensive care unit (ICU) admission. Secondary aims were to (1) combine muscle thicknesses and baseline covariates to evaluate correlation with CT muscle area and (2) assess the ability of the best‐performing ultrasound model to identify patients with low CT muscle area. Methods Adult patients who underwent CT scanning at the third lumbar area <72 hours after ICU admission were prospectively recruited. Muscle thickness was measured at mid‐upper arm, forearm, abdomen, and thighs. Low CT muscle area was determined using published cutoffs. Pearson correlation compared ultrasound‐derived muscle thickness and CT muscle area. Linear regression was used to develop ultrasound prediction models. Bland‐Altman analyses compared ultrasound‐predicted and CT‐measured muscle area. Results Fifty ICU patients were enrolled, aged 52 ± 20 years. Ultrasound‐derived muscle thickness at each landmark correlated with CT muscle area (P < .001). The sum of muscle thickness at mid‐upper arm and bilateral thighs, including age, sex, and the Charlson Comorbidity Index, improved the correlation with CT muscle area (r = 0.85; P < .001). Mean difference between ultrasound‐predicted and CT‐measured muscle area was −2 cm2 (95% limits of agreement, −40 cm2 to +36 cm2). The best‐performing ultrasound model demonstrated good ability to identify 14 patients with low CT muscle area (area under curve = 0.79). Conclusion Ultrasound shows potential for assessing muscularity at ICU admission (Clinicaltrials.gov NCT03019913).

Over time, despite a fall in asthma incidence, readmission rates for childhood asthma significantly increased in younger age groups with girls at a higher risk of being readmitted than boys. Increased risk of repeat admission for boys was observed during the grass pollen season. These findings highlight high-risk groups, which has implications for both clinical services and patient care. More detailed monitoring of readmission rates amongst various risk groups over time is required.

Objective Allergic rhinitis and allergic asthma are important chronic diseases posing serious public health issues in Australia with associated medical, economic, and societal burdens. Pollen are significant sources of clinically relevant outdoor aeroallergens, recognised as both a major trigger for, and cause of, allergic respiratory diseases. This study aimed to provide a national, and indeed international, perspective on the state of Australian pollen data using a large representative sample. Methods Atmospheric grass pollen concentration is examined over a number of years within the period 1995 to 2013 for Brisbane, Canberra, Darwin, Hobart, Melbourne, and Sydney, including determination of the ‘clinical’ grass pollen season and grass pollen peak. Results The results of this study describe, for the first time, a striking spatial and temporal variability in grass pollen seasons in Australia, with important implications for clinicians and public health professionals, and the Australian grass pollen-allergic community. Conclusions These results demonstrate that static pollen calendars are of limited utility and in some cases misleading. This study also highlights significant deficiencies and limitations in the existing Australian pollen monitoring and data. Implications Establishment of an Australian national pollen monitoring network would help facilitate advances in the clinical and public health management of the millions of Australians with asthma and allergic rhinitis.

Food sensitization prevalence is highest in infancy and declines after 12 months of age. Boys with early-life eczema have the highest prevalence of milk and egg sensitization. Food sensitization at 12 months can predict children at greater risk of adolescent sensitization and probable food allergy at 12 and 18 years.

Although boys are more vulnerable to grass pollen, weed, and other pollen are also important triggers of asthma exacerbations in all children and adolescents. These findings are important for urban green space planning and the development of pollen monitoring systems for families with children at risk of asthma exacerbations during peak pollen seasons.