Background Pneumonia is a leading cause of childhood morbidity and mortality. This study aimed to estimate the global hospitalisation due to Staphylococcus aureus pneumonia in under-5 children.Methods We conducted a systematic review and meta-analysis of primary studies following the PRISMA-P guidelines. We searched Medline, Embase, Global Health, CINAHL, Global Index Medicus, Scopus, China National Knowledge Infrastructure, Wanfang, and CQvip. We included studies reporting data on Staphylococcus aureus pneumonia, confirmed by detection of the pathogen in sterile-site samples in under-5 hospitalised children, published in English or Chinese language and conducted between 1st January 1990 and 4th November 2021 and between 1st January 1990 and 30th September 2020, respectively. We excluded those testing upper respiratory tract samples and not reporting data on samples with other bacteria or absence of bacteria. We screened papers against pre-specified criteria, extracted data and assessed the bacteriological quality, and combined epidemiological and microbiological quality of studies using two self-designed checklists. Pooled proportions of hospitalisation episodes for Staphylococcus aureus pneumonia amongst all-cause pneumonia and the 95% confidence intervals were calculated using the random-effects model. The review protocol was registered on PROSPERO (CRD42021236606).Findings Of 26,218 studies identified, thirty-five studies enroling 20,708 hospitalised pneumonia episodes were included. Out of the total hospitalised pneumonia cases in this population, the pooled proportion of Staphylococcal pneumonia cases was 3% (95% CI 2% to 4%; I 2 =96%). Amongst 12 studies with higher microbiological quality, the pooled estimate was 6% (95% CI 2% to 10%; I 2 = 98%). Based on the recent global estimates of hospitalised pneumonia in this age group, the 3% and 6% estimates represent 738 thousand and 1.48 million hospitalisations in 2019, respectively. Based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), the overall quality of evidence was considered to be moderate.Interpretation Our findings are probably an underestimate because of the unknown and the likely limited sensitivity of current testing methods for Staphylococcal pneumonia diagnosis and widespread reported use of antibiotics before recruitment (in 46% of cases). Staphylococcus aureus is an important cause of hospitalisation for pneumonia in young children globally.Funding Bill and Melinda Gates Foundation (OPP 1,172,551) through a prime award to John Hopkins University.

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Current mastalgia assessment diaries are effective in reporting severity and frequency, however recent literature suggests that these diaries assess mastalgia more comprehensively establishing severity, frequency, timing and location. This study aimed to assess validity, reliability, acceptability and minimal detectable change (MDC) of an improved mastalgia diary. Twenty premenopausal females who self-reported pre-menstrual mastalgia completed the diary once a day using paper, email or mobile formats, over one menstrual cycle. Predictive validity was assessed comparing pain pre-and post-menstruation. Test-retest and internal consistency established reliability. Acceptability was assessed using evaluation questions. MDC was calculated using a previously established method using the SEM to a 95% confidence interval. Results showed pre-menstrual mastalgia was significantly higher than post-menstrual, demonstrating diary validity. Reliability tests determined high test-retest reliability (ICC>0.90) and internal consistency (α=0.89). The diary was acceptable for >90% of participants. MDC determined change of 1 on each question would be > measurement error and therefore representing 'real' change. This improved mastalgia diary is a more comprehensive, valid, reliable, and acceptable tool for assessing mastalgia.

OBJECTIVES To compare the proportional representation of healthcare workers in receipt of New Year honours (NYHs) with workers in other industries and to determine whether the NYH system has gender or geographical biases. DESIGNObservational study of the UK honours system with a comparative analysis of proportional representation of the UK workforce and subgroup analyses of gender and geographical representations. PARTICIPANTS Recipients of NYHs from 2009 to 2018.MAIN OUTCOME MEASURES Absolute risk of receiving an NYH based on industry, gender, or region of the UK. Relative risk of receiving an NYH for services to healthcare compared with other industries. RESULTS10 989 NYHs were bestowed from 2009 to 2018, 47% of which were awarded to women. 832 awards (7.6%) were for services to healthcare. People working in sport and in the arts and media were more likely to receive NYHs than those working in healthcare (relative risks of 22.01 (95% confidence interval 19.91 to 24.34) and 5.84 (5.31 to 6.44), respectively). There was no significant difference between the rate of receiving honours for healthcare and for science and technology (P=0.22). 34% (3741) of awards were issued to people living in London and in the southeast of England, and only 496 of 1447 (34%) higher order awards (knighthoods, damehoods, companions of honour, and commanders of the order of the British empire) were received by women. CONCLUSIONSIn relation to the size of its workforce, a career in healthcare is not as "honourable" as careers in certain other industries. Geographical and gender biases might exist in the honours system.The Queen and the government's Cabinet Office are the "fountains of honour" in the United Kingdom Those closest to the fountain are most likely to get splashed WHAT THIS STUDY ADDSThe fountain appears to disproportionately splash politicians, those in arts and media, and sportspeople over healthcare workers and people working in science and technology on 8 July 2020 by guest. Protected by copyright.

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