OM worker discovers unlikely friendships among a group of 'misfit toys' in North Africa.

While praying for her dad to have a spiritual dream, one Muslim background believer dreams of Jesus and surrenders her own life to Him.

Long-term worker teaches Transform seminar about loving Muslim women, encouraging two participants to deepen relationships with Muslim friends back home.

A worker bonds with a North African friend over movies and finds opportunity for deeper discussions about faith.

An OM worker visits an islamic university while trying to build a deeper relationship with a religious friend.

Logos II

OM Ships International celebrates five years of God’s faithfulness through the ministry of Logos Hope around the world.

Lima, Peru- In June four members from OM Peru led a day-long training seminar in Lima. The seminars were attended by over 50 believers from five different churches.

OM Peru recently completed their second medical outreach this year. Mayelo Gensollen, OM Peru's leader, shared his impressions from the experience.

A team of volunteers and doctors attended to over 300 people in a town almost destroyed by an earthquake in 2007.

OBJECTIVES:

Our goals for this study were to characterize the frequency of agitation in patients with autism spectrum disorder (ASD) admitted to an inpatient pediatric medical unit and to identify risk factors associated with agitation.

BACKGROUND:

Long delays between parents’ initial concerns about their children’s development and a subsequent autism spectrum disorder (ASD) diagnosis are common. Although discussions between parents and providers about early ASD concerns can be difficult, they are critical for initiating early, specialized services. The principles of shared decision-making can facilitate these discussions. This qualitative study was designed to gain insights from parents of young children with ASD about their experiences communicating with primary care providers with the goal of identifying strategies for improving conversations and decision-making regarding the early detection of ASD.

CONTEXT:

Recommendations conflict regarding universal application of formal screening instruments in primary care (PC) and PC-like settings for autism spectrum disorder (ASD).

Family involvement in the Autism Intervention Research Network on Physical Health, the Autism Treatment Network, and the Autism Learning Health Network, jointly the Autism Networks, has evolved and grown into a meaningful and robust collaboration between families, providers, and researchers. Family involvement at the center of the networks includes both local and national network-wide coproduction and contribution. Family involvement includes actively co-authoring research proposals for large grants, equal membership of network committees and workgroups, and formulating quality improvement pathways for local recruitment efforts and other network initiatives. Although families are involved in every aspect of network activity, families have been the driving force of specifically challenging the networks to concentrate research, education, and dissemination efforts around 3 pillar initiatives of addressing comorbidities of anxiety, attention-deficit/hyperactivity disorder, and irritability in autism during the networks’ upcoming funding cycle. The expansion of the networks’ Extension for Community Healthcare Outcomes program is an exciting network initiative that brings best practices in autism care to community providers. As equal hub members of each Extension for Community Healthcare Outcomes team, families ensure that participants are intimately cognizant of family perspectives and goals. Self-advocacy involvement in the networks is emerging, with plans for each site to have self-advocacy representation by the spring of 2020 and ultimately forming their own coproduction committee. The Autism Treatment Network, the Autism Intervention Research Network on Physical Health, and the Autism Learning Health Network continue to be trailblazing organizations in how families are involved in the growth of their networks, production of meaningful research, and dissemination of information to providers and families regarding emerging work in autism spectrum disorders.

OBJECTIVES:

To summarize baseline data and lessons learned from the Autism Learning Health Network, designed to improve care and outcomes for children with autism spectrum disorder (ASD). We describe challenging behaviors, co-occurring medical conditions, quality of life (QoL), receipt of recommended health services, and next steps.

An adolescent girl with a history of frequent electronic cigarette use of nicotine was hospitalized with severe necrotizing pneumonia. Blood cultures obtained before the administration of empirical broad-spectrum intravenous antibiotics had positive results for the growth of Fusobacterium necrophorum. The pathogen is an uncommon but well-known cause of anaerobic pneumonia with unique features that are collectively referred to as Lemierre syndrome or postanginal sepsis. The syndrome begins as a pharyngeal infection. Untreated, the infection progresses to involve the ipsilateral internal jugular vein, resulting in septic thrombophlebitis with direct spread from the neck to the lungs causing multifocal necrotizing pneumonia. The teenager we present in this report had neither a preceding pharyngeal infection nor Doppler ultrasonographic evidence for the presence of deep neck vein thrombi, leading us to explore alternative mechanisms for her pneumonia. We propose the possibility that her behavior of frequent vaping led to sufficient pharyngeal irritation such that F necrophorum colonizing her oropharynx was inhaled directly into her lungs during electronic cigarette use. Preexisting, but not yet recognized, vaping-related lung injury may have also contributed to her risk of developing the infection. The patient was hospitalized for 10 days. At follow-up one month later, she still became short of breath with minimal exertion.

Idiopathic acute eosinophilic pneumonia is a rare and potentially life-threatening condition that is defined by bilateral pulmonary infiltrates and fever in the presence of pulmonary eosinophilia. It often presents acutely in previously healthy individuals and can be difficult to distinguish from infectious pneumonia. Although the exact etiology of idiopathic acute eosinophilic pneumonia remains unknown, an acute hypersensitivity reaction to an inhaled antigen is suggested, which is further supported by recent public health risks of vaping (electronic cigarette) use and the development of lung disease. In this case, a patient with a year-long history of vaping in conjunction with tetrahydrocannabinol cartridge use who was diagnosed with idiopathic acute eosinophilic pneumonia with associated bilateral hilar lymphadenopathy is described.

A previously healthy 9-year-old immigrant girl from Mexico was evaluated in the emergency department (ED) with one week of fatigue, fevers, rhinorrhea, and cough. She initially presented to her primary pediatrician, where a complete blood count revealed neutropenia, prompting referral to the ED. In the ED, she was found to be influenza A–positive. Because of dehydration, she received intravenous fluids and was admitted to the pediatric hospital medicine service. After 2 days, influenza symptoms improved, and oral intake increased. However, she was noted to have decreased bilateral lower-extremity strength, absent Achilles reflexes, decreased lower-extremity sensation and proprioception, a positive result on the Romberg sign, and abnormal heel-to-shin testing results. These findings prompted an urgent neurology consultation. After extensive imaging, laboratory evaluation, and further consultations, a diagnosis was established.

Pediatric thrombocytopenia has a wide differential diagnosis, and recently, genetic testing to identify its etiology has become more common. We present a case of a 16-year-old boy with a history of chronic moderate thrombocytopenia, who later developed constitutional symptoms and bilateral hand edema with cold exposure. Laboratory evaluation revealed evidence both of inflammation and elevated muscle enzymes. These abnormalities persisted over months. His thrombocytopenia was determined to be immune mediated. Imaging revealed lymphadenopathy and asplenia, and a muscle biopsy was consistent with tubular aggregate myopathy. Ophthalmology evaluation noted photosensitivity, pupillary miosis, and iris hypoplasia. Genetic testing demonstrated a pathogenic variant in STIM1 consistent with autosomal dominant Stormorken syndrome. Our case is novel because of the overlap of phenotypes ascribed to both gain-of-function and loss-of-function pathogenic variants in STIM1, thereby blurring the distinctions between these previously described syndromes. Pediatricians should consider checking muscle enzymes when patients present with thrombocytopenia and arthralgia, myalgia, and/or muscle weakness. Our case highlights the importance of both multidisciplinary care and genetic testing in cases of chronic unexplained thrombocytopenia. By understanding the underlying genetic mechanism to a patient’s thrombocytopenia, providers are better equipped to make more precise medical management recommendations.

Almost 1 in 4 adolescents have a sexually transmitted infection (STI). These infections are preventable through safe sexual practices and routine screening. Pediatricians are the first line of clinical care for adolescents and are well positioned to offer sexual and reproductive health care counseling and services to their patients; yet, there is a paucity of sexual health screening provided at routine health supervision visits. This article addresses the epidemiology of STIs in adolescents, reviews the evidence of current clinical practice, presents recommended STI screening from government and medical agencies, and offers strategies to address barriers to providing care for adolescents and for sexual health screening in primary care.

Problematic Internet use (PIU) by adolescents is of growing concern among both parents and pediatricians. Early controversies may have contributed to challenges in defining and measuring PIU. A variety of screening tools have evolved, aligned with different constructs of PIU, although a validated screening tool does exist. Current data and American Academy of Pediatrics policy reflect evidence-driven screening for PIU for all youth.

Adolescent use of electronic cigarettes (e-cigarettes) has increased dramatically, with younger and nicotine-naive adolescents starting to use these devices and use them more frequently than combustible cigarettes. In emerging evidence, it is shown that e-cigarettes are not effective in helping adult smokers quit and that youth using e-cigarettes are at risk for becoming nicotine dependent and continuing to use as adults. Important gaps in our knowledge remain regarding the long-term health impact of e-cigarettes, effective strategies to prevent and reduce adolescent e-cigarette use, and the impact of provider screening and counseling to address this new method of nicotine use.

OM Ireland's Immersion team reflects on their first month as interns in churches around Ireland.

The Creative Arts team perform their Christmas show for school children all over Ireland in the course of three weeks.

OM Ireland proclaims the true meaning of Christmas in a relevant and exciting way for primary school children and through Irish national television.

The Bailie family serve with their local church as part of OM in Ireland's Philippian Project.

On 22 August, 150 people climbed in the inaugural OM Boonah Freedom Climb to raise awareness and funding for the Jogini girls of India.

A former Afghan fighter discovers Jesus Christ in the Qur’an.

OM Pakistan restarted ministry in one province to reach the least reached by forming small discipleship groups and training local believers to be disciples of Christ.

Extreme Leadership Training camps create unity in Ukraine.

OM Ukraine's sports team equips and trains churches in using non-traditional sports in their summer camps.

A Christian football coach experiences what he says is the best gift from God, something “so much more than winning”.

A 17 year old high school student shares about how she fled from the war zone and came to stay at OM Odessa's centre.

Through the "Lighthouse" soccer team, Maksim Shlikov is reaching out to young orphanage graduates looking for meaning and hope.

In the weeks around Easter, the OM team in Vinnitsa reached out with a gospel puppet show to more than 1,500 people.

A local church gets excited about bringing the gospel of Christ to their small community.

OM's International Intensive School of Missions in Panama is getting ready to start in January 2012 to equip Latinos for missions.

The needs of the world have become real to Luz Ángela Miranda in OM Panama's Intensive School of Missions.

Compiled by: Antigoni Markitani

A handful of listed companies dominate the investment portfolios of local general equity funds.

A Fin24 user looks to an expert for help in improving his credit score by paying off his debt.

A retired Fin24 user is looking at investing in a retirement annuity to provide him with a cash payout of R500 000 to ensure that he lives within his means. An expert responds.

A Fin24 user is looking to start a retirement savings plan as it does not form part of company benefits, he would have to pay out of pocket.

A Fin24 user asks whether saving is better when debt is paid off or not.

A Fin24 user wants to know whether paying off a car loan or credit card will make her credit score 'look better.'

A Fin24 user who was forced into early retirement is struggling to pay credit card debt amounting to over R109 000. An expert responds.

A Fin24 user set to retire in August this year is looking at options on where he can invest his pension payout.