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Serving on shore for a season

Veracruz, Mexico :: An overview of the various initiatives crewmembers have dispersed to while Logos Hope undergoes her annual maintenance.




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Locked doors, locked hearts

Changing door locks leads to a decades-long relationship for one worker in North Africa.




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God wrote missions on their hearts

A couple adopts a small, struggling church in North Africa and prays for faithfulness and perseverance: “It’s one step forward, 100 steps back.”




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Ten years later hearts are changing

After 10 years in North Africa, an OM worker sees a change in the hearts of neighbours and friends.




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North Africa: Ground-breaking news

God uses a new believer in North Africa to release legal paperwork for the first missions training centre in the district.




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Reaching kids with God’s love

Women work with disabled children in North Africa, desiring to transmit God’s love through physical therapy.




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Dream becomes turning point

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




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Heart for house help

Weekly prayers with cleaning ladies allows long-term worker to build relationships and share Jesus.




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Weekend of creative prayer

Long-term OM workers organize weekends of intercessory art, helping community connect creativity and prayer.




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Grace and peace amidst chaos

OM workers in North Africa explain they have peace even during times of political unrest.




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God uses every season

A long-termer shares how she, as a childless woman, has been given opportunity to speak into local women’s lives in North Africa.




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Learning to love Muslim friends

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




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Meeting Arabic speakers in Spain

God answers a long-term worker’s prayer for an outreach day in Spain, connecting her with people from her host country in North Africa.




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Making broken pieces beautiful

By offering a creative class for women, an OM worker finds ways to transform broken tiles into art and make relationships where she can share God’s truth.




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Praying God’s heart for the nations, Part 2

Workers from the Middle East North Africa Area share how they use strategic prayer to prepare the way for God to move across the region.




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Easter: first taste of church

When a worker apologises for a loud in-home worship gathering, her neighbour responds with the desire to attend church.




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Reaching students and seekers

An OM evangelist follows God to North Africa and pioneers ministry among students and seekers in a new city.




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Amazing race: Outreach edition

10 challenges, 3 people, 0 phones and 1 awesome God.




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Treasure in the souk

A 12-year friendship gains spiritual traction when a North African woman buys a devotional book at the local market.




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Family at sea

The story of a Dutch/Finnish family aboard Logos Hope




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Strength in weakness

Name: Oliviana Tugui Home: Bucharest, Romania Born in: August 1984 Joined OM Ships: February 2013 Previous employment: Teacher’s Assistant and ESL/Spanish Teacher for Primary Students Current job on board: International Café team member




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Bringing hope and healing to South Korea

From 21 July - 19 August, Logos Hope brought the hope of the Gospel to over 50,000 people who visited the ship in Incheon, South Korea.




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A great hope

Kuching, Malaysia :: The Logos Hope family celebrates Easter day together onboard.




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A marine engineer’s heartbeat

Four Nigerian marine engineering students studying in Cebu, Philippines, receive practical training and spiritual encouragement through a Logos Hope engineer.




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From vision to reality

The story of how OM’s Ship Ministry began




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Shipwrecked—yet full steam ahead

Seventeen years after the Ship Ministry sailed into service, OM suffered the loss of Logos at sea. But partners around the world were adamant the work should continue, and gave generously to replace the vessel with something better.




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Doulos: a platform for peace in Papua New Guinea

In 1999, national bitterness and divisions were set aside on board Doulos, which facilitated an historic reconciliation after conflict in the Pacific islands.




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Heartfelt reunion

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




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Many reached during medical clinic in Chincha

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




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Pope asks God to free Catholics from the 'disease' of division

Vatican City, May 4, 2020 / 07:29 am (CNA).- Jesus died for everyone, but disordered attachment to one’s own ideas can cause divisions which break the unity of God’s people, Pope Francis said at Mass on Monday.

“There are ideas, positions that create division, to the point that the division is more important than unity,” the pope said May 4. People think “my idea is more important than the Holy Spirit who guides us.”

Francis called division a “disease of the Church, a disease which arises from ideologies or religious factions…”

Throughout the Church’s history there has always been a spirit of thinking one’s self to be righteous and others to be sinners, he said, describing it as an “us and the others” attitude, which says others are already condemned, while “we have the right position before God.”

Speaking from the chapel of his Vatican residence, the Casa Santa Marta, Francis emphasized that Jesus died for everyone.

Imagining a dialogue with someone questioning the statement, he said, “‘But did [Jesus] also die for that low-life who made my life impossible?’ He died for him too. ‘And for that crook?’ He died for him.”

“For everyone,” Francis underlined. “And also for people who do not believe in him or are of other religions: he died for everyone.”

Without using a name, the pope referenced a retired cardinal living inside the Vatican, who, he said, likes to say “the Church is like a river,” with different people being like different parts of the river.

“But the important thing is that everyone is inside the river,” the pope said. “This is the unity of the Church.”

The Church is a wide river, “because the Lord wants it so.”

Pope Francis quoted a verse from the day’s Gospel reading, John 10:11-18, when Jesus says: “I have other sheep that do not belong to this fold. These also I must lead, and they will hear my voice, and there will be one flock, one shepherd.”

Jesus is saying “I am Shepherd of everyone,” the pope explained. “Everyone: Big and small, rich and poor, good and bad.”

Pointing to the divisions in the Church after the Second Vatican Council, he said it is permissible to think differently from one another, but always “in the unity of the Church, under Jesus the Shepherd.”

He prayed that the Lord would free Catholics from the illness of division and help them to see “this great thing from Jesus, that in him we are all brothers and he is the Shepherd of all.”

Pope Francis offered the day’s Mass for families, that in this time of quarantine because of the coronavirus pandemic they will continue to try new and creative things together and with their children.

He also acknowledged the reality of domestic violence, asking for prayers for families “to continue in peace with creativity and patience in this quarantine.”

After Mass the pope led those following the Mass via livestream in an act of spiritual communion. He concluded with Eucharistic adoration and benediction.

 




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Vatican urges Catholics to reach out to internally displaced people

Vatican City, May 5, 2020 / 08:10 am (CNA).- The Vatican’s migrant and refugee office has released a booklet with guidance on how the Church might respond to the problem of people internally displaced within their own countries due to conflict or disaster.

Many people might be unaware of the existence of internally displaced people, or IDPs, Cardinal Michael Czerny, under-secretary of the migrants and refugees section, said May 5.

Speaking during a livestreamed press conference, he noted that internal displacement “is a current, contemporary reality in a surprising number of countries.”

Internally displaced persons are defined as those who have had to flee their home or residence due to violence, conflict, disaster, or development projects to find refuge in another part of the country. Since IDPs have not crossed international borders, they do not have the legal status of refugee or migrant and do not receive the legal protections those categories can give.

Czerny’s office, which is a part of the Dicastery for Promoting Integral Development, published a booklet May 5 called “Pastoral Orientations on Internally Displaced People.”

The document is directed primarily at dioceses, parishes, Catholic NGOs, and other Catholic organizations. It has short paragraphs on key issues related to the welcome, protection, promotion, and integration of IDPs, interspersed with quotes from relevant Church documents and speeches by Pope Francis.

The importance of spiritual care for Catholics who are internally displaced in their countries is one of the topics addressed. Cardinal Czerny said Tuesday he would like to highlight the response an average Catholic parish might give when it “discovers IDPs in its midst and learns how to reach out to them.”

“To me, this is a great sign of hope,” he said.

“When the Holy Father asks us to go to the peripheries, we might think of going to a faraway foreign land where we will do exotic things,” the cardinal said. “But the real peripheries which hurt are the ones that are very near at hand, the ones where people among us are invisible, are set aside, are discarded, are overlooked.”

According to data from the Internal Displacement Monitoring Centre (IDMC), at the end of 2019, 45.7 million people were living internally displaced from their homes worldwide for reasons of conflict. Including other causes of displacement, the number of IDPs is more than 50 million.

The IDMC reported that the countries with the highest numbers of internally displaced people are Syria, Democratic Republic of Congo, Afghanistan, Iraq, Yemen, and Colombia, though nearly every country in the world has IDPs.

In the United States, the IDMC says there were 916,000 people newly displaced internally due to disaster in 2019. The majority of these new displacements were caused by Hurricane Dorian and the California wildfires.

The Church can do something so that “those among us who have been forced to flee and find themselves among us will receive Christian welcome and the response the Body of Christ wants to give them,” Czerny explained.

He said the aim of “Pastoral Orientations” is for the more than 50 million IDPs “to be recognized and supported, promoted and eventually reintegrated, so that they can play an active, constructive role in their country even if powerful causes, both natural and unjust human causes, have forced them to flee from home and take refuge somewhere.”

“In the post-COVID-19 world that is emerging, their contribution will be very much needed,” the cardinal added.

He explained that publishing the document on internal displacement is “not a lessening on the priority of refugees, migrants, asylum seekers, victims of human trafficking,” but a matter of “continuing to respond to the full range of people’s needs and vulnerabilities,” even in the midst of a global pandemic.

“There are very many needs which didn’t go away just because we were focused on other things in the past weeks,” he underlined. “It’s not a question of COVID-19 displacing priorities. It’s a question of both/and…”

Problems such as internal displacement were already there, “and, on top of it all we also have the challenge as a human family of resisting and overcoming this pandemic.”

The Church, he said, is able “to take on a new challenge without jettisoning other problems as if they suddenly became irrelevant.”




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Pope Francis hails St. John Paul II's 'great witness' ahead of centenary

Vatican City, May 5, 2020 / 11:00 am (CNA).- Pope Francis said that he has looked up to St. John Paul II throughout his priesthood in a book foreword he wrote ahead of the 100-year anniversary of the Polish pope’s birth. 

“St. John Paul II was a great witness of faith … Many times, in the course of my life as a priest and bishop I have looked to him, asking in my prayers for the gift of being faithful to the Gospel as he witnessed to us,” Pope Francis wrote in the forward of a recently published Italian book.

The book, “St. John Paul II: 100 Years. Words and images”, is being issued by the Vatican Publishing House to mark the centenary of Karol Wojtyła’s birth on May 18, 1920.

In his five-page foreword, Pope Francis wrote that St. John Paul II was “a great man of prayer who lived completely immersed in his time and constantly in contact with God, a sure guide for the Church in times of great change.”

“He was a great witness of mercy and throughout his pontificate he called us to this characteristic of God,” Francis said.

When Wojtyła became Pope John Paul II in 1978, a 41-year-old Fr. Jorge Mario Bergoglio was serving as the provincial superior of the Jesuits in Argentina. 

Pope John Paul II appointed Bergoglio an auxiliary bishop in 1992, elevating him to become Archbishop of Buenos Aires in 1998, and creating him a cardinal in 2001. Pope Francis canonized St. John Paul II in 2014.

“Fifteen years now separate us from his death,” Pope Francis said.

The pope pointed out that there are children and young people today who have not known or only have a vague memory of St. John Paul II.

“For this reason, on the centenary of his birth, it was right to remember this great holy witness of the faith that God has given to his Church and to humanity,” he said.

“I hope that this text will reach the hands of many, above all young people. Let us remember his faith. He is an example for us to live our witness today,” the pope said.

Pope Francis wrote that many may not realize how much St. John Paul II suffered in his life. He experienced the death of his mother, brother, and father by the age of 21, and then lived through World War II.

“The suffering that he experienced relying totally on the Lord forged him, and made even stronger the Christian faith in which he had been educated,” Francis said.

“St. John Paul suffered as pope. He suffered a terrible attack in 1981, offered his life, shed his blood for the Church. He testified that even in the difficult trial of disease, shared daily with God made man and crucified for our salvation, we can remain happy. We can remain ourselves,” he continued. 

Pope Francis also commented on John Paul II’s “great passion for the human person” and his openness to dialogue. 

Earlier this year, Pope Francis co-authored a book of reflections on the life of St. John Paul II entitled “St. John Paul the Great.” In this book, Pope Francis said he learned the importance of joy and mercy from the Polish pope.

“It is enough to look at his life” to see that John Paul II had “the smell of the sheep,” Francis said. “He was a pastor who loved people and the people returned it with an immense love.”




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Pope Francis speaks up for ‘harshly exploited’ agricultural workers

Vatican City, May 6, 2020 / 05:30 am (CNA).- The coronavirus crisis can be an opportunity to recenter work on the dignity of each person, Pope Francis said in an appeal at the end of his general audience broadcast on Wednesday. 

“On May 1, I received several messages about the world of work and its problems. I was particularly struck by that of the agricultural workers, among them many migrants, who work in the Italian countryside. Unfortunately, many are very harshly exploited,” Pope Francis said May 6.

“It is true that the current crisis affects everyone, but people's dignity must always be respected. That is why I add my voice to the appeal of these workers and of all exploited workers. May the crisis give us the opportunity to make the dignity of the person and of work the center of our concern,” he said. 

Amid fears of a food shortage, the Italian government is currently discussing whether to legalize some undocumented migrant workers. These workers are particularly vulnerable to exploitation with illegal contracts that can pay less than half of Italy’s minimum wage for the agricultural sector.

May 1 is recognized as Labor Day in Italy and many countries throughout Europe, however it is not an official holiday in the Vatican, which instead celebrates the feast of St. Joseph the Worker, established by Pope Pius XII in 1955.

On the feast day, the pope asked St. Joseph to help Catholics fight for dignified work. He prayed that “no one might be without work and all might be paid a just wage.”

Pope Francis said in his Wednesday audience that prayer is “a cry that comes for the heart of those who believe and entrust themselves to God.” The pope began a new cycle of weekly catechesis on May 6 focused on prayer. 

“Not only do Christians pray, they share the cry of prayer with all men and women. But the horizon can still be widened. Paul says that the whole creation ‘groans and suffers the pains of childbirth,’” he said, quoting St. Paul’s letter to the Romans.

“The Catechism states that ‘humility is the foundation of prayer,’” the pope said. “Prayer … comes from our precarious state, from our continuous thirst for God.”

Pope Francis focused his catechesis on the Gospel account of Bartimaeus, the blind beggar from Jericho.

Bartimaeus “uses the only weapon in his possession: his voice. He starts shouting: ‘Son of David, Jesus, have mercy on me,’” the pope explained.

“And Jesus listens to his cry. Bartimaeus' prayer touches his heart, the heart of God, and the doors of salvation are opened for him,” he said. “He recognizes in that poor, helpless, despised man, all the power of his faith, which attracts the mercy and power of God.”

“Stronger than any argument, there is a voice in the human heart that calls out. We all have this voice inside. A voice that comes out spontaneously, without anyone commanding it, a voice that questions the meaning of our journey down here, especially when we are in the dark: ‘Jesus, have mercy on me! Jesus, have mercy on me!’ This is a beautiful prayer,” Pope Francis said.




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Swiss Guards postpone swearing-in of new recruits due to coronavirus

Vatican City, May 6, 2020 / 11:47 am (CNA).- The annual swearing-in of new Swiss Guards, which would usually take place May 6, was moved to Oct. 4 because of the coronavirus.

Instead, the Pontifical Swiss Guards marked Wednesday’s anniversary of the Sack of Rome with private, more muted celebrations, lacking the presence of guests and streamed over the internet.

The Swiss Guards marked the 493rd anniversary of the May 6, 1527 battle with Mass in the church of Santa Maria of the Pieta in the Teutonic College, followed by the “laying of the wreath,” in the Square of the Roman Protomartyrs in Vatican City.

Afterward, the commander of the Swiss Guards conferred papal honorifics on 15 guards.

After Mass, all but the newest members of the world’s smallest-but-oldest standing army marched to Square of the Roman Protomartyrs, so-named for being the site of the death of several early Christian martyrs, including St. Peter.

The Commander of the Swiss Guards, Christoph Graf, gave a speech at the ceremony in which he recounted the story of the 1527 battle known as the Sack of Rome, when 147 guards lost their lives defending Pope Clement VII from mutinous troops of the Holy Roman Empire.

During the battle, the pope was able to escape from the Vatican to Castel Sant’Angelo via a secret passageway connecting the two. It is the most significant and deadly event in the history of the Swiss Guards.

After the speech, a large wreath was placed in the square in commemoration of the guards who died during the battle.

The anniversary is usually marked by a whole weekend of events attended by representatives of the Swiss army, Swiss government, and Swiss bishops’ conference. Family and friends of the guards, and former guards who return for a visit, also participate.

In past years, the festivities have also included a concert and an audience with Pope Francis.

The main celebrant of the May 6 Mass was the assessor of the Secretariat of State, Msgr. Luigi Roberto Cona. In his homily, Cona said he wishes the guards may “truly experience Christ.”

“May you encounter a Church that is not only an institution, an institution to be defended, to be protected, which you have wisely done for 500 years now, but also a community, a believing community which has met the living and true Christ, which loves him, and intends to serve him in everyday life,” he said.

“Because every day we too, in imitation of the first Christian martyrs – and your brother guards who offered themselves at that very important moment in 1527 – we too, without the heroism of those, can offer ourselves day after day in the services we are called to perform.”




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Women hike for freedom in New Zealand

On 1 December, 22 women hiked Tongariro Alpine Crossing to raise awareness and funds for women and children trafficked in France and India.




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Climbing for freedom in New Zealand

About 110 men, women and children climbed five volcanoes in Auckland in the Freedom Climb New Zealand on Saturday, 16 August.




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Going Off The GRID to learn about God

A French couple attended the Off The GRID discipleship programme in New Zealand, where they learned about missions and God.




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A thanksgiving sacrifice and feast

A man expresses thanks to God for good health after cancer by making a sacrifice to God and holding a feast for family and friends.




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Season of sowing

A church planting team shares their faith with Muslim friends and neighbours during a time set aside for sowing intentionally in people’s lives.




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Service Use Classes Among School-aged Children From the Autism Treatment Network Registry

BACKGROUND AND OBJECTIVES:

Use of specific services may help to optimize health for children with autism spectrum disorder (ASD); however, little is known about their service use patterns. We aimed to (1) define service use groups and (2) determine associations of sociodemographic, developmental, behavioral, and health characteristics with service use groups among school-aged children with ASD.

METHODS:

We analyzed cross-sectional data on 1378 children aged 6 to 18 years with an ASD diagnosis from the Autism Speaks Autism Treatment Network registry for 2008–2015, which included 16 US sites and 2 Canadian sites. Thirteen service use indicators spanning behavioral and medical treatments (eg, developmental therapy, psychotropic medications, and special diets) were examined. Latent class analysis was used to identify groups of children with similar service use patterns.

RESULTS:

By using latent class analysis, school-aged children with ASD were placed into 4 service use classes: limited services (12.0%), multimodal services (36.4%), predominantly educational and/or behavioral services (42.6%), or predominantly special diets and/or natural products (9.0%). Multivariable analysis results revealed that compared with children in the educational and/or behavioral services class, those in the multimodal services class had greater ASD severity and more externalizing behavior problems, those in the limited services class were older and had less ASD severity, and those in the special diets and/or natural products class had higher income and poorer quality of life.

CONCLUSIONS:

In this study, we identified 4 service use groups among school-aged children with ASD that may be related to certain sociodemographic, developmental, behavioral, and health characteristics. Study findings may be used to better support providers and families in decision-making about ASD services.




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Mindfulness-Based Stress Reduction for Parents Implementing Early Intervention for Autism: An RCT

BACKGROUND AND OBJECTIVES:

Systems of care emphasize parent-delivered intervention for children with autism spectrum disorder (ASD). Meanwhile, multiple studies document psychological distress within these parents. This pilot longitudinal randomized controlled trial compared the parent-implemented Early Start Denver Model (P-ESDM) to P-ESDM plus mindfulness-based stress reduction (MBSR) for parents. We evaluated changes in parent functioning during active treatment and at follow-up.

METHODS:

Participants included children (<36 months old) with autism spectrum disorder and caregivers. Participants were randomly assigned to P-ESDM only (n = 31) or P-ESDM plus MBSR (n = 30). Data were collected at baseline, midtreatment, the end of treatment, and 1, 3, and 6 months posttreatment. Multilevel models with discontinuous slopes were used to test for group differences in outcome changes over time.

RESULTS:

Both groups improved during active treatment in all subdomains of parent stress (β = –1.42, –1.25, –0.92; P < 0.001), depressive symptoms, and anxiety symptoms (β = –0.62 and –0.78, respectively; P < 0.05). Parents who received MBSR had greater improvements than those receiving P-ESDM only in parental distress and parent-child dysfunctional interactions (β = –1.91 and –1.38, respectively; P < 0.01). Groups differed in change in mindfulness during treatment (β = 3.15; P < .05), with P-ESDM plus MBSR increasing and P-ESDM declining. Treatment group did not significantly predict change in depressive symptoms, anxiety symptoms, or life satisfaction. Differences emerged on the basis of parent sex, child age, and child behavior problems.

CONCLUSIONS:

Results suggest that manualized, low-intensity stress-reduction strategies may have long-term impacts on parent stress. Limitations and future directions are described.




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Parent Perceptions About Communicating With Providers Regarding Early Autism Concerns

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.

METHODS:

Three 2-hour focus groups were conducted with 23 parents of children with ASD <8 years old. Qualitative analysis employed an iterative and systematic approach to identify key themes related to parents’ experiences.

RESULTS:

Eight themes related to communication about early ASD concerns emerged: characteristics of the child that caused parental concerns, the response of others when the parent brought up concerns, how concerns were brought up to the parent by others, parental responses when others mentioned concerns, information seeking, barriers to and facilitators of acting on concerns, and recommendations to providers. Parent responses suggest the need for increased use of shared decision-making strategies and areas for process improvements.

CONCLUSIONS:

Primary care providers can play a key role in helping parents with ASD concerns make decisions about how to move forward and pursue appropriate referrals. Strategies include responding promptly to parental concerns, helping them weigh options, and monitoring the family’s progress as they navigate the service delivery system.




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Families Experiences With Family Navigation Services in the Autism Treatment Network

BACKGROUND AND OBJECTIVES:

Families of children with autism spectrum disorder (ASD) often experience challenges navigating multiple systems to access services. Family navigation (FN) is a model to provide information and support to access appropriate services. Few studies have been used to examine FN’s effectiveness for families of children with ASD. This study used mixed methods to (1) characterize FN services received by a sample of families in the Autism Treatment Network; (2) examine change in parent-reported activation, family functioning, and caregiver strain; and (3) explore families’ experiences with FN services.

METHODS:

Family characteristics and parent outcomes including parent activation, family functioning, and caregiver strain were collected from 260 parents in the Autism Treatment Network. Descriptive statistics and linear mixed models were used for aims 1 and 2. A subsample of 27 families were interviewed about their experiences with FN services to address aim 3.

RESULTS:

Quantitative results for aims 1 and 2 revealed variability in FN services and improvement in parent activation and caregiver strain. Qualitative results revealed variability in family experiences on the basis of FN implementation differences (ie, how families were introduced to FN, service type, intensity, and timing) and whether they perceived improved skills and access to resources.

CONCLUSIONS:

Findings suggest FN adaptations occur across different health care delivery systems and may result in highly variable initial outcomes and family experiences. Timing of FN services and case management receipt may contribute to this variability for families of children with ASD.




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Family Engagement in the Autism Treatment and Learning Health Networks

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.




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Improving Behavior Challenges and Quality of Life in the Autism Learning Health Network

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.

METHODS:

A cross-sectional study of children 3 to 12 years old with ASD receiving care at 13 sites. Parent-reported characteristics of children with ASD were collected as outcome measures aligned with our network’s aims of reducing rates of challenging behaviors, improving QoL, and ensuring receipt of recommended health services. Parents completed a survey about behavioral challenges, co-occurring conditions, health services, and the Patient-Reported Outcomes Measurement Information System Global Health Measure and the Aberrant Behavior Checklist to assess QoL and behavior symptoms, respectively.

RESULTS:

Analysis included 530 children. Challenging behaviors were reported by the majority of parents (93%), frequently noting attention-deficit/hyperactivity disorder symptoms, irritability, and anxiety. Mean (SD) scores on the Aberrant Behavior Checklist hyperactivity and irritability subscales were 17.9 (10.5) and 13.5 (9.2), respectively. The Patient-Reported Outcomes Measurement Information System Global Health Measure total score of 23.6 (3.7) was lower than scores reported in a general pediatric population. Most children had received recommended well-child (94%) and dental (85%) care in the past 12 months.

CONCLUSIONS:

This baseline data (1) affirmed the focus on addressing challenging behaviors; (2) prioritized 3 behavior domains, that of attention-deficit/hyperactivity disorder, irritability, and anxiety; and (3) identified targets for reducing severity of behaviors and strategies to improve data collection.




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The Autism Treatment Network: Bringing Best Practices to All Children With Autism

The Autism Treatment Network and Autism Intervention Research Network on Physical Health were established in 2008 with goals of improving understanding of the medical aspects of autism spectrum disorders. Over the past decade, the combined network has conducted >2 dozen clinical studies, established clinical pathways for best practice, developed tool kits for professionals and families to support better care, and disseminated these works through numerous presentations at scientific meetings and publications in medical journals. As the joint network enters its second decade continuing this work, it is undergoing a transformation to increase these activities and accelerate their incorporation into clinical care at the primary care and specialty care levels. In this article, we describe the past accomplishments and present activities. We also outline planned undertakings such as the establishment of the Autism Learning Health Network, the increasing role of family members as co-producers of the work of the network, the growth of clinical trials activities with funding from foundations and industry, and expansion of work with primary care practices and autism specialty centers. We also discuss the challenges of supporting network activities and potential solutions to sustain the network.




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Maternal and Child Health Bureaus Autism Research Program

OBJECTIVES:

To provide an overview and quantitatively demonstrate the reach of the Health Resources and Services Administration’s Maternal and Child Health Bureau autism research program.

METHODS:

We reviewed program reports and internal data from 59 autism research grantees. The US federal Interagency Autism Coordinating Committee’s strategic plan questions were used as a framework to highlight the contributions of the autism research program in advancing the field.

RESULTS:

The autism research program grantees advance research in several ways. Grantees have strengthened the evidence for autism interventions by conducting 89 studies at 79 distinct research sites. A total of 212 708 participants have enrolled in autism research program studies and 361 researchers have contributed to furthering autism research. The program addresses topics that align with the majority of the Interagency Autism Coordinating Committee’s priority topic areas, including advancements in treatments and interventions, services and supports, and identifying risk factors. Grantee products include 387 peer-reviewed publications, 19 tools, and 13 practice guidelines for improving care and intervention practices.

CONCLUSIONS:

The autism research program has contributed to medical advances in research, leveraged innovative training platforms to provide specialized training, and provided access to health services through research-based screening and diagnostic procedures. Autism research program studies have contributed to the development of evidence-based practice guidelines, informed policy guidelines, and quality improvement efforts to bolster advancements in the field. Although disparities still exist, the Health Resources and Services Administration’s Maternal and Child Health Bureau can reduce gaps in screening and diagnosis by targeting interventions to underserved populations including minority and rural communities.




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Pediatricians Are Perfectly Positioned to Help Mothers Reach Their Breastfeeding Goals




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Promoting Ideal Cardiovascular Health Through the Life Span




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Anaerobic Necrotizing Pneumonia: Another Potential Life-threatening Complication of Vaping?

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.