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

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.

CONTEXT:

Research reveals racial, ethnic, and socioeconomic disparities in autism diagnosis; there is limited information on potential disparities related to other dimensions of services.

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.

In response to the growing impact of the current opioid public health crisis in the United States on adolescents and young adults, pediatricians have an expanding role in identifying opioid use early, preventing escalation of risky use, reducing opioid-related harms, and delivering effective therapies. Research and expert consensus suggest the use of brief interventions focused on reducing risks associated with ongoing opioid use and using motivational interviewing strategies to engage youth in treatment. Because fatal opioid overdose remains a major cause of opioid-related mortality among youth, delivering overdose education as part of any visit in which a youth endorses opioid use is one evidence-based strategy to decrease the burden of opioid-related mortality. For youth that are injecting opioids, safe injection practices and linkage to needle or syringe exchanges should be considered to reduce complications from injection drug use. It is crucial that youth be offered treatment at the time of diagnosis of an opioid use disorder (OUD), including medications, behavioral interventions, and/or referral to mutual support groups. The 2 medications commonly used for office-based OUD treatment in adolescents are extended-release naltrexone (opioid antagonist) and buprenorphine (partial opioid agonist), although there is a significant treatment gap in prescribing these medications to youth, especially adolescents <18 years of age. Addiction is a pediatric disease that pediatricians and adolescent medicine physicians are uniquely poised to manage, given their expertise in longitudinal, preventive, and family- and patient-centered care. Growing evidence supports the need for integration of OUD treatment into primary care.

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

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.

A Fin24 user urgently seeks guidance on how to pay off debt owing to the amount of R82 000. An expert responds with workable solutions.

A Fin24 set to retire this year is looking to invest his R1.2m savings in order to receive a monthly payout.

A landlord asks if his current tenants will still be able to move out at the end of the month as planned and whether his new tenant would be hindered from taking occupation. An attorney responds.

A Fin24 reader looking to invest in a living annuity, was shocked to find that she would have to pay fees of up to R110 000 per annum. She wants to know if there are other options. An investment expert responds.

IN THE winding lanes of Barcelona’s historic Barri Gòtic it’s no surprise to find a little cheese shop tucked amongst the boutiques and antique shops. What is unexpected though is that this shop, Formageria La Seu, the only one on the Iberian peninsula to feature artisanal cheese from all over Catalonia and Spain, is owned and run by a Scots woman – Katherine McLaughlin.

IT’S becoming a real bore that our main sporting authorities, particularly the Scottish Football Association, the Scottish Professional Football League and the Scottish Rugby Union, continue to get in a fankle over the way to end the 2019-20 season.

The nutritional and immunologic properties of human milk, along with clear evidence of dose-dependent optimal health outcomes for both mothers and infants, provide a compelling rationale to support exclusive breastfeeding. US women increasingly intend to breastfeed exclusively for 6 months. Because establishing lactation can be challenging, exclusivity is often compromised in hopes of preventing feeding-related neonatal complications, potentially affecting the continuation and duration of breastfeeding. Risk factors for impaired lactogenesis are identifiable and common. Clinicians must be able to recognize normative patterns of exclusive breastfeeding in the first week while proactively identifying potential challenges. In this review, we provide new evidence from the past 10 years on the following topics relevant to exclusive breastfeeding: milk production and transfer, neonatal weight and output assessment, management of glucose and bilirubin, immune development and the microbiome, supplementation, and health system factors. We focus on the early days of exclusive breastfeeding in healthy newborns ≥35 weeks’ gestation managed in the routine postpartum unit. With this evidence-based clinical review, we provide detailed guidance in identifying medical indications for early supplementation and can inform best practices for both birthing facilities and providers.

According to Stephan Bauer, short-term mission teams are "less a problem to be solved, but more a tension to be managed, and the aim should be for STTs to have a credible impact on the ministry and be effective in mobilising long-term workers."

By Kristy Dorsey

The great North-South divide in rugby was never more in evidence than when the votes were counted for the chairmanship of World Rugby last week. Sir Bill Beaumont stayed in the job, beating Agustin Pichot by 28 votes to 23, but wow, what an outcome in terms of who actually supported the former England and British Lions captain.

For a limited time, the 7-inch Fire 7 Kids Edition is $40 off while the 8- and 10-inch models are both $50 off. These tablets make a great gift for 3-to-12-year olds.

It’ll be five years next month since Gerry Cinnamon released his debut single Kampfire Vampire on Glasgow-based micro-label First Run Records, a half decade in which the Castlemilk-born singer-songwriter has gone from jobbing gig jockey on the city’s DIY scene to a bona fide musical phenomenon with combined Spotify plays of well over 100 million.

The Scottish political world is holding its breath this weekend.

Co-hosts Keith Lemon and Anna Richardson talk to Gemma Dunn about their new show, The Fantastical Factory Of Curious Craft.

One particularly tense staff meeting helped educator Robert Parker rethink how his school celebrated Black History Month.

Track how educators and district leaders are responding to challenges related to COVID-19 through recurring surveys from The EdWeek Research Center.

Talk to school and district leaders and you’ll hear worries about the next recession, spending restrictions, and a public that knows little about worries that lawmakers and elected officials who know little about their funding needs.

Music

The Florida Department of Education is in a bitter dispute with a software company it hired to create online resources aligned with the standards for teachers and students.

LIKE many of your readers, I would imagine, I am a fairly enthusiastic armchair football supporter with no real club affiliation.

A growing number of students—especially girls—are experiencing bullying online, according to the latest federal data on bullying and crime in schools.

Yong Zhao speaks to BookMarks about the new education paradigm that he proposes in World Class Leaders (Corwin, 2012).

Concerned that schools don't notice or nurture business skills, nonprofits are using the humble lemonade stand to foster entrepreneurship.

As an attempt to mitigate a persistent school supply problem, New Mexico plans to give some 23,000 teachers prepaid gift cards for use on classroom materials. One local union calls it a distraction from larger funding issues.

Babies as young as 12 months are exposed to nearly an hour a day of screen time, despite warnings from pediatricians to avoid digital media exposure for children under a year and a half, according to a new analysis.

Penn State Schuylkill hosted two online celebrations for its Honors Program students, outstanding student scholars and tutors the week of April 20, 2020.

Corticosteroids inhibit the expression of many proinflammatory cytokines released during the course of community-acquired pneumonia infection. Corticosteroids have been found in some studies to be associated with improved clinical outcomes in adults with pneumonia. No studies have investigated corticosteroid use in children with pneumonia.

Results showed that corticosteroid treatment in children with pneumonia is common and its use is highly variable across institutions. Although corticosteroid therapy may benefit children with acute wheezing treated with β-agonists, corticosteroid therapy may lead to worse outcomes for children without wheezing. (Read the full article)

Several qualitative studies have revealed that caregivers use infant fussing as a cue for beginning complementary feeding (CF). Despite a higher prevalence of early CF among black infants, few studies have quantitatively examined the role of maternal perception of infant fussiness.

Results of this study show that in a cohort of low-income, black, first-time mothers, early CF was highly prevalent and that maternal perception of infant temperament, breastfeeding, and maternal obesity and depression were important factors related to early CF. (Read the full article)

The associations between food insecurity and child well-being have been well studied on the basis of household levels of food insecurity, as reported by heads of households.

Household measures, however, may not capture gender biases in food insecurity and morbidity. This study assessed adolescents' own experience with food insecurity and how it was associated with morbidity and the effect of gender in this process. (Read the full article)

Several correlational studies documented that participants who would be classified as "pathological" video gamers demonstrate a pattern of correlations with other variables that are comorbid (eg, depression) or occur with (eg, poorer grades and increased hostility) other addictions.

Following a large sample across 2 years, this study provides needed data on risk factors for becoming a pathological gamer, how long pathological gaming lasts, outcomes, and whether it is a primary problem or is a symptom of comorbid problems. (Read the full article)

Chlamydia testing among adolescents and young women without symptoms is recommended by the US Preventive Services Task Force, but only approximately one-half of eligible young women presenting for health care are screened appropriately.

Our work indicates that providers screen young women for chlamydia differentially according to patient age, race/ethnicity, insurance status, and sexual health history. Biases in chlamydia screening may contribute to higher reported rates of chlamydia among minority and poor young women. (Read the full article)

Preventive asthma medications (PAMs) are a primary management strategy to control asthma morbidity. Little is known about changes over time in prevalence of PAM use among children and adolescents in the United States.

Our analysis demonstrates an increase in use of PAMs among children and adolescents with current asthma in the United States from 1988–1994 to 2005–2008, but racial and ethnic disparities in use of PAMs persist. (Read the full article)

Children with special health care needs (CSHCN) account for more than one-third of pediatric health care costs. Little is known regarding the impact of shared decision-making (SDM) over time on child health care expenditures and utilization.

In a national sample, we found that increasing SDM was associated with decreased health care costs and utilization for CSHCN. Results support prospective studies to determine if pediatric interventions to foster SDM reduce the financial burden of caring for CSHCN. (Read the full article)

Upper respiratory tract infections (URIs) are very common in children. Currently, there are no effective preventive measures for URI. There are no studies on the effect of montelukast for prevention of URI.

In a randomized, double-blind, placebo-controlled study of preschool-aged children, 12-week prophylactic treatment with montelukast did not reduce the incidence of URI. (Read the full article)

Hepatitis A infection causes severe disease among adolescents and adults. Hepatitis A vaccination (HepA) is recommended universally at 1 year, with vaccination through 18 years based on risk or desire for protection.

This is the first study to evaluate adolescent HepA coverage in the United States using provider-reported vaccination data. HepA coverage was low among adolescents, leaving a large population susceptible to hepatitis A infection maturing into adulthood. (Read the full article)