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.

A word of encouragement about being mobilised from a native who stayed in-country, yet encourages all to "go into all the world."

On 1 July 350 teens and leaders poured into the University of Queensland, Australia, for five days of fun and discipleship.

Peter* from MAP Australia has a Muslim friend who attended a church camp. His friend has never been the same since.

MAP Australia hosts Bound for Paradise, a week-long outreach to Muslims from the Persian Gulf in Queensland, Australia, from 25-29 August.

A group of 10 students, including a translator, participate in a two months training programme in Panama. The Mission Extreme Outreach has its students work amongst Panamanians and indigenous tribes. Un grupo de 10 estudiantes,incluyendo la traductora, participan durante los dos meses de gira en Panamá. Una vez más Misión Extrema está en acción con los latinos y grupos indígenas.

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

Volunteers from OM Panama build a roof on a dumping place to be able to minister during raining season.

Investment interest in "frontier" African markets - particularly Nigeria and Kenya - is on the rise.

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.

Try to make sense of this if you can. The other day, a fund-raising event for the Democratic presidential candidate Pete Buttigieg, who is gay, was disrupted by protesters. But they weren’t the kind of protesters you’d expect to get angry about a gay candidate. The protesters were gay themselves. It was a protest against a gay man staged by gays. It was gays against gays. It was pink on pink. It was confusing.

A Thousand Moons

Nirmal Purja, mountaineer

GREAT news. I think. Glasgow is a great place in which to be looking for love, with 44 per cent of the city single, according to an online dating company.Why does this matter? Flash back to Valentine’s Day. There I was, lying in a pool of poetical blood, having been shot in the heart with the killer question no single man over a certain age wants to hear: “How many Valentine’s cards did you get?” asked a friend.

Canada shed three million jobs in the last two months due to the coronavirus lockdown, causing the unemployment rate to shoot up to 13% in April, the government reported Friday.

OM EAST’s latest publication reaches the Nenets tribe in Siberia—a place where few foreigners have ever been.

THE first cap is the sweetest. For hockey player Alan Forsyth it came on October 19, 2015: Great Britain versus Argentina at Bisham Abbey. He scored on his debut, too, teed up by fellow Scot Chris Grassick after 28 minutes.

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.

As expected, the number of passengers at Berlin airports fell in January. Tegel and Schönefeld dealt with a total of 2,252,265 passengers, 6.9% fewer than in the same month last year.

An OM worker and local team of believers visit indigenous Cabecar communities in the mountains of Talamanca, Costa Rica.

STYLE AND SUBSTANCE

Choose a fragrant gift for your gardening mum, whether it's plants, flowers or botanicals. Hannah Stephenson sniffs out 10 ideas.

Prudence Wade chats to self-confessed 'skincare junkie' Dominic Skinner, one of MAC's top make-up artists.

RESEARCHERS have called for a two-track approach to easing lockdown which would strengthen protection for the most vulnerable but relax restrictions for the majority of the population.

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.

LEARNING from the hands of her grandmother in Italy, it was perhaps always going to be Giovanna Eusebi's destiny that she would go on to create culinary masterpieces of her own one day.

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."

One of the loveliest towns in Italy is the walled city of San Gimignano, an hour’s drive from Florence. When I first visited it was bleak midwinter and all but a few shops and cafes were shuttered against the sleet. Its claim to fame is a profusion of medieval towers, hence its hyperbolic label as the Manhattan of Tuscany. When I arrived these fortresses soared overhead, making shadowy streets even darker.

Taking place the same weekend as the UEFA Champions League final in May, the Lennart Johansson Academy Trophy gives youngsters from Europe's bigger clubs a chance to impress.

A GROUP of Glasgow-based students are working on an international project to design the building blocks of a Moon base.

YESTERDAY would have been your birthday. January 24. Six months older than me for six months, I’d remind you. Normally I would have spent the weeks between Christmas and now trying to think of something original to buy you. And then, at the last moment, I’d just buy you another book.

IT was on board a supply ship which had docked in the port of Marseille that Barney Roberts learned the news that the war was over.

By Kristy Dorsey