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.”

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.”

Vatican City, May 7, 2020 / 08:00 am (CNA).- It is important for Catholics to remember the whole of salvation history, and our belonging to the people of God’s covenant with Abraham, Pope Francis said at Mass Thursday.

During daily Mass in the chapel of his Vatican residence, the Casa Santa Marta, Pope Francis reflected on an aspect of the day’s first reading from the Acts of the Apostles, when St. Paul is invited to speak in the synagogue in Antioch.

Instead of speaking directly about Jesus, the apostle begins by telling the history of salvation, the pope noted May 7.

“What is behind Jesus? There is a story. A story of grace, a story of election, a story of promise. The Lord chose Abraham and went with his people,” he said.

“There is a story of God with his people. And for this reason, when Paul is asked to explain the reason for faith in Jesus Christ, he does not start from Jesus Christ: he begins from history.”

The pope pointed to the first part of the entrance antiphon recited at the start of that Mass: “O God, when you went forth before your people, marching with them and living among them...”

He urged Catholics to remember to “pass down the history of our salvation,” and to ask the Lord to help them have the awareness of being children of Abraham, as the Virgin Mary says in the Magnificat and Zechariah in his Benedictus, canticles which are recited or sung in the Liturgy of the Hours.

Christianity, the pope said, is belonging to the people with whom the Lord made his covenant.

Pope Francis also spoke in his homily about what he thinks Christianity is not.

“Christianity is a doctrine, yes, but not only,” he stated. “Christianity is not just an ethic. Yes, indeed, it has moral principles,” but it is not just having an ethical viewpoint.

Francis went on to say that Christianity is also more than an exclusionary vision of an “‘elite’ of people chosen for the truth.” He criticized when this attitude comes into the Church as a belief in the damnation of others.

It is good to be a moral people, he said, but “Christianity is belonging to a people, to a people freely chosen by God.”

“If we do not have this awareness of belonging to a people we would be ideological Christians,” he said.

The pope explained that this is why, in order to speak about Jesus, St. Paul starts by explaining “from the beginning, from belonging to a people.”

He warned that when Christians lose the sense of belonging to the people of God’s covenant, they often fall into “partialities,” whether dogmatic, moral, or elitist.

Francis called this “the most dangerous deviation” Christians can fall into today.

Before Mass, Pope Francis noted that he had received a letter from a group of artists, thanking him for remembering them in prayer in April.

He added that he “would like to ask the Lord to bless them because artists make us understand what beauty is and without beauty the Gospel cannot be understood.”

“Let’s pray for artists again,” he urged.

After Mass, the pope concluded the livestream with Eucharistic adoration, benediction, and the Marian antiphon “Regina coeli.”

CNA Staff, May 7, 2020 / 03:45 pm (CNA).- Hours after the publication of a controversial open letter regarding the coronavirus pandemic, the prefect of the Church’s dicastery for liturgy and sacraments, listed among the signers of the letter, said he did not sign it.

The letter, titled “Appeal for the Church and the World,” says the coronavirus pandemic has been exaggerated to foster widespread social panic and undercut freedom, as a preparation for the establishment of a one-world government.

Cardinal Robert Sarah, prefect of the Vatican's Congregation for Divine Worship and Sacraments, tweeted: “I share on a personal basis some of the questions or concerns raised with regard to restrictions on fundamental freedoms, but I have not signed this petition.”

“A cardinal prefect of the Roman Curia must observe a certain reserve in political matters, Sarah wrote in another tweet, “so I explicitly asked this morning the authors of the petition titled ‘for the Church and for the world’ not to mention me.”

Sarah was listed as a signatory of the letter when it was published May 7 by the National Catholic Register, LifeSiteNews, and other websites. Sarah's denial raises questions about the legitimacy of other reported signatories to the letter.

Jeanette DeMelo, editor of the National Catholic Register, told CNA that the principal author of the letter is Archbishop Carlo Vigano, a former papal emissary to the United States.

Vigano made headlines for an August 2018 letter that alleged Vatican officials had ignored warnings about the sexual abuse of disgraced former cardinal Theodore McCarrick. Since that time, Vigano has released numerous letters expressing his viewpoints on matters in the Church, which include criticisms of Pope Francis and other curial officials.

DeMelo said that Vigano had vouched for the authenticity of Sarah's signature.

“The Register contacted Archbishop Vigano, the principal author, and asked him specifically about the authenticity of the signature of Cardinal Sarah and he said ‘I can confirm 100% that Cardinal Sarah signed it.,” DeMelo told CNA.

The letter laments the social distancing and stay-at-home orders issued to slow the spread of the coronavirus pandemic, suggesting they are contrived mechanisms of social control, with a nefarious purpose.

“We have reason to believe, on the basis of official data on the incidence of the epidemic as related to the number of deaths, that there are powers interested in creating panic among the world’s population with the sole aim of permanently imposing unacceptable forms of restriction on freedoms, of controlling people and of tracking their movements,” the letter said.

“The imposition of these illiberal measures is a disturbing prelude to the realization of a world government beyond all control,” it added. (bold original)

Among the letter’s reported signatories are four cardinals: Sarah, who has now indicated he is not a signatory; Cardinal Gerhard Muller, former prefect of the Congregation for the Doctrine of the Faith, Cardinal Joseph Zen, emeritus bishop of Hong Kong, and Cardinal Janis Pujats, emeritus archbishop of Riga, Latvia.

Two U.S. bishops are also alleged signatories: Bishop Rene Gracida, emeritus bishop of Corpus Christi, and Bishop Joseph Strickland, the Bishop of Tyler, Texas. 

Strickland told CNA by email May 7 that he “did sign off on this letter.”

Along with several other bishops, the well-known auxiliary bishop of Astana, Kazakhstan, Bishop Athanasius Schneider, is listed as a signer of the letter.

Another reported signatory is Fr. Curzio Nitoglia, a priest of the Society of St. Pius X, a traditionalist group in “irregular communion” with the Church. Nitoglia is the author of “The Magisterium of Vatican II,” a 1994 article that claims that “the church of Vatican II is therefore not the Apostolic and Roman Catholic Church instituted by our Lord Jesus Christ.”

The May 7 letter argued that the coronavirus pandemic has been sensationalized and exploited, to impede civil rights and exact government control over individuals and families.

The letter said that “the facts have shown that, under the pretext of the Covid-19 epidemic, the inalienable rights of citizens have in many cases been violated and their fundamental freedoms, including the exercise of freedom of worship, expression and movement, have been disproportionately and unjustifiably restricted.”

“Many authoritative voices in the world of science and medicine confirm that the media’s alarmism about Covid-19 appears to be absolutely unjustified.”

Nearly 4 million people worldwide have tested positive for the coronavirus, and at least 270,000 have died. In some countries, death rates in the months of the coronavirus pandemic have far exceeded death rates over the same months in previous years, suggesting to some demographers and epidemiologists that coronavirus deaths have been dramatically undercounted.

The pandemic, and the social distancing and stay-at-home orders issued to slow its spread, have become a source of considerable controversy in recent weeks. In the U.S., protests in several state capitals have gathered demonstrators in close proximity to one another, a move public health experts say could lead to new outbreaks of the disease.

The letter said that the economic crisis occasioned by the global pandemic “encourages interference by foreign powers and has serious social and political repercussions. Those with governmental responsibility must stop these forms of social engineering, by taking measures to protect their citizens whom they represent, and in whose interests they have a serious obligation to act.”

“The criminalization of personal and social relationships must likewise be judged as an unacceptable part of the plan of those who advocate isolating individuals in order to better manipulate and control them,” the authors added.

No cure or therapeutic treatment has yet been identified for the virus. In early weeks of the pandemic, President Donald Trump hypothesized that hydroxychloroquine, an inexpensive anti-malarial medication, could help treat the disease. U.S. researchers have largely moved away from the medication, especially after a study by the Veterans’ Administration found that administering the drug leads to higher death rates among patients receiving it.

Some, including television hosts Laura Ingraham and Sean Hannity have alleged that the study is inaccurate. Some protestors have suggested the VA study was intended to discredit Trump or profit vaccine manufacturers.

In an apparent reference to the hydroxychloroquine controversy, the letter said that: “Every effort must be made to ensure that shady business interests do not influence the choices made by government leaders and international bodies. It is unreasonable to penalize those remedies that have proved to be effective, and are often inexpensive, just because one wishes to give priority to treatments or vaccines that are not as good, but which guarantee pharmaceutical companies far greater profits, and exacerbate public health expenditures.” 

“Let us also remember, as Pastors, that for Catholics it is morally unacceptable to develop or use vaccines derived from material from aborted fetuses,” the letter added.

The U.S. bishops conference has also said vaccine development should avoid unethical links to abortion.

The letter argues that governments do not have the right to ban or restrict public worship or other kinds of ministry, and asks that any such restrictions be rescinded.

On the sacraments, which have been subject both to voluntary restrictions and public health orders in some states, the letter noted that “the Church firmly asserts her autonomy to govern, worship, and teach.”

“The State has no right to interfere, for any reason whatsoever, in the sovereignty of the Church. Ecclesiastical authorities have never refused to collaborate with the State, but such collaboration does not authorize civil authorities to impose any sort of ban or restriction on public worship or the exercise of priestly ministry. The rights of God and of the faithful are the supreme law of the Church, which she neither intends to, nor can, abdicate. We ask that restrictions on the celebration of public ceremonies be removed.”

While restrictions on public worship have been met with public criticism in many places, the objections have been most pronounced in Italy.

After Italy’s prime minister announced in late April new health measures that would continue prohibiting religious gatherings, the Italian bishops released a statement denouncing the decision, which the bishops criticized as “arbitrary.” Two days later, Pope Francis seemed to signal his own view, praying while celebrating Mass that Christians would respond to the lifting of lockdown restrictions with “prudence and obedience.”

Along with cardinals, bishops, and priests, the letter’s signatories also included some academics, journalists, and scientists. Included among them are Vatican journalists Marco Tosatti and Robert Moynihan, Lifesitenews editor John-Henry Westen, Stephen Mosher, president of the Virginia-based Population Research Institute, and the leaders of pro-life groups in Texas and Ohio.

The letter’s signatories encouraged Catholics, and “all men and women of good will” to “assess the current situation in a way consistent with the teaching of the Gospel. This means taking a stand: either with Christ or against Christ.” (bold original)
 
“Let us not allow centuries of Christian civilization to be erased under the pretext of a virus, and an odious technological tyranny to be established, in which nameless and faceless people can decide the fate of the world by confining us to a virtual reality. If this is the plan to which the powers of this earth intend to make us yield, know that Jesus Christ, King and Lord of History, has promised that ‘the gates of Hell shall not prevail’ (Mt 16:18).”

The Holy See has not yet commented on the letter.
 

This story has been updated since its original publication. It is developing and will continue to be updated.

Stephen Brandon takes on the role of national director for OM New Zealand after serving as OM’s International Web Manager for six years.

OM New Zealand builds relationships with churches and cares for the 50-some New Zealanders serving in cross-cultural missions.

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.

Research suggests that the prevalence of obesity in children with autism spectrum disorder (ASD) is higher than in typically developing children. The US Preventive Services Task Force and the American Academy of Pediatrics (AAP) have endorsed screening children for overweight and obesity as part of the standard of care for physicians. However, the pediatric provider community has been inadequately prepared to address this issue in children with ASD. The Healthy Weight Research Network, a national research network of pediatric obesity and autism experts funded by the US Health Resources and Service Administration Maternal and Child Health Bureau, developed recommendations for managing overweight and obesity in children with ASD, which include adaptations to the AAP’s 2007 guidance. These recommendations were developed from extant scientific evidence in children with ASD, and when evidence was unavailable, consensus was established on the basis of clinical experience. It should be noted that these recommendations do not reflect official AAP policy. Many of the AAP recommendations remain appropriate for primary care practitioners to implement with their patients with ASD; however, the significant challenges experienced by this population in both dietary and physical activity domains, as well as the stress experienced by their families, require adaptations and modifications for both preventive and intervention efforts. These recommendations can assist pediatric providers in providing tailored guidance on weight management to children with ASD and their families.

BACKGROUND AND OBJECTIVES:

Children with autism spectrum disorder (ASD) have a higher prevalence of epilepsy compared with general populations. In this pilot study, we prospectively identified baseline risk factors for the development of seizures in individuals with ASD and also identified characteristics sensitive to seizure onset up to 6 years after enrollment in the Autism Speaks Autism Treatment Network.

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 AND OBJECTIVES:

Guidelines suggest young children with autism spectrum disorder (ASD) receive intensive nonpharmacologic interventions. Additionally, associated symptoms may be treated with psychotropic medications. Actual intervention use by young children has not been well characterized. Our aim in this study was to describe interventions received by young children (3–6 years old) with ASD. The association with sociodemographic factors was also explored.

BACKGROUND:

Emergency department (ED) care processes and environments impose unique challenges for children with autism spectrum disorder (ASD). The implementation of patient- and family-centered care (PFCC) emerges as a priority for optimizing ED care. In this article, as part of a larger study, we explore PFCC in the context of ASD. Our aims were to examine how elements of PFCC were experienced and applied relative to ED care for children with ASD.

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.

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.

CONTEXT:

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

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.

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.

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.

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.

OBJECTIVES:

To determine if a multicomponent intervention was associated with increased use of first-line antibiotics (cephalexin or sulfamethoxazole and trimethoprim) among children with uncomplicated urinary tract infections (UTIs) in outpatient settings.

The American Academy of Neurology believes that doctors have the right to do tests to evaluate whether a patient is brain dead even if the family does not consent. They argue that physicians have "both the moral authority and professional responsibility" to do such evaluations, just as they have the authority and responsibility to declare someone dead by circulatory criteria. Not everyone agrees. Truog and Tasker argue that apnea testing to confirm brain death has risks and that, for some families, those risks may outweigh the benefits. So, what should doctors do when caring for a patient whom they believe to be brain dead but whose parents refuse to allow testing to confirm that the patient meets neurologic criteria for death? In this article, we analyze the issues that arise when parents refuse such testing.

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.

OBJECTIVES:

Reduce postoperative hypothermia by up to 50% over a 12-month period in children’s hospital NICUs and identify specific clinical practices that impact success.

Acne vulgaris is an extraordinarily common skin condition in adolescents. The mainstays of acne treatment have remained largely unchanged over recent years. In the context of increasing antibiotic resistance worldwide, there is a global movement away from antibiotic monotherapy toward their more restrictive use. Classically reserved for nodulocystic acne, isotretinoin has become the drug of choice by dermatologists for moderate to severe acne. Given the virtually ubiquitous nature of acne in teenagers, there remains an appreciable need for novel therapies. In this article, we will cover the currently used acne treatments, evaluate the issues and data supporting their use, explore the issues of compliance and the mental health implications of acne care, and recommend directions for the field of acne management in adolescents in the years ahead.

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.

Various states have legalized marijuana for medical purposes and/or decriminalized recreational marijuana use. These changes coincide with a decrease in perceived harmfulness of the drug and an increase in its use among youth. This change is of critical concern because of the potential harmful impact of marijuana exposure on adolescents. Marijuana use has been associated with several adverse mental health outcomes, including increased incidence of addiction and comorbid substance use, suicidality, and new-onset psychosis. Negative impacts on cognition and academic performance have also been observed. As the trend toward legalization continues, the pediatric community will be called on to navigate the subsequent challenges that arise with changing policies. Pediatricians are uniquely positioned to provide innovative care and educate youth and families on the ever-evolving issues pertaining to the impact of marijuana legalization on communities. In this article, we present and analyze the most up-to-date data on the effects of legalization on adolescent marijuana use, the effects of adolescent use on mental health and cognitive outcomes, and the current interventions being recommended for use in pediatric office settings.

A remarkable story which came to a climax on February 23 this year when OM Ireland took possession of the deeds to Lacken House as their new headquarters and ministry centre.

OM Ireland's community outreach team participates in one of Ireland's biggest events: the 2011 National Ploughing Championships in Athy, Co. Kildare from 20 -22 September.

St. Patrick's Day celebrates the patron saint of Ireland known for bringing Christianity to Ireland. Hundreds of years later, OM Ireland brings the same message.

OM Ireland's Mobilising director shares her thoughts about going "into all the world."

In 2019, OM Ireland hosted its largest St. Patrick's outreach.

A worker shares a story about becoming the fragrance of Christ as she and a team member wash the feet of a local village chief.

Young men from African nations find their identity and destiny through hiking in Namibia with the Wilderness Therapy Programme.

Teens gather in Warwick, Queensland this week for OM Australia's TeenStreet.

God changes teens' lives during TeenStreet Queensland in Australia at the beginning of July.

On 19 March, OM Australia moved into their new home, a place that will help mobilise more people and finances into missions.

Teens in Europe are gathered this week to connect with Jesus and each other. A month ago, teenagers in Australia had this experience.

Loving our Muslim neighbours is an opportunity and privilege.

It matters not if we are from 200 countries; we are one in Christ and shall be for eternity. OMNI-team member Greg Kernaghan about ‘globalisation’.

Extreme Leadership Training camps create unity in Ukraine.

After having some difficulty with the campers and teen leaders, OMer Stephen explains the significance of the cross and following Jesus—many respond positively.

OM Ukraine and experts in crisis management held a seminar for pastors serving on both sides of the conflict line in Eastern Ukraine.

Bus4Life is OM’s mobile missions centre to the unreached people of Central and Eastern Europe, bringing books and also participating in summer programmes, as it did in summer 2017.

Sunday School isn't just for Sundays anymore - it can be on any given day of the week in Ukraine.

Turning organic waste into bio-fuel and French-fry oil into bio-diesel; all these are innovative ways of building sustainable income for the church in Kaharlyk.