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.

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

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.

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.

Asthma is a significant public health issue, impacting quality of life, morbidity, and health care costs nationally. Stock asthma rescue medication policies authorize school districts to maintain unassigned albuterol and enable trained staff members to administer the medication in response to asthma symptoms, exercise premedication, and asthma emergencies. Stock asthma rescue (or reliever) medication laws serve as an important fail-safe measure. Such laws provide districts with the ability to respond if a student has an asthma emergency at school but either lacks a diagnosis or does not have access to their own medication. As of September 2019, 13 states have enacted either a law or regulation authorizing the stocking of asthma rescue medication in schools: Arizona, Colorado, Georgia, Illinois, Missouri, New Hampshire, New Jersey, New Mexico, Oklahoma, Ohio, Texas, Utah, and West Virginia. Three additional states provide stock albuterol asthma guidelines but do not have legislation: Indiana, New York, and Nebraska. Some states have found that these policies reduce the need for 911 calls and emergency medical services transports as a result of asthma exacerbations. Initial data also demonstrate that these policies reach populations in need and improve health outcomes. This case study will describe the current state of asthma in Illinois, an innovative policy solution to address asthma emergencies in schools, and the steps taken to advocate for stock asthma rescue medication in Illinois. Legislation for stock albuterol in Illinois was signed into law in August 2018.

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.

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

Polycystic ovary syndrome (PCOS) is a common female reproductive disorder that often manifests during adolescence and is associated with disruptions in health-related quality of life. Prompt evaluation and clinical support after diagnosis may prevent associated complications and optimize overall health management. This article incorporates the most recent evidence and consensus guidelines to provide an updated review of the pathogenesis, clinical presentation, diagnostic evaluation, and management strategies for adolescents with this complex condition. We will review the recent international guidelines on PCOS; because the diagnosis of PCOS remains controversial, management of this condition is inconsistent. In 2019, PCOS remains a common, yet neglected, condition, in part, because of the lack of agreement around both diagnosis and management.

Chronic sleep deprivation is a common, treatable condition among adolescents. Growing literature supports a myriad consequences that impact overall health, behavior, mood, and academic performance in this vulnerable age group during a time when there are rapid changes in physical development and emotional regulation. This article reviews the epidemiology and health effects of sleep deprivation in adolescents as well as common disorders leading to sleep loss and evidence to support treatment. Although a variety of important sleep disorders may disrupt quality of sleep in adolescents, such as obstructive sleep apnea, restless leg syndrome, and narcolepsy, this article will focus on common disorders that affect the quantity of sleep, such as poor sleep hygiene, circadian rhythm disorders, and insomnia.

As avid users of technology, adolescents are a key demographic to engage when designing and developing technology applications for health. There are multiple opportunities for improving adolescent health, from promoting preventive behaviors to providing guidance for adolescents with chronic illness in supporting treatment adherence and transition to adult health care systems. This article will provide a brief overview of current technologies and then highlight new technologies being used specifically for adolescent health, such as artificial intelligence, virtual and augmented reality, and machine learning. Because there is paucity of evidence in this field, we will make recommendations for future research.

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.

An outreach team learns the value of sharing their personal testimonies and what a little light can do to a community.

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

OM Ireland's Creative Arts Team and a group from the US lead a week-long tour into schools and a kids’ club in a housing estate.

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 journalist Hannah Rueber volunteered for a school programme and witnessed something truly incredible.

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

Walvis Bay, Namibia :: Logos Hope's volunteers rebuild a flimsy church and encourage the grieving pastor and congregation.

Forest Hill is a town in the Lockyer Valley infamous for being one of three towns in Queensland completely evacuated during last January's floods. About 300 people were airlifted by helicopters to higher ground leaving behind homes, all belongings and even pets. They had no idea what would come of those things left behind. OM Australia suggested the idea as a good way to utilise some funds donated to flood recovery. The Forest Hill Development Association Inc. in conjunction with the Laidley Baptist Church used this money to put on a community fair. It was an opportunity for the town to say thank you to those who had helped with the flood clean up and also to build the morale of the community. At the same time the involvement of the Church would raise the profile of Christ in the community.

OM Australia shares about mission opportunities at Australia’s leading three-day music festival in Toowoomba, Queensland, over Easter.

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

OM worker is amazed to see God change lives, as he peers over his book table on a busy Muslim street in Australia.

Team members of MAP Australia seek to live out the message of the Gospel to all people, no matter how sympathetic or opposed.

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

Sport creates a platform for evangelism and discipleship in Ukraine.

Extreme Leadership Training camps create unity in Ukraine.

An OM Ukraine sports team member helps young Ukrainian women gain a healthier understanding and appreciation of the bodies God gave them.

A Ukrainian pastor responds to nearly 100 per cent unemployment in his village by starting biofuel and cash crop business enterprises.

Ministering in a country at war is not fun – but a privilege. Ukraine is going through intense emotions and people are open to Kingdom conversations.

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

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

A welder's life is renewed in Kaharlyk, Ukraine through a new business opportunity with OM.

A team of dentists and volunteers recently visited an orphanage in the Odessa province to fix 75 young smiles.

Christiana, a short term mission participant from Great Britain, shares insights from her visit to Crossroads church plant in Odessa, Ukraine.

Short Term Mission participants bring inspiration to Ukraine's churches for ministry amongst the aged and internally displaced people.

Long-term follower of Jesus, Nikolay, stepped out in faith to help orphans in Ukraine, and partners with OM in this ministry to children.

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.

OM Ukraine team gets excited about church planting in a northern Odessa province after participating in a Bus4Life outreach in the area.

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.

A former student of OM Panama brings the world to her small church in western Panama.

OM Panama team members struggle to continue ministry as the Gnöbe Buglé people protest and bring the country to a halt.

After a week of tensions between government and the indigenous inhabitants, Panamá is on the road to recovery.

The OM Panama International Intensive School of Missions re-opens!

A man goes from being sought by gangsters to being sought by God.

Lighthouse Ministries builds a kitchen to transform a community in Panama.

Participants in OM Panama’s after-school ministry for children from underprivileged neighbourhoods get excited about small things – even ice cubes.