Mental Health Work With Youth Leaving Foster Care: Strengthening Resilience

Leaving the foster care system is a major transitional experience for youth in the child welfare system. This thesis will explore the process of transitioning out of foster care through the policies and resources that affect this population and several clinical models that aim to encourage resilience in youth leaving care. The first section will explore the policies in place to support youth transitioning out of the foster care system and then examine several of the resources specifically available to youth leaving care in New York City. The second section will explore how clinicians might help to develop resilience in therapy through various theoretical perspectives. The third section will reflect on ongoing work with clients and the process of identifying strengths and cultivating resilience in the therapeutic setting. The goal of this thesis is to highlight the roles that both caseworkers and clinicians play in assisting youth to successfully leave care. This paper will provide resources for caseworkers in New York City and clinicians working with this population

A Network-based Approach to Organizational Culture and Learning in System Safety

AbstractWhile it is now generally agreed that system safety cannot be adequately addressed using technical analysis alone, an approach to modeling the organizational issues associated with safety is still needed. This paper offers an analytical approach to assessing the complex relationships among organizational culture and safety practices and outcomes. The paper argues that, in principle, organizational culture can be represented as a network of shared mental models (SMMs). While it would be impractical to construct a network that fully captures an organization's culture, the approach can be used to model particular dimensions of culture. Thus, a network of SMMs is a meaningful representation of safety culture to the extent that the data effectively capture shared knowledge about system safety. Similarly, organizational learning can be quantified as the evolution of that network's structure over time. The goal of the research is to develop a quantitative methodology for analyzing the relationship of organizational culture and learning to safety performance. The research is built on a collaborative effort between academia and industry focused on improving process safety in the oil and gas industry, but it can be applied to safety-related problems across organizations. The results are expected to have implications for training, professional development, safety protocols, and methods for measuring and managing safety practices in the development and operation of complex engineered systems

New advances in the study of bone tumors: A lesson from the 3D environment

Bone primary tumors, such as osteosarcoma, are highly aggressive pediatric tumors that in 30% of the cases develop lung metastasis and are characterized by poor prognosis. Bone is also the third most common metastatic site in patients with advanced cancer and once tumor cells become homed to the skeleton, the disease is usually considered incurable, and treatment is only palliative. Bone sarcoma and bone metastasis share the same tissue microenvironment and niches. 3D cultures represent a new promising approach for the study of interactions between tumor cells and other cellular or acellular components of the tumor microenvironment (i.e., fibroblasts, mesenchymal stem cells, bone ECM). Indeed, 3D models can mimic physiological interactions that are crucial to modulate response to soluble paracrine factors, tumor drug resistance and aggressiveness and, in all, these innovative models might be able of bypassing the use of animal-based preclinical cancer models. To date, both static and dynamic 3D cell culture models have been shown to be particularly suited for screening of anticancer agents and might provide accurate information, translating in vitro cell cultures into precision medicine. In this mini-review, we will summarize the current state-of-the-art in the field of bone tumors, both primary and metastatic, illustrating the different methods and techniques employed to realize 3D cell culture systems and new results achieved in a field that paves the way toward personalized medicine

The microfluidic trainer: Design, fabrication and validation of a tool for testing and improving manual skills

Microfluidic principles have been widely applied for more than 30 years to solve biological and micro-electromechanical problems. Despite the numerous advantages, microfluidic devices are difficult to manage as their handling comes with several technical challenges. We developed a new portable tool, the microfluidic trainer (MT), that assesses the operator handling skills and that may be used for maintaining or improving the ability to inject fluid in the inlet of microfluidic devices for in vitro cell culture applications. After several tests, we optimized the MT tester cell to reproduce the real technical challenges of a microfluidic device. In addition to an exercise path, we included an overfilling indicator and a correct infilling indicator at the inlet (control path). We manufactured the MT by engraving a 3 mm-high sheet of methacrylate with 60W CO2 laser plotter to create multiple capillary paths. We validated the device by enrolling 21 volunteers (median age 33) to fill both the MT and a commercial microfluidic device. The success rate obtained with MT significantly correlated with those of a commercial microfluidic culture plate, and its 30 min-continuous use for three times significantly improved the performance. Overall, our data demonstrate that MT is a valid assessment tool of individual performances in using microfluidic devices and may represent a low-cost solution to training, improve or warm up microfluidic handling skills

Comprehensive evaluation and comparison of different modalities for assessing fetal cardiac function

Fetal cardiac function analysis may provide crucial pathophysiological insights into fetal hemodynamic status, clarify cardiovascular adaptation to perinatal complications and improve clinical diagnosis and management of complicated pregnancies. A broad range of ultrasound techniques aim to predict cardiac dysfunction before there are clinical signs of fetal distress to allow early intervention. This thesis aimed to assess Pulsed-Wave Myocardial Performing Index (PW-MPI), Tissue Doppler Imaging MPI (TDI-MPI) and Tricuspid and Mitral Annular Plane Systolic Excursion (TAPSE and MAPSE) for evaluating fetal cardiac function. This was performed in several aspects: TDI has been proposed to be robust for detecting subclinical cardiac dysfunction over conventional Doppler. We found (79 cases) similar achievability and reproducibility, yet a poor correlation between TDI- and PW-MPI. Most probably due to considerably variable TDI waveform quality. This raised concerns about the technique for TDI-MPI. Online international study aiming to evaluate TDI-MPI demarcation and reliability. We compared annotations of 4 international experts (120 images) and found very high intra-observer repeatability, lower inter-observer reproducibility and variability in landmark definition, questioning the reliability of TDI-MPI. Evaluation of STIC M-mode for measuring TAPSE and MAPSE (102 cases). We found high achievability, high intra-observer repeatability for both sides and higher inter-observer reproducibility for TAPSE compared to MAPSE. We concluded that STIC allows easy and accessible evaluation of systolic function, that is reliable and repeatable, more so for TAPSE than MAPSE. Multimodality, global evaluation, which included a comparison of all modalities in 79 normal pregnancies, and in 30 scans from pregnancies complicated with IUGR or monochorionic twins. Achievability rates were high for all modalities. No single method was superior for both sides, TAPSE was more suited to the right heart and automated PWD-MPI for the left. These reflect each modality's specific qualities that accommodate best to the different structure and function of each heart side. This provides a useful first step for developing a clinical multimodality global scoring system that integrates the most favourable imaging technique for each side of the heart to optimally quantify the global heart function. This thesis also provides a firm basis for further research in this field

The impact of parental involvement and education on academic achievement in elementary school

The academic achievement of students in schools is subject to a variety of factors, many of which are beyond the control of the student. Factors such as parental involvement, parental level of education, and disability all influence the academic achievement and learning of students. The study analyzed nation-wide survey data on students in elementary school and investigates the relationship between student achievement and multiple variables. The variables were parental involvement, and the existence of Autism Spectrum Disorder (ASD) or other disability. Results indicated that students, both ASD and typically developing, have lower parent involvement if they are successful in school

Socio-cognitive analysis of engineering systems design : shared knowledge, process, and product

Thesis (Ph. D.)--Massachusetts Institute of Technology, Engineering Systems Division, 2009.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Cataloged from student-submitted PDF version of thesis.Includes bibliographical references (p. 213-222).This research is based on the well-known but seldom stated premise that the design of complex engineered systems is done by people -- each with their own knowledge, thoughts, and views about the system being designed. To understand the implications of this social dimension, the Integrated Concurrent Engineering (ICE) environment, a real-world setting for conceptual space mission design, is examined from technical and social perspectives. An integrated analysis demonstrates a relationship among shared knowledge, process, and product. The design process is analyzed using a parameter-based Design Structure Matrix (DSM). This model, consisting of 682 dependencies among 172 parameters, is partitioned (reordered) to reveal a tightly coupled design process. Further analysis shows that making starting assumptions about design budgets leads to a straightforward process of well-defined and sequentially executed design iterations. To analyze the social aspects, a network-based model of shared knowledge is proposed. By quantifying team members' common views of design drivers, a network of shared mental models is built to reveal the structure of shared knowledge at a snapshot in time. A structural comparison of pre-session and post-session networks is used to compute a metric of change in shared knowledge. Based on survey data from 12 design sessions, a correlation is found between change in shared knowledge and each of several system attributes, including technological maturity, development time, mass, and cost. Integrated analysis of design process and shared knowledge yields three interdisciplinary insights.(cont.) First, certain features of the system serve a central role both in the design process and in the development of shared knowledge. Second, change in shared knowledge is related to the design product. Finally, change in shared knowledge and team coordination (agreement between expected and reported interactions) are positively correlated. The thesis contributes to the literature on product development, human factors engineering, and organizational and social psychology. It proposes a rigorous means of incorporating the socio cognitive aspects of design into the practice of systems engineering. Finally, the thesis offers a set of recommendations for the formation and management of ICE design facilities and discusses the applicability of the proposed methodology to the full-scale development of complex engineered systems.by Mark Sean Avnet.Ph.D

Perfused Platforms to Mimic Bone Microenvironment at the Macro/Milli/Microscale: Pros and Cons

As life expectancy increases, the population experiences progressive ageing. Ageing, in turn, is connected to an increase in bone-related diseases (i.e., osteoporosis and increased risk of fractures). Hence, the search for new approaches to study the occurrence of bone-related diseases and to develop new drugs for their prevention and treatment becomes more pressing. However, to date, a reliable in vitro model that can fully recapitulate the characteristics of bone tissue, either in physiological or altered conditions, is not available. Indeed, current methods for modelling normal and pathological bone are poor predictors of treatment outcomes in humans, as they fail to mimic the in vivo cellular microenvironment and tissue complexity. Bone, in fact, is a dynamic network including differently specialized cells and the extracellular matrix, constantly subjected to external and internal stimuli. To this regard, perfused vascularized models are a novel field of investigation that can offer a new technological approach to overcome the limitations of traditional cell culture methods. It allows the combination of perfusion, mechanical and biochemical stimuli, biological cues, biomaterials (mimicking the extracellular matrix of bone), and multiple cell types. This review will discuss macro, milli, and microscale perfused devices designed to model bone structure and microenvironment, focusing on the role of perfusion and encompassing different degrees of complexity. These devices are a very first, though promising, step for the development of 3D in vitro platforms for preclinical screening of novel anabolic or anti-catabolic therapeutic approaches to improve bone health

Osteoclast differentiation from human blood precursors on biomimetic calcium-phosphate substrates

The design of synthetic bone grafts to foster bone formation is a challenge in regenerative medicine. Understanding the interaction of bone substitutes with osteoclasts is essential, since osteoclasts not only drive a timely resorption of the biomaterial, but also trigger osteoblast activity. In this study, the adhesion and differentiation of human blood-derived osteoclast precursors (OCP) on two different micro-nanostructured biomimetic hydroxyapatite materials consisting in coarse (HA-C) and fine HA (HA-F) crystals, in comparison with sintered stoichiometric HA (sin-HA, reference material), were investigated. Osteoclasts were induced to differentiate by RANKL-containing supernatant using cell/substrate direct and indirect contact systems, and calcium (Ca++) and phosphorus (P5+) in culture medium were measured. We observed that OCP adhered to the experimental surfaces, and that osteoclast-like cells formed at a rate influenced by the micro- and nano-structure of HA, which also modulate extracellular Ca++. Qualitative differences were found between OCP on biomimetic HA-C and HA-F and their counterparts on plastic and sin-HA. On HA-C and HA-F cells shared typical features of mature osteoclasts, i.e. podosomes, multinuclearity, tartrate acid phosphatase (TRAP)-positive staining, and TRAP5b-enzyme release. However, cells were less in number compared to those on plastic or on sin-HA, and they did not express some specific osteoclast markers. In conclusion, blood-derived OCP are able to attach to biomimetic and sintered HA substrates, but their subsequent fusion and resorptive activity are hampered by surface micro-nano-structure. Indirect cultures suggest that fusion of OCP is sensitive to topography and to extracellular calcium.Preprin