Child Welfare Reform in Bulgaria - from Institutional to Family-Based Community Care: Engaging with Families, Children and Colleagues?

The authors present the child welfare policy reform and the process of deinstitutionalization of children's services in Bulgaria. These developments are examined in the context of the country's transition from a post-totalitarian to a liberal democratic state and from collectivistic to individual-centred practices. Therefore, the implementation of social policy promoting and regulating individualised community-based services faces challenges related to attitudes that support group-oriented and institutional-based care. There are three key contextual barriers to the provision of quality services for children with disability: engaging with the individual client, involving parents, and working in multidisciplinary teams. Clinical social work vignettes are presented to illustrate the above challenges

Detection of Multi-drug Resistant \u3cem\u3eEscherichia coli\u3c/em\u3e in the Urban Waterways of Milwaukee, WI

Urban waterways represent a natural reservoir of antibiotic resistance which may provide a source of transferable genetic elements to human commensal bacteria and pathogens. The objective of this study was to evaluate antibiotic resistance of Escherichia coli isolated from the urban waterways of Milwaukee, WI compared to those from Milwaukee sewage and a clinical setting in Milwaukee. Antibiotics covering 10 different families were utilized to determine the phenotypic antibiotic resistance for all 259 E. coli isolates. All obtained isolates were determined to be multi-drug resistant. The E. coli isolates were also screened for the presence of the genetic determinants of resistance including ermB (macrolide resistance), tet(M) (tetracycline resistance), and β-lactamases (blaOXA, blaSHV, and blaPSE). E. coli from urban waterways showed a greater incidence of antibiotic resistance to 8 of 17 antibiotics tested compared to human derived sources. These E. coli isolates also demonstrated a greater incidence of resistance to higher numbers of antibiotics compared to the human derived isolates. The urban waterways demonstrated a greater abundance of isolates with co-occurrence of antibiotic resistance than human derived sources. When screened for five different antibiotic resistance genes conferring macrolide, tetracycline, and β-lactam resistance, clinical E. coli isolates were more likely to harbor ermB and blaOXA than isolates from urban waterway. These results indicate that Milwaukee’s urban waterways may select or allow for a greater incidence of multiple antibiotic resistance organisms and likely harbor a different antibiotic resistance gene pool than clinical sources. The implications of this study are significant to understanding the presence of resistance in urban freshwater environments by supporting the idea that sediment from urban waterways serves as a reservoir of antibiotic resistance

Assessment of Children with Autism Spectrum Disorder and Post-Assessment Meeting with Parents: Some Issues of Planning and Professional Attitude

The authors, child psychiatrists and clinical psychologists, conducting team assessment of children with developmental disabilities (including autism spectrum disorder) for more than two decades, present some important in their view issues and recommendations concerning planning and proceeding of assessment and post-assessment meetings with parents. It is essential to ensure not only an accurate assessment protocol and diagnosis, but also to "attune" to parents in order to facilitate their understanding and more positive use of assessment outcome results. Parents need further support to "survive" psychically the post - assessment period and to provide for adequate interventions for their child

Asperger’s Syndrome in a Clinical Sample: Reasons for Referral and Comorbidity

Asperger’s Syndrome (AS) is an autism spectrum disorder without mental retardation and language delay. AS often remains unrecognized until these children fail to adapt to school or kindergarten. The comorbid psychiatric disorders, achieving clinical significance, were considered as another pathway to diagnosis. This study is aimed to elucidate the reasons for referral, the frequency and the kinds of comorbidities in a clinical sample of consecutive cases of children and adolescents with AS. To this objective, clinical records of children and adolescents, who have received a DSM-IV diagnosis of AS after multidisciplinary assessment in a given time period were reviewed. After excluding 3 cases due to insufficient information, 24 cases of children and adolescents with Asperger’s Syndrome (23 boys and one girl) were identified. The mean age at the time of assessment and receiving diagnosis was 9.6 yrs. (age range 4 to 17 years). In twenty-one (87%) of the cases the reason for referral was an episode of disorganized behavior following an attempt to enrollthe child at school or kindergarten, and more rare referral occurred within the significant school transition period. In the remaining 3 cases, the reason for referral was a comorbid condition. Comorbid conditions identified at the moment of assessment include: ADHD documented in 4 cases, tics in 3 cases, obsessive-compulsive behaviors in 4 cases, Stereotypic Movement Disorder or Trichotilomania in 4 of the cases. Within the clinical sample, a priori expected to include relatively severe cases, a higher frequency of comorbidity was found as compared to the rates in the general population. Adjustment reactions and comorbidities occasioned the refer

Early Assessment of Mental Development in Children with Autism Spectrum Disorder (ASD) and other Neurodevelopmental Disorders - Sharing of Clinical Experience

The authors present a synthesised review of the methods for assessing mental development and autism, with an emphasis on the general tendency to reduce the age of diagnosis. Based on clinical experience, a number of particularities are described in terms of: testing, working with parents, observing and reflecting on the nature and meaning of autistic behaviours. On focus is a toolkit for detailed assessment of mental development that was elaborated within the inter-university cooperation between Sofia Medical University and Universite catholique de Louvain (UCL) - Belgium. Illustrated and discussed are typical profiles of cognitive and socio-communicative functioning of children with ASD and other neurodevelopmental disorders, which help a differential diagnosis to be made by the multidisciplinary clinical team. Further described are the advantages of early assessment of mental development as a basis for future educational and therapeutic programs

Endogenous transforming growth factor β1 suppresses inflammation and promotes survival in adult CNS

Transforming growth factor β1 (TGFβ1) is a pleiotropic cytokine with potent neurotrophic and immunosuppressive properties that is upregulated after injury, but also expressed in the normal nervous system. In the current study, we examined the regulation of TGFβ1 and the effects of TGFβ1 deletion on cellular response in the uninjured adult brain and in the injured and regenerating facial motor nucleus. To avoid lethal autoimmune inflammation within 3 weeks after birth in TGFβ1-deficient mice, this study was performed on a T- and B-cell-deficient RAG2-/- background. Compared with wild-type siblings, homozygous deletion of TGFβ1 resulted in an extensive inflammatory response in otherwise uninjured brain parenchyma. Astrocytes increased in GFAP and CD44 immunoreactivity; microglia showed proliferative activity, expression of phagocytosis-associated markers [αXβ2, B7.2, and MHC1 (major histocompatibility complex type 1)], and reduced branching. Ultrastructural analysis revealed focal blockade of axonal transport, perinodal damming of axonal organelles, focal demyelination, and myelin debris in granule-rich, phagocytic microglia. After facial axotomy, absence of TGFβ1 led to a fourfold increase in neuronal cell death (52 vs 13%), decreased central axonal sprouting, and significant delay in functional recovery. It also interfered with the microglial response, resulting in a diminished expression of early activation markers [ICAM1 (intercellular adhesion molecule 1), α6β1, and αMβ2] and reduced proliferation. In line with axonal and glial findings in the otherwise uninjured CNS, absence of endogenous TGFβ1 also caused an ∼10% reduction in the number of normal motoneurons, pointing to an ongoing and potent trophic role of this anti-inflammatory cytokine in the normal as well as in the injured brain. Copyright © 2007 Society for Neuroscience

Thermoacoustic tomography arising in brain imaging

We study the mathematical model of thermoacoustic and photoacoustic tomography when the sound speed has a jump across a smooth surface. This models the change of the sound speed in the skull when trying to image the human brain. We derive an explicit inversion formula in the form of a convergent Neumann series under the assumptions that all singularities from the support of the source reach the boundary

Transient growth in Taylor-Couette flow

Transient growth due to non-normality is investigated for the Taylor-Couette problem with counter-rotating cylinders as a function of aspect ratio eta and Reynolds number Re. For all Re < 500, transient growth is enhanced by curvature, i.e. is greater for eta < 1 than for eta = 1, the plane Couette limit. For fixed Re < 130 it is found that the greatest transient growth is achieved for eta between the Taylor-Couette linear stability boundary, if it exists, and one, while for Re > 130 the greatest transient growth is achieved for eta on the linear stability boundary. Transient growth is shown to be approximately 20% higher near the linear stability boundary at Re = 310, eta = 0.986 than at Re = 310, eta = 1, near the threshold observed for transition in plane Couette flow. The energy in the optimal inputs is primarily meridional; that in the optimal outputs is primarily azimuthal. Pseudospectra are calculated for two contrasting cases. For large curvature, eta = 0.5, the pseudospectra adhere more closely to the spectrum than in a narrow gap case, eta = 0.99

Inverse Diffusion Theory of Photoacoustics

This paper analyzes the reconstruction of diffusion and absorption parameters in an elliptic equation from knowledge of internal data. In the application of photo-acoustics, the internal data are the amount of thermal energy deposited by high frequency radiation propagating inside a domain of interest. These data are obtained by solving an inverse wave equation, which is well-studied in the literature. We show that knowledge of two internal data based on well-chosen boundary conditions uniquely determines two constitutive parameters in diffusion and Schroedinger equations. Stability of the reconstruction is guaranteed under additional geometric constraints of strict convexity. No geometric constraints are necessary when $2n$ internal data for well-chosen boundary conditions are available, where $n$ is spatial dimension. The set of well-chosen boundary conditions is characterized in terms of appropriate complex geometrical optics (CGO) solutions.Comment: 24 page

Dynamics of Excited State Proton Transfer in Nitro Substituted 10-Hydroxybenzo[h]quinolines

Barrierless proton transfer in HBQ and a barrier upon nitro substitution.</p