SOCIAL WORKERS\u27 PERCEPTION ON THE NEEDS AND SERVICES FOR FOSTER CHILDREN WITH SPECIAL NEEDS

Foster children are already at a disadvantage given that they tend to live in a home without their parents. Social workers have direct interactions working with children with special needs, and through interviews with the workers, we aimed to understand whether or not the services available are able to meet foster children’s special needs. The research on special needs children in foster care is quite limited. The purpose of the study was to identify social workers’ perceptions of the needs of special needs foster children and their access to services. This study used qualitative interviews with open-ended questions to gather qualitative data from ten social worker participants. The researchers employed thematic analysis techniques to analyze the qualitative data. The themes that emerged from analyzing the data were social workers’ challenges in providing services to special needs foster children, social workers’ access to services, and the need for institutional support to effectively manage service delivery for special needs foster children. This study found that social workers face challenges in obtaining training for parents and social workers, navigating complex funding processes, managing inconsistent desires between parents and court officials, and dealing with the limited number of capable foster homes. The social workers interviewed identified different tactics that could be implemented in order to improve services for the special needs foster children through changes and improvements within the department. Understanding large-scale policy and practice issues, such as organizational change or resource management, can lead county agency social workers to advocate for the challenges of special needs children in child welfare

In-situ estimation of ice crystal properties at the South Pole using LED calibration data from the IceCube Neutrino Observatory

The IceCube Neutrino Observatory instruments about 1 km3 of deep, glacial ice at the geographic South Pole using 5160 photomultipliers to detect Cherenkov light emitted by charged relativistic particles. A unexpected light propagation effect observed by the experiment is an anisotropic attenuation, which is aligned with the local flow direction of the ice. Birefringent light propagation has been examined as a possible explanation for this effect. The predictions of a first-principles birefringence model developed for this purpose, in particular curved light trajectories resulting from asymmetric diffusion, provide a qualitatively good match to the main features of the data. This in turn allows us to deduce ice crystal properties. Since the wavelength of the detected light is short compared to the crystal size, these crystal properties do not only include the crystal orientation fabric, but also the average crystal size and shape, as a function of depth. By adding small empirical corrections to this first-principles model, a quantitatively accurate description of the optical properties of the IceCube glacial ice is obtained. In this paper, we present the experimental signature of ice optical anisotropy observed in IceCube LED calibration data, the theory and parametrization of the birefringence effect, the fitting procedures of these parameterizations to experimental data as well as the inferred crystal properties.</p

Qualitative Evaluation of a High-Resolution 3D Multi-Sequence Intracranial Vessel Wall Protocol at 3 Tesla MRI

BACKGROUND AND PURPOSE: Intracranial vessel wall imaging using MRI has great potential as a clinical method for assessing intracranial atherosclerosis. The purpose of the current study was to compare three 3T MRI vessel wall sequences with different contrast weightings (T1w, PD, T2w) and dedicated sagittal orientation perpendicular to the middle cerebral artery, to the reconstructed sagittal image from a transverse 3D T1w volumetric isotropically reconstructed turbo spin-echo acquisition (VIRTA), and provide a clinical recommendation. MATERIALS AND METHODS: The above-mentioned sequences were acquired in 10 consecutive Chinese ischemic stroke or TIA patients (age: 68 years, sex: 4 females) with angiographic-confirmed MCA stenosis at 3T. Institutional review board approval was obtained. Two raters qualitatively scored all images on overall image quality, presence of artifacts, and visibility of plaques. Data were compared using Repeated measures ANOVA and Sidak's adjusted post hoc tests. RESULTS: All sequences except the T2w sequence were able to depict the walls of the large vessels of the Circle of Willis (p<0.05). T1w sagittal oblique VIRTA showed significantly more artifacts (p<0.01). Peripherally located plaques were sometimes missed on the sagittal sequences, but could be appreciated on the transverse T1w VIRTA. CONCLUSION: With the 3T multi-sequence vessel wall protocol we were able to assess the intracranial plaque with two different image contrast weightings. The sequence of preference to include in a clinical protocol would be the transverse 3D T1w VIRTA based on absence of artifacts, larger coverage including the whole Circle of Willis, and excellent lesion depiction

The clinical impact of chromosomal microarray on paediatric care in Hong Kong.

OBJECTIVE: To evaluate the clinical impact of chromosomal microarray (CMA) on the management of paediatric patients in Hong Kong. METHODS: We performed NimbleGen 135k oligonucleotide array on 327 children with intellectual disability (ID)/developmental delay (DD), autism spectrum disorders (ASD), and/or multiple congenital anomalies (MCAs) in a university-affiliated paediatric unit from January 2011 to May 2013. The medical records of patients were reviewed in September 2013, focusing on the pathogenic/likely pathogenic CMA findings and their "clinical actionability" based on established criteria. RESULTS: Thirty-seven patients were reported to have pathogenic/likely pathogenic results, while 40 had findings of unknown significance. This gives a detection rate of 11% for clinically significant (pathogenic/likely pathogenic) findings. The significant findings have prompted clinical actions in 28 out of 37 patients (75.7%), while the findings with unknown significance have led to further management recommendation in only 1 patient (p < 0.001). Nineteen out of the 28 management recommendations are "evidence-based" on either practice guidelines endorsed by a professional society (n = 9, Level 1) or peer-reviewed publications making medical management recommendation (n = 10, Level 2). CMA results impact medical management by precipitating referral to a specialist (n = 24); diagnostic testing (n = 25), surveillance of complications (n = 19), interventional procedure (n = 7), medication (n = 15) or lifestyle modification (n = 12). CONCLUSION: The application of CMA in children with ID/DD, ASD, and/or MCAs in Hong Kong results in a diagnostic yield of ∼ 11% for pathogenic/likely pathogenic results. Importantly the yield for clinically actionable results is 8.6%. We advocate using diagnostic yield of clinically actionable results to evaluate CMA as it provides information of both clinical validity and clinical utility. Furthermore, it incorporates evidence-based medicine into the practice of genomic medicine. The same framework can be applied to other genomic testing strategies enabled by next-generation sequencing

A 73-year-old female patient presented with subacute infarcts of the left parietal cortex and left internal borderzone area.

<p>(A) On the transverse 3D time-of-flight magnetic resonance angiography two stenoses can be appreciated, one in the left M1 segment of the middle cerebral artery (arrowhead) and one in M2 segment of the middle cerebral artery (arrow). The transverse T₁w VIRTA, after contrast administration, shows a corresponding vessel wall lesion in the M2 segment (B), this lesion is however missed by the transverse reconstruction of the sagittal T₁w VIRTA sequence, also after contrast administration (C) because of its limited field-of-view (indicated by the dashed lines in A).</p

Scan parameters of the acquired 3D sequences.

<p>Scan parameters of the acquired 3D sequences.</p

Proportions of raw agreement values for the four different sequences and three different measurements.

<p>Proportions of raw agreement values for the four different sequences and three different measurements.</p

Patient demographics.

<p>Patient demographics.</p

Box plots of image quality, artifacts, and visibility of the plaque for the two raters.

<p>Red line = median value of rater 1, dashed red line = median value of rater 2, box = interquartile range, whiskers = minimum and maximum values, and rounds = outliers. The image quality and visibility of the plaque were scored on a scale from 0 (poor) to 2 (good); the presence of artifacts was scored on a scale from 0 (not present) to 2 (present with influence on diagnosis). Some whiskers are not visible because the lower quartile is equal to the minimum, or the upper quartile is equal to the maximum. Also, some median values overlap with the upper or lower quartile. The median value of the artifacts of the T₂w VIRTA is 0.5 because equal numbers are scored 0 and 1. Caps over the boxes represent significant differences, p-values for image quality, artifacts and visibility of the plaque were <0.001; <0.01; and <0.05, respectively, as assessed by repeated measures ANOVA and Sidak’s adjusted post hoc tests. As an example for the caps: in the upper panel there is an overall significant difference between the T₂w VIRTA and the PDw VIRTA (p<0.001).</p

Comparison between four different 3D intracranial vessel wall sequences at 3 tesla in a 47-year-old male patient presented with a bilateral partial anterior circulation infarct as caused by an occlusion and stenosis in the left and right middle cerebral artery (MCA), respectively.

<p>(A) On the transverse 3D time-of-flight magnetic resonance angiography two stenoses can be appreciated, one in the left M1 segment of the MCA and one in right M1 segment of the MCA (arrows). (B) Sagittal reconstruction of the transverse T₁w VIRTA, (C) sagittal T₁w VIRTA, (D) sagittal PDw and (E) sagittal T₂w images showing a vessel wall lesion in the left middle cerebral artery (arrows). On both T₁w VIRTA images and the PDw image the plaque can be clearly delineated, however on the T₂w image the vessel wall is less clear.</p