A Look in the Mirror: Unveiling Human Rights Issues Within Social Work Education.

Using a convergent parallel mixed-methods design, this study explored the financial effect of the field practicum requirement on BSW students. This project was conducted at a mid-sized university in the Southwest region of the United States where current and recent field students responded to surveys and social work field instructors and faculty participated in interviews. The study describes financial burdens and reveals human rights issues affecting nontraditional and underserved students that have answered the call to a career of serving the most vulnerable in society. This study fills a gap in the literature and provides recommendations for further research and anti-oppressive approaches for the academy to employ in the education of future social work professionals.

Avatar assistant: improving social skills in students with an ASD through a computer-based intervention.

This study assessed the efficacy of FaceSay, a computer-based social skills training program for children with Autism Spectrum Disorders (ASD). This randomized controlled study (N = 49) indicates that providing children with low-functioning autism (LFA) and high functioning autism (HFA) opportunities to practice attending to eye gaze, discriminating facial expressions and recognizing faces and emotions in FaceSay's structured environment with interactive, realistic avatar assistants improved their social skills abilities. The children with LFA demonstrated improvements in two areas of the intervention: emotion recognition and social interactions. The children with HFA demonstrated improvements in all three areas: facial recognition, emotion recognition, and social interactions. These findings, particularly the measured improvements to social interactions in a natural environment, are encouraging.

Surgical outcomes for velopharyngeal insufficiency in velocardiofacial syndrome and nonsyndromic patients.

OBJECTIVE: To compare speech outcomes after operative intervention for velopharyngeal insufficiency between velocardiofacial syndrome patients and nonsyndromic patients. DESIGN: Retrospective cohort study. SETTING: Tertiary academic center. PATIENTS: Cohorts of 14 velocardiofacial syndrome and 15 nonsyndromic patients without overt cleft palate who underwent operative procedures to correct velopharyngeal insufficiency. All velocardiofacial syndrome patients were positive for 22q11.2 microdeletion by fluorescent in situ hybridization and possessed phenotypic features of velocardiofacial syndrome. INTERVENTIONS: Operative procedures, including sphincter pharyngoplasty, Furlow palatoplasty, or both, were selected based on preoperative endoscopic assessments of velopharyngeal motion and residual gap size and shape, as well as velocardiofacial syndrome status. Five single and 9 combined procedures were performed in the velocardiofacial syndrome group, whereas 13 single and 2 combined procedures were performed in the nonsyndromic group. OUTCOME MEASURES: Pre- and post-op evaluation was conducted by a speech pathologist. Assessment parameters scored on a numerical scale included speech intelligibility, resonance, nasal air emissions, and overall severity of velopharyngeal insufficiency. Postoperative complications were recorded. RESULTS: Most velocardiofacial syndrome patients and nonsyndromic patients demonstrated significant improvements in all parameters. Comparison of the two groups demonstrated similar improvements in both. Changes in speech resonance were significantly different between the two groups, whereas other speech parameters did not reach significance. There was no difference in airway complications between groups. CONCLUSIONS: Velocardiofacial syndrome patients may have comparable outcomes to nonsyndromic patients in selective surgical management of velopharyngeal insufficiency. In addition, the data demonstrate the efficacy of a single-stage combined procedure without increased morbidity.

Arterial embolization in the management of posterior epistaxis.

OBJECTIVES: Treatment of severe epistaxis can encompass many modalities. Control rates with all treatments are good. Morbidity among treatment groups varies. Angiographic embolization is one such method that has a very low complication rate. Over the last 10 years, it has become the preferred treatment at our institution. STUDY DESIGN: Tertiary medical referral centers: OHSU, Portland VAMC. MATERIALS AND METHODS: Retrospective review of 70 patients transferred or admitted with posterior epistaxis and treated with selective angiographic embolization from 1993 to 2002. RESULTS: Patients had bleeding for a median of 4.5 days prior to admission. 79% were unilateral. Etiology of bleeding was: idiopathic (61%), previous surgery (11%), anticoagulants (9%), trauma (7%), and other causes (12%). 30% required blood transfusions prior to admission to OHSU (average 4.4 units). No patient required a transfusion postoperatively following angiographic embolization or during their hospitalization. The internal maxillary artery (IMAX) was embolized in 94% (47% unilateral or bilateral IMAX only, 47% unilateral or bilateral IMAX in combination with other vessels, 6% other vessels besides the IMAX). Mean length of stay was 2.5 days. 86% had minor or no complications after the embolization and were discharged within 24 hours. 13% had a major rebleed that required surgical intervention within 6 weeks of the embolization. One patient had a serious neurological complication. Using the data available on 68 of 70 patients, the cost of hospitalization averaged dollar 18,000 with direct costs of embolization averaging dollar 11,000. CONCLUSIONS: Angiographic embolization is a clinically effective treatment for severe epistaxis. EBM RATING: C.

Otolaryngologic manifestations of PHACE syndrome.

Two case reports of PHACE syndrome (posterior fossa malformations (P), hemangiomas (H), arterial anomalies (A), coarctation of the aorta and cardiac defects (C), and eye abnormalities (E)) are presented. Clinical characteristics consisted of cutaneous and airway hemangiomas, aortic coarctation, and left superior vena cava in one child and cutaneous and airway hemangiomas, sternal clefting, and supraumbilical raphe in the other child. Treatment modalities included systemic and intralesional steroids for cutaneous and airway hemangiomas, submucosal resection and laryngotracheal reconstruction for airway hemangiomas, repair of aortic coarctation, and laser treatment of cutaneous hemangiomas. PHACE syndrome poses a significant potential for airway compromise from hemangiomas, which may require multimodality treatment.