Medical care with dignity can be a challenging topic – and one that you may not have thought much about until now.

Q1

Medical care with dignity can be a challenging topic – and one that you may not have thought much about until now.

Death with dignity is also starting to become a topic of debate within pediatric settings. At what point do patients (and parents) have the right to terminate treatment and focus on quality of life for their time remaining? At what point in medical care to we advocate for what is most important to the patient, which for some may be continued treatment, or for others may be ending painful suffering?

There is no right or wrong answer here, but what are your thoughts on dignity within medical care, and what does that look like to you within a pediatric setting

Q2

A Day in the life of Foster Care.

Part 1. Read Part 1 of scenario  and answer the questions that follow:

Imagine you are Cathy Crow and you and your husband, Matt, have recently been approved as foster parents. You are very anxious to receive your first call to take a child. You quit your job several months ago, as you and your husband had decided that being a foster mother at home would give you more time for your own children. One spring day you are planning a busy day. It is 9 am your biological children are at school. You must make cookies for Dara's open house at Art class today and take them when you pick her up from school. Then your son Liam has a Little League game that you promised to attend. This is the first game in which he will play and he is very excited.

You have also promised to pick up some paint for husband Matt, who is trying to finish the guest room before his parents arrive next week. The phone rings as you are planning. It is the foster care agency saying that they have a child for you. The worker, John Smith, tells you that he is about to go into a hearing on an eighteen-month-old girl named Tanya, but there is a good chance the court will decide to place her in foster care right from court. Her baby brother died due to the mother's neglect and the court will probably remove this child. Can you take her? It will probably be in an hour. You agree and reconsider your day.

What is your initial reaction to that scenario? List the strengths and concerns you see for this family. How do you think the Foster mom, social worker, child, and birth mom are feeling at this point?

Part 2. Now read Part 2 of the scenario, and then answer the following questions:

A few hours later, John Smith arrives. He is carrying an obese twenty-month-old girl who is very dirty and crying. Her face is caked with mucus from her runny nose. The worker hands her to you, telling you that she has lice. She has been badly neglected and does not walk, talk, or sit on her own. He gives you a voucher for clothes, says that he will call later and leaves. There you are with a strange, filthy child who will not stop crying. You give the child a bath, trying to soothe her as best you can. You wash her hair well, but know that you will have to get special shampoo to get rid of the lice. The baby continues screaming and will not be comforted. After another hour you manage to give her a bottle and get her to sleep. You enlist the support of a neighbor to watch her while she sleeps and quickly run to the store to get a few clothes and the medicated shampoo to take care of the lice. You also get some milk, as she is still drinking from a bottle and that seems to be all she will take. You return home to find a frazzled neighbor, an awake and screaming baby, and a whimpering family dog who is apparently distressed at the child's crying. You try to calm everyone. A look at the clock tells you that it is now 2:00 and in a half an hour you should be picking your daughter up at school and taking her and the hastily made cookies to Art class. You manage to arrange a ride for your daughter, begging that they swing by for the cookies. You cannot get a hold of Liam, but you call your husband and ask if there is any way he can get out a bit early to get to the end of the game. He cannot, as his company has a big meeting, but he will pick Liam up after the game. You have managed to calm the baby and she is, for the moment, quiet. You wash her head again with the medicated shampoo to renewed wails. She finally settles down once again and you hoist her on your hip and start dinner. The family should be home soon.

How do you think the Foster mom feels now? How do you think the rest of the family will react to the baby when they finally get home?

Part 3. Finally, read Part 3 of the scenario and answer the questions that follow:

Several months later, the social worker calls saying that the birth mother's visits at the office have been going well, so the agency is considering reunification. To make the visit less traumatic for baby Tanya, they would like it to take place at your home. You agree. The mother is an hour late for the scheduled visit. She is an extremely obese woman who announces that she is there to see her daughter from behind the smoke of the cigarette in her lips. No one in the family smokes and you debate if you should ask her not to, but decide to say nothing. The mother comes into your house and proceeds to go into every room, as if she is inspecting. She handles everything and pays little attention to Tanya. Tanya clings to you and does not seem to want to see her mother either. After an hour of the mother criticizing how Tanya is dressed and how you keep your house, she leaves.

You have had Tanya for almost two years. She now walks, talks, and is just slightly behind developmentally. The social worker, a new one, calls and says that they are definitely not going to return Tanya to her mother, but are considering placing her for adoption. The worker tells you that because Tanya has become so attached to you, they would like your family to consider adopting her. She asks that, either way, you begin to prepare Tanya for the fact that she will be going for adoption.

What does the Foster mom do now? How does this decision impact Tanya, the birth mom, and the Foster family? What should the social worker do to ensure the needs of the child and foster family are met? 

Q3

Topic A: Would you kill the large person?

Looking back at the original trolley problem, throwing one switch to divert a train so it would only kill one person rather than five, discuss whether you think you would throw the switch. Then consider the twist where you could push a rather large person (gender should make no difference) from a bridge to save the lives of five others. What is the difference, if any, between the two scenarios? What do you think your answer says about your moral compass?

Q5

What specific role(s) does risk management play in national security and why is it of importance to homeland security and defense initiatives? Within the homeland security enterprise, how does cyber-security specifically factor into critical infrastructure protection and risk management?

Q6

Alaina is a 4-year-old girl who lives with her mom, dad, and little brother. Alaina was born with bilateral, sensorineural, severeprofound hearing loss. This means she is deaf in both ears. At the age of 10 months, Alaina received cochlear implants which enable her to hear. Alaina and her parents were enrolled in their state’s Early Intervention program from the time she was born to the age of three. Now Alaina receives early childhood special education services in an inclusive classroom with her peers. Her inclusion is supported through services she and her teacher receives from a Teacher of the Deaf/Hard of Hearing (TOD) and a Speech-Language Pathologist (SLP). Alaina loves to play and is very social with her peers. She plays with all the children in her classes but also has special friends who she prefers. Her interests include play-doh, baby dolls, playing chase games outside, and anything pink! Alaina is interested in books and has the attention to listen to long stories but sometimes has a hard time remembering all the details. Often, because Alaina is very socially competent, it can be difficult to notice when Alaina is struggling in the daily classroom routines. She is able to follow other children’s lead when she doesn’t hear the directions or can’t understand what is being said. Alaina’s expressive language is very good but she sometimes is missing the beginnings or ends of words – especially softer sounds. In addition, it is difficult for Alaina to learn new words quickly. Alaina is getting ready to transition to Kindergarten next year. Her mother and father are concerned about Alaina keeping up academically especially as things become more difficult. Alaina is not confident in asking for help and she can get lost in the shuffle.  Discuss the following with your peers:

· How can Alaina’s teachers work with her special education team to develop an IEP that will give her the necessary supports to be successful in Kindergarten? 

· Based on NCFELD standards what goals and strategies are important for Alaina?

· If you were Alaina’s teacher, what would you identify as essential goals for her IEP to guarantee her continued success as a learner? 

· For example, what evidence-based practices might support Alaina in learning to ask for help?

·  What suggestions do you have for incorporating those goals into daily routines and activities in a kindergarten classroom? 

· What practices or strategies might support those goals (e.g., peer supports)?

· When the goals, practices, and strategies you identified are implemented in Alaina’s classroom, what might the possible benefits be for the other children in the class?

,

Q1

Medical care with dignity can be a challenging topic – and one that you may not have thought much about until now.

Death with dignity is also starting to become a topic of debate within pediatric settings. At what point do patients (and parents) have the right to terminate treatment and focus on quality of life for their time remaining? At what point in medical care to we advocate for what is most important to the patient, which for some may be continued treatment, or for others may be ending painful suffering?

There is no right or wrong answer here, but what are your thoughts on dignity within medical care, and what does that look like to you within a pediatric setting

Q2

A Day in the life of Foster Care.

Part 1. Read Part 1 of scenario  and answer the questions that follow:

Imagine you are Cathy Crow and you and your husband, Matt, have recently been approved as foster parents. You are very anxious to receive your first call to take a child. You quit your job several months ago, as you and your husband had decided that being a foster mother at home would give you more time for your own children. One spring day you are planning a busy day. It is 9 am your biological children are at school. You must make cookies for Dara's open house at Art class today and take them when you pick her up from school. Then your son Liam has a Little League game that you promised to attend. This is the first game in which he will play and he is very excited.

You have also promised to pick up some paint for husband Matt, who is trying to finish the guest room before his parents arrive next week. The phone rings as you are planning. It is the foster care agency saying that they have a child for you. The worker, John Smith, tells you that he is about to go into a hearing on an eighteen-month-old girl named Tanya, but there is a good chance the court will decide to place her in foster care right from court. Her baby brother died due to the mother's neglect and the court will probably remove this child. Can you take her? It will probably be in an hour. You agree and reconsider your day.

What is your initial reaction to that scenario? List the strengths and concerns you see for this family. How do you think the Foster mom, social worker, child, and birth mom are feeling at this point?

Part 2. Now read Part 2 of the scenario, and then answer the following questions:

A few hours later, John Smith arrives. He is carrying an obese twenty-month-old girl who is very dirty and crying. Her face is caked with mucus from her runny nose. The worker hands her to you, telling you that she has lice. She has been badly neglected and does not walk, talk, or sit on her own. He gives you a voucher for clothes, says that he will call later and leaves. There you are with a strange, filthy child who will not stop crying. You give the child a bath, trying to soothe her as best you can. You wash her hair well, but know that you will have to get special shampoo to get rid of the lice. The baby continues screaming and will not be comforted. After another hour you manage to give her a bottle and get her to sleep. You enlist the support of a neighbor to watch her while she sleeps and quickly run to the store to get a few clothes and the medicated shampoo to take care of the lice. You also get some milk, as she is still drinking from a bottle and that seems to be all she will take. You return home to find a frazzled neighbor, an awake and screaming baby, and a whimpering family dog who is apparently distressed at the child's crying. You try to calm everyone. A look at the clock tells you that it is now 2:00 and in a half an hour you should be picking your daughter up at school and taking her and the hastily made cookies to Art class. You manage to arrange a ride for your daughter, begging that they swing by for the cookies. You cannot get a hold of Liam, but you call your husband and ask if there is any way he can get out a bit early to get to the end of the game. He cannot, as his company has a big meeting, but he will pick Liam up after the game. You have managed to calm the baby and she is, for the moment, quiet. You wash her head again with the medicated shampoo to renewed wails. She finally settles down once again and you hoist her on your hip and start dinner. The family should be home soon.

How do you think the Foster mom feels now? How do you think the rest of the family will react to the baby when they finally get home?

Part 3. Finally, read Part 3 of the scenario and answer the questions that follow:

Several months later, the social worker calls saying that the birth mother's visits at the office have been going well, so the agency is considering reunification. To make the visit less traumatic for baby Tanya, they would like it to take place at your home. You agree. The mother is an hour late for the scheduled visit. She is an extremely obese woman who announces that she is there to see her daughter from behind the smoke of the cigarette in her lips. No one in the family smokes and you debate if you should ask her not to, but decide to say nothing. The mother comes into your house and proceeds to go into every room, as if she is inspecting. She handles everything and pays little attention to Tanya. Tanya clings to you and does not seem to want to see her mother either. After an hour of the mother criticizing how Tanya is dressed and how you keep your house, she leaves.

You have had Tanya for almost two years. She now walks, talks, and is just slightly behind developmentally. The social worker, a new one, calls and says that they are definitely not going to return Tanya to her mother, but are considering placing her for adoption. The worker tells you that because Tanya has become so attached to you, they would like your family to consider adopting her. She asks that, either way, you begin to prepare Tanya for the fact that she will be going for adoption.

What does the Foster mom do now? How does this decision impact Tanya, the birth mom, and the Foster family? What should the social worker do to ensure the needs of the child and foster family are met? 

Q3

Topic A: Would you kill the large person?

Looking back at the original trolley problem, throwing one switch to divert a train so it would only kill one person rather than five, discuss whether you think you would throw the switch. Then consider the twist where you could push a rather large person (gender should make no difference) from a bridge to save the lives of five others. What is the difference, if any, between the two scenarios? What do you think your answer says about your moral compass?

Q5

What specific role(s) does risk management play in national security and why is it of importance to homeland security and defense initiatives? Within the homeland security enterprise, how does cyber-security specifically factor into critical infrastructure protection and risk management?

Q6

Alaina is a 4-year-old girl who lives with her mom, dad, and little brother. Alaina was born with bilateral, sensorineural, severeprofound hearing loss. This means she is deaf in both ears. At the age of 10 months, Alaina received cochlear implants which enable her to hear. Alaina and her parents were enrolled in their state’s Early Intervention program from the time she was born to the age of three. Now Alaina receives early childhood special education services in an inclusive classroom with her peers. Her inclusion is supported through services she and her teacher receives from a Teacher of the Deaf/Hard of Hearing (TOD) and a Speech-Language Pathologist (SLP). Alaina loves to play and is very social with her peers. She plays with all the children in her classes but also has special friends who she prefers. Her interests include play-doh, baby dolls, playing chase games outside, and anything pink! Alaina is interested in books and has the attention to listen to long stories but sometimes has a hard time remembering all the details. Often, because Alaina is very socially competent, it can be difficult to notice when Alaina is struggling in the daily classroom routines. She is able to follow other children’s lead when she doesn’t hear the directions or can’t understand what is being said. Alaina’s expressive language is very good but she sometimes is missing the beginnings or ends of words – especially softer sounds. In addition, it is difficult for Alaina to learn new words quickly. Alaina is getting ready to transition to Kindergarten next year. Her mother and father are concerned about Alaina keeping up academically especially as things become more difficult. Alaina is not confident in asking for help and she can get lost in the shuffle.  Discuss the following with your peers:

· How can Alaina’s teachers work with her special education team to develop an IEP that will give her the necessary supports to be successful in Kindergarten? 

· Based on NCFELD standards what goals and strategies are important for Alaina?

· If you were Alaina’s teacher, what would you identify as essential goals for her IEP to guarantee her continued success as a learner? 

· For example, what evidence-based practices might support Alaina in learning to ask for help?

·  What suggestions do you have for incorporating those goals into daily routines and activities in a kindergarten classroom? 

· What practices or strategies might support those goals (e.g., peer supports)?

· When the goals, practices, and strategies you identified are implemented in Alaina’s classroom, what might the possible benefits be for the other children in the class?

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