Girls Speak: A New Voice in Global Development

Presents adolescent girls' views on the value of education and its impact on their lives, their aspirations, and barriers to long-term change as guidance for targeting interventions to improve self-determination and health, social, and economic outcomes

LP-based Covering Games with Low Price of Anarchy

We present a new class of vertex cover and set cover games. The price of anarchy bounds match the best known constant factor approximation guarantees for the centralized optimization problems for linear and also for submodular costs -- in contrast to all previously studied covering games, where the price of anarchy cannot be bounded by a constant (e.g. [6, 7, 11, 5, 2]). In particular, we describe a vertex cover game with a price of anarchy of 2. The rules of the games capture the structure of the linear programming relaxations of the underlying optimization problems, and our bounds are established by analyzing these relaxations. Furthermore, for linear costs we exhibit linear time best response dynamics that converge to these almost optimal Nash equilibria. These dynamics mimic the classical greedy approximation algorithm of Bar-Yehuda and Even [3]

Robotic task-specific training of the upper extremity in children with Cerebral Palsy

poster abstractBackground: Cerebral Palsy (CP) affects at least 2 in 1,000 children in the United States. The disorder is non-progressive, yet secondary impairments can worsen over time leading to contracture, decreased strength, increased tone and ultimately, impaired mobility and function. Robotic therapy has been found to have positive outcomes for similar impairments in stroke neuro-recovery, suggesting the need for the application of this technology to CP. Purpose: The purpose of this study was to investigate whether specific upper extremity (UE) robotic training improves UE function in children with CP. Methods: This is an ongoing study currently with 5 children (ages 4-12) with CP that have completed the treatment intervention. Inclusion criteria included a hemiplegic presentation of the UE, a modified Ashworth scale (MAS) score of 2 or less and wrist extension equal to or greater than 0o in the affected arm, and sufficient cognition to attain to a task for 40-60 minutes. Each child participated in 16 total robotic training sessions occurring twice weekly, with each session consisting of 1,040 task-specific reaching movements of the affected arm with real-time impedance control. Pre- and post-testing and a 1-month follow-up were performed for each subject. Clinical outcome measures included active range of motion (AROM), passive range of motion (PROM), manual muscle tests (MMT), and grip strength, in addition to functional tests including the MAS, adaptive Fugl-Meyer scale, and the Pediatric Evaluation of Disability Inventory (PEDI) assessed by parents. Lastly, spatial-temporal control patterns were collected during each session, allowing for a visual assessment of a child’s progress in refining UE movement patterns to 16 positions across all quadrants. Results: For AROM and PROM, 4 of 5 subjects demonstrated an increase in at least 2 joints by 1-month follow-up. The remaining measurements produced no change or change within the standard error for goniometry (+/- 5o), while no decline was noted in any subjects. Pre-test MMT revealed strength measures ranging from 3/5 to 5/5. By 1-month follow-up, 85% of all measurements were 5/5, with the remaining 15% at 4+/5. For grip strength, 3 of 4 subjects (fifth subject unavailable) doubled their strength by 1-month follow-up, with the last demonstrating symmetry with the unaffected limb. Tone, as measured by MAS, did not appear to be a limiting factor as only 1 child displayed any noticeable tone (MAS of 2) across the measured motions. For the Fugl-Meyer, 4 of 5 subjects improved coordination by more than 2 points by 1- month follow-up, while the fifth maintained throughout the study. Parents reported via the PEDI an overall improvement in performing functional tasks for all children during the study, with 4 of 5 subjects improving by 10 or more points. Lastly, spatial-temporal control patterns showed marked improvement for all subjects by 1-month follow-up. Conclusion: Early results indicate that the application of robotic training to children with CP improved several clinical measures of the affected limb. This likely resulted in increased use of the affected limb, leading to improved functional performance

The Impact of Variable Dosage Using Robotic-assisted Task-Specific Upper Extremity Training in Children with Cerebral Palsy

poster abstractBackground: Cerebral Palsy (CP) and other acquired neurological disorders result from brain lesions that alter motor function in children. The impact of these deficits can impair a child’s ability to use their upper extremity (UE) for normal daily activities such as eating and playing. Robotic-assisted therapy has been shown to improve motor function in children with CP. Training parameters such as intensity and frequency were initially based on findings from studies measuring change in adults following stroke. Based on this, high intensity (960 repetitions per session) and increased frequency (2 times per week, 9 weeks) were initially implemented for children. Early findings demonstrated improvement in UE function for children with CP; however, training sessions were long, making them difficult to complete given the shorter attention span of the pediatric population. Determining the potential impact of a shorter, more optimal, dosage of robotic-assisted therapy for children would facilitate rehab training efficiency and maximize cost effectiveness. Purpose: The purpose of this study was to identify the impact on motor impairments and movement capacity with variances in treatment intensity (number of repetitions per session) while holding constant the frequency of the application (2 times per week, 9 weeks) for robotic-assisted UE training for children with CP. Methods: Six children between the ages of 6 and 8 were analyzed from two separate studies evaluating the effectiveness of robotic-assisted training for UE functional improvement. The first study featured training at high intensity and frequency while the second study used lower intensity parameters but the same frequency. To be eligible for either study, children were required to have UE hemiplegia and the ability to participate in a task for up to 60 minutes. Twice weekly, each child participated in robotic training sessions consisting of either 960, 640, or 320 task-specific reaching movements of the affected UE. Each child completed a total of 16 robotic training sessions over a 9-week period as well as one pre- and one post-test session. Outcome measures included active range of motion (AROM), strength testing and tone using the Modified Ashworth Scale (MAS). The children’s motor capacity was evaluated using the adaptive Fugl-Meyer scale (FM). Results: Percent change scores were calculated for each participant for each outcome measurement. AROM results for the shoulder resulted in an average increase of 10.6% for flexion and a 13.3% increase for abduction in both the 320 and 640 groups. Shoulder external rotation increased by an average of 13.6% for all three groups. Arm strength increased an average of 12.3% for all three groups. The MAS had an average decrease in tone of 23.8% across all 3 groups. Scores on the FM increased an average of 23% with in-depth analysis revealing shoulder movement to be the primary area for motor capacity change at 96%. Conclusion: These findings indicate that lower intensities of robotic-assisted therapy (320 and 640 repetitions) were as effective as the larger dose originally prescribed for children with CP. Outcome measures improved in all 3 groups and did not vary between dosing groups. This suggests that longer intensity sessions of robotic-assisted therapies may not be necessary to produce AROM, strength, and motor capacity changes. Further trials with more subjects are needed to validate these results

Manganese in Texas Soils and its Relation to Crops.

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Autism in the Workplace: Assessing the Transition Needs of Young Adults with Autism Spectrum Disorder

Over the next decade, close to half a million people with Autism Spectrum Disorder (ASD) will reach adulthood. Research suggests that the career and life outcomes for young adults with ASD are poor as compared with those of the general population. Nevertheless, there is relatively little research on the work experiences of young adults with ASD that focuses on their career aspirations, preparation for work, career experiences, and the barriers associated with their transition into the world of work. Given the large numbers of young adults with ASD who are exiting secondary school and vocational training programs, it is imperative to understand the issues associated with their transition into the world of work. The purpose of this study, which utilizes a survey questionnaire and focus group, is to assess the transition needs and experiences of young adults with ASD as they prepare to enter the workplace. The results indicate that young adults with ASD face significant transition barriers when navigating the world of work and have certain transition needs. Policy implications for the transition needs identified are presented

Reconciling Taking the Indian out of the Nurse

Currently, we are faced with an important equity gap and opportunity for nursing in higher education related to Indigenous Peoples and health. While Westernized higher education often marginalizes Indigenous Peoples, there is an important opportunity to respectfully engage with Indigenous Knowledges. Furthermore, broadening perspectives beyond a dominant Westernized worldview has the potential to advance higher education for Indigenous and non-Indigenous learners alike. We are concerned that ongoing assimilation of Indigenous learners poses a profound risk of social injustice that is contrary to the aim of higher education. In our effort to reconcile nursing education in this context, we offer this discussion paper of scholarly and grey literature interwoven with story work by Indigenous nursing students regarding their undergraduate experiences in the academy. Two significant interrelated gaps/opportunities are revealed: enactment of cultural safety and respectful engagement with Indigenous Knowledges. Action strategies include heart-mind knowledge connection, contextual learning, and two-way teaching and learning. It is our hope that this discussion will inspire critical conversations and meaningful action for educators to reconcile higher education and address structural racism. While reconciliation may be viewed as a duty in higher education and society, we further recognize it as a natural fit within the caring ethos of nursing. Résumé Nous sommes confrontés à d’importantes inégalités relativement à la santé des Autochtones et aux possibilités d’enseignement supérieur en sciences infirmières pour eux. Alors que l’enseignement supérieur occidentalisé marginalise souvent les peuples autochtones, il a une occasion de faire respectueusement appel à leurs Connaissances. S’ouvrir aux perspectives au-delà de la vision du monde occidentalisée dominante pourrait faire progresser l’enseignement supérieur pour les étudiants autochtones et non autochtones. Nous craignons que l’assimilation en cours des étudiants autochtones constitue un signe important d’injustice sociale contraire à l’objectif de l’enseignement supérieur. Dans un esprit de conciliation de la formation en sciences infirmières, nous proposons ce texte de discussion appuyé de publications universitaires, de la littérature grise et de récits d’étudiantes autochtones en sciences infirmières sur leur parcours universitaire au premier cycle. Deux importantes lacunes/possibilités étroitement inter-reliées ont été mises au jour : la mise en œuvre de la sécurité culturelle et le recours respectueux aux Connaissances Autochtones. Les stratégies d’action préconisées portent notamment sur l’ouverture cœur/esprit aux connaissances, l’apprentissage contextuel ainsi que l’enseignement et l’apprentissage bidirectionnels. Nous espérons que cette discussion inspirera d’importantes conversations et des actions significatives chez les enseignants en vue de rapprocher l’enseignement supérieur et de lutter contre le racisme structurel. Bien que la réconciliation puisse être considérée comme un devoir dans le domaine de l’enseignement supérieur et dans la société, nous reconnaissons également qu’il s’agit d’une adéquation naturelle au sein de la philosophie du soin en sciences infirmières