Measuring Habitual Arm Use Post-stroke With a Bilateral Time-Constrained Reaching Task

Background: Spontaneous use of the more-affected arm is a meaningful indicator of stroke recovery. The Bilateral Arm Reaching Test (BART) was previously developed to quantify arm use by measuring arm choice to targets projected over a horizontal hemi-workspace. In order to improve clinical validity, we constrained the available movement time, thereby promoting more spontaneous decision making when selecting between the more-affected and less affected arm during the BART.Methods: Twenty-two individuals with mild to moderate hemiparesis were tested with the time-based BART in three time-constraint conditions: no-time constraint, medium, and fast conditions. Arm use was measured across three sessions with a 2-week interval in a spontaneous choice block, in which participants were instructed to use either the more-affected or the less-affected arm to reach targets. We tested the effect of time-constraint condition on the more-affected arm use, external validity of the BART with the Actual Amount of Use Test (AAUT), and test-retest reliability across the three test sessions.Results: The fast condition in the time-based BART showed reduced use of the more-affected arm compared to the no-time constraint condition P < 0.0001) and the medium condition P = 0.0006; Tukey post hoc analysis after mixed-effect linear regression). In addition, the fast condition showed strong correlation with the AAUT r = 0.829, P < 0.001), and excellent test-retest reliability (ICC = 0.960, P < 0.0001).Conclusion: The revised BART with a time-restricted fast condition provides an objective, accurate, and repeatable measure of spontaneous arm use in individuals with chronic stroke hemiparesis

Study of Adult Adoptees in India Placed through BSSK in Pune: Adoption and Birth Family Issues

This is a study of adult adoptees in India. Data were gathered via interviews from 48 adult adoptees (81 percent of the eligible participants). The participants ranged in age from 21 to 31 years at the time of the study and were adopted, on an average, at the age of 10.5 months. There were differences between adoptive parent's report of adoption disclosure and adoptee report of adoption disclosure. Overall, most adoptees have thoughts and questions about their birth family. Implications for services for adoptees are presented

Feasibility of the adaptive and automatic presentation of tasks (ADAPT) system for rehabilitation of upper extremity function post-stroke

Abstract Background Current guidelines for rehabilitation of arm and hand function after stroke recommend that motor training focus on realistic tasks that require reaching and manipulation and engage the patient intensively, actively, and adaptively. Here, we investigated the feasibility of a novel robotic task-practice system, ADAPT, designed in accordance with such guidelines. At each trial, ADAPT selects a functional task according to a training schedule and with difficulty based on previous performance. Once the task is selected, the robot picks up and presents the corresponding tool, simulates the dynamics of the tasks, and the patient interacts with the tool to perform the task. Methods Five participants with chronic stroke with mild to moderate impairments (> 9 months post-stroke; Fugl-Meyer arm score 49.2 ± 5.6) practiced four functional tasks (selected out of six in a pre-test) with ADAPT for about one and half hour and 144 trials in a pseudo-random schedule of 3-trial blocks per task. Results No adverse events occurred and ADAPT successfully presented the six functional tasks without human intervention for a total of 900 trials. Qualitative analysis of trajectories showed that ADAPT simulated the desired task dynamics adequately, and participants reported good, although not excellent, task fidelity. During training, the adaptive difficulty algorithm progressively increased task difficulty leading towards an optimal challenge point based on performance; difficulty was then continuously adjusted to keep performance around the challenge point. Furthermore, the time to complete all trained tasks decreased significantly from pretest to one-hour post-test. Finally, post-training questionnaires demonstrated positive patient acceptance of ADAPT. Conclusions ADAPT successfully provided adaptive progressive training for multiple functional tasks based on participant's performance. Our encouraging results establish the feasibility of ADAPT; its efficacy will next be tested in a clinical trial.</p

A Study of Adult Adoptees in India Placed Domestically in India through BSSK, Pune

Bharatiya Samaj Seva Kendra (http://www.bsskindia.org/) is involved in 'Seva' or service as a non-profit making, non-political Indian Charitable Trust. BSSK provides professional social, welfare services to children, women and families in need. BSSK’s programs include a Child Care Centre, Foster Family Care, Adoption and a Community Center that supports children for Educational Sponsorship activities. BSSK operates the adoption program under auspices of CARA, the Central Adoption Resource Authority (http://www.adoptionindia.nic.in/). In 2000, BSSK undertook the planning for their first study of domestic adoptions with support from Holt International Children Services and under the leadership of Dean Hale. Since that first effort to follow up with adoptive families who adopted through BSSK, they have conducted additional studies including Norwegian adoptive families of Indian children and American adoptive families of Indian children. All the children were adopted through BSSK and most were under the age of 18 when these studies were undertaken. This report represents a new initiative for BSSK because the study focuses on adult adoptees. CARA is an autonomous body under the Ministry of Women & Child Development, Government of India. It functions as the nodal body for adoption of Indian children and is mandated to monitor and regulate in-country and inter country adoptions. CARA is designated as the Central Authority to deal with inter-country adoptions in accordance with the provisions of the Hague Convention on Inter-country Adoption, 1993, ratified by Government of India in 2003. Starting in 2010, BSSK worked with the US research team to develop a project to study adult adoptees in India who were adopted through BSSK and placed domestically. The study was designed to focus on early adulthood. Little is known about this period for adoptees in general and domestic adoption in Indian in particular. This is the first known study of adult adoptees in India that uses scientific methods such as standardized measures and sampling strategies. Results from this project will have implications for both policy and practice at BSSK at the micro level and for adoption practice in India at the macro level. It will help strengthen pre and post adoption services. This is timely since currently some major restructuring is happening in adoption and services for children in India

The perceptions of young adult adoptees in India on their emotional well-being

This article presents the findings of a study of 46 adults adopted at very young ages in India and now aged between 20 and 30 years. The results suggest that the majority of respondents were physically healthy and well adjusted. However, 40% scored below the norm for social functioning, suggesting some underlying issues associated with poor well-being in their current phase of life. The mental health issues affecting the young people were associated more with anxiety and stress than depression. However, none of the variables investigated proved to be strong predictors of mental health difficulties. The results are discussed in the context of Indian culture and psychosocial development during early adulthood and include implications for practice

A Visual Analytics System for Improving Attention-based Traffic Forecasting Models

With deep learning (DL) outperforming conventional methods for different tasks, much effort has been devoted to utilizing DL in various domains. Researchers and developers in the traffic domain have also designed and improved DL models for forecasting tasks such as estimation of traffic speed and time of arrival. However, there exist many challenges in analyzing DL models due to the black-box property of DL models and complexity of traffic data (i.e., spatio-temporal dependencies). Collaborating with domain experts, we design a visual analytics system, AttnAnalyzer, that enables users to explore how DL models make predictions by allowing effective spatio-temporal dependency analysis. The system incorporates dynamic time warping (DTW) and Granger causality tests for computational spatio-temporal dependency analysis while providing map, table, line chart, and pixel views to assist user to perform dependency and model behavior analysis. For the evaluation, we present three case studies showing how AttnAnalyzer can effectively explore model behaviors and improve model performance in two different road networks. We also provide domain expert feedback