Humanoid robots for assisting people with physical disabilities in activities of daily living: a scoping review.

The aim of this scoping review was to gather, summarize, and map the knowledge of peoples' experiences on humanoid robots, capable of assisting people with activities of daily living. The review was guided by the framework of Joanna Briggs Institute and PRISMA-ScR. We found 44 papers describing nine robots that could assist with a variety of tasks listed in the International Classification of Functioning, Disability, and Health. The mixed population experienced little or no anxiety toward the robots, and most accepted the robots' ability to monitor for safety reasons. Some participants disliked the robots' large size and slow movements. Most of the participants found the robots easy to use. They wanted improvements in the robots' functionality and the ability to personalize services. Several of the participants found the services interesting and useful, but not for themselves. The experiences of humanoid robotic assistance showed an insufficient level of technical readiness for assisting in physical assistance, a lack of personalization and readiness for use in home settings. The practical relevance of these findings lies in guiding future research and development toward a more individualized approach focusing on user needs and experiences to enhance the efficacy and integration of humanoid robots in health-care.

Care-receivers with physical disabilities' perceptions on having humanoid assistive robots as assistants: a qualitative study.

BACKGROUND: People with physical disabilities due to disease or injury face barriers to their daily activities and participation in society. Many depend on formal or informal caregivers for assistance to live independently. However, future healthcare challenges due to demographic changes threaten access to home care and assistants. Assistive technologies, such as robots for physical assistance, can support the independence and autonomy of people with physical disabilities. This study explore Norwegian care-receivers' perceptions of using robot assistance in their homes, including preferences for tasks acceptable or unacceptable for robot assistance and the underlying reasons. METHOD: Purposive sampling was employed to recruit 18 participants, aged between 18 and 77 years, with differences in physical function including diagnoses such as stroke, spinal cord injury, amputations, and muscular dystrophy. Qualitative data were gathered through four focus group interviews wherein participants watched videos featuring a humanoid assistive robot, EVEr3. The collected data underwent analysis using reflexive thematic analysis. RESULTS: Three themes with associated sub-themes were constructed: (a) How a robot could assist in daily life, (b) The robot's appearance and functionality, and (c) Concerns about having a robot as an assistant. The participants welcomed the idea of a future robotic assistant in areas that may contribute to an increased feeling of independence and autonomy. CONCLUSION: A robot assisting in activities of daily living would need to be individually customized to meet the needs of each user in terms of which tasks to assist with, how to assist in these defined tasks, and how it is controlled.

Effectiveness of robot-assisted arm exercise on arm and hand function in stroke survivors - A systematic review and meta-analysis.

Objective: To examine the treatment effect of commercially available robotic-assisted devices, compared to traditional occupational- and physiotherapy on arm and hand function in persons with stroke. Methods: A systematic literature search was conducted in Medline, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials up to January 2022. Randomized controlled trials (RCT's) involving persons with stroke of all ages and robot-assisted exercise as method for arm and hand function, compared to traditional therapy methods were included. Three authors performed the selection independently. The quality of evidence across studies was assessed using GRADE. Results: Eighteen RCT's were included in the study. A random effects meta-analysis showed a statistically significantly higher treatment effect in the robotic-assisted exercise group (p=<0.0001) compared to the traditional treatment group, with a total effect size of 0.44 (CI = 0.22-0.65). Heterogeneity was high, measured with I2 of 65%). Subgroup analyses showed no significant effects of the type of robotic device, treatment frequency or duration of intervention. Discussion and conclusion: Even though the analysis showed significant improvement in arm and hand function in favor of the robotic-assisted exercise group, the results in this systematic review should be interpreted with caution. This is due to high heterogeneity among the studies included and the presence of possible publication bias. Results of this study highlight the need for larger and more methodological robust RCT's, with a focus on reporting training intensity during robotic exercise.

A multi-center international study on the spinal cord independence measure, version IV: Rasch psychometric validation.

CONTEXT: The Spinal Cord Independence Measure is a comprehensive functional rating scale for individuals with spinal cord lesion (SCL). OBJECTIVE: To validate the scores of the three subscales of SCIM IV, the fourth version of SCIM, using advanced statistical methods. STUDY DESIGN: Multi-center cohort study. SETTING: Nineteen SCL units in 11 countries. METHODS: SCIM developers created SCIM IV following comments by experts, included more accurate definitions of scoring criteria in the SCIM IV form, and adjusted it to assess specific conditions or situations that the third version, SCIM III, does not address. Professional staff members assessed 648 SCL inpatients, using SCIM IV and SCIM III, at admission to rehabilitation, and at discharge. The authors examined the validity and reliability of SCIM IV subscale scores using Rasch analysis. RESULTS: The study included inpatients aged 16-87 years old. SCIM IV subscale scores fit the Rasch model. All item infit and most item outfit mean-square indices were below 1.4; statistically distinct strata of abilities were 2.6-6; most categories were properly ordered; item hierarchy was stable across most clinical subgroups and countries. In a few items, however, we found misfit or category threshold disordering. We found SCIM III and SCIM IV Rasch properties to be comparable. CONCLUSIONS: Rasch analysis suggests that the scores of each SCIM IV subscale are reliable and valid. This reinforces the justification for using SCIM IV in clinical practice and research.

Building Best Practices for Telehealth Record Documentation in the COVID-19 Pandemic.

Telehealth services for patient visits have substantially surged during the COVID-19 pandemic. Thus, there is increased importance and demand for high-quality telehealth clinical documentation. However, little is known about how clinical data documentation is collected and the quality of data items included. This study aimed to identify the current state of and gaps in documentation and develop a best practice strategy for telehealth record documentation. Data were collected from January to February 2021 via a self-designed questionnaire for administrators and managers from physicians' offices and mental health facilities, resulting in 76 valid responses. Survey items included health organization demographic information, use of telehealth policies and procedures, and clinical documentation for telehealth patient visits. Findings from this study can be used to assist government, policymakers, and healthcare organizations in developing best practices in telehealth usage and clinical documentation improvement strategies.

Patient clinical documentation in telehealth environment: are we collecting appropriate and sufficient information for best practice?

BACKGROUND: During the COVID-19 pandemic, the use of telehealth for patient visits grew rapidly and served an important role as a valuable and necessary resource. Although clinical documentation is critical for telehealth patient visits, there is limited information about how healthcare facilities manage telehealth patient visit documentation, technology used for telehealth visits, and challenges encountered with telehealth patient visit documentation. This study aimed to assess the use of telehealth during the pandemic, the quality of clinical documentation in telehealth practice and to identify challenges and issues encountered with telehealth patient visits in order to develop a strategy for best practices for telehealth documentation and data management. METHODS: Data were collected for this cross-sectional study in January-February 2021 via a self-designed survey of administrators/managers from physicians' offices and mental health facilities. Survey questions included four categories: health organization demographic information; telehealth visits; clinical documentation for telehealth visit; and challenges and barriers related to telehealth documentation technology use. RESULTS: Of 76 respondents, more than half (62%) of the healthcare facilities started using telehealth for patient visits within one year of the onset of the COVID-19 pandemic, with 94% of respondents indicating an increased use of telehealth for patient visits since the pandemic. The most common types of telehealth patient care provided during the pandemic included pediatrics, primary care, cardiology, and women's health. The most consistent data documentation of telehealth visits included: date of service, patient identification number, communication methods, patient informed consent, diagnosis and impression, evaluation results, and recommendations. The telehealth visit data was most commonly used for patient care and clinical practice, billing and reimbursement, quality improvement and patient satisfaction, and administrative planning. The top barriers to telehealth use by the healthcare professionals included patient challenges with telehealth services, such as inequities in quality of technology, lack of patient understanding, and lack of patient satisfaction; this was followed by frustration with constant updates of telehealth guidelines and procedures, understanding required telehealth documentation for reimbursement purposes, payer denial for telehealth visits, and legal and risk issues. CONCLUSIONS: Findings from this study can assist government entities, policymakers, and healthcare organizations in developing and advocating best practices in telehealth usage and clinical documentation improvement strategies.

Reliability Validity and Responsiveness of the Spinal Cord Independence Measure 4th Version in a Multicultural Setup.

OBJECTIVE: To examine the fourth version of the Spinal Cord Independence Measure for reliability and validity. DESIGN: Partly blinded comparison with the criterion standard Spinal Cord Independence Measure III, and between examiners and examinations. SETTING: A multicultural cohort from 19 spinal cord injury units in 11 countries. PARTICIPANTS: A total of 648 patients with spinal cord injury. INTERVENTION: Assessment with Spinal Cord Independence Measure (SCIM IV) and Spinal Cord Independence Measure (SCIM III) on admission to inpatient rehabilitation and before discharge. MAIN OUTCOME MEASURES: SCIM IV interrater reliability, internal consistency, correlation with and difference from SCIM III, and responsiveness. RESULTS: Total agreement between examiners was above 80% on most SCIM IV tasks. All Kappa coefficients were above 0.70 and statistically significant (P<.001). Pearson's coefficients of the correlation between the examiners were above 0.90, and intraclass correlation coefficients were above 0.90. Cronbach's alpha was above 0.96 for the entire SCIM IV, above 0.66 for the subscales, and usually decreased when an item was eliminated. Reliability values were lower for the subscale of respiration and sphincter management, and on admission than at discharge. SCIM IV and SCIM III mean values were very close, and the coefficients of Pearson correlation between them were 0.91-0.96 (P<.001). The responsiveness of SCIM IV was not significantly different from that of SCIM III in most of the comparisons. CONCLUSIONS: The validity, reliability, and responsiveness of SCIM IV, which was adjusted to assess specific patient conditions or situations that SCIM III does not address, and which includes more accurate definitions of certain scoring criteria, are very good and quite similar to those of SCIM III. SCIM IV can be used for clinical and research trials, including international multi-center studies, and its group scores can be compared with those of SCIM III.

Population Health: Identifying Skill Sets and Education Alignment for HIM Professionals.

The COVID-19 pandemic has increased the emphasis on population health, therefore potentially amplifying demand for healthcare workforce professionals in this area. There is an urgent need to explore and define the roles of health information management (HIM) professionals in the population health workforce. This study sought to identify the skill sets and qualifications needed, and HIM education alignment with skills necessary for HIM professionals entering the population health workforce. An intentionally broad internet search of job postings was conducted to determine skills in population health. Population health-related job descriptions and qualification requirements were abstracted and analyzed using ATLAS.ti. Three common job categories were identified: management, analytics, and coding. Skill set requirements included soft skills, problem solving, project management, research, and data analysis. The study results identified HIM educational alignment and found that HIM professionals are generally a good fit to meet the increased need in the population health workforce.

A single-subject study of robotic upper limb training in the subacute phase for four persons with cervical spinal cord injury.

Study design: Single-subject design, standard training ("B") compared with Robotic training ("C"). Objectives: To explore the impact of robotic training on upper limb function, activities of daily living (ADL) and training experience in subacute tetraplegic inpatients. Setting: Inpatient subacute Norwegian spinal cord injury (SCI) unit. Methods: Four participants (C4-7, AIS A-C) completed 11 sessions of robotic training using a passive robotic exoskeleton (Armeo Spring®). Descriptive statistics and visual analyses were used for comparing standard occupational therapy and robotic training. Outcome measures included the Spinal Cord Independence Measure (SCIM-III), the Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP), and a questionnaire. Results: All of the participants exhibited an increase in assessments of upper limb function (GRASSP-total) right side (0.4%-61.2%), and all except for one participant (-8%) showed an increase on their left side (20.9%-106.2%). Three out of four participants had improvements in ADL function SCIM-III (ranging from 5.6% to 46.7%). Results demonstrated improvements during the robotic intervention period in five out of 28 measurements. The participants enjoyed the exercise, and found it motivating and relevant to their injury (median ranged from 3.5 to 6.5 on a 0-7 scale). Conclusions: Three out of four participants improved upper limb function and ADL independence, but the study could not confirm that improvements were due to the robotic intervention. The participants enjoyed the robotic training and found it relevant to their injury.

The adaptor protein ARA55 and the nuclear kinase HIPK1 assist c-Myb in recruiting p300 to chromatin.

LIM-domain proteins, containing multiple cysteine-rich zinc finger-like motifs, have been shown to play diverse roles in several cellular processes. A common theme is that they mediate important protein-protein interactions that are key to their function. Androgen receptor-associated protein 55 (ARA55) belongs to this family of bridging proteins containing four C-terminal LIM domains. It has a dual role with functions both at focal adhesions and in the nucleus, apparently shuttling between the two compartments. In the present work, we have expanded our understanding of its nuclear functions by showing that it interacts with three nuclear regulators not previously linked to ARA55. We first identified ARA55 as a novel interaction partner of the nuclear kinase HIPK1 and found that ARA55, like HIPK1, also interacts with the transcription factor c-Myb. In search of a function for these associations, we observed that the coactivator p300 not only binds to c-Myb, but to ARA55 as well. When combined, c-Myb, p300, HIPK1 and ARA55 caused strong synergistic activation of a chromatinized reporter gene. In parallel, all partners, including p300, were efficiently recruited to chromatin at the c-Myb-bound promoter. Consistent with this cooperation, we found that c-Myb and ARA55 share a common set of target genes in an osteosarcoma cellular context. We propose that ARA55 and HIPK1 assist c-Myb in recruiting the coactivator and acetyltransferase p300 to chromatin.

Blocking as a friend of induction in verbal category learning.

We conducted an experiment to investigate the influences of interleaved versus blocked presentation of disparate verbal exemplars on the induction of category concepts. The practice schedules of four experimental groups were juxtaposed such that sets of exemplar-category associations were either solved in succession (i.e., blocked), systematically intermixed (i.e., interleaved), or presented with an incremental transition from blocked to interleaved practice. Counter to current trends in the literature, in which interleaving alone has been facilitative of induction in some tasks, we found that participants whose initial exposure to the category exemplars involved blocked presentation performed better in both implicit and explicit tests of concept learning. The results are discussed with respect to the impacts of task type, task difficulty, and exemplar relatedness on induction.

Repetition Priming Magnitude Depends on Affirmative Prime Responses: A Test of Two Congruity Explanations.

We conducted 2 experiments to evaluate the impact of positive prime responses on repetition priming effects while decoupling this impact from content congruity and specific evaluation operations. Our first experiment consisted of word-meaning comparison trials that required participants to evaluate synonyms or antonyms. A crossing of evaluation operation with semantic content allowed us to test the goal-content congruity hypothesis against the semantic congruity explanation for greater facilitation from positive response primes. Results suggested that operation-based priming is affected by goal-content congruity. A second experiment tested the observed effect of positive responses on repetition priming using mental rotation of irregular shapes, affording a test of the impact of congruity in evaluation goals and content in a nonverbal stimulus domain. Both experiments produced a pattern of results inconsistent with Schulman's (1974) semantic congruity account and instead implicated a different form of congruity that affects memory for prior operations rather than memory for semantic and episodic content.

[A historical perspective of Ebola virus]. / Ebolavirus i et historisk perspektiv.

The 2014 Ebola fever outbreak was the first of its kind in West Africa. This epidemic, affecting multiple countries, by far exceeded any previous outbreak in case counts and geographical spread. But Ebola viruses are not new to Africa, as they have occurred in epidemic proportion in the central part of the continent since 1976. The objective of this article is to compare previous outbreaks with the ongoing epidemic in an effort to identify some of the factors which have con-tributed to the size and scope of the existing outbreak.

Investigating information-processing performance of different command team structures in the NATO Problem Space.

The structure of command teams is a significant factor on their communications and ability to process, and act upon, information. The NATO Problem Space was used in this study to represent three of the main dimensions in the battle-space environment: familiarity, rate of change, and strength of information position. Results show that the five common team structures (chain, Y, circle, wheel and all-connected) did not generally perform as predicted in team literature. Findings suggest that under dynamic and highly variable conditions, high levels of synchronisation and trust should be present. On the other hand, synchronisation and trust are less important in hierarchical, highly centralised structures, because team members are more willing to accept the authority of a single leader and this tight control ensures that these teams can perform well as long as the Problem Space is familiar, information is explicit and the environment does not change. Practitioner Summary: Some types of team structures are better suited to particular constraints of the battle-space than others. This research has shown that the much touted all-connected structure is often the worst performing structure and that the traditional hierarchy of command and control has much merit in the digital information age.

Discordance between urine pH measured by dipstick and pH meter: implications for methotrexate administration protocols.

OBJECTIVES: To minimize toxicity of high-dose methotrexate (MTX) therapy, urinary alkalinization with frequent monitoring of urine pH is required. Urine pH is usually assessed by fast and convenient dipstick methods. When urine color interferes with dipstick measurement, as occurs in patients receiving MTX, alternative methods such as pH meters are used. Nursing staff caring for patients on high-dose MTX reported that urine pH results from dipstick and pH analyzers were often clinically discordant. As a result urine pH by dipstick and pH meter were compared in patients on high-dose MTX therapy and patients with normal-colored urine samples. DESIGN AND METHODS: We measured urine pH by dipstick and pH meter in 116 urine samples from 4 patients receiving high-dose MTX therapy, and in 50 normal-colored urine samples from 50 patients not on MTX therapy. RESULTS: In patients on MTX therapy the mean (±standard deviation) bias between dipstick and pH meter urine pH was 0.7±0.4, compared to 0.4±0.3 in patients not on MTX. For patients on MTX clinical concordance between dipstick and pH meter urine results was poor around a clinical cut-off of pH 8.0. Of the 92 samples with a meter urine pH≤8.0, 72 had a discordant value by dipstick (pH>8). CONCLUSIONS: Urine pH readings by dipstick and pH meter are not equivalent, and the bias between them is exacerbated in patients on MTX. Institutions with high-dose MTX therapy protocols should not alternate between dipstick and pH meter urine pH monitoring.

It's a small world after all: contrasting hierarchical and edge networks in a simulated intelligence analysis task.

This article presents the rationale behind an important enhancement to a socio-technical model of organisations and teams derived from military research. It combines this with empirical results which take advantage of these enhancements. In Part 1, a new theoretical legacy for the model is developed based on Ergonomics theories and insights. This allows team communications data to be plotted into the model and for it to demonstrate discriminate validity between alternative team structures. Part 2 presents multinational data from the Experimental Laboratory for Investigating Collaboration, Information-sharing, and Trust (ELICIT) community. It was surprising to see that teams in both traditional hierarchical command and control and networked 'peer-to-peer' organisations operate in broadly the same area of the model, a region occupied by networks of communication exhibiting 'small world' properties. Small world networks may be of considerable importance for the Ergonomics analysis of team organisation and performance. PRACTITIONER SUMMARY: This article is themed around macro and systems Ergonomics, and examines the effects of command and control structures. Despite some differences in behaviour and measures of agility, when given the freedom to do so, participants organised themselves into a small world network. This network type has important and interesting implications for the Ergonomics design of teams and organisations.