Showcasing Environmental Health and Safety Activities During the Coronavirus Disease 2019 Pandemic.

Introduction: Emergency preparedness is not a novel topic. What has been novel is the fast pace at which organizations, including academic institutions, have had to adapt to infectious disease outbreaks since 2000. Objective: The goal of this article is to highlight the various environmental health and safety (EHS) team activities during the coronavirus disease 2019 (COVID-19) pandemic to ensure that on-site personnel was safe, the research could be conducted, and critical business operations such as academics, laboratory animal care, environmental compliance, and routine healthcare functions could continue during the pandemic. Methods: The response framework is presented by discussing first the lessons learned in preparedness and emergency response during outbreaks that occurred since 2000, namely Influenza virus, Zika virus, and Ebola virus. Then, how the response to the COVID-19 pandemic was activated, and the effects of ramping down research and business activities. Results: Next, the contributions of each EHS unit are presented, namely, environmental, industrial hygiene and occupational safety, research safety and biosafety, radiation safety, supporting healthcare activities, disinfection, and communications and training. Discussion: Lastly, a few lessons learned are shared with the reader for moving toward normalcy.

Expanding stroke telerehabilitation services to rural veterans: a qualitative study on patient experiences using the robotic stroke therapy delivery and monitoring system program.

PURPOSE: The present study reports on a robotic stroke therapy delivery and monitoring system intervention. The aims of this pilot implementation project were to determine participants' general impressions about the benefits and barriers of using robotic therapy devices for in-home rehabilitation. METHODS: We used a qualitative study design employing ethnographic-based anthropological methods including direct observation of the in-home environment and in-depth semi-structured interviews with 10 users of the hand or foot robotic devices. Thematic analysis was conducted using an inductive approach. RESULTS: Participants reported positive experiences with the robotic stroke therapy delivery and monitoring system. Benefits included convenience, self-reported increased mobility, improved mood and an outlet for physical and mental tension and anxiety. Barriers to use were few and included difficulties with placing the device on the body, bulkiness of the monitor and modem connection problems. CONCLUSIONS: Telerehabilitation robotic devices can be used as a tool to extend effective, evidence-based and specialized rehabilitation services for upper and lower limb rehabilitation to rural Veterans with poor access to care. Implications for Rehabilitation Participants whose formal therapy services had ended either because they had exhausted their benefits or because traveling to outpatient therapy was too cumbersome due to distance were able to perform therapeutic activities in the home daily (or at least multiple times per week). Participants who were still receiving formal therapy services either in-home or in the clinic were able to perform therapeutic activities in the home on the days they were not attending/receiving formal therapy. Based on the feedback from these veterans and their caregivers, the manufacturing company is working on modifying the devices to be less cumbersome and more user-friendly (lighter-weight, more mobile, changing software, etc.), as well as more adaptable to participants' homes. Removing these specific barriers will potentially allow participants to utilize the device more easily and more frequently. Since participants expressed that they wished they could have the device in their homes longer than the 3-month usage period required for this pilot project, the project team is working on a proposal to extend this project to a wider area and the new paradigm would extend the usage period until the patient reaches a plateau in progress or no longer wants to use the device.

Improving Upper Extremity Function and Quality of Life with a Tongue Driven Exoskeleton: A Pilot Study Quantifying Stroke Rehabilitation.

Stroke is a leading cause of long-term disability around the world. Many survivors experience upper extremity (UE) impairment with few rehabilitation opportunities, secondary to a lack of voluntary muscle control. We developed a novel rehabilitation paradigm (TDS-HM) that uses a Tongue Drive System (TDS) to control a UE robotic device (Hand Mentor: HM) while engaging with an interactive user interface. In this study, six stroke survivors with moderate to severe UE impairment completed 15 two-hour sessions of TDS-HM training over five weeks. Participants were instructed to move their paretic arm, with synchronized tongue commands to track a target waveform while using visual feedback to make accurate movements. Following TDS-HM training, significant improvements in tracking performance translated into improvements in the UE portion of the Fugl-Meyer Motor Assessment, range of motion, and all subscores for the Stroke Impact Scale. Regression modeling found daily training time to be a significant predictor of decreases in tracking error, indicating the presence of a potential dose-response relationship. The results of this pilot study indicate that the TDS-HM system can elicit significant improvements in moderate to severely impaired stroke survivors. This pilot study gives preliminary insight into the volume of treatment time required to improve outcomes.

Tongue-controlled robotic rehabilitation: A feasibility study in people with stroke.

Stroke survivors with severe upper limb (UL) impairment face years of therapy to recover function. Robot-assisted therapy (RT) is increasingly used in the field for goal-oriented rehabilitation as a means to improve function in ULs. To be used effectively for wrist and hand therapy, the current RT systems require the patient to have a minimal active range of movement in the UL, and those that do not have active voluntary movement cannot use these systems. We have overcome this limitation by harnessing tongue motion to allow patients to control a robot using synchronous tongue and hand movement. This novel RT device combines a commercially available UL exoskeleton, the Hand Mentor, and our custom-designed Tongue Drive System as its controller. We conducted a proof-of-concept study on six nondisabled participants to evaluate the system usability and a case series on three participants with movement limitations from poststroke hemiparesis. Data from two stroke survivors indicate that for patients with chronic, moderate UL impairment following stroke, a 15-session training regimen resulted in modest decreases in impairment, with functional improvement and improved quality of life. The improvement met the standard of minimal clinically important difference for activities of daily living, mobility, and strength assessments.

Sexual Health Information Networks: What are Urban African American Youth Learning?

This qualitative study examined sexual health information networks among urban African American youth living in low-income communities. The authors identified sources, message content, and utility of messages about sex and sexual health in a sample of 15-17-year olds (N = 81). Youth received sexual health information from a variety of sources. Messages from parents and sex education had high utility, whereas messages from the Internet and religion had low utility. Four information network patterns were identified, suggesting considerable variation in how youth are socialized regarding sex. Findings suggest that sexual information networks have the potential to affect sexual health and development.

Influences on Sexual Partnering Among African American Adolescents With Concurrent Sexual Relationships.

Adolescents often engage in concurrent sexual partnerships as part of a developmental process of gaining experience with sexuality. The authors qualitatively examined patterns of concurrency and variation in normative and motivational influences on this pattern of sexual partnering among African American adolescents (31 males; 20 females), ages 15 to 17 years. Using content analysis, gender and contextual differences in social norms and motivations for concurrency were explored. Findings describe the normative influences on adolescent males and females with regard to sexual concurrency and the transfer of these norms from one generation to the next.