bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modeling Human Steering Behavior in Teleoperation of Unmanned Ground Vehicles With Varying Speed
Authors: Li Chen , Tang Yue , Zheng Yingshi , Jayakumar Paramsothy , Ersal Tulga 
Published: September 2020

Objective This paper extends a prior human operator model to capture human steering performance in the teleoperation of unmanned ground vehicles (UGVs) in path-following scenarios with varying speed. Background A prior study presented a human operator model to predict human steering performance in the teleoperation of a passenger-sized UGV at constant speeds. To enable applications to varying speed scenarios, the model needs to be extended to incorporate speed control and be able to predict human performance under the effect of accelerations/decelerations and various time delays induced by the teleoperation setting. A strategy is also needed to parameterize the model without human subject data for a truly predictive capability. Method This paper adopts the ACT-R cognitive architecture and two-point steering model used in the previous work, and extends the model by incorporating a far-point speed control model to allow for varying speed. A parameterization strategy is proposed to find a robust set of parameters for each time delay to maximize steering performance. Human subject experiments are conducted to validate the model. Results Results show that the parameterized model can predict both the trend of average lane keeping error and its lowest value for human subjects under different time delays. Conclusions The proposed model successfully extends the prior computational model to predict human steering behavior in a teleoperated UGV with varying speed. Application This computational model can be used to substitute for human operators in the process of development and testing of teleoperated UGV technologies and allows fully simulation-based development and studies.
Frequency and nature of pain in patients undergoing neurorehabilitation
Authors: Timm Alicja , Knecht Stefan , Florian Matthias , Pickenbrock Heidrun , Studer Bettina , Schmidt-Wilcke Tobias 
Published: September 2020

Objective: This prospective study investigated the extent to which patients undergoing neurorehabilitation reported pain, how this pain developed during inpatient stay and whether patients were treated accordingly (using pain medication). Methods: The extent of pain, performance in daily activities, with a focus on possible impairment from pain, and pain medication were assessed at the beginning and the end of neurorehabilitation treatment. Overall 584 patients, with various neurological diagnoses, such as stroke, intracerebral hemorrhage, polyneuropathy, etc. were classified into four groups based on whether they reported having “no pain,” “mild pain,” “moderate pain,” or “severe pain.” All patients received conventional neurorehabilitation therapy in the Mauritius Hospital, Germany. Results: A total of 149 patients had clinically relevant pain at the beginning of their inpatient stay, at a group level this did not change significantly during the treatment period. At the end of inpatient stay, a slight increase was noted in patients reporting pain. Overall 164 patients suffered from moderate or severe pain, operationalized of pain scores >3 on the visual analog scale. A total of 145 patients who had pain at the end of inpatient stay, did not receive pain medication. There was a weak negative association between pain at baseline and activities of daily living at the end of the treatment period, such that, patients with higher pain levels tended to showed lower Barthel Index scores at the end. Conclusion: In our study, about one-third of patients suffered from clinically relevant pain during neurorehabilitation treatment and most of them did not receive any pain medication.
A dignified last phase of life for patients with a migration background: A qualitative study
Authors: de Voogd X , Oosterveld-Vlug MG , Torensma M , Onwuteaka-Philipsen BD , Willems DL , Suurmond JL 
Published: September 2020

Background: Preserving personal dignity is an important part of palliative care. Generally, autonomy, independency and not being a burden to others are emphasised for preserving dignity. Dignity has not been studied yet from the perspective of the growing group of patients with a migration background living in Western countries. Aim: To gain insight into (1) what patients – and their relatives – with a Turkish, Moroccan or Surinamese background, living in the Netherlands, in their last phase of life find important aspects of dignity, and (2) how care professionals can preserve and strengthen the dignity of these patients. Design: Qualitative thematic analysis of semi-structured interviews. Participants: A total of 23 patients and 21 relatives with a Turkish, Moroccan or Surinamese background were interviewed. Results: For respondents dignity encompassed surrender to God’s or Allah’s will and meaningful relationships with others, rather than preserving autonomy. Surrender to God or Allah meant accepting the illness, the situation and performing religious practice. A meaningful relationship meant being assisted or cared for by family members and maintaining a social role. Professionals could preserve dignity by showing respect and attention; guaranteeing physical integrity, hygiene and self-direction; and indirect communication about diagnoses and prognoses. Conclusions: Religion and appropriate involvement of family members are important aspects of dignity in the last phase of life, in addition to autonomy and independency. Care professionals need to take these factors into account in order to provide person-centred care.
Nursing education on palliative care across Europe: Results and recommendations from the EAPC Taskforce on preparation for practice in palliative care nursing across the EU based on an online-survey and country reports
Authors: Martins Pereira Sandra , Hernández-Marrero Pablo , Pasman H Roeline , Capelas Manuel Luís , Larkin Philip , Francke Anneke L 
Published: September 2020

Background: Nurses are the largest regulated group of healthcare professionals involved in palliative care. In 2004, a taskforce of the European Association for Palliative Care (EAPC) launched the ‘Guide for development of palliative nurse education in Europe’ (hereinafter, the EAPC 2004 Guide). No systematic evaluation of its impact in the development of palliative care education was undertaken. Aims: To describe current undergraduate and postgraduate nursing education across Europe; to identify the roles that nurses with different palliative care educational levels have in palliative care; and to assess the uptake of the EAPC 2004 Guide in the development of palliative care nursing in Europe. Design: Descriptive research involving an online survey among nursing experts, and the consultation of national representatives. Setting/participants: A total of 135 nurses (52% response rate) from 25 countries completed the online survey; representatives from 16 countries were consulted. Results: In 14 (56%) countries, palliative care was not identified as a mandatory subject within undergraduate nursing education. The EAPC 2004 Guide is widely known and was/is being used in many countries to promote palliative care nursing education. Large variations were found across and within country responses. Conclusions: Palliative care nursing education varies largely in Europe. The wide awareness and use of the EAPC 2004 Guide show how policy measures can influence the development of palliative care education. Recommendations are built and focus on both fostering the use of this guide and implementing policy measures to ensure that palliative care nursing is recognised and certified as a specialty in all European countries.
Patient and public involvement in palliative care research: What works, and why? A qualitative evaluation
Authors: Johnson Halle , Ogden Margaret , Brighton Lisa Jane , Etkind Simon Noah , Oluyase Adejoke O , Chukwusa Emeka , Yu Peihan , de Wolf-Linder Susanne , Smith Pam , Bailey Sylvia , Koffman Jonathan , Evans Catherine J 
Published: September 2020

Background: Public involvement is increasingly considered a prerequisite for high-quality research. However, involvement in palliative care is impeded by limited evidence on the best approaches for populations affected by life-limiting illness. Aim: To evaluate a strategy for public involvement in palliative care and rehabilitation research, to identify successful approaches and areas for improvement. Design: Co-produced qualitative evaluation using focus groups and interviews. Thematic analysis undertaken by research team comprising public contributors and researchers. Setting/participants: Researchers and public members from a palliative care and rehabilitation research institute, UK. Results: Seven public members and 19 researchers participated. Building and maintaining relationships, taking a flexible approach and finding the ‘right’ people were important for successful public involvement. Relationship building created a safe environment for discussing sensitive topics, although public members felt greater consideration of emotional support was needed. Flexibility supported involvement alongside unpredictable circumstances of chronic and life-limiting illness, and was facilitated by responsive communication, and opportunities for in-person and virtual involvement at a project- and institution-level. However, more opportunities for two-way feedback throughout projects was suggested. Finding the ‘right’ people was crucial given the diverse population served by palliative care, and participants suggested more care needed to be taken to identify public members with experience relevant to specific projects. Conclusion: Within palliative care research, it is important for involvement to focus on building and maintaining relationships, working flexibly, and identifying those with relevant experience. Taking a strategic approach and developing adequate infrastructure and networks can facilitate public involvement within this field.
Racial and Ethnic Differences in Health Care Utilization Following Severe Acute Brain Injury in the United States
Authors: Jones Rayleen C. , Creutzfeldt Claire J. , Cox Christopher E. , Haines Krista L. , Hough Catherine L. , Vavilala Monica S. , Williamson Theresa , Hernandez Adrian , Raghunathan Karthik , Bartz Raquel , Fuller Matt , Krishnamoorthy Vijay 
Published: September 2020

Objective: To examine racial and ethnic differences in the utilization of 3 interventions (tracheostomy placement, gastrostomy tube placement, and hospice utilization) among patients with severe acute brain injury (SABI). Design: Retrospective cohort study. Setting: Data from the National Inpatient Sample, from 2002 to 2012. Patients: Adult patients with SABI defined as a primary diagnosis of stroke, traumatic brain injury, or post-cardiac arrest who received greater than 96 hours of mechanical ventilation. Exposure: Race/ethnicity, stratified into 5 categories (white, black, Hispanic, Asian, and other). Measurements and Main Results: Data from 86 246 patients were included in the cohort, with a mean (standard deviation) age of 60 (18) years. In multivariable analysis, compared to white patients, black patients had an 20% increased risk of tracheostomy utilization (relative risk [RR]: 1.20, 95% CI: 1.16-1.24, P < .001), Hispanic patients had a 10% increased risk (RR: 1.10, 95% CI: 1.06-1.14, P < .001), Asian patients had an 8% increased risk (RR: 1.08, 95% CI: 1.01-1.16, P = .02), and other race patients had an 10% increased risk (RR: 1.10, 95% CI: 1.04-1.16, P < .001). A similar relationship was observed for gastrostomy utilization. In multivariable analysis, compared to white patients, black patients had a 25% decreased risk of hospice discharge (RR: 0.75, 95% CI: 0.67-0.85, P < .001), Hispanic patients had a 20% decreased risk (RR: 0.80, 95% CI: 0.69-0.94, P < .01), and Asian patients had a 47% decreased risk (RR: 0.53, 95% CI: 0.39-0.73, P < .001). There was no observed relationship between race/ethnicity and in-hospital mortality. Conclusions: Minority race was associated with increased utilization of tracheostomy and gastrostomy, as well as decreased hospice utilization among patients with SABI. Further research is needed to better understand the mechanisms underlying these race-based differences in critical care.
Agents of Europeanization: Think Tanks Discussing the Refugee Crisis in the Czech Republic
Authors: Klásková Markéta , Císař Ondřej 
Published: September 2020

This article belongs to the special cluster, “Think Tanks in Central and Eastern Europe”, guest-edited by Katarzyna Jezierska and Serena Giusti. What is the role of think tanks in Europeanization of national public spheres? To address this question, our paper explores the performance of think tanks in the immigration debate in the Czech Republic. Employing political claims analysis (PCA) and treating think tanks as boundary organizations active in multiple fields, we compare the levels of Europeanization of political claims made by think tanks with other actors. Our data set includes 2,374 political claims made on broadcast public TV in the period from April 2015 to March 2016. According to our quantitative data, Czech think tanks chose the discursive strategy of Europeanization more often than any other actor represented. Thus, think tanks have the potential to support Europeanization of national public spheres. However, their representation in media coverage is relatively low. Our results also demonstrate that think tanks should be treated as sui generis organizations since their strategy in the public sphere deviates from that of other civil society organizations. Think tanks Europeanized their claims-making, but others largely stayed on the national level while discussing the refugee crisis.
Introduction: Travelling from West to East: Think Tank Model Adaptation to Central and Eastern Europe
Authors: Jezierska Katarzyna , Giusti Serena 
Published: September 2020

This article is part of the special section “Think Tanks in Central and Eastern Europe” guest-edited by Katarzyna Jezierska and Serena Giusti. This is an introduction to the Special Section on Think Tanks in Central and Eastern Europe. Apart from this introduction, the Section includes four articles, which explore the nature and conditions of think tanks operating in Belarus, Ukraine, Czech Republic, and Poland. Think tanks are usually understood as institutions claiming autonomy whose main aim is to influence policy making based on the social analysis they produce. The most apparent blind spot in extant think tank research is its predominant focus on the English-speaking world. We argue that by focusing on think tanks in non-Western contexts, we can better understand think tanks. When studying the diffusion of the organizational form of think tanks to new contexts, it is not enough to maintain the “sender” perspective (the formulation of the institutional characteristics of think tanks in the contexts in which they first emerged). We need to complement or even modify that perspective by also taking into account the “receiver” perspective. In other words, internationally circulated ideas and institutional patterns are always interpreted and translated in local “receiving” contexts, which coproduce, reformulate, and readjust the blueprint. Our focus in this Section is therefore on the translation and local adaptation of the think tank institution in the context of Central and Eastern Europe, a region that has undergone deep changes in a relatively short period.
Using a Social Capital Framework to Explore a Broker’s Role in Small Employer Wellness Program Uptake and Implementation
Authors: Thornton Michele , Hammerback Kristen , Abraham Jean M. , Brosseau Lisa , Harris Jeffrey R. , Linnan Laura A. 
Published: September 2020

Purpose: Small employers, while motivated to implement wellness programs, often lack knowledge and resources to do so. As a result, these firms rely on external decision-making support from insurance brokers. The objective of this study was to analyze brokers’ familiarity with wellness programs and to characterize their role and interactions with small employers. Design: Using a newly developed common interview guide (20 questions), protocol and analysis plan, 20 interviews were conducted with health insurance brokers in Illinois, Minnesota, North Carolina and Washington in 2016 and 2017. In addition to exploring patterns of broker interactions and familiarity by segment, we propose a framework to conceptualize the broker-client relationship using social capital theory and the RE-AIM model. Methods: Interviews were transcribed, summarized and a common codebook was established using DeDoose. Themes were identified following multi-rater coding and structured within the framework. Results: Participating brokers reported having a high to moderate familiarity with wellness programs (65%) and a majority (80%) indicated that they have previously advised their small business clients on the availability and features of them. Further, we find that brokers may help eliminate barriers to resources and act as a connector to wellness opportunities within their professional network. Conclusion: New initiatives to promote small employer wellness programs can benefit from examining the influence of brokers on the decision-making process. When engaged and supported with resources, brokers may be effective champions for employer wellness programs.
Prolonged Refractory ICU Delirium Successfully Treated With Valproic Acid: Case Report and Literature Review
Authors: Subedi Bibidh , Louzon Patricia R. , Masood Ahmed , Recksieck Stephanie 
Published: September 2020

Intensive care unit (ICU) delirium is characterized by acute onset of cerebral dysfunction with a change or fluctuation in baseline mental status. Delirium management includes non-pharmacologic and pharmacologic treatment. However at times, alternative pharmacologic treatment is warranted. Valproic acid (VPA) is a potential pharmacologic agent that can be utilized to treat ICU delirium, though there is a paucity of evidence for its use, especially in patients with a history of substance abuse. We review the literature on VPA use in ICU delirium, and describe a challenging case of a 27-year-old female with a history of substance abuse experiencing hyperactive ICU delirium for greater than a month, refractory to multiple treatment modalities, and successfully treated with VPA therapy.
Antibiotics Utilization for Community Acquired Pneumonia in a Community Hospital Emergency Department
Authors: Yu Jessica , Wang Gillian , Davidson Ann , Chow Ivy , Chiu Ada 
Published: September 2020

Background: A local health authority in Canada implemented its own Antimicrobial Stewardship Program (ASP) which provide guidelines to clinicians to utilize when treating infectious diseases such as community-acquired pneumonia (CAP). Objectives: The primary objective is to describe antibiotic usage patterns at the community hospital’s emergency department (ED) and to analyze the patterns in relation to ASP goals of reducing risk of infections, adverse drug events and antibiotic resistance, and to identify potential areas of improvement. Methods: This retrospective chart review included 156 adult patients with a diagnosis of CAP admitted to a community hospital ED from December 1, 2015 to November 30, 2016. Results: 50.6% patients were prescribed moxifloxacin across all severity of CAP patients. Low and moderate severity CAP patients were most often prescribed antibiotic duration > 7 days. In low, moderate and high severity CAP patients who were treated using ceftriaxone, 100%, 88.9% and 66.6% patients were treated with ceftriaxone 2000 mg daily respectively. Conclusions: Antibiotic prescribing patterns suggest fluoroquinolones were frequently being over-prescribed, ceftriaxone dosages were often too high, and duration of antibiotics for low and moderate severity CAP were too long. More efforts are needed to promote appropriate antibiotic usage and optimize patient care.
Musculoskeletal Pain Experienced on Most Days is a Common Accompaniment of Ageing amongst Community-Dwelling Older Australians: A Questionnaire-Based Study
Authors: Gilmartin-Thomas Julia F-M. , Ernst Michael E. , Nelson Mark R. , Lockery Jessica , Ward Stephanie A. , Woods Robyn L. , Britt Carlene , Murray Anne , Workman Barbara , McNeil John ,   The ASPREE Investigators
Published: September 2020

Objective: To describe the prevalence, location and impact of moderate to severe pain experienced on most days in community-dwelling older (≥70 years) adults who were ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial participants. Methods: Cross-sectional ASPREE Longitudinal Study of Older Persons (ALSOP) data were collected from self-reported questionnaires administered to 16,439 ASPREE participants. Results: Of 14,155 respondents, 41% of males ( n = 2651/6475) and 50% of females ( n = 3803/7680) reported experiencing pain on most days. One quarter of respondents reported experiencing pain on most days that was moderate or severe in intensity ( n = 3560/14,155), commonly located in the lower back, knees and upper back. Of those reporting moderate or severe pain, 51% reported taking analgesic medication on most days ( n = 1812/3560), almost one-third also reported regular interference with sleep (29%, n = 1024/3560), walking (35%, n = 1239/3560) and daily activities (41%, n = 1467/3560). Discussion: Lower back, knee or upper back pain is a common accompaniment of ageing.
Velar Closing Ratio As a Predictor for the Verlopharyngeal Function After Double Opposing Z-Plasty for Postpalatoplasty Velopharyngeal Insufficiency in Patients With Cleft Palate
Authors: Wu Cheng-Chun , Huang Faye , Hsieh Ching-Hua , Fu Chih-Pin , Tsai Yi-Lin , Lai Jui-Pin 
Published: September 2020

Background: This study was designed to identify the potential predictors of postoperative velopharyngeal function after double opposing Z-plasty (DOZP) for the treatment of velopharyngeal insufficiency (VPI) in patients who had prior palatoplasty for cleft palate. Methods: This retrospective study reviewed the medical records of consecutive patients who received DOZP for VPI after receiving a prior palatoplasty treating cleft palate between 2004 and 2017. The speech outcome of patient was measured using the Pittsburgh Weighted Speech Scale (PWSS) at 6 months following surgery and determined the outcome suggests velopharyngeal competence (PWSS ≤2) or incompetence (PWSS >2). Stepwise logistic regression was used to identify the variables for the prediction of competent surgical outcome. The specific receiver operating characteristic curves with an area under the curve (AUC) was used to evaluate the predictor related to the surgical outcome as competence. Results: The study included 93 patients. Age, relative velar length, velar lengthening, and closure pattern were not significantly associated with postoperative competence status of the patient. The only variable that predicted a successful surgical outcome was preoperative velar closing ratio. However, the accuracy of velar closing ratio in predicting a competent surgical outcome is only moderate (AUC = 70.37). Conclusion: The results of this study showed that preoperative velar closing ratio may predict, with moderate accuracy, a successful surgical outcome in patients with postpalatoplasty VPI who undergo DOZP. Therefore, in patients with a low preoperative velar closing ratio, some alternative surgical methods other than DOZP may be considered to avoid unsatisfactory surgical outcome.