bluuebunny/crossref_metadata_2025 huggingface dataset:
Women’s Leadership in HF/E: Past, Present and Future
Authors: Hancock Gabriella M. , Stowers Kimberly , Bass Ellen J. , Cooke Nancy , Cuevas Haydee M. , Gawron Valerie , Larson Nancy
Published: September 2018

The objective of this panel is to discuss professionalism and leadership in human factors and ergonomics, namely as they pertain to women in the field. As part of this panel, we aim to provide opportunities and guidance for extending the representation of women in leadership roles throughout the field. The panel will be led by Gabriella Hancock and Kimberly Stowers who will introduce the panel and its role in the HF/E Women’s Organization for Mentoring and Networking’s larger campaign to foster professional development for future leaders. Panelists will offer their unique perspective(s) on leadership and professional development leveraging their diverse training(s), experiences, career paths, and perspectives on leadership. Members of the audience are encouraged to come prepared with questions for panelists to better learn the panelists’ thoughts, opinions, and strategies concerning what could and should be done to encourage female leadership in the future. Drs. Hancock and Stowers will foster discussion amongst the panelists, and invite questions and participation from the general audience.
Detecting Pedestrian Situation Awareness in Real-Time: Algorithm Development Using Heart Rate Variability and Phone Position
Authors: Tong Yourui , Jia Bochen , Wang Yi , Yang Si
Published: September 2018

To help automated vehicles learn surrounding environments via V2X communications, it is important to detect and transfer pedestrian situation awareness to the related vehicles. Based on the characteristics of pedestrians, a real-time algorithm was developed to detect pedestrian situation awareness. In the study, the heart rate variability (HRV) and phone position were used to understand the mental state and distractions of pedestrians. The HRV analysis was used to detect the fatigue and alert state of the pedestrian, and the phone position was used to define the phone distractions of the pedestrian. A Support Vector Machine algorithm was used to classify the pedestrian’s mental state. The results indicated a good performance with 86% prediction accuracy. The developed algorithm shows high applicability to detect the pedestrian’s situation awareness in real-time, which would further extend our understanding on V2X employment and automated vehicle design.
Development and Evaluation of a Computational Human Performance Model of In-vehicle Manual and Speech Interactions
Authors: Jeong Heejin , Liu Yili
Published: September 2018

Usability evaluation traditionally relies on costly and time-consuming human-subject experiments, which typically involve developing physical prototypes, designing usability experiment, and recruiting human subjects. To minimize the limitations of human-subject experiments, computational human performance models can be used as an alternative. Human performance models generate digital simulations of human performance and examine the underlying psychological and physiological mechanisms to help understand and predict human performance. A variety of in-vehicle information systems (IVISs) using advanced automotive technologies have been developed to improve driver interactions with the in-vehicle systems. Numerous studies have used human subjects to evaluate in-vehicle human-system interactions; however, there are few modeling studies to estimate and simulate human performance, especially in in-vehicle manual and speech interactions. This paper presents a computational human performance modeling study for a usability test of IVISs using manual and speech interactions. Specifically, the model was aimed to generate digital simulations of human performance for a driver seat adjustment task to decrease the comfort level of a part of driver seat (i.e., the lower lumbar), using three different IVIS controls: direct-manual, indirect-manual, and voice controls. The direct-manual control is an input method to press buttons on the touchscreen display located on the center stack in the vehicle. The indirect-manual control is to press physical buttons mounted on the steering wheel to control a small display in the dashboard-cluster, which requires confirming visual feedback on the cluster display located on the dashboard. The voice control is to say a voice command, “ deflate lower lumbar” through an in-vehicle speaker. The model was developed to estimate task completion time and workload for the driver seat adjustment task, using the Queueing Network cognitive architecture (Liu, Feyen, & Tsimhoni, 2006). Processing times in the model were recorded every 50 msec and used as the estimates of task completion time. The estimated workload was measured by percentage utilization of servers used in the architecture. After the model was developed, the model was evaluated using an empirical data set of thirty-five human subjects from Chen, Tonshal, Rankin, & Feng (2016), in which the task completion times for the driver seat adjustment task using commercial in-vehicle systems (i.e., SYNC with MyFord Touch) were recorded. Driver workload was measured by NASA’s task load index (TLX). The average of the values from the NASA-TLX’s six categories was used to compare to the model’s estimated workload. The model produced results similar to actual human performance (i.e., task completion time, workload). The real-world engineering example presented in this study contributes to the literature of computational human performance modeling research.
Investigating Architectural and Space Design Considerations for Post-Traumatic Stress Disorder (PTSD) Patients
Authors: Khanade Kunal , Rodriguez-Paras Carolina , Sasangohar Farzan , Lawley Sarah
Published: September 2018

Post-Traumatic Stress Disorder (PTSD) is a prevalent condition among the general U.S. population but in particular for veterans. Anecdotal evidence points to the effect of urban design features on mental well-being of PTSD patients. However, evidence-based architectural and space design guidelines for PTSD patients is largely absent. Such guidelines might alleviate PTSD symptoms and improve patients’ quality of life. Interviews were conducted with combat veterans who were diagnosed with PTSD (sub population focus) to gain insights into their thoughts, needs, expectations, and experiences with physical indoor and out-door spaces. The findings suggest that certain indoor and outdoor design elements such as sharp corners, narrow pathways, blind spots, etc. increase anxiety and leads to triggers while soothing features (e.g. open spaces, situational awareness providing features such as lack of clutter or open floor plans) can relax veterans.
Optimizing Cognitive Performance during Vigilance through Flow Enhancement
Authors: Hidalgo Maartje , Cruit Jessica , Yerdon Valarie A. , Hancock P.A.
Published: September 2018

Research of psychological flow has seen major progress within the recent decades, portraying the peak performance associated with this psychological state. Along with its association with optimal performance, flow has been linked to effortless attention. However, recent work suggests that the state of flow can take considerable cognitive effort. In this paper, we lay the foundation for a theory of effortful attention during flow, and how this may be utilized to mitigate the performance decrement associated with highly demanding tasks such as vigilance. We suspect that the state of flow can delay the vigilance decrement, which can be of great benefit for high-stake fields requiring prolonged cognitive performance, such as air traffic management, where vigilance is vital to the safety of air traffic or nuclear plant monitoring.
Bayesian Network for Assessing Performance in Complex Navigation - A Conceptual Model
Authors: Ernstsen  , Musharraf  , Mallam  , Nazir  , Veitch
Published: September 2018

The maritime industry is considered the backbone of the global economy, enabling efficient transport of goods with a commercial value of about $829 Billion USD through a network of over 90,000 ships, and employing approximately 1.6 million people worldwide. Maritime navigation is a complex and dynamic operational process. On a vessel, demands are put on the human operators (e.g., the captain) with regards to their competence and task execution, as well as the reliability of the technical system. Understanding and assessing human performance is imperative to optimize individual factors for safe and efficient voyages. The human operator and the technical system are interdependent for ensuring this, and sociotechnical characteristics of the system and operations should thus be considered in the assessment. Recent accidents call for a further understanding of this interdependent relationship between socio-related and technical aspects of maritime operations. This paper proposes a conceptual framework using a Bayesian Network and expert elicitation methods to systematically organize maritime navigational demands.
Comparisons of Whole Body Vibration, Muscle Activity and Non-driving Task Performance between Different Seat Suspensions in an Autonomous Passenger Car Application
Authors: Kia Kiana , Johnson Peter W , Kim Jeong Ho
Published: September 2018

This study compared whole body vibration (WBV), muscle activity and non-driving task performance between different seat suspension settings in a simulated autonomous passenger car environment. To simulate autonomous vehicle environment, field-measured vibration profiles were recreated on a large-scale 6-degree-of-freedom motion platform. In a repeated-measures laboratory experiment, we measured whole body vibration, muscle activity (neck, shoulder and low back), participants non-driving task performance while participants performed non-driving tasks (pointing task with a laptop trackpad, keyboard typing, web-browsing, and reading) on three different suspension seats mounted on the motion platform: vertical (z-axis) electromagnetic active suspension, multi-axial (lateral (y-axis) and vertical (z-axis)) electromagnetic active suspension, and no suspension (industry standard suspension-less seat for passenger cars). The average weighted vibration [A(8)] and vibration dose value [VDV(8)] showed that the seat measured vibration on both the vertical [A(8) = 0.29 m/s2 and VDV(8) = 10.70 m/s1.75] and multi-axial suspension seats [A(8) = 0.29 m/s2 and VDV(8) = 10.22m/s1.75] were lower than no-suspension seat vibration [A(8) = 0.36 m/s2 and VDV(8) = 12.84 m/s1.75]. Despite the significant differences in WBV between the different suspensions there were no significant differences across three different suspension seats in typing performance (typing speed and accuracy: p’s > 0.83), pointing task performance (movement time and accuracy: p’s > 0.87), web-browsing (number of questions and webpages read: p = 0.42), and reading (number of words read: p = 0.30). The muscle activity in low back (erector spinae) and shoulder (trapezius) muscles also did not show any significant differences (p’s > 0.22). These laboratory study findings indicated that despite the significant reduction in WBV, neither vertical nor multi-axial active suspension seats improve non-driving task performance as compared to the no-suspension seat.
Looking at Mind Wandering During Driving Through the Windows of PCA and t-SNE
Authors: Alsaid Areen , Lee John D. , Roberts Daniel M. , Barrigan Daniela , Baldwin Carryl L.
Published: September 2018

Mind wandering is a poorly understood phenomenon that can undermine driving safety. Driving performance measures have been found to be associated with mind wandering (e.g., steering wheel movements, standard deviation of lateral position, and speed variation). However, no one measure can fully describe the driver behavior associated with mind wandering. Therefore, in this paper we explore the effect of mind wandering on nine steering measures with data collected from a study that included nine drivers over two sessions of driving over five days. Participants were periodically probed to report their attentional state–whether they were mind wandering or focusing on the task. We used two dimensionality-reduction techniques—Principal component analysis (PCA) and t-distributed stochastic neighbor embedding (t-SNE)—to visualize the dimensions underlying the nine measures. Comparing PCA to t-SNE highlights the benefits of t-SNE in revealing the fine structure that differentiates driving behavior. These visualizations show that a) driver engagement increased during roadway curve segments, and b) mind wandering manifests itself through several types of steering behavior.
Impact of Cognitive Distractions on Drivers’ Anticipation Behavior in Vehicle-bicycle Conflict Situations
Authors: Ebadi Yalda , Mangalore Ganesh Pai , Samuel Siby
Published: September 2018

Overall, the rate of vehicle-bicycle collisions is continually increasing. In the United States alone, bicyclist fatalities contributed to 2.3 percent of all crash related fatalities in 2015. In most of these cases, crashes occur due to distracted drivers who are unable to correctly anticipate the bicyclists at the hazardous locations on the roadways such as, intersections and curves. The objective of the current study is to contribute to the divisive literature surrounding cell phone use while driving by specifically measuring, the effects of a secondary mock cell phone task on hazard anticipation performance across common vehicle-bicycle conflict situations. Two groups of 20 drivers each, navigated seven unique scenarios on a driving simulator while being monitored by an eye tracker. One group of participants performed a hands free mock cellphone task while driving, while the second group drove without any additional tasks outside of the primary task of driving. Analysis of the proportion of anticipatory glances using a logistic regression model revealed a significant main effect of the mock cellphone task at reducing the proportion of such glances made by the drivers towards potential bicyclist threats on the roadway.
Examining Speech-Based Auditory Alerts for Intersection Collision Warning Systems using a Driving Simulator
Authors: O’Brien West M. , Wu Xingwei , Boyle Linda Ng
Published: September 2018

Collision warning systems alert drivers of potential safety hazards. Forward collision warning (FCW) systems have been widely implemented and studied. However, intersection collision warning systems (ICWS), such as intersection movement assist (IMA), are more complex. Additional studies are needed to identify the best alert for directing the driver toward the hazard. A driving simulator study with 48 participants was conducted to examine three speech-based auditory alerts (general, directional, and command) in a simulated red light running (RLR) collision scenario. The command alert that informed the drivers to brake was the most effective in reducing the number of collisions. The post-drive questionnaire showed that drivers also rated the brake alert to be best in terms of interpretation (based on the Kruskal Wallis test). This study provides insight into the performance of different types of speech-based alerts for an intersection collision warning system and can provide guidance for future studies.
Glances That Matter: Applying Quantile Regression to Assess Driver Distraction from Off-Road Glances
Authors: Liu Shu-Yuan , Lee John D. , Lee Ja Young , Venkatraman Vindhya
Published: September 2018

This study assessed whether quantile regression can identify design specifications that lead to particularly long glances, which might go unnoticed with traditional analyses focusing on conditional means of off-road glances. Although substantial research indicates that long glances contribute disproportionately to crash risk, few studies have directly assessed the tails of the distribution. Failing to examine the distribution tails might underestimate the disproportionate risk on long glances imposed by secondary tasks. We applied quantile regression to assess the effects of secondary task type (reading or entry), system delay (delay or no delay), and text length (long or short) on off-road glance duration at 15th, 50th, and 85th quantiles. The results show that entry task, long text, and some combinations of variables led to longer glances than that would be expected given the central tendency of glance distributions. Quantile regression identifies secondary task features that produce long glances, which might be neglected by traditional analyses with conditional means.
Dual-Task Redundant-Target Processing: The Case of the Limited Capacity Parallel Model
Authors: Morey Stephanie A. , Thomas Nicole A. , McCarley Jason S.
Published: September 2018

We examined the effect of a central tracking task on visual target processing efficiency in a combined target detection / manual tracking paradigm. Participants performed a redundant-target task by itself, and concurrently with the tracking task. A measure of workload capacity gauged target processing efficiency. Processing was less efficient than predicted by a standard parallel race model under both levels of task load. However, data suggested no difference in processing efficiency between the single-and dual-task conditions. Our findings provide further evidence that processing capacity for peripheral visual targets is consistently limited but robust against changes to concurrent task load.
An analytical solution for integrity detection of a floating pile embedded in saturated viscoelastic half-space
Authors: Cui Chunyi , Zhang Shiping , Meng Kun , Xu Chengshun , Yang Gang
Published: September 2018

A new mathematical model of a floating pile embedded in a viscoelastic saturated soil for low-strain integrity detection is proposed using the theory of porous media. The saturated surrounding soil is divided into Novak’s thin layers along the pile length and a homogeneous half-space underlying the pile base to consider the effect of excitation frequency on the dynamic stiffness of the soil beneath the pile base. And the corresponding analytical solutions for the dynamic impedance and the reflected wave signal of vertical velocity at the pile head are derived and verified by comparing its reduced solution with the existing solutions for the end-bearing pile. In addition, an extensive parametric analysis is further conducted to investigate the effects of the slenderness ratio of pile, the modulus ratio of pile to the surrounding soil, and the permeability coefficient of saturated soil on the vertical vibration characteristics of the pile–soil interaction system.
Emergent Cultural Differences in Online Communities’ Norms of Fairness
Authors: Strimling Pontus , Frey Seth
Published: September 2018

Unpredictable social dynamics can dominate social outcomes even in carefully designed societies like online multiplayer games. According to theories from economic game theory and evolutionary anthropology, communities that are otherwise identical can spontaneously develop emergent cultural differences. We demonstrate the emergence of norm diversity in comparable populations distributed across identical copies of a single multiplayer game world. We use 2006 data from several servers of World of Warcraft to analyze how social contracts about resource distribution converge within independent communities, while varying across them. We find wide-ranging diversity in the norms that communities consider standard, fair, and common, even where these norms are unenforcable and players face large incentives to deviate from them. By documenting how designed societies come to differ in undesigned ways, we present emergent cultural diversity as a distinguishing feature of human sociality and a major challenge for game designers.
Urinary Bisphenol A Levels and Male Fertility
Authors: Radwan Michał , Wielgomas Bartosz , Dziewirska Emila , Radwan Paweł , Kałużny Paweł , Klimowska Anna , Hanke Wojciech , Jurewicz Joanna
Published: September 2018

Bisphenol A (BPA) is a high-production volume industrial chemical found in many consumer products. BPA is a suspected potent endocrine disruptor, with endocrine-disrupting properties demonstrated in animal studies. Few human studies have examined bisphenol A exposure in relation to male fertility and, results are divergent. The aim of the study is to examine the associations between urinary BPA concentration and male fertility. Bisphenol A urinary concentrations were measured using gas chromatography coupled with tandem mass spectrometry in 315 men under 45 years of age with normal sperm concentration (⩾15 mln/ml) recruited from a male reproductive health clinic. Participants were interviewed and provided a semen sample. BPA was detected in 98.10% of urine samples, with a median concentration of 1.87 µg/l (1.63 µg/ g creatinine). A multiple linear regression analysis identified a positive association between the urinary concentrations of bisphenol A 25th–50th percentile and total sperm sex chromosome disomy ( p = .004). Also when modeled as continuous variable urinary BPA concentration increased total sperm sex chromosome disomy ( p = .01). Urinary concentration of BPA also increase the percentage of immature sperm (HDS) ( p = .018) and decrease motility ( p = .03). The study provides evidence that exposure to BPA is associated with poorer semen quality. Future studies are needed to confirm these findings.
Research on wireless power transfer system for Torpedo autonomous underwater vehicles
Authors: Song Baowei , Wang Yushan , Zhang Kehan , Mao Zhaoyong
Published: September 2018

The wireless power transfer shows great potential in the future for its safety and convenience. Autonomous underwater vehicle is one of the important tools to explore and develop oceans. In this study, we develop and analyze a wireless power transfer system based on magnetic resonance coupling to charge the autonomous underwater vehicle underwater. We have adopted a way that energy transmission underneath the vehicle and the coils in the wireless power transfer system were proposed to obtain a higher mutual inductance based on the shape of the vehicle in this study. In addition, we analyze the equivalent circuit model and propose a kind of impedance matching network to maintain system security. The coils we used in the proposed system are 20 turns and their radii are 70 mm. The system works well with 100 W output and 72% efficiency.
The legitimacy of development nongovernmental organizations as global citizenship education providers in Korea
Authors: Noh Jae-Eun
Published: September 2018

In an era of globalization, social demands for fostering global citizenship are increasing. Global citizens are those who have a critical understanding of interconnectedness, share values of responsibility, have respect for differences, and commit themselves to action. Global citizenship education has recently emerged as a prominent issue in Korea, a nation faced with the inflow of immigrants and international pushing for global citizenship education such as the Sustainable Development Goals. Development nongovernmental organizations have taken up the role of delivering global citizenship education. It is necessary to examine how development nongovernmental organizations’ pedagogic legitimacy has been constructed and exercised in the context of Korea. This article critically discusses development nongovernmental organizations’ roles in global citizenship education and suggests some improvements in the areas of ‘effectiveness and expertise, contextualization, and greater attention to human rights and action for social justice’ to be an alternative to the state-led global citizenship education, which is characterized as assimilation model and ‘us and them’ rhetoric.
Minor harassments: Ethnic minority youth in the Nordic countries and their perceptions of the police
Authors: Haller Mie Birk , Solhjell Randi , Saarikkomäki Elsa , Kolind Torsten , Hunt Geoffrey , Wästerfors David
Published: September 2018

As different social groups are directly and indirectly confronted with diverse forms of police practices, different sectors of the population accumulate different experiences and respond differently to the police. This study focuses on the everyday experiences of the police among ethnic minority young people in the Nordic countries. The data for the article are based on semi-structured interviews with 121 young people in Sweden, Norway, Finland and Denmark. In these interviews, many of the participants refer to experiences of “minor harassments” – police interactions characterized by low-level reciprocal intimidations and subtle provocations, exhibited in specific forms of body language, attitudes and a range of expressions to convey derogatory views. We argue that “minor harassments” can be viewed as a mode of conflictual communication which is inscribed in everyday involuntary interactions between the police and ethnic minority youth and which, over time, can develop an almost ritualized character. Consequently, minority youth are more likely to hold shared experiences that influence their perceptions of procedural justice, notions of legitimacy and the extent to which they comply with law enforcement representatives.
National trends in admissions for potentially preventable conditions among patients with metastatic solid tumors, 2004-2014.
Authors: Daly Robert Michael , Abougergi Marwan S.
Published: September 2018

1

Background: The Centers for Medicare and Medicaid Services (CMS) has identified 10 conditions for hospitalization among patients receiving chemotherapy that are potentially preventable through appropriately managed outpatient care. CMS plans to measure hospitals’ performance based on frequency of admission for: anemia, dehydration, diarrhea, emesis, nausea, neutropenia, fever, pain, pneumonia, and sepsis. Our objective was to measure hospital utilization patterns for these conditions. Methods: Nationally representative data from the 2004 and 2014 National Inpatient Sample were analyzed. Adults with stage IV solid tumors admitted with a principal diagnosis of one of the ten conditions were identified using ICD-9 codes provided by CMS. The primary outcome was number of admissions. Secondary outcomes were total hospitalization costs, length of stay (LOS), and in-hospital mortality rate. Proportions and count data were compared using chi-square and binomial test, respectively. Results: Between 2004 and 2014, potentially preventable hospitalizations increased from 64,053 to 85,740 (p < 0.01). The most frequent reason for admission was pneumonia (32%) in 2004 and sepsis (41%) in 2014. Table 1 provides the results for the year 2014 by condition. Hospitalizations for sepsis had the longest mean LOS (p < 0.01), highest mean total costs (p < 0.01) and most frequently resulted in death (p < 0.01). Conclusions: The Department of Health and Human Services states, “Improving patients’ quality of life by keeping patients out of the hospital is a main goal of cancer care.” Despite supportive care advances, the increased frequency of hospitalization demonstrates a need for continued symptom management innovation. Infectious symptoms should be a focus of these technologies given their high prevalence, mortality and resource utilization. [Table: see text]
Deploying end-of-life utilization measures for oncology patients to assess hospital care quality and value.
Authors: McNiff Kristen K. , Zhang Yichen , Fraile Belen , Hassett Michael J.
Published: September 2018

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Background: Addressing utilization near the end of life (EOL) for cancer patients is critical to enhance the value of cancer care. Cancer EOL utilization measures have been widely endorsed, including by the National Quality Forum (chemotherapy in the last 14 days; ICU in the last 30 days; not admitted to hospice; admitted to hospice for < 3 days). However, efforts to use these measures to assess hospital quality and value have been constrained, in part because currently endorsed specifications do not provide a claims-based approach to cohort identification, and do not include a hospital attribution methodology. Methods: Using Medicare fee-for-service claims for adults ≥65 years, and through an iterative process informed by an expert panel, we developed extensible claims-based algorithms to a) identify patients who were deceased from cancer; b) attribute each patient to a responsible hospital; and c) derive hospital-level performance measures. We sought to ensure that these algorithms had strong face validity and were consistent with standard practices for claims-based analyses. Results: We identified 347,452 cancer decedents as those who had a cancer diagnosis associated with ≥2 hospital inpatient (IP), hospital outpatient (OP), or hospice claims, and died between 2011-2014. A decedent’s care was attributed to a hospital if there were ≥2 claims from that institution during the 6 months before death (N = 221,102). If this identified multiple hospitals, one was selected using the following sequence: total majority of all claims; most OP claims; most IP claims; last IP claim before death. Measure performance reflected national published data: 6% received chemotherapy in the last 14 days; 28% admitted to ICU in the last 30 days; and 34% not admitted to hospice. There was significant variation in hospital performance for all measures. Conclusions: Claims-based EOL measures do not define ‘ideal’ performance, but they do provide hospitals with broad utilization data that can help inform value-based cancer care delivery. These methods addressed gaps hindering the application of endorsed cancer EOL measures to hospitals. Companion quality measures to assess goal-concordant care are also needed.
Teams aren’t enough: Considering multiteam systems for better cancer care.
Authors: Lazzara Elizabeth Hunter , Shuffler Marissa , Lenoble Chelsea , Weaver Sallie , Chollette Veronica
Published: September 2018

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Background: Cancer is a complex disease that manifests differently. Quality care relies on the coordinated integration of many providers with varied background, experience, and expertise. Because care coordination spans across multiple processes (e.g., detection, diagnosis, and treatment), levels (e.g., individuals and teams), provider types (e.g., nurse and physician), specialties (e.g., surgery, radiology, and oncology), we argue that a team-based approach is necessary but solely insufficient. The current system provides care that is fragmented and evidence suggests such fragmentation is associated with missed opportunities, repetitive testing and increased costs. To mitigate fragmentation, effective cancer care requires the synthesis of multiple teams. A single team is characterized by two or more individuals working interdependently towards a shared goal. However, due to the complexity of cancer care, effective care coordination warrants multiple teams with collective, shared goals as well as potentially different, proximal goals. Effective multiteam systems (MTSs) need guidance, particularly for cancer care where this thinking is still relatively novel. With this in mind, the purpose of this paper is to contribute a theoretically grounded foundation and initial guiding principles that can inform efforts to mitigate the fragmentation in cancer care by providing insights on how to facilitate optimal MTSs. Methods: We culled the MTS literature to distill principles that are applicable for cancer care. Results: We offer seven recommendations that practitioners and healthcare delivery researchers can use to strengthen the integrated, coordinative efforts of cancer care: (1) Define the specific cancer care MTS & potential future component teams; (2) Determine critical interdependencies among the component teams; (3) Identify optimal boundary spanner(s); (4) Educate the boundary spanner on the role and responsibilities; (5) Explicate the shared and competing goals; (6) Establish a salient social identity; and (7) Incorporate pre-briefs and debriefs with ‘unlikely’ team members. Conclusions: We posit that a MTS approach is more accurate and more fruitful for examining and improving the delivery of cancer care across the cancer continuum.
Triaging for Supportive Care Services: Do People Want and Accept Referral?
Authors: Wilson C. , Skaczkowski G. , Sanderson P. , Shand M. , Byrne A.
Published: September 2018

Background: Distress is the 6th vital sign in cancer yet it is only assessed in an ad hoc way in most cancer services. The Distress Thermometer (DT) and the associated Problem Checklist (PC) are the most widely available tools although few studies report on how they are used to effectively triage services. Aim: To explore the link between distress assessment, problem identification, referral to specific supportive care services by staff, and service uptake by cancer patients and survivors among a sample of people attending a major cancer hospital in Victoria Australia. Methods: A secondary analysis of quality assurance audit data were undertaken using data collected from patient medical records between January 2013 and June 2014. Data extracted were; age, sex, post code, language spoken, disease and treatment information, distress as measured by the DT and problems as identified by the PC. For the current study the focus was on the number of referrals offered and the number accepted or declined. The type of services referred to was also examined. Results: Data were collected for 877 patients although missing data resulted in a final sample size of 853. Only data associated with the first DT of each patient are presented. 729 patients (86%) participated in distress screening. The distress threshold of 4 was reported by 50% of participants, highlighting the prevalence of distress requiring support. This 50% reported an average of 9 problems on the PC, many of which came from the physical domain, with 91% reporting at least 1 physical problem. Other problems reported were emotional (74% of the sample); practical (24%), family (14%) and spiritual (2%). Referral data, which was available for 614 people, indicated that over 60% (372) were offered at least one referral. Referral offer was significantly predicted by DT score, and number of problems reported. Acceptance was significantly related to total number of problems, treatment type, and type of referral; referral for physical treatment was most likely to be accepted (87%) whereas referral for emotional support was least likely (53%). Conclusion: Routine distress screening and problem identification are critical to triaging to supportive care services. In a tertiary care setting, not all people will be screened or will want to be screened; not all people will be referred to services; and not all people will accept referral. Nonetheless, problems are extensive with most survivors reporting experiencing several problems. Despite a focus on the physical, these problems extend to other domains, including the emotional, and it is important that services are available to support these needs.
A Nomogram for the Prediction of Kras Mutation in Colorectal Cancer
Authors: Xiang W. , Cai G.
Published: September 2018

Background: KRAS mutation status is crucial in treatment decisions regarding the use of EGFR tyrosine kinase inhibitors in colorectal cancer (CRC). However, genetic testing is not available for some patients, either because tissue is limited and/or tests are not routinely offered. Aim: We aimed to build a nomogram based on clinical factors for the prediction of KRAS mutations in CRC. Methods: Colorectal cancer patients who had their tumors genotyped for KRAS mutation at Fudan University Shanghai Cancer Center (FUSCC) were retrospectively analyzed. Variables of interest were integrated in a multivariate logistic regression model. Results: A total of 759 hospitalized patients were extracted from FUSCC database. KRAS mutation presented in 40.1% (309/759) cases. Multivariate logistic regression suggested that female (OR 1.47, 95% CI 1.06-2.04), mucinous histology (OR 2.04, 95% CI 1.28-3.25), right-sided tumor (OR 1.65, 95% CI 1.13-2.39) and high levels of preoperative CEA (OR 1.45, 95% CI 1.03-2.03), CA19-9 (OR 3.87, 95% CI 2.70-5.53) and albumin/globular protein (OR 2.02, 95% CI 1.33-3.06) were significantly correlated with KRAS mutation status. A nomogram was established and showed considerable discriminating accuracy (AUC 0.744, 95% CI 0.709-0.779) in this cohort. Patients with the highest score had 88.6% chance to bear a KRAS-mutant tumor. Subgroup analysis based on metastasis status revealed a sound applicability of the established nomogram both in metastatic (AUC 0.723, 95% CI 0.666-0.781) and nonmetastatic (AUC 0.753, 95% CI 0.707-0.798) CRC. Conclusion: Six simple and easy-to-collect characteristics defined a useful nomogram to predict KRAS status both in metastatic and nonmetastatic CRC with great predictive accuracy.
Ovarian Cancer in Niger: Results of a Nationwide Study
Authors: Garba S. Mamoudou , Hami H. , Zaki H. Mahamadou , Soulaymani A. , Nouhou H. , Mokhtari A. , Quyou A.
Published: September 2018

Background: Ovarian cancer is the fourth most common cancer and the fourth most common cause of cancer death among women in western Africa, with about 3820 new cases and 2912 cancer deaths in 2012 ( GLOBOCAN 2012 ). Aim: The current study aims to estimate the incidence and determine the epidemiologic characteristics of ovarian cancer in Niger. Methods: This is a descriptive retrospective analysis of ovarian cancer cases, reported between 1992 and 2009 to the Niger Cancer Registry, established in 1992, in the Faculty of Health Sciences at the Abdou Moumouni University in Niamey. Results: There were 363 cases diagnosed with ovarian cancer in Niger, accounting for 8.8% of all cancer cases in women reported during 1992-2009. During this period, ovarian cancer was the third most common cancer after breast and cervical cancer and the third leading cause of cancer death after breast and liver cancer in women. In 2009, the incidence of ovarian cancer was 4.9 new cases per 100,000 women and the number of deaths was 5.6 per 1,000,000 women. The average age at diagnosis of ovarian cancer was 42 ± 16 years (range 6-85 years). The risk of developing ovarian cancer is strongly related to age, with 13.2% of new ovarian cancer cases diagnosed in women younger than 25 years, 77.7% in those aged 25-64 years and 9.1% in those aged 65 years and over. Most ovarian cancers were cystadenocarcinomas. Among the cases for whom the outcome was known, 11.3% died during the study period, accounting for 9.3% of all female cancer deaths in Niger. Conclusion: The most recent estimates of ovarian cancer incidence and mortality in the world reveal sharp differences between developed and developing countries possibly related to missed opportunities for early diagnosis and incomplete reporting of ovarian cancer in Western Africa.
Physician Shadowing for Development and Implementation of a Paediatric Palliative Care Service in Enugu, Nigeria
Authors: Onyeka T. , Ugwu I.
Published: September 2018

Background: The challenges facing Nigerian children with cancer and other chronic life-limiting illnesses are enormous, with many of them not surviving due to lack of supportive services. About 80% of children living with cancer in developing countries have no access to proper cancer care and usually present to institutions like ours with very advanced disease. Cost of treatment in hospital is astronomical, with most families having to pay out-of-pocket but being unable to do so. Also, many pediatricians are discouraged when they feel they are not capable of making progress with the child's treatment and are left with feelings of hopelessness, giving patients and families the impression they have given up. The combination of these factors usually results in patients absconding from inpatient admission, defaulting from treatment and eventually dying at home. Aim: The current practice of palliative care in our institution is near-completely adult-based with little pediatric involvement despite the huge pediatric palliative care burden. We want to change the current narrative and build the pediatric palliative care practice in our institution, through the practice of 'shadowing'. Methods: We intend to accomplish this through the opportunity of the 2018 UICC African Cancer Fellowship, by visiting the Paedspal, a nongovernmental South African pediatric palliative care organization affiliated with the Red Cross War Memorial Children's Hospital and the Rondebosch Medical Centre, that offers inpatient, outpatient and hospices services. Results: Outcomes from this project will define the probability of a clinical observer program in effectively serving as a catalyst for the development and implementation of a pediatric palliative care program and as well as a facilitator for the mentoring experience. Conclusion: We posit that 'the shadowing experience' may be an effective strategy to building capacity in hospitals with no specialist pediatric palliative care physicians.
Survival of Patients With Head and Neck Squamous Cell Carcinoma by Housing Subsidy in a Tiered Public Housing System
Authors: Wong T.H. , Skanthakumar T. , Nadkarni N. , Nguyen H.V. , Iyer N.G.
Published: September 2018

Background: Socioeconomic status affects survival in patients diagnosed with head and neck squamous cell carcinoma (HNSCC), even in health systems with universal health care. Singapore has a tiered subsidized housing system, in which income determines eligibility for subsidies by size of apartment. Aim: The objective of this study was to assess whether a patient's residential type (heavily subsidized public housing, moderately subsidized public housing, minimally subsidized or private residential housing type) was associated with mortality. A secondary analysis examined whether patients in more heavily subsidized apartments were more likely to present with advanced disease. Methods: An historical cohort study of patients in a tertiary referral center with HNSCC was identified in the multidisciplinary cancer database from 1992 to 2014. Clinicopathologic data were extracted for analysis. Patient residential postal codes were matched to type of housing. Logistic regression was performed to evaluate the relationship between all-cause mortality and the predictors of interest as well as the association between housing type and disease stage at presentation. Results: Of the 758 patients identified, most were men (73.4%), the median age was 64 years, 30.5% were smokers and 15.2% were ex-smokers. Over one-half (56.8%) of patients presented with advanced disease. Male gender (OR 2.01, 95% CI 1.16-3.48, P = 0.01), age (OR 1.03, 95% CI 1.01-1.05, P < 0.001), stage at presentation (stage 4, reference stage 1, OR 2.03, 95% CI 1.11-3.72, P = 0.02), smoker status (smoker, reference nonsmoker, OR 2.53, 95% CI 1.33-4.87, P < 0.01) and housing subsidy type (living in minimally subsidized or private residences, relative to heavily subsidized public housing, OR 0.36, 95% CI 0.15-0.78, P = 0.01) were significantly associated with increased mortality. Kaplan-Meier curves showed that patients living in the smaller, higher subsidy apartments had the worst adjusted survival, followed by patients in moderately subsidized housing, with those in minimally subsidized or private residences having the best adjusted survival. Patients in higher-subsidy apartments were not more likely to present with advanced disease, suggesting that the survival difference was not because of delayed presentation. Conclusion: Patients with HNSCC living in higher-subsidy residences have worse survival despite no apparent delays in presentation. First published: Cancer. 2017 Jun 1;123(11):1998-2005. doi: 10.1002/cncr.30557 . Epub 2017 Jan 30. Survival of patients with head and neck squamous cell carcinoma by housing subsidy in a tiered public housing system. Wong TH, Skanthakumar T, Nadkarni N, Nguyen HV, Iyer NG.
Ana-Vation #FutureInTheirHands: The Power of Innovation, Robotics, and STEAM Education to Raise Awareness of Childhood Cancer in The Emirates
Authors: De Jonge L.
Published: September 2018

Amount raised: $50,000 (180,000 AED). Background and context: Ana, an Arabic word which means 'I' in English, is a childhood cancer initiative under Friends of Cancer Patients. Ana seeks to raise awareness about the 7 common warning signs of childhood cancer and highlight the importance of early detection, in the United Arab Emirates. In 2018, the Ana initiative launched a 3-year undertaking aimed at using S.T.E.A.M. education to roll out an annual school championship titled “Ana-vation”, a play on words between “Ana” and “innovation”. Ana-vation strategically launched in February during national innovation month, at the Sharjah Center for Astronomy and Space Sciences Planetarium. During the launch, media was invited to observe and 15 participating schools from around the country were briefed on the 4-month championship, electronic components, timeline and expected deliverables. The Ana initiative partnered with a start-up of young engineers to form the Ana-vation team. Students were preselected by their science teachers, to represent their school. Aim: Ana-vation aims to inspire young students to become future researchers, doctors, scientist and engineers, through using innovation and S.T.E.A.M education. The program also offers a bridge to aware parents and teachers, by sending home pamphlets. Strategy/Tactics: Ana-vation is a 4-month campaign (February to May) that rolls out with 15 schools across the Emirates. The program involves the science teacher at each school, who selects 10 students to participate in teams of two (5 teams per school, totaling 75 teams). They have to use the electronic components in the Ana-vation robotic kits and recyclable materials found around their homes, to create a robot to answer in the challenge: “Create an innovative solution to raise awareness about childhood cancer signs and symptoms”. Throughout the 4 months, Ana-vation will conduct workshops at each of the 15 schools to mentor and engage with the students and teach them to code, using basic programing language. Program process: Championship launch - February Training and evaluation roadshows - March Debugging workshops - April Championship and awarding ceremony - May Costs and returns: To cover the cost of the kits + launch event + 15 road show school visits + workshop + award ceremony = $50,000 (180,000 AED) total or $3300 (12,000 AED) per school. FOCP approached corporates to adopt and sponsor a school at $3300. What was learned: Ana-vation was well received by participating schools and sponsoring corporates. It received high media coverage on TV interviews and print media. Offered corporates CSR opportunities, publically associate with a good cause and offered employees volunteer opportunities, plus chance to mentor and engage with young students. FOCP partnered with Manipal University film students and faculty to produce a short documentary on Ana-vation, to be submitted to the Sharjah Children Film Festival in September, to further highlight awareness.