What can we do to improve the coordination of care for cancer patients?

The delivery of cancer services has become increasingly complex as we move to more personalized diagnostic and treatment approaches and cancer is recognized as a chronic disease. Cancer patients today typically come into contact with multiple health services over long periods. Healthcare reforms in many countries also mean that the various services involved in cancer care are funded by a confusing mix of personal, private insurer, and government sources. It is not surprising then that many patients today tell us their cancer experience is disjointed. Importantly, this lack of coordination of cancer care results in poor outcomes that can range from minor inconvenience at best to potentially life-threatening safety incidents at worst.

Utilising big transit data for transfer coordination

In public transport, seamless coordinated transfer strengthens the quality of service and attracts ridership. The problem of transfer coordination is sophisticated due to (1) the stochasticity of travel time variability, (2) unavailability of passenger transfer plan. However, the proliferation of Big Data technologies provides a tremendous opportunity to solve these problems. This dissertation enhances passenger transfer quality by offline and online transfer coordination. While offline transfer coordination exploits the knowledge of travel time variability to coordinate transfers, online transfer coordination provides simultaneous vehicle arrivals at stops to facilitate transfers by employing the knowledge of passenger behaviours.

Crystal structures of the potassium and rubidium salts of (3,5-dichlorophenoxy)acetic acid: Two isotypic coordination polymers

The two-dimensional coordination polymeric structures of the hydrated potassium and rubidium salts of (3,5-dichlorophenoxy)acetic acid, (3,5-D) namely, poly[mu-aqua-bis[mu3-2-(3,5-dichlorophenoxy)acetato]potassium, [K2(C8H5Cl2O3)2 (H2O)]n (I) and poly[mu-aqua-bis[mu3-2-(3,5-dichlorophenoxy)acetato]dirubidium] [Rb2(C8H5Cl2O3)2 (H2O)]n (II), respectively have been determined and are described. The two compounds are isotypic and the polymer is based on centrosymmetric dinuclear bridged complex units. The irregular six-coordination about the metal centres comprises a bridging water molecule lying on a twofold rotation axis, the phenoxy O-atom donor and and a triple bridging carboxylate O-atom of the oxoacetate side chain of the 3,5-D ligand in a bidentate chelate mode, the second carboxy O-donor, also bridging. The K-O and Rb-O bond-length ranges are 2.7238(15)--2.9459(14) and 2.832(2)--3.050(2) \%A respectively and the K...K and Rb...Rb separations in the dinuclear unit are 4.0214(7) and 4.1289(6) \%A, respectively. Within the two-dimensional layers which lie parallel to (100), the coordinated water molecule forms an O---H...O hydrogen bond to the single bridging carboxylate O atom.

Effects of different instructional constraints on task performance and emergence of coordination in children

The objectives of this study were to determine the impact of different instructional constraints on standing board jump (sbj) performance in children and understand the underlying changes in emergent movement patterns. Two groups of novice participants were provided with either externally or internally focused attentional instructions during an intervention phase. Pre- and post-test sessions were undertaken to determine changes to performance and movement patterns. Thirty-six primary fourth-grade male students were recruited for this study and randomly assigned to either an external, internal focus or control group. Different instructional constraints with either an external focus (image of the achievement) or an internal focus (image of the act) were provided to the participants. Performance scores (jump distances), and data from key kinematic (joint range of motion, ROM) and kinetic variables (jump impulses) were collected. Instructional constraints with an emphasis on an external focus of attention were generally more effective in assisting learners to improve jump distances. Intra-individual analyses highlighted how enhanced jump distances for successful participants may be concomitant with specific changes to kinematic and kinetic variables. Larger joint ROM and adjustment to a comparatively larger horizontal impulse to a vertical impulse were observed for more successful participants at post-test performance. From a constraints-led perspective, the inclusion of instructional constraints encouraging self-adjustments in the control of movements (i.e., image of achievement) had a beneficial effect on individuals performing the standing broad jump task. However, the advantage of using an external focus of attentional instructions could be task- and individual-specific.

Two-dimensional coordination polymeric structures in caesium complexes with ring-substituted phenoxyacetic acids

The two-dimensional polymeric structures of the caesium complexes with the phenoxyacetic acid analogues (4-fluorophenoxy)acetic acid, (3-chloro-2-methylphenoxy)acetic acid and the herbicidally active (2,4-dichlorophen­oxy)acetic acid (2,4-D), namely poly[[5-(4-fluorophenoxy)acetato][4-(4-fluorophenoxy)acetato]dicaesium], [Cs2(C8H6FO3)2]n, (I), poly[aqua[5-(3-chloro-2-methylphenoxy)acetato]caesium], [Cs(C9H8ClO3)(H2O)]n, (II), and poly[[7-(2,4-di­chlorophenoxy)acetato][(2,4-dichlorphenoxy)acetic acid]caesium], [Cs(C8H5Cl2O3)(C8H6Cl2O3)]n, (III), are described. In (I), the Cs+ cations of the two individual irregular coordination polyhedra in the asymmetric unit (one CsO7 and the other CsO8) are linked by bridging carboxylate O-atom donors from the two ligand molecules, both of which are involved in bidentate chelate Ocarboxy,Ophenoxy interactions, while only one has a bidentate carboxylate O,O'-chelate inter­action. Polymeric extension is achieved through a number of carboxylate O-atom bridges, with a minimum CsCs separation of 4.3231 (9) Å, giving layers which lie parallel to (001). In hydrated complex (II), the irregular nine-coordination about the Cs+ cation comprises a single monodentate water molecule, a bidentate Ocarboxy,Ophenoxy chelate interaction and six bridging carboxylate O-atom bonding interactions, giving a CsCs separation of 4.2473 (3) Å. The water mol­ecule forms intralayer hydrogen bonds within the two-dimensional layers, which lie parallel to (100). In complex (III), the irregular centrosymmetric CsO6Cl2 coordination environment comprises two O-atom donors and two ring-substituted Cl-atom donors from two hydrogen bis[(2,4-dichlorophenoxy)acetate] ligand species in a bidentate chelate mode, and four O-atom donors from bridging carboxyl groups. The duplex ligand species lie across crystallographic inversion centres, linked through a short O-HO hydrogen bond involving the single acid H atom. Structure extension gives layers which lie parallel to (001). The present set of structures of Cs salts of phenoxyacetic acids show previously demonstrated trends among the alkali metal salts of simple benzoic acids with no stereochemically favourable interactive substituent groups for formation of two-dimensional coordination polymers.

Interpersonal coordination tendencies supporting the creation/prevention of goal scoring opportunities in futsal

Research on 1vs1 sub-phases in team sports has shown how one player coordinates his/her actions with his/her opponent and the location of a target/goal to attain performance objectives. In this study, we extended this approach to analysis of 5vs5 competitive performance in the team sport of futsal to provide a performance analysis framework that explains how players coordinate their actions to create/prevent opportunities to score goals. For this purpose, we recorded all 10 futsal matches of the 2009 Lusophony Games held in Lisbon. We analysed the displacement trajectories of a shooting attacker and marking defender in plays ending in a goal, a goalkeeper's save, and a defender's interception, at four specific moments during performance: (1) assisting attacker's ball reception; (2) moment of passing; (3) shooter's ball reception, and; (4) shot on goal. Statistical analysis showed that when a goal was scored, the defender's angle to the goal and to the attacker tended to decrease, the attacker was able to move to the same distance to the goal alongside the defender, and the attacker was closer to the defender and moving at the same velocity (at least) as the defender. This study identified emergent patterns of coordination between attackers and defenders under key competitive task constraints, such as the location of the goal, which supported successful performance in futsal.

A multi-hierarchical strategy for on-ramp coordination

Ramp metering (RM) is an access control for motorways, in which a traffic signal is placed at on-ramps to regulate the rate of vehicles entering the motorway and thus to preserve the motorway capacity. In general, RM algorithms fall into two categories by their effective scope: local control and coordinated control. Local control algorithm determines the metering rate based on the traffic condition on adjacent motorway mainline and the on-ramp. Conversely, coordinated RM strategies make use of measurements from the entire motorway network to operate individual ramp signals for optimal performance at the network level. This study proposes a multi-hierarchical strategy for on-ramp coordination. The strategy is structured in two layers. At the higher layer, a centralised, predictive controller plans the coordination control within a long update interval based on the location of high-risk breakdown flow. At the lower layer, reactive controllers determine the metering rates of those ramps involved in the ramp coordination with a short update interval. This strategy is modelled and applied to the northbound model of the Pacific Motorway in a micro-simulation platform (AIMSUN). The simulation results show that the proposed strategy effectively delays the onset of congestion and reduces total congestion with better managed on-ramp queues.

Activities of daily living in children with developmental coordination disorder: Performance, learning, and participation

Background Children with developmental coordination disorder (DCD) face evident motor difficulties in daily functioning. Little is known, however, about their difficulties in specific activities of daily living (ADL). Objective The purposes of this study were: (1) to investigate differences between children with DCD and their peers with typical development for ADL performance, learning, and participation, and (2) to explore the predictive values of these aspects. Design. This was a cross-sectional study. Methods In both a clinical sample of children diagnosed with DCD (n=25 [21 male, 4 female], age range=5-8 years) and a group of peers with typical development (25 matched controls), the children’s parents completed the DCDDaily-Q. Differences in scores between the groups were investigated using t tests for performance and participation and Pearson chi-square analysis for learning. Multiple regression analyses were performed to explore the predictive values of performance, learning, and participation. Results Compared with their peers, children with DCD showed poor performance of ADL and less frequent participation in some ADL. Children with DCD demonstrated heterogeneous patterns of performance (poor in 10%-80% of the items) and learning (delayed in 0%-100% of the items). In the DCD group, delays in learning of ADL were a predictor for poor performance of ADL, and poor performance of ADL was a predictor for less frequent participation in ADL compared with the control group. Limitations A limited number of children with DCD were addressed in this study. Conclusions This study highlights the impact of DCD on children’s daily lives and the need for tailored intervention.

Development and psychometric properties of the DCDDaily: a new test for clinical assessment of capacity in activities of daily living in children with developmental coordination disorder

Objective To develop the DCDDaily, an instrument for objective and standardized clinical assessment of capacity in activities of daily living (ADL) in children with developmental coordination disorder (DCD), and to investigate its usability, reliability, and validity. Subjects Five to eight-year-old children with and without DCD. Main measures The DCDDaily was developed based on thorough review of the literature and extensive expert involvement. To investigate the usability (assessment time and feasibility), reliability (internal consistency and repeatability), and validity (concurrent and discriminant validity) of the DCDDaily, children were assessed with the DCDDaily and the Movement Assessment Battery for Children-2 Test, and their parents filled in the Movement Assessment Battery for Children-2 Checklist and Developmental Coordination Disorder Questionnaire. Results 459 children were assessed (DCD group, n = 55; normative reference group, n = 404). Assessment was possible within 30 minutes and in any clinical setting. For internal consistency, Cronbach’s α = 0.83. Intraclass correlation = 0.87 for test–retest reliability and 0.89 for inter-rater reliability. Concurrent correlations with Movement Assessment Battery for Children-2 Test and questionnaires were ρ = −0.494, 0.239, and −0.284, p < 0.001. Discriminant validity measures showed significantly worse performance in the DCD group than in the control group (mean (SD) score 33 (5.6) versus 26 (4.3), p < 0.001). The area under curve characteristic = 0.872, sensitivity and specificity were 80%. Conclusions The DCDDaily is a valid and reliable instrument for clinical assessment of capacity in ADL, that is feasible for use in clinical practice.

Vendors' perspectives of coordination in the information technology offshore outsourcing industry : An exploratory study from the Philippines

This study investigates how offshore information technology (IT) service providers (vendors) coordinate work with their clients (employers) in order to succeed in the global IT offshore outsourcing industry. We reviewed literature on coordination studies, interviewed offshore service providers in the Philippines, and used thematic analysis to analyse coordination practices from the point of view of these individual vendors in a newly industrialized country. We used Olson and Olson's framework on 'collaboration at a distance' as a lens to structure the results. The study provides an understanding of vendors' individual attitudes towards the coordination of distributed work and draws attention to how differences in power affect the work situation of vendors, and by implication all stakeholders. We offer this insight as a way to enhance existing CSCW frameworks, by imbuing them with the perspective of non-equal relationships. The study found that vendors were generally able to produce outputs that satisfy their clients, however these results were only achieved because individuals were willing to take risks and make sacrifices in their personal lives. The relationship was further characterised by a complex interplay between the client's control of the overall work arrangements and the vendors' ability to establish a level of autonomy in their work practices and their flexible use of coordination tools.