Coordination Demands Research Articles

The Mode of Endurance Exercise Influences Changes in EEG Resting-State Graphs among High-Level Cross-Country Skiers.

Acute bouts of exercise influence the communication and organization of brain networks, with exercise intensity and volume regarded as key moderators. However, differences in coordination demands and limb involvement between exercise modes may also affect the communication and organization of brain networks after exercise and should be considered additionally. This study aimed to investigate the effect of mode on exercise-induced changes in electroencephalogaphy (EEG) resting-state networks comparing running (RUN) and cross-country skating (XC). Fifteen male, highly trained participants were tested for peak oxygen uptake (V̇O 2peak ) during RUN (65.3 mL·min -1 ·kg -1 ) and XC (63.5 mL·min -1 ·kg -1 ) followed by incremental protocols at 50%, 70%, and 90% of speed at V̇O 2peak in both modes on the treadmill. After each exercise bout, 5-min resting-state EEG assessments using 64 channels were performed. Upon graph theory, small world index (SWI), clustering coefficient (CC), and path length (PL) were assessed in theta, alpha-1 and alpha-2 frequency bands. Repeated-measures ANOVA was applied to analyze the influence of exercise intensity and mode on modulations in brain network efficiency. Main effects of mode on SWI ( P = 0.047), CC ( P < 0.001), and PL ( P = 0.031) in the alpha-2 network indicated stronger modulations in network efficiency after XC. Main effects of exercise intensity in the theta network indicated modulated SWI ( P < 0.001), CC ( P < 0.001), and PL ( P = 0.003) after exercise at 90% of V̇O 2peak speed. Physiological outcomes (heart rate, blood lactate concentration, and rating of perceived exertion) were influenced by intensity solely. The present study demonstrates that an acute bout of coordinatively challenging endurance exercise may affect brain networks differently compared with running. Future studies may consider exercise mode as a potential moderator in the acute interaction between exercise and the brain.

Рекрутирование губернаторского корпуса в современной России: эволюция патрональных сетей (2017—2021)

The article presents an attempt to study the structural dynamics of federal-regional political networks in the process of recruiting heads of the regions. The authors focus their attention on the current stage of the evolution of the federal center’s approach towards the formation of the governor’s corps, which began with the change of the team in the presidential administration in the second half of 2016. The theoretical framework of the study is the concepts of patron-client relations and patronal politics. For the empirical testing, the authors employ the apparatus of the Social Network Analysis (SNA), which makes it possible to assess both the political elite itself and the specific influence of individual figures. The conducted research documents a distinct tendency towards the growing structural complexity of the federal-regional patronal network, when an increasing number of federal actors are directly or indirectly involved in the process of recruiting regional leaders, which entails the formation of new intra-elite connections. However, despite the intensive personnel rotation, the tectonic shifts in the structure of patronage are not visible. The backbone of the network remains unchanged and contains on the stable basis a part of the federal political and economic elite, who looks to the leader of the state and enjoys his support. At the same time, the process of the growing complexity of the patronal network is accompanied by an increase in the importance of the President of the Russian Federation, primarily from the point of view of intra-network coordination, which, according to the authors, indicates a rising demand for such coordination in the modern Russia.

DC Mental Health Access in Pediatrics: Evaluating a Child Psychiatry Access Program in Washington, DC

Child psychiatry access programs (CPAPs) provide primary care providers (PCPs) with assistance in mental health diagnosis, management, and resource navigation. Data collected from DC Mental Health Access in Pediatrics (MAP) included PCPs and patient demographics, clinical encounter information, and provider satisfaction. DC MAP consult volume increased 349.3% over the first 5 years. Services requested included care coordination (85.8%), psychiatric consultation (21.4%), and psychology/social work consultation (9.9%). Of psychiatry-involved consultations, PCPs managed patient medication care with DC MAP support 50.5% of the time. Most (94.1%) PCPs said they would recommend colleagues use DC MAP, and 29.6% reported diverting patients from the emergency departments using DC MAP. DC MAP grew quickly, highlighting program impact and need. Demand for care coordination required flexible staffing and highlighted the need for coordination in pediatrics. Child psychiatry access programs offer an innovative way to enhance PCP management of their patients' mental health needs.

The gendering of energy household labour

Gender considerations, such as the division of household labour and the coordination of everyday household practices, are important for the energy transition of households. Household labour involves everyday practices (e.g. cooking, laundry and caring for others) and practices of energy household labour (<em>e.g</em>. managing digital technologies and energy systems). Emerging smart energy technologies require energy flexibility and efficiency, thereby introducing new forms of household labour can have implications for the household which are not well understood. Through a literature review and some empirical insights from a European Horizon 2020 project, mental aspects of energy household labour are identified: practices of coordination and multitasking, remembering and anticipating, and powerful emotional labour which shapes the practices. Smart technologies and energy systems add more physical and mental labour to households due to the need for additional coordination and change of practices. This additional demand for coordination can exacerbate existing gender inequalities in the division of household labour: technological strategies and designs need to engage with this and reduce new burdens. Considerations for future research are proposed and a gender-sensitive framework for understanding the transition of energy household labour is outlined. <em><strong>Practice relevance</strong></em> Despite the balancing of more stereotypical gender roles in everyday life at home, the mental load of household labour still overburdens women. Technology design and strategies for its domestication need to recognise this load and adopt more gender-sensitive ways of supporting the mental aspects of household labour performed for the organisation of home and provide appropriate digital literacy opportunities for those who use them, without undermining their contribution in the process. Technology-assisted support for the mental aspects of household labour should allow for better negotiations and distribution of household labour required for a successful energy transition, without at the same time adding extra work for both men and women. The initial empirical insights call for a gender-sensitive framework for investigating the emerging practices that this involves, for the energy transition of households.

The Role of Clean Hydrogen Value Chain in a Successful Energy Transition of Japan

The clean hydrogen in the prioritized value chain platform could provide energy incentives and reduce environmental impacts. In the current study, strengths, weaknesses, opportunities, and threats (SWOT) analysis has been successfully applied to the clean hydrogen value chain in different sectors to determine Japan’s clean hydrogen value chain’s strengths, weaknesses, opportunities, and threats as a case study. Japan was chosen as a case study since we believe that it is the only pioneer country in that chain with a national strategy, investments, and current projects, which make it unique in this way. The analyses include evaluations of clean energy development, power supply chains, regional energy planning, and renewable energy development, including the internal and external elements that may influence the growth of the hydrogen economy in Japan. The ability of Japan to produce and use large quantities of clean hydrogen at a price that is competitive with fossil fuels is critical to the country’s future success. The implementation of an efficient carbon tax and carbon pricing is also necessary for cost parity. There will be an increasing demand for global policy coordination and inter-industry cooperation. The results obtained from this research will be a suitable model for other countries to be aware of the strengths, weaknesses, opportunities, and threats in this field in order to make proper decisions according to their infrastructures, potentials, economies, and socio-political states in that field.

Acute effects of a motor coordination intervention on executive functions in kindergartners: a proof-of-concept randomized controlled trial

BackgroundExecutive functions are pivotal for future academic and social functioning. Causal effects of physical activity on executive functions have been shown in adults. The primary objective of this study was to test the proof-of-concept (i.e., feasibility of implementation and acceptance) of a motor coordination intervention and a sedentary control condition in kindergartners and its preliminary effectiveness on subsequent executive function performance.MethodsThe study used a two-group post-test only design. All children aged between 4 and 7 years old were eligible. One hundred and three children (46% girls; age: M = 5.71 years, 95% CI = 5.50 to 5.92) recruited in a middle-sized town in Germany were randomly assigned to a 20-min motor coordination intervention (n = 51) or a sedentary control condition (n = 52), both of which were conducted in a one-on-one experimenter-child setting in the university or kindergarten. A second blinded-to-condition experimenter assessed the executive function outcomes directly following the conditions. Proof-of-concept criteria were the implementation of the intervention with a moderate-to-vigorous physical activity level assessed via heart rate sensors, and with motor coordination demands, analyzed via video recordings; children’s acceptance via self-reported enjoyment of the conditions; and the post-assessments of executive functions with a behavioral and computerized task.ResultsThe motor coordination intervention and the control condition were feasible in a one-on-one setting with kindergartners. The intervention revealed heart rate increases and challenging motor coordination tasks. Children in both conditions indicated they enjoy them. Performance in the two executive function tasks did not differ between children in the motor coordination intervention and the control condition.ConclusionsA one-on-one experimenter-child setting was feasible to deliver in kindergartners. Future intervention studies should consider pre-testing of executive functions and take into account children’s characteristics as potential moderators, such as motor coordination skills.

A Continuous Dispatch Decision Model for Sustainable IT Service Assignments

Information technology (IT) services are indispensable in the enterprises' sustainability program nowadays. For the outsourcing of IT services, many companies use the contract service model and set up a project to implement timely IT requests which constantly arrive at different IT sites. The demand for outsourced IT services and related workforce coordination is a permanent decisional process, yet existing studies mainly focus on the one-time assignment or the centralized service model. Hence, this paper bases on the multi-period and multi-service allocation requirement to develop a sustainable assignment model. The model handles continuous service requests and decentralized worker assignments to optimize overall costs under the fixed-price contract type of IT service. A real industrial service case is reported to illustrate the model. A comparative review with related works is also provided to discuss the contributions of the model and to outline its future research and development.

Correlations Between Physical Activity Level, Quality of Life, and Cognitive Performance in Elderly Individuals Engaging in Multi-Year Dance Activities.

It is well-acknowledged that cognitive and physical decline associated with aging can be prevented or reduced with the engagement in regular physical activity (PA). Dance activities combine cardiovascular, cognitive, and coordinative demands, providing a popular leisure PA among elderly. This study examined the correlations between quality of life (QoL), cognitive and physical performance, and PA level in older adults who participated in at least 10 years of amateur ballroom dancing. <br/>Methods: The study was designed as an observational study. A sample of 20 (10 men; age range: 65 to 80 years; BMI: 26.3 ± 3.0 kg/m²) amateur senior dancers were compared with a sample of 18 (8 men; age range: 65 to 75 years; BMI: 25.5 ± 2.4 kg/m²) non-sedentary individuals (control group) following an adapted PA program. Quality of life and cognitive functioning assessment tools were administered: 36 Health Status Survey (SF-36v2), Montreal Cognitive Assessment (MoCA), and Cognitive Reserve Index questionnaire (CRIq). Physical performance was measured with their preferred walking speed (PWS), and level of moderate to vigorous physical activity (MVPA) was evaluated using a multi-sensor activity monitor. <br/>Results: Participants presented a good SF-36v2 physical component and a very good mental com- ponent summary, a total MoCA score within the limits, and an average total CRIq score. Their PWS and daily MVPA were high. Differences neither in the three questionnaires nor in PWS and PA level were observed between groups. A significant, moderate, and positive correlation was found between PWS and SF-36v2 physical component summary score. <br/>Conclusion: Ballroom dancing seems to allow elderly individuals to maintain good cognitive and physical abilities, QoL, an acceptable normal cognitive reserve, notable physical performance, and PA level to the same extent as an adapted PA program. Both types of PA seem to be able to contrast the mental and physical decline associated with aging.

Exercise types and working memory components during development.

Working memory is crucial to learning and academic success. Exercise has been found to benefit working memory in late life, but its effects during cognitive development are less clear. Building on findings that working memory is supported by the motor system, we highlight the sensitivity of different working memory components to acute and long-term exercise in children and adolescents. We also consider how the specific skill demands of endurance and coordinative exercise influence this sensitivity. Distinct effects of these exercise types are further linked with neurocognitive and neuroendocrine pathways. Our review suggests long-term rather than acute benefits of exercise for children and adolescents' working memory, which are more pronounced and specific for exercise with high coordinative demands.

Anticipating VA/non-VA care coordination demand for Veterans at high risk for hospitalization.

U.S. Veterans Affairs (VA) patients’ multi-system use can create challenges for VA clinicians who are responsible for coordinating Veterans’ use of non-VA care, including VA-purchased care (“Community Care”) and Medicare.To examine the relationship between drive distance and time—key eligibility criteria for Community Care—and VA reliance (proportion of care received in VA versus Medicare and Community Care) among Veterans at high risk for hospitalization. We used prepolicy data to anticipate the impact of the 2014 Choice Act and 2018 Maintaining Internal Systems and Strengthening Integrated Outside Networks Act (MISSION Act), which expanded access to Community Care.Cross-sectional analysis using fractional logistic regressions to examine the relationship between a Veteran's reliance on VA for outpatient primary, mental health, and other specialty care and their drive distance/time to a VA facility.Thirteen thousand seven hundred three Veterans over the age of 65 years enrolled in VA and fee-for-service Medicare in federal fiscal year 2014 who were in the top 10th percentile for hospitalization risk.Key explanatory variables were patients’ drive distance to VA > 40 miles (Choice Act criteria) and drive time to VA ≥ 30 minutes for primary and mental health care and ≥60 minutes for specialty care (MISSION Act criteria).Veterans at high risk for hospitalization with drive distance eligibility had increased odds of an outpatient specialty care visit taking place in VA when compared to Veterans who did not meet Choice Act eligibility criteria (odds ratio = 1.10, 95% confidence interval 1.05–1.15). However, drive time eligibility (MISSION Act criteria) was associated with significantly lower odds of an outpatient specialty care visit taking place in VA (odds ratio = 0.69, 95% confidence interval 0.67, 0.71). Neither drive distance nor drive time were associated with reliance for outpatient primary care or mental health care.VA patients who are at high risk for hospitalization may continue to rely on VA for outpatient primary care and mental health care despite access to outside services, but may increase use of outpatient specialty care in the community in the MISSION era, increasing demand for multi-system care coordination.

Veteran families with complex needs: a qualitative study of the veterans\u2019 support system

BackgroundFamilies with complex needs face significant challenges accessing and navigating health and social services. For veteran families, these challenges are exacerbated by interactions between military and civilian systems of care, and the density of the veterans’ non-profit sector. This qualitative study was designed to gather rich, detailed information on complex needs in veteran families; and explore service providers’ and families’ experiences of accessing and navigating the veterans’ support system.MethodsThe study comprised participant background questionnaires (n = 34), focus groups with frontline service providers (n = 18), and one-on-one interviews with veteran families (n = 16) in Australia. The semi-structured focus groups and interviews were designed to gather rich, detailed information on four study topics: (i) health and wellbeing needs in veteran families; (ii) service-access barriers and facilitators; (iii) unmet needs and gaps in service provision; and (iv) practical solutions for improving service delivery. The study recruited participants who could best address the focus on veteran families with complex needs. The questionnaire data was used to describe relevant characteristics of the participant sample. The focus groups and interviews were audio-recorded, transcribed, and a reflexive thematic analysis was conducted to identify patterns of shared meaning in the qualitative data.ResultsBoth service providers and families found the veterans’ support system difficult to access and navigate. System fragmentation was perceived to impede care coordination, and delay access to holistic care for veteran families with complex needs. The medico-legal aspects of compensation and rehabilitation processes were perceived to harm veteran identity, and undermine health and wellbeing outcomes. Recovery-oriented practice was viewed as a way to promote veteran independence and self-management. Participants expressed a strong preference for family-centred care that was informed by an understanding of military lifestyle and culture.ConclusionThe health and wellbeing needs of veteran families intensify during the transition from full-time military service to civilian environments, and service- or reintegration-related difficulties may emerge (or persist) for a significant period of time thereafter. Veteran families with complex needs are unduly burdened by care coordination demands. There is a pressing need for high-quality implementation studies that evaluate initiatives for integrating fragmented systems of care.

HuSync - A Model and System for the Measure of Synchronization in Small Groups: A Case Study on Musical Joint Action

Human communication entails subtle non-verbal modes of expression, which can be analyzed quantitatively using computational approaches and thus support human sciences. In this paper we present huSync, a computational framework and system that utilizes trajectory information extracted using pose estimation algorithms from video sequences to quantify synchronization between individuals in small groups. The system is exploited to study interpersonal coordination in musical ensembles. Musicians communicate with each other through sounds and gestures, providing nonverbal cues that regulate interpersonal coordination. huSync was applied to recordings of concert performances by a professional instrumental ensemble playing two musical pieces. We examined effects of different aspects of musical structure (texture and phrase position) on interpersonal synchronization, which was quantified by computing phase locking values of head motion for all possible within-group pairs. Results indicate that interpersonal coupling was stronger for polyphonic textures (ambiguous leadership) than homophonic textures (clear melodic leader), and this difference was greater in early portions of phrases than endings (where coordination demands are highest). Results were cross-validated against an analysis of audio features, showing links between phase locking values and event density. This research produced a system, huSync, that can quantify synchronization in small groups and is sensitive to dynamic modulations of interpersonal coupling related to ambiguity in leadership and coordination demands, in standard video recordings of naturalistic human group interaction. huSync enabled a better understanding of the relationship between interpersonal coupling and musical structure, thus enhancing collaborations between human and computer scientists.

Глобальні фінансові цикли і проблема регулювання міжнародних потоків капіталу: роль банків і макропруденційної політики у протидії кризам

The aggravation of crisis processes in the global financial system produces a request to find tools to eliminate the systemic risk of global instability, which arises primarily through the interaction between the global financial cycle, key global factors (global risk and monetary policy in major economies) and cross-border banking activities. The situation in the monetary and financial spheres of countries with large open economies has a powerful impact on the economic situation, exacerbating the asymmetries of interaction on a global scale, which actualizes the need for macroprudential authorities in countries with small open economies to take preventive measures to maintain internal balance from destructive crisis processes in key economies of the world. The article provides a comprehensive analysis of approaches to substantiating the channels of mutual influence of the internal financial cycle, the global financial cycle and macroprudential policy, and also assesses the potential of macroprudential policy in smoothing out procyclical processes in order to stimulate economic growth. The interdependence of global banks on the dynamics of the global financial cycle and vice versa is determined, because global banks determine the specifics of the manifestations of the latter, given the way they manage their liquidity on a global scale, thereby contributing to the international transmission of shocks. It is found that the existence of a domestic capital market for global banks exacerbates the international spread of domestic liquidity shocks due to the strategic complementarity effect arising from strategic interactions between banks, other financial institutions and agents, which can increase systemic vulnerabilities during booms and busts due to increased competition between banks. It was revealed that the impact of the global financial cycle on the internal financial environment of banks and financial institutions through the mechanisms of external obligations of national banks and the determination of the cost of financing affects the availability of loans for companies and households. This means that the economies of small open economies are more vulnerable to external shocks and are affected by financing conditions determined in the world's financial centers. Under these conditions, the dynamics of global liquidity limits the effectiveness of national monetary policy, and therefore the demand for effective international coordination of macroprudential policy becomes even more urgent. The need to revise monetary policy in order to increase its ability to mitigate the risks of financial instability depends on: (1) the effectiveness of macroprudential policy (for example, the ability to manage the financial cycle); (2) the contribution of monetary policy (including its traditional and non-traditional instruments) to the exacerbation of financial instability; (3) the degree of independence of monetary policy, especially during a crisis.

Analysis on the Demand and Countermeasures of Air Ground Coordination in China’s Aviation Medical Rescue

Compared with ground first aid, aviation medical rescue has better advantages in mountain disaster relief, remote transfer and rapid medical rescue response, which is an effective supplement to ground medical first aid. China’s aviation medical rescue is in its infancy, compared with the level of developed countries there is a big gap. Based on the development and characteristics of aviation medical rescue in China, this paper combs the process of air-ground cooperative rescue, analyzes the demand and current situation of air-ground cooperative rescue in aviation medical rescue in China, and puts forward some countermeasures to improve the ability of aviation medical rescue in China.

Abstract PO-072: Care coordination for older cancer patients with multi-morbidities: Implications for addressing cancer health disparities

Abstract Purpose: Newly diagnosed cancer patients with multi-morbidities require a clinical care team of higher complexity due to greater care coordination demands to simultaneously coordinate cancer care and chronic disease management. Whereas teams of lower complexity may streamline care needs by using one clinician or discipline type to manage all care needs. However, this requires clinicians to understand that they are assuming other clinical roles and responsibilities or else care needs go unmanaged leading to poor health outcomes. Given that chronic disease management drops off following the cancer diagnosis, we examined whether cancer patients identifying as non-Hispanic Black, with dual Medicaid coverage, more chronic diseases, and later cancer stage were more likely to have a clinical care team of higher complexity in the 4-months post cancer diagnosis. Methods: Surveillance, Epidemiology and End Results (SEER)-Medicare data were used to identify patients with invasive breast, colorectal, or non-small cell lung cancer with a co-diagnosis of cardiopulmonary disease or diabetes (n=85,876). The data were linked with American Medical Association files to identify clinician's discipline (e.g., oncology, primary care, cardiology) from encounter claims. Using Zaccaro's classification of multi-team systems, we categorized the degree of complexity of the clinical care team: lower (1-2 disciplines and 1-3 clinicians) versus higher (2+ disciplines and 4+ clinicians). We used multivariable logistic regression to examine patient factors associated with having a clinical care team of higher complexity (compared with lower). Results: Among older cancer patients with multi-morbidities, the most common clinical care team composition was oncology with primary care (37%) followed by oncology, primary care, and medical subspecialty (34%). In the adjusted model, cancer patients were less likely to have a clinical care team of higher complexity if they were non-Hispanic Black compared to non-Hispanic White (OR: 0.88; 95% CI: 0.83, 0.93), dual Medicaid-Medicare covered compared with Medicare only (OR: 0.63; 95% CI: 0.61, 0.65), and diagnosed with stage III cancer compared to stage I (OR: 0.87; 95% CI: 0.84, 0.90). Cancer patients were more likely to have a clinical care team of higher complexity if they had cardiopulmonary disease (OR: 1.74; 95% CI: 1.68, 1.81) or diabetes (OR: 1.69; 95% CI: 1.63,1.75) compared with hypertension only. Conclusion: Clinical care teams of lower complexity were associated with identifying as Black, Medicaid coverage, and later stage, which are known factors associated with poorer care outcomes. This warrants further investigation to examine whether clinicians are assuming other clinicians' roles and responsibilities for patient care or if cancer care is taking precedence over other chronic diseases. Future research to address cancer care disparities need to focus on clinical care teams and the healthcare organizational context that provide and optimize care coordination for newly diagnosed cancer patients with multi-morbidities. Citation Format: Michelle Doose, Dana Verhoeven, Janeth I. Sanchez, Veronica Chollette, Sallie J. Weaver. Care coordination for older cancer patients with multi-morbidities: Implications for addressing cancer health disparities [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-072.

Abstract IA-36: Fragmentation of care among Black women who have breast cancer and multiple comorbidities

Abstract Purpose: Black women newly diagnosed with breast cancer and who have multiple comorbidities at the time of cancer diagnosis require greater care coordination to simultaneously manage cancer care and other chronic conditions. Care coordination may be complicated when multiple clinicians from diverse disciplines are involved in managing care and are located in different health systems, defined as care fragmentation. Given that Black women are disproportionately burdened by comorbidities and breast cancer, we examined the degree of care fragmentation and care coordination experienced by this group from a health system and care team perspective using two population-based cohorts. Methods: We analyzed data from two separate cohorts of Black women diagnosed with breast cancer who had diabetes and/or cardiovascular disease. In the first study we used the Women's Circle of Health Follow-Up Study (n=228) to examine types of practice setting for first primary care visit and primary breast surgery, and, through medical chart abstraction, identified whether care visit was within or outside the same health system. In a separate study, we identified women from the SEER-Medicare database (n=3,420) diagnosed with breast cancer and used encounter claims to examine the complexity and composition of the clinical care team. Results: Care fragmentation was experienced by 79% of Black women in the Women's Circle of Health Follow-Up Study, and individual-level factors (age, health insurance, cancer stage, and comorbidity count) were not associated with care fragmentation (p&amp;gt;.05). In the SEER-Medicare cohort, the most common clinical care team composition was oncology with primary care (45%) followed by oncology, primary care, and medical subspecialty (26%). In the adjusted model, Black women were more likely to have a clinical care team of higher complexity if they had cardiopulmonary disease (OR: 1.74; 95% CI: 1.68, 1.81) or diabetes (OR: 1.69; 95% CI: 1.63,1.75) compared with hypertension only. Women were also less likely to have a complex care team if they were dual Medicaid-Medicare covered (OR: 0.56; 95% CI: 0.48, 0.65) compared with Medicare only, rural residents (OR: 0.54; 95% CI: 0.42, 0.65) compared with urban, or diagnosed with stage III cancer (OR: 0.59; 95% CI: 0.47, 0.75) compared with stage I. Conclusion: The majority of Black breast cancer survivors with comorbidities see multiple clinicians from diverse disciplines and in different health systems, illustrating high care coordination demands and care fragmentation. However, the impact of the health system and care team on care outcomes still need to be assessed, and this includes care transitions into survivorship. To address cancer care disparities experienced by Black women, future research should consider examining clinician's perspectives regarding roles and responsibilities for chronic disease management and cancer care, as well as address care fragmentation across diverse healthcare delivery settings. Citation Format: Michelle Doose, Janeth I. Sanchez, Dana Verhoeven, Veronica Chollette, Joel C. Cantor, Jesse J Plascak, Michael Steinberg, Chi-Chen Hong, Kitaw Demissie, Elisa Bandera, Jennifer Tsui, Sallie J. Weaver. Fragmentation of care among Black women who have breast cancer and multiple comorbidities [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr IA-36.

Association between alcohol consumption, marijuana use and road traffic injuries among commercial motorcycle riders: A population-based, case-control study in Dares Salaam, Tanzania

BackgroundAlcohol consumption and psychoactive drug use are well-recognised risk factors for road traffic injuries (RTIs). Both types of use may impair and affect drivers' performance. Yet, there is limited literature on their contribution to RTIs among commercial motorcycle riders, particularly in low- and middle-income settings. This study aimed to determine the association between alcohol consumption, marijuana use and RTIs among commercial motorcycle riders in the city of Dar es Salaam, Tanzania. MethodsWe conducted a case-control study between July 2018 and March 2019. Cases (n = 164) were commercial motorcycle riders who had sustained an RTIs and attended at a hospital. Controls (n = 400) were commercial motorcycle riders who had not experienced an RTIs that led to hospital attendance during the past six months. Alcohol consumption was assessed using the Alcohol Use Disorder Identification (AUDIT) score, which classified participants as a non-drinker, normal drinker(1–7 scores) and risky drinker (scores ≥ 8). Marijuana use was assessed through self-reported use in the past year. We estimated odds ratios (ORs) using logistic regression adjusted for sociodemographic, driver-, and work-related factors. ResultsRisky drinking was associated with close to six times the odds of RTIs compared to non-drinkers (OR = 5.98, 95% CI: 3.25 – 11.0). The association remained significant even after adjusting for sociodemographic, driving and work-related factors (OR = 2.41, 95% CI: 1.01 – 5.76). The crude odds ratios of RTIs were significantly higher among users of marijuana than non-users (OR = 2.33, 95% CI: 1.38 – 3.95). However, the association did not remain statistically significant after adjusting for confounders (OR = 1.11, 95% CI = 0.49–2.48). ConclusionOur findings confirm increased odds of RTIs among commercial motorcycle riders with risky drinking behaviour even after taking sociodemographic, driving and work-related factors into account. Unlike alcohol consumption the relationship between marijuana use and RTIs among commercial motorcycle riders was unclear. Since motorcycle riders are more susceptible to the effect of alcohol due to higher demands of balance and coordination and because commercial motorcyclist riders, in particular, they spend a considerable amount of time on the road, our results underscore the importance of addressing hazardous alcohol consumption and marijuana use in future prevention strategies to enhance road safety.

Core Competencies for Interprofessional Collaborative Practice Among Teacher Education, Health and Social Care Students in a Large Scaled Blended Learning Course.

IntroductionSociety’s demands for better coordination of services for children are increasing. Interprofessional learning (IPL) has been suggested to achieve the triple aim of better services, better outcomes and reduced costs. The aims were to assess 1) to what extent students taking teacher education, health and social care programmes agreed that blended learning was a suitable approach in a mandatory IPL course, 2) to what extent they had learnt about the WHO’s core IPL competencies (roles and responsibilities, values and ethics, interprofessional communication, and teams and teamwork), and 3) the students’ ranking of the learning outcomes from different components of the IPL course.MethodsThis was a quantitative cross-sectional study. Students completed an online course evaluation after a two-day combination of online and face-to-face IPL small-group training.FindingsThe response rate was 25.8% (n=363). Among the students, 60.6% strongly agreed that blended learning was suitable, while 8.9% strongly disagreed. Among the respondents, 46.8%, 50.2%, 56.8% and 62.3% gained increased insight into roles and responsibilities, values and ethics, interprofessional communication, and teams and teamwork, respectively. In ascending order, students were most satisfied with the learning outcomes from the supervision (16.0%), the syllabus (28.6%), the submission assignment (42.4%), the digital learning content of Canvas (43.8%), the combination of everything (43.8%), and the IPL group discussions (78.6%). In stratified analyses, ‘teacher education and child welfare students’ were significantly more likely to gain better insight into the WHO competencies than “health and social care students”, and they were also more overall satisfied.ConclusionStudents agreed that blended learning was a suitable approach, although the learning outcomes from the face-to-face discussions were markedly higher than from other course components. While the majority had learnt something about the WHO competencies, the teacher and child welfare students achieved the best learning outcomes, including new knowledge about the WHO competencies.

Primary intraocular lens implantation can be applied in infants over 7 months of age and young children with adequate consideration

In recent years, intraocular lenses (IOLs) have been increasingly used in the correction of aphakia after congenital cataract extraction. But IOL implantation in infants and young children, especially under 1 year old, is still controversy. Large-scale, multi-center, randomly controlled clinical observations on this issue have been conducted. The mid-and long-term results have shown that infantile cataract extraction combined with primary IOL implantation can achieve the same or better visual outcome as aphakic contact lens correction. For infants over 7 months of age and young children, primary implantation of IOLs is relatively safe, with a low complication and secondary operation rate. Compared to the way of aphakic contact lens correction, which could be with more inconvenience, high demand of coordination, a higher infection risk, high cost and the need of a secondary IOL implantation surgery, primary implantation of IOLs at over 7 months of age is worth exploring, with appropriate understanding of the surgical indications and adequate surgical techniques. (Chin J Ophthalmol, 2021, 57: 487-491).

NEURAL ACTIVITY PROFILES ASSOCIATED WITH ACL INJURY-RISK MECHANICS IN ECOLOGICAL SPORT SPECIFIC VIRTUAL REALITY

Background:Anterior cruciate ligament (ACL) injury is secondary to a multifactorial etiology encompassing anatomical, biological, mechanical, and neurological factors. The nature of the injury being primarily due to non-contact mechanics further implicates neural control as a key injury-risk factor, though it has received considerably less study.Purpose:To determine the contribution of neural activity to injury-risk mechanics in ecological sport-specific VR landing scenarios.Methods:Ten female high-school soccer players (15.5±0.85 years; 165.0±6.09 cm; 59.1±11.84 kg) completed a neuroimaging session to capture neural activity during a bilateral leg press and a 3D biomechanics session performing a header within a VR soccer scenario. The bilateral leg press involved four 30 s blocks of repeated bilateral leg presses paced to a metronome beat of 1.2 Hz with 30 s rest between blocks. The VR soccer scenario simulated a corner-kick, requiring the participant to jump and head a virtual soccer ball into a virtual goal (Figure 1A-E). Initial contact and peak knee flexion and abduction angles were extracted during the landing from the header as injury-risk variables of interest and were correlated with neural activity.Results:Evidenced in Table 1 and Figure 1 (bottom row), increased initial contact abduction, increased peak abduction, and decreased peak flexion were associated with increased sensory, visual-spatial, and cerebellar activity (r2= 0.42-0.57, p corrected < .05, z max > 3.1, table & figure 1). Decreased initial contact flexion was associated with increased frontal cortex activity (r2= 0.68, p corrected < .05, z max > 3.1).Conclusion:Reduced neural efficiency (increased activation) of key regions that integrate proprioceptive, visual-spatial, and neurocognitive activity for motor control may influence injury-risk mechanics in sport. The regions found to increase in activity in relation to higher injury-risk mechanics are typically activated to assist with spatial navigation, environmental interaction, and precise motor control. The requirement for athletes to increase their activity for more basic knee motor control may result in fewer neural resources available to maintain knee joint alignment, allocate environmental attention, and handle increased motor coordination demands. These data indicate that strategies to enhance efficiency of visual-spatial and cognitive-motor control during high demand sporting activities is warranted to improve ACL injury-risk reduction.Figure 1The virtual reality soccer landing scenario (A, C, E: first person perspective in virtual reality; B, D: articipant wearing the virtual reality headset from an external perspective) and neural activity associated with abduction mechanics (bottom‐left) and flexion mechanics (bottom‐right)