Driving Performance while Engaged in MP-3 Player Interaction: Effects of Practice and Task Difficulty on PRT and Eye Movements

The purpose of this study was to examine the effects of iPod interactions on driver performance over several sessions to determine the distraction effect of iPods on driver performance, as well as to see if performance decrements declined with practice. Nineteen younger drivers (mean age = 19.4, range 18 to 22) participated in a seven-session study in the University of Calgary Driving Simulator. Drivers encountered a number of critical events such as pedestrian incursions, lead vehicle braking, and pullout vehicle events, on the roadways. These events were encountered both while driving alone and when performing iPod tasks of varying difficulty. Participants’ hazard response, frequency of collisions and eye movement measures were examined to determine if there were any changes in performance related to iPod distraction and practice effects. Increases in perception response time (PRT) and frequency of collisions were found during the difficult iPod interactions. The number and duration of glances made into the vehicle increased significantly while performing the difficult iPod interactions, reducing the number of glances made to the roadway. Over the course of the sessions, performance improved significantly in all secondary task conditions, but performance decrements still remained in the difficult iPod condition compared to the baseline

Do In-Vehicle Advance Signs Benefit Older and Younger Driver Intersection Performance?

An experimental study was conducted to determine if intersection behavior of those 18 to 24 and 65+ benefited from advanced in-vehicle signs presented in a head-up display (HUD) format. The University of Calgary Driving Simulator (UCDS) was used to determine whether intersection performance improved in the presence of several advanced signs or whether unwanted adaptive behaviors occurred (e.g., increasing speed to run the light instead of stopping). Invehicle signs facilitated an increase in stopping occurrences for both younger and older drivers at intersections with relatively short yellow onsets. In addition, eye movement analysis revealed significant age effects with regard to vertical and horizontal gaze variablity, with younger drivers showing increases in vertical gaze variability compared to the older drivers. Younger drivers also looked more often and had longer percentage of durations fixating on the HUD compared to the older drivers

Using a Delphi process to determine optimal care for patients with pancreatic cancer

Aim Overall 5-year survival for pancreatic cancer is ~5%. Optimising the care that pancreatic cancer patients receive may be one way of improving outcomes. The objective of this study was to establish components of care which Australian health professionals believe important to optimally manage patients with pancreatic cancer. Methods Using a Delphi process, a multi-disciplinary panel of 250 health professionals were invited to provide a list of factors they considered important for optimal care of pancreatic cancer patients. They were then asked to score and then rescore (from one (no importance/disagree) to 10 (very important/agree) the factors. The mean and coefficient of variation scores were calculated and categorised into three levels of importance. Results Overall 63 (66% of those sent the final questionnaire; 25% of those initially invited) health professionals from 9 disciplines completed the final scoring of 55 statements/factors encompassing themes of presentation/staging, surgery and biliary obstruction, multi-disciplinary team details and oncology. Mean scores ranged from 3.7 to 9.7 with the highest related to communication and patient assessment. There was substantial intra- and inter- disciplinary variation in views about MDT membership and roles. Conclusion Overall the opinions of Australian health professionals reflect international guideline recommended care; however they identified a number of additional factors focusing on where patients should be treated, the importance of clear communication and the need for multi-disciplinary care which were not included in current clinical practice guidelines. Differences in priorities between specialty groups were also identified

Treatment and outcomes of oligometastatic colorectal cancer limited to lymph node metastases

Introduction: The optimal management of isolated distant lymph node metastases (IDLNM) from a colorectal primary, is not clearly established. We aimed to analyze the outcomes of patients with IDLNM treated with systemic therapies plus locoregional therapy with curative intent versus systemic therapies with palliative intent. Materials & Methods: Clinical data were collected and reviewed from the Treatment of Recurrent and Advanced Colorectal Cancer registry, a prospective, comprehensive registry for metastatic colorectal cancer (mCRC) treated at multiple tertiary hospitals across Australia. Clinicopathological characteristics, treatment modalities and survival outcomes were analyzed in patients with IDLNM and compared to patients with disease at other sites. Results: Of 3408 mCRC patients diagnosed 2009 to 2020, with median follow-up of 38.0 months, 93 (2.7%) were found to have IDLNM. Compared to mCRC at other sites, patients with IDLNM were younger (mean age: 62.1 vs. 65.6 years, P = .02), more likely to have metachronous disease (57.0% vs. 38.9%, P < .01), be KRAS wild-type (74.6% vs. 53.9%, P< .01) and BRAF mutant (12.9% vs. 6.2%, P = .01). Amongst mCRC patients with IDLNM, 24 (25.8%) received treatment with curative intent and had a significantly better overall median survival than those treated with palliative intent (73.5 months vs. 23.2 months, P = .01). These 24 patients had an overall median survival similar (62.7 months, P = .82) to patients with isolated liver or lung metastases also treated with curative intent. Conclusion: Curative treatment strategies (radiotherapy or surgery), with or without systemic therapy, should be considered for mCRC patients with IDLNM where appropriate as assessed by the multidisciplinary team