Background The aim of the study was to examine the efficacy of a collaborative care intervention to reduce depression, pain and fatigue and improve quality of life. Participants A total of 261 patients with advanced cancer and 179 family caregivers were randomized to a web-based collaborative care intervention or enhanced usual care. The intervention included (1) a website with written and audiovisual self-management strategies, bulletin board, and other resources; (2) visits with a care coordinator during physician appointment every two months; and (3) telephone follow up every two weeks. Primary patient outcomes included measures of depression, pain, fatigue, and health related quality of life. Secondary outcomes included Interleukin (IL)-1α, IL-1β, IL-6, IL-8, Natural Killer (NK) cell numbers, and caregiver stress and depression. Results At baseline, 51% of patients reported one or more symptoms in the clinical range. For patients who presented with clinical levels of symptoms, and were randomized to the intervention, reductions in depression (Cohen’s d=0.71), pain (Cohen’s d=0.62), and fatigue (Cohen’s d=0.26) and improvements in quality of life (Cohen’s d =0.99) were observed when compared to the enhanced usual care arm at 6-months. Reductions in IL-6 (phi=0.18), IL-1β (phi=0.35); IL-1α (phi=0.19); IL-8 (phi=15) and increases in NK cell numbers (phi=0.23) were observed when compared to enhanced usual care arm at 6-months. Reductions in caregiver stress (Cohen’s d=0.75) and depression (Cohen’s d=0.37) were observed at 6-months for caregivers whose loved one was randomized to the intervention arm. Conclusions Integration of screening and symptom management into cancer care is recommended.

Over the last five years, a range of projects have focused on progressively more elaborated techniques for adaptive news delivery. However, the adaptation process in these systems has become more complicated and thus less transparent to the users. In this paper, we concentrate on the application of open user models in adding transparency and controllability to adaptive news systems. We present a personalized news system, YourNews, which allows users to view and edit their interest profiles, and report a user study on the system. Our results confirm that users prefer transparency and control in their systems, and generate more trust to such systems. However, similar to previous studies, our study demonstrate that this ability to edit user profiles may also harm the system's performance and has to be used with caution.

Personalized Web search has emerged as one of the hottest topics for both the Web industry and academic researchers. However, the majority of studies on personalized search focused on a rather simple type of search, which leaves an important research topicthe personalization in exploratory searches -as an under-studied area. In this paper, we present a study of personalization in taskbased information exploration using a system called TaskSieve. TaskSieve is a Web search system that utilizes a relevance feedback based profile, called a "task model", for personalization. Its innovations include flexible and user controlled integration of queries and task models, task-infused text snippet generation, and on-screen visualization of task models. Through an empirical study using human subjects conducting task-based exploration searches, we demonstrate that TaskSieve pushes significantly more relevant documents to the top of search result lists as compared to a traditional search system. TaskSieve helps users select significantly more accurate information for their tasks, allows the users to do so with higher productivity, and is viewed more favorably by subjects under several usability related characteristics.

Background Collaborative care interventions to treat depression have begun to be tested in settings outside of primary care. However, few studies have expanded the collaborative care model to other settings and targeted comorbid physical symptoms of depression. Purpose The aims of this report were to: (1) describe the design and methods of a trial testing the efficacy of a stepped collaborative care intervention designed to manage cancer-related symptoms and improve overall quality of life in patients diagnosed with hepatobiliary carcinoma; and (2) share the lessons learned during the design, implementation, and evaluation of the trial. Methods The trial was a phase III randomized controlled trial testing the efficacy of a stepped collaborative care intervention to reduce depression, pain, and fatigue in patients diagnosed with advanced cancer. The intervention was compared to an enhanced usual care arm. The primary outcomes included the Center for Epidemiological Studies-Depression scale, Brief Pain Inventory, and Functional Assessment of Cancer Therapy (FACT)-Fatigue, and the FACT-Hepatobiliary. Sociodemographic and disease-specific characteristics were recorded from the medical record; Natural Killer cells and cytokines that are associated with these symptoms and with disease progression were assayed from serum. Results and Discussion The issues addressed include: (1) development of collaborative care in the context of oncology (e.g., timing of the intervention, tailoring of the intervention, ethical issues regarding randomization of patients, and changes in medical treatment over the course of the study); (2) use of a website by chronically ill populations (e.g., design and access to the website, development of the website and intervention, ethical issues associated with website development, website usage, and unanticipated costs associated with website development); (3) evaluation of the efficacy of intervention (e.g., patient preferences, proxy raters, changes in medical treatment, and inclusion of biomarkers as endpoints); and (4) analyses and interpretation of the intervention (e.g., confounding factors, dose and active ingredients, and risks and benefits of collaborative care interventions in chronically ill patients). Limitations The limitations to the study, although not fully realized at this time as the trial is ongoing, include: (1) heterogeneity of the diagnoses and treatments of participants; and (2) inclusion of caregivers as proxy raters but not as participants in the intervention. Conclusions Collaborative care interventions to manage multiple symptoms in a tertiary cancer center are feasible. However, researchers designing and implementing interventions that are web-based, target multiple symptoms, and for oncology patients may benefit from previous experiences.

No abstract