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PubMed1985

Coalition provides hospital-based services for pregnant teens.

After identifying the need to provide programs offering alternatives to abortion in the Buffalo, NY, diocese, the bishop, health care administrators, and social workers began in-service training sessions to inform the community about the need for services and for advertising existing services. The group found that the northern part of the diocese had no accessible services. In 1981, after weeks of meetings, respect life coordinators, hospital administrators, and social service agencies formed Women's Health Services (WHS), an emergency pregnancy hotline based at Kenmore (NY) Mercy Hospital. WHS is cosponsored by four local agencies, three diocesan and one private, who share administrative, managerial, and educational responsibilities. WHS offers free pregnancy testing, hotline counseling, prenatal clinic and residential care, and crisis intervention. The coalition agencies share equally in instructing the volunteer staff, who form the program's foundation. WHS serves as a role model for other dioceses, communities, and health facilities that seek ways to provide a needed health care service.

Adolescent↗
PubMed2001

Domestic violence: level of training, knowledge base and practice among Milwaukee physicians.

BACKGROUND: Domestic violence is a prevalent problem with significant health consequences. Early recognition and appropriate intervention with referral to local domestic violence agencies can be life-saving. Little is known, however, about the current level of training, knowledge base and attitudes of physicians in this area. METHODS: A survey was sent to 1300 physicians practicing in Milwaukee County in the following specialties: Family Practice, Internal Medicine, OB/GYN, Psychiatry. Demographic information was obtained. Questions were designed to explore attitudes towards domestic violence, frequency of encounters with victims or abusers, and knowledge of resources and appropriate intervention. RESULTS: Of the 192 respondents, 74% reported having some training in domestic violence. Thirty percent reported seeing victims in their practice on a daily or weekly basis. Seventy percent feel able to identify a victim of domestic violence. Less than a third of respondents screened at least half of the patients they see for the possibility of abuse. Less than half always refer victims to a hotline or shelter, and less than a quarter of the respondents discuss safety plans with victims. A potentially dangerous response is telling a victim not to go back to an abuser without providing referrals and safety supports. In spite of this, almost a quarter of respondents always tell a victim to not go back to the abuser. Family practitioners and psychiatrists were more likely to discuss abuse with patients than were internists. CONCLUSION: Significant numbers of physicians, in Milwaukee County, practicing certain specialties that potentially have a high rate of contact with domestic violence victims have had insufficient training in domestic violence assessment and intervention. Physicians should be familiar with the domestic violence hotlines and shelters in their communities and need to incorporate screen questions for domestic violence into their regular practice.

Attitude of Health Personnel↗
PubMed2002

Alleviating heat loss associated with modified ultrafiltration.

Modified ultrafiltration (MUF) has been described and utilized for the removal of extracellular water in the immediate postcardiopulmonary bypass (CPB) period. This technique has been associated with improved hematological status and hemodynamic stability post cardiopulmonary bypass. Hypothermia during the MUF period has been described as a complication associated with this technique. Decreased patient temperature may be associated with increased bleeding causing an increase in time to sternal re-approximation, OR time, decreases in cardiac function, peripheral vascular perfusion, and an increase in blood product utilization. These complications may reduce some of the benefits described with the use of MUF. The purpose of this study was to evaluate the use of a heated MUF infusion line to reduce the heat loss associated with this technique in a pediatric population. After obtaining Committee for Protection of Human Subjects exemption, a retrospective review to evaluate the efficiency of the hot MUF infusion line was undertaken. Twenty patients under 10 kg who underwent MUF before the change to a heated infusion line were retrospectively identified and matched to patients undergoing MUF with a heated infusion line with regard to weight, lesion, procedure, surgical staff and technique, and disposable equipment. Groups were evaluated for temperature and hematocrit change during the MUF period, blood loss and transfusion postprotamine in the OR and 24 h, and time to sternal re-approximation postprotamine. Statistical significance was seen between the two groups in temperature (-0.24 +/- 0.72 vs. - 1.58 +/- 0.89 degrees C; p < .0001) with the HotLine group having little change post MUF. Significance was also seen in the last OR temperature recorded (37.0 +/- 1.2 vs. 36.0 +/- 1.0 degrees C; p = .01) with the HotLine group having the higher temperature. There were no significant differences in hematocrit levels at 24 hours, last in the OR, or the change after the MUF period. No significant difference was found in blood transfused postprotamine in the OR, 24-h blood transfused, 24-h chest tube loss, or sternal closure. The study suggests that the use of a heated MUF infusion line safely reduces the heat loss associated with MUF in the immediate post-operative period.

Body Temperature Regulation↗
PubMed2005

Malaria surveillance--United States, 2003.

PROBLEM/CONDITION: Malaria in humans is caused by any of four species of intraerythrocytic protozoa of the genus Plasmodium (i.e., P. falciparum, P. vivax, P. ovale, or P. malariae). These parasites are transmitted by the bite of an infective female Anopheles sp. mosquito. The majority of malaria infections in the United States occur among persons who have traveled to areas with ongoing transmission. In the United States, cases can also occur through exposure to infected blood products, by congenital transmission, or by local mosquitoborne transmission. Malaria surveillance is conducted to identify episodes of local transmission and to guide prevention recommendations for travelers. PERIOD COVERED: This report covers cases with onset of illness in 2003, and summarizes trends over previous years. DESCRIPTION OF SYSTEM: Malaria cases confirmed by blood film are mandated to be reported to local and state health departments by health-care providers or laboratory staff. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS). Data from NMSS serve as the basis for this report. RESULTS: CDC received reports of 1,278 cases of malaria with an onset of symptoms in 2003, including seven fatal cases, among persons in the United States or one of its territories. This number represents a decrease of 4.4% from the 1,337 cases reported for 2002. P. falciparum, P. vivax, P. malariae, and P. ovale were identified in 53.3%, 22.9%, 3.6%, and 2.6% of cases, respectively. Twelve patients (0.9% of total) were infected by two or more species. The infecting species was unreported or undetermined in 212 (16.6%) cases. Compared with 2002, the number of reported malaria cases acquired in Asia (n = 177) and the Americas (n = 147) increased by 3.5% and 4.3% respectively, whereas the number of cases acquired in Africa (n = 840) decreased by 7.0%. Of 762 U.S. civilians who acquired malaria abroad, 132 (17.3%) reported that they had followed a chemoprophylactic drug regimen recommended by CDC for the area to which they had traveled. Ten patients became infected in the United States, including one probable transfusion-related, one in which epidemiologic investigations failed to identify any apparent mode of acquisition, and eight which were introduced cases as a result of local mosquitoborne transmission. Of the seven deaths attributed to malaria, five were caused by P. falciparum, and a species was not identified in the other two. INTERPRETATION: The 4.4% decrease in malaria cases in 2003, compared with 2002, resulted primarily from a decrease in cases acquired in Africa, but this decrease was offset by an increase in the number of cases acquired in the Americas and Asia. This small decrease probably represents year-to-year variation in malaria cases, but also could have resulted from local changes in disease transmission, decreased travel to malaria-endemic regions, or fluctuation in reporting to state and local health departments. In the majority of reported cases, U.S. civilians who acquired infection abroad were not on an appropriate chemoprophylaxis regimen for the country in which they acquired malaria. PUBLIC HEALTH ACTION: Additional information was obtained concerning the seven fatal cases and the 10 infections acquired in the United States. Persons traveling to a malarious area should take one of the recommended chemoprophylaxis regimens appropriate for the region of travel, and travelers should use personal protection measures to prevent mosquito bites. Any person who has been to a malarious area and who subsequently experiences a fever or influenza-like symptoms should seek medical care immediately and report their travel history to the clinician; investigation should include a blood-film test for malaria. Malaria infections can be fatal if not diagnosed and treated promptly. Recommendations concerning malaria prevention can be obtained from CDC by calling the Malaria Hotline at 770-488-7788 or by accessing CDC's Internet site at http://www.cdc.gov/travel. Recommendations concerning diagnosis of malaria and its treatment can be obtained by calling the Malaria Hotline or accessing CDC's Internet site at http://www.cdc.gov/malaria/diagnosis_treatment/treatment.htm.

Humans↗
PubMed2006

Malaria surveillance--United States, 2004.

PROBLEM/CONDITION: Malaria in humans is caused by any of four species of intraerythrocytic protozoa of the genus Plasmodium (i.e., P. falciparum, P. vivax, P. ovale, or P. malariae). These parasites are transmitted by the bite of an infective female Anopheles sp. mosquito. The majority of malaria infections in the United States occur among persons who have traveled to areas with ongoing malaria transmission. In the United States, cases can occur through exposure to infected blood products, congenital transmission, or local mosquitoborne transmission. Malaria surveillance is conducted to identify episodes of local transmission and to guide prevention recommendations for travelers. PERIOD COVERED: This report summarizes cases in persons with onset of illness in 2004 and summarizes trends during previous years. DESCRIPTION OF SYSTEM: Malaria cases confirmed by blood film are mandated to be reported to local and state health departments by health-care providers or laboratory staff. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS). Data from NMSS serve as the basis for this report. RESULTS: CDC received reports of 1,324 cases of malaria, including four fatal cases, with an onset of symptoms in 2004 among persons in the United States or one of its territories. This number represents an increase of 3.6% from the 1,278 cases reported for 2003. P. falciparum, P. vivax, P. malariae, and P. ovale were identified in 49.6%, 23.8%, 3.6%, and 2.0% of cases, respectively. Seventeen patients (1.3% of total) were infected by two or more species. The infecting species was unreported or undetermined in 262 (19.8%) cases. Compared with 2003, the number of reported malaria cases acquired in the Americas (n = 173) increased 17.7%, whereas the number of cases acquired in Asia (n = 172) and Africa (n = 809) decreased 2.8% and 3.7%, respectively. Of 775 U.S. civilians who acquired malaria abroad, only 160 (20.6%) reported that they had followed a chemoprophylactic drug regimen recommended by CDC for the area to which they had traveled. Four patients became infected in the United States; three cases were attributed to congenital transmission and one to laboratory-related mosquitoborne transmission. Four deaths were attributed to malaria, including two caused by P. falciparum, one by P. vivax, and one by a mixed infection with P. falciparum and P. malariae. INTERPRETATION: The 3.6% increase in malaria cases in 2004, compared with 2003, resulted primarily from an increase in the number of cases acquired in the Americas but was offset by a decrease in the number of cases acquired in Africa and Asia. This limited increase might reflect local changes in disease transmission, increased travel to regions in which malaria is endemic, or fluctuations in reporting to state and local health departments. These changes likely reflect expected variation in annual reporting and should not be interpreted as indicating a longer-term trend. In the majority of reported cases, U.S. civilians who acquired infection abroad had not adhered to a chemoprophylaxis regimen that was appropriate for the country in which they acquired malaria. PUBLIC HEALTH ACTIONS: Additional investigations were conducted for the four fatal cases and four infections acquired in the United States. Persons traveling to a malarious area should take one of the recommended chemoprophylaxis regimens appropriate for the region of travel and use personal protection measures to prevent mosquito bites. Any person who has been to a malarious area and who subsequently has a fever or influenza-like symptoms should seek medical care immediately and report their travel history to the clinician; investigation should include a blood-film test for malaria. Malaria infections can be fatal if not diagnosed and treated promptly. Recommendations concerning malaria prevention can be obtained from CDC at http://www.cdc.gov/travel or by calling the Malaria Hotline at telephone 770-488-7788. Recommendations concerning malaria treatment can be obtained at http://www.cdc.gov/malaria/diagnosis_treatment/treatment.htm or by calling the Malaria Hotline.

Adolescent↗
PubMed1982

Economic indicators of mental health service utilization in rural Appalachia.

This exploratory study examined the relative predictive strengths of selected economic factors (welfare cases, banking activity, unemployment, retail sales, motor vehicle sales) for utilization of mental health services (hotline calls, intake at community mental health centers and admissions at mental hospitals) over a 78-month period in rural Appalachia. Monthly data were tested for autocorrelation and adjusted for seasonality and inflation. Regression analyses indicated that (a) economic factors did account for a considerable portion of variance in mental health factors; (b) these factors predicted mental hospital admissions and hotline calls; (c) strengths of these relationships were quite consistent across the areas sampled, but the directions sometimes were different; (d) welfare factors were the best predictors of utilization; (e) Aid to Families with Dependent Children was generally the best single predictor of utilization, especially when mental health factors were lagged by 3 months. A causative model describing the decision-making process involved in the utilization of mental health services was presented.

Appalachian Region↗
PubMed1980

A model for a health career information center.

A model health career information center was developed and evaluated at a university health science center. One part of the information center is a statewide, toll-free health careers hotline which provides information about health careers to high school and college students, parents, counselors, and teachers, especially in small schools and rural areas, which are not usually included in recruiting circuits. Evaluation of the hotline after one year of operation has indicated that it fills a need, is considered useful by callers, and is of a relatively small cost, considering the geographical coverage. The model information system proposed can be implemented in phases with only slight modifications to meet the unique needs of specific health science centers or their geographical location.

Career Choice↗
PubMed2002

Weather and emotional state: a search for associations between weather and calls to telephone counseling services.

Previous research has revealed that an emotional response to weather might be indicated by calls to telephone counseling services. We analyzed call frequency from such "hotlines", each serving communities in a major metropolitan area of the United States (Detroit, Washington DC, Dallas and Seattle). The periods examined were all, or parts of, the years 1997 and 1998. Associations with subjectively derived synoptic weather types for all cities except Seattle, as well as with individual weather elements [cloudiness (sky cover), precipitation, windspeed, and interdiurnal temperature change] for all four cities, were investigated. Analysis of variance and t-tests (significance of means) were applied to test the statistical significance of differences. Although statistically significant results were obtained in scattered instances, the total number was within that expected by chance, and there was little in the way of consistency to these associations. One clear exception was the increased call frequency during destructive (severe) weather, when there is obvious concern about the damage done by it.

Counseling↗
PubMed2005

An evaluation of compliance with practice guidelines on interhospital trauma transfer.

STUDY OBJECTIVES: To prospectively evaluate compliance with current interhospital trauma transfer guidelines in South West Sydney, before and after an implementation programme was instituted. METHODS: A scoring system was developed to assess compliance with the 11 main components of the guideline. Baseline compliance was measured during an initial 3-month period (pre), followed by an implementation programme to alert staff at referring hospitals to the presence of the guidelines. Following this, compliance was again measured over 3 months (post). RESULTS: Twenty-two patients were transferred during the pre-implementation phase and 35 patients during the post-phase. Overall compliance with the guidelines increased from 62 to 67%. Mean pre-hospital compliance rose from 75 to 95%, and referring hospital compliance rose from 59 to 63%. While there was an improvement in compliance with the use of the dedicated trauma hotline (86-97%), the use of a transfer checklist (41-53%), and appropriateness of transfer (95-100%), none of these reached statistical significance. CONCLUSION: Practice guidelines have been developed to optimise the process of interhospital trauma transfers. An implementation programme met with limited success in improving compliance with the guidelines. Further work is needed to ensure awareness of these guidelines, with ongoing monitoring to ensure best practice and optimal patient outcome.

Adult↗
PubMed2004

Evaluation of the Dutch AIDS information helpline: an investigation of information needs and satisfaction of callers.

AIDS telephone hotlines have an important function in AIDS education, HIV prevention and counselling. In this study, consults of the Dutch AIDS information helpline were evaluated to determine the AIDS information needs of the callers and callers' satisfaction with the telephone-delivered information and consultation. Immediately after their telephone consult, callers (N = 309) were redirected to co-workers of an independent telephone survey. They participated in an interview on content and evaluation of the telephone consult. This study shows that most telephone calls concerned questions about personal risk of HIV transmission, HIV transmission in general and HIV testing. Callers were very satisfied with the services of the helpline. Furthermore, helpline employees' counselling and conversation skills were evaluated very positively. These results are discussed within the scope of the professional organization of the Dutch AIDS information helpline.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Caring for the indigent patient: resources to improve care.

Numerous resources can be used to meet the needs of indigent persons with cancer. Most pharmaceutical companies have professional information hotlines and programs to help patients obtain medications when they are unable to pay for them. Most communities provide numerous informational and support services. In order to provide optimal patient care, oncology nurses must be able to make referrals to appropriate community agencies. Programs are also available that provide financial assistance and lodging.

Community Health Services↗
PubMed2004

Implementing a hospitalwide patient safety program for cultural change.

BACKGROUND: After focus groups revealed that staff perceived a punitive culture, Missouri Baptist Medical Center (MBMC) embarked on a comprehensive patient safety program, which was initially directed at creating a just culture of patient safety. INTERVENTIONS: A series of structures, processes, and initiatives were introduced to change the attitudes of management and staff toward human error, to communicate broadly with staff and the community, and to provide feedback on leadership's responses to specific events. All events reported were tracked continuously and recorded each month on a spreadsheet. RESULTS: Total medical events reported by staff increased significantly (p < .001) from 35 to 132 per 1,000 patient days. Reports to the hotline alone increased significantly (p < .001) from 3 to 23 per 1,000 patient days, and the proportion of callers who left their name increased significantly (p < .001) from 30% to 61%. Survey results from staff showed a small but significant increase in awareness of patient safety and in comfort with reporting. CONCLUSION: The implementation of a carefully planned and orchestrated series of interventions designed to improve a hospital's culture of patient safety can, if led by senior hospital executives, lead to a substantial, profound, and lasting increase in error reporting and improvement in employee perceptions of the organization's safety culture.

Adverse Drug Reaction Reporting Systems↗
PubMed1989

Trans-situational consistency in smoking relapse.

This article explores the question of consistency in ex-smokers' experiences of temptation to smoke. Data were collected from 57 ex-smokers who called a relapse-prevention hotline on two occasions. Relapse situations were classified through cluster analysis and were also coded on McKennel's Smoking Motivation factors. Cognitive and behavioral coping efforts were recorded. Only modest trans-situational consistency was observed. The two relapse episodes did not systematically fall into the same cluster. Data suggested that social aspects of relapse situations might be most consistent. Behavioral coping showed modest trans-situational consistency, whereas cognitive coping showed no stability. The implications of these findings for the prospect of individually tailored interventions are discussed.

Adaptation, Psychological↗
PubMed2004

Compliance with poisons center referral advice and implications for toxicovigilance.

BACKGROUND: When Poisons Information, or Poisons Control Centers (PCC) give directive advice in response to general public calls it is usually assumed that the advice will be followed, but it is difficult to measure the actual compliance of callers to a PCC. Epidemiological data regarding the incidence of poisoning incidents (Toxicovigilance) often utilizes reports of calls to a PCC. METHODS: Retrospective review of advice given to all callers to the New Zealand National Poisons Centre (NZNPC) from a defined area for the calendar year 2001. Callers to the NZNPC telephone hotlines who were advised to attend or not to attend the hospital Emergency Department (ED) were subsequently matched with actual ED visits. RESULTS: The compliance rate for those advised to attend the ED was 76.1%, whereas those advised not to attend had a compliance rate of 98.7%. The overall compliance rate was 94.1%. Of the patients presenting to the ED with a potential poisoning, only 10.2% were referred by the PCC. The callers referred by PCC and direct ED visitors appeared to differ in some respects. CONCLUSIONS: Compliance with PCC telephone advice is similar to the compliance rates in many other health interventions. Comparisons between populations calling a PCC and those self-presenting to an ED show that PCC data may not reflect the true burden of poisoning to health care systems.

Adult↗
PubMed1992

Promoting smoking cessation in the United States: effect of public service announcements on the Cancer Information Service telephone line.

BACKGROUND: Although many smokers report making attempts to quit, few seek help or are successful in their attempts. Some of the barriers to seeking help can be overcome by a telephone counseling and information service like that offered by the Cancer Information Service of the National Cancer Institute. This service has been promoted by antismoking public service announcements produced by the Office on Smoking and Health, Centers for Disease Control, Public Health Service, U.S. Department of Health and Human Services. PURPOSE: We determined whether such nationally televised public service announcements were associated with increased use of the Cancer Information Service. We assessed the importance of specifically promoting the telephone line and identified the characteristics of the individuals who responded to such promotion. METHODS: We combined the frequency-of-call data from the Cancer Information Service with the data on the frequency and reach of the television spots. RESULTS: During this 5-year study (1983-1987), the Cancer Information Service received a notably disproportionate number of calls in 3 specific months (August 1983, January 1985, and January 1987). In each case, more than 20% of all calls in that year were received in that month (expected percentage = 8% if the calls had been evenly distributed). These peak periods were associated with the showing of the three public service announcements that mentioned the telephone number of the Cancer Information Service. These promotions were particularly effective in increasing the percentage of callers who were male, who were under the age of 40 years, or who had received a high school education or less. CONCLUSIONS: Television is an effective medium for supporting antismoking goals by motivating more smokers to seek help to quit. IMPLICATIONS: It is important to identify whether the aid offered by the Cancer Information Service hotline is effective in helping the caller to quit. Future work must concentrate on the most effective strategies for using this initial contact to provide aid to prevent relapse, thus maximizing the potential impact of the public service announcement campaigns.

Behavior Therapy↗
PubMed2001

Summary of the practice parameters for the assessment and treatment of children and adolescents with suicidal behavior.

These guidelines review what is known about the epidemiology, causes, management, and prevention of suicide and attempted suicide in young people. Detailed guidelines are provided concerning the assessment and emergency management of the children and adolescents who present with suicidal behavior. The guidelines also present suggestions on how the clinician may interface with the community. Crisis hotlines, method restriction, educational programs, and screening/case-finding suicide prevention strategies are examined, and the clinician is advised on media counseling. Intervention in the community after a suicide, minimization of suicide contagion or imitation, and the training of primary care physicians and other gatekeepers to recognize and refer the potentially suicidal child and adolescent are discussed.

Adolescent↗
PubMed1997

HIV prevention and community-based organizations in Japan.

The first AIDS-related community-based organizations (CBOs) in Japan emerged in the 1980s for persons who contracted HIV through infected blood products. Since then, more than 50 CBOs have been established to reach out to all HIV-infected persons. Most are centered in Tokyo. CBO activities include telephone hotlines, "buddy services," support groups, lobbying efforts, and outreach and prevention activities. Adequate funding continues to be a challenge, although progress has been made in soliciting funds from corporations (often foreign) and, increasingly, from the government. Networking of CBOs has allowed consolidation of funds and efforts, resulting in greater efficiency. Among the tasks that lie ahead for AIDS CBOs are linking family, medical, and social services into a comprehensive care network.

Community Networks↗
PubMed2006

Impact of a media campaign for disaster mental health counseling in post-September 11 New York.

OBJECTIVE: After the September 11, 2001, terrorist attacks on the World Trade Center, the New York State Office of Mental Health (NYOMH) initiated a three-phase multifaceted, multilingual media campaign that advertised the availability of counseling services. This study evaluated the association between patterns of spending within this campaign and the volume of calls received and referred to a counseling program. METHODS: Spending on television, radio, print, and other advertising was examined, as was the corresponding volume of calls to the NetLife hotline seeking referrals to counseling services. RESULTS: From September 2001 to December 2002, $9.38 million was spent on Project Liberty media campaigns. Call volumes increased during months when total monthly expenditures peaked. Initially, flyers, billboards, and other material items accounted for most monthly expenses. Over time, spending for television and radio advertisements increased, whereas other advertising declined. Temporal patterns show that in periods after an increase in media spending, call volumes increased independently of other sentinel events such as the one-year anniversary of the attacks. CONCLUSIONS: Sustained advertising through multiple media outlets appeared to be effective in encouraging individuals to seek mental health services.

Advertising↗