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Telephone Call (telephone + call)
Selected AbstractsVolume and Nature of Telephone Calls in a Specialty Headache PracticeHEADACHE, Issue 9 2002Elizabeth Loder MD Background.,No information exists regarding the contribution of patient-related telephone calls to the burden of headache practice. Objective.,To identify the nature and volume of patient-related telephone calls to a specialty headache practice over a 1-month period. Design and Methods.,The characteristics of all patient-related calls to a single headache practitioner occurring during July 2001 were documented. Information was obtained on the caller, reason for call, length of call, timing and day of call, stated importance of call, patient's principal headache diagnosis, and principal comorbid psychiatric disorder, if any. Results.,One hundred sixty-five outpatient headache-related calls were received in July 2001, 3.17 for every hour of headache clinic scheduled. A total of 65% of all calls was generated by just 36% of callers. Of the 32 patients who placed more than one call during the study period, 50% had chronic daily headache, 53% had a personality disorder, and 38% had both. Twenty-seven percent of all calls were placed by someone other than the patient, 58% involved requests for medication refills, and 17% reported a new symptom or medication side effect. Over half of all calls were placed on Mondays and Tuesdays. Relatively few occurred outside work hours; 18% of calls characterized as "emergency" and 36% of calls characterized as urgent involved requests for controlled substances. Most of these calls were placed by patients with personality disorders. None of the 11 calls characterized as emergency calls was judged so by the physician; only 19% of the urgent calls were judged so by the physician. Conclusions.,Telephone calls contribute substantially to the burden of caring for patients in a specialty headache practice. Patients with chronic daily headache and personality disorders contribute disproportionately to this telephone burden. Efforts to identify such patients at presentation and educate them regarding appropriate telephone use seem to be warranted. [source] ParentLink: A Model of Integration and Support for Parents,FAMILY RELATIONS, Issue 3 2000Carol Mertensmeyer ParentLink represents a collective of Missouri organizations and agencies striving to simplify parents' access to research-based information, services, and problem-solving support pertaining to parenting. It is based on systems theory (von Bertalanffy, 1981) and, more specifically, the ecology of human development (Bronfenbrenner, 1979). A comprehensive array of technologies augments ParentLink professionals' outreach to parents and other citizenry. For parents, the access can be as simple as a telephone call to ParentLink's WarmLine professionals. Other doorways for information and support include ParentLink's Web site, other Web applications, media campaigns, and forthcoming neighborhood-based Parenting Corners. Information gathered from parents and communities about parenting issues will in turn shape future programs and policies. [source] Accessibility, continuity and appropriateness: key elements in assessing integration of perinatal servicesHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2003Danielle D'Amour RN PhD Abstract A trend toward the reduction in the length of hospital stays has been widely observed. This increasing shift is particularly evident in perinatal care. A stay of less than 48 hours after delivery has been shown to have no negative effects on the health of either the mother or the baby as long as they receive an adequate follow-up. This implies a close integration between hospital and community health services. The present article addresses the following questions: To what extent are postnatal services accessible to mothers and neonates? Are postnatal services in the community in continuity with those of the hospital? Are the services provided by the appropriate source of care? The authors conducted a telephone survey among 1158 mothers in a large urban area in the province of Quebec, Canada. The results were compared to clinical guidelines widely recognised by professionals. The results show serious discrepancies with these guidelines. The authors found a low accessibility to services: less than half of the mothers received a home visit by a nurse. In terms of continuity of care, less than 10% of the mothers received a follow-up telephone call within the recommended time frame and only 18% benefited from a home visit within the recommended period. Finally, despite guidelines to the contrary, hospitals continue to intervene after discharge. This results in a duplication of services for 44.7% of the new-borns. On the other hand, 40.7% are not seen in the recommended period after hospital discharge at all. These results raise concerns about the integration of services between agencies. Following earlier work, the present authors have grouped explanatory factors under four dimensions: the strategic dimension, particularly leadership; the structural dimension, including the size of the network; the technological dimension, with respect to information transmission system; and the cultural dimension, which concerns the collaboration process and the development of relationships based on trust. [source] Professional practices and experiences with complementary medicines: a cross-sectional study involving community pharmacists in EnglandINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2007Joanne Barnes associate professor in herbal medicines Objective As retailers of complementary medicines (CMs), pharmacists are well placed to advise consumers on the safe and effective use of these products; where CMs are available in pharmacies, pharmacists should be well informed about such products. This study explored the extent to which CMs are available in community pharmacies in England, and examined pharmacists' experiences, professional practices and training with regard to these products. Method A cross-sectional study was conducted, involving a structured questionnaire posted to community pharmacists. Coded follow-up mailings were sent to non-responders after 2 and 4 months, and a reminder telephone call made after 3 months. Setting All community pharmacists in six areas (Devon, Cornwall, Bradford, Leeds, Manchester, Stockport) of England (total n = 1337). Key findings The response rate was 66.5%. Overall, 92% of respondents reported that CMs (excluding vitamins/minerals) are sold in the pharmacy in which they practise, 81% had received requests from patients/consumers for specific CMs in the previous year, and 58% had recommended CMs. Around 70% of respondents rarely/never asks about CMs use when counter-prescribing conventional medicines or when receiving reports of suspected adverse drug reactions (ADRs) associated with conventional medicines. In total, 40% of respondents had undertaken training in complementary/alternative medicine (CAM). Pharmacists who had undertaken training were more likely to ask patients/consumers specifically about use of CMs when counter-prescribing conventional over-the-counter (OTC) medicines (37.0% versus 23.4%, respectively; ,2 = 17.4; P = 0.0003) and when receiving reports from patients/customers of suspected ADRs associated with conventional (prescribed or OTC) medicines (35.6% versus 23.8%, respectively; ,2 = 13.0; P = 0.0003). Conclusion CMs are widely available in pharmacies in England, and pharmacists interact with users of these products. An opportunity exists for pharmacists to embrace a professional role as expert advisors on CMs. However, pharmacists' training, professional practices and competence with respect to CMs first need to improve. [source] Screening and Brief Intervention to Reduce Marijuana Use Among Youth and Young Adults in a Pediatric Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 11 2009Edward Bernstein MD Abstract Objectives:, Marijuana was involved in 209,563 emergency department (ED) visits in 2006, according to the Drug Abuse Warning Network. Although screening and brief intervention (SBI) has been effective in changing drinking among ED patients in a number of studies, tests of marijuana SBI in a pediatric emergency department (PED) have not yet been reported. The aim of this pilot study was to test whether SBI is effective in reducing marijuana consumption among youth and young adults presenting to a PED with a diverse range of clinical entities. Methods:, A three-group randomized controlled preliminary trial was structured to test 1) differences between Intervention (Int) and standard Assessed Control (AC) groups in marijuana consumption, from baseline to 12 months, and 2) the feasibility of adding a Nonassessed Control (NAC) group to evaluate regression to the mean and assessment reactivity. Patients aged 14,21 years in an urban, academic PED were screened during 2006,2007, using standardized risk factor questions. Subjects were eligible if they used marijuana three or more times in the past 30 days, but were excluded for co-occurring high-risk alcohol use. Consented enrollees were randomized to NAC, AC, and Int groups in a two-stage process that permitted blinding to status during assessment and follow-up. NACs received a resource handout, written advice about marijuana use risks, and a 12-month follow-up appointment. ACs were assessed using standardized instruments and received resources, written advice, and 3- and 12-month follow-up appointments. The Int group received assessment, resources, written advice, 3- and 12-month appointments, a 20-minute structured conversation conducted by older peers, and a 10-day booster telephone call. A peer educator utilized a motivational style interview protocol adapted for adolescents to elicit daily life context and future goals, provide feedback, review pros and cons of marijuana use, assess readiness to change, evaluate strengths and assets, negotiate a contract for change, and make referrals to treatment and/or other resources. Measurements included demographic information; 30-day self-report of marijuana use; attempts to quit, cut back, or change conditions of use; and risk factor questions repeated at follow-up. Results:, Among 7,804 PED patients screened, 325 were eligible; 210 consented and enrolled (Int, n = 68; AC, n = 71; NAC, n = 71), with a 12-month follow-up rate of 71%. For the primary objective, we compared Int to AC. At 12 months, Int participants were more likely to be abstinent for the past 30 days than ACs (odds ratio [OR] for reported abstinence = 2.89, 95% confidence interval [CI] = 1.22 to 6.84, p < 0.014). The Int group had greater reduction in days used, baseline to 12 months, controlling for baseline (Int = ,7.1 vs. AC = ,1.8), were less likely to have been high among those who smoked (OR = 0.39, 95% CI = 0.17 to 0.89, p < 0.05), and were more likely to receive referrals. In a linear regression model controlling for baseline use, NACs smoked 4 fewer days per month than ACs, but consumption was not significantly different, suggesting no assessment reactivity effect. Conclusions:, A preliminary trial of SBI promoted marijuana abstinence and reduced consumption among PED patients aged 14,21 years. A no-contact condition for the NAC group over the year after enrollment was insufficient to capture enrollees for follow-up across a range of baseline acuity. [source] What does doodling do?APPLIED COGNITIVE PSYCHOLOGY, Issue 1 2010Jackie Andrade Doodling is a way of passing the time when bored by a lecture or telephone call. Does it improve or hinder attention to the primary task? To answer this question, 40 participants monitored a monotonous mock telephone message for the names of people coming to a party. Half of the group was randomly assigned to a ,doodling' condition where they shaded printed shapes while listening to the telephone call. The doodling group performed better on the monitoring task and recalled 29% more information on a surprise memory test. Unlike many dual task situations, doodling while working can be beneficial. Future research could test whether doodling aids cognitive performance by reducing daydreaming. Copyright © 2009 John Wiley & Sons, Ltd. [source] Blending telephony and IPTV: Building the TV-link service package using the Alcatel-Lucent Service BrokerÔBELL LABS TECHNICAL JOURNAL, Issue 1 2007Andre Beck This paper discusses the design and implementation of blended services, composite services whose base component services interact within a common control structure. The paper focuses on blended services that combine aspects of Internet Protocol television (IPTV) and IP Multimedia Subsystem, (IMS)-based telephony services and, in particular, focuses on a service that blends TV viewing and telephone call-handling functions. If a subscriber to this service receives a telephone call while watching TV, the caller ID is displayed on the subscriber's TV screen and the subscriber can signal call control instructions using the set-top box remote control. In this service blend, functions from each base service are coordinated with actions in the other. The mechanism allowing this service is an information channel that allows status and control information to move between the subscriber's set-top box and the IMS system. The services described in this paper are built upon a software foundation called the Alcatel-Lucent Service BrokerÔ platform, a platform that has unique capabilities to support such an information channel and to serve as the gateway between IMS and digital TV. This foundation offers service developers a set of important functions for the creation of blended services. Specifically, the Alcatel-Lucent Service Broker offers a means of controlling the invocation of base services, a means of communicating through different protocols, and support for large-scale deployment and for service customization. © 2007 Alcatel-Lucent. [source] The Consent and Prescription Compliance (COPRECO) Study: Does Obtaining Consent in the Emergency Department Affect Study Results in a Telephone Follow-up Study of Medication Compliance?ACADEMIC EMERGENCY MEDICINE, Issue 10 2008CCFP(EM), Samuel G. Campbell MB BCh Abstract Objectives:, The objectives were to determine whether mandated research requirements for consent in the emergency department (ED) falsely distorts the results of a survey of patient-reported compliance with ED prescriptions and, in addition, to ascertain the level of patient compliance to medication instructions and find out the degree of displeasure expressed by patients called without prior consent. Methods:, Patients given new prescriptions for a medicine to be taken regularly over a period of less than 30 days were eligible. A convenience sample of eligible patients was randomized to having consent obtained during their ED visit or at the time of telephone follow-up. Patients were called 7,10 days after their ED visit to determine their compliance with the prescription. Compliance rates between the two groups were compared, as was the prevalence of displeasure expressed by patients called without prior consent. Results:, Of 430 enrolled patients, 221 were randomized to receive ED consent for telephone follow-up, and 209 received telephone follow-up without prior ED consent. Telephone follow-up was successful in 318 patients (74%). The rate of noncompliance was slightly higher in the group without ED consent, 74/149 (50%; 95% confidence interval [CI] = 41% to 58%) than the group who gave ED consent for telephone follow-up, 67/169 (40%; 95% CI = 32% to 42%; p = 0.07). Among the two groups, 141/318 (44%) did not fill the prescription (n = 42) or took it incorrectly (n = 99). Only 1 (0.7%) of the 149 patients with successful telephone follow-up without prior ED consent expressed displeasure at this telephone call. Conclusions:, Medicine noncompliance is a significant issue for patients discharged from the ED in this study. Although there was a trend toward greater compliance in patients who consented to the follow-up call, this did not reach statistical significance. ED patients do not object to receiving telephone follow-up for a research survey without giving prior consent. [source] Cost-effectiveness of targeted and tailored interventions on colorectal cancer screening useCANCER, Issue 4 2008David R. Lairson PhD Abstract BACKGROUND. Colorectal cancer (CRC) screening is cost-effective but underused. The objective of this study was to determine the cost-effectiveness of targeted and tailored behavioral interventions to increase CRC screening use by conducting an economic analysis associated with a randomized trial among patients in a large, racially and ethnically diverse, urban family practice in Philadelphia. METHODS. The incremental costs per unit increase were measured in individuals who were screened during the 24 months after intervention. Percent increase in screening was adjusted for baseline differences in the study groups. Each intervention arm received a targeted screening invitation letter, stool blood test (SBT) cards, informational booklet, and reminder letter. Tailored interventions incrementally added tailored messages and reminder telephone calls. RESULTS. Program costs of the targeted intervention were $42 per participant. Additional costs of adding tailored print materials and of delivering a reminder telephone call were $150 and $200 per participant, respectively. The cost per additional individual screened was $319 when comparing the no intervention group with the targeted intervention group. CONCLUSIONS. The targeted intervention was more effective and less costly than the tailored intervention. Although tailoring plus reminder telephone call was the most effective strategy, it was very costly per additional individual screened. Mailed SBT cards significantly boosted CRC screening use. However, going beyond the targeted intervention to include tailoring or tailoring plus reminder calls in the manner used in this study did not appear to be an economically attractive strategy. Cancer 2008. © 2007 American Cancer Society. [source] Atypical Clinical Features of Pediatric AppendicitisACADEMIC EMERGENCY MEDICINE, Issue 2 2007Theresa Becker DO Background The diagnosis of appendicitis remains challenging in children. Delays in diagnosis, or misdiagnosis, have important medical and legal implications. The typical, or classic, presentation of pediatric appendicitis has been modeled after adult disease; however, many children present atypically with subtle findings or unusual signs. Objectives To determine the frequency of atypical clinical features among pediatric patients with appendicitis and to investigate which atypical features are the strongest negative predictors for appendicitis among patients being evaluated for appendicitis. Methods Children and adolescents with suspected appendicitis were enrolled over 20 consecutive months. Pediatric emergency physicians completed standardized data collection forms on eligible patients. Final diagnosis was determined by pathology or follow-up telephone call. Typical and atypical findings were defined strictly a priori. Results Seven hundred fifty-five patients were enrolled. The median age was 11.9 years (interquartile range [IQR]: 8.5, 14.9 yr); 36% of patients were diagnosed with appendicitis. Among patients with appendicitis, the most common atypical features included absence of pyrexia (83%), absence of Rovsing's sign (68%), normal or increased bowel sounds (64%), absence of rebound pain (52%), lack of migration of pain (50%), lack of guarding (47%), abrupt onset of pain (45%), lack of anorexia (40%), absence of maximal pain in the right lower quadrant (32%), and absence of percussive tenderness (31%). Forty-four percent of patients with proven appendicitis had six or more atypical characteristics. The median number of atypical features for patients with proven appendicitis was five (IQR: 4.0, 7.0). The greatest negative predictors, on the basis of likelihood ratios, were as follows: white blood cell count (WBC) of <10,000 per cubic millimeter (likelihood ratios [LR], 0.18), absolute neutrophil count (ANC) of <7,500 per cubic millimeter (LR, 0.35), lack of percussive tenderness (LR, 0.50), lack of guarding (LR, 0.63), and no nausea or emesis (LR, 0.65). Conclusions Appendicitis in pediatric patients is difficult to diagnose because children present with a wide variety of atypical clinical features. Forty-four percent of patients with appendicitis presented with six or more atypical features. Two atypical features are the strongest negative predictors of appendicitis in children: WBC of <10,000 per cubic millimeter and an ANC of <7,500 per cubic millimeter. [source] Expanding self-help group participation in culturally diverse urban areas: Media approaches to leveraging referent powerJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 4 2004Keith Humphreys Accumulating research attests to the benefits of self-help groups for people who have various chronic health problems. Expansion of self-help group participation may enable a broader portion of society to experience these health benefits. The Media and Education for Self-Help (MESH) Project was an effort to increase interest in health-related self-help groups among middle- and lower-income people in two California urban areas with minority,majority populations. A diverse coalition of self-help group leaders designed English- and Spanish-language radio public service announcements and posters that were disseminated in Oakland and Los Angeles. The outcome measures in each urban area were self-help-group-related telephone inquiries to local information and referral agencies (English and Spanish language) and the number of individuals attending self-help groups at agencies hosting many groups. Telephone caller data were also gathered in a nonintervention control urban area (Sacramento). Los Angeles experienced an overall increase in telephone calls about self-help groups during the MESH intervention, whereas the control urban area had no change in the number of telephone calls over the same period. The initial sharp increase in self-help-group-related telephone calls was not sustained in Oakland, however. The number of Spanish-language calls about self-help groups increased 821% in Los Angeles and 149% in Oakland in the period from the 6 months that preceded the project through the first 6 months of the MESH Project. In the MESH Project urban areas, the number of visits to self-help groups was significantly higher in intervention months than in the same calendar months of the preceding year, particularly in Oakland, where the increase exceeded 300 visits to self-help groups per month. These intriguing findings are discussed in terms of their health policy and program evaluation implications. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 413,424, 2004. [source] Prevalence, risk factors, and outcome of uveitis in juvenile idiopathic arthritis: A long-term followup studyARTHRITIS & RHEUMATISM, Issue 2 2007R. K. Saurenmann Objective To assess the prevalence, risk factors, and long-term outcome of uveitis in patients with juvenile idiopathic arthritis (JIA). Methods An inception cohort of all 1,081 patients diagnosed as having JIA at a single tertiary care center was established. A questionnaire and followup telephone calls were used to confirm the diagnosis of uveitis. Ophthalmologists' records of patients with uveitis were collected. Kaplan-Meier and Cox regression analyses were used to assess risk factors for developing uveitis and for complications of uveitis. Results After a mean followup time of 6.9 years, 142 of 1,081 patients (13.1%) had developed uveitis. Risk factors were young age at diagnosis, female sex, antinuclear antibody positivity, and the subtype of JIA. The relative contribution of these risk factors was different for the different subtypes of JIA. Until the end of the study, uveitis complications had developed in 53 of 142 patients with uveitis (37.3%; 4.9% of the total cohort). Only 16 of 175 involved eyes (9.1%) in 14 of 108 patients (13%; 1.3% of the total cohort) for whom ophthalmology reports were available had best corrected visual acuity less than 20/40 (mean followup time for uveitis of 6.3 years). Abnormal vision was associated with synechiae or cataract. Conclusion Risk factors for developing uveitis were different among subtypes of JIA. The long-term outcome of JIA-associated uveitis in our cohort was excellent despite the high rate of complications. [source] | |||||||||||||