Toll-free Number Research Articles

Recruitment strategies and challenges in a large intervention trial: Systolic Blood Pressure Intervention Trial.

The Systolic Blood Pressure Intervention Trial is a multicenter, randomized clinical trial of 9361 participants with hypertension who are ≥50 years old. The trial is designed to evaluate the effect of intensive systolic blood pressure control (systolic blood pressure goal <120 mm Hg) compared to standard control (systolic blood pressure goal <140 mm Hg) on cardiovascular events using commonly prescribed antihypertensive medications and lifestyle modification. To describe the recruitment strategies and lessons learned during recruitment of the Systolic Blood Pressure Intervention Trial cohort and five targeted participant subgroups: pre-existing cardiovascular disease, pre-existing chronic kidney disease, age ≥75 years, women, and minorities. In collaboration with the National Institutes of Health Project Office and Systolic Blood Pressure Intervention Trial Coordinating Center, five Clinical Center Networks oversaw clinical site selection, recruitment, and trial activities. Recruitment began on 8 November 2010 and ended on 15 March 2013 (about 28 months). Various recruitment strategies were used, including mass mailing, brochures, referrals from healthcare providers or friends, posters, newspaper ads, radio ads, and electronic medical record searches. Recruitment was scheduled to last 24 months to enroll a target of 9250 participants; in just over 28 months, the trial enrolled 9361 participants. The trial screened 14,692 volunteers, with 33% of initial screens originating from the use of mass mailing lists. Screening results show that participants also responded to recruitment efforts through referral by Systolic Blood Pressure Intervention Trial staff, healthcare providers, or friends (45%); brochures or posters placed in clinic waiting areas (15%); and television, radio, newspaper, Internet ads, or toll-free numbers (8%). The overall recruitment yield (number randomized/number screened) was 64% (9361 randomized/14,692 screened), 77% for those with cardiovascular disease, 79% for those with chronic kidney disease, 70% for those aged ≥75 years, 55% for women, and 61% for minorities. As recruitment was observed to lag behind expectations, additional clinics were included and inclusion criteria were broadened, keeping event rates and trial power in mind. As overall recruitment improved, a greater focus on subgroup recruitment was implemented. Systolic Blood Pressure Intervention Trial met its overall projected recruitment goal using diverse, locally adapted enrollment strategies to specifically target persons with cardiovascular disease, chronic kidney disease, ≥75 years old, women, and minority subgroups. The trial exceeded its recruitment goal for minorities but found it a challenge to meet the competing demands of the targeted goals for recruiting into the remaining four subgroups. Important lessons include the imperative to monitor the recruitment process carefully, decide early to add new clinics or modify inclusion and exclusion criteria if recruitment lags, and consider limiting enrollment to subgroups only. We found benefit in using multiple recruitment sources simultaneously; mass mailing produced the largest number of participants, but referrals resulted in the greater randomization yield.

Abstract P2-09-21: HBOC genetic counseling: A genetic counselor-physician partnership model

Abstract Background: In 2003, the American Society of Clinical Oncology (ASCO) issued a policy statement that addressed the oncologist's role in integrating cancer genetic risk assessment and management into clinical practice. ASCO supports access to genetic counseling for patients offered genetic testing and after results disclosure. In 2014, Integrated Genetics (IG) began offering genetic counseling in partnership with OBGYNs and oncologists whose patients have a personal or family history of breast or ovarian cancer. The goal of the program was to provide an easily accessible and comprehensive genetic counseling service for Hereditary Breast and Ovarian Cancer (HBOC) to meet the needs of patients and to support clinicians who currently provide pre- and post-test counseling. Methods: In this study we describe IG's HBOC genetic counseling service and in a retrospective analysis, describe the characteristics of patients referred to the program in 2014. Clinicians were provided a toll free number for patients to call to schedule a genetic counseling session. The scheduling staff facilitated medical record requests and emailed a family history questionnaire. In person or telegenetic counseling (via WebEx) was offered. Telegenetic counseling allowed the patient and genetic counselor to see one another via webcam and view counseling visual aids and relevant medical records. Pedigree analysis and cancer genetic risk assessment were performed and genetic testing options discussed based on National Comprehensive Cancer Network (NCCN) testing criteria. Information discussed at the session, including patient decisions about testing, was documented for the referring physician and patient in the Genetic Counseling Consultation Report. The physician ordered testing and managed patient screening and surveillance. Results: During 2014, 247 counseling sessions were provided to patients from 23 states. All patients had a personal or family history of breast or ovarian cancer and the average age of patients was 44 years (range: 16-85). Sixty four percent (64%) of sessions were done via WebEx and 36% in person. Of the 247 sessions, 198 (80.2%) were for pre-test genetic counseling; of those, 173 (87.4%) met NCCN HBOC genetic testing criteria and genetic testing for BRCA1/2 was offered. Of this group, 70.52% desired testing, 27.75% declined and 1.73% were undecided. The remaining sessions (n=49) included post-test counseling for pathogenic mutations or variants of unknown significance (n=39), and patients who had accepted testing but whose results were pending (n=10). Conclusions: The IG HBOC genetic counseling program extended comprehensive genetic counseling to patients at increased risk for BRCA1/2 mutations who might not otherwise have access to this service. Physicians appropriately selected patients for referral (87% met NCCN testing criteria). The genetic counselors provided cancer genetic risk assessment, time-intensive patient education to facilitate informed decision making, and counseling about the implications of results, including the complexities of variants of unknown significance. This partnership model allowed physicians to retain patient care oversight, including management of screening and surveillance, while leveraging genetic counselor expertise. Citation Format: Oliver JB, Cronister A. HBOC genetic counseling: A genetic counselor-physician partnership model. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-09-21.

Impact of Canadian tobacco packaging policy on use of a toll-free quit-smoking line: an interrupted time-series analysis.

A policy for new pictorial health warning labels on tobacco packaging was introduced by Health Canada in 2012. The labels included, for the first time, a prominently displayed toll-free number for a quit-smoking line. We used data from the Ontario provincial quitline to investigate the call volume and number of new callers receiving treatment in the months before and after the new policy was introduced. We used an interrupted time-series analysis to examine trends in the overall call volume and number of new callers receiving treatment (≥ 1 telephone counselling session) through Ontario's quitline (Smokers' Helpline) between January 2010 and December 2013. We analyzed data using Box-Jenkins autoregressive integrated moving-average models; we adjusted the models for a major campaign promoting the quitline, a seasonality (January) effect and tobacco pricing. We found a relative increase of 160% in the average monthly call volume during the 7 months after the introduction of the new labels (870 calls per month at baseline and 1391 additional calls per month on average after the policy change; standard error [SE] 108.94, p < 0.001), and a sustained increase of 43% in subsequent months. We observed a relative increase of 174% in the number of new callers receiving treatment (153 new callers per month at baseline and 267 additional new callers per month after the policy change; SE 40.03, p < 0.001) and a sustained increase of 80% in subsequent months. The effect was significant even after controlling for a major promotion campaign and the January effect. We found a significant increase in the monthly overall call volume and number of new callers receiving treatment per month after the introduction of the new tobacco health warning labels, with a sustained increase in overall calls and new callers beyond the first 7 months. Our findings add to the body of evidence on the benefit of including a toll-free quitline number on tobacco packaging.

Barriers to Accessing Emergency Medical Services in Accra, Ghana: Development of a Survey Instrument and Initial Application in Ghana.

Emergency medical services (EMS) systems provide professional prehospital emergency medical care and transportation to help improve outcomes from emergency conditions. Ghana's national ambulance service has relatively low public utilization in comparison with the large burden of acute disease. A survey instrument was developed using Pechansky and Thomas's model of access covering 5 dimensions of availability, accessibility, accommodation, affordability, and acceptability. The instrument was used in a cross-sectional survey in 2013 in Accra, Ghana; eligible participants were those 18 years and older who spoke English, French, or Twi. Although the analysis was mainly descriptive, logistic regression was used to identify factors associated with reported intention to call for an ambulance in the case of a medical emergency. 468 participants completed surveys, with a response rate of 78.4%. Few (4.5%) respondents had ever used an ambulance in prior emergency situations. A substantial proportion (43.8%) knew about the public access medical emergency telephone number, but of those only 37.1% knew it was a toll-free call. Most (54.7%) respondents believed EMTs offered high-quality care, but 78.0% believed taxis were faster than ambulances and 69.2% thought the number of ambulances in Accra insufficient. Many (23.4%) thought using ambulances to transport corpses would be appropriate. In two hypothetical emergency scenarios, respondents most commonly reported taxis as the preferred transportation (63.6% if a family member were burned in a house fire, 64.7% if a pedestrian were struck by a vehicle). About 1 in 5 respondents said they would call an ambulance in either scenario (20.7% if a family member were burned in a house fire, 23.3% if a pedestrian were struck by a vehicle) while 15.5% and 10.2%, respectively, would use any available vehicle. Those aged 18-35 years were more likely than older respondents to prefer an ambulance (odds ratio [OR], 2.27; confidence interval [CI], 1.47 to 3.68), as were those with prior ambulance experience (OR, 1.75; CI, 0.98 to 3.09) (compared with those with no prior experience) and those who believed ambulances were safer than taxis (OR, 2.17; CI, 1.1 to 4.2) (compared with those who did not hold such beliefs). Perceptions of public ambulance services in Accra, Ghana, are generally favorable, although use is low. Public health education to improve awareness of the toll-free medical emergency number and about appropriate use of ambulances while simultaneously improving the capacity of ambulance agencies to receive increased caseload could improve use of the EMS system.

A critical appraisal of medication package inserts

Introduction: Package Inserts (PIs) refers to officially specified document that accompanies a drug for relevant, updated and unbiased information for rational drug use based on regulatory guidelines as per section 6.2 and 6.3 of schedule D of Indian Drug and cosmetic Act 1945. But some studies had shown non-uniformity with suboptimal level of informations which frequently can lead to medication errors. Hence this study was conducted to evaluate the completeness of PIs.Aim: To critically evaluate package inserts of allopathic medicines.Material and Methods: 100 allopathic drug PIs were collected from pharmacies in Rohtak and were checked for the presence of each heading as per schedule D criteria, followed by scrutiny of the information included under the heading. Indian guidelines were also compared with US FDA guidelines for PIs.Scoring of package inserts: The informations were evaluated for completeness and scored as 1 if present otherwise scored as zero for no information or partial information. Scores for each heading were calculated by totaling the scores of all the package inserts. The total scores were expressed as absolute numbers and percentages.Results: On an average PIs analyzed for the completeness of the criteria scored 10 (Mean SD = 9.732.48) out of 16. Absence of common layout and headings caused inconvenience. In comparison to US FDA guidelines it lacked, disclaimer statement, boxed warning, revision date, approval date, toll-free number etc.Conclusion: PIs dont seem to be serving effectively because of multiple deficiencies like completeness, uniformity, absence of headings.

Impact of Canadian tobacco packaging policy on quitline reach and reach equity

ObjectiveTo examine the impact of the new Canadian tobacco package warning labels with a quitline toll-free phone number for seven provincial quitlines, focusing on treatment reach and reach equity in selected vulnerable groups. MethodsA quasi-experimental design assessed changes in new incoming caller characteristics, treatment reach for selected vulnerable sub-populations and the extent to which this reach is equitable, before and after the introduction of the labels in June, 2012. Administrative call data on smokers were collected at intake. Pre- and post-label treatment reach and reach equity differences were analysed by comparing the natural logarithms of the reach and reach equity statistics. ResultsDuring the six months following the introduction of the new warning labels, 86.4% of incoming new callers indicated seeing the quitline number on the labels. Treatment reach for the six-month period significantly improved compared to the same six-month period the year before from .042% to .114% (p<.0001) and reach equity significantly improved for young males (p<.0001) and those with high school education or less (p=.004). ConclusionsThe introduction of the new tobacco warning labels with a quitline toll-free number in Canada was associated with an increase in treatment reach. The toll-free number on tobacco warning labels aided in reducing tobacco related inequalities, such as improved reach equity for young males and those with high school or less education.

O14.2 Good call! implementation of a regional online and toll-free std clinical consultation program

Introduction Following significant changes to the United States healthcare system, community health centres and private providers are providing a greater amount of STI screening, treatment and management that, in the past, would have been performed at public health specialty (STI) clinics. However, general healthcare providers without a background in STIs may be unfamiliar with STI treatment protocols and unusual presentations. To assist healthcare providers in an eight state region, the Denver Prevention Training Centre (PTC) collaborated with the Southeastern National TB Centre (SNTC) to modify their tuberculosis clinical consultation database to serve clinicians performing STI exams. Methods The Denver PTC and SNTC created an online database and call management system modelled on the TB system. The system tracks and facilitates the clinical consultation process from initiation to completion. A toll free number (1–800–4-STD-CCN) and website (www. STDCCN.org) were set up. Marketing was done through electronic channels and at healthcare events in the region. Results The STI clinical consultation system received 2–5 requests a week from clinicians around the region. Unlike the TB system, whose requests have been primarily received through the phone, almost all of the requests for STI consultations came through the online portal. The STI consultation program has been successful both as a means of offering clinical consultation, and, importantly, as a way of tracking the consultations and technical assistance delivered by the training centre. As a result, the STI clinical consultation program will be expanded across the United States in the coming months. The Denver PTC and SNTC are also looking at expanding the process to mobile applications so that consultation can be initiated from mobile devices. Conclusion Web-based processes can help simplify, facilitate and track the process of STI clinical consultation. Disclosure of interest statement The Denver PTC and SNTC are funded by the Centres for Disease Control and Prevention, USA. No pharmaceutical grants were received in the development of this study.

Interventions to increase immunisation coverage among children 12–23 months of age in India through participatory learning and community engagement: pilot study for a cluster randomised trial

ObjectiveWith the aim of conducting a future cluster randomised trial to assess intervention impact on child vaccination coverage, we designed a pilot study to assess feasibility and aid in refining...

A Novel Technique for Online Blood Bank Management

Abstract In today's world a number of online blood bank databases are available, however none of them offers the capability for the direct contact between the donor and the recipient. This is a major drawback particularly in cases where there is an urgent need of blood. Our work aims to overcome this communication barrier. By creating a blood bank database that contains entire details and collected from various sources like Blood banks, NSS, NGO's, hospitals and through web interface. The data collected will be maintained in a central server by a database administrator. This central database server will be associated with a Toll free number which is used to connect to the server. An new algorithm is defined based on the various parameters that needs to be accounted for, before blood transfer is done. The willingness of donor and the closeness of the donor to the place from where the call is coming are also considered for in defining this algorithm. Based on the algorithm the most eligible donor is found out. From the server, the call from the required person is routed to the eligible donor's number. Such a system considerably cut down the overheads involved in referring to a online database and then calling the donors and verifying their willingness at a time when there is a critical need for the blood.

Drug package inserts: how accessible is the information?

Background: Information given in drug package inserts is often not easily accessible by patients and practitioners. Presentation of important information in an easily accessible manner fulfills the very purpose of inserts. In the present study, accessibility of important information in drug package inserts is evaluated. Methods: We evaluated 110 package inserts. Accessibility to important information was noted under following headings: use of box, use of special/bigger font or color, use of table of contents and information in front sheet. Each of these parameters was given a point. Cumulative accessibility score of more than three considered as accessible. Provision of toll free numbers and internet addresses of the companies noted. Results: Information in inserts regarding posology, method of administration, precautions under special conditions, contraindications, pharmacokinetics, interactions, pregnancy and lactation, driving, and machine use precautions were adequate and orderly in most. Only seven drug inserts mentioned important information with special font/different color. 18 drug inserts had used boxes. About 13 inserts used bigger font size for revealing important information. We observed a mean accessible score was 0.37 a insert. Only two inserts carried toll free numbers. Conclusion: Important information in drug package inserts is not easily accessible. Display of toll free numbers and internet addresses for queries and reporting adverse drug reactions is highly recommended.

Expanding clinical and information services to the ambulatory older adult through community outreach programs.

To share successful techniques pharmacists can use to educate community-based older adults about health and medications. Events coordinated through MCPHS University Pharmacy Outreach Program and offered at Massachusetts senior centers. The MCPHS University Pharmacy Outreach Program, staffed with pharmacists, caseworkers, and pharmacy students, under the supervision of licensed pharmacists, provides free medication-related information to Massachusetts residents. Clients also receive assistance with cost-minimizing programs and insurance benefits. Seventy percent of contacts are older adults. Services are provided through a toll-free number and outreach programs. Focus on expanding educational health services and includes selecting Medicare D plans, working with support groups, providing medication management for diverse cultures, educating older adults on how to search for health information on the Internet, and discussing medication safety and adherence. Participant and pharmacy student knowledge assessed utilizing survey tools. Additional measurements include savings for Medicare beneficiaries and improvements in medication management. Observed results of the Pharmacy Outreach Program include decreased out-of-pocket costs for Medicare beneficiaries, improved medication adherence resulting in reduction of glycated hemoglobin and blood pressure, identifying and recommending medication treatment changes to reduce patient fall risk, and increased confidence in locating Web-based health information. Pharmacy students demonstrated increased knowledge of and ability to communicate Medicare benefits. Outreach programs can improve older adults' understanding about their health and medications. Pharmacists can increase visibility in the community by engaging in effective outreach programs.

Direct Consumer Reporting of ADRs to PvPI, a Position Paper of Indian Pharmacopoeia Commission

Patients/consumers are end user of medicines and should play important role in reporting the Adverse Drug Reactions (ADRs) to pharmacovigilance system. Consumers can provide detailed first-hand in formation about their experiences with medicines and how these medicines have affected their life. Direct consumer reporting leads to earlier identification and accumulation of signals and may provide neglected details related to psychiatric feelings and quality of life. Consumers may report ADRs due to “over the counter” (OTC) medicines, herbal medicines, and ADRs related to excipients and potential interactions. Direct patient/ consumer reporting will also rectify the under-reporting by patients to physician and will change the attitude related to importance of patient’s experience. NCC-PvPI (National Coordination Centre-Pharmacovigilance Programme of India), IPC (Indian Pharmacopoeia Commission) had launched “Medicines Side Effect Reporting form for Consumer” (blue form) at the National level conference on “Participation of patient/consumer organization in PvPI” on 1st August, 2014, which encourages patient or his/her representative (relative) to report ADRs directly either by submitting the form to the NCC-PvPI or to the nearest AMC (Adverse Drug Reaction Monitoring Centres) under PvPI. Consumers can also reports through toll free helpline number: 1800-180-3024 or email id: pvpi.compat@gmail.com to NCC-PvPI.

Validation of a screening test of auditory function using the telephone.

Several European countries have demonstrated successful use of telephone screening tests for auditory function. The screening test consists of spoken three-digit sequences presented in a noise background. The speech-to-noise ratios of the stimuli are determined by an adaptive tracking method that converges on the level required to achieve 50% correct recognition. A version of the three-digit telephone screening protocol for the United States was developed: the US National Hearing Test (NHT). The objective of the current study was to determine the sensitivity and specificity as well as the feasibility of the NHT for use within the Department of Veterans Affairs (VA). Research Design and Study Sample: Using a multisite study design with convenience sampling, we used the NHT to collect data from 693 participants (1379 ears) from three geographical areas of the United States (Florida, Tennessee, and California). The NHT procedures were as follows: the participants (1) called a toll-free telephone number, (2) entered their assigned ear-specific identification code, (3) listened to 40-sets of digit triplets presented in speech-spectrum background noise, and (4) entered in the numbers that they heard on the telephone key pad. The NHT was performed on each ear, either at home or in a VA clinic. In addition to collecting data from the experimental task, we gathered demographic data and the data from other standard-of-care tests (i.e., audiometric thresholds and speech recognition tests in quiet and in noise). A total of 505 participants completed the NHT at a VA clinic, whereas 188 completed the test at home. Although the ear-specific NHT and mean pure-tone threshold all correlated significantly (p < 0.001), there were more modest correlations in the low- and high-frequency ranges with the highest correlation seen with the 2000 Hz mean pure-tone threshold. When the NHT 50% point or threshold was compared with the three-frequency PTA at 500, 1000, and 2000 Hz, the sensitivity was 0.87 and specificity was 0.54. When comparing the NHT with the four-frequency PTA at 500, 1000, 2000, and 4000 Hz, the sensitivity was 0.81 and specificity increased to 0.65. The NHT also correlated strongly with other speech-in-noise measures. The NHT was found to correlate with other audiometric measures, including pure-tone thresholds and speech recognition tests in noise, at sufficiently high correlation values to support its use as a screening test of auditory function.

Abstract B95: Barriers to completion of a free colorectal cancer screening program in a low-income population

Abstract Colorectal cancer (CRC) is the fourth most common cancer in the US. Screening is effective to prevent and detect CRC, but is underutilized in underserved populations. We assessed a free CRC screening program intended for the underserved population in central Illinois to determine what factors (demographics, medical history, risk factors, perceived barriers, rurality) prevented eligible patients from completing CRC screening. Methods: Potential participants were recruited to the Vince Demuzio Colorectal Screening Initiative via postcard mailing, media advertising and physician referral from July 2010 to June 2012. Interested participants called a toll-free number for an eligibility assessment, which required: being due for a CRC screening, age of 50-64 years, uninsured/underinsured, ≤250% of the federal poverty level, and residence in the 22 county (1 urban and 21 rural counties) catchment area. Eligible participants then completed a questionnaire via phone about their demographics, screening history, risk factors, and screening barriers, and were sent documents to sign for enrollment. Once signed documents were returned, patients chose to complete a fecal occult blood test (FOBT) or schedule a pre screening appointment and colonoscopy at 1 of 13 participating local hospitals. Analysis of 22 factors associated with screening was performed comparing residency (rural vs. urban) and screening completion (completers vs. non-completers) using Fisher's exact tests and independent t-tests. Results: There were 352 eligible participants, and they were: 86 % white, 57% female, 90% with at least a high school education, 60 % rural and 37 % current smokers. 245 participants (69.6%) completed CRC screenings (233 colonoscopies and 12 FOBTs). Ultimately, 107 (30.4%) eligible individuals did not complete screening due to the following: unreturned enrollment documents (54), loss to follow-up or withdrawal (44), did not return FOBT card (4) or were later deemed ineligible (5). Overall, rural participants were more likely than urban to be female (66.2% vs.44.4%, p&amp;lt;0.001), white (98.6% vs.68.3%, p&amp;lt;0.001), to have had a past blood stool test (25.8% vs. 9.4%, p=0.013) and to have a history of polyps (12.9% vs. 4.9%, p=0.016). Screening completion rates did not differ between urban and rural participants (65.5 % vs. 72.4%, p=0.19). The only factor significantly different between completers (C) and non-completers (NC) was report of a past blood stool test (42.4% vs. 29.9%, p=0.03), and among those reporting a past test, having a test within the past year (23.1% vs. 7.5%; p=0.04). Rural NC were more likely to note fear of discomfort as a barrier than urban NC (28.6% vs. 10.6%; p=0.03). There were no other significant differences at these stratifications. Conclusions: Despite meeting eligibility criteria, roughly a third of interested patients did not receive CRC screening. Rural NC differed from urban NC. Rural NC were more often female, white (anticipated in rural Illinois) and reported procedure discomfort as a screening barrier. However, most examined patient-related factors did not differ between groups and stratifications. Patient anecdotes indicated that more efficient processes, such as reduction in enrollment and screening steps and assistance with scheduling, may improve completion rates. Also, efforts should be made to both address gender and race differences that might impact screening in rural populations and develop better survey tools to identify screening barriers. Citation Format: Whitney Zahnd, David Steward, Wiley Jenkins, Jennifer Andoh, Georgia Mueller, Sandra Puczynski. Barriers to completion of a free colorectal cancer screening program in a low-income population. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B95. doi:10.1158/1538-7755.DISP13-B95

Feasibility of automated speech sample collection with stuttering children using interactive voice response (IVR) technology

Purpose: To investigate the feasibility of adopting automated interactive voice response (IVR) technology for remotely capturing standardized speech samples from stuttering children.Method: Participants were 10 6-year-old stuttering children. Their parents called a toll-free number from their homes and were prompted to elicit speech from their children using a standard protocol involving conversation, picture description and games. The automated IVR system was implemented using an off-the-shelf telephony software program and delivered by a standard desktop computer. The software infrastructure utilizes voice over internet protocol. Speech samples were automatically recorded during the calls. Video recordings were simultaneously acquired in the home at the time of the call to evaluate the fidelity of the telephone collected samples. Key outcome measures included syllables spoken, percentage of syllables stuttered and an overall rating of stuttering severity using a 10-point scale.Result: Data revealed a high level of relative reliability in terms of intra-class correlation between the video and telephone acquired samples on all outcome measures during the conversation task. Findings were less consistent for speech samples during picture description and games.Conclusion: Results suggest that IVR technology can be used successfully to automate remote capture of child speech samples.

Process evaluation of an up-scaled community based child obesity treatment program: NSW Go4Fun®

BackgroundCommunity-based obesity treatment programs for children that have a large program reach are a priority. To date, most programs have been small efficacy trials whose findings have yet to be up-scaled and translated into real-world settings. This paper reports on the process evaluation of a government-funded, translated obesity treatment program for children in Australia. It describes the characteristics and reach of children participating in the New South Wales (NSW) Ministry of Health Go4Fun® program.MethodsDelivered across the state of NSW (Australia) by Local Health Districts (LHDs), Go4Fun® is a community-based, multidisciplinary family obesity treatment program adapted from the United Kingdom Mind Exercise Nutrition Do it (MEND) program that targets weight-related behaviours. Children aged 7-13 years with a BMI ≥85th percentile and no co-morbidities were eligible at no cost. Parents/carers self-refer via a toll-free phone number, text messages, online registration or via secondary referrals. LHDs deliver a 16 to 20-session program based on length of school term, holidays and recruitment challenges. Both parent/carer and child attend bi-weekly after school sessions. Parent-reported socio-demographic and measured child weight characteristics are presented using descriptive statistics. Differences between completers (attended at least 75% of sessions) and non-completers were assessed using chi-square tests, independent sample t-tests and adjusted odds ratios. Analyses were adjusted for clustering of programs.ResultsBetween 2009 and 2012, a total of 2,499 children (54.8% girls; mean age [SD]: 10.2 [1.7 years]) participated in the Go4Fun® program. Children were mainly from low-middle socioeconomic status (76.5%), resided in major cities (63.3%), and 5.7% were Aboriginal. At baseline, 96.5% of children were overweight or obese. Mean BMI-z-score was 2.07 (0.41) and 94.5% had a waist-to-height ratio ≥0.5. More than half (57.9%) completed at least 75% of sessions. Amongst completers (N = 1,446), girls (56.8%; p = 0.02), non-Aboriginal children (95.9%; p < 0.01) and children residing in less socially disadvantaged areas (25.9%; p = 0.02) were significantly more likely to complete the program.ConclusionsThe Go4Fun® program successfully reached the targeted population of overweight/obese children at socioeconomic disadvantage and is a rare example of an up-scaled translational program.

A day in the life of digi-key

In the 42 years since its founding, Digi-Key Corp. has grown-and grown-into one of the world's largest electronic-component distributors. Its online catalog features nearly a million parts and products. Last year it sold US $1.6 billion worth of merchandise to more than half a million customers in 170 countries. And the vast majority of Digi-Key's offerings are kept in stock, available for immediate shipping, in a single place: the company's 74 000-square-meter warehouse. . That enormous warehouse sits on the southwestern edge of the tiny town of Thief River Falls, Minn. The nearest city is Grand Forks, N.D., hardly a metropolis. The warehouse operates around the clock, 365 days a year, with the result that any order placed by 8 p.m. local time gets shipped out the same day. . Digi-Key, like its archrival Mouser Electronics, caters to both corporate clients and hobbyists. The company will gladly sell you a Xilinx Virtex-7 fieldprogrammable gate array for $39 452.40, but it will also sell you a single 10-cent through-hole resistor. . When you call Digi-Key's toll-free number, an actual person answers, usually within 5 seconds. From there, you'll be guided expertly, even if you have no idea what you need, even if all you're getting is that 10-cent resistor, even if you speak Chinese, Hindi, or Portuguese. In an age of impersonal e-commerce, of voice mail that never gets returned, of languishing on hold, the experience of being a Digi-Key customer can seem almost surreal.

She Sought Volunteer Clinicians, and Hundreds Answered the Call

Psychiatrists are needed to donate their time and skills to help soldiers piece their lives back together upon returning to the United States from Iraq and Afghanistan.

Probability Theory Predicts That Chunking into Groups of Three or Four Items Increases the Short-Term Memory Capacity

Short-term memory allows individuals to recall stimuli, such as numbers or words, for several seconds to several minutes without rehearsal. Although the capacity of short-term memory is considered to be 7 &#177 2 items, this can be increased through a process called chunking. For example, in Japan, 11-digit cellular phone numbers and 10-digit toll free numbers are chunked into three groups of three or four digits: 090-XXXX-XXXX and 0120-XXX-XXX, respectively. We use probability theory to predict that the most effective chunking involves groups of three or four items, such as in phone numbers. However, a 16-digit credit card number exceeds the capacity of short-term memory, even when chunked into groups of four digits, such as XXXX-XXXX-XXXX-XXXX. Based on these data, 16-digit credit card numbers should be sufficient for security purposes.

Using the Hicks formula to evaluate an estimate of the elasticity of derived demand for toll-free numbers

Duffy-Deno & Parsons D-D & P (2012) estimated the coefficient for the price elasticity of demand for toll-free numbers (TFNs) at between −0.04 and −0.05. Here, the Hicks formula for derived demand is used to check the range of likely demand elasticity for TFNs given the special characteristics of this market. This approach suggests that the demand for TFNs is likely not more elastic than estimated by D-D & P. Therefore, the premise is sound for D-D & P's discussion of the public policy implications of highly inelastic demand for TFNs. The use of industry information for all four parameters of the Hicks formula to check a derived demand elasticity is the first of its kind in the published literature.