Do cancer helplines deliver benefits to people affected by cancer? A systematic review

Objectives

To determine the: (1) proportion of studies that describe characteristics of helpline service delivery, compared to the proportion that report trials testing efficacy or effectiveness of helplines in changing user outcomes; (2) proportion of efficacy or effectiveness studies that meet EPOC criteria for methodological rigor; and (3) potential benefits of cancer helplines for people affected by cancer based on findings from rigorous efficacy or effectiveness trials.

Methods

Electronic databases (Medline, PsycINFO, EMBASE and CINAHL) were searched to identify English-language studies describing original research published from 1991 to 2011.

Results

Twenty-eight publications met the review inclusion criteria. From these studies, data on: the characteristics of cancer helpline users; call content; and user satisfaction, were extracted. The potential for helplines to improve the psychosocial outcomes of callers was examined for the three intervention trials.

Conclusion

There is a lack of robust evidence regarding the level and types of benefits that cancer helplines may deliver to callers affected by cancer. Given increased emphasis on delivering best-practise supportive care, building the evidence base in this field may assist cancer helplines to increase their service uptake, reach, and benefit to callers.

Practise implications

There is a need for more rigorous intervention-focussed studies in this field across a broader range of cancer populations. Future studies should focus on relevant patient-centred outcomes, such as improved knowledge and greater involvement in decision-making, while incorporating process measures to account for intervention fidelity and clinical performance.     

深圳市居民对危机干预热线的认知与态度

目的:调查深圳市居民对危机干预热线的知晓率、知晓途径及使用态度。方法:采用分层随机抽样的方法抽取了3个行政区中的7个街道,对所抽取街道的某公共场所内愿意接受调查的深圳市常住居民(≥14岁)进行调查。使用自编深圳市居民危机干预热线/心理健康热线知晓调查问卷(包括社会人口学资料、是否知道危机干预热线、热线知晓途径、对热线服务利用的态度及相关原因)进行调查。结果:共调查深圳市居民1033人,其中503人(48.7%)表示知道热线电话的存在,123人(11.9%)知道某条具体的热线名称或号码。获得热线信息的途径主要为电视节目、他人告知、网络以及电台节目。在知晓热线的居民中有235人(46.7%,235/503)表示愿意使用热线服务寻求帮助,愿意利用热线服务的主要原因是能够立即获得帮助,不愿意利用热线服务的主要原因是觉得自己不需要或者没必要。结论:本研究中,不足一半的居民知晓热线,知晓热线的居民中不足一半愿意使用热线服务。深圳居民对热线的了解度和信任度均有待进一步提高。     

危机干预热线的发展及研究简介

本文从危机干预热线特征、国内外危机干预热线的发展现状以及相关研究结果三个方面,对危机干预热线的发展及研究进行了简单而全面的介绍。     

A look at Women Alive

Women Alive is an advocacy group for HIV-positive women who are lesbians or have been incarcerated, and provides treatment information and education. Women Alive also provides outreach and counseling through telephone hotlines, Internet discussion groups, and group meetings. The group's philosophy is that creating a supportive environment for HIV-positive women is crucial to their survival. Women Alive also tracks gender-based differences in treatment, and works to ensure that women's health care needs are adequately addressed. Contact information for the group and for their Peer Support Hotline is included.     

Reaching out: the BP helpline

The Body Positive Helpline is one of the oldest AIDS hotlines in New York. It was founded in the late 1980s by a grant given to Body Positive. The types of calls received by the helpline have greatly changed since the earlier days when resources were scarce. Calls used to have a sense of urgency and desperation, and often the helpline assisted many people in dealing with their initial reaction to their diagnosis. Today, the helpline handles more sophisticated questions from patients and caregivers who are considerably more knowledgeable about the disease and their treatment. The Helpline provides a very extensive training program for its volunteers.     

Evaluation of the Dutch AIDS STI information helpline: differential outcomes of telephone versus online counseling

Objective

Health information helplines have an important function in health education, prevention and counseling. Information and help services are increasingly provided online. This study focuses on the differences and similarities between online help services and telephone services.

Methods

The telephone service of the Dutch AIDS STI helpline was compared to its e-mail equivalent. After consulting the helpline service, both callers and e-mailers (N_tot = 455) were asked to participate in a survey that evaluated their background characteristics, contacting reasons, and satisfaction with the specific service and information received. The survey also included questions regarding the advice received from the helpline. A follow-up measure 4 weeks after the baseline survey evaluated to what extent clients acted upon the advice.

Results

The study shows that both services are positively evaluated and are equally persuasive in their counseling. Differences between callers and e-mailers were found regarding background characteristics, content of the consultation, satisfaction, and the advice received.

Conclusion

It can be concluded that online health information services are an important addition to, but not a replacement for, the traditional telephone helplines.

Practice implications

In order to provide an optimal health service to a wide public, both online and telephone counseling should be offered.     

Counseling children at a helpline: chatting or calling?

In a quantitative content analysis, the telephone‐based and Web‐based support of the Dutch child helpline were studied. Both adult judges and the children themselves indicated that the quality of chat conversations was better than that of telephone conversations. Both the chat and telephone service succeeded in improving children's well‐being and decreasing the perceived burden of their problems. The findings lend support to offer a combined telephone‐based and Web‐based support for child helplines. © 2009 Wiley Periodicals, Inc.     

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.     

Organizational selection and assessment of women entering a surrogacy agreement in the UK.

In the UK, surrogacy procedures are unregulated and not monitored. Information concerning the selection and assessment of intended (the mother commissioning) and surrogate mothers (the mother carrying and delivering the baby) is therefore not generally available (BMA, 1996). It is important to determine what type of assessment is used, and how selection takes place within the organizations dealing with surrogate motherhood arrangements. The present survey enquired about the incidence, selection and assessment procedures of all registered surrogate and commissioning couples, and aimed to find out what advice and support is given. Eight organizations took part in the survey, six were clinics and two agencies dealing with surrogate arrangements. Two voluntary organizations/helplines were also surveyed, but their data are not relevant to the results presented here. An interview and questionnaire approach was used. Psychosocial assessment was minimally addressed by all organizations, and no fixed procedures for assessment and selection were employed. Despite this, few incidences of controversial cases were reported. Confidence in this practice could be increased in the future if both parties embarking on a surrogacy arrangement knew they were properly selected and assessed. A regulatory body could monitor consistent use of professional evidence-based criteria prior to arrangements.     

Assessing suicide risk among callers to crisis hotlines: A confirmatory factor analysis

Our goal was to investigate the factor structure of a risk assessment tool utilized by suicide hotlines and to determine the predictive validity of the obtained factors in predicting subsequent suicidal behavior. We conducted an Exploratory Factor Analysis (EFA), an EFA in a Confirmatory Factor Analysis (EFA/CFA) framework, and a CFA on independent subsamples derived from a total sample of 1,085. Similar to previous studies, we found consistent evidence for a two‐factor solution, with one factor representing a more pernicious form of suicide risk (i.e., Resolved Plans and Preparations; RPP) and one factor representing milder suicidal ideation (i.e., Suicidal Desire and Ideation; SDI). The RPP factor trended toward being more predictive of suicidal ideation at follow‐up than the SDI factor. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66:1–24, 2010.     

On the topical aspects of the activity of the Federal Service for Legal and Organizational Providence of the Activity in the Sphere of Sanitary and Epidemiological Providence and Consumer Rights

The reorganization of the Federal Service on the Control Over the Sphere of Consumer Rights and Human Welfare has made it possible to significantly increase the number of specialists working in the sphere of consumer rights. In 2005, Federal Service on the Control Over the Sphere of Consumer Rights and its territorial organs carried out 155000 inspections of the legislation on consumer rights; more than 55% of them were off-schedule inspections of economic subjects. The inspections revealed almost 210000 facts of failure of the subjects to follow the rules of consumer legislation (140 reports on infringements). Of all the infringements, 40% were failures to satisfy consumer's rights for information. The Federal Service has opened a hotline on the actual problems of consumer rights. Similar hotlines have been opened by Magadan and Saint Petersburg etc. territory administrations. Among the main tasks directed to perfection of governmental control over consumer rights protection is development of a complex of measures aimed at prevention of infringements in this area, especially in dwelling sphere, medical aid, transportation, retail etc. Also needed are development and realization of interaction between territory organs of the Federal Service and local offices as well as public and remedial organizations working in the field of consumer rights and human welfare. Problems of hygiene and epidemiology in the Federal Service are nowadays being solved by 28 epidemiological, hygienic, and antiplague research institutes employing 3000 researchers including 290 doctors of science and 820 candidates of science. Territory administrations present the main regional structure of the Federal Service. This should be taken into account when building relations between territory administrations and regional offices of the Federal Service. The main directions of the activity of the Federal Service in 2006 are determined by 15 December 2005 order #794 and include a vast list.     

Tele-health: lessons and strategies from specialists in poison information

Objective

The use of the telephone for providing healthcare is growing. The aim of this exploratory study was to describe tele-health lessons and strategies as discussed by specialists who provide information and recommendations on poison control hotlines.

Methods

Three focus groups of 25 participants who work as specialists in poison information in poison control centers were conducted. Group discussions were analyzed using qualitative content analysis.

Results

Themes that emerged from the data on strategies for telephone communication include: taking control of the call, developing a therapeutic relationship, tailoring communication to fit each caller, preventing information overload, confirming caller understanding, and hands-on training for the development of telephone communication skills.

Conclusion

Specialists in poison information identified challenges specific to communicating with patients over the telephone and reported several types of strategies they used to manage them.

Practice implications

Telephone communication training may be needed to assist health care providers in improving their communication skills.     

Uptake of mental health websites in primary care: Insights from an Australian longitudinal cohort study of depression

Objective

To describe the characteristics of primary care attendees with depressive symptoms who use mental health websites.

Characteristics and Help-Seeking Behaviors of Internet Gamblers Based on Most Problematic Mode of Gambling

Background

Previous studies of problem Internet gamblers have failed to distinguish whether their problem gambling relates to Internet or land-based gambling modes. Therefore, characteristics and help-seeking behaviors of people whose gambling problems relate specifically to Internet gambling are unknown, but could inform the optimal alignment of treatment and support services with the needs and preferences of problem gamblers.

Objective

This study aimed to compare (1) characteristics of problem Internet gamblers and problem land-based gamblers and (2) uptake of different types and modes of help between problem Internet gamblers and problem land-based gamblers. Hypothesis 1 was that problem Internet gamblers are less likely to seek help. Hypothesis 2 was that problem Internet gamblers are more likely to use online modes of help.

Methods

A sample of 620 respondents meeting criteria for problem gambling was drawn from an online survey of 4594 Australian gamblers. Respondents were recruited through advertisements on gambling and gambling help websites, Facebook, and Google. Measures consisted of gambling participation; proportion of gambling on the Internet; most problematic mode of gambling; help seeking from 11 different sources of formal help, informal help, and self-help for gambling problems; psychological distress (Kessler 6); problem gambling severity (Problem Gambling Severity Index, PGSI); and demographics.

Results

Problem Internet gamblers were significantly more likely than problem land-based gamblers to be male (χ² ₁=28.3, P<.001, φ=0.21), younger (t _616.33=4.62, P<.001, d=0.37), have lower psychological distress (χ² ₁=5.4, P=.02, φ=0.09), and experience problems with sports and race wagering (χ² ₄=228.5, P<.001, φ=0.61). Uptake of help was significantly lower among problem Internet compared to problem land-based gamblers (χ² ₁=6.9, P<.001, φ=0.11), including from face-to-face services, gambling helplines, online groups, self-exclusion from land-based venues, family or friends, and self-help strategies. Both problem Internet and problem land-based gamblers had similarly low use of online help. However, problem land-based gamblers (37.6%, 126/335) were significantly more likely to have sought land-based formal help compared to problem Internet gamblers (23.5%, 67/285; χ² ₁=14.3, P<.001, φ=0.15).

Conclusions

The findings suggest that more targeted and innovative efforts may be needed to increase use of gambling help by problem Internet gamblers. Alternatively, their lower PGSI and K6 scores suggest Internet problem gamblers may have less need for gambling-related help. This is the first known study to classify problem Internet gamblers as those whose problem gambling specifically relates to Internet gambling. Further research is needed to better understand why help-seeking rates are lower among Internet problem gamblers.     

Posttraumatic stress disorder symptoms and coping with the lockdown among help-seeking veterans before and during the COVID-19 pandemic

AimsTo compare the severity of posttraumatic stress disorder (PTSD) symptoms and of particular PTSD clusters among help-seeking veterans before and during the COVID-19 lockdown. The second aim was to identify the main coping strategies used.MethodsMale war veterans (N = 176) receiving outpatient treatment at the Referral Center for PTSD were assessed at baseline (12-18 months before the pandemic declaration in March 2020) and during the COVID-19 pandemic lockdown (March-June 2020). The Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, and The Brief COPE were used.ResultsDirect exposure to the virus in our sample was low, and the majority of participants followed the preventive measures. The severity of the overall PTSD symptoms and of clusters of symptoms significantly decreased compared with the first assessment. At the second assessment, all participants still fulfilled the PTSD diagnosis criteria. During the lockdown, the participants used emotion-focused and problem-focused coping rather than dysfunctional coping.ConclusionThe severity of PTSD symptoms decreased during the lockdown. Further research is needed to study the trajectories of long-term psychopathology.

The COVID-19 pandemic has severely threatened the physical and mental health of individuals around the world. Stressors have included isolation, self-isolation or quarantine, restricted movement and physical contact, infection fears, loss of loved ones, lack of supplies, inadequate information (“infodemic”), financial loss, and social stigma (1-3). During emergencies, mental health requires special consideration due to increased rates of stress-related mental health problems and limited availability of mental health services (2-5).Depending on the emergency context, particular groups of people are at an increased risk of experiencing social and psychological problems (6), and ex-combatants have been repeatedly shown to be one of them (7).Exposure to a new traumatic or stressful life event might affect posttraumatic stress disorder (PTSD) symptoms. A growing body of research shows that such exposure is a risk factor for worsening of the condition in various groups of PTSD patients (8,9). This mainly happens if the subsequent event is of the same type as the initial stressors, serving as a reminder and as an additional traumatic factor with a “wear and tear” effect on the exposed person (10-13).Regarding the coping strategies used among PTSD patients, combat veterans with PTSD report a more ineffective and dysfunctional coping style, with the avoidance coping style as a predictive factor of the overall PTSD symptom severity (14-16). PTSD patients try to avoid confrontation with trauma-reminders, intrusive memories, and trauma-related thoughts and emotions (17,18). Some authors emphasize the importance of differentiating between coping strategies with PTSD symptoms and coping strategies with actual traumatic or stressful events as they depend on various factors related to the specific traumatic exposure (19).Twenty-five years after the Homeland War in Croatia (1991–1995), veterans still suffer from numerous health problems and have been highly prevalent among the users of the health facilities for PTSD treatment (20-22). The same is true for PTSD patients treated in the Referral Center of the Ministry of Health of the Republic of Croatia (RCPTSD) at the Clinical Hospital Center (CHC) Rijeka. A recent study revealed high rates of overall symptoms and severe posttraumatic symptoms (ie, complex PTSD) in this population years after the war ended (23).The COVID-19 pandemic lockdown in Croatia started on March 19, 2020. According to Oxford University, Croatia introduced the world''s strictest restrictions in relation to the number of the infected (24,25). On March 21, 2020, mental health experts from RCPTSD recommended self-help strategies for staying in good mental health and advice for front-liners on how to deliver psychological first aid (26,27). On the same day, the Croatian Psychiatric Association Expert Group released recommendations for the organization of psychiatric care, psychiatric interventions, and psychopharmacological treatment of mental conditions during the COVID-19 pandemic, and for de-escalation and appropriate communication techniques with aggressive patients (28-30). In RCPTSD, mental health service was restructured to be delivered via the internet or hotlines during the pandemic, with a possibility for urgent outpatient and inpatient treatment. On April 27, 2020, the lifting of restrictions began.To our knowledge, no study worldwide has examined the psycho-social correlates of the COVID-19 pandemic lockdown in veterans with PTSD. Therefore, we aimed to compare the severity of PTSD symptoms and of particular PTSD symptom clusters before and during the COVID-19 pandemic lockdown. Second, we identified the main coping strategies that veterans used during the lockdown.     

甘肃省虻科昆虫区系研究

采用网捕、畜诱、帐诱和诱虻器诱捕法对甘肃省虻科区系作了调查研究,并对所收藏标本进行整理和前人文献收集。记述甘肃省虻科6属82种(检视标本61种,另有21种依据文献资料,未见标本),即斑虻属10种、黄虻属6种、麻虻属8种、瘤虻属28种、虻属29种和指虻属1种。各分布区的虻种组成与数量不一,陇南南部山地虻科5属31种,其中东洋界成分11种,古北界成分8种,广布种成分12种,是甘肃省虻种分布最多的地区;陇南北部山地虻科5属28种,其中古北界成分18种,广布种成分10种;甘南高原草原虻科5属22种,其中古北界成分18种,广布种成分4种;陇东黄土高原虻科2属5种,其中古北界成分2种,广布种成分3种,该区虻种组成简单,也是虻种数最少的分布区;中部黄土高原虻科5属11种,其中古北界成分6种,广布种成分5种;河西走廊虻科5属28种,其中古北界成分25种,广布种成分3种;祁连山地虻科4属12种,其中古北界成分11种,广布种成分1种。     

良性阵发性位置性眩晕的诊断和治疗

目的：探讨良性阵发性位置性眩晕(BPPV)的诊治方法。方法：回顾性分析8例BPPV的临床资料。对所有患者全面采集病史及耳神经学检查，并施行Dixt-Hallpike试验及仰卧侧头位试验，按BPPV的不同类型分别采用Epley耳石复位法和Lempert翻滚法进行治疗。结果：8例BPPV中有5例属于后半规管性BPPV(PC—BPPV)，2例为水平半规管性BPPV(HC—BPPV)，1例为混合型。采用上述两种治疗方法后效果良好。8例患者经1～7次治疗后症状均缓解。结论：根据典型临床表现及体位试验可明确诊断，根据不同类型BPPV采用不同的复位治疗方法，Epley耳石复位法及Lempert翻滚法是治疗BPPV的首选治疗方法。     

Typing ofSalmonella species

Epidemiological markers of strains ofSalmonella are classified as major or minor. Major epidemiological markers are determined by chromosomal genes and are not affected by extrachromosomal elements. They are subspecies and serovars. Minor epidemiological markers are either affected by extrachromosomal replicons or have an insufficiently proven genetic stability and are used to subdivide serovars in detailed epidemiological investigations. These minor markers are biovars, phagovars, bacteriocinovars, patterns of resistance to antimicrobial agents, and restriction patterns of chromosomal and plasmid DNA.     

Epidemiology of drug allergy

Adverse drug reactions occur in 10-20% of hospitalized patients, and up to one-third of these are of an allergic or pseudo-allergic nature. Allergic reactions are unpredictable adverse effects that are linked to immunological mechanisms. Pseudo-allergic reactions are unpredictable adverse reactions that are clinically similar to allergic reactions, but for which there are no drug-specific antibodies or T lymphocytes. There is a paucity of tools that allow a definite diagnosis, and most of the available ones still require validation. Therefore, there are few true epidemiological data, and most of those that are available, including incidence, mortality and socioeconomic impact data, should be interpreted with caution.     

The ultrastructure of normal myogenesis in the limb of the mouse

The ultrastructure of myogenesis in the mouse hind limb has been studied from day 12 to birth. Mononucleated cells with myofilaments are small and infrequent during myogenesis and never line myotubes. Only mononucleated cells without myofilaments cover the myotubes are involved in mass fusion. These mononucleated cells are pleomorphic and undifferentiated during early myogenesis. They have a heterochromatic nucleus and many accumulate mitochondria and lengthen during days 16-18. After day 18 they are normally elongate with a heterochromatic nucleus and packed with free ribosomes. The multinucleated cell development may be divided into four stages. 1. Immature myotube (days 14-15). Their fibrils are small, out of register and some poorly defined. Many myofilaments are not in rigid hexagonal alignment. The sarcoplasmic reticulum is simple and randomly oriented and triads are absent. Large clumps of glycogen occur between euchromatic nuclei which are in chain formation. 2. Mature myotube (days 16-18). Small groups of fibrils show alignment. Glycogen granules and sarcoplasmic reticulum become numerous between fibrils. Triads are sparse and mitochondria cluster in subsarcolemmal regions and between nuclei. 3. Young myofibers are present by day 19. More fibrils are aligned and compact. The filaments are in a rigid hexagonal array, the glycogen is dispersed and nuclei are peripherally located and moderately heterochromatic. Triads are frequent but often obliquely oriented and mitochondria are elongate and numerous between fibrils. 4. Mature myofibers occur postnatally (2 weeks).