Feasibility of brief psychological distress screening by a community-based telephone helpline for cancer patients and carers

Background Up to one-third of people affected by cancer experience ongoing psychological distress and would benefit from screening followed by an appropriate level of psychological intervention. This rarely occurs in routine clinical practice due to barriers such as lack of time and experience. This study investigated the feasibility of community-based telephone helpline operators screening callers affected by cancer for their level of distress using a brief screening tool (Distress Thermometer), and triaging to the appropriate level of care using a tiered model. Methods Consecutive cancer patients and carers who contacted the helpline from September-December 2006 (n = 341) were invited to participate. Routine screening and triage was conducted by helpline operators at this time. Additional socio-demographic and psychosocial adjustment data were collected by telephone interview by research staff following the initial call. Results The Distress Thermometer had good overall accuracy in detecting general psychosocial morbidity (Hospital Anxiety and Depression Scale cut-off score ≥ 15) for cancer patients (AUC = 0.73) and carers (AUC = 0.70). We found 73% of participants met the Distress Thermometer cut-off for distress caseness according to the Hospital Anxiety and Depression Scale (a score ≥ 4), and optimal sensitivity (83%, 77%) and specificity (51%, 48%) were obtained with cut-offs of ≥ 4 and ≥ 6 in the patient and carer groups respectively. Distress was significantly associated with the Hospital Anxiety and Depression Scale scores (total, as well as anxiety and depression subscales) and level of care in cancer patients, as well as with the Hospital Anxiety and Depression Scale anxiety subscale for carers. There was a trend for more highly distressed callers to be triaged to more intensive care, with patients with distress scores ≥ 4 more likely to receive extended or specialist care. Conclusions Our data suggest that it was feasible for community-based cancer helpline operators to screen callers for distress using a brief screening tool, the Distress Thermometer, and to triage callers to an appropriate level of care using a tiered model. The Distress Thermometer is a rapid and non-invasive alternative to longer psychometric instruments, and may provide part of the solution in ensuring distressed patients and carers affected by cancer are identified and supported appropriately.

Unravelling (e-)government channel selection: A quantitative analysis of individual customer preferences in Germany and Australia

The purpose of this study is to identify the impact of individual differences on service channel selection for e-government services. In a comparative survey of citizens in Germany and Australia (n=1205), we investigate the impact of age, gender, and mobility issues on the selection of personal or mobile communication as channels for service consumption. The results suggest that Australians are more likely to want to use new technology-oriented channels as internet or mobile applications while Germans tend to use classical channels as telephone or in person. Moreover, differences with respect to age, gender, and mobility exist. Implications for practice and issues for future research are discussed.

Detection of the closure-burst transitions of stops and affricates in continuous speech using the plosion index

Automatic and accurate detection of the closure-burst transition events of stops and affricates serves many applications in speech processing. A temporal measure named the plosion index is proposed to detect such events, which are characterized by an abrupt increase in energy. Using the maxima of the pitch-synchronous normalized cross correlation as an additional temporal feature, a rule-based algorithm is designed that aims at selecting only those events associated with the closure-burst transitions of stops and affricates. The performance of the algorithm, characterized by receiver operating characteristic curves and temporal accuracy, is evaluated using the labeled closure-burst transitions of stops and affricates of the entire TIMIT test and training databases. The robustness of the algorithm is studied with respect to global white and babble noise as well as local noise using the TIMIT test set and on telephone quality speech using the NTIMIT test set. For these experiments, the proposed algorithm, which does not require explicit statistical training and is based on two one-dimensional temporal measures, gives a performance comparable to or better than the state-of-the-art methods. In addition, to test the scalability, the algorithm is applied on the Buckeye conversational speech corpus and databases of two Indian languages. (C) 2014 Acoustical Society of America.

The United States and Latin America and the Caribbean: Highlights of economics and trade

Foreword by Alicia Bárcena

The United States and Latin America and the Caribbean: highlights of economy and trade

Document prepared on the occasion of the visit of President Barack Obama to Brazil, Chile and El Salvador in March 2011

Supporting the Revolution: America, Democracy, and the End of the Cold War in Poland, 1981-1989. ACES Working Paper (Report) No. 8, 2007

Early on the morning of December 13, 1981, General Wojciech Jaruzelski, the leader of the communist Polish United Workers' Party (PZPR), declared martial law, ending the so-called "Polish Crisis," which began with the creation of the Independent Free Trade Union "Solidamosc" in August 1980. Over the next eight years, the Communist government and the opposition struggled over power, culminating in 1989 with the creation of a Solidamosc-led government which ended fifty years of Communist rule in Poland and led the way to further democratic revolutions throughout Eastern Europe. The purpose of this dissertation is to utilize newly available and underutilized archival sources as well as oral history interviews, from both international and American perspectives, to fully chronicle American policy toward Poland from the declaration of martial law until the creation of the Solidarnosc government. Rather than explaining Polish-American relations in bilateral terms, the dissertation illuminates the complex web of influences that determined American policy in Washington and affected its implementation within Poland. This includes descriptions of internal tensions within the Reagan administration, differences between American decisions in Washington and implementation in Warsaw, lobbying from Polish-American groups, clashes between Capitol Hill and the White House, coordination with American labor organizations to support Solidarnosc, disagreements with West European allies in NATO and international financial organizations, cooperation with the Vatican and the Polish Catholic Church, synchronization with American humanitarian organizations working in Poland, limitations caused by the realities of Soviet power in Eastern Europe, and complications caused by domestic Polish concerns. By taking a broad view of American policy and highlighting internal Polish decisions, with both the Communist government and the democratic opposition, the dissertation provides concrete examples of America's role in Poland's transformation, arguing, however, that this role was very limited. These conclusions are relevant to arguments about the end of the Cold War, the nature of American power, as well as current discussions about possibilities to promote democracy within hostile regimes.

Graptolites of North America /

Mode of access: Internet.

The works of Francis Parkman.

Each front accompanied by guard sheet with descriptive letterpress.