Cent Of Calls Research Articles

The psychedelic call: analysis of Australian Poisons Information Centre calls associated with classic psychedelics

Introduction The global use of certain classical psychedelics has increased in recent years, but little is known about their spectrum of toxicity within Australia. We aim to describe calls to New South Wales Poisons Information Centre relating to exposures to classical psychedelics including lysergic acid diethylamide, psilocybin, N,N-dimethyltryptamine, ayahuasca, mescaline and ibogaine. Methods This is a retrospective observational study of calls to New South Wales Poisons Information Centre between January 2014 and December 2022. We identified exposures to classical psychedelics within New South Wales Poisons Information Centre database and measured the annual number of exposures, source of call (hospital, health care worker, member of the public), co-ingested substances, clinical features and advice given. Results There were 737 calls related to relevant psychedelic exposures; 352 (47.8 per cent) to lysergic acid diethylamide, 347 (47.0 per cent) to psilocybin, 28 (3.8 per cent) to N,N-dimethyltryptamine, 4 (0.5 per cent) to ayahuasca, 4 (0.5 per cent) to mescaline and 2 (0.3 per cent) to ibogaine. Cases were predominantly male (77.2 per cent) and aged between 20 and 74 years (65.6 per cent). Psychedelic calls more than doubled from 45 in 2014 to 105 in 2022 and 625 (85 per cent) of all calls were either from or referred to hospital. Co-ingestion of psychedelics with another substance occurred in 249 (33.8 per cent) of calls and the most frequent clinical features related to single substance psychedelic exposures were hallucinations (27.6 per cent), gastrointestinal symptoms (21.7 per cent) and tachycardia (18.1 per cent). Seizures occurred in 2.9 per cent of single substance psychedelic exposures. Discussion Increasing incidence of psychedelic exposure calls, including those reporting significant toxicity, likely reflects increasing community use. This may in part be driven by increasing interest in psychedelic assisted psychotherapy trials subsequently increasing public awareness. Conclusion Relatively high poisoning severity contrasts with safety within clinical trials of psychedelic assisted psychotherapy that may relate to the uncontrolled nature of community use which is mitigated within clinical trial environments. Education about safe use may be useful.

Lost in translation: Telephone referrals to a tertiary neurology referral centre.

Cork University Hospital acts as the tertiary referral centre for the HSE southern area, with a catchment population of 1.2 million [1]. The neurology registrars receive telephone consultations from hospitals and primary care practices in the region. While there have been a number of studies examining inpatient neurology consultations in Irish hospitals [2-6], there is a paucity of data examining the support provided by tertiary referral centres to other acute hospitals and primary care centres in their region. The aim of this study is to define the workload of the neurology registrar with respect to telephone consultations and to examine the quality of these referrals. All calls received from the 19th of October 2021 to the 25th of February 2022 were logged by the receiving registrar. Information collected pertained to the nature of the consult and completeness of the referral. The average volume of calls during the study period was six per week. The median call duration was 8min. The cumulative time spent resolving outside calls during the study period was at least 41.25hours. Sixty-three per cent of calls were from other acute hospitals in the region. Thirty-nine per cent of referrals were deemed incomplete with respect to either history, collateral history or examination. This is a necessary service in a system that is not adequately resourced to provide specialist led care in all hospitals. A greater emphasis on complete and accurate referrals, along with robust communication and documentation, could reduce the inherent risk associated with such consultations.

Activity of Forest Elephant (Loxodonta cyclotis) In Two Clearings within Ogooué Leketi National Park, Congo Brazzaville

In order to increase our understanding of forest elephant (Loxodonta cyclotis) vocal communication, this study examined the spatial and temporal activity of elephants from two forest clearings (Bissoloko and Madjouama). To obtain data on the visit of elephant in the clearings daily, it requires considerable human and financial resources for conservation programs observations. However, we deployed autonomous acoustic recorders “SM2” to assess elephants’ activities both day and night time from 2013 to 2014. Elephant visitation in these clearings depends on certain factors as, seasons, years, and preferences of elephant to use one or more site. As a results this study found that (i) elephants visited Bissoloko clearing more than Madjouama, although these two clearings were within 5 km distant one another; (ii) Eighty six per cent of elephant calls occurred at night, and large changes in call density at night often were not reflected in similar changes during the day; (iii) there were significant differences in the calls made at night; (iv) elephants were found to be visiting clearings more often in the wet season than in the dry season; (v) visitation was significantly higher in 2013 than in 2014. Elephants used randomly one or other clearings. This empirical study suggests that African forest elephant has two vocal communication practices. Spatially separated females engage in rumble exchanges that help them to coordinate their movements and to bring them together. Both male and female elephants produce "mate attraction" rumbles to inform the opposite sex of their reproductive status. These results show the value of acoustic monitoring as a tool for better understanding of forest elephant behaviour. We suggest that passive acoustic monitoring should be incorporated into forest elephant monitoring programs to complement direct observations at forest clearings.

A telehealth intervention for families caring for a child with traumatic brain injury (TBI)

Purpose – The purpose of this paper is to determine the preliminary clinical utility of a telephone-support format of the “Signposts” (Hudson et al., 2003) behavioural intervention programme to be used with a paediatric traumatic brain injury (TBI) population. Design/methodology/approach – Nine families caring for a child with moderate or severe TBI, participated in a pilot study of a TBI adapted “Signposts for Building Better Behaviour” manualised programme. The programme is designed to help parents learn positive parenting skills and strategies that empower them to successfully manage their child's challenging behaviour post-TBI. The programme consists of seven core sessions and two supplemental sessions. Parents work through the sessions with an accompaniment of guiding information booklets, a DVD with scenes modelling positive parenting strategies, and a workbook containing written exercises. At the completion of each session parents receive a telephone-support call from a trained Signposts practitioner who provides assistance and feedback on programme content. Findings – On average parents completed eight sessions (range seven to nine) and every family completed the seven core sessions. Participation in the telephone-support calls was high with 96 per cent of calls having been successfully received by families. All parents agreed that the telephone calls were a useful part of the programme and felt that the materials were helpful for managing challenging behaviour. Paired-samples t-tests showed significant reductions for challenging behaviour from pre- to post-intervention. Parenting practices also significantly improved over the course of the intervention. In general, parents rated a high level of consumer satisfaction with the Signposts programme and its content. Originality/value – Overall, these preliminary findings support the potential clinical utility of a telephone-support version of the Signposts programme to improve parenting skills and to reduce challenging child behaviour following TBI. This study has provided the impetus for a larger clinical research trial to be conducted.

Plant poisoning in domestic animals: epidemiological data from an Italian survey (2000–2011)

An Italian epidemiological study based on the human Poison Control Centre of Milan (Centro Antiveleni di Milano (CAV)) data related to domestic animal poisoning by exposure to plants, was carried...

Phone calls to a hospital medicines information helpline: analysis of queries from members of the public and assessment of potential for harm from their medicines

To find out what questions the public ask of pharmacists on a hospital medicines information helpline, and to assess the potential for improving individuals' management of medicines through telephone helpline support. We analysed consecutive phone calls made by members of the public over 6 months to a hospital pharmacy medicines information helpline. Calls were coded for type of medicine, reason for phoning and any error revealed in the call. We also looked at which medicines were associated with harm and/or potential for harm had the caller not enquired about appropriate action to take. Five hundred of the 923 consecutive calls to the helpline were from members of the public (including discharged hospital patients). Antimicrobial agents, analgesics and cardiovascular medicines accounted for approximately half of all calls. The reason for phoning was most often to ask about interactions (22%), directions for use (21%) or advice on adverse effects (15%). In a third of calls it is possible an error had occurred (including patient error and directions missing from a dispensed item). Forty-eight per cent of calls were concerned with harm or judged to have potential for harm had professional information not been available. Four of these cases (0.8%), one of which was patient error and three of which were adverse effects reported by the caller, were categorised as Harm Index category F, defined as requiring intervention and referral. Our medicines information helpline appears to be a valuable resource for discharged patients and public and the advice given may be expected to improve safety with medicines and reduce harm. Our results reveal gaps in patient education about their medicines, some of which could be addressed by dispensing staff or the pharmacist at discharge. The data provide a baseline for measuring improvements in medicines management and will be useful in identifying patients who may benefit from follow-up call support from pharmacists.

News

Ten per cent of calls to the newly launched Dental Complaints Service originated with a dental practice referring a patient to the service for help. While the new service has only been in existence for one month, this early evidence suggests that DCS will be as helpful to dental teams as it is to patients.

Medical Care during the Depression1: A Preliminary Report upon a Survey of Wage‐Earning Families in Seven Large Cities2

The problem of giving services free has faced the doctor and the hospital during the depression to an extent unknown in any other field. A factory manager was able to economize during hard times by eliminating unproductive departments, by introducing labor-saving devices, or, as a last resort, by closing his plant until the return of prosperity. No such expedients were available to the doctor or the hospital director. Business had to continue as usual in spite of the decrease of paying patients and the tremendous increase of free care. While the writers of this paper offer no solution for these economic problems, they do have pertinent data to present on the amount of physician's, hospital, and nursing care, both pay and free, received by a group of nearly 7,000 families in seven large cities surveyed early in 1933 by the United States Public Health Service in cooperation with the Milbank Memorial Fund. The reader is referred to previous papers3 for details, method, and scope of the survey. Briefly, it consisted of a house-to-house canvass of some 12,000 white families in the poorer districts of eight large cities, one group of coal-mining communities, and a group of cotton-mill villages. The records obtained by the canvasses included (a) the economic history of the family in sufficient detail for computing family income for each year from 1929 through 1932, and (b) a record of all illness during the three months immediately preceding the date of the enumerator's visit, in the spring of 1933, with the extent of disability and of medical care for each case. The sample population discussed in the present paper comprised 28,959 individuals in 6,686 families for which the data were sufficiently complete for computing the actual income for each of the four years from 1929 to 1932. The population was largely of the wage-earning class, a considerable proportion of which had experienced loss of income due to unemployment and wage reductions. In 1929, 10 per cent of the persons surveyed were in families with an annual per capita income of $149 or less; by 1932, 43 per cent were in this class. On the other side of the picture, 42 per cent of the persons were in families with an annual per capita income of $425 or more in 1929, but by 1932 this figure had decreased to 14 per cent.

A central role for the health call centre

THERE ARE SIGNIFICANT CHALLENGES facing the health system that stem from the tendency for decisions to be made by disparate groups focusing more on the needs of institutions rather than the needs of patients.1 As a result, patient care is becoming episodic, with poor communication leading to inefficiencies, errors and adverse outcomes. An ideal health system provides ?quality care that is centred on the patient, communitybased, coordinated, continuous and cost-effective, and utilises clinical information systems?.2 (page 229) We believe health call centres (HCCs) could be instrumental in achieving such aims. In May 1999, the Western Australian Department of Health in conjunction with McKesson Asia Pacific established the Western Australian Health Call Centre (WAHCC).3 Clinical governance is overseen by three medical directors and a specialist nurse, and staff participate in comprehensive, continuous education and quality improvement. Since its inception, the WAHCC has witnessed an increase in demand and serves about 225 000 callers annually. This amounts to 600 callers per day at a cost (in 2004) of about $28 per call ? 0.0018% of the health budget. Seventy per cent of calls are received after hours, particularly on weekends and public holidays. The initial program offered by the WAHCC was HealthDirect. Services have expanded to include programs and pilot projects listed in the Box .

Agonistic screams and the classification of dominance relationships: are monkeys fuzzy logicians?

Scream vocalizations of group-living rhesus macaques provoked by higher-ranking aggressors were examined in two contexts: encounters in which the rank difference between opponents was either large or small. Such vocalizations are important in eliciting support from the caller's allies in the group (usually matrilineal kin). Five acoustically distinct recruitment screams encode specific information about features of the agonistic context, for example, relative rank of the opponent and the severity of the attack. Against higher-ranking opponents, noisy screams are most likely to be given during encounters that involve contact aggression, and tonal or undulated screams are most likely for non-contact aggression. We predicted that scream bouts directed to small rank difference opponents would be more likely to comprise calls from scream classes other than the expected type, and that scream bouts from large rank difference encounters would be more in accord with the expected class. For large rank difference bouts, on average 74.2% of calls were of the expected class; for small rank difference bouts, a significantly smaller per cent (53.8%) of calls was accurately predicted. In the large rank difference encounters, 65.6% (55/84) of bouts were composed entirely of expected scream types, but only 47.6% (39/82) were uniformly correct for small rank difference encounters. Large rank difference interactions also yielded significantly fewer bouts where none of the screams produced by the victim of attack belonged to the predicted class. We suggest that a multi-valued or fuzzy logic system, that is one with more than two truth values, might be a more realistic way to conceptualize the categorization of certain referents of monkey vocalizat.

Patterns of Partisanship in a Nonpartisan Representational Setting: The Illinois Constitutional Convention

Roll call voting the convention was highly structured. Using MacRae's clustering and scaling techniques, 78 per cent of the roll calls with disagreement fitted into 13 substantive dimensions. Although members were elected on a nonpartisan ballot, and did not organize the convention a partisan fashion, partisan identification of the members was the best of several political, social, career, and constituency variables accounting for roll call voting variance on most dimensions. Multiple regression analysis reveals that the other independent variables account for little roll call voting variance on dimensions not explained by partisanship. Recent literature on roll call voting has indicated that the key explanatory variable is ordinarily the party identification of the legislators. Where partisans are clearly identified, this variable seems to outweigh the effects of others both structuring and explaining the roll call voting behavior. In essentially one party legislatures, researchers have found relatively little structure to voting.' In his study of the Oklahoma House of Representatives, Patterson found that there were few discernible dimensions of voting, and that those which could be identified related only weakly to one another. What dimensions there were, were modestly related to a variety of independent variables and the explanations offered for the various dimensions were unique. The inference was that, in the absence of party as a reference group, the legislator is likely, consciously or unconsciously, to respond to

Determinants of medical care utilization: the role of the telephone in total medical care.

The importance of the telephone in the American medical care system is only beginning to receive appropriate attention. Fast studies indicate that a significant proportion of new diseases and a significant proportion of all medical care contacts take place by phone. A study of telephone use in a prepaid group practice system is presented. Data on telephone utilization are analyzed to determine the significance of telephone utilization of the population and to identify the patterns of telephone calls within total care seeking behavior. The purpose is to determine alternative modes of dealing with problems presented by phone or at least to assure that this important aspect of care is integrated into medical care. Telephone calls represented a significant proportion of the total medical care of the study population. About 50 per cent of all phone calls to medical core personnel were concerning symptoms of disease and approximately 40 per cent concerned laboratory results or prescriptions. Factors affecting the disposition of symptom phone calls were analyzed. It was hypothesized that the relative probability of a patient being told to come to the clinic after discussing a symptom would vary inversely with the certainty of the physician in his diagnosis and directly with the seriousness of the disease as perceived by the physician. The inferences from the data generally tended to support the hypotheses. These tendencies, however, were not strong enough to accurately predict when the physician would only discuss the symptom, give a prescription, or request a patient to visit. The concepts do not yet lend themselves to operational decision models for use by personnel trained to handle these kinds of calls, because of tremendous individual variation among physicians that confounds attempts to predict the disposition of symptom phone calls using only patient, disease, and situational variables.

The Chronic Caller and an Emergency Telephone Advisory Service

In 1960 a Personal Emergency Advisory (Telephone) Service was opened in Melbourne. The setting up of this facility was largely motivated by a concern with the allegedly rising suicide figures. However, such a facility is perhaps rather more concerned with “the relief of anxiety rather than with the direct prevention of suicide”. Such a point of view is clearly supported by an analysis of the Melbourne figures for the period April, 1960-March, 1962 when the incidence of “suicide calls” was found to be some 10 per cent of the total calls received.

The 1962 Survey of Noise and Loss on Toll Connections

The 1962 sample survey of message circuit noise and loss on Bell System toll connections is described and discussed in this article. The results are presented in terms of the distribution of noise levels on toll calls as established in the present system, the distribution of end-office to end-office losses on these calls, and the distribution of airline distances between end-offices. It is shown that the noise distribution referred to the subscriber's set has a mean of 19.7 dbrnc with a standard deviation of 7.8 db, that the mean of the distribution of end-office to end-office losses is 7.7 db with a standard deviation of 3.0 db, and that 50 per cent of all toll calls are shorter than 30 miles, while only 10 per cent span a distance of more than 250 miles. The noise level versus distance and loss versus distance relationships are investigated and analyzed. The noise level is found to increase by 2.2 db for each doubling of the airline distance between end-offices, while the loss shows an increase of 0.6 db for each doubling of the distance. Finally, present performance of the Bell System toll plant is evaluated in terms of noise and volume grade-of-service estimates.

Digital Simulation of Complex Traffic Problems in Communications Systems

This is a report on a method that was devised for simulating on a digital computer the performance of a large, complex communications system. The communication system consisted of many interconnected switching centers, each center having a large number of trunk groups attached to it. Each trunk group has access, through the switching centers, to any other trunk group located anywhere in the system. In order to conform as closely as possible to reality, the computer was programmed to simulate the performance of a human operator(s) at each of the switching centers. A method for simulating a completely automatic switch system was also devised. The computer logic was flexible enough to account for (1) any routing doctrine (or operator procedure), (2) any type of traffic distribution (Poisson or otherwise), (3) any configuration with any interconnecting facilities, and (4) a large number of trunk group inputs. Outages of either individual lines or entire switching centers due to equipment failure were treated. For a given traffic input, system configuration, and method of servicing calls, system performance data were taken in terms of the following parameters (1) Per cent completed and lost calls at each center and for the over-all system (2) Per cent of calls lost for various reasons (e.g., excessive waiting, busyness of subscriber facilities) (3) Utilities of operators and trunk lines (4) Distribution of and average waiting time. Successful runs were made on a digital computer whose storage capacity was 1000 words, each word consisting of 12 digits.

Application of toll dialing in Pennsylvania

PLANS for mechanizing the handling of long-distance telephone calls, using common control equipment to obtain improved quality of service and economy of operation, were initiated in 1941 and the first installation of this type was made at Philadelphia in 1943.1 In spite of the delays occasioned by the war, substantial progress has since been made in this project which affects nearly every phase of telephone operation, so that by 1954 more than 50 per cent of all long-distance calls in the United States are being completed on a mechanized basis. Many technical articles have been written describing the general plan for mechanization, as well as specific parts. <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> ‾ <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">7 </sup> This paper is intended to cover the problems involved in applying the nationwide dialing plan to the territory operated by The Bell Telephone Company of Pennsylvania. It should be clear, however, that the independent telephone companies which operate a large part of the area of the State of Pennsylvania are participating in these plans.