Helpline Service Research Articles

Prehospital management and outcomes of patients calling with chest pain as the main complaint

BackgroundChest pain is a frequent cause of health care contacts. We examined the prehospital management, in-hospital discharge diagnoses, and mortality of patients calling a non-emergency and emergency medical service with chest pain.MethodsThe Copenhagen Emergency Medical Services (EMS) consists of a non-emergency medical helpline (calls to 1813) and emergency medical service (1-1-2 calls). We included all calls to the Copenhagen EMS with a primary complaint of chest pain from 2014 to 2018 in Copenhagen, Denmark. The outcomes were: emergency response (ambulance dispatch, other transports/self-transport/home visits, self-care, and unknown/cancelled response), in-hospital diagnosis within 7 days after the call (cardiovascular, pulmonary, or other non-cardiovascular/pulmonary) and 30-day mortality.ResultsAmong 4,834,071 calls, 91,671 were registered with chest pain at the Copenhagen EMS. The first call for each patient was kept for analysis (n = 66,762). In total, 91.4% were referred to the hospital, 75.8% (n = 50,627) received an ambulance and 15.6% (n = 10,383) received other transport/self-transport/home visits. Overall, 26.9% (n = 17,937) were diagnosed with a cardiovascular disease, 5.2% (n = 3,490) a pulmonary disease, 52.8% (n = 35.242) other non-cardiovascular/pulmonary disease, and 15.1% (n = 10,093) received no diagnosis. Among ambulance-transported patients, the prevalence of cardiovascular discharge diagnoses was higher (32.1%) and fewer received no diagnosis (11.0%). Cardiovascular disease was less prevalent among patients not transported by ambulance and patients not referred to hospital at all (2-13.4%) and in patients ≤ 40 years of age (< 10%). The 30-day mortality was below 5% regardless of diagnosis (0.6-4%), and 65,704 (98.4%) were still alive 30 days later.ConclusionNearly all patients calling with chest pain were referred for treatment. Among ambulance-transported patients, around half of the patients did not have a cardiovascular/pulmonary disease. While current practices appear reasonable, improved differentiation of chest pain patients in telephone consultations could potentially both improve the treatment and management of these patients and reduce the in-hospital burden of non-acute chest pain consultations.

Talk Time Differences Between Interregional and Intraregional Calls to a Crisis Helpline: Statistical Analysis.

National suicide prevention strategies are general population-based approaches to prevent suicide by promoting help-seeking behaviors and implementing interventions. Crisis helplines are one of the suicide prevention resources available for public use, where individuals experiencing a crisis can talk to a trained volunteer. Samaritans UK operates on a national scale, with a number of branches located within each of the United Kingdom's 4 countries or regions. The aim of this study was to identify any differences in call duration across the helpline service in order to determine whether service varied interregionally and intraregionally and to determine the impact of calls answered in the same region as the caller, compared with calls answered in a different region on the duration of calls made from landlines to Samaritans UK. Calls may be routed by Samaritans, wherein the telephony system sends the call to the next available volunteer, irrespective of location; therefore, individuals may be routed to a branch within the same region as the caller's current region (intraregional calls) or routed to a branch that is in a different region from that of the caller's current region (interregional calls). The origin of calls by region was identified using the landline prefix of the anonymized caller identifier, along with the region of the destination branch (as branch details are recorded in the call details record). First, a Levene's test of homogeneity of variance was carried out for each condition, that is, England calls and Scotland calls. Thereafter, for each condition, a one-way ANOVA or one-way analysis of means was carried out to evaluate any significant differences in call duration. ANOVA results showed that there are significant differences in call durations between intraregional calls and interregional calls (P<.001). Across all conditions within this study, callers stayed on the phone for a shorter period of time when routed to a branch that is within the same region as the call origin than if they were put through to a branch within a different region than the call origin. Statistical analyses showed that there were significant differences between interregional and intraregional calls. On average, callers to crisis helplines stayed on the phone for a shorter period of time if they were routed to a branch within the same region in which the call originated than if they were routed to a branch in a different region of origin. The findings from this study have practical applications, which may allow crisis helplines to manage their resources more effectively and improve caller satisfaction with the service.

Empathic Conversational Agent Platform Designs and Their Evaluation in the Context of Mental Health: Systematic Review.

The demand for mental health (MH) services in the community continues to exceed supply. At the same time, technological developments make the use of artificial intelligence-empowered conversational agents (CAs) a real possibility to help fill this gap. The objective of this review was to identify existing empathic CA design architectures within the MH care sector and to assess their technical performance in detecting and responding to user emotions in terms of classification accuracy. In addition, the approaches used to evaluate empathic CAs within the MH care sector in terms of their acceptability to users were considered. Finally, this review aimed to identify limitations and future directions for empathic CAs in MH care. A systematic literature search was conducted across 6 academic databases to identify journal articles and conference proceedings using search terms covering 3 topics: "conversational agents," "mental health," and "empathy." Only studies discussing CA interventions for the MH care domain were eligible for this review, with both textual and vocal characteristics considered as possible data inputs. Quality was assessed using appropriate risk of bias and quality tools. A total of 19 articles met all inclusion criteria. Most (12/19, 63%) of these empathic CA designs in MH care were machine learning (ML) based, with 26% (5/19) hybrid engines and 11% (2/19) rule-based systems. Among the ML-based CAs, 47% (9/19) used neural networks, with transformer-based architectures being well represented (7/19, 37%). The remaining 16% (3/19) of the ML models were unspecified. Technical assessments of these CAs focused on response accuracies and their ability to recognize, predict, and classify user emotions. While single-engine CAs demonstrated good accuracy, the hybrid engines achieved higher accuracy and provided more nuanced responses. Of the 19 studies, human evaluations were conducted in 16 (84%), with only 5 (26%) focusing directly on the CA's empathic features. All these papers used self-reports for measuring empathy, including single or multiple (scale) ratings or qualitative feedback from in-depth interviews. Only 1 (5%) paper included evaluations by both CA users and experts, adding more value to the process. The integration of CA design and its evaluation is crucial to produce empathic CAs. Future studies should focus on using a clear definition of empathy and standardized scales for empathy measurement, ideally including expert assessment. In addition, the diversity in measures used for technical assessment and evaluation poses a challenge for comparing CA performances, which future research should also address. However, CAs with good technical and empathic performance are already available to users of MH care services, showing promise for new applications, such as helpline services.

IMPACT OF CREATING MENTAL HEALTH HELPLINE AT A TERTIARY CARE PSYCHIATRIC SET-UP IN PAKISTAN DURING THE COVID -19 PANDEMIC

Objectives The objectives of this study were to analyze the calls received at a 24-hour helpline service set up at the Institute of Psychiatry during the first wave of the COVID-19 pandemic for the demographics of the service users, the reasons for calling the helpline phone, and the guidance provided. Design Descriptive retrospective clinical audit Place and Duration of Study The Institute of Psychiatry, from June 2020 and February 2021 Patients and Methods The entries made detailing the call records by psychiatry residents managing the helpline were analyzed. Data was extracted regarding age, area of residence, and reasons for calling by the service users of the helpline, as well as the advice given by the resident on call. The statistical analysis was performed using SPSS version 26, and findings were evaluated in terms of age, geographical distribution, reasons for seeking assistance, and the type of guidance provided thereof. Results Of the 102 calls analyzed, most of the callers were between 30 to 39 years of age (33.3%), and hailed from Rawalpindi (78.4%), followed by Kashmir (5.9%), Chakwal (4.9%) and Murree (3.9%). The most frequently stated reasons for calling were to ask about availability of out-patient services (36.3%), to have medication revised (23.5%), and to enquire about the side effects of medication (11.8%). Other reasons included recurrence of symptoms or lack of improvement in patients already taking treatment (15.7%) and to seek help regarding new psychiatric symptoms (12.7%). The responses given to the callers were invitation to come to the hospital (44.1%), provision of relevant information about the particular questions asked (for example, relating to hospital timings) (36.3%), adjustment of medications (11.8%), and prescribing medication with advice of physical follow-up (7.8%). Conclusion Despite psychiatric out-patient department being temporarily closed down during the initial waves of the COVID 19 pandemic, efforts were made to continue service provision through innovative means, like the 24-hour helpline service. There is a need to further incorporate the use of technology in the delivery of psychiatric services.

SAFE SPACE: A SUICIDE PREVENTION HELPLINE

Abstract – The rising incidence of suicide represents a profound public health crisis that demands immediate and effective intervention. Safe Space is an innovative suicide prevention helpline designed to offer timely, compassionate, and effective support to individuals in crisis. This project aims to establish a robust, accessible helpline service leveraging both human empathy and advanced technologies to provide comprehensive care and intervention. Safe Space operates through a structured, multi-tiered approach to manage incoming calls from individuals experiencing suicidal thoughts. The process begins with call reception, where trained counselors conduct an initial assessment to evaluate the caller’s immediate risk level. Based on this assessment, callers are categorized into low, medium, or high-risk groups, guiding the subsequent intervention steps. For low-risk callers, Safe Space provides emotional support, coping strategies, and referrals to local mental health resources. Medium-risk callers receive personalized safety plans and involvement from trusted individuals in their support network. High-risk callers are provided with immediate crisis intervention, including activating emergency services if necessary. KEYWORDS – Node.js, Tailwind CSS, JavaScript, Rental Accommodation, Mess Facilities, Web-Based Platform.

“Put your personality into the call”: A qualitative interview study illuminating strategies for improving men’s engagement on crisis helplines

BackgroundCrisis telephone helplines are an integral part of community suicide prevention. Despite high male suicide rates, men’s experiences of these services are poorly understood. The current study explored men’s perspectives of their interactions with helpline counsellors to understand how their engagement on helplines can be enhanced.MethodSixteen men (19–71 years) who had previously used a mental health or crisis helpline in Australia completed individual semi-structured interviews about their experiences. Data were analysed using interpretive descriptive methodologies.ResultsTwo themes derived from the data related to how men engaged with counsellors on helpline services. First, men emphasized the importance of helpline counsellors creating and maintaining an authentic connection across the call, providing suggestions for strategies to secure connection. Second, men discussed how counsellors can facilitate outcomes through offering space for their narratives and aiding in referrals to other support services when required.ConclusionsFindings highlight the value of crisis helplines for men’s suicide prevention services while identifying target areas to improve engagement. We discuss implications for the findings including suggestions for gender-sensitive care within crisis helplines.

Implementation of Chatbot Helpline Service for Healthcare using Decision Tree Algorithm

This paper presents a comprehensive review of the application of chatbot helpline services in the healthcare sector. With the advent of artificial intelligence and natural language processing, chatbots have emerged as promising tools to enhance healthcare accessibility,improve patient engagement, and alleviate the burden on healthcare providers. The paper explores the design, implementation, and evaluation of chatbot helpline services, emphasizing their potential to provide timely assistance, symptom assessment, medical advice, and mental health support. Additionally, the paper discusses the challenges and opportunities associated with integrating chatbot helpline services into existing healthcare systems, along with considerations for ensuring privacy, security, and ethical use of patient data. Keywords - Chatbot, Helpline Service, Healthcare, Artificial Intelligence, Natural Language Processing, Patient Engagement, Mental Health Support, Privacy, Security, Ethical Considerations.

Satisfaction Level of the Farmers Regarding Kisan Call Centre (KCC) Advisories

The Kisan Call Centre (KCC), initiated on January 21st, 2004, by the Department of Agriculture and Cooperation, Ministry of Agriculture, Government of India, serves as a crucial support system for farming communities across India. This study, conducted in 2021-22 in Chamarajanagar District of Karnataka, aimed to assess the Satisfaction Level of 200 KCC beneficiaries regarding its advisory services. Utilizing stratified random sampling, the study employed an ex-post facto research design to gather insights. The data collection involved secondary data from the KCC in Bengaluru and primary data through structured interviews with beneficiaries. Results revealed that 76.00% of beneficiaries expressed high satisfaction with the technical knowledge of KCC experts, with 74.50% satisfied with expert availability, and 73.50% with expert guidance in advisory services. Additionally,70.50% were highly satisfied with patience of expert in listening to the complete query of the farmers through helpline services. Regarding technological information provided by the KCC 53.00% expressed high satisfaction with the technological information provided by the KCC, and 52.50% acknowledged the assistance of advisory services in crop preservation and yield improvement. However, including all the aspect like technical information, helpline services and advisory services provided by the KCC. Notably, a significant 44.00% of both dryland and irrigated land farmers expressed high satisfaction with the overall services of the KCC. This research highlights the importance of ICT-driven initiatives like the KCC in empowering farmers and improving agricultural productivity and sustainability.

N21 Shared Decision Making: A Qualitative Exploration of Clinical Nurse Specialists in Gastroenterology

Abstract Background Clinical Nurse Specialists (CNS) participation in the Shared Decision Making (SDM) process and understanding basic concepts and principles related to the decision-making process are critical. (Storms et al. 2015). The core concept role of CNS includes a clinical focus on direct and indirect care of the patients in the specialist area, health educator and trainer, patient advocate, audit and research and consultation (NCNM, 2008). They have many opportunities to participate in the SDM process with patients arising from clinic visits, telephone helpline services and multidisciplinary team meetings. Nurses are progressively deemed influential in shared decision-making; however, studies on the SDM role of the CNS are limited; our study investigates the experiences of CNS in SDM, in the speciality of gastroenterology (GI) in both medical and surgical. Methods This study adopted a qualitative descriptive style. The survey was distributed to medical and surgical GI CNS at a tertiary referral hospital. This study aimed to look at three aspects of CNS's SDM experience: the CNS's knowledge about SDM, generating discussion and coordination, and respect for sociocultural factors. Semi-depth interviews were conducted for data collection. There were 11CNS participants from surgical and medical GI specialities, including IBD, hepatology, endoscopy, upper GI, and colorectal nursing. All interviews were recorded and transcribed verbatim and coded. Results Six themes emerged from the data collected: perceptions, attitudes, positive change, influential factors, reflection and obstacles. SDM is an unknown concept for the majority of the CNS.CNS self-identified as integral to the speciality and the patient's primary contact. Conclusion CNS has little understanding of the SDM concept. SDM is perceived as MDT (Multi-Disciplinary Team) making decisions without patient involvement. Formal education and increased awareness of the SDM process are essential for CNS active participation in individual patients. The procured knowledge of SDM enhances the CNS's confidence in active participation in MDT team meetings and the SDM process. It consequently improves patient experience, knowledge and participation in the SDM process.

Child Sexual Abuse in Pakistan: A Phenomenological Study on Parental Understanding and Prevention Strategies for Child Protection

ABSTRACT Child Sexual Abuse (CSA) is widespread and pervasive in Pakistan, presenting a significant threat to a child’s physical health, psychological well-being, and overall development. This study aimed to empirically substantiate the understanding of parents regarding CSA and their utilized preventive strategies. The study utilized Social Ecological Theory to gain a deeper comprehension of the phenomenon. Data was collected through in-depth semi-structured interviews with 18 parents from Islamabad capital city, using a qualitative phenomenological research approach along with thematic analysis. Results reveal that most of the parents were highly aware of the most common aspects of sexual assault and molestation, but they were unaware of the more manipulative subtle forms such as “grooming.” Additionally, they had a limited understanding of the long-term consequences of sexual abuse. While many parents knew about the option of involving the police in cases of abuse, they were unaware of helpline services and the availability of psychological support. In terms of prevention, most parents employed an integrated approach involving various preventive measures, such as educating their children about appropriate and inappropriate touch. These findings underscore the importance of implementing public-focused initiatives and community-based programs to enhance parental awareness, knowledge, and capabilities in preventing CSA in Pakistan.

Characteristics of availability of psychological assistance for children and their parents (according to child helpline activities)

The purpose of the study is to identify the need of children and their parents for psychological help services via the helpline and to assess its accessibility. The article is the second part of the publications devoted to methodological approaches and analysis of child helpline activities. The empirical basis of the study was the data on the records of helpline services activities in Russian regions, accumulated by the Foundation for Supporting Children in Difficult Life Situations, as well as data from official statistical records and sample surveys on socio-demographic problems of the Federal State Statistics Service. The scope and structure of child helpline activities in Russia have been studied. On the basis of empirical values, dynamics of calls to the child helpline by categories of callers and issues of treatment has been presented, and changes that have occurred characterized. In the structure of appeals and callers, groups and categories of greatest interest have been presented. The largest number of appeals come from children and adolescents, followed by other citizens, and the smallest number of appeals come from the parents of children and persons in loco parentis. The appeals structure analysis shows that the leading place among the problems addressed to child helpline is occupied by child–parent relations, children’s relations with peers, educational problems, and career guidance problems. The analysis in the article can be useful in the work of centers for psychological help to children and child helpline, as well as used in educational and practical educational institutions activities.

Development and Implementation of a Preventive Intervention for Youth with Concerns About Their Sexual Thoughts and Behaviors: A Practitioner Narrative

This practitioner narrative describes the development of an innovative, primary and secondary prevention resource to provide confidential resources to youth with questions about potentially problematic sexual interests and behaviors. WhatsOK is a website and free confidential helpline for youth who are potentially at risk to sexually harm or have harmed someone in the past. By encouraging self-efficacy, helpline counselors respond to these inquires in order to prevent harmful events or lessen the impact. This practitioner narrative begins with an explanation of the planning process, then describes the implementation, piloting and refining the resource, and, finally, explains how evaluation was incorporated. The development of the WhatsOK helpline services was conducted with the goal of creating an evidence-informed resource for youth with concerns about sexual thoughts and behaviors.

Accessibility parameters of psychological assistance for children and their parents (according to the activity of the children’s helpline)

The purpose of this article is to develop a methodology for analyzing the availability of children’s helpline services. This article is the first part of publications devoted to methodological approaches and analysis of the activities of the children’s helpline. The relevance of the work is due to the importance of psychological support in the system of assistance to children who find themselves in a difficult life situation. The complication of social ties in the modern world, in which children are growing up and socializing, the emergence of new risks, contributes to the demand for psychological help.The importance of developing a network of psychological services and, in particular, helplines that provide assistance to children and parents, as well as ensuring the availability of their services, is reflected in the strategic documents of social policy in the interests of children. The article considers the essence of the category “accessibility” in relation to the psychological service of the helpline, which allowed us to form a methodology for analysis. A methodology for analyzing information on the availability of emergency psychological care for children and parents via a children’s helpline is presented, a system of quantitative indicators characterizing the availability of children’s helpline services is proposed. Indicators are proposed that will characterize the availability of a children’s helpline from the position of working hours and indicators of the availability of psychological assistance of a children’s helpline in the context of the federal districts of Russia. The service availability coefficients were grouped.

Role of E-Governance amid the Pandemic in Providing Healthcare, Education, and Social Services (HESS) in Bangladesh

COVID-19 has imposed a severe impact on health, economics, society, trade &amp; commerce, administration, and all aspects of human existence. In this regard, digital governance, i.e., electronic governance (e-governance), is now playing a significant role in tackling the drastic effects of COVID-19 in Bangladesh. E-governance refers to the process of using information and communication technology in the field of delivering public services. The principal aim of this study was to figure out what role e-governance plays in health, education, and social services (HESS) in Bangladesh during the pandemic. This research, in precise, focused on the impact of e-governance on the government's decision-making, emergency health care management, education management, and social welfare in Bangladesh during the COVID-19 pandemic. The study was done using a qualitative method. The findings of the study reveal the significant implications of e-governance in the management of health issues, education issues, and social issues during the pandemic. In particular, the findings of the study demonstrate the contribution of electronic learning, telemedicine, one-stop service centers, and emergency helpline services (999) in terms of addressing the devastating effects of the pandemic in Bangladesh. Moreover, the study incorporated both practical and managerial contributions. As a result, the authors believe that this study's contribution is crucial and practical for determining what the actual effects of e-governance were in Bangladesh during the pandemic.

HELPQUAL scale for measuring the quality of farmers helpline services

ABSTRACT Purpose The study was aimed at measuring farmers’ helpline services quality in India using a standardized multi-factor scale (HELPQUAL) developed as part of this study. Design/methodology/approach The present study is based on 360 farmers' and 45 experts' responses gathered using telephonic interviews and mailed questionnaires during the year 2021–22. The principal axis exploratory factor analysis, parallel analysis and Likert scaling were utilized to assess the scalability of items and identify underlying factors. Findings The 19 item HELPQUAL consisting of four factors, namely dependability, accessibility, understandability and communication effectiveness, was developed. The reliability of the overall scale was excellent (α = 0.908), whereas the factor-wise reliability was excellent to acceptable (i.e. α = 0.918 to 0.72). The convergent validity of the scale was also excellent (0.819). Practical implications The HELPQUAL scale developed is the first to measure the quality of agricultural helpline services. There are several farmers’ helpline services across the globe, however, no standardized scale has been developed to date for measuring their quality. Moreover, HELPQUAL is highly sector-specific, and factors like accessibility and understandability are different from the dimensions of generic SERVQUAL and SERVPERF scales. Therefore, it is advantageous and appropriate in the quality evaluation of agricultural extension services. Originality/value This study provides the first standardized scale for measuring the quality of farmers’ helpline services. Theoretical implications This study supports the argument that widely used SERVEQUAL and SERVPERF scales and their dimensions lack universal applicability in service quality measurement.

Echoes in a “tree hole”: A qualitative study on the service needs and responses at an antidrug helpline in China

IntroductionChina's antidrug measures have been slowly shifting from police-intervention and punitive approaches to supportive services. However, the system is still highly stigmatizing. Helpline services emerged to engage drug users, families, and friends and provide needed support as they seek rehabilitation. This study aimed to explore service needs expressed during helpline calls, operators' use of techniques when responding to different needs, and operators' experiences working at and views toward the helpline. MethodsWe conducted a qualitative mixed-method study using two sources of data. One source was 47 call recordings collected at a drug helpline in China, and the other was five individual and two focus group interviews conducted with 18 helpline operators. Using a six-step thematic analysis method, we explored the patterns of needs expression and response, and the operators' experiences of interacting with callers. ResultsWe found that typical callers were drug users and their relatives or friends. Interactions between the callers and operators involved the expression of and response to needs that emerged from involvement with drugs. Informational and emotional needs were the most common. Operators would respond to these needs with different counseling techniques, such as providing information, advising, normalizing, focusing, and instilling hope. The operators developed a system of practices, such as internal supervision, case summaries, and listening back, to enhance competence and ensure quality of services. The helpline work also prompted their critical reflections on the current antidrug system and gradually reshaped their views toward the population they serve. ConclusionsAntidrug workers who engaged in answering helpline calls employed varying techniques to facilitate callers' expressed needs. They helped by providing much-needed informational and emotional support for drug users, families, and friends. Helpline services opened a private channel for people involved in drug use to express their needs and seek formal help in China's still stigmatizing and punitive antidrug system. Experiences working with anonymous help-seekers outside the statutory rehabilitation system helped workers at the helpline to gain unique reflective insight into the antidrug system and drug users.

Using Vocal Characteristics To Classify Psychological Distress in Adult Helpline Callers: Retrospective Observational Study

Elevated psychological distress has demonstrated impacts on individuals' health. Reliable and efficient ways to detect distress are key to early intervention. Artificial intelligence has the potential to detect states of emotional distress in an accurate, efficient, and timely manner. The aim of this study was to automatically classify short segments of speech obtained from callers to national suicide prevention helpline services according to high versus low psychological distress and using a range of vocal characteristics in combination with machine learning approaches. A total of 120 telephone call recordings were initially converted to 16-bit pulse code modulation format. Short variable-length segments of each call were rated on psychological distress using the distress thermometer by the responding counselor and a second team of psychologists (n=6) blinded to the initial ratings. Following this, 24 vocal characteristics were initially extracted from 40-ms speech frames nested within segments within calls. After highly correlated variables were eliminated, 19 remained. Of 19 vocal characteristics, 7 were identified and validated as predictors of psychological distress using a penalized generalized additive mixed effects regression model, accounting for nonlinearity, autocorrelation, and moderation by sex. Speech frames were then grouped using k-means clustering based on the selected vocal characteristics. Finally, component-wise gradient boosting incorporating these clusters was used to classify each speech frame according to high versus low psychological distress. Classification accuracy was confirmed via leave-one-caller-out cross-validation, ensuring that speech segments from individual callers were not used in both the training and test data. The sample comprised 87 female and 33 male callers. From an initial pool of 19 characteristics, 7 vocal characteristics were identified. After grouping speech frames into 2 separate clusters (correlation with sex of caller, Cramer's V =0.02), the component-wise gradient boosting algorithm successfully classified psychological distress to a high level of accuracy, with an area under the receiver operating characteristic curve of 97.39% (95% CI 96.20-98.45) and an area under the precision-recall curve of 97.52 (95% CI 95.71-99.12). Thus, 39,282 of 41,883 (93.39%) speech frames nested within 728 of 754 segments (96.6%) were classified as exhibiting low psychological distress, and 71455 of 75503 (94.64%) speech frames nested within 382 of 423 (90.3%) segments were classified as exhibiting high psychological distress. As the probability of high psychological distress increases, male callers spoke louder, with greater vowel articulation but with greater roughness (subharmonic depth). In contrast, female callers exhibited decreased vocal clarity (entropy), greater proportion of signal noise, higher frequencies, increased breathiness (spectral slope), and increased roughness of speech with increasing psychological distress. Individual caller random effects contributed 68% to risk reduction in the classification algorithm, followed by cluster configuration (23.4%), spectral slope (4.4%), and the 50th percentile frequency (4.2%). The high level of accuracy achieved suggests possibilities for real-time detection of psychological distress in helpline settings and has potential uses in pre-emptive triage and evaluations of counseling outcomes. ANZCTR ACTRN12622000486729; https://www.anzctr.org.au/ACTRN12622000486729.aspx.

Registered prodromal symptoms of out-of-hospital cardiac arrest among patients calling the medical helpline services

BackgroundEarly identification of warning symptoms among out-of-hospital cardiac arrest (OHCA) patients remains challenging. Thus, we examined the registered prodromal symptoms of patients who called medical helpline services within 30-days before OHCA.MethodsPatients unwitnessed by emergency medical services (EMS) aged ≥18 years during their OHCA were identified from the Danish Cardiac Arrest Registry (2014–2018) and linked to phone records from the 24-h emergency helpline (1−1−2) and out-of-hours medical helpline (1813-Medical Helpline) in Copenhagen before the arrest. The registered symptoms were categorized into chest pain; breathing problems; central nervous system (CNS)-related/unconsciousness; abdominal/back/urinary; psychiatric/addiction; infection/fever; trauma/exposure; and unspecified (diverse from the beforementioned categories). Analyses were divided by the time-period of calls (0-7 days/8-30 days preceding OHCA) and call type (1–1-2/1813-Medical Helpline).ResultsOf all OHCA patients, 18% (974/5442) called helpline services (males 56%, median age 76 years[Q1-Q3:65–84]). Among these, 816 had 1145 calls with registered symptoms. The most common symptom categories (except for unspecified, 33%) were breathing problems (17%), trauma/exposure (17%), CNS/unconsciousness (15%), abdominal/back/urinary (12%), and chest pain (9%). Most patients (61%) called 1813-Medical Helpline, especially for abdominal/back/urinary (17%). Patients calling 1–1-2 had breathing problems (24%) and CNS/unconsciousness (23%). Nearly half of the patients called within 7 days before their OHCA, and CNS/unconsciousness (19%) was the most registered. The unspecified category remained the most common during both time periods (32%;33%) and call type (24%;39%).ConclusionsAmong patients who called medical helplines services up to 30-days before their OHCA, besides symptoms being highly varied (unspecified (33%)), breathing problems (17%) were the most registered symptom-specific category.

Barriers and enablers to the delivery of email communication for a helpline service for young people.

This qualitative study utilises the Behaviour Change Wheel (BCW) approach to identify barriers and enablers to the delivery of email communication in a mental health helpline service for young people, which are then linked to specific intervention strategies for improvement. Semi-structured interviews were conducted with ten volunteers working for a free online helpline service for young people. Transcripts of the interviews were coded according to deductive then inductive themes. Ten core themes were identified. These were barriers or enablers, depending on the volunteers' level of experience with the email service. Enablers included the volunteers' skills, the resources and support offered to them. Barriers related to the asynchronous nature of email communication, need for additional training and volunteers' lack of confidence and motivation in responding to emails. This study expands current research on online mental health support by showing how the BCW can be a useful tool to identify influences on email helpline provision and offer strategies for its optimisation. Offering training targeted to the email service, increasing the level of practice with mock-up emails, and introducing newsletters featuring positive feedback on the email service may improve the delivery of email helpline services for young people.

ISPAD Clinical Practice Consensus Guidelines 2022: Ramadan and other religious fasting by young people with diabetes.

ISPAD Clinical Practice Consensus Guidelines 2022: Ramadan and other religious fasting by young people with diabetes.