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Communication in emergency calls is often agitated and callers almost always speak with a sense of urgency. Call operators often have to struggle in order to get the callers’ cooperation. The questioning sequence is often perceived by callers as inappropriate and a way of delaying assistance, frequently producing annoyance and anger in the caller. Interrupted calls are not uncommon in communications with the call centre, nor are cursing, rudeness and face attacks. The focus of previous studies on emotional work in emergency calls has mainly been devoted to communication problems and the consequences these had on the provision of assistance. This paper aims to focus specifically on how operators manage callers’ anxiety and sense of urgency and the emotions tied to this, such as anger. Transcripts of actual emergency calls are examined through a detailed discourse analysis in order to show operators’ interactional work in maintaining emotional contact with callers. The ability of the operators to control their own emotions and manage those of the caller is an important professional skills in this job. Describing how emotional contact with callers is maintained in actual calls can be useful for training and in-service courses.

In this article I investigate a decentralized infrastructure meant to assist autonomous vehicles in making decisions. More akin to a call centre than a centralized control room, Nissan’s ‘Seamless ...

Background During the COVID-19 crisis, a new nurse and doctor-led telephone triage model of care was evaluated as a method of prioritising essential visits to the ophthalmic accident and emergency department in the Royal Victoria Eye and Ear Hospital. This new method of service is known as “Telehealth” or “E-Health”. Aims To assess the safety and efficacy of a Telehealth model of care ultilised during the COVID-19 pandemic. Methods A prospective study was undertaken in the Royal Victoria Eye and Ear Hospital where the telephone triage records were examined over a 28-day period during the COVID-19 pandemic from 19 March 2020 to 16 April 2020 inclusive. Results During this period, 1120 telephone calls were received by the call centre. A total of 739 patients attended the emergency department over the 28-day period compared to 2247 during the same period in 2019. Conclusion To reduce risk of transmission, the COVID-19 pandemic has necessitated novel ways of interacting with patients and sharing healthcare information. Our new mode of service provision in the RVEEH portrays the effectiveness of Telehealth. This study gives us further scope to improve this model of care into the future.

Marketing research shows that organizations tailor communication for particular customer ‘segments’, but little is known about the live design of interaction for different categories. To investigate this, we examine telephone calls to a holiday sales call-centre (for ‘seniors’) and a university admissions call-centre (for ‘young’ students). While topically different, call-takers in both datasets requested callers’ email addresses in order to progress service. Using conversation analysis, we examine how these requests were designed, where and how ‘age’ was made relevant, and how subsequent service provision was handled in a way that matched callers’ presumed age categories. Contrastive to the static notion of ‘segments’, we show how recipient design is bound up with categorial considerations while being responsive to the live unfolding of actual interaction. The article demonstrates how a comparative collection-based approach can be used to analyse the relevance of social categories in situations where this is implicit or ambiguous. (Membership categorization, customer segmentation, conversation analysis, recipient design, requests, age)*

Humans are considered as emotional beings and so the uttered speech reflect the human emotions. Human computer interaction can be done more effectively by automatically identifying the emotions from speech. Automatic speech emotion recognition is applied in many areas like computer gaming, call centre, speech therapy controlling robots etc. Emotion recognition can be considered as feature space to label space mapping. From the uttered speech, the different features are calculated. Then, to automatically recognize the emotions, the relationship between the emotions and the features are learned. The required preprocessing is done with the collected training samples and the features are extracted from the speech signals. The extracted feature vectors are stored in the database. When the input signal comes, the preprocessing and feature extraction are done and the extracted features are compared with the feature vectors in the database to determine the emotion in that speech signal. We have developed a deep learning model for speech emotion recognition with GRU which take the filterbank energies of the speech signals as input. To overcome the problem with the availability of database and to increase the number of input samples, we have applied data augmentation.

Globally, increased domestic violence against women during the 2020 Covid-19 lockdowns concerned researchers, policymakers, governments and the civil society. In South Africa, an increased risk for gender-based domestic violence against women during the lockdown period was reported by various sources including the national gender-based violence call centre (GBVCC), the South African Police Service (SAPS) and the civil society. Covid-19 lockdown encouraged spatial distance: a public health measure. This measure inadvertently created social distance and social disconnection. Public life, which is frequently a coping mechanism and an escape for some women and girls at risk of domestic violence, was curtailed by the lockdown rules that forbade movements. Informal sources of help for victims of abuse were limited due to closed economic activities, and community-based helping services for domestic violence were not permitted to open. Some victims of domestic violence struggled with public transportation to access informal help, visit the police, social workers and other sources of help. Some organisations offered online and telephone services. The increased risk of gender-based domestic violence during the lockdown is indicative of poly-violence that women are exposed to. The risk of the domesticated poly-violence during crisis periods could be averted by focussing on risk reduction for all forms of violations against women.

Factors affecting employee satisfaction in call centres in Turkey is examined with questionnaire technique through analysing their frequency, Exploratory Factor Analysis (EFA), and factors with t-test and ANOVA, and finally Structural Equation Modelling (SEM). There are significant differences for employee perception of in-service training between age groups, and also differences skills & performance development opportunities (F5) between various education levels. SEM analysis show that five factors affecting their satisfaction are respectively employees’ perception of collaboration and teamwork (F3), skills & performance development opportunities (F5), employees’ perception of employers’ management style (F1), employees’ perception of in-service training (F2), and employees’ perception of working conditions (F4)., Türkiye'deki çağrı merkezlerinde çalışan memnuniyetini etkileyen faktörler anket tekniği kullanilarak frekans analizi, Açımlayıcı Faktör Analizi (EFA) analizi, t-testi ve ANOVA ve son olarak Yapısal Eşitlik Modellemesine (SEM) bakilarak incelenmistir. Bu analizler çalışanların hizmet içi eğitim algısında yaş grupları arasında önemli farklılıkların olduğunu ve bununla birlikte çeşitli eğitim seviyeleri arasında beceri ve performans geliştirme fırsatları (F5) farklılıklarin bulunmuştur. SEM analizi ile bulunan memnuniyetlerini etkileyen beş faktörün sırasıyla, çalışanların işbirliği ve ekip çalışması algısı (F3), beceri ve performans geliştirme fırsatları (F5), çalışanların işverenlerin yönetim tarzı algısı (F1), çalışanların hizmet içi eğitim algısı (F2) ve çalışanların çalışma koşulları (F4) algısı olduğu belirlenmiştir.

Predicting rainfall is an important step in generating data for climate impact studies. Rainfall predictions are a key process for providing climate impact assessments with inputs. A consistent rainfall pattern is typically good for normal plants; nevertheless, too much or too little rainfall can be disastrous to crops, even deadly. Drought can damage plants and lead to erosion, while heavy rainfall can encourage the growth of destructive fungi. Machine Learning (ML) can be helpful in overcoming such issues; for example, ML can be used to predict rainfall and apply it to foresee crop health and yield. Predictive analysis is a subset of data mining that forecasts future probabilities and patterns. Various sectors like the Agricultural Produce Markets Committee (APMC), Kisaan call centre, etc., can use proposed method, enabling the sector and farmers to obtain information on future precipitation, crop yields and crop health.

Introduction: The Centre de Médecine de Plongée du Québec (CMPQ) established a bilingual 24-hour dive emergency call line and diving medicine information service in 2004. The toll-free number (888-835-7121) works throughout Canada. Calls and emails (cmpq.cisssca@ssss.gouv.qc.ca) are answered by a CMPQ coordinator or on-call hyperbaric physicians and other consultants as needed. We reviewed 15 years of activity. Methods: Details of phone calls and email enquiries to the centre were reviewed individually and compiled into a database. Data were analysed to characterise contact volume and issues addressed. Contacts were categorised into five groups: information only (INF); medical opinion required (MOP); medical issue after the critical period of urgency had passed (PUR); current urgent but not immediate life-threatening issue (NLT); and immediate life- or health-threatening issue (ILT). Data presented as mean (standard deviation) or percentage. Results: A total of 3,232 contacts were made from May 2004 through December 2018: 19 (SD 8) per month [215 (70) per year]. Primary issues of concern were: emergency planning (20%); technical (not medical/physiology) questions (16%); otorhinolaryngological (12%); and decompression sickness-related (7%). Categorisation was 52% INF, 28% MOP, 13% PUR, 7% NLT, and 0.1% ILT, with 0.2% lacking sufficient detail to categorise. The nature of the diving activity of interest was determined in 67% of cases: 48% (n = 1,039) professional; 46% (n = 1,008) recreational; and 1% (n = 11) breath-hold. Conclusions: The call centre serves as a resource to the community, providing information on health and safety for diving in addition to being available to assist with emergent needs.

PurposeDrawing on the emotional labour theory, the purpose of this paper is to explore the effects of cultural orientation on emotion regulation and display processes for service employees.Design/methodology/approachBased on a Nigerian study where literature is scarce, data were gathered from semi-structured interviews conducted with 40 call centre service agents.FindingsThe findings identified three key values around reinforcing social cohesion, anticipated self-curtailment, hierarchy and expressions of servility based on broader societal needs to promote relational harmony when managing customer relations during inbound calls into the call centre.Research limitations/implicationsThe extent to which the findings can be generalised is constrained by the limited and selected sample size. However, the study makes contributions to the service work theory by identifying the extent to which communication of emotions is informed in large parts by local culture and seeks to incite scholarly awareness on the differences of emotional display rules from a developing country other than western contexts.Originality/valueThis paper is among the first to focus on the interface between culture and emotional labour from a Sub-Saharan African context.

*Özsoy, Volkan Soner ( Aksaray, Yazar ), Background: Recently, appointment registration systems (especially phone and web-based) that provide easier access to hospital medical services have become more common than traditional queuing registration systems. Therefore, this study aimed to evaluate various appointment registration systems called the Central Physician Appointment System (CPAS) in Turkish public hospitals. Methods: Data obtained from the Health Ministry of Turkey for 2013 to 2018 were analysed to measure patients & rsquo; use of the CPAS using several indicators. Results: In total, 22.1% of patients used the appointment system for registering in 2013, and this rose to 34.6% in 2018. The Hello 182 call centre was used for 60.8% of appointments that were made, whereas patients used other systems less (39.2%). Females accounted for 62.2% of patients who used appointment systems to register. It was observed that the appointment density at training and research hospitals and oral-dental health centres/hospitals was high. Over time, both the waiting time before consultation and the total time at the hospital have decreased. Conclusions: Despite significant gains in the efficiency of outpatient services, effective functioning of the CPAS is not sustainable in Turkey because of the current health policies. Therefore, in order for the CPAS to function effectively, either political measures should be taken such as the creation of a mandatory referral chain or the CPAS should be reorganized based on supply-demand.

Indoor environmental quality is a requirement for good architectural and interior design. The definition of indoor environmental quality refers to the conditions of the interior space that provide health and wellbeing for its occupants. Elements of indoor environmental quality are thermal comfort, indoor air quality, ventilation, ergonomics, natural and artificial lighting, odor, and acoustic quality. Indoor environmental quality is required in every type of interior space including ones with residential, educational, and cultural functions and workspaces. It is also included as one of the factors of energy efficient and sustainable design in building energy certification and accreditation systems. This study focuses on call center interiors as a type of workspaces, where the employees spend a long time in the interior space communicating with customers on the phone. The aim is to provide theoretical information and practical application suggestions for higher quality design in call center interiors. The methodology of this paper consists firstly of a literature review to study and analyze the definition and elements of indoor environmental quality, and its implementation into call center interiors as workspaces. Analytical studies lead to strategy proposals for better designed call center interior spaces. The results of the study indicate that better designed interior spaces in call centers lead to better health and wellbeing of the employees, resulting with higher performance and service quality.

Most of the tribal farmers of Southern Rajasthan are using ICT tools for seeking the agricultural information via mobile phones, television, radio, kisan call centre, information kiosks, internet and expert system. The study was conducted in Southern Rajasthan covering two districts (Banswara and Dungarpur) on the basis of availability of maximum facilities and infrastructures to promote use of ICT. Empirical data were collected personally from 160 farmers through a structured interview schedule. The results showed that majority of the farmers owned mobile phones as well as television and radio. The most frequently used ICT for social communication, contacting middle men for the marketing of produce and contacting experts on real time basis was mobile phone followed by television. The use of radio and kisan call centre was lower as compared to mobile phones and TV due to ICT availability and access levels being lower than other ICTs. Internet, touch screen computer and information kiosk and other application were still being rarely used by young and educated. Majority of the farmers (60.62%) were used the ICTs during the evening hours due to free and leisure time and telecast or broadcast of agricultural programs during the evening hours.

Nowadays, one of the key areas of research on contact centre systems is their automation. The main element that influences the possibility of automation of contact centre processes is the call transcription methods implemented by automatic speech recognition (ASR) systems. Such systems enable developing intention recognition methods and, consequently voice bots. The current solutions used in ASR systems for many less popular languages do not guarantee a fully satisfactory transcription quality for hotline voice calls. This is due to the unique characteristics of the sound signal generated there, whose quality parameters differ significantly from those of studio recordings. The paper presents a comparative study of selected speech recognition systems that were additionally supplemented with elements of preprocessing of sound recordings and postprocessing of originally produced transcriptions. As for preprocessing, the following methods were tested: separation of the client and agent channels into two independent signals, training of ASR systems, and audio signal correction. With regards to postprocessing, on the other hand, tests were performed for inarticulate sounds, normalization of standard phrases (e.g. numbers, dates, times, etc.), and identification of close-sounding phrases and foreign language phrases, and lemmatization. Based on the research conducted and the analyses performed, a new method of call transcription intended specifically for contact center systems was proposed. The research conducted for this paper was based on the Polish language model, for which major problems are observed with the quality of automatic contact center call transcriptions.

Background/Aim: Cardiac arrest (CA) is a leading cause of mortality in the last forty years worldwide. Immediately initiated cardiopulmonary resuscitation (CPR) improves chances for survival. Aim of this study was to determine the efficiency of the Emergency medical service (EMS) dispatch centre in the absence of the uniform emergency medical dispatch assessment protocols in the management of cardiac arrest. Methods: The retrospective and observational study was conducted in Institute for Emergency Medical Service Novi Sad (IEMS Novi Sad) Serbia during a one-year follow-up. The study included patients with out-of-hospital cardiac arrests who underwent CPR. Results: EMS teams of the IEMS Novi Sad had 198 CPRs in the follow-up period. In 142 (71.72 %) calls, the EMS dispatcher got information that the patient was unconscious. The reported reaction time I by the dispatchers for the unconscious patients was 1.37 ± 1.27 minutes, actual duration of the conversation between the dispatcher and a caller - was longer: 138.21 ± 103.02 seconds (p < 0.001). The average conversation time with a caller was 61.37 ± 31.13 seconds. In 6 (4.22 %) cases, the EMS team was dispatched to a patient before the phone call was terminated. At the moment of arrival, all patients were unconscious, 194 (94.37 %) were pulseless, while the remaining 8 (5.63 %) experienced cardiac arrest during the examination. The cardiac arrest was witnessed by a layman in 120 (84.51 %) cases and CPR was initiated by bystanders, before the arrival of the EMS team, only in 13 (10.83 %) patients. Twenty-seven (19.01 %) patients arrived in a hospital with vital signs. Conclusion: The absence of the uniform EMS dispatch assessment protocols for the triage of incoming calls and phone assisted CPR for lay rescuers decreases the survival rate of patients with cardiac arrest.

Introduction Acute myocardial infarction (AMI) is a time sensitive emergency. In resource limited settings, prompt identification and management of patients experiencing AMI in the pre-hospital setting may minimise the negative consequences associated with overburdened emergency medical and hospital services. Expedited care thus, in part, relies on the dispatch of appropriate pre-hospital medical providers by emergency medical dispatchers. Identification of these patients in call centres is challenging due to a highly diverse South African society, with multiple languages, cultures, and levels of education. The aim of this study was therefore, to describe the terms used by members of the South African public when calling for an ambulance for patients suffering an AMI. Methods In this qualitative study, we performed content analysis to identify keywords and phrases that callers used to describe patients who were experiencing an advanced life support (ALS) paramedic-diagnosed AMI. Using the unique case reference number of randomly selected AMI cases, original voice recordings between the caller and emergency medical dispatcher at the time of the emergency were extracted and transcribed verbatim. Descriptors of AMI were identified, coded and categorised using content analysis, and quantified. Results Of the 50 randomly selected calls analysed, 5 were not conducted in English. The descriptors used by callers were found to fall into three categories; Pain: Thorax, No pain: Thorax and Ill- health. The code that occurred most often was no pain, heart related (n = 16; 23.2%), followed by the code describing pain in the chest (n = 15; 21.7%). Conclusion South African callers use a consistent set of descriptors when requesting an ambulance for a patient experiencing an AMI. The most common of these are non-pain descriptors related to the heart. These descriptors may ultimately be used in developing validated algorithms to assist dispatch decisions. In this way, we hope to expedite the correct level of care to these time- critical patients and prevent the unnecessary dispatch of limitedly available ALS paramedics to inappropriate cases.

In response to neighbouring Italy’s accelerating outbreak of the coronavirus disease 2019 (COVID-19), Slovenia established a national toll-free telephone helpline, which operated from 9 March until 12 June 2020 and answered more than 40 thousand calls in its first ten weeks alone. It was operated by medical students and integrated professionals from diverse fields in order to provide trustworthy, accurate, and understandable information to the citizens of Slovenia. We examine the impact that this centralised helpline had on managing the COVID-19 health crisis by shaping and monitoring the public’s response.

Achieving effective, city-wide inclusive sanitation service delivery requires coordination of diverse actors in the sanitation value chain as many factors constrain the efficiency and quality of faecal sludge management (FSM). In partnership with government, consumer, and private sector stakeholders in Bihar’s capital city, Patna, PSI India facilitated extensive market analysis, identified the market challenges, and co-developed a market-based urban FSM services ‘ecosystem’ which resulted in the safe collection, treatment, and disposal of over 7 million litres of faecal sludge from more than an estimated 1,500 households over two years, as part of bundled portable toilet cabins and FSM services. The FSM programme Praashadan, funded by the Bill & Melinda Gates Foundation, built trust, improved coordination, and brokered official agreements between tanker operators and government, tested a portable toilet cabin business model to subsidize operation of a faecal sludge treatment plant, and established a call centre and promotional activities to drive customers to the services of a newly formed tanker operators association. Moving forward there is a need to place the work with these market actors into a wider context of a financed, coordinated, city-wide sanitation planning to address technology, R&D, and other constraints that support better business models and allow regular quality FSM services.

Ensuring newly arrived migrants gain fluency in the language of their host country has challenged governments worldwide. Whilst many governments provide settlement and language programs for migrants, a critical site for language development and cultural integration is the workplace itself. However very few studies have explored how different worksites and job types in the new globalised economy may facilitate migrants' acquisition of the language of a target community with which they need to communicate. Drawing on a long-term ethnographic study and sets of interviews, this research explores how a multilingual call centre based in London facilitates such language acquisition. This site uses English as well as a number of other European languages to market mostly IT products into Europe and beyond and we discuss how the training and provision of scripts contributes to agents being able to develop their language skills. This study revealed a number of facilitators for language acquisition including the spatial layout of the worksite where communication, both socially and professionally, takes place; but perhaps most surprisingly, we learned that the way in which the agents use scripts to scaffold their exchanges on phones plays a significant role in language acquisition.

BackgroundSyndromic surveillance can supplement conventional health surveillance by analyzing less-specific, near-real-time data for an indication of disease occurrence. Emergency medical call centre dispatch and ambulance data are examples of routinely and efficiently collected syndromic data that might assist in infectious disease surveillance. Scientific literature on the subject is scarce and an overview of results is lacking.MethodsA scoping review including (i) review of the peer-reviewed literature, (ii) review of grey literature and (iii) interviews with key informants.ResultsForty-four records were selected: 20 peer reviewed and 24 grey publications describing 44 studies and systems. Most publications focused on detecting respiratory illnesses or on outbreak detection at mass gatherings. Most used retrospective data; some described outcomes of temporary systems; only two described continuously active dispatch- and ambulance-based syndromic surveillance. Key informants interviewed valued dispatch- and ambulance-based syndromic surveillance as a potentially useful addition to infectious disease surveillance. Perceived benefits were its potential timeliness, standardization of data and clinical value of the data.ConclusionsVarious dispatch- and ambulance-based syndromic surveillance systems for infectious diseases have been reported, although only roughly half are documented in peer-reviewed literature and most concerned retrospective research instead of continuously active surveillance systems. Dispatch- and ambulance-based syndromic data were mostly assessed in relation to respiratory illnesses; reported use for other infectious disease syndromes is limited. They are perceived by experts in the field of emergency surveillance to achieve time gains in detection of infectious disease outbreaks and to provide a useful addition to traditional surveillance efforts.

Since 2006, numerous movies and TV series have depicted outsourcing to India as a source of both economic and personal opportunity for American, Canadian, British and Indian characters. There has b...

To detect the number of agents needed to serve customers, it is necessary to consider the call centre as a mass service system. Then it is possible to asses the convenient number of agents according to the probability of the system receiving a request and the time in which the request is serviced by employing a Markov chain and the Erlang model. In an archetypal call centre, the incoming calls are added to a waiting queue and subsequently they are assisted by an agent. In case all agents are occupied, the customer has to wait in the queue until one of the agents becomes available. It is, therefore, important to compromise on the number of agents and the time the customers spend waiting in the queue. The result should be that there are enough agents in the call centre to serve the customers in the time required. This article focuses on solving this problem.

International audience; We aimed to both quantitatively and qualitatively describe interventional research performed in emergency medical communication centres. We conducted a systematic review of articles published in MEDLINE, Cochrane Central Register of Controlled Trials and Web of Science. Studies evaluating therapeutic or organizational interventions directed by call centres in the context of emergencies were included. Studies of call centre management for general practice or nonhealthcare agencies were excluded. We assessed general characteristics and methodological information for each study. Quality was evaluated by the Cochrane Risk of Bias tool or the Newcastle-Ottawa Scale. Among 3896 articles screened, we retained 59; 41 studies were randomized controlled trials (69%) and 18 (31%) were before-after studies; 41 (69%) took place in a single centre. For 33 (56%), 22 (37%) and 4 (7%) studies, the models used were simulation training, patient-based or experimental, respectively. The main topic was cardiac arrests (n = 45, 76%), with outcome measures of cardiopulmonary resuscitation quality and dispatch assistance. Among randomized controlled trials, risk of bias was unclear or high for selective reporting for 37 (90%) studies, low for blinding of outcomes for 34 (83%) and low for incomplete outcomes for 31 (76%). Regarding before-after studies, quality was high in 9 (50%) studies. Few interventional studies have been performed in call centres. Studies mainly involved simulation and focussed on cardiac arrest. The quality of studies needs improvement to allow for a better recognition and understanding of emergency medical call control.

Call Centres can be considered as important channels of communication in an organisation as they are the first point of integration between call centre agents that represent the business and customers. Therefore, it is key that agents should be correctly sizing the opportunity of any given call, because a Call Centre can bring benefits not only in terms of improved customer service through efficiency, but also in terms of increasing market share through effectiveness. This paper sorts to assess outsourcing of offshore call centres on customer service as most studies have not yet examined impact of offshore call centres on customer service in Zambian commercial banks. In order to address this gap, this study explores the different types of call centres, challenges faced and discuss what would help the organisations grow in market share and at the same time deliver excellent customer service. The study was based on 125 commercial bank customers. Purposive sampling was used in the study. Descriptive statistics and correlation were used to analyse the data. The results show that the call centre is a very important aspect of customer relations as all the customers sampled indicated that they utilise the call centre line for various services ranging from balance inquiries, account transactions, internet banking services, mobile banking services as well as other inquiries. Following the various challenges experienced by customers as shown in the results, it is therefore concluded and recommended that creating local call centres in Zambia would help so much in alleviating these challenges and improve customer experience.

Various companies choose to outsource the delivery of part of their services, so as not to deviate from its core business and improve the service level. This approach leads to a new type of organizations, so-called networked and virtual enterprises, where possibly a great number of companies work together without having direct contact but through a broker, as an intermediary, that streamlines the relationships between them. To enable high level efficiency, as well as some other functional requirements, the meta-organizations and brokering services are conceived as environments and services for networked and virtual enterprises operation and dynamic reconfigurations, representing a model of organizations-of-organizations, as an implementation of one of the Industry 4.0 models and ecosystem for networked and virtual enterprises dynamic reconfiguration. In this paper, the meta-organizations with embedded brokering services, modelled as call centres, are analyzed. Various simulations are presented, based on Erlang's formulas for some of design and performance measures parameters evaluation, such as service level, average waiting time, agent occupancy and service traffic intensity.

Introduction In order to allocate resources in an effective manner, emergency medical services (EMS) systems use dispatch-based triaging to prioritise patients by acuity. Over-triage, wherein patients are assigned a higher priority level than necessary, can serve as a safety measure. However, it places strain on EMS systems, a problem believed to be experienced by South Africa's Western Cape Government EMS system, with almost half of its calls designated at the highest priority level. To begin improving dispatch within WCG EMS, we aimed to describe the current system by identifying the most common conditions dispatched, and those most perceived to be suffering from over-triage. Methods A multi-methods approach was taken: First, a quantitative chart review was used to analyse all calls assigned a dispatch priority by WCG EMS between December 2016 and November 2017. These descriptive data then informed qualitative focus groups to further investigate emergency medical dispatch (EMD). Three focus groups were conducted, each with a convenience sample of staff from: WCG EMS staff, call takers/dispatchers, and call centre managers. Data were reviewed and coded, after which the lead researcher aggregated coded transcripts and conducted thematic content analysis. Results Seventy-nine condition categories were identified from 649,544 completed patient records for the study period. Non-specific pain accounted for the greatest proportion of dispatched complaints (16.88%), followed by assault with a weapon (10.00%) and respiratory complaints (9.71%). Sixteen WCG EMS personnel took part in focus groups, highlighting challenges of the current EMD system, including time constraints, legal risks, communication, overuse of the system, and lack of training. Chest pain, collapsed/unresponsive patients, and vomiting and diarrhoea were frequently noted to be potentially over-triaged conditions. To improve this, participants suggested trainings, modifications to the electronic EMD system, additional protocols, and public education. Conclusion This study identified where over-triage is possibly occurring in the WCG EMS dispatch system, as well as potential solutions proposed by those working within the system., Highlights • There are many types of effective emergency medical dispatch (EMD) established within high-income countries’ EMS systems. • EMDs are often the first opportunity for the recognition of time-critical conditions. • Effective EMDs can improve time-to-care and patient outcomes • This study explored potential causes of, and solutions to, over-triage in the WCG EMS dispatch system.

Access to information has become a key to decision making in modern agriculture. In order to take care of these needs of farmers, Government of India has set up twenty five Kisan Call Centers (KCC) in different states of India. The present study was designed to analyze the Chandigarh based KCC catering to Punjab state. Asample of 100 KCC user farmers and 20 nonuser farmers was studied to have an in-depth knowledge. Average number of calls to KCC per farmer were found to be 6-7 in a year. Main interest area of queries was pertaining to technical aspects .The traditional sources like fellow farmers and kisan melas were also of high importance to these KCC users. However, awareness about agriculture related websites/portal was almost lacking. Some aspects of decision making have shown positive impact of KCC like insect-pest control, disease control, variety selection, fertilizer application and weather related queries.

England’s covid-19 testing and tracing system failed to achieve its main objective—to break chains of transmission and enable people to return to a more normal life—despite an “eye watering” budget of £37bn (€44bn; $51bn), MPs have said.1 The damning report from the House of Commons Public Accounts Committee said that the contact tracing service was one of the most expensive health programmes delivered during the pandemic, equal to nearly 20% of the entire 2020-21 NHS England budget. However, after it was set up the UK still had two national lockdowns and significant case numbers. “Its outcomes have been muddled and a number of its professed aims have been overstated or not achieved,” the MPs said. Although named NHS Test and Trace the system was largely run by two private companies, Serco and Sitel, that handled the national call centre and online system. Led by the Conservative peer and former head of NHS Improvement Dido Harding, the system has been widely criticised …

Technology innovation and its impact on the progress of electronic banking establish the requirement for this research regarding customer demographics, their financial portfolio and banking preferences. In this research, banking financial data were collected from three Kuwaiti banks. The data included usage information in all electronic banking channels for each customer, their characteristics and financial portfolio. The aim of this study is to predict the customer use of electronic channels, treated as dependent variables, considering individual customer information, which is treated as independent variables. To bring the most benefit to bankers and financial analysts, machine learning techniques (ML), specifically multinomial logistic regression, were used to deal with the data from cleaning to analysing. The results disclosed that banks can determine the preferred electronic banking channel for each of their customers by knowing some information about their characteristics and financial product portfolio.

Background While women are taking a greater role in decisions about menopause symptom management, the legacy of the Women’s Health Initiative (WHI) studies persist. Despite hormone therapy (HT) being effective in reducing all-cause mortality, many women seeking relief of menopausal symptoms exaggerate HT harms and overstate the perceived benefits or ignore the risks of alternative therapies. We aimed to explore the longitudinal impact of the widely-publicised WHI 2002 study on women’s information-seeking and describe determinants of decision-making about managing menopausal symptoms. Methods In a longitudinal analysis of both quantitative and qualitative data, we explored consumer questions about menopause-related medicines received by two Australian medicines call centres (1996–2010) before, during, and after WHI 2002. We analysed calls by age and gender of caller and patient, their relationship, postcode, enquiry type, and motivation to help-seek. We compared calls regarding HT and herbal medicines (HM) with the rest of calls, and thematically analysed question narratives across the three time-periods. Results There were 1,829 menopause-related calls received of over this time-period, with a call surge, primarily from women in their mid-fifties, in the two months after the WHI 2002 publication. Two in three calls were motivated by negative media reports as women sought support for decision-making, primarily reassurance to cease HT. While HT safety concerns persisted for eight years post-publication, the nature of information-seeking changed over time. Callers subsequently sought reassurance to use menopause treatments together with their other medicines; and pursued HT substitutes, including HM, in response to HT product discontinuation. Conclusions Women sought information or reassurance to support a decision, based on dynamic changes in internal (symptom or risk intolerance, attitude towards menopause and treatment preferences) and external factors (perceived source trust and changes in treatment availability). In assessing HT benefit versus risk, women tend to overestimate risk with HT safety concerns persisting over time. Decision-making in managing menopause symptoms is complex and dynamic. Reassurance to reach or justify decisions from a perceived trusted source can support informed decision-making.

The present study was conducted with the specific objective of “To identify the problems of pomegranate growers in information management and to obtain their suggestions”. For the study, Aurangabad district was purposively selected for the present study as it is one of the maximum pomegranate growing district of Marathwada region. There are nine talukas in Aurangabad district out of which two talukas purposively selected for the study. Four villages from each talukas selected randomly and fifteen farmers from each village selected on the lottery basis. Thus total sample size 120. Ex-post facto research design was adopted in this study. From the study it was found that, pomegranate growers faced the problems like Lack of sufficient training programmes conducted by KVK, SAUs followed by they cant visit easily because good distance from KVK, SAUs, lack of information about disease and pest management, network problems in using internet and kisan call centre, non availability of farm publications like farm magazine, lack of proper market information and its source, lack of skills of using internet and lack of time and mobility to meet agricultural scientists and extensionists. Pomegranate growers given the suggestions on problems like Regular training programmes should be conducted by KVK and SAUs followed by Government should take steps to improve mobile networks in villages, agricultural department should disseminate disease and pest management information in proper time, KVK, SAUs should sent representative to villages, more field visits should be undertaken by the researchers and extensionists, farm publications like farm magazine should be multiplied and distribute in villages, training should be provided to the farmers to use internet and mobile SMS service and steps should be taken to disseminate proper information about market in time.

Many call centre shift scheduling approaches focus on one call centre day when determining the number of agents to be assigned to each shift. However, this approach makes the assumption that shifts will be filled with the same agents everyday, and ignores the practicalities of an actual call centre like day-offs, which would require shift assignments over longer time horizons. Moreover, many of these shift scheduling approaches use the arrival rate and service rate as inputs. This presents an issue because it might be difficult to estimate these rates with confidence from the data, especially the arrival rate which fluctuates during the day. We present a local search heuristic approach of assigning shifts and day-offs to existing call centre agents using hill climbing, tabu search, and simulated annealing. This is achieved without increasing the staffing costs. Our methods use individual calls data directly, therefore removing the need to estimate the arrival rate, and minimising the need to estimate the service rate. The methods are applied to real-life data from a call centre and the results show improvements in the achieved service level and a significant drop in the number of abandoned calls.

For many customers, call centres seem like a distant memory. Most customers recall, with disparagement, the frustration and long waiting queues before a call is answered. However, today with the aid of technology, some may think that the call centre is now an obsolete function of a business. This is not true; many businesses still use the call centre as they believe that it is still the best way to connect efficiently with customers in delivering a superior customer experience. Some companies even refer to the call centre as the frontline of the business. Technology has changed the way that companies are now interacting with customers [1]. The call centre has evolved from its predecessor over the last two decades. Although call centres still use telephones, many have embraced email, webchat, social media, texting and chatbots. The key to ensuring satisfaction, though, is the system's efficiency and ease of use. This study aims to assess the influence of the sub-dimensions of Technology (systems efficiency, ease of use, clarity and understanding) in enhancing customer exchanges within a call centre. A study was undertaken in EThekwini (Durban), South Africa. It was directed within a Public Sector service environment comprising of four major call centres employing a total of 240 call centre agents. Using simple random sampling, 220 customers were drawn from all consumers subscribing to e-billing in EThekwini (Durban). Data for the customer sample was collected using a pre-coded, self-developed questionnaire whose psychometric properties were statistically determined. Data were evaluated using descriptive and inferential statistics. The results stipulate that in terms of customers' perceptions of the influence of technology on call centre efficacy, the majority of the customers found it challenging to use the technology and to understand the self-help options that were provided to them by the call centre. There were complications encountered with logging in customer queries and complaints, and most customers were dissatisfied with their overall customer experience. Based on the study results, recommendations have been made to manage the interactions between the customers and call centre's more proficiently and powerfully.

Introduction: The support of prehospital and emergency call handling and the impact of Covid-19 is discussed throughout this study. The initial purpose was to create an electronic system (eEmergency system) in order to support, improve, and help the procedure of handling emergency calls. This system was expanded to facilitate needed operation changes for Covid-19.Materials and Methods: An effort to reform the procedures followed for emergency call handling and Ambulance dispatch started on the Island of Cyprus in 2016; along that direction, a central call centre was created. The electronic system presented in this work was designed for this call centre and the new organization of the ambulance services. The main features are the support for ambulance fleet handling, the support for emergency call evaluation and triage procedure, and the improvement of communication between the call centre and the ambulance vehicles. This system started regular operation at the end of 2018. One year later, when Covid-19 period started, we expanded it with the addition of several new features in order to support the handling of patients infected with the new virus.Results: This system has handled 112,414 cases during the last 25 months out of which 4,254 were Covid-19 cases. These cases include the transfer of patients from their house to the reference hospital, or the transfer of critical patients from the reference hospital to another hospital with an intensive care unit or transfer of patients from one hospital to another one for other reasons, like the number of admissions.Conclusion: The main purpose of this study was to create an electronic system (eEmergency system) in order to support, improve, and help the procedure of handling emergency calls. The main components and the architecture of this system are outlined in this paper. This system is being successfully used for 25 months and has been a useful tool from the beginning of the pandemic period of Covid-19.

ObjectiveHealthLine is Saskatchewan's provincial 24-hour health information and support telephone line. A proportion of HealthLine's callers are referred to the emergency department (ED) for further assessment. The purpose of this study was to gain insight into the appropriateness of these referrals and assess whether they increased the burden on an already strained ED system.MethodsA list of callers referred from HealthLine to Saskatoon EDs from January 1, 2014, to March 31, 2014 was obtained. This list was cross-referenced with Saskatoon Health Region registration data to determine which of those callers had been registered in one of the three Saskatoon EDs within 48 hours of the original call.ResultsDuring the 90-day time period in question, 707/3,938 (17.9%) of callers were referred by HealthLine to the ED. Out of those referred, 601 were identifiable and 358 attended the ED. Hospital charts were pulled for full data extraction and analysis of the 276 who met inclusion criteria. Of those who presented to the ED and met inclusion criteria, 60% had investigations performed while 66% received some form of treatment. The overall admission rate for the patient population studied was 12.0% v. 16% for non-referred patients. Referred pediatric patients had fewer investigations and treatments with a lower admission rate compared with the adult patients.ConclusionThe Saskatchewan HealthLine is doing an effective job at directing callers both to and away from EDs in Saskatoon and not overburdening our local EDs with unnecessary referrals.

Job crafting as a mediator between situational factors and well-being at work among outbound call centre operators in Peru Sandra Corso de Zúñiga1, Luis Antonino Lazarte Aranguren2 1 Pacífico Business School, Jirón Sánchez Cerro 2121, Jesús María, Lima, Perú 2 Universidad Privada del Norte, Avenida Andrés Belaunde cdra. 10, Comas, Lima, Perú Recibido 15 de noviembre del 2018, Revisado el 22 de marzo de 2019 Aceptado el 25 de abril de 2019 DOI: https://doi.org/10.33017/RevECIPeru2019.0002/ Resumen En este estudio, se analiza el papel explicativo del rediseño del propio trabajo (job crafting) en la relación entre las demandas situacionales (demandas y recursos laborales) que enfrenta el trabajador y su bienestar. Los participantes del estudio fueron 518 operadores de tres centros de contacto de tamaño pequeño y mediano en Perú. Para ello nos basamos en el modelo de Demandas-Recursos laborales. Nuestra hipótesis principal sostiene que a pesar que los centros de llamadas son entornos de trabajo muy estructurados y controlados, los operadores rediseñan sus trabajos y los adaptan a sus necesidades y capacidades, y éstas actividades a su vez tienen un impacto positivo en su bienestar laboral. Pusimos a prueba nuestras hipótesis utilizando modelos de ecuaciones estructuradas (SEM). Los resultados confirmaron las hipótesis y demostraron que, a pesar de tener un diseño de trabajo muy estructurado, las actividades de rediseño tienen un impacto positivo en el bienestar de los operadores, en términos de mayor energía, dedicación y concentración (engagement) y menor agotamiento y distanciamiento del trabajo (burnout). Los resultados de este estudio sugieren que los centros de llamadas de tamaño pequeño y mediano en países emergentes podrían aprovechar mejor sus limitados recursos y ofrecer un entorno que facilite el rediseño de trabajo: proporcionando una adecuada retroalimentación (feedback), ofreciendo cierto nivel de autonomía, mejorando la comodidad en el trabajo y dando oportunidades para que el teleoperador desarrolle habilidades. Asimismo, se demuestró que el rediseño de trabajo disminuye el efecto de las demandas en el agotamiento, aunque en menor grado. Finalmente, discutimos las implicaciones de estos hallazgos. Descriptores: Modelo de demandas y recursos laborales, engagement, burnout, job crafting, recursos laborales, demandas laborales. Abstract In this study, we analyse the mediation effect of job crafting in the relationship between situational demands (job resources and job demands) and well-being among 518 employees in three small to medium-sized outbound call centres in Peru using the Job Demands-Resources model as theoretical framework. Our primary hypothesis is that despite call centres being very structured and controlled work environments, call centre operators craft their jobs through stimulation from situational factors and adapt them to their needs and capabilities, and that these activities have a positive impact in their well-being at work. We test our secondary hypotheses simultaneously using structured equation modelling. The results confirm the hypotheses and demonstrate that despite having a very structured job design, job crafting activities have a positive impact on those call centre operators who engage in them, in terms of increased work engagement and decreased job burnout. The results of this study suggest that small to medium-sized call centres in emerging countries could leverage their limited resources by offering an environment that stimulates job crafting activities: providing feedback, autonomy, opportunities for development and comfort at work. Job crafting also explains the softer impact of job demands on job burnout, but in this case the effect was lower. We discuss the implications of these findings. Keywords: JD-R model, work engagement, job burnout, job crafting, job resources, job demands.

Customer call centres have become a critical form of service delivery for many organisations hence technological innovations serve as a critical point of contact between the organisation and its customers and can assist in raising the stakes in businesses in terms of customer service delivery (Burgess & Connell, 2004). According to the 2017 Global Customer Experience Benchmarking Report technology has been the number one enabler to positively enhance customer service experience in the last 5 years (Business Tech, 2017). Customers have become so empowered that they expect to have flexibility to contact a business however they choose; either via a telephone, email or Facebook. The key to ensuring satisfaction though is system’s efficiency and ease of use. This study was undertaken in EThekwini (Durban), South Africa and was directed within a Public Sector service environment comprising of four major call centres employing a total of 240 call centre agents. Using simple random sampling, 220 customers were drawn from all consumers subscribing to e-billing in EThekwini (Durban). Data for the customer sample was collected using a precoded, self-developed questionnaire whose psychometric properties were statistically determined. Data was analyzed using descriptive and inferential statistics. The results specify that in terms of customers’ perceptions of the influence of technology, on call centre effectiveness the majority of the customers found it challenging to use the technology and to understand the self-help options that were provided to them by the call centre. There were problems encountered with logging in customer queries and complaints and most customers were dissatisfied with their overall customer experience. Based on the results of the study recommendations have been made to manage the interactions between the customers and call centre’s more proficiently and powerfully.

Purpose The purpose of this paper is to explore the underlying asymmetries in training evaluation practices of call centre (CC) firms based on their “in-house” and “subcontractor” ownership heterogeneity. Design/methodology/approach The data for this qualitative inquiry were collected from key informants of 13 different CCs in Pakistan through semi-structured interviews. Findings The findings revealed various asymmetries in training evaluation practices among in-house and subcontractor CCs based on five different dimensions of two renowned training evaluation frameworks. Practical implications Training evaluation professionals can benefit from training evaluation methods identified in this study for measuring training evaluation practice and advancing future research. Originality/value This study has theoretically contributed to the existing research on firm heterogeneity and human resource management by focussing on training evaluation practices in CCs.

Purpose of the Study: The researchers critique the linear-compensatory combinatorial rule used in the expectancy-value model that is widely applied to explain how customers integrate attribute-level information in satisfaction judgements. Data/Methodology: The data have been collected from customers of an online travel agency. The surveys were administered via email, after their interaction with customer service advisor on telephone. The survey instrument is largely based on the SERVQUAL model, with a few additional items pertaining to the call centre context. A randomly selected sample of 626 usable responses was obtained based on completeness of data. As compared to the traditional methods, where a summary analysis of aggregated data is done, the present data analysis follows a deconstructive approach, involving assessing changes in degree of satisfaction brought about by change in each degree of performance for every quality attribute. Findings: By following a unique analytical approach to analysing survey data, the study classifies customer satisfaction as not unlike other evaluative judgements, such as morality and likableness, where summary evaluations are a result of a cumulative assessment of all attributes that constitute the particular context. Originality: This study explores the process of cognitive appraisal, which underlies the combination of varied service quality information, in the form of attributes of service quality into unitary satisfaction judgements.

Integrated information systems enable governments to provide better services to citizens. With the aid of such systems, citizens and service agents are able to communicate and resolve issues faster and with ease. The present study looks at an integrated information system employed in a government call centre in South India to gauge its value for the government and citizens. A holistic evaluation of the integrated information system was made in order to identify the impact on governance-centric values for citizen services. Analysis of call logs, process flows, citizen feedback and web-presence led to an understanding of aspects that disable better utilization of the integrated information systems for citizen-centric services. The call centre lagged in efficient resource allocation, agent utilization and process flow that are essential for creating value for the government by improving operations and processes. Citizen-centric values that were affected emerged mainly from the inadequateness in service quality and paucity of digital access. Resource utilization, process efficiency, higher participation by citizens through the digital medium and citizen satisfaction were seen as areas that could impact services offered to the citizens positively.

As per the reports of November 2020, around 58% of India's population earns a primary source of living from agriculture. But, close to 10,000 farmers every year succumb to the harsh conditions in the agricultural sector. These conditions arise when the product of crops is not as desired, spoilt crops, which leads to large loans on the farmers.In this paper, we present an Artificial Intelligence (Al) chatbot that assists the farmers by providing solutions to agricultural queries. Some of the questions are concerning crop sowing, crop diseases, seasons related issues. Thus, benefit the farmers in making the right decisions regarding their crops, thereby increasing their yield.Krushi - The Farmer Chatbot is an end-to-end trainable learning model to create a conversational system with minimum error and answer questions about current conditions. The chatbot is build using Artificial Intelligence (AI) and Machine Learning (ML) techniques. The dataset for the chatbot is used from Kisan Call Centre (KCC). The proposed system, answers queries related to weather, plant protection, animal husbandry, market price, fertilizer uses, government schemes, soil testing with an overall accuracy of 96.1% using RASA X.

IntroductionThere is growing interest in assessing the impact of health interventions, particularly when women are the focus of the intervention, on women’s empowerment. Globally, research has shown that interventions targeting nutrition, health and economic development can affect women’s empowerment. Evidence suggests that women’s empowerment is also an underlying determinant of nutrition outcomes. Depending on the focus of the intervention, different domains of women’s empowerment will be influenced, for example, an increase in nutritional knowledge, or greater control over income and access to resources.ObjectiveThis study evaluates the impact of the Shonjibon Cash and Counselling (SCC) Trial that combines nutrition counselling and an unconditional cash transfer, delivered on a mobile platform, on women’s empowerment in rural Bangladesh.Methods and analysisWe will use a mixed-methods approach, combining statistical analysis of quantitative data from 2840 women in a cluster randomised controlled trial examining the impact of nutrition behaviour change communications (BCCs) and cash transfers on child undernutrition. Pregnant participants will be given a smartphone with a customised app, delivering nutrition BCC messages, and will receive nutrition counselling via a call centre and an unconditional cash transfer. This study is a component of the SCC Trial and will measure women’s empowerment using a composite indicator based on the Project-Level Women’s Empowerment in Agriculture Index, with quantitative data collection at baseline and endline. Thematic analysis of qualitative data, collected through longitudinal interviews with women, husbands and mothers-in-law, will elicit a local understanding of women’s empowerment and the linkages between the intervention and women’s empowerment outcomes. This paper describes the study protocol to evaluate women’s empowerment in a nutrition-specific and sensitive intervention using internationally validated, innovative tools and will help fill the evidence gap on pathways of impact, highlighting areas to target for future programming.Ethics and disseminationEthical approval has been obtained from the International Centre for Diarrhoeal Disease Research (Ref. PR 17106) and The University of Sydney (Ref: 2019/840). Findings from this study will be shared in Bangladesh with dissemination sessions in-country and internationally at conferences, and will be published in peer-reviewed journals.

Introduction Out-of-Hospital Cardiac Arrest (OHCA) is a time-sensitive emergency requiring prompt identification and emergency care to reduce morbidity and mortality. The first step in managing OHCA is rapid identification by the emergency dispatch centre. Identification of these patients remains challenging in South Africa due to multiple languages and widely differing levels of education. This study aimed to identify the key descriptors (words and phrases) of OHCA used by callers in the Western Cape when contacting the provincial Emergency Medical Services' emergency call centre. Methodology Computer-aided dispatch data with a corresponding “patient unresponsive” incident type were drawn for a 12-month period (January–December 2018). Corresponding patient care records were extracted to verify OHCA. The original voice recordings between the caller and emergency call taker at the time of the emergency were extracted and transcribed verbatim. Transcriptions were subjected to inductive, qualitative content analysis to the manifest level. Descriptors of OHCA in isiXhosa, English and Afrikaans calls were coded, categorised, and quantified. Results A total of 729 confirmed OHCA cases were identified, of which 38 (5.2%) Afrikaans, 24 (3.3%) isiXhosa and a random sample of 50 (6.8%) English calls were transcribed. Following content analysis, five distinct categories were identified. The most prevalent categories were descriptors related to ill health (medical history and suspected diagnosis; 35.5%), level of consciousness (unresponsive; 18.6%) and cardiac activity (pulselessness and suspected death; 17.2%). Conclusion The vast majority of callers within the Western Cape province of South Africa use consistent descriptors across languages when requesting an ambulance for OHCA. Future studies should focus on the development and validation of OHCA recognition algorithms, based on these findings.

This research presents a detailed case analysis of BGL Group, a leading, international, distributor of insurance and household financial services. The AI strategy is described by analysing and evaluating a set of AI applications covering a variety of business areas: 1. Machine learning for pricing; 2. Chatbot AI technology to improve the customer experience in e-service; 3. Customer experience design thinking and a/b testing in new product development; 4. Voice recognition and Natural Language Processing (NLP) in call centre operations; 5. AI techniques for market segmentation. Each application is described in detail, and the concept of value creation in service markets is illustrated using data flow diagrams of customer interactions for different stages of the customer journey. A benefits matrix model is proposed that captures the principal AI benefits to both the supplier and the customer. The case discussion uses a new model, an AI systems map, to describe and explain the overall landscape of current AI applications, traditional Management Information Systems (MIS) and possible future application areas based on broad AI strategies and cognitive AI/thinking machines. Some concluding remarks are made on the importance of a digital first culture, up-to-date digital infrastructure and technology partnerships for successful implementation of AI systems, the crucial role of big data in AI strategies, and the growing importance of AI ethics in business applications. Finally, some propositions are offered regarding the future direction of AI in insurance markets.

According to the 2011 Agricultural Census of India, 61.5% population depends on Agriculture for livelihood. Agriculture contributes to only 23% of the country’s population. The low performance economically is primarily because of a lack of proper information and resources to obtain genuine information. The farmers’ queries are hardly solved and heard by the concerned individuals thus leading to chaos and confusion in their minds regarding their farming activities. Proper attention and implementation are thus needed to assist the farmers of India. We propose to build a smart chatbot using learning techniques to get correct information to farmers quickly. A farmer can interact with the chatbot in their local language as our chatbot is multi-linguistic. We use the dataset from Kisan Call Centre to train the chatbot. We use the k-Nearest Neighbors algorithm and sequence-to-sequence framework to enable Natural Language Processing as well as Natural Language Generation. Farmers will get real-time answers to their questions through our system assisted by Machine Learning.

There is a general understanding that mankind began civilization with the discovery of farming, which is arguably the most crucial profession on this planet. The simple yet scientific definition of farming is growing crops for food and nourishment. Farmers are the people who undertake this noble job. At the start of twenty-first century, 1/3rd of the global workforce was employed in the agricultural job.

Background: Inappropriate dispatch of urgent ambulances by call-centre personnel causes an unnecessary drain on existing resources. How often these urgent dispatches are appropriate has not been evaluated in the lower-middle-income setting, nor have factors been assessed that contribute to these decisions. This study aimed to establish the rates of pre-hospital over-triage in Cape Town, South Africa, and to assess the call-centre decision-making processes. Methods: This was a descriptive, retrospective study examining all urgent ambulance dispatches made from a large public sector ambulance call centre in Cape Town over a single month. This urgent dispatch was then compared to the on-scene South African Triage Scale (SATS) score assigned by the pre-hospital personnel to assess which cases were ‘over-triaged’ by the call taker. Factors potentially contributing to the call taker’s decision were also analysed and included the time of day, nature of presenting complaint, and the call taker’s training and experience – all of which may have affected the rates of over-triage. Results: In the course of one month in 2017, 4,169 urgent calls were assessed; of these, 2,701 were over-triaged (58.48%). The over-triage rate was similar during the day (58.02%) and night (59.11%). The most regularly over-triaged complaint was obstetric and gynaecological (84.87%), followed by motor vehicle accidents (65.70%); the lowest rate was for cardiac call-outs (47.12%). We reviewed the 38 highest workload call takers, and found no statistically significant factors that contributed to higher levels of over-triage when reviewing higher levels of training (Ambulance Emergency Assistant 62.16%, no medical training 59.42%; p=0.669), more years as a call taker ( 5 years 60.23%; p=0.932), and more years working in the field (0 years 59.36%, > 5 years 63.66%; p=0.305). Conclusion: The rates of pre-hospital over-triage in Cape Town are marginally lower than those described internationally. The nature of the complaint had a strong impact on these rates, notably in terms of trauma and gynaecological disorders. The call taker’s training and years of experience did not have a statistically significant impact on decision-making.

BackgroundThis paper discusses the concept of acoustic shock based on a literature review and the results of our own research into cases seen in both clinical and medicolegal practice. With the demise of traditional ‘metal bashing’ and ‘smoke stack’ heavy industries, there has been a decline in the incidence of noise-induced hearing loss and tinnitus in this form of employment. However, with the increasing establishment of call centre work, the emergence of acoustic shock has been noted. Acoustic shock is recognised as a clinical entity distinct from noise-induced hearing loss and acoustic trauma.ObjectiveThis article discusses clinical implications, medicolegal considerations in light of a recent high-profile court case and proposed criteria for diagnosis.