Search results for: Alyssa Adams
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 63

Search results for: Alyssa Adams

33 Social Discussion Networks during the Covid-19 Pandemic: A Study of College Students Core Discussion Groups

Authors: Regan Harper, Song Yang, Douglas Adams

Abstract:

During the historically unprecedent time of Covid-19 pandemic, we survey college students with social issue generators to measure their core discussion groups. For the total 191 students, we elicit 847 conversation partners (alters) with our five social issue generators such as school closing, facemasks, collegiate sports, race and policing, and social inequality, producing an average of 4.43 alters per respondent. The core discussion groups of our sample are very gender balanced, with female alters slightly outnumbering male alters. However, the core discussion groups are racially homogenous, consisting of mostly white students (around or above 80 percent). Explanatory analyses reveal that gender and race of respondents significantly impact the size, gender composition, and racial composition of their core discussion networks. We discuss those major findings and implications of future studies in our conclusion section.

Keywords: core discussion groups, social issue generators, ego-centric network, Covid-19 pandemic

Procedia PDF Downloads 48
32 Model Based Simulation Approach to a 14-Dof Car Model Using Matlab/Simulink

Authors: Ishit Sheth, Chandrasekhar Jinendran, Chinmaya Ranjan Sahu

Abstract:

A fourteen degree of freedom (DOF) ride and handling control mathematical model is developed for a car using generalized boltzmann hamel equation which will create a basis for design of ride and handling controller. Mathematical model developed yield equations of motion for non-holonomic constrained systems in quasi-coordinates. The governing differential equation developed integrates ride and handling control of car. Model-based systems engineering approach is implemented for simulation using matlab/simulink, vehicle’s response in different DOF is examined and later validated using commercial software (ADAMS). This manuscript involves detailed derivation of full car vehicle model which provides response in longitudinal, lateral and yaw motion to demonstrate the advantages of the developed model over the existing dynamic model. The dynamic behaviour of the developed ride and handling model is simulated for different road conditions.

Keywords: Full Vehicle Model, MBSE, Non Holonomic Constraints, Boltzmann Hamel Equation

Procedia PDF Downloads 182
31 A Study on the Influence of Pin-Hole Position Error of Carrier on Mesh Load and Planet Load Sharing of Planetary Gear

Authors: Kyung Min Kang, Peng Mou, Dong Xiang, Gang Shen

Abstract:

For planetary gear system, Planet pin-hole position accuracy is one of most influential factor to efficiency and reliability of planetary gear system. This study considers planet pin-hole position error as a main input error for model and build multi body dynamic simulation model of planetary gear including planet pin-hole position error using MSC. ADAMS. From this model, the mesh load results between meshing gears in each pin-hole position error cases are obtained and based on these results, planet load sharing factor which reflect equilibrium state of mesh load sharing between whole meshing gear pair is calculated. Analysis result indicates that the pin-hole position error of tangential direction cause profound influence to mesh load and load sharing factor between meshing gear pair.

Keywords: planetary gear, load sharing factor, multibody dynamics, pin-hole position error

Procedia PDF Downloads 547
30 A Comparison of Bias Among Relaxed Divisor Methods Using 3 Bias Measurements

Authors: Sumachaya Harnsukworapanich, Tetsuo Ichimori

Abstract:

The apportionment method is used by many countries, to calculate the distribution of seats in political bodies. For example, this method is used in the United States (U.S.) to distribute house seats proportionally based on the population of the electoral district. Famous apportionment methods include the divisor methods called the Adams Method, Dean Method, Hill Method, Jefferson Method and Webster Method. Sometimes the results from the implementation of these divisor methods are unfair and include errors. Therefore, it is important to examine the optimization of this method by using a bias measurement to figure out precise and fair results. In this research we investigate the bias of divisor methods in the U.S. Houses of Representatives toward large and small states by applying the Stolarsky Mean Method. We compare the bias of the apportionment method by using two famous bias measurements: The Balinski and Young measurement and the Ernst measurement. Both measurements have a formula for large and small states. The Third measurement however, which was created by the researchers, did not factor in the element of large and small states into the formula. All three measurements are compared and the results show that our measurement produces similar results to the other two famous measurements.

Keywords: apportionment, bias, divisor, fair, measurement

Procedia PDF Downloads 335
29 Knowledge Reactor: A Contextual Computing Work in Progress for Eldercare

Authors: Scott N. Gerard, Aliza Heching, Susann M. Keohane, Samuel S. Adams

Abstract:

The world-wide population of people over 60 years of age is growing rapidly. The explosion is placing increasingly onerous demands on individual families, multiple industries and entire countries. Current, human-intensive approaches to eldercare are not sustainable, but IoT and AI technologies can help. The Knowledge Reactor (KR) is a contextual, data fusion engine built to address this and other similar problems. It fuses and centralizes IoT and System of Record/Engagement data into a reactive knowledge graph. Cognitive applications and services are constructed with its multiagent architecture. The KR can scale-up and scaledown, because it exploits container-based, horizontally scalable services for graph store (JanusGraph) and pub-sub (Kafka) technologies. While the KR can be applied to many domains that require IoT and AI technologies, this paper describes how the KR specifically supports the challenging domain of cognitive eldercare. Rule- and machine learning-based analytics infer activities of daily living from IoT sensor readings. KR scalability, adaptability, flexibility and usability are demonstrated.

Keywords: ambient sensing, AI, artificial intelligence, eldercare, IoT, internet of things, knowledge graph

Procedia PDF Downloads 148
28 Molecular Characterization and Determination of Bioremediation Potentials of Some Bacteria Isolated from Spent Oil Contaminated Soil Mechanic Workshops in Kaduna Metropolis

Authors: David D. Adams, Ibrahim B. Bello

Abstract:

Spent oil contaminated Soil from ten selected mechanic workshops were investigated for their bacteria and bioremediation potentials. The bacterial isolates were morphologically and molecularly identified as Enterobacter hormaechei, Escherichia coli, Klebsiella pneumoniae, Shigella flexneri , Wesiella cibaria, Lactobacillus planetarium. The singles and a consortium of these bacteria incubated in the minimal salt medium incorporated with 1% engine oil exhibited various biodegradation rates, with the mixed consortium exhibiting the highest for this oil. The gene for the hydrocarbon enzyme Catechol 2, 3 dioxygenase (C2,30) was detected and amplified in Enterobacter hormaechei, Escherichia coli and Shigella flexneri using PCR and Agarose gel electrophoresis. The detection of the (C2,30) enzyme gene in, and the spent oil biodegradation activity exhibited by these bacteria suggest their possible possession of bioremediating potentials for the spent engine oil. It is therefore suggested that a pilot study on the field application of these bacteria for bioremediation and restoration of spent oil polluted environment should be done in mechanic workshops.

Keywords: spent engine oil, pollution, bacteria, enzyme, bioremediation, mechanic workshop

Procedia PDF Downloads 190
27 Learning and Teaching Styles of Student Nurses

Authors: Jefferson S. Galanza, Jewel An Mischelle R.Camcam, Alyssa Karryl C. Co, Stephanie P. De Guzman, Jet Jet K. Dongui-is, Rodolfo Dane C. Frias, Ovelle C. Jueco, Harvey L. Matbagan, Victoria Luzette T. Rillon, Christelle Romyna H. Saruca, Jeanette Roma M. Villasper

Abstract:

Background: Amidst numerous studies conducted on learning styles of students from a variety of courses, levels and school, a recent study recommended a great need for research on learning styles of student nurses. Moreover, related literatures have not been found exploring both the learning and teaching style of student nurses. Aims: The study aimed to determine the learning and teaching styles of student nurses and if there is an association between them. It also intended to discover whether student nurses are unimodal or multimodal in their styles and identified which faculty teaching style affords maximum outcome for student’s learning styles. Methods: Quantitative Descriptive-Correlational design was used. Participants were randomly selected 312 student nurses at School of Nursing X, Baguio City, Philippines. The questionnaire utilized a modified version of an adopted tool from Fleming’s VARK learning style version 7.2 (Visual, Auditory, Reader/Writer, Kinaesthetic) and Grasha’s teaching styles (Formal Authority, Demonstrator, Facilitator, Delegator). SPSS 19 was used for statistical treatment of data, where Chi square was used for the correlation of unimodal learning and teaching styles. Results/Finding: Majority of student nurses’ learning style is Kinesthetic and their teaching style is Demonstrator, which was also found to be significantly associated. Moreover, 8 out of 10 students are Unimodal in their learning and teaching modalities. In general, their preferred faculty teaching style is similar to their teaching style, which supports the concept, that teachers teach the way they learn. Conclusion: Study concludes that student nurses’ learning styles and teaching styles are varied, which exemplifies the uniqueness of every learner.This diversity in styles provided more evidence that a variety of mode of teaching and learning should be used by faculty and students to increase learning outcome and academic achievement. Recommendation: Future studies could be carried out in various schools of nursing utilizing faculty as respondents. Conduct assessment of learning style at the onset of classes/clinical placements so that faculty will become aware of the diversity of learners leading them to deliver diverse teaching methods.

Keywords: learning, learning styles, teaching styles, student nurses

Procedia PDF Downloads 511
26 Estimation of Adult Patient Doses for Chest X-Ray Diagnostic Examinations in a Tertiary Institution Health Centre

Authors: G. E. Okungbowa, H. O. Adams, S. E. Eze

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This study is on the estimation of adult patient doses for Chest X-ray diagnostic examinations of new admitted undergraduate students attending a tertiary institution health centre as part of their routine clearance and check up on admitted into the institution. A total of 531 newly admitted undergraduate students were recruited for this survey in the first quarter of 2016 (January to March, 2016). CALDOSE_X 5.0 software was used to compute the Entrance Surface Dose (ESD) and Effective Dose (ED); while the Statistical Package for Social Sciences (SPSS) version 21.0 was used to carry out the statistical analyses. The basic patients' data and exposure parameters required for the software are age, sex, examination type, projection posture, tube potential and current-time product. The mean Entrance Surface Dose and Effective Doses of the undergraduate students were calculated using the software, and the values were compared with existing literature and internationally established diagnostic reference levels. The mean ESD calculated is 0.29 mGy, and the mean effective dose is 0.04 mSv. The values of ESD and ED obtained are below the internationally established diagnostic reference levels, which could be attributed to good radiographic techniques employed during the chest X-ray procedure for these students.

Keywords: x-ray, dose, examination, chest

Procedia PDF Downloads 155
25 Dynamic Analysis and Design of Lower Extremity Power-Assisted Exoskeleton

Authors: Song Shengli, Tan Zhitao, Li Qing, Fang Husheng, Ye Qing, Zhang Xinglong

Abstract:

Lower extremity power-assisted exoskeleton (LEPEX) is a kind of wearable electromechanical integration intelligent system, walking in synchronization with the wearer, which can assist the wearer walk by means of the driver mounted in the exoskeleton on each joint. In this paper, dynamic analysis and design of the LEPEX are performed. First of all, human walking process is divided into single leg support phase, double legs support phase and ground collision model. The three kinds of dynamics modeling is established using the Lagrange method. Then, the flat walking and climbing stairs dynamic information such as torque and power of lower extremity joints is derived for loading 75kg according to scholar Stansfield measured data of flat walking and scholars R. Riener measured data of climbing stair respectively. On this basis, the joint drive way in the sagittal plane is determined, and the structure of LEPEX is designed. Finally, the designed LEPEX is simulated under ADAMS by using a person’s joint sports information acquired under flat walking and climbing stairs. The simulation result effectively verified the correctness of the structure.

Keywords: kinematics, lower extremity exoskeleton, simulation, structure

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24 Kinetics, Equilibrium and Thermodynamic Studies on Adsorption of Reactive Blue 29 from Aqueous Solution Using Activated Tamarind Kernel Powder

Authors: E. D. Paul, A. D. Adams, O. Sunmonu, U. S. Ishiaku

Abstract:

Activated tamarind kernel powder (ATKP) was prepared from tamarind fruit (Tamarindus indica), and utilized for the removal of Reactive Blue 29 (RB29) from its aqueous solution. The powder was activated using 4N nitric acid (HNO₃). The adsorbent was characterised using infrared spectroscopy, bulk density, ash content, pH, moisture content and dry matter content measurements. The effect of various parameters which include; temperature, pH, adsorbent dosage, ion concentration, and contact time were studied. Four different equilibrium isotherm models were tested on the experimental data, but the Temkin isotherm model was best-fitted into the experimental data. The pseudo-first order and pseudo-second-order kinetic models were also fitted into the graphs, but pseudo-second order was best fitted to the experimental data. The thermodynamic parameters showed that the adsorption of Reactive Blue 29 onto activated tamarind kernel powder is a physical process, feasible and spontaneous, exothermic in nature and there is decreased randomness at the solid/solution interphase during the adsorption process. Therefore, activated tamarind kernel powder has proven to be a very good adsorbent for the removal of Reactive Blue 29 dyes from industrial waste water.

Keywords: tamarind kernel powder, reactive blue 29, isotherms, kinetics

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23 Determining the Functionality of Urban Wildlife with Large Megafauna: A Case Study from Chobe District, Northern Botswana

Authors: Tempe S. F. Adams, Michael J. Chase, Tracey L. Rogers, Keith E. A. Leggett

Abstract:

Transfrontier wildlife corridors can be successful conservation tools, connecting protected areas and reducing the impact of habitat fragmentation on mobile species. Urban wildlife corridors have been proposed as a potential mitigation tool to facilitate the passage of elephants through towns without causing conflict with urban communities. However, because such corridors are typically narrow and close to human development, wildlife (particularly large mammals) may be less likely to use them. We used remote-sensor camera traps and global positioning system collars to identify the movement patterns of African elephants Loxondonta africana through narrow, urban corridors in Botswana. The corridors were in three types of human-dominated land-use designations with varying levels of human activity: agricultural, industrial and open space recreational land. We found that elephants used the corridors within all three land-use designations and we identified, using a model selection approach, that season, time of day and rainfall were important factors in determining the presence of elephants in the corridors. Elephants moved more slowly through the narrow corridors compared with their movement patterns through broader, wide-ranging corridors. Our results indicate that urban wildlife corridors are useful for facilitating elephants to pass through urban areas.

Keywords: camera traps, conservation, human-elephant coexistence, land management, urban wildlife corridors

Procedia PDF Downloads 272
22 Characterising the Processes Underlying Emotion Recognition Deficits in Adolescents with Conduct Disorder

Authors: Nayra Martin-Key, Erich Graf, Wendy Adams, Graeme Fairchild

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Children and adolescents with Conduct Disorder (CD) have been shown to demonstrate impairments in emotion recognition, but it is currently unclear whether this deficit is related to specific emotions or whether it represents a global deficit in emotion recognition. An emotion recognition task with concurrent eye-tracking was employed to further explore this relationship in a sample of male and female adolescents with CD. Participants made emotion categorization judgements for presented dynamic and morphed static facial expressions. The results demonstrated that males with CD, and to a lesser extent, females with CD, displayed impaired facial expression recognition in general, whereas callous-unemotional (CU) traits were linked to specific problems in sadness recognition in females with CD. A region-of-interest analysis of the eye-tracking data indicated that males with CD exhibited reduced fixation times for the eye-region of the face compared to typically-developing (TD) females, but not TD males. Females with CD did not show reduced fixation to the eye-region of the face relative to TD females. In addition, CU traits did not influence CD subjects’ attention to the eye-region of the face. These findings suggest that the emotion recognition deficits found in CD males, the worst performing group in the behavioural tasks, are partly driven by reduced attention to the eyes.

Keywords: attention, callous-unemotional traits, conduct disorder, emotion recognition, eye-region, eye-tracking, sex differences

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21 Alcohol and Soda Consumption of University Students in Manila

Authors: Alexi Colleen F. Lim, Inna Felicia I. Agoncillo, Quenniejoy T. Dizon, Jennifer Joyce T. Eti, Carlota Aileen H. Monares, Neil Roy B. Rosales, Joshua F. Santillan, Alyssa Francesca D. S. Tanchuling, Josefina A. Tuazon, Mary Joan Therese C. Valera-Kourdache

Abstract:

Majority of leading causes of mortality in the Philippines are NCDs, which are preventable through control of known risk factors such as smoking, obesity, physical inactivity, and alcohol. Sugar-sweetened beverages such as soda and energy drinks also contribute to NCD risk and are of concern particularly for youth. This study provides baseline data on beverage consumption of university students in Manila with the focus on alcohol and soda. It further aims to identify factors affecting consumption. Specific objectives include: (1) to describe beverage consumption practices of university students in Manila; and (2) to determine factors promoting excessive consumption of alcohol and soda including demographic characteristics, attitude, interpersonal and environmental variables. Methods: The study employed correlational design with randomly selected students from two universities in Manila. Students 18 years or older who agreed to participate were included after obtaining ethical clearance. The study had two instruments: (1) World Health Organization’s Alcohol Use Disorders Identification Test (AUDIT) was used with permission, to determine excessive alcohol consumption; and (2) a questionnaire to obtain information regarding soda and energy drink consumption. Results: Out of 400 students surveyed, 70% were female and 78.75% were 18-20 years old (mean=19.79; SD=3.76). Among them, 51.50% consumed alcohol, with 30.10% excessive drinkers. Soda consumption is 91.50% with 37.70% excessive consumers. For energy drinks, 36.75% consume this and only 4.76% drink excessively. Using logistic regression, students who were more likely to be excessive alcohol drinkers belonged to non-health courses (OR=2.21) and purchased alcohol from bars (OR=7.84). Less likely to drink excessively are students who do not drink due to stress (OR=0.05) and drink when it is accessible (OR=0.02). Excessive soda consumption was less likely for female students (OR=0.28), those who drink when it is accessible (OR=0.14), do not drink soda during stressful situations (OR=0.19), and do not use soda as hangover treatment (OR=0.15). Conclusion: Excessive alcohol consumption was greater among students in Manila (30.10%) than in US (20%). Drinking alcohol with friends was not related to excessive consumption but availability in bars was. It is expected that health sciences students are less likely to engage in excessive alcohol as they are more aware of its ill effects. Prevalence of soda consumption in Manila (91.50%) is markedly higher compared to 24.5% in the US. These findings can inform schools in developing appropriate health education interventions and policies. For greater understanding of these behaviors and factors, further studies are recommended to explore knowledge and other factors that may promote excessive consumption.

Keywords: alcohol consumption, beverage consumption, energy drinks consumption, soda consumption, university students

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20 Medication Errors in a Juvenile Justice Youth Development Center

Authors: Tanja Salary

Abstract:

This paper discusses a study conducted in a juvenile justice facility regarding medication errors. It includes an introduction to data collected about medication errors in a juvenile justice facility from 2011 - 2019 and explores contributing factors that relate to those errors. The data was obtained from electronic incident records of medication errors that were documented from the years 2011 through 2019. In addition, the presentation reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional health care facilities to juvenile justice residential facilities and acknowledges a gap in research. The theoretical/conceptual framework for the research study was Bandura and Adams’s self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory. Despite the lack of evidence in previous studies addressing medication errors in juvenile justice facilities, this presenter will share information that adds to the body of knowledge, including the potential relationship of medication errors and contributing factors of race and age. Implications for future research include the effect that education and training will have on the communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: Juvenile justice, medication errors, juveniles, error reduction strategies

Procedia PDF Downloads 33
19 Maternal-Fetal Bonding for African American Mothers

Authors: Tracey Estriplet-Adams

Abstract:

This paper focuses on the influence of maternal-fetal bonding by examining attachment theory, psycho-social-cultural influences/adaptations, and maternal well-being. A systematic review methodology was used to synthesize research results to summarize current evidence that can contribute to evidence-based practices. It explores the relationship between attachment styles, prenatal attachment, and perceptions of maternal-infant bonding/attachment six weeks postpartum. It also examines the protective factors of maternal-fetal attachment development. The research explores Bowlby's attachment theory and its relevance to maternal-fetal bonding with a Black Feminist Theory lens. Additionally, it discusses the impact of perceived stress, social support, and ecological models on maternal-fetal attachment. The relationship between maternal well-being, maternal-fetal attachment, and early postpartum bonding is reviewed. Moreover, the paper specifically addresses black mothers and maternal-fetal bonding, exploring the intersectionality of race, ethnicity, class, geographic location, cultural identities, and immigration status. It considers the role of familial and partner support, as well as the relationship between maternal attachment style and maternal-fetal bonding, within the framework of attachment theory and black feminist theory. Therefore, it is imperative to center Black women's voices in research, policy, and healthcare practices. Black women are experts in their own experiences and advocate for their autonomy in decision-making regarding maternal-fetal health. By amplifying their voices, we can ensure that interventions are grounded in their lived experiences.

Keywords: maternal-fetal bonding, infant well-being, maternal-infant attachment, black mothers

Procedia PDF Downloads 43
18 4D Modelling of Low Visibility Underwater Archaeological Excavations Using Multi-Source Photogrammetry in the Bulgarian Black Sea

Authors: Rodrigo Pacheco-Ruiz, Jonathan Adams, Felix Pedrotti

Abstract:

This paper introduces the applicability of underwater photogrammetric survey within challenging conditions as the main tool to enhance and enrich the process of documenting archaeological excavation through the creation of 4D models. Photogrammetry was being attempted on underwater archaeological sites at least as early as the 1970s’ and today the production of traditional 3D models is becoming a common practice within the discipline. Photogrammetry underwater is more often implemented to record exposed underwater archaeological remains and less so as a dynamic interpretative tool.  Therefore, it tends to be applied in bright environments and when underwater visibility is > 1m, reducing its implementation on most submerged archaeological sites in more turbid conditions. Recent years have seen significant development of better digital photographic sensors and the improvement of optical technology, ideal for darker environments. Such developments, in tandem with powerful processing computing systems, have allowed underwater photogrammetry to be used by this research as a standard recording and interpretative tool. Using multi-source photogrammetry (5, GoPro5 Hero Black cameras) this paper presents the accumulation of daily (4D) underwater surveys carried out in the Early Bronze Age (3,300 BC) to Late Ottoman (17th Century AD) archaeological site of Ropotamo in the Bulgarian Black Sea under challenging conditions (< 0.5m visibility). It proves that underwater photogrammetry can and should be used as one of the main recording methods even in low light and poor underwater conditions as a way to better understand the complexity of the underwater archaeological record.

Keywords: 4D modelling, Black Sea Maritime Archaeology Project, multi-source photogrammetry, low visibility underwater survey

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17 Avoiding Medication Errors in Juvenile Facilities

Authors: Tanja Salary

Abstract:

This study uncovers a gap in the research and adds to the body of knowledge regarding medication errors in a juvenile justice facility. The study includes an introduction to data collected about medication errors in a juvenile justice facility and explores contributing factors that relate to those errors. The data represent electronic incident records of the medication errors that were documented from the years 2011 through 2019. In addition, this study reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional healthcare facilities to juvenile justice residential facilities. The theoretical/conceptual framework for the research study pertains to Bandura and Adams’s (1977) framework of self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory (2005). Despite the lack of evidence in previous studies about addressing medication errors in juvenile justice facilities, this presenter will relay information that adds to the body of knowledge to note the importance of how assessing the potential relationship between medication errors. Implications for more research include recommendations for more education and training regarding increased communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: juvenile justice, medication errors, psychotropic medications, behavioral health, juveniles, incarcerated youth, recidivism, patient safety

Procedia PDF Downloads 32
16 Exploring the Knowledge from the Public on Technical and Vocational Education Training (TVET) in Ghana

Authors: Abubakar-Zagoon Adams, Emmanuel Intsiful, Haruna Zagoon-Sayeed

Abstract:

Within the Ghanaian context, the promotion of Technical and Vocational Education and Training (TVET) has been faced with many obstacles which are of great concern to national development. One of the obstacles that have been identified as having some negative impact on TVET promotion is the poor public perception of TVET. Poor public perception, as identified in the sub-sectors report in a number of Ghana Education Service reports, has received little attention in both research and the government’s effort to address the poor performance of the TVET sub-sector. This study investigated TVET stakeholders in the Ayawaso-West Municipality in the Greater Accra Region of Ghana to ascertain knowledge of technical and vocational education in Ghana. This study explored parents’ and students’ views and knowledge about technical and vocational education. The study adopted an exploratory research design and a qualitative research approach. Thirty-six (36) participants were selected by employing a purposive sampling technique. Twelve (ten parents and two school personnel) out of the total sample were engaged in key informant interviews, whereas three focus group discussions were conducted with students, eight in each group. The study found that the public has fair knowledge (positive) about TVET, and the other side of the coin knows that TVET is only meant for school dropouts, underprivileged students, and weak academic students. The study recommended that the government should intensify public education on TVET, deliberate investment should be made in TVET infrastructure, as well as proper regulation of the sub-sector.

Keywords: public perception, TVET promotion, socioeconomic, self-employment

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15 Digital Interventions for Older People Experiencing Homelessness (OPEH): A Systematic Scoping Review

Authors: Emily Adams, Eddie Donaghy, David Henderson, Lauren Ng, Caroline Sanders, Rowena Stewart, Maria Wolters, Stewart Mercer

Abstract:

Ongoing review abstract: Older People Experiencing Homelessness (OPEH) can have mental and physical indicators of aging 10–20 years earlier than the general population and experience premature mortality due to age-related chronic conditions. Emerging literature suggests digital interventions could positively impact PEH’s well-being. However, the increased reliance on digital delivery may also perpetuate digital inequalities for socially excluded groups, including PEH. The potential triple disadvantage of being older, homeless, and digitally excluded creates a uniquely problematic situation that warrants further research. This scoping review aims to investigate and synthesise the range and type of digital interventions available to OPEH and the organisations that support OPEH. The following databases were searched on 28th July 2023: Medline, Scopus, International Bibliography of the Social Sciences (IBSS)‎, Applied Social Sciences Index & Abstracts (ASSIA)‎, Association for Computing Machinery Digital Library (ACMDL) and Policy commons. A search strategy was developed in collaboration with an academic librarian. The presentation will include: An introduction to OPEH and digital exclusion Overview of the results of this review: OPEH usage of digital platforms Current digital interventions available The role of support organisations Current gaps in the evidence, future research and recommendations for policy and practice

Keywords: homeless, digital exclusion, aging, technology

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14 Laparoscopic Resection Shows Comparable Outcomes to Open Thoracotomy for Thoracoabdominal Neuroblastomas: A Meta-Analysis and Systematic Review

Authors: Peter J. Fusco, Dave M. Mathew, Chris Mathew, Kenneth H. Levy, Kathryn S. Varghese, Stephanie Salazar-Restrepo, Serena M. Mathew, Sofia Khaja, Eamon Vega, Mia Polizzi, Alyssa Mullane, Adham Ahmed

Abstract:

Background: Laparoscopic (LS) removal of neuroblastomas in children has been reported to offer favorable outcomes compared to the conventional open thoracotomy (OT) procedure. Critical perioperative measures such as blood loss, operative time, length of stay, and time to postoperative chemotherapy have all supported laparoscopic use rather than its more invasive counterpart. Herein, a pairwise meta-analysis was performed comparing perioperative outcomes between LS and OT in thoracoabdominal neuroblastoma cases. Methods: A comprehensive literature search was performed on PubMed, Ovid EMBASE, and Scopus databases to identify studies comparing the outcomes of pediatric patients with thoracoabdominal neuroblastomas undergoing resection via OT or LS. After deduplication, 4,227 studies were identified and subjected to initial title screening with exclusion and inclusion criteria to ensure relevance. When studies contained overlapping cohorts, only the larger series were included. Primary outcomes include estimated blood loss (EBL), hospital length of stay (LOS), and mortality, while secondary outcomes were tumor recurrence, post-operative complications, and operation length. The “meta” and “metafor” packages were used in R, version 4.0.2, to pool risk ratios (RR) or standardized mean differences (SMD) in addition to their 95% confidence intervals in the random effects model via the Mantel-Haenszel method. Heterogeneity between studies was assessed using the I² test, while publication bias was assessed via funnel plot. Results: The pooled analysis included 209 patients from 5 studies (141 OT, 68 LS). Of the included studies, 2 originated from the United States, 1 from Toronto, 1 from China, and 1was from a Japanese center. Mean age between study cohorts ranged from 2.4 to 5.3 years old, with female patients occupying between 30.8% to 50% of the study populations. No statistically significant difference was found between the two groups for LOS (SMD -1.02; p=0.083), mortality (RR 0.30; p=0.251), recurrence(RR 0.31; p=0.162), post-operative complications (RR 0.73; p=0.732), or operation length (SMD -0.07; p=0.648). Of note, LS appeared to be protective in the analysis for EBL, although it did not reach statistical significance (SMD -0.4174; p= 0.051). Conclusion: Despite promising literature assessing LS removal of pediatric neuroblastomas, results showed it was non-superior to OT for any explored perioperative outcomes. Given the limited comparative data on the subject, it is evident that randomized trials are necessary to further the efficacy of the conclusions reached.

Keywords: laparoscopy, neuroblastoma, thoracoabdominal, thoracotomy

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13 Opposed Piston Engine Crankshaft Strength Calculation Using Finite Element Method

Authors: Konrad Pietrykowski, Michał Gęca, Michał Bialy

Abstract:

The paper presents the results of the crankshaft strength simulation. The crankshaft was taken from the opposed piston engine. Calculations were made using finite element method (FEM) in Abaqus software. This program allows to perform strength tests of individual machine parts as well as their assemblies. The crankshaft that was used in the calculations will be used in the two-stroke aviation research aircraft engine. The assumptions for the calculations were obtained from the AVL Boost software, from one-dimensional engine cycle model and from the multibody model using the method developed in the MSC Adams software. The research engine will be equipped with 3 combustion chambers and two crankshafts. In order to shorten the calculation time, only one crankcase analysis was performed. The cut of the shaft has been selected with the greatest forces resulting from the engine operation. Calculations were made for two cases. For maximum piston force when maximum bending load occurs and for the maximum torque. Cast iron material was adopted. For this material, Poisson's number, density, and Young's modulus were determined. The computational grid contained of 1,977,473 Tet elements. This type of elements was chosen because of the complex design of the crankshaft. Results are presented in the form of stress distributions maps and displacements on the surface and inside the geometry of the shaft. The results show the places of tension stresses, however, no stresses are exceeded at any place. The shaft can thus be applied to the engine in its present form. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK 'PZL-KALISZ’ S.A. and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: aircraft diesel engine, crankshaft, finite element method, two-stroke engine

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12 The Budget Impact of the DISCERN™ Diagnostic Test for Alzheimer’s Disease in the United States

Authors: Frederick Huie, Lauren Fusfeld, William Burchenal, Scott Howell, Alyssa McVey, Thomas F. Goss

Abstract:

Alzheimer’s Disease (AD) is a degenerative brain disease characterized by memory loss and cognitive decline that presents a substantial economic burden for patients and health insurers in the US. This study evaluates the payer budget impact of the DISCERN™ test in the diagnosis and management of patients with symptoms of dementia evaluated for AD. DISCERN™ comprises three assays that assess critical factors related to AD that regulate memory, formation of synaptic connections among neurons, and levels of amyloid plaques and neurofibrillary tangles in the brain and can provide a quicker, more accurate diagnosis than tests in the current diagnostic pathway (CDP). An Excel-based model with a three-year horizon was developed to assess the budget impact of DISCERN™ compared with CDP in a Medicare Advantage plan with 1M beneficiaries. Model parameters were identified through a literature review and were verified through consultation with clinicians experienced in diagnosis and management of AD. The model assesses direct medical costs/savings for patients based on the following categories: •Diagnosis: costs of diagnosis using DISCERN™ and CDP. •False Negative (FN) diagnosis: incremental cost of care avoidable with a correct AD diagnosis and appropriately directed medication. •True Positive (TP) diagnosis: AD medication costs; cost from a later TP diagnosis with the CDP versus DISCERN™ in the year of diagnosis, and savings from the delay in AD progression due to appropriate AD medication in patients who are correctly diagnosed after a FN diagnosis.•False Positive (FP) diagnosis: cost of AD medication for patients who do not have AD. A one-way sensitivity analysis was conducted to assess the effect of varying key clinical and cost parameters ±10%. An additional scenario analysis was developed to evaluate the impact of individual inputs. In the base scenario, DISCERN™ is estimated to decrease costs by $4.75M over three years, equating to approximately $63.11 saved per test per year for a cohort followed over three years. While the diagnosis cost is higher with DISCERN™ than with CDP modalities, this cost is offset by the higher overall costs associated with CDP due to the longer time needed to receive a TP diagnosis and the larger number of patients who receive a FN diagnosis and progress more rapidly than if they had received appropriate AD medication. The sensitivity analysis shows that the three parameters with the greatest impact on savings are: reduced sensitivity of DISCERN™, improved sensitivity of the CDP, and a reduction in the percentage of disease progression that is avoided with appropriate AD medication. A scenario analysis in which DISCERN™ reduces the utilization for patients of computed tomography from 21% in the base case to 16%, magnetic resonance imaging from 37% to 27% and cerebrospinal fluid biomarker testing, positive emission tomography, electroencephalograms, and polysomnography testing from 4%, 5%, 10%, and 8%, respectively, in the base case to 0%, results in an overall three-year net savings of $14.5M. DISCERN™ improves the rate of accurate, definitive diagnosis of AD earlier in the disease and may generate savings for Medicare Advantage plans.

Keywords: Alzheimer’s disease, budget, dementia, diagnosis.

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11 The New Far-Right: The Social Construction of Hatred against the Contemporary Islamic Community in Multicultural Australia

Authors: Angel Adams

Abstract:

In Australia, the contemporary social construction of hatred against the Islamic community was facilitated through the mainstream media. Australian public figures who have depicted Muslims and Islam not only as potential terrorists but also as incompatible with the country’s values and identities have helped to increase the level of fear against the Islamic community, leading sympathetic far-right movements to shift discussions towards anti-Islamic and anti-Muslim rhetoric. Political opportunities combined with a socially constructed narrative of fear of the ‘other’, introduced during the White Australia Policy of 1901, has allowed extreme and radical far-right movements to justify hate against the contemporary Australian Islamic community. This study aims to answer the following question: How does Australia’s founding provide a fertile environment to the spread of hatred against the contemporary Islamic community? The paper demonstrates that a forged social construct of grievances concerning the Islamic community in Australia has led to a surge in supply of far-right activism to combat what has become a perceived ‘national threat’. In essence, Australia’s history of a fear of the ‘other’ brings challenges to a multicultural society, and can potentially lead to a more unstable socio-political environment where abuse and violence are normalized and more likely to develop. Furthermore, the paper aims to bring a more nuanced understanding of what is considered ‘new far-right’ discourses with shared anti-Islam and anti-Muslim agendas in Australia. The political opportunity structures theory was the mechanism used to determine how new forms of far-right groups have become more mainstream in Australia. Previous studies on far-right groups in Australia have relied on qualitative data, but further empirical research in this area is sorely needed. Above all, this paper clarifies how hatred against minorities can have a negative impact on wider communities and allow a global narrative of ‘us’ versus ‘them’ to erupt from the fringes of society in Australia.

Keywords: Australia, Islamophobia, far-right, nationalism, political opportunity structures, political violence, social construction

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10 Design, Analysis and Obstacle Avoidance Control of an Electric Wheelchair with Sit-Sleep-Seat Elevation Functions

Authors: Waleed Ahmed, Huang Xiaohua, Wilayat Ali

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The wheelchair users are generally exposed to physical and psychological health problems, e.g., pressure sores and pain in the hip joint, associated with seating posture or being inactive in a wheelchair for a long time. Reclining Wheelchair with back, thigh, and leg adjustment helps in daily life activities and health preservation. The seat elevating function of an electric wheelchair allows the user (lower limb amputation) to reach different heights. An electric wheelchair is expected to ease the lives of the elderly and disable people by giving them mobility support and decreasing the percentage of accidents caused by users’ narrow sight or joystick operation errors. Thus, this paper proposed the design, analysis and obstacle avoidance control of an electric wheelchair with sit-sleep-seat elevation functions. A 3D model of a wheelchair is designed in SolidWorks that was later used for multi-body dynamic (MBD) analysis and to verify driving control system. The control system uses the fuzzy algorithm to avoid the obstacle by getting information in the form of distance from the ultrasonic sensor and user-specified direction from the joystick’s operation. The proposed fuzzy driving control system focuses on the direction and velocity of the wheelchair. The wheelchair model has been examined and proven in MSC Adams (Automated Dynamic Analysis of Mechanical Systems). The designed fuzzy control algorithm is implemented on Gazebo robotic 3D simulator using Robotic Operating System (ROS) middleware. The proposed wheelchair design enhanced mobility and quality of life by improving the user’s functional capabilities. Simulation results verify the non-accidental behavior of the electric wheelchair.

Keywords: fuzzy logic control, joystick, multi body dynamics, obstacle avoidance, scissor mechanism, sensor

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9 The Efficacy of Pre-Hospital Packed Red Blood Cells in the Treatment of Severe Trauma: A Retrospective, Matched, Cohort Study

Authors: Ryan Adams

Abstract:

Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

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8 E-Government Development in Nigeria, 'Bank Verification No': An Anti-Corruption Tool

Authors: Ernest C. Nwadinobi, Amanda Peart, Carl Adams

Abstract:

The leading countries like the USA, UK and some of the European countries have moved their focus away from just developing the e-government platform towards just the electronic services which aim at providing access to information to its citizens or customers, but they have gone to make significant backroom changes that can accommodate this electronic service being provided to its customers or citizens. E-government has moved from just providing electronic information to citizens and customers alike to serving their needs. In developing countries like Nigeria, the enablement of e-government is being used as an anti-corruption tool. The introduction of the Bank verification number (BVN) scheme by the Central Bank of Nigeria, has helped the government in not just saving money but also protecting customer’s transaction and enhancing confidence in the banking sector. This has helped curtail the high rate of cyber and financial crime that has been part of the system. The use of BVN as an anti-corruption tool in Nigeria came at a time there was need for openness, accountability, and discipline, after years of robbing the treasury and recklessness in handling finances. As there has not been a defined method for measuring the strength or success of e-government development, in this case BVN, in Nigeria, progress will remain at the same level. The implementation strategy of the BVN in Nigeria has mostly been a quick fix, quick win solution. In fact, there is little or no indication to show evidence of a framework for e-government. Like other leading countries, there is the need for proper implementation of strategy and framework especially towards a customer orientated process, which will accommodate every administrative body of the government institution including private business rather than focusing on a non-flexible organisational structure. The development of e-government must have a strategy and framework for it to work, and this strategy must enclose every public administration and will not be limited to any individual bodies or organization. A defined framework or monitoring method must be put in place to help evaluate and benchmark government development in e-government. This framework must follow the same concept or principles. In censorious analyses of the existing methods, this paper will denote areas that must be included in the existing approach to be able to channel e-government development towards its defined strategic objectives.

Keywords: Bank Verification No (BVN), quick-fix, anti-corruption, quick-win

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7 Two-Dimensional Analysis and Numerical Simulation of the Navier-Stokes Equations for Principles of Turbulence around Isothermal Bodies Immersed in Incompressible Newtonian Fluids

Authors: Romulo D. C. Santos, Silvio M. A. Gama, Ramiro G. R. Camacho

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In this present paper, the thermos-fluid dynamics considering the mixed convection (natural and forced convections) and the principles of turbulence flow around complex geometries have been studied. In these applications, it was necessary to analyze the influence between the flow field and the heated immersed body with constant temperature on its surface. This paper presents a study about the Newtonian incompressible two-dimensional fluid around isothermal geometry using the immersed boundary method (IBM) with the virtual physical model (VPM). The numerical code proposed for all simulations satisfy the calculation of temperature considering Dirichlet boundary conditions. Important dimensionless numbers such as Strouhal number is calculated using the Fast Fourier Transform (FFT), Nusselt number, drag and lift coefficients, velocity and pressure. Streamlines and isothermal lines are presented for each simulation showing the flow dynamics and patterns. The Navier-Stokes and energy equations for mixed convection were discretized using the finite difference method for space and a second order Adams-Bashforth and Runge-Kuta 4th order methods for time considering the fractional step method to couple the calculation of pressure, velocity, and temperature. This work used for simulation of turbulence, the Smagorinsky, and Spalart-Allmaras models. The first model is based on the local equilibrium hypothesis for small scales and hypothesis of Boussinesq, such that the energy is injected into spectrum of the turbulence, being equal to the energy dissipated by the convective effects. The Spalart-Allmaras model, use only one transport equation for turbulent viscosity. The results were compared with numerical data, validating the effect of heat-transfer together with turbulence models. The IBM/VPM is a powerful tool to simulate flow around complex geometries. The results showed a good numerical convergence in relation the references adopted.

Keywords: immersed boundary method, mixed convection, turbulence methods, virtual physical model

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6 Biomechanical Modeling, Simulation, and Comparison of Human Arm Motion to Mitigate Astronaut Task during Extra Vehicular Activity

Authors: B. Vadiraj, S. N. Omkar, B. Kapil Bharadwaj, Yash Vardhan Gupta

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During manned exploration of space, missions will require astronaut crewmembers to perform Extra Vehicular Activities (EVAs) for a variety of tasks. These EVAs take place after long periods of operations in space, and in and around unique vehicles, space structures and systems. Considering the remoteness and time spans in which these vehicles will operate, EVA system operations should utilize common worksites, tools and procedures as much as possible to increase the efficiency of training and proficiency in operations. All of the preparations need to be carried out based on studies of astronaut motions. Until now, development and training activities associated with the planned EVAs in Russian and U.S. space programs have relied almost exclusively on physical simulators. These experimental tests are expensive and time consuming. During the past few years a strong increase has been observed in the use of computer simulations due to the fast developments in computer hardware and simulation software. Based on this idea, an effort to develop a computational simulation system to model human dynamic motion for EVA is initiated. This study focuses on the simulation of an astronaut moving the orbital replaceable units into the worksites or removing them from the worksites. Our physics-based methodology helps fill the gap in quantitative analysis of astronaut EVA by providing a multisegment human arm model. Simulation work described in the study improves on the realism of previous efforts, incorporating joint stops to account for the physiological limits of range of motion. To demonstrate the utility of this approach human arm model is simulated virtually using ADAMS/LifeMOD® software. Kinematic mechanism for the astronaut’s task is studied from joint angles and torques. Simulation results obtained is validated with numerical simulation based on the principles of Newton-Euler method. Torques determined using mathematical model are compared among the subjects to know the grace and consistency of the task performed. We conclude that due to uncertain nature of exploration-class EVA, a virtual model developed using multibody dynamics approach offers significant advantages over traditional human modeling approaches.

Keywords: extra vehicular activity, biomechanics, inverse kinematics, human body modeling

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5 Contribution of PALB2 and BLM Mutations to Familial Breast Cancer Risk in BRCA1/2 Negative South African Breast Cancer Patients Detected Using High-Resolution Melting Analysis

Authors: N. C. van der Merwe, J. Oosthuizen, M. F. Makhetha, J. Adams, B. K. Dajee, S-R. Schneider

Abstract:

Women representing high-risk breast cancer families, who tested negative for pathogenic mutations in BRCA1 and BRCA2, are four times more likely to develop breast cancer compared to women in the general population. Sequencing of genes involved in genomic stability and DNA repair led to the identification of novel contributors to familial breast cancer risk. These include BLM and PALB2. Bloom's syndrome is a rare homozygous autosomal recessive chromosomal instability disorder with a high incidence of various types of neoplasia and is associated with breast cancer when in a heterozygous state. PALB2, on the other hand, binds to BRCA2 and together, they partake actively in DNA damage repair. Archived DNA samples of 66 BRCA1/2 negative high-risk breast cancer patients were retrospectively selected based on the presence of an extensive family history of the disease ( > 3 affecteds per family). All coding regions and splice-site boundaries of both genes were screened using High-Resolution Melting Analysis. Samples exhibiting variation were bi-directionally automated Sanger sequenced. The clinical significance of each variant was assessed using various in silico and splice site prediction algorithms. Comprehensive screening identified a total of 11 BLM and 26 PALB2 variants. The variants detected ranged from global to rare and included three novel mutations. Three BLM and two PALB2 likely pathogenic mutations were identified that could account for the disease in these extensive breast cancer families in the absence of BRCA mutations (BLM c.11T > A, p.V4D; BLM c.2603C > T, p.P868L; BLM c.3961G > A, p.V1321I; PALB2 c.421C > T, p.Gln141Ter; PALB2 c.508A > T, p.Arg170Ter). Conclusion: The study confirmed the contribution of pathogenic mutations in BLM and PALB2 to the familial breast cancer burden in South Africa. It explained the presence of the disease in 7.5% of the BRCA1/2 negative families with an extensive family history of breast cancer. Segregation analysis will be performed to confirm the clinical impact of these mutations for each of these families. These results justify the inclusion of both these genes in a comprehensive breast and ovarian next generation sequencing cancer panel and should be screened simultaneously with BRCA1 and BRCA2 as it might explain a significant percentage of familial breast and ovarian cancer in South Africa.

Keywords: Bloom Syndrome, familial breast cancer, PALB2, South Africa

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4 Improving Patient and Clinician Experience of Oral Surgery Telephone Clinics

Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

Abstract:

During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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