Search results for: the urban improvement

Authors: Armin Nabaei, M. Omair Ahmad, M. N. S. Swamy

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Many facial expression and emotion recognition methods in the traditional approaches of using LDA, PCA, and EBGM have been proposed. In recent years deep learning models have provided a unique platform addressing by automatically extracting the features for the detection of facial expression and emotions. However, deep networks require large training datasets to extract automatic features effectively. In this work, we propose an efficient emotion detection algorithm using face images when only small datasets are available for training. We design a deep network whose feature extraction capability is enhanced by utilizing several parallel modules between the input and output of the network, each focusing on the extraction of different types of coarse features with fined grained details to break the symmetry of produced information. In fact, we leverage long range dependencies, which is one of the main drawback of CNNs. We develop this work by introducing a Dynamic Soft-Margin SoftMax.The conventional SoftMax suffers from reaching to gold labels very soon, which take the model to over-fitting. Because it’s not able to determine adequately discriminant feature vectors for some variant class labels. We reduced the risk of over-fitting by using a dynamic shape of input tensor instead of static in SoftMax layer with specifying a desired Soft- Margin. In fact, it acts as a controller to how hard the model should work to push dissimilar embedding vectors apart. For the proposed Categorical Loss, by the objective of compacting the same class labels and separating different class labels in the normalized log domain.We select penalty for those predictions with high divergence from ground-truth labels.So, we shorten correct feature vectors and enlarge false prediction tensors, it means we assign more weights for those classes with conjunction to each other (namely, “hard labels to learn”). By doing this work, we constrain the model to generate more discriminate feature vectors for variant class labels. Finally, for the proposed optimizer, our focus is on solving weak convergence of Adam optimizer for a non-convex problem. Our noteworthy optimizer is working by an alternative updating gradient procedure with an exponential weighted moving average function for faster convergence and exploiting a weight decay method to help drastically reducing the learning rate near optima to reach the dominant local minimum. We demonstrate the superiority of our proposed work by surpassing the first rank of three widely used Facial Expression Recognition datasets with 93.30% on FER-2013, and 16% improvement compare to the first rank after 10 years, reaching to 90.73% on RAF-DB, and 100% k-fold average accuracy for CK+ dataset, and shown to provide a top performance to that provided by other networks, which require much larger training datasets.

Keywords: computer vision, facial expression recognition, machine learning, algorithms, depp learning, neural networks

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Authors: Siphesihle Hlongwane

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Background: Globally, alcohol consumption, smoking, and the use of illicit drugs kill more than 11.8 million people each year. In sub-Saharan Africa, substance abuse is responsible for more than 6.4% of all deaths recorded and about 4.7% of all Disability Adjusted Life Years (DALYs), with numbers still expected to grow if no drastic measures are taken to curb and address drug use. In a setting where substance use is rife, understanding contextual factors that influence an individual’s perceived eligibility to seek rehabilitation is paramount. Using the candidacy framework, we unpack how situational factors influence an individual’s perceived eligibility for healthcare uptake in adolescents and youth with substance use disorder (SUD). Methods: The candidacy framework is concerned with how people consider their eligibility for accessing a health service. The study collected and analyzed primary qualitative data to answer the research question. Data were collected between January and July 2022 on participants aged between 18 and 35 for drug users and 18 to 60 for family members. Participants include 20 previous and current drug users and 20 family members that experience the effects of addiction. A pre-drafted semi-structured interview guide was administered to a conveniently sampled population supplemented with a referral sampling method. Data were thematically analyzed using the NVivo 12pro software to manage the data. Findings: Our findings show that people with substance use disorders are aware of their drug use habits and acknowledge their candidacy for health services. Candidacy for health services is also acknowledged by those around them, such as family members and peers, and as such, information on the navigation of health services for drug users is shared by those who have attended health services, those affected by drug use, and this includes health service research by family members to identify accessible health services. While participants reported willingness to quit drug use if assistance is provided, the permeability of health care services is hindered by both individual determinations to quit drug use from long-time use and the availability of health services for drug users, such as rehabilitation centers. Our findings also show that drug users are conscious and can articulate their ailments; however, the hunt for the next dose of drugs and long waiting cues for health service acquisition overshadows their claim to health services. Participants reported a mixture of treatments prescribed, with some more gruesome than others prescribed, thus serving as both a facilitator and barrier for health service uptake. Despite some unorthodox forms of treatments prescribed in health care, the majority of those who enter treatment complete the process of treatment, although some are met with setbacks and sometimes relapse after treatment has finished. Conclusion: Drug users are able to ascertain their candidacy for health services; however, individual and environmental characteristics relating to drug use hinder the use of health services. Drug use interventions need to entice health service uptake as a way to improve candidacy for health use.

Keywords: substance use disorder, rehabilitation, drug use, relapse, South Africa, candidacy framework

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Authors: Rafael Alexandre Dos Reis

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Research has shown a substantial increase in the participation of Conventionally Fuelled Vehicles (CFVs) in the urban transport modal split. The reasons for this unsustainable reality are multiple, from economic interventions to individual behaviour. The development and delivery of positive incentives for the adoption of more environmental-friendly modes of transport is an emerging strategy to help in tackling the problem of excessive use of conventionally fuelled vehicles. The efficiency of this approach, like other information-based schemes, can benefit from the knowledge of their potential impacts in theoretical constructs of multiple behaviour change theories. The goal of this research is to critically analyse theories of behaviour that are relevant to transport research and the impacts of positive incentives on the theoretical determinants of behaviour, strengthening the current body of evidence about the benefits of this approach. The main method to investigate this will involve a literature review on two main topics: the current theories of behaviour that have empirical support in transport research and the past or ongoing positive incentives programs that had an impact on car use reduction. The reviewed programs of positive incentives were the following: The TravelSmart®; Spitsmijden®; Incentives for Singapore Commuters® (INSINC); COMMUTEGREENER®; MOVESMARTER®; STREETLIFE®; SUPERHUB®; SUNSET® and the EMPOWER® project. The theories analysed were the heory of Planned Behaviour (TPB); The Norm Activation Theory (NAM); Social Learning Theory (SLT); The Theory of Interpersonal Behaviour (TIB); The Goal-Setting Theory (GST) and The Value-Belief-Norm Theory (VBN). After the revisions of the theoretical constructs of each of the theories and their influence on car use, it can be concluded that positive incentives schemes impact on behaviour change in the following manners: -Changing individual’s attitudes through informational incentives; -Increasing feelings of moral obligations to reduce the use of CFVs; -Increase the perceived social pressure to engage in more sustainable mobility behaviours through the use of comparison mechanisms in social media, for example; -Increase the perceived control of behaviour through informational incentives and training incentives; -Increasing personal norms with reinforcing information; -Providing tools for self-monitoring and self-evaluation; -Providing real experiences in alternative modes to the car; -Making the observation of others’ car use reduction possible; -Informing about consequences of behaviour and emphasizing the individual’s responsibility with society and the environment; -Increasing the perception of the consequences of car use to an individual’s valued objects; -Increasing the perceived ability to reduce threats to environment; -Help establishing goals to reduce car use; - iving personalized feedback on the goal; -Increase feelings of commitment to the goal; -Reducing the perceived complexity of the use of alternatives to the car. It is notable that the emerging technique of delivering positive incentives are systematically connected to causal determinants of travel behaviour. The preliminary results of the reviewed programs evidence how positive incentives might strengthen these determinants and help in the process of behaviour change.

Keywords: positive incentives, private car use reduction, sustainable behaviour, voluntary travel behaviour change

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Authors: Zongping Wang, Chengjun Cui, Jiacun Wang

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The concept of intelligence has been widely used to access an individual's cognitive abilities to learn, form concepts, understand, apply logic, and reason. According to the multiple intelligence theory, there are eight distinguished types of intelligence. One of them is the bodily-kinaesthetic intelligence that links to the capacity of an individual controlling his body and working with objects. Motor intelligence, on the other hand, reflects the capacity to understand, perceive and solve functional problems by motor behavior. Both bodily-kinaesthetic intelligence and motor intelligence refer directly or indirectly to bodily capacity. Inspired by these two intelligence concepts, this paper introduces motional intelligence (MI). MI is two-fold. (1) Body strength, which is the capacity of various organ functions manifested by muscle activity under the control of the central nervous system during physical exercises. It can be measured by the magnitude of muscle contraction force, the frequency of repeating a movement, the time to finish a movement of body position, the duration to maintain muscles in a working status, etc. Body strength reflects the objective of MI. (2) Level of psychiatric willingness to physical events. It is a subjective thing and determined by an individual’s self-consciousness to physical events and resistance to fatigue. As such, we call it subjective MI. Subjective MI can be improved through education and proper social events. The improvement of subjective MI can lead to that of objective MI. A quantitative score of an individual’s MI is motional quotient (MQ). MQ is affected by several factors, including genetics, physical training, diet and lifestyle, family and social environment, and personal awareness of the importance of physical exercise. Genes determine one’s body strength potential. Physical training, in general, makes people stronger, faster and swifter. Diet and lifestyle have a direct impact on health. Family and social environment largely affect one’s passion for physical activities, so does personal awareness of the importance of physical exercise. The key to the success of the MQ study is developing an acceptable and efficient system that can be used to assess MQ objectively and quantitatively. We should apply different accessing systems to different groups of people according to their ages and genders. Field test, laboratory test and questionnaire are among essential components of MQ assessment. A scientific interpretation of MQ score is part of an MQ assessment system as it will help an individual to improve his MQ. IQ (intelligence quotient) and EQ (emotional quotient) and their test have been studied intensively. We argue that IQ and EQ study alone is not sufficient for an individual’s all round development. The significance of MQ study is that it offsets IQ and EQ study. MQ reflects an individual’s mental level as well as bodily level of intelligence in physical activities. It is well-known that the American Springfield College seal includes the Luther Gulick triangle with the words “spirit,” “mind,” and “body” written within it. MQ, together with IQ and EQ, echoes this education philosophy. Since its inception in 2012, the MQ research has spread rapidly in China. By now, six prestigious universities in China have established research centers on MQ and its assessment.

Keywords: motional Intelligence, motional quotient, multiple intelligence, motor intelligence, all round development

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Authors: Julia Terlet, Thomas H. Beach, Yacine Rezgui

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Urbanization, population growth, climate change and the current increase in water demand have made the adoption of innovative demand management strategies crucial to the water industry. Water conservation in urban areas has to be improved by encouraging consumers to adopt more sustainable habits and behaviours. This includes informing and educating them about their households’ water consumption and advising them about ways to achieve significant savings on a daily basis. This paper presents a study conducted in the context of the European FP7 WISDOM Project. By integrating innovative Information and Communication Technologies (ICT) frameworks, this project aims at achieving a change in water savings. More specifically, behavioural change will be attempted by implementing smart meters and in-home displays in a trial group of selected households within Cardiff (UK). Using this device, consumers will be able to receive feedback and information about their consumption but will also have the opportunity to compare their consumption to the consumption of other consumers and similar households. Following an initial survey, it appeared necessary to implement these in-home displays in a way that matches consumer's motivations to save water. The results demonstrated the importance of various factors influencing people’s daily water consumption. Both the relevant literature on the subject and the results of our survey therefore led us to include within the in-home device a variety of elements. It first appeared crucial to make consumers aware of the economic aspect of water conservation and especially of the significant financial savings that can be achieved by reducing their household’s water consumption on the long term. Likewise, reminding participants of the impact of their consumption on the environment by making them more aware of water scarcity issues around the world will help increasing their motivation to save water. Additionally, peer pressure and social comparisons with neighbours and other consumers, accentuated by the use of online social networks such as Facebook or Twitter, will likely encourage consumers to reduce their consumption. Participants will also be able to compare their current consumption to their past consumption and to observe the consequences of their efforts to save water through diverse graphs and charts. Finally, including a virtual water game within the display will help the whole household, children and adults, to achieve significant reductions by providing them with simple tips and advice to save water on a daily basis. Moreover, by setting daily and weekly goals for them to reach, the game will expectantly generate cooperation between family members. Members of each household will indeed be encouraged to work together to reduce their water consumption within different rooms of the house, such as the bathroom, the kitchen, or the toilets. Overall, this study will allow us to understand the elements that attract consumers the most and the features that are most commonly used by the participants. In this way, we intend to determine the main factors influencing water consumption in order to identify the measures that will most encourage water conservation in both the long and short term.

Keywords: behavioural change, ICT technologies, water consumption, water conservation

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Authors: Lina Shinhwa Koo

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The Korean Empire, or Daehanjeguk, was proclaimed by King Gojong (1852–1919) in 1897 with the aim of promoting its sovereignty as a nation-state amid the political situation with threats from neighbouring countries, such as Japan and Russia. The Korean Empire period (1897–1910), which lasted until 1910, when Japan annexed Korea, is a pivotal time in the modern history of Korea. It was also during the period when many infrastructures for tourism, including transportation and lodging systems, were established. Throughout the Korean Empire period, tourists from Japan and Euro-American countries popularly visited Korea after it opened its doors relatively recently. The government of the Korean Empire also actively engaged with foreign officials and professionals. Train stations were built to connect Busan, where foreigners first arrived through the port of Jemulpo, with Seoul, the capital of Korea. In addition, hotels were built to accommodate the increasing number of tourists. Shedding new light on the modern architectural history of Korea, this paper discusses buildings that were made for tourism during the Korean Empire period to examine the historical background behind the tourism development in Korea and the concept of travelling related to architecture history. Foreigners came to Korea for varying reasons, from ethnographic research and diplomacy to business and missionary. They also played a key role in the transportation and hotel businesses. For instance, American entrepreneur James R. Morse received a concession to construct a railway between Busan and Seoul in 1896, which was later granted to a Japanese firm. Japanese entrepreneurs came to Korea and built hotels, such as Daebul Hotel in Incheon and Paseonggwan in Seoul. Sontag Hotel, Station Hotel and Hotel du Palais, all located in central areas of Seoul, were owned by German, British and French entrepreneurs, respectively. Each building showed distinctive architectural elements. For example, Sontag Hotel was built in Russian architectural style, whereas Paseonggwan was created with a combination of Japanese and European styles. Such various architectural designs indicated the multicultural urban scenes of the Korean Empire at the time. The existing scholarship has paid more attention to the royal buildings built during the Korean Empire period, such as Seokjojeon of the Duksu Palace. However, it is important to study the tourism-related architecture that reflected the societal situation of the Korean Empire when contrasting ideologies, landscapes, historical narratives and political tensions intertwined and co-existed. Examining both textual and visual resources, such as news articles and photographs, this paper surveys architectural styles and the trajectories of selective examples of hotels and train stations within the discussion of temporality and spatiality in the discipline of social science. In doing so, one can re-assess the history of the Korean Empire as the intersection of modern and traditional, intrinsic and extrinsic and national and international.

Keywords: Korean empire, modern Korean architecture, tourism, hotel, train station

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Authors: Alireza Barari, Saeed Shirali, Ahmad Abdi

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Abstract: Introduction: Physical activity may be related to male reproductive function by affecting on thehypothalamic-pituitary-gonadal(HPG) axis. Our aim was to determine the effects of 6 weeks resistance exercise on reproductive hormones, HPG axis. The hypothalamic-pituitary-gonadal (HPG) axis refers tothe effects of endocrine glands in three-level including (i) the hypothalamic releasing hormone GnRH, which is synthesized in in a small heterogenous neuronal population and released in a pulsatile fashion, (ii) the anterior pituitary hormones, follicle-stimulating hormone(FSH) and luteinizing hormone (LH) and (iii) the gonadal hormones, which include both steroid such as testosterone (T), estradiol and progesterone and peptide hormones (such as inhibin). Hormonal changes that create a more anabolic environment have been suggested to contribute to the adaptation to strength exercise. Physical activity has an extensive impact on male reproductive function depending upon the intensity and duration of the exercise and the fitness level of the individual. However, strenuous exercise represents a physical stress and inflammation changed that challenges homeostasis. Materials and methods: Sixteen male volunteered were included in a 6-week control period followed by 6 weeks of resistance training (leg press, lat pull, chest press, squat, seatedrow, abdominal crunch, shoulder press, biceps curl and triceps press down) four times per week. intensity of training loading was 60%-75% of one maximum repetition. Participants performed 3 sets of 10 repetitions. Rest periods were two min between exercises and sets. Start with warm up exercises include: The muscles relax and stretch the body, which was for 10 minutes. Body composition, VO2max and the circulating level of free testosterone (fT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone binding globulin (SHBG) and inhibin B measured prior and post 6-week intervention. The hormonal levels of each serum sample were measured using commercially available ELISA kits. Analysis of anthropometrical data and hormonal level were compared using the independent samples t- test in both groups and using SPSS (version 19). P ≤ 0.05 was considered statistically significant. Results: For muscle strength, both lower- and upper-body strength were increased significantly. Aerobic fitness level improved in trained participant from 39.4 ± 5.6 to 41.9 ± 5.3 (P = 0.002). fT concentration rise progressively in the trained group and was significantly greater than those in the control group (P = 0.000). By the end of the 6-week resistance training, serum SHBG significantly increased in the trained group compared with the control group (P = 0.013). In response to resistance training, LH, FSH and inhibin B were not significantly changed. Discussion: According to our finfings, 6 weeks of resistance training induce fat loss without any changes in body weight and BMI. A decline of 25.3% in percentage of body fat with statiscally same weight was due to increase in muscle mass that happened during resistance exercise periods . Six weeks of resistance training resulted in significant improvement in BF%, VO2max and increasing strength and the level of fT and SHBG.

Keywords: resistance, hypothalamic, pituitary, gonadal axis

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Authors: Anna Bjällmark, Victoria Persson, Bodil Karlsson, May Bazzi

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Introduction: Interventional radiology (IR) is a continuously growing discipline that allows minimally invasive treatments of various medical conditions. The IR environment is, in several ways, comparable to the complex and accident-prone operation room (OR) environment. This implies that the IR environment may also be associated with various types of risks related to the work process and communication in the team. Patient safety is a central aspect of healthcare and involves the prevention and reduction of adverse events related to patient care. To maintain patient safety, it is crucial to build a safety culture where the staff are encouraged to report events and incidents that may have affected patient safety. It is also important to continuously evaluate the staff´s attitudes to patient safety. Despite the increasing number of IR procedures, research on the staff´s view regarding patients is lacking. Therefore, the main aim of the study was to describe and compare the IR team members' attitudes to patient safety. The secondary aim was to evaluate whether the WHO safety checklist was routinely used for IR procedures. Methods: An electronic survey was distributed to 25 interventional units in Sweden. The target population was the staff working in the IR team, i.e., physicians, radiographers, nurses, and assistant nurses. A modified version of the Safety Attitudes Questionnaire (SAQ) was used. Responses from 19 of 25 IR units (44 radiographers, 18 physicians, 5 assistant nurses, and 1 nurse) were received. The respondents rated their level of agreement for 27 items related to safety culture on a five-point Likert scale ranging from “Disagree strongly” to “Agree strongly.” Data were analyzed statistically using SPSS. The percentage of positive responses (PPR) was calculated by taking the percentage of respondents who got a scale score of 75 or higher. The respondents rated which corresponded to response options “Agree slightly” or “Agree strongly”. Thus, average scores ≥ 75% were classified as “positive” and average scores < 75% were classified as “non-positive”. Findings: The results indicated that the IR team had the highest factor scores and the highest percentages of positive responses in relation to job satisfaction (90/94%), followed by teamwork climate (85/92%). In contrast, stress recognition received the lowest ratings (54/25%). Attitudes related to these factors were relatively consistent between different professions, with only a few significant differences noted (Factor score: p=0.039 for job satisfaction, p=0.050 for working conditions. Percentage of positive responses: p=0.027 for perception of management). Radiographers tended to report slightly lower values compared to other professions for these factors (p<0.05). The respondents reported that the WHO safety checklist was not routinely used at their IR unit but acknowledged its importance for patient safety. Conclusion: This study reported high scores concerning job satisfaction and teamwork climate but lower scores concerning perception of management and stress recognition indicating that the latter are areas of improvement. Attitudes remained relatively consistent among the professions, but the radiographers reported slightly lower values in terms of job satisfaction and perception of the management. The WHO safety checklist was considered important for patient safety.

Keywords: interventional radiology, patient safety, safety attitudes questionnaire, WHO safety checklist

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Authors: Brogan Guest, Amy Donaldson-Perrott

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The Master’s of Physician Associate Studies (MPAS) programme at St George’s, University of London (SGUL), is an intensive two-year course that trains students to become physician associates (PAs). PAs are generalized healthcare providers who work in primary and secondary care across the UK. PA programmes face the difficult task of preparing students to become safe medical providers in two short years. Our goal is to teach students to develop clinical reasoning early on in their studies and historically, this has been done predominantly though problem-based learning (PBL). We have had an increase concern about student engagement in PBL and difficulty recruiting facilitators to maintain the low student to facilitator ratio required in PBL. To address this issue, we created ‘Clinical Application of Anatomy and Physiology (CAAP)’. These peer-led, interactive, problem-based, small group sessions were designed to facilitate students’ clinical reasoning skills. The sessions were designed using the concept of Team-Based Learning (TBL). Students were divided into small groups and each completed a pre-session quiz consisting of difficult questions devised to assess students’ application of medical knowledge. The quiz was completed in small groups and they were not permitted access of external resources. After the quiz, students worked through a series of openended, clinical tasks using all available resources. They worked at their own pace and the session was peer-led, rather than facilitator-driven. For a group of 35 students, there were two facilitators who observed the sessions. The sessions utilised an infinite space whiteboard software. Each group member was encouraged to actively participate and work together to complete the 15-20 tasks. The session ran for 2 hours and concluded with a post-session quiz, identical to the pre-session quiz. We obtained subjective feedback from students on their experience with CAAP and evaluated the objective benefit of the sessions through the quiz results. Qualitative feedback from students was generally positive with students feeling the sessions increased engagement, clinical understanding, and confidence. They found the small group aspect beneficial and the technology easy to use and intuitive. They also liked the benefit of building a resource for their future revision, something unique to CAAP compared to PBL, which out students participate in weekly. Preliminary quiz results showed improvement from pre- and post- session; however, further statistical analysis will occur once all sessions are complete (final session to run December 2022) to determine significance. As a post-graduate healthcare professional programme, we have a strong focus on self-directed learning. Whilst PBL has been a mainstay in our curriculum since its inception, there are limitations and concerns about its future in view of student engagement and facilitator availability. Whilst CAAP is not TBL, it draws on the benefits of peer-led, small group work with pre- and post- team-based quizzes. The pilot of these sessions has shown that students are engaged by CAAP, and they can make significant progress in clinical reasoning in a short amount of time. This can be achieved with a high student to facilitator ratio.

Keywords: problem based learning, team based learning, active learning, peer-to-peer teaching, engagement

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Authors: Deepa Shokeen, Bani Tamber Aeri

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Food choice is a complex process influenced by the interplay of multiple factors, including physical, socio-cultural and economic factors comprising macro or micro level food environments. While a clear understanding of the relationship between what we eat and the environmental context in which these food choices are made is still needed; it has however now been shown that food environments do play a significant role in the obesity epidemic and increasing cardio-metabolic risk factors. Evidence in other countries indicates that the food environment may strongly influence the prevalence of obesity and cardio-metabolic risk factors among young adults. Although in the Indian context, data does indicate the associations between sedentary lifestyle, stress, faulty diets but very little evidence supports the role of food environment in influencing cardio-metabolic health among employed adults. Thus, this research is required to establish how different environments affect different individuals as individuals interact with the environment on a number of levels. Methodology: The objective of the present study is to assess the effect of selected food and nutrition environments with emphasis on worksite environment and to analyse its impact on the food choices and dietary behaviour of the employees (25-45 years of age) of the organizations under study. In the proposed study an attempt will be made to randomly select various worksite environments from Delhi and NCR. The study will be conducted in two phases. In phase I, Information will be obtained on their socio-demographic profile and various factors influencing their food choices including most commonly consumed foods and most frequently visited eating outlets in and around the work place. Data will also be gathered on anthropometry (height, weight, waist circumference), biochemical parameters (lipid profile and fasting glucose), blood pressure and dietary intake. Based on the findings of phase I, a list of the most frequently visited eating outlets in and around the workplace will be prepared in Phase II. These outlets will then be subjected to nutrition environment assessment survey (NEMS). On the basis of the information gathered from phase I and phase II, influence of selected food and nutrition environments on food choice, dietary behaviour and prevalence of cardio-metabolic risk factors among employed adults will be assessed. Expected outcomes: The proposed study will try to ascertain the impact of selected food and nutrition environments on food choice and dietary intake of the working adults as it is important to learn how these food environments influence the eating perceptions and health behavior of the adults. In addition to this, anthropometry blood pressure and biochemical assessment of the subjects will be done to assess the prevalence of cardio-metabolic risk factors. If the findings indicate that the work environment, where most of these young adults spend their productive hours of the day, influence their health, than perhaps steps maybe needed to make these environments more conducive to health.

Keywords: food and nutrition environment, cardio-metabolic risk factors, India, worksite environment

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Authors: Huan Peng, Chenye Zeng, Zhao Wang

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Alzheimer’s disease (AD) is an age-related neurodegenerative disease that is a leading cause of dementia syndromes and has become a huge burden on society and families. The main pathological features of AD involve excessive deposition of β-amyloid (Aβ) and Tau proteins in the brain, resulting in loss of neurons, expansion of neuroinflammation, and cognitive dysfunction in patients. Researchers have found effective drugs to clear the brain of error-accumulating proteins or to slow the loss of neurons, but their direct administration has key bottlenecks such as single-drug limitation, rapid blood clearance rate, impenetrable blood-brain barrier (BBB), and poor ability to target tissues and cells. Therefore, we are committed to seeking a suitable and efficient delivery system. Inspired by the possibility that exosomes may be involved in the secretion and transport mechanism of many signaling molecules or proteins in the brain, exosomes have attracted extensive attention as natural nanoscale drug carriers. We selected exosomes derived from bone marrow mesenchymal stem cells (MSC-EXO) with low immunogenicity and exosomes derived from hippocampal neurons (HT22-EXO) that may have excellent homing ability to overcome the deficiencies of oral or injectable pathways and bypass the BBB through nasal administration and evaluated their delivery ability and effect on AD. First, MSC-EXO and HT22 cells were isolated and cultured, and MSCs were identified by microimaging and flow cytometry. Then MSC-EXO and HT22-EXO were obtained by gradient centrifugation and qEV SEC separation column, and a series of physicochemical characterization were performed by transmission electron microscope, western blot, nanoparticle tracking analysis and dynamic light scattering. Next, exosomes labeled with lipophilic fluorescent dye were administered to WT mice and APP/PS1 mice to obtain fluorescence images of various organs at different times. Finally, APP/PS1 mice were administered intranasally with two exosomes 20 times over 40 days and 20 μL each time. Behavioral analysis and pathological section analysis of the hippocampus were performed after the experiment. The results showed that MSC-EXO and HT22-EXO were successfully isolated and characterized, and they had good biocompatibility. MSC-EXO showed excellent brain enrichment in APP/PS1 mice after intranasal administration, could improve the neuronal damage and reduce inflammation levels in the hippocampus of APP/PS1 mice, and the improvement effect was significantly better than HT22-EXO. However, intranasal administration of the two exosomes did not cause depression and anxious-like phenotypes in APP/PS1 mice, nor significantly improved the short-term or spatial learning and memory ability of APP/PS1 mice, and had no significant effect on the content of Aβ plaques in the hippocampus, which also meant that MSC-EXO could use their own advantages in combination with other drugs to clear Aβ plaques. The possibility of realizing highly effective non-invasive synergistic treatment for AD provides new strategies and ideas for clinical research.

Keywords: Alzheimer’s disease, exosomes derived from mesenchymal stem cell, intranasal administration, therapy-carrier dual roles

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Authors: A. Kourou, A. Ioakeimidou, E. Pelli, M. Panoutsopoulou, V. Abramea

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Worldwide there is a growing recognition that education is a critical component of any disaster impacts reduction effort and a great challenge too. Given this challenge, a broad range of awareness raising projects at all levels are implemented and are continuously evaluated by Earthquake Planning and Protection Organization (EPPO). This paper presents an overview of EPPO educational initiative (seminars, lectures, workshops, campaigns and educational material) and its evaluation results. The abovementioned initiative is focused to aware the public, train teachers and civil protection staff, inform students and educate people with disabilities on subjects related to earthquake reduction issues. The better understating of how human activity can link to disaster and what can be done at the individual, family or workplace level to contribute to seismic reduction are the main issues of EPPO projects. Survey results revealed that a high percentage of teachers (included the ones of special schools) from all over the country have taken the appropriate preparedness measures at schools. On the other hand, the implementation of earthquake preparedness measures at various workplaces (kindergartens, banks, utilities etc.) has still significant room for improvement. Results show that the employees in banks and public utilities have substantially higher rates in preventive and preparedness actions in their workplaces than workers in kindergartens and other workplaces. One of the EPPO educational priorities is to enhance earthquake preparedness of people with disabilities. Booklets, posters and applications have been created with the financial support of the Council of Europe, addressed to people who have mobility impairments, learning difficulties or cognitive disability (ή intellectual disabilities). Part of the educational material was developed using the «easy-to-read» method and Makaton language program with the collaboration of experts on special needs education and teams of people with cognitive disability. Furthermore, earthquake safety seminars and earthquake drills have been implemented in order to develop children’s, parents’ and teachers abilities and skills on earthquake impacts reduction. To enhance the abovementioned efforts, EPPO is a partner at prevention and preparedness projects supported by EU Civil Protection Financial Instrument. One of them is E-PreS’ project (Monitoring and Evaluation of Natural Hazard Preparedness at School Environment). The main objectives of E-PreS project are: 1) to create smart tools which define, simulate and evaluate drills procedure at schools, centers of vocational training of people with disabilities or other workplaces, and 2) to involve students or adults with disabilities in the E-PreS system evacuation procedure in case of earthquake, flood, or volcanic occurrence. Two other EU projects (RACCE educational kit and EVANDE educational platform) are also with the aim of contributing to raising awareness among people with disabilities, students, teachers, volunteers etc. It is worth mentioning that even though in Greece many efforts have been done till now to build awareness towards earthquakes and establish preparedness status for prospective earthquakes, there are still actions to be taken.

Keywords: earthquake, emergency plans, E-PreS project, people with disabilities, special needs education

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Authors: Georgios Boustras, Cleo Varianou Mikellidou, Christos Argyropoulos

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Summer 2021 was marked by a number of prolific fires in the EU (Greece, Cyprus, France) as well as outside the EU (USA, Turkey, Israel). This series of dramatic events have stretched national civil protection systems and first responders in particular. Despite the introduction of National, Regional and International frameworks (e.g. rescEU), a number of challenges have arisen, not only related to climate change. RESPOND-A (funded by the European Commission by Horizon 2020, Contract Number 883371) introduces a unique five-tier project architectural structure for best associating modern telecommunications technology with novel practices for First Responders of saving lives, while safeguarding themselves, more effectively and efficiently. The introduced architecture includes Perception, Network, Processing, Comprehension, and User Interface layers, which can be flexibly elaborated to support multiple levels and types of customization, so, the intended technologies and practices can adapt to any European Environment Agency (EEA)-type disaster scenario. During the preparation of the RESPOND-A proposal, some of our First Responder Partners expressed the need for an information management system that could boost existing emergency response tools, while some others envisioned a complete end-to-end network management system that would offer high Situational Awareness, Early Warning and Risk Mitigation capabilities. The intuition behind these needs and visions sits on the long-term experience of these Responders, as well, their smoldering worry that the evolving threat of climate change and the consequences of industrial accidents will become more frequent and severe. Three large-scale pilot studies are planned in order to illustrate the capabilities of the RESPOND-A system. The first pilot study will focus on the deployment and operation of all available technologies for continuous communications, enhanced Situational Awareness and improved health and safety conditions for First Responders, according to a big fire scenario in a Wildland Urban Interface zone (WUI). An important issue will be examined during the second pilot study. Unobstructed communication in the form of the flow of information is severely affected during a crisis; the flow of information between the wider public, from the first responders to the public and vice versa. Call centers are flooded with requests and communication is compromised or it breaks down on many occasions, which affects in turn – the effort to build a common operations picture for all firstr esponders. At the same time the information that reaches from the public to the operational centers is scarce, especially in the aftermath of an incident. Understandably traffic if disrupted leaves no other way to observe but only via aerial means, in order to perform rapid area surveys. Results and work in progress will be presented in detail and challenges in relation to civil protection will be discussed.

Keywords: first responders, safety, civil protection, new technologies

Procedia PDF Downloads 142

Authors: Zylfi Shehu, Shpetim Madani, Bashkim Delia

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Context: The study focuses on the interest and engagement of high school students in Tirana, Albania, in physical activity, sports, and foreign languages. It acknowledges the numerous physiological benefits of physical activity, such as cardiovascular health and improved mood. It also recognizes the importance of physical activity in childhood and adolescence for proper skeletal development and long-term health. Research Aim: The main purpose of the study is to investigate and analyze the preferences and interests of male and female high school students in Tirana regarding their functional development, physical activity, sports participation, and choice of foreign languages. The aim is to provide insights for the students and teachers to guide future objectives and improve the quality of physical education. Methodology: The study employed a survey-based approach, targeting both male and female students in public high schools in Tirana. A total of 410 students aged 15 to 19 years old, participated in the study. The data collected from the survey were processed using Excel and presented through tables and graphs. Findings: The results revealed that team sports were more favored by the students, with football being the preferred choice among males, while basketball and volleyball were more popular among females. Additionally, English was found to be the most preferred foreign language, selected by a higher percentage of females (38.57%) compared to males (16.90%). German followed as the second preferred language. Theoretical Importance: This study contributes to the understanding of students' interests in physical activity, sports, and foreign languages in Tirana's high schools. The findings highlight the need to focus on specific sports and languages to cater to students' preferences and guide future educational objectives. It also emphasizes the importance of physical education in promoting students' overall well-being and highlights potential areas for policy and program improvement. Data Collection and Analysis Procedures: The study collected data through surveys administered to high school students in Tirana. The survey responses were processed and analyzed using Excel, and the findings were presented through tables and graphs. The data analysis allowed for the identification of preferences and trends among male and female students, providing valuable insights for future decision-making. Question Addressed: The study aimed to address the question of high school students' interest in physical activity, sports, and foreign languages. It sought to understand the preferences and choices made by students in Tirana and investigate factors such as gender, family income, and accessibility to extracurricular sports activities. Conclusion: The study revealed that high school students in Tirana show a preference for team sports, with football being the most favored among males and basketball and volleyball among females. English was found to be the most preferred foreign language. The findings provide important insights for educators and policymakers to enhance physical education programs and consider students' preferences and interests to foster a more effective learning environment. The study also emphasizes the importance of physical activity and sports in promoting students' physical and mental well-being.

Keywords: female, male, foreign languages, sports, physical education, high school students

Procedia PDF Downloads 94

Authors: Amine Ganibardi, Cherif Arab Ali

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This paper addresses the data cleaning issue as a part of web usage data preprocessing within the scope of Web Usage Mining. Weblog data recorded by web servers within log files reflect usage activity, i.e., End-users’ clicks and underlying user-agents’ hits. As Web Usage Mining is interested in End-users’ behavior, user-agents’ hits are referred to as noise to be cleaned-off before mining. Filtering hits from clicks is not trivial for two reasons, i.e., a server records requests interlaced in sequential order regardless of their source or type, website resources may be set up as requestable interchangeably by end-users and user-agents. The current methods are content-centric based on filtering heuristics of relevant/irrelevant items in terms of some cleaning attributes, i.e., website’s resources filetype extensions, website’s resources pointed by hyperlinks/URIs, http methods, user-agents, etc. These methods need exhaustive extra-weblog data and prior knowledge on the relevant and/or irrelevant items to be assumed as clicks or hits within the filtering heuristics. Such methods are not appropriate for dynamic/responsive Web for three reasons, i.e., resources may be set up to as clickable by end-users regardless of their type, website’s resources are indexed by frame names without filetype extensions, web contents are generated and cancelled differently from an end-user to another. In order to overcome these constraints, a clustering-based cleaning method centered on the logging structure is proposed. This method focuses on the statistical properties of the logging structure at the requested and referring resources attributes levels. It is insensitive to logging content and does not need extra-weblog data. The used statistical property takes on the structure of the generated logging feature by webpage requests in terms of clicks and hits. Since a webpage consists of its single URI and several components, these feature results in a single click to multiple hits ratio in terms of the requested and referring resources. Thus, the clustering-based method is meant to identify two clusters based on the application of the appropriate distance to the frequency matrix of the requested and referring resources levels. As the ratio clicks to hits is single to multiple, the clicks’ cluster is the smallest one in requests number. Hierarchical Agglomerative Clustering based on a pairwise distance (Gower) and average linkage has been applied to four logfiles of dynamic/responsive websites whose click to hits ratio range from 1/2 to 1/15. The optimal clustering set on the basis of average linkage and maximum inter-cluster inertia results always in two clusters. The evaluation of the smallest cluster referred to as clicks cluster under the terms of confusion matrix indicators results in 97% of true positive rate. The content-centric cleaning methods, i.e., conventional and advanced cleaning, resulted in a lower rate 91%. Thus, the proposed clustering-based cleaning outperforms the content-centric methods within dynamic and responsive web design without the need of any extra-weblog. Such an improvement in cleaning quality is likely to refine dependent analysis.

Keywords: clustering approach, data cleaning, data preprocessing, weblog data, web usage data

Procedia PDF Downloads 170

Authors: Ramesh P., Aby Joseph

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Micro Inverters provide Module Embedded Solution for harvesting energy from small-scale solar photovoltaic (PV) panels. In addition to higher modularity & reliability (25 years of life), the MicroInverter has inherent advantages such as avoidance of long DC cables, eliminates module mismatch losses, minimizes partial shading effect, improves safety and flexibility in installations etc. Due to the above-stated benefits, the renewable energy technology with Solar Photovoltaic (PV) Micro Inverter becomes more widespread in Village Nano Grid application ensuring grid independence for rural communities and areas without access to electricity. While the primary objective of this paper is to discuss the problems related to rural electrification, this concept can also be extended to urban installation with grid connectivity. This work presents a comprehensive analysis of the power circuit design, control methodologies and prototyping of 300Wₚ Single Phase PV Micro Inverter. This paper investigates two different topologies for PV Micro Inverters, based on the first hand on Single Stage Flyback/ Forward PV Micro-Inverter configuration and the other hand on the Double stage configuration including DC-DC converter, H bridge DC-AC Inverter. This work covers Power Decoupling techniques to reduce the input filter capacitor size to buffer double line (100 Hz) ripple energy and eliminates the use of electrolytic capacitors. The propagation of the double line oscillation reflected back to PV module will affect the Maximum Power Point Tracking (MPPT) performance. Also, the grid current will be distorted. To mitigate this issue, an independent MPPT control algorithm is developed in this work to reject the propagation of this double line ripple oscillation to PV side to improve the MPPT performance and grid side to improve current quality. Here, the power hardware topology accepts wide input voltage variation and consists of suitably rated MOSFET switches, Galvanically Isolated gate drivers, high-frequency magnetics and Film capacitors with a long lifespan. The digital controller hardware platform inbuilt with the external peripheral interface is developed using floating point microcontroller TMS320F2806x from Texas Instruments. The firmware governing the operation of the PV Micro Inverter is written in C language and was developed using code composer studio Integrated Development Environment (IDE). In this work, the prototype hardware for the Single Phase Photovoltaic Micro Inverter with Double stage configuration was developed and the comparative analysis between the above mentioned configurations with experimental results will be presented.

Keywords: double line oscillation, micro inverter, MPPT, nano grid, power decoupling

Procedia PDF Downloads 133

Authors: I. Martinez-Conesa, E. Garcia-Meca, M. Barradas-Quiroz

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The objective of this study is to assess the impact on earnings management of latest two Hofstede cultural dimensions: long-term orientation and indulgence. Long-term orientation represents the alignment of a society towards the future and indulgence expresses the extent to which a society exhibits willingness, or restrain, to realise their impulses. Additionally, this paper tests if there are relevant differences by testing the moderating role of the legal tradition, Continental versus Anglo-Saxon. Our sample comprises 15 countries: Belgium, Canada, Germany, Spain, France, Great Britain, Hong Kong, India, Japan, Korea, Netherlands, Philippines, Portugal, Sweden, and Thailand, with a total of 12,936 observations from 2003 to 2013. Our results show that managers in countries with high levels of long-term orientation reduce their levels of discretionary accruals. The findings do not confirm the effect of indulgence on earnings management. In addition, our results confirm previous literature regarding the effect of individualism, noting that firms in countries with high levels of collectivism might be more inclined to use earnings discretion to protect the welfare of the collective group of firm stakeholders. Uncertainty avoidance results in downwards earnings management as well as high disclosure, suggesting that less manipulation takes place when transparency is higher. Indulgence is the cultural dimension that confronts wellbeing versus survival; dimension is formulated including happiness, the perception of live control and the importance of leisure. Indulgence shows a weak negative correlation with power distance indicating a slight tendency for more hierarchical societies to be less indulgent. Anglo-Saxon countries are a positive effect of individualism and a negative effect of masculinity, uncertainty avoidance, and disclosure. With respect to continental countries, we can see a significant and positive effect of individualism and a significant and negative effect of masculinity, long-term orientation, and indulgence. Therefore, we observe the negative effect on earnings management provoked by higher disclosure and uncertainty avoidance only happens in Anglo-Saxon countries. Meanwhile, the improvement in reporting quality motivated by higher long-term orientation and higher indulgence is dominant in Continental countries. Our results confirm that there is a moderating effect of the legal system in the association between culture and earnings management. This effect is especially relevant in the dimensions related to uncertainty avoidance, long term orientation, indulgence, and disclosure. The negative effect of long-term orientation on earnings management only happens in those countries set in continental legal systems because of the Anglo-Saxon legal systems is supported by the decisions of the courts and the traditions, so it already has long-term orientation. That does not occur in continental systems, depending mainly of contend of the law. Sensitivity analysis used with Jones modified CP model, Jones Standard model and Jones Standard CP model confirm the robustness of these results. This paper collaborates towards a better understanding on how earnings management, culture and legal systems relate to each other, and contribute to previous literature by examining the influence of the two latest Hofstede’s dimensions not previously studied in papers.

Keywords: Hofstede, long-term-orientation, earnings management, indulgence

Procedia PDF Downloads 239

Authors: Naniek Widayati Priyomarsono

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Introduction: In beginning of Karaton formation, namely, era of Javanese kingdom town had the power region outside castle town (called as Mancanegara), settlement of karaton can function as “the space-between” and “space-defense”, besides it was one of components from governmental structure and karaton power at that time (internal servant/abdi dalem and sentana dalem). Upon the Independence of Indonesia in 1945 “Kingdom-City” converted its political status into part of democratic town managed by statutes based on the classification. The latter affects local culture hierarchy alteration due to the physical development and events. Dynamics of social economy activities in Kampung Karaton surrounded by buildings of Complex of Karaton Kasunanan ini, have impact on the urban system disturbed into the región. Also cultural region image fades away with the weak visual access from existant cultural artefacts. That development lacks of giving appreciation to the established region image providing identity of Karaton Kasunanan particularly and identity of Surakarta city in general. Method used is strategy of grounded theory research (research providing strong base of a theory). Research is focused on actors active and passive relevantly getting involved in change process of Karaton settlement. Data accumulated is “Investigation Focus” oriented on actors affecting that change either internal or external. Investigation results are coupled with field observation data, documentation, literature study, thus it takes accurate findings. Findings: Karaton village has potential products as attraction, possessing human resource support, strong motivation from society still living in that settlement, possessing facilities and means supports, tourism event-supporting facilities, cultural art institution, available fields or development area. Data analyzed: To get the expected result it takes restoration in social cultural development direction, and economy, with ways of: Doing social cultural development strategy, economy, and politics. To-do steps are program socialization of Karaton village as Tourism Village, economical development of local society, regeneration pattern, filtering, and selection of tourism development, integrated planning system development, development with persuasive approach, regulation, market mechanism, social cultural event sector development, political development for region activity sector. Summary: In case the restoration is done by getting society involved as subject of that settlement (active participation in the field), managed and packed interestingly and naturally with tourism-supporting facilities development, village of Karaton Kasunanan Surakarta is ready to receive visit of domestic and foreign tourists.

Keywords: karaton village, finding, restoration, economy, Indonesia

Procedia PDF Downloads 440

Authors: Ibrahim Abdulla Labib, Medhat Mohamed Morsy, Gamal Hosny, Hanan Dawood Yassa, Gaber Hassan

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Amiodarone is a very effective drug, widely used for arrhythmia. Unfortunately it has many side effects involving many organs especially thyroid gland. The current work was conducted to elucidate the effect of amiodarone on the thyroid gland and the possible protective role of vitamin E. Fifty adult male albino rats weighed 200 – 250 grams were divided into five groups; ten rats each. Group I (Control): Five rats were sacrificed after three weeks and five rats were sacrificed after six weeks. Group II (Sham control): Each rat received sunflower oil orally; the solvent of vitamin E for three weeks. Group III (Amiodarone-treated): each rat received an oral dose of amiodarone; 150 mg/kg/day for three weeks. Group IV (Recovery): Each rat received amiodarone as group III then the drug was stopped for three weeks to evaluate recovery. Group V (Amiodarone + Vitamin E-treated): Each rat received amiodarone as group III followed by 100 mg/kg/day vitamin E orally for three weeks. Thyroid gland of the sacrificed animals were dissected out and prepared for light and electron microscopic studies. Amiodarone administration resulted in loss of normal follicular architecture as many follicles appeared either shrunken, empty or contained scanty pale colloid. Some follicles appeared lined by more than one layer of cells while others showed interruption of their membrane. Masson's Trichrome stained sections showed increased collagen fibers in between the thyroid follicles. Ultrastructurally, the apical border of the follicular cells showed few irregular detached microvilli. The nuclei of the follicular cells were almost irregular with chromatin condensation. The cytoplasm of most follicular cells revealed numerous dilated rough endoplasmic reticulum with numerous lysosomes. After three weeks of stopping amiodarone, the follicles were nearly regular in outline. Some follicles were filled with homogenous eosinophilic colloid and others had shrunken pale colloid or were empty. Some few follicles showed exfoliated cells in their lumina and others were still lined by more than one layer of follicular cells. Moderate amounts of collagen fibers were observed in-between thyroid follicles. Ultrastructurally, many follicular cells had rounded euchromatic nucleui, moderate number of lysosomes and moderately dilated rough endoplasmic reticulum. However, few follicular cells still showing irregular nucleui, dilated rough endoplasmic reticulum and many cytoplasmic vacuoles. Administration of vitamin E with amiodarone for three weeks resulted in obvious structural improvement. Most of the follicles were lined by a single layer of cuboidal cells and the lumina were filled with homogenous eosinophilic colloid with very few vacuolations. The majority of follicular cells had rounded nuclei with occasional detection of ballooned cells and dark nuclei. Scanty collagen fibers were detected among thyroid follicles. Ultrastructurally, most follicular cells exhibited rounded euchromatic nuclei with few short microvilli were projecting into the colloid. Few lysosomes were also noticed. It was concluded that amiodarone administration leads to many adverse histological changes in the thyroid gland. Some of these changes are reversible during the recovery period however concomitant vitamin E administration with amiodarone has a major protective role in preventing many of these changes.

Keywords: amiodarone, recovery, ultrastructure, vitamin E.

Procedia PDF Downloads 351

Authors: Mengdan Guo, Zongmin Wang, Haibo Yang

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Drought is one of the most complex and destructive natural disasters, with a huge impact on both nature and society. In recent years, adverse climate conditions and uncontrolled human activities have exacerbated the occurrence of global droughts, among which socio-economic droughts are closely related to human survival. The study of socio-economic drought risk assessment is crucial for sustainable social development. Therefore, this study comprehensively considered the risk of disaster causing factors, the exposure level of the disaster-prone environment, and the vulnerability of the disaster bearing body to construct a socio-economic drought risk assessment model for Chuxiong Prefecture in Yunnan Province. Firstly, a threedimensional frequency analysis of intensity area duration drought was conducted, followed by a statistical analysis of the drought risk of the socio-economic system. Secondly, a grid analysis model was constructed to assess the exposure levels of different agents and study the effects of drought on regional crop growth, industrial economic growth, and human consumption thresholds. Thirdly, an agricultural vulnerability model for different irrigation levels was established by using the DSSAT crop model. Industrial economic vulnerability and domestic water vulnerability under the impact of drought were investigated by constructing a standardized socio-economic drought index and coupling water loss. Finally, the socio-economic drought risk was assessed by combining hazard, exposure, and vulnerability. The results show that the frequency of drought occurrence in Chuxiong Prefecture, Yunnan Province is relatively high, with high population and economic exposure concentrated in urban areas of various counties and districts, and high agricultural exposure concentrated in mountainous and rural areas. Irrigation can effectively reduce agricultural vulnerability in Chuxiong, and the yield loss rate under the 20mm winter irrigation scenario decreased by 10.7% compared to the rain fed scenario. From the perspective of comprehensive risk, the distribution of long-term socio-economic drought risk in Chuxiong Prefecture is relatively consistent, with the more severe areas mainly concentrated in Chuxiong City and Lufeng County, followed by counties such as Yao'an, Mouding and Yuanmou. Shuangbai County has the lowest socio-economic drought risk, which is basically consistent with the economic distribution trend of Chuxiong Prefecture. And in June, July, and August, the drought risk in Chuxiong Prefecture is generally high. These results can provide constructive suggestions for the allocation of water resources and the construction of water conservancy facilities in Chuxiong Prefecture, and provide scientific basis for more effective drought prevention and control. Future research is in the areas of data quality and availability, climate change impacts, human activity impacts, and countermeasures for a more comprehensive understanding and effective response to drought risk in Chuxiong Prefecture.

Keywords: DSSAT model, risk assessment, socio-economic drought, standardized socio-economic drought index

Procedia PDF Downloads 50

Authors: M. Isabel Santos, Ana Breda, Ana Margarida Almeida

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Research on academic abilities of individuals with autism spectrum disorder (ASD) underlines the importance of mathematics interventions. Yet the proposal of digital applications for children and youth with ASD continues to attract little attention, namely, regarding the development of mathematical reasoning, being the use of the digital technologies an area of great interest for individuals with this disorder and its use is certainly a facilitative strategy in the development of their mathematical abilities. The use of digital technologies can be an effective way to create innovative learning opportunities to these students and to develop creative, personalized and constructive environments, where they can develop differentiated abilities. The children with ASD often respond well to learning activities involving information presented visually. In this context, we present the digital Learning Environment on Mathematics for Autistic children (LEMA) that was a research project conducive to a PhD in Multimedia in Education and was developed by the Thematic Line Geometrix, located in the Department of Mathematics, in a collaboration effort with DigiMedia Research Center, of the Department of Communication and Art (University of Aveiro, Portugal). LEMA is a digital mathematical learning environment which activities are dynamically adapted to the user’s profile, towards the development of mathematical abilities of children aged 6–12 years diagnosed with ASD. LEMA has already been evaluated with end-users (both students and teacher’s experts) and based on the analysis of the collected data readjustments were made, enabling the continuous improvement of the prototype, namely considering the integration of universal design for learning (UDL) approaches, which are of most importance in ASD, due to its heterogeneity. The learning strategies incorporated in LEMA are: (i) provide options to custom choice of math activities, according to user’s profile; (ii) integrates simple interfaces with few elements, presenting only the features and content needed for the ongoing task; (iii) uses a simple visual and textual language; (iv) uses of different types of feedbacks (auditory, visual, positive/negative reinforcement, hints with helpful instructions including math concept definitions, solved math activities using split and easier tasks and, finally, the use of videos/animations that show a solution to the proposed activity); (v) provides information in multiple representation, such as text, video, audio and image for better content and vocabulary understanding in order to stimulate, motivate and engage users to mathematical learning, also helping users to focus on content; (vi) avoids using elements that distract or interfere with focus and attention; (vii) provides clear instructions and orientation about tasks to ease the user understanding of the content and the content language, in order to stimulate, motivate and engage the user; and (viii) uses buttons, familiarly icons and contrast between font and background. Since these children may experience little sensory tolerance and may have an impaired motor skill, besides the user to have the possibility to interact with LEMA through the mouse (point and click with a single button), the user has the possibility to interact with LEMA through Kinect device (using simple gesture moves).

Keywords: autism spectrum disorder, digital technologies, inclusion, mathematical abilities, mathematical learning activities

Procedia PDF Downloads 116

Authors: Gautam, Gurcharan Singh, Mandeep Kaur, Yogesh Aggarwal, Sanjeev Naval

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The present ground reality scenario of suffering of humanity shows the evidence of failure to take wrong decisions to shape the civilization with Irresponsibilities in the history. A strong positive will of right responsibilities make the right civilization structure which affects itself and the whole world. Present suffering of humanity shows and reflect the failure of past decisions taken to shape the true culture with right social structure of society, due to unplanned system of Indian civilization and its rapid disaster of population make the failure to face all kind of problems which make the society sufferer. Our India is still suffering from disaster like earthquake, floods, droughts, tsunamis etc. and we face the uncountable disaster of deaths from the beginning of humanity at the present time. In this research paper our focus is to make a Disaster Resistance Structure having the solution of dense populated urban cities area by high vertical expansion HYBRID STRUCTURE. Our efforts are to analyse the Reinforced Concrete Hybrid Structure at different seismic zones, these concrete frames were analyzed using the response spectrum method to calculate and compare the different seismic displacement and drift. Seismic analysis by this method generally is based on dynamic analysis of building. Analysis results shows that the Reinforced Concrete Building at seismic Zone V having maximum peak story shear, base shear, drift and node displacement as compare to the analytical results of Reinforced Concrete Building at seismic Zone III and Zone IV. This analysis results indicating to focus on structural drawings strictly at construction site to make a HYBRID STRUCTURE. The study case is deal with the 10 story height of a vertical expansion Hybrid frame structure at different zones i.e. zone III, zone IV and zone V having the column 0.45x0.36mt and beam 0.6x0.36mt. with total height of 30mt, to make the structure more stable bracing techniques shell be applied like mage bracing and V shape bracing. If this kind of efforts or structure drawings are followed by the builders and contractors then we save the lives during earthquake disaster at Bhuj (Gujarat State, India) on 26th January, 2001 which resulted in more than 19,000 deaths. This kind of Disaster Resistance Structure having the capabilities to solve the problems of densely populated area of cities by the utilization of area in vertical expansion hybrid structure. We request to Government of India to make new plans and implementing it to save the lives from future disasters instead of unnecessary wants of development plans like Bullet Trains.

Keywords: history, irresponsibilities, unplanned social structure, humanity, hybrid structure, response spectrum analysis, DRIFT, and NODE displacement

Procedia PDF Downloads 211

Authors: Ludmila Polechonska, Agnieszka Klink

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The biogeochemical studies of macrophytes shed light on elements bioavailability, transfer through the food webs and their possible effects on the biota, and provide a basis for their practical application in aquatic monitoring and remediation. Measuring the accumulation of elements in plants can provide time-integrated information about the presence of chemicals in aquatic ecosystems. The aim of the study was to determine and compare the contents of micro- and macroelements in two cosmopolitan macrophytes, submerged Ceratophyllum demersum (hornworth) and free-floating Hydrocharis morsus-ranae (European frog-bit), in order to assess their bioaccumulation potential, elements stock accumulated in each plant and their role in nutrients cycling in small water reservoirs. Sampling sites were designated in 25 oxbow lakes in urban areas in Lower Silesia (SW Poland). In each sampling site, fresh whole plants of C. demersum and H. morsus-ranae were collected from squares of 1x1 meters each where the species coexisted. European frog-bit was separated into leaves, stems and roots. For biomass measurement all plants growing on 1 square meter were collected, dried and weighed. At the same time, water samples were collected from each reservoir and their pH and EC were determined. Water samples were filtered and acidified and plant samples were digested in concentrated nitric acid. Next, the content of Ca, Cu, Fe, K, Mg, Mn, Ni and Zn was determined using atomic absorption method (AAS). Statistical analysis showed that C. demersum and organs of H. morsus-ranae differed significantly in respect of metals content (Kruskal-Wallis Anova, p<0.05). Contents of Cu, Mn, Ni and Zn were higher in hornwort, while European frog-bit contained more Ca, Fe, K, Mg. Bioaccumulation Factors (BCF=content in plant/concentration in water) showed similar pattern of metal bioaccumulation – microelements were more intensively accumulated by hornwort and macroelements by frog-bit. Based on BCF values both species may be positively evaluated as good accumulators of Cu, Fe, Mn, Ni and Zn. However, the distribution of metals in H. morsus-ranae was uneven – the majority of studied elements were retained in roots, which may indicate to existence of physiological barriers developed for dealing with toxicity. Some percent of Ca and K was actively transported to stems, but to leaves Mg only. Although the biomass of C. demersum was two times greater than biomass of H. morsus-ranae, the element off-take was greater only for Cu, Mn, Ni and Zn. Nevertheless, it can be stated that despite a relatively small biomass, compared to other macrophytes, both species may have an influence on the removal of trace elements from aquatic ecosystems and, as they serve as food for some animals, also on the incorporation of toxic elements into food chains. There was a significant positive correlation between content of Mn and Fe in water and roots of H. morus-ranae (R=0.51 and R=0.60, respectively) as well as between Cu concentration in water and in C. demersum (R=0.41) (Spearman rank correlation, p<0.05). High bioaccumulation rates and correlation between plants and water elements concentrations point to their possible use as passive biomonitors of aquatic pollution.

Keywords: aquatic plants, bioaccumulation, biomonitoring, macroelements, phytoremediation, trace metals

Procedia PDF Downloads 189

Authors: Rachael Andrews, Viktoria McMillan, Shuaib Nasser, Christopher M. Roberts

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Background and objective: The National Review of Asthma Deaths (NRAD) found that asthma management and care was inadequate in 26% of cases reviewed. Major shortfalls identified were adherence to national guidelines and standards and, particularly, the organisation of care, including supervision and monitoring in primary care, with 70% of cases reviewed having at least one avoidable factor in this area. 5.4 million people in the UK are diagnosed with and actively treated for asthma, and approximately 60,000 are admitted to hospital with acute exacerbations each year. The majority of people with asthma receive management and treatment solely in primary care. This has therefore created concern that many people within the UK are receiving sub-optimal asthma care resulting in unnecessary morbidity and risk of adverse outcome. NRAD concluded that a national asthma audit programme should be established to measure and improve processes, organisation, and outcomes of asthma care. Objective: To develop a primary care dataset enabling extraction of information from GP practices in Wales and providing robust data by which results and lessons could be drawn and drive service development and improvement. Methods: A multidisciplinary group of experts, including general practitioners, primary care organisation representatives, and asthma patients was formed and used as a source of governance and guidance. A review of asthma literature, guidance, and standards took place and was used to identify areas of asthma care which, if improved, would lead to better patient outcomes. Modified Delphi methodology was used to gain consensus from the expert group on which of the areas identified were to be prioritised, and an asthma patient and carer focus group held to seek views and feedback on areas of asthma care that were important to them. Areas of asthma care identified by both groups were mapped to asthma guidelines and standards to inform and develop primary and secondary care datasets covering both adult and pediatric care. Dataset development consisted of expert review and a targeted consultation process in order to seek broad stakeholder views and feedback. Results: Areas of asthma care identified as requiring prioritisation by the National Asthma Audit were: (i) Prescribing, (ii) Asthma diagnosis (iii) Asthma Reviews (iv) Personalised Asthma Action Plans (PAAPs) (v) Primary care follow-up after discharge from hospital (vi) Methodologies and primary care queries were developed to cover each of the areas of poor and variable asthma care identified and the queries designed to extract information directly from electronic patients’ records. Conclusion: This paper describes the methodological approach followed to develop primary care datasets for a National Asthma Audit. It sets out the principles behind the establishment of a National Asthma Audit programme in response to a national asthma mortality review and describes the development activities undertaken. Key process elements included: (i) mapping identified areas of poor and variable asthma care to national guidelines and standards, (ii) early engagement of experts, including clinicians and patients in the process, and (iii) targeted consultation of the queries to provide further insight into measures that were collectable, reproducible and relevant.

Keywords: asthma, primary care, general practice, dataset development

Procedia PDF Downloads 175

Authors: B. Ozarisoy, E. Ampatzi, G. Z. Lancaster

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This research project is undertaken in the Turkish Republic of Northern Cyprus (T.R.N.C). The study focuses on identifying refurbishment activities capable of diagnosing and detecting the underlying problems alongside the challenges offered by the buildings’ typology in addition to identifying the correct construction materials in the refurbishment process which allow for the maximisation of expected energy savings. Attention is drawn to, the level of awareness and understanding of refurbishment activity that needs to be raised in the current construction process alongside factors that include the positive environmental impact and the saving of energy. The approach here is to look at buildings that have been built by private construction companies that have already been refurbished by occupants and to suggest additional control mechanisms for retrofitting that can further enhance the process of renewal. The objective of the research is to investigate the occupants’ behaviour and role in the refurbishment activity; to explore how and why occupants decide to change building components and to understand why and how occupants consider using energy-efficient materials. The present work is based on data from this researcher’s first-hand experience and incorporates the preliminary data collection on recent housing sector statistics, including the year in which housing estates were built, an examination of the characteristics that define the construction industry in the T.R.N.C., building typology and the demographic structure of house owners. The housing estates are chosen from 16 different projects in four different regions of the T.R.N.C. that include urban and suburban areas. There is, therefore, a broad representation of the common drivers in the property market, each with different levels of refurbishment activity and this is coupled with different samplings from different climatic regions within the T.R.N.C. The study is conducted through semi-structured interviews to identify occupants’ behaviour as it is associated with refurbishment activity. The interviews provide all the occupants’ demographic information, needs and intentions as they relate to various aspects of the refurbishment process. This research paper presents the results of semi-structured interviews with 70 homeowners in a selected group of 16 housing estates in five different parts of the T.R.N.C. The people who agreed to be interviewed in this study are all residents of single or multi-family housing units. Alongside the construction process and its impact on the environment, the results point out the need for control mechanisms in the housing sector to promote and support the adoption of retrofit strategies and minimize non-controlled refurbishment activities, in line with diagnostic information of the selected buildings. The expected solutions should be effective, environmentally acceptable and feasible given the type of housing projects under review, with due regard for their location, the climatic conditions within which they were undertaken, the socio-economic standing of the house owners and their attitudes, local resources and legislative constraints. Furthermore, the study goes on to insist on the practical and long-term economic benefits of refurbishment under the proper conditions and why this should be fully understood by the householders.

Keywords: construction process, energy-efficiency, refurbishment activity, retrofitting

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Authors: Marzieh Nojomi, Azadeh Mottaghi, Arghavan Haj-Sheykholeslami, Narjes Khalili, Arash Tehrani Banihashemi

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Background and objectives: Domestic violence is a global problem with severe consequences throughout the life of the victims. Iran’s Ministry of Health has launched an intimate partner violence (IPV) prevention program, integrated in the primary health care services since 2016. The present study is a part of this national program’s evaluation. In this section, we aimed to examine spousal abuse victims’ knowledge and attitude towards domestic violence before and after receivingthese services. Methods: To assess the knowledge and attitudes of victims, a questionnaire designed by Ahmadzadand colleagues in 2013 was used. This questionnaire includes 15 questions regarding knowledge in the fields of definition, epidemiology, and effects on children, outcomes, and prevention of domestic violence. To assess the attitudes, this questionnaire has 10 questions regarding the attitudes toward the causes, effects, and legal or protective support services of domestic violence. To assess the satisfaction and the effect of the program on prevention or reduction of spousal violence episodes, two more questions were also added. Since domestic violence prevalence differs in different parts of the country, we chose nine areas with the highest, the lowest, and moderate prevalence of IPVfor the study. The link to final electronic version of the questionnaire was sent to the randomly selected public rural or urban health centers in the nine chosen areas. Since the study had to be completed in one month, we used newly identified victims as pre-intervention group and people who had at least received one related service from the program (like psychiatric consultation, education about safety measures, supporting organizations and etc.) during the previous year, as our post- intervention group. Results: A hundred and ninety-two newly identified IPV victims and 267 victims who had at least received one related program service during the previous year entered the study. All of the victims were female. Basic characteristics of the two groups, including age, education, occupation, addiction, spouses’ age, spouses’ addiction, duration of the current marriage, and number of children, were not statistically different. In knowledge questions, post- intervention group had statistically better scores in the fields of domestic violence outcomes and its effects on children; however, in the remaining areas, the scores of both groups were similar. The only significant difference in the attitude across the two groups was in the field of legal or protective support services. From the 267 women who had ever received a service from the program, 91.8% were satisfied with the services, and 74% reported a decrease in the number of violent episodes. Conclusion: National IPV prevention program integrated in the primary health care services in Iran is effective in improving the knowledge of victims about domestic violence outcomes and its effects on children. Improving the attitude and knowledge of domestic violence victims about its causes and preventive measures needs more effective interventions. This program can reduce the number of IPV episodes between the spouses, and satisfaction among the service users is high.

Keywords: intimate partner violence, assessment, health services, efficacy

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Authors: Gideon Nyuimbe Gasu

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Sub Saharan Africa is at a critical point, experiencing rapid population growth, particularly in urban areas and young growing force. At the same time, the growing risk of catastrophic global climate change threatens to weaken food production system, increase intensity and frequency of drought, flood, and fires and undermine gains on development and poverty reduction. Although the region has the lowest per capital greenhouse gas emission level in the world, it will need to join global efforts to address climate change, including action to avoid significant increases and to encourage a green economy. Thus, there is a need for the concept of 'greening the economy' as was prescribed at Rio Summit of 1992. Renewable energy is one of the criterions to achieve this laudable goal of maintaining a green economy. There is need to address climate change while facilitating continued economic growth and social progress as energy today is critical to economic growth. Fossil fuels remain the major contributor of greenhouse gas emission. Thus, cleaner technologies such as carbon capture storage, renewable energy have emerged to be commercially competitive. This paper sets out to examine how to achieve a low carbon economy with minimal emission of carbon dioxide and other greenhouse gases which is one of the outcomes of implementing a green economy. Also, the paper examines the different renewable energy sources such as nuclear, wind, hydro, biofuel, and solar voltaic as a panacea to the looming climate change menace. Finally, the paper assesses the different renewable energy and energy efficiency as a propeller to generating new sources of income and jobs and in turn reduces carbon emission. The research shall engage qualitative, evaluative and comparative methods. The research will employ both primary and secondary sources of information. The primary sources of information shall be drawn from the sub Saharan African region and the global environmental organizations, energy legislation, policies and related industries and the judicial processes. The secondary sources will be made up of some books, journal articles, commentaries, discussions, observations, explanations, expositions, suggestions, prescriptions and other material sourced from the internet on renewable energy as a panacea to climate change. All information obtained from these sources will be subject to content analysis. The research result will show that the entire planet is warming as a result of the activities of mankind which is clear evidence that the current development is fundamentally unsustainable. Equally, the study will reveal that a low carbon development pathway in the sub Saharan African region should be embraced to minimize emission of greenhouse gases such as using renewable energy rather than coal, oil, and gas. The study concludes that until adequate strategies are devised towards the use of renewable energy the region will continue to add and worsen the current climate change menace and other adverse environmental conditions.

Keywords: carbon dioxide, climate change, legislation/law, renewable energy

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Authors: Jo Anne Rey

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Caring for Country (Ngurrain Dharug language) is core to Aboriginal identity, Law/Lore, practice, and resilience within the continent called ‘Australia’. It is the basis of thousands of years of sustainability. However, when Ngurra is a city known as Sydney, due to 235 years of colonial impact, caring for the Country is limited, being controlled by the State and private ownership of the land title. Recent research indicates that localised Indigenous activism is most successful when community members are geographically proximate to the presences and places of connection, caring, and belonging. This article frames these findings through the cadence that proximity provides. This presentation is centred on the proximate agency that is being exercised by Dharug community through three significant sites within the Sydney basin. Those sites include, firstly, Shaw’s Creek Aboriginal Place, at the foot of the Blue Mountains in far western Sydney. Second inclusion is the site of Blacktown Native Institution, that was the part of the authoritarian colonial governance of British Governor Lachlan Macquarie (after who Macquarie University is named), which saw the beginnings of the removal of children from their families and culture to ‘civilize’ them. The third site is that of the so-called Brown’s Waterhole in the State government administered Lane Cove National Park. Each of these sites is being activated through Dharug and, more broadly, Aboriginalways of knowing, doing, and being. These ways involvethe land, water, wind, and star-based ecologies interwoven with traditional transgenerational storying of the presences (Ancestral and spiritual) creating them. Activations include, but are not limited to, the return of cultural fire for reviving plants, soils, animals, and birds. These fire practices have traditionally been at the basis of sustainable, regenerative biodiversity. These practices involve the literacy of reading Ngurra and the seasonal interactions across the ecologies. Together, they both care for the Country and support humanity, and have done so across thousands of years. However, when the cost of real-estate and rental accommodation prevents community members from being able to live on Dharug Ngurra when bureaucratic governance restricts and/or excludes traditional custodial relationships, and when private treaty land title destroys the presences and places while disconnecting people from their Ancestral practices, it becomes clear that caring for Country is only possible when the community can afford to live nearby. Recognising the cadence of proximityas the agency that underpinscaring for Country-in-the-city, sustainable change opportunities don’t have to only focus on regional and remote areas. Urban-based Aboriginal relationality offers an alternative to the unsustainable practices that underpin human-centric disconnection. Weaving Indigenous cadence offers opportunities for sustainable futures even when facing the extremes of climate changing catastrophes.

Keywords: australian aboriginal, biocultural knowledges, climate change, dharug ngurra, sustainability, resilience

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Authors: Same Noel Ngando, Yakub Abdulfatai Olatunji

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Renewable energy micro-grids, such as those powered by solar or wind energy, are often intermittent in nature. This means that the amount of energy generated by these systems can vary depending on weather conditions or other factors, which can make it difficult to ensure a steady supply of power. To address this issue, energy storage systems have been developed to increase the reliability of renewable energy micro-grids. Battery systems have been the dominant energy storage technology for renewable energy micro-grids. Batteries can store large amounts of energy in a relatively small and compact package, making them easy to install and maintain in a micro-grid setting. Additionally, batteries can be quickly charged and discharged, allowing them to respond quickly to changes in energy demand. However, the process involved in recycling batteries is quite costly and difficult. An alternative energy storage system that is gaining popularity is hydrogen storage. Hydrogen is a versatile energy carrier that can be produced from renewable energy sources such as solar or wind. It can be stored in large quantities at low cost, making it suitable for long-distance mass storage. Unlike batteries, hydrogen does not degrade over time, so it can be stored for extended periods without the need for frequent maintenance or replacement, allowing it to be used as a backup power source when the micro-grid is not generating enough energy to meet demand. When hydrogen is needed, it can be converted back into electricity through a fuel cell. Energy consumption data is got from a particular residential area in Daegu, South Korea, and the data is processed and analyzed. From the analysis, the total energy demand is calculated, and different hybrid energy system configurations are designed using HOMER Pro (Hybrid Optimization for Multiple Energy Resources) and MATLAB software. A techno-economic and environmental comparison and life cycle assessment (LCA) of the different configurations using battery and hydrogen as storage systems are carried out. The various scenarios included PV-hydrogen-grid system, PV-hydrogen-grid-wind, PV-hydrogen-grid-biomass, PV-hydrogen-wind, PV-hydrogen-biomass, biomass-hydrogen, wind-hydrogen, PV-battery-grid-wind, PV- battery -grid-biomass, PV- battery -wind, PV- battery -biomass, and biomass- battery. From the analysis, the least cost system for the location was the PV-hydrogen-grid system, with a net present cost of about USD 9,529,161. Even though all scenarios were environmentally friendly, taking into account the recycling cost and pollution involved in battery systems, all systems with hydrogen as a storage system produced better results. In conclusion, hydrogen is becoming a very prominent energy storage solution for renewable energy micro-grids. It is easier to store compared with electric power, so it is suitable for long-distance mass storage. Hydrogen storage systems have several advantages over battery systems, including flexibility, long-term stability, and low environmental impact. The cost of hydrogen storage is still relatively high, but it is expected to decrease as more hydrogen production, and storage infrastructure is built. With the growing focus on renewable energy and the need to reduce greenhouse gas emissions, hydrogen is expected to play an increasingly important role in the energy storage landscape.

Keywords: renewable energy systems, microgrid, hydrogen production, energy storage systems

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Authors: Qudsiya Baig

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Empathy yields an unparalleled therapeutic value within patient physician interactions. Medical research is inundated with evidence to support that a physician’s ability to empathise with patients leads to a greater willingness to report symptoms, an improvement in diagnostic accuracy and safety, and a better adherence and satisfaction with treatment plans. Furthermore, the Institute of Medicine states that empathy leads to a more patient-centred care, which is one of the six main goals of a 21st century health system. However, there is a paradox between the theoretical significance of empathy and its presence, or lack thereof, in clinical practice. Recent studies have reported that empathy declines amongst students and physicians over time. The three most impactful contributors to this decline are: (1) disagreements over the definitions of empathy making it difficult to implement it into practice (2) poor consideration or regulation of empathy leading to burnout and thus, abandonment altogether, and (3) the lack of diversity in the curriculum and the influence of medical culture, which prioritises science over patient experience, limiting some physicians from using ‘too much’ empathy in the fear of losing clinical objectivity. These issues were investigated by conducting a fully inductive thematic narrative analysis of patient narratives in the UK to evaluate the behaviours and attitudes that patients associate with empathy. The principal enquiries underpinning this study included uncovering the factors that affected experience of empathy within provider-patient interactions and to analyse their effects on patient care. This research contributes uniquely to this discourse by examining the phenomenon of empathy directly from patients’ experiences, which were systematically extracted from a repository of online patient narratives of care titled ‘CareOpinion UK’. Narrative analysis was specifically chosen as the methodology to examine narratives from a phenomenological lens to focus on the particularity and context of each story. By enquiring beyond the superficial who-whatwhere, the study of narratives prescribed meaning to illness by highlighting the everyday reality of patients who face the exigent life circumstances created by suffering, disability, and the threat of life. The following six themes were found to be the most impactful in influencing the experience of empathy: dismissive behaviours, judgmental attitudes, undermining patients’ pain or concerns, holistic care and failures and successes of communication or language. For each theme there were overarching themes relating to either a failure to understand the patient’s perspective or a success in taking a person-centred approach. An in-depth analysis revealed that a lack of empathy was greatly associated with an emotive-cognitive imbalance, which disengaged physicians with their patients’ emotions. This study hereby concludes that competent providers require a combination of knowledge, skills, and more importantly empathic attitudes to help create a context for effective care. The crucial elements of that context involve (a) identifying empathy clues within interactions to engage with patients’ situations, (b) attributing a perspective to the patient through perspective-taking and (c) adapting behaviour and communication according to patient’s individual needs. Empathy underpins that context, as does an appreciation of narrative, and the two are interrelated.

Keywords: empathy, narratives, person-centred, perspective, perspective-taking

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