Search results for: fuzzy numbers
446 Intensive Intercultural English Language Pedagogy among Parents from Culturally and Linguistically Diverse Backgrounds (CALD)
Authors: Ann Dashwood
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Using Standard Australian English with confidence is a cultural expectation of parents of primary school aged children who want to engage effectively with their children’s teachers and school administration. That confidence in support of their children’s learning at school is seldom experienced by parents whose first language is not English. Sharing language with competence in an intercultural environment is the common denominator for meaningful communication and engagement to occur in a school community. Experience in relevant, interactive sessions is known to enhance engagement and participation. The purpose of this paper is to identify a pedagogy for parents otherwise isolated from daily use of functional Australian cultural language learned to engage effectively in their children’s learning at school. The outcomes measure parents’ intercultural engagement with classroom teachers and attention to the school’s administrative procedures using quantitative and qualitative methods. A principled communicative task-based language learning approach, combined with intercultural communication strategies provide the theoretical base for intensive English inquiry-based learning and engagement. The quantitative analysis examines data samples collected by classroom teachers and administrators and parents’ writing samples. Interviews and observations qualitatively inform the study. Currently, significant numbers of projects are active in community centers and schools to enhance English language knowledge of parents from Language Backgrounds Other Than English (LBOTE). The study is significant to explore the effects of an intensive English pedagogy with parents of varied English language backgrounds, by targeting inquiry-based language use for social interactions in the school and wider community, specific engagement and cultural interaction with teachers and school activities and procedures.Keywords: engagement, intercultural communication, language teaching pedagogy, LBOTE, school community
Procedia PDF Downloads 120445 The Development of Sports Medicine and Physical Fitness in China from Reviewing Their Studies from the Journal of China Sports Science
Authors: Dong Zhan
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China sports science is the core periodical of scientific research in the field of sports in China at present. It is the first academic periodical ranked in China. The author has studied the characteristics and trends of articles on sports medicine and physical fitness published in the journal since it founded. Now, the articles on sports medicine and physical fitness published in the Journal of Sports Science from 2013 to 2017 are reviewed. The results show that 1) The characteristics of previous sports medicine articles showed that there were more articles on the basis of sports medicine than that on the application. The research on animal experiments was far more than that on the human body. Moreover, the trend was getting worse and worse as time goes on. But in the past five years, there had been a marked improvement. The basic/application has been improved from 2.1/1 to 1.3/1. This shows that sports medicine researchers have been paid more attention to the application research in sports medicine. 2) There are few articles on sports injury, because the state put the sports injury specialty into the medical colleges, and the research scope of sports research institutes does not include sports injury. It cannot meet the need for the development of sports medicine, and it should change sooner or later. 3) In the past, researchers’ effort was on athletes' physical health, not on ordinary people. Now, there is a great change, they not only research on the sportsmen’s health but also research on the health of the ordinary people. 4) Researchers mainly studied on the young people’s physical fitness in the past; now, it has been greatly improved. Researchers study on the physical health of the elderly, especially those over the age of 60. Numbers of paper researching on the young were much more than those on the old. In the past 10 years, the ratio of number of paper researching on the young to the old people was (young/old) 16.6/1, while in the past 5 years, this ratio was 6.3/1. However, this is not enough. China has a large population and needs to focus on promoting the health of the people. Conclusion: It is important to pay more attention to the application research on sports medicine and on the physical fitness, and it is also important to make a research on physical health of the elderly.Keywords: sports medicine, people's health, the young, the old
Procedia PDF Downloads 152444 The Effect of Vertical Integration on Operational Performance: Evaluating Physician Employment in Hospitals
Authors: Gary Young, David Zepeda, Gilbert Nyaga
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This study investigated whether vertical integration of hospitals and physicians is associated with better care for patients with cardiac conditions. A dramatic change in the U.S. hospital industry is the integration of hospital and physicians through hospital acquisition of physician practices. Yet, there is little evidence regarding whether this form of vertical integration leads to better operational performance of hospitals. The study was conducted as an observational investigation based on a pooled, cross-sectional database. The study sample comprised over hospitals in the State of California. The time frame for the study was 2010 to 2012. The key performance measure was hospitals’ degree of compliance with performance criteria set out by the federal government for managing patients with cardiac conditions. These criteria relate to the types of clinical tests and medications that hospitals should follow for cardiac patients but hospital compliance requires the cooperation of a hospital’s physicians. Data for this measure was obtained from a federal website that presents performance scores for U.S. hospitals. The key independent variable was the percentage of cardiologists that a hospital employs (versus cardiologists who are affiliated but not employed by the hospital). Data for this measure was obtained from the State of California which requires hospitals to report financial and operation data each year including numbers of employed physicians. Other characteristics of hospitals (e.g., information technology for cardiac care, volume of cardiac patients) were also evaluated as possible complements or substitutes for physician employment by hospitals. Additional sources of data included the American Hospital Association and the U.S. Census. Empirical models were estimated with generalized estimating equations (GEE). Findings suggest that physician employment is positively associated with better hospital performance for cardiac care. However, findings also suggest that information technology is a substitute for physician employment.Keywords: physician employment, hospitals, verical integration, cardiac care
Procedia PDF Downloads 395443 Effects of Injectable Thermosensitive Hydrogel Containing Chitosan as a Barrier for Prevention of Post-operative Peritoneal Adhesion in Rats
Authors: Sara Javanmardi, Sepehr Aziziz, Baharak Divband, Masoumeh Firouzamandi
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Post-operative adhesions are the most common cause of intestinal obstruction, female infertility and chronic abdominal pain. We developed a novel approach for preventing post-operative peritoneal adhesions using a biodegradable and thermosensitive curcumin hydrogel in rats. Thirteen male Sprague-Dawley rats were assigned randomly into five groups of six animals each: In SHAM group, the cecum was exteriorized, gently manipulated and sent back into the abdomen. In CONTROL group, the surgical abrasion was performed with no further treatment. In Hydrogel group, surgical abrasion was performed with local application of blank hydrogel (1 mL). In Curcumin group, surgical abrasion was performed with local application of curcumin (1 mL). In CUR/HGEL group, surgical abrasion was performed with local application of curcumin hydrogel (1 mL). On day 10, adhesions were assessed using a standardized scale (Evans model), and samples were collected for the Real-time PCR. Real-time PCR was performed to determine mRNA levels of VCAM-1, ICAM-1 and GAPDH. The macroscopic adhesion intensity showed statistically significant differences between the CUR/HGEL and other groups (P=0.0005). The findings of the present study revealed there were statistically significant differences between the groups regarding adhesion band length and numbers (P<0.0001). The protein and mRNA expression of VCAM-1 and ICAM-1 in secal tissues were significantly down regulated due to curcumin-hydrogel application in CUR/HGEL compared to other groups (p<0.05). The thermosensitive hydrogel could reduce the severity and even prevent formation of intra-abdominal adhesion. Curcumin hydrogel could serve as a potential barrier agent to prevent post-operative peritoneal adhesion in rats.Keywords: peritoneal adhesion, hydrogel, curcumijn, ICAM-1, VCAM-1
Procedia PDF Downloads 88442 Interactive IoT-Blockchain System for Big Data Processing
Authors: Abdallah Al-ZoubI, Mamoun Dmour
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The spectrum of IoT devices is becoming widely diversified, entering almost all possible fields and finding applications in industry, health, finance, logistics, education, to name a few. The IoT active endpoint sensors and devices exceeded the 12 billion mark in 2021 and are expected to reach 27 billion in 2025, with over $34 billion in total market value. This sheer rise in numbers and use of IoT devices bring with it considerable concerns regarding data storage, analysis, manipulation and protection. IoT Blockchain-based systems have recently been proposed as a decentralized solution for large-scale data storage and protection. COVID-19 has actually accelerated the desire to utilize IoT devices as it impacted both demand and supply and significantly affected several regions due to logistic reasons such as supply chain interruptions, shortage of shipping containers and port congestion. An IoT-blockchain system is proposed to handle big data generated by a distributed network of sensors and controllers in an interactive manner. The system is designed using the Ethereum platform, which utilizes smart contracts, programmed in solidity to execute and manage data generated by IoT sensors and devices. such as Raspberry Pi 4, Rasbpian, and add-on hardware security modules. The proposed system will run a number of applications hosted by a local machine used to validate transactions. It then sends data to the rest of the network through InterPlanetary File System (IPFS) and Ethereum Swarm, forming a closed IoT ecosystem run by blockchain where a number of distributed IoT devices can communicate and interact, thus forming a closed, controlled environment. A prototype has been deployed with three IoT handling units distributed over a wide geographical space in order to examine its feasibility, performance and costs. Initial results indicated that big IoT data retrieval and storage is feasible and interactivity is possible, provided that certain conditions of cost, speed and thorough put are met.Keywords: IoT devices, blockchain, Ethereum, big data
Procedia PDF Downloads 150441 Keynote Talk: The Role of Internet of Things in the Smart Cities Power System
Authors: Abdul-Rahman Al-Ali
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As the number of mobile devices is growing exponentially, it is estimated to connect about 50 million devices to the Internet by the year 2020. At the end of this decade, it is expected that an average of eight connected devices per person worldwide. The 50 billion devices are not mobile phones and data browsing gadgets only, but machine-to-machine and man-to-machine devices. With such growing numbers of devices the Internet of Things (I.o.T) concept is one of the emerging technologies as of recently. Within the smart grid technologies, smart home appliances, Intelligent Electronic Devices (IED) and Distributed Energy Resources (DER) are major I.o.T objects that can be addressable using the IPV6. These objects are called the smart grid internet of things (SG-I.o.T). The SG-I.o.T generates big data that requires high-speed computing infrastructure, widespread computer networks, big data storage, software, and platforms services. A company’s utility control and data centers cannot handle such a large number of devices, high-speed processing, and massive data storage. Building large data center’s infrastructure takes a long time, it also requires widespread communication networks and huge capital investment. To maintain and upgrade control and data centers’ infrastructure and communication networks as well as updating and renewing software licenses which collectively, requires additional cost. This can be overcome by utilizing the emerging computing paradigms such as cloud computing. This can be used as a smart grid enabler to replace the legacy of utilities data centers. The talk will highlight the role of I.o.T, cloud computing services and their development models within the smart grid technologies.Keywords: intelligent electronic devices (IED), distributed energy resources (DER), internet, smart home appliances
Procedia PDF Downloads 324440 Two Dimensional Steady State Modeling of Temperature Profile and Heat Transfer of Electrohydrodynamically Enhanced Micro Heat Pipe
Authors: H. Shokouhmand, M. Tajerian
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A numerical investigation of laminar forced convection flows through a square cross section micro heat pipe by applying electrohydrodynamic (EHD) field has been studied. In the present study, pentane is selected as working fluid. Temperature and velocity profiles and heat transfer enhancement in the micro heat pipe by using EHD field at the two-dimensional and single phase fluid flow in steady state regime have been numerically calculated. At this model, only Coulomb force is considered. The study has been carried out for the Reynolds number 10 to 100 and EHD force field up to 8 KV. Coupled, non-linear equations governed on the model (continuity, momentum, and energy equations) have been solved simultaneously by CFD numerical methods. Steady state behavior of affecting parameters, e.g. friction factor, average temperature, Nusselt number and heat transfer enhancement criteria, have been evaluated. It has been observed that by increasing Reynolds number, the effect of EHD force became more significant and for smaller Reynolds numbers the rate of heat transfer enhancement criteria is increased. By obtaining and plotting the mentioned parameters, it has been shown that the EHD field enhances the heat transfer process. The numerical results show that by increasing EHD force field the absolute value of Nusselt number and friction factor increases and average temperature of fluid flow decreases. But the increasing rate of Nusselt number is greater than increasing value of friction factor, which makes applying EHD force field for heat transfer enhancement in micro heat pipes acceptable and applicable. The numerical results of model are in good agreement with the experimental results available in the literature.Keywords: micro heat pipe, electrohydrodynamic force, Nusselt number, average temperature, friction factor
Procedia PDF Downloads 271439 Access to Livelihoods for Urban Refugees in Kenya: The Case Study of Somalis Living in Eastleigh
Authors: Nancy Njoka, Manuela Ramos Cacciatore
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In Kenya, refugee situations are becoming increasingly protracted, stretching over the years or even decades. As urbanization rates increase, so do the numbers of urban refugees in the country. Refugees living in urban areas face a range of challenges. In their efforts to pursue livelihoods, refugees have identified strategies to confront these challenges. In the same manner, humanitarian actors have come up with different interventions to promote access to livelihoods working through obstacles and barriers created by host governments. This paper seeks to understand the experience of Somali urban refugees living in the urban area of Eastleigh, Nairobi, both by investigating their own actions towards creating avenues to access livelihoods and by understanding their social, economic and policy context in which they forge livelihoods. The empirical data collected through fieldwork in Nairobi in 2020 serves as the basis of this qualitative case study. Drawing upon the themes of urban refugee movement, Somali ethnicity, citizenship discrimination and the livelihoods of refugees, the paper highlights how the actions of the Kenyan government and international non-governmental organization (INGO)s affect access to livelihoods and the consequences of these actions for Somali urban refugees. The results of the paper found that Somali urban refugees are taking active steps to create livelihoods for themselves. This is seen in the growth of Eastleigh as an economic hub in Kenya which is owned and run mostly by Somalis. Indeed, the Somali community is central to the establishment of networks in the neighborhood. Somali urban refugees are marginalized by the Kenyan government, reducing their opportunity to create dignified lives in Eastleigh. Findings also point out the community-based approaches used by INGOs in livelihood interventions. The relevance of this research lies in the interconnection of humanitarian development interventions for protracted refugees and the promotion of livelihoods in an urban and global context.Keywords: Kenya, livelihoods, Somali, urban refugees
Procedia PDF Downloads 179438 The Application of Line Balancing Technique and Simulation Program to Increase Productivity in Hard Disk Drive Components
Authors: Alonggot Limcharoen, Jintana Wannarat, Vorawat Panich
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This study aims to investigate the balancing of the number of operators (Line Balancing technique) in the production line of hard disk drive components in order to increase efficiency. At present, the trend of using hard disk drives has continuously declined leading to limits in a company’s revenue potential. It is important to improve and develop the production process to create market share and to have the ability to compete with competitors with a higher value and quality. Therefore, an effective tool is needed to support such matters. In this research, the Arena program was applied to analyze the results both before and after the improvement. Finally, the precedent was used before proceeding with the real process. There were 14 work stations with 35 operators altogether in the RA production process where this study was conducted. In the actual process, the average production time was 84.03 seconds per product piece (by timing 30 times in each work station) along with a rating assessment by implementing the Westinghouse principles. This process showed that the rating was 123% underlying an assumption of 5% allowance time. Consequently, the standard time was 108.53 seconds per piece. The Takt time was calculated from customer needs divided by working duration in one day; 3.66 seconds per piece. Of these, the proper number of operators was 30 people. That meant five operators should be eliminated in order to increase the production process. After that, a production model was created from the actual process by using the Arena program to confirm model reliability; the outputs from imitation were compared with the original (actual process) and this comparison indicated that the same output meaning was reliable. Then, worker numbers and their job responsibilities were remodeled into the Arena program. Lastly, the efficiency of production process enhanced from 70.82% to 82.63% according to the target.Keywords: hard disk drive, line balancing, ECRS, simulation, arena program
Procedia PDF Downloads 225437 Community Perceptions on Honey Quality in Tobacco Growing Areas in Kigoma Region, Tanzania
Authors: Pilly Kagosi, Cherestino Balama
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Beekeeping plays major role in improving biodiversity, increasing household income, and crop production through pollination. Tobacco farming is also the main source of household income for smallholder farmers. In Kigoma, production of Tobacco has increased and is perceived to threaten honey quality. The study explored the perception of the community on quality of honey in tobacco and non tobacco growing areas. The study was conducted in Kigoma Region, Tanzania. District and Villages were purposively sampled based on large numbers of people dealing with beekeeping activities and tobacco farming. Socioeconomic data were collected and analysed using Statistical Package for Social Sciences and content analysis. The perception of stakeholders on honey quality was analysed using Likert scale. Majority of the respondents agreed that tobacco farming greatly affects honey quality because honey from beehives near tobacco farms test bitter and sometimes irritating, which was associated with nicotine content and agrochemicals applied to tobacco crops. Though they cannot differentiate honey bitterness from agrochemicals and bee fodders. Furthermore, it was revealed that chemicals applied to tobacco and vegetables have negative effect on the bees and honey quality. Respondents believe that setting bee hives near tobacco farms might contaminate honey and therefore affect its quality. Beekeepers are not aware of the nicotine content from other bee fodders like miombo of which do not have any effect on human beings. Actually, tobacco farming does not affect beekeeping activities in issue of quality when farmers follow proper management of tobacco flowers and proper handling of honey. Though, big challenge in tobacco farming is chemically applied to the crops and harvest bee fodders for curing tobacco. The study recommends training to community on proper management of tobacco and proper handling of bee products.Keywords: community, honey, perceptions, tobacco
Procedia PDF Downloads 144436 Security of Database Using Chaotic Systems
Authors: Eman W. Boghdady, A. R. Shehata, M. A. Azem
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Database (DB) security demands permitting authorized users and prohibiting non-authorized users and intruders actions on the DB and the objects inside it. Organizations that are running successfully demand the confidentiality of their DBs. They do not allow the unauthorized access to their data/information. They also demand the assurance that their data is protected against any malicious or accidental modification. DB protection and confidentiality are the security concerns. There are four types of controls to obtain the DB protection, those include: access control, information flow control, inference control, and cryptographic. The cryptographic control is considered as the backbone for DB security, it secures the DB by encryption during storage and communications. Current cryptographic techniques are classified into two types: traditional classical cryptography using standard algorithms (DES, AES, IDEA, etc.) and chaos cryptography using continuous (Chau, Rossler, Lorenz, etc.) or discreet (Logistics, Henon, etc.) algorithms. The important characteristics of chaos are its extreme sensitivity to initial conditions of the system. In this paper, DB-security systems based on chaotic algorithms are described. The Pseudo Random Numbers Generators (PRNGs) from the different chaotic algorithms are implemented using Matlab and their statistical properties are evaluated using NIST and other statistical test-suits. Then, these algorithms are used to secure conventional DB (plaintext), where the statistical properties of the ciphertext are also tested. To increase the complexity of the PRNGs and to let pass all the NIST statistical tests, we propose two hybrid PRNGs: one based on two chaotic Logistic maps and another based on two chaotic Henon maps, where each chaotic algorithm is running side-by-side and starting from random independent initial conditions and parameters (encryption keys). The resulted hybrid PRNGs passed the NIST statistical test suit.Keywords: algorithms and data structure, DB security, encryption, chaotic algorithms, Matlab, NIST
Procedia PDF Downloads 265435 Validation of the Formula for Air Attenuation Coefficient for Acoustic Scale Models
Authors: Katarzyna Baruch, Agata Szelag, Aleksandra Majchrzak, Tadeusz Kamisinski
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Methodology of measurement of sound absorption coefficient in scaled models is based on the ISO 354 standard. The measurement is realised indirectly - the coefficient is calculated from the reverberation time of an empty chamber as well as a chamber with an inserted sample. It is crucial to maintain the atmospheric conditions stable during both measurements. Possible differences may be amended basing on the formulas for atmospheric attenuation coefficient α given in ISO 9613-1. Model studies require scaling particular factors in compliance with specified characteristic numbers. For absorption coefficient measurement, these are for example: frequency range or the value of attenuation coefficient m. Thanks to the possibilities of modern electroacoustic transducers, it is no longer a problem to scale the frequencies which have to be proportionally higher. However, it may be problematic to reduce values of the attenuation coefficient. It is practically obtained by drying the air down to a defined relative humidity. Despite the change of frequency range and relative humidity of the air, ISO 9613-1 standard still allows the calculation of the amendment for little differences of the atmospheric conditions in the chamber during measurements. The paper discusses a number of theoretical analyses and experimental measurements performed in order to obtain consistency between the values of attenuation coefficient calculated from the formulas given in the standard and by measurement. The authors performed measurements of reverberation time in a chamber made in a 1/8 scale in a corresponding frequency range, i.e. 800 Hz - 40 kHz and in different values of the relative air humidity (40% 5%). Based on the measurements, empirical values of attenuation coefficient were calculated and compared with theoretical ones. In general, the values correspond with each other, but for high frequencies and low values of relative air humidity the differences are significant. Those discrepancies may directly influence the values of measured sound absorption coefficient and cause errors. Therefore, the authors made an effort to determine an amendment minimizing described inaccuracy.Keywords: air absorption correction, attenuation coefficient, dimensional analysis, model study, scaled modelling
Procedia PDF Downloads 421434 Bioinformatics Identification of Rare Codon Clusters in Proteins Structure of HBV
Authors: Abdorrasoul Malekpour, Mohammad Ghorbani Mojtaba Mortazavi, Mohammadreza Fattahi, Mohammad Hassan Meshkibaf, Ali Fakhrzad, Saeid Salehi, Saeideh Zahedi, Amir Ahmadimoghaddam, Parviz Farzadnia Dr., Mohammadreza Hajyani Asl Bs
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Hepatitis B as an infectious disease has eight main genotypes (A–H). The aim of this study is to Bioinformatically identify Rare Codon Clusters (RCC) in proteins structure of HBV. For detection of protein family accession numbers (Pfam) of HBV proteins; used of uni-prot database and Pfam search tool were used. Obtained Pfam IDs were analyzed in Sherlocc program and RCCs in HBV proteins were detected. In further, the structures of TrEMBL entries proteins studied in PDB database and 3D structures of the HBV proteins and locations of RCCs were visualized and studied using Swiss PDB Viewer software. Pfam search tool have found nine significant hits and 0 insignificant hits in 3 frames. Results of Pfams studied in the Sherlocc program show this program not identified RCCs in the external core antigen (PF08290) and truncated HBeAg protein (PF08290). By contrast the RCCs become identified in Hepatitis core antigen (PF00906) Large envelope protein S (PF00695), X protein (PF00739), DNA polymerase (viral) N-terminal domain (PF00242) and Protein P (Pf00336). In HBV genome, seven RCC identified that found in hepatitis core antigen, large envelope protein S and DNA polymerase proteins and proteins structures of TrEMBL entries sequences that reported in Sherlocc program outputs are not complete. Based on situation of RCC in structure of HBV proteins, it suggested those RCCs are important in HBV life cycle. We hoped that this study provide a new and deep perspective in protein research and drug design for treatment of HBV.Keywords: rare codon clusters, hepatitis B virus, bioinformatic study, infectious disease
Procedia PDF Downloads 488433 Intensive Intercultural English Language for Enhanced School Community Engagement: An Exploratory Study Applied to Parents from Language Backgrounds Other Than English in a Regional Australian Primary School
Authors: Ann Dashwood
Abstract:
Using standard Australian English with confidence is a cultural expectation of parents of primary school aged children who want to engage effectively with their children’s teachers and school administration. That confidence in support of their children’s learning at school is seldom experienced by parents whose first language is not English. Sharing language with competence in an intercultural environment is the common denominator for meaningful communication and engagement to occur in a school community. Experience in relevant interactive sessions is known to enhance engagement and participation. The purpose of this paper is to identify interactional settings for which parents who are isolated from the daily use of functional Australian cultural language learned to engage more effectively in their children’s learning at school. The outcomes measured parents’ intercultural engagement with classroom teachers and attention to the school’s administrative procedures. The study used quantitative and qualitative methods. The principles of communicative task-based language learning combined with intercultural communication principles provided the theoretical base for intensive English task-based learning and engagement. The quantitative analysis examined data samples collected by classroom teachers and administrators and parents’ writing samples. Interviews and observations qualitatively informed the study. Currently significant numbers of projects are active in community centres and schools to enhance English language knowledge of parents from Language Backgrounds Other Than English (LBOTE). The study was significant to explore the effects of conducting intensive English with parents of varied English language backgrounds by targeting language use for social interactions in the community, specific engagement in school activities, cultural interaction with teachers and responsiveness to complying with school procedures.Keywords: engagement, intercultural communication, LBOTE, school community
Procedia PDF Downloads 107432 Shadows and Symbols: The Tri-Level Importance of Memory in Jane Yolen's 'the Devil's Arithmetic' and Soon-To-Be-Published 'Mapping the Bones'
Authors: Kirsten A. Bartels
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'Never again' and 'Lest we forget' have long been messages associated with the events of the Shoah. Yet as we attempt to learn from the past, we must find new ways to engage with its memories. The preservation of the culture and the value of tradition are critical factors in Jane Yolen's works of Holocaust fiction, The Devil's Arithmetic and Mapping the Bones, emphasized through the importance of remembering. That word, in its multitude of forms (remember, remembering, memories), occurs no less than ten times in the first four pages and over one hundred times in the one hundred and sixty-four-page narrative The Devil’s Arithmetic. While Yolen takes a different approach to showcasing the importance of memory in Mapping the Bones, it is of equal import in this work and arguably to the future of Holocaust knowing. The idea of remembering, the desire to remember, and the ability to remember, are explored in three divergent ways in The Devil’s Arithmetic. First, in the importance to remember a past which is not her own – to understand history or acquired memories. Second, in the protagonist's actual or initial memories, those of her life in modern-day New York. Third, in a reverse mode of forgetting and trying to reacquire that which has been lost -- as Hannah is processed in the camp and she forgets everything, all worlds prior to the camp are lost to her. As numbers replace names, Yolen stresses the importance of self-identity or owned memories. In addition, the importance of relaying memory, the transitions of memory from perspective, and the ideas of reflective telling are explored in Mapping the Bones -- through the telling of the story through the lens of one of the twins as the events are unfolding; and then the through the reflective telling from the lens of the other twin. Parallel to the exploration of the intersemiosis of memory is the discussion of literary shadows (foreshadowing, backshadowing, and side-shadowing) and their impact on the reader's experience with Yolen's narrative. For in this type of exploration, one cannot look at the events described in Yolen's work and not also contemplate the figurative shadows cast.Keywords: holocaust literature, memory, narrative, Yolen
Procedia PDF Downloads 237431 Energy System Analysis Using Data-Driven Modelling and Bayesian Methods
Authors: Paul Rowley, Adam Thirkill, Nick Doylend, Philip Leicester, Becky Gough
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The dynamic performance of all energy generation technologies is impacted to varying degrees by the stochastic properties of the wider system within which the generation technology is located. This stochasticity can include the varying nature of ambient renewable energy resources such as wind or solar radiation, or unpredicted changes in energy demand which impact upon the operational behaviour of thermal generation technologies. An understanding of these stochastic impacts are especially important in contexts such as highly distributed (or embedded) generation, where an understanding of issues affecting the individual or aggregated performance of high numbers of relatively small generators is especially important, such as in ESCO projects. Probabilistic evaluation of monitored or simulated performance data is one technique which can provide an insight into the dynamic performance characteristics of generating systems, both in a prognostic sense (such as the prediction of future performance at the project’s design stage) as well as in a diagnostic sense (such as in the real-time analysis of underperforming systems). In this work, we describe the development, application and outcomes of a new approach to the acquisition of datasets suitable for use in the subsequent performance and impact analysis (including the use of Bayesian approaches) for a number of distributed generation technologies. The application of the approach is illustrated using a number of case studies involving domestic and small commercial scale photovoltaic, solar thermal and natural gas boiler installations, and the results as presented show that the methodology offers significant advantages in terms of plant efficiency prediction or diagnosis, along with allied environmental and social impacts such as greenhouse gas emission reduction or fuel affordability.Keywords: renewable energy, dynamic performance simulation, Bayesian analysis, distributed generation
Procedia PDF Downloads 495430 Design and Analysis of Hybrid Morphing Smart Wing for Unmanned Aerial Vehicles
Authors: Chetan Gupta, Ramesh Gupta
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Unmanned aerial vehicles, of all sizes, are prime targets of the wing morphing concept as their lightweight structures demand high aerodynamic stability while traversing unsteady atmospheric conditions. In this research study, a hybrid morphing technology is developed to aid the trailing edge of the aircraft wing to alter its camber as a monolithic element rather than functioning as conventional appendages like flaps. Kinematic tailoring, actuation techniques involving shape memory alloys (SMA), piezoelectrics – individually fall short of providing a simplistic solution to the conundrum of morphing aircraft wings. On the other hand, the feature of negligible hysteresis while actuating using compliant mechanisms has shown higher levels of applicability and deliverability in morphing wings of even large aircrafts. This research paper delves into designing a wing section model with a periodic, multi-stable compliant structure requiring lower orders of topological optimization. The design is sub-divided into three smaller domains with external hyperelastic connections to achieve deflections ranging from -15° to +15° at the trailing edge of the wing. To facilitate this functioning, a hybrid actuation system by combining the larger bandwidth feature of piezoelectric macro-fibre composites and relatively higher work densities of shape memory alloy wires are used. Finite element analysis is applied to optimize piezoelectric actuation of the internal compliant structure. A coupled fluid-surface interaction analysis is conducted on the wing section during morphing to study the development of the velocity boundary layer at low Reynold’s numbers of airflow.Keywords: compliant mechanism, hybrid morphing, piezoelectrics, shape memory alloys
Procedia PDF Downloads 311429 Determinants of the Income of Household Level Coir Yarn Labourers in Sri Lanka
Authors: G. H. B. Dilhari, A. A. D. T. Saparamadu
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Sri Lanka is one of the prominent countries for the coir production. The coir is one of the by-products of the coconut and the coir industry is considered to be one of the traditional industries in Sri Lanka. Because of the inherent nature of the coir industry, labourers play a significant role in the coir production process. The study has analyzed the determinants of the income of the household level coir yarn labourers. The study was conducted in the Kumarakanda Grama Niladhari division. Simple random sampling was used to generate a sample of 100 household level coir yarn labourers and structured questionnaire, personal interviews, and discussion were performed to gather the required data. The obtained data were statistically analyzed by using Statistical Package for Social Science (SPSS) software. Mann-Whitney U and Kruskal-Wallis test were performed for mean comparison. The findings revealed that the household level coir yarn industry is dominated by the female workers and it was identified that fewer numbers of workers have engaged in this industry as the main occupation. In addition to that, elderly participation in the industry is higher than the younger participation and most of them have engaged in the industry as a source of extra income. Level of education, the methods of engagement, satisfaction, engagement in the industry by the next generation, support from the government, method of government support, working hours per day, employed as a main job, number of completed units per day, suffering from job related diseases and type of the diseases were related with income level of household level coir yarn laboures. The recommendations as to flourish in future includes, technological transformation for coir yarn production, strengthening the raw material base and regulating the raw material supply, introduction of new technologies, markets and training programmes, the establishment of the labourers’ association, the initiation of micro credit schemes and better consideration about the job oriented diseases.Keywords: coir yarn, determinants, income, Sri Lanka
Procedia PDF Downloads 312428 The Application of Dynamic Network Process to Environment Planning Support Systems
Authors: Wann-Ming Wey
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In recent years, in addition to face the external threats such as energy shortages and climate change, traffic congestion and environmental pollution have become anxious problems for many cities. Considering private automobile-oriented urban development had produced many negative environmental and social impacts, the transit-oriented development (TOD) has been considered as a sustainable urban model. TOD encourages public transport combined with friendly walking and cycling environment designs, however, non-motorized modes help improving human health, energy saving, and reducing carbon emissions. Due to environmental changes often affect the planners’ decision-making; this research applies dynamic network process (DNP) which includes the time dependent concept to promoting friendly walking and cycling environmental designs as an advanced planning support system for environment improvements. This research aims to discuss what kinds of design strategies can improve a friendly walking and cycling environment under TOD. First of all, we collate and analyze environment designing factors by reviewing the relevant literatures as well as divide into three aspects of “safety”, “convenience”, and “amenity” from fifteen environment designing factors. Furthermore, we utilize fuzzy Delphi Technique (FDT) expert questionnaire to filter out the more important designing criteria for the study case. Finally, we utilized DNP expert questionnaire to obtain the weights changes at different time points for each design criterion. Based on the changing trends of each criterion weight, we are able to develop appropriate designing strategies as the reference for planners to allocate resources in a dynamic environment. In order to illustrate the approach we propose in this research, Taipei city as one example has been used as an empirical study, and the results are in depth analyzed to explain the application of our proposed approach.Keywords: environment planning support systems, walking and cycling, transit-oriented development (TOD), dynamic network process (DNP)
Procedia PDF Downloads 344427 An Investigation into the Decision-Making Process of Choosing Long-Term Care Services in Taiwan
Authors: Yu-Ching Liu
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Background: Family numbers usually take responsibility for taking care of their elderly relatives, especially parents. Caring for a patient with chronic diseases is a stressful experience, which makes carers suffer physical and mental health stress, difficulties maintaining family relationships and issues in participating in the labor market, which may lower their quality of life (QoL). The issue of providing care to relatives with chronic illness has been widely explored in Taiwan, but most studies focus on the need for full-time caregivers. Objective: The main goal of this study was to examine the topic of working carers involved in the decision-making process of LTC services and to explore what affects working carers considering when they choose the care services for their disabled, elderly relatives. Method: A total of 7 working caregivers were enrolled in this study. A face-to-face and semi-structured in-depth qualitative interview study were conducted to explore the caregivers' perspectives. Results: Working carers have a positive experience of using LTC service because it allows them to kill two birds with one stone, continue employment, and care for an elderly disabled relative. However, working carers have still been struggling to find friendly community-based LTC services. There were no longer available community services that could be used with the illness condition of patients getting worse. As such, patients have to be cared for at home, which might increase the caregiver burden of carers. Conclusion: Working family caregivers suffer from heavy physical and psychological burdens as they not only have to maintain their employment but care for elderly disabled relatives; however, the current support provided is insufficient. The design of services should consider working carers' employment situation and need rather than the only caring situation of patients at home.Keywords: family caregiver, Long-term care, work-life balance, decision-making
Procedia PDF Downloads 180426 Research on the Ecological Impact Evaluation Index System of Transportation Construction Projects
Authors: Yu Chen, Xiaoguang Yang, Lin Lin
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Traffic engineering construction is an important infrastructure for economic and social development. In the process of construction and operation, the ability to make a correct evaluation of the project's environmental impact appears to be crucial to the rational operation of existing transportation projects, the correct development of transportation engineering construction and the adoption of corresponding measures to scientifically carry out environmental protection work. Most of the existing research work on ecological and environmental impact assessment is limited to individual aspects of the environment and less to the overall evaluation of the environmental system; in terms of research conclusions, there are more qualitative analyses from the technical and policy levels, and there is a lack of quantitative research results and quantitative and operable evaluation models. In this paper, a comprehensive analysis of the ecological and environmental impacts of transportation construction projects is conducted, and factors such as the accessibility of data and the reliability of calculation results are comprehensively considered to extract indicators that can reflect the essence and characteristics. The qualitative evaluation indicators were screened using the expert review method, the qualitative indicators were measured using the fuzzy statistics method, the quantitative indicators were screened using the principal component analysis method, and the quantitative indicators were measured by both literature search and calculation. An environmental impact evaluation index system with the general objective layer, sub-objective layer and indicator layer was established, dividing the environmental impact of the transportation construction project into two periods: the construction period and the operation period. On the basis of the evaluation index system, the index weights are determined using the hierarchical analysis method, and the individual indicators to be evaluated are dimensionless, eliminating the influence of the original background and meaning of the indicators. Finally, the thesis uses the above research results, combined with the actual engineering practice, to verify the correctness and operability of the evaluation method.Keywords: transportation construction projects, ecological and environmental impact, analysis and evaluation, indicator evaluation system
Procedia PDF Downloads 105425 When Conducting an Analysis of Workplace Incidents, It Is Imperative to Meticulously Calculate Both the Frequency and Severity of Injuries Sustain
Authors: Arash Yousefi
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Experts suggest that relying exclusively on parameters to convey a situation or establish a condition may not be adequate. Assessing and appraising incidents in a system based on accident parameters, such as accident frequency, lost workdays, or fatalities, may not always be precise and occasionally erroneous. The frequency rate of accidents is a metric that assesses the correlation between the number of accidents causing work-time loss due to injuries and the total working hours of personnel over a year. Traditionally, this has been calculated based on one million working hours, but the American Occupational Safety and Health Organization has updated its standards. The new coefficient of 200/000 working hours is now used to compute the frequency rate of accidents. It's crucial to ensure that the total working hours of employees are equally represented when calculating individual event and incident numbers. The accident severity rate is a metric used to determine the amount of time lost or wasted during a given period, often a year, in relation to the total number of working hours. It measures the percentage of work hours lost or wasted compared to the total number of useful working hours, which provides valuable insight into the number of days lost or wasted due to work-related incidents for each working hour. Calculating the severity of an incident can be difficult if a worker suffers permanent disability or death. To determine lost days, coefficients specified in the "tables of days equivalent to OSHA or ANSI standards" for disabling injuries are used. The accident frequency coefficient denotes the rate at which accidents occur, while the accident severity coefficient specifies the extent of damage and injury caused by these accidents. These coefficients are crucial in accurately assessing the magnitude and impact of accidents.Keywords: incidents, safety, analysis, frequency, severity, injuries, determine
Procedia PDF Downloads 90424 Anterior Tooth Misalignment: Orthodontics or Restorative Treatment
Authors: Maryam Firouzmandi, Moosa Miri
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Smile is considered to be one of the most effective methods of influencing people. Increasing numbers of patients are requesting cosmetic dental procedures to achieve the perfect smile. Based on the patient’s age, oral and facial characteristics, and the dentist’s expertise, different concepts of treatment would be available. Orthodontics is the most conservative and the ideal treatment alternative for crowded anterior teeth; however, it may be rejected by patients due to occupational limitations of time, physical discomfort including pain and functional limitations, psychological discomfort, and appearance during treatment. In addition, orthodontic treatment will not resolve deficits of contour and color of the anterior teeth. In consequence, patients may demand restorative techniques to resolve their anterior mal-alignment instead, often called "instant orthodontics". Following its introduction, however, adhesive dentistry has suffered at times from overuse. Creating short-term attractive smiles at the expense of long-term dental health and optimal tooth biomechanics by using cosmetic techniques should not be considered an ethical approach. The objective of this narrative review was to investigate the literature for guidelines with regard to decision making and treatment planning for anterior tooth mal-alignment. In this regard, indications of orthodontic, restorative, combination of both treatments, and adjunctive periodontal surgery were discussed in clinical cases to achieve a proportional smile. Restorative modalities would include disking, cosmetic contouring, veneers, and crowns and were compared with limited or comprehensive orthodontic options. A rapid review was also presented on pros and cons of snap on smile to mask malalignments. Diagnostic tools such as mock up, wax up, and digital smile design were also considered to achieve more conservative and functional treatments with respect to biologic factors.Keywords: crowding, misalignment, veneer, crown, orthodontics
Procedia PDF Downloads 116423 Standardization of a Methodology for Quantification of Antimicrobials Used for the Treatment of Multi-Resistant Bacteria Using Two Types of Biosensors and Production of Anti-Antimicrobial Antibodies
Authors: Garzon V., Bustos R., Salvador J. P., Marco M. P., Pinacho D. G.
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Bacterial resistance to antimicrobial treatment has increased significantly in recent years, making it a public health problem. Large numbers of bacteria are resistant to all or nearly all known antimicrobials, creating the need for the development of new types of antimicrobials or the use of “last line” antimicrobial drug therapies for the treatment of multi-resistant bacteria. Some of the chemical groups of antimicrobials most used for the treatment of infections caused by multiresistant bacteria in the clinic are Glycopeptide (Vancomycin), Polymyxin (Colistin), Lipopeptide (Daptomycin) and Carbapenem (Meropenem). Molecules that require therapeutic drug monitoring (TDM). Due to the above, a methodology based on nanobiotechnology based on an optical and electrochemical biosensor is being developed, which allows the evaluation of the plasmatic levels of some antimicrobials such as glycopeptide, polymyxin, lipopeptide and carbapenem quickly, at a low cost, with a high specificity and sensitivity and that can be implemented in the future in public and private health hospitals. For this, the project was divided into five steps i) Design of specific anti-drug antibodies, produced in rabbits for each of the types of antimicrobials, evaluating the results by means of an immunoassay analysis (ELISA); ii) quantification by means of an electrochemical biosensor that allows quantification with high sensitivity and selectivity of the reference antimicrobials; iii) Comparison of antimicrobial quantification with an optical type biosensor; iv) Validation of the methodologies used with biosensor by means of an immunoassay. Finding as a result that it is possible to quantify antibiotics by means of the optical and electrochemical biosensor at concentrations on average of 1,000ng/mL, the antibodies being sensitive and specific for each of the antibiotic molecules, results that were compared with immunoassays and HPLC chromatography. Thus, contributing to the safe use of these drugs commonly used in clinical practice and new antimicrobial drugs.Keywords: antibiotics, electrochemical biosensor, optical biosensor, therapeutic drug monitoring
Procedia PDF Downloads 82422 Laminar Separation Bubble Prediction over an Airfoil Using Transition SST Turbulence Model on Moderate Reynolds Number
Authors: Younes El Khchine, Mohammed Sriti
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A parametric study has been conducted to analyse the flow around S809 airfoil of a wind turbine in order to better understand the characteristics and effects of laminar separation bubble (LSB) on aerodynamic design for maximizing wind turbine efficiency. Numerical simulations were performed at low Reynolds numbers by solving the Unsteady Reynolds Averaged Navier-Stokes (URANS) equations based on C-type structural mesh and using the γ-Reθt turbulence model. A two-dimensional study was conducted for the chord Reynolds number of 1×10⁵ and angles of attack (AoA) between 0 and 20.15 degrees. The simulation results obtained for the aerodynamic coefficients at various angles of attack (AoA) were compared with XFoil results. A sensitivity study was performed to examine the effects of Reynolds number and free-stream turbulence intensity on the location and length of the laminar separation bubble and the aerodynamic performances of wind turbines. The results show that increasing the Reynolds number leads to a delay in the laminar separation on the upper surface of the airfoil. The increase in Reynolds number leads to an accelerated transition process, and the turbulent reattachment point moves closer to the leading edge owing to an earlier reattachment of the turbulent shear layer. This leads to a considerable reduction in the length of the separation bubble as the Reynolds number is increased. The increase in the level of free-stream turbulence intensity leads to a decrease in separation bubble length and an increase in the lift coefficient while having negligible effects on the stall angle. When the AoA increased, the bubble on the suction airfoil surface was found to move upstream to the leading edge of the airfoil, that causes earlier laminar separation.Keywords: laminar separation bubble, turbulence intensity, S809 airfoil, transition model, Reynolds number
Procedia PDF Downloads 83421 Hydraulics of 3D Aerators with Lateral Enlargements
Authors: Nirmala Lama
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The construction of high dams has led to significant challenges in managing flow rates discharging over spillways, resulting in cavitation damages on hydraulic surfaces. To address this, aerator devices were designed and installed to promote fore aeration, thereby controlling and mitigating damages caused by cavitation. Consequently, these aerator types, three-dimensional aerators (3DAEs), have demonstrated superior efficiency in introducing forced air into the flow.This research focuses on the installation and evaluation of three-dimensional aerator devices at the high discharge spillway surface. In the laboratory, the air concentration downstream of the hydraulic structures was extensively measured, and the data were analyzed in details.Multiple flow scenarios and structural arrangements of the aerators were adopted for the study. The outcomes of these experiments are listed as In terms of air concentration value, the comparison between 3 DAE (three-dimensional aerator) with offset only and offset with ramp reveals significant differences. The concentration value on the side wall was justified. The side cavity length was found to increase with higher approach Froude numbers and lateral enlargement widths. Furthermore, 3DAE exhibited shorter side cavity lengths compared to three-dimensional aerator devices without ramps (3DAD), a beneficial features for controlling water fins. An empirical formula to express the side cavity length was derived from the measured data. Also, the comparison were made on the basis of water fin formation between the different arrangements of 3D aerators. In conclusion, this research provides valuable insights into the performance of three-dimensional aerators in mitigating cavitation damages and controlling water fins in high dam spillways. The findings offer practical implications for designers and engineers seeking to enhance the efficiency and safety of hydraulic structures subjected to high flow rates.Keywords: three-dimension aerator, cavity, water fin, air entrainment
Procedia PDF Downloads 68420 Access and Outcome of Khas Land in Bangladesh: An Insight into Its Distribution Process and Influence on Landless Farmers
Authors: M. Foysul Alam
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Land diluvion is a common phenomenon in Bangladesh. According to Bangladesh land administration manual, land gained by diluvion and alluvion are considered as Khas (state) lands. Distributing khas lands to the poorest landless people was suggested as a way of improving the livelihood by mobilizing their economic activity and improving their social status in Bangladesh. The impact of this initiative, which started in 1980 as a state policy, is perhaps one of the least experimentally documented ones in the country. The primary aim of this study was to investigate the economic and social status of some landless farmers focusing on determining whether the distribution of khas lands provide part of the explanation for possible improvement of their livelihood during this period of almost four decades. If not, the secondary objective of this study was to identify the issues and challenges of this policy, whether in strategic planning or implementation efforts. Both subjectively observable and objectively measurable data were collected from 150 households from 30 villages of 6 districts worse suffering from landlessness. A well-organized questionnaire, including 10 open ended question, were used to collect specific data and experiences of the landless farmers. Special attention was given to those who left peasantry becoming involved in other economic activities. The study found that Khas lands have very nominal or even zero influence on landless farmers due to 1. Lack of Khas land inventory 2. Lack of availability of information to the farmers 3. Complexity in application procedure for demanding Khas land and 4. Political nexus of local influential farmers makes it nearly impossible for those farmers who actually deserve it. It also found that most of the lucky farmers who eventually got a piece of Khas land had links with the local elites of their community. The research concludes that it is too early to decide how good the Khas land is for the marginalized landless farmers in Bangladesh, with actually a few numbers of them given the possession of one. This document provides crucial recommendations for overcoming the prevailing challenges.Keywords: Khas land, land distribution, marginalized farmers, rural livelihood
Procedia PDF Downloads 125419 As a Little-Known Side a Passionate Statistician: Florence Nightingale
Authors: Gülcan Taşkıran, Ayla Bayık Temel
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Background: Florence Nightingale, the modern founder of the nursing, is most famous for her role as a nurse. But not so much known about her contributions as a mathematician and statistician. Aim: In this conceptual article it is aimed to examine Florence Nightingale's statistics education, how she used her passion for statistics and applied statistical data in nursing care and her scientific contributions to statistical science. Design: Literature review method was used in the study. The databases of Istanbul University Library Search Engine, Turkish Medical Directory, Thesis Scanning Center of Higher Education Council, PubMed, Google Scholar, EBSCO Host, Web of Science were scanned to reach the studies. The keywords 'statistics' and 'Florence Nightingale' have been used in Turkish and English while being screened. As a result of the screening, totally 41 studies were examined from the national and international literature. Results: Florence Nightingale has interested in mathematics and statistics at her early ages and has received various training in these subjects. Lessons learned by Nightingale in a cultured family environment, her talent in mathematics and numbers, and her religious beliefs played a crucial role in the direction of the statistics. She was influenced by Quetelet's ideas in the formation of the statistical philosophy and received support from William Farr in her statistical studies. During the Crimean War, she applied statistical knowledge to nursing care, developed many statistical methods and graphics, so that she made revolutionary reforms in the health field. Conclusions: Nightingale's interest in statistics, her broad vision, the statistical ideas fused with religious beliefs, the innovative graphics she has developed and the extraordinary statistical projects that she carried out has been influential on the basis of her professional achievements. Florence Nightingale has also become a model for women in statistics. Today, using and teaching of statistics and research in nursing care practices and education programs continues with the light she gave.Keywords: Crimean war, Florence Nightingale, nursing, statistics
Procedia PDF Downloads 293418 A Suggested Study Plan for Mining Engineering Program in Northern Border University (NBU) to Match the Requirements of the Local Mining Industry
Authors: Mohammad Aljuhani, Yasamina Aljuhani
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The Mining Engineering Department at College of Engineering in NBU is under establishment. It is essential to establish such department in NBU. This is because, it is the only university in the region. Moreover, the mining industry is very active in the northern borders region. However, there is no mining engineering department in KSA except one in King Abdulziz University, which is 1400 km from the mining industry in the northern borders. As a result, department graduates from KAU find difficulties to get suitable jobs in their specialization in spite of their few numbers graduated per year and the presence of many jobs vacancies at the local mining sector. Therefore, the objectives of this research are to identify, measure and analyze the above mentioned problem from educational point of view. One more objective is to add a contribution towards solving such vital, society affecting problem. For achieving the first task of the research, that is problem size identification and analyses, a questionnaire was designed. The questionnaire was directed towards experienced engineers, in the mining and related industries, including the ministry of petroleum and minerals, Saudi Geological Survey, and Ma’aden Company as being prospective employers for the mining sector. The questionnaire target was to evaluate the Saudi mining engineers from an industrial point of view and to detect the main reasons behind their failure to find jobs. In addition, the study focuses in the demand of mining engineers in the northern borders region. Moreover, the study plan of the suggested department is designed based on the requirements of the mining industry. The feedback received from the industry reflected major educational shortcomings. In order to overcome the revealed defects, the second objective of the research was achieved where a suggested study plan “curriculum” has been prepared to take into consideration all the points of weakness so as to improve the graduates’ quality to fit the local mining work market.Keywords: mining engineering, labor market, qualifications, curriculum, mining industry, mining engineers
Procedia PDF Downloads 271417 Analyzing the Impact of the COVID-19 Pandemic on Clinicians’ Perceptions of Resuscitation and Escalation Decision-Making Processes: Cross-Sectional Survey of Hospital Clinicians in the United Kingdom
Authors: Michelle Hartanto, Risheka Suthantirakumar
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Introduction Staff redeployment, increased numbers of acutely unwell patients requiring resuscitation decision-making conversations, visiting restrictions, and varying guidance regarding resuscitation for patients with COVID-19 disrupted clinicians’ management of resuscitation and escalation decision-making processes. While it was generally accepted that the COVID-19 pandemic disturbed numerous aspects of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process in the United Kingdom, a process which establishes a patient’s CPR status and treatment escalation plans, the impact of the pandemic on clinicians’ attitudes towards these resuscitation and decision-making conversations was unknown. This was the first study to examine the impact of the COVID-19 pandemic on clinicians’ knowledge, skills, and attitudes towards the ReSPECT process. Methods A cross-sectional survey of clinicians at one acute teaching hospital in the UK was conducted. A questionnaire with a defined five-point Likert scale was distributed and clinicians were asked to recall their pre-pandemic views on ReSPECT and report their current views at the time of survey distribution (May 2020, end of the first COVID-19 wave in the UK). Responses were received from 171 clinicians, and self-reported views before and during the pandemic were compared. Results Clinicians reported they found managing ReSPECT conversations more challenging during the pandemic, especially when conducted over the telephone with relatives, and they experienced an increase in negative emotions before, during, and after conducting ReSPECT conversations. Our findings identified that due to the pandemic there was now a need for clinicians to receive training and support in conducting resuscitation and escalation decision-making conversations over the telephone with relatives and managing these processes.Keywords: cardiopulmonary resuscitation, COVID-19 pandemic, DNACPR discussion, education, recommended summary plan for emergency care and treatment, resuscitation order
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