Search results for: psychological safety

Authors: S. P. Rana

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Objectives: For the manufacture of a very thin strip or a strip with a high-quality finish, the stainless steel sheet that is called billet is re-rolled in re-rolling mill to make stainless steel sheet of 18 gauges. The rolls of re-rolling mill exert tremendous pressure over the sheet and there is likely chance of breaking of stainless steel strip from the sheet. The objective of the study was to minimise the number of accidents in steel re-rolling mills due to ejection of stainless steel strip and to minimize the pollution caused by the pickling process used in these units. Methods: Looking into the high rate of frequency and severity of accidents as well as pollution hazard in re-rolling and pickling mills, it becomes essential to make necessary arrangements for prevention of accidents in such type of industry. The author carried out survey/inspections of a large number of re-rolling and pickling mills and allied units. During the course of inspection, the working of these steel re-rolling and pickling mills was closely studied and monitored. A number of accidents involving re-rolling mills were investigated and subsequently remedial measures to prevent the occurrence of such accidents were suggested. Assessment of occupational safety and health system of these units was carried out and compliance level of the statutory requirements was checked. The workers were medically examined and monitored to ascertain their health conditions. Results: Proper use of safety gadgets by workers, machine guarding and regular training brought down the risk to an acceptable level and discharged effluent pollution was brought down to permissible limits. The fatal accidents have been reduced by 83%. Conclusions: Effective enforcement and implementation of the directions/suggestions given to the managements of such units brought down the no. of accidents to a rational level. The number of fatal accidents has reduced by 83% during the study period. The effective implementation of pollution control device curtailed the pollution level to an acceptable level.

Keywords: re-rolling mill, hazard, accident, health hazards

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Authors: Atefeh Omidkhah, Mohammadreza Bemanian

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The issue of way-finding earmarks a wide range of literature in architecture and despite the 50 year background of way-finding studies, it still lacks a comprehensive theory for indoor settings. Way-finding has a notable role in emergency evacuation as well. People in the panic situation of a fire emergency need to find the safe egress route correctly and in as minimum time as possible. In this regard the parameters of an appropriate way-finding are mentioned in the evacuation related researches albeit scattered. This study reviews the fire safety related literature to extract a way-finding related framework for architectural purposes of the design of a safe evacuation route. In this regard a research trend review in addition with applied methodological approaches review is conducted. Then by analyzing eight original researches related to way-finding parameters in fire evacuation, main parameters that affect way-finding in emergency situation of a fire incident are extracted and a framework was developed based on them. Results show that the issues related to exit route and emergency evacuation can be chased in task oriented studies of way-finding. This research trend aims to access a high-level framework and in the best condition a theory that has an explanatory capability to define differences in way-finding in indoor/outdoor settings, complex/simple buildings and different building types or transitional spaces. The methodological advances demonstrate the evacuation way-finding researches in line with three approaches that the latter one is the most up-to-date and precise method to research this subject: real actors and hypothetical stimuli as in evacuation experiments, hypothetical actors and stimuli as in agent-based simulations and real actors and semi-real stimuli as in virtual reality environment by adding multi-sensory simulation. Findings on data-mining of 8 sample of original researches in way-finding in evacuation indicate that emergency way-finding design of a building should consider two level of space cognition problems in the time of emergency and performance consequences of them in the built environment. So four major classes of problems in way-finding which are visual information deficiency, confusing layout configuration, improper navigating signage and demographic issues had been defined and discussed as the main parameters that should be provided with solutions in design and interior of a building. In the design phase of complex buildings, which face more reported problem in way-finding, it is important to consider the interior components regarding to the building type of occupancy and behavior of its occupants and determine components that tend to become landmarks and set the architectural features of egress route in line with the directions that they navigate people. Research on topological cognition of environmental and its effect on way-finding task in emergency evacuation is proposed for future.

Keywords: architectural design, egress route, way-finding, fire safety, evacuation

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Authors: Ali Göksenli, Barlas Eryürek

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In this study, failure analysis of pipe system at a micro hydroelectric power plant is investigated. Failure occurred at the pipe system in the powerhouse during shut down operation of the water flow by a valve. This locking had caused a sudden shock wave, also called “Water-hammer effect”, resulting in noise and inside pressure increase. After visual investigation of the effect of the shock wave on the system, a circumference crack was observed at the pipe flange weld region. To establish the reason for crack formation, calculations of pressure and stress values at pipe, flange and welding seams were carried out and concluded that safety factor was high (2.2), indicating that no faulty design existed. By further analysis, pipe system and hydroelectric power plant was examined. After observations it is determined that the plant did not include a ventilation nozzle (air trap), that prevents the system of sudden pressure increase inside the pipes which is caused by water-hammer effect. Analyses were carried out to identify the influence of water-hammer effect on inside pressure increase and it was concluded that, according Jowkowsky’s equation, shut down time is effective on inside pressure increase. The valve closing time was uncertain but by a shut down time of even one minute, inside pressure would increase by 7.6 bar (working pressure was 34.6 bar). Detailed investigations were also carried out on the assembly of the pipe-flange system by considering technical drawings. It was concluded that the pipe-flange system was not installed according to the instructions. Two of five weld seams were not applied and one weld was carried out faulty. This incorrect and inadequate weld seams resulted in; insufficient connection of the pipe to the flange constituting a strong notch effect at weld seam regions, increase in stress values and the decrease of strength and safety factor

Keywords: failure analysis, hydroelectric plant, crack, shock wave, welding seam

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Authors: Weichao Yu, Kai Wen, Weihe Huang, Yang Yang, Jing Gong

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Metal-loss corrosion is a major threat to the safety and integrity of gas pipelines as it may result in the burst failures which can cause severe consequences that may include enormous economic losses as well as the personnel casualties. Therefore, it is important to ensure the corroding pipeline integrity and efficiency, considering the value of wall thickness, which plays an important role in the failure probability of corroding pipeline. Actually, the wall thickness is controlled during pipe purchase stage. For example, the API_SPEC_5L standard regulates the allowable tolerance of the wall thickness from the specified value during the pipe purchase. The allowable wall thickness tolerance will be used to determine the wall thickness distribution characteristic such as the mean value, standard deviation and distribution. Taking the uncertainties of the input variables in the burst limit-state function into account, the reliability approach rather than the deterministic approach will be used to evaluate the failure probability. Moreover, the cost of pipe purchase will be influenced by the allowable wall thickness tolerance. More strict control of the wall thickness usually corresponds to a higher pipe purchase cost. Therefore changing the wall thickness tolerance will vary both the probability of a burst failure and the cost of the pipe. This paper describes an approach to optimize the wall thickness tolerance considering both the safety and economy of corroding pipelines. In this paper, the corrosion burst limit-state function in Annex O of CSAZ662-7 is employed to evaluate the failure probability using the Monte Carlo simulation technique. By changing the allowable wall thickness tolerance, the parameters of the wall thickness distribution in the limit-state function will be changed. Using the reliability approach, the corresponding variations in the burst failure probability will be shown. On the other hand, changing the wall thickness tolerance will lead to a change in cost in pipe purchase. Using the variation of the failure probability and pipe cost caused by changing wall thickness tolerance specification, the optimal allowable tolerance can be obtained, and used to define pipe purchase specifications.

Keywords: allowable tolerance, corroding pipeline segment, operation cost, production cost, reliability approach

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Authors: Olga Giovani

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In this research, Bronfenbrenner's theory will be used to investigate the individual, microsystemic, and exosystemic factors that may affect adolescents' academic achievement as well as their expectations in Greece. First, the topic of academic achievement in an adolescent developmental context will be set as the target of the proposed study while focusing on the aspects of community influences on adolescents. More specifically, the effect of available resources and the perceived sense of safety and support will be further investigated. Then the issue of family factors will be analyzed, as they are subjectively perceived by the adolescents, focusing on the perceived parental style, parental monitor, and involvement as a mesosystemic factor. In turn, the school will also be discussed with emphasis on the perceived school climate and support as well as the academic aspects of student achievement. Finally, the adolescent's individual perspective will be taken into consideration in developmental terms, examining their perceptions regarding their community/neighborhood, their family, their school, as well as their sense of self-concept and self-esteem as these are expressed through their academic performance and prosocial behavior. The aim of the proposed research is to study these associations through the prism of the systemic perspective, the relationship between aspects of educational achievement and socioeconomic background, with an emphasis on the role of the community, which has not been adequately researched in the Greek context. Community will be defined by the available community resources (recreational activities, public library, local orchestras, free entrance museums, etc.), adolescents' own perception of social support, safety, and support inside that community. These perceptions need to be investigated since they may serve as possible predictors of a child's current cognitive, developmental, and psycho-social outcomes, such as their perceived self-concept and self-esteem, as well as on their future expectations related to the entrance to university and job expectations.

Keywords: bioecological model, developmental psychology, ecosystemic approach, student achievement, microsystemic factors, mesosystemic factors, individual perceptions

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Authors: N. Lakshmipathy, Ch. S. N. Murthy, M. Aruna

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The design of lighting systems for surface mines is not an easy task because of the unique environment and work procedures encountered in the mines. The primary objective of this paper is to identify the major problems encountered in mine lighting application and to provide guidance in the solution of these problems. In the surface mining reflectance of surrounding surfaces is one of the important factors, which improve the vision, in the night hours. But due to typical working nature in the mines it is very difficult to fulfill these requirements, and also the orientation of the light at work site is a challenging task. Due to this reason machine operator and other workers in a mine need to be able to orient themselves in a difficult visual environment. The haul roads always keep on changing to tune with the mining activity. Other critical area such as dumpyards, stackyards etc. also change their phase with time, and it is difficult to illuminate such areas. Mining is a hazardous occupation, with workers exposed to adverse conditions; apart from the need for hard physical labor, there is exposure to stress and environmental pollutants like dust, noise, heat, vibration, poor illumination, radiation, etc. Visibility is restricted when operating load haul dumper and Heavy Earth Moving Machinery (HEMM) vehicles resulting in a number of serious accidents. one of the leading causes of these accidents is the inability of the equipment operator to see clearly people, objects or hazards around the machine. Results indicate blind spots are caused primarily by posts, the back of the operator's cab, and by lights and light brackets. The careful designed and implemented, lighting systems provide mine workers improved visibility and contribute to improved safety, productivity and morale. Properly designed lighting systems can improve visibility and safety during working in the opencast mines.

Keywords: contrast, efficacy, illuminance, illumination, light, luminaire, luminance, reflectance, visibility

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Authors: Asfa Hussain, Chee Tang, Mien Nguyen

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Introduction: The safe usage of medications is dependent on clear, well-documented prescribing. Medical drug charts should be regularly checked to ensure that they are fit for purpose. Aims: The purpose of this study was to evaluate whether the Isabel Hospice drug charts were effective or prone to medical errors. The aim was to create a comprehensive palliative care drug chart in line with medico-legal guidelines and to minimise drug administration and prescription errors. Methodology: 50 medical drug charts were audited from March to April 2020, to assess whether they complied with medico-legal guidelines, in a hospice within East of England. Meetings were held with the larger multi-disciplinary team (MDT), including the pharmacists, nursing staff and doctors, to raise awareness of the issue. A preliminary drug chart was created, using the input from the wider MDT. The chart was revised and trialled over 15 times, and each time feedback from the MDT was incorporated into the subsequent template. In the midst of the COVID-19 pandemic in September 2020, the finalised drug chart was trialled. 50 new palliative drug charts were re-audited, to evaluate the changes made. Results: Prescribing and administration errors were high prior to the implementation of the new chart. This improved significantly after introducing the new drug charts, therefore improving patient safety and care. The percentage of inadequately documented allergies went down from 66% to 20% and incorrect oxygen prescription from 40% to 16%. The prescription drug-drug interactions decreased by 30%. Conclusion: It is vital to have clear standardised drug charts, in line with medico-legal standards, to allow ease of prescription and administration of medications and ensure optimum patient-centred care. This closed loop audit demonstrated significant improvement in documentation and prevention of possible fatal drug errors and interactions.

Keywords: palliative care, drug chart, medication errors, drug-drug interactions, COVID-19, patient safety

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Authors: Jennifer Hunter, Francisco Ramirez, Neil A. Nedley, Thania Solorio, Christian Freed, Erica Kinjo

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People who have autoimmune disease are often at an increased risk for psychological disorders such as anxiety. Untreated psychological conditions can affect the development of disease and can affect one’s general quality of life. In this study, it was hypothesized that an educational community-based intervention would be useful in decreasing the anxiety levels of participants with autoimmune disease. Programs, 2-hours long each, were held weekly over a period of eight weeks. During every meeting, a 45-minute DVD presentation by a skilled physician was shown, a small group discussion was guided by trained facilitators, and weekly practical assignments were given to each participant. The focus of the program was to educate participants about healthy lifestyle behaviors such as exercise, nutrition, sleep hygiene, helpful thought patterns etc., and to provide a group environment in which each participant was supported. Participants were assessed pre-post program for anxiety using the Depression and Anxiety Assessment Test (registration TX 7-398-022), a validated mental health test based on DSM-5 criteria and demographics. Anxiety scores were classified according to the DSM-5 criteria into 4 categories: none (0-6), mild (7-10), moderate (11-19) or severe (20 or more). Out of the participants who participated in programs conducted in the manner explained above (n=431), the average age was 54.9 (SD 16.6) and 81.9% were female. At baseline, the mean group anxiety level was 9.4 (SD 5.4). Within the baseline group, anxiety levels were as follows: none (21.1%), mild (22.0%), moderate (27.1%) and severe (29.7%). After the program, mean group anxiety decreased to 4.7 (SD 4.0). Post-program anxiety levels were as follows: none (54.8%), mild (27.1%), moderate (12.5%), severe (5.6%). The decrease in overall anxiety levels was significant t(431)=19.3 p<.001, 95% CI [0.815, 1.041]. It was concluded that the eight-week intensive was beneficial in decreasing the anxiety levels of participants. A long-term follow-up study would be beneficial in determining how lasting such improvements are especially since autoimmune diseases are often chronic. Additionally, future studies that utilize a control group would aid in establishing whether the improvements seen are due to the use of this specific lifestyle-educational program.

Keywords: anxiety, auto-immune disease, community-based educational program, lifestyle

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Authors: Sudip Subedi, Nipesh Pradhananga

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The musculoskeletal disorders, also known as MSDs, are common in construction workers. MSDs include lower back injuries, knee injuries, spinal injuries, and joint injuries, among others. Since most construction tasks are still manual, construction workers often need to perform repetitive, labor-intensive tasks. And they need to stay in the same or an awkward posture for an extended time while performing such tasks. It induces significant stress to the joints and spines, increasing the risk of getting into MSDs. Manual monitoring of such tasks is virtually impossible with the handful of safety managers in a construction site. This paper proposes a methodology for performing kinetic analysis of the working postures while performing such tasks in real-time. Skeletal of different workers will be tracked using a depth-sensing camera while performing the task to create training data for identifying the best posture. For this, the kinetic analysis will be performed using a human musculoskeletal model in an open-source software system (OpenSim) to visualize the stress induced by essential joints. The “safe posture” inducing lowest stress on essential joints will be computed for different actions involved in the task. The identified “safe posture” will serve as a basis for real-time monitoring and identification of awkward and unsafe postural behaviors of construction workers. Besides, the temporal simulation will be carried out to find the associated long-term effect of repetitive exposure to such observed postures. This will help to create awareness in workers about potential future health hazards and encourage them to work safely. Furthermore, the collected individual data can then be used to provide need-based personalized training to the construction workers.

Keywords: construction workers’ safety, depth sensing camera, human body kinetics, musculoskeletal disorders, real time monitoring, repetitive labor-intensive tasks

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Authors: Tamrat Girma Biru

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Multidrug-resistant tuberculosis (MDR-TB) is defined as resistant to at least Refampicin and Isoniazed: the most two power full TB drugs. It is a leading cause of high rates of morbidity and mortality, and increasing psychosocial challenges to patients, especially when co-infected with Human Immunodeficiency Virus (HIV). Ethiopia faces the highest rates of MDR-TB infection in the world. Objectives: The main objective of this study was to identify the psychosocial challenges of MDR-TB patients, to investigate the extent of the psychosocial challenges on (self-esteem, depression, and stigma) that MDR-TB patients encounter, to examine whether there is a sex difference in experiencing psychosocial challenges and assess the counseling needs of MDR-TB patients. Methodology: A cross-sectional study was conducted at St. Peter TB Specialized Hospital, Addis Ababa on 40 patients (25 males and 15 females) who are hospitalized for treatment. The patients were identified by using purposive sampling and made fill a questionnaire measuring their level of self-esteem, depression and stigma. Besides, data were collected from 16 participants, 28 care providers and 8 guardians, using semi-structured interview. The obtained data were analyzed using SPSS statistical program, descriptive statistics, independent t-test, and qualitative description. Results and Discussion: The results of the study showed that the majority (80%) of the respondents had suffered psychological challenges and social discriminations. Thus, the significance of MDR-TB and its association with HIV/AIDS problems is considered. Besides the psychosocial challenges, various aggravating factors such as length of treatment, drug burden and insecurity in economy together highly challenges the life of patients. In addition, 60% of participants showed low level of self-esteem. The patients also reported that they experienced high self-stigma and stigma by other members of the society. The majority of the participants (75%) showed moderate and severe level of depression. In terms of sex there is no difference between the mean scores of males and females in the level of depression and stigmatization by others and by themselves. But females showed lower level of self-esteem than males. The analysis of the t-test also shows that there were no statistically significant sex difference on the level of depression and stigma. Based on the qualitative data MDR-TB patients face various challenges in their life sphere such as: Psychological (depression, low self value, lowliness, anxiety), social (stigma, isolation from social relations, self-stigmatization,) and medical (drug side effect, drug toxicity, drug burden, treatment length, hospital stays). Recommendations: Based on the findings of this study possible recommendations were forwarded: develop and extend MDR-TB disease awareness creation through by media (printing and electronic), school net TB clubs, and door to door community education. Strengthen psychological wellbeing and social relationship of MDR-TB patients using proper and consistent psychosocial support and counseling. Responsible bodies like Ministry of Health (MOH) and its stakeholders and Non Governmental Organizations (NGOs) need to assess the challenges of patients and take measures on this pressing issue.

Keywords: psychosocial challenges, counseling, multi-drug resistant tuberculosis (MDR-TB), tuberculosis therapy

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Authors: Vu Hoang Thu Huong

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Background: Surface electrical stimulation (SES) is a popular non-invasive approach that offers a wide range of treatments for many diseases of physical therapy. It involves applying electrical stimulation to the skin via surface electrodes to stimulate nerve fibers. SES was regularly used to treat the back and upper or lower extremities, but it was rarely used to treat the chest and abdomen. SES on the thorax and abdomen should be administered with more attention because crucial organs are under those areas (i.e., heart, lungs, liver, etc.). In these areas, safety precautions are suggested, and some SES applications might even be a contraindication. The fact that physical therapists have less experience with SES in these situations can also be attributed to these. Although a few earlier studies applied it to these settings and discovered hopeful results, none of them highlight the relationship between the intensity of SES and its depth of impact for safety considerations. Objective: To assure feasibility when using SES in these areas, the purpose of this study is to summarize the common location and intensity of those areas that have been conducted in previous studies. Method: A thorough systematic review was conducted to determine the common surface electrode position for the thorax and abdomen areas. The studies with the randomized controlled design were systematically searched using inclusion and exclusion criteria through nine electronic databases, including Pubmed, Scopus, etc., between 1975 and Dec 2021. Results: Thirty-three studies with over 1800 participants and 4 types of SES (TENS, IFC, NMES, and FES) with various categories of department hospitals were found. Following an anterior, lateral, and posterior observation, the particular SES positions found that it concentrated on 6 regions (the thoracic, abdomen, upper lateral, lower lateral, upper back, and lower back regions), and its intensity for each region was also summarized. Conclusion: This systematic review figured out the popular locations of SES in the thorax and abdominal areas as well as a summarized maximum of intensity that was found in previous studies with outstanding outcomes.

Keywords: surface electrical stimulation, electrical stimulation, thoracic, abdomen, abdominal.

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Authors: Houssam Hijazi, Laurent Cantrel, Jean-François Paul

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Periodic DFT calculations were performed to study the chemistry of CsI particles and the possible release of volatile iodine from CsI surfaces for nuclear safety interest. The results show that water adsorbs at low temperature associatively on the (011) surface of CsI, while water desorbs at higher temperatures. On the other hand, removing iodine species from the surface requires oxidizing the surface one time for each removed iodide atom. The activation energy of removing I₂ from the surface in the presence of two OH is 1,2 eV.

Keywords: aerosols, CSI, reactivity, DFT, water adsorption

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Authors: Constance Singo, Choja Oduaran

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Child mental disorders are strongly associated with different forms of challenges, including behavioural problems. The burden of care for children with a mental disorder is high and put primary caregivers, parents in particular, at risk of poor mental wellbeing. Understanding the experience of parents of children with mental disorders is crucial to developing a relevant intervention to assist them to attain optimal mental wellbeing. The aim of this study was to explore the experiences of parents of children with conduct disorder by focussing on the psychological and social stress experience of the parents in raising and caring for their children with conduct disorder. A qualitative research approach, using in-depth interview was utilized in this study. Purposive and snowballing sampling techniques were used to select 9 parents of children with conduct disorder in Thulamela Municipality, Limpopo Province of South Africa. Participants comprising of 2 males and 7 females aged between 30 years and 49 years were interviewed individually at scheduled appointment in-home setting. Interviews were conducted in both English and Setswana language. Data collected in Setswana language were translated to English by 'expert in language translation'. Ethical approval was obtained from appropriate authority before data collection. Thematic analysis was conducted to analyse the collected data. The findings identified anger, fear, depressive symptoms, denial, and suicidal ideation as predominant psychological experiences of the parents. Furthermore, deteriorated interpersonal relationships with family and community members, financial stress, and stigma emerged as social problems being the experience of the parents. It was concluded that parents of children with conduct disorder are highly traumatized by the challenges of caring for their children. We recommend professional engagement in terms of counselling service to support the parents. There is also a need for massive enlightenment programmes for members of the community in order to support the parents of children with child mental disorders.

Keywords: conduct disorder, parents, psychosocial experiences, South Africa

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Authors: Ahn Christine Myunghee, Sim Wonjin, Cho Kristina, Ahn Mira, Hong Yeju, Kwok Jihae, Lim Sooyeon, Park Hansol

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With a sharp increase in the prevalence rate for mental health issues in Korea, there is a need for specific and effective intervention strategies in counseling and psychotherapy for use with Korean clients. With the cultural emphasis on restraining emotional expression and not disclosing personal and familial problems to outsiders, clients often find it difficult to discuss their emotional issues even to therapists. Exploring a client’s internal psychological processes bypassing this culture-specific mode of therapeutic communication often becomes a challenge in the therapeutic setting. Given this socio-cultural context, the purpose of the current study was to investigate the effectiveness of using dream work to individuals in Korea. The current study conducted one 60-90 minute dream session and analyzed the dream content of 39 Korean young adults to evaluate the effectiveness of the Hill dream model in accessing the intra-psychic materials, determining essential emotional themes, and learning how the individuals interpreted the contents of their dreams. The transcribed data, which included a total of 39 sessions from 39 volunteer university students, were analyzed by the Consensus Qualitative Research (CQR) approach in terms of domains and core ideas. Self-report measures on Dream Salience, Gains from Dream Interpretations and the Session Evaluation Scale were administered before and after each of their dream sessions. The results indicated that dream work appears to be an effective way to understand unconscious motivations, thoughts, and feelings related to a person’s sense of self, and also how these people relate to other people. Current findings need to be replicated with clients referred for counseling and psychotherapy to determine if the dream work is an appropriate and useful intervention in counseling settings. Limitations of the current study and suggestions for future follow-ups are included in the discussion.

Keywords: dream work, dream interpretation, Korean, young adults, CQR

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Authors: Olga Kruzhkova, Irina Vorobyeva, Roman Porozov

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Vandalism is a common phenomenon, but its definition is still not clearly defined. In the public sense, vandalism is the blatant cases of pogroms in cemeteries, destruction of public places (regardless of whether these actions are authorized), damage to significant objects of culture and history (monuments, religious buildings). From a legal point of view, only such an act can be called vandalism, which is aimed at 'desecrating buildings or other structures, damaging property on public transport or in other public places'. The key here is the notion of public property that is being damaged. In addition, the principal is the semantics of messages, expressed in a kind of sign system (drawing, inscription, symbol), which initially threatens public order, the calmness of citizens, public morality. Because of this, the legal qualification of vandalism doesn’t include a sufficiently wide layer of environmental destructions that are common in modern urban space (graffiti and other damage to private property, broken shop windows, damage to entrances and elevator cabins), which in ordinary consciousness are seen as obvious facts of vandalism. At the same time, the understanding of vandalism from the position of psychology implies an appeal to the question of the limits of the activity of the subject of vandalism and his motivational basis. Also recently, the discourse on the positive meaning of some forms of vandalism (graffiti, street-art, etc.) has been activated. But there is no discussion of the role and significance of vandalism in public and individual life, although, like any socio-cultural and socio-psychological phenomenon, vandalism is not groundless and meaningless. Our aim of the study was to identify and describe the functions of vandalism as a socio-cultural and socio-psychological phenomenon of the life of the urban community, as well as personal determinants of its manifestations. The study was conducted in the spatial environment of the Russian megalopolis (Ekaterinburg) by photographing visual results of vandal acts (6217 photos) with subsequent trace-assessment and image content analysis, as well as diagnostics of personal characteristics and motivational basis of vandal activity of possible subjects of vandalism among youth. The results of the study allowed to identify the functions of vandalism at the socio-environmental and individual-subjective levels. The socio-environmental functions of vandalism include the signaling function, the function of preparing of social changes, the constructing function, and the function of managing public moods. The demonstrative-protest function, the response function, the refund function, and the self-expression function are assigned to the individual-subjective functions of vandalism. A two-dimensional model of vandal functions has been formed, where functions are distributed in the spaces 'construction reconstruction', 'emotional regulation/moral regulation'. It is noted that any function of vandal activity at the individual level becomes a kind of marker of 'points of tension' at the social and environmental level. Acknowledgment: The research was supported financially by Russian Science Foundation, (Project No. 17-18-01278).

Keywords: destruction, urban environment, vandal behavior, vandalism, vandalism functions

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Authors: Antanas Žiliukas, Mindaugas Kukis

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The work deals with cellular pressure vessels subjected to internal pressure. Their cellular insert can be used for placing liquids or gases, which is necessary to carry out technological processes, and the vessel itself has a good bearing capacity. Numerical calculations of the three core structures, which measure the influence of the inner cylinder thickness on maximum bearing capacity are presented. The calculations are compared using strength criteria and they show the different strength safety level.

Keywords: pressure, strength criterion, sandwich plate, cellular vessel

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Authors: Matthew Pleshaw, Caroline Lynch, Caleb Eaton, Ali Kiapour

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The problem addressed in this proposal is that of the lacking comfort and safety of inpatient rooms, specifically at Boston Children’s Hospital, with the implementation of a system that will allow inpatient children to feel more comfortable in the unfamiliar environment of a hospital. The focus is that of advancing and enhancing the healing process for children in a long-term inpatient stay at the hospital, though a combination of announcing a clinician or hospital staff’s arrival utilizing RFID (Fig. 1), and improving communication between clinicians, parents/guardians, patients, etc. by integrating a mobile application.

Keywords: Pediatrics, Hospital, RFID, Technology

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Authors: Debabrata Biswas

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The current trend in the development of antibiotic resistance by multiple bacterial pathogens has resulted in a troubling loss of effective antibiotic options for human. The emergence of multi-drug-resistant pathogens has necessitated higher dosages and combinations of multiple antibiotics, further exacerbating the problem of antibiotic resistance. Zoonotic bacterial pathogens, such as Salmonella, Campylobacter, Shiga toxin-producing Escherichia coli (such as enterohaemorrhagic E. coli or EHEC), and Listeria are the most common and predominant foodborne enteric infectious agents. It was observed that these pathogens gained/developed their ability to survive in the presence of antibiotics either in farm animal gut or farm environment and researchers believe that therapeutic and sub-therapeutic antibiotic use in farm animal production might play an important role in it. The mechanism of action of antimicrobial components used in farm animal production in genomic interplay in the gut and farm environment, has not been fully characterized. Even the risk of promoting the exchange of mobile genetic elements between microbes specifically pathogens needs to be evaluated in depth, to ensure sustainable farm animal production, safety of our food and to mitigate/limit the enteric infection with multiple antibiotic resistant bacterial pathogens. Due to the consumer’s demand and considering the current emerging situation, many countries are in process to withdraw antibiotic use in farm animal production. Before withdrawing use of the sub-therapeutic antibiotic or restricting the use of therapeutic antibiotics in farm animal production, it is essential to find alternative natural antimicrobials for promoting the growth of farm animal and/or treating animal diseases. Further, it is also necessary to consider whether that compound(s) has the potential to trigger the acquisition or loss of genetic materials in zoonotic and any other bacterial pathogens. Development of alternative therapeutic and sub-therapeutic antimicrobials for farm animal production and food processing and preservation and their effective implementation for sustainable strategies for farm animal production as well as the possible risk for horizontal gene transfer in major enteric pathogens will be focus in the study.

Keywords: food safety, natural antimicrobial, sustainable farming, antibiotic resistance

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Authors: Taha Benarbia

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The advent of automated and connected vehicles has revolutionized the transportation industry, presenting new opportunities for enhancing the efficiency, safety, and sustainability of our transportation networks. This paper explores the integration of automated and connected vehicles into a smart transportation framework, leveraging the power of deep learning techniques to optimize the overall network performance. The first aspect addressed in this paper is the deployment of automated vehicles (AVs) within the transportation system. AVs offer numerous advantages, such as reduced congestion, improved fuel efficiency, and increased safety through advanced sensing and decisionmaking capabilities. The paper delves into the technical aspects of AVs, including their perception, planning, and control systems, highlighting the role of deep learning algorithms in enabling intelligent and reliable AV operations. Furthermore, the paper investigates the potential of connected vehicles (CVs) in creating a seamless communication network between vehicles, infrastructure, and traffic management systems. By harnessing real-time data exchange, CVs enable proactive traffic management, adaptive signal control, and effective route planning. Deep learning techniques play a pivotal role in extracting meaningful insights from the vast amount of data generated by CVs, empowering transportation authorities to make informed decisions for optimizing network performance. The integration of deep learning with automated and connected vehicles paves the way for advanced transportation network optimization. Deep learning algorithms can analyze complex transportation data, including traffic patterns, demand forecasting, and dynamic congestion scenarios, to optimize routing, reduce travel times, and enhance overall system efficiency. The paper presents case studies and simulations demonstrating the effectiveness of deep learning-based approaches in achieving significant improvements in network performance metrics

Keywords: automated vehicles, connected vehicles, deep learning, smart transportation network

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Authors: Annunziata Albano

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Intimate Partner Violence (IPV) and Non-Partner Sexual Violence (NPSV) are still the most common forms of interpersonal violence against women today, and numerous studies have shown how they can affect women's physical and psychological well-being, frequently leading to depression, posttraumatic stress disorder (PTSD), and substance abuse. The primary goal of Italian Anti-Violence Centres (AVCs) is to provide an appropriate context for women to embark on a personalised path out of violence by providing various services such as listening groups, psychological and legal support, housing support in collaboration with shelters, work orientation, and specific support in the case of minor children. However, their physical environment is frequently overlooked, partly because these centres are typically established in pre-existing buildings and have a limited budget. Several studies on healthcare design and mental health, on the other hand, emphasise the potential of the built environment to facilitate healing by providing a restorative setting that aids in coping with stress and traumatic experiences, investigating the positive role of natural features and sensorial qualities such as light, colours, sound, and smell. This research aims to collect and summarise the key evidence-based principles derived from a multidisciplinary literature review about interior design elements that can help women recover after their traumatic experience. Furthermore, the study examines multiple case studies of Italian AVCs through the lens of previously determined principles, to understand how and whether these guidelines have been applied and which outcomes can provide relevant insights for design practice, with an emphasis on sensory qualities, usually overlooked in favour of other requirements. The outlined guidelines may serve as a framework for various typologies of services provided to women who are the victims of interpersonal violence, such as women's crisis centres and shelters.

Keywords: anti-violence centres, environmental psychology, interior design, interpersonal violence, restorative environments

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Authors: Genziana Lay

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A wide majority of older children and adolescents who enter the juvenile court system present with an array of problematic symptoms and behaviors including anxiety, depression, aggressive acting out, detachment, and substance abuse. Attachment theory offers a framework for understanding normative and pathological functioning, which during development is influenced by emotional, social and cognitive elements. There is clear evidence that children and adolescents with the highest risk of developing adaptation problems present an insecure attachment profile. Most offending minors have experienced dysfunctional family relationships as well as social and/or economic deprivation. Their maladaptive attachment develops not only through their relationship with caregivers but with the environment at large. Activation of their faulty attachment system leads them to feel emotionally overwhelmed and engage in destructive behaviors and decision-making. A psycho-social intervention with this population conceptualized as attachment therapy is a multi-faceted, practical approach that has shown excellent results in terms of increased psychological well-being and drastically reduced rates of re-offense/ destructive behavior. Through several; components including psychotherapy, monitoring, volunteering, meditation and socialization, the program focuses on seven dimensions: self-efficacy, responsibility, empathy/reparation, autonomy/security, containment/structure, insight building, and relational health. This paper presents the program and illustrates how the framework of attachment theory practically applied to psycho-social intervention has great therapeutic and social reparation potential. Preliminary evidence drawn from the Sassari Juvenile Court is very promising; this paper will illustrate these results and propose an even more comprehensive, applicable approach to psycho-social reparative intervention that leads to greater psychological health and reduced recidivism in the child and adolescent population.

Keywords: attachment, child, adolescent, crime, juvenile, psychosocial

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Authors: Nasrin Akter, Bilkis Banu, Farhana Faruque, Fatema Afrin, Sujana Haque Chowdhury, Sarder Mahmud Hossain

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Objectives: To combat the growing prevalence of hypertension in Bangladesh, it is pivotal to have an in-depth understanding of quality of life (QOL) among hypertensive people. The aim of this study was to measure QOL of hypertensive people and its determinants in a selected tertiary hospital in Dhaka city. Design & Methods: This analytical cross-sectional study was conducted among randomly selected 300 hypertensive patients from two cardiac departments of Square Hospitals Limited. Data were collected through the face-to-face interview method. WHOQOL-BREF questionnaire was used to assess the QOL. Mean scores of quality of life were analyzed through descriptive statistics. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement among different domains of WHOQOL-BREF, respectively. Chi-square test followed by binary regression analyses were used to measure the association between QOL domains and independent variables. Results: Both overall QOL and domains had a good internal consistency, (r = 0.13–0.77, p< 0.01). The QOL among hypertensive patients was found to be poor in the psychological (71%) and social (74.7%) domains and good in the environmental (63%) and physical (65%) domains. Backward binary regressions revealed that being older (p=0.01), diabetic (p=0.02), having history of COVID-19 (p=0.01), and poor monthly income (USD ≤853.14) (p=0.01) were significantly associated with poor QOL in all domain. Moreover, older age (p=0.01) and poor lifestyle (p=0.02) were significantly associated with poor overall quality of life and poor general health perception. Conclusion: The results revealed low QOL in the psychological and social domain including significant factors associated with the poor QOL in all domains. To enhance the quality of life for hypertensive patients—especially those who are older, diabetic, have lower incomes, experienced COVID-19, and maintain poor lifestyles—effective interventions and health system strengthening are crucial.

Keywords: quality of life, hypertension, WHOQOL-BREF, analytical cross-sectional study

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Authors: Emir Sunguroglu, Merve Sunguroglu, Yesim Aliefendioglu, Harun Tanrivermis

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Basic human needs range from physiological needs such as food, water and shelter to safety needs such as security, protection from natural disasters and even urban terrorism which are extant and not fulfilled even in urban areas where people live civilly in large communities. These basic needs when arose in urban life lead to a different kind of crime set defined as urban crimes. Urban crimes mostly result from differences between socioeconomic conditions in society. Income inequality increases tendency towards urban crimes. Especially in slum areas and suburbs, urban crimes not only threaten public security but they also affect deliverance of public services. It is highlighted that, construction of urban security against problems caused by urban crimes is not only achieved by involvement of urban security in security of the community but also comprises juridical development and staying above a level of legal standards concurrently. The idea of urban transformation emerged as interventions to demolishment and rebuilding of built environment to solve the unhealthy urban environment, inadequate infrastructure and socioeconomic problems came up during the industrialization process. Considering the probability of urbanization process driving citizens to commit crimes, The United Nations Commission on Human Security’s focus on this theme is conferred to be a proper approach. In this study, the analysis and change in security before, through and after urban transformation, which is one of the tools related to urbanization process, is strived to be discussed through the case of Sincan County Saraycik District. The study also aims to suggest improvements to current legislation on public safety, urban resilience, and urban transformation. In spite of Saraycik District residing in a developing County in Ankara, Turkey, from urbanization perspective as well as socioeconomic and demographic indicators the District exhibits a negative view throughout the County and the country. When related to the county, rates of intentional harm reports, burglary reports, the offense of libel and threat reports and narcotic crime reports are higher. The District is defined as ‘crime hotspot’. Interviews with residents of Saraycik claim that the greatest issue of the neighborhood is Public Order and Security (82.44 %). The District becomes prominent with negative aspects, especially with the presence of unlicensed constructions, occurrence of important social issues such as crime and insecurity and complicated lives of inhabitants from poverty and low standard conditions of living. Additionally, the social structure and demographic properties and crime and insecurity of the field have been addressed in this study. Consequently, it is claimed that urban crime rates were related to level of education, employment and household income, poverty trap, physical condition of housing and structuration, accessibility of public services, security, migration, safety in terms of disasters and emphasized that urban transformation is one of the most important tools in order to provide urban security.

Keywords: urban security, urban crimes, urban transformation, Saraycik district

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Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Civil war in Sri Lanka ended a decade ago, leaving thousands of army veterans permanently disabled following lower-limb amputations. Quantifying long-term functional health and psychological wellbeing will inform the development of tailored home-based rehabilitation intervention. Objectives: To assess the long-term health and quality of life of Sri Lankan soldiers with traumatic lower-limb amputation.Methods and Materials: A comparative cross-sectional study was conducted in five districts of Sri Lanka. Using stratified random sample technique, two groups of 85 participants were selected; group 1, community re-integrated male army veterans with unilateral lower-limb amputation, and group 2, age and sex matched normal healthy individuals. Long-term health and quality of life (QoL) outcomes were assessed and compared between the two groups using self-administered Short-Form Health Survey-36 questionnaire (SF-36) previously validated for use in Sri Lanka. Results: Group 1 were active prosthetic users who had undergone amputation > ten years ago (Mean±SD: 21.7±5.9). The most prevalent comorbidities for group 1 and 2 were hypertension and diabetes (22.4% and 30.6% and 9.4% and 9.8%, respectively). In group 1, injury-associated long-term health outcomes included knee osteoarthritis (18.8%), knee pain (20.0%), and back pain (69.4%). Scores of physical health and psychological wellbeing were 53.1 (IQR 64.4- 43.8) and 63.5 (IQR 73.3- 51.4) for each group, respectively. Scores revealed the highest QoL related to social functioning (75 (IQR 87.5- 62.5)) and the poorest aspects of QoL related to general health (40 (IQR 50- 35)). Prevalence of comorbidities was significantly higher, and QoL outcomes were significantly lower among soldiers compared to normal healthy individuals (p<0.05).Conclusion: Higher prevalence of comorbidities, poor physical health, and lower QoL outcomes were more prevalent in soldiers with lower-limb amputation when compared to healthy counterparts.

Keywords: community-based, disability, health outcomes, quality of life, soldiers

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Authors: Chueh Chang, Chia-jung Hsieh, Fu-yu Yu, Yu-Hwa Lin

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Background:The majority of women diagnosed with breast cancer undergo treatment involving surgery and radiotherapy or chemotherapy, or both. With these major advances in breast cancer management, many patients still have to deal with short or long-term side effects and psychological distress related to the disease and treatment, which have a substantial impact on their quality of life. The Laughing Qigong Program (LQP) is an interactive laughter program that combines the physical and physiological benefits of laughter with the mental benefits of Chinese qigong. Purpose: In order to improve the quality of life for breast cancer women in the community as well as echoing the WHO 2004 “Promoting Mental Health” for every one. This study focused on how to promote the positive mental health for women of breast cancer through the “laughter program” in Taiwan. During the presentation, how to practice Laughing Qigong will be demonstrated. Method: Using nonequivalent pretest-posttest design, ix-one breast cancer patients were volunteered to enroll in this study from the Taiwan Breast Cancer Alliance (TBCA). Thirty patients were assigned to the experimental group and the other 31 patients were assigned to the control group. The women who were assigned to the experimental group received laughter program one hour per session, once a week, totally 12 sessions. All subjects were tested before and after the intervention on the following: Self-Esteem scale (RSE), Face Scale (FS), Anxiety and pain experience were measured as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR),and heart rate variability (HRV) as physiological markers of the body’s response to stress. Results: After comparing the experimental and control groups, the results revealed that those breast cancer women with “laughing program” their sense of humor were improved, less uncomfortable on self report physical conditions, more positive attitudes toward stress management by using laughter, and had emotional improvement according to the face scale.

Keywords: mental health promotion, breast cancer, laughing Qigong, women

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Authors: Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshenas, Fatemeh Rezaei

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Surgical procedures aim at preserving human life and improving quality of their life. However, there are many potential risk sources that can cause serious harm to patients. For centuries, managers believed that technical competence of a surgeon is the only key to a successful surgery. But over the past decade, risks are considered in terms of process-based safety procedures, teamwork and inter departmental communication. Aims: This study aims to determine how the process- biased surgical risk management should be done in terms of project management tool named ABS (Activity Breakdown Structure). Settings and Design: This study was conducted in two stages. First, literature review and meeting with professors was done to determine principles and framework of surgical risk management. Next, responsible teams for surgical patient journey were involved in following meeting to develop the process- biased surgical risk management. Methods and Material: This study is a qualitative research in which focus groups with the inductive approach is used. Sampling was performed to achieve representativeness through intensity sampling biased on experience and seniority. Analysis Method used: context analysis of interviews and consensus themes extracted from FDG meetings discussion was the analysis tool. Results: we developed the patient journey process in 5 main phases, 24 activities and 108 tasks. Then, responsible teams, transposition and allocated places for performing determined. Some activities and tasks themes were repeated in each phases like patient identification and records review because of their importance. Conclusions: Risk management of surgical departments is significant as this facility is the hospital’s largest cost and revenue center. Good communication between surgical team and other clinical teams outside surgery department through process- biased perspective could improve safety of patient under this procedure.

Keywords: risk management, activity breakdown structure (ABS), surgical department, medical sciences

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Authors: M. Brockes, S. Beck, A. Sigaroudi, C. Brockes

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Over the last few years, telemedicine and telemonitoring have become popular ways of treatment, especially in other chronic diseases. Therefore, this type of treatment methodology was also implemented in patients with interstitial lung disease (ILD). In January 2024, a new service for patients with interstitial lung disease (ILD) treated with Nintedanib was established, which contains daily telemonitoring (home spirometry, pulse oximetry, and daily level of activity), daily evaluation of parameters as well as a telemedical availability answered by doctors and telemedical specialists throughout 365 days per year. The main motivational points of this service are the early detection of first signs of exacerbations and/or other symptoms/complications, as well as easier access to healthcare professionals. The evaluation of the patient’s quality of life and the subjective feeling of safetyness was measured through patient-reported experience measurements (PREMs) and patient-reported outcome measurements (PROMs). Patients were introduced to the telemedical and telemonitoring service six months ago. Within this period, every sixty days, the questionnaires were conducted by the scientific employees. Due to the unlimited time frame of the long-term service, the evaluation has not been completed. The first analysis of patient-reported experience measurements (PREMs) and patient reported outcome measurements (PROMs) had shown an increased positive effect on the patients' quality of life as well as an increased positive effect on the subjective feeling of safety at home, plus a reduction and avoidance of secondary damages (e.g., exacerbations, deterioration of typical interstitial lung disease ILD symptoms and pharmaceutical side effects). The first results have shown a tendency that the telemedical treatment combined with telemonitoring at home and the encouragement of patients to actively participate in their healthcare has a positive effect on the patient’s overall well-being and could be implemented as a complementation of the traditional standard of care.

Keywords: avoidance of secondary damages, interstitial lung disease, telemedicine and telemonitoring, subjective feeling of safety

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Authors: Allison Streutker, Josephine Tan

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Universities across Canada have experienced unprecedented growth in international student enrollment from across the world. As cultural diversity in Canada and other countries increases, understanding the social support needs of all students is important for providing them with the assistance they need to thrive psychologically and academically. Those from individualistic cultural orientations tend to seek explicit social support, which involves expressly asking for assistance in times of stress. However, those from collectivistic cultural orientations are more likely to seek implicit social support, where encouragement is obtained from spending time among valued social groups without explicitly talking about problems. This study explored whether the relationship between the type of social support needs (implicit or explicit) and psychological and academic functioning might be moderated by cultural orientations (individualistic, collectivistic) among university students. Participants were 110 university students (70 women, 40 men; mean age = 24.8 years, SD = 6.6). They completed the Individualism and Collectivism Scale (ICS), Perceived Stress Scale (PSS), Interpersonal Support Evaluation List (ISEL) which assesses implicit and explicit social support, Satisfaction with Life Scale (SWLS), Scale of Positive and Negative Experience (SPANE) which yields positive and negative experience scores, Flourishing Scale (FS), and reported their grade point average (GPA) as a measure of academic performance. Moderated regression analysis demonstrated that, for those scoring lower on individualism, reporting lower level of implicit support predicted higher levels of perceived stress. For those scoring higher on individualism, lower levels of explicit social support predicted higher levels of perceived stress and a greater number of negative experiences. Generally, higher levels of implicit support were associated with greater satisfaction with life for all students, with the association becoming stronger among students with higher collectivism scores. No other significant findings were found. The results point to the value of considering the cultural orientations of students when designing programs to maintain and improve their sense of well-being.

Keywords: cultural orientation, social support, university students, well-being

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Authors: R. Premasiri, W. A. H. A. Abeygunasekara, S. M. Hewavidana, T. Jananthan, R. M. S. Madawala, K. Vaheeshan

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Forecasting the potential for disastrous events such as landslides has become one of the major necessities in the current world. Most of all, the landslides occurred in Sri Lanka are found to be triggered mostly by intense rainfall events. The study area is the landslide near Gerandiella waterfall which is located by the 41st kilometer post on Nuwara Eliya-Gampala main road in Kotmale Division in Sri Lanka. The landslide endangers the entire Kotmale town beneath the slope. Geographic Information System (GIS) platform is very much useful when it comes to the need of emulating the real-world processes. The models are used in a wide array of applications ranging from simple evaluations to the levels of forecast future events. This project investigates the possibility of developing a dynamic model to map the spatial distribution of the slope stability. The model incorporates several theoretical models including the infinite slope model, Green Ampt infiltration model and Perched ground water flow model. A series of rainfall values can be fed to the model as the main input to simulate the dynamics of slope stability. Hydrological model developed using GIS is used to quantify the perched water table height, which is one of the most critical parameters affecting the slope stability. Infinite slope stability model is used to quantify the degree of slope stability in terms of factor of safety. DEM was built with the use of digitized contour data. Stratigraphy was modeled in Surfer using borehole data and resistivity images. Data available from rainfall gauges and piezometers were used in calibrating the model. During the calibration, the parameters were adjusted until a good fit between the simulated ground water levels and the piezometer readings was obtained. This model equipped with the predicted rainfall values can be used to forecast of the slope dynamics of the area of interest. Therefore it can be investigated the slope stability of rainfall induced landslides by adjusting temporal dimensions.

Keywords: factor of safety, geographic information system, hydrological model, slope stability

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Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

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