Search results for: life cycle GHG

Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

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Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

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Authors: David Quevedo, Diana Coronel

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The present article carries out an evaluation of the drinking water system in the Bellavista sector of the city of Azogues, with the purpose of determining the appropriate equipment to record the actual consumption flows of the inhabitants in said sector. Taking into account that the study area is located in a rural and economically disadvantaged area, there is an urgent need to establish a control system for the consumption of drinking water in order to conserve and manage the vital resource in the best possible way, considering that the water source supplying this sector is approximately 9km away. The research began with the collection of cartographic, demographic, and statistical data of the sector, determining the coverage area, population projection, and a provision that guarantees the supply of drinking water to meet the water needs of the sector's inhabitants. By using hydraulic modeling through the United States Environmental Protection Agency Application for Modeling Drinking Water Distribution Systems EPANET 2.0 software, theoretical hydraulic data were obtained, which were used to design and justify the most suitable measuring equipment for the Bellavista drinking water system. Taking into account a minimum service life of the drinking water system of 30 years, future flow rates were calculated for the design of the macro-measuring device. After analyzing the network, it was evident that the Bellavista sector has an average consumption of 102.87 liters per person per day, but considering that Ecuadorian regulations recommend a provision of 180 liters per person per day for the geographical conditions of the sector, this value was used for the analysis. With all the collected and calculated information, the conclusion was reached that the Bellavista drinking water system needs to have a 125mm electromagnetic macro-measuring device for the first three quinquenniums of its service life and a 150mm diameter device for the following three quinquenniums. The importance of having equipment that provides real and reliable data will allow for the control of water consumption by the population of the sector, measured through micro-measuring devices installed at the entrance of each household, which should match the readings of the macro-measuring device placed after the water storage tank outlet, in order to control losses that may occur due to leaks in the drinking water system or illegal connections.

Keywords: macrometer, hydraulics, endowment, water

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Authors: Akriti Kafle Baral, Ruixing Zhang, Dzifa K Lalit, Manthar M Alli

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Introduction: Hemodialysis is the most common type of dialysis globally approximately million are reported to receive this type of dialysis. Psychosocial issues in hemodialysis are the psychological and socioeconomic burdens emanating from the initiation and course of treatment and have the potential for gross deterioration in the quality of life and general well-being of patients. Understanding the psychosocial issues and needs of patients undergoing hemodialysis could pave the way for comprehensive support and therapies designed to reduce stress, improve social support, and foster mental resilience. Objectives: The aim of this study was to explore the psychosocial issues and support needs of patients undergoing hemodialysis at a tertiary care center in Nepal. Methods: A qualitative descriptive study was conducted among 20 purposefully selected patients attending hemodialysis treatment at Pokhara Academy of Health Sciences, Nepal. Data was analyzed via thematic analysis. Results: The study resulted in three major themes which included Emotional, psychological, and spiritual struggles, Social and economic impacts, and Support and information needs. Moreover, 16 sub-themes emerged which are Frustration with daily life, Constant fear of death, Thoughts of self-harm, Perceived Burden on Family, Sense of Divine Punishment, Sense of Unfairness, Fear about future uncertainties, Social avoidance, Social stigmatization, Loss of employment, Financial strain, Transportation challenges, Need for early, clear and comprehensive information, Need for support and reassurance from family, Support through peer connections, and Reassurance from healthcare providers. Conclusion: The findings of this study indicate that patients undergoing hemodialysis in Nepal experience numerous hardships and multifaceted struggles that require support from different dimensions. Establishing robust support systems that include family involvement, peer networks, and effective communication from healthcare professionals can significantly mitigate feelings of anxiety and isolation.

Keywords: hemodialysis, psychosocial issues, support needs, chronic kidney disease, end stage renal disease, Nepal

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Authors: Gamze Ozel, Selen Cakmakyapan

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We introduce a new model called the Marshall-Olkin Rayleigh distribution which extends the Rayleigh distribution using Marshall-Olkin transformation and has increasing and decreasing shapes for the hazard rate function. Various structural properties of the new distribution are derived including explicit expressions for the moments, generating and quantile function, some entropy measures, and order statistics are presented. The model parameters are estimated by the method of maximum likelihood and the observed information matrix is determined. The potentiality of the new model is illustrated by means of real life data set.

Keywords: Marshall-Olkin distribution, Rayleigh distribution, estimation, maximum likelihood

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Authors: Haruka Ito, Toru Maruyama, Michihiro Ito, Chuya Shinzato, Hiroyuki Fujimura, Yoshikatsu Nakano, Shoichiro Suda, Sachiyo Aburatani, Haruko Takeyama

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Clarifying symbiotic relationships is one of the most important theme for understanding the marine eco-system. Coral reef has been regarded as an important environmental resource. Coral holobiont composed by coral, symbiotic microalgae zooxanthellae, and bacteria have complexed relationship. Zooxanthellae mainly supply organic matter to the host corals through their photosynthetic activity. The symbiotic relationship is indispensable for corals but may easily collapses due to the rise of seawater temperature. However, the molecular mechanism how seawater temperature influences their relationships still remain unclear. In this study, the transcriptomic analysis has applied to elucidate the coral-zooxanthellae relationships under high seawater temperature stress. To observe reactions of corals and zooxanthellae against the rise of seawater temperature, meta-gene expression in coral have been analyzed. The branches from six different colonies of a stony coral, Acropora tenuis, were sampled at nine times by 2016 at two locations, Ishikawabaru and South of Sesoko Island, Okinawa, Japan. The mRNAs extracted from the branches including zooxanthellae were sequenced by illumina HiSeq. Gene Set Enrichment Analysis (GSEA) based on hyper geometric distribution was performed. The seawater temperature at 2016 summer was unusually high, which was caused by El Niño event, and the number of zooxanthellae in coral was decreased in August. GSEA derived the several specific genes expressed in A. tenuis under heat stress conditions. The upregulated genes under heat stress highly related with infection immunity. The downregulated genes significantly contained cell cycle related genes. Thu, it is considered that heat stress cause disorder in cell metabolism of A. tenuis, resulting in serious influence to coral holobiont.

Keywords: coral, symbiosis, thermal stress response, transcriptome analysis

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Authors: F. DelGaudio, H. Gill

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Resuscitation during cardiopulmonary (CPA) arrest is dynamic, high stress, high acuity situation, which can easily lead to communication breakdown, and errors. The care of these high acuity patients has also been shown to increase physiologic stress and task saturation of providers, which can negatively impact the care being provided. These difficulties are further complicated during a global pandemic and pose a significant safety risk to bedside providers. Nurse-led codes are a relatively new concept that may be a potential solution for alleviating some of these difficulties. An experienced nurse who has completed advanced cardiac life support (ACLS), and additional training, assumed the responsibility of directing the mechanics of the appropriate ACLS algorithm. This was done in conjunction with a physician who also acted as a physician leader. The additional nurse-led code training included a multi-disciplinary in situ simulation of a CPA on a suspected COVID-19 patient. During the CPA, the nurse leader’s responsibilities include: ensuring adequate compression depth and rate, minimizing interruptions in chest compressions, the timing of rhythm/pulse checks, and appropriate medication administration. In addition, the nurse leader also functions as a last line safety check for appropriate personal protective equipment and limiting exposure of staff. The use of nurse-led codes for CPA has shown to decrease the cognitive overload and task saturation for the physician, as well as limiting the number of staff being exposed to a potentially infectious patient. The real-world application has allowed physicians to perform and oversee high-risk procedures such as intubation, line placement, and point of care ultrasound, without sacrificing the integrity of the resuscitation. Nurse-led codes have also given the physician the bandwidth to review pertinent medical history, advanced directives, determine reversible causes, and have the end of life conversations with family. While there is a paucity of research on the effectiveness of nurse-led codes, there are many potentially significant benefits. In addition to its value during a pandemic, it may also be beneficial during complex circumstances such as extracorporeal cardiopulmonary resuscitation.

Keywords: cardiopulmonary arrest, COVID-19, nurse-led code, task saturation

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Authors: Erdal Eroğlu, Özhan Çetinkaya

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The purpose of this paper is to show how state plays a regulatory role in the relations of distribution by analyzing tax and expenditure in Turkey. This paper has two main arguments. First, state intervenes in economic and social life via budget policies and steers the relations of distribution within the scope of the reproduction of the capital accumulation and legitimacy. Secondly, a great amount of public expenditure benefits capital owners while state gains its tax income mainly from low and middle income groups.

Keywords: distribution, public expenditure, state budget, taxes

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Authors: Vinti Davar

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Introduction: Childhood overweight increases the risk for certain medical and psychological conditions. Millions of school-age children worldwide are affected by serious yet easily treatable and preventable illnesses that inhibit their ability to learn. Healthier children stay in school longer, attend more regularly, learn more and become healthier and more productive adults. Schools are an important setting for nutrition education because one can reach most children, teachers and parents. These years offer a key window for shaping their lifetime habits, which have an impact on their health throughout life. Against this background, an attempt was made to impart nutrition education to school children in Haryana state of India to promote healthy food choices and assess the effectiveness of this program. Methodology: This study was completed in two phases. During the first phase, pre-intervention anthropometric and dietary survey was conducted; the teaching materials for nutrition intervention program were developed and tested; and the questionnaire was validated. In the second phase, an intervention was implemented in two schools of Kurukshetra, Haryana for six months by personal visits once a week. A total of 350 children in the age group of 6-12 years were selected. Out of these, 279 children, 153 boys and 126 girls completed the study. The subjects were divided into four groups namely: underweight, normal, overweight and obese based on body mass index-for-age categories. A power point colorful presentation to improve the quality of tiffin, snacks and meals emphasizing inclusion of all food groups especially vegetables every day and fruits at least 3-4 days per week was used. An extra 20 minutes of aerobic exercise daily was likewise organized and a healthy school environment created. Provision of clean drinking water by school authorities was ensured. Selling of soft drinks and energy-dense snacks in the school canteen as well as advertisements about soft drink and snacks on the school walls were banned. Post intervention, anthropometric indices and food selections were reassessed. Results: The results of this study reiterate the critical role of nutrition education and promotion in improving the healthier food choices by school children. It was observed that normal, overweight and obese children participating in nutrition education intervention program significantly (p≤0.05) increased their daily seasonal fruit and vegetable consumption. Fat and oil consumption was significantly reduced by overweight and obese subjects. Fast food intake was controlled by obese children. The nutrition knowledge of school children significantly improved (p≤0.05) from pre to post intervention. A highly significant increase (p≤0.00) was noted in the nutrition attitude score after intervention in all four groups. Conclusion: This study has shown that a well-planned nutrition education program could improve nutrition knowledge and promote positive changes in healthy food choices. A nutrition program inculcates wholesome eating and active life style habits in children and adolescents that could not only prevent them from chronic diseases and early death but also reduce healthcare cost and enhance the quality of life of citizens and thereby nations.

Keywords: children, eating habits healthy food, obesity, school going, fast foods

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Authors: Ruyang Ren, Yaohua Zhao, Yanhua Diao

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The intermittent and unstable characteristics of renewable energy such as solar energy can be effectively solved through battery energy storage system. Lithium-ion battery is widely used in battery energy storage system because of its advantages of high energy density, small internal resistance, low self-discharge rate, no memory effect and long service life. However, the performance and service life of lithium-ion battery is seriously affected by its operating temperature. Thus, the safety operation of the lithium-ion battery module is inseparable from an effective thermal management system (TMS). In this study, a new type of TMS based on micro heat pipe array (MHPA) for lithium-ion battery is established, and the TMS is applied to a battery energy storage box that needs to operate at a high temperature environment of 40 °C all year round. MHPA is a flat shape metal body with high thermal conductivity and excellent temperature uniformity. The battery energy storage box is composed of four battery modules, with a nominal voltage of 51.2 V, a nominal capacity of 400 Ah. Through the excellent heat transfer characteristics of the MHPA, the heat generated by the charge and discharge process can be quickly transferred out of the battery module. In addition, if only the MHPA cannot meet the heat dissipation requirements of the battery module, the TMS can automatically control the opening of the external fan outside the battery module according to the temperature of the battery, so as to further enhance the heat dissipation of the battery module. The thermal management performance of lithium-ion battery TMS based on MHPA is studied experimentally under different ambient temperatures and the condition to turn on the fan or not. Results show that when the ambient temperature is 40 °C and the fan is not turned on in the whole charge and discharge process, the maximum temperature of the battery in the energy storage box is 53.1 °C and the maximum temperature difference in the battery module is 2.4 °C. After the fan is turned on in the whole charge and discharge process, the maximum temperature is reduced to 50.1 °C, and the maximum temperature difference is reduced to 1.7 °C. Obviously, the lithium-ion battery TMS based on MHPA not only could control the maximum temperature of the battery below 55 °C, but also ensure the excellent temperature uniformity of the battery module. In conclusion, the lithium-ion battery TMS based on MHPA can ensure the safe and stable operation of the battery energy storage box in high temperature environment.

Keywords: heat dissipation, lithium-ion battery thermal management, micro heat pipe array, temperature uniformity

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Authors: Luqman Shah

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The myopic gender discrimination is now a well-documented and recognized fact. However, gender is only one facet of an individual’s multiple identities. The aim of this work is to investigate gender discrimination highlighted in print media in the subcontinent with a specific focus on Pakistan and India. In this study, an approach is adopted by using the James Paul Gee model for the identification of gender discrimination. As a matter of fact, gender discrimination is not consistent in its nature and intensity across global societies and varies as social, geographical, and cultural background change. The World has been changed enormously in every aspect of life, and there are also obvious changes towards gender discrimination, prejudices, and biases, but still, the world has a long way to go to recognize women as equal as men in every sphere of life. The history of the world is full of gender-based incidents and violence. Now the time came that this issue must be seriously addressed and to eradicate this evil, which will lead to harmonize society and consequently heading towards peace and prosperity. The study was carried out by a mixed model research method. The data was extracted from the contents of five Pakistani English newspapers out of a total of 23 daily English newspapers, and likewise, five Indian daily English newspapers out of 52 those were published 2018-2019. Two news stories from each of these newspapers, in total, twenty news stories were taken as sampling for this research. Content and semiotic analysis techniques were used to analyze through James Paul Gee's seven building tasks of language. The resources of renowned e-papers are utilized, and the highlighted cases in Pakistani newspapers of Indian gender-based stories and vice versa are scrutinized as per the requirement of this research paper. For analysis of the written stretches of discourse taken from e-papers and processing of data for the focused problem, James Paul Gee 'Seven Building Tasks of Language' is used. Tabulation of findings is carried to pinpoint the issue with certainty. Findings after processing the data showed that there is a gross human rights violation on the basis of gender discrimination. The print media needs a more realistic representation of what is what not what seems to be. The study recommends the equality and parity of genders.

Keywords: gender discrimination, print media, Paul Gee model, subcontinent

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Authors: N. Ismail, O. Thammajinda, U. Thongpanya

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Games-based learning (GBL) has become increasingly important in teaching and learning. This paper explains the first two phases (analysis and design) of a GBL development project, ending up with a prototype design based on students’ and teachers’ perceptions. The two phases are part of a full cycle GBL project aiming to help secondary school students in Thailand in their study of Comprehensive Sex Education (CSE). In the course of the study, we invited 1,152 students to complete questionnaires and interviewed 12 secondary school teachers in focus groups. This paper found that GBL can serve students in their learning about CSE, enabling them to gain understanding of their sexuality, develop skills, including critical thinking skills and interact with others (peers, teachers, etc.) in a safe environment. The objectives of this paper are to outline the development of GBL variables from the research question(s) into the developers’ flow chart, to be responsive to the GBL beneficiaries’ preferences and expectations, and to help in answering the research questions. This paper details the steps applied to generate GBL variables that can feed into a game flow chart to develop a GBL prototype. In our approach, we detailed two models: (1) Game Elements Model (GEM) and (2) Game Object Model (GOM). There are three outcomes of this research – first, to achieve the objectives and benefits of GBL in learning, game design has to start with the research question(s) and the challenges to be resolved as research outcomes. Second, aligning the educational aims with engaging GBL end users (students) within the data collection phase to inform the game prototype with the game variables is essential to address the answer/solution to the research question(s). Third, for efficient GBL to bridge the gap between pedagogy and technology and in order to answer the research questions via technology (i.e. GBL) and to minimise the isolation between the pedagogists “P” and technologist “T”, several meetings and discussions need to take place within the team.

Keywords: games-based learning, engagement, pedagogy, preferences, prototype

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Authors: P. Y. Chiang, Y. H. Chen, Y. J. Lin, C. C. Chang, W. C. Hsu

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The number of the elderly in the world population and the rate of falls in this increasing numbers of older people are increasing. Decreasing muscle strength and an increasing risk of falling are associated with the ageing process. Because the effects of seated stepping training on the walking performance in the elderly remain unclear, the main purpose of the proposed study is to perform electromyography analysis during walking and seated stepping in the elderly. Four surface EMG electrodes were sticked on the surface of lower limbs muscles, including vastus lateralis (VL), and gastrocnemius (GT) of both sides. Before test, maximal voluntary contraction (MVC) of the respective muscle was obtained using manual muscle testing. The analog raw data of EMG signals were digitized with a sampling frequency of 2000 Hz. The signals were fully rectified and the linear envelope were calculated. Stepping motion cycle was separated into two phases by stepping timing (ST) and pedal return timing (PRT). ST refer to the time when the pedal marker reached the highest height, representing the contra-lateral leg was going to release the pedal. PRT refer to the time when the pedal marker reached the lowest height, representing the contra-lateral leg was going to step the pedal. We assumed that ST acted the same role in initial contact during walking, and PRT for toe-off. The period from ST to next PRT was called pushing phase (PP), during which the leg would start to step with resistance, and we compare this phase with the stance phase in level walking. The period from PRT to next ST was called returning phase (RP), during which leg would not have any resistance in this phase, and we compare this phase with the swing phase in level walking. VL and Gastro muscular activation had similar patterns in both side. The ability may transfer to those needed during loading response, mid-stance and terminal swing phase. User needed to make more effort in stepping compared with walking with similar timing; thus the strengthening of the VL and Gastro may be helpful to improve the walking endurance and efficiency for the elderly.

Keywords: elderly, electromyography, seated stepping, walking

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Authors: Sikhumbuzo Zondi, Serges A. Kamga

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Human security and human rights are mutually reinforcing concepts given that human security addresses questions related to human conditions such as the safety of individuals and the protection of individual rights and civil liberties. It does this by suggesting that the proper referent for security should be the individual and not the nation-state, due to the individual’s vulnerability to threats such as malnutrition and poverty, conflicts, exploitation and marginalization, despotism and climate change. Due to the primacy of the individual, human security comfortably expand to the notion of social justice, given that for far too-long, many individuals around the world have been denied of their basic human rights through racial discrimination, unfair labour and segregation policies and as a result encountered widespread social, environmental and economic injustices which are evident in the current structural division of the world between the developed north and the underdeveloped or developing south. In light of this view, ensuring freedom from want and freedom from fear, for all individuals is arguably the sound route to addressing and remedying the global ills of our time and a way to promoting human rights for all. The promotion of human security provides an important part of human/societal progress because inclusive security facilitates development and human rights protection, while insecurity reduces people’s growth and investment prospects and prolongs historical injustices. Therefore, this paper seeks to show that human security and human rights complements one another and that this correlation provides the necessary mechanisms for addressing and remedying the historical injustices that still affect most of the world’s population. It will look at linkages between human security and the individual right to equality and freedom from discrimination, right to life, liberty, and personal security; development; own property; adequate living standard; education; desirable work and to join trade unions; participate in government and in free elections; social security and equality before the law. The paper considers these human rights and liberties as vital for securing the core values of human life while at the same addressing socio-economic injustices that still persist in the contemporary world. The paper will be a desktop study using qualitative research methods on two case studies in Africa namely Cameroun and South Africa.

Keywords: justice, human security, human rights, injustices

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Authors: Dong Xie, Jun Zhao, Yiming Weng

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One of the challenges in dental cement biomaterials is how to make a restorative with mechanical strengths and wear resistance that are comparable to contemporary dental resin composites. Currently none of the dental cement restoratives has been used in high stress-bearing sites due to their low mechanical strengths and poor wear-resistance. The objective of this study was to synthesize and characterize the poly(alkenoic acid)s with different molecular structures, use these polymers to formulate a dental cement restorative, and study the effect of molecular structures on reaction kinetics, viscosity, and mechanical strengths of the formed polymers and cement restoratives. In this study, poly(alkenoic acid)s with different molecular structures were synthesized. The purified polymers were formulated with commercial Fuji II LC glass fillers to form the experimental cement restoratives. The reaction kinetics was studied via 1HNMR spectroscopy. The formed restoratives were evaluated using compressive strength, diametral tensile strength, flexural strength, hardness and wear-resistance tests. Specimens were conditioned in distilled water at 37 oC for 24 h prior to testing. Fuji II LC restorative was used as control. The results show that the higher the arm number and initiator concentration, the faster the reaction was. It was also found that the higher the arm number and branching that the polymer had, the lower the viscosity of the polymer in water and the lower the mechanical strengths of the formed restorative. The experimental restoratives were 31-53% in compressive strength, 37-55% in compressive modulus, 80-126% in diametral tensile strength, 76-94% in flexural strength, 4-21% in fracture toughness and 53-96% in hardness higher than Fuji II LC. For wear test, the experimental restoratives were only 5.4-13% of abrasive and 6.4-12% of attritional wear depths of Fuji II LC in each wear cycle. The aging study also showed that all the experimental restoratives increased their strength continuously during 30 days, unlike Fuji II LC. It is concluded that polymer molecular structures have significant and positive impact on mechanical properties of dental cement restoratives.

Keywords: dental materials, polymers, strength, biomaterials

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Authors: Endalew Fufa Kufi

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Every married person aspires to be a parent regardless of the situation in which s/he lives. Such aspiration meets with reality when the destined parent is able to give adequate supports and services to his/her children, whether the latter are got by birth or through adoption. The adequacy of services parents provide their children is both enriched and tempted by the work on which they involve. On the one hand, parents need to work and earn a living in order to support their family. On the other hand, they must spend most of their time outside home to do the work, which shortens the time and might they spare to care for their children. Where the sufficiency of services parents owe their children could be ascertained by in terms of life skills, physical care and related provisions, the role of working fathers and mothers in providing such supports could be diverse across cultures and work traditions. Hence, this research deals with the investigation of working mothers’ parental practices, challenges they face in providing parental services and the implication for the future progress of the parents and their children. Target of the study will be Arsi University in Oromia Regional State of Ethiopia. Descriptive survey design in holding the research, and data for the research will be collected in the form of experiential self-report from 150 working mothers selected from the entire working women population of Colleges of Agriculture and Environmental Studies and College of Health Sciences through stratified random-sampling. Instruments of data collection will be closed and open-ended questionnaire. Complementary data will also be collected from purposively selected samples through semi-structured interview. Data for the research will be collected through questionnaire first and then through interview. Data analysis will also follow the same procedure. The collected data will systematically be organized and statistically and thematically analyzed in order to come up with indicative findings. The overarching thesis is that, working mothers in the study area bear a lot of responsibilities both at home and at work place which leave them very little time for parenting services. Unless due attention is given to the way they can spare time for their children, they are more likely to be tense between work-life and family care services, which tempt them in different directions.

Keywords: challenges, mothers, practices, university, working

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Authors: Shu-Yen Wang, Shyh-Huei Hwang

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Designated as an important architectural complex of settlement by the Ministry of Culture, Hua-Zhai Settlement located in Wang-An Township, Peng-Hu County, of Taiwan has been progressively restored year by year and is now at the revitalization and reutilization stage. Over the last 5 years, YunTech has participated in the restoration project while being in compliance with the Bureau of Cultural Heritage’s spirit of 'Living Heritage Conservation'. In this study, reflections have been made to evaluate the contemporariness of traditional settlement development from the aspects of revitalization and reutilization. On the one hand, the connection between settlers’ experiences and emotions have been clarified through the living nodes, collective memory, and social-cultural connotation. On the other hand, activity design has promoted the reconstruction of living nodes and facilitated the reconnection of collective memory, enabling us to explore the contemporariness of living nodes after the reconstruction. With the adoption of literature review, participant observation, and interview analysis methods, this study concludes the following results: 1) The node reconstruction brings back the memories and makes emotional connections: the spatial collective memory is composed of different components. During the reconstruction of node space, villagers participated not only in the narration of the history but also in the restoration of the space. This process enables villagers to bring back their memories and make emotional connections thereto. 2) Villagers’ understanding towards revitalization has been facilitated through node reconstruction: as a medium of this project, activity design has facilitated node reconstruction by offering villagers a natural environment to build up emotional connections to the settlement. This also enables us to better understand the meaning of settlement activation for the local community. 3) New connections are established in life between villagers and the university through the construction of living nodes: through the local implementation of node reconstruction, new connections have been established in life between villagers who participated in the project and the university. In the meantime, the university’s entrance to the community has also been revalued.

Keywords: collective memory, local sense of belonging, reconstruction of living nodes, the important architectural complex of Wang-An Hua-Zhai settlement

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Authors: Yu-Wen Lin, Li-Ni Liu

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Introduction: Fatigue is the most common symptoms experienced by cancer patients undergoing chemotherapy. Patients receiving anticancer therapies develop a higher proportion of fatigue compared with patients who do not receive anticancer therapies. Fatigue has significant impacts on quality of life, daily activities, mood status, and social behaviors. A warm-water footbath (WWF) at 41℃ promotes circulation and removes metabolites resulting in improving sleep and relieving fatigue. The aim of this study is to determine the effectiveness of WWF for relieving fatigue with cancer patients undergoing chemotherapy. Materials and Methods: This is a single-center, prospective, quasi-experimental design study in the oncology ward in Taiwan. Participants in this study were assigned to WWF group as experimental group and standard care group as a control group by purposive sampling. In the WWF group, the participants were asked to soak their feet in 42-43℃ water 15 minutes for consecutive 6 days at one day before chemotherapy. Each participant was evaluated for fatigue level by the Taiwanese version of the Brief Fatigue Inventory (BFI-T). BFI-T was completed for consecutive 8 days of the study. The primary outcome was compared the BFI-T score of WWF group to the standard care group. Results: There were 60 participants enrolled in this study. Thirty participants were assigned to WWF group and 30 participants were assigned to standard care group. Both groups have comparable characteristic. The BFI-T scores of both groups were increased associated with the days of chemotherapy. The highest BFI-T scores of both groups were on the day 4 of chemotherapy. The BFI-T scores of both groups were decreased since day 5 and significantly decreased in WWF group on day 5 compared to standard care group (4.17 vs. 5.7, P ＜ .05). At the end of the study the fatigue at its worse were significantly decreased in WWF group (2.33 vs. 4.37, P ＜ .001). There was no adverse event reported in this study. Conclusion: WWF is an easy, safe, non-invasive, and relatively inexpensive nursing intervention for improving fatigue of cancer patients undergoing chemotherapy. In summary, this study shows the WWF is a simple complementary care method, and it is effective for improving and relieving fatigue in a short time. Through improving fatigue is a way to enhance the quality of life which is important for cancer patients undergoing chemotherapy. Larger prospective randomized controlled trial and long-term effectiveness and outcomes of WWF should be performed to confirm this study.

Keywords: chemotherapy, warm-water footbath, fatigue, Taiwanese version of the brief fatigue inventory

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Authors: Pronab Ganguly, Ahmed A. Moustafa

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Holistic management of schizophrenia involves mainstream pharmacological intervention, complimentary medicine intervention, therapeutic intervention and other psychosocial factors such as accommodation, education, job training, employment, relationship, friendship, exercise, overall well-being, smoking, substance abuse, suicide prevention, stigmatisation, recreation, entertainment, violent behaviour, arrangement of public trusteeship and guardianship, day-day-living skill, integration with community, and management of overweight due to medications and other health complications related to medications amongst others. Our review shows that there is no integrated survey by combining all these factors. An international web-based survey was conducted to evaluate the significance of all these factors and present them in a unified manner. It is believed this investigation will contribute positively towards holistic management of schizophrenia. There will be two surveys. In the pharmacological intervention survey, five popular drugs for schizophrenia will be chosen and their efficacy as well as harmful side effects will be evaluated on a scale of 0 -10. This survey will be done by psychiatrists. In the second survey, each element of therapeutic intervention and psychosocial factors will be evaluated according to their significance on a scale of 0 - 10. This survey will be done by care givers, psychologists, case managers and case workers. For the first survey, professional bodies of psychiatrists in English speaking countries will be contacted to request them to ask their members to participate in the survey. For the second survey, professional bodies of clinical psychologist and care givers in English speaking countries will be contacted to request them to ask their members to participate in the survey. Additionally, for both the surveys, relevant professionals will be contacted through personal contact networks. For both the surveys, mean, mode, median, standard deviation and net promoter score will be calculated for each factor and then presented in a statistically significant manner. Subsequently each factor will be ranked according to their statistical significance. Additionally, country specific variation will be highlighted to identify the variation pattern. The results of these surveys will identify the relative significance of each type of pharmacological intervention, each type of therapeutic intervention and each type of psychosocial factor. The determination of this relative importance will definitely contribute to the improvement in quality of life for individuals with schizophrenia.

Keywords: schizophrenia, holistic management, antipsychotics, quality of life

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Authors: Samira Mehrabi

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Geriatric depression is a common late-life mental health disorder that increases morbidity and mortality. It has been shown that exercise is effective in alleviating symptoms of geriatric depression. However, inconsistencies across studies and lack of optimal dose-response of exercise for improving geriatric depression have made it challenging to draw solid conclusions on the effectiveness of exercise in late-life depression. Purpose: To further investigate the moderators of the effectiveness of exercise on geriatric depression across the current body of evidence. Methods: Based on the Arksey and O’Malley framework, an extensive search strategy was performed by exploring PubMed, Scopus, Sport Discus, PsycInfo, ERIC, and IBSS without limitations in the time frame. Eight systematic reviews with empirical results that evaluated the effect of exercise on depression among people aged ≥ 60 years were identified and their individual studies were screened for inclusion. One additional study was found through the hand searching of reference lists. After full-text screening and applying inclusion and exclusion criteria, 21 studies were retained for inclusion. Results: The review revealed high variability in characteristics of the exercise interventions and outcome measures. Sample characteristics, nature of comparators, main outcome assessment, and baseline severity of depression also varied notably. Mind-body and aerobic exercises were found to significantly reduce geriatric depression. However, results on the relationship between resistance training and improvements in geriatric depression were inconsistent, and results of the intensity-related antidepressant effects of exercise interventions were mixed. Extensive use of self-reported questionnaires for the main outcome assessment and lack of evidence on the relationship between depression severity and observed effects were of the other important highlights of the review. Conclusion: Several literature gaps were found regarding the potential effect modifiers of exercise and geriatric depression. While acknowledging the complexity of establishing recommendations on the exercise variables and geriatric depression, future studies are required to understand the interplay and threshold effect of exercise for treating geriatric depression.

Keywords: exercise, geriatric depression, healthy aging, older adults, physical activity intervention, scoping review

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Authors: Yoftahe Nigussie

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This research explores the implementation of a vapor absorption refrigeration system (VARS) in mini-bus cars to enhance air conditioning efficiency. The conventional vapor compression refrigeration system (VCRS) in vehicles relies on mechanical work from the engine, leading to increased fuel consumption. The proposed VARS aims to utilize waste heat and exhaust gas from the internal combustion engine to cool the mini-bus cabin, thereby reducing fuel consumption and atmospheric pollution. The project involves two models: Model 1, a two-fluid vapor absorption system (VAS), and Model 2, a three-fluid VAS. Model 1 uses ammonia (NH₃) and water (H₂O) as refrigerants, where water absorbs ammonia rapidly, producing a cooling effect. The absorption cycle operates on the principle that absorbing ammonia in water decreases vapor pressure. The ammonia-water solution undergoes cycles of desorption, condensation, expansion, and absorption, facilitated by a generator, condenser, expansion valve, and absorber. The objectives of this research include reducing atmospheric pollution, minimizing air conditioning maintenance costs, lowering capital costs, enhancing fuel economy, and eliminating the need for a compressor. The comparison between vapor absorption and compression systems reveals advantages such as smoother operation, fewer moving parts, and the ability to work at lower evaporator pressures without affecting the Coefficient of Performance (COP). The proposed VARS demonstrates potential benefits for mini-bus air conditioning systems, providing a sustainable and energy-efficient alternative. By utilizing waste heat and exhaust gas, this system contributes to environmental preservation while addressing economic considerations for vehicle owners. Further research and development in this area could lead to the widespread adoption of vapor absorption technology in automotive air conditioning systems.

Keywords: room, zone, space, thermal resistance

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Authors: Stavroula Stavropoulou-Tatla, Danyal Awal, Mohammad Ayaz Hossain

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The first wave of the COVID-19 pandemic saw several countries issue guidance postponing all non-urgent diagnostic evaluations and operations, leading to an estimated backlog of 28 million cases worldwide and over 4 million in the UK alone. In an attempt to regulate the resumption of elective surgical activity, the National Institute for Health and Care Excellence (NICE) introduced the ‘COVID-19 rapid guideline [NG179]’. This project aimed to increase healthcare staff knowledge of the aforementioned guideline to a targeted score of 100% in the disseminated questionnaire within 3 months at the Royal Free Hospital. A standardized online questionnaire was used to assess the knowledge of surgical and medical staff at baseline and following each 4-week-long Plan-Study-Do-Act (PDSA) cycle. During PDSA1, the A4 visual summary accompanying the guideline was visibly placed in all relevant clinical areas and the full guideline was distributed to the staff in charge together with a short briefing on the salient points. PDSA2 involved brief small-group teaching sessions. A total of 218 responses was collected. Mean percentage scores increased significantly from 51±19% at baseline to 81±16% after PDSA1 (t=10.32, p<0.0001) and further to 93±8% after PDSA2 (t=4.9, p<0.0001), with 54% of participants achieving a perfect score. In conclusion, the targeted distribution of guideline printouts and visual aids, combined with small-group teaching sessions, were simple and effective ways of educating healthcare staff about the new standards of elective surgical care at the time of COVID-19. This could facilitate the safe restoration of surgical activity, which is critical in order to mitigate the far-reaching consequences of surgical delays on an unprecedented scale during a time of great crisis and uncertainty.

Keywords: COVID-19, elective surgery, NICE guidelines, quality improvement

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Authors: Ali Mahamat

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This paper explores the application of Functional Communication Training (FCT) as an intervention to decrease maladaptive behaviors among individuals diagnosed with Intellectual Disability (ID) and Autism Spectrum Disorders (ASD) within an extensive support needs residential program. Evidence suggests that FCT can be ef ective in promoting positive behavioral changes and enhancing communication skills in this population. The prevalence of maladaptive behaviors in individuals with ID and ASD is a significant concern for caregivers and professionals in residential programs. These behaviors can include aggression, self-injury, and disruptive activities, which can impede the individual's quality of life. Functional Communication Training (FCT) has been identified as a potential solution to these challenges, providing individuals with the communication skills needed to express their needs and desires effectively. Method: A quasi-experimental design was used to investigate the effectiveness of FCT in a residential setting for individuals with ID and ASD. Participants included individuals with varying degrees of ID and ASD who exhibited maladaptive behaviors. A baseline was established for each participant's behavior before introducing FCT as an intervention. The FCT intervention involved teaching the individuals alternative, functionally equivalent communication behaviors to replace maladaptive behaviors. The training was implemented in the participants' natural environment and was incorporated into their daily routines. The intervention period lasted for six months, with follow-ups conducted at three months and six months post-intervention.Results indicated a significant decrease in maladaptive behaviors for individuals who received the FCT intervention. In addition, an enhancement in communication skills was observed, with the majority of participants demonstrating an increased ability to express their needs and desires appropriately. The findings of this study provide support for the effectiveness of FCT in reducing maladaptive behaviors in individuals with ID and ASD in a residential setting. Moreover, the study highlights the importance of incorporating functional communication skills training in the daily routines of these individuals. By providing these individuals with an effective means of communication, FCT not only reduces the occurrence of maladaptive behaviors but also improves the quality of life for these individuals. However, future research should explore the long-term effects of FCT and consider the influence of individual differences on the effectiveness of the intervention.

Keywords: functional communication training, intellectual disability, autism spectrum disorders, maladaptive behavior, residential program

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Authors: Nihal Atif Salim

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To improve the quality of life in cities, a variety of interventions are used. Noise is a substantial and important sort of pollution that has a negative impact on the urban environment and human health. According to the complaint survey, it ranks second among environmental contamination complaints (conducted by EEAA in 2019). The most significant source of noise in the city is traffic noise. In order to improve the sound urban environment, many physical techniques are applied. In the local area, noise barriers are considered as one of the most appropriate physical techniques along existing traffic routes. Alexandria is Egypt's second-largest city after Cairo. It is located along the Mediterranean Sea, and El- Gish Road is one of the city's main arteries. It impacts the waterfront promenade that extends along with the city by a high level of traffic noise. The purpose of this paper is to clarify the design considerations for the most appropriate noise barrier type along with the promenade, with the goal of improving the Quality of Life (QOL) and the sonic urban environment specifically. The proposed methodology focuses on how noise affects human perception and the environment. Then it delves into the various physical noise control approaches. After that, the paper discusses sustainable design decisions making. Finally, look into the importance of incorporating sustainability into design decisions making. Three stages will be followed in the case study. The first stage involves doing a site inspection and using specific sound measurement equipment (a noise level meter) to measure the noise level along the promenade at many sites, and the findings will be shown on a noise map. The second step is to inquire about the site's user experience. The third step is to investigate the various types of noise barriers and their effects on QOL along existing routes in order to select the most appropriate type. The goal of this research is to evaluate the suitable design of noise barriers that fulfill environmental and social perceptions while maintaining a balanced approach to the noise issue in order to improve QOL along existing roadways in the local area.

Keywords: noise pollution, sonic urban environment, traffic noise, noise barrier, acoustic sustainability, noise reduction techniques

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Authors: Ni Tang, Jinping Zhang

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An effective and sustainable volunteer team is needed to create a more available blood supply system. In order to promote the sustainable development of blood donation in Zhejiang Province, China, a “three-exemption” policy was proposed in 2014: blood donors who received the National Award for unpaid blood donation may government-invested and funded parks, scenic spots and other places for free, visit non-profit medical institutions for free outpatient fees, and be exempted from urban public transportation fees. As the policy has been in place for seven years, this study evaluated the effectiveness of the policy by comparing the increasing rate of blood donation in Hangzhou (capital city of Zhejiang) before and after the policy using the intermittent time series analysis. The blood donation in Anhui, a Province near Zhejiang, was also compared as a negative control. Blood donation data from 2012 to 2018 were obtained from the donation center's official websites. The increasing rate of blood donation volume since 2012 in Hangzhou is 34.37 units/month, and after 2014, the increasing rate additionally increases 71.69 (p=0.1442), which indicating a statistically non-significant change after the policy. While as a negative control, in Anhui, the increasing rate of blood donation volume since 2012 is -163.3 unit/month, and the increasing rate additionally increases 167.2 (p=5.63e-07) after 2014. The result shows that the three-exemption policy had a certain level of impact on encouraging volunteers to donate blood, but the effect was not substantial. One possible reason for the ineffectiveness of the policy might be a lack of public awareness of the policy. On the other hand, this policy mainly waived unnecessary life expenses, such as fares and scenic entrance fees, and requires a certain number of blood donations, registration procedures, and blood donation certificates. Perhaps, reducing life-related expenses such as oil, water and electricity, could better attract people to participate in blood donation. This current study on the three-exemption policy provides a new direction for promoting people's blood donation. Incentive policies may require greater publicity and incentives. In order to better ensure the operation of the blood donation system, other policies, especially incentive policies, should be further explored.

Keywords: blood donation, policy, Zhejiang, unpaid blood donation, three-exemption policy

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Authors: Dedie Tooy, Rio Kolibu, Rio Putra, Herry Frits Pinatik, Daniel P. M. Ludong

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This study presents the design and development of a smart greenhouse prototype tailored to optimize Pak choi (Brassica chinensis L.) cultivation in tropical rural climates. Pak choi, a high-demand leafy vegetable in Indonesia, often experiences suboptimal growth due to elevated temperatures and humidity. The objective of this research is to design and develop an intelligent greenhouse to optimize pak choi cultivation in tropical rural climates. The design of a smart greenhouse provides a controlled environment to stabilize these conditions, but managing fluctuating temperature, humidity, and light in tropical regions remains challenging. This system regulates critical environmental factors, including temperature, humidity, irrigation system, and light, creating optimal conditions for Pak Choi. The prototype's effectiveness was evaluated by monitoring growth indicators such as leaf weight, freshness, and moisture content, alongside the consistency of the internal climate compared to external conditions. Results indicate that the smart greenhouse supports superior crop growth, enhances yield quality, and reduces environmental resource consumption. The irrigation control system test was carried out for 40 days. Researchers observed the results of the automatic system working according to the sensor value readings. The results of the temperature control system test work: when the air temperature in the greenhouse is more than 33 degrees, the condensation pump will turn on, and when the temperature is below 32 degrees, the pump will automatically turn itself off. The cycle repeats continuously. The results achieved pak coy can live up to 40 days. As part of our ongoing research, we are actively considering integrating double-layered roofs to improve insulation and reduce external temperature fluctuations, which could further enhance the effectiveness of the smart greenhouse.

Keywords: smart greenhouse, horticulture, rural tropical climate, sustainable agriculture

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Authors: Rukhsar Ahmed, Jawed Aziz Masudi

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In the present study, an attempt has been made about the right to an education in Pakistan. The research is the focus in respect of International Law Article 26 of the Universal Declaration of Human Rights. The main motivation behind getting great training is, as a rule, decent resident and afterward being effective in close to home and expert life. We are fragmented without decent instruction since training makes us the right mastermind and right chief. In such a focused world, instruction has turned into a need for people after sustenance, dress and haven. It can give answers for all issues; it advances great propensities and mindfulness about defilement, fear-mongering, and other social issues among us.

Keywords: education, right to education, human right, universal declaration, law

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Authors: Clara T. Fatoye, April Betts, Abayomi Odeyemi, Francis A. Fatoye, Isaac O. Odeyemi

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Background: The post-launch stage is the last stage in the development of a pharmaceutical product. It is important to involve patients in the development of pharmaceutical products at the post-launch stage, as patients are the end-users of pharmaceutical products. It is expected that involving them might ensure an effective working relationship among the various stakeholders. However, involving patients in the development of pharmaceutical products comes with its problems. Hence, this study examined how to resolve problems experienced by involving patients in the developments of pharmaceutical products’ at post-launch consisting of Positioning of pharmaceutical products (POPP), detailing of pharmaceutical products (DOPP) and reimbursement and Formulary Submission (R&FS). Methods: A questionnaire was used for the present study. It was administered at the ISPOR Glasgow 2017 to 104 participants, all of which were professionals from Market access (MA) and health economics and outcomes research (HEOR) backgrounds. They were asked how the issues experienced by patients can be resolved. Participants responded under six domains as follows: communication, cost, effectiveness, external factors, Quality of life (QoL) and safety. Thematic analysis was carried out to identify strategies to resolve issues experienced by patients at the post-launch stage. Results: Three (3) factors cut across at POPP, DOPP, and R&FS that is (external factors, communication and QoL). The first resolution method was an external factor that is, the relationship with stakeholders and policymakers. Communication was also identified as a resolution method that can help to resolve problems experienced by patients at the post-launch stage. The third method was QoL as perceived by the patients based on professionals’ opinions. Other strategies that could be used to resolve problems experienced were the effectiveness of pharmaceutical products at the DOPP level and cost at R&FS. Conclusion: The study showed that focusing on external factors, communication, and patients’ QoL are methods for resolving issues experienced by involving patients at the post-launch stage of pharmaceutical product development. Hence, effective working relationships between patients, policymakers and stakeholders may help to resolve problems experienced at the post-launch stage. Healthcare policymakers are to be aware of these findings as they may help them to put appropriate strategies in place to enhance the involvement of patients in pharmaceutical product development at the post-launch stage, thereby improving the health outcomes of the patients.

Keywords: patients, pharmaceutical products, post-launch stage, quality of life, QoL

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Authors: Preeti Madan, Shalini Malhotra, Nirmaljit Kaur, Charoo Hans, VK Sabarwal

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Hospital is one of the most diverse and complex institutions frequented by people from every walk of life without any distinction between age, sex, gender, religion or intellect. This is over and above the normal inhabitant of hospital i.e. doctors, patients, and paramedical staff. The hospital waste generated 85% is non hazardous, 10% infectious and around 5% are non-infectious but hazardous waste. The management of biomedical waste is still in its infancy. There is a lot of confusion with the problems among the generators, operators, decision makers, and general community about the safe management of biomedical waste prompt action initiated to seek new scientific, safe, and cost-effective management of waste.

Keywords: biomedical waste, nosocomial infection, waste management, hospitals

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Authors: Mamta

Abstract:

Communication is the mixture of the various activities such as words, body language, volume and voice tone. Mankind has always throughout its history had the necessity for communication. It starts from birth and continues throughout life. Communication is just the right means of success and advancement in a workplace. Communication is one of the means to connect to different people at far distances. The modern workplace is inherently collaborative, and this collaboration relies on effective communication among co-workers. Also it has been observed that a lack in good communication skills especially within a workplace can result in conflicts and chaos hence hindering the productivity of an organization. Thus there is a dire need for developing good and effective communication skills which will result in increase in productivity and will enhance its efficiency.

Keywords: communication skills, professional communication, workplace communication, workplace efficiency

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Authors: Atitallah Sofien, Bouyahia Olfa, Attar Souleima, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Ciliopathies are a spectrum of diseases that have in common a defect in the synthesis of ciliary proteins. It is a rare cause of neonatal cholestasis. Clinical presentation varies extremely, and the main affected organs are the kidneys, liver, and pancreas. Methodology: This is a descriptive case report of a newborn who was admitted for exploration of neonatal cholestasis in the Paediatric Department C at the Children’s Hospital of Tunis, where the investigations concluded with a rare genetic mutation. Results: This is the case of a newborn male with no family history of hepatic and renal diseases, born to consanguineous parents, and from a well-monitored uneventful pregnancy. He developed jaundice on the second day of life, for which he received conventional phototherapy in the neonatal intensive care unit. He was admitted at 15 days for mild bronchiolitis. On clinical examination, intense jaundice was noted with normal stool and urine colour. Initial blood work showed an elevation in conjugated bilirubin and a high gamma-glutamyl transferase level. Transaminases and prothrombin time were normal. Abdominal sonography revealed hepatomegaly, splenomegaly, and undifferentiated renal cortex with bilateral medullar micro-cysts. Kidney function tests were normal. The infant received ursodeoxycholic acid and vitamin therapy. Genetic testing showed a homozygous mutation in the DCDC2 gene that hadn’t been documented before confirming the diagnosis of renal-hepatic ciliopathy. The patient has regular follow-ups, and his conjugated bilirubin and gamma-glutamyl transferase levels have been decreasing. Conclusion: Genetic testing has revolutionized the approach to etiological diagnosis in pediatric cholestasis. It enables personalised treatment strategies to better enhance the quality of life of patients and prevent potential complications following adequate long-term monitoring.

Keywords: cholestasis, newborn, ciliopathy, DCDC2, genetic

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