Lack Of Proper Guidelines Research Articles

Are There Any Developments in the Attitudes and Practices of Oncologists Regarding Fertility Preservation in Saudi Arabia After 12 Years?

The current practice of offering fertility preservation (FP) counseling and treatment has become one of the focal points in patient care throughout cancer treatment. The turning point was the approval of the Council of Senior Religious Scholars four years ago to freeze tissues from the ovarian membrane, the entire ovary, and the eggs for later use in reproduction to preserve the offspring. Thus, we aimed to assess any development in oncologists' knowledge, attitude, and referral practices regarding FP in Saudi Arabia. This is a cross-sectional survey using a self-administered questionnaire. We assessed oncologists' opinions on the importance of FP, their perception of the patient's preferences, and factors to consider when discussing the subject. Then, we assessed the knowledge and referral practices, including the timing of referral before starting cancer treatment. Most oncologists showed good knowledge and positive attitudes toward FP; however, their referral practices could be better. Most were familiar with FP options. The most significant factors influencing the oncologist-patient FP discussion were the number of existing children, marital status, cost, and type of cancer (96.6%, 76.7%, 65.7%, and 58.9%, respectively). There is a significant improvement in the knowledge and attitude of oncologists toward FP. However, patients' counseling and referral to fertility services still need to be improved. There is a shortfall in the clinical practice guidelines for FP in cancer patients in Saudi Arabia. The implementation of clinical practice guidelines would enhance FP. However, patients' counseling and referral to fertility services still need to be improved. The lack of proper guidelines on FP is affecting oncologists' practice.

Effect of Online Class during COVID- 19 in Dhaka

Background: The whole world is fighting the coronavirus, which has spread to nearly every point of the globe over the first three months of 2020. To control this quick spread, many countries were prosecuted for lockdown that caused a significant impact on all aspects of our daily lives. As the virus is spreading across the country, more than 90% of enrolled students were affected by some kind of limitation posed by the educational institutions, with more than a billion impacted around the world. Objective: To assess the effect of online classes among secondary school students during COVID-19. Methods: This was a Descriptive type of cross-sectional study. It was conducted from September 2022 to November 2022. Data were collected using self-administered structured questionnaire consisting of information about socio-demographic data and information about effect of online classes during COVID-19. The data were processed by computer and statistical analysis of data was carried out by using SPSS (Statistical Package for Social Science). A total of 100 participants participated in the study. Result: Result showed that among 100 respondents' majority were in class ten (58.0%). Most of the respondents were female (52.0%) and all respondents were Muslim. 95.0% mentioned that they had the facility of online classes which was arranged by their school authority. 50.0% students enjoyed the online classes and agreed that they were benefited by online class. Most of the respondents 71.0% thought that online classes are not easy to understand for study material. 69.0% respondents expressed that physical classroom education is much better than online class. Majority 92.0% respondents were believed that online classes are effective during global emergency situation. Conclusion: COVID-19 crisis on education system was unprecedented, which eventually became a reason to transform the physical classroom learning into online classes. From the findings of this study state that, students lost the motivation to participate in the online classes because of poor internet connection, monotonous nature of classes and lack of proper guidelines. Course curriculum must be informative and attentive. Must focus on the importance of teachers training about new teaching material of online education which is needed for encouraging student participation. This study strongly recommends for making the online classes more effective and inclusive by planning strategic method for the course curriculum of online education.

Review on the effect of systemic melatonin in periodontal disease.

It is of interest to determine the efficacy of adjunctive systemically administered (via oral route) melatonin compared to a placebo, on changes in clinical parameters in patients with periodontitis undergoing periodontal therapy. Literature search was performed systematically after searching with 4 electronic databases until December 2022. Primary outcome measures were changes in Probing Pocket Depth (PPD) and bleeding on probing (BOP%). Secondary outcome measures taken were Clinical attachment Level (CAL) gain and level of Tumor Necrosis Factor-alpha (TNF-α). Risk of bias analysis was done for all the studies. With the adjunctive use of melatonin, improved probing depth reduction and gain in clinical attachment levels was observed in all four studies and was found to be statistically significant compared to the placebo group, suggesting that melatonin administered systemically was able to exert a positive effect at diseased sites. Melatonin drug administered at 10 mg dosage for 2 months showed a significant decrease in TNF-α levels; but showed no significant difference between TNF-α levels in the test and control group at 6 mg administration for 2 months. Systemically administered melatonin as an adjunct in treating periodontal disease could potentially be used due to its antioxidant, anti-inflammatory and bone remodelling properties from increasing evidence. However, a lack of proper guidelines, side effects, standardization of dosage for treating periodontitis and its long-term effect on various other systems in the body, patient related outcome factors and the effect of increased dietary melatonin efficacy have yet to be taken into consideration. Due to the lack of homogeneity, differences in dosage uniformity, and varying follow up intervals, more randomized controlled trial protocols are required to fill the lacunae and better improve our understanding.

A Case Report of Rare Vocal Cord Hemangioendothelioma in a Paediatric Larynx.

Hemangioendothelioma (HEM) is a vascular tumour which is locally aggressive with a low-grade malignant potential. We present a rare case of HEM arising from the vocal cord of a 10-year-old female child. Video laryngoscopy clearly showed a large vocal cord polyp-like mass attached to middle one-third of left cord. Histopathological examination showed fragments of tissue with a neoplasm composed of spindle cells arranged diffusely admixed with numerous small vascular channels. These specific cells were positive for CD31, CD34, vimentin and ERG. Flexiblescopy and narrow band imaging were performed 3weeks after surgery which showed no residual mass. Treatment of HEM is hampered by lack of proper guidelines and protocol. In this case of localized vocal cord lesion, a wide excision with regular follow up is considered ideal.

CONTRIBUTIONS OF NONPROFESSIONAL LOCAL PHYSICAL THERAPIST IN THE PROMOTION OF COMMUNITY HEALTH ACTIVITIES IN THE ARSI ZONE, SOUTHEAST ETHIOPIA

Background: Physical activity is a first-line therapy and secures against persistent illnesses. Essential medical care professionals are obviously situated to advance actual action. Active recuperation mediations are focused on advancement and upkeep of well-being, personal satisfaction and wellness. There is, notwithstanding, a deficiency of such examination proof in Ethiopia. Objective: We planned to assess the degree of KAP of nonprofessional local physical therapists toward well-being advancement in the Arsi Zone of Oromia, Southeast Ethiopia. Methods: A community-based cross-sectional study was conducted in April 2018 among 45 physical therapists. Data were collected using pre-tested, structured and self-administrative questionnaires. Participants were selected by the quota sampling technique. The questionnaire was drafted specifically to test the KAP. Data were double entered and analyzed by SPSS, Version 20.0, program. Descriptive statistics were used. The KAP was estimated using proportion. Result: The present response rate is 90.0%. The ages of respondents ranged between 24 and 87 years. Then, 57.8% of participants got initial physical therapy knowledge from either of their parents. Again, 53.3% of the respondents hear about health promotion from families and friends. Then, 57.8% of them provided health promotion at their workplace. The overall percentage of all the respondents’ KAP in health promotion was 60.1%. Conclusion: The respondents have good KAP toward health promotion. However, there is still room for improvement. Also, there is a lack of proper guidelines in determining the impact of physical therapy.

Spatio-Temporal Analysis to Dynamically Map and Audit Urban Growth in Peri-Urban Areas

Villages located today in the peri-urban area, are in continuous agglomeration. The lack of proper guidelines and monitoring systems to define, promote, regulate and manage the pattern of development in these areas, causes massive deteriorations to the environment and quality of life. In Egypt, very few states have a dedicated legal framework that addresses the need for planned development in the peri-urban areas. A Spatio-temporal model framework consisting of a set of geospatial indicators is required to regulate and direct the growth and development of these areas and prevent further spill across administrative boundaries. This article responds to the lack of a geo-spatial quantifiable criterion as a key to detect, analyze, and better govern spatial and temporal patterns of urban growth in peri-urban areas, where the results are to be represented dynamically in forms of spatial patterns evolving in time. The research aims to develop a process-wise, contextual mapping of peri-urban dynamics using GIS to detect and analyze spatial and temporal patterns of urban growth. It has been applied to one of the peri-urban areas in Egypt, in Meet Assas Village, chosen as a case study. Miscellaneous primary and secondary data sources together with the methods used for monitoring: UN Criteria (Goal 11) targets, thematic headlines, village’s problems and geo-spatial indicators were the main constitutions of the model frame work. The results show that the village is characterized by a dispersed pattern of development with the absence of basic infrastructure and services. Besides that, the study reveals, through temporal patterns, that the future and unplanned growth will continue to intensify; posing numerous threats on the environment and the quality of life. A harmonized standardized measurement framework for planning, development, and management is crucial rather than demolishing these areas.

Smart Speaker Recommendations: Impact of Gender Congruence and Amount of Information on Users' Engagement and Choice.

The relevance of smart speakers is steadily increasing, allowing users perform several daily tasks. From a commercial perspective, smart speakers also provide recommendations of products and services that may influence the consumer decision-making process. However, previous studies have mainly focused on the adoption of smart speakers, but there is a lack of proper guidelines that help design the way these devices should offer their consumption recommendations. Based on a stimulus-organism-response approach, we analyze how two features of smart speakers' recommendations (the gender congruence between the customer and the speaker, and the length of the message) influence on the effectiveness of such recommendations (i.e., visiting intentions) through its impact on user engagement and attitude. Data was collected from a sample of undergrad students in Spain using an experiment design that focused on a restaurant recommendation, and analyzed using partial least squares. On the one hand, our results suggests that gender congruence generates user engagement with the smart speaker. On the other hand, message length is positively related to attitudes towards the restaurant, at a declining rate. In addition, while better attitudes lead to higher visiting intentions, the influence of engagement on visiting intentions is partially mediated via attitudes. Thus, our findings contribute to understand the antecedents of users' engagement with smart speakers, as well as its impact on the customers' willingness to follow smart speakers' recommendations, constituting a base to analyze the impact of artificial intelligence solutions aimed to smooth the transitions of a customer through the stages of purchase process.

Pediatric Asthma: Prevalence and Socio-Cultural Factors Affecting Asthma Management in a Rural Area of Northern Karnataka.

Context:Asthma prevalence and severity is increasing among Indian children. There is the paucity of data on pediatric asthma in rural India and treatment received by asthmatics is not up-to-standard treatment guidelines.Aim:The aim is to estimate asthma prevalence and factors influencing access to standard asthmatic care among 5–15 years aged children.Settings and Design:Cross-sectional study conducted in rural north-Karnataka for 1 year.Subjects and Methods:The International Study of Asthma and Allergies in Childhood questionnaire was administered to participants followed by clinical examination. A child was considered as asthmatic if there was affirmative response to: (a) History of wheeze in the past 12 months, (b) Physician diagnosed/ever asthma, (c) history of taking inhaled/oral bronchodilators.Statistical Analysis:All characteristics were summarized descriptively.Results:Prevalence of Current-wheeze, Ever-asthma, and wheeze on exertion were 4%, 2%, and 3.7%, respectively. About 63.9% of asthmatics had severe-asthma and 44.4% reported severe attack of wheezing limiting speech. About 89% of current-wheezers used only oral medications for wheeze/asthma, 50% did not take medicines as per doctors' advice. None availed regular follow-up. Financial constraints and ignorance were major reasons cited.Conclusions:Illiteracy, poverty, lack of proper guidelines, and non-availability of inhalational medications have affected treatment adherence resulting in severe asthma.

Reactive Case Detection (RACD) and foci investigation strategies in malaria control and elimination: a review

BackgroundReactive case detection (RACD) and foci investigation are key strategies in malaria elimination and prevention of its re-establishment. They are a key part of surveillance that has been recommended by the World Health Organization (WHO) to be considered as a core intervention and as one of the three pillars of the Global Technical Strategy for Malaria 2016–2030.MethodsA search using the key words “Reactive Case Detection”, “RACD”, “RCD” and “Malaria” was carried out in PubMed, Scopus, Taylor and Francis online databases for studies published until 31st July 2019. The inclusion criteria for selection of articles for review included (1) how RACD is implemented in each country; (2) challenges faced in RACD implementation; (3) suggestions on how the effectiveness of RACD process can be improved.Results411 titles were identified, 41 full text articles were screened and 29 were found eligible for inclusion in the review. Published literature on RACD, and case and foci investigations has mostly assessed the process of the activity. Most studies have documented that the yield of positives in RACD has been highest in the index case’s household and the immediate neighbourhood of the index case. Microscopy and RDTs are the common tests used in RACD. The guidelines for case and foci investigation, and RACD and PACD, are not universally adopted and are country-specific. Some of the limitations and challenges identified include lack of proper guidelines, logistic issues and problems with public compliance.ConclusionsAlthough there is no documented evidence that RACD is useful in malaria elimination settings, most authors have opined that RACD is necessary for malaria elimination. Lack of knowledge in the target populations, a target radius and how to carry out the RACD process is a major challenge in the decision-making process.

THE DESIGN PROCESS OF AN OCCUPATIONALLY SAFE AND FUNCTIONAL 3D PRINTING LEARNING ENVIRONMENT FOR ENGINEERING EDUCATION

Learning environment is a physical environment which enables and supports interaction and learning of an individual. Practical learning happens usually in a physical learning environment allowing students to learn through using a certain technology when engineering education is in focus. 3D printing offers a low-cost and easy to access way to learn technology through different 3D printing technologies. There is lack of proper guidelines and solutions how to design practical and safe 3D printing learning environment in current literature. The design of a 3D printing environment consists of designing the physical environment and the operational model for the environment. The most important issue in the design work is the occupational safety of the environment including identifying different risks for health. This study presents a process of designing a 3D printing environment in Lapland University of Applied Sciences mechanical engineering degree programme (B.Sc. degree) including layout and operational planning from educational point of view. The study emphasizes the importance of connecting technology with learning in engineering. This study also includes an educational process model presenting the actions which the environment enables from educational point of view. Functionality of the environment refers to the possibility to learn by doing and work in the environment in a way that enables diverse learning possibilities. The process model presents how a 3D printing learning environment can be connected with other functions in a university or in a company and therefore be a part of a manufacturing chain from educational point of view.
 
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Challenges and Opportunities for Septage Management in the Urban Areas of Indonesia – Case Study in Bandung City

Because of the burgeoning urban population, there is huge pressure on both natural resources and basic urban infrastructure, especially sewerage systems, with Indonesia as no exception. It is estimated that about 95% of human waste in Indonesia ends up untreated or partially treated in septic tanks before being discharged in the natural environment, contaminating the living environment as well as adversely affecting human health and economic development. This study conducted a comprehensive investigation on septage management in Bandung City, Indonesia, to gain a better understanding of the challenges and opportunities for improved performance of on-site sanitation systems as well as septage management across its sanitation service chain. The results showed that the following issues are the main reasons behind poor sanitation in Bandung city: a) poor design and construction of septic tanks with no or only partial lining, resulting in leaking (>90% of septic tanks are malfunctioning); b) irregular desludging, i.e. about 2/3 of population desludge their septic tanks only once in more than 5 years; c) lack of proper guidelines and awareness about the benefits of regular monitoring and operation of septic tanks; d) lack of good sanitation service providers; and e) lack of funds for building sufficient capacity of septage treatment plants.

The challenges faced by halal certification authorities in managing the halal certification process in Malaysia

The massive demand for halal food is the main reason business enterprises engage in halal food production, namely for the purpose of increasing profits. Halal certification has been managed by Malaysian halal certification authorities, namely the Islamic Development Department Malaysia (JAKIM) and the State Islamic Religious Department (JAIN). This study triangulates the viewpoints of Halal Auditors, Halal Executives, and Halal Certification Panel in managing the halal certification process in Malaysia. The main aim of this study is to explore the challenges faced by halal certification authorities and the initiatives that can be taken to improve their roles. A qualitative research method via indepth interviews with Halal Auditors from JAKIM and JAIS, Halal Certification Panel, and Halal Executives from various companies has been used to gather the data for this study. Findings from the interviews highlighted six challenges in the halal certification process which are lack of manpower, Halal Auditor’s lack of skills and knowledge, problems with MYeHALAL system, issues in reviewing halal certification applications, lack of proper guidelines in Malaysia halal certification, and competition from the foreign certification body. The initiatives and suggestions to improve the standard and performance of the Malaysian halal certification authorities are also highlighted. In terms of practical implications, the findings of this study can be used as baseline data for any policy intervention and improvement or advocacy efforts related to halal certification process in Malaysia.

Preliminary Study on Decision Making Factors to Replace Medical Equipment in Hospital

Maintaining medical equipment in hospital is a cost-deprived process yet is a crucial process that needs to be looked into. Maintaining is an ongoing process that starts with installation and ended up with disposed. The cost for maintaining equipment is often held a large portion in life cycle costing and huge amount of money need to be allocated to complete this process. The cost invested on maintaining the medical equipment should be worth the value without comprising the safety requirement and regulations. However, there are circumstances where hospitals are unable to decide when to dispose the equipment especially when the equipment reach the end of its life, incur high repairing cost, aging, and frequent failed to function. Management of hospital come into dead end solution as there are lack of proper guidelines on maintaining medical equipment and therefore the equipment may be over maintained or under maintained. This paper provides a review of 100 papers from credible sources on maintaining activities of equipment to identify factors that are important for decision making to replace the medical equipment.

Rampant Development of Water Diversion Projects as a Threat to Fish Diversity: A Case of the Modi Khola

The current focus of the country in meeting the increasing demands for energy has led to the increase in number of river water diversion projects for hydropower generation. But the lack of proper guidelines and monitoring mechanism has resulted in rampant licensing of hydropower projects. There are no rules for determining the appropriate number of water diversion projects in a single river. By discussing the case of rampant water diversion projects in the Modi Khola, of western Nepal, this paper raises an important issue of environmental feasibility of projects in the context where, only the engineering and economic feasibility of a project is taken as the basis for project approval and implementation.

The role of physical therapists' knowledge, attitudes, and practices in health promotion in Arsi zone, Southeast Ethiopia

BACKGROUND: Physical activity is a first-line therapy and protects against many chronic health conditions. Primary health-care practitioners are ideally positioned to promote physical activity. Physical therapy interventions should be aimed at promotion and maintenance of health, quality of life, and fitness. There is, however, a shortage of such research evidence in Ethiopia. OBJECTIVE: We aimed to estimate the level of knowledge, attitude, and practice (KAP) of physical therapists toward health promotion in Arsi zone of Oromia, Southeast Ethiopia. MATERIALS AND METHODS: This community-based, cross-sectional study was conducted in April 2018 among 45 physical therapists. Data were collected using pretested, structured, and self-administered questionnaires. Participants were selected by quota sampling technique. The questionnaire was drafted specifically to test the KAP. The data were double entered and analyzed by SPSS program version 20.0. Descriptive statistics were used. The KAP were estimated using proportion. RESULTS: In the present study, the response rate was 90.0%. Ages of the respondents ranged between 24 and 87 years. Nearly 57.8% of the participants got initial physical therapy knowledge from either of their parents, 53.3% of the respondents heard about health promotion from families and friends, and 57.8% of them received health promotion at their workplace. The overall percentage of all the respondents' KAP in health promotion was 60.1%. CONCLUSIONS: The respondents' have good KAP toward health promotion. However, there is still room for improvement. In addition, there is a lack of proper guidelines in determining the impact of physical therapy.

A study of physicians’ experiences with recommending HPV vaccines to adolescent boys

Assessing physicians’ experiences in HPV vaccine recommendation and delivery to adolescent boys is essential to providing an understanding of the issues of vaccine acceptance and an insight for policymakers to enhance HPV vaccinations among adolescent boys. Between January and April 2014 a mail survey was conducted using physicians in Malaysia known to provide either one or both HPV vaccine (Gardasil and Cervarix) immunisation services. A total of 357 completed questionnaires were received (response rate 22.5%). Of these, 335 physicians see adolescent boys aged 11 to 18 years old in their practice. Only 26.3% (n = 88) recommended the HPV vaccine to these boys. A total of 46.6% (n = 41) have successfully given the HPV vaccine to adolescent boys. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to the boys (37.2%) and a lack of awareness of the availability of the vaccine for boys (32.8%) were the most commonly cited reasons for non-recommendation. Impact statement Recommending the HPV vaccine for adolescent boys remains a challenge for physicians. Our study provides evidence of challenges and barriers faced by Malaysian physicians who recommend the HPV vaccines (Gardasil and Cervarix) in their practices. In this study, physicians reported HPV vaccine uptake by adolescent boys was very poor. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to boys and a lack of awareness of the availability of the vaccine for boys were the most commonly cited reasons for non-recommendation. Physicians viewed that support and encouragement from the health authorities are needed to promote the recommendation of the HPV vaccine to adolescent boys. Physicians were also of the opinion that the lay public should be educated about the availability of the HPV vaccine for boys, and its benefits, safety and efficacy, and the high susceptibility of boys to getting HPV infections. The findings provide insights that could be helpful to policymakers or high-level decision-makers of the potential strategies to enhance HPV uptake among adolescent boys.

Successful removal of a penile constriction wedding ring in a rural area.

Penile strangulation is a rarely described medical emergency. Removal of the strangulating object is challenging, with a lack of proper guidelines. To describe the challenges faced during an attempt to urgently remove a metal object (wedding ring) constricting an erect penis. We report a case of penile strangulation with a wedding ring in an adult man who presented at Van Velden Hospital casualty department, Limpopo, South Africa, and review the related literature. The ring was successfully removed using an aspiration technique (via a pink needle). No proper guidelines exist for the treatment of this condition, so the 'best method' is the one with a successful outcome.

Advanced Machines and Automation Techniques in Modern Construction Practice and their Possible Use in India

Robotics and automation are playing very imperative role in the modern construction practice to meet the challenges and expectation specifically in the infrastructural projects. Automation is a tool for operating or controlling different stages of construction process using mechanized and electronic devices or control systems to reduce the human intervention to a minimum. The design and implementation of these automation technologies has shown progressive outcomes compared to conventional methods. Moreover, considerable improvement in working condition, reduction in accidents and significant increase in production have been evidently observed in the recent construction projects as well as in the earlier research studies. Although several countries have adopted automation in their construction projects, application of these techniques in India is limited to a greater extent due to lack of proper guidelines and specifications. It is important to develop appropriate standards and guidelines for Indian construction sector. This paper reviews different automation techniques that are currently used in many parts of the world and suggestions for their application in the Indian construction scenario are discussed in detail. Moreover, guidelines for efficient design and implementation of automation techniques in India are highlighted in this paper.

Aesthetic Practice in Nepal

DOI: http://dx.doi.org/10.3126/kumj.v11i2.12483 Kathmandu University Medical Journal Vol.11(2) 2013: 109

Mixture Design for Minimizing Cement Content in Pavement Concrete

Pavement concrete containing aggregates that do not meet ASTM C33 often experiences workability problems. One of the reasons is the lack of proper guidelines for proportioning concrete that contains aggregates with poor shape, texture, and grading. Commonly used methods, such as ACI 211, were developed for aggregates that meet ASTM C33; these methods are not adequate for optimizing mixtures containing aggregates such as manufactured sands. This paper presents a simple mixture proportioning method for designing pavement concrete with low slump. The proposed method has the potential to minimize the cement content of paving mixtures with any available source or combination of aggregate without affecting performance. Several combinations of aggregates were tested and the results for slump, compressive strength, and modulus of elasticity are presented in this paper.