Psychometric Properties of the Arabic Version of the Perceived Physical Ability Scale for Children in Oman

This study aimed at examining the psychometric properties of the Perceived Physical Ability Scale for Children (PPASC) within an Omani context. A sample of 250 fourth graders (130 males and 120 females) from six public primary schools in four governorates in Oman responded to Arabic translated version of the PPASC. Data on students' in-class physical activity, social desirability, and teachers' nominations of students' physical ability were also collected. Confirmatory factor analysis revealed that the unidimensional model of the PPASC had adequate fit to the data. Multigroup CFA revealed gender invariance for PPASC unidimensional model when it was compared across male and female groups. A latent mean analysis showed that there were significant gender differences in perceived physical ability favoring males. The PPASC correlated positively with in-class physical activity and teachers' nominations of students' physical ability but not with social desirability

Modeling the Causal Relationships among Test Anxiety, Working Memory, and Academic Achievement of Primary Stage Students in Oman in the Light of the Processing Efficiency Theory

This study aimed at investigating the relationships among test anxiety, working memory, and academic achievement in the light of the processing efficiency theory. The sample of the study included 159 fifth graders (84 females and 75 males) distributed over three public elementary schools in the Sultanate of Oman. Results of the mean testing analysis showed that the participants had high levels of worry and emotionality as well as overall test anxiety (both worry and emotionality). The results of the structural equation modeling analysis showed that (1) worry and emotionality had negative effects on central executive, phonological loop, and visuo-spatial sketch pad; (2) emotionality had a negative effect on the visuo-spatial sketch pad, and (3) central executive, phonological loop, and visuo-spatial sketch pad had positive effects on academic achievement. The results of the mediation analysis showed that the central executive and the phonological loop mediated the relationship between worry and academic achievement, and that the central executive, phonological loop, and visuo-spatial sketch pad mediated the relationship between emotionality and academic achievement. The results of the moderation analysis showed that gender was not a moderator of the relationships among worry, emotionality, central executive, phonological loop, visuo-spatial sketch pad, and academic achievement

Rasch Rating Scale Analysis of the Arabic Version of the Physical Activi-ty Self-Efficacy Scale for Adolescents: A Social Cognitive Perspective

Abstract This study uses the Rasch rating scale analysis within the framework of the social cognitive theory to examine four psychometric properties of the Arabic version of the Physical Activity Self-efficacy Scale for Adolescents (PASESA-Av): 1) item technical quality to evidence content validity; 2) unidimensionality structure to evidence structural validity; 3) rating scale functioning to evidence substantive validity; and 4) person and item separation and reliability. The analyses showed that the PASESA-Av items represented the physical activity self-efficacy trait adequately. The PASESAAv demonstrated good fit to the Rasch model and formed a unidimensional structure. The PASESAAv response categories advanced monotonically. The PASESA-Av demonstrated satisfactory person and item separation and reliability

Academic Delay of Gratification and its Relationship to Motivational Determinants, Academic Achievement, and Study Hours among Omani High School Students: A Path Analysis

This study was aimed at investigating the relationships of academic delay of gratification to motivational determinants, academic achievement, and study hours. The sample of the study included 200 Omani high school students. A path analysis showed that motivational determinants were positively related to academic delay of gratification which in turn was positive-ly related to academic achievement and study hours. A mediational analysis showed that academic delay of gratification mediated the relationships among motivational determinants and academic achievement and study hours. There were significant gender differences in academic delay of gratification which favored females

SYNERGISTIC CYTOTOXIC EFFECT OF STATINS AND BISPHOSPHONATES ON SQUAMOUS CELL CARCINOMA CELL LINE

Objective: The present study aimed at evaluating the in vitro cytotoxic effect of simvastatin (sv) and alendronate (aln) on squamous cell carcinoma cell line (Hep-2 cells).Methods: Hep-2 cells were divided into four groups; Control group where cells were cultured in the routine culture medium. Alendronate Group (A) consisting of cells cultured in aln in its IC 50. Simvastatin Group(S) cultured in sv in its IC 50. And finally, a combined group (A+S) comprising cells cultured in combined IC 50 dose of sv and aln. To assess the effect of these drugs on Hep-2 cells, cell viability was measured in addition to measuring vascular endothelial growth factor (VEGF) expression by Elisa.Results: In all groups, a decrease in the mean viability percentages of the treated Hep-2 cells in relation to control cells was observed in all groups. The combination of both agents exhibited a significant (P-values Ë‚0.05) synergistic effect on decreasing cell viability and angiogenesis of Hep-2 cells in vitro. VEGF measures in all groups were significantly lower than the control group (P-values Ë‚ 0.05). The combination of both drugs at their IC 50 doses can lower the VEGF production by Hep-2 cancer cells (P-values Ë‚ 0.05).Conclusion: A combination of sv and aln in their Ic50 doses has a dramatic effect on lowering the proliferation and VEGF expression in Hep-2 cancer cells cultured in vitro

A Rasch analysis of the teachers music confidence scale

This article presents a new measure of teachers’ confidence to conduct musical activities with young children; Teachers Music Confidence Scale (TMCS). The TMCS was developed using a sample of 284 in-service and pre-service early childhood teachers in Hong Kong Special Administrative Region (HKSAR). The TMCS consisted of 10 musical activities. Teachers rated their confidence levels to conduct each activity on a scale from 1 (Not confident at all) to 5 (Very confident). An exploratory factor analysis retained a 10-item single factor that was replicated using confirmatory factor analysis procedures. All items of the TMCS fitted the Rasch model adequately. In-service teachers showed higher confidence levels to conduct several musical activities with young children than pre-service teachers. Implications of these findings for measuring teachers’ confidence to conduct musical activities with young children were discussed

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)