Dominant Management Styles of the Classrooms by the Faculty Members in Alia University College

This study aimed at identifying the dominant classroom management styles by the faculty members in Alia University College, as viewed by its (female) students. It also aimed to identify whether there are statistically significant differences among the dominant management styles of the college faculty members attributed to the gender variable of the faculty member. The study population consisted of all the BA stage female students in the College (n=2584) in 2012/2013 university year. The sample consisted of (400) students representing (15.48%) pf the total study population, who were selected by the stratified random manner. The study concluded that the democratic style is the more dominant with the faculty members of the college, as viewed by the female students, with (3.98) mean, followed by the leisurely style with (2.92) mean. Meanwhile, the study revealed that the autocratic style is the least used of all the management styles. The study further found that there are no apparent differences in the in the dominant management styles of the classrooms with the faculty members (traditional, autocratic or democratic styles) in the college attributed to the faculty member gender variable. However, the study found apparent differences in the leisurely management style with the faculty members attributed to the gender variable, in favor of males. The study concluded in a number of recommendations. Keywords: Classroom management, Alia University College, Balqa' Applied University

MyMosqueNet2Cloud collaborative system: a network of mosques towards eradicating poverty in Malaysia

This paper proposes a conceptual collaborative system based on the deployment of the (a) Quadruple Helix Model (QHM), where a country's economic structure lies on four actors namely: academia, industry, government, and citizen, and the economic growth are generated by the clustering and concentration of talented and productive actors; (b) “Whole of-Government” (WoG) implementation that demands for a collaborative and co-operative arrangement of open consultation, open data, shared knowledge and expertise, consolidation of shared services and enhanced horizontal application across government agencies; and (c) citizen-centric Network-of-Mosques (NoM) – and focusing on achieving a higher quality of life and sustainable prosperity for all poor families in Malaysia. The proposed system, called MyMosqueNet2Cloud Collaborative System, will be accomplished through leveraging the advances in cloud computing and mobile applications. The System will expand the use of the eKasih database, managed by the Department of Social Welfare (DSW), and it can be used and updated by all other relevant government agencies. This proposed collaborative inter-organizational system is to enable a consolidated approach for government agencies, NGOs,the private sector and individuals in building up a single and trusted national database based on the poor families in Malaysia. This database, proposed to be co-owned and managed by government agencies such as DSW and Department of Islamic Development Malaysia (JAKIM) through NoM, can be used and updated by all other authorized organizations and individuals in making a consolidated contribution in nurturing and developing the poor families. Thus, this System shall eliminate unnecessary silos in efforts as well as duplication in data. The expected outcome of the System will be an enhanced quality of life for the poor families through the execution of government-led programs such as eKasih and 1Azam, with close collaboration with other QHM actors

Gestational diabetes prevalence and risk factors among pregnant women — Jazan Region, Saudi Arabia

Background. The gestational diabetes (GDM) is considered as a global public health problem that affects pregnant women. GDM can become chronic type II and usually it is associated with many risk factors that may lead to many serious complications for the mother and the fetus. The main objective of this study was to estimate the prevalence of GDM among pregnant women in Jazan region and to determine the possible associated factors of the GDM. Material and methods. The study involved pregnant women attending department of Obstetrics and Gynecology at government hospitals of Jazan region. A sample of 440 pregnant women were randomly selected. Interviews were conducted using a questionnaire prepared to measure the GDM prevalence, risk factors, awareness and adherence to the advice of the doctor and medications. Results. The prevalence of gestational diabetes among pregnant women in Jazan is estimated at 8.2%. The GDM prevalence was significantly higher among obese women (20.2%; 95% CI 13.2–29.2) compared with women with normal weight (7.1%; 95% CI 1.7–7.6). The analysis showed that GDM was significantly associated with child weight more than 3.5 kg (OR 4.315; p = 0.004), mother’s BMI more than 30 kg/m2 (OR 4.703; p = 0.001), and family history of GDM (OR 2.606; p = 0.046). Conclusion. In conclusion, the GDM prevalence obtained in this study is more than global prevalence and less than other studies in KSA. The BMI of mothers and having neonates that weight more than 3.5 kg are the main risk factors for GDM. Suitable interventions programs are highly required for control and risk factor modifications

Częstość występowania cukrzycy ciążowej i jej czynników ryzyka u ciężarnych kobiet w prowincji Dżazan w Arabii Saudyjskiej

Wstęp. Cukrzycę ciążową (GDM) uważa się za globalny problem zdrowotny dotyczący ciężarnych kobiet. Może ona przejść w cukrzycę typu 2 i zwykle wiąże się z wieloma czynnikami ryzyka, które mogą prowadzić do poważnych powikłań u matki i płodu. Głównym celem badania było oszacowanie częstości GDM u kobiet w ciąży mieszkających w prowincji Dżazan oraz określenie czynników, które mogą wiązać się z GDM. Materiał i metody. Badanie obejmowało kobiety w ciąży będące pod opieką oddziałów położniczo-ginekologicznych szpitali państwowych w prowincji Dżazan. Wybrano losowo próbę liczącą 440 ciężarnych kobiet. Przeprowadzając wywiady z uczestniczkami badania, korzystano z kwestionariusza opracowanego w celu oceny częstości występowania GDM, czynników ryzyka, wiedzy kobiet na temat GDM i przestrzegania zaleceń lekarskich oraz przyjmowania leków. Wyniki. Częstość GDM wśród ciężarnych kobiet w prowincji Dżazan wynosiła 8,2%. Była ona istotnie wyższa u kobiet otyłych [20,2%; 95-procentowy przedział ufności (CI) 13,2–29,2) niż u osób z prawidłową masą ciała (7,1%; 95% CI 1,7–7,6). Analiza wykazała, że GDM wiązała się istotnie z urodzeniem dziecka o masie ciała wynoszącej ponad 3,5 kg [iloraz szans (OR) 4,315; p = 0,004), wskaźnikiem masy ciała (BMI) matki wynoszącym ponad 30 kg/m2 (OR 4,703; p = 0,001) oraz dodatnim wywiadem rodzinnym dotyczącym GDM (OR 2,606; p = 0,046). Wnioski. Podsumowując, częstość GDM stwierdzona w badaniu była większa niż globalna częstość występowania GDM, lecz mniejsza niż obserwowana w innych badaniach w populacji saudyjskiej. Wskaźnik BMI matki i urodzenie dziecka o masie ciała powyżej 3,5 kg to główne czynniki ryzyka GDM. Potrzebne są odpowiednie programy interwencyjne w celu kontroli i modyfikacji czynników ryzyka

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Ergonomics in robotic surgery: patients’ safety and protection during complex procedures

Specific injuries due to poor positioning seen in robotic pelvic surgery include slips, compartment syndrome, facial oedema, injuries on pressure points, and accidental injuries caused by the robotic arms. The use of the vacuum bean-bag positioner, L-bar against the patient’s face, and inflated gloves for hand support are simple and effective techniques and should be included in the standard operating policies for robotic surgery. We recommend use of the “L” shaped safety bar against the patient’s face to ensure protection against accidental injuries caused by the robotic arms. The anti-slip bean-bag mattress is efficient to prevent slipping; it conforms to the shape of the body for stable positioning and allows extremities to lie in a natural position. Protection of pressure points of hands and elbows can be done with inflated medical gloves placed in the patient’s hands. Surgeons, anaesthetists and theatre teams are together responsible for ensuring that safety measures are in place to reduce the risk of these complications

Diabetogenic effect of hepatitis C virus and insulin resistance among chronic hepatitis C patients

Context Hepatitis C virus (HCV) is a major cause of chronic liver disease worldwide. In addition to established liver injury, type 2 diabetes mellitus is one of the most important extrahepatic metabolic disorders that are attributed to HCV infection. Aim The aim of this study was to investigate the impact of HCV infection in insulin resistance (IR). Patients and methods Our study included 100 patients with HCV who were divided into two groups according to the presence and absence of diabetes and 25 diabetic patients who served as a control group. They were subjected to full medical history and examination and laboratory investigations including high-sensitivity C-reactive protein (CRP), serum tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), fasting insulin, and fasting glucose. Results Our study showed increased IR among diabetic HCV-infected patients (group I) with a mean level of homeostasis model assessment of IR of 3.02, 1.457, and 1.064 in groups I, II, and III, respectively. There was also an increased level of proinflammatory cytokines (CRP, TNF-α, and IL-6) in this group, with mean levels of high-sensitivity CRP of 9.448, 7.7062, and 5.8229 mg/dl in groups I, II, and III, respectively. The mean level of IL-6 in group I was 215.63 pg/ml, in group II it was 167.62 pg/ml, and in group III it was 173.72 pg/ml. The mean level of TNF-α was 626.12, 618, and 422.76 pg/ml in groups I, II, and III, respectively, suggesting the role of proinflammatory cytokines in the pathogenesis of IR in chronic HCV. Conclusion HCV infection is associated with an increased level of proinflammatory cytokines that play a crucial role in the pathogenesis of IR in chronic HCV