The Degree to with Secondary School Principals in Jerash Governorate Practice Methods for Resolving Student Conflict from the Teachers\u27 Point of View درجة ممارسة مديري المدارس الثانوية في محافظة جرش لأساليب حل النزاعات الطلابية من وجهة نظر المعلمين

Abstract: This study aimed to identify the degree of practicing high school principals in Jerash Governorate of students conflict resolution methods from teachers\u27 point of view, The study used the descriptive methodolo in data collection. To achieve the objectives of this study, a questionnaire on conflict resolution methods consisting of (26) items was developed where its validity and reliability were assured, The sample of the study consisted of (421) teachers chosen by using stratified randomly sample method. The results of the study revealed that the degree of practicing high school principals in Jerash Governorate conflict resolution methods students from teachers\u27 point of view as a whole was medium. The results also revealed that there were statistically significant differences between the mean responses of the study sample in the degree of practicing high school principals students conflict resolution methods to variable of gender in favor of females, While no significant differences between the mean responses of the study sample in the degree of practicing high school principals students conflict resolution methods to variables of academic qualification and years of experience. ملخص: هدفت الدِّراسة التعرف إلى درجة ممارسة مديري المدارس الثانوية في محافظة جرش لأساليب حل النزاعات الطلابية من وجهة نظر المعلمين, واتبعت الدِّراسة المنهج الوصفي, واستخدمت الدِّراسة في جمع بياناتها استبانة عن أساليب حل النزاعات مكونة من (26) فقرة, وجرى التأكد من صدقها وثباتها. وتكونت عينة الدِّراسة من (421) معلماً ومعلمة تم اختيارهم بالطريقة الطبقية العشوائية. وقد أظهرت نتائج الدِّراسة أنَّ ممارسة مديري المدارس الثانوية في محافظة جرش لأساليب حل النزاعات الطلابية من وجهة نظر المعلمين ككل جاءت متوسطة, وأظهرت النتائج وجود فروق ذات دلالة إحصائية بين متوسطات استجابات أفراد عينة الدِّراسة في درجة ممارسة مديري المدارس الثانوية لأساليب حل النزاعات الطلابية تعزى لمتغير الجنس, ولصالح الإناث. بينما لم توجد فروق ذات دلالة إحصائية بين متوسطات استجابات أفراد عينة الدِّراسة في درجة ممارسة مديري المدارس الثانوية لأساليب حل النزاعات الطلابية تعزى لمتغيرات المؤهل العلمي, والخبرة

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

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

Seat belt syndrome: Delayed or missed intestinal injuries, a case report and review of literature

Introduction: Seat belt injuries are not uncommon. The use of seat belts is associated with a unique injury profile collectively termed “the seat belt syndrome”. The aim is to aid in the early diagnosis of seat belt injuries. Case presentation: Two different patients presented to the emergency after sustaining a motor vehicle accident. Both were the drivers, restrained and had a frontal impact. On presentation they were hemodynamically stable with mild tenderness on the abdomen and the abdominal computed tomography (CT) did not show any signs of bowel or mesenteric injuries. The signs of peritonitis became obvious after 24 h in one case and after 3 days in the other. Discussion: Early diagnosis provides better outcomes for patients with seat belt injuries, but this remains a challenge to trauma surgeons. The typical findings of peritonitis might not be present initially. The presence of abdominal wall ecchymosis (seat belt sign) increases the chance of intraabdominal injuries by eight folds. Conclusion: Clinical signs of intestinal injuries might not be obvious on presentation. In the presence of seat belt sign the possibility of bowl injury must be suspected. Admit the patient for observation even if no clinical or radiological findings are present at presentation

The Degree of Practicing of Schools Principals at Irbid Governorate for Strategic Leadership درجة ممارسة مديري مدارس محافظة اربد للقيادة الاستراتيجية

Abstract: This study aimed to identify the degree of practicing of school principals at Irbid Governorate for strategic leadership from the teachers ’point of view, To achieve that purpose, a descriptive method was used, To collect data, a questionnaire on strategic leadership was developed, consisting of (23) items, The validity and reliability of the instruments have been verified through applying both instruments on a sample of (302) teachers chosen by using stratified random sample method. The results of the study showed that the degree of practicing of school principals at Irbid Governorate for strategic leadership from teachers\u27 point of view as a whole is a high, The results indicated that there were no statistically significant differences at level (α ≤0.05) between the average responses of the estimates of the individuals of the study sample in the degree of practicing of school principals at Irbid Governorate for strategic leadership to variables of sex, and educational qualification, While the significant differences appeared according to years of experience variable for favor to the less than ten years. The study recommended that the principal provide a suitable environment for teachers to work efficiently and psychologically, and encourages them to exercise their leadership roles. ملخص: هدفت هذه الدراسة تعرف درجة ممارسة مديري مدارس محافظة اربد للقيادة الاستراتيجية من وجهة نظر المعلمين, ولتحقيق أهداف الدراسة تم استخدام المنهج الوصفي, ولجمع البيانات تم تطوير إستبانة عن القيادة الاستراتيجية مكونة من (23) فقرة, وتم التحقق من صدقها وثباتها, وتطبيقها على عينة مكونة من (302) من المعلمين والمعلمات تم إختيارهم بالطريقة الطبقية العشوائية. وقد توصلت الدراسة إلى مجموعة من النتائج أهمها أن درجة ممارسة مديري مدارس محافظة اربد للقيادة الاستراتيجية من وجهة نظر المعلمين جاءت مرتفعة, وأظهرت النتائج عدم وجود فروق ذات دلالة إحصائية عند مستوى دلالة (α ≤0.05) بين متوسطات تقديرات أفراد عينة الدراسة لدرجة ممارسة مديري مدارس محافظة اربد للقيادة الاستراتيجية تعزى لمتغيري الجنس والمؤهل العلمي, في حين ظهرت الفروق على متغير سنوات الخبرة ولصالح أصحاب الخبرة (10 سنوات فأكثر), وأوصت الدراسة أن يوفر مدير المدرسة الأجواء المناسبة للمعلمين للعمل بكفاءة وراحة نفسية, ويشجعهم على ممارسة أدوارهم القيادية

Learning points from a case of severe amoebic colitis

A case of amoebic colitis and liver abscess is described in a previously fit 59-year old man who had been given the incorrect diagnosis of ulcerative colitis. His symptoms were so severe that a colectomy was being considered. The patient had a significant travel history including trips to Morocco, the Gambia and Cape Verde, putting him at risk of acquiring amoebic disease. However, this history was not ascertained until much later on in the disease process. The case highlighted crucial learning points including the importance of taking a lifelong travel history, the difficulties in telling ulcerative colitis and amoebic colitis apart both clinically and histopathologically, and the importance of sending multiple stool samples for parasitological microscopy analysis in patients being investigated for inflammatory bowel disease

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

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

Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March - May 2020, "period 1"), and then again between May and June ("period 2") and June and July 2020 ("period 3"). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries' first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic "normal" by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries