The Extent of Employment of Teachers of The Basic Education Stage (Second Cycle) for Networks Social Communication In The Educational Process Field Study In Lattakia

The aim of the research is to identify the extent to which the teachers of the basic education stage (H2) in Lattakia for social networks in the educational process and the study of the differences between teachers in basic education (H2) in relation to the extent of employment of social networks in the educational process, Qualifications, years of teaching experience. The research was based on the descriptive approach. The research community included all the teachers and teachers in the basic education stage in Lattakia. The sample of the study is a random sample of (200) teachers and teachers. The questionnaire was distributed to them. The research found a number of results, the most important of which are: The teachers of the second cycle of basic education in Lattakia employ social networks (as a source of knowledge, teaching, promotion of education, evaluation) to a medium degree. The results showed that there were no statistically significant differences between the average teachers of the second cycle of basic education in Lattakia in the extent of their employment of social networks in the educational process due to gender variables, scientific qualification and years of experience.

Obstacles To the Use of E-Learning From the Point of View of Secondary School Teachers Field Study in Lattakia

  The study aims to identify obstacles to the use of e-learning (administrative and physical obstacles, obstacles related to teacher and student, obstacles related to e-learning) from the point of view of secondary school teachers in Lattakia, and study differences between teachers regarding the obstacles of using e-learning according to variables: gender, , And years of teaching experience. The study was based on a descriptive approach. The research community included all teachers and teachers in secondary education in Lattakia. The sample of the research is a random sample of 200 teachers and a secondary school. The questionnaire was distributed to them, 185 of which were complete and valid for statistical analysis . The results showed that the use of e-learning from the point of view of secondary education teachers in Lattakia faced administrative and physical obstacles with a relative importance (75.9%). Administrative and material obstacles came first, followed by obstacles related to teacher and student with relative importance (74.58% , And the third place is the obstacles related to e-education with relative importance (72.16%). The results also showed no statistically significant differences between the average scores of secondary school teachers in relation to the obstacles of the use of e-learning according to the gender variables, the scientific qualification and the number of years of experience.

Synthesis, X-ray, Hirshfeld, and AIM Studies on Zn(II) and Cd(II) Complexes with Pyridine Ligands

The synthesis and crystal structures of three heteroleptic complexes of Zn(II) and Cd(II) with pyridine ligands (ethyl nicotinate (EtNic), N,N-diethylnicotinamide (DiEtNA), and 2-amino-5-picoline (2Ampic) are presented. The complex [Zn(EtNic)2Cl2] (1) showed a distorted tetrahedral coordination geometry with two EtNic ligand units and two chloride ions as monodentate ligands. Complexes [Zn(DiEtNA)(H2O)4(SO4)]·H2O (2) and [Cd(OAc)2(2Ampic)2] (3) had hexa-coordinated Zn(II) and Cd(II) centers. In the former, the Zn(II) was coordinated with three different monodentate ligands, which were DiEtNA, H2O, and SO42−. In 3, the Cd(II) ion was coordinated with two bidentate acetate ions and two monodentate 2Ampic ligand units. The supramolecular structures of the three complexes were elucidated using Hirshfeld analysis. In 1, the most important interactions that governed the molecular packing were O···H (15.5–15.6%), Cl···H (13.6–13.8%), Cl···C (6.3%), and C···H (10.3–10.6%) contacts. For complexes 2 and 3, the H···H, O···H, and C···H contacts dominated. Their percentages were 50.2%, 41.2%, and 7.1%, respectively, for 2 and 57.1%, 19.6%, and 15.2%, respectively, for 3. Only in complex 3, weak π-π stacking interactions between the stacked pyridines were found. The Zn(II) natural charges were calculated using the DFT method to be 0.8775, 1.0559, and 1.2193 for complexes 1–3, respectively. A predominant closed-shell character for the Zn–Cl, Zn–N, Zn–O, Cd–O, and Cd–N bonds was also concluded from an atoms in molecules (AIM) study

Synthesis, structure diversity, and antimicrobial studies of Ag(i) complexes with quinoline-type ligands

Compounds [Ag(5NO2Qu)2]BF4 (1) and [Ag(Qu3CN)(H2O)]BF4 (2) were prepared and studied from a structural perspective and screened for antimicrobial activity. The Ag(i) in the monomeric complex 1 is coordinated to two 5-nitroquinoline (5NO2Qu) ligands via the N-atoms of the quinoline rings with equidistant Ag-N bonds (2.146(2) \uc5) and a N-Ag-N# bond angle of 171.42(8)\ub0. The 2D coordination polymer 2 contains tetracoordinated Ag(i) with two N-atoms (N1 and N2#1) from two quinoline-3-carbonitrile (Qu3CN) ligands and two O-atoms (O1 and O1#1) from two water molecules. The Qu3CN ligand acts as a connector between the Ag(i) sites along the b-direction via two short Ag1-N1 (2.185(4) \uc5) and Ag1-N2#1 (2.204(4) \uc5) bonds. In addition, the Ag(i) is coordinated with two symmetry related water molecules which are also acting as connectors between the Ag(i) sites along the a-direction via two longer Ag1-O1 (2.470(4) \uc5) and Ag1-O1#2 (2.546(4) \uc5) bonds. Hirshfeld surface analysis confirmed the significance of the polar F⋯H contacts in the molecular packing of 1 (25.9%) and 2 (39.9%). In addition, the crystal packing of 1 showed a significant amount of polar O⋯H (23.5%) contacts. Also, both complexes displayed π-π stacking interactions. The Ag(i) complexes and the free ligand were assessed for their antimicrobial activities. It was found that 1 (MIC = 7.8 μg mL−1) and 2 (MIC = 31.25 μg mL−1) have higher antifungal potency against C. albicans than their free ligands (MIC = 125 μg mL−1). Interestingly, 1 has better antifungal activity than the standard nystatin (15.6 μg mL−1). Also, both Ag(i) complexes and the free ligands as well have better activity against P. mirabilis than the common antibiotic amoxicillin

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

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

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

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)