Reading Clinic to Improve At-Risk Seventh Graders' Reading Comprehension Skills in Gaza UNRWA Schools

The purpose of this study was to examine the effectiveness of a proposed Reading Clinic program as a remedial intervention program to improving reading comprehension skills of at-risk students of grade 7 in UNRWA schools at Gaza. The main question guiding this study was: To what extent reading clinic program is effective in improving reading comprehension skills of at risk categorized students of grade seven at UNRWA Schools in Gaza? Minor questions were: What comprehension skills are necessary for middle school students to be successful readers? What is a reading clinic as a remedial intervention reading program? Does the use of the proposed reading clinic program improve the comprehension skills of seventh grade at-risk students? From the participants' perspectives, does the proposed reading clinic program tutoring instruction help them improve their reading comprehension skills? To answer the first question, the researcher prepared a list of the most important reading comprehension skills for the seventh graders. Having reviewed the literature and the Ministry of Education handbook (1999), the researcher concluded that scanning, skimming, inference making, prediction /anticipation making and word recognition skills are the most necessary reading skills for the seventh graders. To answer the second question, however, the researcher reviewed the related literature, also visited many reading clinics available online and hence concluded that the reading clinic program is a remedial intervention program that aims at improving reading basic skills. Reading clinic programs scaffold reading instruction as to gradually allow students move from instructional reading practices to independent reading practices. To answer the third question, the researcher collected data using an achievement pre-post test and two supportive tools; classroom teachers' observation checklist and a weekly assessment selection reading texts. As the researcher ensured the validity and the reliability of her tools, she constructed her program and administrated it for 14 weeks; 12 weeks for tutoring and two weeks for administrating the pre-post test and to conduct the preliminary meetings with parents, classroom teachers and the students themselves. The sample of the study was 21 girl students from Beach Prep. Girls “C” in UNRWA school in West Gaza Education Area. Data collected was analyzed using the SPSS using Willcson Z test and Eta square to measure the effect size. After the researcher had finished the program tutoring sessions, she administrated the post test. The post test results were compared with those of the per test and the comparison indicated statistically significant differences on students’ performance on each comprehension skill domain and the total test domains in favour of the post test, which means that the proposed reading clinic program was effective and helped students improve their reading comprehension skills. To answer the fourth question, the researcher constructed a student's self-assessment questionnaire by which she helped the participants to reflect on their experience in the reading clinic tutoring sessions. Results indicated that the participants perceived reading clinic tutoring instructions as supportive learning strategies that helped them improve their reading comprehension skills. In the light of these findings, the researcher suggests the following: Utilizing reading clinic programs to help at-risk students, to improve other reading comprehension skills, for example reading fluency and summarizing. Utilizing reading aloud and cooperative reading instructions to support students build their basic reading skills. Helping students to acquire scanning, skimming making predictions and word recognition as basic reading comprehension skills. In order to extend the findings of this study, the researcher recommends the following: A study should be conducted to investigate the effectiveness of reading clinic programs in improving other reading skills, for example decoding and reading fluency. A study to examine the impact reading clinic program may have on teachers perception and professional practices in teaching at-risk students

Evaluation of Imprint Cytology of Endoscopic Gastric Mucosa Biopsy in the Diagnosis of Helicobacter pylori Infection

Background:Helicobacter pylori colonization of the gastric mucosa is associated with the pathogenesis of gastritis, peptic ulcer disease, and gastric malignancy. There are several methods to detect the presence of Helicobacter pylori.These tests include noninvasive method (serology, urea breath test, or stool antigen test) and invasive methods, such as, culture, histological examination, and rapid urease test. Method:This descriptive prospective cross sectional study was conducted in Gezira state in Wad Madeni from March - August 2016;it aimed to determine the sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of imprint cytology in the detection of H. pylori compared with stool Ag test. H.pylori stool Ag test was done for 50 clinically suspected patients for H.pylori infection and one gastric biopsy from each patient was collected during endoscopy. Air-dried imprint smears of gastric biopsies were stained by the Diff-Quik method and examined for H.pylori. The presence of inflammation and intestinal metaplasia were documented. Results: The H. pylori prevalence was 38% by stool Ag test and 42% by imprint cytology. The sensitivity and specificity of imprint cytology in the detection of H. pylori were 89.5% and 87.1% respectively. The PPV and NPV were 80.1% and 93.1%, respectively. The accuracy of the test was 88.0%. Conclusion:This study concludes that gastric imprint smears stained with Diff-Quik method is a rapid, cheap, and reliable method for the detection of H.pylori infection.It recommends the use of Imprint cytology for detection of Helicobacter pylori inpatients undergoing upper gastrointestinal endoscopy

False Beliefs About Diabetes Mellitus in the Kurdistan Region of Iraq: A Population-Based Study

Background. Diabetes mellitus (DM) is a chronic, non-transmissible health condition distinguished by high blood glucose levels caused by faulty insulin secretion and impaired insulin activity. People play an essential role in preventing and managing their illnesses. Thus, the misconceptions may negatively influence the prevention and management of DM. The aim of this study was to gauge the extent of knowledge among the general population concerning DM, to determine the prevalence of misconceptions about DM in the community, and to find the factors influencing them. Methods. A population-based study was conducted in Duhok Province, the Kurdistan Region of Iraq. A total of 2,305 adults were enrolled in the study. The study data were collected by face-to-face interview. The survey questionnaire comprised two sections: the first section included basic demographic characteristics of participants, while the second section consisted of ten questions to identify common misconceptions about DM among participants. Results. Among the participants, there were 1,406 (61.0%) females. Participants’ age ranged from 18 to 90 years (the mean age: 54 ± 13.69 years). The most common misconceptions positively responded to were “Will I become addicted to insulin if I start taking it?”, followed by“ Does DM occur because of increased sugar intake?”. Male gender was associated with higher level of misconceptions. In addition, the misconceptions were more prevalent among diabetics as they might seek treatment from non-professionals. There was a significant association between education status and the prevalence of misconceptions. Healthcare workers were found to have a better knowledge about DM compared to the general population. Surprisingly, certain myths were prevalent even among healthcare workers. Conclusions. Certain myths and misconceptions have been pervasive in our society. Actions must be taken to dispel these misconceptions as they lead to an avoidable burden of disease. Therefore, people’s knowledge of DM needs to be enhanced through educational programs, social media, television, newspapers and campaigns

Intestinal parasitic infections among expatriate workers in various occupations in Sharjah, United Arab Emirates

Intestinal parasitic infections are prevalent throughout many countries. This study aimed to determine the prevalence of intestinal parasite carriers among 21,347 expatriate workers, including food handlers and housemaids attending the public health center laboratory in Sharjah, UAE. Stool sample collection was performed throughout the period between January and December 2013. All samples were examined microscopically. Demographic data were also obtained and analyzed. Intestinal parasites were found in 3.3% (708/21,347) of the studied samples (single and multiple infections). Among positive samples, six hundred and eighty-three samples (96.5%) were positive for a single parasite: Giardia lamblia (257; 36.3%) and Entamoeba histolytica/Entamoeba dispar (220; 31.1%), respectively, whereas mono-infections with helminths accounted for 206 (29.1%) of the samples. Infection rates with single worms were: Ascaris lumbricoides (84; 11.9%), Hookworm (34; 4.8%), Trichuris trichiura (33; 4.7%), Taenia spp. (27; 3.81%), Strongyloides stercoralis (13; 1.8%), Hymenolepis nana (13; 1.8%), and Enterobius vermicularis (2; 0.28%), respectively. Infections were significantly associated with gender (x2 = 14.18; p = 0.002) with males as the most commonly infected with both groups of intestinal parasites (protozoa and helminths). A strong statistical association was noted correlating the parasite occurrence with certain nationalities (x2= 49.5,

Dry cooling with night cool storage to enhance solar power plants performance in extreme conditions areas

Solar thermal power plants are usually installed in locations with high yearly average solar radiation, often deserts. In such conditions, cooling water required for thermodynamic cycles is rarely available. Moreover, when solar radiation is high, ambient temperature is very high as well; this leads to excessive condensation temperature, especially when air-condensers are used, and decreases the plant efficiency. However, temperature variation in deserts is often very high, which drives to relatively low temperatures during the night. This fact can be exploited with the use of a closed cooling system, so that the coolant (water) is chilled during the night and store. Chilled water is then used during peak temperature hours to cool the condenser (dry cooling), thus enhancing power output and efficiency. The present work analyzes the performance improvement achieved by night thermal cool storage, compared to its equivalent air cooled power plant. Dry cooling is proved to be energy-effective for moderately high day–night temperature differences (20 °C), often found in desert locations. The storage volume requirement for different power plant efficiencies has also been studied, resulting on an asymptotic tendency

Isolation, identification, and characterization of resistant bacteria to antibiotics from pharmaceutical effluent and study of their antibiotic resistance

Pharmaceutical effluents primarily enter aquatic environments through the discharge of treated and untreated wastewater from various sources, including hospitals, pharmaceutical manufacturing facilities, and households. Microbes sourced from pharmaceutical effluents such as Pseudomonas spp. pose a significant public health concern because of their high levels of resistance to multiple drugs and extreme multidrug resistance. Therefore, the present study was conducted for the isolation, identification, and molecular characterization of selected isolates from pharmaceutical effluents and also determined their antibiotic sensitivity patterns. From June 2016 to March 2017, a study was conducted on four well-known pharmaceutical companies specializing in antibiotic production in Dhaka and Gazipur. Four wastewater samples were collected from various origins and then brought to the Bacteriology laboratory for microbiological examination. Twelve pure isolates were obtained and characterized through cultural and biochemical tests while molecular identification of Pseudomonas spp. was performed using the 16S rRNA gene sequence. Twelve commercially available antibiotics were used for antibiotic sensitivity tests using Kirby-Bauer disk diffusion methods. We isolated the most predominant isolates, Pseudomonas aeruginosa (41.67%), followed by Bacillus spp. (33.33%) and Staphylococcus spp. (25%) respectively. Among 12 antibiotics, ciprofloxacin is 100% sensitive against P. aeruginosa, while the remaining 11 antibiotics are 100% resistant. Bacillus spp. showed 100% resistance to all antibiotics while 50% sensitive to vancomycin and 100% to chloramphenicol, respectively. Staphylococcus spp. was 100% resistant to all antibiotics. Our research suggested that P. aeruginosa is the reservoir of antibiotic resistance genes and spreads disease to humans from the environment. The findings of this study, i.e., the isolation, identification, and characterization of antibiotic-resistant bacteria from pharmaceutical effluent have highlighted, comprehended, and mitigated the dissemination of antibiotic resistance and opportunistic bacteria

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