The Invariance of Factorial Structure of the Academic Delay of Gratification Scale across Two Samples of Omani and British Adolescents: A Cross-Cultural Psychometric Study

The present study aimed at investigating the factorial structure of the Academic Delay of Gratification Scale (ADGS) that best fit the data of two Omani and British samples, and whether this factorial structure is invariant across these two samples. The sample of the study included 450 (235 males and 215 females) and 410 (215 males and 195 females) Omani and British adolescents, respectively. The results of the multi-group confirmatory factor analysis showed that the scale had a unidimensional factorial structure in both samples and that this factorial structure was completely invariant when compared between gender across the two samples (Omani males versus British males, and Omani females versus British females) and between males and females in the British sample. However, this factorial structure was partially invariant when compared between males and females in the Omani sample. The results of the latent mean analysis showed that females had significantly higher levels of academic delay of gratification when compared with males in both samples. The results showed that there was a positive correlation between students’ scores on the ADGS and their academic achievement scores in both samples. The results also showed that high achievers had significantly higher levels of academic delay of gratification than low achievers in both samples

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society