Summary Background 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov , NCT03471494 . Findings Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding National Institute for Health Research Global Health Research Unit.
Introduction: this study is part of a research project concerning the teacher training in information and communication technologies (ICT) profile. Its aim is to develop and validate an instrument for measuring this profile in primary and secondary schools.
The aims of this research are the following: (a) to design a scale to measure the job satisfaction of school administrators, (b) to analyze the satisfaction level of this group. Coherently, this paper presents a reliable, valid and unprecedented scale with an Alfa Coefficient of 0.80 and with a factorial structure that explains 64% of the variance. It is concluded that administrators are highly satisfied; first of all, with management team and secretary's collaboration; secondly, with teaching staff and students/families; and, finally, with work conditions. Sex variable does not show any relation with head teachers' satisfaction, contrary to the type of educational institution variable that it does. ResumenEste trabajo se articula en torno a dos objetivos: uno, diseñar una escala que permita medir la satisfacción laboral de los directores escolares y, dos, analizar el nivel de satisfacción de este colectivo. En consecuencia, se presenta un instrumento inédito, válido y fiable, con un Coeficiente Alfa igual a 0.80 y una estructura factorial que explica el 64% de la varianza del instrumento. Se concluye que los directores escolares muestran altos niveles de satisfacción, de forma jerarquizada: en primer lugar, con el equipo directivo y el personal de secretaría; en segundo lugar, con el profesorado y el alumnado/familias; y, finalmente, con las condiciones laborales. La variable sexo no muestra relación con la satisfacción del director pero sí el tipo de centro donde trabaja.
El objetivo es evaluar el efecto de la Geometría de la Tortuga del lenguaje de programación Scratch 2 en el aprendizaje de conceptos geométricos de futuros profesores de Primaria. Se ha realizado un estudio cuasi-experimental en la Facultad de Educación de la Universidad Complutense de Madrid. Se han hecho análisis descriptivos, diferenciales y correlacionales sobre el rendimiento académico y la satisfacción de los estudiantes con una metodología con Scratch 2 y, además, análisis clúster para la identificación de tipologías de alumnado. Los resultados muestran que los estudiantes que han seguido esta metodología tienen niveles significativamente más altos en geometría. Se han identificado tres tipologías de alumnado, estando relacionado su rendimiento matemático y su actitud hacia la metodología. Así, esta metodología favorece el desarrollo de habilidades geométricas en futuros docentes de Primaria.
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