Demographic covariates and vocational rehabilitation services as predictors of employment outcomes of people with physical disabilities: a hierarchical logistic regression analysis

PURPOSE

Stable employment is essential for the health, psychosocial, and financial well-being of people with physical disabilities (PwPD). Unfortunately, the low employment rate for PwPD in the U.S. exposes them to adverse effects of unemployment, including depression, anxiety, low self-esteem, and physical pain. Helping PwPD find gainful employment will improve their general health and well-being. However, few empirical studies examine factors affecting the employment outcomes of PwPD. This study aims to examine the relationship between demographic covariates, vocational rehabilitation (VR) services, and employment outcomes of PwPD.

MATERIALS AND METHODS

This secondary data analysis study includes 17,598 PwPD from the U.S. Department of Education's Rehabilitation Services Administration's Case Service Report (RSA-911) dataset. Our analysical approach was hierarchical logistic regression analysis.

RESULTS

For VR services, workplace support, technology support, job placement assistance, and VR counseling significantly contribute to predicting employment outcomes for PwPD. Even after entering VR services, the demographic variables (age, race, education, referral sources, low-income, long-term unemployment, and disability significancy) were still significant predictors of employment.

CONCLUSIONS

Findings from this study can be used by state VR counselors and other disability service providers to plan and select effective employment-related interventions to improve the employment outcomes of PwPD.

Effects of COVID-19 on Overdose Risk Behaviors Among People Who Inject Drugs in Wisconsin

BACKGROUND

The United States is currently experiencing the worst epidemic of drug overdose in the country's history. We sought to understand whether changes in drug use behavior and access to prevention services during the COVID-19 pandemic may have contributed to increased drug overdose.

METHODS

We recruited adults with a history of injection drug use to complete an online survey during March through June 2021 to assess whether overdose experiences, drug use behaviors, and access to prevention services changed due to the pandemic.

RESULTS

Diminished social support during the pandemic was correlated with reporting disrupted access to harm reduction services (P = 0.006) and experiencing an overdose (P = 0.005). Disrupted access to harm reduction services also was correlated with being female (P = 0.03) and reporting feeling pressure to share drugs or equipment (P = 0.01), worrying about withdrawal (P = 0.03), and changes to how and where individuals got their drugs, drug price and availability, with whom and where drugs were used, and the quantity or properties of drugs purchased (all P < 0.01).

DISCUSSION

The cumulative impact of COVID-19-related disruptions may have resulted in heightened risk for overdose, as these findings suggest that, in many cases, experiencing one risk factor was suggestive of experiencing several risk factors.

The Impact of Work Incentives Benefits Counseling on Employment Outcomes: A National Vocational Rehabilitation Study

BACKGROUND

Millions of Americans receiving Social Security Administration (SSA) disability benefits aspire to work and reduce reliance on disability benefits, but find the rules about entering or rejoining the workforce too complex or confusing and fear that working will cause loss of important benefits.

PURPOSE

A case control study was conducted to investigate the impact of receiving work incentives benefits counseling (WIBC) on employment outcomes, and its relationship with demographic covariates for U.S. vocational rehabilitation (VR) clients who are SSA disability benefit recipients.

METHOD

Data for this study were extracted from the Rehabilitation Service Administration (RSA-911) database. Mahalanobis distance matching procedures were used to match clients who received WIBC with those who did not receive it. Chi-square independence tests and independent samples t tests were used to compare receipt of WIBC and employment outcomes based on the demographic variables. Additionally, chi squared automatic interaction detection (CHAID) analysis was used to divide VR clients into homogeneous groups based on the covariates.

RESULTS

Clients who received WIBC were more likely to obtain competitive integrated employment (CIE). Impairment type, referral source, long-term employment and education level were significantly associated with CIE for clients who received WIBC. Additionally, VR clients with sensory/communicative impairments and low-income status were less likely to receive WIBC.

CONCLUSION

Modifying VR structure to be more inclusive; understanding of stigma; and increasing the functioning, psychological well-being and self-efficacy of VR clients might improve employment outcomes.

Do Virtues Influence Well-Being: The Role of Perceived Stress

The positive results of life satisfaction among university students have been well studied in the literature. However, the forecasters of the phenomenon have not been thoroughly investigated. In the current study, multiple models were tested to investigate the mediating role of perceived stress in the relationships between virtues and life satisfaction to fill this gap. When testing the model, the effect of demographic variables was controlled. Data were collected through an online survey from a sample of 235 undergraduates. The participants responded to measures of character strengths, perceived stress, and life satisfaction. The findings reveal that perceived stress partially mediates the relationship between leadership, wisdom and life satisfaction controlling for age and gender. The leadership skills of students can be improved, and age and gender should be considered when studying life satisfaction.

A Psychometric Validation of the Impact on Participation and Autonomy Questionnaire in a Sample of Turkish Cancer Survivors

Community participation and autonomy are two of the vital treatments and rehabilitation outcomes for people with chronic health conditions and disabilities, including people with cancer. The purpose of this study is to investigate psychometric properties of the Impact on Participation and Autonomy Scale (IPA) in a sample of Turkish cancer survivors. An exploratory factor analysis was used to analyze data collected from 186 cancer survivors who completed the IPA, Health Care Climate Questionnaire, Satisfaction with Life Scale, and the Role Functioning subscale of the EORTC Core Quality of Life Questionnaire. In contrast to the original five-factor solution, the results provided a better fit for a three-factor correlated model ( Activities of Daily Living [ADL]/ Instrumental ADL, social relations, and employment and education). The IPA factors were significantly associated with supportive healthcare climate, role functioning, and life satisfaction in the theoretically expected directions, providing support for the nomological construct validity of the Turkish version of the IPA. Overall, the Turkish version of the IPA is a psychometrically sound measure of participation and autonomy that can be used to assess cancer survivors’ levels of community participation for treatment planning and selection of evidence-based healthcare and psychosocial interventions for cancer survivors.

Appropriateness of aspirin use among diabetic patients in primary prevention of atherosclerotic cardiovascular diseases: an analysis of the ASSOS study

OBJECTIVE

Aspirin is an essential drug in the prevention of atherosclerotic cardiovascular disease (ASCVD). It is ultimately indicated in a patient with ASCVD. However, its role is debated in primary prevention. We aimed to investigate the appropriateness of aspirin use in diabetic patients according to recommendations of recent guidelines.

PATIENTS AND METHODS

ASSOS was a multicenter observational study investigating aspirin use in cardiology outpatient clinics. We evaluated aspirin use in diabetic patients in primary prevention from the ASSOS study. We also assessed the appropriate use of aspirin according to the European Society of Cardiology (ESC), American College of Cardiology/American Heart Association (ACC/AHA), American Diabetes Association (ADA), Consensus Statement of Endocrinology, Cardiology, and Nephrology (ENCARNE), and the United States Preventive Services Task Force (USPTF).

RESULTS

A total of 5,007 patients of whom 1,537 had type 2 diabetes mellitus (DM) were included in the study. 1,132 of the total participants used aspirin for primary prevention; 313 of them had type 2 DM. Only 248 (76.7%), 132 (40.8%), and 128 (39.6%) diabetic patients indicated aspirin use according to the ESC/INCARNE, ACC/AHA, and ADA/USPTF guidelines, respectively.

CONCLUSIONS

Inappropriate aspirin use was common among diabetic patients, according to clinical practice guideline recommendations. In addition, the differences between the indications for the use of aspirin in diabetic patients according to the guidelines were remarkable. Guidelines that minimize these differences are needed for clinicians, and compliance with these guidelines in clinical practice could reduce inappropriate aspirin use.

Characteristics of individuals with disabilities receiving transportation services in vocational rehabilitation

BACKGROUND: Adequate, accessible public transportation is essential to fully address social and economic disparities that exist among individuals with disabilities. Despite removal of many physical barriers within transportation systems, significant barriers to public transportation for people with disabilities are still widespread. OBJECTIVE: Transportation is commonly cited as an obstacle to employment for individuals with disabilities, and as a result, a thorough analysis of specific factors influencing the use of public transportation by individuals with disabilities is necessary to fully understand patterns of use. METHOD: The current study used a national sample of individuals with disabilities in pursuit of employment to investigate characteristics that predict the receipt of transportation services by vocational rehabilitation personnel. RESULTS: Results indicate individuals who were not employed, who were receiving welfare and/or TANF, who were homeless, who were living in rehabilitation facilities, and/or living in substance abuse treatment centers were more likely to receive transit services from vocational rehabilitation programs. Also, individuals with substance use problems, mental health disorders, HIV/AIDS or other immune deficiency disorders, and/or people from racial or ethnic minority backgrounds were more likely to receive transit service support from vocational rehabilitation programs. CONCLUSION: Improvement in transportation services for individuals with disabilities is needed on a systems and individual level. State rehabilitation counselors can evaluate the extent high-risk clients identified in this study can benefit from transit services as well as other wrap around services that can improve their engagement in VR services leading to better employment outcomes.

Demographic Covariates, Vocational Rehabilitation Services, and Employment Outcomes of Working-Age Adults with Anxiety Disorders: A Multivariate Logistic Regression Analysis

PURPOSE

This study aimed to investigate the relationships between demographic covariates, vocational rehabilitation (VR) services, and employment outcomes of individuals with anxiety disorders. The specific research question for the current study investigate demographic variables and vocational rehabilitation services as predictors of competitive employment outcomes.

METHODS

Data for the present study were extracted from the most recent United States Rehabilitation Service Administration 2018 Case Service Report (RSA-911) data. A purposeful selection, multivariate logistic regression analysis was conducted to examine the case service report data of 9266 individuals with anxiety disorders who received vocational rehabilitation services based on their demographic variables and receipt of VR services.

RESULTS

The results indicated that African Americans and Latinx, people who have completed high school or more, people who do not receive disability-related benefits, and those who received more vocational rehabilitation services were more likely to be gainfully employed. In addition, receipt of financial support for life crises and occupational credentials (i.e., other services and maintenance services) and vocational rehabilitation counseling and guidance services were significant predictors of employment outcomes. Conversely, receipt of supported employment and transition services were negatively associated with employment outcome.

CONCLUSIONS

In the present study, we identified VR services that can improve and risk factors that can impede employment outcomes of people with anxiety disorders. We also identified medical, psychosocial, and vocational interventions that can lessen the effect of anxiety disorders on physical and mental health functioning.

Factors Impacting Functioning Level of Cancer Survivors in Turkey

The purpose of this study was to investigate the relationships between demographic variables, personal factors, impairment-related variables, and functioning levels of cancer survivors in Turkey. Data for this study were collected from a major oncology institute and a nonprofit cancer organization in Turkey. Hierarchical regression analyses were conducted to investigate the sequential effect of demographic variables (i.e., age, gender, income, and education), personal factors (i.e., core self-evaluations, purpose in life, and religiosity), and impairment-related variables (i.e., pain, fatigue, perceived stress, and sleep disturbance) on the functioning level of Turkish cancer survivors (i.e., physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning). The results indicated that impairment-related variables explained a significant amount of variance in functioning scores above and beyond demographic and personal factors. Pain intensity and perceived stress were most prominent factors impacting functioning levels of Turkish cancer survivors. Pain and stress self-management training, psychotherapy and counseling, physical activity and exercise, and cognitive remediation training are recommended interventions to increase the functioning level and well-being of cancer survivors.

Adaptation and Preliminary Validation of a Positive Psychology Assessment Tool: Character Strengths Semantic Differential Scale

Character strengths are a protective factor against psychological symptoms. However, there is a lack of research that has investigated the psychometric properties of abbreviated character strengths scales. The purpose of this study was to adapt and validate the Character Strengths Semantic Differential Scale (CS-SDS) with a sample of 235 college students. Using the back-translation method, the CS-SDS was translated from English into Turkish and then adapted. Next, exploratory factor analysis was conducted to determine the factorial structure of the Turkish version of CS-SDS (T-CS-SDS). The results indicated that the T-CS-SDS had a four-factor structure, namely, leadership, humanity, wisdom, and vitality. Significant moderate correlations were found for the character strengths factors with perceived stress, depression, and life satisfaction. Cronbach’s alpha coefficients for the factors were above .70. This is the first study that supported the use of the T-CS-SDS as a positive psychology assessment tool to design and implement innovative interventions to increase the well-being of college students.

IS REPEAT FNAB NECESSARY FOR THYROID NODULES WITH ND / UNS CYTOLOGY?

CONTEXT/OBJECTIVE

The standard approach is to perform repeat FNAB (rFNAB) in thyroid nodules with non-diagnostic (ND) / insufficient (UNS) cytology. However, due to the nature of these nodules, recurrent FNABs may also be insufficient. Therefore, by comparing the clinical-radiological-pathological parameters of nodules with a definite diagnosis of excision, we questioned the possibility of patient management without rFNAB.

METHODS

Clinical-radiological parameters of 275 nodules belonging to 264 patients in the ND/UNS aspiration group with definite pathological diagnosis after surgery were determined. Under the guidance of these parameters, those with and without rFNAB were compared.

RESULTS

The incidence of malignancy was found to be significantly higher in nodules without rFNAB compared to nodules with rFNAB (p = 0.036). In addition, the incidence of malignancy in BC-1 nodules without rFNAB was significantly higher than in nodules with rFNAB result also BC-1 (p = 0.009). In all cases, nodule size smaller than 10 mm and border irregularity were found to be statistically significant for malignancy (p <0.020, p <0.002). When looking at the distribution of rFNAB results, a significant correlation was observed with female gender, solid component, hypoechogenicity, border irregularity and halo loss around the nodule in patients with BC-4,5,6 cytology results (respectively, 0.005 / 0.031 / 0.001 / 0.012 / 0.004).

CONCLUSION

rFNAB did not show the expected effect in ND / UNS nodules. We recommend direct surgical excision without rFNAB for nodules with border irregularity, solid structure, halo loss and hypoechogenicity, which should be considered more important in female patients.

What are the factors affecting glanular dehiscence after hypospadias surgery?

BACKGROUND

Glanular dehiscence (GD) is one of the main complications after hypospadias surgery. There is a limited number of publications regarding GD in the literature.

OBJECTIVE

The aim of this work is to reveal the factors that affect GD after a literature review.

EVIDENCE ACQUISITION

A literature search for relevant articles was performed in database using the search term glans dehiscence without setting date range limit or any other limits. All articles related to GD after hypospadias surgery were included in this study. After collecting the information from full text articles, 71 articles were included in this systematic review. In these studies, localization of hypospadic meatus, type of surgery, and other clinical data which were thought to behave as risk factors for GD were obtained. Chi-Square test was used to evaluate the differences between the parameters, where p < 0.05 was taken as statistically significant.

RESULTS

After evaluating the 71 articles that met the inclusion criteria, 309 cases (3.48%) of GD after 8858 hypospadias repairs were obtained in this review. GD rates were found significantly high for proximal hypospadias (5%), two-stage hypospadia repairs (5%) and re-do hypospadias repair (8.75%) (p = 0.002, 0.022, and 0.004, respectively). Glans width <14 mm, urethral plate (UP) width <7 mm, hypospadias surgeries performed before 6 months of age and after puberty, and caudal block anesthesia increased the rate of GD.

CONCLUSIONS

The rate of GD increases after proximal, cripple and staged hypospadias surgeries, a glans width <15 mm and UP width <8 mm, postpubertal surgeries, and caudal anesthesia use during surgery.

Demographic, Transition, and Vocational Rehabilitation Service Variables’ Association With High School Completion Outcomes of Youth With Disabilities Receiving SSI

Completing high school expands career prospects for young adults with disabilities, increasing their likelihood for gainful employment. Those who graduate from high school are more likely to have higher salaries and longer job tenure than those who do not have high school diplomas. As such, graduating from high school is a significant milestone for students with disabilities. Yet, the specific predictors of high school completion among youth with disabilities are not well understood. This study used three multiple logistic regression analyses and a hierarchical logistic regression analysis to evaluate demographic, PROMISE transition services, and vocational rehabilitation (VR) services as predictors of high school completion in a sample of 350 transition-age youth receiving Supplemental Security Income. Among the demographic variables examined, race, disability type, parent education, and family income were significant predictors of completion. For transition services, social skills training and self-advocacy training were independently associated with high school completion, while miscellaneous training was the only independent significant VR service predictor. Findings support the importance of pre-employment transition services, especially in the areas of social skills training, self-advocacy training, and VR services in the areas of miscellaneous training that can be used to promote completion of high school.

P–336 The role of endoplasmic reticulum stress in endometriosis; preliminary results

Study question

Can X-box binding protein 1 (XBP–1) be used in evaluation of endoplasmic reticulum (ER) stress in endometriosis patients?

Summary answer

High levels of XBP–1 among endometriosis patients indicate an association between ER stress and endometriosis.

What is known already

ER is responsible for protein folding, lipid synthesis, and calcium homeostasis. ER stress occurs due to the accumulation of unfolded or misfolded proteins in the ER. ER stress causes the activation of several signal transduction cascades, defined as the unfolded protein response (UPR). In the studies conducted with ectopic endometrial tissue and cells, it was reported that UPR plays a role in the pathogenesis of endometriosis. The XBP–1 is a transcription factor involved in UPR, where it regulates ER stress-mediated apoptosis. XBP–1 is also responsible for endometrial cell migration, which is also a part of the pathogenesis of endometriosis.

Study design, size, duration

This prospective case-controlled study was conducted at University of Health Sciences Turkey, Istanbul Kanuni Sultan Suleyman Training and Research Hospital Department of Obstetrics and Gynecology between March 2020 – August 2020. A total of 60 subjects were included in the study. All patients gave their written informed consent before their enrollment in the study.

Participants/materials, setting, methods

30 endometriosis patients aged 18–45 years were included in the study group. Patients with a history of ovarian surgery, endocrine, autoimmune and metabolic disorders, and hormonal treatment during the previous three months were excluded. 30 healthy subjects without endometriosis were included in the control group. Endometriomas were measured with transvaginal ultrasonography and pain was evaluated with visual analogue scale (VAS). XBP–1 levels were determined from serum samples using Human XBP–1 ELISA Kit (Elabscience Co., USA).

Main results and the role of chance

The mean age of the control group was 28.33±2.49, and the study group was 27.76±2.45 (p = 0.374). The mean endometrioma volume in the study group was calculated to be 9.9± 9.05. The mean XBP–1 level in the control group was 1008.31± 329.05, whereas this level in the study group was significantly higher (2710.65±1484.13, p &lt; 0.001). When the study group was divided according to VAS scores into two groups, the mean XBP–1 level, and endometrioma volumes were significantly higher in the group with VAS scores &gt; 6 (p &lt; 0.001 and p = 0.03 respectively). A receiver operating curve (ROC) analysis was conducted in the study group. The area under the curve AUC for XBP–1 levels was 91% (95%CI: 0.86–0.96, p &lt; 0.001) for the cut-off value of 1279.52 with a sensitivity 87.2%, specificity 86.7%, PPV: 90.4%, NPV: 82.5%, +LR: 6.5, -LR: 0.1. The AUC for VAS scores &gt;6 was 96.2% (95%CI: 0.93–0.98, p &lt; 0.001) for the cut-off value 2227.71, with a sensitivity 90% and a specificity 91.1%, PPV: 87.1%, NPV: 96.1%, +LR: 10, -LR: 0.1.

Limitations, reasons for caution

A limitation of this study was the methodology of serum sample collection. Since there are no data available on the timing of sample collection with regard to the menstruation cycle of the subjects, samples were collected at the first consultation of the patients without considering the date of their cycle.

Wider implications of the findings: In this study, XBP–1 levels in the endometriosis group and also among patients with VAS scores of &gt; 6 were significantly higher. This association between XBP–1 and endometriosis and the positive correlation with pain indicates that XBP–1 can be a potential biomarker, especially in the presence of severe pain symptoms

Trial registration number

NCT04440397

Comparison of decentration, tilt and lenticular astigmatism of ıntraocular lens between sutured and sutureless scleral fixation techniques

PURPOSE

To evaluate at six months the intraocular lens (IOL) decentration, tilt and lenticular astigmatism between foldable sutured and sutureless scleral fixation IOLs compared to conventional phacoemulsification surgery.

METHODS

We retrospectively reviewed records for 22 eyes with sutureless scleral fixation, 16 eyes with sutured scleral fixation and 23 eyes with conventional phacoemulsification. IOL decentration and angle of IOL tilt were compared on Scheimpflug images 6 months after surgery. Lenticular astigmatism is described as the difference between refractive and net corneal astigmatism.

RESULTS

The angle of tilt in both meridians was significantly lower in the sutureless group than in the sutured group (P=0.008 horizontally and P=0.002 vertically). IOL decentration did not show a significant difference between the three groups in either horizontal or vertical meridians (P˃0.05). Lenticular astigmatism was significantly lower in the sutureless and control groups than in the sutured group (P=0.003 and P<0.001).

CONCLUSION

In addition to being relatively quick and easy to perform, the sutureless scleral fixation technique showed superior results in terms of IOL tilt and lenticular astigmatism at the six-month follow-up compared to the sutured technique.

Differential vocational rehabilitation service patterns and outcomes for transition-age youth with specific learning disabilities: Implications in the COVID-19 era

BACKGROUND: It is essential to ensure that youth with specific learning disabilities (SLD) receive an appropriate type and amount of vocational rehabilitation (VR) services to facilitate their entrance to employment and career development. METHODS: In this study, the chi-squared automatic interaction detector (CHAID) analysis and multivariate logistic regression analysis were used to investigate the relationship among demographic variables, VR services, and employment outcomes for transition-age youth with SLD. RESULTS: Results indicated that age, gender, race, educational level, and cash benefits from the Social Security Administration were significant predictors of employment outcomes for transition-age youth with SLD. After controlling for the effects of demographic variables, job and training related services had significant relationships with employment outcomes. Most notably, job placement, occupational/vocational training, and on-the-job support services had the strongest relationships with competitive employment outcomes. CONCLUSION: These findings support the effectiveness of job-related services and supported employment for transition-age youth with SLD. Implications for future research and practice in the wake of the COVID-19 pandemic are discussed.

Evaluation of the performance of the partograph in the Kisanga health zone in Lubumbashi

Introduction

The partograph allows adequate fetal-maternal care during childbirth and the immediate postpartum in a maternity hospital. The objective of this study was to determine the proportion of the correct use of the partograph in maternity hospitals in the Kisanga Health Zone in Lubumbashi.

Materials and Methods

It was a cross-sectional study on the holding of the partograph, carried out in the Kisanga health zone in Lubumbashi during the month of November 2018. In total 794 partograms completed during the study period by providers in 89 maternity wards were analyzed. Two indicators have been known for the proper use of the partograph (for the decision price) and compliance with the benchmark. An element was considered correctly applied if its compliance rate was greater than 75%. The data were analyzed using SPSS 20

Results

Of 794 partograms collected, 63.6% were official (MSP or WHO) and 36.4% of wealth. In 32.6% of maternities, filling the partograph was easy. In total, 10.1% of maternities made the decision based on the line of attention of the partograph and 17.2% based on the line of action. The overall compliance rate for filling the partograph was 43.4% [41.1-45.6]; it was 50.0% [47.8-52.5] for maternal parameters, 54% [52.8-56.0] for fetal-adnexal parameters and 48.2% [47.4- 49.0] postpartum. The decision-making was 18.4% [18.2-18.5] and the filling time 33.3% [29.3-37.3]. It was found that 85.1% of partograms were completed during labor and 3.0% postpartum. The first point was correctly placed on the alert line in 19.6%

Conclusions

Partograph coverage, correct use and compliance rate are low in the Kisanga health zone. It turns out to be imperative to reinforce the correct use of the partograph and to rethink, if possible, a more simplified model with very sensitive items.

Key messages

This study has just helped to identify the parts of the partograms which are among the least filled and therefore the least understood by health care providers in health facilities. It has the merit of putting the thorny question of simplifying partograms back on the table for discussion in order to facilitate optimal use.

Autonomy Support, Life Satisfaction, and Quality of Life of Cancer Patients

Abstract. Previous research shows that perceived autonomy support is significantly associated with positive health outcomes for different clinical populations. However, there is not a standardized measurement tool that assesses perceived autonomy support for the Turkish population. This study translated the Health Care Climate Questionnaire (HCCQ), a perceived autonomy support measurement tool, into Turkish and investigated the factorial structure of the questionnaire with a group of patients with cancer. This study used a convenience-sampling method with 192 people with cancer. The participants were recruited from a major cancer institute and a non-profit organization in Turkey by research partners. Volunteer participants either filled out a hard copy of a survey packet or completed the survey packet through a secured online survey tool website (i.e., https://www.surveymonkey.com ). In addition, a closed Facebook group for cancer survivors in Turkey was used to advertise the study’s link. The results indicated the participants perceived a moderate level of autonomy support. In comparison to German and US populations, perceived autonomy support was low among Turkish cancer patients. The results also indicated that the HCCQ has a two-factor measurement structure. Correlations with external variables indicated that the scores of HCCQ were significantly positively associated with life satisfaction and quality of life of cancer patients and negatively associated with cancer related symptoms (e.g., fatigue).

New triazepine carboxylate derivatives: correlation between corrosion inhibition property and chemical structure

In this investigation, attempts have been made to study the corrosion inhibition properties of three new triazepine carboxylate compounds for mild steel in 1.0 M hydrochloric acid medium. The evaluation was carried out using mass loss, electrochemical impedance spectroscopy and polarization curves measurement. Impedance diagrams and Bode plots for uninhibited and inhibited systems were analyzed using Zview program. The fitted data observed trails in nearly the same pattern as the experimental results. It is showed that triazepine carboxylate compounds are very good inhibitors for mild steel corrosion in 1.0 M hydrochloric acid medium which act as mixed-type inhibitors. So, the inhibition efficiency was increased with inhibitor concentration in the order Cl–Me–CN > Me–CN > Cl–Me–CO2Et which depended on their molecular structures. Electrochemical impedance spectroscopy showed that all compounds act by the formation of a protective film at the metal surface. Surface analyses via SEM and Optical 3D profilometry were used to investigate the morphology of the steels before and after immersion in 1.0 M HCl solution containing inhibitors. The correspondence between inhibition property and molecular structure of the triazepine carboxylate compounds was investigated, using density functional theory (DFT). Experimental and DFT study was further supported by molecular dynamic simulations study.

The Buffering Effect of Character Strengths on Depression

Abstract. The transition from high school to college can be very stressful for Turkish students because they may experience value conflicts and adjustment issues, which can trigger the development of mental health problems. Character strengths can serve as a buffer against psychopathology. The aim of the study was to examine perceived stress and negative attributional style as mediating factors between character strengths and depression among Turkish college students. Bootstrap testing approach was implemented to compute direct and indirect effects and total effect in the mediation analysis. Altogether 235 students from two Turkish universities participated in the study. The results showed that character strengths were associated with lower levels of depression and it was negatively associated with perceived stress and negative attributional style. The results also indicated that perceived stress and negative attribution style completely mediated the relationship between character strengths and depression among Turkish college students. These findings suggested the need to develop empirically supported interventions that can promote character strengths toward reducing stress, negative attributions, and depression in this population.

WHICH FACTORS ARE ASSOCIATED WITH MALIGNANCY IN THYROID NODULES CLASSIFIED AS BETHESDA CATEGORY 3 (AUS/FLUS) AND HOW DO THEY INFLUENCE THE PATIENT'S MANAGEMENT?

Background

Thyroid nodules are a common pathology worldwide. Fine needle aspiration biopsy (FNAB) is an important diagnostic method for the investigation of malignancy in thyroid nodules. However, according to the Bethesda System used to classify the results, patients with atypia of undetermined significance/follicular lesion of undetermined significance (AUS / FLUS) may not be classified as benign or malignant. Therefore, it may be necessary to determine some clinical risk factors to apply the best treatment in these patients.

Aim

To determine the factors that increase the risk of malignancy in this patient group.

Methods

A retrospective study including 138 patients with an FNAB categorized as AUS/FLUS and operated between June 2015-September 2018. Demographical, Laboratory (TSH) and Ultrasound variables (number, size and characteristics of nodules) of the patients were compared among postoperative histopathological results.

Results

Hypo-echoic structure, microcalcification and irregular margin of the nodules were detected to be associated with malignancy in patients with FNAB results of AUS/FLUS (p <0.001).

Conclusion

We suggest that surgical treatment should be considered if the patients have nodules with the hypo-echoic structure, microcalcification and irregular margin with an FNAB histopathological result of AUS / FLUS.

Evaluating the World Health Organization’s International Classification of Functioning, Disability and Health Framework as a Participation Model for Cancer Survivors in Turkey

Improvements in diagnosis and treatment options for cancer now allow cancer survivors to live longer, and as a result, services are necessary to help individuals live an active and meaningful life in the community. The purpose of this study was to evaluate the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework as a participation model for cancer survivors in Turkey. Results from simultaneous regression analyses indicated educational attainment, fatigue, perceived stress, role functioning, social functioning, core self-evaluations, independent self-construal, social support, and autonomy support were significantly associated with participation. Specific interventions including health education, psychological workshops, support groups, and assistive technology may improve cancer survivors’ motivation and desire to actively engage in community activities. Higher levels of participation were also found when cancer survivors were involved in the treatment decision-making process, and felt cared for and understood by their treatment providers.

Validation of the Behavioural Regulation in Exercise Questionnaire-2 for adults with chronic musculoskeletal pain

BACKGROUND/AIMS

The Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2) has demonstrated reliability and validity in the general population; yet the psychometric properties have not been tested among rehabilitation populations, such as persons experiencing chronic musculoskeletal pain. The objective of the current study was to examine the factorial structure and psychometric properties of the BREQ-2 in a sample of adults with chronic musculoskeletal pain.

METHODS

Adults with chronic musculoskeletal pain (n=211) were recruited from clinical and community networks in the United States. Data were collected using a cross-sectional online survey and analysed using confirmatory factor analysis, multiple indicators multiple causes analysis, and correlational techniques. Participants completed the BREQ-2 and other measures relevant to self-determination theory, including outcome expectancies, self-efficacy and family and friend support for physical activity and exercise.

FINDINGS

Results indicated the intercorrelated model fit the data well. The five factors of amotivation, external regulation, introjected regulation, identified regulation and intrinsic regulation toward physical activity and exercise demonstrated good reliability and construct validity.

CONCLUSIONS

This study provides evidence of factorial and construct validity for the BREQ-2 among people with chronic musculoskeletal pain. Implications for rehabilitation practitioners and researchers are discussed.

A new species of Petroleuciscus (Teleostei: Cyprinidae) from the Büyük Menderes River, southwestern Anatolia, Turkey

Petroleuciscus ninae sp. nov. is described from the Büyük Menderes River drainage. The new species is distinguished by having a black lateral stripe from head to base of caudal fin, stripe distinct anteriorly and posteriorly, wider than eye diameter; numerous black pigments on anal-fin rays; body depth at dorsal-fin origin 27-30% standard length (L_S ); head width at posterior margin of eye 16-19% L_S ; and eye diameter smaller than snout length. Petroleuciscus ninae is also distinguished from other species in adjacent waters by having six fixed diagnostic nucleotide substitutions in the mitochondrial DNA coI barcode region.

Differential vocational rehabilitation service patterns and outcomes for transition-age youth with autism

BACKGROUND

It is important to investigate receipt of vocational rehabilitation (VR) services, service patterns and outcomes for youth with autism, so that limited public resources can be used more efficiently.

METHOD

This study used chi-squared automatic interaction detector, and multivariate logistic regression analysis to investigate relationships between demographic variables, receipt of VR services and employment outcomes for transition-age youth (TAY) with Autism.

RESULTS

The results indicate that gender, education level and cash benefits are significant predictors of employment outcomes. After controlling for the effect of demographic variables, several VR services (i.e., job placement, on-the-job support, on-the-job training, maintenance, other services, information referral, and diagnostic and treatment services) were significantly associated with competitive employment.

CONCLUSIONS

Overall, the results indicate that job-related services were significantly related to employment outcomes for TAY with Autism; therefore, it is important these youths are provided with more targeted job placements and supported employment services (Wehman et al., ).

Psychometric evaluation of Turkish version of the Perceived Stress Scale with Turkish college students

BACKGROUND

The Turkish version of the Perceived Stress Scale (T-PSS-10) measures the extent to which situations in one's life are appraised as stressful.

AIMS

The purpose of this study was to evaluate the measurement structure of T-PSS-10.

METHOD

Two-hundred and thirty-five Turkish university students (93 men and 142 women) completed the T-PSS-10, the Patient Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder 7-Item Scale (GAD-7), and the Inventory of Common Problems (ICP).

RESULTS

Confirmatory factor analysis results indicated that a one-factor model did not fit the data, whereas a two-factor correlated model (stress related self-efficacy beliefs, stress related feelings of helplessness) provided a better fit between the model and the data. Significant moderate correlations were found for the stress-related self-efficacy beliefs and stress-related feelings of helplessness factors with depression, anxiety, academic difficulty, relationship problems and health problems. The internal consistency reliability coefficients for the stress-related self-efficacy beliefs and stress-related feelings of helplessness factors were 0.68 and 0.85, respectively.

CONCLUSIONS

This study provided support for the reliability and validity of T-PSS-10 suggesting that it can be used as a screening instrument by health professionals working with Turkish college students.

Resilience and Quality of Life

The construct of resilience is key to understanding adaptation to disability from a strengths-based perspective. The objective of this study was to examine the impact of factors identified in Kumpfer’s resilience model on quality of life (QOL) outcomes for adults with spinal cord injury (SCI), specifically taking into account injury characteristics, self-efficacy, resiliency characteristics, and social support using hierarchical regression analysis. Participants included 255 adults with SCI. Findings revealed that the overall model accounted for 75% of the variance in QOL outcomes. In particular, coexisting pain, participation self-efficacy, core self-evaluation, resiliency characteristics, cognitive strength, general health, and social support independently contributed to the variance in QOL scores. Implications of these findings for developing theory-driven, strengths-based approaches for improving rehabilitation outcomes for individuals with SCI are discussed.

Assessing Vocational Rehabilitation Engagement of People With Disabilities

The purpose of this study was to validate the Vocational Rehabilitation Engagement Scale (VRES) in a sample of state vocational rehabilitation (VR) service consumers. A total of 277 individuals with disabilities were recruited from Alaska, Kentucky, Florida, Michigan, New Mexico, Texas, Utah, and Wisconsin. The measurement structure of the VRES was evaluated using exploratory factor analysis and confirmatory factor analysis. Exploratory factor analysis results support a one-factor measurement structure of the VRES. Confirmatory factor analysis results also indicated a good model fit for the one-factor measurement model. Internal consistency reliability (Cronbach’s α) for the scores on the VRES was computed to be .94. VR engagement was found to be associated with working alliance, vocational self-efficacy, internal motivation, and VR outcome expectancy in the expected direction. The VRES is a brief, reliable, and valid instrument for assessing VR engagement and contributes to the use of self-determination as a paradigm for improving motivation and engagement of people with disabilities receiving services from state VR agencies.

Comparison of injection pain caused by the DentalVibe Injection System versus a traditional syringe for inferior alveolar nerve block anaesthesia in paediatric patients

AIM

To compare paediatric patients' pain during needle insertion and injection in inferior alveoler nerve block (IANB) anaesthesia injected by either a traditional syringe (TS) or the DentalVibe Injection Comfort System (DV).

STUDY DESIGN

the study was a randomised controlled crossover clinical trial, comprised of 60 children aged 6-12 requiring an operative procedure with IANB anaesthesia on their mandibular molars bilaterally. One of the molar teeth was treated with TS and the contralateral tooth was treated with DV. On each visit, subjective and objective pain was evaluated using the Wond-Baker Faces Pain Rating Scale (PRS) and the Face, Legg, Cry, Consolability Scale (FLACC Scale). Patients were asked which anaesthesia technique they preferred. Data were analysed using Wilcoxon signed rank, Spearman correlation, and Mann-Whitney U tests.

RESULTS

There were no statistically significant differences for pain evalution during needle insertion and injection of each injection system. However, a negative correlation was found on the FLACC between age and pain scores during injection after using DV.

CONCLUSION

Paediatric patients experienced similar pain during IANB anaesthesia administered with TS and DV. With increased age, pain values reduced during anaesthetic agent injection with DV according to FLACC. The traditional procedure was preferred to DV in paediatric patients.

Psychometric Validation of the Brief Resilience Scale in a Sample of Vocational Rehabilitation Consumers

Existing research has indicated an association between resilience and psychosocial adjustment to disability. The purpose of this study was to validate the Brief Resilience Scale (BRS) in a sample of vocational rehabilitation (VR) consumers. Participants were 277 individuals with disabilities receiving state VR services. Findings support the identification of two factors in the BRS, labeled succumbing and resilience by the researchers. The succumbing factor was positively associated with reporting of depression while the resilience factor was associated with well-being. Implications for practice in state VR agencies are provided.

A successful management of a giant mucinous ovarian tumor with intraoperative controlled fluid aspiration

BACKGROUND

The aim of this article was to present management of a giant ovarian mass.

CASE REPORT

A 61-year-old patient was admitted with compliants of abdominal swelling and dyspnea. Ultrasound revealed a giant ovarian mass with dimesnions 47x43x30 cm. The patient underwent laparatomy and the cyst's content was aspirated before total cyst excision. The total weight of the mass was calculated to be 42.5 kg. Postoperatively, the patient was discharged on her postoperative seventh day.

CONCLUSION

Giant ovarian cysts can be managed with controlled aspiration before total cyst excision.