Problems Facing the Working Poor: Implications for Counseling

The most recent reports from U.S. Bureau of Labor Statistics indicate that 8.6 million people in the United States are among the working poor, a population whose formal employment does not provide sufficient income to remain above the poverty threshold. The problems facing the working poor are examined in this article. Labor market issues, job stress, mental health concerns, stigma, and barriers to appropriate treatment were all identified as problems facing this disadvantaged population. Implications for counselors and counseling practice are discussed including considerations for the working poor population and counselor education training programs

Natural convection in a vertical slot: accurate solution of the linear stability equations

The linear stability of natural convection in a fluid between vertical hot and cold walls was studied using a collocation method. Seven figure accurate results for monotonic disturbances were obtained by Ruth (1979) using numerical power series, but this method is intrinsically limited and failed for Pr ? 10 . In contrast, Chebyshev collocation converges more rapidly and allows the computation of results at higher Pr for which oscillatory disturbances dominate. Accurate results are now obtained across the entire Prandtl number range. These match the zero and infinite Pr asymptotes which are also refined here

Skirting subsets of the plane, with application to marginal stability curves

An easily implemented algorithm is described for tracing the margin of a plane region defined by a predicate. Given a point inside and one outside, a sequence of marginal points is produced. The algorithm is a modified specialization of the `simplicial decomposition' method for n equations in n+1 dimensions. The case n=1 has special properties and its importance motivates their present exploitation. It is directly applicable to finding level curves. It does not require differentiability and copes well with cusps. Two questions of accuracy are the proximity of the outputs to the margin and the proximity of the margin to the output set. The first is answered precisely. The second is complicated and predicate-dependent, but is addressed in practical terms by adaptivity, which also improves the scheme's efficiency

Measurement in sports biomechanics

One of the major roles of a sports biomechanist or coach is to assess the movement patterns within sports performances. Movements can be analysed to enhance an individual's technique in terms of efficiency or to provide technical advantage. This paper aims to highlight the different measurement techniques available for the biomechanist to assess the movement characteristics of the technical and mechanical aspects of athletic performance. </jats:p

Reduced live birth rates in frozen versus fresh single cleavage stage embryo transfer cycles: A cross-sectional study

Background: Studies have suggested that embryo-endometrial developmental asynchrony caused by slow-growing embryos can be corrected by freezing the embryo and transferring it back in a subsequent cycle. Therefore, we hypothesized that live birth rates (LBR) would be higher in frozen embryo transfer (FET) compared with fresh embryo transfers. Objective: To compare LBR between fresh and FET cycles. Materials and Methods: A cross-sectional analysis of 10,744 single autologous embryo transfer cycles that used a single cleavage-stage embryo was performed. Multivariate analysis was performed to compare LBR between FET and fresh cycles, after correcting for various confounding factors. Sub-analysis was also performed in cycles using slow embryos. Results: Both LBR (19.13% vs 14.13%) and clinical pregnancy (22.48% vs 16.25%) rates (CPR) were higher in the fresh cycle group (p &lt; 0.00). Multivariate analysis for confounding factors also confirmed that women receiving a frozen-thawed embryo had a significantly lower LBR rate compared to those receiving a fresh embryo (OR 0.76, 95% CI 0.68-0.86, p &lt; 0.00). In the sub-analysis of 1,154 cycles using slow embryos, there was no statistical difference in LBR (6.40% vs 6.26%, p = 0.92) or CPR (8.10% vs 7.22%, p = 0.58) between the two groups. Conclusion: This study shows a lower LBR in FET cycles when compared to fresh cycles. Our results suggest that any potential gains in LBR due to improved embryo-endometrial synchrony following FET are lost, presumably due to freeze-thaw process-related embryo damage. Key words: Fresh, Frozen embryo transfer, Live birth, Embryo, Transfer

Psychosocial interventions for improving quality of life outcomes in adults undergoing strabismus surgery (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: To investigate the effects of psychosocial interventions versus no intervention on quality of life and psychosocial outcomes in adults undergoing strabismus surgery. The primary objective is to assess whether patients who have taken part in a sychosocial intervention prior to their strabismus surgery report significantly improved quality of life compared to those who receive standard care,i.e. strabismus surgery alone. The secondary outcome measures will include anxiety, depression, social anxiety and social avoidance, as well as degree of success in terms of surgical outcome

Opposing effects of final population density and stress on Escherichia coli mutation rate

Evolution depends on mutations. For an individual genotype, the rate at which mutations arise is known to increase with various stressors (stress-induced mutagenesis-SIM) and decrease at high final population density (density-associated mutation-rate plasticity-DAMP). We hypothesised that these two forms of mutation-rate plasticity would have opposing effects across a nutrient gradient. Here we test this hypothesis, culturing Escherichia coli in increasingly rich media. We distinguish an increase in mutation rate with added nutrients through SIM (dependent on error-prone polymerases Pol IV and Pol V) and an opposing effect of DAMP (dependent on MutT, which removes oxidised G nucleotides). The combination of DAMP and SIM results in a mutation rate minimum at intermediate nutrient levels (which can support 7 × 10  cells ml ). These findings demonstrate a strikingly close and nuanced relationship of ecological factors-stress and population density-with mutation, the fuel of all evolution

Psychometric Analysis of the Adult Sickle Cell Quality of Life Measurement Information System (ACSQ-Me) in a UK Population

Background: The Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me) has been shown to be a reliable and valid questionnaire measuring health-related quality of life (HRQoL) in the US sickle cell disease (SCD) population. The study objective was to test the validity and reliability of the ASCQ-Me for use in the UK. Methods: The US ASCQ-Me, Hospital Anxiety and Depression Scale (HADS), self-reported symptoms, and Medical Outcome Survey Short Form 36 (SF-36) were administered to 173 patients with SCD. Clinical severity was assessed by the number of painful episodes indicated by hospital admissions. Results: The results showed that the item banks of the UK ASCQ-Me had good internal consistency. Anxiety and depression were strongly correlated with the emotional, and social item banks of the UK ASCQ-Me, with moderate correlations between the UK ASCQ-Me item banks and SF-36 components suggesting convergent validity. A confirmatory factor analysis confirmed the conceptual framework of the scale as being the same as the US ASCQ-Me, indicating construct validity. Known groups validity was found, with the ASCQ-Me being able to differentiate by SCD severity groups. Conclusion: The analysis of the sample shows evidence of both validity and reliability of the ACCQ-Me for use in the UK SCD population

Patients’ Expectations of the Functional and Psychosocial Outcomes of Orbital Decompression Surgery for Thyroid Eye Disease: A Qualitative Study

Patients with appearance-altering conditions may be dissatisfied with the outcomes of reconstructive surgery due to unmet expectations. This study explored patients’ expectations of orbital decompression surgery for thyroid eye disease (TED) and whether these were met. Semi-structured interviews were conducted at two times: (1) in the weeks after patients were listed for decompression surgery and before surgery; (2) up to 12 months after surgery. Thematic analysis was performed for each time point, to identify themes within the data. Fourteen adults with TED were interviewed prior to surgery and five were followed up after surgery. Thematic analyses found: (1) Prior to surgery, patients had formed expectations through online information about the procedure, consultations with physicians, the impact TED had on their lives, and speaking to relevant others. Patients had specific expectations about the procedure, the recovery, post-operative appearance and post-operative vision. (2) After surgery, patients generally felt their appearance and well-being had improved. However, dissatisfaction was linked to unanticipated specific aspects of surgical care, recovery, or appearance. Dissatisfaction can arise from unmet expectations for the outcomes of reconstructive surgery. Physicians should be aware of the processes by which patients form expectations, for example different types and quality of online information. Ensuring that preoperative expectations are realistic could enhance satisfaction after surgery

The psychosocial and clinical outcomes following orbital decompression surgery for thyroid eye disease and predictors of change in quality of life

Objective: Thyroid eye disease (TED) has been found to reduce quality of life for many patients due to changes in their appearance and vision, although some appear to adjust better than others. This study was designed to investigate whether a patient’s quality of life changes after having orbital decompression for improvement of appearance, vision, or both, and whether any demographic, clinical or psychosocial factors can predict which patients might benefit from this surgery. Design: This study employed a within-subjects repeated measures design, where patients were assessed before, and at 6 weeks and 6 months after surgery. Subjects: One hundred and twenty-three adults (>18 years) with TED and undergoing orbital decompression surgery were recruited at Moorfields Eye Hospital. Methods: Participants received lateral wall, medial wall, 2.5 or 3 wall decompression, and were followed up after surgery with a range of psychosocial and clinical assessments. Main Outcome Measures: The Graves’ Ophthalmopathy Quality of Life (GO-QOL) scale was completed at each time point and this was used as the dependent variable in each hierarchical multiple regression model. Results: Significant improvements were found in all clinical characteristics following orbital decompression and in most psychosocial variables. GO-QOL visual function scores did not change significantly until 6 months after surgery. In contrast, GO-QOL appearance scores changed significantly by 6 weeks after surgery and continued to increase to 6 months, reaching a minimal clinically important difference for this scale. None of the changes in clinical or psychosocial outcomes significantly predicted change in GO-QOL visual function. However, the hierarchical regression model explained 79% of the variance in change in GO-QOL appearance, with change in subjective evaluation of appearance being the only unique predictor of change in appearance-related quality of life. Conclusions: This study highlights the importance of appearance-related cognitions in predicting quality of life outcomes after surgery. Implications for clinical practice need to be considered in light of the limitations of this study, but it is suggested that psychosocial interventions targeting appearance-related cognitive processes - in particular personal evaluation of appearance - could enhance the quality of life outcomes for patients with TED undergoing orbital decompression surgery