The Mediating Effect of Well-Being, Happiness, and Trust in the Relationship Between Work-Life Balance and Work Effectiveness in Seafarers.

In the contemporary global context, seafarers persist as the uncelebrated heroes of international trade, despite their substantial contributions. The current estimate places the number of STCW- certified officers at 857 540, reflecting a notable increase of 10.8% since 2015. Nevertheless, there is a growing recognition of the imperative to accord specific attention to seafarers' mental and physical well-being. During their tenures aboard ships, seafarers confront various challenges, including psychological well-being, work-life imbalance, dissatisfaction, diminished performance, and a sense of mistrust toward the organizational framework. The primary objective of this research is to scrutinize the nexus between work-life balance and work effectiveness, exploring the mediating roles of psychological well-being, organizational happiness, and organizational trust. A questionnaire-based survey is meticulously crafted to achieve this, employing a dataset comprising 420 seafarers engaged in diverse vessel types in Turkey, operating under both Turkish and international flags. Methodologically, structural equation modeling and correlation analyses are executed to assess the formulated research hypotheses rigorously. The empirical findings of this research reveal noteworthy mediating roles: psychological well-being exhibits a complete mediation effect, organizational happiness demonstrates a full mediation effect, and organizational trust manifests a partial mediation effect. These outcomes underscore the nuanced interplay between work-life balance and work effectiveness in the seafaring context. The implications of these findings extend significantly to the maritime sector and industry, accentuating the imperative for targeted interventions to enhance the well-being and performance of seafaring professionals.

The Incidence of Intrahepatic Cholestasis of Pregnancy and its Maternal, Fetal, and Neonatal Adverse Outcomes: A Systematic Review and Meta-Analysis.

INTRODUCTION: Intrahepatic cholestasis of pregnancy (ICP) is a problem with an increasing incidence and negative maternal, fetal, and neonatal consequences. This problem is becoming increasingly important. This systematic review and meta-analysis aimed to determine the incidence of ICP and its adverse maternal, fetal, and neonatal adverse outcomes based on primary research studies. METHODS: This systematic review and meta-analysis used Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines and was conducted between June and September 2023 using the following keywords: obstetric cholestasis OR intrahepatic cholestasis AND pregnancy OR pregnant OR prenatal OR antenatal OR perinatal OR maternal OR fetal OR neonatal. Quality assessment of the studies was performed using the Critical Appraisal Checklists developed by the JBI Institute. Data were synthesized using meta-analysis methods. RESULTS: The analysis included 10 studies published between 2013 and 2023. The meta-analysis showed that the incidence of ICP was 1.7% (odds ratio [OR], 0.021; 95% CI, 0.012-0.027), whereas maternal, fetal, and neonatal adverse outcomes included cesarean birth (OR, 2.938; 95% CI, 1.467-5.881), preterm birth or preterm prelabor rupture of membranes (OR, 4.241; 95% CI, 1.996-9.009), hypertensive disorders of pregnancy (OR, 3.715; 95% CI, 1.545-8.929), maternal infection (OR, 3.301; 95% CI, 2.917-3.737), neonatal intensive care unit admission (OR, 2.715; 95% CI, 1.458-5.056), birth weight less than or equal to 2500 g (OR, 2.518; 95% CI, 1.296-4.892), and small for gestational age (OR, 1.915; 95% CI, 1.424-2.573). DISCUSSION: This systematic review and meta-analysis revealed that ICP has a high incidence and several maternal, fetal, and neonatal adverse outcomes. Therefore, midwives and other health professionals must be aware of these outcomes and provide appropriate care to pregnant individuals with ICP.

Organic and functional dysphonias: comparison of Self-Assessment protocols by confirmatory factor analysis.

OBJECTIVE: This study aims to see if the effects of the sub-domains of the Voice Handicap Index-10 (VHI-10) and Voice Related Quality of Life (VRQoL) differ in organic (OD) and functional dysphonia (FD). METHOD: A total of 162 patients completed the validated Turkish versions of the Voice Handicap Index-10 (VHI-10) and Voice-Related Quality of Life (VRQoL). Physical (pVHI-10), emotional (eVHI-10) and functional (fVHI-10) sub-domains of VHI-10 and physical-functional (PF-VRQoL), socio-emotional (SE-VRQoL) dimensions of VRQoL were assessed. Confirmatory factor analysis (CFA) was used to compare the sub-domains of these questionnaires between diagnostic categories. RESULTS: The total and sub-domain scores of both VHI-10 and VRQoL were not statistically different between the two etiologic categories of dysphonia (MANOVA, p > .05). The total VHI-10 and total VRQoL scores were significantly and moderately correlated in both the OD and FD groups. During CFA, 4 models were constructed for the OD and FD groups for VHI-10 and VRQoL factors. There was no significant difference between OD and FD groups in terms of path coefficients of sub-domains (z test, p > .05). CONCLUSION: In terms of VHI-10 and VRQoL, the sub-domains of each questionnaire are equally important in both organic and functional dysphonia. Functional disorders do not depend only on "emotional" factors, and neither do organic problems. Factor analysis should be included when performing a study on patient-reported outcome measures.

The Effectiveness of New Adiposity Indices on Plasma Lipid Profile in Patients with Multiple Sclerosis: A Cross-Sectional Study with A Body Shape Index, Body Roundness Index, and Visceral Adiposity Index.

OBJECTIVE: This study aimed to determine the effectiveness of three different indices used to identify the effect of visceral adiposity on lipid profile markers in patients with multiple sclerosis. METHODS: The study consisted of a total of 152 patients with relapsing-remitting multiple sclerosis who were aged 18 years and older. High-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), total cholesterol (TC), and triglyceride (TG) were accessed from the patient system. Patients' height, body weight, waist circumference, and hip circumference measurements were also obtained. The effects of three different adiposity indices, including A Body Shape Index (ABSI), the Body Roundness Index (BRI), and the Visceral Adiposity Index (VAI), on plasma lipid profile in multiple sclerosis patients were evaluated. The data were analyzed using the R software and SPSS 21 statistical software package. RESULTS: HDL-c was impacted by ABSI and VAI in males and only VAI in females (p < 0.05). An increase of 0.01 units of ABSI in males led to an increase of 5.88 mg/dL in plasma HDL-c level. In male patients with multiple sclerosis, LDL-c was positively affected by BRI and VAI changes (p < 0.05). One unit increase in BRI in males increased LDL-c level by 5.56 mg/dL, whereas 1 unit increase in VAI increased LDL-c level by 3.52 mg/dL (p < 0.05). CONCLUSION: This study indicated that these three different indices employed to evaluate adiposity were associated with plasma lipid profile. The effect of VAI on plasma lipids is higher than that of the other indices. In patients with multiple sclerosis, the use of these practical and non-invasive indices will be useful in assessing plasma lipid profile.