Factors Shaping Occupational Injustice among Resettled Syrian Refugees in the United States.

Background: There have been a limited number of studies that have focused on factors which shape the experiences of resettlement and occupational injustice among refugee populations. Purpose: To explore the factors that shape the living difficulties of Syrian refugees who were lawfully admitted into the United States and ways whereby they might interfere with shaping occupational injustice. Method: Mixed methodologies were incorporated. The living difficulty scale for refugees (LDSR) was disseminated. Semistructured interviews were conducted, and fieldnotes were collected as sources of qualitative data. Results: 254 participants (mean age 36.2 ± 9.6 yrs; 159 females and 95 males) completed the survey, and nine of them participated in the semistructured interviews. Age (p < 0.01), region (p < 0.001), and time in the United States (p < 0.05) had significant effects on the experiences of the participants, but not gender (p = 0.308). Occupational injustice is an outcome of an interaction between interpersonal and contextual factors. Practice Implications. Occupational therapists need to assume a vital role in maximizing opportunities of engagement in meaningful occupations for Syrian refugees to counteract occupational injustice and difficulties associated with resettlement.

Validation of the Arabic version of vocal tract discomfort scale.

Aim: To explore the internal consistency, criterion validity, and discriminative validity of the Arabic version of the vocal tract discomfort scale (VTDS-Arab); and to establish cut-off scores for the VTDS-Arab.Methodology: An overall of 202 participants (31 patients with voice disorders of organic and functional causes, and 171 healthy subjects, mean age 25.3 ± 6.7) were recruited in this study. Participants completed the VTDS-Arab scale and the Arabic version of the voice handicap index (VHI-Arab).Results: The VTDS-Arab had a positive internal consistency confirmed by Cronbach's α = 0.91. The criterion validity of the VTDS-Arab was confirmed by the strong positive correlation between the total scores of the VTDS-Arab and the VHI-Arab (r = 0.64, p < .001). Patients scored higher than the healthy subjects in all the subscales of the VTDS-Arab (p < .001) which confirmed the discriminative validity of the VTDS-Arab. Age and gender were not found to affect the scores of the VTDS as confirmed by Pearson r test (r = 0.02, p = .80) and insignificant p values of Levene's test (F1, 200 = 0.43, p = .51), respectively, which supports the validity of the VTDS-Arab. The study posited interpretations for the ranges of scores of the VTDS-Arab based, where the cut-off score for the VTDS-Arab total was 26.Conclusion: The VTDS-Arab is a reliable and a clinically valid tool that can be used in the evaluation of voice disorders alongside other subjective and objective tools of evaluation.

Exploration of Occupational Deprivation Among Syrian Refugees Displaced in Jordan.

IMPORTANCE: Research is needed to situate occupational deprivation (OD) within each unique refugee population and displacement context. OBJECTIVE: To explore the way refugees manage their day-to-day lives within the limits of displacement contexts in Jordan. DESIGN: A grounded theorizing approach was used. Sampling methods used were convenience sampling, purposive sampling, snowball sampling, and theoretical sampling. Data were collected through semistructured interviews. SETTING: Inside and outside the Zaatari refugee camp in Jordan. PARTICIPANTS: Forty-nine adult Syrian refugees (19 women, 30 men; mean age = 34.6 yr) who fled to Jordan after the war in Syria began in 2011. Twenty-four lived outside the refugee camps, and 25 lived inside Zaatari camp. Written consent was required before participation. OUTCOMES AND MEASURES: Participants' unique experiences were targeted to generate a theory to facilitate understanding of the effects of displacement on participation in meaningful occupations. A topic guide was designed, and the questions included served as pointers for the interviewers. RESULTS: Syrian refugees experienced OD, which had negative effects on their health, well-being, and sense of humanity. CONCLUSIONS AND RELEVANCE: Further research studies are required to investigate the influence of sociocultural differences on the meaning and consequences of OD. Contextual factors and living difficulties associated with OD need to be further explored. WHAT THIS ARTICLE ADDS: OD is a concept with sociocultural connotations. The meaning of OD needs to be conceptualized for each unique refugee population and displacement context. Displacement contexts need to provide a repertoire of socioculturally meaningful occupations to counteract OD. Occupational therapy needs to assume a leading role in the design and delivery of programs directed to fulfill refugees' occupational needs.

Applicability of the Arabic version of Vocal Tract Discomfort Scale (VTDS) with student singers as professional voice users.

AIM: This pilot study aimed to evaluate the internal consistency, convergent construct validity and criterion validity of Arabic version of the Vocal Tract Discomfort Scale (VTDS), and to investigate the correlation between the scores of the VTDS, the VHI and the acoustic measures of fundamental frequency (F0), shimmer, jitter and signal-to-noise ratio (SNR). METHODOLOGY: A cross-sectional study where 97 participants participated (47 males and 50 females) (mean age 20.5 ± 2.1 years) (31 student singers and 66 other non-professional voice user students). Participants were without self-perceived voice disorders who completed the VTDS-Arab scale and the Voice Handicap Index (VHI-Arab), and recorded a vocal sample of/a:/at a comfortable level. RESULTS: A positive internal consistency that signifies reliability was confirmed by Cronbach's α = .884 and 0.874 for the VTDS-Arab frequency and severity subscales, respectively. A moderate positive correlation was found between the VTDS-Arab (frequency, severity, total) and the VHI-Arab total where values of Pearson's correlation coefficient were r= 0.459, 0.430 and 0.451, respectively. Weak correlations were found between all of the acoustic measures and the scores of the VTDS-Arab and VHI-Arab (total and subscales). The area under curve for the VTDS was AUC= 0.824, 0.804 and 0.817 for the VTDS frequency, VTDS severity and VTDS total, respectively. CONCLUSIONS: The VTDS-Arab is a valid and reliable tool in measuring vocal tract sensations and predicting the perception of vocal handicap in student singers and can be used to predict the vocal load among professional voice users.

A study of VHI scores and acoustic features in street vendors as occupational voice users.

PURPOSE: to investigate acoustic features of phonation and perception of voice handicap in street vendors. METHODS: Eighty-eight participants (44 street vendors, 44 controls) were recruited. The mean age of the group was 38.9±16.0 years (range: 20-78 years). Scores of the Arabic version of the Voice Handicap Index (VHI-Arab) were used for analysis. Acoustic measures of fundamental frequency (F0), jitter, shimmer, and signal-to-noise ratio (SNR) were also analyzed. RESULTS: Analysis showed a significant difference between street vendors and controls in the total score of the VHI-Arab (p<0.001) as well as scores of all three VHI-Arab subsections: functional (p<0.001), physical (p<0.001), and emotional (p=0.025). Weak correlations were found among all of the VHI scores and acoustic measures (-0.219≤ r≤0.355), except for SNR where a moderate negative correlations were found (r=-0.555; -0.4) between the VHI (physical and total) scores and SNR values. Significant differences also were found in F0, jitter, and SNR among specific subgroups of street vendors when stratified by weekly hours worked (p<0.05), and in jitter (p=0.39) when stratified by educational level. CONCLUSIONS: Perception of voice handicap and a possible effect on vocal quality in street vendors were noted. The effect of factors, namely work hours and educational level, on voice quality should be further studied.

Kuwaiti Teachers' Perceptions of Voice Handicap.

OBJECTIVES: The study aimed to investigate the effects of age, gender, level of education, experience, and class level taught on the perception of voice handicap by Kuwaiti teachers using the Arabic version of the Voice Handicap Index (VHI-Arab). The mean VHI scores of Kuwaiti teachers were compared with those of Jordanian and Emirati teachers. METHODS: The study had a cross-sectional survey design. A total of 460 individuals (100 controls and 360 teachers) participated in this study and completed the paper copy of the VHI-Arab. We recruited 360 teachers, 180 males and 180 females (age range: 20-50 years), from 60 schools in 6 Kuwaiti districts. Teachers' VHI scores were compared with 100 nonteaching voice users (50 males and 50 females, with an age range of 18-42 years). RESULTS: Female teachers scored significantly higher than male teachers in all subscales (ie, physical: P = 0.02; emotional: P = 0.007; total: P = 0.017), except for the functional subscale (P = 0.147). Elementary school teachers scored significantly higher than teachers of other levels (middle and high school) in all VHI subscales (physical: P = 0.047; emotional: P = 0.01; total: P = 0.039), except for the functional subscale (P = 0.47). The mean score of Jordanian teachers was higher than that of Kuwaiti and Emirati teachers in all VHI subscales. CONCLUSIONS: Teachers with a more favorable teaching environment scored better on the VHI. Gender differences were found in all the Arabic nationalities studied. Female teachers of the elementary level, in particular, should be the focus of attention of efforts to prevent voice damage.