Factors That Influence the Tenure of Direct Support Professionals in New York State Provider Agencies

The New York State Office for People With Developmental Disabilities seeks to better understand the direct support professional (DSP) workforce and offer data-informed strategies for DSP retention. We used the 2018 NCI-IDD Staff Stability Survey (now called State of the Workforce Survey) to investigate agency-level factors influencing DSP tenure. A total 303 provider agencies completed the survey in New York State, representing 72,252 DSPs. Multiple linear regression analysis revealed that selected agency-level variables explained 12.6% of the variance in DSP tenure, R2 = .16, Radj2 = .126, F (11, 260) = 4.54, p < .05. This study yielded strong empirical evidence consistent with existing national reports and research on the role that wages, benefits, and supervisory support play on DSP tenure.

Cytology-Histology Correlation of Hydatid Cyst: A Case Study and Literature Review

Casestudy: Hydatid cyst results when humans get infected by ingesting the eggs of Echinococcus Granulosus. Upon release, the six-hooked oncospheres penetrate the intestinal wall and migrate via circulation to various organs, mostly liver and lung. Here, they develop into hydatid cyst. The cyst enlarges gradually and is filled with daughter cysts and protoscolices.

We report the case of a 69-year old female, native of Uzbekistan, who presented with right upper quadrant pain. Imaging showed a 20 cm liver cyst and multiple pelvic cysts with a stage of CE2 implying that they were most likely functional. Serum Echinococcal antibody was positive. After 2 months of Albendazole treatment, there was no radiological change. The patient underwent laparoscopic puncture aspiration and injection with 20% saline (PAIR) and pericystectomy of the pelvic cysts. The aspirate revealed scattered scolices, inflammatory cells and abundant amorphous debris consistent with hydatid cyst. Bilateral 5-cm pelvic cysts had pale yellow, soft to firm walled, multiple cavities. Microscopy revealed a fibrofatty outermost layer with chronic inflammation and a two-layered cyst wall including a thin germinal epithelium covered by a thick acellular outer membrane. Multiple parasites, some degenerate (dense eosinophilic) were present, confirming the cytologic diagnosis of cystic echinococcosis. Following further treatment with Albendazole, she underwent a robotic assisted PAIR and partial peri-cystectomy of the liver cyst with repair of the duct to cyst communication. The liver cyst contained daughter cysts of Echinococcus and brood capsule with protoscolices. After 2 months more of Albendazole her Elisa was intermediate.

A prior study reported cytopathologic diagnosis of hydatid cyst in 17 patients evaluated for various masses. Our case highlights the role of cytology sampling in confirming the diagnosis of hydatid disease. Potentially fatal in untreated patients, this entity has to be considered in the differential diagnosis of cystic lesions.