Nursing students' exposure to violence in clinical practice and violence management competence levels.

INTRODUCTION: The violence nursing students experience in the clinic may affect their attitudes towards the profession. AIM: This study was conducted to determine nursing students' exposure to violence during their clinical practice and their violence management competence levels. DESIGN: This was a two-centred, descriptive, and correlational study. PARTICIPANTS: A total of 512 nursing students from two universities in Türkiye participated in this study. METHODS: The study data was collected between March and April 2023 with the Student Information Form, Violence Exposure Form, and Management of Workplace Violence Competence Scale for Nursing Students. Institutional permission and ethics committee approval were obtained before starting the study (Date: 05/01/2023, No: 50). Descriptive statistics, Mann-Whitney U test, Kruskal Wallis test and linear regression analysis were used to evaluate the data. Statistical significance was accepted as p < 0.05. RESULTS: It was determined that 17.4 % (n = 89) of the participant students felt competent in managing violence, and 94.3 % (n= 483) were concerned about being exposed to violence at various levels. In these results, 20.5 % (n = 105) of them were exposed to violence during clinical practice, 60.9 % (n = 64) of whom experienced verbal violence and 52.3 % (n = 55) psychological violence. The total mean score from the violence management competence scale was 103.29 ± 16.64. No statistically significant difference was found between the scale total and subscale scores according to gender (p > 0.05). The scale total scores of fourth-grade students with a good perceived academic success and who received training on coping with violence were statistically significantly higher (p˂0.05). The regression model created between the scale score and students' perceived academic success and receiving white code training (Training on the use of the alarm system that will enable security guards to reach the scene as soon as possible in cases where healthcare workers are exposed to all kinds of violence.) was statistically significant (F = 23.108, p < 0.001). CONCLUSION: Some of the students participating in the study experienced violence in clinical practices. Their violence management competence levels were good. It can be said that academic success, coping with violence, and white code training are useful in increasing competence levels.

The effect of warm moist compresses in peripheral intravenous catheter-related phlebitis.

PURPOSE: Phlebitis is a common complication in palliative patients. There are limited nursing practices in phlebitis care. The study was conducted to determine the effect of warm moist compresses in patients with peripheral intravenous catheter-related phlebitis. METHODS: 70 patients (35 control and 35 experimental) with phlebitis symptoms who were hospitalized in the palliative clinic of a training and research hospital were recruited for the study. The phlebitis site of the patients in the control and experimental groups were followed for three days. While the control group received routine nursing care, the experimental group received a warm moist compresses at 28 °C for 15 min three times a day for three days in addition to routine nursing care. RESULTS: According to the results, there was a decrease in the initial and final phlebitis grades between the control and experimental groups, but the difference was not statistically significant (p = 0.957, p = 0.078). In the final evaluation of the phlebitis site, a statistically significant difference was observed in redness, edema width, and pain intensity between the control and experimental groups in favor of the experimental group (p˂0.001, p = 0.006, p˂0.001, respectively). CONCLUSIONS: It was determined that applying warm water compresses three times a day in phlebitis care had a positive effect on healing.

Yield, quality and physiological variation of strawberry in response to irrigation regimes and exogenous proline with a cost benefit analysis.

Strawberry (Fragaria × ananassa Duch.) production is a major aspect of the agricultural economy in Turkey's Mediterranean region, offering high rates of employment and farm revenue. The effects of treatment of the exogenous amino acid on yield, quality, and physiological diversity for strawberry production was analyzed considering the economic aspects. To achieve this, 4 different irrigation regimes (IR (irrigation) 125, IR100, IR75, IR50) with proline treatment was tested. The total berry yield, photosynthesis and leaf water potential (LWP) significantly decreased as irrigation application rates declined. The IR125 treatment with proline (PIR125) produced the highest overall berry production. The use of proline significantly increased berry production by 23%. Exogenous proline generated 3.5 kg/1 m3 greater yields than control in terms of irrigation water use efficiency (IWUE). Under the IR50 conditions, the treatment of proline yielded a 32% higher than the control. Moreover, proline significantly increased fruit soluble solids content (SSC) by 6.4%. The production system achieves the highest cost-benefit ratio (CBR) under PIR125 whereas the lowest cost-benefit ratio under IR50. When each scenario was considered at individually, it was evident that the more water used the more efficient high tunnel strawberry production. The fact that proline generated an increase in CBR in all four irrigation regimes proves this amino acid's economic effectiveness. As a result, PIR125 is recommended for the highest efficiency and CBR in Mediterranean environment. However, it has been discovered that using proline to alleviate this problem in areas where water is limited could be quite helpful.

Nursing students' perceptions of nursing diagnoses, critical thinking motivations, and problem-solving skills during distance learning: A multicentral study.

PURPOSE: To determine the relationship between attitude towards nursing diagnosis, critical thinking motivation, and problem-solving skills of nursing students during distance learning. METHOD: The descriptive and correlational study was conducted with 450 first-year nursing students from four universities. The "Positions on Nursing Diagnosis Scale," "Critical Thinking Motivational Scale," and "Problem Solving Inventory" were used for data collection in June-July 2021. FINDINGS: The students' mean score of nursing diagnosis perception was 114.90 ± 18.47, the score for expectancy main subdimension of critical thinking motivation was 4.17 ± 1.16 and the score for value main subdimension was 4.81 ± 1.12, and score for problem-solving skills was 90.65 ± 19.03. A statistically significant positive correlation was found between nursing diagnosis perception and subdimension of critical thinking motivation scores (p < 0.001) and problem-solving skills score (p < 0.001). The linear regression model established to examine the effect of other scales on nursing diagnosis perception was found to be statistically significant (F = 17.516, p < 0.001). As the expectancy score increases by one unit, the perception of nursing diagnosis score increases 3.452 times (p = 0.001), the cost score increases by one unit, the perception of nursing diagnosis score increases by 3.894 (p = 0.001), and the problemsolving skills score increases by one unit, the perception of nursing diagnosis score decreases by 0.246 (p < 0.001). CONCLUSIONS: To conclude that nursing diagnosis perception, critical thinking motivation, and problem-solving skills of nursing students were high and have a relationship with each other during distance education. As nursing diagnosis perception scores of students increase, their critical thinking motivation and problem-solving skills also increase. IMPLICATIONS FOR NURSING PRACTICE: The high skills of critical thinking and problem solving have an important place effectively to identify the nursing diagnosis more quickly and easily in the nursing care process.

Point-of-care lung ultrasound findings in the pediatric emergency clinic during the COVID-19 pandemic.

PURPOSE: To describe our experience concerning lung ultrasound (LUS) in the pediatric emergency clinic, and to investigate the diagnostic value of LUS in coronavirus disease-2019 (COVID-19). METHODS: Patients aged under 18 admitted to the pediatric emergency clinic with suspicion of COVID-19, who underwent point-of-care LUS and from whom COVID-19 reverse transcription polymerase chain reaction (RT-PCR) samples were collected, were included in the study. RESULTS: Point-of-care LUS was performed on 74 patients in the emergency room. LUS findings were more sensitive than chest X-ray in the early stages of the disease and in mild cases. Involvement was observed at LUS despite RT-PCR being negative in some symptomatic patients with a COVID-19 contact history. CONCLUSIONS: We think that LUS can be beneficial in terms of identifying patients with lung involvement and staging their severity in this new disease in pediatric emergency clinics. The procedure is noninvasive, rapid, reproducible, and low cost, involving simple sterilization. Based on the current literature and our own practical experience, we think that increased use of point-of-care LUS can protect patients from unnecessary radiation and treatment delays during the COVID-19 pandemic.

Maternal serum Netrin-1 levels as a new biomarker of preeclampsia.

AIM: The aim of this study was to investigate whether the Netrin-1 levels in maternal serum was associated with the presence of preeclampsia (PE). METHODS: Total 72 patients, including 28 normal pregnant women and 44 patients with PE, were included in this study. Maternal serum Netrin-1 concentration was measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Maternal serum Netrin-1 levels were detected statistically higher in preeclamptic group than control group (p < 0.05). When compared with subgroups, Netrin-1 levels were also higher in severe PE group than mild PE group but this was not detected statistically significant (p > 0.05). CONCLUSION: Maternal serum Netrin-1 has a potential to be a new marker for the detection of PE.

Reliability and validity of the Turkish version of the EORTC QLQ-C15-PAL for patients with advanced cancer.

OBJECTIVE: Assessing quality of life, which is the main focus of palliative care, is highly important. The number of available, specific, simple, and valid assessment instruments for patients with advanced cancer in Turkey is limited. The aim of our study was to perform a psychometric evaluation of the Turkish version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-PAL (EORTC QLQ-C15-PAL). METHOD: The study was conducted in Izmir with patients who had received treatment in the palliative care unit of a university hospital between November of 2011 and December of 2013. Sociodemographic and disease characteristics forms, the Karnofsky Performance Status (KPS) Scale, and the EORTC QLQ-C15-PAL Scale were employed in order to gather data. RESULTS: A total of 150 patients completed the study: 55.3% of participants were female, 80.7% were married, and the average age was 52.76 ± 14.55. The value of Cronbach's α in the analyses ranged from 0.93 to 0.98. Most questionnaire areas had low to moderate correlations with the others. The moderate correlations were between fatigue and physical function (-0.41) and between insomnia and emotional function (-0.53). Conversely, weak correlations were found between nausea/vomiting and appetite loss (0.31) and between insomnia and pain (0.22). KPS scores decreased, patient physical and emotional function were diminished, global QoL declined, and patients' symptoms became more frank. SIGNIFICANCE OF RESULTS: We concluded that the EORTC QLQ-C15-PAL is a valid and reliable tool to determine the quality of life of advanced cancer patients who are undergoing palliative treatment in Turkey.

Identifying division symmetry of mouse embryonic stem cells: negative impact of DNA methyltransferases on symmetric self-renewal.

Cell division is a process by which a mother cell divides into genetically identical sister cells, although sister cells often display considerable diversity. In this report, over 350 sister embryonic stem cells (ESCs) were isolated through a microdissection method, and then expression levels of 48 key genes were examined for each sister cell. Our system revealed considerable diversities between sister ESCs at both pluripotent and differentiated states, whereas the similarity between sister ESCs was significantly elevated in a 2i (MEK and GSK3b inhibitors) condition, which is believed to mimic the ground state of pluripotency. DNA methyltransferase 3a/3b were downregulated in 2i-grown ESCs, and the loss of DNA methyltransferases was sufficient to generate nearly identical sister cells. These results suggest that DNA methylation is a major cause of the diversity between sister cells at the pluripotent states, and thus demethylation per se plays an important role in promoting ESC's self-renewal.

Ultrasound evaluation of the normal fetal pharynx.

OBJECTIVE: To obtain normative data for fetal pharyngeal diameter and to investigate the ability to visualize pharynx at different gestational ages during routine prenatal sonography. METHODS: Sonographic studies were performed in 292 consecutive pregnant women. The diameters of the pharynx were measured and our ability to visualize pharynx was evaluated at different gestational ages. RESULTS: Sonographic measurements of the pharyngeal diameter were obtained in 153 of the 292 fetuses. The diameter of the pharynx increased from a mean of 4.5+/-0.53 mm at 16 weeks to 9.1+/-1.72 mm at 36 weeks. Pharyngeal diameters showed a significant positive relationship with advancing gestational age (p<0.0001, R2=0.571). The differences in visualization among different gestational age groups were found to be significant (p<0.05 by Chi-Square). CONCLUSION: This study reports normative data for fetal pharyngeal diameter. Pharyngeal measurements were similar to previous reports in the literature. Our success in visualizing the pharynx was best between 21 and 30 weeks of gestation. This period might be the optimum time for evaluating fetal pharynx.

[Dynamic contrast-enhanced brain perfusion imaging: Technique, pitfalls and problems]. / Dinamik kontrastli beyin perfüzyon görüntüleme: teknik prensipler, tuzak ve sorunlar.

Conventional magnetic resonance and computed tomography imaging, despite their sensitivity in delineating tissue anatomy and detecting head and neck pathology, are nonspecific in their ability to physiologically characterize abnormal tissue. The perfusion imaging attempts to measure the steady-state delivery of blood to a given parenchymal region. In this article, the technique of magnetic resonance perfusion and computed tomographic perfusion is discussed in addition to the pitfalls and problems in the light of the latest literature and our own experience.

CT angiography with whole brain perfused blood volume imaging: added clinical value in the assessment of acute stroke.

BACKGROUND AND PURPOSE: In CT angiographic and perfusion imaging (CTA/CTP), rapid CT scanning is performed during the brief steady state administration of a contrast bolus, creating both vascular phase images of the major intracranial vessels and perfused blood volume-weighted parenchymal phase images of the entire brain. We assessed the added clinical value of the data provided by CTA/CTP over that of clinical examination and noncontrast CT (NCCT) alone. METHODS: NCCT and CTA/CTP imaging was performed in 40 patients presenting with an acute stroke. Short clinical vignettes were retrospectively prepared. After concurrent review of the vignettes and NCCT, a stroke neurologist rated infarct location, vascular territory, vessel(s) occluded, and Trial of Org 10172 in Acute Stroke Treatment (TOAST) and Oxfordshire Community Stroke Project classifications. The ratings were repeated after serial review of each of the CTA/CTP components: (1) axial CTA source images; (2) CTP whole brain blood volume-weighted source images; and (3) maximum-intensity projection 3-dimensional reformatted images. The sequential ratings for each case were compared with the final discharge assessment. RESULTS: Compared with the initial review after NCCT, CTA/CTP improved the overall accuracy of infarct localization (P<0.001), vascular territory determination (P=0.003), vessel occlusion identification (P<0.001), TOAST classification (P=0.039), and Oxfordshire Community Stroke Project classification (P<0.001) by 40%, 28%, 38%, 18%, and 32%, respectively. CONCLUSIONS: Admission CTA/CTP imaging significantly improves accuracy, over that of initial clinical assessment and NCCT imaging alone, in the determination of infarct localization, site of vascular occlusion, and Oxfordshire classification in acute stroke patients.

Evaluation of findings in Crouzon's syndrome.

PURPOSE. The purpose of this study was to investigate the ocular, facial and radiological signs of Crouzon's syndrome in a group of older patients who had not undergone previous craniofacial surgery. METHODS. Six cases of Crouzon's syndrome, four of whom belonged to a three-generation family, were examined systemically, ophthalmologically and roentgenographically; five of these cases were additionally evaluated with computed tomography and compared with Apert syndrome. RESULTS. On radiologic evaluation, all cases had synostosis of all cranial sutures and fontanelles and brachycephalic skulls, crowding of the upper teeth due to maxillary hypoplasia, and serious nasal septum deviation. Bilateral ethmoidal, maxillary and sphenoidal chronic sinusitis was found in 50% of cases. Three patients had hypertelorism and two others had a tendency toward hypertelorism. The typical facial appearance with shallow orbits, globe protrusion and exorbitism was present in all cases. Two of them had V-pattern exotropia while the other four were orthophoric. The single case with mental retardation had bilateral cataract. CONCLUSION. Crouzon's syndrome can present with different findings and must be evaluated multidisciplinarly.