The effect of a stress management program on first-year nursing students' clinical stress: A randomized controlled experimental study.

BACKGROUND: Clinical clerkships lie at the core of nursing education and are crucial for developing professional skills. However, nursing students, especially freshmen, often encounter significant stress during their clinical experiences. OBJECTIVES: This study investigated the effect of a stress management program on first-year nursing students' clinical stress levels. DESIGN: This randomized controlled experimental study adopted a pretest-posttest-follow-up test research design. SETTINGS AND PARTICIPANTS: Participants were recruited using simple randomization. The sample consisted of 64 first-year nursing students (intervention = 32; control = 32) from the nursing department of the faculty of health sciences of a university in Türkiye. METHODS: Participants were randomized into intervention and control groups. The intervention group attended a stress management program, one weekly session for five weeks (intervention). The research was conducted between 21.02.2022 and 20.05.2022. Data were collected using a personal information form, the Perceived Stress Scale, the Physio-Psycho-Social Response Scale, and the Coping Behavior Inventory. The data were collected pretest and posttest the intervention and two months follow-up test. The data were analyzed using the two-way repeated measures analysis of variance (ANOVA). RESULTS: The changes in the Perceived Stress Scale mean scores, group*time interaction, were statistically significant (p < 0.05). The results showed that the changes in the Coping Behavior Inventory "problem-solving" subscale mean scores, group*time interaction, were statistically significant (p < 0.05). The multiple comparisons showed a statistically significant difference in posttest Physio-Psycho-Social Response Scale "social behavioral symptoms" and "emotional symptoms" subscale scores between the intervention and control groups (p < 0.05). The multiple comparisons showed a statistically significant difference in posttest Coping Behavior Inventory "problem-solving" and "avoidance" subscale scores between the intervention and control groups (p < 0.05). CONCLUSION: The stress management program helps first-year nursing students experience less stress and develop problem-solving skills before they perform clinical clerkships. It also allows them to suffer from fewer emotional and social behavioral symptoms and exhibit fewer avoidance behaviors.

The effect of stigmatization education on the social distancing of nursing students toward patients with a diagnosis of schizophrenia.

PURPOSE: To assess the effect of a program designed to reduce nursing students' social distancing from individuals diagnosed with schizophrenia. METHOD: This experimental study was designed using a pretest, a posttest, and a control group. All participants were nursing students, of which 25 were included in the intervention group and 23 were placed in the control group. A 13-week program was offered to the intervention group. The measuring instruments consisted of a personal information form and the Social Distance Scale. Data were analyzed using the two-way repeated measures analysis of variance. FINDINGS: A significant difference was found between the two groups. CONCLUSION: The Education Program on Stigmatization in Schizophrenia is an effective intervention that reduces the social distance of nursing students from individuals diagnosed with schizophrenia.

Evaluation of low-to-moderate arsenic exposure, metabolism and skin lesions in a Turkish rural population exposed through drinking water.

BACKGROUND: There is no human data regarding the exposure, metabolism and potential health effects of arsenic (As) contamination in drinking water in the Central Anatolian region of Turkey. METHODS: Residents in ten villages with drinking water of total As (T-As) level >50 µg L-1 and 10-50 µg L-1 were selected as an exposed group (n = 420) and <10 µg L-1 as an unexposed group (n = 185). Time-weighted average-As (TWA-As) intake was calculated from T-As analysis of drinking water samples. Concentrations of T-As in urine and hair samples, urinary As species [i.e., As(III), As(V), MMA(V) and DMA(V], and some micronutrients in serum samples of residents of the study area were determined. Primary and secondary methylation indices (PMI and SMI, respectively) were assessed from urinary As species concentrations and the presence of skin lesion was examined. RESULTS: TWA-As intake was found as 75 µg L-1 in the exposed group. Urinary and hair T-As and urinary As species concentrations were significantly higher in the exposed group (P < 0.05). The PMI and SMI values revealed that methylation capacities of the residents were efficient and that there was no saturation in As metabolism. No significant increase was observed in the frequency of skin lesions (hyperpigmentation, hypopigmentation, keratosis) of the exposed group (P > 0.05). Only frequency of keratosis either at the hand or foot was higher in individuals with hair As concentration >1 µg g-1 (P < 0.05). CONCLUSIONS: Individuals living in the study area were chronically exposed to low-to-moderate As due to geological contamination in drinking water. No significant increase was observed in the frequency of skin lesions. Because of the controversy surrounding the health risks of low-to-moderate As exposure, it is critical to initiate long-term follow-up studies on health effects in this region.

The effect of mindfulness levels on the life satisfaction of nursing students.

PURPOSE: This study was carried out to determine the effect of mindfulness levels on the life satisfaction of nursing students. DESIGN AND METHODS: A descriptive correlational study was conducted on 333 nursing students enrolled at a state university in Turkey. FINDINGS: The statistical analysis of the data indicated that students' mindfulness levels had a significantly positive impact on their satisfaction with life. IMPLICATIONS FOR PRACTICE: Activities that include exercises, meditation and training geared to raise the level of mindfulness can also be beneficial in terms of increasing satisfaction with life.

A phenomenological study of nurses' experiences with maternal guilt in Turkey.

AIM: This study aims to describe nurses' views on what it is like to be a working mother in Turkey. BACKGROUND: Most mothers are in the workforce but continue to fulfil their traditional roles at home. This emerges as an important factor causing mothers to try to find a balance between work and home. METHOD: For this purpose, a semi-structured form was used in face-to-face interviews conducted with 17 participants. A phenomenological design was preferred in this qualitative study. RESULTS: The findings obtained from the study revealed the six themes of 'the sense of inadequacy/helplessness, the sense of responsibility, the strong desire to have a positive effect, gender role stereotypes, the choice between achieving a successful career and being a good mother, but with a sense of depletion'. CONCLUSION: The results obtained from the study of nurses in Turkey have shed light on how policies should be developed to eliminate work-life barriers in realizing the roles of motherhood. IMPLICATIONS FOR NURSING MANAGEMENT: The study results will guide nurse managers in taking the steps needed to incorporate arrangements that will result in balanced conduct of work and home for nurses.

SRC Signaling in Cancer and Tumor Microenvironment.

Pioneering experiments performed by Harold Varmus and Mike Bishop in 1976 led to one of the most influential discoveries in cancer research and identified the first cancer-causing oncogene called Src. Later experimental and clinical evidence suggested that Src kinase plays a significant role in promoting tumor growth and progression and its activity is associated with poor patient survival. Thus, several Src inhibitors were developed and approved by FDA for treatment of cancer patients. Tumor microenvironment (TME) is a highly complex and dynamic milieu where significant cross-talk occurs between cancer cells and TME components, which consist of tumor-associated macrophages, fibroblasts, and other immune and vascular cells. Growth factors and chemokines activate multiple signaling cascades in TME and induce multiple kinases and pathways, including Src, leading to tumor growth, invasion/metastasis, angiogenesis, drug resistance, and progression. Here, we will systemically evaluate recent findings regarding regulation of Src and significance of targeting Src in cancer therapy.

The potential application of gold-apoferritin nanocages conjugated with 2-amino-2-deoxy-glucose for imaging of breast cancer cells.

Development of biocompatible and multifunctional nanoprobes for tumor targeting, imaging, and therapy still remains a great challenge. Herein, gold nanoparticles (AuNPs) were synthesized in the cavity of horse spleen apoferritin protein (HoSAF) and protein surface was labeled with 2-amino-2-deoxy-glucose (2DG) as a cell surface glucose transport protein specific targeting probe to study the feasibility of its usage as a computer tomography (CT) contrast agent with tumor targeting capability through in vitro experiments. 2DG conjugated and gold-loaded apoferritin (Au-HoSAF-2DG) nanoparticles (NPs) showed selective targeting for human breast adenocarcinoma (MCF-7) cells when compared to normal breast (MCF-10A) cells. This AuNP-based imaging agent was found to be non-cytotoxic in a given concentration range with an apoptotic effect upon longer exposure times towards MCF-7 cells, while MCF-10A cells were affected less. This selective cell death would also be useful for further cancer treatments with the ability of X-ray attenuation in in vitro X-ray and computed tomography (CT) imaging.

An evaluation of a psychoeducation programme for emotion identification and expression in individuals diagnosed with schizophrenia.

The inability of individuals diagnosed with schizophrenia to recognize facial expressions is an important issue that has an impact on social functioning. This study was conducted to determine the effects of a psychoeducation programme for emotion identification and expression in those diagnosed with schizophrenia on their ability to identify and discriminate between emotions and social functionality. This quasi-experimental study (pretest-post-test, with control group) comprised an intervention (21) and a control (21) group conducted with individuals diagnosed with schizophrenia. A 10-week psychoeducation programme was offered to the intervention group. Measuring instruments were administered to the groups before the intervention, after the intervention, and 3 months after that. The measuring instruments consisted of a personal information form, the Facial Emotion Identification Test, Facial Emotion Discrimination Test, and Personal and Social Performance Scale. The data were analysed using the 'two-way repeated measures analysis of variance'. The TREND method was used for reporting. In the first measurements taken after the psychoeducation programme, a significant difference was found between the two groups in terms of their 'Facial Emotion Identification Test' and 'Personal and Social Performance Scale' mean scores. In the measurements taken 3 months after the psychoeducation programme, this difference had disappeared. The psychoeducation programme is an effective programme that makes recognition of facially expressed emotions possible and increases the social functioning of patients.

EF2-kinase targeted cobalt-ferrite siRNA-nanotherapy suppresses BRCA1-mutated breast cancer.

Aim: To investigate the role of EF2K in BRCA1-mutated breast cancer. Materials & methods: We developed silica coated cobalt-ferrite (CoFe) nanoparticles for in vivo delivery of small interfering RNAs (siRNAs) into BRCA1-mutated breast cancer. Results: Expression of EF2K is highly upregulated in the majority (78.5%) of BRCA1-mutated patients and significantly associated with poor patient survival and metastasis. Silencing of EF2K reduced cell proliferation, migration and invasion of the cancer cells. In vivo therapeutic targeting of EF2K by CoFe-siRNA-nanoparticles leads to sustained EF2K gene knockdown and suppressed tumor growth in orthotopic xenograft models of BRCA1-mutated breast cancer. Conclusion: EF2K is a potential novel molecular target in BRCA1-mutated tumors and CoFe-based siRNA nanotherapy may be used as a novel approach to target EF2K.

Development and Assessment of a Coping Scale for Infertile Women in Turkey.

Infertile women feel more psychological stress and pressure than their husbands, and the prevalence of anxiety and depression among them are higher. This study aimed to develop a culture-specific measurement tool to identify the strategies of infertile women in dealing with infertility-related problems. This was a scale development study. This study was carried out in three different fertility centers in the three largest cities in Turkey. The data were collected using personal information form and through the application of a Coping Scale for Infertile Women (CSIW) protocol. Ways of Coping with Stress Inventory. Cronbach's alpha, Intraclass Correlation Coefficient and Spearman's Rank correlation analyses were used to determine the reliability of the scale. The results of explanatory factor analysis and a factor structure of the Coping Scale for Infertile Women, comprising 50 items, were examined, and the data were determined to be suitable to perform factor analysis. The internal consistency of the scale was found to be 0.880. The number of factors in the scale was 10, and the internal consistency of the factors was 0.720. The results showed that the CSIW had good reliability and validity.

Cellular uptake and apoptotic potential of rhenium labeled magnetic protein cages in MDA-MB-231 cells.

188Re-magnetoferritin nanoparticles (NPs) provide an attractive platform for localized radiation therapy due to their magnetic targeting capability while enhancing contrast in magnetic resonans imaging (MRI) signals. In this study, cellular uptake, in vitro cytotoxicity, apoptotic potential of a non-radioactive isotope of rhenium in the form of 187Re-magnetoferritin NPs were evaluated in both human normal mammary epithelial and breast metastatic adenocarcinoma cell lines. The results showed that, NP administration into the cells is through receptor mediated endocytosis and cancer cells displayed significantly higher uptake and cytotoxicity compared to normal cells. IC50 values of nanoparticles were calculated as 0.96 mg/mL for cancer and 1.73 mg/mL for normal cells. Annexin V/ Propidium Iodide (PI) staining also showed that, NPs induced higher apoptotic rates in cancer cells compared to normal cells. Gene expression analyses confirming the results showed that, pro-apoptotic PUMA and BAX genes were significantly up-regulated while anti-apoptotic BCL-2 and SURVIVIN genes were down-regulated in cancer cells compared to normal cells. Overall, these in vitro results suggest that, 187Re-magnetoferritin NPs have a promising potential for cancer therapy and can be used for imaging and diagnostic purposes for breast cancer at concentrations lower than 0.96 mg/mL. At concentrations above 1 mg/mL, NPs induce apoptosis which can also be used for cancer treatments.

Modified gold-based siRNA nanotherapeutics for targeted therapy of triple-negative breast cancer.

AIM: In this study, we aimed to therapeutically target eukaryotic elongation factor 2 kinase (eEF-2K) in an in vivo triple-negative breast cancer (TNBC) tumor model. MATERIALS & METHODS: We synthesized a highly monodisperse nanoformulation using polyethylenimine-modified gold nanoparticles (AuNP-PEI) as siRNA delivery vehicle and evaluated gene downregulation. RESULTS: We found that AuNP-PEI/eEF-2K nanoformulation was highly effective for in vitro and in vivo gene downregulation and showed remarkable antitumor efficacy that was associated with eEF-2K knockdown, inhibition of Src and MAPK-ERK signaling pathways in a TNBC orthotopic tumor model. CONCLUSION: Our study suggests that eEF-2K plays an important role in TNBC tumorigenesis and its inhibition by AuNP-PEI/eEF-2K siRNA-based nanotherapeutics may be a potential therapeutic strategy for TNBC.

2-Amino-2-deoxy-glucose conjugated cobalt ferrite magnetic nanoparticle (2DG-MNP) as a targeting agent for breast cancer cells.

In this study, 2-amino-2-deoxy-glucose (2DG) was conjugated to COOH modified cobalt ferrite magnetic nanoparticles (COOH-MNPs), which were designed to target tumor cells as a potential targetable drug/gene delivery agent for cancer treatment. According to our results, it is apparent that, 2DG labeled MNPs were internalized more efficiently than COOH-MNPs under the same conditions in all cell types (MDA-MB-231 and MCF-7 cancer and MCF-10A normal breast cells) (p<0.001). Moreover, the highest amount of uptake was observed in MDA-MB-231, followed by MCF-7 and normal MCF-10A cells for both MNPs. The apoptotic effects of 2DG-MNPs were further evaluated, and it was found that apoptosis was not induced at low concentrations of 2DG-MNPs in all cell types, whereas dramatic cell death was observed at higher concentrations. In addition, the gene expression levels of four drug-metabolizing enzymes, two Phase I (CYP1A1, CYP1B1) and two Phase II (GSTM3, GSTZ1) were also increased with the high concentrations of 2DG-MNPs.

Cellular uptake, genotoxicity and cytotoxicity of cobalt ferrite magnetic nanoparticles in human breast cells.

Magnetic nanoparticles (MNPs) have been increasingly used for many years as MRI agents and for gene delivery and hyperthermia therapy, although there have been conflicting results on their safety. In this study, cobalt ferrite magnetic nanoparticles (CoFe-MNPs) were prepared by the co-precipitation method and their surfaces were modified with silica by the sol-gel method. The particle and hydrodynamic sizes, morphology and crystal structure of the bare and silica-coated CoFe-MNPs were evaluated by transmission electron microscopy (TEM), dynamic light scattering (DLS), X-ray diffraction spectroscopy (XRD) and Fourier transform infrared spectroscopy (FTIR). The size of the bare CoFe-MNPs was in the range 8-20 nm and they were homogeneously coated with 3-4 nm silica shells. The bare and silica-coated CoFe-MNPs were agglomerated at physiological pH. However, the sizes of the agglomerates were below 200 nm both in water and complete medium. The cytotoxic and genotoxic potentials of the bare and silica-coated CoFe-MNPs were evaluated in a metastatic breast cancer cell line, MDA-MB-231, as well as a noncancerous mammary epithelial cell line, MCF-10A, by using XTT cytotoxicity, single-cell gel electrophoresis (comet), and cytokinesis-blocked (CB) micronucleus (CBMN) assays. Characterization studies with TEM, inductively coupled plasma optical emission spectroscopy (ICP-OES) and Prussian blue staining indicated that the CoFe-MNPs were internalized into the cells by energy-dependent endocytosis. The highest amount of uptake was observed in the cancer cells and the uptake of the silica-coated CoFe-MNPs was higher than that of the bare ones in both cell lines. The bare CoFe-MNPs showed higher levels of both cytotoxicity and genotoxicity than the silica-coated CoFe-MNPs. Moreover, the cancer cells seemed to be more susceptible to the CoFe-MNPs' toxicity compared to the noncancerous cells. There was a concentration and time-dependent increase in DNA damage and the micronucleus (MN) frequency, which was statistically significant starting with the lowest concentration of bare CoFe-MNPs (p < 0.05), while no significance was observed below the concentration of 250 µg mL-1 for the silica-coated MNPs. Also, the extent of both DNA damage and MN frequency was much higher in the cancer cells compared to the noncancerous cells. According to our results, the silica coating ameliorated both the cytotoxicity and genotoxicity as well the internalization of the CoFe-MNPs.

Short-term effects of intravitreal bevacizumab (Avastin(®)) on retrobulbar hemodynamics in patients with neovascular age-related macular degeneration.

PURPOSE: To evaluate the short-term effects of intravitreal bevacizumab on retrobulbar hemodynamics in patients with neovascular age-related macular degeneration (AMD). METHODS: This study was carried out at Ataturk Training and Research Hospital 1st Ophthalmology Clinic, Ankara. Fourteen patients with neovascular AMD, who were treated with intravitreal injection of bevacizumab, were included in this study. Peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistivity index (RI) were measured with colour Doppler imaging (CDI) in the ophthalmic artery, central retinal artery (CRA) and posterior ciliary artery. RESULTS: The mean age of the 14 patients was 78 ± 9 (64-87). Of the 14 patients, eight were men and six were women. Colour Doppler imaging measurements of EDV (p = 0.015) and RI (p = 0.009) parameters of CRA revealed statistically significant difference among all three periods. End-diastolic velocity values decreased at the end of the 1st week and returned close to preoperative values at the end of the 1st month after the procedure. Also, EDV of posterior ciliary artery (PCA) decreased at the end of the 1st week and returned close to preoperative values at the end of the 1st month after the procedure. Resistivity index of PCA showed a temporary increase at the end of the 1st week and returned close to preoperative values at the end of the 1st month after the procedure. CONCLUSION: Injection of bevacizumab decreased blood velocities of CRA and PCA and increased RI of CRA and PCA in the early postoperative period and returned to preoperative values at the end of the first month.

Prenatal diagnosis of fetal intra-abdominal umbilical vein varix: report of 2 cases.

Fetal intra-abdominal umbilical vein varix (FIUVV) is a focal aneurysmal dilatation of the umbilical vein. Its clinical importance has not yet been clearly established, but it has been reported to be associated with increased fetal death rate (in nearly 44% of cases) and chromosomal abnormalities (in 12% of cases). We report 2 cases of FIUVV diagnosed via sonography in the third trimester.