Mediating effect of self-esteem on the relationship between academic self-efficacy and depression symptoms among nursing students participating in blended learning.

Background: Blended learning, which comprises a combination of online and classroom-based activities, in nursing education can cause significant academic stress and depression symptoms among students. However, self-esteem may mediate the relationship between academic self-efficacy and depression symptoms. Studies of the relationship between academic self-efficacy, self-esteem, and depression symptoms among nursing students participating in blended learning are limited. Objectives: To examine the determinants of depression symptoms and the mediating effect of self-esteem on the relationship between academic self-efficacy and depression symptoms among nursing students who participate in blended learning. Design: Cross-sectional study using convenience sampling. Settings: Ten universities across five provinces and two major Indonesian islands. Participants: A total of 534 undergraduate nursing students with a mean age of 20.30 years (standard deviation, ±1.36 years). Methods: An online survey was conducted between April and August 2022 to collect data from 10 universities applying blended learning. The study instruments included the General Self-Efficacy Scale, Rosenberg Self-Esteem Scale, and a 9-item Patient Health Questionnaire. Data were analysed by hierarchical linear regression using PROCESS macro version 4.1. Results: Of the 534 participants, 213 (39.14 %) experienced moderate-to-severe depression symptoms. Two variables, online learning difficulties (ß = 0.10; p = .012) and self-esteem (ß = -0.40; p < .001), were significant determinants of depression symptoms. Self-esteem mediated the relationship between academic self-efficacy and depression symptoms. Conclusions: It is necessary to understand the online learning difficulties experienced by blended learning students and improve their self-esteem by maximising academic self-efficacy to prevent depression symptoms.

Expression of Circulating MicroRNA-141 in Epithelial Ovarian Cancer.

BACKGROUND: Epithelial ovarian cancer (EOC) is a lethal disease due to late diagnosis and lack of effective screening methods. MicroRNA (miR/miRNA) plays an important role in ovarian carcinogenesis and may serve as a non-invasive biomarker for EOC. This study aimed to assess miR-141 expression in the blood plasma of patients with EOC and healthy subjects and determine its association with the clinical stage of EOC. METHODS: This cross-sectional study used blood plasma from 30 newly diagnosed untreated patients with EOC and 25 healthy subjects. The mean age was 47.73 (SD = 10.29) years for EOC and 44.48 (SD = 16.14) years for healthy subject. The total RNA was isolated from blood plasma and reversed transcribed to obtain cDNA. The expression of miR-141 was measured by real-time quantitative polymerase chain reaction (qRT-PCR), and calculated using 2-ΔΔCt methods. The data were analysed using Mann-Whitney test. RESULTS: The expression of miR-141 was upregulated 8.41 fold in the blood plasma of EOC patients compared to healthy controls (P < 0.001). Expression of miR-141 in the advanced stage was upregulated 4.2 fold compared to the early stage (P < 0.001). CONCLUSION: The miR-141 was upregulated in the blood plasma of EOC and associated with an advanced stage of disease, suggesting it has potential as a biomarker for EOC detection.