Unusual neonatal case of superior mesenteric artery syndrome with Meckel's diverticulum and literature review.

Superior mesenteric artery syndrome (SMAS) is a rare cause of duodenal obstruction which is characterized by compression of the duodenum due to narrowing of the space between the superior mesenteric artery and aorta. Incomplete duodenal obstruction due to SMAS in neonates is rarely reported in the literature. In this case, it is a full-term 2-day-old male with the complaint of recurrent vomiting starting soon after birth. The patient was diagnosed with SMAS and duodenoduodenostomy was performed. Accompanying Meckel's diverticulum was excised.

El síndrome de la arteria mesentérica superior (SMAS) es una causa rara de obstrucción duodenal que se caracteriza por la compresión del duodeno debido al estrechamiento del espacio entre la arteria mesentérica superior y la aorta. La obstrucción duodenal incompleta por SMAS en recién nacidos rara vez se informa en la literatura. En este caso se trata de un varón de 2 días nacido a término que presenta vómitos recurrentes desde poco después del nacimiento. El paciente fue diagnosticado de SMAS y se le realizó duodenoduodenostomía. Se extirpó el divertículo de Meckel que lo acompañaba.

Immunosuppression with cyclosporine versus tacrolimus shows distinctive nephrotoxicity profiles within renal compartments.

AIM: Calcineurin inhibitors (CNIs) are the backbone for immunosuppression after solid organ transplantation. Although successful in preventing kidney transplant rejection, their nephrotoxic side effects contribute to allograft injury. Renal parenchymal lesions occur for cyclosporine A (CsA) as well as for the currently favored tacrolimus (Tac). We aimed to study whether chronic CsA and Tac exposures, before reaching irreversible nephrotoxic damage, affect renal compartments differentially and whether related pathogenic mechanisms can be identified. METHODS: CsA and Tac were administered chronically in wild type Wistar rats using osmotic minipumps over 4 weeks. Functional parameters were controlled. Electron microscopy, confocal, and 3D-structured illumination microscopy were used for histopathology. Clinical translatability was tested in human renal biopsies. Standard biochemical, RNA-seq, and proteomic technologies were applied to identify implicated molecular pathways. RESULTS: Both drugs caused significant albeit differential damage in vasculature and nephron. The glomerular filtration barrier was more affected by Tac than by CsA, showing prominent deteriorations in endothelium and podocytes along with impaired VEGF/VEGFR2 signaling and podocyte-specific gene expression. By contrast, proximal tubule epithelia were more severely affected by CsA than by Tac, revealing lysosomal dysfunction, enhanced apoptosis, impaired proteostasis and oxidative stress. Lesion characteristics were confirmed in human renal biopsies. CONCLUSION: We conclude that pathogenetic alterations in the renal compartments are specific for either treatment. Considering translation to the clinical setting, CNI choice should reflect individual risk factors for renal vasculature and tubular epithelia. As a step in this direction, we share protein signatures identified from multiomics with potential pathognomonic relevance.

Propolis-Loaded Poly(lactic-co-glycolic Acid) Nanofibers: An In Vitro Study.

Nanofibers have high potential through their high porosity, small pore sizes, lightweight materials, and their ability to mimic the extracellular matrix structure for use in the manufacture of wound dressings for wound treatment. In this study, poly(lactic-co-glycolic acid) (PLGA) nanofibers were produced by electrospinning. Propolis was loaded into the PLGA nanofibers by the dropping method. The average diameters and effects of propolis loading on the morphology of 37.5, 50, and 100% propolis-loaded PLGA nanofibers (PLGA-P37.5, PLGA-P50, and PLGA-P100) were evaluated by scanning electron microscopy (SEM). The successful loading of propolis into PLGA nanofibers was confirmed with Fourier transform infrared spectroscopy (FTIR) analysis. In vitro propolis release was examined at physiological pH. The antioxidant activity of propolis-loaded nanofibers was studied with 2,2-diphenyl-1-picrylhydrazyl (DPPH). Antimicrobial activities of the nanofibers against Escherichia coli, Staphylococcus aureus and Candida albicans strains were determined by the disk diffusion method. Consequently, PLGA-P50 and PLGA-P100 showed high antimicrobial activity on S. aureus and C. albicans. Cell viability was tested by 3-[4,5-dimethylthiazole-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay, and propolis-loaded PLGA nanofibers were found to be biocompatible with human fibroblast cells. In the wound scratch assay, propolis-loaded nanofibers supported wound closure with cell migration and proliferation. Thus, in vitro wound closure properties of propolis-loaded PLGA nanofibers were evaluated for the first time in the literature.

The effect of yoga practice on pain intensity, menstruation symptoms and quality of life of nursing students with primary dysmenorrhea.

The researchers aimed to determine the effects of yoga on pain severity, menstrual symptoms and quality of life of undergraduate nursing students with primary dysmenorrhea. The 60 female students were divided into intervention (n = 30) and control groups (n = 30) by block randomization. In the study, data were evaluated with the Visual Analog Scale for Pain, the Menstruation Symptom Scale and the Short Form-36 Health Survey Scale. The 12-week intervention program, which included all components of Hatha yoga, was carried out twice a week for a total of 24 sessions of 60 min. The control group did not receive any intervention. The severity of menstrual pain and symptoms decreased in yoga group compared to control group, and there were significant improvements in quality of life (p < 0.001). The researchers shows that regular Hatha yoga may be a possible nonpharmacological treatment for primary dysmenorrhea in young women in this study.

Children's expectations about the stability of others' knowledge and preference states.

It is a crucial ability to predict others' psychological states across time and contexts. Focusing on cultural inventions such as songs and stories, we contrasted children's attributions of stability with others' knowledge and preference states across time and space and whether these attributions change as a function of children's familiarity with the known/liked items. Children (91 4-year-olds and 97 6-year-olds) were introduced to characters who knew or liked a song, a story, a game and a dance that were either novel or familiar. Children were asked whether the characters would still know/like these when they move to another city or when they grow up to be an adult. Both age groups expected these attributes to be more durable in the moving scenario compared with the growing-up scenario, but this trend became more robust with age. Whereas overall children did not judge knowledge as more durable than preferences, children found knowledge to be more enduring with age. The 6-year-olds' stability attributions also increased when known/liked items were familiar. These results suggest that, across the preschool years, children become more nuanced in their predictions about the future forms of knowledge and preference states.

Furosemide rescues hypercalciuria in familial hypomagnesaemia with hypercalciuria and nephrocalcinosis model.

AIM: Perturbed calcium homeostasis limits life expectancy in familial hypomagnesaemia with hypercalciuria and nephrocalcinosis (FHHNC). This rare disease occurs by loss-of-function mutations in CLDN16 or CLDN19 genes, causing impaired paracellular reabsorption of divalent cations along the cortical thick ascending limb (cTAL). Only partial compensation takes place in the ensuing late distal convoluted tubule, connecting tubule, and collecting duct, where the luminal transient receptor potential channel V5 (TRPV5), as well as basolateral plasma membrane calcium ATPase (PMCA) and sodium-potassium exchanger (NCX1) mediate transcellular Ca2+ reabsorption. The loop diuretic furosemide induces compensatory activation in these distal segments. Normally, furosemide enhances urinary calcium excretion via inhibition of the aforementioned cTAL. As Ca2+ reabsorption in the cTAL is already severely impaired in FHHNC patients, furosemide may alleviate hypercalciuria in this disease by activation of the distal transcellular Ca2+ transport proteins. METHODS: Cldn16-deficient mice (Cldn16-/- ) served as a FHHNC model. Wild-type (WT) and Cldn16-/- mice were treated with furosemide (7 days of 40 mg/kg bw) or vehicle. We assessed renal electrolyte handling (metabolic cages) and key divalent transport proteins. RESULTS: Cldn16-/- mice show higher Ca2+ excretion than WT and compensatory stimulation of Cldn2, TRPV5, and NCX1 at baseline. Furosemide reduced hypercalciuria in Cldn16-/- mice and enhanced TRPV5 and PMCA levels in Cldn16-/- but not in WT mice. CONCLUSIONS: Furosemide significantly reduces hypercalciuria, likely via upregulation of luminal and basolateral Ca2+ transport systems in the distal nephron and collecting duct in this model for FHHNC.

XBP1 Activation Reduces Severity of Polycystic Kidney Disease due to a Nontruncating Polycystin-1 Mutation in Mice.

BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is caused by mutations in Pkd1 and Pkd2. They encode the polytopic integral membrane proteins polycystin-1 (PC1) and polycystin-2 (PC2), respectively, which are expressed on primary cilia. Formation of kidney cysts in ADPKD starts when a somatic second hit mechanism inactivates the wild-type Pkd allele. Approximately one quarter of families with ADPDK due to Pkd1 have germline nonsynonymous amino acid substitution (missense) mutations. A subset of these mutations is hypomorphic, retaining some residual PC1 function. Previous studies have shown that the highly conserved Ire1 α -XBP1 pathway of the unfolded protein response can modulate levels of functional PC1 in the presence of mutations in genes required for post-translational maturation of integral membrane proteins. We examine how activity of the endoplasmic reticulum chaperone-inducing transcription factor XBP1 affects ADPKD in a murine model with missense Pkd1 . METHODS: We engineered a Pkd1 REJ domain missense murine model, Pkd1 R2216W , on the basis of the orthologous human hypomorphic allele Pkd1 R2220W , and examined the effects of transgenic activation of XBP1 on ADPKD progression. RESULTS: Expression of active XBP1 in cultured cells bearing PC1 R2216W mutations increased levels and ciliary trafficking of PC1 R2216W . Mice homozygous for Pkd1 R2216W or heterozygous for Pkd1 R2216Win trans with a conditional Pkd1 fl allele exhibit severe ADPKD following inactivation in neonates or adults. Transgenic expression of spliced XBP1 in tubule segments destined to form cysts reduced cell proliferation and improved Pkd progression, according to structural and functional parameters. CONCLUSIONS: Modulating ER chaperone function through XBP1 activity improved Pkd in a murine model of PC1, suggesting therapeutic targeting of hypomorphic mutations.

Examination of individuals' depression, anxiety, and stress levels during the COVID-19 pandemic in Turkey.

PURPOSE: This research was conducted to determine the depression, anxiety, and stress levels of individuals during the COVID-19 epidemic. In addition, the compatibility of the Depression-Anxiety-Stress Scale (DASS-21) scale results with the participants' feeling depressed, anxious, and stressed were examined. DESIGN AND METHODS: The sample of the study consisted of 870 individuals over the age of 18 between May-August 2021. The data of the study were collected online, using the personal information form and DASS-21. RESULTS: In our study, it was observed that 22.3 % of the participants were severely depressed, 19.0 % were highly anxious and 14.3 % were highly stressed. In addition, a relationship was determined between many sociodemographic variables and depression, anxiety, and stress levels. It was found that individuals who were not vaccinated, did not receive health care, and were not satisfied with health care were more depressed, anxious, and stressed. The agreement between all DASS-21 sub-dimensions and participants' feeling is poor in terms of Cohen's kappa. The agreement is poor in the anxiety sub dimension, but moderate in the other sub-dimensions in terms of Gwet's AC1. PRACTICE IMPLICATIONS: It is recommended that nurses develop new care and evaluation strategies for the psychosocial field in order to protect and maintain the health of individuals during the COVID-19 pandemic process, as well as more practices promoting the COVID-19 vaccine in our country.

Advanced molecular imaging for the characterisation of complex medicines.

A growing number and diversity of complex medicines is in development and reaching the market, with many of these medicines utilising innovative delivery technology to achieve appropriate biodistribution and exposure. Accurate assessment of biodistribution, cell penetration, internalised form, cargo release and efficacy are essential for the development of these medicines. Advanced imaging technologies, deploying different labelling techniques that allow the assessment of both carrier and cargo, are enabling in-depth analysis and providing a mechanistic understanding of each step in the drug delivery pathway. Translation across cell, tissue and whole-body settings using multiple imaging methods can provide decision-making information that is critical for clinical phase selection and for the development of complex medicines.

Immunosuppressive calcineurin inhibitor cyclosporine A induces proapoptotic endoplasmic reticulum stress in renal tubular cells.

Current immunosuppressive strategies in organ transplantation rely on calcineurin inhibitors cyclosporine A (CsA) or tacrolimus (Tac). Both drugs are nephrotoxic, but CsA has been associated with greater renal damage than Tac. CsA inhibits calcineurin by forming complexes with cyclophilins, whose chaperone function is essential for proteostasis. We hypothesized that stronger toxicity of CsA may be related to suppression of cyclophilins with ensuing endoplasmic reticulum (ER) stress and unfolded protein response (UPR) in kidney epithelia. Effects of CsA and Tac (10 µM for 6 h each) were compared in cultured human embryonic kidney 293 (HEK 293) cells, primary human renal proximal tubule (PT) cells, freshly isolated rat PTs, and knockout HEK 293 cell lines lacking the critical ER stress sensors, protein kinase RNA-like ER kinase or activating transcription factor 6 (ATF6). UPR was evaluated by detection of its key components. Compared with Tac treatment, CsA induced significantly stronger UPR in native cultured cells and isolated PTs. Evaluation of proapoptotic and antiapoptotic markers suggested an enhanced apoptotic rate in CsA-treated cells compared with Tac-treated cells as well. Similar to CsA treatment, knockdown of cyclophilin A or B by siRNA caused proapoptotic UPR, whereas application of the chemical chaperones tauroursodeoxycholic acid or 4-phenylbutyric acid alleviated CsA-induced UPR. Deletion of protein kinase RNA-like ER kinase or ATF6 blunted CsA-induced UPR as well. In summary, inhibition of cyclophilin chaperone function with ensuing ER stress and proapoptotic UPR aggravates CsA toxicity, whereas pharmacological modulation of UPR bears potential to alleviate renal side effects of CsA.

Caffeic Acid Phenethyl Ester Loaded Electrospun Nanofibers for Wound Dressing Application.

Electrospinning is an advantageous method with a wide usage area, which enables the production of materials consisting of nano-thickness fibers. In this study, caffeic acid phenethyl ester (CAPE) molecule was loaded onto the poly(lactic-co-glycolic acid) (PLGA) nanofibers and obtained nanofibers were physicochemically and biologically investigated for the first time in the literature. The existence of CAPE molecules, loaded on PLGA membranes by dropping and spraying methods, was evaluated by a comparative investigation of Fourier-transform infrared (FTIR) spectra and X-Ray diffraction (XRD) patterns. Fiber morphology of the membranes was investigated by scanning electron microscope (SEM). CAPE release and swelling behaviors of the membranes were studied in vitro. The radical scavenging activity of CAPE-loaded wound dressing materials was determined by using an antioxidant assay. The antimicrobial properties of PLGA and CAPE-loaded PLGA membranes were evaluated against S. aureus, P. aeruginosa and C. albicans strains by the time-kill method. The biocompatibility study of the obtained CAPE-loaded fibers conducted on human fibroblast cell line and wound healing promoting effect of the fibers was investigated in vitro scratch assay. The results show that CAPE-loaded PLGA membranes are highly antimicrobial against all strains used in the experiment. Additionally, the results show that they are biocompatible and have wound healing properties on human fibroblasts.

Activation of homologous recombination in G1 preserves centromeric integrity.

Centromeric integrity is key for proper chromosome segregation during cell division1. Centromeres have unique chromatin features that are essential for centromere maintenance2. Although they are intrinsically fragile and represent hotspots for chromosomal rearrangements3, little is known about how centromere integrity in response to DNA damage is preserved. DNA repair by homologous recombination requires the presence of the sister chromatid and is suppressed in the G1 phase of the cell cycle4. Here we demonstrate that DNA breaks that occur at centromeres in G1 recruit the homologous recombination machinery, despite the absence of a sister chromatid. Mechanistically, we show that the centromere-specific histone H3 variant CENP-A and its chaperone HJURP, together with dimethylation of lysine 4 in histone 3 (H3K4me2), enable a succession of events leading to the licensing of homologous recombination in G1. H3K4me2 promotes DNA-end resection by allowing DNA damage-induced centromeric transcription and increased formation of DNA-RNA hybrids. CENP-A and HJURP interact with the deubiquitinase USP11, enabling formation of the RAD51-BRCA1-BRCA2 complex5 and rendering the centromeres accessible to RAD51 recruitment and homologous recombination in G1. Finally, we show that inhibition of homologous recombination in G1 leads to centromeric instability and chromosomal translocations. Our results support a model in which licensing of homologous recombination at centromeric breaks occurs throughout the cell cycle to prevent the activation of mutagenic DNA repair pathways and preserve centromeric integrity.

The relationship between quality of life and fear of Turkish individuals during the COVID-19 pandemic: A cross-sectional study.

OBJECTIVE: In this study, it was aimed to determine the relationship between quality of life and the fear experienced due to the COVID-19 pandemic. METHOD: This cross-sectional descriptive study was conducted with a total of 1060 participants from Turkey's 65 provinces. The research data were collected through an online questionnaire consisting of three parts: "Personal Information Form", "The Fear of COVID-19 Scale (FCS)" and "World Health Organization Life Quality Scale-Short Form (WHOQOL-BREF)". Independent two-group t-test (Student's t-test), and one-way ANOVA test were used to compare the means of groups. The Pearson Correlation Coefficient was calculated to determine the level of correlation between two independent continuous variables. A value of p < .05 was accepted as the threshold for statistical significance. RESULTS: The fear levels of women, married individuals and primary school graduates were found to be high, while quality of life was low among participants with poor economic status, those with COVID-19 symptoms and subjects who had been in close contact with a COVID-19-positive patient. In addition, there was an inverse relationship between the level of fear related to COVID-19 and quality of life (physical and psychological health). PRACTICE IMPLICATIONS: Nurses are recommended to develop new care and evaluation strategies that will cover psychosocial and economic areas, as well as physical health, in order to protect and maintain the well-being of individuals during the COVID-19 pandemic.

A psychosocial examination of feelings and thoughts about pregnancy: A qualitative study.

BACKGROUND: during pregnancy, which is a developmental period, there are risks that may cause pathological changes when physical, mental and social adaptation is not achieved. During antenatal appointments, it is possible to provide necessary care for pregnant women at the right time by screening for risks that threaten health. In addition to physical risk factors, psychosocial risk factors that can have significant effects on the health of pregnant women should also be included in antenatal appointments. A woman's inability to meet her needs or difficulties encountered in psychosocial areas, such as mental health, family relations, social life and job status during pregnancy, may result in mental and social problems as well as physical problems. Insufficient social support, job loss and family communication problems can leave pregnant women vulnerable to stress and cause many pregnancy complications, such as preterm labor. When problems in these areas cannot be detected at an early stage, they can threaten the life of the woman and the fetus. As such, knowledge of the specific feelings and thoughts of pregnant women from a psychosocial perspective will be useful in the evaluation of psychosocial risk factors. PURPOSE: to determine the feelings and thoughts of pregnant women from a psychosocial perspective. METHOD: this study used a qualitative descriptive approach to investigate pregnancy-related feelings and thoughts in a sample of 23 healthy pregnant women. Data were collected using a personal information form and a semi-structured interview form. The interviews, which were conducted using the semi-structured interview form and individual in-depth interviews, were recorded on a voice recorder. A thematic approach was used to analyze the data. RESULTS: according to the results, the mean age of the pregnant women was 30.39 (standard deviation 4.03) years, 73.9% were university graduates and 78.3% were multiparous. Three main themes ('Pregnancy perception', 'Emotions in pregnancy' and 'Psychosocial dimension of pregnancy') and eight subthemes emerged from the data analysis. For 'Pregnancy perception', the subtheme was 'Meaning of pregnancy'. For 'Emotions in pregnancy', the subthemes were 'Emotional status (mood) in pregnancy' and 'Fear in pregnancy'. For 'Psychosocial dimension of pregnancy', the subthemes were 'Reflections of pregnancy on social life', 'Reflections of pregnancy on body image', 'Reflections of pregnancy on sexual life', 'Reflections of pregnancy on marital relationship' and 'Reflections of pregnancy on working life'. CONCLUSIONS: in order to protect and maintain the health of the mother and fetus during pregnancy, it is recommended that women should be provided with the best physical and psychosocial care within the context of social and cultural structure, not only in this period but in every stage of their lives.

Comparative Study: Impacts of Ca and Mg Salts on Iron Oxygen Carriers in Chemical Looping Combustion of Biomass.

Chemical looping combustion (CLC) is one of the most promising methods for carbon capture and storage (CCS). An oxygen carrier, i.e., a mineral that can be oxidized and reduced, is used to convert the fuel in the process. The produced CO2 is inherently separated from the air components that enables easier CCS. The use of biomass-based fuels is desirable since it can lead to negative CO2 emissions. On the other hand, alkali compounds from the biomass may interact with the oxygen carrier causing problems, such as deactivation of the oxygen carrier. The most common oxygen carriers contain iron, since iron-based ores and industrial waste materials are readily available and cost-efficient. Therefore, the interaction between the iron oxygen carriers and the biomass ash-forming compounds needs to be investigated. Since Ca/Mg are abundant in biomass, it is important to clarify how their compounds interact with the oxygen carrier. In this study, the effect of Ca/Mg carbonates, chlorides, nitrates, sulfates, and phosphates along with synthetic biomass-derived ash on iron oxides was investigated. Redox reactions were investigated at 950 °C during 5 h under both oxidizing and reducing atmospheres. The results showed that the effect of Ca/Mg salts on the oxygen carrier varied depending on the anion of the salt. Generally, the nitrate- and phosphate-based salts of both Ca and Mg showed the harshest effect regarding agglomeration of the oxygen carriers. It was shown that the Ca/Mg-based compounds interacted differently with iron oxides, which was an unexpected result.

Connexin43 is differentially distributed within renal vasculature and mediates profibrotic differentiation in medullary fibroblasts.

Connexins (Cxs) form gap junctions for intercellular exchange of inorganic ions and messenger molecules. In the kidney, Cxs play essential roles within its compartments, but data on the precise cellular localization and cell type-related function of their isoforms are scarce. We tested whether Cx43 distribution is restricted to vascular and interstitial cells and whether medullary fibroblasts express Cx43 to coordinate profibrotic signaling. Confocal immunofluorescence techniques, ultrastructural labeling, and functional experiments in cell culture were performed. Cx43 was chiefly expressed in the vasculature but was absent from tubular epithelia. All arterial, arteriolar, and lymphatic endothelia showed continuous Cx43 signal along their borders. In the inner medulla, only the interstitium showed Cx43 signals, which were assigned to fibroblasts and their processes. Cultured Cx43-expressing medullary fibroblasts served to study the role of gap junctions in a profibrotic context. In a dye spreading assay, Cx43-sensitive diffusion of Lucifer yellow was dependent on gap junctional passage. The addition of transforming growth factor-ß1 (5 ng/mL for 48 h) activated Cx43 biosynthesis and caused Cx43-sensitive transformation of the fibroblasts into a myofibroblast phenotype. This suggested that Cx43 gap junctional channels enable the coordination of profibrotic signaling between cells of the medullary interstitium. In summary, we demonstrate the presence of Cx43-expressing gap junctions within the two major renal compartments, the vasculature and interstitium. Endothelial Cx43 likely provides functions of an earlier-defined "electrical syncytium" within the vascular wall. Additionally, Cx43 facilitates profibrotic signaling between medullary interstitial fibroblasts.

How to maintain the genome in nuclear space.

Genomic instability can be life-threatening. The fine balance between error-free and mutagenic DNA repair pathways is essential for maintaining genome integrity. Recent advances in DNA double-strand break induction and detection techniques have allowed the investigation of DNA damage and repair in the context of the highly complex nuclear structure. These studies have revealed that the 3D genome folding, nuclear compartmentalization and cytoskeletal components control the spatial distribution of DNA lesions within the nuclear space and dictate their mode of repair.

The relationship between psychosocial health status and social support of pregnant women.

PURPOSE: The aim of this study was to determine the relationship between psychosocial health status and social support, which has important effects on pregnancy, and to determine the factors related to both psychosocial health and social support. METHOD: The research was planned to be a descriptive study. The sample of the study consisted of 393 pregnant women. 'Personal Information Form', 'Pregnancy Psychosocial Health Assessment Scale (PPHAS)', and 'Multidimensional Scale of Perceived Social Support (MSPSS)' were used to collect data, and Student's t-test, ANOVA and Tukey's HSD tests were used for the data analysis. The relationship between the two continuous variables was evaluated according to the Pearson correlation coefficient. RESULTS: Psychosocial health conditions and perceived social supports of pregnant women whose spouses were working were determined to be significantly higher (p < .05), and at a lower level (p < .05) in pregnant women with two or more children. As MSPSS total mean scores of the pregnant women increased, their PPHAS total mean scores were weakly affected in the positive direction (r = 0.393, p < .01). CONCLUSIONS: It is recommended that health care needs of pregnant women should be evaluated not only in terms of physical health but also together with their psychosocial health and social supports. Furthermore, this assessment should be done in their own home environment with their spouses and other family members.

The relationship of postpartum sleep quality and breastfeeding self-efficacy of Turkish mothers.

INTRODUCTION: Breastfeeding self-efficacy reflects the mother's confidence regarding breastfeeding, and it positively affects breastfeeding. Traditionally, people attach importance to breastfeeding in Turkey and the vast majority of mothers breastfeed their babies. It is a known fact that mothers feel sleepless and tired in the postpartum period reduces the amount of secreted milk. However, it is not known whether there is a relationship between the perception of breastfeeding self-efficacy which positively affects breastfeeding and sleep quality of the mothers in this period. AIM: This study was conducted in order to determine the relationship between sleep quality and breastfeeding self-efficacy of the mothers in the postpartum period. MATERIALS AND METHODS: This descriptive study included 128 primiparous women who had vaginal deliveries from 2 January to 27 May 2018 in a public obstetrics and children's hospital in Mersin. The data of the research were gathered with a questionnaire intended for collecting the sociodemographic characteristics of mothers who completed their second week in the postpartum period, Postpartum Sleep Quality Scale intended for determining their sleep quality and Breastfeeding Self-efficacy Scale intended for determining their breastfeeding self-efficacy. The data obtained were assessed with the Pearson correlation coefficient to determine the relationship between the descriptive statistics and two continuous variables. RESULTS: The mean score gotten by the mothers from Postpartum Sleep Quality Scale and Breastfeeding Self-efficacy Scale was determined to be '33.57 ± 11.26' and '46.82 ± 14.89', respectively. A strong relationship in the negative direction was detected between the scores gotten from Postpartum Sleep Quality Scale and Breastfeeding Self-efficacy Scale (p < 0.01). CONCLUSIONS: As a result of the research, it was determined that as the sleep quality of mothers in the postpartum period increases their breastfeeding self-efficacy increases as well. In the light of the results obtained, it is suggested that nurses, being aware that there is a strong relationship between sleep quality and breastfeeding self-efficacy in the postpartum period, should pay more attention to the role of education and counselling in these subjects. In addition, it is recommended that nurses make attempts intended for improving the sleep quality of primiparous individuals in order to increase their self-efficacy of breastfeeding.