"I don't Want to Die Alone" Nurses' Perception of Ageism: A Qualitative Study

The aim of the study was to learn the perceptions and thoughts of nurses with whom older patients interact constantly. In this research, semi-structured interview was used. In a research hospital in Istanbul between March-June 2019, 16 volunteers were included in the study. Researchers led individual semi-structured interviews regarding nurses' perceptions, how they overcame those challenges, and need and expectations aging care (dying patients). All interviews were analysed using thematic analysis methods and synthesized into major themes. The research was planned based on the 32-item checklist (COREQ) guideline. Nurses (N = 16) reported three themes: (i) ageing perceptions (ii) care for dying patients, (iii) expectations and five subthemes emerged in this study. It is understood that nurses have a positive perception of ageing. In addition, nurses have expectations from the state (financial support, gerontology service etc.) and society (respectful, understanding etc.) to reduce the difficulties they experience while caring for dying patient.

Non-Pharmacologic Approaches to Sleep Problems for Palliative Care Cancer Patients: A Systematic Review

OBJECTIVE

This present systematic review aims to examine the effectiveness of non-pharmacological approaches to sleep problems for cancer patients in palliative care.

METHOD

In this review, the data of the last 5 years from 2018 to 2023 are included in Scopus, Web of Science, CINAHL, PubMed, Medline, Ulakbim National Database and Cochrane Library databases were scanned using the keywords "palliative care, sleep disorder, non-pharmacologic, insomnia, cancer, randomized controlled trial" in English and Turkish. As a result of the search, we identified 90 articles. This review was based on Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 Statement recommendations.

RESULTS

This current review comprised 5 randomized controlled trials. The included studies were found to examine methods such as aromatherapy, massage, therapeutic touch, and white light, leaving out other methods (sleep hygiene, exercise, etc.), which are effective in treating insomnia. We established that the methods discussed in these studies were highly effective in improving sleep quality.

CONCLUSION

Non-pharmacological methods for treating sleep problems in cancer patients in palliative care have been shown to be effective. We consider it important that nurses were involved in these studies. On the other hand, we would recommend that studies be conducted to evaluate the effect of other nonpharmacologic methods on sleep problems.

The correlation between nursing students' healthy lifestyle behaviors, cardiovascular disease risk factors' knowledge level, and obsession symptoms

BACKGROUND

Nursing students have a role in the awareness of risk factors in the development of healthy lifestyle behaviors. Nursing students' awareness of disease risk factors plays a role in developing healthy lifestyle behaviors. Therefore, it was aimed to determine the relationship between the effect of nursing students' healthy lifestyle behaviors and cardiovascular disease risk factors' knowledge levels and obsessive-compulsive symptoms.

MATERIALS AND METHODS

This was a descriptive cross-sectional study. Two hundred and twenty-four students studying in the nursing departments of two foundation universities participated in the study between April and October 2020. Sociodemographic information form, Health Promoting Lifestyle Profile II (HPLP-II), Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL), and Maudsley Obsessive-Compulsive Inventory (MOCI) were applied to the students.

RESULTS

It was found that the nursing students' healthy lifestyle behaviors (123.53 ± 25.78) and cardiovascular risk factors' knowledge level (21.08 ±± 2.70) were high. Obsessive-compulsive symptoms (16.12 ± 6.22) were moderate. In the correlation of sociodemographic characteristics, it was found that age correlated with the nutrition subdimension of CARRF-KL and HPLP-II, income level correlated with HPLP-II, place of residence correlated with HPLP-II, CARRF-KL, and MOCI, and having a health problem correlated with health responsibility. Income status, place of residence, and presence of health problems were found to be correlated with HPLP-II in all subdimensions in the regression analysis. In the regression analysis of HPLP-II with CARRF-KL and MOCI scales, it was found that it was significantly related to interpersonal relations, spiritual growth, stress management, and total score dimensions.

CONCLUSION

Healthy lifestyle behaviors of nursing students are related to cardiovascular risk factors' knowledge level and obsession symptoms. In addition, some demographic characteristics affect healthy lifestyle behaviors.

Caregiver Burden, Quality of Life and Related Factors in Family Caregivers of Dementia Patients in Turkey

This study aimed to evaluate caregiver burden and quality of life (QoL) and their predictors in family caregivers of dementia patients. A descriptive cross-sectional survey was carried out with a sample of 102 patients and their family caregivers. The Caregiver Burden Inventory (CBI) and Short Form-12 (SF-12) were used to collect data. CBI mean score was 37.97 ± 21.30. Mean scores of SF-12 sub-domains varied between 36.02 and 77.94 and were significantly lower as compared to normative means of the general population, excluding only the physical health subdomain. Among several patient and caregiver-related correlations, the number of medications and worse cognitive function of the patient, caregiver's age and having limited space at home were found as predictors of burden, whereas caregiver's chronic disease and having a limited space were predictors of QoL. Also, the burden and QoL were correlated. This study demonstrated a high burden and low QoL in dementia caregivers. In societies where caregivers are mostly informal such as that in Turkey, supportive systems should be established.

Evaluation of friction properties of hydrogels based on a biphasic cartilage model

Characterizing hydrogels using a biphasic cartilage model, which can predict their behavior based on structural properties, such as permeability and aggregate modulus, may be useful for comparing active lubrication modes of cartilage and hydrogels for the design of articular cartilage implants. The effects of interstitial fluid pressurization, inherent matrix viscoelasticity and tension-compression nonlinearity on mechanical properties of the biphasic material were evaluated by linear biphasic (KLM), biphasic poroviscoelastic (BPVE) and linear biphasic with anisotropy cartilage models, respectively. The BPVE model yielded the lowest root mean square error and highest coefficient of determination when predicting confined and unconfined compression stress-relaxation response of hydrogels (n=15): 0.220±0.316MPa and 0.93±0.08; and 0.017±0.008MPa and 0.98±0.01 respectively. Since the differences in error between models were not statistically significant, the simplest model we considered, KLM model, was sufficient to predict the mechanical response of this family of hydrogels. The coefficient of friction (COF) of a hydrogel-ceramic articulation was measured at varying loads and pressures to explore the full range of lubrication behavior of hydrogel. Material parameters obtained by biphasic models correlated with COF. Based on the linear biphasic model, COF correlated positively with aggregate modulus (spearman's rho=0.5; p<0.001) and velocity (rho=0.3; p<0.001), and negatively with permeability (rho=-0.3; p<0.001) and load (rho=-0.6; p<0.001). Negative correlation of COF with load and positive correlation with velocity indicated that hydrogel-ceramic articulation was separated by a fluid film. These results together suggested that interstitial fluid pressurization was dominant in the viscoelasticity and lubrication properties of this biphasic material.

Cloning and identification of regulatory sequences of the human thrombin receptor gene

Thrombin, via activation of vascular endothelial and smooth muscle cell thrombin receptors, modulates vascular wall healing. To understand the mechanisms that regulate human thrombin receptor (HTR) expression, we cloned and characterized the HTR gene. The HTR gene consists of Exon I, which contains the 5'-regulatory region and 85 nucleotides of coding sequence; a approximately 15-kb intron; and Exon II, which contains the remainder of the coding sequence and the entire 3'-untranslated region. Multiple transcription initiation sites were identified by S1 mapping and ribonuclease protection assay. DNA sequence analysis indicated the presence of two SP-1-AP-2 consensus binding sequences, near or within the transcription initiation sites, and consensus binding sequences for numerous regulatory proteins that potentially modulate HTR expression. Functional analysis of the HTR promoter was performed by transfecting human microvascular endothelial cells with HTR promoter region-luciferase constructs. The highest level of expression was obtained with a 0.7-kb promoter sequence and was progressively less with fragments of 0.54, 1.16, 1.6, and approximately3.2 kb. The data presented in this report provide a foundation for further characterization of the HTR gene and the mechanisms that regulate its expression within the blood vessel wall.

Role of the thrombin receptor in restenosis and atherosclerosis

Thrombus generation is central to thrombosis at vascular lesion sites, including post-PCTA acute reocclusion and chronic restenosis. Thrombin stimulates platelet activation, monocyte and neutrophil chemotaxis, and endothelial production of prothrombotic factors. The varied physiologic effects of thrombin are due to the widespread presence of thrombin receptors in many cell types. The receptor is uniquely activated: thrombin binds to the receptor at the thrombin anion-binding exosite, the receptor ligand ("tethered ligand") apparently being a sequence of 6 amino acids (SFLLRN). Thus, peptides corresponding to the sequence of the tethered ligand can stimulate almost all functions of native thrombin itself. Several intracellular signaling pathways have been identified as important in the restenosis process: the G protein-related pathway, cyclic adenosine monophosphate (cAMP) mediator pathway, and tyrosine kinase activation pathway. In situ hybridization has demonstrated an increase in thrombin receptor mRNA throughout the period of neointimal and vascular lesion development. The mechanism of this increase is unknown, but may be mediated by multiple inflammatory modulators. Several strategies have been tested in animal models for inhibiting thrombin: (1) Hirudin not only prevents thrombin from cleaving fibrinogen, but also prevents thrombin receptor activation. (2) Thrombin receptor antagonist peptides block platelet aggregation effects of thrombin. (3) Mono- and polyclonal antibodies inhibit thrombin receptor activation. (4) Antisense oligonucleotides block thrombin receptor expression.