Enlightening the mechanism of ferroptosis in epileptic heart.

Epilepsy is a chronic neurological degenerative disease with a high incidence, affecting all age groups. Refractory Epilepsy (RE) occurs in approximately 30-40% of cases with a higher risk of sudden unexpected death in epilepsy (SUDEP). Recent studies have shown that spontaneous seizures developed in epilepsy can be related to an increase in oxidative stress and reactive oxygen derivatives (ROS) production. Increasing ROS concentration causes lipid peroxidation, protein oxidation, destruction of nuclear genetic material, enzyme inhibition, and cell death by a mechanism known as "ferroptosis" (Fts). Inactivation of glutathione peroxidase 4 (GPX4) induces Fts, while oxidative stress is linked with increased intracellular free iron (Fe+2) concentration. Fts is also a non-apoptotic programmed cell death mechanism, where a hypoxia-inducible factor 1 alpha (HIF-141) dependent hypoxic stress-like condition appears to occur with accumulation of iron and cytotoxic ROS in affected cells. Assuming convulsive crises as hypoxic stress, repetitive convulsive/hypoxic stress can be an effective inducer of the "epileptic heart" (EH), which is characterized by altered autonomic function and a high risk of malignant or fatal bradycardia. We previously reported that experimental recurrent seizures induce cardiomyocyte Fts associated with SUDEP. Furthermore, several genes related to Fts and hypoxia have recently been identified in acute myocardial infarction. An emerging theme from recent studies indicates that inhibition of GPX4 through modulating expression or activities of the xCT antiporter system (SLC7A11) governs cell sensitivity to oxidative stress from ferroptosis. Furthermore, during hypoxia, an increased expression of stress transcriptional factor ATF3 can promote Fts induced by erastin in a HIF-141-dependent manner. We propose that inhibition of Fts with ROS scavengers, iron chelators, antioxidants, and transaminase inhibitors could provide a therapeutic effect in epilepsy and improve the prognosis of SUDEP risk by protecting the heart from ferroptosis.

Meaning and Affecting Factors of Spirituality in Adolescents.

Purpose: The aim of this study was to explore the perceptions of adolescents about spirituality via semistructured, in-depth interviews. Method/Design: A qualitative research design using interviews was performed with 17 adolescents in a mostly Muslim region in Turkey. Interviews were conducted via five open-ended questions. Findings: Three main categories and eight themes emerged from the analysis. The "Spirituality Meaning" category included five themes, such as mind, emotions, mind/emotions, ethical principles, and religion. Personal practices and environmental factors as well as mind, emotions, ethical principles, and religion themes were in the "Factors That Increase Spirituality" category. The theme living negativity was in the "Factors That Decrease Spirituality" category. Most of the adolescents (58.8%) stated that the meaning of spirituality was love, respect, and the ability to think, analyze, and synthesize. Conclusion: It is important to determine and evaluate the perceptions and experiences of children about spirituality in different cultures to improve the quality of care.

Effects of providing nursing care with web-based program on maternal self-efficacy and infant health.

OBJECTIVE: The study was conducted to examine the efficacy of a web-based program, informed by Pender's Health Promotion Model, given to primiparous women on the growth and development of infant, infants' health, and women's self-efficacy level. METHODS: This randomized controlled study with a posttest design was conducted in three primary care clinics. The study group comprised 71 primiparous women and their infants (intervention group: N = 35; control group: N = 36). The women who are at the 33-37th gestational week in the intervention group participated in the web-based program. They completed four education modules. Women in the control group received routine care in clinics. Data forms were completed in the first week and first, second, and third months postpartum. Breastfeeding status, weight, head circumference, development of infants and women's self-efficacy were evaluated in the postnatal period up to 3 months. RESULTS: In the intervention group, the ratio of infants who were exclusively breastfed was higher compared to the control group. The mean scores for the LATCH instrument which measures breastfeeding status and Parental Self-Efficacy Scale, were significantly higher in the intervention compared to the control group (p < .05). CONCLUSION: The women who participated in the web-based program demonstrated better self-efficacy and their infants demonstrated better scores on measures of growth, development, and health than those in the control group.

The effect of drawing and writing technique on the anxiety level of children undergoing cancer treatment.

PURPOSE: To determine the effect of the drawing and writing technique on the anxiety level of children undergoing cancer treatment in hospital. METHOD: Research was conducted in the haematology-oncology clinic of a university hospital, using a quasi-experimental design (pre-and-post intervention evaluations of a single group). The sample comprised 30 hospitalised children aged 9-16 years. Data were collected with Socio-demographic form, clinical data form, and the State Anxiety Inventory. The institution gave written approval for the study and parents provided written consent. Drawing, writing and mutual story-telling techniques were used as part of a five-day programme. Children were asked to draw a picture of a hospitalised child and write a story about this drawing. After drawing and writing, mutual storytelling were used to more constructive story with positive feelings. The drawing, writing techniques was implemented on the first and third days of the programme and mutual storytelling was implemented on the second and fourth days. Data were reported as percentages and frequencies and the intervention effect analysed with the Wilcoxon test. RESULTS: The average age of children was 12.56 years ± 2.67 and 76.7% were girls. The mean age diagnosis and mean treatment duration were 11.26 years ± 3.17 and 16.56 months ± 20.75 respectively. Most of the children (50%) had leukaemia and were receiving chemotherapy (66.7%). In most cases (76.7%) the mother was the primary caregiver. Scores on the State Anxiety Inventory were lower-indicating lower anxiety-after the intervention (36.86 ± 4.12 than before it (40.46 ± 4.51) (p < 0.05). CONCLUSION: The therapeutic intervention reduced children's state anxiety.

The Validity and Reliability of the Turkish Version of the Neonatal Skin Risk Assessment Scale.

PURPOSE: The study created a Turkish translation of the Neonatal Skin Risk Assessment Scale (NSRAS) that was developed by Huffines and Longsdon in 1997. Study authors used a cross-sectional survey design in order to determine the validity and reliability of the Turkish translation. SUBJECTS AND SETTING: The study was conducted at the neonatal intensive care unit of a university hospital in Ankara between March 15 and June 30, 2014. The research sample included 130 neonatal assessments from 17 patients. METHODS: Data were collected by questionnaire regarding the characteristics of the participating neonates, 7 nurse observers, and the NSRAS and its subarticles. After translation and back-translation were performed to assess language validity of the scale, necessary corrections were made in line with expert suggestions, and content validity was ensured. Internal consistency of the scale was assessed by its homogeneity, Cronbach's α, and subarticle-general scale grade correlation. RESULTS: Cronbach's α for the scale overall was .88, and Cronbach's α values for the subarticles were between .83 and .90. Results showed a positive relationship among all the subarticles and the overall NSRAS scale grade (P < .01) with correlation values between 0.333 and 0.721. Explanatory and predicative factor analysis was applied for structural validity. Kaiser-Meyer-Olkin analysis was applied for sample sufficiency, and Bartlett test analysis was applied in order to assess the factor analysis of the sample. The Kaiser-Meyer-Olkin coefficient was 0.73, and the χ value found according to the Bartlett test was statistically significant at an advanced level (P < .05). In the 6 subarticles of the scale and in the general scale total grade, a high, positive, and significant relationship among the grades given by the researcher and the nurse observers was found (P < .05). CONCLUSION: The Turkish NSRAS is reliable and valid.

Determination of social support needs and expectations of mothers of children with cancer.

The aim of this study was to determine the social support needs of mothers of children with cancer and their expectations regarding nurses. The sample consisted of 88 mothers of children aged 0 to 18 years. The data were collected by a questionnaire and the Multidimensional Scale of Perceived Social Support (MSPSS) was used. The variables were investigated using visual methods (histograms and probability plots) and the Mann-Whitney U, Kolmogorov-Smirnov, Kruskal-Wallis, and Spearman tests. All the mothers stated that they needed social support but only 73.9% received it. Support was obtained mostly from families (83.0%), physicians (44.6%), nurses (38.4%), friends (30.7%), and neighbors (24.6%). Most of the social support was emotional (76.9%) and informational (49.2%). A total of 54.5% of the mothers expected social support from nurses. The mean total MSPSS score was 51.18 ± 25.30. In conclusion, all mothers felt that they needed social support, but their rate of receiving social support was lower than their needs.