The effects of open and closed suctioning systems on neonatal pain and vital signs in neonatal intensive care units.

BACKGROUND: Endotracheal suctioning is a procedure used by neonatal intensive care unit nurses to maximize oxygenation and clear airways of secretions, and is one of the most common painful procedures causing stress in intubated newborns. AIM: This aim of this study is to compare the effects of open and closed endotracheal suctioning on pain, peak heart rate and oxygen saturation in neonates on mechanicalventilation. MATERIALS AND METHODS: This experimental-design study was conducted on 30 newborns who were mechanically ventilated in the tertiary neonatal intensive care unit of a public hospital. First, closed suctioning and then open suctioning was performed on patients during the day. Pain, peak heart rate and oxygen saturation levels were evaluated before, during and 30 min after each suctioning procedure. RESULTS: Of the newborns included in the study, 53.3 % were male and 36.6 % were admitted to intensive care unit due to a heart defect. No statistically significant differences were found in pain, peak heart rate, or oxygen saturation between the open and closed suctioning methods. However, oxygen saturation levels during suctioning were lower compared to levels before and 30 min after the procedure. Additionally, peak heart rate was lower during suctioning compared to 30 min afterward. CONCLUSIONS: The study concludes that there is no significant difference between open and closed suctioning techniques concerning pain, peak heart rate, and oxygen saturation. IMPLICATIONS TO PRACTICE: Given its sterility and ease of use, the closed suction method may be preferable in clinical settings.

Mapping QTLs for Super-Earliness and Agro-Morphological Traits in RILs Population Derived from Interspecific Crosses between Pisum sativum × P. fulvum.

Earliness in crop plants has a vital role in prevention of heat-induced drought stress and in combating global warming, which is predicted to exacerbate in the near future. Furthermore, earliness may expand production into northern areas or higher altitudes, having relatively shorter growing season and may also expand arable lands to meet global food demands. The primary objective of the present study was to investigate quantitative trait loci (QTLs) for super-earliness and important agro-morphological traits in a recombinant inbred line (RIL) population derived from an interspecific cross. A population of 114 RILs developed through single-seed descent from an interspecific cross involving Pisum sativum L. and P. fulvum Sibth. et Sm. was evaluated to identify QTLs for super-earliness and important agro-morphological traits. A genetic map was constructed with 44 SSRs markers representing seven chromosomes with a total length of 262.6 cM. Of the 14 QTLs identified, two were for super-earliness on LG2, one for plant height on LG3, six for number of pods per plant on LG2, LG4, LG5 and LG6, one for number of seeds per pod on LG6, one for pod length on LG4 and three for harvest index on LG3, LG5, and LG6. AA205 and AA372-1 flanking markers for super-earliness QTLs were suggested for marker-assisted selection (MAS) in pea breeding programs due to high heritability of the trait. This is the first study to map QTLs originating from P. sativum and P. fulvum recently identified species with super-earliness character and the markers (AA205 and AA372-1) linked to QTLs were valuable molecular tools for pea breeding.

Role of the systemic immune-inflammation index in threatened abortion patients and predicting of abortion.

PURPOSE: Our study aimed to compare the systemic immune inflammation index (SII), one of the hematological inflammation parameters, between pregnant women diagnosed with threatened abortion (TA) and healthy pregnant women, and to evaluate the prediction of abortion in pregnant women with TA. METHODS: This retrospective study compared 150 patients with TA group and 150 age- and gestational week-matched healthy pregnant women (control group). Complete blood count parameters were assessed. SII, white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), plateletcrit (PCT), platelet distribution width and monocyte to lymphocyte ratio (MLR) values were calculated. The SII value was calculated as follows: platelet count × (neutrophil/lymphocyte). RESULTS: SII, NLR, MLR, WBC, RDW, and PCT values were significantly higher in the TA group compared to the control group (923 ± 683 vs. 579 ± 364 [p < 0.001], 3.3 ± 2.0 vs. 2.1 ± 1.1 [p < 0.001], 0.3 ± 0.1 vs. 0.2 ± 0.2 [p < 0.001], 9.84 ± 2.87 vs. 8.6 ± 1.6 [p < 0.001], 13.9 ± 1.9 vs. 14.4 ± 2.3 [p = 0.032] and 0.3 ± 0.1 vs. 0.2 ± 0.0 [p < 0.001], respectively). Using receiver operating characteristics curve analysis to predict abortion in AI patients, the highest area under the curve was found for SII (0.727 for SII and 0.666 for NLR). CONCLUSION: SII, NLR, MLR, RDW, and platelet to lymphocyte ratio (PLR) levels were significantly increased in patients with TA. This study supports the idea that several inflammatory pathways may play an important role in the pathogenesis of this disorder. SII may be a much better marker than NLR and PLR for predicting the inflammatory status of the disease and abortion in an ongoing pregnancy.

The popularisation of self-care: Tracing the dissemination of Orem's Self-Care Deficiency Nursing Theory into the scientific disciplines.

BACKGROUND: Bibliometric methods may be used to examine research trends, and information visualisation techniques are useful in illustrating the diffusion of knowledge and how theories are applied. OBJECTIVES: The present study aimed to illustrate how Orem's Self-Care Deficiency Nursing Theory (SCDNT) has been cited and applied in nursing science and beyond. METHODS: A bibliometric analysis examined scientific publications that cited Orem's nursing theory. In addition, the diffusion of SCDNT was assessed using data visualisation methods and integration scores of SCDNT versions were calculated to define trends in its theoretical usage in other scientific domains. RESULTS: The information visualisation demonstrated increased usage of SCDTN in different disciplines. Integration scores demonstrated that the scientific community still recognises and uses versions of SCDTN. DISCUSSION: Studying citation patterns helps to identify which publications are still cited and relevant, as well as illustrating the dissemination of theory. Findings may be used in the collection weeding of SCDTN book versions. CONCLUSIONS: Findings provided nursing scientists with a better conceptual understanding of SCDNT diffusion and development. For academic library managers, the findings identify which SCDNT should be retained for historical interest and curriculum needs.

Complications of peripheral intravenous catheters and risk factors for infiltration and phlebitis in children.

AIM: This study aimed to identify the types of complications of peripheral intravenous catheters (PIVCs) in hospitalised children and possible risk factors for the development of extravasation, infiltration and phlebitis. METHOD: The study was conducted in the largest children's hospital in a region of Turkey, with a bed capacity of 354 and 1400 employees, which provides care only to paediatric patients aged from newborn to 18 years old. In this 5-month prospective study, the complications of PIVCs in hospitalised children and risk factors leading to the development of extravasation, infiltration and phlebitis were recorded. During morning and afternoon daily visits, the researcher examined catheter sites for complications and indications for removal. RESULTS: The study covered 244 patients aged from 1 month to 17 years, 575 PIVCs and 1600 catheter days. The rates of infiltration and phlebitis observed in children with PIVCs were 8.7 % and 15.8% respectively. Logistic regression revealed that using 22- and 24-gauge catheters, hospitalisation in the surgery ward and continuous infusion were significant independent risk factors for the development of infiltration (P<0.001). Direct logistic regression revealed that age in months, hospitalisation in a surgery ward and placement of the catheter in the veins of the antecubital fossa were significant independent risk factors for the development of phlebitis (P<0.001). CONCLUSION: Catheter size, hospitalisation in the surgery ward and continuous infusion contributed to the development of infiltration. Age, hospitalisation in the surgery ward and catheter placement in the antecubital vein contributed to the development of phlebitis.

Nurses' knowledge and experiences of peripheral intravenous catheter insertion at a tertiary paediatric health centre.

AIM: The aim of the study was to determine paediatric nurses' knowledge and experiences of PIVC insertion. METHOD: In this cross-sectional study, nurses working in a paediatric hospital in Izmir, Türkiye, between May and September 2019 were included (225; 67.4%). A PIVC knowledge and experience form, and a sociodemographic characteristics questionnaire were used to collect data. RESULTS: Nurses most often inserted the PIVC on the dorsum of the hand (83.1%). Their choice of vein was influenced by the condition of the patient's veins (91.1%), medications (72%) and the patient's activity status (70.2%). The most preferred PIVC size was 24 gauge (98.2%), and the most frequently used cannula was a short peripheral cannula (96.9%). To clean the insertion site of the cannula, 93.8% of the nurses used 70% alcohol. Distractions used while inserting the PIVC were: letting the child play with a toy (51.1%), having the child sit on the mother's lap (45.8%), letting the child watch cartoons (45.3%), and administering oral sucrose (43.6%). Of the nurses, 69.3% attached a split septum/vein valve to the PIVC insertion site, and 82.2% cleaned the split septum/vein valve with 70% alcohol and waited until it dried before administering the medication. Some 79.6% secured the cannula with a hypoallergenic nonwoven adhesive fixation tape bandage. Some 94.7% performed catheter flushing for control after inserting PIVCs, 93.8% performed catheter flushing before IV fluid treatment, 89.8% flushed the catheter before drug administration through the bolus method, 53.3% flushed the PIVC catheter with a slow technique and 42.2% flushed it with an intermittent technique. CONCLUSION: The nurses generally acted in accordance with Infusion Nurses Society (2016) guidance. It would be helpful if the hospital developed algorithms that include standards to prevent and manage PIVC insertions and complications.

Investigating intercultural effectiveness of paediatric nurses in a Turkish hospital.

BACKGROUND: Cultural competence, an important part of patient-centred care, has been on the nursing agenda for many years. AIM: The aim of this study was to measure the intercultural effectiveness level of paediatric nurses, and to explore relationships between the level of intercultural effectiveness and some sociodemographic variables in paediatric nurses. METHOD: The study was conducted at Izmir Tepecik Training and Research Hospital's children's clinics in Turkey. A convenience sample of 98 paediatric registered nurses practising at the hospital was evaluated. To collect the study data, a sociodemographic characteristics questionnaire, a Cultural Approach in Nursing Care form and the Intercultural Effectiveness Scale (IES) were used. RESULTS: The participating paediatric nurses' intercultural effectiveness levels were moderate, the problem they experienced most was the language problem and although many of them had not received adequate training in cultural care, based on their experiences, they regarded themselves as culturally competent. CONCLUSION: Cultural competence is vital in multi-ethnic and multicultural societies. Cultural competence training should be provided to nurses during nurse education, or in-service training during their professional life.

Nasogastric Tube Feeding Experiences in Pediatric Oncology Patients and Their Mothers: A Qualitative Study.

The aim of this qualitative research study is to reveal children's and their mothers' views and experiences related to nasogastric tube feeding, which is the most frequently performed nutrition delivery method in pediatric oncology. The present study was carried out at an university pediatric oncology inpatient service. A total of three children and 14 mothers participated in the study. The analysis of the data was conducted according to Kolcaba's Comfort Theory. The findings resulting from the content analysis were explained under four main themes: (1) physical: includes the inability to be fed orally, nasogastric tube intervention, comfort because of feeding, medication administration, and satisfaction; (2) psychospiritual: includes anxiety, fear, distorted body image, and compliance; (3) sociocultural: includes conflicts with the child about feeding and advice on feeding via the nasogastric tube to other mothers and children; and (4) environmental: includes unrestricted/freedom of feeding. Gastroenterology professionals can also provide basic counseling and resources to children and mothers about the importance of maintaining an optimal weight and of enteral nutrition.

Experiences of Infant and Child Care of Mothers with Disabilities in Turkey: A Qualitative Study.

Mothers with disabilities have difficulties fulfilling their gender and motherhood roles. The purpose of this study was to determine the infant and child care-related experiences of mothers with disabilities in Turkey. A conventional content analysis was used in this qualitative design. Fourteen mothers with disabilities participated in semi-structured in-depth interviews consisting of open-ended questions about their infant and child care experiences. Three themes and eight subthemes emerged from the data analysis. The themes were: role fulfillment, barriers, and coping and support. All of the women said that they wanted to become mothers, and when they did so, they felt they had fulfilled their roles in society. However, there was a societal misconception that woman with disabilities 'could not give birth to children or would not properly care for them. Measures should be taken to eliminate negative social perceptions of mothers with disabilities. Public support should be provided to meet the needs of mothers with disabilities.

Determination of school-related problems in children treated for cancer.

This descriptive and case-control study was carried out in a pediatric oncology outpatient clinic to determine the school-related physical, social, and psychological problems and problems experienced in academic achievement of children treated for cancer. The sample of the study consisted of 56 Turkish patients with cancer, aged 7-18 years, who were in remission and attending school as well as their parents, a control group of patients who did not have cancer, and their teachers. A Child Information Form, a Child Health Questionnaire Parent's Form of 50 questions, a Behavior Evaluation Scale for Children, and Young People and a Teacher's Report Form were used as data collection tools in the study. Of the children, 30.3% experienced various physical difficulties stemming from cancer therapy that affected their school life. The number of late enrollments, the number of children repeating a grade, and the rates of school absenteeism were also found to be higher in the survivors than in the controls.