Spiritual care, compassion and associated factors of midwives working in delivery rooms.

AIM: This study aimed to determine the level of spiritual care and compassion among midwives working in delivery rooms and associated factors. METHODS: A descriptive design was utilized to collect data using self-report questionnaires from 181 midwives working in delivery rooms in Turkey. Data were collected between 1 February 2020 and 20 March 2020. RESULTS: The mean Spiritual Care-Giving Scale (SCGS) (min: 25- max: 175) and Compassion Scale (CS) (min: 24- max: 120) scores were 147.88 ± 17.84 and 96.37 ± 12.84. It was determined that there was a significant difference between the SCGS and CS scores of the midwives based on age, working year, work schedule, job satisfaction and traumatic birth experiences. Furthermore, there were positive correlations between scores on certain SCGS and CS subdimensions. CONCLUSION: Midwifery is a continuously evolving profession based on helping others. However, long working hours and their exposure to traumatic birth events negatively affect both spiritual caregiving and compassion levels of midwives. Working conditions of midwives need to improve and this would contribute to the quality of maternal healthcare. Also, studies should be conducted in different contexts, societies and cultures to identify barriers to compassionate and spiritual care during childbirth.

Protective Effects of Antioxidant Chlorophyllin in Chemically Induced Breast Cancer Model In vivo.

Glutathione-related enzymes belong to the protection mechanism of the cells against harmful oxidative damage and chemicals. Glutathione S-transferase (GST) is frequently over-expressed in various cancer cells and is involved in drug resistance. Chlorophyllin is an antioxidant molecule interfering with the GST P1-1 activity. The purpose of this study is to evaluate the short- and long-term protective effects of chlorophyllin as an antioxidant molecule on DNA damage, antioxidant enzyme activities, trace elements, and minerals in chemically induced breast cancer model in vivo. In our study, N-methyl-N-nitrosourea (MNU) was used for inducing breast carcinogenesis in female Sprague-Dawley rats. A total of 36 rats were divided into groups as short term and long term. Each group was divided into four sub-groups as control group received physiological saline solution (n = 3), Chl group (n = 5) received chlorophyllin, MNU group (n = 5) was administered MNU, and Chl + MNU group (n = 5) was treated with both chlorophyllin and MNU. Results illustrated that chlorophyllin had a significant anti-genotoxic effect in the short term, and glutathione-related enzyme activities were protected by chlorophyllin treatment in MNU-induced breast cancer model. Additionally, MNU administration impaired mineral and trace element levels including Na, Mg, K, Fe, Zn, and Co in the liver, kidney, spleen, heart, and tumor tissues; however, adverse effects of MNU were recovered upon chlorophyllin treatment in the indicated tissues of the rats. In conclusion, chlorophyllin can be used as an antioxidant molecule to ameliorate adverse effects of MNU by enhancing antioxidant enzyme activities and regulating trace element and mineral balance in several organs and tumor tissue in the breast cancer model.

Midwives' experiences of witnessing traumatic hospital birth events: A qualitative study.

AIMS AND OBJECTIVES: The aim of this study was to investigate in detail the traumatic birth experiences of midwives in the delivery rooms, and their attitudes, reactions, and coping strategies. METHODS: The design of the study is descriptive and the purposive sampling method was used. This approach is ideal for a preliminary exploration of the nature of a phenomenon. Between October 2018 and January 2019, semi-structured interviews were conducted with a purposeful sample of midwives. The research was carried out with the participation of 29 midwives, who work in labour and birth room. They were asked to describe a particular stressful situation they had experienced during the birth process, their emotions about the event, and their coping strategies and support systems. All interviews were digitally recorded, stored in a database, and transferred to MAX Qualitative Data Analysis 18.1.0 for analysis. FINDINGS: As a result of the content analysis, three main themes emerged: psychological impact, defensive practice, and expectations in terms of support from the hospital. It was revealed that, after the traumatic birth, midwives experienced highly emotional exhaustion in the form of sadness, flashbacks, guilt, fear, and empathy, and they performed an increasingly defensive practice. During the interviews, we observed that 19 midwives needed psychological support. Besides, midwives explicitly stated that they were not prepared enough for traumatic events and that most traumatic births were simply ignored in their workplace. Eventually, it was determined that midwives received support mostly from their colleagues in case of a traumatic birth. CONCLUSION(S): Midwives need to feel valued and be supported by their institutions in coping with emotional stress. Therefore, performing clinical inspections by experienced or specialist midwives may serve as a supporting framework for reducing defensive interventions.

FDA-approved drugs and other compounds tested as inhibitors of human glutathione transferase P1-1.

OBJECTIVE: Glutathione transferase P1-1 (GST P1-1) is often overexpressed in tumor cells and is regarded as a contributor to their drug resistance. Inhibitors of GST P1-1 are expected to counteract drug resistance and may therefore serve as adjuvants in the chemotherapy of cancer by increasing the efficacy of cytostatic drugs. Finding useful inhibitors among compounds used for other indications would be a shortcut to clinical applications and a search for GST P1-1 inhibitors among approved drugs and other compounds was therefore conducted. METHODS: We tested 1040 FDA-approved compounds as inhibitors of the catalytic activity of purified human GST P1-1 in vitro. RESULTS: We identified chlorophyllide, merbromine, hexachlorophene, and ethacrynic acid as the most effective GST P1-1 inhibitors with IC50 values in the low micromolar range. For comparison, these compounds were even more potent in the inhibition of human GST A3-3, an enzyme implicated in steroid hormone biosynthesis. In distinction from the other inhibitors, which showed conventional inhibition patterns, the competitive inhibitor ethacrynic acid elicited strong kinetic cooperativity in the glutathione saturation of GST P1-1. Apparently, ethacrynic acid serves as an allosteric inhibitor of the enzyme. CONCLUSION AND PRACTICAL IMPLICATIONS: In their own right, the compounds investigated are less potent than desired for adjuvants in cancer chemotherapy, but the structures of the most potent inhibitors could serve as leads for the synthesis of more efficient adjuvants.

CD26/dipeptidyl-peptidase IV and adenosine deaminase serum levels in psoriatic patients treated with cyclosporine, etanercept, and psoralen plus ultraviolet A phototherapy.

OBJECTIVE: The aim of this study is to determine serum levels of soluble forms of CD26/dipeptidyl-peptidase IV (DPP-IV) and adenosine deaminase (ADA), thought to be markers of T-cell activation, and changes in their levels in response to cyclosporine, etanercept, and psoralen plus ultraviolet A (PUVA) treatments with respect to disease activity. METHODS: This study is designed as a prospective clinical study with a control group and three months of follow-up. The study included 41 patients with psoriasis and 41 healthy controls that were older than 18years of age. There were three different treatment groups: PUVA (n=15), cyclosporine (n=15), and etanercept (n=11). To determine disease severity of patients with psoriasis, psoriasis area and severity index (PASI) scores were calculated. RESULTS: Only mean serum ADA levels were different between patients with psoriasis [mean1±standard deviation (SD)=13.9±3.3U/ml] and control group (mean±SD=12±3.5U/ml). Mean serum ADA levels were significantly higher before treatment than after treatment (mean±SD=12.4±3.4U/ml). Contrarily, following three months of therapy, mean serum CD26 levels increased significantly from 777.7±214.6 to 835.3±203ng/ml (P<0.05) and mean serum DPP-IV activity increased significantly from 12.1±4 to 15.9±4.2nmol/min (P<0.05). There was no correlation between ADA and CD 26/DPP-IV with PASI values. CONCLUSIONS: The results show that ADA might be a useful marker indicating disease activity and T-cell activation. As significant changes were observed in serum CD26/DPP-IV before and after treatment, we think CD26/DPP-IV might play a role in psoriasis pathogenesis, which should be clarified by further studies.