Nationwide registry-based trial of risk-stratified cervical screening.

In well-screened populations, most cervical cancers arise from small groups of women with inadequate screening. The present study aims to assess whether registry-based cancer risk assessment could be used to increase screening intensity among high-risk women. The National Cervical Screening Registry identified the 28,689 women residents in Sweden who had either no previous cervical screening or a screening history indicating high risk. We invited these women by SMS and/or physical letter to order a free human papillomavirus (HPV) self-sampling kit. The Swedish national HPV reference laboratory performed extended HPV genotyping and referred high-risk HPV-positive women to their regional gynecologist. A total of 3691/28,689 (12.9%) women ordered a self-sampling kit and 10.0% (2853/28,689) returned a sample for testing. Participation among women who had never attended screening was low, albeit improved. Up to 22.5% of women in other high-risk groups attended. High-risk HPV types were detected in 8.3% of samples. High-risk HPV-positive women (238/2853) were referred without further triaging and severe cervical precancer or cancer (HSIL+) in histopathology were detected in 36/158 (23%) of biopsied women. Repeat invitations gave modest additional participation. Nationwide contacting of women with high risk for cervical cancer with personal invitations to order HPV self-sampling kits resulted in high yield of detected CIN2+. Further efforts to improve risk-stratified screening strategies should be directed to improving (i) the precision of the risk-stratification algorithm, (ii) the convenience for the women to participate and, (iii) ensuring that screen-positive women are followed-up.

Continuous Global Improvement of Human Papillomavirus (HPV) Genotyping Services: The 2022 and 2023 HPV LabNet International Proficiency Studies.

The International Human Papillomavirus (HPV) Reference Center launches annual global HPV genotyping proficiency panels to enhance the precision and international standardization of HPV genotyping services. This study aims to assess the proficiency levels achieved in the global HPV genotyping proficiency panels conducted in 2022 and 2023, and to evaluate trends in performance over time. The proficiency panels comprised 44 blinded samples each, including 40 samples containing various purified plasmids corresponding to HPV types combined with human DNA, plus four control samples (one negative control and three extraction controls). Proficiency required a sensitivity of 50 International Units (IU)/5 µL for HPV 16 and HPV 18 500 IU/5 µL for HPVs 6, 11, 31, 33, 45, 52, and 58 and 500 genome equivalents (GE)/5 µL for other HPV types in both single and multiple infections, while avoiding false positivity. In 2022, 78 laboratories submitted a total of 154 data sets, and in 2023, 81 laboratories contributed 141 data sets. Most data sets (87%, 258/295) utilized commercially available HPV assays. Proficiency was common, with 77% of data sets meeting the proficiency criteria in 2022 and 79% in 2023. False positive results significantly decreased from 22% in 2022 to 13% in 2023. The high proficiency and increasing specificity in HPV genotyping services indicates progress toward more reliable HPV testing. High accuracy is crucial for supporting global efforts in HPV and cervical cancer elimination.

Medication Adherence and Functioning in Individuals With Bipolar Disorder Type I.

PURPOSE: To determine the correlation between medication adherence and functioning in individuals with bipolar disorder (BD) and the predictors of functionality. METHOD: This cross-sectional and correlational study was conducted with 145 individuals with BD type I. Data were collected using a Patient Information Form, the Medication Adherence Rating Scale, and Functioning Assessment Short Test. RESULTS: Findings showed that most participants did not take medication as prescribed. Medication adherence was negatively correlated with functionality. Predictors of functionality were years of treatment, number of hospitalizations, working status, medication adherence, family history of mental illness, and history of suicide. CONCLUSION: Medication nonadherence is a fundamental problem for individuals with BD. Nursing interventions to increase functionality and medication adherence among this at-risk group should be planned and implemented. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Suicide Probability Among Patients With Schizophrenia and Bipolar Disorder.

PURPOSE: To evaluate the possibility of suicide and related factors among individuals with schizophrenia and bipolar disorder (BD). METHOD: Data were collected for 270 individuals registered in a community mental health center using the Suicide Probability Scale (SPS). Subsequently, t test and multiple linear regression analyses were conducted on independent samples. RESULTS: There was no statistically significant difference found between mean SPS scores of participants with schizophrenia and BD. However, hostility subscale mean scores of participants with schizophrenia were higher than those of participants with BD, and the difference was statistically significant. Sex, family history of mental illness, need for help with medication, suicidal ideation in the past 10 days, and number of suicide attempts were important predictors of suicide probability. CONCLUSION: Individuals with schizophrenia and BD and in remission should be evaluated periodically for the possibility of suicide. [Journal of Psychosocial Nursing and Mental Health Services, 62(8), 37-45.].

Nursing and midwifery students' perceptions of the elderly in nursing homes: a metaphor analysis.

BACKGROUND: Nursing and midwifery students' perceptions and attitudes toward older adults affect their behaviours, career choices and/or the quality of care provided to older adults after graduation. This study aimed to evaluate the perceptions of second year nursing and midwifery students toward elderly people staying in nursing homes through metaphor analysis. METHODS: This qualitative study has used the phenomenological approach. The sample of the study consisted of 128 nursing and midwifery students by purposive sampling method. Students were prompted to complete a sentence to express their perceptions about the elderly living in nursing homes: 'The elderly in the nursing home is similar to … because …' Participants were required to fill in their responses in two stages, providing metaphors in the first blank and reasons for their metaphors in the second blank. RESULTS: The results indicated that five main themes and 12 sub-themes were obtained from student metaphors: (i) needing help in meeting their needs (need for care and need for love); (ii) the emotional burden of a life away from loved ones (loneliness, abandonment, and helplessness); (iii) exhaustion at the end of the road (end, loss, and unproductive); (iv) holding on to life again (friendship and beginning); and (v) post-traumatic growth (strong and experienced). CONCLUSION: Students should question how to create opportunities and increase interaction for the elderly in the age of changing and developing technology before graduation and should be trained as professional individuals who are willing for this purpose.

Analysis of dementia research trends in nursing using text mining approach.

This research aimed to analyze dementia research trends in nursing using a text mining approach. In this study, text mining approach was used to analyze the studies on dementia in the field of nursing around the world. In this study, summaries of all available publications in English between the years 1990-2023 were extracted from the database and transferred to an Excel table by using the 'Nursing' AND 'Dementia' query from the Thomson Reuters-ISI Web of Science database. According to the results of this research, a total of 21 concept groups were identified, four of which were the most important. It was determined that the most frequently used word in all of the studies obtained from the database was 'cost'. In this direction, scientific research on dementia in the field of nursing can be planned by evaluating the most frequently used concepts.

Developing the better and effective nursing education for improving transcultural nursing skills cultural competence and cultural sensitivity assessment tool (BENEFITS-CCCSAT).

BACKGROUND: A clear need for the development of new comprehensive, reliable, sensitive and valid measurement tools to adequately asses the cultural competence and cultural sensitivity of nursing students exists. This study aimed to develop a new measurement tool to assess the nursing students' cultural competence and sensitivity. METHODS: This cross-sectional, instrument development study's first phase included postgraduate nursing students (n = 60) for the piloting study, and the second one included undergraduate nursing students (n = 459) for the main survey. This study used two data collection forms: The Student Descriptive Information Form and the Better and Effective Nursing Education for Improving Transcultural Nursing Skills Cultural Competence and Cultural Sensitivity Assessment Tool (BENEFITS-CCCSAT) draft. The content validity index was calculated using the Davis method. Cronbach's α coefficient and the item total correlation were calculated during the reliability analysis. The Kaiser-Meyer-Olkin (KMO) coefficient test, Bartlett significance test, and explanatory factor analysis (EFA) were used to evaluate the validity of the assessment tool. RESULTS: Scale validity and reliability analyses showed that the BENEFITS-CCCSAT included 26 items and five sub-dimensions: respect for cultural diversity; culturally sensitive communication; achieving cultural competence; challenges and barriers in providing culturally competent care; and perceived meaning of cultural care. CONCLUSION: The BENEFITS-CCCSAT appears to be a valid and reliable instrument for measuring the cultural sensitivity and cultural competence of nursing students. This can be of great use, especially before attending clinical areas, and can offer both students and faculty reliable information to promote reflective and critical thinking, especially in areas where improvement is needed.

Spiritual Well-Being and Psychological Well-Being Among Hemodialysis Patients in Turkey: A Descriptive and Correlational Study.

This study aimed to determine the psychological and spiritual well-being of hemodialysis patients in Turkey. This descriptive and correlational study included 86 hemodialysis patients. Data were collected using the Spiritual Well-Being Scale and Psychological Well-Being Scale. There was a positive correlation between spiritual and psychological well-being (r = 0.315, p = 0.003). Psychological well-being and age explained 39% of total variance (F = 7.593, p = 0.001). In conclusion, there should be provided individualized spiritual care and counseling to improve the psychological well-being of hemodialysis patients.

Atypical glandular cells and development of cervical cancer: Population-based cohort study.

The effect of cervical screening on cervical adenocarcinoma has been variable, possibly because the risk associated with the precursor atypical glandular cells (AGC) is not well known. A cohort of all 885 women in the capital region of Sweden with AGC, a concomitant human papillomavirus (HPV) analysis, and a histopathology was followed until 2019. Cumulative incidence proportions of cervical intraepithelial lesion grade 3 or worse (CIN3+) by HPV type was determined by 1-Kaplan-Meier estimates. Hazard ratios (HR) for CIN3+ or for invasive cancer were estimated with Cox regression. After 2 years of follow-up, the cumulative incidence proportions of CIN3+ were 80% (95% confidence interval [CI]: 74-86%), 58% (95% CI: 50-60%) and 10% (95% CI: 5-18%) among HPV16/18 positive, "other HPV" positive and HPV-negative women, respectively. Among the 300 women with HPV16/18 positive AGC, 217 developed CIN3+ of which 35 were invasive cervical cancer. The 2-year cumulative invasive cancer risk for HPV16/18 positive AGC was 17% (95% CI: 12-24%). Primary HPV-screening had a similar yield of CIN3+ as cytology screening, albeit HPV-negative AGC is by design not detected by HPV screening. Among 241 women with HPV-negative AGC, 11 developed CIN3+ mostly after clinically indicated samples. We found no significant risk differences depending on age or sampling indication. The low CIN3+ risk after HPV-negative AGC implies safety of primary HPV screening. The high risk of invasive cervical cancer after HPV16/18 positive AGC implies that management of this finding is a priority in cervical screening.

An outbreak of Ralstonia insidiosa bloodstream infections caused by contaminated heparinized syringes.

INTRODUCTION: Ralstonia insidiosa, a gram-negative waterborne bacteria able to survive and grow in any type of water source, can cause nosocomial infections, and are considered emerging pathogens of infectious diseases in hospital settings. In this study, we report an outbreak of R. insidiosa at our center related to contaminated heparinized syringes. MATERIAL AND METHODS: The present study was conducted in a tertiary care university hospital in Turkey. An outbreak analysis was performed between September 2021 and December 2021. Microbiological samples were obtained from environmental sources and from patient blood cultures. Species identification was performed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). To investigate the clonality of strains, all confirmed isolates were sent to the National Reference Laboratory and pulsed-field gel electrophoresis (PFGE) was used to perform molecular typing. RESULTS: Seventeen R. insidiosa isolates were identified from the blood cultures of 13 patients from various wards and intensive care units. Isolates from seven patient blood cultures and two heparinized blood gas syringes were characterized by PFGE. All isolates were found to belong to the same clone of R. insidiosa. CONCLUSION: R. insidiosa was identified as the cause of a nosocomial infection outbreak in our hospital, which was then rapidly controlled by the infection-control team. When rare waterborne microorganisms grow in blood or other body fluid cultures, clinicians and the infection-control team should be made aware of a possible outbreak.

The Relationship between Alexithymia, Psychological Well-Being and Religious Coping in Fibromyalgia Patients in Turkey.

This study aimed to investigate the relationship between alexithymia, psychological well-being, and religious coping in fibromyalgia patients. This study was planned as a descriptive and cross-sectional research design. The sample consisted of 175 fibromyalgia patients. Data were collected using the Toronto Alexithymia Scale-20, the Psychological Well-being Scale, and the Religious Coping Scale. Data were analyzed by Pearson's correlation test and Multiple Linear Regression analysis. A negative correlation was found between alexithymia and negative religious coping (r = - 0.377, p = 0.000). A positive correlation was found between psychological well-being and negative religious coping (r = 0.364, p = 0.000). The alexithymia was predicted by psychological well-being level (ß = - 0.629), positive (ß = 0.170) and negative (ß = - 0.216) religious coping levels (p < 0.05). Negative and positive religious coping strategies can affect psychological well-being and expressive thinking in patients with FMS.

The Effect of Mindfulness-Based Psychosocial Skills Training on Functioning and Insight Level in Patients with Schizophrenia.

This study aims to determine the effect of mindfulness-based psychosocial skills training (MBPST) on the functional recovery and insight level in patients with schizophrenia. In this study, 40 patients with schizophrenia registered in the Aksaray Community Mental Health Centre were divided into two groups: the intervention group (n = 20) and the non-intervention group (n = 20). The Functional Recovery Scale in Schizophrenia (FRSS) and the Beck Cognitive Insight Scale (BCIS) were measured at preintervention and postintervention. The posttest mean scores of FRSS and BCIS of the intervention group were statistically higher than the non-intervention group (p < 0.05). The MBPST program improved functional recovery and cognitive insight in schizophrenia. In line with these results, it has been recommended that MBPST program should be provided along with medical treatment in Community Mental Health Centres.

Evaluation of Multi-Objective Optimization Algorithms for NMR Chemical Shift Assignment.

An automated NMR chemical shift assignment algorithm was developed using multi-objective optimization techniques. The problem is modeled as a combinatorial optimization problem and its objective parameters are defined separately in different score functions. Some of the heuristic approaches of evolutionary optimization are employed in this problem model. Both, a conventional genetic algorithm and multi-objective methods, i.e., the non-dominated sorting genetic algorithms II and III (NSGA2 and NSGA3), are applied to the problem. The multi-objective approaches consider each objective parameter separately, whereas the genetic algorithm followed a conventional way, where all objectives are combined in one score function. Several improvement steps and repetitions on these algorithms are performed and their combinations are also created as a hyper-heuristic approach to the problem. Additionally, a hill-climbing algorithm is also applied after the evolutionary algorithm steps. The algorithms are tested on several different datasets with a set of 11 commonly used spectra. The test results showed that our algorithm could assign both sidechain and backbone atoms fully automatically without any manual interactions. Our approaches could provide around a 65% success rate and could assign some of the atoms that could not be assigned by other methods.

Factors Affecting the Quality of Life of Hospitalized Persons with Chronic Foot and Lower Leg Wounds.

OBJECTIVE: To determine the factors affecting the quality of life of patients with chronic wounds. METHODS: This descriptive cross-sectional study was conducted in a university hospital wound care unit in western Turkey with 134 patients. The data were collected via personal information form, Barthel Index for activities of daily living, visual analog scale, and Short Form-12 questionnaire. Descriptive statistics and Spearman correlation were used for data analysis. RESULTS: The mean age of the participants was 60.4 ± 10.7 years; 79.9% of the research group had diabetic foot wounds, and 56.7% had wounds on their right/left big toe. The mean duration of wounds was 9.4 ± 11.4 months, and 68.7% had previously been hospitalized because of wounds. The average visual analog scale pain level was 3.5 ± 2.5, and 45.5% of the patients were PEDIS (perfusion, extent, depth, infection, and sensation) classification grade II. A positive correlation was detected between Short Form-12 physical summary score and activities of daily living score. CONCLUSIONS: Patients with chronic wounds have a poor quality of life. Patient quality of life decreases as pain and PEDIS score increase and increases with their level of independence.

The diagnostic utility of the "Thwaites' system" and "lancet consensus scoring system" in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients.

BACKGROUND: Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The "Thwaites' system" and "Lancet consensus scoring system" are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. METHODS: A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The "Thwaites' system" and "Lancet consensus scoring system" scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The "Thwaites' system" and "Lancet consensus scoring system" suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively. RESULTS: A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P < 0.001). A total of 162 patients with TBM and 233 patients with non-TBM had unknown (140, 60.1%), fungal (41, 17.6%), viral (29, 12.4%), miscellaneous (16, 6.7%), and bacterial (7, 3.0%) etiologies. TMB patients were older and presented with lower Glasgow coma scores, lower CSF glucose and higher CSF protein (P < 0.001). Both criteria were able to distinguish TBM from bacterial meningitis; only the Lancet score was able to differentiate TBM from fungal, viral, and unknown etiologies even though significant overlap occurred between the etiologies (P < .001). Both criteria showed poor diagnostic accuracy to distinguish TBM from non-TBM etiologies (AUC-ROC was <. 5), but Lancet consensus scoring system was fair in diagnosing TBM (AUC-ROC was .738), sensitivity of 50%, and specificity of 89.3%. CONCLUSION: Both criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair.

A qualitative study of the operating room experience of patients who underwent surgery under spinal anesthesia: "It was like an adventure".

This study aimed to explore the experiences of the people who underwent orthopedic surgery under spinal anesthesia and to report their feelings and thoughts. The study was carried out using a qualitative approach. Twenty-one patients were interviewed who underwent orthopedic surgery on the first or second postoperative day. Content analysis was performed after the collection of raw data. NVIVO 12 Pro software was used for data analysis. The frequency count (f) and participant codes (P) were used for the presentation of the findings. The themes and frequency counts obtained by analyzing the interviews with the patients were as follows: "Time passed like watching a movie" (f = 213), "Like an adventure" (f = 587), and "See, feel, look" (f = 405). Five of 21 participants (23.8%) stated that they would not recommend spinal anesthesia. The findings generally indicated the anxiety caused by the unknown, fear in the preanesthetic period, operation experienced like an adventure, and a process generally completed with satisfaction.

The Effect of Soft Tissue Injury Cold Application Duration on Symptoms, Edema, Joint Mobility, and Patient Satisfaction: A Randomized Controlled Trial.

INTRODUCTION: The aim of this study was to determine the effect of cold application time on symptoms, edema, and patient satisfaction in soft tissue injuries. METHODS: A randomized controlled trial was conducted with 105 patients who were treated with cold applications of different durations (10, 20, and 30 minutes). Interview-assisted data were collected on symptoms and patient satisfaction. Edema and range of motion were objectively measured in patients with an ankle injury. Data were analyzed using repeated-measures analysis of variance. RESULTS: Pain reduction was greatest in the 20 minutes of cold application group (F = 46.35, P < 0.05). Symptoms of discomfort such as tingling (F = 65.93, P < 0.05), redness (F = 61.95, P < 0.05), itching (F = 36.49, P < 0.05), numbness (F = 57.94, P < 0.05), and burning (F = 55.40, P < 0.05) were more frequent in the group with 30 minutes of cold application. Both joint mobility (F = 45.28, P < 0.05) and patient satisfaction (F = 130.99, P < 0.05) were the highest in the group with 20 minutes of cold application. DISCUSSION: Our findings suggest that a duration of 20 minutes for cold application for a soft tissue ankle injury is recommended to maximize pain control, joint mobility, and patient satisfaction while decreasing other symptoms of discomfort.

The Effect of Hand Massage Before Cataract Surgery on Patient Anxiety and Comfort: A Randomized Controlled Study.

PURPOSE: This study aimed to determine the effectiveness of hand massage on patient anxiety and comfort before cataract surgery. DESIGN: A randomized controlled trial. METHODS: The 140 patients in this study were assigned to the intervention group (n = 70), which received a 10-minute hand massage before cataract surgery, and to the control group (n = 70), which received routine nursing care. The visual analog scale (VAS) and Spielberger State-Trait Anxiety Inventory (STAI) were used to collect data. FINDINGS: The median STAI state scores of the intervention and control groups were found to be 46.0 (44.7 to 48.0) and 57.0 (55.75 to 59.00), respectively. The VAS comfort score of the intervention group after hand massage (4.0 [1.7-5.0]) was lower than that of the control group immediately before surgery (8.0 [6.0-10.0]) (P < .05). In addition, except oxygen saturation, the remaining vital signs were lower in the intervention group. CONCLUSIONS: Hand massage reduced the anxiety of patients, positively affected their vital signs, and increased their comfort.

Effect of Transcutaneous Electrical Nerve Stimulation on Postoperative Pain and Patient Satisfaction.

BACKGROUND AND AIMS: This study was conducted to investigate the effect of transcutaneous electrical nerve stimulation on postoperative pain, changes in patients' vital signs, and patient satisfaction after inguinal herniorrhaphy. DESIGN: This study used a randomized controlled design. SETTING: A state hospital in the west of Turkey. PARTICIPANTS/SUBJECTS: The study was conducted on 52 patients who had inguinal herniorrhaphy between January and July 2015. METHODS: Patients were randomly divided into two groups (intervention and control). Intervention group patients received transcutaneous electrical nerve stimulation postoperatively five times for 30 minutes each. Electrodes in control group patients were placed, but the device was not started. At each transcutaneous electrical nerve stimulation session, the patients' vital signs and pain severity were recorded. A satisfaction scale was administered before discharge to assess patient satisfaction with nursing care. RESULTS: Pain scores of patients in the intervention group were lower than those in the control group (p < .05). No differences were found in pre-and post-transcutaneous electrical nerve stimulation in the vital signs. Satisfaction scores were higher in the intervention group than control group (p < .05). CONCLUSIONS: After inguinal herniorrhaphy, transcutaneous electrical nerve stimulation reduced postoperative pain without a negative impact on vital signs and increased patient satisfaction with nursing care.

Experiences and Perceptions of Abused Turkish Women Regarding Violence Against Women.

This study qualitatively explored abused Turkish women's experiences and perceptions regarding violence against women. The research sample comprised 30 women who were seen by the police and referred to the Family Counseling Center between 2 October 2012 and 30 August 2013 due to domestic violence. Study data were collected using a Demographic Information Datasheet and a Semi-Structured Interview Form. Qualitative data were gathered using face-to-face interviews, which were transcribed verbatim then analyzed and interpreted to determine themes using the conceptual framework. Qualitative analysis yielded five themes: (1) being subjected to all types of violence; (2) everything is an excuse for violence; (3) forgetting what it is like to be a woman; (4) having to continue the marriage against her will; (5) being forced to do some things involuntarily in order to reduce the violence. In the light of these results, it seems that multidisciplinary approaches are required in order to support women both psychologically and socially. Women need to be supported in order to determine their mental health problems and to get the required medical assistance.