Effectiveness of flipped classroom among nursing students on venous thromboembolism (VTE).

BACKGROUND: Modern innovative education approaches are crucial to be incorporated into nursing education that leads to improving evidence-based teaching strategies, and closes the gap between theory and practice, as well as to prepare the nursing students to their future workplaces. AIM: Aim of the study was evaluation the effectiveness of the flipped classroom method among nursing students regarding VTE basic knowledge, risk factors, and prophylaxis. SUBJECTS AND METHODS: This study was implemented in a Faculty of Nursing in Northern Cyprus at Nicosia, and used pre-test and post-test, and interventional design. A total of 100 bachelor-degree nursing students were composed the sample of the study. The Implementation of the study was conducted in three phases including pre-test, educational intervention, and post-test. Data were evaluated using the independent-sample t test. RESULTS: The findings of the study showed statistically significant improvement in the overall mean scores of all VTE after the educational intervention through flipped classroom. Students classified the strength points with four themes; deep motive learning, technology support, team-based learning, and satisfaction. CONCLUSIONS: Our results support the effectiveness of the flipped classroom method in nursing education; the method may be useful for developing of educational strategies in nursing.

Evaluation of vascular endothelial growth factor-A and Endostatin levels in induced sputum and relationship to bronchial hyperreactivity in patients with persistent allergic rhinitis monosensitized to house dust.

BACKGROUND: Studies about the pathogenesis of bronchial hyperreactivity (BHR) in patients with persistent allergic rhinitis (PAR) and its relationship with lower airway remodeling are extremely limited. OBJECTIVE: This study evaluated bronchial vascular remodeling via the measurement of angiogenic factor, vascular endothelial growth factor-A (VEGF-A), and anti-angiogenic factor, Endostatin, and evaluated their relationship with BHR in patients with PAR. METHODS: The study group consisted of 30 patients with PAR monosensitized to house dust mites and 14 non-allergic healthy controls. All subjects underwent induced sputum and methacholine (M) bronchial provocation tests. VEGF-A and Endostatin levels were measured by ELISA in induced sputum supernatants. RESULTS: The percentages of eosinophils in induced sputum were significantly increased in patients with PAR compared with healthy controls. There were no significant differences between patients with PAR and healthy controls in terms of levels of VEGF (37.9pg/ml, min-max: 5-373pg/ml vs. 24.9, min-max: 8-67pg/ml, p=0.8 respectively), Endostatin (532.5pg/ml, min-max: 150-2125pg/ml vs. 644, min-max: 223-1123pg/ml, p=0.2 respectively) and VEGF/Endostatin ratio (0.057 vs. 0.045, p=0.8 respectively). In addition, there were no significant differences between patients who are BHR positive (n=8), or negative to M (n=22) in terms of levels of VEGF, Endostatin and VEGF/Endostatin ratio and no correlations among value of PD20 to M and levels of VEGF, Endostatin and VEGF/Endostatin ratio. CONCLUSION: We conclude that VEGF-A and Endostatin did not differ between patients with PAR and healthy controls regardless of BHR to M.

Relationship between inflammation and sex hormone profile in female patients receiving different types of renal replacement therapy.

BACKGROUND: Patients with end-stage renal disease (ESRD) experience female sexual dysfunction (FSD). The purpose of this study was to compare FSD in different types of renal replacement therapy and control patients. METHODS: The study was consisted of 47 renal transplantation (RT), 46 hemodialysis (HD), and 28 continuous ambulatory peritoneal dialysis (CAPD) patients and 36 healthy control subjects. All groups were evaluated with the following scales: Female Sexual Function Index (FSFI) questionnaire, Short Form (SF)-36 questionnaires, and Beck Depression Inventory (BDI). Demographic data, laboratory values, and hormone levels were obtained. The patients with FSFI score <26.55 were accepted as experiencing sexual dysfunction. RESULTS: Overall, total FSFI scores in RT, HD, CAPD, and control were 22 (range, 2-35), 22.4 (4-34), 18.35 (2-34), and 29.6 (2-35), respectively. The mean total FSFI score was not different in patients receiving different kinds of renal replacement therapy (P > .05) although they were significantly worse then the control group (P < .001). On regression analysis, age was significantly associated with FSD (ß = -0.14; P = .001). In addition, the physiologic health domain of SF-36 was significantly better in control groups (P < .001). The difference in terms of mean of BDI score did not reach statistical significance among patient groups (P > .05). Female sexual dysfunction score was negatively correlated with BDI (r = -0.371; P < .001) and positively correlated with the mental-physical components score of SF-36 (r = 0.423 [P < .001] and r = 0.494 [P < .001], respectively) in all patients groups. Regarding the hormones of the patients, there was a significant difference between RT and the HD and CAPD groups in dihydroepiandrosterone sulfate (DHEAS; P < .001), RT and HD in prolactin (P < .001), and RT and CAPD in free testesterone (P < .001). CONCLUSIONS: Renal transplantation, hemodialysis, and peritoneal dialysis patients were at more risk of developing sexual dysfunction and lower quality of life scores than healthy subjects. Notably, the mode of renal replacement therapy had no impact on female sexual function.

Agronomic importance of first development of chickpea (Cicer arietinum L.) under semi-arid conditions: II. Seed imbibition.

Due to the slowness growth and weakness of the first developments of chickpea (Cicer arietinum L.), it could not combated with weeds and easily caught up by Ascochyta blight (Ascochyta rabiei (Pass) Labr.) disease. Additionally, due to biotic and abiotic stress factors, esp. at the late sowing, important seed yield losses could be happened. To be able to avoid from them is only possible to accelerate of its first development as possible as. So, one of the best solutions to is to use chemical compounds such as Humic Acid (HA) known soil regulator under the semi-arid conditions. With this aim this research was performed in a Randomized Complete Block Design (RCBD) with four replications under semi-arid field conditions during (2008/2009) and (2009/2010) in Turkiye. Two cultivars (V1 = Gokce and V2 = Ispanyol) and four seed imbibition methods (A0 = 0, A1 = Tap Water, A2 = 1/2 Tap Water + 1/2 Humic acid (HA), A3 = Full HA, as w/w) and seven yield components Plant Height (PH), Number of Branches per Plant (NBP), Number of Pods per Plant (NPP), First Pod Height (NFP), Number of Seeds per Pod (NSP), Seed Weight per Plant (SWP) and 100-Seed weight (HSW) were investigated. The PH and FPH were affected the A0, the NBP, NPP and NSP were affected the A2 and the SWP and HSW were given the varied but not clear responses according to varieties for all the parameters in A1. The A0 and A1 were encouraged the germination and top soil of the plant but, the A2 to A3 were encouraged root system's development. It was concluded that the A2 is a promising method which makes the maximum and positive effect to the first development of the chickpea agronomy under the semi-arid conditions.

Agronomic importance of first development of chickpea (Cicer arietinum L.) under semi-arid conditions: I. Effect of powder humic acid.

Due to slow growth and weakness of the first development of chickpea (Cicer arietinum L.) plant could not combatted with weeds and easily get caught up by Ascochyta blight (Ascochyta rabiei (Pass) Labr.) disease; esp. under the late sowing and semi-arid conditions, due to effect of biotic and abiotic stress factors, significant yield losses could be arised. To be able to avoid from them is only possible to accelerate the first development of this crop. So, one of the best solutions is to use of "soil conditioner" chemical compounds such as HA at optimum dose. With this aim, it was established in order to find out the optimum dose range of HA. Three doses (D0 = 0 g, D1 = 100 g and D2 = 200 g), four varieties (V1 = Er-99, V2 = Gökçe, V3 = ILC-482 and V4 = Australia) and five yield components Plant Height (PH), First pod height (FPH), Number of Branches per Plant (NBP), Number of Pods per Plant (NPP) and Number of seeds per pod (NSP) were investigated. Obtained results are: Recommended (Optimum) HA doses and interactions were ranged and found as (V4 > V2 = V3 > V1); (D2 > D0 = D1); (D1 x V4) for the PH and FPH, (D2 x V3) for the NBP and (D1 x V3) for the NPP, respectively. It was concluded that when the recommended HA dose applied, it was seen that the first development has been clearly accelerated and increased under the semi-arid conditions in terms of investigated traits and cultivars.

Iodine intake is still inadequate among pregnant women eight years after mandatory iodination of salt in Turkey.

BACKGROUND: A recent study showed first sign of reduction in goiter prevalence and elimination of iodine deficiency state among school-age children in Turkey after a decade of mandatory iodination of table salt. However, iodine status among pregnant women is a still debated issue in our country. AIM: To investigate iodine status, iodized salt consumption rate, and goiter prevalence in 1st trimester pregnant women 8 yr after the mandatory iodination. MATERIAL/ SUBJECTS AND METHODS: One hundred and forty-one 1sttrimester pregnant women who had been followed-up between January and October 2006 in the obstetric outpatient clinics in Turkey were included. Besides a physical examination, subjects underwent laboratory investigations for free T(3), free T(4), and urinary iodine concentration (UIC). All subjects completed a questionnaire regarding sociodemographic parameters, use of iodized salt, and pregnancy history. Goiter status was revealed by a palpation method according to World Health Organization (WHO) guidelines. RESULTS: In this study, we found that the median UIC of pregnant women was 149.7 microg/l (range 20.9-275.1 microg/l). Almost half of the subjects were below the WHO, United Nations Children's Fund, and International Council for the Control of Iodine Deficiency Disorders lower median reference limits of 150 microg/l. Total goiter prevalence was 24.8%, of which 9.2% were visible goiters. Among the study patients, 2.1% had subclinical hypothyroidism, and 0.7% had overt hypothyroidism. The rate for iodized salt use among the pregnant women was 95%. CONCLUSION: Our study revealed that iodine deficiency still remains a serious problem for pregnant women. Based on our results, antenatal follow-up protocols in the primary care setting in Turkey must include iodine supplementation.

The effects of methylene blue on lung injury in septic rats.

PURPOSE: We aimed to investigate the effects of methylene blue (MB) on NO production, myeloperoxidase (MPO) activity, antioxidant status and lipid peroxidation in lung injury during different stages of sepsis in rats. MATERIAL AND METHODS: Rats were randomly divided into 4 groups (n = 20): group C, sham operated; group CMB, sham operated and receiving MB (25 mg/kg, i.p.); group S, sepsis; group SMB, sepsis and receiving MB (25 mg/kg, i.p.). Sepsis was induced by cecal ligation and puncture (CLP). The MB dose was administered after CLP. Each group was subdivided into two subgroups (n = 10) which were sacrificed at 9 or 18 h after the surgical procedure. The levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX) and MPO activity, total nitrite/nitrate and malondialdehyde (MDA) in the lung tissue were measured. Lung injury was graded from 1 (injury to 25% of the field) to 4 (diffuse injury) by the pathologist. RESULTS: In group SMB, while SOD and CAT increased in both early and late sepsis periods, GSH-PX increased significantly only in the early sepsis period when compared with group S. Increase in lung MPO activity after CLP-induced sepsis was prevented by MB administration. MB significantly decreased to nitrite/nitrate and MDA levels both in early and late sepsis periods when compared with group S (p < 0.05). Group S showed a marked increase in neutrophil infiltration into the interstitial space and thickening of the alveolar septa, whereas the alveolar damage score was lower in the SMB group (p < 0.05). CONCLUSION: MB reduced the MPO activity and lipid peroxidation by both decreasing oxidative stress and NO overproduction in the lungs, which resulted in the attenuation of lung injury after CLP-induced sepsis in rats.

Oxidant/antioxidant parameters and their relationship with chemotherapy in Hodgkin's lymphoma.

This study investigated changing levels of serum oxidant/antioxidant with chemotherapy and their relation to treatment in 34 Hodgkin's lymphoma patients. The patient population consisted of 19 males and 15 females. Mean age was 30.41 +/- 12.08 years. All patients received the adriamycin, bleomycin, vincristine and dexamethasone (ABVD) treatment protocol. Blood samples were taken before treatment, and on days 1 and 7 during treatment for measurement of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), malondialdehyde (MDA), nitric oxide (NO) and enzyme activities. After ABVD treatment, mean free radical levels were increased and antioxidant levels were significantly decreased in the serum. ABVD treatment results in an increase of free radical levels and a decrease of antioxidant levels in the serum of patients with Hodgkin's lymphoma.

Determination of the usage of body mechanics in clinical settings and the occurrence of low back pain in nurses.

This explorative study was designed to identify the usage of body mechanics in clinical settings and the occurrence of low back pain in nurses. The sample was composed of 56 nurses who work on the medical, surgical, emergency and intensive care units of a state hospital in Bolu, Turkey. Data collected through observation and interviews were evaluated using percentages, Chi-square and Mann-Whitney U tests. Results of the study showed that the majority of the nurses (87.5%) experienced low back pain at some time in their lives. Among the contributing factors for back pain, the relationship between wearing high heels, heavy lifting and back pain was significant statistically. According to the observations, the majority of the nurses used body mechanics correctly while sitting (53.6%), standing (58.7%), carrying (64.3%), pulling or pushing (79.4%), moving the patient to the side of the bed without an assistant (53.4%), moving the patient to a sitting position in bed (71.4%) and assisting the patient to a standing position (66.6%). However 57.1% of the nurses lifted and 82% extended incorrectly. The conclusion from this research was that some of the nurses do not use body mechanics correctly and the majority have low back pain.

Plasma lipid peroxidation products and antioxidant enzyme activities in patients with type 2 diabetes mellitus.

Diabetes is associated with a significant increase in thiobarbituric acid reactive substances (TBARS) which are considered as an index of endogenous lipid peroxidation. The human body has a complex antioxidant defense system that prevents the initiation of free radical chain reactions. We measured plasma TBARS levels, superoxide dismutase (SOD) and catalase (CAT) activities and compared their relation to the metabolic control of diabetes and diabetic microangiopathy. Sixty-four patients (19 men), aged 52.35+/-9.31 years with type 2 diabetes mellitus were included in the study. Thirty-six healthy subjects (12 men), aged 51.02+/-7.01 years formed the control group. TBARS levels and SOD activity were elevated in the diabetic group when compared with the control group ( p<0.001 and p<0.00001, respectively). However CAT activity was significantly decreased in the diabetic group when compared with the control group ( p<0.00001). Patients with diabetic nephropathy and retinopathy, but not neuropathy, had elevated TBARS levels but there was no statistically significant difference when compared with diabetic patients without microangiopathy ( p>0.05). There was a positive correlation between plasma TBARS levels and SOD activity (r=0.770, p=0.0001) and a negative correlation between plasma TBARS levels and CAT activity (r=0.482, p=0.0001). There was also a negative correlation between SOD and CAT activities (r=-0.609, p=0.0001). We found significantly elevated TBARS levels in diabetic patients. We did not observe any correlation between TBARS levels and blood glucose and HbA(1c) levels. Elevated TBARS levels and SOD activity and decreased CAT activity may be due to a compensation mechanism of the body.

Blood transfusion knowledge and practice among nurses in Turkey.

This descriptive study was planned to identify blood transfusion practice and knowledge of 100 nurses from three hospitals in Ankara, Turkey. Data collected through observation and interviews were evaluated using percentages, chi 2, and correlation methods. Nurses' knowledge and practice related to blood transfusions were measured against a total score of 100. None of the participating nurses achieved a score of 100, and only a few had scores higher than 50. Although a positive correlation existed between the nurses' knowledge and practice scores, the correlation coefficient was insignificant. There was a statistically significant relation between the experience and knowledge scores, but not between the experience and practice scores. The results of the study showed insufficient knowledge about blood transfusion, which was reflected in undesirable practice.

The oxidation of isomeric amino and acetamidobiphenyls by rat hepatic microsomal preparations.

The metabolism of isomeric amino and acetamidobiphenyls was studied using rat liver microsomal preparations. The aromatic amines were hydroxylated ortho or para to the amino group, whereas the aromatic amides were mainly oxidized in the para position. The carcinogenic amines 3- and 4- aminobiphenyl were converted to hydroxylamines and nitroso compounds. The non-carcinogenic amine 2-aminobiphenyl was resistant to enzymic nitrogen oxidation. The results support the concept that oxidation of aromatic amino groups is a prerequisite for carcinogenic and mutagenic activity.

The metabolism of 3-aminobiphenyl and 3-acetamidobiphenyl in vitro.

The metabolism of 3-aminobiphenyl (3-ABP) and 3-acetamidobiphenyl (3-AABP) has been studied using fortified rat liver microsomal preparations. Metabolites in concentrates of ether extracts from hepatic microsomal preparations were analysed by TLC and GLC. The metabolites were characterised by a comparison of their chromatographic characteristics with synthetic compounds and response to detection reagents. 3-ABP appeared to be hydroxylated predominantly at the 2- and 4-ortho positions and to a minor extent at the 6-position, whereas 3-AABP was converted to 3-acetamido-6-hydroxybiphenyl as the major metabolite. 3-ABP was also converted to the corresponding hydroxylamine, nitroso and nitro compound although the latter may have arisen via a non enzymic process.