Clinical trials

Early postoperative pain following shoulder surgery is a significant clinical problem for both patients and orthopedic surgeons. Effective pain control is crucial for improving postoperative comfort and optimizing rehabilitation. Pericapsular nerve group block (PENG) is a regional anesthesia method that has recently gained attention due to its lack of motor block and absence of pulmonary complications. The aim of this study is to evaluate the effect of PENG block, applied at two different volumes, on postoperative pain and opioid consumption in patients undergoing arthroscopic shoulder surgery.

The Effect of Virtual Reality Glass Use on Fetal Health Anxiety, Prenatal Distress, and Maternal-Fetal Attachment in Women with Premature Rupture of Membranes: A Randomized Controlled Trial

This study aims to evaluate the validity and reliability of mixed reality (MR)-based adaptations of functional mobility and performance tests developed using the Meta Quest 3 platform by comparing their outcomes with conventional clinical assessments. Virtual and mixed reality technologies have gained increasing attention in clinical measurement due to their potential advantages, including assessment standardization, enhanced user interaction, and automated data collection. Previous studies have demonstrated that virtual reality-based performance assessments can provide high reliability and show meaningful associations with traditional clinical measures across different populations. However, visual and vestibular stimuli, depth perception, and changes in movement strategies may cause performance in virtual environments to differ from performance in conventional settings. Therefore, the validity and reliability of each virtual or mixed reality adaptation should be established within the target population. Overweight and obese individuals exhibit biomechanical and physiological characteristics that may affect balance, gait mechanics, joint loading, and physical performance. Consequently, measurement properties established in other populations cannot be assumed to apply directly to overweight and obese individuals. In addition, factors related to head-mounted displays and motion-tracking systems may influence assessment outcomes. The purpose of this study is to evaluate the concurrent validity and test-retest reliability of mixed reality-based performance tests developed using the Meta Quest 3 platform. Measurement error parameters will also be determined to assess the clinical applicability of these MR-based assessments. The findings of this study are expected to contribute to the development of safe, standardized, digital, and potentially remote assessment approaches for evaluating functional performance in overweight and obese individuals. Furthermore, the results may strengthen the scientific evidence supporting the use of digital assessment technologies in clinical practice.

Type 2 Diabetes Mellitus (T2DM) is a multifaceted metabolic disease associated not only with impaired glycemic control but also with reductions in muscle strength, balance, functional mobility, and walking performance. Individuals with T2DM may experience impairments in lower extremity function, postural control, and overall functional performance, which can negatively affect activities of daily living and quality of life. Therefore, the assessment of functional performance using reliable and valid methods is important for clinical monitoring and rehabilitation planning. The 6-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), and Five-Repetition Sit-to-Stand Test (5xSTS) are widely used clinical assessments for evaluating walking capacity, functional mobility, lower extremity function, and physical performance in individuals with T2DM. Previous studies have demonstrated that these tests provide reliable and clinically meaningful measurements in this population. In recent years, virtual and mixed reality technologies have provided opportunities to conduct assessments in a more objective, standardized, and user-friendly manner. These technologies also offer important advantages, including real-time data collection, enhanced user interaction, and potential integration into future remote assessment applications. However, evidence regarding the measurement properties of mixed reality-based adaptations of commonly used functional performance tests in individuals with T2DM remains limited. The aim of this study is to evaluate the validity and reliability of mixed reality-based adaptations of the 6-Minute Walk Test, Timed Up and Go Test, and Five-Repetition Sit-to-Stand Test developed using the Meta Quest 3 platform. In addition, convergent validity will be examined by investigating the relationships between outcomes obtained from the mixed reality-based assessments and measures of knee extensor muscle strength and handgrip strength. The findings of this study are expected to contribute to the development of innovative, safe, standardized, and digital approaches for assessing functional performance in individuals with Type 2 Diabetes Mellitus. Furthermore, the results may provide a scientific foundation for future digital health applications and remote assessment strategies.

The 6-Minute Walk Test (6MWT) is a widely used field test for assessing functional exercise capacity, walking endurance, and submaximal performance related to activities of daily living. However, in conventional applications, environmental conditions, observer-related differences, and standardization issues may lead to variability in measurement outcomes. In addition, evaluating only the total walking distance may not adequately reflect clinically important changes such as performance decline and walking-related motor fatigue occurring during the test. For this reason, recent studies have recommended analyzing 6MWT data by dividing the test into minute-by-minute segments and using performance change metrics such as the Distance Walked Index (DWI). These approaches allow a more detailed evaluation of changes in walking performance throughout the test duration. With advances in measurement technologies, mixed reality (MR)-based applications have attracted attention as a means of enabling more objective, standardized, and reproducible implementation of conventional clinical tests. MR technology allows users to maintain interaction with the real environment while receiving digital guidance and feedback, thereby providing a safe and standardized assessment setting. Nevertheless, evidence regarding the validity and reliability of mixed reality-based adaptations of the 6MWT, particularly in asymptomatic adults, remains limited. The aim of this study is to evaluate the criterion validity and test-retest reliability of a mixed reality-based 6-Minute Walk Test (MR-6MWT) developed using the Meta Quest 3 and Unity platform. In addition, convergent validity will be examined by analyzing the relationships between total walking distance, minute-by-minute performance changes, fatigue effect (%), and outcomes of the 4-Meter Walk Test, Timed Up and Go Test, and knee extensor muscle strength. The findings of this study are expected to contribute to the development of a more objective, standardized, and digitally based mixed reality adaptation of the 6MWT. Furthermore, the results may provide a scientific foundation for future remote assessment and digital monitoring applications.

Aim: This experimental study aims to investigate the impact of an Artificial Intelligence (AI)-based orientation program on the clinical orientation process of nursing students during their pediatric nursing clinical practice.Materials and Methods: The study population will consist of 186 third-year nursing students enrolled in the spring semester at a state university. The sample will include 90 students (45 intervention, 45 control) who meet the study criteria and volunteer to participate. Students in the intervention group will receive an AI-based clinical orientation program, while the control group will receive no additional intervention beyond the standard faculty and hospital orientation. Data will be collected between February and March 2026 using a "Descriptive Information Form," the "Clinical Adaptation Scale for Student Nurses," and the "Therapeutic Communication Skills Scale for Nursing Students" in a pre-test/post-test design.Statistical Analysis: Data will be analyzed using SPSS 25.0. Descriptive statistics (frequency, percentage, mean, and standard deviation) will be used. Normality will be assessed via Kolmogorov-Smirnov/Shapiro-Wilk tests. For group comparisons, Chi-square, ANOVA, independent samples t-test, Mann-Whitney U, and Wilcoxon tests will be utilized. The statistical significance level will be set at $p \< 0.05$.Ethical Considerations: Ethical committee approval and necessary permissions from scale authors will be obtained before the study begins. Informed consent will be collected from all participants after explaining the study objectives.Keywords: Orientation training, nursing, student, artificial intelligence, clinical practice.

Pregnancy is a physiological process; however, it is also a dynamic period during which obstetric and medical complications that may threaten maternal and fetal health can occur. In the presence of such complications, pregnancy is defined as a high-risk pregnancy, accounting for approximately 10-20% of all pregnancies. Due to the increased risk of maternal and fetal morbidity and mortality, high-risk pregnancies are considered a significant public health issue. Among high-risk pregnancies, premature rupture of membranes (PROM) and particularly preterm premature rupture of membranes (PPROM) are obstetric conditions associated with serious risks for maternal and perinatal outcomes. PPROM is responsible for a substantial proportion of preterm births and is associated with an increased risk of neonatal complications. During the course of PROM and PPROM, the latency period between membrane rupture and delivery constitutes a significant source of uncertainty and psychosocial burden for pregnant women. Factors such as prolonged hospitalization, risk of complications, and fear of fetal loss may lead to increased levels of stress, anxiety, and depression in this population. In the face of intense stress and uncertainty, coping strategies emerge as an important determinant of psychological outcomes. Coping refers to the cognitive and behavioral efforts individuals employ to manage situations perceived as threatening and is generally classified into active and avoidant coping strategies. Avoidant coping strategies have been associated with higher levels of anxiety and depression, whereas adaptive coping strategies are reported to enhance psychological resilience. Maternal psychological status may influence not only the mother's mental health but also fetal well-being. In this context, the non-stress test (NST) is an important tool for evaluating fetal autonomic nervous system function and allows monitoring of the relationship between maternal psychological status and fetal physiological responses. However, findings regarding the relationship between maternal anxiety and depression and NST parameters remain inconsistent. Current clinical management of PROM and PPROM primarily focuses on preventing obstetric complications, while the maternal psychological dimension often remains secondary. Therefore, safe and feasible non-pharmacological interventions during pregnancy have gained increasing attention. Emotional Freedom Technique (EFT) and music therapy are among the non-pharmacological interventions shown to be effective in reducing stress, anxiety, and depression during pregnancy. However, no studies have been identified in the literature evaluating the effects of these interventions on maternal psychological status, coping strategies, and fetal well-being in high-risk pregnancy groups such as PROM and PPROM. Therefore, randomized controlled trials are needed to evaluate the effects of EFT and music therapy on maternal psychological status, coping strategies, and fetal well-being in pregnant women diagnosed with PPROM.

Cesarean section is a common surgical procedure performed to deliver a baby when vaginal birth may pose risks to the mother or infant. Although it is often life-saving, recovery after cesarean section is frequently associated with multiple physical and psychological challenges, including postoperative pain, delayed gastrointestinal function, reduced mobility, fatigue, and decreased overall well-being. These factors may negatively affect a woman's ability to care for her newborn, initiate breastfeeding, and adapt to the postpartum period. In recent years, there has been increasing interest in non-pharmacological interventions that can safely support postoperative recovery without causing additional side effects. Among these, music therapy, breathing exercises, and virtual reality applications have been identified as promising approaches. Music therapy may promote relaxation and reduce pain and anxiety through auditory stimulation and emotional regulation. Breathing exercises may enhance parasympathetic activity, improve oxygenation, reduce stress, and support gastrointestinal motility. Virtual reality applications, by providing immersive audiovisual experiences, may reduce pain perception, decrease anxiety, and improve overall comfort through distraction and relaxation mechanisms. Although these interventions have individually demonstrated beneficial effects in postoperative care, the existing literature is limited in directly comparing their relative effectiveness within the same study design. Furthermore, most studies have primarily focused on pain outcomes, while other important aspects of recovery, such as obstetric recovery quality and gastrointestinal symptoms, have received less attention. This randomized controlled trial aims to comparatively investigate the effects of music therapy, breathing exercises, and virtual reality application on obstetric recovery, pain, and gastrointestinal symptoms in women following cesarean section. Participants will be randomly assigned to one of three intervention groups or a control group receiving routine care. Standardized protocols will be applied for each intervention to ensure consistency. The primary outcomes of this study include obstetric recovery, pain intensity, and gastrointestinal symptoms. By evaluating these outcomes simultaneously, the study aims to provide a more comprehensive understanding of post-cesarean recovery. The findings of this study are expected to contribute to evidence-based clinical practice by identifying effective, safe, and feasible non-pharmacological interventions that can be integrated into routine post-cesarean care. Ultimately, this research may help improve maternal comfort, accelerate recovery, and enhance the overall postpartum experience for women undergoing cesarean section.

In today's world where digital technologies are integrated into every aspect of life, adolescents' unhealthy and uncontrolled use of digital media causes important psychosocial problems such as digital addiction and cyberbullying. This research aims to examine the effects of an art-based nursing intervention program in order to help adolescents born into the digital world gain healthy digital habits. The art-based nursing intervention program that helps gain healthy digital habits aims to increase adolescents' expressive expression skills, develop their skills in coping with challenging situations in the digital environment and strengthen their self-efficacy levels through creative art activities. The research is a randomized controlled trial designed as an experimental type, pre-test-post-test design. The research will be carried out in Prof. Dr. Fuat Sezgin Secondary School in Karatay district of Konya province. The sample group was determined as a total of 64 adolescents, 32 intervention and 32 control. Adolescents will be randomly assigned to the intervention and control groups. The pre-test data of the intervention and control groups were collected before the program started; The post-test data will be collected face-to-face by the researcher after the program is completed using the Personal Information Form, Digital Addiction Scale for Children, Revised Cyberbullying Scale (YSZE-II) and Self-Efficacy Scale for Children. It is expected that the digital addiction and cyberbullying levels of adolescents who are applied the art-based nursing intervention program that helps them gain healthy digital habits will be lower than the control group, and their self-efficacy levels will be higher than the control group. It is anticipated that the findings to be obtained as a result of the research will enable the development of creative and holistic intervention approaches that will increase the functionality of school health nurses against the risks posed by the digital age on young people. It is also thought that it can provide an evidence-based basis for the usability of art-based interdisciplinary practices in the field.

This study aims to evaluate the effect of video-supported education, prepared for pediatric nurses, on their knowledge, attitudes, and perceived professional competence regarding peripheral venous catheter (PVC) infiltration and extravasation. The research will be conducted as a parallel-group, randomized controlled experimental design, involving pre-test and post-test measurements. The study will be carried out with nurses working in the pediatric clinics of Konya Dr. Ali Kemal Belviranlı Women's Health and Pediatric Hospital. During the data collection process, a Descriptive Information Form, an Infiltration and Extravasation Knowledge Questionnaire, an Attitude Scale Towards Preventing Infiltration and Extravasation, and a Competency Scale for Clinical Nurses will be utilized. Nurses in the intervention group will receive video-supported education on peripheral venous catheter infiltration and extravasation, which will be prepared by the researchers with expert consultation. No intervention will be applied to nurses in the control group. Pre-test data will be collected face-to-face from both the intervention and control groups within one week prior to the intervention, and post-test data will be collected one month after the intervention. The findings are expected to improve nurses' knowledge and attitudes towards complications they may encounter in PVC applications, enhance patient safety in clinical practice, and provide evidence-based contributions to nursing education. In these respects, the study aims to make a significant contribution to the literature and pediatric nursing practice.

"This study aims to evaluate the impact of climate change workshops grounded in Protection Motivation Theory (PMT) on students' climate change awareness, environmental consciousness, and pro-environmental behaviors. The primary objective is to foster awareness, environmental literacy, and sustainable behavioral shifts among middle school students, thereby empowering them to adopt eco-friendly practices to mitigate the effects of climate change. Note on Protocol Revision: Due to cognitive suitability concerns identified during the pilot phase, the target population was shifted from primary to middle school students following expert consultation. This shift necessitated modifications to certain assessment instruments. These revisions have been approved by the ethics committee, and a new ethics approval number has been issued (Date of first protocol entry: July,2024).

This randomized controlled study aims to evaluate the effects of mandala coloring activity on stress, anxiety, pain, and physiological parameters in women diagnosed with missed abortion. Participants will be randomly assigned to either a mandala coloring group or a control group receiving standard care. Outcomes will be measured at hospital admission and after completion of the mandala coloring session.

This study evaluates whether an immersive virtual reality (VR) version of the Timed Up and Go (TUG) test can accurately measure functional mobility in adults with chronic non-specific low back pain. The standard TUG test measures the time needed to stand up from a chair, walk 3 meters, turn around, walk back, and sit down. In the VR version (VR-TUG), participants perform the same movements while wearing a VR headset that displays a virtual environment. We will examine: (1) whether VR-TUG results are similar to the standard TUG, (2) whether VR-TUG is reliable when repeated about one week later, and (3) whether VR-TUG performance is associated with pain, disability, and fear of movement. Participants will complete questionnaires (VAS, ODI, and TSK), perform standard TUG and VR-TUG at baseline, and repeat VR-TUG 7 ± 2 days later. Results will help determine whether VR-based functional mobility testing is a practical assessment tool for people with chronic low back pain.

Posture is maintained through the interaction of the musculoskeletal system, visual input, vestibular function, and proprioception to provide optimal balance with minimal energy expenditure. Various factors, including prolonged static sitting, unsuitable work environments, prolonged screen use, and low physical activity levels, may contribute to postural misalignment, particularly in student populations. Rounded shoulder posture is commonly associated with muscle imbalance, altered scapular alignment, pain in the neck and shoulder region, reduced range of motion, and functional limitations. Kinesio taping is a physiotherapy intervention commonly used in orthopedic and musculoskeletal rehabilitation. Proposed effects include facilitation of proper muscular and fascial alignment, enhancement of proprioceptive feedback, and potential improvement in posture and movement quality. However, evidence regarding the immediate effects of kinesio taping on posture-related outcomes in individuals with rounded shoulder posture remains limited. The purpose of this study is to evaluate the immediate effects of kinesio taping on posture, shoulder range of motion, and proprioception in students with rounded shoulder posture.

Fibromyalgia syndrome (FMS) is a chronic rheumatic condition characterized by widespread pain, fatigue, and functional impairments that negatively affect physical activity levels, muscle strength, balance, and functional mobility. These impairments may lead to reduced functional capacity and increased sedentary behavior. Therefore, objective assessment of mobility, balance, and functional performance is essential in individuals with FMS. Performance-based tests such as the Five Times Sit-to-Stand Test (5xSTS) and the Timed Up and Go (TUG) test are commonly used to evaluate lower extremity muscle function, balance, and functional mobility due to their simplicity, feasibility, and clinical relevance. Recently, virtual reality (VR)-based assessment methods have emerged as a standardized and objective approach for evaluating functional performance. This study aims to investigate the feasibility and measurement properties of virtual reality-based adaptations of the 5xSTS and TUG tests in individuals with fibromyalgia syndrome using a head-mounted VR system. Findings from this study are expected to contribute to the clinical use of VR technology in mobility and balance assessment in individuals with FMS.

Multiple sclerosis (MS) is a chronic and progressive autoimmune disease of the central nervous system characterized by inflammation, demyelination, and axonal degeneration. Depending on lesion localization and disease severity, individuals with MS may develop a wide range of neurological manifestations affecting motor and sensory functions. Current evidence indicates that pulmonary function impairments may occur in individuals with MS even in the absence of overt respiratory symptoms. Compared with healthy individuals, people with MS have been reported to exhibit significantly reduced values in several respiratory parameters, particularly respiratory muscle strength. Moreover, these reductions appear to become more pronounced in parallel with increasing Expanded Disability Status Scale (EDSS) scores, regardless of disease duration. Indeed, previous studies have demonstrated that even individuals with MS who have mild disability levels (EDSS 0-4.5) experience significant declines in respiratory muscle strength, pulmonary function, and functional exercise capacity compared with healthy controls. These findings suggest that the respiratory system may be affected not only in the advanced stages of MS but also during the early phases of the disease, with functional impairments emerging before clinically evident respiratory complaints arise. Despite this, the existing literature lacks studies that define clear, clinically applicable cut-off values for respiratory muscle strength and endurance that can discriminate disability levels in individuals with MS. This gap highlights the absence of objective criteria that clinicians can rely on for early detection and for planning targeted rehabilitation interventions. The present study aims to address this gap by identifying optimal cut-off points for respiratory muscle strength and endurance in individuals with MS to facilitate early and accurate discrimination of disability status. By doing so, this research seeks to make an original contribution to the literature. The findings are expected to support the standardization of respiratory assessment processes in clinical practice, thereby improving patient quality of life and enhancing the efficiency of healthcare services. Furthermore, the results will provide a strong scientific basis for integrating respiratory function assessments into MS follow-up protocols and will offer a methodological framework for future intervention-oriented studies.

Lower extremity muscle strength is a fundamental determinant of an individual's ability to maintain functional mobility, preserve balance, and perform activities of daily living independently. One of the methods used for the comprehensive evaluation of these functions is the Five-Repetition Sit-to-Stand (5STS) test, which is considered an effective tool for assessing lower extremity strength, balance, and functional mobility in both healthy individuals and various clinical populations. In this test, participants are required to consecutively stand up from and sit down on a chair five times without using their arms, and the completion time is recorded in seconds to objectively evaluate functional capacity. Due to its simplicity, low cost, and high reliability, the 5STS test is widely used in clinical and research settings. However, functional tests administered in conventional clinical environments may be insufficiently standardized due to factors such as examiner-related variability, measurement errors, and environmental influences. This limitation makes it difficult to detect small performance differences and restricts test repeatability. In recent years, rapidly advancing virtual reality (VR) technology has contributed to overcoming these limitations by offering the potential to digitally standardize measurement processes. VR systems, which recreate real-life scenarios in a three-dimensional and interactive manner, allow for a more comprehensive and objective assessment of motor performance. In addition, by increasing user interaction and reducing observer-related errors, VR enhances clinical validity. One study has reported that the most important advantage of VR in clinical balance assessments is its ability to provide a fully controllable, repeatable, and standardized environment. Similarly, a systematic review found that VR-based exercises resulted in significant improvements in motor skills, balance, and cognitive function, while increasing user engagement and motivation and thereby contributing to more effective rehabilitation outcomes. Current literature indicates that VR technology is increasingly being utilized in physiotherapy and exercise sciences. In one study, the validity and feasibility of a VR adaptation of the Wingate Anaerobic Test were investigated, and it was reported that the VR version produced performance outcomes comparable to the conventional test, while participant satisfaction was significantly higher with the VR-based method. Likewise, another study demonstrated that the VR adaptation of the Six-Minute Pegboard and Ring Test exhibited high levels of validity and reliability. Together, these studies indicate that VR-based functional tests are both feasible and clinically consistent. Despite this, no studies to date have examined the validity and reliability of the Five-Repetition Sit-to-Stand test in an immersive VR environment for assessing lower extremity function. Therefore, the present study aims to determine the validity, reliability, and feasibility of a virtual reality-based Five-Repetition Sit-to-Stand test (5STS-VR) developed on the Meta Quest 3 platform in asymptomatic young adults. Additionally, convergent validity will be evaluated by analyzing the relationships between performance data obtained from the virtual environment and outcomes of the Y-Balance Test and lower extremity muscle strength measurements.

Objective assessment of mobility, balance, and lower extremity function in older adults is of great importance in both clinical practice and scientific research. For this purpose, performance-based tests that can be administered in a short time, are easily repeatable, and have high clinical practicality are widely preferred. These tests provide valuable information about older adults' ability to perform activities of daily living, levels of functional independence, and risk of falls, thereby contributing significantly to both diagnostic processes and treatment planning. One of these tests, the 4-Meter Walk Test (4MWT), is among the simplest and most reliable methods used to assess walking speed in older adults. Gait speed is considered a strong indicator of functional capacity and overall health status in older individuals and is also used as a critical parameter for predicting mortality, morbidity, hospitalization rates, and duration of independent living. Therefore, due to its short administration time, high repeatability, and clinical validity, the 4MWT has become one of the standard assessment tools in the field of geriatrics. Another frequently used assessment tool, the Five-Times Sit-to-Stand Test (5xSTS), is based on measuring the time required for an individual to consecutively stand up from and sit down on a chair five times. This test is closely associated with lower extremity muscle strength, functional independence, and the ability to maintain activities of daily living. In addition, the 5xSTS test is an important clinical tool for identifying muscle weakness and mobility limitations in older adults with a history of falls. Owing to its short administration time, lack of requirement for specialized equipment, and ease of understanding, it is widely used in both clinical settings and field studies. In addition, the Timed Up and Go (TUG) test is considered one of the gold standard methods for the assessment of functional mobility. The test is simple to administer: the time required for an individual to stand up from a chair, walk a specified distance, turn around, and return to sit down is measured. The TUG test not only assesses mobility but is also a reliable and valid method for predicting balance impairments and fall risk. Given that falls represent a major health concern in older adults, data obtained from the TUG test provide valuable guidance for both clinicians and researchers. In recent years, virtual reality (VR)-based assessment methods have attracted increasing attention due to their potential to provide a safe, motivating, and standardized environment, particularly for older adults. In this study, the Meta Quest 3 virtual reality headset and controllers will be used to implement VR-based functional tests. The Meta Quest 3 device features a resolution of 2064 × 2208 pixels per eye, a maximum refresh rate of 120 Hz, and a six-degrees-of-freedom (6 DoF) inside-out tracking system. The device tracks participants' head and body movements in real time and accurately reflects them within the virtual environment. This system does not require external sensors and automatically provides positional tracking in the virtual space. Previous studies have demonstrated that VR applications can produce valid and reliable outcomes when used as digital adaptations of functional tests. However, the validity and reliability of VR adaptations of the 4MWT, 5xSTS, and TUG tests in older adults have not yet been systematically investigated. The rationale of this study is to determine whether VR-based short performance tests can serve as a safer, more easily repeatable, and potentially more accessible alternative to conventional clinical assessments. The findings of this study are expected to provide important evidence supporting the use of VR technology in clinical practice for the assessment of mobility and balance in older adults.

Functional mobility encompasses the essential motor skills required for individuals to perform activities of daily living independently and safely. One of the most commonly used methods for assessing this parameter is the Timed Up and Go (TUG) test. The TUG test involves standing up from a chair, walking, turning, walking back three meters, and sitting down, and it is a measurement tool that has demonstrated high sensitivity and reliability in clinical practice for evaluating lower extremity function, mobility, and fall risk. However, tests conducted in conventional clinical settings have limitations in terms of standardization due to examiner-related variability, environmental influences, and measurement subjectivity. These factors may lead to measurement errors, particularly when detecting small performance differences. Advances in virtual reality (VR) technology offer an innovative approach to the assessment and training of motor performance by recreating real-life scenarios in a three-dimensional and interactive manner. VR-based systems allow simultaneous observation of motor and cognitive processes while enhancing user motivation and engagement, thereby making the assessment process more dynamic. Recent studies have demonstrated that VR applications are effective tools in neurological rehabilitation, particularly in conditions such as multiple sclerosis (MS), for improving balance, walking speed, and functional mobility. A review of the existing literature reveals that studies evaluating the validity and reliability of VR-based functional tests are limited. Moreover, to date, no study has specifically focused on the validity and reliability of the TUG test in an immersive VR environment for assessing lower extremity functional mobility. Therefore, this study aims to address a significant gap in the literature by being one of the first investigations to examine the validity and reliability of a VR-based version of the TUG test. This study aims to determine the feasibility, validity, and reliability of the TUG test administered in an immersive VR environment in asymptomatic young adults aged 18-30 years. Additionally, the relationships between VR-based TUG outcomes and the 4-Meter Walk Test, the Four Square Step Test, and lower extremity muscle strength measurements will be examined.

Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease of the central nervous system, with common symptoms including muscle weakness, balance impairments, gait difficulties, and fatigue. These symptoms significantly affect individuals' functional mobility, independence, and quality of life. In individuals with MS, reduced lower extremity muscle strength leads to decreased walking speed and loss of balance, resulting in substantial limitations in activities of daily living. Conventional clinical assessment tools, such as the Timed Up and Go (TUG), Five-Repetition Sit-to-Stand Test (5xSTS), and the Timed 25-Foot Walk (T25FW), have been widely used for many years to evaluate functional mobility in individuals with MS. However, these tests typically rely on unidimensional measurement parameters and may demonstrate subjective variability depending on the testing environment and the examiner's experience. Advances in measurement technologies now allow these clinical tests to be transformed into more objective, standardized, and interactive assessment tools. Virtual reality (VR) provides a new perspective for the assessment of motor performance by enabling three-dimensional and interactive simulations of real-world scenarios. VR-based applications allow for the simultaneous evaluation of both motor and cognitive components while also increasing individuals' motivation and engagement. Previous studies have demonstrated that VR technology is effective in neurological rehabilitation, particularly in improving balance, walking speed, and functional mobility in the MS population. In contrast to VR, mixed reality (MR) is a technology that allows individuals to maintain interaction with the real environment while integrating virtual objects into the physical space. The existing literature reveals a notable gap in research focusing on the validity and reliability of VR or MR-based functional tests in individuals with multiple sclerosis. However, no studies to date have investigated the adaptation of lower extremity functional tests (TUG, 5xSTS, and T25FW) to a mixed reality environment. Therefore, the primary rationale of this study is to evaluate the digital applicability of commonly used functional tests in individuals with MS on the Meta Quest 3 virtual reality platform and to determine the validity and reliability of these tests. Additionally, this study aims to examine the relationships between data obtained from the virtual tests and fatigue (Modified Fatigue Impact Scale, MFIS), walking performance (12-Item Multiple Sclerosis Walking Scale: MSWS-12), and knee extensor muscle strength in order to establish the convergent validity of this novel approach. The findings of this study are expected to contribute to the development of an objective, standardized, safe, and innovative digital assessment tool for functional evaluation in individuals with multiple sclerosis. Furthermore, the results will strengthen the scientific foundation for remote monitoring of the rehabilitation process and for the development of personalized treatment programs.

Preterm birth is associated with increased physiological instability, stress responses, and developmental vulnerability due to immature organ systems and prolonged exposure to invasive procedures and environmental stressors in neonatal intensive care units (NICUs). In recent years, non-pharmacological, touch-based interventions have gained attention for their potential to support neurodevelopment, improve comfort, and stabilize physiological parameters in preterm infants. Therapeutic Touch (TT) is a non-invasive, holistic intervention based on the modulation of the human energy field through gentle hand movements, aiming to reduce stress, promote relaxation, and support physiological regulation. Although TT has demonstrated beneficial effects in various populations, evidence regarding its effects on preterm infants remains limited. This randomized controlled study aims to evaluate the effects of Therapeutic Touch on behavioral responses, comfort levels, and physiological parameters (heart rate, respiratory rate, oxygen saturation, and body temperature) in preterm infants hospitalized in the NICU. The findings are expected to contribute evidence for safe, supportive, and holistic neonatal care practices.

Frailty is defined as a state of weakness resulting from a decrease in physiological reserves due to physiological changes, diseases, and/or malnutrition associated with advancing age. Frail older adults face increased mortality, morbidity, and healthcare costs when exposed to stressors, making this issue increasingly important. The FRAIL Scale, developed by Morley et al. , is a 5-item measure that assesses frailty. The FRAIL Scale has been validated in many countries and has been proven to be an effective method for detecting frailty. This scale assesses the patient's fatigue, resistance, mobility, weight loss, and other diseases. In the 5-item FRAIL scale, patients receive 0 or 1 point based on their answers, and a total of 0 points is considered non-frail, 1-2 points is considered pre-frail, and \>2 points is considered frail. Frailty is associated with a higher risk of postoperative complications. Rothenberg and colleagues reported in a study involving more than 400,000 patients that frailty doubles the risk of postoperative complications . Hypotension following anesthesia induction is a common complication in geriatric patients. Decreased cardiopulmonary reserve with age leads to an exaggerated drop in blood pressure during induction . In this study, the investigators aimed to determine the effect of frailty level in geriatric patients on hypotension observed after anesthesia induction.

Multiple Sclerosis (MS) is a chronic disease affecting the central nervous system, exhibiting autoimmune and neurodegenerative properties. Neurological deficits, mobility limitations, and decreased muscle strength are commonly observed in MS patients as the disease progresses. The literature indicates that low physical activity levels and neurological deficits in individuals with MS can lead to decreased muscle mass and functional losses. Sarcopenia is a condition characterized by decreased skeletal muscle mass and strength associated with aging and chronic diseases, and studies on the prevalence of sarcopenia in MS patients are limited. Recent studies have revealed a high prevalence of sarcopenia in MS patients, which can have negative effects on physical performance, quality of life, and disease progression. Low muscle mass in MS patients can accelerate the loss of motor function and increase the level of disability. Additionally, nutritional deficiencies and low protein intake seen in MS patients are among the factors that accelerate muscle loss. Studies examining the relationship between MS and sarcopenia in the literature emphasize the importance of early diagnosis and intervention to improve patients' quality of life and functional independence. Factors such as muscle strength, physical activity level, and nutritional status should be assessed to determine the risk of sarcopenia in MS patients. This study was designed to determine the prevalence of sarcopenia in patients with Multiple Sclerosis (MS) and to examine the relationship between sarcopenia and fatigue, disability level (EDSS), nutritional status, and physical activity level. In this context: * The prevalence of sarcopenia in MS patients will be determined, * The relationship between sarcopenia and muscle strength, physical performance, and body composition will be evaluated, * The effects of nutrition and physical activity on sarcopenia in MS patients will be investigated.

Children are particularly vulnerable to injuries resulting from medication errors due to the severity of the illness, the need for high-risk drugs with a narrow therapeutic range, and the frequent use of intravenous infusions. Despite recent advances in pharmacological research in the pediatric population, the issue of availability of medications suitable for children has not yet been resolved. Therefore, in the pediatric group, it is necessary to calculate the correct dosage of medications, prepare them with appropriate methods, and dilute them with suitable diluents. The literature indicates that dosage calculation errors are the most common medication errors in neonatal and pediatric patients. It is unclear whether nursing students are adequately prepared to provide pharmaceutical care in practice. Nursing students and new nursing graduates often lack the competence to administer medications safely. Therefore, training should be planned to enhance students' competencies and knowledge levels. The inclusion of newer methods in educational techniques has become essential as technology and social media increasingly engage nursing students. Today's nursing students need alternative, innovative ways to be involved in the learning process. Among these methods, gaming is used in nursing education to support the development of critical thinking and practical skills in students. Game-based learning has the potential to engage students and enhance learning, offering numerous advantages alongside innovation and excitement. In light of these advantages, the aim of this study is to evaluate the effects of a virtual escape room application on nursing students' knowledge level, self-efficacy, clinical comfort, and anxiety in pediatric medication management.

Childhood home accidents are a significant health problem in our country and the world. Home accidents are more common in children aged 1-5, and cause temporary and permanent disabilities in deaths. In the project proposal, it is planned to conduct a randomized controlled trial to determine the effects of digital and classical home accident and first aid training given to mothers in the risk group with children aged 1-3 in line with the Planned Behavior Theory (PDT) on home accident safety precautions and first aid self-efficacy. In the study, the features of the education model that will provide original value and original contribution are that it is digitally based (animated video) education, which will allow individuals to receive training at their own pace and in accordance with their needs due to its individualizable feature. This will encourage mothers to participate more at the appropriate time and actively participate in the training. It is a more cost-effective and time-saving application compared to other teaching materials. In addition, it is original in that the group to be trained is mothers in the risk group. It is different from other studies on 'home accidents' in that it is planned in line with the PDT, randomized controlled, and the outputs will be measured with repeated measurements. The implementation of this project will consist of four main stages. In the first stage, the creation of the educational content, preparation of digital and classical educational materials in line with expert opinions and their evaluation by expert opinions. In the second stage, the final version will be arranged in line with the preliminary application. In the third stage, the implementation of the initiative and the collection of data. In the fourth stage, the statistical analysis of the data. The total duration of the project will be divided into approximately 3 months in the first stage, 1 month in the second, 7 months in the third and the last stage in the 1-month stage. In order for the project to be carried out healthily and effectively, the project manager and the doctoral student specialist nurse will take part. Since the project is original, if it is successful, there is a high probability that a doctoral thesis will be formed. It is highly likely that a researcher with a doctorate title will be formed upon completion of the project. The importance of the digital education method is very clear and its active use in nursing education will positively contribute to the development of child and family health. It is highly probable that the training model to be created will be recommended for use in secondary and tertiary healthcare institutions, including primary healthcare.