Search

Background: This study evaluated the Mobile Information Software Evaluation Tool (MISET) with a sample of Canadian undergraduate nursing students ( N = 240). Method: Psychometric analyses determined how well the MISET assessed the extent that nursing students find mobile device-based information resources useful and supportive of learning in the clinical and classroom settings. Results: The MISET has a valid three-factor structure with high explained variance (74.7%). Internal consistency reliabilities were high for the MISET total (.90) and three subscales: Usefulness/Helpfulness, Information Literacy Support, and Use of Evidence-Based Sources (.87 to .94). Construct validity evidence included significantly higher mean total MISET, Helpfulness/Usefulness, and Information Literacy Support scores for senior students and those with higher computer competence. Conclusion: The MISET is a promising tool to evaluate mobile information technologies and information literacy support; however, longitudinal assessment of changes in scores over time would determine scale sensitivity and responsiveness. [ J Nurs Educ . 2016;55(7):385–390.]

Background Due to the toxicity of drugs involved, chemotherapy represents an high-risk treatment, both for operators and patients. To improve the safety of the oncologic therapy admixture process, in 2007 the clinical pharmacy introduced an automated system for the compounding of toxic drugs. The system is integrated with the hospital electronic medical record (EMR) and assures high levels of quality controls and a total traceability of the entire process. Purpose Since the safety and high-quality standards of the re-engineered process have been assessed,1 the purpose of this study is to evaluate also its economic sustainability and the related production efficiency. Material and methods To assess the economic sustainability of the automation, a cost analysis has been performed. Fixed costs (equipment investment, maintenance, human resources, personal protective equipments) and variable costs (compounding disposables and administrative management of the process) have been calculated both for the manual and automated compounding model, and the consequent differential saving has been estimated. In addition, we have evaluated the possibility of also centralising the production by taking into consideration the need of other hospitals and healthcare facilities in the region. Results The re-engineering of the onco-haematology process led to an annual saving of €85.715, with a marginal saving of €5.49 per preparation, a break-even point of 4.1 therapies and a return on investment in 3.3 years (against 8 years’ life-time of the robotic system). Furthermore, the total automated production capacity is estimated in 24.865 preparations per year where the 79.3% is sufficient to cover the annual hospital (hub) needs. Therefore, the residual capacity, corresponding to 5.145 annual preparations, can be allocated to satisfy the requests coming from other compounding facilities (spokes). Conclusion Besides the minimisation of the risks related to the automated production and the benefits coming from the re-engineering of the process,1 the economic sustainability of the investment and the production centralisation feasibility have been demonstrated. Reference and/or Acknowledgements 1. Bufarini C, et al. Safe and integrated onco-haematology workflow, 19th EAHP Congress 2014. No conflict of interest

Comparative education research and courses are needed to identify real revolutionary movements in the current cultural revolution in the United States. The presence of cultural revolution is indicated by, among other things, the development of microcultures. Intranational instead of cross-national studies are of importance in the next few years to understand this cultural revolution. There are several problems with implementing this new focus, but a broad knowledge of the components of American culture are needed, as well as a preparation in the study of the processes used in understanding cultural revolution. Multicultural education would teach the desirability of cultural pluralism, and would purport to bring about interaction among groups in the nation. The discipline of comparative education is suited to the study of this interaction: the tools of scientific investigation; the methodology of area studies; the analysis and interpretation of cultural patterns within the framework of a whole culture. Students could be sensitized to cultural change, and develop renewed interest and sharpened awareness of the nature of cultural revolution as participants in the process. (Author/KSM)

Although negative outcomes from intimate partner violence (IPV) are not inevitable, IPV is recognized to have profound negative effects on child development. We conducted a qualitative descriptive study of service providers' understandings of the impact of IPV on mothers, young children (birth to 36 months), and mother-infant/child relationships, and of the support needs of these mothers and young children. Service providers suggested that IPV negatively influenced caregiving and identified a pressing need for information and strategies to help mothers promote and protect their young children's development. Although service providers struggled to articulate ideal forms of assistance to promote maternal-infant/child relationships, they agreed that mothers and young children experiencing IPV required more support than is currently available.

Objective To assess the extent that anticipated maternal emotions in response to infant care (infant care emotionality or frustration and dissatisfaction with infant crying or fussing, or both), several forms of social support, and socioeconomic status explain fourth‐week postpartum depressive symptoms of adolescent mothers. Design Secondary multiple regression analysis of a subset of variables from a larger longitudinal study that examined adolescent mothers and infants. Setting Two university teaching hospitals in Western Canada. Participants Convenience sample of 78 healthy adolescent mothers. Main outcome measures Prenatal anticipated infant care emotionality, perceived family and friend social support, socioeconomic status, enacted social support, and postpartum depressive symptoms. Results Anticipated infant care emotionality ( R 2 = .19) and socioeconomic status ( R 2 = .07) significantly predicted postpartum depressive symptoms. Family support, friend support, and enacted social support were not significant predictors of postpartum depressive symptoms. Conclusion Nurses in various settings can assess the pregnant adolescent's anticipated infant care emotionality and socioeconomic status to determine their potential risk or vulnerability to postpartum depressive symptoms. More negative prenatal infant care emotionality was the strongest predictor of postpartum depressive symptoms. Validation of study findings with a larger, more representative sample is recommended.

Parenting a child with, or at risk for, a developmental delay or disability can be stressful. Abidin's parenting stress model was used as a framework to examine how several maternal, child, and family factors predict parent stress outcomes. Stepwise regression models revealed that maternal and child factors were significant contributors to parenting stress. However, family factors (income and family functioning) were not retained. Parenting stress was lower when child (cognitive and adaptive ability) and maternal (depression and child care competence) characteristics were more positive. Child cognitive ability was a strong contributor to total parenting stress and two parenting stress subscales. Findings suggest that these parents need stress lowering interventions such as supportive child care, respite relief, and a child behaviour-focused program.

In order that graduates have the ability to access, manage, and apply up-to-date information (Scollin, Healey-Walsh, Kafel, Mehta, & Callahan, 2007) and make evidence-informed decisions, nurse educators must integrate informatics and information management tools within the nursing curriculum (Canadian Association of Schools of Nursing, 2012; Hebda & Calderone, 2010; National League for Nursing, 2008). Nurse experts have recommended that pre-licensure nurses use smart information technologies to enable them to provide informed, safe, and competent patient care (TIGER, 2009). Smart technologies, such as handheld devices, improve access to clinical information and drug dosage calculations (Farrell & Rose, 2008; White et al., 2005). Such devices, including smartphones, iPods, and tablets, can house current, reliable, digital resources and textbooks. Current studies suggest that, with handheld devices, nursing students search for information more frequently, make fewer medication errors (Koeniger-Donohue, 2008), and report more positive attitudes and lower stress when acquiring clinical information (Jamieson et al., 2009). Students in one small, local study highly recommended adoption of Nursing Central [TM] (NC) as an information support software system for clinical learning (Jamieson et al., 2009). However, more knowledge about student perspectives on the usability and usefulness of specific information-support software and technologies is required before adoption of this learning resource. METHOD This pilot study evaluated the perspectives of nursing students who used NC in a clinical practice rotation. NC, a software program developed by Unbound(r) Medicine (Charlottesville, VA) specifically for nurses, enables the download and searching of electronic quick reference guides (Taber's Medical Dictionary, Davis's Drug Guide for Nurses, Davis's Comprehensive Handbook of Laboratory and Diagnostic Tests, Davis's Diseases and Disorders, and Handbook of Nursing Diagnosis) to a handheld device. NC also enables Medline search capability and download of journal Table of Contents alerts. For a trial period, Unbound Medicine donated NC software licenses for interested students and waived the annual individual software fee of US$159. Fourth-year students were oriented to NC in the classroom while third-year students received orientation in the clinical setting before use during a clinical rotation. While the third-year students completed their clinical rotation with a clinical instructor who also used NC, the fourth-year students used NC independently in their final preceptored placement. One hundred fifty students (third-year, 70; fourth year, 80) from a four-year baccalaureate nursing program were invited to participate in the pilot study. Students were eligible if they had an appropriate handheld device or smartphone and, for third-year students, if their clinical instructor also used NC. From this population, 80 nursing students requested an NC licence from Unbound Medicine, and 65 students downloaded software programs. Recruitment for the study began after courses were completed, course grades were received, and ethics approval was provided by the university ethics committee. The study explanation and online survey link (Askitonline.com) were emailed to participants; all study data were anonymous. The survey consisted of 25 Likert items with scores ranging from 1 (do not agree) to 5 (strongly agree), with one item rating of overall helpfulness and three textboxes designed to measure NC user-friendliness, information support, and resource quality for clinical learning. RESULTS A total of 31 students completed the online survey (third year, n = 16; fourth-year, n = 15). Their average age was 25.86 years, with ages ranging from 20 to 43 years. Quantitative Findings The rating of overall helpfulness of NC as a resource during the clinical rotation was high (M = 4. …

Despite strong evidence of negative developmental outcomes resulting from the use of physical (or corporal) punishment with children, its use by parents and other caregivers is common. Such negative outcomes include child aggression, mental health issues, and physical abuse. Health care providers have a responsibility to promote disciplinary strategies that facilitate positive parent-children relationships and keep children's self-esteem and bodies healthy and intact. The incidence, factors, and outcomes associated with parental use of physical punishment are reviewed and useful advice for parents and age-appropriate disciplinary strategies and resources are outlined for the various stages of child development from infancy to school age.

Although some pre-licensure nursing programs now require students to use handheld devices to retrieve and manage information (Farrell & Rose, 2008; Williams & Dittmer, 2009), few researchers have studied nurse educators' perspectives about the use of handheld devices and information support software in clinical teaching. The current pilot study explored the reported experiences of clinical instructors (CIs) after using Nursing CentralTM (NC), a nursing-oriented software program (www.unboundmedicine.com/products) in clinical teaching. METHOD NC contains five electronic, quick reference guides (Taber's Medical Dictionary, Davis's Drug Guide for Nurses, Davis's Comprehensive Handbook of Laboratory and Diagnostic Tests, Davis's Diseases and Disorders, and Handbook of Nursing Diagnosis). It also enables online journal searching via Medline and the download of tables of content of favorite journals. Instrument A survey developed by the research team contains 23 Likert-rated items with responses ranging from 1 (strongly agree) to 5 (strongly disagree). The items assessed experiences learning to use NC (n = 3), ease of use (n = 5), ways NC was used (n = 6), and attitudes toward NC (n = 9). Two text boxes collected qualitative perspectives and comments. Sample To join the study, CIs met the following inclusion criteria: a) taught in third-year clinical practice, b) owned a handheld device, c) emailed Unbound Medicine for a trial NC at no charge, and d) used NC during at least one seven-week clinical rotation teaching nursing students. After the trial period of use, a study explanation and voluntary online survey were emailed to participants for data collection. Ten Cls who met the criteria completed the voluntary survey. The participants ranged from 26 to 47 years of age (M = 39.8 years). The highest educational level for nine CIs was baccalaureate; one had a graduate degree, and six were enrolled in graduate studies. The CIs had one to 19 years of teaching experience (M = 5.95 years). Four reported having beginner and six reported having advanced computer skills; no participant reported expert computer skill. Nine CIs reported their first use of NC during this study; eight reported using a handheld device for six months. RESULTS Quantitative Findings Mean responses for 14 items were greater than 4.0, with the overall mean 4.26. (See Table.) Scores for items related to learning to use NC were high (M = 4.97). For example, CIs reported being "confident" and "glad they learned to use NC." Scores for perspectives on ease of use were positive (M = 4.17) but there was a range of responses. While CIs rated both use of NC (M = 4.6) and "finding information" (M = 4.5) easy, scores were lower for "ease of downloading" (M = 3.63) and taking longer than expected to learn to use the software (M = 3.86). These scores suggest that some CIs experienced challenges in setting up NC. CIs were found to use NC "to get information for clinical teaching" (M = 4.4). Although they "advised students to use the Davis Drug Guide" (M = 4.5), CIs were less likely to access NC to "answer questions of other health care professionals" (M = 3.9). CIs demonstrated relatively high agreement that they will "continue to use NC in clinical teaching" (M = 4.1) and that NC may "prevent medication errors" (M = 4.0). Means were lower for preference for NC "over traditional textbooks" (M = 3.8). Qualitative Findings The text box comments reflected benefits and pitfalls of using NC in clinical teaching. One CI noted that "students had to purchase a handheld device," but was surprised to see how many students already owned one. One CI cautioned that NC is "a great resource for quick things but does not have the depth...to have a good understanding of a diagnosis... Still need to have the textbooks." Another described Diseases and Disorders as the most ineffective resource, as it "rarely gave me the information about the keyword that I would use. …

This survey study explored use of different information sources among a convenience sample of 113 bedside pediatric nurses. The study was guided by three interrelated concepts: types of information sources, levels of evidence, and computer skill. The Nursing Information Use Survey measured use of information sources, impact of information sources on nursing care, barriers to information, and expectations that a computerized clinical desktop or patient information management system would improve patient care. Significant correlations between use of interpersonal and non-computer-based information and non-computer- and computer-based information supported the conceptual model. Use of traditional, non-computer information sources such as textbooks and print-based journals was higher among baccalaureate, compared with diploma, prepared nurses. Nurses with greater computer and online searching skill used more computer-based information. Findings suggested that strategies to improve nurses' computer and information searching skills may promote use of higher-level evidence in planning nursing care.

This longitudinal exploratory study compared maternal psychosocial, situational, and home-environment characteristics at 4 weeks and at 12-18 months postnatal for a convenience sample of 71 Métis, First Nations, and Caucasian adolescent mothers. The combined group of Métis/First Nations mothers had significantly higher infant-care emotionality scores than the Caucasian mothers at 4 weeks. The Caucasian mothers scored considerably higher on quality of the home environment; a refined multiple regression model containing infant-care emotionality, education level of the infant's maternal grandmother, ethnicity, and enacted social support explained 49% of the variance, with significant influences being infant-care emotionality and grandmother's education level.

This longitudinal study compared infant care competence, infant temperament, and parenting stress of younger (less than 17 years) and older (greater than or equal to 17 years) adolescent mothers. Relationships were examined between situational, maternal infant care competence, and infant temperament. Staged multiple regression was used to quantify the role of various situational, maternal, and infant characteristics as predictors of parenting stress. A convenience sample of 78 adolescent mothers was recruited from two major teaching hospitals in Winnipeg, Canada. No significant age group differences were found for infant care competence or parenting stress. However, younger adolescent mothers reported more difficult infant temperament, t = 2.24, p =.03. A significant Pearson correlation was found between the MomBaby subscale of the Infant Care Questionnaire (ICQ) and the Parenting Stress Index (PSI) subscale, Relationship with Spouse, r =.59, p =.01. The Emotionality subscale of the ICQ was significantly associated with both the PSI subscales of Depression, r =.52, p =.006, and Relationship with Spouse, r =.50, p =.02. A second-stage multiple regression model that included situational (social support), infant (difficult temperament), and maternal (emotionality) variables significantly explained both total parent stress domain scores, R2 =.46, p =.04, and the depression subscale, R2 =.66, p =.000. While the study findings suggest that situational, infant temperament, and infant care competence variables together predict parenting stress, confirmation of study findings with larger and more diverse samples is required. The finding that difficult temperament and enacted social support were the most salient predictors of parenting stress underscores the need for nurses to evaluate these parenting factors.

The investigators examined differences in perceived and performed infant care competence for younger (less than 17 years of age) and older (17 to 19 years of age) adolescent mothers. Associations were tested between perceived infant care competence measured at several time points and performed mothering at 12 to 18 months infant age. A convenience sample of 78 adolescent mothers was recruited from two major teaching hospitals in Winnipeg, Canada. The Infant Care Questionnaire (ICQ), a self-report measure of infant care ability, was completed during the 3rd trimester and the 1st and 4th postnatal weeks. Performed mothering was assessed with Caldwell's HOME scale administered in the adolescent mother's home when the infant was 12 to 18 months old. Significant increases in competence perceptions over time were demonstrated for both ICQ subscales, the MomBaby, F(2, 47) = 22.73, p = 0.000, and Emotionality, F(2, 47) = 43.16, p = 0.000. This increase in infant care competence mirrors the maternal role competence trajectory reported in studies with older mothers. While no significant age group differences were found for MomBaby or Emotionality, older adolescent mothers were rated significantly higher on one of the HOME subscales, Variety in Daily Stimulation, t(n = 45), = 2.12, p =.04, and a second approached significance, Responsiveness, t(n = 45) = 1.86, p =.07. Pearson correlations between the MomBaby and Emotionality and the HOME subscales, Responsiveness and Environment, ranged between -0.30 and -0.37. Future research is required to further explain the negative correlations between perceived and performed infant care competence, establish clinical validity of self-report methods with adolescent mothers, and assess the influence of social, cultural, and economic factors not considered in this study.

This article reviews the theories and instruments used in 14 studies that measured social support levels of adolescent mothers. Two general trends were revealed, a tendency for researchers to: (1) avoid stating their theoretical perspective of social support and (2) develop new social support instruments rather than take advantage of those already in existence. Strategies are offered to match the social support theories and instruments with the particular study purpose and outcome variables. Use of both an established and a new social support instrument within the same study is recommended as a method of providing concurrent validation for the new instrument and promoting comparability across studies in different situations. Assessment of confounding among variables, construct overlap between measures, and the validity of social support and outcome instruments with adolescent mothers will promote a more accurate description of the role of social support in adolescent mothering.

1. 1. Under all experimental conditions the protein concentration of the hemolymph rose during the first half of the fifth stadium. During the second half of the fifth stadium the pattern is not clear. The concentration increases during the first 4 days of the adult stage and remains high until at least the fourteenth day post-molt. 2. 2. In 1 lambda, non-pooled samples, a significant difference for mean protein concentration values was found between the following groups: (a) male and female adults, 5 days post-molt; (b) male and female adults, 10 days post-molt; and (c) the 10 per cent and 50 per cent fifth instar. 3. 3. The concentration values reported can be used in comparative studies of protein concentration in insects of known age, sex, developmental stage and nutritional state; for studies on the hemolymph from the milkweed bug under various experimental conditions; and for comparison with other animals.

1. 1. Starch gel electrophoresis of hemolymph from fifth instar nymph and adult milkweed bugs may give four anodic and eight cathodic protein fractions. The anodic band closest to the origin is the predominant fraction in hemolymph from insects of both stadia and either sex. The two cathodic bands closest to the origin stained for protein with an intensity slightly less than that of the predominant anodic band. 2. 2. All the protein fractions of hemolymph from fifth instar nymphs and adults of either sex contained antigens which reacted with antiserum to fifth instar nymph hemolymph. Protein fractions taken from corresponding portions of the starch gel block gave reactions of identity. One antigen was common to all fractions. At least four different antigens were detected. 3. 3. The presence of the major nymphal proteins in the adult hemolymph is discussed with regard to the feeding behavior and life cycle of the insect. 4. 4. Some of the hemolymph proteins bound Evans Blue, but dye bound to hemolymph protein did not have the mobility observed when it was bound to human serum albumin.

1. 1. Using immunoelectrophoresis at least eleven antigens were detected in hemolymph from fourth-instar nymphs, from male and female fifth-instar nymphs 1–8 days post-molt, from male and female adults 1–14 days post-molt, and in the egg. A minimun of five and as many as ten antigens were observed in preparation of first-, second- or third-instar nymphs. Fusion was observed between corresponding precipitin arcs containing antigens from insects of both sexes and all physiological ages studied as well as from the egg. 2. 2. Five of the precipitin arcs gave an esterase reaction which was inhibited by 10 −4 M eserine. 3. 3. Two of the precipitin arcs which stained for esterase also gave a tyrosinase reaction. 4. 4. One of the tyrosine and esterase positive arcs bound-dye specific for lipoprotein and also reacted as a glycoprotein. 5. 5. Some of the protein present bound evans blue, but it did not have the mobility characteristic of human serum albumin. 6. 6. Although the protein concentrations do change during development, the data support the idea that the proteins of the milkweed bugs in different developmental stages do not differ qualitatively in a significant manner.

• Glucocorticoids cause growth retardation in children. We have studied the effect of these hormones on serum somatomedin (Sm) levels in seven children with nephrosis. Intravenous administration of methyl-prednisolone sodium succinate, 2.2 mg/kg, causes a rapid fall in serum Sm activity. The activity remains suppressed during continuous therapy, but returns toward normal when medication is omitted during the course of alternate-day therapy. We conclude that one reason for growth retardation secondary to continuous glucocorticoid therapy is suppression of Sm generation. A direct effect of these hormones on the cartilage cell or induction of an Sm inhibitor cannot be excluded by the reported experiments. ( Am J Dis Child 129:1393-1396, 1975)

Glucocorticoid hormones inhibit the biosynthesis of glycosaminoglycans (GAGS) which are essential for normal skeletal growth. Previous studies have shown that these hormones alter both somatomedin, which stimulates GAGS biosynthesis, and the cartilage cell directly. We have further studied the effect of cortisol on GAGS biosynthesis in embryonic chick cartilage. When cortisol was administered to 9 day old embryos 24 hours prior to injecting radioactive precursors, 35SO4 uptake into GAGS was decreased 70%. 14C-proline into OH-proline 14%, 14C-serine into protein 15% and 3H-thymidine into DNA 17%, suggesting cortisol specifically inhibited GAGS biosynthesis without comparable inhibition of DNA or protein biosynthesis. Assays of the glycosyltransferases responsible for the formation of the protein-polysaccharide linkage region in cartilage from cortisol treated embryos showed xylosyltransferase activity decreased by 50% in both long and short term incubations, while the activities of other glycosyltransferases were unchanged. Addition of exogenous xylose acceptor stimulated the activity several fold. In vitro addition of cortisol to the enzyme assays was without effect. These data suggest the site of action of cortisol is to decrease the endogenous acceptor protein in growing cartilage or the activity of the enzyme, xylosyl transferase.