Validation of the Mobile Information Software Evaluation Tool (MISET) With Nursing Students.

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.].

[Emergency nephrectomies: retrospective monocentric study, about eight cases]. / Néphrectomies réalisées dans un contexte d'urgence: étude rétrospective, monocentrique à propos de huit cas.

OBJECTIVE: Emergency nephrectomies are rare because of the improvement of the management of urinary tract infections and the development of radio-embolization. Few series of patients have been reported. The objective of our study is to assess the indication, the morbi-mortality and the outcome of the emergency nephrectomy performed in our hospital. PATIENTS: Between January 2011 and November 2012, eight patients underwent an emergency nephrectomy at the University Hospital Center of Caen. The present review reports the characteristics of this emergency nephrectomy and their morbi-mortality. RESULTS: Six women and two men were analyzed retrospectively between January 2011 and November 2012. All patients except one needed intensive care for a multiple-organ failure. All these eight emergency nephrectomies concerned a native kidney with a surgical approach as a lombotomy or subcostal laparotomy. Both patients survived. One patient need a renal dialysis support. CONCLUSION: Emergency nephrectomy are rare. Uncontrolled urinary sepsis represents the main indication. Identifying the population at risk of evolution to the toxic shock is indispensable for a better and faster care and to reduce the mortality bound to the sepsis.

[A new technique for ensuring negative surgical margins during partial nephrectomy: the ex vivo ultrasound control]. / Une nouvelle technique de contrôle des marges de résection au cours de la néphrectomie partielle : l'échographie ex vivo.

OBJECTIVE: To evaluate the feasibility and the efficiency of intraoperative ex vivo ultrasound of resection margins in patients undergoing partial nephrectomy by urologist. PATIENTS AND METHODS: Patients undergoing partial nephrectomy from July 2010 to November 2012 for T1-T2 renal tumors were included in analysis. Tumor margin status was immediately determined by ex vivo ultrasound done by the surgeon himself. Results were compared with margin status on definitive pathological evaluation. RESULTS: A total of 26 men and 15 women with a median age of 61 (30-82) years old were included in analysis. Intraoperative ex vivo ultrasound revealed negative surgical margins in 38 cases and positive margins in two. Final pathological results revealed negative margins in all except one case. Ultrasound sensitivity and specificity were 100% and 97%, respectively. Mean ultrasound duration was 1minute±1. Mean tumor and margin sizes were 3.4±1.8cm and 2.38±1.76mm, respectively. CONCLUSION: Intraoperative ex vivo ultrasound of resection margins in patients undergoing partial nephrectomy by a urologist seemed to be feasible, efficient and easy.

Human adipose-derived mesenchymal stromal cells injected systemically into GRMD dogs without immunosuppression are able to reach the host muscle and express human dystrophin.

Duchenne muscular dystrophy (DMD), a lethal X-linked disorder, is the most common and severe form of muscular dystrophies, affecting 1 in 3,500 male births. Mutations in the DMD gene lead to the absence of muscle dystrophin and a progressive degeneration of skeletal muscle. The possibility to treat DMD through cell therapy has been widely investigated. We have previously shown that human adipose-derived stromal cells (hASCs) injected systemically in SJL mice are able to reach and engraft in the host muscle, express human muscle proteins, and ameliorate the functional performance of injected animals without any immunosuppression. However, before starting clinical trials in humans many questions still need to be addressed in preclinical studies, in particular in larger animal models, when available. The best animal model to address these questions is the golden retriever muscular dystrophy (GRMD) dog that reproduces the full spectrum of human DMD. Affected animals carry a mutation that predicts a premature termination codon in exon 8 and a peptide that is 5% the size of normal dystrophin. These dogs present clinical signs within the first weeks and most of them do not survive beyond age two. Here we show the results of local and intravenous injections of hASCs into GRMD dogs, without immunosuppression. We observed that hASCs injected systemically into the dog cephalic vein are able to reach, engraft, and express human dystrophin in the host GRMD dystrophic muscle up to 6 months after transplantation. Most importantly, we demonstrated that injecting a huge quantity of human mesenchymal cells in a large-animal model, without immunosuppression, is a safe procedure, which may have important applications for future therapy in patients with different forms of muscular dystrophies.

Human multipotent mesenchymal stromal cells from distinct sources show different in vivo potential to differentiate into muscle cells when injected in dystrophic mice.

Limb-girdle muscular dystrophies are a heterogeneous group of disorders characterized by progressive degeneration of skeletal muscle caused by the absence or deficiency of muscle proteins. The murine model of Limb-Girdle Muscular Dystrophy 2B, the SJL mice, carries a deletion in the dysferlin gene. Functionally, this mouse model shows discrete muscle weakness, starting at the age of 4-6 weeks. The possibility to restore the expression of the defective protein and improve muscular performance by cell therapy is a promising approach for the future treatment of progressive muscular dystrophies (PMD). We and others have recently shown that human adipose multipotent mesenchymal stromal cells (hASCs) can differentiate into skeletal muscle when in contact with dystrophic muscle cells in vitro and in vivo. Umbilical cord tissue and adipose tissue are known rich sources of multipotent mesenchymal stromal cells (MSCs), widely used for cell-based therapy studies. The main objective of the present study is to evaluate if MSCs from these two different sources have the same potential to reach and differentiate in muscle cells in vivo or if this capability is influenced by the niche from where they were obtained. In order to address this question we injected human derived umbilical cord tissue MSCs (hUCT MSCs) into the caudal vein of SJL mice with the same protocol previously used for hASCs; we evaluated the ability of these cells to engraft into recipient dystrophic muscle after systemic delivery, to express human muscle proteins in the dystrophic host and their effect in functional performance. These results are of great interest for future therapeutic application.

[Renal angiomyolipoma with inferior vena cava extension]. / Angiomyolipome renal à extension veineuse cave inférieure.

Angiomyolipoma is generally a benign and noninvasive tumor. We report a case of angiomyolipoma with tumor thrombus from the renal vein into the inferior vena cava suggesting a malignant disease.

Isolation, characterization, and differentiation potential of canine adipose-derived stem cells.

Adipose tissue may represent a potential source of adult stem cells for tissue engineering applications in veterinary medicine. It can be obtained in large quantities, under local anesthesia, and with minimal discomfort. In this study, canine adipose tissue was obtained by biopsy from subcutaneous adipose tissue or by suction-assisted lipectomy (i.e., liposuction). Adipose tissue was processed to obtain a fibroblast-like population of cells similar to human adipose-derived stem cells (hASCs). These canine adipose-derived stem cells (cASCs) can be maintained in vitro for extended periods with stable population doubling and low levels of senescence. Immunofluorescence and flow cytometry show that the majority of cASCs are of mesodermal or mesenchymal origin. cASCs are able to differentiate in vitro into adipogenic, chondrogenic, myogenic, and osteogenic cells in the presence of lineage-specific induction factors. In conclusion, like human lipoaspirate, canine adipose tissue may also contain multipotent cells and represent an important stem cell source both for veterinary cell therapy as well as preclinical studies.

[Periurethral pseudocysts following urethral injections of Zuidex: review of the literature]. / Pseudokystes periurétraux en complication des injections urétrales de Zuidex: revue de la littérature.

Periurethral dextranomer/hyaluronic acid (Zuidex) is a mini-invasive technique for female stress-urinary incontinence and minimal adverse effects were described. Pseudocysts were recently described. Twenty-nine cases only are reported in the literature and the authors illustrate the review with an additional case. Asymptomatic cases, pain and low stream were observed. On clinical examination, a tenderness or visible periurethral deformation need to precise the characteristics with ultrasonography and MRI. Symptomatic cases may benefit from puncture, although the patients must be informed of a potential recurrence of the incontinence.

Predictors of depressive symptoms in primary caregivers of young children with or at risk for developmental delay.

BACKGROUND: Despite extensive research with families raising children with or at risk for developmental delay (DD), it is not clear whether primary caregivers of these children are at increased risk for depressive symptoms. Discrepant findings in the literature may be owing to heterogeneity of child problems. More research is needed on child, parent and family variables that may increase risk for, or resilience to, caregiver depressive symptoms. Some studies have found that parental resources (e.g. social support and coping strategies) may buffer the effects of parental distress, while other studies have highlighted the role of parental self-efficacy. METHODS: We examined Beck Depression Inventory (BDI) scores in 178 primary caregivers (mainly biological mothers) who had 2-year-old children with or at risk for DD owing to: (a) low birthweight, prematurity or multiple birth (n = 58), (b) other known reasons (e.g. Down syndrome, spina bifida) (n = 67), or (c) unknown reasons (n = 69). RESULTS: We found that 20% (n = 35) of the caregivers scored above the BDI clinical cut-off for depression. Analysis of variance revealed that caregivers with elevated BDI scores had higher child behaviour problem and escape-avoidance coping scores, and lower social support and parent self-efficacy, compared with caregivers without depressive symptoms. Caregivers with children who had DD for unknown reasons had higher BDI scores than caregivers of the other two groups of children. Regression analyses showed that child behaviour problems, escape-avoidance coping strategies and social support predicted caregiver BDI scores, but caregiver self-efficacy only did so when entered independently of social support. Only social support mediated and (marginally) moderated the relationship between child behaviour problems and caregiver depressive symptoms. CONCLUSIONS: These findings suggest that early intervention programmes should carefully consider the interaction of child characteristics (e.g. Diagnosis and behaviour problems), caregiver resources (e.g. coping strategies and social support), and parental mental health and mood when planning and tailoring services for families of children with or at risk for DD.

Evaluation of an epilepsy education program for Grade 5 students: a cluster randomized trial.

OBJECTIVE: Epilepsy is a common and often highly stigmatized disorder. Several international organizations indicate a need to assess the stigma that exists and to develop and evaluate interventions to dispel myths about epilepsy. METHODS: A stratified cluster randomized controlled trial evaluated whether an epilepsy education program (intervention) increases knowledge of and positive attitudes about epilepsy in Grade 5 students (ages 9-11). The study also investigated characteristics of the individuals (gender, language spoken at home, familiarity with epilepsy) and schools (Catholic vs public, size of school, and school level socioeconomic status) that affect epilepsy knowledge and attitudes. We assessed epilepsy knowledge and attitudes at baseline and 1 month following the program using a 33-item questionnaire. RESULTS: In total, 24 schools (783 individuals) were cluster randomized. Those in the intervention group had an average 11.8-point increase (95% confidence interval (CI)=11.4-12.5) in knowledge 1 month following the program, compared with the control group increase of 2.2 points (95% CI=1.8-2.6) out of a total of 57 points. For attitudes, the intervention group had a mean increase of 8.15 points (95% CI=4.70-11.60), compared with the control group increase of 1.64 points (95% CI=-0.84-4.42) out of a total of 50 points. The intervention was responsible for 63% of the variation in postprogram epilepsy knowledge and 28% of the variation in postprogram attitudes about epilepsy. CONCLUSIONS: The epilepsy education program was associated with a significant increase in epilepsy knowledge and positive attitudes in the intervention group 1 month later compared with the control group.

Factors affecting postpartum depressive symptoms of adolescent mothers.

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 (R2=.19) and socioeconomic status (R2=.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.

Factors affecting parenting stress among biologically vulnerable toddlers.

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.

A survey study of pediatric nurses' use of information sources.

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.

The home environment of Métis, First Nations, and Caucasian adolescent mothers: an examination of quality and influences.

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.

Situational, maternal, and infant influences on parenting stress among adolescent mothers.

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 Mom&Baby 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 risks and alternatives to physical punishment use with children.

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.

Perceived and performed infant care competence of younger and older adolescent mothers.

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 Mom&Baby, 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 Mom&Baby 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 Mom&Baby 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.