Pediatric Practicums Conducted in School Settings: An Integrative Review.

Background Examining nursing pedagogical strategies is important to assure that nursing students have opportunities to become knowledgeable and skilled clinicians. However, little is known about the nursing pedagogical strategy of using schools for pediatric practicum. The purpose of this review is to integrate the evidence regarding the use of schools as practicum sites for nursing students to obtain pediatric clinical experience. Method Searches were conducted in three electronic databases resulting in 70 publications; eight publications met the inclusion criteria. Results Five themes were identified using content analysis: description of practicum settings; level of education, number of students, clinical time and geographic region of the college; theoretical framework; nursing student activities and assignments; nursing student outcomes, evaluation of pediatric practicum experience, and school student health outcomes. Conclusion Findings support the use of schools for pediatric practicums.  This practicum broadens nursing students' knowledge of promoting health among well and chronically ill children.

Cloacolithiasis and intestinal lymphosarcoma in an African black-footed penguin (Spheniscus demersus).

A 13-yr-old male African black-footed penguin (Spheniscus demersus) presented thrice over 7 mo with gastrointestinal obstruction secondary to cloacolithiasis. Clinical signs consistently resolved with cloacolith removal and supportive care. However, 10 mo after initial presentation, it presented with similar signs, plus significant weight loss. No cloacolith was found, and it subsequently died. Significant gross findings included bilateral cecal masses, colonic perforation, and marked secondary coelomitis, multifocal tan to pale hepatic nodules, and pale kidneys with miliary white foci. Histopathologic diagnoses were intestinal lymphosarcoma with hepatic and renal metastases, secondary intestinal rupture, and subacute severe bacterial coelomitis. To the authors' knowledge, this is the first full report of either cloacolithiasis or lymphosarcoma in a penguin.

Glomerular filtration rate determined by measuring serum clearance of a single dose of inulin and serum symmetric dimethylarginine concentration in clinically normal cheetahs (Acinonyx jubatus).

OBJECTIVE: To establish a reference interval for glomerular filtration rate (GFR) determined by measuring serum clearance of a single IV dose of inulin in clinically normal cheetahs (Acinonyx jubatus) and compare serum symmetric dimethylarginine (SDMA) concentration in cheetahs with GFR. ANIMALS: 33 cheetahs housed at 3 institutions. PROCEDURES: A single bolus of inulin (3,000 mg/m2) was administered IV, and 5 serial blood samples were collected and analyzed for serum inulin concentration with the anthrone technique. The GFR was estimated with a modified slope-intercept method for the slow component of the serum concentration-versus-time curve. Blood urea nitrogen and serum creatinine concentrations were measured in samples obtained immediately prior to inulin administration, and serum SDMA concentration was measured in stored samples. RESULTS: Mean ± SD measured GFR was 1.58 ± 0.39 mL/min/kg, and the calculated reference interval was 0.84 to 2.37 mL/min/kg. There were significant negative correlations between GFR and serum creatinine concentration (r = -0.499), BUN concentration (r = -0.592), and age (r = -0.463). Serum SDMA concentration was not significantly correlated with GFR (r = 0.385), BUN concentration (r = -0.281), or serum creatinine concentration (r = 0.165). CONCLUSIONS AND CLINICAL RELEVANCE: A reference interval for GFR in clinically normal cheetahs was obtained. Further evaluation of animals with renal disease is needed to determine whether measuring serum clearance of a single IV dose of inulin is a reliable diagnostic test for early detection of renal disease in cheetahs.

Severe Hypoxemia in Muskoxen ( Ovibos moschatus ) Immobilized with Etorphine and Xylazine Corrected with Supplemental Nasal Oxygen.

Twenty-three muskoxen ( Ovibos moschatus ) housed in a captive facility for rewilding in Sweden were chemically immobilized for annual health evaluations and hoof trimming. The muskoxen were darted in May to September (2012-15) in their holding pen with etorphine (0.015 mg/kg) and xylazine (0.1 mg/kg) intramuscularly. Twenty-two of the 23 animals were immobilized with a single dart injection. The mean (SD) induction time was 4 (2) min. Arterial blood gases were collected from 18 animals. All animals were severely hypoxemic with varying degrees of respiratory acidosis. The hypoxemia resolved in 17 of 18 animals with intranasal oxygen supplementation at 1 L/min per 100 kg. Relative arterial oxygen saturation (SpO2) measured by pulse oximetry was significantly higher than the arterial oxygen saturation calculated from the partial pressure of arterial oxygen (SaO2) obtained by a blood gas analyzer. Based on these findings, muskox can be immobilized successfully with etorphine (0.015 mg/kg) and xylazine (0.1 mg/kg) but should receive supplemental oxygen.

Evaluating Stress Physiology and Parasite Infection Parameters in the Translocation of Critically Endangered Woylies (Bettongia penicillata).

Translocation can be stressful for wildlife. Stress may be important in fauna translocation because it has been suggested that it can exacerbate the impact of infectious disease on translocated wildlife. However, few studies explore this hypothesis by measuring stress physiology and infection indices in parallel during wildlife translocations. We analysed faecal cortisol metabolite (FCM) concentration and endoparasite parameters (nematodes, coccidians and haemoparasites) in a critically endangered marsupial, the woylie (Bettongia penicillata), 1-3 months prior to translocation, at translocation, and 6 months later. FCM for both translocated and resident woylies was significantly higher after translocation compared to before or at translocation. In addition, body condition decreased with increasing FCM after translocation. These patterns in host condition and physiology may be indicative of translocation stress or stress associated with factors independent of the translocation. Parasite factors also influenced FCM in translocated woylies. When haemoparasites were detected, there was a significant negative relationship between strongyle egg count and FCM. This may reflect the influence of glucocorticoids on the immune response to micro- and macro-parasites. Our results indicate that host physiology and infection patterns can change significantly during translocation, but further investigation is required to determine how these patterns influence translocation success.

Breastfeeding among adolescent mothers: a systematic review of interventions from high-income countries.

Despite growing evidence of the benefits of breastfeeding, rates of breastfeeding remain disproportionately low among adolescent mothers compared with older mothers in the United States. Current interventions primarily target adult women, and little evidence is available for breastfeeding promotion among young women. Accordingly, we aim to review interventions designed to improve breastfeeding rates among adolescents to make recommendations for future research and practice. We searched MEDLINE and PsycINFO for articles that evaluated interventions aiming to improve rates of breastfeeding initiation, duration, or exclusivity among adolescents. Inclusion criteria included interventions targeting pregnant or postpartum adolescents (mean/median age <22 years) that were conducted in high-income settings. Six interventions met our inclusion criteria; of these, 4 interventions aimed to increase breastfeeding initiation, 5 aimed to increase breastfeeding duration, and 4 aimed to increase breastfeeding exclusivity. Interventions included school-based programs, home visits, and telephone support that were implemented by a combination of peer counselors, nurse clinicians, doulas, and lactation consultants. Only 1 intervention, a combination of education and counseling provided by a lactation consultant-peer counselor team, significantly improved both breastfeeding initiation and duration. Other results were mixed, and studies were subject to several methodological limitations. We recommend that more interventions should be developed and evaluated. In addition, interventions should be less resource intensive, be more theoretically driven, and specifically include mothers and partners of adolescents to successfully promote breastfeeding among adolescent mothers.

Hematology, serum chemistry, and serum protein electrophoresis ranges for free-ranging roe deer (Capreolus capreolus) in Sweden.

We present the first reference ranges for hematology (n = 35 animals), serum biochemistry (n = 62), and serum protein electrophoresis (n = 32) in physically restrained free-ranging roe deer (Capreolus capreolus). Animals were captured in box traps and physically restrained for blood sampling during the winter in Sweden, 2011-13. No clinically significant sex or age differences were found.

Serological signature of tick-borne pathogens in Scandinavian brown bears over two decades.

BACKGROUND: Anthropogenic disturbances are changing the geographic distribution of ticks and tick-borne diseases. Over the last few decades, the tick Ixodes ricinus has expanded its range and abundance considerably in northern Europe. Concurrently, the incidence of tick-borne diseases, such as Lyme borreliosis and tick-borne encephalitis, has increased in the human populations of the Scandinavian countries. METHODS: Wildlife populations can serve as sentinels for changes in the distribution of tick-borne diseases. We used serum samples from a long-term study on the Scandinavian brown bear, Ursus arctos, and standard immunological methods to test whether exposure to Borrelia burgdorferi sensu lato, the causative agent of Lyme borreliosis, and tick-borne encephalitis virus (TBEV) had increased over time. Bears had been sampled over a period of 18 years (1995-2012) from a southern area, where Ixodes ricinus ticks are present, and a northern area where ticks are uncommon or absent. RESULTS: Bears had high levels of IgG antibodies against B. burgdorferi sensu lato but not TBEV. Bears at the southern area had higher values of anti-Borrelia IgG antibodies than bears at the northern area. Over the duration of the study, the value of anti-Borrelia IgG antibodies increased in the southern area but not the northern area. Anti-Borrelia IgG antibodies increased with the age of the bear but declined in the oldest age classes. CONCLUSIONS: Our study is consistent with the view that ticks and tick-borne pathogens are expanding their abundance and prevalence in Scandinavia. Long-term serological monitoring of large mammals can provide insight into how anthropogenic disturbances are changing the distribution of ticks and tick-borne diseases.

Evaluation of a ferret-specific formula for determining body surface area to improve chemotherapeutic dosing.

OBJECTIVE: To use CT-derived measurements to create a ferret-specific formula for body surface area (BSA) to improve chemotherapeutic dosing. ANIMALS: 25 adult ferrets (19 live and 6 cadavers). PROCEDURES: Live subjects were weighed, and body measurements were obtained by each of 3 observers while ferrets were awake and anesthetized. Computed tomography was performed, and a 3-D surface model was constructed with open-source imaging software, from which BSA was estimated. The CT-derived values were compared with BSA calculated on the basis of the traditional tape method for 6 cadavers. To further validate CT analysis software, 11 geometric shapes were scanned and their CT-derived values compared with those calculated directly via geometric formulas. Agreement between methods of surface area estimation was assessed with linear regression. Ferret-specific formulas for BSA were determined with nonlinear regression models. RESULTS: Repeatability among the 3 observers was good for all measurements, but some measurements differed significantly between awake and anesthetized ferrets. Excellent agreement was found between measured versus CT-derived surface area of shapes, traditional tape- versus CT-derived BSA of ferret cadavers, and CT-derived BSA of cadavers with and without monitoring equipment. All surface area formulas performed relatively similarly. CONCLUSIONS AND CLINICAL RELEVANCE: CT-derived BSA measurements of ferrets obtained via open-source imaging software were reliable. On the basis of study results, the recommended formula for BSA in ferrets would be 9.94 × (body weight)(2/3); however, this represented a relatively minor difference from the feline-derived formula currently used by most practitioners and would result in little practical change in drug doses.