Reducing the Risk: An Evidence-Based Approach to the Febrile Infant <60 Days of Age in the Emergency Department.

Fever is the most common complaint for children of all ages who present to an emergency department (ED) for evaluation and treatment. Although most children with fever have a self-limiting viral illness, the infant less than 60 days of age with fever poses a higher risk for an underlying serious bacterial illness (SBI) including urinary tract infections, bacteremia and bacterial meningitis, or an invasive bacterial infection (IBI) including bacteremia. This case is a discussion of a high-risk febrile infant that was evaluated in the emergency department and was ultimately diagnosed with Streptococcus B meningitis.

The Path to Certification for Emergency Nurse Practitioners.

Certification serves to validate the knowledge, skills, and experience required for clinical practice. Availability of a certification for emergency nurse practitioners (ENPs) has had an arduous path. This article examines the history of ENP certification in the United States, its territories and Canada, and how the certification examination has arrived at its current state.

A Feasibility Study of Thermography for Detecting Pressure Injuries Across Diverse Skin Tones.

Pressure injury (PI) detection is challenging, especially in dark skin tones, due to the unreliability of visual inspection. Thermography may serve as a viable alternative as temperature differences in the skin can indicate impending tissue damage. Although deep learning models hold considerable promise toward reliably detecting PI, existing work fails to evaluate performance on diverse skin tones and varying data collection protocols.

Thermal measurement of erythema across skin tones: Implications for clinical identification of early pressure injury.

Aim: To assess the effectiveness of thermography, colorimetry, and oximetry at detecting temperature changes after erythema induction across diverse skin tones in healthy adults.

Materials And Methods: Erythema was induced at the forearm and ulnar head (UH) using a cupping device. Temperature via thermal image, erythema value via colorimeter, and oxygen saturation via oximeter were collected immediately and 5-10 min (delayed) after cupping at both sites.

Improving Nurse Practitioner Students' Knowledge and Confidence in the Identification and Management of Human Trafficking Victims.

Human trafficking is a global public health problem affecting millions of people worldwide. In the United States, many trafficking victims seek medical care for physical, sexual, and mental health concerns. Unfortunately, many of these individuals go unrecognized by health care providers as being victims of human trafficking and return to their trafficker without interventions for their safety and protection.

The usability of two mobile health assistive technologies for wheelchair-related in-seat movement and pressure.

Introduction: This study aimed to understand the degree to which two different mobile health assistive technologies, AW-Shift© and Sensoria® Mat, addressed seven constructs for managing wheelchair-related in-seat movement and pressure.

Methods: After using each intervention system, participants answered questions regarding the general usability and usefulness of the systems.

Results: System Usability Survey scores ranged from 5 (Poor) to 97.

Discovering useful genetic variation in the seed parent gene pool for sorghum improvement.

Multi-parent populations contain valuable genetic material for dissecting complex, quantitative traits and provide a unique opportunity to capture multi-allelic variation compared to the biparental populations. A multi-parent advanced generation inter-cross (MAGIC) B-line (MBL) population composed of 708 F recombinant inbred lines (RILs), was recently developed from four diverse founders. These selected founders strategically represented the four most prevalent botanical races (kafir, guinea, durra, and caudatum) to capture a significant source of genetic variation to study the quantitative traits in grain sorghum [ (L.

Atopic Dermatitis: A Common Pediatric Diagnosis That Is Not Just Another Rash.

Emergency nurse practitioners are expected to assess and manage a variety of patients. These patients may present with urgent care-type complaints to severe life-threatening illnesses or injuries. For some, dermatological problems can sometimes be just as challenging as a critically ill patient.

The Diagnostic Challenge of an Older Adult With Epigastric Pain in the Emergency Department: High Risk and High Volume.

Epigastric pain is a common complaint in patients who present to the emergency department (ED); abdominal pain is the most common chief complaint in older adult patients who request treatment by a provider (A. B. Friedman et al.

Improving Reporting Culture Through Daily Safety Huddles.

Background And Objectives: A major obstacle to safer care is lack of error reporting, preventing the opportunity to learn from those events. On an acute care unit in a children's hospital in southeastern United States, error reporting and Survey for Patient Safety Culture (SOPS 1.0) scores fell short of agency benchmarks.

Development and characterization of a sorghum multi-parent advanced generation intercross (MAGIC) population for capturing diversity among seed parent gene pool.

Multiparent advanced eneration inter-cross (MAGIC) populations improve the precision of quantitative trait loci (QTL) mapping over biparental populations by incorporating increased diversity and opportunities to reduce linkage disequilibrium among variants. Here, we describe the development of a MAGIC B-Line (MBL) population from an inter-cross among 4 diverse founders of grain sorghum [Sorghum bicolor (L.) Moench] across different races (kafir, guinea, durra, and caudatum).

The COVid-19 pandemic through the eyes of pediatric nurses: A qualitative study.

Purpose: This study explored pediatric nurses' lived experiences during the first calendar year (2020) of the COVid-19 pandemic.

Design And Methods: An electronic survey used an exploratory-descriptive qualitative approach to gather data from 231 pediatric nurses working in a variety of settings across the United States. The survey consisted of seven open-ended questions to capture participants' experiences in the workplace.

Urticaria Multiforme: An Uncommon Hypersensitivity Rash in Children.

The differential diagnosis of rashes in children is challenging. Pediatric rashes indicate a broad spectrum of clinical conditions and include those that are benign and self-limiting to those that may indicate a serious multisystem inflammatory response. It is essential that emergency nurse practitioners have the knowledge and skill set to accurately identify the spectrum of rashes in the pediatric population to arrive at the correct diagnosis for patient management and avoid costly and unnecessary diagnostic testing.

Dissecting the Genetic Architecture of Carbon Partitioning in Sorghum Using Multiscale Phenotypes.

Carbon partitioning in plants may be viewed as a dynamic process composed of the many interactions between sources and sinks. The accumulation and distribution of fixed carbon is not dictated simply by the sink strength and number but is dependent upon the source, pathways, and interactions of the system. As such, the study of carbon partitioning through perturbations to the system or through focus on individual traits may fail to produce actionable developments or a comprehensive understanding of the mechanisms underlying this complex process.

Identification of caregiver's knowledge and perceptions of pediatric asthma management: A quality improvement initiative.

Introduction: Asthma is the most prevalent chronic disease of childhood. Caregiver knowledge is essential to optimize patient quality and safety. Asthma education is an opportunity that can lead to decreased morbidity and mortality, reduced admission rates, lower cost, and improved outcomes for a child with chronic asthma.

Implementing Safe and Effective Pediatric Procedural Sedation in the Emergency Department.

There has been a great increase in the number of diagnostic and therapeutic procedures performed in the emergency department (ED) setting over the past several decades. Most of these procedures are unscheduled, unplanned, and much more likely to be successful and result in a positive outcome when the child's pain, fear, anxiety, and movement are controlled. To promote patient quality and safety, increase the effectiveness and efficiency of care, and improve patient and caregiver satisfaction, there has been a proportionate increase in the number of pediatric procedural sedations performed in the ED.

Implementation of an Ask Me 3 ® education video to improve outcomes in post-myocardial infarction patients.

Objective: The Advanced Practice Providers (APPs) in an adult cardiology practice in a large metropolitan city, provide hospital follow-up care to post-myocardial infarction (MI) patients. The APPs identified a problem: patients retained very little of the information they receive during their hospitalization. The purpose of this pilot project was to evaluate the impact of an Ask Me 3 ® post-MI education video on patients' knowledge of self-care activities.

Comparing nurse practitioners/physician assistants and physicians in diagnosing pediatric abdominal pain for ESI level 3 patients seen in the emergency department.

Background: Accuracy of emergency department (ED) diagnosis affects care management including tests, discharges, and readmissions.

Purpose: This retrospective study compared nurse practitioners/physician assistants (NPs/PAs) with physicians (MDs/DOs) on accuracy of diagnosing Emergency Severity Index (ESI) level 3 pediatric abdominal pain (AP) in the ED. Abdominal pain unrelated to trauma is a common ED pediatric visit.

Genetic characterization of a Sorghum bicolor multiparent mapping population emphasizing carbon-partitioning dynamics.

Sorghum bicolor, a photosynthetically efficient C4 grass, represents an important source of grain, forage, fermentable sugars, and cellulosic fibers that can be utilized in myriad applications ranging from bioenergy to bioindustrial feedstocks. Sorghum's efficient fixation of carbon per unit time per unit area per unit input has led to its classification as a preferred biomass crop highlighted by its designation as an advanced biofuel by the U.S.

Identification of Novel Genomic Associations and Gene Candidates for Grain Starch Content in Sorghum.

Starch accumulated in the endosperm of cereal grains as reserve energy for germination serves as a staple in human and animal nutrition. Unraveling genetic control for starch metabolism is important for breeding grains with high starch content. In this study, we used a sorghum association panel with 389 individuals and 141,557 single nucleotide polymorphisms (SNPs) to fit linear mixed models (LMM) for identifying genomic regions and potential candidate genes associated with starch content.

A Case of Nonfatal Strangulation Associated With Intimate Partner Violence.

Intimate partner violence (IPV) is a significant public health problem that has profound effects on the physical and psychological well-being of millions of Americans. It is known that strangulation is one of the most lethal forms of IPV. Frequently, a lack of visible external trauma is present, and attempted strangulation may be accompanied by other more severe injuries to the head and face; thus, the signs and symptoms of nonfatal strangulation may be overlooked.

Species-Specific Duplication Event Associated with Elevated Levels of Nonstructural Carbohydrates in .

Simple sugars are the essential foundation to plant life, and thus, their production, utilization, and storage are highly regulated processes with many complex genetic controls. Despite their importance, many of the genetic and biochemical mechanisms remain unknown or uncharacterized. Sorghum, a highly productive, diverse C grass important for both industrial and subsistence agricultural systems, has considerable phenotypic diversity in the accumulation of nonstructural sugars in the stem.

Associations of Patient Mood, Modulators of Quality of Life, and Pharmaceuticals with Amyotrophic Lateral Sclerosis Survival Duration.

Associations of modulators of quality of life (QoL) and survival duration are assessed in the fatal motor neuron disease, Amyotrophic Lateral Sclerosis. Major categories include clinical impression of mood (CIM); physical health; patient social support; and usage of interventions, pharmaceuticals, and supplements. Associations were assessed at < 0.

An Atypical Case of Abdominal Pain in a Toddler: A Diagnostic Challenge.

Abdominal pain in the pediatric patient presents a unique diagnostic challenge for emergency department (ED) providers due to the wide range of possible etiologies and sequelae. The list of differential diagnoses is extensive and includes the spectrum of conditions that range from benign and self-limiting to those that are potentially life-threatening. This article describes a case of a young toddler with an acute appendicitis complicated by perforation and abscess formation.

Staphylococcal Scalded Skin Syndrome: A Pediatric Dermatological Emergency.

Staphylococcal scalded skin syndrome (SSSS) is a major exfoliating skin infection primarily seen in neonates and young children that can lead to serious morbidity. Although this condition is not commonly encountered, evidence indicates that the incidence and prevalence of this infection is increasing. It is essential that emergency care providers are knowledgeable regarding the differential diagnosis and clinical-decision making process for accurate and timely diagnosis and treatment.