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Letter From The Editor, Damara Goff Paris

JADARA

Overview of the status of the JADARA issue and introduction of the Associate Editor.

The Effects Of Childhood Maltreatment In A Sample Of Deaf Adults, Teresa Crowe Ph.D

JADARA

This research studied the impacts of child maltreatment on 87 deaf adults' use of substances, anxiety and depression, involvement in victimization and perpetration of intimate partner violence, age, gender identity, and parental language use. After IRB approval, participants completed an online survey about experiences of childhood maltreatment and its effects on their lives. Results showed that the sample: a) had low to moderate incidence of childhood physical abuse, sexual abuse, physical neglect, and emotional neglect, b) reported mild levels of anxiety and depression, c) included 32.5% who met the threshold for IPV victimization and/or perpetration, d) relatively low levels of …

Authentication Of Shallots From Brebes Using Gas Chromatography Fingerprinting Technique Combined With Chemometrics, Yana Setyani Pradina, Adelia Puteri, Gina Fauzia Rachma, Nazwa Balqis, Gerli Puspita Anggraini, Hendri Wasito

Makara Journal of Science

Shallots from Brebes, also called Bima Brebes, have a more pungent aroma compared to other varieties. Its high demand results in increased prices in the market, leading to frequent cases of fraud wherein Bima Brebes shallots are replaced with other types of shallots. This study aimed to develop an analytical method using gas chromatography–flame ionization detector (GC-FID) fingerprinting combined with chemometrics to authenticate Bima Brebes shallots. Essential oils were extracted through ultrasonic hydrodistillation, followed by organoleptic, refractive index, GC-FID fingerprinting and chemometric analysis. The yield value of the five studied shallot varieties ranged from 0.02% to 0.08% w/w. Meanwhile, the …

Phenotypic Correlation, Path Analysis, And Quantitative Trait-Based Selection Of Elite Wheat Genotypes Under Heat Stress Conditions In The Terai Region Of Nepal, Radhakrishna Bhandari, Binod Panthi, Shivalal Nyaupane, Sandesh Shrestha, Prabin Sharma, Rajesh Kumar Gupta, Sansar Sahani, Mukti Ram Poudel

Makara Journal of Science

Wheat is one of the most important cereal crops worldwide, but the production and productivity of wheat is affected by heat stress. A field experiment using an alpha lattice design with seven blocks was conducted on 35 elite wheat genotypes in the Terai region of Nepal to identify the most appropriate trait resulting in a high-yielding wheat genotype with high tolerance to heat stress. Correlation analysis revealed that booting-to-heading duration (BtoH), booting-to-anthesis duration (BtoA), plant height (Ph), spike length (SL), spike weight (SW), thousand grain weight (TGW), straw yield (SY), and total biomass yield (TY) had a significant positive correlation …

First-Principles Calculations Of Thermoelectric Properties Of Fe-Based Full- Heusler Fe2cusi, Ai Nurlaela, Dwi Nanto, Anugrah Azhar, Elvan Yuniarti, Tony Kristiantoro, Dedi Dedi

Makara Journal of Science

A first-principle study using density functional theory (DFT) and Boltzmann transport was conducted to evaluate the thermoelectric (TE) properties of an Fe-based full-Heusler alloy. The compound studied is Fe₂CuSi with a Cu₂MnAl-type structure. The electronic properties of Fe₂CuSi were obtained using DFT calculations by running the Quantum ESPRESSO (QE) package. By contrast, TE properties, including electron thermal conductivity, electric conductivity, and Seebeck coefficient, were computed using a semi-empirical Boltzmann transport model solved through the BoltzTraP software at 50–1,500 K temperature range. The spin-orbit coupling effect on these properties was also evaluated, demonstrating notable effects …

Study Uncovers The Role Of Polygenic Risk Scores In Hypertension Management, Staff

Browse All News

No abstract provided.

Alumni Entrepreneurs And Innovators Celebrated At Homecoming, Julia Perez

News and Events (Discontinued Series)

No abstract provided.

Utility Of Individualised Homoeopathic Medicines In Improving Social Interaction In Childhood Autism: A Prospective, Open-Label, Single Arm Study, Sreeja Kudukayil Radhakrishnan Nair, Deepthi Gilla, Mohan Narvelil Devasia

Indian Journal of Research in Homoeopathy

Background: Childhood autism is a pervasive developmental disorder. There has been an upsurge in its prevalence in past few decades. The social deficit is the most disabling symptom of autism. There is an immediate need to explore new interventions to effectively address childhood autism. Objective: The objective of the study was to assess the usefulness of individualised homoeopathic medicine in improving social interaction in childhood autism. Materials and Methods: This one-year duration study was conducted in the outpatient department of the National Homoeopathy Research Institute in Mental Health, Kottayam, Kerala. Thirty-five children fulfilling the diagnostic criteria of childhood autism (as …

Optimal Radar Ranging Pulse To Resolve Two Reflectors, Andrew N. Jordan, John C. Howell, Achim Kempf, Shunxing Zhang, Derek White

Mathematics, Physics, and Computer Science Faculty Articles and Research

Previous work established fundamental bounds on subwavelength resolution for the radar range resolution problem, called superradar [Phys. Rev. Appl. 20, 064046 (2023)]. In this work, we identify the optimal waveforms for distinguishing the range resolution between two reflectors of identical strength, leveraging results in quantum metrology. We discuss both the unnormalized optimal waveform as well as the best square-integrable pulse and their variants. Using orthogonal function theory, we give an explicit algorithm to optimize the wave pulse in finite time to have the best performance. We also explore range resolution estimation with unnormalized waveforms with multiparameter methods to …

Volume Cxliv, Number 1, September 27, 2024, Lawrence University

The Lawrentian

No abstract provided.

Inexcusable Error: Finding A Balance Betweensound Will And The Stability Oftransactions, Moustafa Abou Mandour Moussa Aissa

Sultan Qaboos University Legal Studies Journal

Every contractor has a responsibility to be vigilant when finalizing a contract. This responsibility is founded on the belief that each contractor is best placed to evaluate their own goals and interests, and is therefore best equipped to protect and advocate for them. The contract is a receptacle of conflicting interests and differing objectives for its parties, so each party should hold themselves accountable before blaming the other. In legal practice and doctrine, it has been established that a contracting party's error will not render the contract invalid or terminated if it is an inexcusable error resulting from negligence or …

Leaving No Patient Behind! Expert Recommendation In The Use Of Innovative Technologies For Diagnosing Rare Diseases., Clara D M Van Karnebeek, Anne O'Donnell-Luria, Gareth Baynam, Anaïs Baudot, Tudor Groza, Judith J M Jans, Timo Lassmann, Mary Catherine V Letinturier, Stephen B Montgomery, Peter N Robinson, Stefaan Sansen, Ruty Mehrian-Shai, Charles Steward, Kenjiro Kosaki, Patricia Durao, Bekim Sadikovic

Faculty Research 2024

Genetic diagnosis plays a crucial role in rare diseases, particularly with the increasing availability of emerging and accessible treatments. The International Rare Diseases Research Consortium (IRDiRC) has set its primary goal as: "Ensuring that all patients who present with a suspected rare disease receive a diagnosis within one year if their disorder is documented in the medical literature". Despite significant advances in genomic sequencing technologies, more than half of the patients with suspected Mendelian disorders remain undiagnosed. In response, IRDiRC proposes the establishment of "a globally coordinated diagnostic and research pipeline". To help facilitate this, IRDiRC formed the Task Force …

A New Invasive Lepidosaphes Armored Scale (Hemiptera: Coccomorpha: Diaspididae) For Florida: First Records, Natural Enemies, And An Identification Key, Erin C. Powell, Mark Zenoble, Douglass R. Miller, Benjamin B. Normark, Gregory A. Evans

Insecta Mundi

The invasive armored scale, Lepidosaphes laterochitinosa Green 1925 (Hemiptera: Coccomorpha: Diaspididae), was found in the Florida landscape for the first time in November 2022 and is now known from two south Florida counties: Broward and Miami-Dade. In Florida thus far, this polyphagous species has been found on Epipremnum pinnatum (L.) Engl. (Araceae), Dracaena Vand. ex. L. (Asparagaceae), and Breynia disticha J. R. Forst. and G. Forst. (Phyllanthaceae), all common landscape ornamentals. New parasitoid host records are provided for Encarsia lounsburyi (Berlese and Paoli), Encarsia citrina (Craw), and Aphytis lingnanensis Compere (Hymenoptera: Aphelinidae) that emerged from L. laterochitinosa in Broward …

Little Lungs, Big Care: Prevent Unplanned Extubation, Leslie Huntington, Emily Jordan Ressman, Carmen Yearego

2024

QUALITY

Background: The pediatric critical care unit in a large medical center benchmarks a variety of quality metrics to ensure we are providing our patients with the best care. At the end of 2023, the unit rate of 0.58 was higher than the national benchmark rate of 0.33 for unplanned extubation (UE). Additionally, the unit was lower for failed extubation rate than the national benchmark which led to questioning if the unit was too conservative with when patients are deemed ready to extubate.

Objectives: The primary goal is to lower the rate of UE while maintaining a failed extubation rate …

Exploring Parent/Child Peri-Anesthesia Anxiety And Anesthesia Effects On Children, Ann Johnson, Alejandra Lozano, Pauline Chen

2024

RESEARCH

Approximately four million children undergo procedures with anesthesia yearly. For children and parents, this can be anxiety-provoking. In extant literature, level and timing of pre-anesthesia anxiety in children are not adequately studied; associated factors are largely unknown in humans. Preparing for anesthesia and its effects may cause parental worry, and little is known about these effects on school-age children in the weeks following a procedure. The purpose of this study was to explore longitudinal peri-anesthesia factors of anxiety and behavior in children ages 7 through 12. Spanish and English-speaking dyads consented to four data collection points beginning at the …

Nurse Manager Hiring Practices And The Experience Of New Graduate Nurses, Tiffany Montgomery, Zara Sajwani-Merchant

2024

RESEARCH

Purpose
/="/">Hiring decisions have implications for the hiring unit and the healthcare organization, including nursing retention, orientation costs, and organizational culture. Despite available literature, hiring practices, and diversity, equity, and inclusion practices are unknown within nurse residency programs. This study explores the experiences of nursing hiring managers and newly hired nurse candidates with the interview and hiring process into residency programs within the DFW metroplex.
/="/">Methods
/="/">A qualitative phenomenological study was conducted to describe the nursing manager experiences and thoughts through the hiring process and how they compare to nurse candidate’s perspective hired into an established …

Reducing The Burden Of Tracking Age Of Majority (Aom) Research Participant Consents, Beena Pappen, Lindsay Therrian, Bobby Lawrence

2024

QUALITY

Background
/="/">Reconsenting research participants when they reach Age of Majority (AOM) – age 18 in the state of Texas – is a vital responsibility of the pediatric research world. It requires tracking and planning for an activity that may not happen until months, years, or over a decade later. Not obtaining AOM consent may violate the rights of the research participant, as well as impede the ongoing collection and usage of their research data. At the Center for Cancer and Blood Disorders (CCBD) Clinical Research Office (CRO), a very manual process was being used to identify and notify …

Preventing Patient Deterioration By Creating A Reassessment And Escalation Process For The Ed Waiting Room, Virginia Elizondo, Amanda Caipo, Cory Carlos

2024

EBP

Practice Problem:

Long wait times in the emergency department (ED) waiting room significantly impact patient outcomes. Waiting times increase the risk of deterioration, the number of patients leaving without being seen (LWBS), and lead to dissatisfaction with care. 1,2,3 The urgency and significance of early recognition of abnormal vital signs and the appropriate responses cannot be overstated.3 Current ED practices lack a structured process for regular reassessment and escalation in the waiting room.

Literature/Evidence:

A comprehensive literature search was conducted, utilizing EBSCOhost, PubMed, and Ovid. The literature supports continuous reassessment to enhance safety and satisfaction in the waiting room. …

A Transformative Leadership Approach To Reducing Nursing Turnover In A Pediatric Cardiac Intensive Care Unit, Deniro Brown, Lindsey Daigle, Brandi Brown, Julia Gerstmann, Emily Hernandez, Delaney O’Brien, Casey Conrad, Christina Whittington, Lindsey Wren, Gustavo Barbero

2024

INNOVATION

Introduction/Objective:
Retention of nurses in the pediatric cardiac intensive care unit (CICU) is essential for optimal patient outcomes, as nurse experience significantly impacts patient mortality and hospital-acquired conditions. In April 2022, our CICU faced high voluntary turnover among direct bedside nurses. Our immediate goal was to reduce this turnover, with a longer-term objective of improving overall nurse retention.

Methods:|
We established global and SMART aims by comparing organizational benchmarks for nurse turnover with unit-specific data from human resources. Co-managers and eight nurse team leaders conducted stay interviews with direct bedside nurses during the first half of 2022. These …

Improving Sepsis Response, Awareness, And Engagement In The Emergency Department, Virginia Elizondo, Nicole Bizzack, Amber Dayton, Angie Rodick, Ashley Collins, Georgina Hernandez, Amber Albiar

2024

QUALITY

Sepsis background:
Sepsis is the leading cause of death in children² and a global health problem³. The primary source of infection is often not apparent¹, making early patient identification, initiation of sepsis protocols, and continued awareness crucial to improve outcomes and prevent mortality in patients at risk for sepsis.

Purpose:
An emergency department (ED) Sepsis Response Team (SRT) and other initiatives were designed to enhance workflow efficiency, improve time to antibiotic administration (TTA) tominutes, improve sepsis recognition, and uphold standards by maintaining staff engagement.

Implementations:
Once a patient screens positive for sepsis risk, an …

Bridging The Gap: Leveraging Cnap To Enhance Professional Development, Align With Organization Goals And Create A Culture Of Safety, Marissa Crosley, Brooke Harris, Gwenetta Hicks, Cornelius Metili

2024

INNOVATION

Abstract: As our organization strives for its fifth Magnet designation, enhancing nurse professional development has become a clear priority. Currently, only half of our nursing staff participate in the Clinical Nurse Achievement Program (CNAP), highlighting a need for increased engagement. Additionally, feedback from the latest Experience, Inclusion, and Engagement (EIE) Survey identified an opportunity to improve nurse recognition within our department. These insights prompted an exploration of how the Team Lead role, uniquely positioned between frontline nurses and leadership, could be more effectively utilized.

A key challenge identified is the time-consuming process of documenting CNAP achievements. Nurses often defer …

Closing The Gap For Psychiatric Resource Nurse Orientation, Kelly Bonilla, Madison Mcqueen, Cornelius Metili, Annietra Udoh

2024

EBP

A nursing orientation program can positively impact new nurses that are joining the organization (Nobles, 2022). The implementation of a new psychiatric nurse role within the hospital system developed the necessity for an orientation program that would provide quality, safe, and positive outcomes. Psychiatric Resource Nurse roles were created within the organization to provide support and education to staff regarding patients with behavioral or mental health needs. An orientation program was created to support the specific role of the Psychiatric Resource Nurse role to fulfill the need for patient centered care.

A need for an orientation program for Psychiatric …

Fall Prevention Strategies In A Pediatric Epilepsy Monitoring Unit, Bailey Cochrum

2024

EBP

Practice Problem: In 2023, our Epilepsy Monitoring Unit (EMU) had 8 falls, 5 with injuries, up from zero falls with injury in 2022. Enhancing patient and family education on fall risks and prevention is crucial for improving safety and reducing falls.

Literature: Falls in an EMU are common adverse events. Patients with epilepsy are at increased risk of falls due to seizures. In the EMU, seizures are provoked by changing medications, sleep patterns, and stimulation, increasing fall risk and possible injury.

Practice Change(s): For planned EMU admissions, we developed additional seizure-specific education for patients and families, sent prior …

Improving The Lactation Journey: Empowering Moms’ Utilization Of Breast Milk From Admission To Discharge In A Level Iv Neonatal Intensive Care Unit, Rebecca Palmer, Jerithea Tidwell, Traci Hankins, Sharetha Hollier, Nicole Jenkins, Dawn Schindler, Jeanne Gaines

2024

INNOVATION

Background
The benefits of MBM is well-known in literature, especially for infants admitted to the NICU. There is difficulty in engaging and empowering NICU mothers due to multiple barriers including holding limitations, inability to feed orally, and separation of mother and infant for extended periods. Opportunities for improving MBM utilization throughout admission include oral immune therapy (OIT) and/or oral care with MBM, skin to skin (STS), and non-nutritive attempts at breast. Access to lactation education, support, and resources throughout admission is imperative.

Methodology
Utilization of the plan-do-study-act (PDSA) cycle of quality improvement (QI) has improved our overall lactation processes …

Emergent Medication Labels In The Pediatric Intensive Care Unit, Christine Hajovsky

2024

EBP

PICOT: In emergent situations in a pediatric ICU requiring nurses to draw up emergent doses of medication, is it safer to use color coded, pre-printed fill-in-the-dose medication labels vs. our current practice of white handwritten labels? In our pediatric ICUs, nurses use handwritten labels for emergent drug administration, which can lead to illegibility and increased risks of adverse events. This project assessed whether pre-printed, color-coded, fill-in-the-blank labels enhance nurse confidence and nurses’ perceptions of patient safety during emergent drug procedures.

Literature/Evidence: Search strategy in the CINAHL (EBSCOhost) database used MeSH headings and keywords, including English articles published within the …

Ironing Out The Details: Early Detection And Treatment Of Iron Deficiency In A Level 4 Nicu, Rachel Mills

2024

EBP

Practice Problem: In a level 4 neonatal intensive care unit (NICU), no standardized method existed for identifying and treating iron deficiency (ID) in preterm or low birth weight (LBW) infants. Common practice was to adjust iron supplementation based on hematocrit levels, though this was not based on any formal protocol or guideline. ID of the brain in neonates may be associated with neurologic and developmental deficits. Thus, it is prudent to identify and treat early. In a recent survey, providers reported a lack of familiarity with biomarkers for early identification of ID.

Literature/Evidence: A comprehensive review of the literature …

Ready, Set, Code! Investigating The Use Of Two Standardized Resuscitation Algorithms To Improve Outcomes In Patients In A Level 4 Nicu, Lauren Ayala, Grace Farina, Shelby Hudson, Anna Nguyen, Mireya Ortiz, Luke Wuesthoff

2024

EBP

Background:
Resuscitation efforts can be challenging in a Level IV NICU. Most Heath Care Providers in pediatric hospitals are Pediatric Advanced Life Support (PALS) certified. Some NICU providers are certified in both Neonatal Resuscitation Program (NRP) & PALS. There is concern regarding use of NRP vs PALS for Level IV NICU patients who are up to one year of age. Strategies need to be identified to assist nurses in determining which resuscitation algorithm (PALS or NRP) to utilize during a code/peri-arrest event involving patients in a Level IV NICU.

PICO:
Will designing a resuscitation tool improve outcomes and effectiveness …

Partnering Up To Prevent Pediatric Peripheral Intravenous Infiltration, Melissa Ruffini, Ashlyn Coenraad, Rachael Burris-Alcala, Victoria Washington, Emily Jordan Ressman, Alexandra Birely

2024

QUALITY

Background: Peripheral Intravenous Infiltrations and Extravasations (PIVIE) occur in up to 78% of peripheral IVs (PIVs) in some pediatric studies. Proper site assessment is essential in preventing patient harm from PIVIEs, with hourly nursing assessments considered best practice for patients receiving continuous infusions. Many nurses work 12-hour shifts, and evidence suggests that inattentional blindness and cognitive bias can contribute to failure to notice physiologic differences in patient assessments over time. To address this challenge and ensure early identification of symptoms, the local project team proposed an innovative ‘buddy check’ approach to minimize patient harm.

Methods: This quality improvement project …

Standardization Of Adult Transition Across Ambulatory, Virginia Vecchio, Monica Fuller

2024

QUALITY

Background:

Historically, at Children’s Health initiatives involving patient transition to adult care have been focused on the clinics which are ranked in U.S. News & World Report’s Best Children’s Hospitals. Other clinics had no process for transition and were unaware of available resources.

Purpose:

A subgroup from the Ambulatory Clinical Practice Council identified the need for a standardized framework and EPIC documentation that every clinic could utilize.

Methodology:

The Office of Patient Transition (OPT) was onboard with revamping the current program and allowing nurses to drive the changes. A knowledge assessment was performed with nurses in 2022. The results …

Collaboration Is Key: Engaging A Multidisciplinary And Multi-Departmental Team To Create Clinical Practice Guidelines (Cpg) Within A Level Iv Nicu, Rebecca Palmer, Sushmita Yallapragada, Jeanne Gaines, Jerithea Tidwell, Kymeyone Lanehart, Charmaine Shaw

2024

INNOVATION

Background
Within a Level IV collaboration between different disciplines and departments is needed to provide care delivery that is effective and efficient. Emergent situations arise that require care to be provided quickly, including patients with necrotizing enterocolitis (NEC) and/or require bedside surgery. Upon review, multiple inconsistencies and inefficiencies were identified in these processes.

Implementation
Utilizing Lean and Quality Improvement methodology, CPGs were created for both necrotizing enterocolitis and bedside surgery. The steps taken in creation of these CPG include:
 • Identification of key stakeholders of all departments, including neonatology, surgery, and anesthesia
 • Evaluation of the Sepsis CPG to …