Sickle cell crisis, or vaso-occlusive crisis (VOC), is a major cause of hospitalizations for adults and children with sickle cell disease, and is associated with increased morbidity and mortality. Despite prompt pharmacological treatment and multimodal pain management, acute pain during a VOC is often not adequately controlled in the pediatric population. We placed a continuous popliteal sciatic nerve block under ultrasound guidance in a pediatric patient for localized refractory pain during a VOC, resulting in improved pain control with preserved sensorimotor function.

This evidence-based practice paper evaluates a set of resources to help first-year engineering students choose their major among four fields. Choosing a major can be a daunting task for firstyear college students, especially if the choices span fields with which students have little experience. In order to provide first-year engineering students time to discern, a set of resources and course activities were designed to assist students in this decision-making process. The educational theory that serves as a framework for this study is social cognitive career theory, developed by Lent, Brown, and Hackett in 1994. In particular, resources, activities, and experiences in the introduction to engineering course were designed to assist students with selfefficacy beliefs and personal goals. At this University all engineering and computer science students take an introduction to engineering course that covers the engineering process, teamwork, communication skills, the different branches of engineering, ethics, and co-curricular and extracurricular opportunities. Section sizes are ~30 students, so students can build community with peers and their professor. The professor of the Introduction to Engineering course is the academic advisor for his/her set of students. Students declare or confirm their major by the end of the first semester. Resources to help students choose a major include laboratories, advisor meetings, student panels, a semesterlong team project, student chapters of professional society meetings, and on-line resources. In the fall 2012 offering of the course, we collected paper surveys from students, asking them to rate the effectiveness of a suite of resources in helping them choose their major. We asked about exposure to engineering and/or computer science prior to entering college and course materials and activities that were helpful for selecting a major. Based on the responses, we created a new set of videos and blogs featuring upper-class students who shared their journeys in how they chose their major and what they value about their major. We added new labs for the 2015 version. In fall 2015, we again asked students about the impact of all the course activities and their confidence in their major selection. The professor as advisor, laboratories and the course project have the most impact on helping students decide their major. More informational activities such as talking to other students, attending club meetings, and watching videos of other students had less impact. Based on these results, students seem to need personal, hands-on experience to determine if their self-efficacy beliefs and the values of the outcomes align with the intended major. 145 of 154 (94.2%) of students were somewhat or very confident about their major at the end of the semester. This paper describes a suite of resources and activities along with students' evaluation of those materials in terms of discernment of their major. By disseminating the information, other universities can adopt and adapt these activities to use in t...