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The purpose of this quality improvement initiative project is to implement a sepsis screening tools, treatment bundle, and educate emergency department (ED) registered nurses about sepsis and identification of patients who visit the ED with signs and symptoms of sepsis.This project used a collaborative, inter-professional approach comprising of a team of essential department heads that developed a screening tool using the most recent Survival Sepsis Campaign guidelines. Based on the findings of the team, St. Johns Sepsis Screening Tool and the Survival Sepsis Campaign bundle treatment was adopted. A data analysis was done using descriptive statistics entered in Statistical Analysis System (SAS) to determine the statistical significance of the education on the knowledge of sepsis early interventions. Data from before and after implementation of the sepsis screening tool was compared using the institution's sepsis core quality measure outcome. This project used the plan-do-study-act (PDSA) model and Lewin Change Model to determine sepsis care. This project found that education had a positive impact upon the early recognition and intervention of sepsis patients. Improvement was found in the three categories of the sepsis bundle analyzed in patients diagnosed with sepsis. This quality improvement project has addressed the need for increased sepsis screening in the emergency department. In fact, East Orange General Hospital (EOGH) has adopted the screening tool developed from this project as its official sepsis screening tool in the ED.
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The introduction will emphasize that my concern is with the transmission and reception of the text. As such, I carefully set aside all questions of the quality off various manuscripts as far as their usefulness in recreating the original, that is the problem of an edition. I also set aside the questions of content and authorship. I am not interested in who Suetonius was, how accurate was his work, or what were his sources. I am interested in anyone who has asked these questions, if they have, and why they asked them. I am also interested in how they used the text: for literary references, epigrams, moral exegesis, a study of the Roman empire. Also, how changes to text make it more useful to them. Thus, where those wishing to prepare an edition may set aside a manuscript as hopelessly conflated or filled with later accretions, this very manuscript can be very useful to me.
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The simultaneous learning of a phonological map from inputs to outputs and a lexicon of phonological underlying forms has been a focus of several research efforts (Jarosz 2006; Apoussidou 2007; Merchant 2008; Merchant & Tesar 2008; Tesar 2014). One of the numerous challenges is that of computational efficiency, which led to the investigation of learning with output-driven maps (Tesar 2014). Prior work on learning with output-driven maps has focused on systems in which the only disparities between inputs and outputs were segmental identity disparities (differences in the value of a feature). Inclusion of segmental insertion and deletion disparities exacerbates computational concerns, as it increases the number of possible correspondence relations between an input and an output, and makes the space of possible inputs for a word infinite due to the possible presence of an unbounded number of deleted segments. We propose an extension of that earlier work to handle phonologies that permit insertion and deletion, and evaluate the proposal by applying it to cases in Basic CV Syllable Theory (Jakobson 1962; Clements & Keyser 1983; Prince & Smolensky 2004). First, we propose that a learner represent information about the possible presence/absence of a segment in an underlying form via a presence feature. The presence feature can be set using the same inconsistency detection method that has previously been used to set other segmental features. This allows the learner to combine evidence from paradigmatically related words in a single compact representation. Second, we propose that the learner only consider for underlying forms segments that surface in at least one surface realization of the morpheme. This approach is justified by the structure of output-driven maps, and avoids the potential for an unbounded number of possibly deleted segments in an underlying form. A proof is given for the validity of the method for avoiding unbounded deletion. The resulting learner is able to learn some grammatical regularities about segmental insertion and deletion; this is shown via two manual step-by-step applications of the algorithm. Verificatory simulations for learning the entire typology of Basic CV Syllable Theory are left to work in the near future.
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This dissertation covers a collection of supervised learning methods targeted to data with complex dependence patterns. Part of our work orbits around the concept of variable importance, that is, the relative contribution an input variable to the prediction or the explanation of an output variable. Our interest in variable importance, and its estimation, is two-fold. On the one hand, as a tool for the characterization of data sets produced by multi-stage systems, where variables are related to each other via a network of correlations and causal dependencies. On the other hand, as a tool for the selection of minimal input-variable subsets with optimal predictive performance, in a more general framework involving data sets with an interesting structure of inter-variable dependence and redundancy. The rest of our work focuses on the problem of function approximation in the presence of uncertainty, and, specifically, on the calculation of optimal interpolating hyperplanes from data represented by convex polyhedra, rather than points. In this context, we propose algorithms to determine the spatial orientation of such polyhedra based on the multivariate relationships observed in the data, with particular focus on missing-value scenarios. For all of our methods, we present successful validation on an extensive and diverse array of real-world and simulated problems.
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Uncommon foreskin dermatopathology conditions were reviewed.
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Sensing Meaning: Aesthetics and Vulnerability in the Romantic Age examines the politics of aestheticization by investigating how Romantic era literature aestheticized precarity and vulnerable persons. Romantic aesthetics have been characterized by twentieth century philosophers as apolitcal, elitist, and even as fascist. Similarly, scholars have criticized Romantic poets like William Wordsworth and John Keats for a solipsism that favors poetry and art at the expense of the material world. Many of these criticisms share an assumption that the period was primarily––or, perhaps, exclusively––an aesthetic ideology. This project re-conceptualizes aesthetics into the process by which we scrutinize, contest, and eventually alter the value of our values. My chapters highlight the ways literature and aesthetics participate in more overtly political debates. The opening section discusses the ability to find meaning in the environment and link this cognitive capacity to the Romantic notion of poiesis, or the faculty of fictioning. This faculty is crucial to the Romanticism’s project of refiguring the human subject. In this chapter, I read Mary Wollstonecraft’s Letters Written during a Short Residence in Sweden, Norway, and Denmark as articulating an ethics predicated on this faculty to forge affective connections to the land, the poor, the non-living, and future generations, culminating in Wollstonecraft’s own prescient thoughts on our current ecological crises. The subsequent chapter, “Working,” claims that the Romantic period comes to aestheticize the ongoingness of labor and the uneven distribution of care along lines of gender and class.In “Noticing,” I use Keats’s “The Eve of St. Agnes” to discuss sexual assault and the ability to notice or perceive injustice. The chapter calls for an epistemic justice that is built on what the philosopher Debra Bergoffen has called the “Politics of the Vulnerable Body.” To quote Bergoffen, this strives to make “the ‘we’ of humanity... the ‘we’ of vulnerability.” The final chapter, “Feeling,” explores the complications of fragility, race, and the Romantic subject. Partially at stake in my project is the role literature and the arts has played––and can still play––in the reformation of our values, in how a subject connects to vulnerable others, and in underscoring the importance of the natural and social environment we find ourselves embedded within. As such, my dissertation demonstrates one way the Humanities can speak to today’s conflicts: in critiquing not only how our present can offer new answers to old questions, but also the value of some old answers to our new, pressing political questions.
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People living with HIV (PLWH) and adequate health literacy understand pertinent knowledge needed for self-management, including the importance of CD4 counts, viral loads, drug resistance, and need to adhere to a strict antiretroviral therapy (ART) regimen. The purpose of this project was to improve HIV-related knowledge and intent for self-management for PLWH and limited health literacy. Visual educational interventions have been shown to enhance self management knowledge. This project was piloted at a local HIV support group. A visual educational intervention that discussed the pertinent aspects of HIV was implemented for all participants. The visual educational intervention consisted of a brief video followed by the distribution of a pocket-sized handout and further discussion to enhance the knowledge learned from the video. The handout was given to take home to help serve as a reminder for the need to continue the use of a strict ART regimen. A pre and post design was used to measure health literacy and self-management intent before implementing the visual educational intervention and after the implementation phase was completed. After the intervention, participants with limited health literacy achieved moderate health literacy. Majority of participants scored with high self management intention prior to the intervention. No change was seen after the intervention was implemented. A negative correlation was found between age and HIV-related health literacy. The findings of this project support the use of the visual interventions to enhance self-management discussion for PLWH.
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