179 research outputs found

    Entrevia v. Hood: Back to Loescher v. Parr

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    Perceptions Of Nurse Practitioners In Primary Care Toward Rationing Of Health Care

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    The United States has the highest cost of health care in the world. In an effort to control this continually escalating expense, the concept of rationing of health care has been offered as a solution. Health care providers, such as nurse practitioners, will be confronted with making decisions related to the allocation of health care. Thus, the purpose of this descriptive study was to explore the perceptions that nurse practitioners have regarding rationing of health care. Henderson\u27s Model of Nursing served as the theoretical framework. The research question that guided this study was what are the perceptions of nurse practitioners toward rationing of health care? A sample of 7 9 nurse practitioners who practiced in primary care in the state of Mississippi were surveyed. Perceptions were measured using the Baucum Rationing Questionnaire, which contained four vignettes that primary care providers might encounter. Respondents were asked to agree or disagree with situations concerning rationing of health care. Results indicated that of the 315 responses, 224 (79%) did not choose rationing, while 91 (21%) did choose rationing. Seven common themes were identified in the comment section: patient responsibility, prevention, ethics/morality, quality of life, equal access, patlent/family choices, and alternate delivery systems. Based on these findings, the researcher concluded that nurse practitioners\u27 perceptions toward rationing of health care was such that rationing would not be an acceptable means to decrease the expense of health care. Implications for nursing were focused on the need for nurse practitioners to support political activists who lobby for a realignment of health care financing. Additionally, preventive care by nurse practitioners must be accepted as a viable alternative to sick care. Recommendations included implementation of a similar study to substantiate these findings and development of nursing curricula which address health care financing and case management

    Examination of Pre-emergence Control of Johnsongrass in Sugarcane Seedlings

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    Sugarcane is susceptible to many diseases and insect pests; therefore, to maintain high sugar yield new varieties must be developed. Producing new varieties contributes to the overall crop success through enhanced yield, insect and/or disease resistance, cold tolerance, and ratooning ability. However, unlike conventional sugarcane, which is vegetatively propagated, new sugarcane varieties are produced from true seed. These seedlings are more susceptible to herbicidal injury and weed competition than conventional sugarcane. For sugarcane seedlings to succeed, weeds must be controlled therefore, the most effective herbicide program with regards to seedling safety must be implemented. The objectives of this research were to determine the safety of several preemergence (PRE) herbicides on sugarcane seedling crosses and to evaluate their efficacy in controlling seedling johnsongrass. Field studies were conducted at the LSU AgCenter’s Sugar Research Station in 2019 and 2020 to evaluate crop injury, seedling mortality, and yield of ten sugarcane crosses against seven PRE herbicide treatments applied directly after seedlings were transplanted into the field. Of the seven herbicide treatments evaluated, three of the treatments contained the active ingredient S-metolachlor which was labeled for use in sugarcane production in 2018. Results revealed that metribuzin (1.68 kg ha-1) was the only treatment that significantly increased sugarcane seedling mortality at 90 days after the transplanting procedure. Supplementary experiments were conducted in 2020 at the LSU AgCenter’s Sugar Research Station to test the efficacy of these treatments in controlling seedling johnsongrass. Plots were overseeded with johnsongrass seed and were shallowly tilled prior to herbicide application. Johnsongrass emergence was counted 7, 14, and 28 days after treatment (DAT), and johnsongrass dry weight was measured 28 DAT. Results showed that pendimethalin and metribuzin provided the best control of johnsongrass seedlings, and control with S-metolachlor was not as sufficient. Based on the results of these studies, pendimethalin at 2.32 kg ha-1 is a sound option for controlling seedling johnsongrass without compromising the survival of newly established sugarcane

    Improving Reinforcement Learning Techniques for Medical Decision Making

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    Reinforcement learning (RL) is a powerful tool for developing personalized treatment regimens from healthcare data. In RL, an agent samples experiences from an environment (such as a model of patient health) to learn a policy that maximizes long-term reward. This dissertation proposes methodological and practical developments in the application of RL to treatment planning problems. First, we develop a novel time series model for simulating patient health states from observed clinical data. We use a generative neural network architecture that learns a direct mapping between distributions over clinical measurements at adjacent time points. We show that this model produces realistic patient trajectories and can be paired with on-policy RL to learn effective treatment policies. Second, we develop a novel extension of hidden Markov models, which are commonly used to model and predict patient health states. Specifically, we develop a special case of recurrent neural networks with the same likelihood function as a corresponding discrete-observation hidden Markov model. We demonstrate how combining our model with other predictive neural networks improves disease forecasting and offers novel clinical interpretations compared with a standard hidden Markov model. Third, we develop a method for selecting high-performing reinforcement learning-based treatment policies for underrepresented patient subpopulations using limited observations. Our method learns a probability distribution over treatment policies from a reference patient group, then adapts its recommendations using limited data from an underrepresented patient group. We show that our method outperforms state-of-the-art benchmarks in selecting effective treatment policies for patients with non-typical clinical characteristics, and predicting these patients\u27 outcomes under its policies. Finally, we use RL to optimize medication regimens for Parkinson\u27s disease patients using high-frequency wearable sensor data. We build an environment model of how patients\u27 symptoms respond to medication, then use RL to recommend optimal medication types, timing, and dosages for each patient. We show that these patient-specific RL-prescribed medication regimens outperform physician-prescribed regimens and provide clinically defensible treatment strategies. Our framework also enables physicians to identify patients who could could switch to lower-frequency regimens for improved adherence, and to identify patients who may be candidates for advanced therapies

    Bell Ringer Activity to Retain Chinese

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    Many high school students have difficulty retaining Chinese characters. Students are expected to memorize Chinese characters from each lesson to enhance further learning. Chinese language teachers introduce an average of 20 new vocabulary words during a given lesson. Students are expected to pronounce and know how to write these new words during the first week they are introduced and master them during the following week. A tool that may be useful to engage students at the beginning of a Chinese class is the bell ringer activity. This study seeks to determine through analysis whether the bell ringer activity may be an effective tool to engage student learning. The participants for this study are two girls and seven boys from a Chinese II class. The study will be done in a control group

    Through the Lens of Perspective Transformation: The Impact of Parent Education on the Parenting Styles of Court-Ordered Participants

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    Parenting is one of the most widespread developmental tasks of adulthood. Simply put, most adults are or eventually will be parents. Even though parenting is commonplace, it is nonetheless a complex and sometimes overwhelming process. Support for parents can be found in the form of parent education, a topic which has been extensively researched over the last several decades. This research consistently upholds the efficacy of parent education (Heath & Palm, 2009; Marienau & Segal, 2006; Miller & Sambell, 2002); however, there is far less research related to parent education for court-ordered parents. This study sought to fill that gap by analyzing the experiences of participants in court-ordered parent education with the ultimate goal of identifying a framework which promotes learning that is transformative. A basic qualitative design, which consisted of a before-training interview, training, an after-training interview, and a follow-up interview, was used in this research. Participants included eleven parents who had been court-ordered to attend parent education classes through the Department of Human Services. Through the data collection and data analysis process, the researcher was able to assess the outcome and the experience of the parent education class for the participants. She contends that most of the participants experienced a transformation of the parenting practices which characterize responsiveness and demandingness, the essential elements of parenting style. The researcher therefore concludes that these participants experienced a transformation of parenting style. She further contends that the transformative experience began with a disorienting dilemma and was fostered through critical self­ reflection and rational discourse. This study has implications for adult education theory, practice and policy. For example, this study suggests that transformative learning can occur in a mandated setting providing that the incentive is powerful enough. Additionally, this study indicates that transformative learning can be lasting in non-life threatening situations, such as the potential loss of custody of one\u27s children. The researcher recommends that this program be replicated with other court­ ordered audiences and taught by other facilitators to determine if it is relevant in alternative settings. It is also recommended that this theoretical framework be applied in other types of adult education programs that promote major life-style changes (e.g. family-life education, substance abuse, weight loss, etc.

    Proteomic Analysis of Postsynaptic Protein Complexes Underlying Neuronal Plasticity

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    Normal neuronal communication and synaptic plasticity at glutamatergic synapses requires dynamic regulation of postsynaptic molecules. Protein expression and protein post-translational modifications regulate protein interactions that underlie this organization. In this Review, we highlight data obtained over the last 20 years that have used qualitative and quantitative proteomics-based approaches to identify postsynaptic protein complexes. Herein, we describe how these proteomics studies have helped lay the foundation for understanding synaptic physiology and perturbations in synaptic signaling observed in different pathologies. We also describe emerging technologies that can be useful in these analyses. We focus on protein complexes associated with the highly abundant and functionally critical proteins: calcium/calmodulin-dependent protein kinase II, the N-methyl-d-aspartate, and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid glutamate receptors, and postsynaptic density protein of 95 kDa

    Gradients of Fear and Anger in the Social Media Response to Terrorism

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    Research suggests that public fear and anger in wake of a terror attack can each uniquely contribute to policy attitudes and risk-avoidance behaviors. Given the importance of these negative-valanced emotions, there is value in studying how terror events can incite fear and anger at various times and locations relative to an attack. We analyze 36,259 Twitter posts authored in response to the 2016 Orlando nightclub shooting and examined how fear- and anger-related language varied with time and distance from the attack. Fear-related words sharply decreased over time, though the trend was strongest at locations near the attack, while anger-related words slightly decreased over time and increased with distance from Orlando. Comparing these results to users’ pre-attack emotional language suggested that distant users remained both angry and fearful after the shooting, while users close to the attack remained angry but quickly reduced expressions of fear to pre-attack levels
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