Len Lanham Collection

Papers of Len Lanham, relating to the teaching of Linguistics and the the teaching of Reading and Writing. Includes materials relating to the Molteno Projec

Alignment of patient and primary care practice member perspectives of chronic illness care: a cross-sectional analysis

Polly H. Noel and Luci K. Leykum are with the South Texas Veterans Health Care System, 7400 Merton Minter Blvd, San Antonio, TX 78229, USA -- Polly H. Noel, Ray F. Palmer, Raquel L. Romero, Luci K. Leykum, Holly J. Lanham, and Krista W. Bowers are with the Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229, USA -- Michael L. Parchman is with the MacColl Center for Healthcare Innovation, Group Health Research Institute, Group Health Cooperative, 1730 Minor Ave 1600, Seattle, WA 98101, USA -- Holly J. Leykum is with the The McCombs School of Business, The University of Texas at Austin, 2110 Speedway, Stop B6000, Austin, TX 78712, USA -- John E. Zeber is with the Central Texas Veterans Health Care System, 1901 S. 1st St, Temple, TX 76504, USA and Scott and White Healthcare Center for Applied Health Research, 2401 S. 31st St, Temple, TX 76508, USABackground: Little is known as to whether primary care teams’ perceptions of how well they have implemented the Chronic Care Model (CCM) corresponds with their patients’ own experience of chronic illness care. We examined the extent to which practice members’ perceptions of how well they organized to deliver care consistent with the CCM were associated with their patients’ perceptions of the chronic illness care they have received. Methods: Analysis of baseline measures from a cluster randomized controlled trial testing a practice facilitation intervention to implement the CCM in small, community-based primary care practices. All practice “members” (i.e., physician providers, non-physician providers, and staff) completed the Assessment of Chronic Illness Care (ACIC) survey and adult patients with 1 or more chronic illnesses completed the Patient Assessment of Chronic Illness Care (PACIC) questionnaire. Results: Two sets of hierarchical linear regression models accounting for nesting of practice members (N = 283) and patients (N = 1,769) within 39 practices assessed the association between practice member perspectives of CCM implementation (ACIC scores) and patients’ perspectives of CCM (PACIC). ACIC summary score was not significantly associated with PACIC summary score or most of PACIC subscale scores, but four of the ACIC subscales were consistently associated with PACIC summary score and the majority of PACIC subscale scores after controlling for patient characteristics. The magnitude of the coefficients, however, indicates that the level of association is weak. Conclusions: The ACIC and PACIC scales appear to provide complementary and relatively unique assessments of how well clinical services are aligned with the CCM. Our findings underscore the importance of assessing both patient and practice member perspectives when evaluating quality of chronic illness care.Information, Risk, and Operations Management (IROM)[email protected]

Kidney cell electrophoresis in space flight: Rationale, methods, results and flow cytometry applications

Cultures of human embryonic kidney cells consistently contain an electrophoretically separable subpopulation of cells that produce high levels of urokinase and have an electrophoretic mobility about 85 percent as high as that of the most mobile human embryonic kidney cells. This subpopulation is rich in large epithelioid cells that have relatively little internal structure. When resolution and throughput are adequate, free fluid electrophoresis can be used to isolate a broad band of low mobility cells which also produces high levels of plasminogen activators (PAs). In the course of performing this, it was discovered that all electrophoretic subpopulations of cultured human embryonic kidney cells produce some PAs and that separate subpopulations produce high quantities of different types of PA's. This information and the development of sensitive assays for this project have provided new insights into cell secretion mechanisms related to fibrinolysis. These advances would probably not have been made without the NASA program to explore fundamental questions of free fluid electrophoresis in space

Building a GPS Receiver for Space Lessons Learned

Over the past 4 years the Component Systems and Hardware branch at NASA GSFC has pursued an inhouse effort to build a unique space-flight GPS receiver. This effort has resulted in the Navigator GPS receiver. Navigator's first flight opportunity will come with the STS-125 HST-SM4 mission in August 2008. This paper covers the overall hardware design for the receiver and the difficulties encountered during the transition from the breadboard design to the final flight hardware design. Among the different lessons learned, the paper stresses the importance of selecting and verifying parts that are appropriate for space applications, as well as what happens when these parts are not accurately characterized by their datasheets. Additionally, the paper discusses what analysis needs to be performed when deciding system frequencies and filters. The presentation also covers how to prepare for thermal vacuum testing, and problems that may arise during vibration testing. It also contains what criteria should be considered when determining which portions of a design to create in-house, and which portions to license from a third party. Finally, the paper shows techniques which have proven to be extraordinarily helpful in debugging and analysis

Proceedings of the Rank Forum on Vitamin D

The Rank Forum on Vitamin D was held on 2nd and 3rd July 2009 at the University of Surrey, Guildford, UK. The workshop consisted of a series of scene-setting presentations to address the current issues and challenges concerning vitamin D and health, and included an open discussion focusing on the identification of the concentrations of serum 25-hydroxyvitamin D (25(OH)D) (a marker of vitamin D status) that may be regarded as optimal, and the implications this process may have in the setting of future dietary reference values for vitamin D in the UK. The Forum was in agreement with the fact that it is desirable for all of the population to have a serum 25(OH)D concentration above 25 nmol/l, but it discussed some uncertainty about the strength of evidence for the need to aim for substantially higher concentrations (25(OH)D concentrations . 75 nmol/l). Any discussion of ‘optimal’ concentration of serum 25(OH)D needs to define ‘optimal’ with care since it is important to consider the normal distribution of requirements and the vitamin D needs for a wide range of outcomes. Current UK reference values concentrate on the requirements of particular subgroups of the population; this differs from the approaches used in other European countries where a wider range of age groups tend to be covered. With the re-emergence of rickets and the public health burden of low vitamin D status being already apparent, there is a need for urgent action from policy makers and risk managers. The Forum highlighted concerns regarding the failure of implementation of existing strategies in the UK for achieving current vitamin D recommendations

Aircraft-borne, laser-induced fluorescence instrument for the in situ detection of hydroxyl and hydroperoxyl radicals

The odd-hydrogen radicals OH and HO2 are central to most of the gas-phase chemical transformations that occur in the atmosphere. Of particular interest is the role that these species play in controlling the concentration of stratospheric ozone. This paper describes an instrument that measures both of these species at volume mixing ratios below one part in 10(exp 14) in the upper troposphere and lower stratosphere. The hydroxyl radical (OH) is measured by laser induced fluorescence at 309 nm. Tunable UV light is used to pump OH to the first electric state near 282 nm. the laser light is produced by a high-repetition rate pulsed dye-laser powered with all solid-state pump lasers. HO2 is measured as OH after gas-phase titration with nitric oxide. Measurements aboard a NASA ER-2 aircraft demonstrate the capability of this instrument to perform reliably with very high signal-to-noise ratios (greater than 30) achieved in short integration times (less than 20 sec)

Lumko Xhosa self-instruction course

This course, while primarily designed for use with tapes, has been re-programmed for use as a self-instruction manual suitable for use without tapes or an instructor. However, the student is advised to use tapes, at least with the pronunciation lessons. This language course builds up step by step in a systematic fashion. Each step is clearly presented with the aid of diagrams where useful and adequate practice material is provided. These practice d rills are so constructed that every item elicits a creative response from the learner, who can then check his response against the master response given on the right-hand column, which can be gradually revealed with the use of the sliding mask.Digitised by Rhodes University Library on behalf of the Institute of Social and Economic Research (ISER

Aircraft-borne, laser-induced fluorescence instrument for the in situ detection of hydroxyl and hydroperoxyl radicals

The odd-hydrogen radicals OH and HO2 are central to most of the gas-phase chemical transformations that occur in the atmosphere. Of particular interest is the role that these species play in controlling the concentration of stratospheric ozone. This paper describes an instrument that measures both of these species at volume mixing ratios below one part in 10^14 in the upper troposphere and lower stratosphere. The hydroxyl radical (OH) is measured by laser induced fluorescence at 309 nm. Tunable UV light is used to pump OH to the first electronic state (A-tilde 2Sigma+(v[script ']=1) ~30) achieved in short integration times (< 20 sec)