Guiding Transformation: How Medical Practices Can Become Patient-Centered Medical Homes

Describes in detail eight change concepts as a guide to transforming a practice into a patient-centered medical home, including engaged leadership, quality improvement strategy, continuous and team-based healing relationships, and enhanced access

Viral Interactions with Host RNA Decay Pathways

Eukaryotes have evolved a wide variety of RNA decay pathways to maintain cellular homeostasis, carry out programs of gene expression, and respond to changing environmental conditions. Individual RNA turnover mechanisms can operate constitutively or under only particular cellular conditions; similarly, some target many RNAs, while others act with great specificity. It has become increasingly clear that there are extensive interactions between viruses and the host RNA decay machinery. Often, the cellular RNA decay machinery poses a threat to viral gene expression, but viruses can also manipulate RNA decay pathways to promote viral replication. This special issue focuses on how cellular RNA decay factors recognize and degrade viral RNAs and viral strategies to subvert or evade these pathways

Introduction to the new usability

This paper introduces the motivation for and concept of the "new usability" and positions it against existing approaches to usability. It is argued that the contexts of emerging products and systems mean that traditional approaches to usability engineering and evaluation are likely to prove inappropriate to the needs of "digital consumers." The paper briefly reviews the contributions to this special issue in terms of their relation to the idea of the "new usability" and their individual approaches to dealing with contemporary usability issues. This helps provide a background to the "new usability" research agenda, and the paper ends by posing what are argued to be the central challenges facing the area and those which lie at the heart of the proposed research agenda

Spatial and temporal disaggregation of anthropogenic CO2 emissions from the City of Cape Town

Abstract This paper describes the methodology used to spatially and temporally disaggregate carbon dioxide emission estimates for the City of Cape Town, to be used for a city-scale atmospheric inversion estimating carbon dioxide fluxes. Fossil fuel emissions were broken down into emissions from road transport, domestic emissions, industrial emissions, and airport and harbour emissions. Using spatially explicit information on vehicle counts, and an hourly scaling factor, vehicle emissions estimates were obtained for the city. Domestic emissions from fossil fuel burning were estimated from household fuel usage information and spatially disaggregated population data from the 2011 national census. Fuel usage data were used to derive industrial emissions from listed activities, which included emissions from power generation, and these were distributed spatially according to the source point locations. The emissions from the Cape Town harbour and the international airport were determined from vessel and aircraft count data, respectively. For each emission type, error estimates were determined through error propagation techniques. The total fossil fuel emission field for the city was obtained by summing the spatial layers for each emission type, accumulated for the period of interest. These results will be used in a city-scale inversion study, and this method implemented in the future for a national atmospheric inversion study

Histogram Analysis of ADC in Brain Tumor Patients

At various stage of progression, most brain tumors are not homogenous. In this presentation, we retrospectively studied the distribution of ADC values inside tumor volume during the course of tumor treatment and progression for a selective group of patients who underwent an anti-VEGF trial. Complete MRI studies were obtained for this selected group of patients including pre- and multiple follow-up, post-treatment imaging studies. In each MRI imaging study, multiple scan series were obtained as a standard protocol which includes T1, T2, T1-post contrast, FLAIR and DTI derived images (ADC, FA etc.) for each visit. All scan series (T1, T2, FLAIR, post-contrast T1) were registered to the corresponding DTI scan at patient\u27s first visit. Conventionally, hyper-intensity regions on T1-post contrast images are believed to represent the core tumor region while regions highlighted by FLAIR may overestimate tumor size. Thus we annotated tumor regions on the T1-post contrast scans and ADC intensity values for pixels were extracted inside tumor regions as defined on T1-post scans. We fit a mixture Gaussian (MG) model for the extracted pixels using the Expectation-Maximization (EM) algorithm, which produced a set of parameters (mean, various and mixture coefficients) for the MG model. This procedure was performed for each visits resulting in a series of GM parameters. We studied the parameters fitted for ADC and see if they can be used as indicators for tumor progression. Additionally, we studied the ADC characteristics in the peri-tumoral region as identified by hyper-intensity on FLAIR scans. The results show that ADC histogram analysis of the tumor region supports the two compartment model that suggests the low ADC value subregion corresponding to densely packed cancer cell while the higher ADC value region corresponding to a mixture of viable and necrotic cells with superimposed edema. Careful studies of the composition and relative volume of the two compartments in tumor region may provide some insights in the early assessment of tumor response to therapy for recurrence brain cancer patients

Teacher Turnover: Examining Exit Attrition, Teaching Area Transfer, and School Migration

The purposes of this research were to quantify trends in three components of teacher turnover and to investigate claims of excessive teacher turnover as the predominant source of teacher shortages. Attrition and teaching area transfer rates were comparable in special and general education and increased substantially from 1991-1992 to 2000-2001. School migration was stable over years, but higher in special than general education. Although annual turnover was high and increased to 1 in 4 teachers (25.6%) by 2000-2001, teacher attrition was lower than in other occupations. Evidence suggests that retention is unlikely to increase without dramatic improvements in the organization, management, and funding of public schools. Until then, an increased supply of qualified teachers is needed to reduce teacher shortages

A letter to the right reverend the Lord Bishop of London containing queries, doubts and difficulties, relative to a vernacular version of the holy scriptures being an appendix to a prospectus of a new translation of the bible from a corrected text of the originals

Sign.: A-M4Anteport

Tabooed Terrain: Reflections On Conducting Adult Education Research In Lesbian/Gay/Queer Arenas

Introduction: The issues to be explored in this symposium are the multiple ways that same-sex orientation is negotiated and mediated in Adult Education research. The sociology of learning and other diverse bodies of literature (e.g. gay/queer theory) show that, in the main, same-sex orientation (matter related to Lesbians, Gay men, Transgendered, Bisexuals and Transsexuals) is treated as tabooed terrain in both the academy and society (Hill, 1995), often with grave results. In this symposium, panelist Andre Grace positions his early developmental denial of queer being and acting as a form of self-mutilation. Andre has taken up a self-directed project of autobiographical writing and theorizing as a means to subvert society’s forbidden parameters. Since many educators and community members fall back on stereotypes, internalized homophobia and homoprejudice that flagrantly compromise the very principles for which they labor (Harbeck, 1997), Andre has learned to name and express his outlawed self

The Leiden Ranking 2011/2012: Data collection, indicators, and interpretation

The Leiden Ranking 2011/2012 is a ranking of universities based on bibliometric indicators of publication output, citation impact, and scientific collaboration. The ranking includes 500 major universities from 41 different countries. This paper provides an extensive discussion of the Leiden Ranking 2011/2012. The ranking is compared with other global university rankings, in particular the Academic Ranking of World Universities (commonly known as the Shanghai Ranking) and the Times Higher Education World University Rankings. Also, a detailed description is offered of the data collection methodology of the Leiden Ranking 2011/2012 and of the indicators used in the ranking. Various innovations in the Leiden Ranking 2011/2012 are presented. These innovations include (1) an indicator based on counting a university's highly cited publications, (2) indicators based on fractional rather than full counting of collaborative publications, (3) the possibility of excluding non-English language publications, and (4) the use of stability intervals. Finally, some comments are made on the interpretation of the ranking, and a number of limitations of the ranking are pointed out

Restrictions and extensions of semibounded operators

We study restriction and extension theory for semibounded Hermitian operators in the Hardy space of analytic functions on the disk D. Starting with the operator zd/dz, we show that, for every choice of a closed subset F in T=bd(D) of measure zero, there is a densely defined Hermitian restriction of zd/dz corresponding to boundary functions vanishing on F. For every such restriction operator, we classify all its selfadjoint extension, and for each we present a complete spectral picture. We prove that different sets F with the same cardinality can lead to quite different boundary-value problems, inequivalent selfadjoint extension operators, and quite different spectral configurations. As a tool in our analysis, we prove that the von Neumann deficiency spaces, for a fixed set F, have a natural presentation as reproducing kernel Hilbert spaces, with a Hurwitz zeta-function, restricted to FxF, as reproducing kernel.Comment: 63 pages, 11 figure