125 research outputs found

    Evaluation of Structural Change in Primary Care

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    National health systems are complex and new initiatives are continually being introduced. Well-established instruments exist for evaluating the outcomes of short-term projects and the introduction of new programs within the health system. However, large scale reform involving substantial structural change challenges the ability of existing tools to appropriately evaluate outcomes. In Australia, the National Disability Insurance Scheme (NDIS) and the Health Care Home (HCH) initiatives are examples of structural change although they are not widely recognised as such. This research makes an important contribution to knowledge by exploring structural change and using this exploration to develop new methods for evaluating structural change in the context of primary care in Australia

    “I’m touching myself” An Investigation of Ann Hirsch’s Twelve

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    Ann Hirsch is an emerging video and performance artist based in Brooklyn, New York whose work focuses on women’s sexuality on the Internet. Hirsch’s digital work is constantly in flux, appearing, disappearing and reappearing online. Her work, like her identity, reflects the possibilities of self- representation at the turn of the millennium. The paper that follows examines Hirsch’s artwork Twelve (2013) and its evolution from a pseudo biographical eBook to an art object, a shift which transpired during the course of my own research and engagement. A complex piece addressing the nexus of youth culture, online intimacies and social regulation; the transformation of Twelve’s construction and preservation indicates the possibility for a teleological shift in new media scholarship that recognizes the ephemeral nature of technology- dependent art and the slower pace of traditional forms of academic scholarship. The speed of production, destruction, and reconstruction of Twelve is distinct to new media art fields and digital cultures

    Nationwide Results of Microorganism Antigen Testing as a Component of Preoperative Synovial Fluid Analysis.

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    BACKGROUND: Antigen immunoassays to detect synovial fluid (SF) microorganisms have recently been made available for clinical use. The purpose of this study was to determine the sensitivity and specificity of an SF microorganism antigen immunoassay detection (MID) panel, evaluate the panel\u27s capability to detect microorganisms in the setting of culture-negative periprosthetic joint infection (PJI), and determine diagnostic predictive values of the MID panel for PJI. METHODS: This study included 67,441 SF samples obtained from a hip or knee arthroplasty, from 2,365 institutions across the United States, submitted to 1 laboratory for diagnostic testing. All data were prospectively compiled and then were analyzed retrospectively. Preoperative SF data were used to classify each specimen by the International Consensus Meeting (2018 ICM) definition of PJI: 49,991 were not infected, 5,071 were inconclusive, and 12,379 were infected. The MID panel, including immunoassay tests to detect Staphylococcus, Candida, and Enterococcus, was evaluated to determine its diagnostic performance. RESULTS: The MID panel demonstrated a sensitivity of 94.2% for infected samples that yielded positive cultures for target microorganisms (Staphylococcus, Candida, or Enterococcus). Among infected samples yielding positive cultures for their respective microorganism, individual immunoassay test sensitivity was 93.0% for Staphylococcus, 92.3% for Candida, and 97.2% for Enterococcus. The specificity of the MID panel for samples that were not infected was 98.4%, yielding a false-positive rate of 1.6%. The MID panel detected microorganisms among 49.3% of SF culture-negative infected samples. For PJI as a diagnosis, the positive predictive value of the MID panel was 91.7% and the negative predictive value was 93.8%. Among MID-positive PJIs, 16.2% yielded a discordant cultured organism instead of that detected by the antigen test. CONCLUSIONS: SF microorganism antigen testing provides a timely adjunct method to detect microorganisms in the preoperative SF aspirate, yielding a low false-positive rate and enabling the detection of a microorganism in nearly one-half of SF culture-negative PJIs. LEVEL OF EVIDENCE: Prognostic Level II . See Instructions for Authors for a complete description of levels of evidence

    Locus Reference Genomic sequences: an improved basis for describing human DNA variants

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    As our knowledge of the complexity of gene architecture grows, and we increase our understanding of the subtleties of gene expression, the process of accurately describing disease-causing gene variants has become increasingly problematic. In part, this is due to current reference DNA sequence formats that do not fully meet present needs. Here we present the Locus Reference Genomic (LRG) sequence format, which has been designed for the specific purpose of gene variant reporting. The format builds on the successful National Center for Biotechnology Information (NCBI) RefSeqGene project and provides a single-file record containing a uniquely stable reference DNA sequence along with all relevant transcript and protein sequences essential to the description of gene variants. In principle, LRGs can be created for any organism, not just human. In addition, we recognize the need to respect legacy numbering systems for exons and amino acids and the LRG format takes account of these. We hope that widespread adoption of LRGs - which will be created and maintained by the NCBI and the European Bioinformatics Institute (EBI) - along with consistent use of the Human Genome Variation Society (HGVS)-approved variant nomenclature will reduce errors in the reporting of variants in the literature and improve communication about variants affecting human health. Further information can be found on the LRG web site: http://www.lrg-sequence.org

    Have I grooved to this before? Discriminating practised and observed actions in a novel context

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    Learning a new motor skill typically requires converting actions observed from a third-person perspective into fluid motor commands executed from a first-person perspective. In the present study, we test the hypothesis that during motor learning, the ability to discriminate between actions that have been observed and actions that have been executed is associated with learning aptitude, as assessed by a general measure of physical performance. Using a multi-day dance-training paradigm with a group of dance-naĂŻve participants, we investigated whether actions that had been regularly observed could be discriminated from similar actions that had been physically practised over the course of three days, or a further set of similar actions that remained untrained. Training gains and performance scores at test were correlated with participants' ability to discriminate between observed and practised actions, suggesting that an individual's ability to differentiate between visual versus visuomotor action encoding is associated with general motor learning
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