A blinded evaluation of privacy preserving record linkage with Bloom filters.

BACKGROUND: Privacy preserving record linkage (PPRL) methods using Bloom filters have shown promise for use in operational linkage settings. However real-world evaluations are required to confirm their suitability in practice. METHODS: An extract of records from the Western Australian (WA) Hospital Morbidity Data Collection 2011-2015 and WA Death Registrations 2011-2015 were encoded to Bloom filters, and then linked using privacy-preserving methods. Results were compared to a traditional, un-encoded linkage of the same datasets using the same blocking criteria to enable direct investigation of the comparison step. The encoded linkage was carried out in a blinded setting, where there was no access to un-encoded data or a 'truth set'. RESULTS: The PPRL method using Bloom filters provided similar linkage quality to the traditional un-encoded linkage, with 99.3% of 'groupings' identical between privacy preserving and clear-text linkage. CONCLUSION: The Bloom filter method appears suitable for use in situations where clear-text identifiers cannot be provided for linkage.

Mechanistic role of the CREB-regulated transcription coactivator 1 in cardiac hypertrophy.

The sympathetic nervous system is the main stimulator of cardiac function. While acute activation of the ß-adrenoceptors exerts positive inotropic and lusitropic effects by increasing cAMP and Ca2+, chronically enhanced sympathetic tone with changed ß-adrenergic signaling leads to alterations of gene expression and remodeling. The CREB-regulated transcription coactivator 1 (CRTC1) is activated by cAMP and Ca2+. In the present study, the regulation of CRTC1 in cardiomyocytes and its effect on cardiac function and growth was investigated. In cardiomyocytes, isoprenaline induced dephosphorylation, and thus activation of CRTC1, which was prevented by propranolol. Crtc1-deficient mice exhibited left ventricular dysfunction, hypertrophy and enlarged cardiomyocytes. However, isoprenaline-induced contractility of isolated trabeculae or phosphorylation of cardiac troponin I, cardiac myosin-binding protein C, phospholamban, and ryanodine receptor were not altered, suggesting that cardiac dysfunction was due to the global lack of Crtc1. The mRNA and protein levels of the Gαq GTPase activating protein regulator of G-protein signaling 2 (RGS2) were lower in hearts of Crtc1-deficient mice. Chromatin immunoprecipitation and reporter gene assays showed stimulation of the Rgs2 promoter by CRTC1. In Crtc1-deficient cardiomyocytes, phosphorylation of the Gαq-downstream kinase ERK was enhanced. CRTC1 content was higher in cardiac tissue from patients with aortic stenosis or hypertrophic cardiomyopathy and from two murine models mimicking these diseases. These data suggest that increased CRTC1 in maladaptive hypertrophy presents a compensatory mechanism to delay disease progression in part by enhancing Rgs2 gene transcription. Furthermore, the present study demonstrates an important role of CRTC1 in the regulation of cardiac function and growth.

A collaborative model of community health nursing practice.

This paper discusses a strategic collaborative partnership between a Western Australian university and a community health service based on a Practice-Research Model. The partnership has involved a senior academic (0.2 FTE) working in the community health setting as a Nurse Research Consultant since 1998. The first section of the paper draws on the nursing literature on collaborative models and describes the broad background to the partnership and development of the Model. The second section presents in detail the results of a recent evaluation that involved a brief survey and follow-up interviews to determine community health nurses' understanding and perceptions of the partnership Model. Three main themes emerged from the interviews: (1) Advancement of learning captured the extent to which the Nurse Research Consultant position helped to educate nurses and promote and develop research and best-practice; (2) Job satisfaction and self-confidence encompassed the extent to which participants felt nursing management were supportive of their professional education and pursuit of best-practice solutions, and (3) Situational opportunity, which reflected the more negative comments expressed by participants and related mostly to the restricted availability of Nurse Research Consultant and a focus on mainstream research priorities. The results suggest that the partnership Model provided the nurses with the opportunity to develop an increased understanding of the role of research in clinical practice and confidence in their own ability to reflect on current nursing practice. This allowed them to identify clinical problems in order to deliver and evaluate best-practice solutions, as evidenced by a change in attitude from the previous evaluation. However, it was also noted that the operational performance of the Model needs continual monitoring to ensure that all nurses have equitable access opportunities.