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Personal Data (personal + data)
Selected AbstractsPrivacy and Commercial Use of Personal Data: Policy Developments in the United StatesJOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 1 2003Priscilla Regan In the online and offline worlds, the value of personal information , especially information about commercial purchases and preferences , has long been recognised. Exchanges and uses of personal information have also long sparked concerns about privacy. Public opinion surveys consistently indicate that overwhelming majorities of the American public are concerned that they have lost all control over information about themselves and do not trust organisations to protect the privacy of their information. Somewhat smaller majorities favour federal legislation to protect privacy. Despite public support for stronger privacy protection, the prevailing policy stance for over thirty years has been one of reluctance to legislate and a preference for self-regulation by business to protect privacy. Although some privacy legislation has been adopted, policy debates about the commercial uses of personal information have been dominated largely by business concerns about intrusive government regulation, free speech and the flow of commercial information, costs, and effectiveness. Public concerns about privacy, reflected in public opinion surveys and voiced by a number of public interest groups, are often discredited because individuals seem to behave as though privacy is not important. Although people express concern about privacy, they routinely disclose personal information because of convenience, discounts and other incentives, or a lack of understanding of the consequences. This disconnect between public opinion and public behaviour has been interpreted to support a self-regulatory approach to privacy protections with emphasis on giving individuals notice and choice about information practices. In theory the self-regulatory approach also entails some enforcement mechanism to ensure that organisations are doing what they claim, and a redress mechanism by which individuals can seek compensation if they are wronged. This article analyses the course of policy formulation over the last twenty years with particular attention on how policymakers and stakeholders have used public opinion about the commercial use of personal information in formulating policy to protect privacy. The article considers policy activities in both Congress and the Federal Trade Commission that have resulted in an emphasis on "notice and consent." The article concludes that both individual behaviour and organisational behaviour are skewed in a privacy invasive direction. People are less likely to make choices to protect their privacy unless these choices are relatively easy, obvious, and low cost. If a privacy protection choice entails additional steps, most rational people will not take those steps. This appears logically to be true and to be supported by behaviour in the physical world. Organisations are unlikely to act unilaterally to make their practices less privacy invasive because such actions will impose costs on them that are not imposed on their competitors. Overall then, the privacy level available is less than what the norms of society and the stated preferences of people require. A consent scheme that is most protective of privacy imposes the largest burden on the individual, as well as costs to the individual, while a consent scheme that is least protective of privacy imposes the least burden on the individual, as well as fewer costs to the individual. Recent experience with privacy notices that resulted from the financial privacy provisions in Gramm-Leach-Bliley supports this conclusion. Finally, the article will consider whether the terrorist attacks of 11 September have changed public opinion about privacy and what the policy implications of any changes in public opinion are likely to be. [source] A review of gastrointestinal foreign bodiesINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 6 2006A. A. Ayantunde Summary Gastrointestinal tract (GIT) foreign bodies represent a significant clinical problem in the Emergency Department, causing a high degree of financial burden, morbidity and mortality. A large variety of foreign bodies are accidentally ingested or inserted into the GIT in different age groups. This a retrospective review of 38 patients who presented to the Emergency Department with GIT foreign bodies between January 2001 and December 2004. Computer database and case note search of patients' personal data, nature of the foreign objects and mode of entry to the GIT were recorded. There were 30 males and eight females (M : F ratio of 3.75:1) with an age range of 10 months to 87 years (median age 25.5 years). Foreign body ingestion/insertion was accidental in 14 patients, deliberate in 11, for anal erotism in 11 and as a result of assault in two cases. The median time before presentation was 12 h, and the mean length of hospital stay was 1.7 days. Treatment was conservative in 15 patients; five patients had gastroscopic retrieval; 15 patients underwent examination under anaesthetic, retrieval and proctosigmoidoscopy and three patients underwent laparotomy for impacted foreign bodies. GIT foreign body ingestion or insertion is common; however, majority of cases can be successfully managed conservatively. [source] A modified Mini Nutritional Assessment without BMI can effectively assess the nutritional status of neuropsychiatric patientsJOURNAL OF CLINICAL NURSING, Issue 13 2009Alan C Tsai Aim and objectives., To determine whether a modified version of the Mini Nutritional Assessment (MNA) without body mass index (BMI) can effectively identify individuals at risk of malnutrition among patients with neuropsychiatric disorders. Background., Neuropsychiatric patients have an additional risk of nutritional disorder due to functional impairments and drug effects. However, their nutritional status is generally neglected. It is important to find a tool that is simple, easy to use and non-invasive. Design., The study involved 105 patients in the acute phase of confirmed neuropsychiatric disorders in an area hospital. All subjects were cognitively able to have effective verbal communication. Method., The study included serum biochemical and anthropometric measurements and an on-site, in-person interview using a structured questionnaire to elicit personal data, health condition and answers to questions in the MNA. Subjects' nutritional statuses were graded with a MNA that adopted population-specific anthropometric cut-off points or one further with the BMI question removed and its assigned score redistributed to other anthropometric questions. Results., Both versions of the modified MNA effectively graded the nutritional status of neuropsychiatric patients and showed good correlations with the major nutritional indicators such as BMI, calf circumference and the length of hospital stay. Conclusions., The MNA can effectively assess the nutritional status of neuropsychiatric patients and enhance timely detection and intervention of their nutritional disorders. A modified MNA without the BMI question can maintain the full functionality of the tool. The version does not require weight and height measurements and thus will enhance the usefulness of the instrument. Relevance to clinical practice., Neuropsychiatric patients are a high-risk group of nutritional disorders. The MNA, especially the one without BMI, has the potential to improve professional efficiency of the primary care workers. [source] Drug use investigation (DUI) and prescription-event monitoring in Japan (J-PEM),PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 7 2001Katsutoshi Tanaka BSc Abstract Objective To present ethical issues and relevant problems in observational studies of drug safety in Japan. Methods The Pharmaceutical Affairs Law, associated ordinances, and notifications relevant to Drug Use Investigations (DUIs), and published documents for two pilot studies of prescription-event monitoring in Japan (J-PEM) were examined, particularly with regard to the protection of privacy. Information relevant to the proposed legislation intended to protect personal information and proposed guidelines on ethical issues in epidemiological studies were also collected. Results and Conclusion The formal studies inaugurated as the ,side-effect investigations' in the late 1960s and replaced by those of the DUI in 1980 have been conducted by drug manufacturers, in accordance with the Pharmaceutical Affairs Law. The first pilot study of J-PEM was started in 1997 and the second one is currently operated under a Health Sciences Research grant, supported by the Ministry of Health and Welfare. Those observational studies have been conducted while maintaining the confidentiality of personal data, but without requiring either approval by institutional ethics boards or informed consent from patients. However, according to the Pharmaceutical Affairs Law, those involved in postmarketing surveillance studies must protect the privacy of study subjects and those who break this rule may be subject to penalties. Ethical issues associated with pharmacoepidemiological studies will be clearly determined in Japan before the end of 2001 when the law designed to protect personal information will be introduced and official guidelines on ethical issues in epidemiological studies will have come into effect. Copyright © 2001 John Wiley & Sons, Ltd. [source] Influence of methotrexate exposure on outcome in patients treated with MBVP chemotherapy for primary central nervous system lymphomaBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 3 2010Hélène Blasco WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Although treated using the same high-dose methotrexate (HD-MTX)-based multiagent chemotherapy, patients with primary central nervous system lymphoma (PCNSL) have significant differences in outcome. However, little information has been published about factors influencing outcome in PCNSL. As it is known that the pharmacokinetics of MTX vary considerably between subjects leading to different exposure in patients receiving the same dose, it is important to evaluate its role in response to chemotherapy. WHAT THIS STUDY ADDS This study is the first to evaluate the exposure,response relationship in patients treated with MBVP chemotherapy. We found that patients who were early non-responders to MBVP chemotherapy had poor survival, whatever the salvage regimen. Tumour response at early evaluation was not associated with MTX pharmacokinetics and increasing the dose would probably not improve results. AIMS Although the standard treatment for primary central nervous system lymphoma (PCNSL) consists of three cycles of MBVP (methotrexate, BCNU, VP16, methylprednisolone) and radiotherapy, early failure of treatment may require modification of the treatment. However, our understanding of the outcome in such patients and of the factors involved in early failure of treatment is poor. In addition to known prognostic factors, we evaluated the influence of methotrexate (MTX) exposure on the response to MBVP chemotherapy in patients treated for PCNSL after the first two cycles. METHODS We retrospectively analyzed all patients with PCNSL treated with the MBVP regimen over the previous 10 years. Clinical, personal data and known prognostic factors were studied. The parameters of MTX exposure were estimated using a population pharmacokinetic approach with NONMEM. Objective response (OR), overall survival (OS) and failure-free survival (FFS) were evaluated in all patients. RESULTS Thirty-seven patients were studied. We observed lower FFS and OS (0.49 years) in patients who were not able to receive the planned treatment (group 1, n= 12) than in those who received three cycles (8.04 years) (group 2, n= 25). Known prognostic factors were comparable in both groups, but mean dose of MTX and mean AUC tended to be lower in patients who failed prematurely or showed no response after two cycles. CONCLUSIONS We found that patients who were early non-responders to MBVP chemotherapy had poor survival, without major influence of MTX exposure. It is thus probably unlikely that increasing the dose of MTX would improve outcome. [source] Face down posturing for macular hole surgery.ACTA OPHTHALMOLOGICA, Issue 2009Is it really required? Purpose Background: In macular hole surgery pars plana vitrectomy and intravitreal gas injection with or without inner limiting membrane peel, is considered the mainstay of treatment. The requirement for face down posturing is generally regarded as part of the traditional postoperative routine. Several mechanisms have been postulated to explain the action of the gas bubble including exertion of a large floatation force on the macula and prevention of the macular hole exposure to vitreous fluid. Recently the need to face down has been chalenged since this regime compromises patients' postoperative quality of life and it makes macular hole surgery almost impossible for individuals with mental or physical limitations. Methods Review of personal data and systermatic literature review of studies investigating macular hole surgery with shortened or eliminated face down posturing. Results There is considerable body of evidence suggesting successful anatomical and functional outcome in patients with shorter duration of posturing or no posturing at all following macular hole surgery. The pros and cons of each technique will be presented in detail. Conclusion Prone posturing following macular hole surgery provides no functional or anatomic benefit but it is associated with slower progression of cataract. Combined phacovitrectomy without face down positioning may be considered for phakic patients undergoing macular hole surgery. [source] Healthcare service use in adolescents with non-specific musculoskeletal painACTA PAEDIATRICA, Issue 8 2010Stefano Masiero Abstract Aim:, To estimate occurrence of non-specific musculoskeletal pain in a wide population sample of Italian adolescents, and to investigate their use of healthcare services (seeking of medical attention, referral for diagnostic tests and treatment use). Methods:, We investigated 7542 high-school adolescents (aged between 12 and 16 years) by a structured questionnaire and consisting of personal data, presence of pain, health provider consulted, referral for diagnostic tests and compliance with the prescribed treatments. Results:, In 3399 (45.1%) reported musculoskeletal pain (the most affected sites being the spine and knees), 2525 (74.2%) of whom had sought medical attention. Of the 2525 subjects who had sought healthcare, 1061 (42.0%) had consulted more than one health provider, 2410 (95.4%) had been referred for diagnostic tests, and some form of treatment had been recommended for 2445 (96.8%), but only 1694 (69.2%) had complied with prescribed therapies. The most important factors linked to health seeking behaviour were pain intensity, pain lasting longer than 3 months, injury, interruption to or absence of physical activity and localization in the spine and knee. Conclusion:, Non-specific musculoskeletal pain is a frequent event in Italian adolescents and that a large number of these subjects consult a healthcare service. [source] | ||||||||||