WhatsApp-propriate? A retrospective content analysis of WhatsApp use and potential breaches in confidentiality among a team of doctors at a district hospital, South Africa.

BACKGROUND: There has been a steady increase in the use of electronic media and instant messaging among healthcare professionals, where it has been almost universally adopted in the workplace. The use of WhatsApp and its perceived benefits in healthcare have been extensively studied; however, there are concerns regarding the potential for ethical breaches in confidentiality through shared electronic patient information. OBJECTIVES: To identify the usage characteristics and incidence of shared patient information with WhatsApp use in a team of medical doctors in an unobserved and unregulated setting. METHODS: We conducted a retrospective cross-sectional content analysis of WhatsApp messages (n=3 340) among a team of 20 doctors in a South African district hospital over 6 months. All messages found within this time period were allocated unique identifiers. The text and image messages were thematically grouped into four categories, i.e. clinical care, resource allocation, social and administrative. Messages that contained patient-identifying information were included in the analysis. RESULTS: Of a total of 3 340 messages sent, 220 (6.6%) contained patient-identifying information. Of these, 109 (3.3%) contained non-anonymised patient information, while in 111 (3.3%) messages, the information was anonymised. The likelihood of sharing patient identifiers was proportionally much higher in shared images (odds ratio (OR) 5.1; 95% confidence interval (CI) 3.2 - 8.2; p<0.0001) compared with text messages, and in messages that related to clinical care (OR 9.3; 95% CI 2.2 - 38.8; p=0.0023) compared with those sent for resource allocation, and social or administrative purposes. CONCLUSIONS: Non-anonymised patient identifiers were found in 3.3% of messages, constituting the potential for breaching patient confidentiality. While WhatsApp groups have significant utility in co-ordinating aspects of clinical care, resource allocation, as well as social and administrative functions, the safe use of WhatsApp should be promoted to ensure that patient confidentiality is maintained.

Assessing the feasibility of an in vitro cytotoxicity method to detect harmful ubiquitous chemicals (detection of non-warfare hazardous chemicals in the operational theater).

The objective of this work was to assess the feasibility of accomplishing aqueous extracts of soil samples and determining if the extracted solution induced adverse effects in the human myelomonocytic cell line, HL60. Dosing of HL60 cells was accomplished over a 24-hour period using 100% of extracted media from standard soil samples containing known contaminants. Assessments of viability, apoptosis, reduced thiols, and mitochondrial membrane integrity were accomplished by argon-ion laser flow cytometric analysis, using chemical labels specific for each end-point. The in vitro cytotoxicity data was compared with the results of Microtox and Mutatox tests as well as earthworm and plant toxicity tests. In vitro cytotoxicity tests' results exhibited good correlation with other tests' results.

An evaluation of the U.S. Air Force's detailed follow-up audiometric examination program.

The authors used information on individuals demonstrating permanent threshold shifts contained in the United States Air Force Hearing Conservation Data Registry to evaluate the effectiveness of detailed follow-up audiometric examinations as part of the USAF Hearing Conservation Program. Analysis yielded a relative risk of 1.00 with a 95% confidence interval of 0.97-1.03, which indicates a high probability that the true effect of these audiograms on the results of the next annual exam is minuscule, if not zero.