ABSTRACT
INTRODUCTION: Medical research studies which involve electronic data capture of sensitive data about human subjects need to manage medical and identifying participant data in a secure manner. To protect the identity of data subjects, an independent trusted third party should be responsible for pseudonymization and management of the identifying data. METHODS: We have developed a web-based integrated solution that combines REDCap as an electronic data capture system with the trusted third party software tools of the University Medicine Greifswald, which provides study personnel with a single user interface for both clinical data entry and management of identities, pseudonyms and informed consents. RESULTS: Integration of the two platforms enables a seamless workflow of registering new participants, entering identifying and consent information, and generating pseudonyms in the trusted third party system, with subsequent capturing of medical data in the electronic data capture system, while maintaining strict separation of medical and identifying data in the two independently managed systems. CONCLUSION: Our solution enables a time-efficient data entry workflow, provides a high level of data protection by minimizing visibility of identifying information and pseudonym lists, and avoids errors introduced by manual transfer of pseudonyms between separate systems.
Subject(s)
Biomedical Research , Computer Security , Confidentiality , Software , Informed Consent , Anonyms and Pseudonyms , Humans , Electronic Health Records , Systems Integration , User-Computer InterfaceABSTRACT
Secondary use of data for research purposes is especially important in rare diseases (RD), since, per definition, data are sparse. The European Joint Programme on Rare Diseases (EJP RD) aims at developing an RD infrastructure which supports the secondary use of data. Significant amounts of RD data are a) distributed and b) available only in pseudonymised format. Privacy-Preserving Record Linkage (PPRL) concerns the linking of such distributed datasets without disclosing the participant's identities. We present a concept for linking a PPRL Service to the EJP RD Virtual Platform (VP). Level 1 (resource discovery) connection is provided by running an FDP within the PPRL Service. On Level 2 (data discoverability), the PPRL Service can represent both, an individual and a catalog endpoint. Our solution can count patients in PPRL-supporting resources, count duplicates only once, and count only patients registered to multiple resources. Currently, we are preparing the deployment within the EJP RD VP.
Subject(s)
Medical Record Linkage , Rare Diseases , Humans , Europe , Medical Record Linkage/methods , Confidentiality , Anonyms and Pseudonyms , Electronic Health Records , Computer SecurityABSTRACT
Many state-of-the-art results in natural language processing (NLP) rely on large pre-trained language models (PLMs). These models consist of large amounts of parameters that are tuned using vast amounts of training data. These factors cause the models to memorize parts of their training data, making them vulnerable to various privacy attacks. This is cause for concern, especially when these models are applied in the clinical domain, where data are very sensitive. Training data pseudonymization is a privacy-preserving technique that aims to mitigate these problems. This technique automatically identifies and replaces sensitive entities with realistic but non-sensitive surrogates. Pseudonymization has yielded promising results in previous studies. However, no previous study has applied pseudonymization to both the pre-training data of PLMs and the fine-tuning data used to solve clinical NLP tasks. This study evaluates the effects on the predictive performance of end-to-end pseudonymization of Swedish clinical BERT models fine-tuned for five clinical NLP tasks. A large number of statistical tests are performed, revealing minimal harm to performance when using pseudonymized fine-tuning data. The results also find no deterioration from end-to-end pseudonymization of pre-training and fine-tuning data. These results demonstrate that pseudonymizing training data to reduce privacy risks can be done without harming data utility for training PLMs.
Subject(s)
Natural Language Processing , Humans , Privacy , Sweden , Anonyms and Pseudonyms , Computer Security/standards , Confidentiality/standards , Electronic Health Records/standardsABSTRACT
Urinary flow measurement and colorimetry are vital medical indicators for critically ill patients in intensive care units. However, there is a clinical need for low-cost, continuous urinary flow monitoring devices that can automatically and in real-time measure urine flow. This need led to the development of a non-invasive device that is easy to use and does not require proprietary disposables. The device operates by detecting urine flow using an infrared barrier that returns an unequivocal pattern, and it is capable of measuring the volume of liquid in real-time, storing the history with a precise date, and returning alarms to detect critical trends. The device also has the ability to detect the color of urine, allowing for extended data and detecting problems in catheterized patients such as hematuria. The device is proposed as an automated clinical decision support system that utilizes the concept of the Internet of Medical Things. It works by using a LoRa communication method with the LoRaWAN protocol to maximize the distance to access points, reducing infrastructure costs in massive deployments. The device can send data wirelessly for remote monitoring and allows for the collection of data on a dashboard in a pseudonymous way. Tests conducted on the device using a gold standard medical grade infusion pump and fluid densities within the 1.005 g/ml to 1.030 g/ml urine density range showed that droplets were satisfactorily captured in the range of flows from less than 1 ml/h to 500 ml/h, which are acceptable ranges for urinary flow. Errors ranged below 15%, when compared to the values obtained by the hospital infusion pump used as gold standard. Such values are clinically adequate to detect changes in diuresis patterns, specially at low urine output ranges, related to renal disfunction. Additionally, tests carried out with different color patterns indicate that it detects different colors of urine with a precision in detecting RGB values <5%. In conclusion, the results suggest that the device can be useful in automatically monitoring diuresis and colorimetry in real-time, which can facilitate the work of nursing and provide automatic decision-making support to intensive care physicians.
Subject(s)
Body Fluids , Flowmeters , Humans , Anonyms and Pseudonyms , Colorimetry , DiuresisABSTRACT
The Internet of vehicles (IoVs) is an innovative paradigm which ensures a safe journey by communicating with other vehicles. It involves a basic safety message (BSM) that contains sensitive information in a plain text that can be subverted by an adversary. To reduce such attacks, a pool of pseudonyms is allotted which are changed regularly in different zones or contexts. In base schemes, the BSM is sent to neighbors just by considering their speed. However, this parameter is not enough because network topology is very dynamic and vehicles can change their route at any time. This problem increases pseudonym consumption which ultimately increases communication overhead, increases traceability and has high BSM loss. This paper presents an efficient pseudonym consumption protocol (EPCP) which considers the vehicles in the same direction, and similar estimated location. The BSM is shared only to these relevant vehicles. The performance of the purposed scheme in contrast to base schemes is validated via extensive simulations. The results prove that the proposed EPCP technique outperformed compared to its counterparts in terms of pseudonym consumption, BSM loss rate and achieved traceability.
Subject(s)
Anonyms and Pseudonyms , Computer Security , Internet , CommunicationABSTRACT
Este estudo tem como objetivo analisar traços da mentalidade potencialmente autoritária a partir do discurso de usuários do Facebook vinculados a páginas de cunho político autodeclarado de direita e de esquerda no Brasil. A Netnografia é utilizada como aporte metodológico para imersão on-line nas páginas "Eu era Direita e não sabia" e "Jovens de Esquerda", selecionadas por meio do Facebook Audience Insights, ferramenta disponibilizada pelo Facebook. Delas, foram extraídas oito postagens com maior engajamento (número de comentários, curtidas e compartilhamentos), identificadas pelo Netvizz. Foram coletados 3.489 comentários, os quais foram organizados em um corpus textual submetido ao software IRAMUTEQ e analisados sob a perspectiva da análise crítica imanente da teoria crítica. Como resultado, apresenta-se a forma como o pensamento autoritário se manifesta na racionalização da sociedade contemporânea e nas práticas discursivas em redes sociais on-line, enraizada no âmbito sociopolítico brasileiro, ameaçando o processo democrático e a construção de uma sociedade plural e liberta.(AU)
This study aims to analyze traits of the potentially authoritarian mentality from the speech of Facebook users linked to political pages self-declared as rightist and leftist in Brazil. Netnography is used as a methodological contribution for online immersion in the pages "Eu era Direita e não sabia" and "Jovens de Esquerda" selected via Facebook Audience Insights, a tool provided by Facebook. From these, eight posts with greater engagement (number of comments, likes and shares), identified by Netvizz, were extracted. We collected 3,489 comments, which were organized in a textual corpus submitted to IRAMUTEQ software and analyzed from the perspective of immanent critical analysis of Critical Theory. As a result, we present the way in which authoritarian thinking manifests itself in the rationalization of contemporary society and in discursive practices in online social networks, rooted in the Brazilian socio-political sphere, threatening the democratic process and the construction of a plural and free society.(AU)
Este estudio tiene como objetivo analizar las huellas de la mentalidad potencialmente autoritaria a partir de los discursos de usuarios en Facebook vinculados a páginas políticas autodeclaradas de derecha y de izquierda en Brasil. La netnografía se utiliza como marco metodológico para la inmersión en línea en las páginas "Eu era Direita e não sabia" y "Jovens de Esquerda", seleccionadas por Facebook Audience Insights, herramienta proporcionada por Facebook. Se extrajeron las ocho publicaciones con mayor compromiso (número de comentarios, gustos y compartidas), identificadas por Netvizz. Se recogieron 3.489 comentarios, los cuales fueron organizados en un corpus textual sometido al software IRAMUTEQ y analizado bajo la perspectiva del análisis crítico inmanente de la teoría crítica. Los resultados presentan la forma en que el pensamiento autoritario se manifiesta en la racionalización de la sociedad contemporánea y en prácticas discursivas en redes sociales en línea, arraigada en el ámbito sociopolítico brasileño, que amenazan el proceso democrático y la construcción de una sociedad plural y liberada.(AU)
Subject(s)
Humans , Male , Female , Politics , Authoritarianism , Social Networking , Permissiveness , Persuasive Communication , Policy Making , Prejudice , Psychology , Scapegoating , Social Behavior , Social Change , Social Conformity , Social Desirability , Psychological Distance , Social Dominance , Social Identification , Social Isolation , Social Justice , Social Problems , Social Support , Social Welfare , Socioeconomic Factors , Sociology , Stereotyping , Unemployment , Social Control Policies , Attitude , Character , Conflict of Interest , Congress , Civil Rights , Civilization , Computer Security , Competitive Behavior , Community Participation , Cultural Diversity , Feminism , Internet , Journalism , Modernization of the Public Sector , Crime , Cybernetics , Legislative , Democracy , Whistleblowing , Dehumanization , Dissent and Disputes , Aggression , Racial Groups , Economics , Research Policy Evaluation , Information Society Indicators , Ethics , Altruism , Social Media , Sexism , Social Discrimination , External Debt , Social Skills , Self-Control , Diplomacy , Defamation , Censorship, Research , Health Governance , Harassment, Non-Sexual , Incivility , Political Activism , Cultural Rights , Freedom , Sustainable Development , Cyberbullying , Egocentrism , Corruption , Civil Society , Empowerment , Social Evolution , Social Defeat , Social Representation , Disinformation , Intersectional Framework , Social Cohesion , Citizenship , Psychological Well-Being , Government , Hate , Human Rights , Interpersonal Relations , Lobbying , Deception , Mass Behavior , Mass Media , Anonyms and Pseudonyms , NegativismABSTRACT
Existing identity-based schemes utilized in Vehicular Ad hoc Networks (VANETs) rely on roadside units to offer conditional privacy-preservation authentication and are vulnerable to insider attacks. Achieving rapid message signing and verification for authentication is challenging due to complex operations, such as bilinear pairs. This paper proposes a secure pseudonym-based conditional privacy-persevering authentication scheme for communication security in VANETs. The Elliptic Curve Cryptography (ECC) and secure hash cryptographic function were used in the proposed scheme for signing and verifying messages. After a vehicle receives a significant amount of pseudo-IDs and the corresponding signature key from the Trusted Authority (TA), it uses them to sign a message during the broadcasting process. Thus, the proposed scheme requires each vehicle to check all the broadcasting messages received. Besides, in the proposed scheme, the TA can revoke misbehaving vehicles from continuously broadcasting signed messages, thus preventing insider attacks. The security analysis proved that the proposed scheme fulfilled the security requirements, including identity privacy-preservation, message integrity and authenticity, unlinkability, and traceability. The proposed scheme also withstood common security attacks such as man-in-the-middle, impersonation, modification, and replay attacks. Besides, our scheme was resistant against an adaptive chosen-message attack under the random oracle model. Furthermore, our scheme did not employ bilinear pairing operations; therefore, the performance analysis and comparison showed a lower resulting overhead than other identity-based schemes. The computation costs of the message signing, individual signature authentication, and batch signature authentication were reduced by 49%, 33.3%, and 90.2%, respectively.
Subject(s)
Anonyms and Pseudonyms , Privacy , Communication , Computer Security , HumansABSTRACT
This paper describes an advanced form of pseudonymisation in a large cohort study on Parkinson's disease, called Personalized Parkinson Project (PPP). The study collects various forms of biomedical data of study participants, including data from wearable devices with multiple sensors. The participants are all from the Netherlands, but the data will be usable by research groups worldwide on the basis of a suitable data use agreement. The data are pseudonymised, as required by Europe's General Data Protection Regulation (GDPR). The form of pseudonymisation that is used in this Parkinson project is based on cryptographic techniques and is 'polymorphic': it gives each participating research group its own 'local' pseudonyms. Still, the system is globally consistent, in the sense that if one research group adds data to PPP under its own local pseudonyms, the data become available for other groups under their pseudonyms. The paper gives an overview how this works, without going into the cryptographic details.
Subject(s)
Anonyms and Pseudonyms , Computer Security , Parkinson Disease , Cohort Studies , Humans , Netherlands , Parkinson Disease/therapySubject(s)
Anonyms and Pseudonyms , Malpractice , Child , Compensation and Redress , Humans , Liability, Legal , Sterilization , Sterilization, Reproductive , Wrongful LifeABSTRACT
Name-altering practices are common in many creative fields-pen names in literature, stage names in the performing arts, and aliases in music. More than just reflecting artistic habits or responding to the need for distinctive brands, these practices can also serve as test devices to probe, validate, and guide the artists' active participation in a cultural movement. At the same time, they constitute a powerful probe to negotiate the boundaries of a subculture, especially when its features are threatened by appropriation from the mass-oriented culture. Drawing evidence from electronic music, a field where name-altering practices proliferate, we outline dynamics of pseudonymity, polyonymy, and anonymity that surround the use of aliases. We argue that name-altering practices are both a tool that artists use to probe the creative environment and a device to recursively put one's creative participation to the test. In the context of creative subcultures, name-altering practices constitute a subtle but effective form of underground testing.
Subject(s)
Anonyms and Pseudonyms , Electronics , Music , Creativity , Female , Humans , MaleABSTRACT
RESUMEN Objetivo: Estimar la asociación entre la adicción a internet (AI) y el rendimiento académico de los estudiantes de Odontología de la Universidad de Cartagena. Material y métodos: Estudio de corte transversal en 402 estudiantes, seleccionados de modo no probabilístico, que respondieron a un cuestionario anónimo autoaplicado que incluía variables sociodemográficas, rendimiento académico (promedio acumulado del último semestre), presencia de AI (test de Young) y variables relacionadas con la AI en función del rendimiento académico. Los datos se analizaron a partir de proporciones, relaciones entre variables con test de la X 2, y la asociación se obtuvo por razones de disparidad (OR) a través de regresión logística nominal. Resultados: El 75,3% de los estudiantes mostraban AI; el 24,63% utilizaba internet mucho menos que la población promedio; el 73,13% mostraba una AI leve; el 2,24%, una AI moderada y no hubo casos de AI grave; el 5,2% tenía bajo rendimiento académico. En el análisis multivariable, el modelo que mejor explica la AI en relación con el rendimiento académico fue: estudiar en semestres inferiores (OR = 0,54; IC95%, 0,32-0,91), estudiar en lugar distinto de la casa (OR = 3,38; IC95%, 1,71-6,68), usar elemento no portátil para estudiar (OR = 0,41; IC95%, 0,19-0,89), chatear por celular (OR = 2,43; IC95%, 1,45-3,06) y demorar más de 18 min (OR = 3,20; IC95%, 1,71-5,99) mientras se estudia. Conclusiones: El rendimiento académico no se asocia con la AI. Sin embargo, estudiar en semestres inferiores, en un lugar distinto de la casa, emplear elementos no portátiles para estudiar e invertir más de 18 min en contestar el celular y chatear mientras se estudia son covariables estadísticamente asociadas con la AI.
ABSTRACT Objective: To determine the association between Internet addiction (IA) and academic performance in dental students at the University of Cartagena. Material and methods: A cross-sectional study was conducted in 402 students included through non-probabilistic sampling who answered an anonymous and self-reporting questionnaire that included socio-demographic variables, academic performance (last semester overall grade), presence of IA (Young's Test) and covariates related to IA based on academic performance. Data were analysed by means of proportions, relationships between variables with the X 2 test and strength of association was estimated with odds ratios (OR) using nominal logistic regression. Results: Approximately 24.63% of the students used the Internet much less than the average population, but 75.3% had IA; 73.13% of cases were considered mild and 2.24% moderate. There were no severe cases. Around 5.2% had poor academic performance. In multivariate analysis, the model that best explained IA in relation to academic performance was: studying in lower-level courses (OR=0.54; 95% CI, 0.32-0.91); studying in a different places of the house (OR=3.38; 95% CI, 1.71-6.68); not using laptop for studying (OR=0.41; 95% CI, 0.19-0.89), chatting on mobile phone (OR=2.43; 95% CI, 1.45-3.06); and spending more than 18 minutes on mobile phone while studying (OR=3.20; 95% CI, 1.71-5.99). Conclusions: Academic performance was not associated with AI. However, studying in lower-level courses, in a different place of the house, not using laptop to study, and spending more than 18 minutes answering their mobile phone and chatting on mobile phone while studying were covariates statistically associated with IA.
Subject(s)
Humans , Male , Female , Adult , Students, Dental , Internet , Academic Performance , Universities , Odds Ratio , Cross-Sectional Studies , Multivariate Analysis , Cell Phone , Ego , Anonyms and PseudonymsABSTRACT
BACKGROUND: The collection of data and biospecimens which characterize patients and probands in-depth is a core element of modern biomedical research. Relevant data must be considered highly sensitive and it needs to be protected from unauthorized use and re-identification. In this context, laws, regulations, guidelines and best-practices often recommend or mandate pseudonymization, which means that directly identifying data of subjects (e.g. names and addresses) is stored separately from data which is primarily needed for scientific analyses. DISCUSSION: When (authorized) re-identification of subjects is not an exceptional but a common procedure, e.g. due to longitudinal data collection, implementing pseudonymization can significantly increase the complexity of software solutions. For example, data stored in distributed databases, need to be dynamically combined with each other, which requires additional interfaces for communicating between the various subsystems. This increased complexity may lead to new attack vectors for intruders. Obviously, this is in contrast to the objective of improving data protection. What is lacking is a standardized process of evaluating and reporting risks, threats and countermeasures, which can be used to test whether integrating pseudonymization methods into data collection systems actually improves upon the degree of protection provided by system designs that simply follow common IT security best practices and implement fine-grained role-based access control models. To demonstrate that the methods used to describe systems employing pseudonymized data management are currently heterogeneous and ad-hoc, we examined the extent to which twelve recent studies address each of the six basic security properties defined by the International Organization for Standardization (ISO) standard 27,000. We show inconsistencies across the studies, with most of them failing to mention one or more security properties. CONCLUSION: We discuss the degree of privacy protection provided by implementing pseudonymization into research data collection processes. We conclude that (1) more research is needed on the interplay of pseudonymity, information security and data protection, (2) problem-specific guidelines for evaluating and reporting risks, threats and countermeasures should be developed and that (3) future work on pseudonymized research data collection should include the results of such structured and integrated analyses.
Subject(s)
Anonyms and Pseudonyms , Biomedical Research , Confidentiality , Computer Communication Networks , Computer Security/standards , HumansABSTRACT
Intelligent Transport System (ITS) uses the IEEE 802.11P standard for the wireless communication among vehicles. A wireless ad hoc network of vehicles is established to improve road safety, comfort, security, and traffic efficiency. Wireless communication in ITS leads to many security and privacy challenges. Security and privacy of ITS are important issues that demand incorporation of confidentiality, privacy, authentication, integrity, non-repudiation, and restrictive obscurity. In order to ensure the privacy of vehicles during communication, it is required that the real identity of vehicles should not be revealed. There must be robust and efficient security and privacy mechanisms for the establishment of a reliable and trustworthy network. Therefore, we propose Advanced Strong Pseudonym based Authentication (ASPA), which is a distributed framework to handle the security and privacy issues of vehicle communications in ITS. ASPA only allows vehicles with valid pseudonyms to communicate in ITS. Pseudonyms are assigned to vehicles in a secure manner. The pseudonym mappings of vehicles are stored at different locations to avoid any chance of vehicle pseudonyms certificates linkability. In addition, the most recent communication pseudonyms of a malicious vehicle are revoked and are stored in the Certificate Revocation List (CRL) that results in small size of the CRL. Therefore, the CRL size does not increase exponentially. The distributed framework of ASPA guarantees, the vehicles privacy preservation in the real identities mapping and revocation phase. The empirical results prove that ASPA is robust and efficient with low computational cost, overhead ratio, average latency, and an increased delivery ratio.
Subject(s)
Accidents, Traffic/prevention & control , Anonyms and Pseudonyms , Transportation/ethics , Wireless Technology/ethics , Automobiles/legislation & jurisprudence , Computer Security , Humans , PrivacyABSTRACT
This contribution aims at analysing and presenting a comparative dimension concerning the issues raised for the upcoming French Bioethics law revision in the field of assisted reproductive technologies (ART) : access of female same-sex couples and single women to ART ; the authorization of post-mortem procreation ; enlarging eligibility criteria for oocyte self-conservation ; and lifting the anonymity of gamete donation. These questions touch at the very heart of the French bioethics model conceived in 1994, and their revision would constitute a conceptual upheaval.
Subject(s)
Bioethical Issues , Reproductive Techniques, Assisted/ethics , Reproductive Techniques, Assisted/legislation & jurisprudence , Anonyms and Pseudonyms , Bioethics/trends , Female , Fertility Preservation/ethics , Fertility Preservation/legislation & jurisprudence , Humans , Infertility, Female/psychology , Infertility, Female/therapy , Marriage , Oocyte Donation/ethics , Oocyte Donation/legislation & jurisprudence , Posthumous Conception/ethics , Posthumous Conception/legislation & jurisprudence , Reproductive Techniques, Assisted/standards , Reproductive Techniques, Assisted/trends , Sexual and Gender Minorities/legislation & jurisprudence , Single Person/legislation & jurisprudenceABSTRACT
BACKGROUND/AIMS: Current knowledge and viewpoints regarding biosimilars among physicians in Asia are unknown, even though these were investigated by European Crohn's and Colitis Organization (ECCO) members in 2013 and 2015. Thus, this study conducted a multinational survey to assess the awareness of biosimilar monoclonal antibodies among Asian physicians.METHODS: A 17-question multiple-choice anonymous web survey was conducted with the logistic support of the Asian Organization of Crohn's and Colitis (AOCC). Randomly selected AOCC members were invited by e-mail to participate between February 24, 2017 and March 26, 2017.RESULTS: In total, 151 physicians from eight Asian countries responded to the survey. Most of the participants were gastroenterologists (96.6%), and 77.5% had cared for inflammatory bowel diseases (IBD) patients for more than 5 years. The majority of the respondents (66.2%) were aware that a biosimilar is similar but not equivalent to the originator. The majority of respondents (77.5%) considered cost saving to be the main advantage of biosimilars, but a high percentage of respondents (38.4%) were concerned about a different immunogenicity from that of the originator (92.4% and 27.1% respectively in ECCO 2015). Only 19.2% considered that the originator and biosimilars were interchangeable, and only 6.0% felt very confident in the use of biosimilars (44.4% and 28.8% respectively in ECCO 2015).CONCLUSIONS: Asian gastroenterologists in 2017 are generally well informed about biosimilars. On the other hand, compared to the ECCO members surveyed in 2015, Asian gastroenterologists had more concerns and less confidence about the use of biosimilars in clinical practice. Thus, IBD-specific data on the comparison of the efficacy, safety, and immunogenicity in Asian patients are needed.
Subject(s)
Humans , Anonyms and Pseudonyms , Antibodies, Monoclonal , Asia , Asian People , Biosimilar Pharmaceuticals , Colitis , Cost Savings , Electronic Mail , Hand , Inflammatory Bowel Diseases , Infliximab , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To explore current practice and influencing factors on adoption of the opportunistic salpingectomy (OS), particularly regarding the decision making, to eventually enhance the development and implementation of clear guidelines. METHODS: This nationwide cross-sectional survey study was conducted in all hospitals in the Netherlands. An anonymous online survey was sent to gynecologists with special interest in gynecological oncology, gynecological endoscopy or urogynecology and all Dutch gynecology trainees. The survey mainly focused on current practice regarding OS and identification of influencing factors on the level of innovation, organization, healthcare professional and individual patient. RESULTS: The response rate was 348 out of 597 gynecologists (58.3%) and 142 out of 340 trainees (41.8%). Current practice of discussing and performing the OS varied widely, with ovarian cancer (OC) risk reduction as most important supportive factor on innovation level. Supportive factors on the level of organization and healthcare provider were; working in a non-training hospital, knowledge of current literature and extensive work experience (in years and annual number of hysterectomies). On individual patient level, a vaginal approach of hysterectomy, negative family history for OC and the presence of firm adhesions were suppressive factors for the OS. CONCLUSION: In this study we evaluated the current practice regarding the opportunistic salpingectomy in the Netherlands and identified influencing factors on different levels to raise awareness and attribute to development of a targeted implementation strategy, on both national and international level.
Subject(s)
Humans , Anonyms and Pseudonyms , Cross-Sectional Studies , Decision Making , Delivery of Health Care , Endoscopy , Gynecology , Health Personnel , Hysterectomy , Netherlands , Ovarian Neoplasms , Primary Prevention , Risk Reduction Behavior , SalpingectomyABSTRACT
OBJECTIVE: This study examined the incidence of workplace violence (WPV) in an emergency department (ED), and its influence on ED workers' mental health. METHODS: A cross-sectional, anonymous survey was conducted on ED workers employed in a local emergency medical center during August 2018. The survey respondents' data on the demographic characteristics, WPV episode, Korean-translated Brief Encounter Psychosocial Instrument (BEPSI-K), stress questionnaire for Korean National Health and Nutrition Examination Survey (KNHANES), and Patient Health Questionnaire-9 (PHQ-9) were obtained. The results of the stress (BEPSI-K, KNHANES) and depression (PHQ-9) score were compared with the WPV experience of ED workers. RESULTS: A total of 104 of 120 ED workers (86.7%) were exposed to WPV. ED workers that experienced physical violence within the past year had higher KNHANES, BEPSI-K, and PHQ-9 than the workers, who did not experience such violence (P≤0.001). In addition, this survey demonstrated that a physical violence episode within the past year was associated with above moderate depression (P≤0.001; odds ratio, 19.597). CONCLUSION: Recent physical violence can cause psychiatric disorders in ED workers, such as depression or stress disorder. Therefore, policies are needed to prevent WPV in ED and support ED workers who have experienced WPV.
Subject(s)
Humans , Anonyms and Pseudonyms , Depression , Emergencies , Emergency Service, Hospital , Incidence , Mental Health , Nutrition Surveys , Odds Ratio , Physical Abuse , Violence , Workplace ViolenceABSTRACT
BACKGROUND AND OBJECTIVES: Pediatric vocal health problems are relatively common. However, it is not yet well studied whether uniform diagnosis and treatment is done properly in South Korea. The purpose of this study was to investigate the methods that the Korean speech therapists use to diagnose and treat pediatric voice problem. MATERIALS AND METHOD: An anonymous online questionnaire was administered to 32 speech language therapists registered at the Korean laryngeal speech linguistics society detailing demographics, employment institution, general management of pediatric patients with vocal problem including assessment and treatment procedures. RESULTS: Current practice patterns were analyzed on 32 speech language therapists providing services in South Korea mostly working at tertiary university hospital. One third of pediatric patients were assessed without proceeding to treatment. One fifth of patients were treated without assessment. Perceptual assessment was the main pre-treatment assessment methods used. Treatment was done in the following order : Voice rest, SOVT, yawn-sigh and resonant voice. Post-treatment evaluation was used in the following order : Instrumental assessment, clinical judgment, and recording comparison. CONCLUSION: Speech language therapists practice in South Korea mostly follows the ASHA practice guidelines. However, there are still great amount of cases in which only the evaluation was done without appropriate treatment. Further research is needed to make SPLs more systematic and efficient for evaluating and treating pediatric vocal patients.
Subject(s)
Humans , Anonyms and Pseudonyms , Clothing , Demography , Diagnosis , Employment , Judgment , Korea , Linguistics , Methods , VoiceABSTRACT
OBJECTIVE: The suicide rate in South Korea was the second highest among the Organization for Economic Cooperation and Development countries in 2017. The purpose of this study is to understand the characteristics of people who died by suicide in Korea from 2013–2017 and to better prevent suicide. METHODS: This study was performed by the Korea Psychological Autopsy Center (KPAC), an affiliate of the Korea Ministry of Health and Welfare. According to the Korea National Statistical Office, the number of suicide victims nationwide was estimated to reach about 70,000 from 2013 to 2017. Comprehensive suicide records from all 254 police stations in South Korea were evaluated by 32 investigators who completed a 14-day didactic training program. Then, we evaluated the characteristics of suicide victims in association with disease data from the National Health Insurance Database (NHID), which is anonymously linked to personal information of suicide victims. RESULTS: Thirty-one of 254 police stations in the Seoul metropolitan area were analyzed by August 10, 2018. Findings showed that the characteristics of suicide victims differed according to the nature of the region. CONCLUSION: Our results suggest that different strategies and methods are needed to prevent suicide by regional groups.
Subject(s)
Humans , Anonyms and Pseudonyms , Autopsy , Education , Korea , Methods , National Health Programs , Organisation for Economic Co-Operation and Development , Police , Research Personnel , Seoul , SuicideABSTRACT
PURPOSE: Residents' duty-hour regulations and the evolution of minimally invasive surgical techniques require more effective and efficient surgical skill teaching models. We used frozen-thawed human tissue remnants harvested during abdominoplasty or abdominal tissue-based breast reconstruction to allow for a medium-sized group workshop program, simulating a realistic surgical environment and visual/haptic feedback. METHODS: Full-thickness abdominal tissue (skin and subcutaneous fat) were donated from patients who underwent autologous breast reconstruction and gave consent to use their tissue for comprehensive research and medical educational purposes. Anonymized tissue was frozen-preserved and then thawed the day of the surgical skills workshop. A total of 53 residents completed 50-minute hands-on training in 3-to-5 person modules in four sessions of the workshop program. RESULTS: Thawed tissue regained almost normal texture and consistency. Structural integrity was also histologically confirmed. All participants were generally satisfied with the program, especially regarding the suture material provided. CONCLUSION: Frozen-thawed tissue remnants from abdominoplasty or autologous breast reconstruction could be preserved and used as a suture education material in medium-group workshops for surgery residents or medical students given anonymity and with proper consent guaranteed. This approach provided an excellent model maintaining relatively real anatomic structure and consistency with minimal cost.