217 research outputs found

    Keys in the Clouds: Auditable Multi-device Access to Cryptographic Credentials

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    Personal cryptographic keys are the foundation of many secure services, but storing these keys securely is a challenge, especially if they are used from multiple devices. Storing keys in a centralized location, like an Internet-accessible server, raises serious security concerns (e.g. server compromise). Hardware-based Trusted Execution Environments (TEEs) are a well-known solution for protecting sensitive data in untrusted environments, and are now becoming available on commodity server platforms. Although the idea of protecting keys using a server-side TEE is straight-forward, in this paper we validate this approach and show that it enables new desirable functionality. We describe the design, implementation, and evaluation of a TEE-based Cloud Key Store (CKS), an online service for securely generating, storing, and using personal cryptographic keys. Using remote attestation, users receive strong assurance about the behaviour of the CKS, and can authenticate themselves using passwords while avoiding typical risks of password-based authentication like password theft or phishing. In addition, this design allows users to i) define policy-based access controls for keys; ii) delegate keys to other CKS users for a specified time and/or a limited number of uses; and iii) audit all key usages via a secure audit log. We have implemented a proof of concept CKS using Intel SGX and integrated this into GnuPG on Linux and OpenKeychain on Android. Our CKS implementation performs approximately 6,000 signature operations per second on a single desktop PC. The latency is in the same order of magnitude as using locally-stored keys, and 20x faster than smart cards.Comment: Extended version of a paper to appear in the 3rd Workshop on Security, Privacy, and Identity Management in the Cloud (SECPID) 201

    Consumption patterns and living conditions inside Het Steen, the late medieval prison of Malines (Mechelen, Belgium)

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    Excavations at the Main Square (Grote Markt) of Malines (Mechelen, Belgium) have unearthed the building remains of a tower, arguably identifiable as the former town prison: Het Steen. When this assumption is followed, the contents of the fills of two cesspits dug out in the cellars of the building illustrate aspects of daily life within the early 14th-century prison. An integrated approach of all find categories, together with the historical context available, illuminates aspects of the material culture of the users of the cesspits, their consumption patterns and the living conditions within the building

    Professionals' perspectives on interventions to reduce problematic alcohol use in older adults:A realist evaluation of working elements

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    Objectives This study set out to understand how (which elements), in what context and why (which mechanisms) interventions are successful in reducing (problematic) alcohol use among older adults, from the perspective of professionals providing these interventions.Design Guided by a realist evaluation approach, an existing initial programme theory (IPT) on working elements in alcohol interventions was evaluated by conducting semistructured interviews with professionals.Setting and participants These professionals (N=20) provide interventions across several contexts: with or without practitioner involvement; in-person or not and in an individual or group setting. Data were coded and links between contexts, elements, mechanisms and outcomes were sought for to confirm, refute or refine the IPT.Results From the perspective of professionals, there are several general working elements in interventions for older adults: (1) pointing out risks and consequences of drinking behaviour; (2) paying attention to abstinence; (3) promoting contact with peers; (4) providing personalised content and (5) providing support. We also found context-specific working elements: (1) providing personalised conversations and motivational interviewing with practitioners; (2) ensuring safety, trust and a sense of connection and a location nearby home or a location that people are familiar with in person and (3) sharing experiences and tips in group interventions. Furthermore, the mechanisms awareness and accessible and low threshold participation were important contributors to positive intervention outcomes.Conclusion In addition to the IPT, our findings emphasise the need for social contact and support, personalised content, and strong relationships (both between client and practitioner, and client and peers) in interventions for older adults

    Professionals' views on interventions to reduce and prevent problematic alcohol use in older adults

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    BackgroundInterventions to address problematic alcohol use in older adults are needed as alcohol use is highly prevalent among those over 55 years of age. For interventions to be most effective, their working elements should be leveraged. However, understanding of working elements specifically in interventions for older adults is limited. The aim of this study was to understand how (i.e., which elements), in which context, and why (which mechanisms) interventions are successful in preventing or reducing (problematic) alcohol use among older adults, from the perspective of professionals providing these interventions.MethodsGuided by a Realist Evaluation approach, an existing Initial Program Theory (IPT) on working elements in alcohol interventions, was tested by conducting semi-structured interviews with professionals (N = 20). These professionals provide interventions targeting alcohol use across several contexts: with or without practitioner involvement; in-person or not; and in an individual or in a group setting. Data were coded and links between contexts, elements, mechanisms and outcomes were sought for in order to confirm, refute or refine the IPT.ResultsSeveral general working elements were found: 1) pointing out the risks and consequences of drinking behavior, 2) paying attention to abstinence, 3) contact with peers, 4) personalized content and 5) providing support. We also found context-specific working elements:1) personalized content and conversations in interventions with practitioners, 2) safety, trust and feeling connected in in-person interventions and 3) sharing experiences and tips in group interventions.ConclusionsFindings are in general in line with the IPT. Our findings emphasize the need for social contacts and support for older adults. The mechanisms awareness and accessibility were important contributors to positive interventions outcomes. Further research should study the perspective of older adults and their relatives on interventions.Key messages• Social contacts and support are needed in interventions to reduce and prevent problematic alcohol use in older adults.• Awareness and accessibility are important contributors to positive interventions outcomes in interventions to reduce and prevent problematic alcohol use in older adults

    Working elements of alcohol interventions to prevent and reduce (problematic) alcohol use among people aged 55 and older: A systematic review

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    IntroductionProblematic alcohol use has been increasing in older adults (55+). Many of the interventions that are available to prevent or reduce alcohol consumption are aimed at adults in general. It is unclear whether these interventions also work for older adults. The objective of this review was to understand in what way (i.e., which elements), in which context and why interventions (which mechanisms) are successful in preventing or reducing (problematic) alcohol consumption among older adults.MethodsA systematic review of articles published between 2000 and 2022 was performed using PubMed, PsycINFO, Web of Science and CINAHL. A realist evaluation approach was used to analyze the data.ResultsWe found 61 studies on interventions aimed at preventing or reducing (problematic) alcohol use, of which most interventions were not specifically designed for older adults. Three major effective elements of interventions were found: 1) providing information on the consequences of alcohol consumption; 2) personalized feedback about drinking behavior; and 3) being in contact with others and communicating with them about (alcohol) problems. The first two elements were used in interventions designed for older adults.ConclusionMore research is needed on interventions aimed at preventing or reducing (problematic) alcohol use among older adults and on how older adults can be provided help in making contacts with people who support their decision to reduce alcohol consumption

    Nurse-sensitive outcomes in district nursing care: A Delphi study

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    Objectives To determine nurse-sensitive outcomes in district nursing care for community-living older people. Nurse-sensitive outcomes are defined as patient outcomes that are relevant based on nurses' scope and domain of practice and that are influenced by nursing inputs and interventions. Design A Delphi study following the RAND/UCLA Appropriateness Method with two rounds of data collection. Setting District nursing care in the community care setting in the Netherlands. Participants Experts with current or recent clinical experience as district nurses as well as expertise in research, teaching, practice, or policy in the area of district nursing. Main outcome measures Experts assessed potential nurse-sensitive outcomes for their sensitivity to nursing care by scoring the relevance of each outcome and the ability of the outcome to be influenced by nursing care (influenceability). The relevance and influenceability of each outcome were scored on a nine-point Likert scale. A group median of 7 to 9 indicated that the outcome was assessed as relevant and/or influenceable. To measure agreement among experts, the disagreement index was used, with a score of <1 indicating agreement. Results In Delphi round two, 11 experts assessed 46 outcomes. In total, 26 outcomes (56.5%) were assessed as nurse-sensitive. The nurse-sensitive outcomes with the highest median scores for both relevance and influenceability were the patient's autonomy, the patient's ability to make decisions regarding the provision of care, the patient's satisfaction with delivered district nursing care, the quality of dying and death, and the compliance of the patient with needed care. Conclusions This study determined 26 nurse-sensitive outcomes for district nursing care for communityliving older people based on the collective opinion of experts in district nursing care. This insight could guide the development of quality indicators for district nursing care. Further research is needed to operationalise the outcomes and to determine which outcomes are relevant for specific subgroups

    ROBO2 is a stroma suppressor gene in the pancreas and acts via TGF-β signalling.

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    Whereas genomic aberrations in the SLIT-ROBO pathway are frequent in pancreatic ductal adenocarcinoma (PDAC), their function in the pancreas is unclear. Here we report that in pancreatitis and PDAC mouse models, epithelial Robo2 expression is lost while Robo1 expression becomes most prominent in the stroma. Cell cultures of mice with loss of epithelial Robo2 (Pdx1Cre;Robo2F/F) show increased activation of Robo1+ myofibroblasts and induction of TGF-β and Wnt pathways. During pancreatitis, Pdx1Cre;Robo2F/F mice present enhanced myofibroblast activation, collagen crosslinking, T-cell infiltration and tumorigenic immune markers. The TGF-β inhibitor galunisertib suppresses these effects. In PDAC patients, ROBO2 expression is overall low while ROBO1 is variably expressed in epithelium and high in stroma. ROBO2low;ROBO1high patients present the poorest survival. In conclusion, Robo2 acts non-autonomously as a stroma suppressor gene by restraining myofibroblast activation and T-cell infiltration. ROBO1/2 expression in PDAC patients may guide therapy with TGF-β inhibitors or other stroma /immune modulating agents

    Duty of Karius: media framing of concussion following the 2018 UEFA Champions League Final

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    Concussion is a growing issue within sport, including within soccer. Despite the developing medical understanding of concussion, there is still an array of sociocultural discourses and misconceptions around it. In the 2018 UEFA Champions League Final, Liverpool Football Club goalkeeper Loris Karius suffered a head collision in the 48th minute. Postmatch, he was subsequently diagnosed as being concussed. As a result of his concussion, Karius’ performance was arguably impeded, with suggestions that this may have resulted in him making some key errors in the game. Through an analysis of media framing in 52 news articles in the days following the incident, four dominant frames were identified: deflection away from concussion, misunderstanding concussion, education on concussion, and recommendations. Frames that focussed on the lack of awareness and preventative measures that are present in soccer served to highlight the lack of significance afforded to concussion at this particular point in time. In particular, we highlight differences in concussion discourses between those working inside and outside the soccer industry. Overall, these findings contribute to the growing body of sociological work examining concussion in sport
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