That’s the Ticket: Arguing for a Narrower Interpretation of the Exceptions Clause in the Driver’s Privacy Protection Act

The Driver\u27s Privacy Protection Act of 1994 restricts states from disclosing personal identifying information contained in an individual\u27s motor vehicle record without that person\u27s express consent. The DPPA was a response to tragic incidents in which such information was released to members of the public who used it to locate people and commit crimes against them. However, Congress inserted into the Act a list of fourteen exceptions under which certain parties may still access these state records for specific permissible uses. These exceptions recognized the need for such disclosure in the interests of the legitimate operational needs of government and some business entities, including law enforcement administration. However, the protections Congress intended to give licensed drivers in DPPA are mostly meaningless when the party requesting private information is a business or government entity that invokes one of the exceptions, which have been broadly interpreted by the courts. When the party disclosing private information is a law enforcement agency, it is especially difficult for an individual to succeed in an action under DPPA no matter how unreasonable or unnecessary the use of his information appears. Such was the case in Senne vs. Palatine, a 2011 Seventh Circuit decision that was vacated and argued before an en banc panel in February 2012, in which the court for the first time addressed how far a public entity may go in using an individual\u27s personal information pursuant to the enumerated exceptions in the law. This Note discusses how the Seventh Circuit and other federal courts have interpreted this exceptions clause and argues that it is allowing courts to find loopholes that were not intended by the drafters of DPPA. This Note concludes that federal courts should narrowly apply the exceptions in keeping with the original intent of the law to protect drivers\u27 privacy

Methadone and Corrected QT Prolongation in Pain and Palliative Care Patients: A Case–Control Study

Background: Methadone (ME) is commonly used in pain and palliative care (PPC) patients with refractory pain or intolerable opioid adverse effects (AEs). A unique ME AE is its corrected QT (QTc) interval prolongation risk, but most evidence exists in methadone maintenance therapy patients. Objective: Our goal was to identify QTc interval prolongation risk factors in PPC patients receiving ME and other medications known to prolong the QTc interval and develop a risk stratification tool. Design: We performed a case–control study of adult inpatients receiving ME for pain management. Settings/Subjects: Adult inpatients receiving ME with a QTc \u3e470 msec (males) and \u3e480 msec (females) were matched 1:2 according to age, history of QTc prolongation, and gender with ME patients who did not have a prolonged QTc interval. QTc prolongation risk factors were collected for both groups. Covariates were analyzed using conditional logistic regression. Classification and regression tree analysis was used to identify the ME dose associated with QTc prolongation. Results: Predictors of QTc prolongation included congestive heart failure (CHF) (OR: 11.9; 95% CI: 3.7–38.2; p \u3c 0.00), peptic ulcer disease (PUD) (odds ratio [OR]: 8.3; 95% confidence interval [95% CI]: 2.4–28.9; p \u3c 0.00), hypokalemia (OR: 6.5; 95% CI: 1.5–28.2; p \u3c 0.01), rheumatologic diseases (OR: 4.7; 95% CI: 1.6–13.9; p \u3c 0.00), taking medications with a known torsades de pointes (TdP) risk (OR: 4.4; 95% CI: 1.8–10.7; p \u3c 0.01), malignancy (OR: 3.3; 95% CI: 1.2–9.3; p \u3c 0.03), hypocalcemia (OR: 2.1; 95% CI: 0.9–4.8; p \u3c 0.07), and ME doses \u3e45 mg per day (OR: 1.9; 95% CI: 0.8–4.8; p \u3c 0.16). Mild liver disease was protective against QTc prolongation (OR: 0.05; 95% CI: 0.0–0.46; p \u3c 0.01). Conclusions: Predictors of QTc prolongation in our multivariate conditional logistic regression model included CHF, PUD, hypokalemia, rheumatologic disorders, use of medications with a known TdP risk, malignancy, hypocalcemia, and ME doses \u3e45 mg per day

Thermohaline variability of AAIW in the Atlantic sector of the Southern Ocean investigated using an Altimetry Gravest Empirical Mode

The southeast Atlantic sector of the Southern Ocean connects the Atlantic with the Indian Ocean and the Antarctic Circumpolar Current, thereby acting as a major conduit within global ocean circulation. Thermohaline transports in this region are widely thought to have a critical influence on global climate. Yet magnitudes of the associated heat and salt content variations are poorly understood due to a lack of hydrographic observations and model limitations. An improved Gravest Empirical Mode (GEM) is set up for the Southern Ocean south of Africa using the updated store of hydrographic measurements obtained from CTD transects for the area, combined with the available Argo profiles sampled in the region. Satellite altimetry is combined with the GEM relationships to create an Altimetry GEM (AGEM), thereby generating 20 years of temperature and salinity fields. These thermohaline sections for the region of the ocean south of Africa are found to be proficient at reproducing observations, with associated RMS errors being two orders of magnitude smaller than those reported by other comparable Southern Ocean GEM studies. Confident in the accuracy of the AGEM produced fields, an examination of the temporal evolution of Antarctic Intermediate Water (AAIW) is undertaken. The fluctuation and trends in heat and salt content anomalies and budgets is presented for each Southern Ocean frontal zone, along with the examination of the change in position of the isopycnal limits and resultant water mass thickness. So as to better understand one of the factors that may be influencing some of the changes detected within AAIW, property alterations of eddies identified in the region from 1992 to 2010 are investigated. A general decrease in magnitude and frequency of cyclones, coupled with an increase in absolute dynamic topography (ADT) of anticyclones, designates elevated injection of warm, saline water into the area. The connection identified between eddy property variations and AAIW modification in the region of the ocean south of Africa indicates that the water mass experiences ventilation with the mixed layer at latitudes further north than previously thought to occur. Obtaining an improved image of the magnitudes and variability of AAIW thermohaline properties in the Atlantic sector of the Southern Ocean greatly improves our understanding of its role in the ocean-climate system

Adelphi Club Two - Step

https://digitalcommons.library.umaine.edu/mmb-ps/2317/thumbnail.jp

A Qualitative Study of Patients' Attitudes toward HIV Testing in the Dental Setting

An estimated 1.1 million people in the USA are living with HIV/AIDS. Nearly 200,000 of these individuals do not know that they are infected. In 2006, the CDC recommended that all healthcare providers routinely offer HIV screening to adolescent and adult patients. Nurse-dentist collaborations present unique opportunities to provide rapid oral HIV screening to patients in dental clinic settings and reach the many adults who lack primary medical providers. However, little is known about the feasibility and acceptability of this type of innovative practice. Thus, elicitation research was undertaken with dental providers, students, and patients. This paper reports the results of qualitative interviews with 19 adults attending a university-based dental clinic in New York City. Overall, patients held very positive attitudes and beliefs toward HIV screening in dental sites and identified important factors that should be incorporated into the design of nurse-dentist collaborative HIV screening programs

The Crossroads of Interprofessionalism: Four Avenues of Collaboration at the Wegmans School of Pharmacy

Objective: The utilization of interprofessional education and collaborative practice delivers optimal health services and improves patient outcomes. Training future healthcare providers in an integrated environment promotes a “collaborative practice-ready” workforce. The aim of this study was to identify ongoing specific interprofessional collaborative projects and promote their awareness among faculty at the St. John Fisher College Wegmans School of Pharmacy. Methods: Faculty members were surveyed to identify the ongoing interprofessional collaborative initiatives among pharmacy faculty. Results: A total of four collaborative practices were identified among faculty: ambulatory care, assisted-living, didactic, and assessment. The ambulatory care setting at an osteoporosis clinic provides patient-centered care with a clinical component. Each patient with a new diagnosis or change in medication therapy receives education/counseling from a pharmacist, a registered nurse for medication administration and a physician for a physical exam. In the assisted-living setting, pharmacy and nursing students are paired to conduct a high-level health assessment in their respective disciplines. Didactic interprofessional efforts are being conducted to create a flexible and comprehensive pain education curriculum. Physicians, dentists, nurses, pharmacists, psychologists, chiropractors, and oriental medicine practitioners will develop the curriculum. The pain module will be adaptable for interprofessional education activities. Finally, recognizing the similarities in accreditation standards for communication and professionalism, the School of Pharmacy and the NY Chiropractic School are sharing strategies and rubrics for assessing these outcomes. Implications: The survey revealed a broader range of interprofessional collaborations than was originally suspected. The school will continue to foster and support interprofessional education and collaborative practice

Health Diplomacy the Adaptation of Global Health Interventions to Local Needs in sub-Saharan Africa and Thailand: Evaluating Findings from Project Accept (HPTN 043).

Study-based global health interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1) respond to socio-cultural differences in risk determinants, (2) to make interventions more relevant to target population needs, and (3) in recognition of 'global health diplomacy' issues. We report on the adaptations development, approval and implementation process from the Project Accept voluntary counseling and testing, community mobilization and post-test support services intervention. We reviewed all relevant documentation collected during the study intervention period (e.g. monthly progress reports; bi-annual steering committee presentations) and conducted a series of semi-structured interviews with project directors and between 12 and 23 field staff at each study site in South Africa, Zimbabwe, Thailand and Tanzania during 2009. Respondents were asked to describe (1) the adaptations development and approval process and (2) the most successful site-specific adaptations from the perspective of facilitating intervention implementation. Across sites, proposed adaptations were identified by field staff and submitted to project directors for review on a formally planned basis. The cross-site intervention sub-committee then ensured fidelity to the study protocol before approval. Successfully-implemented adaptations included: intervention delivery adaptations (e.g. development of tailored counseling messages for immigrant labour groups in South Africa) political, environmental and infrastructural adaptations (e.g. use of local community centers as VCT venues in Zimbabwe); religious adaptations (e.g. dividing clients by gender in Muslim areas of Tanzania); economic adaptations (e.g. co-provision of income generating skills classes in Zimbabwe); epidemiological adaptations (e.g. provision of 'youth-friendly' services in South Africa, Zimbabwe and Tanzania), and social adaptations (e.g. modification of terminology to local dialects in Thailand: and adjustment of service delivery schedules to suit seasonal and daily work schedules across sites). Adaptation selection, development and approval during multi-site global health research studies should be a planned process that maintains fidelity to the study protocol. The successful implementation of appropriate site-specific adaptations may have important implications for intervention implementation, from both a service uptake and a global health diplomacy perspective

Seismic Performance Assessment in Dense Urban Environments: Evaluation of Nonlinear Building-Foundation Systems Using Centrifuge Tests

In dense urban areas, buildings are generally constructed in clusters, forming city blocks. New buildings are designed assuming their response is independent of adjacent buildings, which ignores potentially important structure-soil-structure-interaction (SSSI) effects. Although a few studies have revealed the significance of SSSI effects, validated simulation and design tools do not exist. In this paper, we present the results from the first in a series of centrifuge tests intended to investigate SSSI effects. Results herein are focused on the design and measured response of two model building-foundation systems placed on dense dry Nevada sand and tested at 55-g. The two models represent prototypical nine-story and three-story special moment resisting frame buildings, with the former structure supported by a three-level basement-mat and the later on isolated spread footings. Nonlinear response-history simulations are performed to aid in the design of the models, with particular attention to reproducing prototype building periods and nonlinear characteristics. Yielding of the model buildings is achieved using custom-designed fuses placed strategically throughout the superstructures. At present, the two models are placed as far apart as possible to characterize soil-structure interaction on individual buildings; subsequent experiments will move the structures in near proximity, allowing direct experimental assessment of structuresoil- structure-interaction