Terveydenhuolto ja kyberuhkat

Finland’s cyber security strategy states that Finland has to be capable of protecting the vital functions of society, such as health care, against cyber threats. Currently, health care heads the TOP-5 list of cyber attacks because of the value of patient data in dark markets. In this article, we describe actual cyber threats, cyber vulnerabilities, and cyber attacks covering different dimensions of the cyber world. In this study, we use a five-layer cyber world network-model including physical, syntactic, semantic, service, and cognitive layers. The model covers widely the devices and networks from the physical layer to the human problem solving and interpretation environments in the cognitive layer. Also, the vulnerabilities of e.g. device-specific or human factor-related and realised attacks like phishing can be classified with the help of the model. Ransomwares, affecting the semantic layer, have received a lot of publicity lately. There are many ways to take safeguards against cyber threats in different layers. The starting point is that each organisation takes care of their cyber security in collaboration with other actors in recognising threats and in taking action against them. Creating cyber security is actually about managing the system. It is vital to focus on systems as a whole instead of individual devices. The target of the collaboration is that comprehensive know-how supports the facilities of each actor against a common threat. The continuous improvement of cyber security in health care, increasing awareness, and educating staff should be an essential part of the cyber strategy of any organisation.Kyberturvallisuusstrategian vision mukaan Suomen tulee kyetä suojaamaan elintärkeät toimintonsa kyberuhkaa vastaan kaikissa tilanteissa. Terveydenhuolto on yksi elintärkeistä toiminnoista. Terveystoimiala on kyberhyökkäysten top-5-listalla ensimmäisenä. Hyökkäysten keskeisin motivaatio on potilastietojen arvo pimeillä markkinoilla. Vuonna 2015 varastettiin yli satamiljoonaa potilastietoa, jotka sisältävät rikollisille arvokkaita tietoja, kuten luottokorttinumeroita, työnantajatietoja ja sairaushistoriatietoja. Tässä artikkelissa kuvataan terveydenhuoltoon liittyviä kyberuhkia, kyberhaavoittuvuuksia ja toteutuneita kyberhyökkäyksiä kybermaailman eri ulottuvuudet kattaen. Tarkastelussa käytetään kybermaailman viisikerroksista verkostomallia, joka sisältää fyysisen, syntaktisen, semanttisen, palvelu- ja kognitiivisen kerroksen. Malli kattaa laajasti koko kybermaailman fyysisen kerroksen laitteista ja verkoista kognitiivisen kerroksen inhimillisiin ongelmanratkaisu- ja tulkintaympäristöihin. Haavoittuvuuksia ja toteutuneita hyökkäyksiä voidaan mallin mukaan jaotella laitekohtaisista haavoittuvuuksista aina koulutuksen puutteista johtuviin haavoittuvuuksiin ja pelottelu- ja kalasteluohjelmilla tapahtuneisiin hyökkäyksiin. Paljon julkisuutta ovat saaneet myös terveydenhuoltoon kohdistuneet kiristyshaittaohjelmahyökkäykset. Kyberuhkia vastaan voidaan suojautua useilla eri tasoilla ja tavoilla. Lähtökohtana on se, että jokainen organisaatio huolehtii oman toimintansa kyberturvallisuudesta tehden yhteistyötä muiden toimijoiden kanssa uhkien tunnistamisessa ja torjumisessa. Terveydenhuollon kyberturvallisuuden rakentaminen on systeemin hallintaa, jossa tulee keskittyä järjestelmien kokonaisuuteen yksittäisten laitteiden sijaan. Yhteistoiminnan tavoitteena on, että kokonaisosaaminen tukee yksittäisen toimijan toimintaedellytyksiä yhteistä uhkaa vastaan. Terveydenhuollon kyberturvallisuuden jatkuva parantaminen ja tietoisuuden lisääminen ovat kaikkien kansalaisten etuja, jotka vaativat vahvaa ymmärrystä niin tietoturvasta kuin terveydenhuollon toimintatavoistakin. Tämän vuoksi tietoisuuden kohottamisen ja henkilökunnan kouluttamisen tuleekin olla keskeisellä sijalla organisaatioiden kyberturvallisuudessa

Digitization of data for a historical medical dictionary

What are known as specialized or specialist dictionaries are much more than lists of words and their definitions with occasional comments on things such as synonymy and homonymy. That is to say, a particular specialist term may be associated with many other concepts, including quotations, different senses, etymological categories, semantic categories, superordinate and subordinate terms in the terminological hierarchy, spelling variants, and references to background sources discussing the exact meaning and application of the term. The various concepts, in turn, form networks of mutual links, which makes the structure of the background concepts demanding to model when designing a database structure for this type of dictionary. The Dictionary of medical vocabulary in English, 1375–1550 is a specialized historical dictionary that covers the vast medical lexicon of the centuries examined. It comprises over 12,000 terms, each of them associated with a host of background concepts. Compiling the dictionary took over 15 years. The process started with an analysis of hand-written manuscripts and early printed books from different sources and ended with the electronic dictionary described in the present paper. Over these years, the conceptual structure, database schema, and requirements for essential use cases were iteratively developed. In our paper, we introduce the conceptual structure and database schema modelled for implementing an electronic dictionary that involves different use cases such as term insertion and linking a term to related concepts. The achieved conceptual model, database structure, and use cases provide a general framework for reference-oriented specialized dictionaries, including ones with a historical orientation.publishedVersionPeer reviewe

Effect of external cervical orthoses on clinical and radiological outcome of patients undergoing anterior cervical discectomy and fusion

Background The current use of external cervical orthoses (ECO) after cervical discectomy is still based on a common practice than a solid scientific literature. The aim of this study is to evaluate the impact of ECO on radiological and functional outcomes in patients undergoing anterior cervical discectomy and fusion (ACDF). Methods We compared two cohorts of consecutive patients who underwent ACDF with and without ECO after surgery. Thirty-six patients operated from January 2015 to June 2016 received an ECO whereas 36 patients, operated from July 2016 to December 2017, did not. Each patient underwent radiological and functional evaluation using plain x-ray at 1, 6, and 12 months after surgery and Neck Disability Index (NDI) at 2 weeks and 3, 6, and 12 months after surgery, respectively. Results In the ECO group, 5 patients (13.9%) presented an incomplete fusion and 31 patients (86.1%) presented a complete fusion (CI 0.705-0.953). In the non-ECO group, 8 patients (22.2%) presented an incomplete fusion and 28 patients (77.8% [CI 0.608-0.899]) had a complete fusion, with no statistically significant differences between two groups. No statistically significant differences were also observed regarding the NDI neither at 2 weeks nor at 3-, 6-, and 12-month follow-up. At multivariate analysis, patients who underwent two-level ACDF showed a five-fold increased risk of worse NDI at 3-, 6-, 12-month (p = 0.003, CI 1.770-14.584) follow-up. Conclusions We advise against the routine use of ECO after single- or two-level ACDF as we did not find out any significant statistical differences between the two groups

Plants and aromatics for embalming in Late Middle Ages and modern period: a synthesis of written sources and archaeobotanical data (France, Italy)

International audienceOccasionally mentioned in written sources since the Early Middle Ages, embalming with evisceration spreads considerably and becomes quite usual practice for aristocratic elites from the late 13th century to the early 19th century. Apothecaries prepare aromatic powders including many plant organs and exudates supposed to preserve the body. Numerous encyclopaedias and treatises of medicine list these ingredients and show that the recipes are very diverse. Moreover, several studies of embalmed bodies have demonstrated the potential of archaeobotanical analyses coupling pollen and macro-remains for identifying this material. This paper aims to compile a synthesis of written and archaeological sources from France and Italy, and to assess the relevance of an interdisciplinary approach for a better understanding of this aristocratic burial practice. It demonstrates that both types of sources and approaches are strongly complementary and highlights their inherent advantages and methodological limitations. In order to understand which criteria were determinant in the composition of the embalming powders, their medicinal, odoriferous and symbolic properties are discussed. Finally, this work proposes some methodological perspectives and triggers new research avenues on the history of pharmacy in Late Medieval and modern Europe

Security cafés : a deliberative democratic method to engage citizens in meaningful two-way conversations with security authorities and to gather data

The Security Café is a deliberation and data collection method developed for security authorities and researchers to access the opinion of the general public on issues of importance to their safety and security. It is based on the ideals of deliberative democracy, and the method derives from Citizens’ Juries and World Cafés. A Security Café typically lasts for 3–5 h and involves receiving information, facilitated small group discussions and the use of idea rating sheets, or pre- and post-deliberation attitudinal surveys. This study examines three projects conducted in Finland and concludes that the method has both intrinsic and extrinsic value: it empowers ordinary citizens and gives them an opportunity to engage in the construction of safer and more secure societies. At the same time, it offers authorities the opportunity to inform the public and most importantly to harvest the opinion of the public. For researchers, the method offers a feasible way to gather extensive reliable qualitative data quickly and effectively.fi=vertaisarvioitu|en=peerReviewed