International Relations and Cyber Attacks: Official and Unofficial Discourse

The potential for cyberwarfare is vast and is of concern to all nations, and national security defence. It appears that many countries are actively trying to protect their computer networks, whilst looking for ways that might bring down the networks of other countries, although this is not officially acknowledged. Bringing down another nations computer networks could give the attacking national intelligence and control. These kinds of interactions are now a part of the way in which international relations are played out, and the internet is also a place in which international relations are contested. As such the internet plays a role in the visualisation and articulation of international relations both officially and unofficially, via official pronouncements and the activities of private citizens. What makes the internet different to other media forms is that the internet also represents a space in which international relations are contested in terms of cyber attacks and information warfare. This paper analyses official and unofficial discourses surrounding the way in which international relations in regards to cyber attacks have been played out via the internet, using North Korea and Stuxnet as case studies

An Information Security Governance Framework for Australian Primary Care Health Providers

The competitive nature of business and society means that the protection of information, and governance of the information security function, is increasingly important. This paper introduces the notion of a governance framework for information security for health providers. It refines the idea of an IT Balanced Scorecard into a scorecard process for use in governing information security for primary care health providers, where IT and security skills may be limited. The approach amends and justifies the four main elements of the scorecard process. The existence of a governance framework specifically tailored for the needs of primary care practice is a critical success factor if such organizations are to move to a robust level of information security. The challenge is twofold. Firstly, measures for governance need to be understandable to the target audience using the framework. Secondly, the number of measures needs to be controllable otherwise the process will become unviable and unused. This research synthesizes existing models and industry standards to formulate a new governance process that meets these two important criteria. The contribution of this research is in the refinement of governance metrics to make them useful to healthcare providers, specifically in relation to IT and new information communication technologies

Comparison of efficacy in patients with metastatic melanoma treated with ipilimumab and nivolumab who did or did not discontinue treatment due to immune-related adverse events:A real-world data study

SIMPLE SUMMARY: This retrospective study of real-world patients with metastatic melanoma shows that discontinuing treatment with combination immunotherapy due to adverse events does not result in a poorer outcome compared to patients that did not discontinue due to toxicity. This is important knowledge for clinicians and patients, as discontinuing treatment may cause great anxiety for patients because they believe that it may limit the response. ABSTRACT: Immune-related adverse events (irAEs) are very prevalent when treating patients with ipilimumab and nivolumab in combination, and 30–40% of patients discontinue the treatment for this reason. It is of high clinical relevance to investigate the consequences of discontinuing the treatment early since combination therapy with ipilimumab and nivolumab is the first line of treatment for many patients with metastatic melanoma. In this follow-up study, with real-world data from the nationwide DAMMED database, we investigated whether there was a difference in progression-free survival (PFS) and overall survival (OS) for patients who discontinued or did not discontinue treatment within the first four doses of treatment due to irAEs. In total, 448 patients were treated with ipilimumab and nivolumab. Of these, 133 patients discontinued due to irAEs in the induction phase. Using the Cox proportional hazards model, there was no significant difference in PFS when comparing the group that discontinued with the group that did not discontinue. The group that discontinued had a significantly longer OS than the group that received the full length of treatment. Therefore, we conclude that there is no significant negative impact on efficacy for patients who discontinue due to irAEs in the induction phase of combination immunotherapy for metastatic melanoma

Designing clinical trials for assessing the effects of cognitive training and physical activity interventions on cognitive outcomes: The Seniors Health and Activity Research Program Pilot (SHARP-P) Study, a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>The efficacy of non-pharmacological intervention approaches such as physical activity, strength, and cognitive training for improving brain health has not been established. Before definitive trials are mounted, important design questions on participation/adherence, training and interventions effects must be answered to more fully inform a full-scale trial.</p> <p>Methods</p> <p>SHARP-P was a single-blinded randomized controlled pilot trial of a 4-month physical activity training intervention (PA) and/or cognitive training intervention (CT) in a 2 × 2 factorial design with a health education control condition in 73 community-dwelling persons, aged 70-85 years, who were at risk for cognitive decline but did not have mild cognitive impairment.</p> <p>Results</p> <p>Intervention attendance rates were higher in the CT and PACT groups: CT: 96%, PA: 76%, PACT: 90% (p=0.004), the interventions produced marked changes in cognitive and physical performance measures (p≤0.05), and retention rates exceeded 90%. There were no statistically significant differences in 4-month changes in composite scores of cognitive, executive, and episodic memory function among arms. Four-month improvements in the composite measure increased with age among participants assigned to physical activity training but decreased with age for other participants (intervention*age interaction p = 0.01). Depending on the choice of outcome, two-armed full-scale trials may require fewer than 1,000 participants (continuous outcome) or 2,000 participants (categorical outcome).</p> <p>Conclusions</p> <p>Good levels of participation, adherence, and retention appear to be achievable for participants through age 85 years. Care should be taken to ensure that an attention control condition does not attenuate intervention effects. Depending on the choice of outcome measures, the necessary sample sizes to conduct four-year trials appear to be feasible.</p> <p>Trial Registration</p> <p>Clinicaltrials.gov Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00688155">NCT00688155</a></p

AUSTRALIAN PRIMARY CARE HEALTH CHECK: WHO IS ACCOUNTABLE FOR INFORMATION SECURITY?

Primary healthcare in Australia is vulnerable to a multitude of information security threats and insecure practices. This situation is increasingly important in the developing e-health environment. Information security is everyone’s responsibility and it is extensively documented in international standards and best practice frameworks, that this responsibility should be part of formal job descriptions. This necessitates incorporation of security at a functional level for all staff. These responsibilities are integral to demonstrable accountability, together with an authority to take action. Indeed, whilst senior management will ultimately be held accountable, staff need to be aware of the potential issues, given the responsibility to be vigilant, and the authority to act when information security issues arise. This is pertinent within Australian primary healthcare where the accountability for information security is most often devolved to the role of the practice manager. This paper analyses information security accountability from an operational and strategic security capability viewpoint in terms of responsibility and authority. Further, it discusses this in regard to the associated information security governance perspective. In the trustful primary healthcare environment, the accountability for information security resides with operational level staff who have many competing aspects to their role. The paper suggests how to manage this layer of security without burdening the already busy practice manager

Australian primary health care check: Who is accountable for information security?

Primary healthcare in Australia is vulnerable to a multitude of information security threats and insecure practices. This situation is increasingly important in the developing e-health environment. Information security is everyone‘s responsibility and it is extensively documented in international standards and best practice frameworks, that this responsibility should be part of formal job descriptions. This necessitates incorporation of security at a functional level for all staff. These responsibilities are integral to demonstrable accountability, together with an authority to take action. Indeed, whilst senior management will ultimately be held accountable, staff need to be aware of the potential issues, given the responsibility to be vigilant, and the authority to act when information security issues arise. This is pertinent within Australian primary healthcare where the accountability for information security is most often devolved to the role of the practice manager. This paper analyses information security accountability from an operational and strategic security capability viewpoint in terms of responsibility and authority. Further, it discusses this in regard to the associated information security governance perspective. In the trustful primary healthcare environment, the accountability for information security resides with operational level staff who have many competing aspects to their role. The paper suggests how to manage this layer of security without burdening the already busy practice manager