The Discovery of Medical Records Maintained by Health Care Facilities: Inconsistent Law in Need of Legislative Correction

This article will review current law in Ohio regarding the protection of medical records maintained by Ohio health care facilities. The Ohio law of privileged communications between health care professionals and patients also will be traced to show how only communications between patients and their physicians, dentists, psychologists, and social workers are currently protected. Since similar public policy reasons may apply to the protection of communications between a wider range of health care professionals and their patients as those communications with physicians, dentists, psychologists, and social workers, this article will discuss why the public policy reasons supporting the initial adoption of the law of privileged communications are not adequately served by Ohio\u27s limited law. This article will set forth a course of action to be utilized by health care facilities to protect their facility and patient records as fully as possible. This course of action, however, involves significant judicial involvement. If followed, it will be an expense for health care facilities and place additional burdens on the judicial system. Finally, this article will comment on how the burden for determining whether records should be released is unfairly placed upon the health care provider. Suggestions will be given for legislation to rectify the current problems with Ohio law and for actions which may be taken by those involved in litigation to reduce problems with obtaining these records

The Discovery of Medical Records Maintained by Health Care Facilities: Inconsistent Law in Need of Legislative Correction

This article will review current law in Ohio regarding the protection of medical records maintained by Ohio health care facilities. The Ohio law of privileged communications between health care professionals and patients also will be traced to show how only communications between patients and their physicians, dentists, psychologists, and social workers are currently protected. Since similar public policy reasons may apply to the protection of communications between a wider range of health care professionals and their patients as those communications with physicians, dentists, psychologists, and social workers, this article will discuss why the public policy reasons supporting the initial adoption of the law of privileged communications are not adequately served by Ohio\u27s limited law. This article will set forth a course of action to be utilized by health care facilities to protect their facility and patient records as fully as possible. This course of action, however, involves significant judicial involvement. If followed, it will be an expense for health care facilities and place additional burdens on the judicial system. Finally, this article will comment on how the burden for determining whether records should be released is unfairly placed upon the health care provider. Suggestions will be given for legislation to rectify the current problems with Ohio law and for actions which may be taken by those involved in litigation to reduce problems with obtaining these records

A knight's tale: a rare case of inter-personal violence from medieval Norton Priory

YesThe opportunity to assess human skeletal remains from Norton Priory, near Runcorn (Cheshire), led to the discovery of peri-mortem blade trauma on an adult male skeleton. The burial evidence suggests that this individual was a wealthy knight and lay benefactor of the priory in the thirteenth century and skeletal evidence has revealed that he was the victim of inter-personal violence. Additionally, many skeletal elements were affected by advanced Paget’s disease, which may have resulted in a certain level of vulnerability due to restricted movement of his arms as a result of Pagetic thickening of the bones. This is the only evidence found of weaponrelated trauma on the Norton Priory skeletal assemblage, making it a rare case and contributing to our understanding of inter-personal violence associated with an ecclesiastical establishment in medieval Britain

GPS TEC observations of dynamics of the mid‐latitude trough during substorms

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95166/1/grl28288.pd

GPS phase scintillation and proxy index at high latitudes during a moderate geomagnetic storm

The amplitude and phase scintillation indices are customarily obtained by specialised GPS Ionospheric Scintillation and TEC Monitors (GISTMs) from L1 signal recorded at the rate of 50 Hz. The scintillation indices S[subscript 4] and σ[subscript Φ] are stored in real time from an array of high-rate scintillation receivers of the Canadian High Arctic Ionospheric Network (CHAIN). Ionospheric phase scintillation was observed at high latitudes during a moderate geomagnetic storm (Dst = −61 nT) that was caused by a moderate solar wind plasma stream compounded with the impact of two coronal mass ejections. The most intense phase scintillation (σ[subscript Φ] ~ 1 rad) occurred in the cusp and the polar cap where it was co-located with a strong ionospheric convection, an extended tongue of ionisation and dense polar cap patches that were observed with ionosondes and HF radars. At sub-auroral latitudes, a sub-auroral polarisation stream that was observed by mid-latitude radars was associated with weak scintillation (defined arbitrarily as σ[subscript Φ] 0.1 rad and DPR > 2 mm s[superscript −1], both mapped as a function of magnetic latitude and magnetic local time, are very similar.National Science Foundation (U.S.) (Grant ATM-0856093

Changes in quality of life following hypoglycaemia in adults with type 2 diabetes: a systematic review of longitudinal studies

AIM: To conduct a systematic review of published studies reporting on the longitudinal impacts of hypoglycaemia on quality of life (QoL) in adults with type 2 diabetes. METHOD: Database searches with no restrictions by language or date were conducted in MEDLINE, Cochrane Library, CINAHL and PsycINFO. Studies were included for review if they used a longitudinal design (e.g. cohort studies, randomised controlled trials) and reported on the association between hypoglycaemia and changes over time in patient-reported outcomes related to QoL. RESULTS: In all, 20 longitudinal studies published between 1998 and 2020, representing 50,429 adults with type 2 diabetes, were selected for review. A descriptive synthesis following Synthesis Without Meta-analysis guidelines indicated that self-treated symptomatic hypoglycaemia was followed by impairments in daily functioning along with elevated symptoms of generalised anxiety, diabetes distress and fear of hypoglycaemia. Severe hypoglycaemic events were associated with reduced confidence in diabetes self-management and lower ratings of perceived health over time. Frequent hypoglycaemia was followed by reduced energy levels and diminished emotional well-being. There was insufficient evidence, however, to conclude that hypoglycaemia impacted sleep quality, depressive symptoms, general mood, social support or overall diabetes-specific QoL. CONCLUSIONS: Longitudinal evidence in this review suggests hypoglycaemia is a common occurrence among adults with type 2 diabetes that impacts key facets in the physical and psychological domains of QoL. Nonetheless, additional longitudinal research is needed-in particular, studies targeting diverse forms of hypoglycaemia, more varied facets of QoL and outcomes assessed using hypoglycaemia-specific measures

Consumption of cocoa flavanols results in acute improvements in mood and cognitive performance during sustained mental effort

Cocoa flavanols (CF) positively influence physiological processes in ways that suggest their consumption may improve aspects of cognitive function. This study investigated the acute cognitive and subjective effects of CF consumption during sustained mental demand. In this randomized, controlled, double-blinded, balanced, three period crossover trial 30 healthy adults consumed drinks containing 520 mg, 994 mg CF and a matched control, with a three-day washout between drinks. Assessments included the state anxiety inventory and repeated 10-min cycles of a Cognitive Demand Battery comprising of two serial subtraction tasks (Serial Threes and Serial Sevens), a Rapid Visual Information Processing (RVIP) task and a mental fatigue scale, over the course of 1 h. Consumption of both 520 mg and 994 mg CF significantly improved Serial Threes performance. The 994 mg CF beverage significantly speeded RVIP responses but also resulted in more errors during Serial Sevens. Increases in self-reported mental fatigue were significantly attenuated by the consumption of the 520 mg CF beverage only. This is the first report of acute cognitive improvements following CF consumption in healthy adults. While the mechanisms underlying the effects are unknown they may be related to known effects of CF on endothelial function and blood flow

Electrodynamics of the high‐latitude trough: Its relationship with convection flows and field‐aligned currents

We present a detailed case study of the electrodynamics of a high‐latitude trough observed at ~ 12 UT (~1 MLT) on 8 March 2008 using multiple instruments, including incoherent scattering radar (ISR), GPS total electron content (TEC), magnetometers, and auroral imager. The electron density within the trough dropped as much as 80% within 6 minutes. This trough was collocated with a counterclockwise convection flow vortex, indicating divergent horizontal electric fields and currents. Together with a collocated dark area shown in auroral images, the observations provide strong evidence for an existence of downward field‐aligned currents (FACs) collocated with the high‐latitude trough. This is further supported by assimilative mapping of ionospheric electrodynamics results. In addition, the downward FACs formed at about the same time as a substorm onset and east of the Harang reversal, suggesting it is part of the substorm current wedge. It has long been a puzzle why this type of high‐latitude trough predominantly occurs just east of the Harang reversal in the postmidnight sector. We suggest that the high‐latitude trough is associated with the formation of downward FACs of the substorm current system, which usually occur just east of the Harang reversal. In addition, we find that the ionospheric electron temperature within the high latitude trough decreases in the F region while increasing in the E region. We discuss possible mechanisms responsible for the complex change in electron temperature, such as ion composition change and/or presence of downward FACs. Key Points Multi‐instrument study of the high‐latitude trough electrodynamics Trough is associated with anti‐clockwise flow vortex and substorm downward FACs Complex Te profile observed in the trough and due to downward FACsPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98817/1/jgra50120.pd

Multiradar observations of the polar tongue of ionization

[1] We present a global view of large‐scale ionospheric disturbances during the main phase of a major geomagnetic storm. We find that the low‐latitude, auroral, and polar latitude regions are coupled by processes that redistribute thermal plasma throughout the system. For the large geomagnetic storm on 20 November 2003, we examine data from the high‐latitude incoherent scatter radars at Millstone Hill, Sondrestrom, and EISCAT Tromso, with SuperDARN HF radar observations of the high‐latitude convection pattern and DMSP observations of in situ plasma parameters in the topside ionosphere. We combine these with north polar maps of stormtime plumes of enhanced total electron content (TEC) derived from a network of GPS receivers. The polar tongue of ionization (TOI) is seen to be a continuous stream of dense cold plasma entrained in the global convection pattern. The dayside source of the TOI is the plume of storm enhanced density (SED) transported from low latitudes in the postnoon sector by the subauroral disturbance electric field. Convection carries this material through the dayside cusp and across the polar cap to the nightside where the auroral F region is significantly enhanced by the SED material. The three incoherent scatter radars provided full altitude profiles of plasma density, temperatures, and vertical velocity as the TOI plume crossed their different positions, under the cusp, in the center of the polar cap, and at the midnight oval/polar cap boundary. Greatly elevated F peak density (>1.5E12 m[superscript −3]) and low electron and ion temperatures (∼2500 K at the F peak altitude) characterize the SED/TOI plasma observed at all points along its high‐latitude trajectory. For this event, SED/TOI F region TEC (150–1000 km) was ∼50 TECu both in the cusp and in the center of the polar cap. Large, upward directed fluxes of O+ (>1.E14 m[superscript −2] s[superscript −1]) were observed in the topside ionosphere from the SED/TOI plume within the cusp

Exploring the ‘active mechanisms’ for engaging rural-dwelling older men with dementia in a community technological initiative

Research has suggested ecopsychosocial initiatives can promote a sense of well-being and inclusion in people with dementia. However, few studies have elucidated the ‘active mechanisms’ whereby such initiatives can achieve these outcomes, so hindering their generalisability. This is particularly pertinent when seeking to support community-dwelling older men with dementia who are reluctant to engage with traditional health and social care initiatives. This paper reports on a study that drew from the principles of Participatory Action Research to explore the ‘active mechanisms’ of a technological initiative for older men (65+ years) with dementia in rural England. An individually-tailored, male-only initiative, using off-the-shelf computer game technology (e.g. iPad, Nintendo Wii and Microsoft Kinect) was delivered over a nine week period. Multiple qualitative methods were employed including; focus groups, open interviews and extensive reflexive field-notes, to gather data from the perspective of twenty-two men, fifteen care partners and five community volunteers. The data were analysed thematically and interpreted using a masculinity lens. Three mechanisms contributed to the initiative’s success: the use of the technology; the male-only environment; and the empowering approach adopted. The paper argues that initiatives aimed at community-dwelling older men with dementia would be advised to consider these gendered experiences and ensure participants can maximise their masculine capital when participating in them, by providing enabling activities, non-threatening environments and empowering approaches of delivery