Legal Bases for Disclosing Confidential Patient Information for Public Health: Distinguishing Between Health Protection and Health Improvement

The disclosure of confidential patient data without an individual’s explicit consent should be for purposes that persons have reason to both expect and accept. We do not currently have the required level of clarity or consistency in understanding regarding the disclosure of confidential patient information for public health purposes to support effective public dialogue. The Health Service (Control of Patient Information) Regulations 2002 establish a legal basis in England and Wales for data to be disclosed for public health purposes without patient consent. Under the Regulations, there is more than one potential route towards lawful processing: Data may be processed for public health purposes under both Regulations 3 and 5. The alternatives have different safeguards and conditions attached, and their respective applicability to processing for purposes of public health improvement is currently unclear and subject to review. Beyond the need for clarity regarding the safeguards applicable to processing for particular public health purposes, there are reasons to prefer recognition that Regulation 5 is the most appropriate legal basis for disclosure when the purpose is public health improvement rather than public health protection. Where health improvement, rather than protection, is the aim, there is no justification for discarding the additional safeguards associated with processing under Regulation 5

Using and Disclosing Confidential Patient Information and the English Common Law: What are the Information Requirements of a Valid Consent?

The National Health Service in England and Wales is dependent upon the flow of confidential patient data. In the context of consent to the use of patient health data, insistence on the requirements of an ‘informed’ consent that are difficult to achieve will drive reliance on alternatives to consent. Here we argue that one can obtain a valid consent to the disclosure of confidential patient data, such that this disclosure would not amount to a breach of the common law duty of confidentiality, having provided less information than would typically be associated with an ‘informed consent’. This position protects consent as a practicable legal basis for disclosure from debilitating uncertainty or impracticability and, perhaps counter-intuitively, promotes patient autonomy

Catching NGC4051 in the low state with XMM-Newton

The Narrow Line Seyfert 1 galaxy NGC4051 shows unusual low flux states, lasting several months, when the 2-10 keV X-ray spectrum becomes unusually hard (photon index<1) while the spectrum at lower X-ray energies is dominated by a large soft excess. A Chandra TOO of the low state has shown that the soft excess and hard components are variable and well-correlated. The variability of the hard component rules out an origin in a distant reflector. Here we present results from a recent XMM-Newton TOO of NGC4051 in the low state, which allows a much more detailed examination of the nature of the hard and soft spectral components in the low state. We demonstrate that the spectral shape in the low state is consistent with the extrapolation of the spectral pivoting observed at higher fluxes. The XMM-Newton data also reveals the warm absorbing gas in emission, as the drop in the primary continuum flux unmasks prominent emission lines from a range of ion species.Comment: 4 pages, 4 figures. Proc. of the meeting: "The Restless High-Energy Universe" (Amsterdam, The Netherlands), E.P.J. van den Heuvel, J.J.M. in 't Zand, and R.A.M.J. Wijers Ed

The Breast Size Rating Scale: Development and psychometric evaluation

Existing measures of breast size dissatisfaction have poor ecological validity or have not been fully evaluated in terms of psychometric properties. Here, we report on the development of the Breast Size Rating Scale (BSRS), a novel measure of breast size dissatisfaction consisting of 14 computer-generated images varying in breast size alone. Study 1 (N = 107) supported the scale’s construct validity, insofar as participants were able to correctly order the images in terms of breast size. Study 2 (N = 234) provided evidence of the test-retest reliability of BSRS-derived scores after 3 months. Studies 3 (N = 730) and 4 (N = 234) provided evidence of the convergent validity of BSRS-derived breast size dissatisfaction scores, which were significantly associated with a range of measures of body image. The BSRS provides a useful tool for researchers examining women’s breast size dissatisfaction

Where are the strongest associations between autistic traits and traits of ADHD? Evidence from a community-based twin study

Autism spectrum conditions (ASC) and attention-deficit/hyperactivity disorder (ADHD) regularly co-occur. Twin studies increasingly indicate that these conditions may have overlapping genetic causes. Less is known about the degree to which specific autistic traits relate to specific behaviours characteristic of ADHD. We hence tested, using the classical twin design, whether specific dimensional autistic traits, including social difficulties, communication atypicalities and repetitive behaviours, would display differential degrees of aetiological overlap with specific traits of ADHD, including hyperactivity/impulsivity and inattention. Parents of approximately 4,000 pairs of 12-year-old twins completed the Childhood Autism Spectrum Test and Conners' Parent Rating Scale. These measures were divided into subscales corresponding to different types of autistic and ADHD behaviours. Twin model fitting suggested that the degree of genetic overlap was particularly strong between communication difficulties and traits of ADHD (genetic correlations = .47-.51), while repetitive behaviours and social difficulties showed moderate (genetic correlations = .12-.33) and modest (.05-.11) genetic overlap respectively. Environmental overlap was low across all subscales (correlations = .01-.23). These patterns were also apparent at the extremes of the general population, with communication difficulties showing the highest genetic overlap with traits of ADHD. These findings indicate that molecular genetic studies seeking to uncover the shared genetic basis of ASC and ADHD would benefit from taking a symptom-specific approach. Furthermore, they could also help to explain why studies of the communication abilities of individuals with ASC and ADHD have produced overlapping findings

Air Flow Distortion Over Merchant Ships

Anemometers on voluntary observing ships (VOS) are usually sited above the bridge in a region where the effects of flow distortion may be large. Until recently it was unclear whether measurements from such anemometers would be biased high or low, and the magnitude of any such bias was not known. This report describes the progress made in determining the effects of flow distortion and hence in predicting the possible bias in such anemometer measurements of the wind speed

When Can the Child Speak for Herself? The Limits of Parental Consent in Data Protection Law for Health Research.

Draft regulatory guidance suggests that if the processing of a child's personal data begins with the consent of a parent, then there is a need to find and defend an enduring consent through the child's growing capacity and on to their maturity. We consider the implications for health research of the UK Information Commissioner's Office's (ICO) suggestion that the relevant test for maturity is the Gillick test, originally developed in the context of medical treatment. Noting the significance of the welfare principle to this test, we examine the implications for the responsibilities of a parent to act as proxy for their child. We argue, contrary to draft ICO guidance, that a data controller might legitimately continue to rely upon parental consent as a legal basis for processing after a child is old enough to provide her own consent. Nevertheless, we conclude that data controllers should develop strategies to seek fresh consent from children as soon as practicable after the data controller has reason to believe they are mature enough to consent independently. Techniques for effective communication, recommended to address challenges associated with Big Data analytics, might have a role here in addressing the dynamic relationship between data subject and processing. Ultimately, we suggest that fair and lawful processing of a child's data will be dependent upon data controllers taking seriously the truism that consent is ongoing, rather than a one-time event: the core associated responsibility is to continue to communicate with a data subject regarding the processing of personal data

Efficacy, persistence, ground deposition, and human exposure of polymer-encapsulated lindane and chlorpyrifos used for control of the southern pine beetle

Des applications de lindane et de chlorpyrifos ont été étudiées pour déterminer si l'encapsulation dans un polymère augmente la répression du dendroctone méridional du pin (Dendroctonusfrontalis), diminue l'étendue des retombées, augmente la durée d'adhésion à l'écorce ou réduit les contacts humains, en comparaison avec des applications de concentrés émulsifiés.L'encapsulation n'augmente pas l'efficacité et ne réduit pas les retombées des insecticides par rapport aux applications émulsifiées normales. L'encapsulation du chlorpyrifos augmente la persistance résiduelle mais n'affecte pas la persistance du lindane. Le risque de contact humain avec l'écorce encore humidifiée par le chlorpyrifos encapsulé est 2,2 fois plus élevé tandis que le risque de contact du lindane n'est pas influencé par l'encapsulation. Cependant, une fois l'insecticide séché, les applications encapsulées réduisent le risque de contact humain de 90% pour le lindane et de 83% pour le chlorpyrifos.Formulations of lindane and chlorpyrifos were evaluated to determine if polymer encapsulation extended the duration of southern pine beetle (Dendroctonusfrontalis) control, reduced ground deposition, increased persistence on bark or reduced potential human exposure relative to emulsifiable concentrate formulations. Encapsulation did not extend efficacy or reduce ground deposition of either insecticide when compared with the standard emulsifiable formulations. Encapsulation extended residue persistence of chlorpyrifos on bark, but not of lindane. The potential risk of human exposure to bark which was still wet with chlorpyrifos was increased 2.2 times by encapsulation, whereas, similar exposure to lindane was unaffected by encapsulation. After the insecticides had dried on the bark, the encapsulated formulations reduced risk to lindane by approximately 90% and by 83 % for chlorpyrifos