Comprehending the Safety Paradox and Privacy Concerns with Medical Device Remote Patient Monitoring

Medical literature identifies a number of technology-driven improvements in disease management such as implantable medical devices (IMDs) that are a standard treatment for candidates with specific diseases. Among patients using implantable cardiac defibrillators (ICD), for example, problems and issues are being discovered faster compared to patients without monitoring, improving safety. What is not known is why patients report not feeling safer, creating a safety paradox, and why patients identify privacy concerns in ICD monitoring. There is a major gap in the literature regarding the factors that contribute to perceived safety and privacy in remote patient monitoring (RPM). To address this gap, the research goal of this study was to provide an interpretive account of the experience of RPM patients. This study investigated two research questions: 1) How did RPM recipients perceive safety concerns?, and 2) How did RPM recipients perceive privacy concerns? To address the research questions, in-depth, semi-structured interviews were conducted with six participants to explore individual perceptions in rich detail using interpretative phenomenological analysis (IPA). Four themes were identified and described based on the analysis of the interviews that include — comfort with perceived risk, control over information, education, and security — emerged from the iterative review and data analysis. Participants expressed comfort with perceived risk, however being scared and anxious were recurrent subordinate themes. The majority of participants expressed negative feelings as a result of an initial traumatic event related to their devices and lived in fear of being shocked in inopportune moments. Most of these concerns stem from lack of information and inadequate education. Uncertainties concerning treatment tends to be common, due to lack of feedback from ICD RPM status. Those who knew others with ICD RPM became worrisome after hearing about incidences of sudden cardiac death (SCD) when the device either failed or did not work adequately to save their friend’s life. Participants also expressed cybersecurity concerns that their ICD might be hacked, maladjusted, manipulated with magnets, or turned off. They believed ICD RPM security was in place but inadequate as well as reported feeling a lack of control over information. Participants expressed wanting the right to be left alone and in most cases wanted to limit others’ access to their information, which in turn, created conflict within families and loved ones. Geolocation was a contentious node in this study, with most of participants reporting they did not want to be tracked under any circumstances. This research was needed because few researchers have explored how people live and interact with these newer and more advanced devices. These findings have implications for practice relating to RPM safety and privacy such as identifying a gap between device companies, practitioners, and participants and provided directions for future research to discover better ways to live with ICD RPM and ICD shock

How effective is lifeline banking in assisting the 'unbanked'?

Many consumers who lack checking accounts are paying relatively high costs to access the nation's payments system. Legislation aimed at opening the system to these unbanked individuals has centered on requiring commercial banks to offer low-cost "lifeline" accounts. But will cost savings alone motivate these consumers to access the payments system through banks?Checking accounts ; Banks and banking - Service charges ; Poverty

Antitrust and Free Movement Risks of Expanding U.S. Professional Sports Leagues into Europe

This article discusses the legal risks that would emerge if the NBA and NFL decide to expand into Europe. Part I of this article explains the differences in operating structure between U.S. and European professional sports leagues. Part II discusses the differences in competition law between the United States and European Community. Part III explains why the legal status of age and education (age/education requirements) is more favorable to professional sports leagues under U.S. law than under EC law. Part IV explains why the legal status of league drafts and reserve systems also might be more favorable to professional sports leagues under U.S. law

Antitrust and Free Movement Risks of Expanding U.S. Professional Sports Leagues into Europe

This article discusses the legal risks that would emerge if the NBA and NFL decide to expand into Europe. Part I of this article explains the differences in operating structure between U.S. and European professional sports leagues. Part II discusses the differences in competition law between the United States and European Community. Part III explains why the legal status of age and education (age/education requirements) is more favorable to professional sports leagues under U.S. law than under EC law. Part IV explains why the legal status of league drafts and reserve systems also might be more favorable to professional sports leagues under U.S. law

Performance validation of the Caltech ducted-fan at a fixed operating point

Using measured input and output data and a priori assumptions on a nominal model and a linear fractional transformation uncertainty structure, a family of model validating uncertainty sets are constructed for robust control analysis and design of the Caltech ducted fan. Based on an identified uncertainty set, the predicted closed loop performance for any given controller is compared to the directly measured performance. The paper reports current status of the ongoing work at Caltech

X-Ray Evidence for Flare Density Variations and Continual Chromospheric Evaporation in Proxima Centauri

Using the XMM-Newton X-ray observatory to monitor the nearest star to the Sun, Proxima Centauri, we recorded the weakest X-ray flares on a magnetically active star ever observed. Correlated X-ray and optical variability provide strong support for coronal energy and mass supply by a nearly continuous sequence of rapid explosive energy releases. Variable emission line fluxes were observed in the He-like triplets of OVII and NeIX during a giant flare. They give direct X-ray evidence for density variations, implying densities between 2x10^{10} - 4x10^{11} cm^{-3} and providing estimates of the mass and the volume of the line-emitting plasma. We discuss the data in the context of the chromospheric evaporation scenario.Comment: 10 pages, 2 figures, accepted by The Astrophysical Journal, Letters; improved calculations of radiative loss of cool plasma (toward end of paper

Digital Holographic Interferometry in the Long-Wave Infrared for the Testing of Large Aspheric Space Reflectors

Digital holographic (DH) interferometry has been developed in the long-wave infrared spectral range with CO2 lasers and microbolometer arrays. This application has been driven by the European Space Agency’s constant need of techniques for monitoring large displacements of large structures. Here the study focuses on the case of aspheric mirrors, like parabola and ellipses. Usually they are tested through interferometric wavefront error measurements which require expensive null-lenses matching each of the reflectors considered. In the case of monitoring deformation a holographic technique can be considered where the wavefront is compared with itself at different instant. Therefore the optical can be quite simple and easily reconfigurable from one reflector to another. The advantage of using long wavelength is that large deformations can be measured at once, in addition to being more immune against environmental perturbations. Another advantage of DH at such wavelengths is that the ratio between the wavelength and the pixel size allows reconstructing objects 5 to 10 times larger than with DH in the visible. In this project we considered first the case of a 1.1 meter diameter parabola for submillimeter range observations. Such specimen shows strong specular reflectivity. We have developed several set-ups with different ways to illuminate the object and to collect rays to form the object beam: either through point source or through and extended diffuser working by reflection of the laser beam. Both possibilities have been compared in terms of fringe quality as well as measurement range. We selected the diffuser illumination for applying the set-up into a large vacuum facility for measuring the deformation of the parabola between 224 and 107 K. Results of this measurement campaign are presented. A further application has been shown by observation of off-axis ellipse. In this case interferometric testing is difficult to achieve and LWIR DHI with diffuser illumination is found quite simple to implement and gives straightforward results.GSTP HOLODI

Performance validation of the Caltech ducted-fan at a fixed operating point

Using measured input and output data and a priori assumptions on a nominal model and a linear fractional transformation uncertainty structure, a family of model validating uncertainty sets are constructed for robust control analysis and design of the Caltech ducted fan. Based on an identified uncertainty set, the predicted closed loop performance for any given controller is compared to the directly measured performance. The paper reports current status of the ongoing work at Caltech