Using Lessons from Health Care to Protect the Privacy of Library Users: Guidelines for the De-Identification of Library Data based on HIPAA

While libraries have employed policies to protect the data about use of their services, these policies are rarely specific or standardized. Since 1996 the U.S. healthcare system has been grappling with the Health Insurance Portability and Accountability Act (HIPAA), which is designed to provide those handling personal health information with standardized, definitive instructions as to the protection of data. In this work, the authors briefly discuss the present situation of privacy policies about library use data, outline the HIPAA guidelines to understand parallels between the two, and finally propose methods to create a de-identified library data warehouse based on HIPAA for the protection of user privacy

A Model Made of Paper: Clinicians Navigate the Electronic Health Record

The electronic health record (EHR) is actually an aggregation of individual clinical documents. Medical records document not only the knowledge domains of clinical practice, but the work processes and practices that support these domains. Human-computer interaction is an important factor in EHR system success: researchers have argued that clinician readers consciously perceive the context of production, and integrate an understanding of the producer into their understanding of the data. In support, this paper reports findings of an information retrieval study using a simulated EHR containing deidentified clinical documents. Physician subjects verbally demonstrated use of a mental model of the paper medical record during their navigation of the system. Clinicians may actively apply a mental representation of their domain of practice—and actively refer to this paperbased knowledge base—when they access medical data. An understanding of the mental models that clinicians use would greatly inform our understanding of EHR systems

Using Lessons from Health Care to Protect the Privacy of Library Users: Guidelines for the De-Identification of Library Data based on HIPAA

While libraries have employed policies to protect the data about use of their services, these policies are rarely specific or standardized. Since 1996 the U.S. healthcare system has been grappling with the Health Insurance Portability and Accountability Act (HIPAA), which is designed to provide those handling personal health information with standardized, definitive instructions as to the protection of data. In this work, the authors briefly discuss the present situation of privacy policies about library use data, outline the HIPAA guidelines to understand parallels between the two, and finally propose methods to create a de-identified library data warehouse based on HIPAA for the protection of user privacy

Making Primarily Professional Terms More Comprehensible to the Lay Audience

Certain texts, such as clinical reports and clinical trial records, are written by professionals for professionals while being increasingly accessed by lay people. To improve the comprehensibility of such documents to the lay audience, we conducted a pilot study to analyze terms used primarily by health professionals, and explore ways to make them more comprehensible to lay people

British Society of Gastroenterology guidance for management of inflammatory bowel disease during the COVID-19 pandemic.

The COVID-19 pandemic is putting unprecedented pressures on healthcare systems globally. Early insights have been made possible by rapid sharing of data from China and Italy. In the UK, we have rapidly mobilised inflammatory bowel disease (IBD) centres in order that preparations can be made to protect our patients and the clinical services they rely on. This is a novel coronavirus; much is unknown as to how it will affect people with IBD. We also lack information about the impact of different immunosuppressive medications. To address this uncertainty, the British Society of Gastroenterology (BSG) COVID-19 IBD Working Group has used the best available data and expert opinion to generate a risk grid that groups patients into highest, moderate and lowest risk categories. This grid allows patients to be instructed to follow the UK government's advice for shielding, stringent and standard advice regarding social distancing, respectively. Further considerations are given to service provision, medical and surgical therapy, endoscopy, imaging and clinical trials

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

A História da Alimentação: balizas historiográficas

Os M. pretenderam traçar um quadro da História da Alimentação, não como um novo ramo epistemológico da disciplina, mas como um campo em desenvolvimento de práticas e atividades especializadas, incluindo pesquisa, formação, publicações, associações, encontros acadêmicos, etc. Um breve relato das condições em que tal campo se assentou faz-se preceder de um panorama dos estudos de alimentação e temas correia tos, em geral, segundo cinco abardagens Ia biológica, a econômica, a social, a cultural e a filosófica!, assim como da identificação das contribuições mais relevantes da Antropologia, Arqueologia, Sociologia e Geografia. A fim de comentar a multiforme e volumosa bibliografia histórica, foi ela organizada segundo critérios morfológicos. A seguir, alguns tópicos importantes mereceram tratamento à parte: a fome, o alimento e o domínio religioso, as descobertas européias e a difusão mundial de alimentos, gosto e gastronomia. O artigo se encerra com um rápido balanço crítico da historiografia brasileira sobre o tema

I Am Not A Specialist: Why We All Need to be Worrying About Medical Information

This is a 13-page juried paper presented on Wednesday, January 12, 2005, Session 4.4, Special Information Agencies and Issues, at the ALISE 2005 Conference