Violation Of Confidentiality Research Articles

The impact of social networks on health care

Our work examines the risks and benefits stemming from the evolution of Social Network Services (SNSs) in the healthcare domain. More specifically, we study the impact of specific health-oriented social networks such as PatientsLikeMe. Social networks evolved to a ubiquitous part of daily life and WEB 2.0 paved the way for the internet to be used as a method of interactive communication and information immersion. Health SNSs have the strength to influence healthcare services delivery and information availability supported by emerging technologies which track, gather and quantify real-time medical data from patients. SNSs support publicly provided information to patients, offering them the power not only to educate themselves but take part in the decision-making process of their health. On the other hand, healthcare stakeholders have gained access to new information which can help to cut costs, progress research, and improve the healthcare system. However, apart from the unambiguous benefits of SNSs, several risks are identified such as patient confidentiality violation. By incorporating the volumes of data collected by websites like PatientsLikeMe and other WEB 2.0 applications, the patient–industry partnership could ensure better products at lesser costs. Web 3.0 is the next step toward a heath care eco-system which will evolve out of micro-contributions creating the most accurate representations of medicine for the stakeholders.

Disclosure and Data Linkage

ABSTRACT
 ObjectivesSharing of health data, including linkage of research with administrative and health records, is crucial in order to reduce waste and inefficiency as well as to maximise the scientific potential of data. However, there is a well-recognised need to protect the privacy and confidentiality of participant’s and their data. Consequently calls for increasing the openness of health data have been accompanied by new norms and techniques to evaluate and control disclosure risk. We review some of the central concepts deployed in debates about disclosure control—privacy, anonymity, identification—and highlight ethical and social scientific issues around their history, their significance, and the complex and changing contexts in which they are deployed.
 ApproachReview of the literature about the history and state-of-the-art of disclosure control. We focus on the framing of key problems and solutions, as well as arguments about how concepts are defined and why they are valuable.
 ResultsWe identify central concepts deployed in the literature about disclosure control. Concepts include: the construction of risk in terms of the internal statistical properties of data, and in terms of the external context, or ‘data environments’ (Elliot et al, 2010), which data inhabit and move through; notions of balance regarding security and release of microdata and its juxtaposition with data protection and/or risks of confidentiality violations; protection versus information loss; and the construction of methods for constraining disclosure.
 ConclusionDespite the clear relevance of the concepts and context of disclosure control to ethicists, Science & Technology Studies and other scholars, there has been little engagement with the field of Statistical Disclosure Control. We outline a series of key issues for the social study of disclosure control.

PİŞMANLIK VE ISLAH MÜESSESESİNİN VERGİ CEZALARININ YAPTIRIM GÜCÜ ÜZERİNE ETKİSİ

As the ultimate consequence of the rule of law, there is a penalty for every crime and offense. The offenses and punishments of these are not unlawful. In law it is also possible to talk about offenses and crimes. While barriers and irregularities are called smuggling is a crime, violation of confidentiality, and doing exclusive works. Therefore, criminal sanctions have been introduced in the relevant laws, especially the laws for each offense and crime. In some cases, penalties seem to have been partially or completely removed. Examples include exemptions, reconciliation, repentance and adjustment. It is an important element that removes penalties when demanded in writing by the taxpayer in the period of , repentance and adjustment. This element removes both punishment for offenses and crimes. Tax efficiency and volunteerism that are desired to be earned through offenses and are voluntary compliance. However, it is also clear that this establishment negatively affects the sanction power of penalties. In this framework, tax offenses, crimes and their penalties will be explained in detail, the regret and correctional system will be examined and a number of suggestions will be made about the regret and correctional system which is thought to reduce the sanction of the penalties

Formation of Concept of Provision of Economic Security of Organization: Personnel Aspect

1. Introduction As is known, under the conditions of increased risk and threats for companies' activities both from external and internal business environments, success can be achieved only by the organization that uses innovational approaches to conduct of business which cover all aspects of its activities. A peculiarity of economic activities of recent years is growing attention of industrial organizations' managers to the problem of personnel aspect of economic security. 2. Materials and Methods During this research, the authors came to conclusion that economic security of organization has a complicated internal structure, in which three most important elements are distinguished (Rubina R.Y., Rubin A.G., 2009): 1) economic independence; 2) economic sustainability; 3) capability for development, self-development, and progress. Development is the most important component of not only economic security, but one of the important conditions for increase of profitability and competitiveness of organization (Grigoryeva V.V., Polozova A.N., 2013). It is necessary to control the process of development in order to maximize the effect from transformations realized in organization. Development of organization cannot be performed without development of personnel, but these changes should be systemic and aimed at organization in whole (Bryantseva L.V., Makushnikova E.S., 2014). Main components of the system organization's economic security are the following (Gorkovenko E.V., Platonova I.V., 2014): 1) protection of business environment; 2) protection of informational resources; 3) protection of material resources; 4) protection of financial independence; 5) protection of employees (personnel security). The last component of economic security is the most interesting for our research--personnel security, which is personnel's protection from external and internal threats for the purpose of provision of conditions for effective personnel management and, as a consequence, high level of organization's competitiveness. 3. Discussion and Results The purpose of provision of organization's personnel security is prevention of negative influence of factors of external and internal business environment on economic security of organization by means of timely elimination (or minimization) of risks and threats, related to personnel, its intellectual potential and labor relations on the whole. Effectiveness of organization's work and its economic security largely depend on how personnel risks are taken into account in personnel management (risks related to actions of employees). As personnel participate in all spheres of economic relations in organization, it is possible to state that personnel risks are complex ones, the most important of which are risks of violation of information confidentiality. Main causes of risks are shown in Figure 2. Risks lead to emergence of various threats. We emphasize the difference between external and internal threats to personnel security. Internal threats of personnel security include: rival's enticing highly qualified employees; availability of better working conditions and motivation; external pressure on employees; various types of employees' addictions (physical addictions: alcohol, drug; psychological addiction: internet, game, etc.). External threats to personnel security include: weak personnel management in organization; low level of employees' qualification; highly qualified employees' quitting; formal check of candidates during hiring; absence (or underdevelopment) of the system of studying in organization; ineffective program of motivation and stimulation (absence of connection of work results to level of employees' wages); absence of corporate culture (Egorova L.S., Frolova P.S., Frolova O.N., 2013). …

Reasons for Picture Archiving and Communication System (PACS) data security breaches: Intentional versus non-intentional breaches

Background: The Picture Archiving and Communication System (PACS) has led to an increase in breached health records and violation of patient confidentiality. The South African constitution makes provision for human dignity and privacy, virtues which confidentiality seeks to preserve. Confidentiality thus constitutes a human right which is challenged by the use of technology. Humans, as managers of information technology, constitute the weakest link in safeguarding confidentiality. Nonetheless, it is argued that most security breaches are nonintentionally committed by well-meaning employees during routine activities.Objective: The purpose of this article is to explore the nature of and reasons for confidentiality breaches by PACS users in a South African context.Methods: A closed-ended questionnaire was used to collect quantitative data from 115 health professionals employed in a private hospital setting, including its radiology department and a second independent radiology department. The questionnaire sought to explore the attitudes of participants towards confidentiality breeches and reasons for suchbehaviour.Results: Breach incidences were expressed as percentage compliance and classified according to the nature and reasons provided by Sarkar's breach classification. Cross tabulations indicated a statistical significance (p < 0.00) between the expected and observed confidentiality practices of participants and also the adequacy of training, system knowledge and policy awareness.Conclusion: Our study supports previous findings that, in the absence of guidelines, most security breaches were non-intentional acts committed due to ignorance. Of concern are incidents in which sensitive information was intentionally shared via social media.

Reasons for Picture Archiving and Communication System (PACS) data security breaches: Intentional versus non-intentional breaches

BackgroundThe Picture Archiving and Communication System (PACS) has led to an increase in breached health records and violation of patient confidentiality. The South African constitution makes provision for human dignity and privacy, virtues which confidentiality seeks to preserve. Confidentiality thus constitutes a human right which is challenged by the use of technology.Humans, as managers of information technology, constitute the weakest link in safeguarding confidentiality. Nonetheless, it is argued that most security breaches are non-intentionally committed by well-meaning employees during routine activities. ObjectiveThe purpose of this article is to explore the nature of and reasons for confidentiality breaches by PACS users in a South African context. MethodsA closed-ended questionnaire was used to collect quantitative data from 115 health professionals employed in a private hospital setting, including its radiology department and a second independent radiology department. The questionnaire sought to explore the attitudes of participants towards confidentiality breeches and reasons for such behaviour. ResultsBreach incidences were expressed as percentage compliance and classified according to the nature and reasons provided by Sarkar's breach classification. Cross tabulations indicated a statistical significance (p < 0.00) between the expected and observed confidentiality practices of participants and also the adequacy of training, system knowledge and policy awareness. ConclusionOur study supports previous findings that, in the absence of guidelines, most security breaches were non-intentional acts committed due to ignorance. Of concern are incidents in which sensitive information was intentionally shared via social media.

Social media policy for graduate students: Challenges and opportunities for professional psychology training programs.

The use of social media has undoubtedly proliferated in the past 20 years and has become a common way that people communicate and connect with one another (Williams, Johnson, & Patterson, 2013). Social media is a broad term that is defined as websites that use collaborative virtual applications that enable the creation, exchange, and broadcasting of online user generated (Pham, 2014) and includes social networking sites (e.g., Facebook, MySpace), content sharing (e.g., YouTube, Flickr, Instagram), web chat/discussion (e.g., Yahoo Messenger, Google Talk, Skype), microblogging (e.g., Twitter, Tumblr), and livestreaming (e.g., Lifestream). Social media use is particularly common amongst college/university students, with 85-90% of students reporting regular social media use (Caruso & Salaway, 2007; Dahlstrom, de Boor, Grunwald, & Vockley, 2011) and 81-91% of psychology graduate students reporting personal profiles on social networking sites (Lehavot, Barnett, & Powers, 2010; Taylor, McMinn, Bufford, & Chang, 2010). As Canadians have the highest social media network penetration in the world (with 82% of the population using a social network compared to only 75% of Americans; Mckinnon, 2014), it is reasonable to assume that a large majority of Canadian psychology graduate students are using social media.For psychologists-in-training, social media offers a number of advantages such as the dissemination of information, opportunities for professional development, advertising, and a forum for advocacy (Myers, Endres, Ruddy, & Zelikovsky, 2012), and a new ease with which to communicate with colleagues, network with others, and share information (Lehavot et al., 2010). Despite these numerous advantages, this online medium also poses a number of ethical dilemmas such as concerns about privacy and confidentiality, issues with credibility of information, unintended self-disclosure, and unacknowledged dual relationships. Additional ethical or potentially legal complications can arise associated with safety issues, confidentiality, and a duty to report dangerous activities related to the potential harm of self or others (Myers et al., 2012).The popularity of social media use amongst psychology graduate students, coupled with its ethical and professional complexities, make social media an important training and policy issue for Canadian professional psychology programs. The purpose of this article is to (a) highlight the need for social media policy in professional psychology training programs; (b) examine the content and nature of existing social media policies in Canadian training programs; and (c) summarize the policy-related challenges and opportunities relevant to social media use by psychologistsin-training.A Need for Social Media PolicyAlthough this is a developing area of research, there is evidence to suggest that social media misuse is common amongst health professional trainees, including psychology graduate students. This misuse at minimum suggests there is a significant training need regarding the ethical and professional issues surrounding social media use; however cohort differences between trainees and supervisors and a lack of procedural guidelines in this area suggest that formalized social media policy would be beneficial to trainees, supervisors, and training programs. For example, a survey of medical schools in the United States found that 60% of deans admitted to experiencing incidents of students posting unprofessional content online such as violation of confidentiality, sexually suggestive content, discriminatory language, profanity, and depictions of intoxication (Chretien, Greysen, Chretien, & Kind, 2009). Forty percent of marriage and family counselling programs in Canada and the United States had experienced a problem with student's inappropriate use of social media (Williams et al., 2013). A salient issue is that of unintentional personal disclosure, which involves the risk that personal information will be viewed by unintended recipients (Zur, Williams, Lehavot, & Knapp, 2009). …

CERTIFICATELESS ENCRYPTION FOR SECURE DATA SHARING IN PUBLIC CLOUD

Cloud computing is more popular in organizations and institutions because it provides storage and computing services at low cost. Cloud computing provide users and enterprises with various capabilities to store and process their data in third-party data centers that may be located far from the user ranging in distance from across a city to across the world. However, it also introduces new challenges for ensuring the confidentiality, integrity and access control of the data. Some approaches are given to ensure these security requirements but they are lacked in some ways such as violation of data confidentiality due to collusion attack and heavy computation (due to large no keys).To address these issues we propose a scheme that uses efficient certificate less in which data owner divides users in groups and gives single key to each user group for decryption of data and, each user in the group shares parts of the key. Certificateless cryptography is a Capricious of ID-based cryptography intended to prevent the key escrow problem. Ordinarily, keys are generated by a certificate authority or a key generation center (KGC) who is given complete power and is implicitly trusted. For prevention of a complete breakdown of the system in the case of a compromised KGC, the key generation process (KGP) is split between the KGC and the user. In this paper, we use capability list and access list to control the access. Authentication and access control are often merged into a single operation, so that access is approved based on successful authentication or based on an anonymous access token. This scheme not only provides the strong data confidentiality but also reduces the number of keys. Key words- capability list, authentication, certificateless cryptography, confidentiality, access control, malicious outsiders

A Trusted IaaS Environment with Hardware Security Module

With the proliferation of cloud computing, security concerns about confidentiality violations of user data by the privileged domain and system administrators have been growing. This paper proposes secure cloud architecture with a hardware security module, which isolates cloud user data from potentially malicious privileged domains or cloud administrators. Within a securely isolated execution environment, the hardware security module provides essential security functionality with only restricted interfaces exposed to vulnerable management systems or cloud administrators. Such restriction prevents cloud administrators from affecting the security of guest VMs. The proposed architecture not only defends against wide attack vectors but also achieves a small TCB. This paper discusses our hardware and software implementation of the proposed cloud architecture, analyzes its security, and presents its performance results.

The method of socio-technical systems informational stability evaluation at the informational war conditions

The method of evaluation of the informational stability of socio-technical systems, which are influenced by specific informational and psychological operations in the information war is presented. The method uses a logical-probabilistic model and a probabilistic measure for evaluating the informational stability of the system. The proposed informational stability measure is based on the concept of minimum unit of information, designed to change human consciousness - a meme and uses probabilistic estimates of occurrence of so-called destructive and compensatory memes, i.e. the meme, used for the informational and psychological operation (reprogramming of the consciousness of the social part of the SLS) and the compensating meme, the use of which minimizes the consequences of the destructive meme. For decision-making with regard to the stability of the social part of the SLS, a flexible scale that can be adapted to any object of research is proposed. An approach to the construction of the so-called vector of stability of the social part of the SLS, which provides a visualization of the derived probabilistic estimates of a violation of confidentiality, integrity and availability, is proposed. The method is of practical interest since it allows considering an actually weakly formalized class of threats - informational and psychological operations, the aim of which is a destructive impact on the social part of the SLS. The proposed method is useful for the decision-making on the management of complex informational security at the enterprise-region-state level.

Professor sufficiently alleged failure to accommodate, confidentiality violation

Case name: Gascard v. Franklin Pierce University, et al., No. 14‐cv‐220 (D. N.H. 03/11/15).

Investigation of Unethical and Unprofessional Behavior in Korean Residency Training

Phenomenon: Medical ethics and professionalism are fundamental competencies for all physicians, and resident physicians have to develop these competencies during their training. Although Korea has a reputation for having the highest quality medical practice in East Asia, improvements in the technological aspects of care have outpaced the developments in institutional systems and education needed to fulfill social responsibility. Enhancing professionalism education during postgraduate training requires thorough exposition of this situation. Approach: Twenty residents from 17 clinical departments at 1 Korean tertiary university-affiliated hospital were recruited, and in-depth interviews were conducted in person by an interviewer who was a fellow resident with participants. Interviewees recalled and described personal experiences or observations of misbehaviors that had occurred during their residency training. Researchers recorded and transcribed all interviews, and 4 researchers conducted a thematic analysis. Findings: Authors extracted 48 descriptors representing 8 categories of unethical and unprofessional behaviors from the transcripts: (a) substandard practice, (b) violation of work ethics, (c) misconduct related to conflict of interest, (d) dishonesty with patients, (e) violation of patient confidentiality, (f) lack of respect for patients, (g) lack of respect for colleagues, and (h) misconduct in research. Each of the interviewees mentioned between 3 and 18 descriptors. “Not fulfilling basic duties for patient care” was the most frequently mentioned misconduct, followed by “fabricating patient medical status or test results to meet preoperative criteria for anesthesia” and “verbal or physical abuse of junior doctors.” Insights: Residents reported a diverse variety of unethical and unprofessional behaviors throughout their training and described the ethical distress they suffered in the real clinical situations. The results of this study support the notion that reinforcing ethics and professionalism education during postgraduate medical training in a practical and authentic way will help trainees manage the ethical conflicts or dilemmas they will inevitably encounter.

The effect of a multi-component intervention on disrespect and abuse during childbirth in Kenya.

BackgroundDisrespect and abuse (D & A) during labor and delivery are important issues correlated with human rights, equity, and public health that also affect women’s decisions to deliver in facilities, which provide appropriate management of maternal and neonatal complications. Little is known about interventions aimed at lowering the frequency of disrespectful and abusive behaviors.MethodsBetween 2011 and 2014, a pre-and-post study measured D & A levels in a three-tiered intervention at 13 facilities in Kenya under the Heshima project. The intervention involved working with policymakers to encourage greater focus on D & A, training providers on respectful maternity care, and strengthening linkages between the facility and community for accountability and governance. At participating facilities, postpartum women were approached at discharge and asked to participate in the study; those who consented were administered a questionnaire on D & A in general as well as six typologies, including physical and verbal abuse, violations of confidentiality and privacy, detainment for non-payment, and abandonment. Observation of provider-patient interaction during labor was also conducted in the same facilities. In both exit interview and observational studies, multivariate analyses of risk factors for D & A controlled for differences in socio-demographic and facility characteristics between baseline and endline surveys.ResultsOverall D & A decreased from 20–13 % (p < 0.004) and among four of the six typologies D & A decreased from 40–50 %. Night shift deliveries were associated with greater verbal and physical abuse. Patient and infant detainment declined dramatically from 8.0–0.8 %, though this was partially attributable to the 2013 national free delivery care policy.ConclusionAlthough a number of contextual factors may have influenced these findings, the magnitude and consistency of the observed decreases suggest that the multi-component intervention may have the potential to reduce the frequency of D & A. Greater efforts are needed to develop stronger evaluation methods for assessing D & A in other settings.

A review of this month's lawsuits and rulings

Dismissal: Delay in filing suit stops former employee's case Constructive Discharge: Slight reduction in pay not an ADA violation Student Affairs: Unusual agreement requirement sinks university Confidentiality: Professor sufficiently alleged failure to accommodate, confidentiality violation

Do emergency physicians and medical students find it unethical to 'look up' their patients on facebook or Google?

IntroductionThe use of search engines and online social media (OSM) websites by healthcare providers is increasing and may even be used to search for patient information. This raises several ethical issues. The objective of this study is to evaluate the prevalence of OSM and web-searching for patient information and to explore attitudes towards the ethical appropriateness of these practices by physicians and trainees in the emergency department (ED).MethodsWe conducted an online survey study of Canadian emergency physicians and trainees listed under then Canadian Association of Emergency Physicians (CAEP) and senior medical students at the University of Toronto.ResultsWe received 530 responses (response rate 49.1%): 34.9% medical students, 15.5% residents, 49.6% staff physicians. Most had an active Facebook account (74%). Sixty-four participants (13.5%) had used Google to research a patient and 10 (2.1%) had searched for patients on Facebook. There were no differences in these results based on level of training, and 25% of physicians considered using Facebook to learn about a patient “very unethical.” The most frequent ethical concerns were with violation of patient confidentiality, dignity, and consent. The practice was usually not disclosed to patients (14%), but often disclosed to senior colleagues (83%).ConclusionThis is the first study examining the prevalence of and attitudes towards online searching for obtaining patient information in the ED. This practice occurs among staff physicians and trainees despite ethical concerns. Future work should explore the utility and desirability of searching for patient information online.

Social Media Etiquette for the Modern Medical Student:A Narrative Review

Most medical students worldwide are using some form of social media platform to supplement their learning via file sharing and to stay up-to-date on medical events. Often, social media may blur the line between socialization and educational use, so it is important to be aware of how one is utilizing social media and how to remain professional. Research has yielded some troublesome themes of misconduct: drunken behaviour, violations of confidentiality and defamation of institutions. Because there is no universal policy to monitor online professionalism, there exists the potential for indiscretions to occur. It has been reported that misdemeanours can affect future residency placements and employment for medical students. Accordingly, studies suggest that educators need to recognize this new era of professionalism and adapt policies and reprimands to meet modern outlets where professionalism may be violated.

Disrespect and Abuse During Childbirth in Tanzania

Introduction:HIV-related stigma and discrimination and disrespect and abuse during childbirth are barriers to use of essential maternal and HIV health services. Greater understanding of the relationship between HIV status and disrespect and abuse during childbirth is required to design interventions to promote women's rights and to increase uptake of and retention in health services; however, few comparative studies of women living with HIV (WLWH) and HIV-negative women exist.Methods:Mixed methods included interviews with postpartum women (n = 2000), direct observation during childbirth (n = 208), structured questionnaires (n = 50), and in-depth interviews (n = 18) with health care providers. Bivariate and multivariate regressions analyzed associations between HIV status and disrespect and abuse, whereas questionnaires and in-depth interviews provided insight into how provider attitudes and workplace culture influence practice.Results:Of the WLWH and HIV-negative women, 12.2% and 15.0% reported experiencing disrespect and abuse during childbirth (P = 0.37), respectively. In adjusted analyses, no significant differences between WLWH and HIV-negative women's experiences of different types of disrespect and abuse were identified, with the exception of WLWH having greater odds of reporting non-consented care (P = 0.03). None of the WLWH reported violations of HIV confidentiality or attributed disrespect and abuse to their HIV status. Provider interviews indicated that training and supervision focused on prevention of vertical HIV transmission had contributed to changing the institutional culture and reducing HIV-related violations.Conclusions:In general, WLWH were not more likely to report disrespect and abuse during childbirth than HIV-negative women. However, the high overall prevalence of disrespect and abuse measured indicates a serious problem. Similar institutional priority as has been given to training and supervision to reduce HIV-related discrimination during childbirth should be focused on ensuring respectful maternity care for all women.

Mitigating Event Confidentiality Violations in Smart Grids: An Information Flow Security-Based Approach

Modern smart grids, by and large, merge physical interconnections and cyber controllers. Invariably, this tight coupling results in cyber commands manifesting in the physical layer as observable changes, leading to possible disclosure of sensitive system settings. Thus, cyber event confidentiality of the smart grid is violated. Attacks on confidentiality can ultimately lead to integrity and availability attacks; with adequate knowledge of the system topology, internal settings, and how the physical layer responds to cyber commands, a malicious adversary gains knowledge to attack the system. This work shows how to develop self-obfuscating systems based on information flow security properties that can mitigate event confidentiality violations in smart grids.

Virtual colleagues, virtually colleagues—physicians’ use of Twitter: a population-based observational study

ObjectiveTo investigate potential violations of patient confidentiality or other breaches of medical ethics committed by physicians and medical students active on the social networking site Twitter.DesignPopulation-based cross-sectional observational study.SettingThe social...

Client-Initiated, Provider-Initiated, or Self-Testing for HIV: What do South Africans Prefer?

HIV testing is a critical gateway to HIV prevention, treatment, and care, but uptake of HIV testing remains disappointingly low in many sub-Saharan African countries. The purpose of this study was to investigate which HIV-testing model a sample of South Africans (N = 466) preferred if given a choice between client-initiated, provider-initiated, or self-testing. A semi-structured questionnaire was used. Results indicated that 66.1% preferred client-initiated counseling and testing, 11.6% preferred provider-initiated counseling and testing, and 22.3% preferred self-testing. Themes associated with the choice of testing model were patient autonomy, violation of human rights, confidentiality and privacy, fear of discrimination and stigma, confusion when being offered an HIV test for unrelated conditions, suspicion of government motives, and an aversion to mandatory face-to-face counseling. It was concluded that HIV-testing models in South Africa should be revised to include a multi-faceted approach to give clients a wider choice in how and where to test.