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Informatics For Health & Social Care Jan 2023Information security and privacy are matters of concern in every industry. The healthcare sector has lagged in terms of implementing cybersecurity measures. Therefore,...
Information security and privacy are matters of concern in every industry. The healthcare sector has lagged in terms of implementing cybersecurity measures. Therefore, hospitals are more exposed to cyber events due to the criticality of patient data. Currently, little is known about state-of-the-art research on information security and privacy in hospitals. The purpose of this study is to report the outcome of a systematic literature review on research about the application of information security and privacy in hospitals. A systematic literature review following the PRISMA methodology was conducted. To reference our sample according to cybersecurity domains, we benchmarked each article against two cybersecurity frameworks: ISO 27001 Annex A and the NIST framework core. Limited articles in our papers referred to the policies and compliance sections of ISO 27001. In addition, most of our sample is classified by the NIST function "Protect," meaning activities related to identity management, access control and data security. Furthermore, we have identified key domains where research in security and privacy are critical, such as big data, IOT, cloud computing, standards and regulations. The results indicate that although cybersecurity is a growing concern in hospitals, research is still weak in some areas. Considering the recrudescence of cyber-attacks in the healthcare sector, we call for more research in hospitals in managerial and non-technical domains of information security and privacy that are uncovered by our analysis.
Topics: Humans; Privacy; Evidence Gaps; Hospitals; Computer Security; Cloud Computing
PubMed: 35300555
DOI: 10.1080/17538157.2022.2049274 -
BMJ Open Feb 2022Urine pregnancy tests are often inaccessible in low-income settings. Expanded provision of home pregnancy testing could support self-care options for sexual and... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Urine pregnancy tests are often inaccessible in low-income settings. Expanded provision of home pregnancy testing could support self-care options for sexual and reproductive health and rights. We conducted a systematic review of pregnancy self-testing effectiveness, values and preferences and cost.
DESIGN
Systematic review and meta-analysis using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.
DATA SOURCES
PubMed, CINAHL, LILACS and EMBASE and four trial registries were searched through 2 November 2020.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
We included trials and observational studies that compared urine self-testing for pregnancy to health worker-led pregnancy testing on effectiveness outcomes; quantitative and qualitative studies describing values and preferences of end users and health workers and costs of pregnancy self-testing.
DATA EXTRACTION AND SYNTHESIS
Two independent reviewers used standardised methods to search, screen and code included studies. Risk of bias was assessed using the Cochrane Collaboration and Evidence Project tools. Meta-analysis was conducted using random effects models. Findings were summarised in GRADE evidence profiles and synthesised qualitatively.
RESULTS
For effectiveness, four randomised trials following 5493 individuals after medical abortion showed no difference or improvements in loss to follow-up with home pregnancy self-testing compared with return clinic visits. One additional trial of community health workers offering home pregnancy tests showed a significant increase in pregnancy knowledge and antenatal counselling among 506 clients. Eighteen diverse values and preferences studies found support for pregnancy self-testing because of quick results, convenience, confidentiality/privacy, cost and accuracy. Most individuals receiving pregnancy self-tests for postabortion home management preferred this option. No studies reported cost data.
CONCLUSION
Pregnancy self-testing is acceptable and valued by end users. Effectiveness data come mostly from articles on postabortion care, and cost data are lacking. Greater availability of pregnancy self-tests, including in postabortion care and CHW programs, may lead to improved health outcomes.
PROSPERO REGISTRATION NUMBER
CRD42021231656.
Topics: Abortion, Induced; Female; Health Personnel; Humans; Pregnancy; Qualitative Research; Self-Testing
PubMed: 35228285
DOI: 10.1136/bmjopen-2021-054120 -
Contraception Jul 2022We sought to systematically review the literature on values and preferences for contraception among adolescents and young adults globally.
OBJECTIVE
We sought to systematically review the literature on values and preferences for contraception among adolescents and young adults globally.
STUDY DESIGN
We searched ten electronic databases for articles from January 1, 2005 through July 27, 2020 regarding end-users' values and preferences for contraception. We included studies that report specifically on people up to 25 years old.
RESULTS
Fifty-five studies out of 7,846 met our inclusion criteria. These studies included participants aged 10-25 years and were conducted in 16 countries. Through open coding, we identified 18 content areas. The five most commonly discussed content areas were: (1) general preferences regarding contraception, (2) contraceptive method benefits, (3) contraceptive method drawbacks, (4) the influence of the social context, and (5) the influence of myths and misconceptions, including safety and side effects, on contraceptive choice. Privacy and autonomy were important overarching themes, along with safety of the method. These considerations affected participants' access to and use of contraception.
CONCLUSION
Various social, cultural, and method-specific factors influence a young person's values and preferences around contraceptive methods. Understanding their values and preferences can help providers and programs improve contraceptive care for young people.
Topics: Adolescent; Contraception; Contraception Behavior; Contraceptive Agents; Contraceptive Devices; Family Planning Services; Humans; Young Adult
PubMed: 34077748
DOI: 10.1016/j.contraception.2021.05.018 -
Early Intervention in Psychiatry Apr 2016Social media platforms are commonly used for the expression of suicidal thoughts and feelings, particularly by young people. Despite this, little is known about the ways... (Review)
Review
AIM
Social media platforms are commonly used for the expression of suicidal thoughts and feelings, particularly by young people. Despite this, little is known about the ways in which social media can be used for suicide prevention. The aim of this study was to conduct a systematic review to identify current evidence pertaining to the ways in which social media are currently used as a tool for suicide prevention.
METHODS
Medline, PsycInfo, Embase, CINHAL and the Cochrane Library were searched for articles published between 1991 and April 2014. English language articles with a focus on suicide-related behaviour and social media were included. No exclusion was placed on study design.
RESULTS
Thirty studies were included; 4 described the development of social media sites designed for suicide prevention, 6 examined the potential of social media in terms of its ability to reach or identify people at risk of suicide, 15 examined the ways in which people used social media for suicide prevention-related purposes, and 5 examined the experiences of people who had used social media sites for suicide prevention purposes. No intervention studies were identified.
CONCLUSION
Social media platforms can reach large numbers of otherwise hard-to-engage individuals, may allow others to intervene following an expression of suicidal ideation online, and provide an anonymous, accessible and non-judgmental forum for sharing experiences. Challenges include difficulties controlling user behaviour and accurately assessing risk, issues relating to privacy and confidentiality and the possibility of contagion. Social media appears to hold significant potential for suicide prevention; however, additional research into its safety and efficacy is required.
Topics: Humans; Social Media; Suicide Prevention
PubMed: 25702826
DOI: 10.1111/eip.12229 -
JMIR MHealth and UHealth Jul 2022COVID-19 digital contact-tracing apps were created to assist public health authorities in curbing the pandemic. These apps require users' permission to access specific...
BACKGROUND
COVID-19 digital contact-tracing apps were created to assist public health authorities in curbing the pandemic. These apps require users' permission to access specific functions on their mobile phones, such as geolocation, Bluetooth or Wi-Fi connections, or personal data, to work correctly. As these functions have privacy repercussions, it is essential to establish how contact-tracing apps respect users' privacy.
OBJECTIVE
This study aimed to systematically map existing contact-tracing apps and evaluate the permissions required and their privacy policies. Specifically, we evaluated the type of permissions, the privacy policies' readability, and the information included in them.
METHODS
We used custom Google searches and existing lists of contact-tracing apps to identify potentially eligible apps between May 2020 and November 2021. We included contact-tracing or exposure notification apps with a Google Play webpage from which we extracted app characteristics (eg, sponsor, number of installs, and ratings). We used Exodus Privacy to systematically extract the number of permissions and classify them as dangerous or normal. We computed a Permission Accumulated Risk Score representing the threat level to the user's privacy. We assessed the privacy policies' readability and evaluated their content using a 13-item checklist, which generated a Privacy Transparency Index. We explored the relationships between app characteristics, Permission Accumulated Risk Score, and Privacy Transparency Index using correlations, chi-square tests, or ANOVAs.
RESULTS
We identified 180 contact-tracing apps across 152 countries, states, or territories. We included 85.6% (154/180) of apps with a working Google Play page, most of which (132/154, 85.7%) had a privacy policy document. Most apps were developed by governments (116/154, 75.3%) and totaled 264.5 million installs. The average rating on Google Play was 3.5 (SD 0.7). Across the 154 apps, we identified 94 unique permissions, 18% (17/94) of which were dangerous, and 30 trackers. The average Permission Accumulated Risk Score was 22.7 (SD 17.7; range 4-74, median 16) and the average Privacy Transparency Index was 55.8 (SD 21.7; range 5-95, median 55). Overall, the privacy documents were difficult to read (median grade level 12, range 7-23); 67% (88/132) of these mentioned that the apps collected personal identifiers. The Permission Accumulated Risk Score was negatively associated with the average App Store ratings (r=-0.20; P=.03; 120/154, 77.9%) and Privacy Transparency Index (r=-0.25; P<.001; 132/154, 85.7%), suggesting that the higher the risk to one's data, the lower the apps' ratings and transparency index.
CONCLUSIONS
Many contact-tracing apps were developed covering most of the planet but with a relatively low number of installs. Privacy-preserving apps scored high in transparency and App Store ratings, suggesting that some users appreciate these apps. Nevertheless, privacy policy documents were difficult to read for an average audience. Therefore, we recommend following privacy-preserving and transparency principles to improve contact-tracing uptake while making privacy documents more readable for a wider public.
Topics: COVID-19; Contact Tracing; Data Management; Humans; Mobile Applications; Policy; Privacy
PubMed: 35709334
DOI: 10.2196/35195 -
Schizophrenia Research Apr 2023Schizophrenia spectrum disorders (SSD) have heterogeneous outcomes. If we could predict individual outcome and identify predictors of outcome, we could personalize and... (Meta-Analysis)
Meta-Analysis Review
Systematic review and meta-analysis on predictors of prognosis in patients with schizophrenia spectrum disorders: An overview of current evidence and a call for prospective research and open access to datasets.
BACKGROUND
Schizophrenia spectrum disorders (SSD) have heterogeneous outcomes. If we could predict individual outcome and identify predictors of outcome, we could personalize and optimize treatment and care. Recent research showed that recovery rates tend to stabilize early in the course of disease. Short- to medium- term treatment goals are most relevant for clinical practice.
METHODS
We performed a systematic review and meta-analysis to identify predictors of outcome ≤1 year in prospective studies of patients with SSD. For our meta-analysis risk of bias was assessed with the QUIPS tool.
RESULTS
178 studies were included for analysis. Our systematic review and meta-analysis showed that the chance of symptomatic remission was lower in males, and in patients with longer duration of untreated psychosis, more symptoms, worse global functioning, more previous hospital admissions and worse treatment adherence. The chance of readmission was higher for patients with more previous admissions. The chance of functional improvement was lower in patients with worse functioning at baseline. For other proposed predictors of outcome, like age at onset and depressive symptoms, limited to no evidence was found.
DISCUSSION
This study illuminates predictors of outcome of SSD. Level of functioning at baseline was the best predictor of all investigated outcomes. Furthermore, we found no evidence for many predictors proposed in original research. Possible reasons for this include the lack of prospective research, between-study heterogeneity and incomplete reporting. We therefore recommend open access to datasets and analysis scripts, enabling other researchers to reanalyze and pool the data.
Topics: Humans; Access to Information; Prognosis; Prospective Studies; Psychotic Disorders; Schizophrenia
PubMed: 36863229
DOI: 10.1016/j.schres.2023.02.024 -
Sensors (Basel, Switzerland) Nov 2022Recently, the number of vehicles equipped with wireless connections has increased considerably. The impact of that growth in areas such as telecommunications,... (Review)
Review
Recently, the number of vehicles equipped with wireless connections has increased considerably. The impact of that growth in areas such as telecommunications, infotainment, and automatic driving is enormous. More and more drivers want to be part of a vehicular network, despite the implications or risks that, for instance, the openness of wireless communications, its dynamic topology, and its considerable size may bring. Undoubtedly, this trend is because of the benefits the vehicular network can offer. Generally, a vehicular network has two modes of communication (V2I and V2V). The advantage of V2I over V2V is roadside units' high computational and transmission power, which assures the functioning of early warning and driving guidance services. This paper aims to discover the principal vulnerabilities and challenges in V2I communications, the tools and methods to mitigate those vulnerabilities, the evaluation metrics to measure the effectiveness of those tools and methods, and based on those metrics, the methods or tools that provide the best results. Researchers have identified the non-resistance to attacks, the regular updating and exposure of keys, and the high dependence on certification authorities as main vulnerabilities. Thus, the authors found schemes resistant to attacks, authentication schemes, privacy protection models, and intrusion detection and prevention systems. Of the solutions for providing security analyzed in this review, the authors determined that most of them use metrics such as computational cost and communication overhead to measure their performance. Additionally, they determined that the solutions that use emerging technologies such as fog/edge/cloud computing present better results than the rest. Finally, they established that the principal challenge in V2I communication is to protect and dispose of a safe and reliable communication channel to avoid adversaries taking control of the medium.
Topics: Computer Security; Confidentiality; Cloud Computing; Computer Communication Networks; Communication
PubMed: 36501828
DOI: 10.3390/s22239123 -
Journal of Cloud Computing (Heidelberg,... 2022The fog computing concept was proposed to help cloud computing for the data processing of Internet of Things (IoT) applications. However, fog computing faces several... (Review)
Review
The fog computing concept was proposed to help cloud computing for the data processing of Internet of Things (IoT) applications. However, fog computing faces several challenges such as security, privacy, and storage. One way to address these challenges is to integrate blockchain with fog computing. There are several applications of blockchain-fog computing integration that have been proposed, recently, due to their lucrative benefits such as enhancing security and privacy. There is a need to systematically review and synthesize the literature on this topic of blockchain-fog computing integration. The purposes of integrating blockchain and fog computing were determined using a systematic literature review approach and tailored search criteria established from the research questions. In this research, 181 relevant papers were found and reviewed. The results showed that the authors proposed the combination of blockchain and fog computing for several purposes such as security, privacy, access control, and trust management. A lack of standards and laws may make it difficult for blockchain and fog computing to be integrated in the future, particularly in light of newly developed technologies like quantum computing and artificial intelligence. The findings of this paper serve as a resource for researchers and practitioners of blockchain-fog computing integration for future research and designs.
PubMed: 36438442
DOI: 10.1186/s13677-022-00353-y -
The Journal of Adolescent Health :... Nov 2022Technology-based services, including telehealth, text messaging, and the internet are increasingly popular methods for adolescents and young adults (AYA) to access... (Review)
Review
Technology-based services, including telehealth, text messaging, and the internet are increasingly popular methods for adolescents and young adults (AYA) to access sexual and reproductive health (SRH) information and healthcare. This systematic review examined AYA perceptions of privacy and confidentiality of technology-based SRH services. The PubMed, Scopus, and PsycINFO were systematically searched in May 2021 to capture relevant qualitative or quantitative articles from the past 10 years. Included studies had AYA (i.e., mean age, 13-26-years with <10% of the sample outside this range), technology-based services for SRH, and outcomes of perceived privacy or confidentiality. Twenty-eight articles were included (N = 8638 AYA). Most studies utilized the internet and mobile apps to address human immunodeficiency virus infection (HIV), sexually transmitted infections, and general SRH topics. Most AYA reported that these services were private and confidential, with minimal differences across SRH topic addressed. More interactive services had greater concerns (e.g., family or friends seeing notifications). Most AYA considered technology-based SRH to be confidential and private. As technology will likely remain an integrated part of healthcare delivery, improving the privacy and confidentiality of these services can facilitate AYA's independent and autonomous engagement in SRH care, and potentially improve their SRH outcomes.
Topics: Young Adult; Adolescent; Humans; Adult; Reproductive Health Services; Sexual Behavior; Reproductive Health; Sexual Health; Technology; Adolescent Health Services
PubMed: 35717326
DOI: 10.1016/j.jadohealth.2022.05.012 -
HERD Jan 2023To provide a live-experience knowledge base about biophilic design parameters and environmental features to inform policy and design in clinical therapeutic environments. (Review)
Review
OBJECTIVES
To provide a live-experience knowledge base about biophilic design parameters and environmental features to inform policy and design in clinical therapeutic environments.
BACKGROUND
It is increasingly important to review hospital design to make the best use of the affordances of natural elements in supporting both patients' and staff's physical and psychological well-being. The biophilic design theory provides an appropriate design approach. However, current biophilic design frameworks fail to provide efficiently standardized guidance. This systematic review aims to examine the experience of hospital users (patients and staff) with a view to informing a standardized biophilic design framework to improve future design in this context.
METHODS
This study performed a review and synthesis of nine studies identified using systematic procedures focusing on biophilic design features in healthcare environments.
RESULTS
The study identified a selection of biophilic parameters specifically relevant to this building typology, according to three different user groups: outpatients (fresh air, light-daylight, thermal comfort, welcoming and relaxing), inpatients (feeling relaxed and comfortable, prospect refuge, security and protection, light-daylight, view), and staff (privacy-refuge, quietness).
CONCLUSIONS
The systematically identified studies helped to identify and rank the biophilic design parameters that appear the most critical for promoting and supporting human health and well-being in clinical therapeutic environments from the user's perspective. It also provides an up-to-date compilation of crucial design interventions related to biophilic parameters and as such provides benchmark information for future research and design guidance in these environments.
PubMed: 35996349
DOI: 10.1177/19375867221118675