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Column: In the middle of a race to cure COVID, the medical file is ‘not kept secret as we think’

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Column: In the middle of a race to cure COVID, the medical file is 'not kept secret as we think'

To hear President Trump say, the COVID-19 vaccine will arrive soon.

“We think we will have a vaccine by the end of this year and we are trying very hard,” he said to Fox News last week.

While many health experts say that ambitious goals are unrealistic – most say vaccines for widespread use are unlikely until the earliest next year – Trump’s comments raise some interesting questions.

How will researchers recruit subjects for the COVID-19 vaccine or healing test? Will scientists wait for infected or interested people to contact them? Will they use other ways to find suitable research participants?

If the latter, it seems fair to wonder how confidential our medical records are. There is no faster way to recruit research subjects than by reading people’s health service files and seeing who qualifies.

Joel Engel, a resident of Westlake Village, suspected this happened to him a few days after he received two phone calls asking if he wanted to enroll in UCLA’s sleep study.

Engel, a writer, said he was treated at a UCLA facility about five years ago.

“Callers say they need people of a certain age in good health,” he told me. “I asked how they knew my age and condition. I can’t get a straight answer. “

Engel’s concern is that UCLA violates federal medical privacy law Health Insurance Portability and Accountability Act, which prohibits unauthorized access to people’s medical information.

“How else do they know to call me?” he wondered.

That’s a fair question.

And with the global pandemic raging, maybe all Americans should wonder if their medical records are as confidential as they thought.

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Are we all a fair game for research given the extraordinary circumstances?

Short answer: No. And yes.

“You can’t just fish around people’s medical records,” said Arthur Caplan, a professor of bioethics at New York University. “HIPAA forbids it.”

In addition, there are no provisions in the law that say a pandemic or other public health emergency creates exceptions that allow researchers to protect privacy protection.

“The public health crisis should not affect recruitment for sleep studies,” said Mildred Cho, associate director of the Center for Biomedical Ethics at Stanford University.

However, he and other medical privacy experts note that legal loopholes do exist.

Perhaps the most important exception to HIPAA in the age of coronavirus is what is known as the “preparation for research” provision.

This allows researchers to examine people’s medical records to ascertain whether there are enough potential candidates for the study.

This provision does not give the researcher the right to contact possible study participants. That will require advance permission from the patient.

“Usually the only people who are allowed to make direct patient contact for research are patient health care providers,” Cho said, which means that only your doctor can reach out in this regard.

But, once again, there are exceptions.

Nancy M.P. King, co-director of the Center for Bioethics, Health and Society at Wake Forest University, said the hospital’s institutional review board, which oversees ethical issues, can independently limit patient privacy rights if at all possible.

Such councils “have a set of protocols that investigators must follow, which can produce summons like your readers mentioned,” he told me.

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This clearly has implications for high-speed race and high stakes for the COVID-19 vaccine.

If researchers believe certain types of patients show the most promising promise for testing, such work can be greatly accelerated if scientists know who to contact.

Which brings us back to the question: How did they find you?

Engel said he was told about the sleep study he wanted being carried out by the Norman Cousins ​​Center for Psychoneuroimmunology at UCLA, which he had never dealt with.

He asked the woman who called his house. He contacted the director of the Norman Cousins ​​Center. No one can or will say how they got access to Engel’s information.

Phil Hampton, a UCLA Health spokesman, told me by email that the campus medical center conducted “clinical trials and other research involving patients.”

“Consistent with the laws governing patient privacy, when looking for patients to participate in research studies, our practice is to contact only patients from whom we have written consent,” he said.

I conveyed this to Engel, who replied that he “did not remember giving them written permission to use my medical records for anything other than medical care.”

Apparently there is a reason for that.

Acting on an allegation, I asked Hampton if there was a good print in the form of routine privacy that people signed when they were treated at a UCLA medical facility that allowed the use of their information for research purposes.

He replied: “I can confirm that the patient’s signature on the privacy practice form authorizes UCLA outreach for the purpose of asking about the patient’s interest in participating in an approved research study.”

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Bingo.

The practice seems to be widespread. Spokesmen for the Cedars-Sinai Medical Center and USC told me that their patients agreed with the same language when they checked in. They say this is the “standard” in many hospitals.

If so, this is another reminder of the importance of reading printed documents. You never know what’s lurking there.

Although we would like to consider our medical records locked up, this is far from the case.

“Our records are not kept as secret as we thought,” said Matthew Weinberg, a professor of medical ethics at the Philadelphia College of Osteopathic Medicine. “Many individuals and organizations have official access to our personal medical information.”

If this makes you unable to sleep well at night, don’t worry. UCLA is researching that.

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Who is Paulo Bento, the Portuguese coach from South Korea who coached Cruzeiro?

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The coach commanded the Portuguese national team at the 2014 World Cup in Brazil and left the South Korean national team after being eliminated in Qatar.

Portuguese coach Paulo Bento qualified South Korea for the playoffs of the World Cup, something the team had not achieved since 2010, when the South Korean team reached the 1/8 finals of this championship. But 4-1 rout against Brazil as a result, shortened the path of the Asian team, as well as put an end to the work of Paulo Sousa in the national team.

Paulo Bento started his career as a coach with the youth team of Sporting Clube Portugal in 2004. At the club, he commanded the youth team for two seasons, winning the junior national tournament in his first year. Incidentally, the coach took over the first team shortly after he announced his retirement as a player.

Given his prominence in the youth categories, Paulo was chosen to replace José Peseiro, who was eliminated in European competition, in the professional team of Sporting CP for the 2005 season./2006.

Professionally, Bento was runner-up for four seasons in a row in the Portuguese Championship. Despite this, the coach won two Portuguese Cups and two Candido de Oliveira Super Cups. On November 6, 2009, the coach resigned.

Having distinguished himself at Sporting, Paulo Bento was announced as Portugal’s coach on 21 September 2010 after the World Cup in South Africa, where the then-champion Spain was selected in the round of 16.

Gettyimages

In qualifying, the coach managed to show good results in the first games, plus, of course, take Portugal to the semi-finals of Euro 2012, taking off from Spain on penalties. Having stood out in competitions, the coach extended the contract until Euro 2016.

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However, after losing to Albania in qualifying for Euro 2016, the coach could not resist and was fired in September 2014. The unsuccessful campaign at the World Cup of the same year in Brazil also affected.

After the Portugal national team, Paulo Bento returned to Brazil in May 2016, but this time to coach the Cruzeiro club. With a contract until December 2017, the coach made his debut in the second round of the Brasileirão the same year.

Paulo Bento Cruzeiro Brazilian Championship in Sao Paulo 05062016Washington Alves/Light Press/Cruzeiro

However, Bento only lasted 17 matches in power with six wins, three draws and eight losses, leaving the team in second-to-last place in the tournament.

On 11 August 2016, the coach was announced as the new commander of Olympiacos, Greece, where he remained until 6 March 2017, winning the Greek title. Following this, Paulo Bento was announced as Chongqing Dangdai of China leading the team for only 15 matches.

20221124 Paulo BentoGetty Images

On August 16, 2018, Paulo Bento was announced as the new coach of South Korea following the departure of Shin Tae-yong, who lost in the group stage of the 2018 World Cup.

As part of the South Korean national team, the coach has 55 wins, 12 draws and eight losses, having won the East Asian Cup title and classified the team at the 2022 World Cup in Qatar. After being knocked out against Brazil in the 1/8 finals, the Portuguese announced his retirement from the national team.

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Pioli ‘pulls’ Leao by the ears and says the Portuguese ‘must make a dash’

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Pioli 'pulls' Leao by the ears and says the Portuguese 'must make a dash'

FROMTefano Pioli, Milan coach, gave an interview on the Italian radio program Sky Calcio Club on Sunday in which he talked about Rafael Leao’s participation in the 2022 Mundial, a test in which the Portuguese striker was a replacement for Fernando Santos. ‘, indicating that he has been talking to his player over the past few days.

“If we talk? They have an obligation to call me at the end of the game. He is happy because Portugal is doing well. It is clear that he would like to play more. I can take advantage of this for a contract extension,” said Pioli, who also spoke about the Portuguese’s renewal process.

“He is fine with us and management and Rafael are talking. We are waiting for good news,” the Transalpine coach fired.

Looking at his player’s short playing time at this 2022 World Cup, Pioli admitted that Rafael Leau would like to have more playing time for the national team, but hinted that the Portuguese striker is not unhappy.

“If he plays a little? It’s hard to judge because Portugal has a very high quality team. Rafael is happy because Portugal is having a good World Cup, but there is a lot of quality and competitiveness in the attacking sector of the Portuguese team. “, – stressed the coach of the Italian, who also left a small warning to Rafael Leau.

“When you see him in training, you immediately understand that he has incredible potential. He has technique and speed that few others have. Over the course of a period, he had to develop and adapt to the reality at Milan, where the pressure is different from what he is. he was in Lille. It took time, but his potential to become a great player was always there. But he still needs to make the leap to become a champion because he can be even more decisive in the opponent’s zone,” he stressed.

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“If you think about Rafael from two years ago, he has made tremendous progress. He’s missing a few things, but he’s smart and approachable. I can give him all the ideas he wants, but his talent must be left free. should improve his heading, given his physique,” he concluded.

Read also: Spaniards say Carlo Ancelotti is “in love” with Rafael Leao

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Portugal, nuts and the Portuguese consumer: a successful trilogy

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Portugal, nuts and the Portuguese consumer: a successful trilogy

Nuts have become part of a limited group of Portuguese agri-food sectors that manage to achieve much-desired food self-sufficiency. In the case of almonds it is 170% and in the case of chestnuts it is 116% in relation to the national consumption.

The value of Portuguese agricultural production in 2021 was 9.6 billion euros, representing a growth rate of 14.6% compared to 2020, and therefore it is fair to say that dried fruits today, with a production of 80,000 tons and exports reaching 100 million euros contributed. to this success.

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