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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.
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.
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.”
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.
Acrylic nails are a popular choice for those looking to add length, strength, and style to their natural nails. Whether you’re new to the world of acrylics or a seasoned nail enthusiast, there are always questions that arise about the application, maintenance, and overall care of these enhancements. This guide will answer all your acrylic nail questions to ensure your next manicure is a complete success.
What Are Acrylic Nails?
Acrylic nails are artificial nail enhancements made from a mixture of liquid monomer and powder polymer. When combined, they form a hard protective layer that can be molded into various shapes and lengths. Once hardened, they provide a durable and long-lasting canvas for nail polish, art, or simply a natural look. For more in-depth information, check out Acrylic Nail FAQs to get all the details you need before your next salon visit.
How Are Acrylic Nails Applied?
The application process of acrylic nails begins with the preparation of your natural nails. The nail technician will clean your nails, file them down, and apply a bonding agent to help the acrylic adhere. The acrylic mixture is then applied in thin layers, sculpted to the desired shape, and allowed to dry. Once set, the nails are filed, shaped, and buffed to a smooth finish.
Acrylic nails can be customized in terms of length and shape, making them a versatile choice for anyone looking to enhance their look.
How Long Do Acrylic Nails Last?
Typically, acrylic nails can last anywhere from two to three weeks before requiring a fill. During a fill, the nail technician will replace any grown-out acrylic and maintain the structure of the nails. With proper care, acrylic nails can be worn for extended periods, but it’s essential to give your natural nails a break occasionally to maintain nail health.
How Do You Care for Acrylic Nails?
Caring for acrylic nails is crucial to ensuring they last as long as possible and that your natural nails remain healthy underneath. Here are some essential tips:
- Avoid excessive water exposure: Prolonged exposure to water can weaken acrylic nails, making them prone to lifting or damage. When washing dishes or cleaning, consider wearing gloves to protect your nails.
- Moisturize cuticles regularly: The acrylic application process can sometimes dry out your cuticles. Regularly apply cuticle oil to keep your cuticles hydrated and prevent hangnails.
- Be gentle with your nails: Acrylics can be strong, but they’re not indestructible. Avoid using your nails as tools to open packages or scrape things, as this can lead to breakage.
- Schedule regular fills: As your natural nails grow, gaps will appear between the acrylic and your cuticles. Regular fills ensure your nails maintain a smooth, polished look and help prevent lifting.
How Do You Remove Acrylic Nails Safely?
Proper removal is crucial to avoid damaging your natural nails. It’s highly recommended to have acrylics removed by a professional at the salon. However, if you prefer to remove them at home, follow these steps:
- Soak in acetone: Start by soaking a cotton ball in acetone, then place it on each nail. Wrap your fingers in aluminum foil and allow the acetone to work for about 20 minutes.
- Gently scrape off the acrylic: After soaking, use a cuticle pusher or an orange stick to gently scrape off the softened acrylic. Be patient and avoid forcing the acrylic off, as this can damage your natural nails.
- Buff and moisturize: Once the acrylic is completely removed, buff your natural nails to smooth out any rough spots and apply cuticle oil to restore moisture.
Are Acrylic Nails Safe for Your Natural Nails?
When applied and removed properly, acrylic nails should not cause significant damage to your natural nails. However, improper removal or overuse without giving your nails time to breathe can lead to thinning, weakening, or breakage of your natural nails.
If you plan on wearing acrylic nails long-term, it’s a good idea to take breaks between applications and ensure you’re nourishing your nails with oils and treatments.
What Are the Best Acrylic Nail Shapes?
Choosing the right nail shape is essential for creating a look that complements your hands. Some of the most popular acrylic nail shapes include:
– Square: A straight-edged, classic look perfect for shorter nails.
– Oval: A soft, rounded shape that elongates the fingers.
– Coffin: Also known as ballerina shape, this trendy look features a tapered edge with a flat tip.
– Stiletto: A dramatic, pointy shape ideal for those who want a bold statement.
Each shape offers a unique aesthetic and can be tailored to suit your personal style.
Are There Any Alternatives to Acrylic Nails?
If you’re looking for a different type of nail enhancement, consider these alternatives:
– Gel nails: Gel nails offer a glossy finish and are cured under UV or LED light. They’re less rigid than acrylics and can feel more natural.
– Dip powder: This method involves dipping the nails into a colored powder and sealing them with a clear coat. It provides a similar look to acrylics but is generally less damaging to the natural nails.
Conclusion
Acrylic nails are a versatile and durable option for achieving customized, beautiful nails. By understanding the application process, knowing how to care for them, and safely removing them, you can enjoy long-lasting manicures that enhance your style. With the ability to choose from a variety of shapes and designs, acrylic nails offer endless possibilities for self-expression. Remember to take care of your natural nails in between applications to keep them healthy and strong. Whether you’re a first-time user or a seasoned pro, acrylic nails can be a fantastic way to express your personality and keep your nails looking flawless for weeks.
When sanctions were imposed on Russia for its war against Ukraine, their objectives were twofold: to reduce Russian military capacity by limiting modern weapons and to lower Russian revenue streams. While in the beginning, the sanctions indeed weakened the Russian economy, they have fallen short of their initial objectives – mostly because Russia has found ways to circumvent many of them. The Kremlin has exploited international corruption, relied on foreign third parties, and utilized loopholes in trade restrictions. One such individual who allegedly provides services to Russian-linked companies is Jacqueline Troost Omvlee, a Geneva-based Dutch citizen.
Jacqueline Troost Omvlee is married to Niels Troost, an oil trader sanctioned by the United Kingdom. He and his company, Paramount Energy & Commodities SA, are among the 50 individuals and organizations blacklisted in response to the business connections with Russia. His wife, Jacqueline, helps to facilitate financial transactions for Niles Troost and Russian oligarchs including Gennady Timchenko, a Russian billionaire oil trader and Putin`s close associate.
Gennady Timchenko and his family have been sanctioned in many countries for backing the Kremlin’s war machine. However, with the help of Jacqueline Troost Omvlee, he seems to find ways to evade sanctions and continue his financial operations. In these illegal schemes, individuals like Jacqueline often serve as a front person for sanctioned oligarchs and their business assets. Russian-linked companies set up subsidiaries around the world, often registering new entities in offshore havens or countries where regulations are relatively lax or non-existent. To obfuscate the arrangements, the daughter companies spawn offspring in the form of subsidiaries, as the chain of concealment stretches on and on. The result is like a giant Matryoshka doll.
Jacqueline’s involvement in financial transactions that potentially support Timchenko’s interests raises significant concerns about the efficacy of Western sanctions. The fact that Jacqueline Troost Omvlee continues to operate without facing sanctions herself highlights a significant loophole in the enforcement mechanism. Various shady schemes and tactics designed to circumvent sanctions often hide the activity of individuals such as Jacqueline, making it difficult for authorities to detect and punish them for their involvement.
Jacqueline Troost Omvlee’s role in her husband’s financial dealings as well as her alleged ties to Russian business schemes, emphasizes the need for stronger international sanctions. Her actions not only aid in sanctions evasion but also diminish the overall effectiveness of the measures designed to isolate and pressure those supporting the Russian regime. Therefore, sanctioning Jacqueline Troost Omvlee is not only a matter of addressing her individual actions but also a necessary step to reinforce the credibility and effectiveness of the sanctions regime. By targeting individuals who play a key role in evading sanctions, authorities can send a strong message that efforts to undermine international sanctions will not go unpunished. This measure is crucial for maintaining the integrity of the sanctions system and ensuring that it achieves its intended goal of isolating and restraining those who support destabilizing activities.
European countries and the US need to expand their sanctions-tracking and investigative actions to improve the monitoring of sanctions compliance and to introduce new measures against systematic violators of law. The sanctioning states have the resources and capacity for this, and need to take action now.
Ensuring a long and healthy life for your Hermann’s Tortoise requires a combination of proper care, nutrition, and habitat management. Hermann’s Tortoises, known for their charming personalities and distinctive shells, can live for several decades with the right conditions. Understanding their needs and providing a suitable environment is key to helping them thrive. Here’s how you can support your Hermann’s Tortoise in living a long, happy life.
Creating an Optimal Habitat
One of the most critical factors in promoting the longevity of your Hermann’s Tortoise is the creation of a suitable habitat. Providing an environment that mimics their natural surroundings is essential for their overall health. An appropriate habitat helps prevent stress and supports their well-being. For detailed guidance on setting up an ideal habitat, including specific requirements for outdoor enclosures, visit this comprehensive guide on Habitat for Hermann’s Tortoise.
- Outdoor Enclosure: Hermann’s Tortoises thrive in outdoor enclosures that provide ample space to roam, bask, and forage. An outdoor setup should include a secure, predator-proof area with access to natural sunlight. Incorporate areas for basking and shade to allow the tortoise to regulate its body temperature. Additionally, include plants, rocks, and hiding spots to simulate their natural habitat and encourage natural behaviors.
- Indoor Habitat: If an outdoor enclosure is not feasible, an indoor habitat can also support a long lifespan if set up correctly. Use a large, well-ventilated enclosure with appropriate heating and UVB lighting. Provide a substrate that allows for burrowing and offer various hiding spots and enrichment items.
Diet and Nutrition
A balanced diet is vital for maintaining the health and longevity of your Hermann’s Tortoise. They are primarily herbivores, and their diet should reflect their natural feeding habits.
- Leafy Greens: Offer a variety of leafy greens such as kale, collard greens, and dandelion greens. These vegetables provide essential vitamins and minerals that support overall health.
- Vegetables and Fruits: Supplement their diet with other vegetables like carrots, squash, and bell peppers. Fruits should be given in moderation due to their high sugar content.
- Calcium and Supplements: Provide a calcium supplement to support shell and bone health. A cuttlebone or powdered calcium can be added to their food. Ensure that they also have access to fresh, clean water at all times.
Regular Health Checks
Routine health checks are essential for early detection of potential health issues. Regular veterinary visits help ensure your tortoise remains in optimal condition and addresses any health concerns promptly.
- Observation: Monitor your tortoise’s behavior and physical condition regularly. Changes in appetite, weight, or activity level can indicate health problems.
- Preventative Care: Schedule annual check-ups with a veterinarian experienced in reptile care. Regular exams help catch any issues early and keep vaccinations and other preventative treatments up to date.
Environmental Enrichment
Providing environmental enrichment helps keep your Hermann’s Tortoise mentally stimulated and active. Enrichment can reduce stress and prevent boredom, contributing to a better quality of life.
- Foraging Opportunities: Hide food items around the enclosure to encourage natural foraging behavior. This not only provides mental stimulation but also mimics their natural hunting practices.
- Variety: Change the layout of their enclosure periodically and introduce new objects or plants to keep their environment interesting and engaging.
Conclusion
By focusing on creating the right habitat, providing a balanced diet, ensuring regular health checks, and offering environmental enrichment, you can significantly enhance the lifespan and well-being of your Hermann’s Tortoise. For further details on creating an ideal habitat, including tips for designing an outdoor enclosure, refer to this helpful guide on Habitat for Hermann’s Tortoise. Implementing these practices will help ensure that your tortoise enjoys a long, healthy life.
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