Pennsylvania health system agrees to $65 million settlement after hackers leaked nude photos of cancer patients

Sean Lyngass

CNN.com

Originally posted 23 Sept 24

A Pennsylvania health care system this month agreed to pay $65 million to victims of a February 2023 ransomware attack after hackers posted nude photos of cancer patients online, according to the victims’ lawyers.

It’s the largest settlement of its kind in terms of per-patient compensation for victims of a cyberattack, according to Saltz Mongeluzzi Bendesky, a law firm that for the plaintiffs.

The settlement, which is subject to approval by a judge, is a warning to other big US health care providers that the most sensitive patient records they hold are of enormous value to both hackers and the patients themselves, health care cyber experts told CNN. Eighty percent of the $65-million settlement is set aside for victims whose nude photos were published online.

The settlement “shifts the legal, insurance and adversarial ecosystem,” said Carter Groome, chief executive of cybersecurity firm First Health Advisory. “If you’re protecting health data as a crown jewel — as you should be — images or photos are going to need another level of compartmentalized protection.”

It’s a potentially continuous cycle where hackers increasingly seek out the most sensitive patient data to steal, and health care providers move to settle claims out of courts to avoid “ongoing reputational harm,” Groome told CNN.

According to the lawsuit, a cybercriminal gang stole nude photos of cancer patients last year from Lehigh Valley Health Network, which comprises 15 hospitals and health centers in eastern Pennsylvania. The hackers demanded a ransom payment and when Lehigh refused to pay, they leaked the photos online.

The lawsuit, filed on behalf of a Pennsylvania woman and others whose nude photos were posted online, said that Lehigh Valley Health Network needed to be held accountable “for the embarrassment and humiliation” it had caused plaintiffs.

“Patient, physician, and staff privacy is among our top priorities, and we continue to enhance our defenses to prevent incidents in the future,” Lehigh Valley Health Network said in a statement to CNN on Monday.

The info is here.

Here are some thoughts:

The ransomware attack on Lehigh Valley Health Network raises significant ethical and healthcare concerns. The exposure of nude photos of cancer patients is a profound breach of trust and privacy, causing significant emotional distress and psychological harm. Healthcare providers have a duty of care to protect patient data and must be held accountable for their failure to do so. The decision to pay a ransom is ethically complex, as it can incentivize further attacks and potentially jeopardize patient safety. The frequency and severity of ransomware attacks highlight the urgent need for stronger cybersecurity measures in the healthcare sector. By addressing these ethical and practical considerations, healthcare organizations can better safeguard patient information and ensure the delivery of high-quality care.

Real-Time Exposure to Negative News Media and Suicidal Ideation Intensity Among LGBTQ+ Young Adults

Clark, K. A., Kellerman, J. K., et al. (2024).

JAMA Pediatrics.

https://doi.org/10.1001/jamapediatrics.2024.3133

Abstract

Importance  With a recent surge in anti–lesbian, gay, bisexual, transgender, or queer (LGBTQ+) policies and associated news and media coverage, there is a need to study the association of LGBTQ+ focused news or media exposure and short-term changes in suicidal ideation (SI) among LGBTQ+ youth.

Objective  To examine within-person direct and indirect associations between exposure to general and LGBTQ+ negative news or media and SI intensity through expectations of rejection.

Conclusions and Relevance  This intensive longitudinal cohort study found that SI intensity modestly increased in the hours immediately following exposure to LGBTQ+ negative news or media among LGBTQ+ young adults. These findings have timely implications for research and intervention, particularly within sociopolitical and geographic contexts where news or media coverage about LGBTQ+ topics is intensified.

Key Points

Question  Is real-time exposure to negative news or media (eg, a news headline) associated with short-term changes in suicidal ideation (SI) intensity among lesbian, gay, bisexual, transgender, or queer (LGBTQ+) young adults?

Findings  In this intensive longitudinal cohort study of 31 LGBTQ+ young adults aged 18 to 24 years, participants completed 3 assessments per day for 28 consecutive days, resulting in 2189 total assessments. Real-time exposure to LGBTQ+ negative news or media, but not general negative news or media, was significantly associated with heightened intensity of active SI, passive SI, and self-harm ideation.

Meaning  These findings suggest that SI intensity may modestly increase in the hours immediately following identity-specific, but not general, negative news or media exposure among LGBTQ+ young adults.

The article is paywalled.

Here are some thoughts:

This intensive longitudinal cohort study conducted in Tennessee examined the impact of negative LGBTQ+ news and media exposure on suicidal ideation (SI) among LGBTQ+ young adults. The findings revealed that participants reported exposure to negative LGBTQ+ news and media in 11.8% of total assessments over the 28-day study period. Notably, recent exposure to LGBTQ+ negative news and media was associated with a small but statistically significant increase in the intensity of active SI, passive SI, and self-harm ideation. Importantly, no significant associations were observed with exposure to general negative news and media, underscoring the unique impact of identity-specific negative media. Furthermore, a moderate proportion of the association between LGBTQ+ negative media exposure and SI intensity was mediated by expectations of rejection. The study also found stronger associations among participants who reported some active SI during the study period, indicating heightened vulnerability.

The context of this study is particularly relevant given the sociopolitical climate in Tennessee during the data collection period, which coincided with the introduction of numerous bills targeting LGBTQ+ residents. These findings suggest that interventions targeting media organizations could promote responsible reporting practices and increase awareness of the potential suicidogenic impact of negative LGBTQ+ news coverage. Additionally, the study contributes to the growing body of evidence documenting the mental health harms associated with policies that restrict LGBTQ+ visibility and rights, while also highlighting that inclusive and affirming policies are linked to mental health benefits.

From a clinical perspective, the results indicate that routinely assessing the impact of negative media exposure among LGBTQ+ young adults receiving clinical services may be warranted, especially during periods of heightened negative public discourse. Implementing LGBTQ+ affirmative cognitive behavioral therapy could help these individuals cope with minority stress experiences, particularly in high-stigma contexts.

However, the study does have several limitations. It did not assess the type or content of negative media exposure, which could influence SI intensity. The generalizability of the findings may be constrained due to a relatively small sample size from one Southern state, and the focus was solely on SI intensity rather than suicidal behavior. Additionally, the study did not evaluate positive news and media exposure, which could also play a role in mental health outcomes. Lastly, due to sample size constraints, it was not possible to explore potential heterogeneity of effects across different social identities. Overall, this study provides rigorous evidence of the impact of negative LGBTQ+ news and media on mental health among LGBTQ+ young adults, emphasizing the need for responsible media practices and supportive policies and interventions.

Is It Better to Be Happy or Right? Examining the Relative Role of the Pragmatic and Epistemic Imperatives in Momentary Affective Evaluations

Raz, I., Reggev, N., & Gilead, M. (2024).

Emotion, 24(6), 1343–1357.

https://doi.org/10.1037/emo0001349

Abstract

According to research highlighting the importance of predictions, the confirmation of expectations may be a positively-laden experience. A strong test of this principle is the case of the “doomsayer’s delight”: the possibility that belief confirmation can be rewarding even when negative expectations are realized. In order to investigate this idea, we conducted two high-powered experiments examining people’s immediate affective reactions following exposure to expected or unexpected positive and negative stimuli. The results show that people feel significantly worse when their pessimistic expectations are confirmed than when their optimistic expectations are violated. This finding was not moderated by several theoretically relevant individual difference measures or temporal dynamics. Findings from this study contribute to our understanding of the interplay between epistemic and pragmatic motivations in guiding emotional responses.

Here are some thoughts:

This research has importance to psychotherapy. The study's findings challenge traditional theories about emotional responses to expectation confirmation, particularly in the context of negative outcomes. This is crucial for clinical psychologists as it provides new insights into how individuals process and react to negative events, which is fundamental in treating various mental health conditions. The research suggests that confirming pessimistic expectations actually leads to worse feelings than unexpected negative events, contradicting the notion of "doomsayer's delight." This understanding can help clinicians develop more effective therapeutic approaches for patients with anxiety, depression, or other disorders characterized by negative thought patterns.

The study's emphasis on the interplay between epistemic (knowledge-driven) and pragmatic (practical) motivations in shaping emotional responses offers a more nuanced framework for understanding human emotions. This perspective can inform cognitive-behavioral therapies, helping psychologists address both the cognitive and practical aspects of their patients' emotional experiences. Additionally, the research's exploration of immediate emotional reactions provides valuable information about the initial stages of emotional processing, which can be particularly relevant in treating acute stress reactions or developing early intervention strategies.

Furthermore, the study's findings on individual differences and the complexity of emotional experiences underscore the importance of personalized treatment approaches. Clinical psychologists can use this information to tailor their interventions to each patient's unique emotional response patterns, potentially improving treatment outcomes. The research also highlights the role of cognitive processing time in emotional responses, which could have implications for techniques like mindfulness or cognitive restructuring used in therapy.

Lastly, the study's methodology and findings contribute to the broader understanding of human emotional processes, which is fundamental to clinical psychology practice. By challenging existing theories and providing new perspectives on how people respond to negative events, this research encourages clinicians to continually update their knowledge and adapt their therapeutic approaches based on the latest empirical evidence.

National politics ignites more talk of morality and power than local politics

Dillion, D., et al. (2024).

PNAS Nexus, 3(9).

https://doi.org/10.1093/pnasnexus/pgae345

Abstract

Politics and the media in the United States are increasingly nationalized, and this changes how we talk about politics. Instead of reading the local news and discussing local events, people are more often consuming national media and discussing national issues. Unlike local politics, which can rely on shared concrete knowledge about the region, national politics must coordinate large groups of people with little in common. To provide this coordination, we find that national-level political discussions rely upon different themes than local-level discussions, using more abstract, moralized, and power-centric language. The higher prevalence of abstract, moralized, and power-centric language in national vs. local politics was found in political speeches, politician Tweets, and Reddit discussions. These national-level linguistic features lead to broader engagement with political messages, but they also foster more anger and negativity. These findings suggest that the nationalization of politics and the media may contribute to rising partisan animosity.

Here are some thoughts:

In recent years, American politics has undergone a significant transformation, becoming increasingly divisive and focused on national issues at the expense of local concerns. Researchers have identified a key factor contributing to this shift: the reliance on moral, power-centric, and abstract language in national politics. This linguistic style serves as a unifying framework, capturing attention and coordinating opinions across broad and diverse audiences.

Studies have revealed striking differences in language styles between national and local politics. Across various mediums, including politician speeches, Twitter, and Reddit, national politics consistently employs more moral, power-centric, and abstract language. Furthermore, this language style fosters widespread engagement, but also cultivates anger and negativity. Notably, politicians and individuals adapt their language depending on the context, using more moralized language in national settings than local ones.

These findings have significant implications for our understanding of the nationalization of politics and its consequences. The shift towards national politics may contribute to increased polarization and division, highlighting the need for further research into the effectiveness of abstract, moralized, and power-centric language in different contexts. Additionally, exploring how these dynamics play out in more homogeneous societies could provide valuable insights.

Ultimately, recognizing the benefits and drawbacks of national politics' reliance on moral, power-centric language is crucial. While it unites people and encourages participation, it also diverts attention from important local issues and fosters animosity. By understanding these complexities, we can work towards more effective coordination and communication in diverse groups, minimizing conflict and promoting constructive engagement.

Discrimination in Medical Settings across Populations: Evidence from the All of Us Research Program.

Wang, V. H., Cuevas, A. G., et al. (2024).

American Journal of Preventive Medicine.

https://doi.org/10.1016/j.amepre.2024.05.018

Abstract

Introduction

Discrimination in medical settings (DMS) contributes to healthcare disparities in the United States, but few studies have determined the extent of DMS in a large national sample and across different populations. This study estimated the national prevalence of DMS and described demographic and health-related characteristics associated with experiencing DMS in seven different situations.

Methods

Survey data from 41,875 adults participating in the All of Us Research Program collected in 2021–2022 and logistic regression were used to examine the association between sociodemographic and health-related characteristics and self-reported DMS among adults engaged with a healthcare provider within the past 12 months. Statistical analysis was performed in 2023–2024.

Results

About 36.89% of adults reported having experienced at least one DMS situation. Adults with relative social and medical disadvantages had higher prevalence of experiencing DMS. Compared to their counterparts, respondents with higher odds of experiencing DMS in at least one situation identified as female, non-Hispanic Black, having at least some college, living in the South, renter, having other living arrangement, being publicly insured, not having a usual source of care, having multiple chronic conditions, having any disability, and reporting fair or poor health, p<0.05.

Conclusions

The findings indicate a high prevalence of DMS, particularly among some population groups. Characterizing DMS may be a valuable tool for identifying populations at risk within the healthcare system and optimizing the overall patient care experience. Implementing relevant policies remains an essential strategy for mitigating the prevalence of DMS and reducing healthcare disparities.

The article is paywalled here.

Here are some thoughts:

A recent national study revealed alarming rates of discrimination in healthcare settings, affecting approximately 37% of U.S. adults. Disproportionately impacted groups include women, Black and Hispanic individuals, those with limited English proficiency, renters, publicly insured or uninsured individuals, and those with chronic conditions or disabilities. These populations face higher odds of experiencing discrimination in healthcare settings, perpetuating existing health disparities.

The study highlights the intersectionality of race/ethnicity and socioeconomic status as a critical factor in exposure to discrimination. Furthermore, specific situations drive experiences of discrimination for certain populations, such as lack of respect or poor communication from healthcare providers.

To address these disparities, healthcare institutions are developing implicit bias training, though research suggests modest effectiveness. Coupling bias training with reflective exercises or perspective-taking may enhance efficacy. Additionally, promoting diversity within the healthcare workforce and policy interventions, such as the Hospital Consumer Assessment of Healthcare Providers and Systems survey, can help monitor and improve patient-provider relationships.

However, the current survey lacks components measuring discrimination. Incorporating these measures can inform national trends, identify vulnerable populations, and guide targeted interventions. Study limitations include data collection during the COVID-19 pandemic and potential underestimation of discrimination due to measurement constraints.

Key Takeaways:

• 37% of U.S. adults experience discrimination in healthcare settings
• Disproportionate impact on vulnerable populations
• Intersectionality of race/ethnicity and socioeconomic status exacerbates disparities
• Targeted interventions and policy changes are necessary to address discrimination
• Measuring discrimination in healthcare settings is crucial for improvement

Recommendations:

• Develop effective bias training programs
• Promote diversity within the healthcare workforce
• Incorporate discrimination measures into national surveys
• Tailor interventions to address specific experiences of discrimination
• Foster patient-centered care to reduce healthcare disparities

Liberal-conservative asymmetries in anti-democratic tendencies are partly explained by psychological differences in a nationally representative U.S. sample

De Oliveira Santos, D., & Jost, J. T. (2024).

Communications Psychology, 2(1).

https://doi.org/10.1038/s44271-024-00096-3

Abstract

Based on theory and research in political psychology, we hypothesized that liberal-conservative differences in right-wing authoritarianism, social dominance orientation, and political system justification would contribute to asymmetries in anti-democratic tendencies. These hypotheses were tested in a nationally representative survey of U.S. adults (N = 1557). Results revealed that conservatives were less supportive of political equality and legal rights and guarantees and more willing to defect from democratic “rules of the game” and vote for anti-democratic candidates, even after adjusting for political extremism. Mediational analyses suggested that conservatives’ anti-democratic tendencies were partially attributable to higher levels of right-wing authoritarianism and social dominance orientation. Conservatives also scored higher in political system justification, which was associated with support for free speech and mitigated anti-democratic tendencies. Democrats and Republicans who approved January 6, 2021, insurrectionists were more conservative and higher in right-wing authoritarianism than those who did not. Implications for social psychology and society are discussed.

The research is here.

Here are some thoughts:

This research study investigated ideological asymmetries in pro- and anti-democratic sentiments among a nationally representative sample of U.S. adults. The findings revealed that conservatives were less supportive of political equality and legal rights, and more willing to deviate from democratic norms and vote for anti-democratic candidates, even after accounting for political extremism.

These anti-democratic tendencies were partially attributed to higher levels of right-wing authoritarianism (RWA) and social dominance orientation (SDO) among conservatives. Interestingly, conservatives also scored higher in political system justification (PSJ), which was associated with support for free speech and mitigated anti-democratic tendencies.

The study examined seven different indicators of pro- and anti-democratic sentiment, providing a comprehensive view of how political orientation affects various aspects of democratic support. Mediational analyses showed that RWA and SDO significantly mediated the negative effects of political conservatism on democratic principles, while PSJ played a role in maintaining support for democratic norms.

The research also explored attitudes towards the January 6, 2021 insurrectionists, finding that both Democrats and Republicans who approved of them were more conservative and higher in RWA than those who disapproved.

Overall, this study provides evidence of an ideological asymmetry in adherence to democratic norms and principles in the United States, contributing to our understanding of the relationship between political ideology and support for democracy.

Traveling To Die: The Latest Form of Medical Tourism

Debby Waldman

KFF News

Originally posted 20 Aug 24

In the 18 months after Francine Milano was diagnosed with a recurrence of the ovarian cancer she thought she’d beaten 20 years ago, she traveled twice from her home in Pennsylvania to Vermont. She went not to ski, hike, or leaf-peep, but to arrange to die.

“I really wanted to take control over how I left this world,” said the 61-year-old who lives in Lancaster. “I decided that this was an option for me.”

Dying with medical assistance wasn’t an option when Milano learned in early 2023 that her disease was incurable. At that point, she would have had to travel to Switzerland — or live in the District of Columbia or one of the 10 states where medical aid in dying was legal.

But Vermont lifted its residency requirement in May 2023, followed by Oregon two months later. (Montana effectively allows aid in dying through a 2009 court decision, but that ruling doesn’t spell out rules around residency. And though New York and California recently considered legislation that would allow out-of-staters to secure aid in dying, neither provision passed.)

Despite the limited options and the challenges — such as finding doctors in a new state, figuring out where to die, and traveling when too sick to walk to the next room, let alone climb into a car — dozens have made the trek to the two states that have opened their doors to terminally ill nonresidents seeking aid in dying.

The info is here.

Here are some thoughts:

This article delves into the complex ethical and psychological dimensions of medical aid in dying, highlighting several key issues. At its core, the story of Francine Milano underscores the importance of personal autonomy in end-of-life decisions, with many terminally ill patients finding empowerment and dignity in having control over their final moments.

The legal requirement of a six-month prognosis reflects the ongoing ethical debate surrounding quality versus quantity of life. However, the logistical challenges and travel burdens placed on patients seeking this option raise questions about equitable access and the ethics of imposing additional stress on those already suffering.

The article also touches on the impact on family dynamics, with out-of-state patients often having fewer loved ones present during their final moments. Safeguards such as mental capacity assessments and waiting periods attempt to balance patient autonomy with societal protections, addressing concerns about vulnerable individuals being coerced.

The article acknowledges moral and religious objections, illustrating the ongoing ethical debate in society. Interestingly, the observation that a third of approved patients don't follow through suggests that for some, the mere option provides psychological comfort.

The geographic inequity in access to aid in dying based on state laws raises further ethical concerns.

Lastly, the gradual expansion of these laws points to evolving societal attitudes towards death and dying, which has profound implications for how we approach end-of-life care psychologically and ethically. These multifaceted issues highlight the intricate interplay between individual rights, societal values, and the psychological needs of terminally ill patients and their families in the context of assisted dying.

Tubal Sterilization Rates by State Abortion Laws After the Dobbs Decision

Xu, X., Chen, L.,  et al. (2024).

JAMA.

https://doi.org/10.1001/jama.2024.16862

Abstract

The June 2022 US Supreme Court decision Dobbs v Jackson Women’s Health Organization overturned the federal constitutional right to abortion. Consequently, legality of abortion is now regulated by individual states, and multiple states have banned or restricted abortion. Because women may turn to sterilization if abortion is more difficult to obtain, we examined whether the use of sterilization procedures changed after the Dobbs ruling by restrictiveness of state abortion laws.

Here are some thoughts:

The study revealed a significant increase in tubal sterilization rates among women in the United States following the Dobbs v. Jackson Women's Health Organization ruling. This decision overturned Roe v Wade, leading to stricter abortion laws in many states. The researchers found that the increase in tubal sterilizations was particularly pronounced in states with strict abortion bans, suggesting a direct correlation between limited abortion access and women seeking permanent contraception. The study emphasizes the importance of considering the permanent nature of tubal sterilization when making decisions about contraception, highlighting the potential unintended consequences of abortion restrictions on reproductive health and access to healthcare.

This AI chatbot got conspiracy theorists to question their convictions

Helena Kudiabor

Nature.com

Originally posted 12 Sept 24

Researchers have shown that artificial intelligence (AI) could be a valuable tool in the fight against conspiracy theories, by designing a chatbot that can debunk false information and get people to question their thinking.

In a study published in Science on 12 September1, participants spent a few minutes interacting with the chatbot, which provided detailed responses and arguments, and experienced a shift in thinking that lasted for months. This result suggests that facts and evidence really can change people’s minds.

“This paper really challenged a lot of existing literature about us living in a post-truth society,” says Katherine FitzGerald, who researches conspiracy theories and misinformation at Queensland University of Technology in Brisbane, Australia.

Previous analyses have suggested that people are attracted to conspiracy theories because of a desire for safety and certainty in a turbulent world. But “what we found in this paper goes against that traditional explanation”, says study co-author Thomas Costello, a psychology researcher at American University in Washington DC. “One of the potentially cool applications of this research is you could use AI to debunk conspiracy theories in real life.”

The info is here.

Here are some thoughts:

Researchers have developed an AI chatbot capable of effectively debunking conspiracy theories and influencing believers to reconsider their views. The study challenges prevailing notions about the intractability of conspiracy beliefs and suggests that well-presented facts and evidence can indeed change minds.

The custom-designed chatbot, based on OpenAI's GPT-4 Turbo, was trained to argue convincingly against various conspiracy theories. In conversations averaging 8 minutes, the chatbot provided detailed, tailored responses to participants' beliefs. The results were remarkable: participants' confidence in their chosen conspiracy theory decreased by an average of 21%, with 25% moving from confidence to uncertainty. These effects persisted in follow-up surveys conducted two months later.

This research has important implications for combating the spread of harmful conspiracy theories, which can have serious societal impacts. The study's success opens up potential applications for AI in real-world interventions against misinformation. However, the researchers acknowledge limitations, such as the use of paid survey respondents, and emphasize the need for further studies to refine the approach and ensure its effectiveness across different contexts and populations.