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1. Perspectives of internal medicine physicians regarding medication abortion provision in the primary care setting

Author

Jamie Stern, Tierney Wolgemuth, Colleen Judge-Golden, Sonya Borrero, and Katherine Lane

Subjects
Male, 2019-20 coronavirus outbreak, medicine.medical_specialty, Scope of practice, Attitude of Health Personnel, Internal medicine physicians, Psychological intervention, Primary care, Abortion, Article, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Physicians, Surveys and Questionnaires, Internal Medicine, Humans, Medicine, 030212 general & internal medicine, 030219 obstetrics & reproductive medicine, Primary Health Care, Reproductive Rights, Descriptive statistics, business.industry, Obstetrics and Gynecology, Abortion, Induced, Reproductive justice, Reproductive Medicine, Family medicine, Women's Health, Female, business
Abstract

OBJECTIVE: To better understand medication abortion attitudes and interest in future provision among Internal Medicine primary care providers (IM PCPs), and to characterize barriers to provision. STUDY DESIGN: We conducted a survey with IM attendings and trainees at a large academic medical center in Western Pennsylvania. We used descriptive statistics to characterize attitudes towards medication abortion provision, including the belief that it is within their scope of practice and interest in future provision, and to explore perceived barriers to provision. We used logistic regression models to assess factors associated with each of these attitudes. RESULTS: Of 397 eligible attendings and trainees, 121 (30%) completed the survey. Among those surveyed, 44% believed medication abortion is within the scope of practice of IM PCPs with trainees and female-identifying providers being significantly more likely to believe medication abortion is within their scope of practice compared to attending physicians and male physicians (60% vs 30%, p < 0.01 and 53% vs 31%, p = 0.01, respectively). Similarly, 43% endorsed interest in future provision, with trainees (67% vs 23%, p < 0.001) and female providers (54% vs 27%, p = 0.002) being more likely to express interest. The most cited barriers to provision included limited training in residency (70%) and low familiarity with abortion medications (57%). CONCLUSIONS: Many IM providers– particularly trainees– believe medication abortion is within their scope of practice and would like to provide this care. Interventions are needed to provide education and assistance complying with state and federal regulations to enable safe and efficient medication abortion provision by IM providers. IMPLICATIONS: IM departments and residency programs should seek to ensure training is offered to clinicians interested in providing medication abortion as a part of their primary care practice.

Published
2021
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2. Protocol for direct reporting of awareness in maternity patients (DREAMY): a prospective, multicentre cohort study of accidental awareness during general anaesthesia

Author

P.M. Odor, S. Bampoe, D.N. Lucas, S.R. Moonesinghe, J. Andrade, J.J. Pandit, Alicja A'Court, Dina Abdel-Gadir, Ayman Abdu, Caroline Abisogun, Zainab Aboud, Judith Abrams, Andrea Ackerman, Christine Adamso, Rachel Addison, Adedayo Adeyeye, Rachel Adler, Maame Aduse-Poku, Siddharth Adyanthaya, Najmiah Ahmad, Dabeeruddeen Ahmed, Atif Ahmed, Bucky Akindele, Olubukola Akindele, Sonia Akrimi, Samar Al-Rawi, Yousif Ali, Jo Allam, Alisha Allana, Kellie Allen, Orlanda Allen, Natasha Amaradasa, Lareina Amarasekara, Freda Amoakwa-adu, Padmanabhan Anandageetha, Suresh Anandakrishnan, Rathai Anandanadesan, Michelle Anderson, Simon Apps, Audrey Aquilina, Gill Arbane, Alice Arch, Sarah Armstrong, Rita Arya, Gloria Ashiru, Keri Ashpole, Claire Atkinson, Francesca Atkinson, Elizabeth Auer, Ben Avery, Maite Babio-Galan, Hareth Bader, George Badham, Subha Bagchi, Sarah Bailey, Yolanda Baird, Cristina Balaka, Melissa Baldwin, Paul Balfour, Shreya Bali, Samantha Banks, Philip Barclay, Lucy Barnes, Thomas Barnes, Niraj Barot, Stephen Barrett, Venetia Barrett, Kate Barrett, Louise Bates, Katherine Batte, Beki Baytug, Mona Behravesh, Suzanne Bell, Raul Benloch, Richard Bentley, Jennifer Berg, Charlotte Berwick, Richard Berwick, Rashmi Bhadange, Sanjoy Bhattacharyya, Egidija Bielskute, Sian Birch, Scott Bird, Ruth Bird, William Birts, Becky Black, Tatyana Blagova, Holly Blake, Oliver Blightman, Susara Blunden, Richard Bolton, Caroline Borkett-Jones, John Boselli, Manuella Bowen, Ruth Bowen, James Bowye, Henry Boyle, Zameen Brar, Jo Bray, Samantha Brayshaw, Catherine Bressington, Alison Brewer, Naomi Brice, Laura Bridge, James Briscoe, Sonia Brocklesby, Harry Brown, Sarah Brown, Derek Brunnen, Keshavareddy Burijintichenna, Sara Burnard, Agnieszka Burtt, Victoria Buswell, Hannah Bykar, Matthew Cairney, Clare Calvert, Laura Camarasa, Natasha Campbell, Frederick Campbell-Jones, Jane Cantliffe, William Carrol, Joanna Carvalho, Catherine Cashell, Sarah Cassie, Kadu Cassim, Marika Chandler, Rachel Chapman, Robert Charles, Ping Chen, Deanne Cheyne, Kiran Chima, Floju Chin, Radu Chirvasuta, Martin Shao Chong, Sadia Choudhury, Priyakam Chowdhury, Tracey Christmas, Shilpa Chughwani, Sarah Ciechanowicz, Emma Clarey, Rob Coe, Jolyon Cohen, Nicholas Coker, Karen Collins, Lauren Collis, Jasna Comar, Marianne Conroy, Kathy Constantin, Jeremy Corfe, Elaine Coulborn, Vanessa Cowie, Rachel Crone, James Cronin, Jennifer Crooks, Nicola Crowther, Elizabeth Crowther, Carina Cruz, Alexa Curtis, Sarah Curtis, Sam Curtis, Adrian Dabrowicz, Nick Daines, Viral Dalal, Peter Dannatt, Dinesh Das, Jennifer Dash, Katherine Davidson, Sarah Davies, Yvette Davis, James Dawson, Jonathan Dean, Caroline Dean, Jane Denman, Neel Desai, Preeti Dewan, Sarah Dimont, Clare Donovan, Mano Doraiswami, Kate Doughty, Jamie Douglass, Michelle Dower, Samantha Downing, Wendy Duberry, Emily Duckham, Lucy Dudgeon, Stephanie Dukes, Leigh Dunn, Venkat Duraiswamy, Anthony O' Dwyer, Kristyn Dyer, Suresh Eapen, Mark Earl, Sally Eason, Kylie-Ellen Edwards, Zara Edwards, Osinachi Egole, John Ekpa, Olivia El-Amin, Kariem El-Boghdadly, Okba Elbasir, James Eldridge, Laura Elgie, Matt Ellington, Katharine Elliott, Justine Elliott, Mohamed Elmi, Ramy Elnoumeir, Eunice Emeakaraoha, Matt Evans, Mary Everett, Philippa Fabb, Hadia Farooq, Rohan Farrimond, Fiona Faulds, Erik Fawcett, Andrew Feneley, Dinushi Fernando, Janis Ferns, Claire Finlay, Simon Fitzgerald, Doireann O'Flaherty, Mark Fleet, Lydia Fletcher, Vanessa Fludder, Terri Follet, Jane Forbes, Mark Forth, Greg Foster, John Francis, Kate Fraser, Lauren Friedman, Luca Fruggeri, Laura Fulton, Sam Funnell, Amit Gadre, Ajay Gandhi, Harriet Gardiner, Zoe Garner, Gráinne Garvey, Tom Gately, Richard George, Siobhan Gillespie, Stephanie Glover, Jennifer Goddard, Ben Goodman, Tarikere Gopal, George Graham, David Green, Denise Griffin, Jessica Griffith, Stephanie Grigsby, Julie Grindey, Huw Griffiths, Jonathan Groome, Christine Grother, Gabrielle Grounds, Alice Groves, Abhik Guha, Amila Gunawardhana, Aman Gupta, Rekha Gupta, James Gutsell, Richard Haddon, Dina Hadi, Nicola Hadjipavlou, Henry Hammerbeck, Laura Hammon, Sarah Hammond, Hampesh Hampanna, Holly Hancock, Hemantha Handapangoda, Yumna Haroon-Mowahed, Dawn Harpham, Grant Harris, Abigail Harrison, Divya Harshan, Andrew Hartopp, Eoin Harty, Nick Haslam, Gemma Hawkins, Edith Hawkins, Sarah Hawksey, Carole Hays, Tracy Hazelton, Andrew Heavyside, Chibuzo Hemeson, Katrina Henderson, Oliver Henry, Lara Herbert, Nikki Higgins, James Hilton, Claire Hindmoor, Rachael Hitchcock, Laura Hobbs, Michele Homsy, Cassandra Honeywell, Nazima Hoque, Kirsty House, Ryan Howle, Amanda Tiller, Matthew Huniak, Jeremy Hunte, Tauqeer Husain, Coralie Huson, Catriona Hussain, Tawhida Hussain, Zainab Hussein, Jeremy Hyams, Eleanor Hyde, Marina Iaverdino, Alex Ignacka, Erin Innes, Stefanos Ioannidis, Rehana Iqbal, Fahja Ismail, Jenny Jackson, Michael Jackson, Guy Jackson, Robyn Jacobs, Poonam Jadhav, Aisha Jalaly, Lorraine James, Monica James, Surekha Jani, Chandran Jeganathan, Claire Joannides, Robert Johnson, Thosa Johnson, Carolyn Johnston, Reeanne Jones, Tom Jones, Miran Kadr, Rasmeet Kainth, Jenna Kane, Rafiq Kanji, Sunil Kannanparambil, Girish Kar, Theanalli Kasianandan, Husam Kaskos, Lisa Kavanagh, Richard Kaye, Leith Kelliher, Serena Kelliot, Jemma Kelly, Jenna Kelly, Carol Kenyon, Laura Kessack, Samuel Kestner, Mohammed Khaku, Sophia Khaleeq, Pervaz Khan, Sabeen Khan, Usamah Kidwai, Christopher King, Helen King, Elizabeth Kingston, Waisun Kok, Rebekka Konig, Zheyna Konstantinova, Priya Krishnan, Justin Kua, Kavitha Kuntumalla, Emira Kursumovic, Krzysztof Kurzatkowski, Hariprasad Kuttambakam, Katherine Lane, Sophie Lane, Andrew Langton, Hamad Latif, Norlan Lau, Shyam Laxman, Helen Laycock, Rachel Lee, Silvia Leonardi, Karen Light, Heidi Lightfoot, Shuang Liu, Sanduni Liyanage, Jessica Lowe, Nuala Lucas, Miyoba Lungu, Marianne Lunn, Heather Lynes, Kishore Machavarapu, Matthew Mackenzie, Jonathan Major, Victoria Male, Zain Malik, Katarina Manso, Myrna Maquinana, Katarzyna Marciniak, Lizzie Maronge, Chris Marsh, Carmela Martella, Nicki Martin, Nicole Martins, Jaspreet Marway, Louisa Mason, Lucy Mason, Nadia Masood, James Masters, Matthew Maton-Howarth, Francesca Mazzola, Tamsin McAllister, Rachel McCarthy, Claire McCormick, Sharon McCready, Steffan McDougall, Lorna Mcewan, Jon McGarry, Helen McKevitt, Stephanie Mckinley, Anna Mckskeane, Eloise McMaster, Martina McMonagle, Helen McNamara, Hannah McPhee, Laura McRae, Dee Mead, Emma Meadows, Madhur Mehta, Joanne Meikle, Yavor Metodiev, Chloe Michael, Victoria Millar, Sarah Miller, Gregg Miller, Sezanne Milne, Kostas Miltsios, Lucia Misquita, Simone Misquita, Manasi Mittal, Mohamed Mohamed, Katherine Powell Monaghan, Joanna Monk, Alexandra Monkhouse, David Monks, Laura Montague, Angela Moon, Jennifer Moran, Annette Moreton, Endaf Morgan, Oliver Morgan, Danny Morland, Monica Morosan, Kimberley Morris, Andrea Morris, Clare Moser, Manulella Mount, Carol Muir, McDonald Mupudzi, Mayur Murali, Iona Murdoch, Heather Murray, Theresa Murray, Karen Murrell, Girish Narasimha Murthy, Diana Neeley, Hannah Nei, Kerry Neil, Tara Nejim, Mark Nel, Anne Nicholson, Angela Nicklin, Catherine Nolan, Tracey Nolan, Eveliina Nurmi, Bridie O'Neill, Christie Oakes, Neil Oakes, Maria Ochoa-Ferraro, Nike Odeleye, Katy Oliver, Mark Oliver, Julie Onslow, Desire Onwochei, Thomas Oommen, Tim Orr, Osato Osagie, Hannah Osborn, Jennie Overend, Hazel Owston, Emma Pack, Pulak Padhi, Prabvathy Palani, Rajesh Pandey, Dhruti Pandya, Navjot Panesar, Con Papageorgiou, Georgios Papanastasiou, Costas Papoutsos, Suji Pararajasingham, James Parry, Hasita Patel, Jaishel Patel, Jiten Patel, Kaumudi Patel, Kiran Patel, Mitul Patel, Reshma Patel, Ruchira Patel, Nimisha Patel, Sangeeta Pathak, Fiona Pearson, Viktorija Peciulene, Beth Peers, Benjamin Peirce, Stacey Pepper, Jasmina Perinpanayagam, Hollie Perry, Nadya Petrova, Trudie Phillips, Sioned Phillips, Leonidas Phylactides, Felicity Pilkington, James Plumb, Evangelia Poimenidi, Anna Sau Kuk Poon, Thomas Potter, Una Poultney, Lucy Powell, Andrew Prenter, Katie Preston, Anna Price, Naomi Pritchard, Jenny Pullen, Manishi Purohit, Charlotte Quamina, Jibran Qureshi, Zahra Rajput, Stephen Ramage, Tamilselvi Ramanathan, Upeka Ranasinghe, Kalum Ranatunga, Abby Rand, Seema Randive, Desikan Rangarajan, Chandana Rao, Sambasiva Rao Pelluri, Antony Ratnasingham, Jamil Razzaque, Anuvidya Reddy, Katie Redington, Emma Reel, Peter Remeta, Francesca Ricco, Anna Riccoboni, Polly Rice, Mel Rich, Nicole Richards, Joanne Riches, Simon Ripoll, Fleur Roberts, Kitty Roberts, Kay Robins, Susie Robinson, Samantha Roche, Maria Rojo, Milena Carmela Romano, Hilary Rosser, Lindsay Roughley, Catriona Routley, Christine Rowley, Pallab Rudra, Robin Russell, Christine Ryan, Chloe Saad, Abtin Sadeghi, Armorel Salberg, Matt Samuel, Rebecca Samuels, Suresh Sanapala, Seliat Sanusi, Sarbpreet Sarao, Sathyabhama Sathyabhama, Zoe Saunders, Bernadetta Sawarzynska-ryszka, Panagiota Sceales, Penny Sceales, Natasha Schumacher, Nuala Schwartz, Claudia Sellers, Heather Sellers, Jessica Sellick, Soumen Sen, Dhaneesha Senaratne, Sarah Senbeto, Dineth Seneviratna, Thunga Setty, Raj Shah, Sonia Shah, James Shambly, Saju Sharafudeen. Imran Sharieff, Laurence Sharifi, Lisa Sharpe, Michael Shaw, Ian Sheldrake, Priya Shinde, Adam Shonfeld. Jonathon Short, Julian Siah, Sheena Sibug. Omar Siddique, Sara Siew, Matthew Simpson, Georgina Singleton, Kathryn Sinha, Aneeta Sinha, Matthew Sinnott, Harry Sivadhas, Sivanth Sivakumar, Boopathi Sivarajan, Sinduja Sivarajan, Chris Skeoch, Samuel Slade, Paul Slater, Camilla Smith, Carys Smith, Christopher Smith, James Smith, Lorraine Smith, Annika Smith, Edward Smith, Ruth Smith, Sue Smith, Tim Smith, Helen Smithers, Sue Smolen, Claire Smyth, Toni Snel, Carol Snipe, Sam Soltanifar, Nilesh Sonawane, Andal Soundararaja, Emily Spence, Mark Spiliopoulos, Chhavi Srivastava, Karen Stacey, Helena Stafford, Nikki Staines, Richard Stead, Emma Stevens, Alex Stilwell, Gary Stocks, Aaron Stokes, Christopher Stone, Ben Straughan, Vanitha Subbarathnam, Srinath Sudunagunta, Pervez Sultan, Puvan Suppiah, Priyanka Surve, Angus Sutherland, Rob Swanton, Claire Swarbrick, Amy Swinson, Eleni Syrrakou, Shahrzad Tadbiri, Preetam Tamhane, Perumal Tamilselvan, Andrew Tan, Shamil Tanna, Hayley Tarft, Laura Tarry, Ian Taylor, Suzanne Taylor, Julie Tebbot, Svetlana Theron, Megan Thomas, Sarah Todd, Hermione Tolliday, Charlotte Topham, Nicholas Tovell, Martyn Traves, Dawn Trodd, Aseem Tufchi, Katie Turley, Marc Turnbull, Chris Turnbull, Oliver Turner, William Turner, Sharon Turney, Eleanor Tyagi, David Uncles, Vanessa Unsworth, Pradnya Vadnere, Rama Varadan, Vik Vasishta, Andrew Veal, Lalitha Vedham, Jessica Venkaya, Miriam Verghese, Icel Veronica, Dinesh Vidanagamage, Rachel Vincent, Vinodhan Vyapury, Harris Wain, Fiona Walbridge, Elaine Walker, Pete Walsh, Eleanor Walshe, Michelle Walters, Yize Wan, Cherry Wang, Kavita Wankhade, Gareth Waters, Christopher Watts, Alex Webber, Tom Wedgwood, Michael Wee, Susan Wellstead, Alison White, Michael Whitear, Lucy Whitefield, Sarah Wilkinson, Lauren Williams, Rhys Williams, Dawn Wilson, Samantha Wilson, Katie Wimble, Elaine Winkley, Luke Winslow, Paul Winwright, Karolina Wloch, Gideon Wong, Hannah Wong, Jan Man Wong, Tim Wood, Sarah Wray, Ian Wrench, James Wu, Kynn Wynn, Yeng Yap, Chia Kuan Yeow, Emily Young, Alex Yusaf, Saeed Uz Zafar, Darius Zeinali, Sheldon Zhang, Sarvesh Zope, Liana Zucco, Sibtain Anwar, Nadia Blunt, John Cronin, Vimal Grover, Kate Grailey, Martin Grey, David Highton, Phil Hopkins, Harriet Kemp, Queenie Lo, Daniel Martin, Clare Morkane, James O'Carroll, Charles Oliver, Benjamin Post, Anil Visram, and Alex Wickham

Subjects
Adult, One year follow up, Trial protocol, Guidelines as Topic, Anesthesia, General, Intraoperative Awareness, Cohort Studies, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Anesthesia, Obstetrical, Humans, Medicine, General anaesthesia, Prospective Studies, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics and Gynecology, medicine.disease, United Kingdom, Anesthesiology and Pain Medicine, Accidental, Cohort, Structured interview, Female, Medical emergency, business, Surgical patients, Cohort study
Abstract

Background Accidental awareness during general anaesthesia (AAGA) is a complex and rare outcome to investigate in surgical patient populations, particularly obstetric patients. We report the protocol of the Direct Reporting of Awareness in Maternity patients (DREAMY) study, illustrating how the research was designed to address practical and methodological challenges for investigating AAGA in an obstetric cohort. Methods This is the trial protocol of a prospective, multicentre cohort study of patients undergoing obstetric surgery under general anaesthesia. Accidental awareness during general anaesthesia will be detected using three repetitions of standardised direct questioning over 30 days, with responses indicating memories during general anaesthesia verified using structured interviews. Reports will be adjudicated, then classified, in accordance with pre-defined and pre-validated structures, including the Michigan Awareness Classification tool. Quantitative data will be collected on general anaesthesia conduct for all participants. This descriptive study is being conducted in England and aims to recruit a minimum of 2015 patients. Results The DREAMY study was prospectively registered (ClinicalTrials.gov Identifier: NCT03100396) and ethical approval granted. Participant recruitment began in May 2017 and one year follow up concluded in August 2019. Publication of the results is anticipated in 2020. Conclusions The DREAMY study will provide data on incidence, experience and implications of AAGA for obstetric patients, using a robust methodology that will reliably detect and translate subjective AAGA reports into objective outcomes. In addition, the study is expected to improve vigilance for AAGA in participating hospitals and encourage adoption of recommendations for support of patients experiencing AAGA.

Published
2020
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4. Regulation of Digital Platforms as Part of Economy-Wide Reforms to Australia's Failed Privacy Laws (Australian Privacy Foundation Submission to the Australian Government on Implementation of the ACCC's Digital Platforms Inquiry—Final Report)

Author

Katherine Lane, Nigel Waters, Elizabeth Coombs, Bruce Baer Arnold, David Lindsay, Graham Greenleaf, and Roger Clarke

Subjects
Government, Economy, Privacy laws of the United States, Data Protection Act 1998, Consumer privacy, ComputingMilieux_LEGALASPECTSOFCOMPUTING, Business, Privacy law, Information security, Consumer protection, Personally identifiable information
Abstract

This is the final submission to the Australian Government by the Australian Privacy Foundation (APF) on the final report of the Australian Consumer & Competition Commission (ACCC) Report on regulation of digital platforms. APF welcomes the contribution made by the ACCC to improving the understanding of how the protection of privacy is central to addressing anti-competitive concerns and consumer protection in the data economy. APF's primary focus in this submission is on the consumer privacy aspects of the Inquiry, but with an eye to the issues of market power, and the trust that is fundamental for public administration in online environments. The APF strongly supports the ACCC's analysis and recommendations, across the board. ACCC’s analysis is consistent with a wide range of Australian and international official and private reports over the past three years, demonstrating that there is international recognition of a substantive problem that must be addressed. In particular, APF urges the Government’s adoption of the recommendations in Chapter 7 to achieve vital and substantial upgrades in Australia’s privacy protection, in order to address the major inroads into privacy because of the enormous growth in data surveillance by the private sector since 2000, the pressing need for a more powerful and much more effective Privacy Commissioner, and to achieve the privacy right of action previously recommended. For reasons detailed in this Submission (and summarised at its end), APF expresses its strong support for the adoption by the Australian Government of all of the following Recommendations: 16: Strengthen protections in the Privacy Act (a) Update ‘personal information’ definition (b) Strengthen notification requirements (c) Strengthen consent requirements and pro-consumer defaults (d) Enable the erasure of personal information (e) Introduce direct rights of action for individuals (f) Higher penalties for breach of the Privacy Act 17: Broader reform of Australian privacy law, having regard to: 1. Objectives 2. Scope 3. Higher standard of protections 4. Inferred information 5. De-identified information 6. Overseas data flows 7. Third-party certification 18: OAIC privacy code for digital platforms, including but not limited to: 1. Information requirements 2. Consent requirements 3. Opt-out controls 4. Children’s data 5. Information security 6. Retention period 7. Complaints-handling 19: Statutory tort for serious invasions of privacy 20: Prohibition against unfair contract terms 21: Prohibition against certain unfair trading practices

Published
2019
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