Porn stars exposed.(HIGH TECH PROBLEMS IN THE PRESS)(Brief article) - Risk Management

In March, the multi-billion-dollar pornography industry may have been the victim of a major data breach that underscores the concerns that many have regarding the health care industry's transition to digital medical records. Though the source remains uncertain, PornWikiLeaks.com posted the names, stage names and birth dates of more than 12,000 current and former adult video performers, some of whom also had the results of their HIV tests revealed. Due to the nature of the information, many have suspected that the breach occurred at AIM Medical Center, a Sherman Oaks, California, health clinic where the majority of industry workers are tested for STDs. For the clinic, which launched an investigation into the matter, this could be a serious violation of the Health Insurance Portability and Accountability Act, not to mention a reputational black eye from which it may not be able to recover. Regardless of where the info came from, the episode shows that health records are not immune to data breaches. And that is what has so many privacy advocates worried about a future in which all patient records-not just those of porn stars--are stored digitally instead of in file cabinets.

COUNTY TO PROPOSE RIVER BEAUTIFICATION.(News) - Daily News (Los Angeles, CA)

Byline: Eric Wahlgren Daily News Staff Writer

One day, cyclists may be able to hop on their bikes at the Los Angeles River's source in Canoga Park and pedal alongside the wash for 51 miles before it flows into the Pacific Ocean in Long Beach.

The riverside bike path, which is the centerpiece of the Los Angeles River Master Plan approved by the County Board of Supervisors in June, may take half a century to complete.

But flush with millions in public money raised by recent ballot measures, Los Angeles and other county cities are gearing up to beautify the mostly concrete-lined waterway, making it a recreational destination.

``We want the river to serve as a corridor that would unite communities,'' said Cynthia D'Agosta, a landscape architect, and one of the people behind a cooperative effort to implement the county's master plan. ``We have lost a river here, basically. It is encased, channelized and doesn't serve the community in the same cultural way that a river does in other communities. People will be able to engage in all sorts of recreational activities, including walking and biking.''

The Los Angeles River Master Plan presentation is scheduled for 6:30 p.m. today in the main conference room of the Sherman Oaks Hospital and Health Center, 4929 Van Nuys Blvd.

D'Agosta is among Los Angeles River advocates who will discuss possibilities for enhancements along the San Fernando Valley stretches of the waterway.

City Councilman Michael Feuer lobbied for $10 million to be set aside for river improvements in Proposition K, a ballot measure passed by voters in November for $771 in city parks and recreation projects.

Some of the proposed river enhancements in the Valley include planting native vegetation along the waterway, connecting a small stretch of bike path in Griffith Park to the Sepulveda Basin and improving flood-control sites.

``In (Feuer's) district, there is not the opportunity to acquire a lot of additional land,'' said Sharon Mayer, Feuer's chief field deputy. ``This river area is already public land. It would be an opportunity to enjoy a different atmosphere than exists now.''

Although enhancements are proposed for Sherman Oaks and Studio City, the river passes through many Valley communities where work might also be done, including Winnetka, Reseda, Encino and Toluca Lake.

Proposition A, a county parks improvement measure, also passed in November, making an additional $12 million available for river enhancements in county areas.

The Los Angeles River Master Plan is perhaps the first attempt among various cities and agencies to come up with a universal guideline for how to make the best use of the waterway, which begins at the confluence of Bell Creek and Arroyo Calabasas in Canoga Park.

The county Public Works Department, the Santa Monica Mountains Conservancy, and the cities of Los Angeles, Bell Gardens and Long Beach are among agencies and communities involved in the long-term effort.

In memoriam: Hildegard E Peplau, 1909-1999 - Journal of Child and Adolescent Psychiatric Nursing

Hildegard E. Peplau, 89, one of the world's leading nurses and known to many as the 'Nurse of the Century,' died March 17,1999, at her home in Sherman Oaks, CA. Dr. Peplau is the only nurse to serve the American Nurses Association (ANA) as Executive Director and later as President. She was also elected to serve two terms on the board of the International Council of Nurses (ICN). In 1997 she received the world of nursing's highest honor, the Christiane Reimann Prize, at the ICN Quadrennial Congress. This award is given once every 4 years for outstanding national and international contributions to nursing and health care. In 1996 the American Academy of Nursing honored Peplau as a 'Living Legend,' and in 1998 the ANA inducted her into the ANA Hall of Fame.

Dr. Peplau is universally regarded as the mother of psychiatric nursing. Her theoretical and clinical work led to the development of the distinct specialty field of psychiatric nursing. Dr. Peplau's seminal book, Interpersonal Relations in Nursing (1952), was completed in 1948. Publication was delayed for 4 years because at that time it was considered too revolutionary for a nurse to publish a book without a physician co-author. Peplau's book has been widely credited with transforming nursing from a group of skilled workers to a fully fledged profession. Since the publication of Peplau's work, interpersonal process has been universally integrated into nursing education and nursing practices throughout the United States and abroad. It has been argued that Dr. Peplau's life and work produced the greatest changes in nursing practice since Florence Nightingale.

Dr. Peplau was awarded honorary doctoral degrees from universities including Alfred, Duke, Indiana, Ohio State, Rutgers, and the University of Ulster in Ireland. She was named one of '50 Great Americans' in Who's Who in 1995 by Marquis. She was an elected fellow of the American Academy of Nurses and of Sigma Theta Tau, the national nursing honorary society.

Hilda Peplau was born September 1, 1909, in Reading, PA, the second daughter of immigrants Gustav and Ottylie Peplau, and one of six children. As a child, she witnessed the devastating flu epidemic of 1918, a personal experience that greatly influenced her understanding of the impact of illness and death on families.

Peplau began her career in nursing in 1931 as a graduate of the Pottstown, PA, School of Nursing. She then worked as a staff nurse in Pennsylvania and New York City. A summer position as nurse for the New York University summer camp led to a recommendation for Peplau to become the school nurse at Bennington College in Vermont. There she earned a bachelor's degree in interpersonal psychology in 1943. At Bennington and through field experiences at Chestnut Lodge, a private psychiatric facility, she studied psychological issues with Erich Fromm, Frieda FrommReichmann, and Harry Stack Sullivan. Peplau's life-long work was largely focused on extending Sullivan's interpersonal theory for use in nursing practice.

From 1943 to 1945 she served in the Army Nurse Corps and was assigned to the 312th Field Station Hospital in England, where the American School of Military Psychiatry was located. Here she met and worked with all the leading figures in British and American psychiatry. After the war, Peplau was at the table with many of these same men as they worked to reshape the mental health system in the United States through the passage of the National Mental Health Act of 1946.

Peplau held master's and doctoral degrees from Teachers College, Columbia University. She was also certified in psychoanalysis at the William Alanson White Institute of New York City. In the early 1950s, Peplau developed and taught the first classes for graduate psychiatric nursing students at Teachers College. Dr. Peplau was a member of the faculty of the College of Nursing at Rutgers University from 1954 to 1974. At Rutgers, Peplau created the first graduatelevel program for the preparation of clinical specialists in psychiatric nursing. She was a prolific writer and was equally well known for her presentations, speeches, and clinical training workshops. Peplau vigorously advocated that nurses should become further educated so they could provide truly therapeutic care to patients rather than the custodial care that was prevalent in the mental hospitals of that era. During the 1950s and 1960s, she conducted summer workshops for nurses throughout the United States, mostly in state psychiatric hospitals. In these seminars, she taught interpersonal concepts and interviewing techniques, as well as individual, family, and group therapy. Peplau was an advisor to the World Health Organization and was a visiting professor at universities in Africa, Latin America, Belgium, and throughout the United States. A strong advocate for graduate education and research in nursing, she served as a consultant to the U.S. Surgeon General, the U.S. Air Force, and the National Institutes of Mental Health. She participated in many government policy-making groups. After her retirement from Rutgers, she served as a visiting professor at the University of Leuven in Belgium in 1975 and 1976. There she helped establish the first graduate nursing program in Europe.

Peplau once said that the test of a good idea was whether it had staying power. Her original book from 1952 has been translated into nine languages and in 1989 was reissued in Great Britain by Macmillan. In 1989 Springer published a volume of selected works of Peplau from previously unpublished papers. Peplau's ideas have, indeed, stood the test of time. The archives of her work and life are housed at the Schlesinger Library at Harvard University.

JOEL WEISMAN - The Independent (London, England)

Physician who alerted the world to the Aids virus

Dr Joel D Weisman, a brilliant and compassionate generalpractitioner and pioneer in HIV/Aids care and research, died at hishome in Los Angeles, California on 18 July. He was 66. He had beensuffering from heart disease and was being looked after by hispartner of 17 years, the singer and actor Bill Hutton.

In 1978 in North Hollywood, Weisman had been noticing some vexingsymptoms in some patients - skin cancers that would normally afflictan older age group, and some patients with swollen lymph glands,often an indication of lymphoma, a cancer that originates in theimmune system. In 1980, after Weisman expanded his practice inSherman Oaks with Dr Eugene Rogolsky, alarm bells started to ringwhen he observed that several gay male patients of his had similarsymptoms of pneumonia, as well as serious ailments ranging frompersistent diarrhoea and fungal infections to low white blood cellcounts.

In 1981 Weisman was put in touch with the immunologist Dr MichaelGottlieb at UCLA Medical Centre, who also had a patient withsimilarly unusual symptoms. The two doctors collated theirobservations and came to the conclusion that something not seenbefore was happening. They wrote the seminal report that signalledthe official start of the Aids epidemic and which sounded an alarmwhich was heard around the world. Aids deaths in the US roseexponentially, from 618 in 1982 to almost 90,000 by the end of thedecade. By 2002, the death toll, still climbing, passed 500,000.

'I had a feeling that what this represented was the tip of theiceberg,' Weisman told the Washington Post two decades later in2001. 'My sense was that these people were sick and we had a lot ofpeople that were potentially right behind them.'

On top of these early referral cases, the journalist and authorRandy Shilts noted in his Aids chronicle And the Band Played On(1987), 'another 20 men had appeared at Weisman's office that yearwith strange abnormalities of their lymph nodes' - the verycondition that had triggered the spiral of ailments besettingWeisman and Rogolsky's original, very sick patients.

Weisman pressed for services for people with HIV and Aids asfounding chairman of Aids Project Los Angeles in 1983. He advocatedfor research dollars as an original board member of amfAR, which wasformed in 1985, and served as its chairman from 1988 to 1992.

Described by Shilts as 'the dean of Southern California gaydoctors', Weisman was loved and respected by patients and colleaguesalike. He continued to see patients, building his partnership withRogolsky at what is now Sherman Oaks Hospital and Health Center, oneof the largest private practices in Southern California for thetreatment of Aids and HIV.

As soon as he became convinced that Aids was sexuallytransmitted, Weisman began to urge patients to change their sexualbehaviour. But during the early years of the crisis, his warningswere too often ignored. 'I couldn't even make some of my friendslisten, and they're dead now and that's disconcerting,' he told TheNew York Times in 1988. Among the casualties was his partner of 10years, Timothy Bogue, who died in 1991.

Battling the epidemic on the front lines 'made me look at issuesof death and dying in a very different way,' he said in 1988. 'Whatmakes somebody a good physician in this situation? Is it justwinning? Keeping people alive? If I looked at every death as adefeat, I would not be able to continue.' In 1997, he stepped awayfrom the front line, just as new drug cocktails were extending thelives of Aids patients.

In 2000, he moved to upstate New York, where he ran an inn withHutton. They returned to Southern California five years ago where heremained an active ambassador for Aids Project Los Angeles untilillness overtook him this year.

My wife and I got to know Joel in 1993 when he walked into TheRedfern Gallery and bought several paintings of mine for his beachhouse in Malibu. He and Bill also made a studio visit to the EastEnd of London, when, much to my dealer's annoyance, I refused topart with a painting they liked which I didn't think was goodenough.

This episode cemented a bond between us and we were asked to stayin their beautiful modernist house in Beverly Hills. For a youngishartist it was an intoxicating experience. Joel became like an uncleand over the next 15 years his passion for the theatre meant that hewould come and visit and regularly take us and our children to playsand musicals in the West End, some of which he had part funded.

In addition to Bill Hutton, Joel Weisman is survived by hisbrother Mark, his daughter Stacey Weisman-Bogue Foster, hisgranddaughter, and two nieces. He was a wonderful man.

Physicians Join With National Healthcare Leaders to Explore New Ways to Enhance Geriatric Care in America. - Cancer Weekly

More than 200 physicians and nurses gathered with national healthcare leaders in Long Beach this weekend to address a myriad of issues surrounding geriatric care in America. Topics covered ranged from such clinical areas as diabetes, dementia and prostate cancer to more process-oriented issues such as how to best transition patients through various levels of care to assure that they receive the right care at the right time in the right setting (see also Managed Care).

'Our goal through this symposium and others like it is to improve the healthcare process by providing practical, hands-on knowledge that attendees can take back to their practice and begin implementing to make a difference,' said Dan Osterweil, M.D., professor of medicine at UCLA, director of the Specialized Ambulatory Evaluation Center in Sherman Oaks, a consulting geriatrician at SCAN Health Plan, and one of the planners of the conference. 'What we try to share is another way to provide care to older individuals that is efficient, is evidence-based, and in many cases has been proven to improve quality.'

Sponsored by the not-for-profit SCAN Health Plan, this fifth annual geriatric symposium has been growing in prestige and popularity as evidenced both by its increasing attendance and by the nationally known keynote speakers at this year's event. These included, among others: John Morley, M.D., editor-in-chief of Journal of American Medical Directors Association; Betty Ferrell, Ph.D., from The City of Hope; and Joseph G. Ouslander from the Institute of Successful Aging in Boca Raton, Florida, and executive editor of the Journal of the American Geriatric Society.

'In assembling our agenda and speakers, we look for gaps that exist in continuing medical education and try to fill those with information that can directly impact performance,' says Dr. Osterweil. 'For example, it is unique for a symposium like ours to cover the management of dementia and depression, but by focusing on this we believe physicians can improve care of other co-morbidities associated with dementia and thus improve a patient's quality of life.'

This year the conference also included a special hospitalist track in recognition of hospital-based medicine as the fastest-growing specialty in healthcare. There was also a focus on discharge planning and care coordination post-hospitalization. 'It is important that we take a holistic approach and look for new solutions if we are to care for a society where in two decades one of every five American's will be 65 or older,' Dr. Osterweil said.

As a health plan dedicated exclusively to seniors and others on Medicare, SCAN's sponsorship of the symposium is part of its ongoing commitment to better understand the aging process and advocate on behalf of the needs of seniors. Earlier this year, SCAN joined with the UCLA Academic Geriatric Resource Center and the California Geriatric Education Center to sponsor the seventh annual Leadership and Management in Geriatrics conference.

For more than 30 years, SCAN Health Plan has been focusing on the unique needs of people with Medicare and today is the fourth-largest nonprofit Medicare Advantage Plan in the United States. The company currently serves 110,000 members in Los Angeles, Orange, Riverside, San Bernardino, San Diego, Ventura and Kern counties. In Arizona, SCAN offers a Medicare Advantage Plan in Maricopa County and provides long-term care services to individuals in that county who are enrolled in the state's long-term care system. Further information may be obtained at scanhealthplan.com.

Keywords: Aging, Central Nervous System Disease, Dementia, Diabetes, Managed Care, Oncology, Prostate Cancer, Prostatic Neoplasms, SCAN Health Plan.

Relief aid affects national debt - San Bernardino County Sun (San Bernardino, CA)

WASHINGTON The federal deficit may have been the last thing onCalifornia congressional leaders' minds Friday as lawmakers approved$10.5 billion in Hurricane Katrina relief aid, but analysts say thenewest burden on the national debt shows a federal unwillingness tobudget for major disasters.

'Obviously, it's going to cost a lot of money. My guess is that itwill add tens of billions of dollars to the budget, and since thereis no extra money, it's going to add to the deficit,' said RobertBixby, executive director of the Concord Coalition, a D.C.-basedgroup that advocates for the elimination of the national debt.

Members of Congress, Bixby said, 'pretend that emergencies likethis are not going to happen when they make the budget.'

President Bush has vowed the money approved Friday for HurricaneKatrina relief is just a down payment and that more will follow foremergency efforts and rebuilding.

'In terms of dollars and cents, we know it's going to be veryexpensive in terms of the federal share,' said House AppropriationsChairman Jerry Lewis, R-Redlands.

He noted that Congress spent a total of $14 billion for relief forthe four previous hurricanes that have hit the United States.

'This one, all by itself, will be much larger than that, but Idon't know yet what that means,' he said.

Regardless, lawmakers said that with the federal governmentalready spending about $330 billion more than it has, any emergencyfunds will add to the debt but it's a moral imperative to do so.

'We will spend what we have to spend,' Rep. Adam Schiff, D-Pasadena, said. But, he added, 'our overall budget picture is veryproblematic. We have deficits as far as the eye can see.'

'We're generous with our children's money rather than our own,'said Rep. Brad Sherman, D-Sherman Oaks.

Congress should bring back Clinton-era tax policies to reduce thedeficit, he said.

'But that's off the mark. Right now the focus has got to be doingeverything we can do to help the people of Louisiana andMississippi,' Sherman said.

Bixby said Congress and the White House do a disservice to thecountry's financial health when they unveil budgets that fail toinclude money everyone knows must be spent: funding for Iraq, forexample, or for long-predicted disasters.

'It's a way of making your numbers look good, and the presidentcan go out and say, 'We're cutting the deficit,'' he said, addingthat while few predicted the enormity of Hurricane Katrina, Congressshould have been prepared for a major disaster-related budgetary blowand needs to get ready for the next one.

BUDGET DEFICIT YET ANOTHER STORM VICTIM - Daily News (Los Angeles, CA)

WASHINGTON - The federal deficit may have been the last thing onCalifornia congressional leaders' minds Friday as lawmakers approved$10.5 billion in Hurricane Katrina relief aid, but analysts say thenewest burden on the national debt shows a federal unwillingness tobudget for major disasters.

'Obviously it's going to cost a lot of money. My guess is that itwill add tens of billions of dollars to the budget, and since thereis no extra money, it's going to add to the deficit,' said RobertBixby, executive director of the Concord Coalition, a D.C.-basedgroup that advocates for the elimination of the national debt.

Members of Congress, Bixby said, 'pretend that emergencies likethis are not going to happen when they make the budget.'

President Bush has vowed that the money approved Friday forHurricane Katrina relief is just a down payment, and that more willfollow for emergency efforts and rebuilding.

'In terms of dollars and cents, we know it's going to be veryexpensive in terms of the federal share,' said House AppropriationsChairman Rep. Jerry Lewis, R-Redlands.

He noted that Congress spent a total of $14 billion for relieffor the four previous hurricanes that have hit the United States.'This one, all by itself, will be much larger than that, but I don'tknow yet what that means,' he said.

Regardless, lawmakers said that with the federal governmentalready spending about $330 billion more than it has, any emergencyfunds will add to the debt - but it's a moral imperative to do so.

'We will spend what we have to spend,' Rep. Adam Schiff, D-Pasadena, said. But, he added, 'our overall budget picture is veryproblematic. We have deficits as far as the eye can see.'

'We're generous with our children's money rather than our own,'added Rep. Brad Sherman, D-Sherman Oaks, who said Congress shouldbring back Clinton-era tax policies to reduce the deficit.

'But that's off the mark. Right now the focus has got to be doingeverything we can do to help the people of Louisiana andMississippi,' Sherman said.

Bixby said Congress and the White House do a disservice to thecountry's financial health when they unveil budgets that fail toinclude money everyone knows must be spent: funding for Iraq, forexample, or for long-predicted disasters.

'It's a way of making your numbers look good, and the presidentcan go out and say, 'We're cutting the deficit,'' he said, addingthat while few predicted the enormity of Hurricane Katrina, Congressshould have been prepared for a major disaster-related budgetaryblow and needs to get ready for the next one.

'It's kind of like saying, could New Orleans have been betterprepared? Well, could the federal budget have been better prepared?'

Lisa Friedman, (202) 662-8731