Hyperledger Fabric-based Reliable Personal Health Information Sharing Model

There has been a consistent concern about the inadvertent disclosure of personal information through peer-to-peer file sharing applications, such as Limewire and Morpheus. Examples of personal health and financial information being exposed have been published. We wanted to estimate the extent to which personal health information (PHI) is being disclosed in this way, and compare that to the extent of disclosure of personal financial information (PFI). After careful review and approval of our protocol by our institutional research ethics board, files were downloaded from peer-to-peer file sharing networks and manually analyzed for the presence of PHI and PFI. The geographic region of the IP addresses was determined, and classified as either USA or Canada. We estimated the proportion of files that contain personal health and financial information for each region. We also estimated the proportion of search terms that return files with personal health and financial information. We ascertained and discuss the ethical issues related to this study. Approximately 0.4% of Canadian IP addresses had PHI, as did 0.5% of US IP addresses. There was more disclosure of financial information, at 1.7% of Canadian IP addresses and 4.7% of US IP addresses. An analysis of search terms used in these file sharing networks showed that a small percentage of the terms would return PHI and PFI files (ie, there are people successfully searching for PFI and PHI on the peer-to-peer file sharing networks). There is a real risk of inadvertent disclosure of PHI through peer-to-peer file sharing networks, although the risk is not as large as for PFI. Anyone keeping PHI on their computers should avoid installing file sharing applications on their computers, or if they have to use such tools, actively manage the risks of inadvertent disclosure of their, their family's, their clients', or patients' PHI.

Personal health record (PHR) is a patient-centric model of health information exchange, which greatly facilitates the storage, access, and share of personal health information. In order to share the valuable resources and reduce the operational cost, the PHR service providers would like to store the PHR applications and health information data in the cloud. The private health information may be exposed to unauthorized organizations or individuals since the patient lost the physical control of their health information. Ciphertext-policy attribute-based signcryption is a promising solution to design a cloud-assisted PHR secure sharing system. It provides fine-grained access control, confidentiality, authenticity, and sender privacy of PHR data. However, a large number of pairing and modular exponentiation computations bring heavy computational overhead during designcryption process. In order to reconcile the conflict of high computational overhead and low efficiency in the designcryption process, an outsourcing scheme is proposed in this paper. In our scheme, the heavy computations are outsourced to ciphertext transformed server, only leaving a small computational overhead for the PHR user. At the same time, the extra communication overhead in our scheme is actually tolerable. Furthermore, theoretical analysis and the desired securing properties including confidentiality, unforgeability, and verifiability have been proved formally in the random oracle model. Experimental evaluation indicates that the proposed scheme is practical and feasible.

BackgroundWhile Personal Health Records (PHRs) are increasingly adopted globally, understanding public attitudes toward health information sharing remains crucial for successful implementation. This study investigated patterns in willingness to share personal health information among Japanese adults and identified factors influencing their sharing decisions.MethodsA nationwide cross-sectional web-based survey was conducted among 20,000 Japanese adults in December 2023. Participants were recruited through quota sampling based on age, gender, and prefecture population ratios from the 2020 National Census. The survey examined willingness to share personal health information with nine types of recipients (healthcare providers, ambulance crew, application providers, family members, local authorities, employers, pharmaceutical companies, government agencies, and research institutions), trust levels in these recipients, and 17 factors influencing sharing decisions across health benefits, convenience, economic incentives, social significance, information details, transparency, and privacy considerations. Clustering analysis using Uniform Manifold Approximation and Projection (UMAP) and Ordering Points to Identify the Clustering Structure (OPTICS) algorithms was performed to identify distinct patterns in sharing preferences.ResultsDespite low PHR familiarity (88.4% unfamiliar), participants showed willingness to share health information with healthcare providers (65.0%) and family members (65.6%), but expressed lower willingness toward government agencies (28.6%) and research institutions (28.8%). Five distinct clusters were identified: family-only sharers (3.9%), mixed preference sharers (47.9%), comprehensive sharers (12.9%), non-sharers (22.1%), and healthcare-selective sharers (13.2%). Trust levels were highest for family members (85.6%) and healthcare professionals (78.8%), while significantly lower for government agencies (44.2%). Higher education, income, and PHR familiarity were associated with greater willingness to share, while privacy and security concerns were universal across all clusters.ConclusionsThe heterogeneous patterns in health information sharing preferences suggest the need for tailored PHR implementation strategies that address varying privacy concerns and trust levels across different population segments. Success in PHR adoption requires balanced approaches to trust-building, robust data protection, and targeted communication strategies that acknowledge diverse user needs while promoting the benefits of health data sharing.

Case reports in medicine are fundamentally individual patient stories generally describing unique or unexpected findings in terms of disease or treatment. Anecdotally based, they are considered to be less rigorous an evidentiary base than other types of research. As described by Jenicek (1), although case reports rank low on the scale of types of evidence to be relied on, they are highly important in their frequent role as the “first line of evidence”. Historically, case reports were published without consent of the patient. However, standards have been evolving in law and ethics such that consent should now be viewed as mandatory. The remainder of the present commentary provides justification for this assertion. The interests at stake include, on the one hand, confidentiality and autonomy and, on the other hand, the need for scientific advancement, described by Levine and Stagno (2) as “pedagogical freedom”. Since at least Hippocrates’ era, patients have been seen to be entitled to respect for the confidentiality of their personal health information (3). The elemental value of confidentiality is rooted in the need for absolute trust by patients that revelations of personal matters to health care providers will not be indiscriminately broadcasted. Furthermore, the right of the individual to choose among treatment options has been enshrined in the concept of ‘informed consent.’ Its roots may be found in the right to respect for autonomy, and the right to determine the course of treatment may be extended to the right to determine what may be done with personal information that is garnered along the way. There is also, however, great interest in scientific advancement, which has led to some reluctance to seek patient consent to publication of case reports for fear that a negative decision would result in a lack of opportunity to publicize new information that has been gained by a particular case. Psychiatrists, in particular, have voiced concern that patients may not consent due to the nature of their illness – Munchausen’s syndrome being emblematic of this concern (2,4). Thus, there are legitimate interests on both sides of this issue. However, arguably, confidentiality and autonomy are taking precedence in ethics and in law. Confidentiality is protected through federal and provincial legislation regarding information generally and health information specifically (57-7). Such legislation would require, at the least, that case reports not contain any identifiable information about a patient without the patient’s consent. Likewise, a number of medical journals have enshrined the protection of confidentiality into their guidelines for publication. The International Committee of Medical Journal Editors (8) requires informed consent for publication if identifiable information is to be used, but does not refer specifically to case reports. This is similar to the approach of the Paediatrics & Child Health journal (9). Following legal advice, the British Journal of Psychiatry (10) has adopted a guideline saying that consent must be obtained if an individual patient is described; if consent cannot be obtained, “the report can be published only if all details that would enable any reader (including the individual or anyone else) to identify the person are omitted”. It is important to note that, particularly for case reports in our digital age, the bar may actually be quite high under these laws and guidelines. Case reports often deal with a rare disease or constellation of characteristics and, therefore, a person may be identifiable even if no direct identifiers are mentioned. Furthermore, the prospect of identifiability has increased due to broader access to the case reports themselves, both by professionals and by the public more generally, through medical journals that previously had a circumscribed distribution range, but are now available online. This, combined with the fact that patients are being urged to access health information both online and through libraries, increases the likelihood that case reports will be viewed and individuals may be identified. Confidentiality is the obligation of third parties to guard the secrecy of personal information; informational privacy refers to the person or group’s entitlement to make decisions regarding uses of the information. Even if there is no reasonable prospect that the individual patient would be identified, autonomy and privacy interests are at stake. As stated above, autonomy is the underpinning for the doctrine of informed consent. The Supreme Court of Canada signalled a dramatic shift in the ‘doctor knows best’ phenomenon when it ruled that patients are entitled to make their own decisions (11). Privacy, with its concomitant right to make decisions regarding the use of one’s information, engages the autonomy interest even if identifiability is not of concern (12). There is a consensus in Canadian law that personal health information is “fundamentally one’s own” (13), and that individuals should, in most circumstances, be the ones deciding how the information should be used. It might be argued, therefore, that case reports, even without any identifiable information, cannot be published without consent (but it must be noted that this has not been addressed by any Canadian court). Indeed, this is the position taken by the Journal of Medical Case Reports (14), which has adopted a blanket requirement of informed consent before publication. In the case of immature minors and those unable to provide consent, consent is required from the parents or guardians. No case report is to be published in the absence of consent. It is notable that this Journal, which exclusively deals with case reports, has taken this strong stance in favour of informed consent. This takes us to the bottom line. Consent is certainly required under a confidentiality analysis for the publication of case reports that contain any identifiable information. Consent is arguably required under an autonomy analysis for all case reports.

—Health information custodians and networkproviders within the circle of care for a patient must meetcertain legal obligations regarding the collection, access anddisclosure of personal health information. We present aframework for consent and risk management that can be usedto help manage a patient’s consent for releasing personal healthinformation, and analyze the risk involved in handling this typeof data. A patient’s preferences for specific privacy policies(expressed in P3P) are elicited through querying, and extrainformation is inferred using a Bayesian network. A risk analysisis performed to help a custodian to make informed decisionswhen handling personal health information. Thus the custodianand provider can help each other meet their respective legalobligations, and patients are more easily able to exercise theirprivacy rights. I. I NTRODUCTION One of the major technical challenges faced by Ontarianhealth care providers under the Personal Health InformationProtection of Privacy Act, 2004 (PHIPA) is ensuring the pri-vacy and security of personal information collected from theirpatients. PHIPA governs practices to protect personal healthinformation (PHI), including consent, collection, use, disclo-sure and handling requests for access/correction to records byindividuals.Most patients deal with multiple health care workers, desig-nated as health information custodians (HICs) under PHIPA.Each HIC may need different levels of access and use to apatient’s health record in the course of providing care, all ofwhich are associated with new legal obligations under PHIPA.As a result, there are several concerns:1) How does a HIC meet their legal obligations surroundingindirect collection of PHI?2) How does a patient retain control over access to theirPHI? How does the primary care physician (PCP) ensurethat appropriate personnel have access to the informationwhen they need it, e.g. in an emergency situation?3) How does a HIC ensure that patient preferences sur-rounding disclosure are being acted on?Fulfillment of these legal obligations necessitates extractingspecific preferences from the patient. Determining qualitativeattitudes toward the handling of data, such as “I care mostabout my information being shared with third parties”, isnontrivial enough. However, determining a given patient’squantitative valuations of actions on their PHI, which isnecessary for a full risk analysis, can be a very difficult task.A HIC grappling with the risks of non-compliance canuse the services of a health information network provider(HINP) to enable electronic means to manage patient PHI.

Personal health record (PHR) is an emerging patient-centric model of health information exchange, which is often outsourced to be stored at a third party, such as cloud providers. However, there have been wide privacy concerns as personal health information could be exposed to those third party servers and to unauthorized parties. To assure the patients' control over access to their own PHRs, it is a promising method to encrypt the PHRs before outsourcing. Yet, issues such as risks of privacy exposure, scalability in key management, flexible access, and efficient user revocation, have remained the most important challenges toward achieving fine-grained, cryptographically enforced data access control. In this paper, we propose a novel patient-centric framework and a suite of mechanisms for data access control to PHRs stored in semitrusted servers. To achieve fine-grained and scalable data access control for PHRs, we leverage attribute-based encryption (ABE) techniques to encrypt each patient's PHR file. Different from previous works in secure data outsourcing, we focus on the multiple data owner scenario, and divide the users in the PHR system into multiple security domains that greatly reduces the key management complexity for owners and users. A high degree of patient privacy is guaranteed simultaneously by exploiting multiauthority ABE. Our scheme also enables dynamic modification of access policies or file attributes, supports efficient on-demand user/attribute revocation and break-glass access under emergency scenarios. Extensive analytical and experimental results are presented which show the security, scalability, and efficiency of our proposed scheme.

The adoption of Electronic Health Records (EHRs) in India has been rapid and the significance of protecting privacy of personal health information has proportionally increased as well. The research emanates from scenario of rapidly rising frequency of cyber-threats to personal health information and lower efficiency of the legal framework in handling such threats. The latest development made towards protection of general digital information Digital Personal Data Protection Act, 2023 ensures protection of digital personal data and incorporates important provisions which were not available in the former legislations and regulatory frameworks. However, the aforementioned Act still lacks several significant provisions in comparison to other legislations governing personal health information in other countries. The research identifies several lacunas existing in the Indian legal landscape which can consequently lay an adverse impact on the privacy of personal health information. Furthermore, it also analyzes the legal framework and further conducts a comparative review of the legislations in European Union and United States. The comparative assessment highlights absence of several provisions in Indian legal framework and consequently affecting the data privacy of health information. The analysis following the comparative assessment lays down broad spectrum of provisions which can be incorporated in the Indian legislative structure.

The purpose of this research was to solve the complication associated with the recommendation of traditional herbal medicines, concerning the fact that an appropriate use of traditional herbal medicines entails contemplation of personal health information that include age, body temperature, pregnancy, lactation, chronic diseases, and medicines taken on a regular basis. Likewise, some traditional herbal medicines cannot be taken by patients with certain health conditions. Accordingly, this research proposed a system that provides recommendations of traditional herbal medicines according to each patient’s health information by applying an ontology-based knowledge representation technique that employs Web Ontology Language (OWL) to process and describe data in the ontology. Rules were expressed in the form of a rule language so as to enable the computer to infer and provide recommendations of traditional herbal medicines and their contraindications in a similar manner to a medical specialist. To test the efficiency of the proposed system in solving the complication and providing personalized recommendations, an experiment was conducted based on three scenarios: (1) the case of more than one diseases with different personal health information; (2) the case of more than one diseases with specified personal health information; and (3) the case of same disease with different personal health information. Upon assessment of the system efficiency by a medical specialist, the system was found to be capable of providing personalized recommendations of traditional herbal medicines and their contraindications in an efficient manner.

Protecting personal health information has long been a key ethical concern in healthcare. With the rise of digital health systems, privacy concerns have intensified. In least developed countries like Myanmar, where digital literacy is low, public and governmental awareness of privacy issues is limited, and data protection laws are lacking, the health information privacy area remains largely unaddressed and understudied. This study, therefore, aimed to assess the level of privacy concerns related to personal health information in Myanmar and identify the factors associated with these concerns. A cross-sectional survey was conducted from March to May 2024 among 424 participants recruited online and through two private clinics. A validated 21-item scale measuring six domains: Collection, Errors, Unauthorized Secondary Use, Improper Access, Control, and Awareness, was used. Confirmatory factor analysis was performed to validate the scale, and logistic regression was used to identify factors associated with the concerns. Among the 424 participants, 77.83% reported high concerns. The highest concern was observed in the Awareness domain (mean 5.02, SD 1.65), while the Collection domain showed the lowest (mean 3.41, SD 1.44). Participants aged 45 years or older had significantly lower odds of high concerns compared to those aged 18-24 years, with an adjusted odds ratio (aOR) of 0.29 (95% CI 0.09-0.88). In contrast, those reporting good health (aOR 3.72, 95% CI 1.69-8.23) and high health concerns (aOR 5.26, 95% CI 3.02-9.45) had increased odds of high privacy concerns. These findings highlight the need for robust privacy safeguards, legal frameworks, and trust-building measures to support Myanmar's transition to digital health systems. Sampling via online channels and private clinics likely introduced an urban/educated bias, limiting generalizability. However, the findings may still provide insights relevant for other least developed countries facing similar challenges in balancing digital innovation with the protection of personal health information.

Trust, authority and credibility in the digital environment have attracted the interest of many researchers in the recent years. Reliable and credible information are key factors for making numerous decisions in our everyday lives, from making political choices to choosing a healthy lifestyle. Various health-related narratives are present in the public sphere. Health advice and recommendations on vaccination, antibiotics, nutrition, exercise and numerous other topics are provided by different sources, scientific community, healthcare professionals, media, lay people, patients, social networks, etc. It was the infodemic associated with the coronavirus pandemic that again brought to the forefront the importance of reliable and credible health information and health information literacy in this complex digital environment. In such fragmented information ecosystem, characterized by the post-truth era, where misinformation and fake news spread by uninformed individuals or advocates of various conspiracy theories are considered equivalent to reliable scientific information, individuals have to choose whom to trust, based on their critical capacities and competencies, in order to make health decisions for themselves and their families. The young people of today, especially those born after the year 2000, represent the generation of digital natives, who grew up and spent their entire lives surrounded by digital technologies that have become an integral part of their lives. They think and process information differently than their predecessors. Most of them use the Internet as their primary source for accessing information, most often through smartphones, spend the vast majority of time online, increasingly use social networks for private and professional purposes, but at the same time have difficulty assessing the reliability of online information. The way they assess trust in digital information is different from the way they question information credibility in traditional media. Given that trust and credibility of information strongly influence the effect of information message itself, which, in extraordinary circumstances and public health crisis such as the coronavirus pandemic, is of vital importance for the lives of people, it is very important to understand how users decide whom to trust. Health information literacy is a multidimensional and dynamic concept that incorporates social, cognitive, economic, and personal skills to search, understand, and use health information in order to improve and maintain good health. The evaluation of online health information, i.e. its reliability and credibility, plays a significant role in the process of health behavior change. Research to date has not reached a consensus on unique framework for understanding the process of building user confidence in online health information. The focus of this doctoral dissertation are theoretical and analytical challenges of health information literacy as a multidimensional and dynamic concept, particularly in understanding the process of creating trust in online health information. By examining the attitudes and opinions of medical students about the evaluation of online health information we aimed to determine factors that influence the assessment of health information quality and credibility. The main research objective is to examine the element of information appraisal in the concept of health information literacy and to determine the processes of creating trust in health information in an online environment. The specific research objectives are as follows: 1. to identify factors and techniques for assessing the quality, reliability and credibility of online health information; 2. to determine the elements of cognitive heuristics for assessing the reliability of online health information; 3. to determine the impact of infodemic during a healthcare crisis on online health information trust issues; 4. to examine methods for assessing the quality and reliability of user-generated online health information; 5. to investigate medical students' attitudes and knowledge of the concepts and tools for assessing health information literacy. Our research aimed to determine common elements of information appraisal in the concept of health information literacy and related concepts dealing with online health information (health literacy, information literacy, media literacy, digital literacy, etc.). The research was performed using multiple methods conducted in three phases: 1. literature review and comparative analysis of selected tools and instruments for assessment of health information literacy and related concepts; 2. a survey questionnaire that examined the attitudes and opinions of medical students of the University of Zagreb School of Medicine regarding online health information appraisal, and 3. semi-structured interviews with a smaller subgroup of respondents in order to build on the findings from the survey questionnaire related to the determination of factors that influence trust in online health information, i.e. assessment of their quality and credibility. The results of our research demonstrated that medical students have the knowledge, skills and techniques necessary to assess the quality, reliability and credibility of online health information. Although medical students generally considered Internet to be a questionable source for health information, the majority reported that they always use online search engines as the first step when searching for health topics, regardless of their purpose (general interest, academic assignment, or personal or health problem among family and friends, etc.). Medical students consider the following analytical criteria when assessing the credibility of online health information: trustworthiness, completeness, objectivity and comprehensiveness of information, referencing other data sources and author disclosure. Apart from analytical criteria, medical students also use cognitive heuristics when assessing the reliability of online health information, especially user-generated content that is published and shared via social networks. Students also emphasized the importance of critical thinking, factual analysis, information verification on multiple sources, determination of source credentials as well as sharing information with family members, friends, colleagues, physicians and university professors who they consider as cognitive authorities in health communication. Research results indicate an overall positive relationship between perceived health information literacy of medical students, their ability to evaluate online health information and trust in the Internet as a source of health information. Students with high self-perceived level of e-health literacy more often use websites of government institutions and professional medical associations than other sources for online health information. Our research also revealed that the degree of trust that medical students have in online sources of information affects their behavior when searching and evaluating online health information. In healthcare crisis situations, medical students apply additional evaluation criteria for usergenerated health information on social media. In general, medical students expressed mistrust towards social networks, especially as a source of credible health information in the context of an infodemic. Although the majority of students use social networks only passively, they also believe that social networks present a platform that has the potential, if used appropriately, to convey reliable information and improve health information literacy. Students also stressed that, during infodemic, strategic crisis communication skills should be applied for proactive dissemination of credible, factual and scientific evidence in order to contribute to a faster and more efficient containment of the spread of misinformation and fake news on social media. The results of our research have shown that online health information should be comprehensive, accurate, evidence-based, objective and up-to-date in order to convey a quality health message. According to medical students, quality of information, source credibility, comprehensibility and readability, as well as verification of information in evidence-based sources are main predictors of trust in online health information. Understanding which health channels and sources are considered most reliable among different user groups can help health professionals reach at-risk patients in order to communicate health messages more successfully and implement interventions aimed at strengthening skills that are important for health information appraisal. By analyzing medical students` attitudes and opinions about credibility of online health information, we explored ways to promote critical thinking in the digital environment in order to empower individuals to make decisions in their everyday life based on verified and credible sources of information. Placing greater emphasis on lifelong learning about health, and formal and informal health information literacy education, enables greater autonomy and empowerment of individuals, and can be viewed as part of personal development towards an improved quality of life. Health information literacy increases individual and community resistance to harmful and misleading information and reduces the impact of the infodemic on human health. Improving health information literacy among population requires joint action and cooperation between stakeholders and policymakers (government authorities, media, scientific, educational and health institutions, healthcare professionals, scientists, researchers, librarians and others). Health information literacy is an important competence of every individual, but its implications for society are much broader. They include personal and social responsibility of individuals and taking ethical actions for the benefit of the community. A modern democratic society implies engaged citizens who autonomously reflect on political, ethical and social challenges in everyday life. Empowerment in health and social care, achieved by developing critical competencies, helps in distancing oneself from various social pressures, making independent informed decisions and taking responsibility for one's own health. Croatia, unlike most other European countries, still does not have an official strategy or action plan for developing and improving health information literacy among its population. Our research results point out the importance of including health information literacy in the national health policy and education strategy, with particular emphasis on developing critical thinking skills and competencies in evidence-based approach to online health information appraisal. The results of this research contribute to the conceptual linking of theoretical constructs on information appraisal and critical theories from information and communication sciences with constructs from the field of public health. The mentioned approach resulted in unifying the narratives of different domains, and synthesizing separate theoretical frameworks, namely health information and related literacies, which adds to the value of this research. The results of this research serve as a basis for defining skills for critical appraisal of online health information in order to increase the level of health information literacy and development of tools for evaluating the reliability of online health information. On the applicative level, this doctoral dissertation provides recommendations for communication of reliable online health information from the current infodemic perspective, in planning public health activities and interventions in the future.

Patient portals are secure online platforms that offer patients access to various functions such as personal health information. While patient portals are being increasingly offered by health services, there are limited data on their use for persons living with home mechanical ventilation (HMV) and/or long-term tracheostomy. This study, conducted at an Australian hospital’s home mechanical ventilation and long-term tracheostomy services, aimed to explore the perspectives and attitudes of patients and carers regarding the introduction of a patient portal. There were 231 survey responses and 6 semi-structured interview participants. Interest in using a patient portal was high with 87% of survey respondents indicating that they would consider using a patient portal if it were offered. Those that were more likely to be interested were younger, had higher levels of education, and reported being confident with using technology and accessing health information. The functions of a patient portal that were of most interest were the ability to view their own health information including ventilation and/or tracheostomy information and the ability to order ventilation and tracheostomy-related equipment. This study is the first step of a user-centered design for the implementation of a patient portal for persons living with home mechanical ventilation and/or long-term tracheostomy.

The Protection of Personal Information Act (POPIA) 2013 came into force in South Africa on 1 July 2020. It seeks to strengthen the processing of personal information, including health information. While POPIA is to be welcomed, there are concerns about the impact it will have on the processing of health information. To ensure that the National Health Laboratory Service [NHLS] is compliant with these new strict processing requirements and that compliance does not negatively impact upon its current screening, treatment, surveillance and research mandate, it was decided to consider the development of a NHLS POPIA Code of Conduct for Personal Health. As part of the process of developing such a Code and better understand the challenges faced in the processing of personal health information in South Africa, 19 semi-structured interviews with stakeholders were conducted between June and September 2020. Overall, respondents welcomed the introduction of POPIA. However, they felt that there are tensions between the strengthening of data protection and the use of personal information for individual patient care, treatment programmes, and research. Respondents reported a need to rethink the management of personal health information in South Africa and identified 5 issues needing to be addressed at a national and an institutional level: an understanding of the importance of personal information; an understanding of POPIA and data protection; improve data quality; improve transparency in data use; and improve accountability in data use. The application of POPIA to the processing of personal health information is challenging, complex, and likely costly. However, personal health information must be appropriately managed to ensure the privacy of the data subject is protected, but equally that it is used as a resource in the individual’s and wider public interest.

<span>The public and governmental focus have been shifted increasingly onto data and privacy due to Facebook’s standoff with Apple and several Nations’ Governments. An imperative for the discussion of data handling has been made, while Biofeedback human interfacing device (HID) companies such as CTRL-labs and Neuralink introduce new risks in the access, use, and control of personal health information. This paper combines the lexicon of digital self-extension with line drawing analysis to help visualize the industry use of personally identifiable information (PII). Through this analysis encapsulation methods of users' PII have been identified such that discussion of encrypting personal health information (PHI) can be facilitated through analogy. To reduce the likelihood that companies generating biometric hardware are subject to future legal action through laws analogous to European Privacy Law, it is in their best interest to be transparent with their users about data sharing, and educate them on how the companies encrypt their PHI. Should users consent to the use of biometric hardware, this process validates the user control of their own PHI.</span>

Maternal health and nutritional Information form the cradle of healthy genetic development and population health, safeguarding the right to life and the quality of future livelihoods. Thus, this health and nutrition information often enables most females of reproductive age 15 to 49 years, globally, regionally and locally in western Kenya, to access quality, affordable and reliable health education on maternal health care and nutrition, and to mediate a primordial prevention and reduce maternal disease burden rates. It also promotes health demography and human development, through prevention and protection missions of public health, via community health awareness and capacity building, empowering population health and promote a healthy population. This is achieved by enabling regular health education on maternal and child nutrition, for better primary prevention than cure among rural females of the reproductive age and the larger population health through synergistic community participation. It was these reasons that led to the study, which aimed to evaluate the factors influencing increased accessibility to maternal and nutritional health information and their effects on reproductive health practices among rural females of reproductive age (15–49 years) in Western Kenya. Specifically, the study focuses on determining the prevalence of population health in the accessibility to affordable maternal health and balanced diet nutrition practices, determining the level of community participation in the promotion on maternal child health nutritional health education/information for quality primordial prevention and decrease of maternal child health and nutrition, and lastly assessing how social economic, social cultural and religious beliefs influence the increased accessibility of maternal child health and nutrition health information on maternal health nutrition practices among rural females of the reproductive age in Western Kenya. The study also aimed to achieve in global health goals number 3 and 17 of Vision 2030 and beyond, in global health. Over 80% of community households have limited access to efficient, affordable, reliable, and sustainable quality maternal child health and nutrition information to promote primordial prevention in the general basic health population, especially in Sub Saharan Africa (SSA), through capacity building of health service providers and community health workers (CHWs), as their main sources of accessibility of maternal child health information, in the large diversified society of demographic health population and development, to improve the health population of the population health and their health live hoods. The study exploited descriptive, cross-sectional, cohort and triangulation designs. Purposive clusters, census retrospective and prospective sampling techniques were used to explore the ante and postnatal mothers with children aged 0-24 months as the target population. The questionnaire used as tool of survey and key informant interview and focused group discussion (FGD) was used in interview guides. Data was managed by SPSS version 27 and analysed by cross-tabulation of descriptive and inferential statistics to provide a significant inference. Results showed that health service providers and community health workers were the main sources of providing quality health education/information 97 (46.2%) and 69 (32.9%) respectively, with significant support from the global health of RR (0. 463, 0.335). The prevalence of the increased accessibility of maternal health nutrition was health/education information 101 (48%). Community awareness on the uptake of balance dietary intake from both animal proteins and plant was 67%, and majority opined significant uptake of animal protein was determined by social cultural with P value of 0.025, 95 % CI, and social economic has an influence remain insignificant with OD 1.0 and RR (0.25, 0.345), due to existing synergistic public private partnership global health to decrease unmated needs in the inequality at maternal health and nutrition community households. Need to advocate for more global health in public-private partnership participation to mediate the unmet basic needs of maternal health, nutrition and need to partner with urban reproductive of reproductive in issues of maternal health and nutrition, mediate global maternal health and nutrition global health goals number 3 and 17 of Vision 2030 and beyond to sustain quality global livelihoods and population health development.

Personal electronic health records: MySpace or HealthSpace?