Health-ID: A Blockchain-Based Decentralized Identity Management for Remote Healthcare.

COVID-19 has made eHealth an imperative. The pandemic has been a true catalyst for remote eHealth solutions such as teleHealth. Telehealth facilitates care, diagnoses, and treatment remotely, making them more efficient, accessible, and economical. However, they have a centralized identity management system that restricts the interoperability of patient and healthcare provider identification. Thus, creating silos of users that are unable to authenticate themselves beyond their eHealth application's domain. Furthermore, the consumers of remote eHealth applications are forced to trust their service providers completely. They cannot check whether their eHealth service providers adhere to the regulations to ensure the security and privacy of their identity information. Therefore, we present a blockchain-based decentralized identity management system that allows patients and healthcare providers to identify and authenticate themselves transparently and securely across different eHealth domains. Patients and healthcare providers are uniquely identified by their health identifiers (healthIDs). The identity attributes are attested by a healthcare regulator, indexed on the blockchain, and stored by the identity owner. We implemented smart contracts on an Ethereum consortium blockchain to facilities identification and authentication procedures. We further analyze the performance using different metrics, including transaction gas cost, transaction per second, number of blocks lost, and block propagation time. Parameters including block-time, gas-limit, and sealers are adjusted to achieve the optimal performance of our consortium blockchain.

Domestic Violence Against Married Women During the COVID-19 Quarantine in Saudi Arabia.

Background  Before the coronavirus disease 2019 (COVID-19) pandemic, cases of domestic abuse and aggressive behaviour between Saudi married couples were increasing annually, a topic of growing concern both socially and medically. With the forced indoor confinement enacted as a containment measure, international studies regarding domestic abuse indicated an almost unanimous increase in prevalence. This cross-sectional national study aimed to assess the change between the pre-and intra-pandemic prevalence of abuse in Saudi Arabia.  Material and methods  Anonymous data were gathered using a web-based Arabic version of the World Health Organization (WHO) multi-country instrument measuring violence against women residing in Saudi Arabia. The previously validated questionnaire included a series of multiple-choice questions related to demographic information, family infrastructure, experienced situations of abuse, and the severity and form of abuse during the quarantine period, from March 23, 2020, to June 21, 2020. Associations were tested using a two-tailed Pearson's Chi-square test and odds ratios. A binary multivariate logistic regression was used to identify the independent factors associated with domestic violence.  Results  In total, 2254 participants were included in the present study. The majority (n=2129, 94.7%) were Saudi nationals. The highest proportion (n=1022, 45.3%) was in the 30 to 40 years age group. The self-reported prevalence of domestic violence before COVID-19 pandemic and quarantine was 25.4% and 16.6% during the confinement, indicating an overall decrease of 8.8% in the reported cases. Regarding the type of violence, of the 315 (16.6%) women who endured violence since the confinement, the majority (n=301, 95.6%) experienced multiple forms of violent abuse, 264 (87.7%) suffered from psychological/emotional violence, 114 (37.9%) from physical violence, and 50 (16.6%) from sexual violence. Of the group who experienced multiple forms of violence, 120 (39.9%) reported an increase in the frequency and perceived intensity of the violence since the confinement. The only variable that directly increased the likelihood of suffering domestic violence had more than three children [OR = 1.59, P = 0.018]. Conclusions  Contrary to trends observed in other countries, the national prevalence of abusive conduct towards married women showed a marked decrease during the quarantine period-more children directly correlated with a higher reported frequency of being abused. Further studies in neighbouring countries with comparable societies and structures must be conducted to assess the validity of our findings in the context of the global trends of violence in the marital home.