The minimum necessary standard, a key protection of the HIPAA Privacy Rule, is derived from confidentiality codes and practices in common use today. It is based on sound current practice that protected health information should not be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function. The minimum necessary standard requires covered entities to evaluate their practices and enhance safeguards as needed to limit unnecessary or inappropriate access to and disclosure of protected health information. The Privacy Rule’s requirements for minimum necessary are designed to be sufficiently flexible to accommodate the various circumstances of any covered entity.
How the Rule Works
The Privacy Rule generally requires covered entities to take reasonable steps to limit the use or disclosure of, and requests for, protected health information to the minimum necessary to accomplish the intended purpose. The minimum necessary standard does not apply to the following:
- Disclosures to or requests by a health care provider for treatment purposes.
- Disclosures to the individual who is the subject of the information.
- Uses or disclosures made pursuant to an individual’s authorization.
- Uses or disclosures required for compliance with the Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Rules.
- Disclosures to the Department of Health and Human Services (HHS) when disclosure of information is required under the Privacy Rule for enforcement purposes.
- Uses or disclosures that are required by other law.
The implementation specifications for this provision require a covered entity to develop and implement policies and procedures appropriate for its own organization, reflecting the entity’s business practices and workforce. While guidance cannot anticipate every question or factual application of the minimum necessary standard to each specific industry context, where it would be generally helpful we will seek to provide additional clarification on this issue in the future. In addition, the Department will continue to monitor the workability of the minimum necessary standard and consider proposing revisions, where appropriate, to ensure that the Rule does not hinder timely access to quality health care.
Uses and Disclosures of, and Requests for, Protected Health Information
For uses of protected health information, the covered entity’s policies and procedures must identify the persons or classes of persons within the covered entity who need access to the information to carry out their job duties, the categories or types of protected health information needed, and conditions appropriate to such access. For example, hospitals may implement policies that permit doctors, nurses, or others involved in treatment to have access to the entire medical record, as needed. Case-by-case review of each use is not required. Where the entire medical record is necessary, the covered entity’s policies and procedures must state so explicitly and include a justification. For routine or recurring requests and disclosures, the policies and procedures may be standard protocols and must limit the protected health information disclosed or requested to that which is the minimum necessary for that particular type of disclosure or request. Individual review of each disclosure or request is not required. For non-routine disclosures and requests, covered entities must develop reasonable criteria for determining and limiting the disclosure or request to only the minimum amount of protected health information necessary to accomplish the purpose of a non-routine disclosure or request. Non-routine disclosures and requests must be reviewed on an individual basis in accordance with these criteria and limited accordingly. Of course, where protected health information is disclosed to, or requested by, health care providers for treatment purposes, the minimum necessary standard does not apply. Reasonable Reliance. In certain circumstances, the Privacy Rule permits a covered entity to rely on the judgment of the party requesting the disclosure as to the minimum amount of information that is needed. Such reliance must be reasonable under the particular circumstances of the request. This reliance is permitted when the request is made by:
- A public official or agency who states that the information requested is the minimum necessary for a purpose permitted under 45 CFR 164.512 of the Rule, such as for public health purposes (45 CFR 164.512(b)).
- Another covered entity.
- A professional who is a workforce member or business associate of the covered entity holding the information and who states that the information requested is the minimum necessary for the stated purpose.
- A researcher with appropriate documentation from an Institutional Review Board (IRB) or Privacy Board.
The Rule does not require such reliance, however, and the covered entity always retains discretion to make its own minimum necessary determination for disclosures to which the standard applies.
by Conscious Reminder
If you feel like you are lonely a lot of the times, this might be because of your deep personality.
A deep personality can intimidate the people around you. Here are 9 signs to prove that you have a deep personality that intimidates the people around you:
1. You are curious about things:
You just want to know everything that you can and this makes you ask a lot of questions. When you ask a lot of questions, people feel intimidated but the truth is that you are just someone who seeks knowledge and wants to know more things than others.
2. You are very honest:
Somehow, honesty as a trait has become extremely rare. People just praise each other and try to get things from them by the means of flattery and sycophancy. But if you are a person who is brutally honest; a person who speaks his mind, people won’t be very comfortable around you because of your ability to do something that they cannot do at all.
3. You know about your ambitions:
The thing is that not all of us know what we want from our life. But if you know about your goals and ambitions, certainly people will be intimidated by you.
4. You want deep relationships:
Most of us lead a life on social media apps these days. So, not all of us have deep relationships or connections that last a lifetime. But if you are someone who wants to have deep relationships, people will certainly be scared of you. In a romantic relationship, people might think of you as someone who gets too serious too fast. But the truth is that there is nothing wrong in wanting to be in serious relationships.
5. You aren’t afraid to be intimate:
In relationships, you are not at all afraid to be close and vulnerable. On the contrary, you express yourself emotionally and make sure that the relationship is emotionally stable all the time and that you provide emotionally for your partner as well. This is the reason why your relationships will certainly have more meaning as well.
6. You know when someone is playing games with you:
You always come to know when someone is cheating on you or taking you for a ride. You don’t want to be comfortable with this at all as you are very serious about loyalty in any relationship or friendship. So, you always pay attention to the actions of people and make sure that no one is cheating or lying to you.
7. You like consistent effort:
You don’t like sporadic efforts. You work hard every single day in the same way because you like consistency. You like to work hard every single day. You even work hard on your relationships and nurture them every single day. Your singular aim is to become as best as possible.
8. You are passionate and intense:
You aren’t cold in your efforts. You know that lukewarm is not enough and therefore you are passionate and intense and you make sure you are the same about everything that you do, however small or inconsequential it might be.
9.You don’t wait for other people around you:
You don’t need people to get things done in life. This doesn’t mean that you are too proud to ask for help. The truth is that you are too independent and you have absolute faith on your caliber and actions.
So, if you have these 9 signs, then surely people are quite intimidated by you.
Don’t worry, just be the same as you are.
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“I know I have great inner strength … I can blank things out, cut people out, and I know that I can go and live in a cave on my own if necessary.” – Charlotte Rampling
If you’ve never heard of Ms. Rampling, she’s a prolific English actress. She has enjoyed a successful career as an actress and model for over 50 years. She’s also an exceptional figure that segues into a discussion on inner strength – an aspect of the personality some consider intimidating.
Charlotte Rampling’s life off the screen and out of the public eye could be what demonstrates her exceptional character. Divorced twice, she raised two sons on her own. After finding love and staying in a relationship for over 17 years, her partner passed away unexpectedly in 2015. She showed tremendous strength admitting her battle with depression.
Those who know Ms. Rampling attest to her tremendous strength. What is it, exactly, that makes a strong or “intimidating” personality? From how some of us converse to creating opportunities where others may see impossibility, a common set of attributes can determine the strength of a personality.
Here are 5 signs you have an intimidating personality:
1. Simplistic conversations are annoying
It isn’t surprising that strong people detest simple banter. They welcome conversations that invite intellectual curiosity, while they find small talk revolting.
People with strong personalities generally let people know exactly what they think, including their take on irrelevant questions. If dialogue accomplishes little to nothing, they might tune out completely. This is particularly true when they are concentrating on some other important task. Strong personalities simply don’t have the time or inclination to engage in trivial conversations.
Needless to say, small talk is a big part of daily life in America. This is part of the reason that those who are repulsed by it can been seen as intimidating.
2. Ignorant attitudes are repulsive
Generally speaking, strong people are well (often self) educated. They possess a wide breadth of knowledge. This open-minded attitude often invites curiosity and promotes acceptance. They strive to learn as much as possible, and are willing to maintain an open mind to the differences of others. At the same time, strong people rarely accept ignorant attitudes in others.
The strong among us dislike judgmental or artificial comments and behaviors. They acquire knowledge in order to understand people and the world on a deeper level, and are irked by those who do not. Most notably, these people don’t require the consensus of others to determine whether or not their outlook is valid.
3. Opportunities are forcefully created
Strong people have a way of making opportunities without needing much assistance from others. This tremendous work ethic can intimidate the less motivated, which can invite hostility. Whether or not they’re viewed as intimidating for being ambitious is irrelevant to strong people. The hostile attitudes of those around them, even more. Strong individuals are willing to recognize and work towards opportunities where others may not. They make no apologies for this.
4. Others’ attention is not important
In a society that craves attention, strong people couldn’t care less. While their strength of character may invite attention – positive or negative – from the people around them, strong personalities rarely notice. They won’t spend precious time and effort seeking attention. Instead, strong people simply do what needs to be done. These folks are happy and secure without attention. They epitomize the old axiom, “Your actions speak so loudly, I can’t hear what you’re saying.”
5. Excuses are not acceptable
Strong people forge ahead – regardless of the fallout. It’s no surprise that people who waste time whining and complaining about trivialities fail to interest them. When a problem arises, someone with a strong personality will simply focus on fixing it. Why agonize over a problem or situation one cannot control? As those who continuously strive to do their best, they quickly turn away those who try to use them as a sounding board for meaningless complaints and pointless banter.
Have people sometimes accused you of being intimidating? They may judge you for what you are as a person, without even knowing anything about you or your personal life.
Nowadays, a person’s personality is a result of the experiences that person has gone through in the past. As a result of that, the attitude of that person towards life becomes strong, as well as tough. Other people may not support the way you are, but you should not be worried about that. You are not supposed to be sorry for who you indeed are.
Recognized by tension, your life saw a lot of ups and downs in your career, as well as your relationships with people. All this made you an independent, or better said stronger individual. Hence, you are not anymore soft for other people.
Frequently, people misunderstand you as a rude, as well as mean person, as a result of your way of behaving and reacting around other people. What a lot of people are not able to see is your soft side which is behind what you wear – a tough person. Those people that are considered as intimidating are usually with kind nature and a big heart.
These are the five most common personality traits which can be seen on an intimidating person:
1. You consider small talk as annoying.
You consider small talks as annoying, and you do not participate in them frequently. Something which calls on your attention is profound and severe conversations that include the participation of the brain. Minor conversations which concern the weather or glamour world don’t catch your eye at all. In fact, you are annoyed if a person interrupts you with their small talk.
2. You don’t tolerate deliberate ignorance.
You are not just individual with a strong personality, but you are also wise, as well as learned simultaneously. You are a person with an open mind, and you don’t entertain someone that is judgmental. Unsupported judgment comes from ignorance. One of the ways of easing ignorance is educating yourself. However, when someone is too unwilling to do so for his sake, then you are probably going to walk away, or you will also lose your patience with them.
3. You can notice additional opportunities than other people.
As you are an individual with an open mind, you can notice a lot more opportunities in some situations than other people. Such point of view will not just help you to survive, but it is also going to push you through some harsh conditions in life. At the same instant, you can even come into contact with hostility and jealousy from other people, as you can achieve success neediness.
4. You focus more on solutions and not on problems.
People with strong will are often focused and they well-know how they can get their things done. Also, they cannot tolerate excuses from other people that attempt to impede their work. Strong-willed people do not like weak individuals, as well as individuals that complain and fail to be in charge of things on their own.
5. You are an honest person.
What you value the most is honesty. You are a simple person that speaks its mind, a person that is not afraid of coming off as someone that is rude. You do not have two faces, and you tell people what you really think in their faces. Also, you stick by your word all of the time, and you never lie your friends. However, you cannot become friends with anyone or everyone. You hate liars and people that are not honest.
If everything from above depicts your personality or the personality of someone else you know, then you need to understand that those people who have strong characters may appear intimidating, but that they do not have brutal hearts. They simply cannot hide their frustration or anger when they are with individuals that wear masks.
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There are times in life where people don’t give you what you want, but you don’t have to settle for disappointment. When life gives you lemons, manipulate the lemon salesman. Here’s how.
It’s worth noting that manipulating people is generally a bad thing to do. Please do not take this advice. Instead, use it as a guide to spot manipulation in your day-to-day interactions and protect yourself from manipulative people. Such is the goal of Evil Week .
Emotion vs. Logic
The easiest way to manipulate people—especially Americans—is by playing on their emotions. If you let people think too much they’re more likely to make a logical choice. If you can guide them to feel a certain way—a way that benefits you—you’ll have a much easier time getting what you want. This is what emotional manipulation is all about.
Master Your Own Emotions
Ideally your target won’t have an exceptional amount of control over their emotions, but that doesn’t mean you get to be lazy. A master manipulator needs to be able to act. Shedding a tear when it suits your needs or losing yourself in a fit of rage are both important skills you’ll want to master. Whether you want to incite fear, sympathy, or anything else will depend on the situation, so it’s important to master your own emotions so you’ll have the proper tools for the task at hand.
Be Charming and Flirt Often
But you can’t just cry and throw tantrums whenever you want something—people have to like you. Charm is an important part of manipulating people. If you’re ridiculously likable most of the time, when you react with extreme emotion it’ll have a greater impact. Having control over your emotions also involves keeping them in check most of the time and not just being able to act.
Charm is great, but when you can flirt you should. Because manipulation generally makes the target feel poorly, whether they understand that they’re being manipulated or not, the more they like you the better. Disregard the boundaries of your own sexuality and throw in some suggestive touches when you think they’ll be effective. This tactic is especially effective with people who are lonely and have low self-esteem.
Overcome Trust Issues and Heal Doubt
People who’ve been manipulated a number of times before are generally on the lookout for this kind of behavior and don’t trust people easily, so you need to watch for signs. If you believe trust is an issue, the quickest way around that problem is to share something very personal and very private with the target. It’s always best if it’s relevant to them, or if they feel you trust them enough to confide something so personal. It’s not important that your story is true, but that they believe it. Again, acting is key.
The biggest enemy you’ll have when trying to manipulate another person is doubt. If they don’t notice something fishy about your behavior, they might start to notice that they’re not acting like themselves. Hopefully, at this point, you’ve managed to learn a few of their problems and what they want to change about their lives. If they openly question the way they’re acting, remind them that change is often uncomfortable but they need to go through this tumultuous period in their lives to make positive progress. Save any negativity for a necessary emotional outburst. Positivity is always your best friend when trying to convince people to do what you want. Negative manipulation should only be used when necessary. Too much negativity will make you an ineffective manipulator.
The Bible clearly teaches us to “be content” no matter what our circumstances are. In Philippians 4:11, Paul said, I have learned in whatsoever state I am in therewith to be content. The Amplified Bible describes being content as satisfied to the point where you are not disturbed or disquieted. It doesn’t say satisfied to the point where you don’t want change, but satisfied for now until God brings the change. Philippians 4:6-7 sheds more light in this area by saying, Have no anxiety about anything, but in all things by prayer and supplication, with thanksgiving, continue to let God know what you want, and verse 7 the peace that passes understanding shall keep your hearts and minds in Christ Jesus.
Allow me to paraphrase these scriptures in my language for you. Don’t be upset about anything, no matter what is happening. Pray about it, and tell God your need. While you are waiting for God to move, be a very thankful and grateful person for all that God has done for you already. (Note: Let me say here that if God never did one thing for us except write our names in the Lamb’s Book of Life, that alone is more than enough.)
Being thankful from the heart is necessary for the receiving of God’s continued favors in our lives. Then verse 7 says after this:
- Have no anxiety or care,
- Tell God your need, and
- Be thankful.
Then you will have tremendous peace and contentment no matter what state you are in while you are waiting for God to work out His will in your life.
Let us not forget Romans 8:28 that says, All things work together and are fitting into a plan for good to those who love God and are called according to His purpose. Even the hard times can work into God’s perfect plan for your life. Cast your care, and be a thankful person. Take inventory each day of what you have instead of counting up all the things that you have not. Meditate on what God has done in your life instead of what you are still waiting on Him to do. Your flesh wants you to concentrate on what you don’t have. Your spirit wants you to ask God for what you don’t have, yet concentrate on what you do have.
John 14:27 (AMPC) says, Stop allowing yourselves to be agitated and disturbed; do not permit yourselves to be fearful and intimidated and cowardly and unsettled. Jesus left us a legacy of peace, and He wants us to use it. I have discovered through years of experience, many of these years spent in frustration and discontentment, that the secret of being content is to ask God for what I want, and know that “if it is right” He will bring it to pass “at the right time,” and if it isn’t right, God will do something much better than what I asked for anyway. We must learn to trust God completely if we ever intend to enjoy peaceful living. It is good to trust God for something, but God is calling His people not only to trust Him “for something,” but to trust Him “in everything.”
In Genesis 50:20, Joseph, speaking to his brothers who had severely mistreated him, said As for you, you thought evil against me, but God meant it for good. The very things we think are awful right now, very often can turn out to be a great blessing. The greatest trial can develop in you the greatest faith. God spoke this to my heart a while ago: “Joyce, you see to the end of your nose (which isn’t very far), and you assume that anything that doesn’t feel good isn’t good. But I see from beginning to end because I am The Beginning and The End, and I know many things you don’t know.” We know in part. God is “The All.”
Exercise doesn’t feel good, but it is good. When a rebellious child receives a spanking, it doesn’t feel good, but it is good. Hebrews 12 teaches us that no chastening for the present seems joyous but grievous, nevertheless, later on it yields the peaceable fruit of righteousness to those who have been trained by it. Perhaps we need to learn to be more concerned with later on than with right now. Hebrews 12 also says that for the joy set before Him, Jesus endured the cross, despising the shame, but He is now seated at the right hand of God. Let’s be willing to endure for a season, if it will seat us at His right hand of authority and power.
In conclusion, let me say that the sum of the whole matter is this: Trust God! Hide yourself in the secret place (in Him). God loves you. He is a good God who only does good things. Be content knowing that His way is perfect, and He brings with Him a great recompense of reward for those who trust in Him.
The binomial distribution describes the behavior of a count variable X if the following conditions apply: 1: The number of observations n is fixed. 2: Each observation is independent. 3: Each observation represents one of two outcomes (“success” or “failure”). 4: The probability of “success” p is the same for each outcome.
If these conditions are met, then X has a binomial distribution with parameters n and p , abbreviated B(n,p) .
Suppose individuals with a certain gene have a 0.70 probability of eventually contracting a certain disease. If 100 individuals with the gene participate in a lifetime study, then the distribution of the random variable describing the number of individuals who will contract the disease is distributed B(100,0.7) .
Note: The sampling distribution of a count variable is only well-described by the binomial distribution is cases where the population size is significantly larger than the sample size. As a general rule, the binomial distribution should not be applied to observations from a simple random sample (SRS) unless the population size is at least 10 times larger than the sample size.
To find probabilities from a binomial distribution, one may either calculate them directly, use a binomial table, or use a computer. The number of sixes rolled by a single die in 20 rolls has a B(20,1/6) distribution. The probability of rolling more than 2 sixes in 20 rolls, P(X>2) , is equal to 1 – P(X 2) = 1 – (P(X=0) + P(X=1) + P(X=2)) . Using the MINITAB command “cdf” with subcommand “binomial n=20 p=0.166667” gives the cumulative distribution function as follows: The corresponding graphs for the probability density function and cumulative distribution function for the B(20,1/6) distribution are shown below:
Since the probability of 2 or fewer sixes is equal to 0.3287, the probability of rolling more than 2 sixes = 1 – 0.3287 = 0.6713.
The probability that a random variable X with binomial distribution B(n,p) is equal to the value k , where k = 0, 1. n , is given by , where .
The latter expression is known as the binomial coefficient , stated as ” n choose k ,” or the number of possible ways to choose k “successes” from n observations. For example, the number of ways to achieve 2 heads in a set of four tosses is “4 choose 2”, or 4!/2!2! = (4*3)/(2*1) = 6. The possibilities are
Mean and Variance of the Binomial Distribution
These definitions are intuitively logical. Imagine, for example, 8 flips of a coin. If the coin is fair, then p = 0.5. One would expect the mean number of heads to be half the flips, or np = 8*0.5 = 4. The variance is equal to np(1-p) = 8*0.5*0.5 = 2.
In the example of rolling a six-sided die 20 times, the probability p of rolling a six on any roll is 1/6, and the count X of sixes has a B(20, 1/6) distribution. The mean of this distribution is 20/6 = 3.33, and the variance is 20*1/6*5/6 = 100/36 = 2.78. The mean of the proportion of sixes in the 20 rolls, X/20 , is equal to p = 1/6 = 0.167, and the variance of the proportion is equal to (1/6*5/6)/20 = 0.007.
Normal Approximations for Counts and Proportions
Note: Because the normal approximation is not accurate for small values of n , a good rule of thumb is to use the normal approximation only if np > 10 and np(1-p) > 10.
For example, consider a population of voters in a given state. The true proportion of voters who favor candidate A is equal to 0.40. Given a sample of 200 voters, what is the probability that more than half of the voters support candidate A?
The count X of voters in the sample of 200 who support candidate A is distributed B(200,0.4) . The mean of the distribution is equal to 200*0.4 = 80, and the variance is equal to 200*0.4*0.6 = 48. The standard deviation is the square root of the variance, 6.93. The probability that more than half of the voters in the sample support candidate A is equal to the probability that X is greater than 100, which is equal to 1- P(X 100).
To use the normal approximation to calculate this probability, we should first acknowledge that the normal distribution is continuous and apply the continuity correction . This means that the probability for a single discrete value, such as 100, is extended to the probability of the interval (99.5,100.5). Because we are interested in the probability that X is less than or equal to 100, the normal approximation applies to the upper limit of the interval, 100.5. If we were interested in the probability that X is strictly less than 100, then we would apply the normal approximation to the lower end of the interval, 99.5.
So, applying the continuity correction and standardizing the variable X gives the following:
1 – P(X 100)
= 1 – P(X 100.5)
= 1 – P(Z (100.5 – 80)/6.93)
= 1 – P(Z 20.5/6.93)
= 1 – P(Z 2.96) = 1 – (0.9985) = 0.0015. Since the value 100 is nearly three standard deviations away from the mean 80, the probability of observing a count this high is extremely small.
Before you can begin to understand statistics, you need to understand mean, median, and mode. Without these three methods of calculation, it would be impossible to interpret much of the data we use in daily life. Each is used to find the statistical midpoint in a group of numbers, but they all do so differently.
When people talk about statistical averages, they are referring to the mean. To calculate the mean, simply add all of your numbers together. Next, divide the sum by however many numbers you added. The result is your mean or average score.
For example, let’s say you have four test scores: 15, 18, 22, and 20. To find the average, you would first add all four scores together, then divide the sum by four. The resulting mean is 18.75. Written out, it looks something like this:
- (15 + 18 + 22 + 20) / 4 = 75 / 4 = 18.75
If you were to round up to the nearest whole number, the average would be 19.
The median is the middle value in a data set. To calculate it, place all of your numbers in increasing order. If you have an odd number of integers, the next step is to find the middle number on your list. In this example, the middle or median number is 15:
- 3, 9, 15, 17, 44
If you have an even number of data points, calculating the median requires another step or two. First, find the two middle integers in your list. Add them together, then divide by two. The result is the median number. In this example, the two middle numbers are 8 and 12:
- 3, 6, 8, 12, 17, 44
Written out, the calculation would look like this:
- (8 + 12) / 2 = 20 / 2 = 10
In this instance, the median is 10.
In statistics, the mode in a list of numbers refers to the integers that occur most frequently. Unlike the median and mean, the mode is about the frequency of occurrence. There can be more than one mode or no mode at all; it all depends on the data set itself. For example, let’s say you have the following list of numbers:
- 3, 3, 8, 9, 15, 15, 15, 17, 17, 27, 40, 44, 44
In this case, the mode is 15 because it is the integer that appears most often. However, if there were one fewer 15 in your list, then you would have four modes: 3, 15, 17, and 44.
Other Statistical Elements
Occasionally in statistics, you’ll also be asked for the range in a set of numbers. The range is simply the smallest number subtracted from the largest number in your set. For example, let’s use the following numbers:
- 3, 6, 9, 15, 44
To calculate the range, you would subtract 3 from 44, giving you a range of 41. Written out, the equation looks like this:
- 44 – 3 = 41
Once you’ve mastered the basics of mean, median, and mode, you can begin to learn about more statistical concepts. A good next step is studying probability, the chance of an event happening.