Confidentiality: a survey in a research hospital

Despite the many justifications for protecting patient confidentiality, we recognize that confidentiality cannot be absolute. Our world of automated information and easy access and storage poses many threats to confidentiality. This paper has described a survey conducted at the NIH Clinical Center to assess the knowledge, attitudes, and behaviors of clinical physicians and nurses about confidentiality of patient information. The survey findings demonstrate the need for reminders and increased awareness about confidentiality in our setting. Most of the survey respondents had a good knowledge of what was expected of them, and they believed that confidentiality was important and maintaining it was their responsibility. Of interest was that in several simulated clinical situations, there was a discrepancy between what respondents indicated they should do and what they thought they would do. The biggest discrepancies appeared in situations that involved overhearing a patient conversation on the elevator, approaching an unfamiliar person who is reading a medical record in the nurses' station, and answering a patient's inquiry about the status of another patient. The findings support the speculation that this difference may be attributed to discomfort or decreased awareness, and not necessarily to lack of knowledge. Results indicate that policies and administrative expectations should be frequently communicated and enforced, and that educational programs that address issues of confidentiality should be provided. The results of this survey have been influential in guiding educational strategies and administrative activities at the clinical center. The clinical center initiated a confidentiality awareness campaign, displaying a new poster every three months in strategic locations and distributing other tangible reminders (such as pens, magnets, and buttons) containing the same confidentiality message.(ABSTRACT TRUNCATED AT 250 WORDS)     

Creating Creativity: A Behavior Analytic Approach

The Psychological Record - Creativity and innovation have brought about phenomenal changes throughout human history. Art, science, medicine, industry, and technology have all grown through creative...     

An Intersectional Approach to the Glass Ceiling: Gender,Race and Share of Middle and Senior Management in U.S. Workplaces

A robust body of research examines factors affecting the likelihood that women experience increasing barriers to promotion in workplaces. However, limited research examines how racialized and gendered processes may intersect and work differently for racially and gender marginalized workers. Specifically, the processes relating to a worker’s ability to reach middle-level management positions (e.g., those managers who oversee a small group of employees) and senior-level management positions (e.g., CEOs and other executive positions) may vary based on workers’ race and gender. Using 2015 EEO-1 data collected by the U.S. Equal Opportunity Employment Commission (EEOC), we examine how the characteristics of a workplace affect Black men, Black women, White men, and White women’s share of middle- and senior-level management. We find Black women and Black men are strikingly under-represented in both middle and senior management in private-sector workplaces. Our results demonstrate that access to middle- and senior-management varies by the characteristics of the workplace and workers’ race and gender. Overall, our findings point to an important implication: Greater oversight of workplaces, including by the EEOC, is associated with marginalized race/gender groups having higher shares of management.

     

The horsemen of the Apocalypse: messianism and terror

Continental Philosophy Review - I draw a phenomenological approach to religious violence by using as an example the terror apparatus called Daesh (or ISIS). After a brief reminder of my method (the...     

Problem-solving in a cooperative task in peach-fronted conures (Eupsittula aurea)

Animal Cognition - Cooperation is a complex behaviour found in many kinds of organisms and occurs between individuals of the same and different species. Several studies have examined the...     

Pathophysiology, prevention, and potential treatment of neural tube defects

Neural tube defects (NTD) remain a major cause of morbidity in spite of the reduction in liveborn incidence with periconceptional folic acid. However, the etiology remains unknown. This article reviews studies that address causation and potential treatment of NTD in humans and in animal models that resemble aspects of the common human NTD. Studies of nutritional markers of vitamin B12 and folic acid support a defect in homocysteine metabolism; a thermolabile variant of methylene tetrahydrofolate reductase, an enzyme that remethylates homocysteine to methionine, correlates with a risk of NTD in some human populations. Numerous mouse mutant models of NTD exist, attesting to the ease of disruption of neurulation, and a genetic basis for this malformation. Of these models, the curly tail mouse mutant most closely resembles the common human NTD. Folic acid does not prevent NTD in this model; however inositol supplementation does result in a significant reduction in incidence. Recent advances in fetal surgery, and evidence from mechanically created myelomeningocele in large animals amenable to surgical intervention suggest that the handicaps associated with myelomeningocele and associated Chiari Type II malformation may be prevented by in utero NTD closure. Success will depend on preservation of neurological tissue until such intervention is possible. Further research in animal models at the genetic and cellular levels, together with technological surgical advances, provide hope that prevention of more NTD and the associated handicaps may be possible. MRDD Research Reviews 6:6-14, 2000.     

Achievement in mathematics in grades 9 and 11 in Limpopo Province of South Africa: introduction of a problem-based approach

800 students in Grades 9 and 11 of schools in the Central Region of the Limpopo Province of South Africa completed the Study Orientation Questionnaire in Mathematics. Mean age in Grade 11 was 17.5 yr. (SD = 1.4) and in Grade 9 15.1 yr. (SD = 1.2). Intervention was aimed at teachers and students in this group. Teachers in the trained group received training in a problem-based approach to teaching and learning in mathematics and introduced these principles into their classes. Analysis of variance on the differences between post- and pretest scores of the six subscales and the marks in mathematics and English yielded no effects for grade, sex, or grade after 6 mo. Pearson correlations for students in Grade 11 were positive between study orientation and achievement in mathematics. Improving teachers' training and expertise, transforming disadvantaged learning environments, and developing necessary formal and informal mathematical knowledge seem both essential and difficult.