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)     

The effects of encoding task on age-related differences in the functional neuroanatomy of face memory

Age-related differences in brain activity mediating face recognition were examined using positron emission tomography. Participants encoded faces using a pleasant-unpleasant judgment, a right-left orientation task, and intentional learning. Scans also were obtained during recognition. Both young and old groups showed signficant effects of encoding task on recognition accuracy, but older adults showed reduced accuracy overall. Increased brain activity in older adults was similar to that seen in young adults during conditions associated with deeper processing, but was reduced during the shallow encoding and recognition conditions. Left prefrontal activity was less in older adults during encoding, but greater during recognition. Differential correlations of brain activity and behavior were found that suggest older adults use unique neural systems to facilitate face memory.     

Ordering autobiographical experiences

This study examined individuals' memory for the temporal order of autobiographical events and for the components that constitute autobiographical events. Study 1 measured performance on an across-event ordering task that involved the chronological arrangement of cards that displayed event labels. Results indicated poor ordering ability across events, but a reasonable ability to order clusters of events. Study 2 compared within-event and across-event ordering using computer-presented digital photographs. Participants were better at ordering the photographs in their own across-event trials than in their within-event trials. The results are discussed in terms of the retrieval of temporal information under within- and across-event conditions.     

Temporal delay,type of forewarning,and resistance to influence

Previous researchers have manipulated forewarning by providing premessage information about the topic and position of the upcoming communication, or the communicator's persuasive intent. Subjects in the present experiment were force-warned either 10 min prior to the communication, or just before the message began of the speaker's topic and position, persuasive intent, or topic only. As hypothesized, forewarning of the communicator's persuasive intent inhibited persuasion regardless of the length of the delay period, but forewarning of the topic and position required a delay in order to confer resistance to subsequent persuasion, suggesting that although both manipulations have been called “forewarning they may lead to reduced persuasion through different mechanisms. Foreknowledge of the source's topic, but not his position also increased resistance to persuasion when followed by a delay period. The results were discussed in terms of both cognitive and motivational mechanisms that may underly the persuasion inhibiting effects of forewarning.