The new JCAHO patient safety standards and the disclosure of unanticipated outcomes. Joint Commission on Accreditation of Healthcare Organizations

This article looks at the newly-issued JCAHO standards and their increased focus on patient safety in performance standards for healthcare organizations. As part of these standards, hospitals are required to inform patients of outcomes of care, including unanticipated outcomes. This article examines this requirement and suggests varying interpretations of it. After looking at the current legal and ethical standards requiring disclosure of errors or negligent acts, the article suggests that hospitals are faced with many difficulties in implementing the standard. Specifically, the article argues that more details are necessary regarding what events must be reported and what hospitals are required to do when members of the medical staff refuse to inform patients of medical error.     

Predictors of Adolescents’ Disclosure to Parents and Perceived Parental Knowledge: Between- and Within-Person Differences

Adolescents’ willingness to share information with parents is a central process through which parents gain knowledge of their adolescents’ lives. This paper addresses four questions important to understanding adolescents’ decisions to voluntarily disclose areas of parent-adolescent disagreement: What are the contribution of parent-adolescent agreement and adolescents’ non-disclosure of disagreement to adolescents’ perceptions of parental knowledge?; Which adolescents are most likely to disclose to parents in case of disagreement?; Under what conditions are adolescents more or less likely to disclose disagreement?; and What type of non-disclosure will different adolescents use and under what conditions? Self-report data from 120 adolescents (M age=15.8) revealed that failure to disclose disagreement, but not overall agreement, predicted perceived parental knowledge. Adolescents from authoritative homes and those less involved in disapproved leisure were more likely to disclose disagreement and less likely to lie. Within-person differences in disclosure were predicted by the presence of explicit rules and adolescents’ beliefs about required obedience.Dr. Darling is a developmental psychologist whose research focuses on social relationships during adolescence, with a special interest in contextual variation in developmental processes. Correspondence should be addressed to Dr. Darling atDr. Cumsille is a developmental methodologist whose research focuses on adolescent well-being.Dr. Caldwell's research focuses on the experience of adolescent leisure, with a particular interest in adolescent boredom and well-being.Dr. Dowdy is a developmental psychologist specializing in adolescent social relations.     

Considering Knowledge Uptake within a Cycle of Transforming Data,Information, and Knowledge

Knowledge uptake, having decision makers assimilate the ideas of experts, is recognized as an important stimulus to bringing about policy change. This is particularly true in the realm of environmental policymaking, which is characterized by knowledge intensity, complexity, and multifaceted concerns. Using examples from an innovative watershed management organization, this article presents a heuristic for understanding how knowledge uptake occurs within a cycle of organizational reasoning. This cycle is driven by activities that transform data, information, and knowledge and that link specialists with decision makers. The heuristic can be used as a diagnostic tool to identify breaks in the transformation process that impede mandate fulfillment and impair capacity building. Lack of appreciation of the dynamic relationship between data, information and knowledge leads to mistimed and ineffective policy interventions that do not result in the hoped for progress in science intended to underpin policy advances.     

Willingness to Self-Disclose among Late Adolescent Female Survivors of Childhood Sexual Abuse

The primary aim of this study was to compare the willingness of sexually abused (n = 22) and non–sexually abused (n = 36) late adolescent women to self-disclose both general and sexual information to strangers and intimate partners. Results, based on a sample of college women, indicate that those who were sexually abused in childhood are less likely than nonabused counterparts to be highly disclosing of sexual and general information to intimate partners. Avoiding extensive disclosure of personal information to intimate partners may serve to keep survivors of abuse at a relatively safe distance from their own dysphoric feelings and suggests that mistrust of others is an ongoing issue for this population.     

Ideology and Political Alienation

A substantial literature over the years has focused on the relationship between political alienation and ideology. Much of this research contends that conservatives are more alienated than liberals because philosophically they believe that the best government is that which governs least. A close reading of the literature, however, reveals little consistency in the empirical findings. Survey data from Norway, Sweden, and the United States are used to provide a more extensive and consistent test of the hypothesis. Ideology is defined as both left/right self-identification and policy preference on economic and "new political" issues. The evidence reveals that in Scandinavia higher levels of alienation are found among conservatives, whereas in the US the left has been consistently more alienated, except on "new politics" issues. The discrepancy between the citizen's preferred ideological orientation and that which the public perceives the government to take, is used to explain the different findings for the three countries and the shifts in the relationship between ideology and alienation across time.