ABSTRACT
Quartz Hill, in Misty Fjords National Monument near Ketchikan, Alaska, is the site of a proposed molybdenum-producing mine. To provide baseline data for use in post-development comparisons, we analyzed tissues of Barrow's goldeneyes (Bucephala islandica), common mergansers (Mergus merganser), and blue mussels (Mytilus edulis) for seven heavy metals that could potentially be released into the environment as a result of mining operations. Specimens were collected in 1980, 1981, and 1982 from two fjords likely to be used for discharge of tailings from the proposed mine and from two control fjords. Concentrations of arsenic, cadmium, copper, chromium, molybdenum, lead, and zinc were measured in soft tissues of mussels and in kidney, liver, and muscle of birds. The highest mean concentrations of metals found in bird tissues were 55.7 ppm dry weight cadmium in kidneys and 154 ppm dry weight zinc in livers of Barrow's goldeneyes. Concentrations of several metals in blue mussels differed among seasons and locations, but the most significant finding in mussels was a maximum mean cadmium concentration of 9.6 ppm dry weight, a level higher than normally found in undisturbed areas. With the exception of 104 ppm dry weight cadmium in the kidney of one common merganser and 12.7 ppm dry weight lead in the kidney of another, concentrations of other metals in seaduck and mussel tissues were low, consistent with what would be expected for a pre-development environment. Molybdenum was found in low concentrations (<10 ppm dry weight) in all avian kidney samples and most liver samples, but was not detected in blue mussels.
ABSTRACT
Two hundred and fifty patients at a university hospital teaching clinic and 200 patients in a small private medical office were questioned about their expectations for confidentiality. It was found that in general, subjects in both groups had similar expectations of how physicians handle confidential information. This included physician behavior in situations such as discussing cases with other physicians for second opinions, submitting cases to medical journals, and discussing cases at parties or with spouses and friends. The similarity existed despite demographic differences between the two groups and despite marked differences in the two practice settings. A few differences between the groups were noted, however. University clinic patients were more likely than private office patients (54.5% vs 38.5%) to expect that cases are discussed at large physicians' meetings. Private office patients were more likely (77.8% vs 67%) to expect physicians to discuss cases with nurses. Men in both practice settings were more likely than women to believe that physicians commonly submit cases to medical journals (75.8% vs 59.9%), or discuss cases with nurses (81% vs 67%), non-medical friends (10.9% vs 4.4%), spouses (53% vs 36.4%), and at parties with physicians (56.4% vs 39.6%).
KIE: Confidentiality expectations were solicited from 250 patients of a University of Arizona outpatient teaching clinic and from 200 private office practice patients of two of the authors. Despite demographic and practice setting differences, both groups of patients in general had similar impressions of how physicians handle confidential information with other health professionals, spouses, and friends, at medical meetings, and for publication. The authors conclude that physicians' behavior regarding confidentiality is not of critical importance in patient choice of a health care setting. They note, however, that their study evaluated perceptions of confidentiality and not preferences about confidentiality.
