In three experiments subjects given either impression formation or memory task instructions read a series of behavior descriptions that either did or did not contain a highly distinctive item. In each study subjects given impression formation instructions recalled significantly more items than did subjects in the memory condition. Subjects given impression formation instructions were more likely to recall a distinctive item, but presence of a distinctive item in the stimulus list had little effect on recall of the other items. Results are discussed in terms of the organization of information acquired during the process of impression development.

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Background and Purpose: There are limited data on the impact of site enrollment volume on risk factor control and outcome of patients in secondary prevention trials. We sought to compare outcomes and risk factor control between high and low enrolling sites in the stenting and medical groups in SAMMPRIS. Materials and Methods: 451 patients with recent TIA or stroke attributed to 70%-99% intracranial stenosis were randomized to aggressive medical management alone or stenting plus aggressive medical management. We compared the Kaplan-Meier (K-M) curves for the primary endpoint (any stroke or death within 30 days of enrollment or ischemic stroke in the territory beyond 30 days) using the log-rank test and the percentages of patients with mean LDL < 70 mg/dl and mean systolic blood pressure (SBP) < 140 mmHg (< 130 mmHg if diabetic) during the study using the chi-square test between patients at high (≥ 12 patients) and low enrolling (< 12 patients) sites in the stenting and medical groups. Results: In the stenting group, the K-M curves for the primary endpoint were not significantly different between high vs. low enrolling sites (p=0.93) with rates of 13.5% vs. 14.7% at 30 days and 19.0% vs. 20.6% at 2 years. In the medical group, the K-M curves for the primary endpoint were significantly different between high enrolling sites vs. low enrolling sites (p=0.0005) with rates of 1.8% vs. 9.8% at 30 days and 7.3% vs. 20.9% at 2 years. Control of LDL and SBP during the study at high vs. low enrolling sites in the medical and stenting groups are shown in the table . Conclusions: High enrolling sites had significantly lower 30-day and 2 years rates of the primary endpoint in the medical group but not in the stenting group compared with low enrolling sites in SAMMPRIS. One contributing factor to the lower event rate in the medical group at high enrolling sites may be the significantly higher percent of patients who achieved a mean LDL < 70 mg/dl during follow-up at high enrolling sites.

Objective: The role of physician experience and patient volumes on the outcome of surgical or endovascular procedures has been well-studied but there are limited data on how these factors affect the outcome of medical therapy. Methods:In the stenting and medical cohorts of the Stenting and Aggressive Medical Management for the Prevention of Recurrent Ischemic Stroke (SAMMPRIS) trial, we compared KaplanMeier (K-M) curves for the primary endpoint (any stroke or death within 30 days of enrollment or ischemic stroke in the territory beyond 30 days) using the log-rank test and the percentages of patients achieving target levels for primary and secondary risk factors during the study using Fisher exact test between patients at high-enrolling ($12 patients) vs low-enrolling (,12 patients) sites.Results: In the stenting group, the K-M curves for the primary endpoint were similar at highenrolling sites and low-enrolling sites (p 5 0.93) with rates of 13.5% vs 14.7% at 30 days and 19.0% vs 20.6% at 2 years. In the medical group, the K-M curves differed between highenrolling sites and low-enrolling sites (p 5 0.0005) with rates of 1.8% vs 9.8% at 30 days and 7.3% vs 20.9% at 2 years. The percentages of patients who achieved targets for low-density lipoprotein cholesterol and systolic blood pressure at high-vs low-enrolling sites in both treatment groups combined were 64% vs 49% (p 5 0.003) and 70% vs 59% (p 5 0.026), respectively.Conclusions: High-enrolling sites in SAMMPRIS achieved better control of primary risk factors and much lower rates of the primary endpoint than low-enrolling sites in the medical group, suggesting that experience with medical management is an important determinant of patient outcome. It is an oft-quoted axiom that the favorable results of surgical and endovascular procedures depend on the skill, experience, and track record of the operator. The interventionist's previous performance and case volume, for instance, are known to impact outcomes of carotid stenting.

now would he to help identify the more dynamic and creative enterprises and more actively to assist our students in locating these positions.In conclusion, how much flexibility do we, as staff, have as we approach the above problems? Can our programs be anything more than we are? What kinds of psychologists do we hope to become? Do we share common values as we approach the future? If there does seem to be a sharing of common values, is this only at a high level of abstraction or can we also find common ground at the operational level? If we can do more to implement our common values, do the unthinkable thoughts presented above provide any guidance for us?The above is only a general outline of some unthinkable thoughts based on the assumption that we arc not taking as much responsibility as we should, for ourselves, for our students, or even for society. None of us are doing a very adequate job within the context of these unthinkable thoughts. The problem is within ourselves-our values, our fears, and our desires to create people exactly in our image rather than to stimulate, to encourage and, in turn, to be stimulated.