Developing an efficient clinical information system for a comprehensive psychiatric institute: I. Principles,design, and organization

The principles, design considerations, and components of a clinical information system intended to support and enhance the patient care, educational, and research missions of a comprehensive psychiatric institute are presented. Major characteristics of the system are its emphases on efficiency, simplicity, and intensive user involvement throughout the development of the system.     

Prevention of nonadherence to nonsteroidal anti-inflammatory medications for newly diagnosed patients with juvenile rheumatoid arthritis.

Adherence to medications for chronic pediatric diseases decreases overtime. This randomized controlled trial evaluated a clinic-based, nurse-administered educational and behavioral intervention to prevent the anticipated drop in adherence to nonsteroidal medications among newly diagnosed patients with juvenile rheumatoid arthritis. Thirty-four participants completed the study (mean age = 8.44 years, SD = 3.96), including 19 in the experimental group and 15 in the standard-treatment (education) control group. There were significant group and Group x Time effects for adherence (assessed with an electronic monitor over a 13-month period) favoring the experimental group. In contrast, the groups did not differ significantly in disease activity or functional limitations. Factors that may have prevented detection of differences in these health parameters are dicussed.     

Attitudes,Tracing, and Control

There is an apparent tension in our everyday moral responsibility practices. On the one hand, it is commonly assumed that moral responsibility requires voluntary control: an agent can be morally responsible only for those things that fall within the scope of her voluntary control. On the other hand, we regularly praise and blame individuals for mental states and conditions that appear to fall outside the scope of their voluntary control, such as desires, emotions, beliefs, and other attitudes. In order to resolve this apparent tension, many philosophers appeal to a tracing principle to argue that agents are morally responsible (only) for those attitudes whose existence can be traced back, causally, to a voluntary action or omission in the past. My aim in this article is to critically evaluate this tracing strategy and to argue that it gives us a misguided picture of when and why we are morally responsible for our attitudes. I argue that we should accept a ‘judgment sensitivity’ condition of moral responsibility rather than a ‘voluntary control’ condition, and defend this account against various objections.     

A BLACK FEMINIST MODEL OF RAPE MYTH ACCEPTANCE

A Black feminist model was used to investigate rape myth acceptance between African American antirape activists and a comparison group of nonactivists using Cross's (1991) racial identity model and Downing and Roush's (1985) feminist identity model. As predicted, activists rejected rape myths more than nonactivists; the earlier stages of both models were associated with rape myth acceptance; the later stages were associated with rape myth rejection; and activists evidenced more sociopolitical maturity (race and gender consciousness) than nonactivists. The findings suggest that researchers may need to investigate to what degree rape myth acceptance serves an overarching system of social domination where racism and sexism overlap.