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.     

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.     

Type A behavior, family history of hypertension, and cardiovascular responsivity among black women

The purpose of this study was to determine the effects of Type A behavior and family history of hypertension on cardiovascular reactivity to mental stress in a group of employed black women. Measures of heart rate and of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were taken at rest, during a mental arithmetic task, and during the Type A Structured Interview (SI). Results indicated that the Type A behavior pattern was associated with SBP and DBP hyperresponsivity during the SI but not during mental arithmetic. Additionally, certain speech components of the Type A pattern, as well as features of the potential-for-hostility component, were also related to cardiovascular responses during the SI. Family history of hypertension did not influence the cardiovascular parameters either alone or in combination with Type A behavior. The results suggest that many of the cardiovascular response characteristics of the Type A pattern that have been observed in predominantly white samples also hold true for blacks. Replication of these findings with other subgroups of blacks, such as young females and middle-aged males, will help document the generality of these findings within the black population.