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.     

PERCEIVING PERVASIVE DISCRIMINATION OVER TIME: IMPLICATIONS FOR COPING

This study provides evidence that the effects of perceived pervasive discrimination may be dynamic over time. It was expected that participants who perceived discrimination to be highly pervasive would initially be more likely to engage in inactive coping strategies than those who perceived low pervasiveness; however, those who continued to perceive high pervasiveness over time were expected ultimately to engage in more active strategies than those perceiving low pervasiveness. Using a 28-day diary, women and ethnic minorities described their daily experiences of discrimination and indicated their appraisals of its pervasiveness as well as their coping strategies. Results showed that participants who initially perceived low pervasiveness reported more active coping and religion use as well as less behavioral disengagement than those initially perceiving high pervasiveness. However, this pattern was reversed by the end of the study. Implications for integrating time into the assessment of coping with discrimination are discussed.     

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.