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.     

A Taxonomy of Part-Whole Relations

A taxonomy of part-whole or meronymic relations is developed to explain the ordinary English-speaker's use of the term “part of” and its cognates. The resulting classification yields six types of meronymic relations: 1. component-integral object (pedal-bike), 2. member-collection (ship-fleet), 3. portion-mass (slice-pie), 4. stuff-object (steel-car), 5. feature-activity (paying-shopping), and 6. place-area (Everglades-Florida). Meronymic relations ore further distinguished from other inclusion relations, such as spatial inclusion, and class inclusion, and from several other semantic relations: attribution, attachment, and ownership. This taxonomy is then used to explain cases of apparent intransitivity in merological syllogisms, and standard form syllogisms whose premises express different inclusion relations. The data suggest that intransitivities arise due to equivocations between different types of semantic relations. These results are then explained by means of the relation element theory which accounts for the character and behavior of semantic relations in terms of more primitive relational elements. The inferential phenomena observed are then explained by means of a single principle of element matching.