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.     

Grounding: Necessary or Contingent?

Recent interest in the nature of grounding is due in part to the idea that purely modal notions are too coarse‐grained to capture what we have in mind when we say that one thing is grounded in another. Grounding not being purely modal in character, however, is compatible with it having modal consequences. Is grounding a necessary relation? In this article I argue that the answer is ‘yes’ in the sense that propositions corresponding to full grounds modally entail propositions corresponding to what they ground. The argument proceeds upon two substantive principles: the first is that there is a broadly epistemic constraint on grounding, while the second links this constraint with Fine's Aristotelian notion of essence. Many think grounding is necessary in something like the sense specified above, but just why it's necessary is an issue that hasn't been carefully addressed. If my argument is successful, we now know why grounding is necessary.     

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.