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.     

Understanding cross-cultural sales manager–salesperson relationships in the Asia-Pacific Rim region: a grounded theory approach

Abstract

As more organizations implement multinational strategies, sales managers leading sales forces encounter complex cultural challenges that affect relationships, processes, and outcomes. We undertake a qualitative study with the objective of understanding the sales manager–salesperson relationship when the sales manager is leading sales representatives located in other cultures. Because of the significant size and growth of Asian countries, we focus our study on the Asia-Pacific Rim region. In-depth interviews conducted with 21 sales managers working for a large multinational technology firm in our focal region provide the data for our analysis. Using a grounded theory approach, we identify five key themes: building and sustaining cross-cultural relationships, cross-cultural communication effectiveness, acquisition and maintenance of trust across cultures, language, and decision-making. From our findings, research propositions are offered and implications for researchers and practitioners are discussed.     

Intensive follow-up does not decrease the risk of repeat suicide attempts.

We carried out a randomized controlled trial to determine whether an intensive intervention after a suicide attempt could decrease by half the risk of a repeat attempt in the following two years. After initial assessment and randomization, experimental subjects attended 18 therapy appointments over one year, including one home visit, and measures to improve attendance. Control subjects received the usual care. Of 63 experimental subjects, 35% made a repeat attempt, and so did 30% of 63 control subjects. The study had a 99% power to detect the desired decrease of risk (30% to 15%). Clearly, the intervention did not achieve its objective.