Physician perceptions of risk regarding mood disorders and pharmacological management during pregnancy: What is current practice?

Mood disorders are the most common form of mental illness and one of the leading causes of morbidity worldwide. Major depressive disorder and bipolar disorder have a lifetime prevalence of 16.2% and 4.4%, respectively. Women comprise a substantial proportion of this population, and an estimated 500,000 pregnancies each year involve women with a psychiatric condition. Management with psychotropic medications is considered standard of care for most patients with mood disorders. However, many of these medications are known human teratogens. Because pregnant women with mood disorders face a high risk of relapse if unmanaged, the obstetrician faces a unique challenge in providing the best care to both mother and baby. It has been suggested that many obstetricians overestimate the teratogenic risks associated with psychotropic medications, while concurrently underestimating the risks associated with unmanaged mood disorders. This may be due a knowledge gap regarding the most current teratogen information, and lack of official management guidelines. Therefore, the purpose of this study is to determine the current knowledge base of obstetricians regarding the teratogenic effects of common psychotropic medications, as wells as to capture current management practices for pregnant women with mood disorders. A total of 117 Texas obstetricians responded to a survey regarding teratogen knowledge and management practice. It was common for respondents to encounter women who disclose both having a mood disorder and taking a psychotropic medication during pregnancy. Many respondents did not utilize up-to-date drug counseling resources, and were unaware of or over-estimated the teratogenic risks of common medications used to treat mood disorders. Finally, many respondents reported wanting to refer pregnant patients with mood disorders to psychiatrists for co-management, but are reportedly restricted in doing so due to accessibility or insurance issues. This study demonstrates that there is a knowledge gap among obstetricians regarding the teratogenicity of common psychotropic medications utilized to manage a patient population they frequently encounter. Further, obstetricians have vastly different risk perceptions of these medications, resulting in various management approaches and recommendations. Future research should focus on establishing standard practice guidelines, as well as better accessibility to psychiatric services for pregnant women.

The Effect That Project Management Certification Has on Employability: Agent's Perceptions from Spain

This study analyses the effects that the project management certification has on employability. This analysis started with a participative process in which various groups of experts who are involved in the certification of people were consulted. A personal interview was carried out amongst 106 professionals —certifying bodies, training institutions, the civil service, and international organisations— and amongst professional who are certified in project management by the International Project Management Association in Spain. The results show that the certification emerges as a powerful tool for improving employability. The effects are demonstrated across two complementary aspects: internal company aspects and external aspects relating to the labour market. Finally, by compiling the different agents’ opinions, a series of measures emerge for improving the accreditation processes as an employability tool and increasing the mutual learning between public and private actors.

Leadership and project management competences in executive women: different styles from the agents' perceptions

The exercise of management and leadership are key aspects to achieve objectives, goals and relationships in the current knowledge society marked by increasingly competitive environments in which cognitive factors, creativity, knowledge and information determine the success of organizations. Both concepts have been historically associated with the male domain because of the underrepresentation of women in managerial positions. However, the increasing participation of women in the workplace has led to the development of an extensive literature on the possible existence of differences between the styles of male and female leadership, although it has not been addressed from the analysis of competences associated with each sex. Through a participatory process the abilities and skills related to women managers are analyzed and the differences in leadership styles. The results indicate that women particularly value the skills associated with human relationships, and that female leadership style tends to be transformational.

Understanding users of cloud music services: selection factors, management and access behavior, and perceptions

Interview Protocol Experience with cloud music services General experience with cloud services About their music collection Managing music collection General music listening behavior Mobile music consumption behavior Future of cloud music services Summary of Codebook

Action research to explore perceptions of risk in project management

Uses research in a major UK company on the introduction of an electronic document management system to explore perceptions of, and attitudes to, risk. Phenomenological methods were used; with subsequent dialogue transcripts evaluated with Winmax dialogue software, using an adapted theoretical framework based upon an analysis of the literature. The paper identifies a number of factors, and builds a framework, that should support a greater understanding of risk assessment and project management by the academic community and practitioners.

Accommodative communication as a mediator to the negative effects of cultural identity on perceptions of foreign management practices and perceptions of organisational climate

This Study examines whether cultural identity has an impact on perceptions of foreign management practices and perceptions of organisational climate. Based on social identity theory as a conceptual framework, it is assumed that the salience of cultural identity leads to in-group bias in interpreting organisational events. This study also examines whether managers' accommodative communication behaviour mediates these relationships. In a multinational organisation, employees see the foreign company as a symbol, and the person that deals with them in everyday working relationships in the organisation is their direct leader. It is argued that the salience of cultural identity wiU depend on employees' perceptions of the way managers attach meaning to foreign managerial practices and communicate it to them. Interaction with managers who create a distance with their employees and who fail to Usten to what employees need may be a socially appropriate way to invoke the salience of cultural identity in the working relationship. The participants were 206 Indonesian employees from three multinational organisations. Using a questionnaire, this study shows that participants with strong cultural identity had more negative perceptions of foreign management practices and organisational climate. Furthermore, this study indicates that managers' accommodative communication behaviour mediated these relationships.

Perceptions of earnings management:the effect of national culture

Manipulating, or "managing," reported earnings is a temptation faced by every accountant and corporation around the world. This study investigates whether national culture influences perceptions of the acceptability of earnings management. Participants from eight countries evaluated 13 vignettes describing various earnings management practices (Merchant & Rockness, 1994). Our results demonstrate considerable variation in perceptions across nations to the earnings management scenarios, providing strong evidence that the practice of earnings management was not perceived similarly in all countries. Using Hofstede’s (1991) cultural indices, we find that the differences in aggregate perceptions across countries were not closely associated with any of the cultural dimensions examined. We do, however, find that perceptions of earnings manipulations involving the timing of operating decisions were associated with both the Power Distance Index and the Masculinity Index.

Managerial perceptions of factors influencing technology management in South Africa

A challenge for developing countries is to become part of the global economy. Their economic well being is dependent on their ability to attain the levels of technological development which could make them globally competitive. Infrastructural and educational problems pose immediate barriers which should be addressed as these countries embark on projects to enhance their technological base. The technology selected should be appropriate for the country's level of development and expertise. The implementation of that technology will place a new set of demands on managers and workers. This paper describes an investigation of perceptions of technology management in South Africa, a country which is developed in certain areas, but which remains desperately poor in other respects. South Africa's politics and history have always confronted managers with unique demands. The paper examines the perceptions of 132 South African managers regarding technology management by studying the relationship between the importance of different factors in managing new technology, and the extent to which a manager can control them. An importance-control grid framework is used to isolate individual parameters and to assess these in relation to the complexity of a manager's environment. The research highlights imbalances between importance and control, and suggests reasons therefor. Some broader implications for managers are also discussed. © 2002 Elsevier Science Ltd. All rights reserved.

Group perceptions of knowledge management

This paper reports preliminary results of a project investigating how staff in UK organisations perceive knowledge management in their organisation as a group. The group setting appears to be effective in surfacing opinions and enabling progress in both understanding and action to be made. Among the findings thus far are the importance of the knowledge champion role and the state of the “knowledge management life cycle” in each organisation, and continuing confusion between knowledge, information and mechanisms.

Accounting students' perceptions of a Learning Management System:an international comparison

Purpose - The purpose of this study is to investigate student perceptions of the design features included in an off the shelf Learning Management System (LMS) in teaching undergraduate accounting students. Design/methodology/approach - Questionnaire responses from 846 accounting students studying in the UK, Australia and New Zealand provide international data to develop a model to explain student perception of the LMS. Findings - The final model shows student satisfaction with the use of a LMS is positively associated with three variables: usefulness of lecture notes, bulletin boards and discussion forums, and other LMS tools. Further, the comparison of cultural differences of the three countries shows all students treat the provision of notes as a desirable attribute on a LMS. Findings also suggest that although students find the provision of materials over the LMS does not enhance student engagement in class, overall a comparison of the three countries shows all students treat the provision of notes as a desirable attribute of a LMS. Research limitations/implications - Future research should collect ethnicity data to enable an analysis of cultural influence on student perceptions of the LMS. Practical implications - As increased motivation to learn is found to contribute to improved achievement of learning outcomes, the study's findings have implications for faculty contemplating the adoption of a LMS in their courses. The findings specifically confirm that usefulness of lecture notes, use of bulletin/discussion boards, and other LMS tools are positively endorsed by students and hence increase their motivation to learn. Originality/value - The current paper adds to the literature as the motivation to use and engage with LMSs by accounting students is not well understood. © Emerald Group Publishing Limited.

Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings:protocol for a systematic review of qualitative studies

Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

Mobile Clinics & Bundled Healthcare: An Exploration of Patient Perceptions of the SughaVazhvu Approach to Chronic Care Management

As the burden of non-communicable diseases increases worldwide, it is imperative that health systems adopt delivery approaches that will enable them to provide accessible, high-quality, and low-cost care to patients that need consistent management of their lifelong conditions. This is especially true in low- and middle-income country settings, such as India, where the disease burden is high and the health sector resources to address it are limited. The subscription-based, managed care model that SughaVazhvu Healthcare—a non-profit social enterprise operating in rural Thanjavur, Tamil Nadu—has deployed demonstrates potential for ensuring continuity of care among chronic care patients in resource-strained areas. However, its effectiveness and sustainability will depend on its ability to positively impact patient health status and patient satisfaction with the care management they are receiving. Therefore, this study is not only a program appraisal to aid operational quality improvement of the SughaVazhvu Healthcare model, but also an attempt to identify the factors that affect patient satisfaction among individuals with chronic conditions actively availing services.