BackgroundPrevious studies have reported differing rates of consultation with GPs prior to suicide. Patients with a psychiatric history have higher rates of consultation and consult closer to the time of their death. AimTo investigate the frequency and nature of general practice consultations in the year before suicide for patients in current, or recent, contact with secondary mental health services. Design of studyRetrospective case-note study and semi-structured interviews. SettingGeneral practices in the northwest of England. MethodGeneral practice data were obtained by a retrospective review of medical records (n = 247) and semistructured interviews with GPs (n = 159). ResultsGP records were reviewed in 247 of the 286 cases (86%). Overall, 91% of individuals (n = 224) consulted their GP on at least one occasion in the year before death. The median number of consultations was 7 (interquartile range = 3-10). Interviews were carried out with GPs with regard to 159 patients. GPs reported concerns about their patient's safety in 43 (27%) cases, but only 16% of them thought that the suicide could have been prevented. Agreement between GPs and mental health teams regarding risk of suicide was poor. Both sets of clinicians rated moderate to high levels of risk in only 3% of cases for whom information was available (n = 139) (overall κ = 0.024). ConclusionConsultation prior to suicide is common but suicide prevention in primary care is challenging. Possible strategies might include examining the potential benefits of risk assessment and collaborative working between primary and secondary care.

Over 40% of our clinical sample attended an ED in the year prior to death, and some individuals attended particularly frequently. EDs may therefore represent an important additional setting for suicide prevention in mental health patients. The majority of attendances prior to suicide were for self-harm or to request psychiatric help. Clinicians should be alert to the risk associated with such presentations and to the possible association between frequent attendance and suicide.

Two studies investigated 4- to 7-year-old children's understanding that traits can be causal mechanisms based on desires, as well as mere summaries of behavioral regularities. In Experiment 1, children made predictions given trait information. Children from 5 years made different emotion predictions about the same situation for actors with different traits, thus appreciating traits as psychological causes. For behavior prediction, children over age 4 generalized across situations. In Experiment 2, accurate emotion prediction by 3- to 7-year-olds was linked to understanding desire as a subjective mental property. The results suggest that children change from viewing traits as behavioral regularities to understanding them as internal mediators, and that advances in understanding desire underlie this change. These changes in understanding traits extend research on theory of mind beyond the basic concepts of desire and belief.

There have been considerable changes in the way that Research and Development (R&D) has been managed over recent years, many of which have been influenced by the external environment. These have been discussed in a number of publications with much of the debate centring around the movement from the so-called first generation to fifth generation models of R&D management.What has not been debated to the same extent are the implications of recent and likely future trends in R&D management for the way performance is, and should be, measured. In this paper we focus on these implications, drawing upon both the existing literature on performance measurement (PM) in R&D and our own research into organisations which have chosen to move towards a more profit-centred approach to the management of their technical resources.Finally, we present and discuss the findings of our review, which indicate that although there are common features, some differences, requiring careful consideration by management, can be identified when movement from a cost-to a profit-centred approach occurs.

Currently, the need for R&D performance measurements that are both practically useful and theoretically sound seems to be generally acknowledged; indeed, the rising cost of R&D, greater emphasis on value management and a trend towards decentralization are escalating the need for ways of evaluating the contribution of R&D to corporate performance. However, although recent research and writing on the subject shows that the challenge of developing such sound measurements has been taken up by many academics and organizations, it is also clear that there is no generally applicable approach.In this review, we consider various approaches for measuring the performance in industrial R&D and identify their key characteristics. We also include a brief summary of the`history' of performance measurement in R&D, which shows that although there are some new ways of looking at the issue there are many examples from the past that can contribute to our current thinking.The approaches found in the literature and practice are very varied in their application, some being more suitable for the project level, others for the R&D department, and some for the development process or for the organization as a whole. Furthermore, the uses of the approaches tend to be different. For example, some approaches are intended to justify the continuation of investment in R&D to upper management, whilst others are more suited to support learning and self-correction by empowered R&D teams. In this paper these uses, or functions', of performance measurement and a taxonomy of typical subjects of measurement in R&D environments are explored.Finally, we conclude the review with a discussion of some limitations of the growing literature on R&D performance measurement. Trends in R&D Arousing the Interest in Performance MeasurementSeveral studies have pointed to changes in the business environment that have taken place over recent decades, which have had a substantial impact on the way R&D processes are practised and managed, though it has also been noted that these trends do not apply equally throughout all industries (see, for

BackgroundPrimary care may be a key setting for suicide prevention. However, comparatively little is known about the services available in primary care for suicide prevention. The aims of the current study were to describe services available in general practices for the management of suicidal patients and to examine GPs views on these services. We carried out a questionnaire and interview study in the North West of England. We collected data on GPs views of suicide prevention generally as well as local mental health service provision.FindingsDuring the study period (2003-2005) we used the National Confidential Inquiry Suicide database to identify 286 general practitioners (GPs) who had registered patients who had died by suicide. Data were collected from GPs and practice managers in 167 practices. Responses suggested that there was greater availability of services and training for general mental health issues than for suicide prevention specifically. The three key themes which emerged from GP interviews were: barriers accessing primary or secondary mental health services; obstacles faced when referring a patient to mental health services; managing change within mental health care servicesConclusionsHealth professionals have an important role to play in preventing suicide. However, GPs expressed concerns about the quality of primary care mental health service provision and difficulties with access to secondary mental health services. Addressing these issues could facilitate future suicide prevention in primary care.

The objective of this paper is to explore the relationship between performance in new product development (hereinafter NPD) and functional integration under different conditions of project uncertainty. Functional integration is conceived as a two-dimensional concept, encompassing a behavioural -collaboration -and a structural -interaction -dimension.This study is based on 92 questionnaires looking at NPD activities in more than 40 British and Dutch companies from various industrial sectors. The results suggest that the nature of the relationship between integration and performance is contingent upon the project stage and the degree of novelty in the new product. Integration in the initial stages of the project assumes a prominent role in the quality of the end product, whereas in later stages it is more associated with time to market than with costs and end product quality. Results further show that the dimension collaboration of integration may be more relevant under circumstances of high new product innovativeness than when minor variations are introduced in a new product. The paper ends with a discussion of the use of universal approaches to NPD management. 

This paper studies the relationship between senior management support to new product development activities by means of a quantitative and qualitative analysis of questionnaire and interview data collected in the United Kingdom and the Netherlands. The quantitative analysis showed that there is a small to medium association between senior management support to new product development and project performance in the dimensions of time, cost, and end product quality. The qualitative analysis suggests that these weak links could be explained by separating the influence of senior management support on new product development activities into direct and indirect effects. Direct effects include issues such as the use of multifunctional senior teams and process champions, whereas indirect effects include issues such as organization mission and goals, and learning and knowledge management systems.