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In recent years, the rapid development of mobile medical technology has provided multiple ways for the long-term management of chronic diseases, especially diabetes. As a new type of management model, smartphone apps are global, convenient, cheap, and interactive. Although apps were proved to be more effective at glycemic control, compared with traditional computer- and Web-based telemedicine technologies, how to gain a further and sustained improvement is still being explored. The objective of this study was to investigate the effectiveness of an app-based interactive management model by a professional health care team on glycemic control in Chinese patients with poorly controlled diabetes. This study was a 6-month long, single-center, prospective randomized controlled trial. A total of 276 type 1 or type 2 diabetes patients were enrolled and randomized to the control group (group A), app self-management group (group B), and app interactive management group (group C) in a 1:1:1 ratio. The primary outcome was the change in glycated hemoglobin (HbA ) level. Missing data were handled by multiple imputation. At months 3 and 6, all 3 groups showed significant decreases in HbA levels (all P<.05). Patients in the app interactive management group had a significantly lower HbA level than those in the app self-management group at 6 months (P=.04). The average HbA reduction in the app interactive management group was larger than that in the app self-management and control groups at both months 3 and 6 (all P<.05). However, no differences in HbA reduction were observed between the app self-management and control groups at both months 3 and 6 (both P>.05). Multivariate line regression analyses also showed that the app interactive management group was associated with the larger reduction of HbA compared with groups A and B at both months 3 and 6 (all P>.05). In addition, the app interactive management group had better control of triglyceride and high-density lipoprotein cholesterol levels at both months 3 and 6 compared with baseline (both P<.05). In Chinese patients with poorly controlled diabetes, it was difficult to achieve long-term effective glucose improvement by using app self-management alone, but combining it with interactive management can help achieve rapid and sustained glycemic control. ClinicalTrials.gov NCT02589730; https://clinicaltrials.gov/ct2/show/NCT02589730.

The purpose of this paper is to advance our understanding of core entrepreneurial competencies and their interdependencies. Developing entrepreneurial competencies is increasingly seen as important to foster entrepreneurship. Studies to date have highlighted different entrepreneurial competencies in the context of different sectors, regions and countries. However, there has been a lack of consensus in relation to the perceived relative importance of core entrepreneurial competences and their interdependencies among students, academic and entrepreneurs. Our paper focuses on two key questions: first , what are the core entrepreneurial competencies that need to be developed in educational contexts? Second , what are the interdependencies between these entrepreneurial competencies that need to be developed in educational contexts? Using a collective intelligence methodology a comparative study of Iran and Ireland was undertaken that involved three stakeholder groups of students, academics and entrepreneurs. This methodology was used to identify, rank, and structure entrepreneurial competencies considered important for university students. The results of the study indicated that productive thinking, motivation, interpersonal skills and leadership are core entrepreneurial competences that need to be developed in educational contexts. Findings also highlight critical interdependencies between entrepreneurial competencies and the relative influence of different competencies across groups and regions. We outline the implications of our findings for designing a curriculum for improving students’ entrepreneurial competencies.

Critical thinking (CT) is a metacognitive process, consisting of a number of subskills and dispositions that, when used appropriately, increases the chances of producing a logical conclusion to an argument or solution to a problem. Though the CT literature argues that dispositions are as important to CT as is the ability to perform CT skills, the majority of research in the area has focused on CT skills. In addition, though most CT interventions are designed based on academic or expert definitions of CT, students are rarely, if ever, asked to guide their instruction by describing their perspectives on what constitutes CT. Thus, the current study used interactive management to examine similarities and differences in the way students and educators conceptualise CT dispositions. Interactive management (IM) is a computer-assisted process that allows a group to build a consensus-based structural model describing relations between elements in a system. Consistent with previous research, it is suggested that addressing how students conceptualise CT may provide a starting point to negotiate and innovative the CT curriculum and learning process. Furthermore, evaluating similarities and differences in the way students and educators understand CT dispositions may facilitate the building of complementary and integrative models of CT dispositions that reflect the full range of perspectives in University teaching environments. Results of the current study suggest that while students' conceptualisation of CT dispositions was largely consistent with both the educators' conceptualisation and dispositions highlighted in the extant literature, students' descriptions were broader, less abstract and more concrete accounts of CT dispositions; and were also primarily focused on utility or function rather than ideal principles of action. Results are discussed in light of research and theory on CT and best practice for CT instruction.

Organizations are increasingly aware of the importance of managing the acquisition processes of new and sustainable knowledge, which allows them to increase performance. These knowledge-acquisition processes require top management teams to focus on the external environment to search for sustainable opportunities and initiatives. This spurs top teams to make strategic decisions that require more comprehensive managerial information, which is provided by management accounting systems. Our research analyzes how top management team composition facilitates the acquisition of new knowledge. Our management accounting paper also analyzes the mediating effect of the interactive use of management accounting systems (MASs) and their impact on sustainable firm performance. A survey was conducted among the main manufacturer firms in the Republic of Ecuador. Results were analyzed by using the partial least squares methodology, and they showed a positive effect for the interactive use of management accounting systems on sustainable knowledge-acquisition processes. Results also showed that knowledge acquisition increased firm performance through an interactive use of MASs.

This paper explores the risk factors threatening Zimbabwean Information Technology (IT) projects and build a systemic model demonstrating how the identified risk factors are interconnected. Drawn on systemic thinking, a soft systems approach called Interactive Management (IM) was adopted to identify the risk factors. The Interactive Management session involved the relevant stakeholders to interactively produce the systemic model through four major phases: idea generation, idea clarification, idea structuring, and interpretation of the structured ideas. The output of the Interactive Management process is a digraph showing the causal relationships between the identified risks. Six risk drivers were identified through the Interactive Management process: limited computer literacy, poor communication, lack of executive support, complexity of design, bureaucracy, and employee turnover. The constructed model demonstrates how the identified risk factors are interconnected. It also shows that non-linear relationships exist between risk factors. The output from this exploration has the potential to be used as a starting point to mitigate the risks impacting on Zimbabwean IT projects. Different from the output of frequently used approaches, the risk drivers identified in the systemic model inform decision makers to exploit the effective strategies in preventing other risks from materializing.

This study develops and tests a model to assess the impact of the ambidextrous management control that refers to a balance between interactive management control system (iMCS) and diagnostic management control (dMCS) on ambidextrous innovation. Our results, based on data collected from 232 senior managers in the context of French companies, indicate that iMCS promotes exploratory innovation, while dMCS has a positive and significant influence on exploitative innovation. Data analysis revealed also that the ambidextrous MCS conducts to ambidextrous innovation. Furthermore, our results show that transformational leadership moderates the relationship between iMCS and exploratory innovation, while transactional leadership moderates the link between dMCS and exploitative innovation. Finally, our findings revealed that ambidextrous leadership reinforces the link between ambidextrous MCS and ambidextrous innovation.

Since its inception, the Critical Success Factor (CSF) concept has been increasingly adopted by industries to achieve business goals. However, the conventional approaches used for identifying critical success factors are underpinned by the mechanism paradigm. The mechanism paradigm doesn’t take the interlaced relationships between system elements into account. Neither does it promote interaction between the relevant stakeholders. This paper proposes a systemic approach called Interactive Management (IM) to complement conventional ideas in determining the critical success factors. The Interactive Management process embraces the relevant stakeholders to collectively identify the critical success factors through four phases: generating critical success factors, clarifying the generated critical success factors, structuring a systemic digraph showing the interlaced relationships between the critical success factors, and identifying the real critical success factors in the systemic digraph. An example is provided to demonstrate how the Interactive Management methodology can be used to identify the real critical success factors.

In many parts of the world, men who have sex with men and transgender individuals face criminalization and discrimination. As a result, they are less likely to seek medical help, despite experiencing higher rates of HIV/AIDS, mental health issues, and other health problems. Reaching key populations (KPs) with essential testing, care, and treatment services can be challenging, as they often have a higher likelihood of contracting and spreading the virus. They have limited access to antiretroviral (ARV) therapy (ART) services, which means that KPs may continue to serve as reservoirs for new HIV infections if they do not receive effective HIV programming. This ongoing issue complicates efforts to control the epidemic. Therefore, modeling a digital health system to track ARV medication access and use is crucial. This paper advocates for the use of digital interventions to manage the health of KPs in underserved regions, using Nigeria as a case study. This study aims to assess digital health interventions for monitoring medication and consultations among transgender people in underserved communities. It also sought to determine whether a system exists that could support ART adherence in Nigeria. Additionally, the study evaluated design strategies to address privacy and confidentiality concerns, aiming to reduce nonadherence to ARV medications among KPs in Nigeria. A qualitative approach was adopted for this research, involving a thematic analysis of information collected from interviews with clinicians and other health practitioners who work directly with these communities, as well as from an interactive (virtual) workshop. The findings from the thematic analysis indicate a need to increase attendance at ART therapy sessions through the implementation of an intensive care web app. Unlike previous solutions, this study highlights the importance of incorporating a reminder feature that integrates with an in-app telemedicine consultancy platform. This platform would facilitate discussions about client challenges, such as adverse drug effects, counseling sessions with clinical psychologists, and the impact of identity discrimination on mental health. Other data-driven health needs identified in the study are unique drug request nodes, client-led viral load calculators, remote requests, and drug delivery features within the web app. Participants also emphasized the importance of monitoring medication compliance and incorporating user feedback mechanisms, such as ratings and encouragement symbols (eg, stars, checkmarks), to motivate adherence. The study concludes that technology-driven solutions could enhance ART adherence and reduce HIV transmission among transgender people. It also recommends that local governments and international organizations collaborate and invest in health management services that prioritize health needs over identity.

Though there is wide support for the application of biopsychosocial perspectives in clinical judgement of chronic pain cases, such perspectives are often overlooked due to either inadequate training or attitudes favoring a biomedical approach. Recent research has indicated that despite such explanations, both established general practitioners (GP) and medical students account for some psychosocial factors when making clinical judgements regarding chronic pain cases, but report not being likely to apply these in real-world, clinical settings due to numerous factors, including available time with patients. Thus, it is evident that a greater understanding of clinical judgement-making processes and the factors that affect application of these processes is required, particularly regarding chronic pain. The aims of the current study were to investigate medical students' conceptualizations of the factors that influence application of a biopsychosocial approach to clinical judgement-making in cases of chronic pain using interactive management (IM), model the relationships among these factors, and make recommendations to chronic pain treatment policy in light of the findings. The current study used IM to identify and model factors that influence the application of a biopsychosocial approach to clinical judgement-making in cases of chronic pain, based on medical students' conceptualizations of these factors. Two university classrooms. IM is a systems thinking and action mapping strategy used to aid groups in developing outcomes regarding complex issues, through integrating contributions from individuals with diverse views, backgrounds, and perspectives. IM commonly utilizes the nominal group technique and interpretive structural modeling, which in this context were employed to help medical students identify, clarify, and model influences on the application of biopsychosocial perspectives in treating chronic pain patients. Results of IM group work revealed 7 core biopsychosocial approach application categories: GP attitudes, cost, GP knowledge, time, patient-doctor relationship, biomedical factors. and patient perception. GP attitudes was the most critical driver of all other competencies in the system, with cost and GP knowledge revealed as secondary drivers. Potential differences in level of prior biopsychosocial perspective knowledge across participants and a potentially small sample size (though consistent with past research and appropriate for an exploratory study of this nature - for purposes of achieving the depth and richness of the deliberation and qualitative insights revealed by participants using the IM methodology). Results from this study may be used to both recommend further research on the identified factors influencing application of biopsychosocial perspectives in treatment of chronic pain and support amendment to extant health care policy, particularly with respect to cost, GP attitudes, and knowledge. Though this research claims neither that the influences identified are the only influences on biopsychosocial application, nor the order of their importance, the research does contribute to an on-going effort to better understand the factors that influence doctors in their treatment of chronic pain.Key words: Chronic pain, biopsychosocial, medical education, clinical judgement, interactive management, pain management.