Une vue globale du secteur ambulatoire: étude structurelle et fonctionnelle dans les cantons de Vaud et Fribourg. [A general view of the ambulatory care sector: Structural and functional study in the cantons of Vaud and Fribourg].

The project "Quantification and qualification of ambulatory health care", financed by the Swiss National Science Foundation and covering the Cantons of Vaud and Fribourg, has two main goals: --a structural study of the elements of the ambulatory care sector. This is done through inventories of the professions concerned (physicians, public health nurses, physiotherapists, pharmacists, medical laboratories), allowing to better characterize the "offer". This inventory work includes the collect and analysis of existing statistical data as well as surveys, by questionnaires sent (from September 1980) to the different professions and by interviews. --a functional study, inspired from the US National Ambulatory Medical Care Survey and from similar studies elsewhere, in order to investigate the modes of practice of various providers, with particular regard to interprofessional collaboration (through studying referrals from the ones to the others). The first months of the project have been used for a methodological research in this regard, centered on the use of systems analysis, and for the elaboration of adequate instruments.

HRM Practices, Intrinsic Motivators, and Organizational Performance in the Public Sector

This article aims to determine the impact of human resource management (HRM) practices on public service motivation (PSM) and organizational performance. Based on a survey of Swiss cantonal public employees (N = 3,131), this study shows that several HRM practices may be considered as organizational antecedents of PSM and strong predictors of perceived organizational performance. Fairness, job enrichment, individual appraisal, and professional development are HRM practices that are positively and significantly associated with PSM and perceived organizational performance. Moreover, these results suggest that HRM practices are stronger predictors than either PSM or organizational commitment when explaining the individual perception of organizational performance.

The data treatment dependent variability of U-Pb zircon ages obtained using mono-collector, sector field, laser ablation ICP-MS

U-Pb dating of zircons by laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS) is a widely used analytical technique in Earth Sciences. For U-Pb ages below 1 billion years (1 Ga), Pb-206/U-238 dates are usually used, showing the least bias by external parameters such as the presence of initial lead and its isotopic composition in the analysed mineral. Precision and accuracy of the Pb/U ratio are thus of highest importance in LA-ICPMS geochronology. We consider the evaluation of the statistical distribution of the sweep intensities based on goodness-of-fit tests in order to find a model probability distribution fitting the data to apply an appropriate formulation for the standard deviation. We then discuss three main methods to calculate the Pb/U intensity ratio and its uncertainty in the LA-ICPMS: (1) ratio-of-the-mean intensities method, (2) mean-of-the-intensity-ratios method and (3) intercept method. These methods apply different functions to the same raw intensity vs. time data to calculate the mean Pb/U intensity ratio. Thus, the calculated intensity ratio and its uncertainty depend on the method applied. We demonstrate that the accuracy and, conditionally, the precision of the ratio-of-the-mean intensities method are invariant to the intensity fluctuations and averaging related to the dwell time selection and off-line data transformation (averaging of several sweeps); we present a statistical approach how to calculate the uncertainty of this method for transient signals. We also show that the accuracy of methods (2) and (3) is influenced by the intensity fluctuations and averaging, and the extent of this influence can amount to tens of percentage points; we show that the uncertainty of these methods also depends on how the signal is averaged. Each of the above methods imposes requirements to the instrumentation. The ratio-of-the-mean intensities method is sufficiently accurate provided the laser induced fractionation between the beginning and the end of the signal is kept low and linear. We show, based on a comprehensive series of analyses with different ablation pit sizes, energy densities and repetition rates for a 193 nm ns-ablation system that such a fractionation behaviour requires using a low ablation speed (low energy density and low repetition rate). Overall, we conclude that the ratio-of-the-mean intensities method combined with low sampling rates is the most mathematically accurate among the existing data treatment methods for U-Pb zircon dating by sensitive sector field ICPMS.

Oxygen isotope sector zoning in natural hydrothermal quartz

Oxygen isotope measurements using SIMS and laser-fluorination methods confirm the presence of concentric and sector zoning in low-temperature (200 degrees C to < 400 degrees C) hydrothermal quartz from Alpine veins. While concentric zoning is most readily explained by changes in the chemical composition of the fluid or temperature of crystallization, the reasons for sector zoning are more difficult to explain. Relative enrichment in (18)O for crystallographically different sectors of quartz corresponds to m > r > z. Sector zoning is, however, largely limited to the exterior zones of crystals and/or to crystals with large Al (> 1000 ppm) and trace element contents, probably formed at temperatures < 250 degrees C. Differences in delta(18)O between the prismatic (m) relative to the rhombohedral (r and z) growth sectors of up to 2 parts per thousand can be explained by a combination of a face-related crystallographic and/or a growth rate control. In contrast, isotopic sector zoning of up to about 1.5 parts per thousand amongst the different rhombohedral faces increases in parallel with the trace element content and is likely to represent disequilibrium growth. This is indicated by non-systematic, up to 2 parts per thousand, differences within single growth zones and the irregular, larger or smaller, delta(18)O values (of several permil) of the exterior compared to the inner zones of the same crystals. Disequilibrium growth may be related to the large trace element content incorporated into the growing quartz at lower temperatures (< 250 degrees C) and/or be related to fluid-vapour separation, allowing crystal growth from both a vapour as well as a liquid phase.

Interprofessional practices of physiotherapists working with adults with low back pain in Québec's private sector: results of a qualitative study.

BACKGROUND: Collaboration and interprofessional practices are highly valued in health systems, because they are thought to improve outcomes of care for persons with complex health problems, such as low back pain. Physiotherapists, like all health providers, are encouraged to take part in interprofessional practices. However, little is known about these practices, especially for private sector physiotherapists. This study aimed to: 1) explore how physiotherapists working in the private sector with adults with low back pain describe their interprofessional practices, 2) identify factors that influence their interprofessional practices, and 3) identify their perceived effects. METHODS: Participants were 13 physiotherapists, 10 women/3 men, having between 3 and 21 years of professional experience. For this descriptive qualitative study, we used face-to-face semi-structured interviews and conducted content analysis encompassing data coding and thematic regrouping. RESULTS: Physiotherapists described interprofessional practices heterogeneously, including numerous processes such as sharing information and referring. Factors that influenced physiotherapists' interprofessional practices were related to patients, providers, organizations, and wider systems (e.g. professional system). Physiotherapists mostly viewed positive effects of interprofessional practices, including elements such as gaining new knowledge as a provider and being valued in one's own role, as well as improvements in overall treatment and outcome. CONCLUSIONS: This qualitative study offers new insights into the interprofessional practices of physiotherapists working with adults with low back pain, as perceived by the physiotherapists' themselves. Based on the results, the development of strategies aiming to increase interprofessionalism in the management of low back pain would most likely require taking into consideration factors associated with patients, providers, the organizations within which they work, and the wider systems.

Gender and Security Sector Reform: Gendering Differently?

Recent efforts to implement gender mainstreaming in the field of security sector reform have resulted in an international policy discourse on gender and security sector reform (GSSR). Critics have challenged GSSR for its focus on 'adding women' and its failure to be transformative. This article contests this assessment, demonstrating that GSSR is not only about 'adding women', but also, importantly, about 'gendering men differently' and has important albeit problematic transformative implications. Drawing on poststructuralist and postcolonial feminist theory, I propose a critical reading of GSSR policy discourse in order to analyse its built-in logics, tensions and implications. I argue that this discourse establishes a powerful 'grid of intelligibility' that draws on gendered and racialized dualisms to normalize certain forms of subjectivity while rendering invisible and marginalizing others, and contributing to reproduce certain forms of normativity and hierarchy. Revealing such processes of discursive in/exclusion and marginalized subjectivities can serve as a starting point to challenge and transform GSSR practice and identify sites of contestation.

The Challenges Of Implementing High Performance Work Practices In The Nonprofit Sector

The last economic crisis raised huge challenges for nonprofit organizations. It is now critical for nonprofit organizations to show not only their social legitimacy but also their efficiency and competency to claim for grants (Kearns, Bell, Deem, & McShane, 2012). High Performance Work Practices (HPWP) are a way to foster performance and thus to answer challenges nonprofit organizations are currently facing. However, such practices have until then only been considered for the corporate world. The entire philosophy behind nonprofit organizations contrasts radically from the for-profit sector. Human resources management in particular may differ as well. The aim of this article is precisely to analyze the challenges of implementing HPWP in nonprofit organizations. In order to explore those challenges, we study the HR practices of a nonprofit organization based in UK that struggles against poverty. Discussion of results highlights good practices that should be applied along the nonprofit sector.

How useful is consolidation of public sector entities' financial statements ?

Whether or not to consolidate financial statements is dealt with in IPSAS#6. This standard is by and large based on IAS#27. It deals with the criterion according to which an entity's financial statements should be considered and which consolidation technique should be used. However, it remains silent when it comes to exposing the reason why a public sector entity should consolidate its financial statements. The literature is almost as silent as IPSAS on this issue. Which means that there is a lack of both theoretical and empirical knowledge on this subject. This paper explores the usefulness of the consolidation of financial statements (CFS) for different categories of users. It aims at investigating for which purposes consolidation is most useful and whether enlarging the scope of the consolidate group serves these purposes. Five purposes are considered: information, decision- making, accountability, risk-assessment, statistics improvement. The paper also aims at investigating if some categories of users consider CFS more useful than others. The issue is essentially empirical. Therefore it is examined in light of the results of an in-person interviews. We surveyed 25members of parliament, officials, creditors, and consultants of the Swiss central government. The results show that consolidating FS is considered especially important and useful for risk- assessment, information and accountability and to a somewhat lesser extent for decision-making and statistics improvement. Extending the scope of CFS may improve the situation when it comes to statistics but it would only marginally make CFS more relevant for decision making. Consultants and, to a lesser extent, members of the finance ministry are those respondents who deem the scope enlargement to be the most useful.

Can the administration be trusted? An analysis of the concept of trust, applied to the public sector

In the first part of this paper, we present the various academic debates and, where applicable, questions that remain open in the literature, particularly regarding the nature of trust, the distinction between trust and trustworthiness, its role in specific relationships and its relationship to control. We then propose a way of demarcating and operationalizing the concepts of trust and trustworthiness. In the second part, on the basis of the conceptual clarifications we present, we put forward a number of "anchor points" regarding how trust is apprehended in the public sector with regard to the various relations hips that can be studied. Schematically, we distinguish between two types of relations hips in the conceptual approach to trust: on one hand, the trust that citizens, or third parties, place in the State or in various public sector authorities or entities, and on the other hand, trust within the State or the public sector, between its various authorities, entities, and actors. While studies have traditionally focused on citizens' trust in their institutions, the findings, limitations and problems observed in public - sector coordination following the reforms associated with New Public Management have also elicited growing interest in the study of trust in the relationships between the various actors within the public sector. Both the theoretical debates we present and our propositions have been extracted and adapted from an empirical comparative study of coordination between various Swiss public - service organizations and their politico - administrative authority. Using the analysis model developed for this specific relationship, between various actors within the public service, and in the light of theoretical elements on which development of this model was based, we propose some avenues for further study - questions that remain open - regarding the consideration and understanding of citizens' trust in the public sector.