Conclusion : les usages possibles et contestables des normes et des institutions dans l'internationalisation des services

The conclusion of this volume on technical standards in the regulation of services reviews the authors' contributions to understanding the relation between tertiarisation, internationalisation and standardisation from three distinct perspectives : theoretical, institutional, and sectorial. It argues that conventional views on conditions for standardisation and internationalisation of service activities are overly restrictive, making them dependent on sectorial and institutional specificity. In emphasizing the possible and contestable uses of service standards, the volume opens a critical debate on service offshoring, underlining the social and historical constructions of its transnational logic.

Revue des cas d'intoxication aux champignons dans un service d'urgence entre 2005 et 2011

Introduction: Les services d'urgences sont régulièrement confrontés à des intoxications par ingestion de champignons. Ces situations, souvent banales, peuvent nécessiter une prise en charge intensive et comporter un risque réel de morbi-mortalité, en particulier lors de cytolyse hépatique aiguë. La prévalence, ainsi que la fréquence réelle des complications liées à l'ingestion de champignons sont mal connues. Méthodes: Etude rétrospective dans un service d'urgence universitaire entre décembre 2004 et octobre 2011. Les codes diagnostics «intoxication aux champignons», ainsi que les termes «amanite» ou «champignons» ont été extraits de la base de données des urgences. Les caractéristiques des patients, leurs présentations cliniques, durées de séjour et complications ont été analysées. Résultats: 72 cas ont été répertoriés et revus, âge 44,3 ± 2,0 ans (moy ± SE, 95%CI 40,2-48,4), ratio H:F 1:1,2 (33H, 39F). 81% des cas sont survenus entre août et décembre. 14 cas sont arrivés sous forme de clusters familiaux (35 patients, moyenne = 2,6 cas/cluster, min: 2, max: 7). Un spécialiste en mycologie a été contacté dans 25 cas pour identifier les champignons. 69 patients (96%) sont rentrés à domicile depuis les urgences (séjour de 10,8 ± 1,3 heures, 95%CI 8,2-13,4 h). Lorsque les symptômes survenaient <= 4 heures après l'ingestion, les patients restaient moins longtemps (N = 57, durée séjour médiane 6,1 h, P25-P75 3,2-11,8 h) que les cas avec des symptômes plus tardifs (N = 15, durée séjour médiane 13,3 h, P25-P75 10,2-36,2) (p = 0,0001 selon Mann-Whitney). Une patiente a nécessité un transfert dans un centre spécialisé (intoxication par amanite phalloïde, avec dosage positif de l'alpha-amanitine). Elle a bénéficié de silibinine et d'une hospitalisation (9 jours), avec une évolution favorable sans nécessité de transplantation. Les symptômes étaient apparus tardivement (7 h). Conclusions: Sur les 72 cas, un seul (1,4%) a nécessité une prise en charge spécialisée. Les autres patients ont pu rentrer à domicile dans les heures qui ont suivi leur admission. Une grande partie des cas est survenue entre août et décembre, période favorable pour la récolte ou la consommation de champignons. Cette analyse confirme que la plupart des cas sont bénins et que les patients peuvent rentrer rapidement à domicile une fois les symptômes passés. Le seul cas potentiellement grave a présenté des symptômes tardifs et une longue hospitalisation, ce qui réaffirme les données de la littérature.

Savoir s'assurer : économie politique internationale des normes de services et mondialisation du marché de la (ré)assurance

The significance of the insurance industry in the functioning of the world economy is often underestimated, with premiums reaching 7.5 % of world gross domestic product (GDP), three times as much as worldwide military expenses. Insurance services mutualise risks in such a way as they provide a form of private governance that complements or makes up for guarantees otherwise supplied by the State. This case study of international standards developed for the insurance market provides evidence that deviates from conventional accounts considering service standards as heavily dependent of national environments and industry specificities. The chapter examines the relationship between tertiarisation, internationalisation and standardisation of contemporary economies by highlighting the complementarity between institutionalist approaches of the French regulation school and international political economy scholarship shedding light on the polarisation in the possible use of standards, notwithstanding thesectoraland institutional specificities of the activities concerned.

De la "gelosie" d'Arthur à l'ire d'Yder : les émotions négatives au service de la nouvelle chevalerie dans le "Romanz du reis Yder"

Oeuvre arthurienne en vers du XIIIe siècle, le Romanz du reis Yder n'a guère suscité l'intérêt des chercheurs, excepté pour le comportement singulier du roi Arthur qui démontre de nombreux travers, comme le manquement à ses devoirs royaux, l'avarice ou la jalousie. Pathologique, cette dernière a particulièrement retenu l'attention des médiévistes: dans le récit, Guenièvre est présentée comme une femme aimante et fidèle et les accusations que lui porte Arthur sont donc injustifiées. Notre étude se propose d'observer la jalousie et les autres vices du roi en parallèle d'une autre émotion négative, la colère, qui apparaît avec le héros du roman, Yder. Comme le roi censé représenter un idéal, le chevalier se doit de défendre les traditions courtoises et l'ire semble, dans un premier temps, s'y opposer. Pourtant, au fil de notre analyse, nous verrons au contraire comment elle permet la sauvegarde des valeurs chevaleresques. Instrumentalisée, la colère pousse le personnage d'Yder à s'opposer à la dégénérescence de son souverain. Le jeune homme se fait ainsi le porte-parole d'une nouvelle chevalerie qui doit désormais se construire de façon individuelle, sans ses repères traditionnels et hors de la communauté arthurienne.

Impact of a telenursing service on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their families: a crossover randomized trial study protocol.

BACKGROUND: Pediatric rheumatic diseases have a significant impact on children's quality of life and family functioning. Disease control and management of the symptoms are important to minimize disability and pain. Specialist clinical nurses play a key role in supporting medical teams, recognizing poor disease control and the need for treatment changes, providing a resource to patients on treatment options and access to additional support and advice, and identifying best practices to achieve optimal outcomes for patients and their families. This highlights the importance of investigating follow-up telenursing (TN) consultations with experienced, specialist clinical nurses in rheumatology to provide this support to children and their families. METHODS/DESIGN: This randomized crossover, experimental longitudinal study will compare the effects of standard care against a novel telenursing consultation on children's and family outcomes. It will examine children below 16 years old, recently diagnosed with inflammatory rheumatic diseases, who attend the pediatric rheumatology outpatient clinic of a tertiary referral hospital in western Switzerland, and one of their parents. The telenursing consultation, at least once a month, by a qualified, experienced, specialist nurse in pediatric rheumatology will consist of providing affective support, health information, and aid to decision-making. Cox's Interaction Model of Client Health Behavior serves as the theoretical framework for this study. The primary outcome measure is satisfaction and this will be assessed using mixed methods (quantitative and qualitative data). Secondary outcome measures include disease activity, quality of life, adherence to treatment, use of the telenursing service, and cost. We plan to enroll 56 children. DISCUSSION: The telenursing consultation is designed to support parents and children/adolescents during the course of the disease with regular follow-up. This project is novel because it is based on a theoretical standardized intervention, yet it allows for individualized care. We expect this trial to confirm the importance of support by a clinical specialist nurse in improving outcomes for children and adolescents with inflammatory rheumatisms. TRIAL REGISTRATION: ClinicalTrial.gov identifier: NCT01511341 (December 1st, 2012).

Les insectes nécrophages au service de la Justice: entomologie forensique en Suisse romande

Science méconnue en Suisse, l'entomologie forensique a été développée depuis 1993 en Suisse romande. Les insectes utilisés dans cette discipline appartiennent principalement aux ordres des diptères et des coléoptères. Une présentation des principales familles et leur biologie permettent de comprendre l'utilité de ces espèces dans le calcul de l'intervalle post-mortem et leur utilisation potentielle dans les affaires criminelles

Financial Markets and Real Ecinomy: Four Essays in International Trade

Financial markets play an important role in an economy performing various functions like mobilizing and pooling savings, producing information about investment opportunities, screening and monitoring investments, implementation of corporate governance, diversification and management of risk. These functions influence saving rates, investment decisions, technological innovation and, therefore, have important implications for welfare. In my PhD dissertation I examine the interplay of financial and product markets by looking at different channels through which financial markets may influence an economy.My dissertation consists of four chapters. The first chapter is a co-authored work with Martin Strieborny, a PhD student from the University of Lausanne. The second chapter is a co-authored work with Melise Jaud, a PhD student from the Paris School of Economics. The third chapter is co-authored with both Melise Jaud and Martin Strieborny. The last chapter of my PhD dissertation is a single author paper.Chapter 1 of my PhD thesis analyzes the effect of financial development on growth of contract intensive industries. These industries intensively use intermediate inputs that neither can be sold on organized exchange, nor are reference-priced (Levchenko, 2007; Nunn, 2007). A typical example of a contract intensive industry would be an industry where an upstream supplier has to make investments in order to customize a product for needs of a downstream buyer. After the investment is made and the product is adjusted, the buyer may refuse to meet a commitment and trigger ex post renegotiation. Since the product is customized to the buyer's needs, the supplier cannot sell the product to a different buyer at the original price. This is referred in the literature as the holdup problem. As a consequence, the individually rational suppliers will underinvest into relationship-specific assets, hurting the downstream firms with negative consequences for aggregate growth. The standard way to mitigate the hold up problem is to write a binding contract and to rely on the legal enforcement by the state. However, even the most effective contract enforcement might fail to protect the supplier in tough times when the buyer lacks a reliable source of external financing. This suggests the potential role of financial intermediaries, banks in particular, in mitigating the incomplete contract problem. First, financial products like letters of credit and letters of guarantee can substantially decrease a risk and transaction costs of parties. Second, a bank loan can serve as a signal about a buyer's true financial situation, an upstream firm will be more willing undertake relationship-specific investment knowing that the business partner is creditworthy and will abstain from myopic behavior (Fama, 1985; von Thadden, 1995). Therefore, a well-developed financial (especially banking) system should disproportionately benefit contract intensive industries.The empirical test confirms this hypothesis. Indeed, contract intensive industries seem to grow faster in countries with a well developed financial system. Furthermore, this effect comes from a more developed banking sector rather than from a deeper stock market. These results are reaffirmed examining the effect of US bank deregulation on the growth of contract intensive industries in different states. Beyond an overall pro-growth effect, the bank deregulation seems to disproportionately benefit the industries requiring relationship-specific investments from their suppliers.Chapter 2 of my PhD focuses on the role of the financial sector in promoting exports of developing countries. In particular, it investigates how credit constraints affect the ability of firms operating in agri-food sectors of developing countries to keep exporting to foreign markets.Trade in high-value agri-food products from developing countries has expanded enormously over the last two decades offering opportunities for development. However, trade in agri-food is governed by a growing array of standards. Sanitary and Phytosanitary standards (SPS) and technical regulations impose additional sunk, fixed and operating costs along the firms' export life. Such costs may be detrimental to firms' survival, "pricing out" producers that cannot comply. The existence of these costs suggests a potential role of credit constraints in shaping the duration of trade relationships on foreign markets. A well-developed financial system provides the funds to exporters necessary to adjust production processes in order to meet quality and quantity requirements in foreign markets and to maintain long-standing trade relationships. The products with higher needs for financing should benefit the most from a well functioning financial system. This differential effect calls for a difference-in-difference approach initially proposed by Rajan and Zingales (1998). As a proxy for demand for financing of agri-food products, the sanitary risk index developed by Jaud et al. (2009) is used. The empirical literature on standards and norms show high costs of compliance, both variable and fixed, for high-value food products (Garcia-Martinez and Poole, 2004; Maskus et al., 2005). The sanitary risk index reflects the propensity of products to fail health and safety controls on the European Union (EU) market. Given the high costs of compliance, the sanitary risk index captures the demand for external financing to comply with such regulations.The prediction is empirically tested examining the export survival of different agri-food products from firms operating in Ghana, Mali, Malawi, Senegal and Tanzania. The results suggest that agri-food products that require more financing to keep up with food safety regulation of the destination market, indeed sustain longer in foreign market, when they are exported from countries with better developed financial markets.Chapter 3 analyzes the link between financial markets and efficiency of resource allocation in an economy. Producing and exporting products inconsistent with a country's factor endowments constitutes a serious misallocation of funds, which undermines competitiveness of the economy and inhibits its long term growth. In this chapter, inefficient exporting patterns are analyzed through the lens of the agency theories from the corporate finance literature. Managers may pursue projects with negative net present values because their perquisites or even their job might depend on them. Exporting activities are particularly prone to this problem. Business related to foreign markets involves both high levels of additional spending and strong incentives for managers to overinvest. Rational managers might have incentives to push for exports that use country's scarce factors which is suboptimal from a social point of view. Export subsidies might further skew the incentives towards inefficient exporting. Management can divert the export subsidies into investments promoting inefficient exporting.Corporate finance literature stresses the disciplining role of outside debt in counteracting the internal pressures to divert such "free cash flow" into unprofitable investments. Managers can lose both their reputation and the control of "their" firm if the unpaid external debt triggers a bankruptcy procedure. The threat of possible failure to satisfy debt service payments pushes the managers toward an efficient use of available resources (Jensen, 1986; Stulz, 1990; Hart and Moore, 1995). The main sources of debt financing in the most countries are banks. The disciplining role of banks might be especially important in the countries suffering from insufficient judicial quality. Banks, in pursuing their rights, rely on comparatively simple legal interventions that can be implemented even by mediocre courts. In addition to their disciplining role, banks can promote efficient exporting patterns in a more direct way by relaxing credit constraints of producers, through screening, identifying and investing in the most profitable investment projects. Therefore, a well-developed domestic financial system, and particular banking system, would help to push a country's exports towards products congruent with its comparative advantage.This prediction is tested looking at the survival of different product categories exported to US market. Products are identified according to the Euclidian distance between their revealed factor intensity and the country's factor endowments. The results suggest that products suffering from a comparative disadvantage (labour-intensive products from capital-abundant countries) survive less on the competitive US market. This pattern is stronger if the exporting country has a well-developed banking system. Thus, a strong banking sector promotes exports consistent with a country comparative advantage.Chapter 4 of my PhD thesis further examines the role of financial markets in fostering efficient resource allocation in an economy. In particular, the allocative efficiency hypothesis is investigated in the context of equity market liberalization.Many empirical studies document a positive and significant effect of financial liberalization on growth (Levchenko et al. 2009; Quinn and Toyoda 2009; Bekaert et al., 2005). However, the decrease in the cost of capital and the associated growth in investment appears rather modest in comparison to the large GDP growth effect (Bekaert and Harvey, 2005; Henry, 2000, 2003). Therefore, financial liberalization may have a positive impact on growth through its effect on the allocation of funds across firms and sectors.Free access to international capital markets allows the largest and most profitable domestic firms to borrow funds in foreign markets (Rajan and Zingales, 2003). As domestic banks loose some of their best clients, they reoptimize their lending practices seeking new clients among small and younger industrial firms. These firms are likely to be more risky than large and established companies. Screening of customers becomes prevalent as the return to screening rises. Banks, ceteris paribus, tend to focus on firms operating in comparative-advantage sectors because they are better risks. Firms in comparative-disadvantage sectors finding it harder to finance their entry into or survival in export markets either exit or refrain from entering export markets. On aggregate, one should therefore expect to see less entry, more exit, and shorter survival on export markets in those sectors after financial liberalization.The paper investigates the effect of financial liberalization on a country's export pattern by comparing the dynamics of entry and exit of different products in a country export portfolio before and after financial liberalization.The results suggest that products that lie far from the country's comparative advantage set tend to disappear relatively faster from the country's export portfolio following the liberalization of financial markets. In other words, financial liberalization tends to rebalance the composition of a country's export portfolio towards the products that intensively use the economy's abundant factors.

Qualitative and Hierarchical Analysis of Protective Factors against Illicit Use of Doping Substances in Athletes Calling a National Anti-Doping Phone-Help Service

Evidence of a sport-specific hierarchy of protective factors against doping would thus be a powerful aid in adapting information and prevention campaigns to target the characteristics of specific athlete groups, and especially those athletes most vulnerable for doping control. The contents of phone calls to a free and anonymous national anti-doping service called 'ecoute dopage' were analysed (192 bodybuilders, 124 cyclists and 44 footballers). The results showed that the protective factors that emerged from analysis could be categorised into two groups. The first comprised 'Health concerns', 'Respect for the law' and 'Doping controls from the environment' and the second comprised 'Doubts about the effectiveness of illicit products, 'Thinking skills' and 'Doubts about doctors'. The ranking of the factors for the cyclists differed from that of the other athletes. The ordering of factors was 1) respect for the law, 2) doping controls from the environment, 3) health concerns 4) doubts about doctors, and 5) doubts about the effectiveness illicit products. The results are analysed in terms of the ranking in each athlete group and the consequences on the athletes' experience and relationship to doping. Specific prevention campaigns are proposed to limit doping behaviour in general and for each sport.

La planification de sortie des personnes âgées hospitalisées dans un service de médecine

Contexte: la planification infirmière de sortie des personnes âgées est une composante importante des soins pour assurer une transition optimale entre l'hôpital et la maison. Beaucoup d'événements indésirables peuvent survenir après la sortie de l'hôpital. Dans une perspective de système de santé, les facteurs qui augmentent ce risque incluent un nombre croissant de patients âgés, l'augmentation de la complexité des soins nécessitant une meilleure coordination des soins après la sortie, ainsi qu'une augmentation de la pression financière. Objectif: évaluer si les interventions infirmières liées à la planification de sortie chez les personnes âgées et leurs proches aidants sont prédictives de leur perception d'être prêts pour le départ, du niveau d'anxiété du patient le jour de la sortie de l'hôpital et du nombre de recours non programmé aux services de santé durant les trente jours après la sortie. Méthode: le devis est prédictif corrélationnel avec un échantillon de convenance de 235 patients. Les patients âgés de 65 ans de quatre unités d'hôpitaux dans le canton de Vaud en Suisse ont été recrutés entre novembre 2011 et octobre 2012. Les types et les niveaux d'interventions infirmières ont été extraits des dossiers de soins et analysés selon les composantes du modèle de Naylor. La perception d'être prêt pour la sortie et l'anxiété ont été mesurées un jour avant la sortie en utilisant l'échelle de perception d'être prêt pour la sortie et l'échelle Hospital Anxiety and Depression. Un mois après la sortie, un entretien téléphonique a été mené pour évaluer le recours non programmé aux services de santé durant cette période. Des analyses descriptives et un modèle randomisé à deux niveaux ont été utilisés pour analyser les données. Résultats: peu de patients ont reçu une planification globale de sortie. L'intervention la plus fréquente était la coordination (M = 55,0/100). et la moins fréquente était la participation du patient à la planification de sortie (M = 16,1/100). Contrairement aux hypothèses formulées, les patients ayant bénéficié d'un plus grand nombre d'interventions infirmières de préparation à la sortie ont un niveau moins élevé de perception d'être prêt pour le départ (B = -0,3, p < 0,05, IC 95% [-0,57, -0,11]); le niveau d'anxiété n'est pas associé à la planification de sortie (r = -0,21, p <0,01) et la présence de troubles cognitifs est le seul facteur prédictif d'une réhospitalisation dans les 30 jours après la sortie de l'hôpital ( OR = 1,50, p = 0,04, IC 95% [1,02, 2,22]). Discussion: en se focalisant sur chaque intervention de la planification de sortie, cette étude permet une meilleure compréhension du processus de soins infirmiers actuellement en cours dans les hôpitaux vaudois. Elle met en lumière les lacunes entre les pratiques actuelles et celles de pratiques exemplaires donnant ainsi une orientation pour des changements dans la pratique clinique et des recherches ultérieures. - Background: Nursing discharge planning in elderly patients is an important component of care to ensure optimal transition from hospital to home. Many adverse events may occur after hospital discharge. From a health care system perspective, contributing factors that increase the risk of these adverse events include a growing number of elderly patients, increased complexity of care requiring better care coordination after discharge, as well as increased financial pressure. Aim: To investigate whether older medical inpatients who receive comprehensive discharge planning interventions a) feel more ready for hospital discharge, b) have reduced anxiety at the time of discharge, c) have lower health care utilization after discharge compared to those who receive less comprehensive interventions. Methods: Using a predictive correlational design, a convenience sample of 235 patients was recruited. Patients aged 65 and older from 4 units of hospitals in the canton of Vaud in Switzerland were enrolled between November 2011 and October 2012. Types and level of interventions were extracted from the medical charts and analyzed according to the components of Naylor's model. Discharge readiness and anxiety were measured one day before discharge using the Readiness for Hospital Discharge Scale and the Hospital Anxiety and Depression scale. A telephone interview was conducted one month after hospital discharge to asses unplanned health services utilization during this follow-up period. Descriptive analyses and a two- level random model were used for statistical analyses. Results: Few patients received comprehensive discharge planning interventions. The most frequent intervention was Coordination (M = 55,0/100) and the least common was Patient participation in the discharge planning (M = 16,1/100). Contrary to our hypotheses, patients who received more nursing discharge interventions were significantly less ready to go home (B = -0,3, p < 0,05, IC 95% [-0,57, -0,11]); their anxiety level was not associated with their readiness for hospital discharge (r = -0,21, p <0,01) and cognitive impairment was the only factor that predicted rehospitalization within 30 days after discharge ( OR = 1,50, p = 0,04, IC 95% [1,02, 2,22]). Discussion: By focusing on each component of the discharge planning, this study provides a greater and more detailed insight on the usual nursing process currently performed in medical inpatients units. Results identified several gaps between current and Best practices, providing guidance to changes in clinical practice and further research.

La "guerre des talents" est-elle perdue d'avance? Attirer et fidéliser les salariés par les valeurs du service public

L'idée selon laquelle les organisations productives se trouvent en concurrence pour attirer à elles les meilleurs salariés est aujourd'hui très largement répandue, que ce soit parmi les dirigeants, dans la presse, ou même dans les manuels de management. Dès lors, la guerre des talents paraît inéluctable. C'est oublier toutefois que les salariés, qu'ils travaillent dans le secteur public ou privé par ailleurs, ne sont pas uniquement mus par des considérations utilitaristes, rationnelles et matérielles. Ils ne visent pas avant tout à vendre leurs talents, pour autant qu'ils soient conscients qu'ils en possèdent, mais plutôt à travailler dans un environnement organisationnel en accord avec les valeurs auxquelles ils croient et auxquelles ils sont attachés. Les aspects matériels du travail ont de l'importance, à n'en pas douter, mais les dimensions idéelles et valorielles ont souvent été sous-estimées dans la littérature scientifique contemporaine. Cet article a pour ambition de montrer que les valeurs doivent être réintroduites dans l'analyse des processus motivationnels des salariés. Grâce à la notion de « motivation à l'égard du service public » (MSP) nous montrons que les agents publics sont attachés à des missions, objectifs et valeurs qui définissent en partie leurs activités professionnelles. L'étude empirique se base sur un important échantillon d'agents publics municipaux et cantonaux suisses et analyse les antécédents et les résultats de la MSP. Les enseignements qui en découlent suggèrent que, si guerre des talents il doit y avoir, alors les valeurs compteront elles aussi.

Catholic Loyalism, Service and Careerism: Lewes Lewkenor's Quest for Favour

This article discusses one of Lewkenor's more obscure works, The Resolved Gentleman (1594 - STC 15139), in the context of Elizabethan court politics in the 1590s, with a particular emphasis on the author's own experience of dissent, exile to Catholic Spain in the 1580s and return to England in the early 1590s. A translation of Hernando de Acuña's El Caballero Determinado, itself a reworking of Olivier de la Marche's Chevalier Délibéré (1483), the Resolved Gentleman bends the conventions of medieval chivalric allegory to articulate Lewkenor's own experience of alienation and dissent in the specific context of the factionalism of the 1590s. Beneath Lewkenor's seemingly self-effacing, 'humanist' translation it is in fact possible to discern a complex set of criticisms of Elizabeth's court. The knight's 'wandering' and 'errance' thus becomes a complex, multivalent figure that reverberates with a number of autobiographical meanings: the knight's exile becomes in Lewkenor's hands a figure of his own forced exile to Catholic Spain, and the account of the knight's quest functions as an oblique allusion to his own efforts to make his way back to Elizabeth's court. More importantly, however, these 'personal' meanings acquire a wider, political valence in the context of the allegory, and the narrative as a whole thus becomes a subtle, perceptive but scathing criticism of the Elizabethan court in the 1590's and the 'contraction' of royal favour that resulted in particular in the exclusion of capable, experienced but Catholic counsellors like Lewkenor himself. Articulating the frustration of this younger generation of alienated but fundamentally loyalist Catholics, Lewkenor paints a picture of a failed quest for favour, where the questing knight is finally forced to retire from the active life and withdraw to a rustic hermitage that is not only incompatible with his own ideal of the vita activa, but also dangerously smacks of unregenerate, and potentially seditious Catholicism.

Toward a Statistically Robust Assessment of Social and Solidarity Economy Actors. Conceptual Development and Empirical Validation

Many definitions and debates exist about the core characteristics of social and solidarity economy (SSE) and its actors. Among others, legal forms, profit, geographical scope, and size as criteria for identifying SSE actors often reveal dissents among SSE scholars. Instead of using a dichotomous, either-in-or-out definition of SSE actors, this paper presents an assessment tool that takes into account multiple dimensions to offer a more comprehensive and nuanced view of the field. We first define the core dimensions of the assessment tool by synthesizing the multiple indicators found in the literature. We then empirically test these dimensions and their interrelatedness and seek to identify potential clusters of actors. Finally we discuss the practical implications of our model.

Education, disease prevalence and health service utilization in the Swiss National Health Survey "SOMIPOPS".

The relation among education, disease prevalence, and frequency of health service utilization was analyzed using data from the Swiss National Health Survey SOMIPOPS, conducted in 1981-1983 on a randomly selected sample of 4,255 individuals, representative of the entire Swiss population. The prevalence of several important cardiovascular, respiratory, digestive, osteoarticular, and psychiatric disorders was higher among less educated individuals; only allergic conditions were directly associated with indicators of social class. More educated individuals reported lower frequencies of general practitioner visits, but higher frequencies of specialized consultations. These findings confirm that education is an important determinant not only of mortality but also of morbidity and health-care utilization and require careful consideration in terms of the planning and evaluation of health services.