Le rôle de l’évaluation économique dans la pratique des médecins de famille = The role of economic evaluation in the practice of family physicians

L’évaluation économique en santé consiste en l’analyse comparative d’alternatives de services en regard à la fois de leurs coûts et de leurs conséquences. Elle est un outil d’aide à la décision. La grande majorité des décisions concernant l’allocation des ressources sont prises en clinique; particulièrement au niveau des soins primaires. Puisque chaque décision est associée à un coût d’opportunité, la non-prise en compte des considérations économiques dans les pratiques des médecins de famille peut avoir un impact important sur l’efficience du système de santé. Il existe peu de connaissances quant à l’influence des évaluations économiques sur la pratique clinique. L’objet de la thèse est de comprendre le rôle de l’évaluation économique dans la pratique des médecins de famille. Ses contributions font l’objet de quatre articles originaux (philosophique, théorique, méthodologique et empirique). L’article philosophique suggère l’importance des questions de complexité et de réflexivité en évaluation économique. La complexité est la perspective philosophique, (approche générale épistémologique) qui sous-tend la thèse. Cette vision du monde met l’attention sur l’explication et la compréhension et sur les relations et les interactions (causalité interactive). Cet accent sur le contexte et le processus de production des données souligne l’importance de la réflexivité dans le processus de recherche. L’article théorique développe une conception nouvelle et différente du problème de recherche. L’originalité de la thèse réside également dans son approche qui s’appuie sur la perspective de la théorie sociologique de Pierre Bourdieu; une approche théorique cohérente avec la complexité. Opposé aux modèles individualistes de l’action rationnelle, Bourdieu préconise une approche sociologique qui s’inscrit dans la recherche d’une compréhension plus complète et plus complexe des phénomènes sociaux en mettant en lumière les influences souvent implicites qui viennent chaque jour exercer des pressions sur les individus et leurs pratiques. L’article méthodologique présente le protocole d’une étude qualitative de cas multiples avec niveaux d’analyse imbriqués : les médecins de famille (niveau micro-individuel) et le champ de la médecine familiale (niveau macro-structurel). Huit études de cas furent réalisées avec le médecin de famille comme unité principale d’analyse. Pour le niveau micro, la collecte des informations fut réalisée à l’aide d’entrevues de type histoire de vie, de documents et d’observation. Pour le niveau macro, la collecte des informations fut réalisée à l’aide de documents, et d’entrevues de type semi-structuré auprès de huit informateurs clés, de neuf organisations médicales. L’induction analytique fut utilisée. L’article empirique présente l’ensemble des résultats empiriques de la thèse. Les résultats montrent une intégration croissante de concepts en économie dans le discours officiel des organisations de médecine familiale. Cependant, au niveau de la pratique, l'économisation de ce discours ne semble pas être une représentation fidèle de la réalité puisque la très grande majorité des participants n'incarnent pas ce discours. Les contributions incluent une compréhension approfondie des processus sociaux qui influencent les schèmes de perception, de pensée, d’appréciation et d’action des médecins de famille quant au rôle de l’évaluation économique dans la pratique clinique et la volonté des médecins de famille à contribuer à une allocation efficiente, équitable et légitime des ressources.

Intergenerational transmission of social anxiety: the role of social referencing processes in infancy

Responses to an unfamiliar adult were examined in infants of mothers with social phobia (N = 79) and infants of nonanxious comparison mothers (N = 77) at 10 and 14 months in a social referencing paradigm. On each occasion, a female stranger first interacted with the mother and then approached and interacted with the infant. Over time, infants of mothers with social phobia showed increasing avoidance of the stranger, particularly when they were behaviorally inhibited. In boys, maternal social phobia was associated with increasing fearful responses. Infant avoidance was predicted by expressed maternal anxiety and low levels of encouragement to interact with the stranger. The findings are discussed in relation to theories concerning the intergenerational transmission of social anxiety.

The ebbing hegemon? An evolutionary perspective on the emergence of holistic governance and the efficient role of Institutional Investors in Environmental, Social and Governance issues (ESG)

This paper seeks to chronicle the roots of corporate governance form its narrow shareholder perspective to the current bourgeoning stakeholder approach while giving cognizance to institutional investors and their effective role in ESG in light of the King Report III of South Africa. It is aimed at a critical review of the extant literature from the shareholder Cadbury epoch to the present day King Report novelty. We aim to: (i) offer an analytical state of corporate governance in the Anglo-Saxon world, Middle East and North Africa (MENA), Far East Asia and Africa; and (ii) illuminate the lead role the king Report of South Africa is playing as the bellwether of the stakeholder approach to corporate governance as well as guiding the role of institutional investors in ESG.

Building employee relationships through corporate social responsibility: the moderating role of social cynicism and reward for application

We explore the role of deeply held beliefs, known as social axioms, in the context of employee–organization relationships. Specifically, we examine how the beliefs identified as social cynicism and reward for application moderate the relationship between employees’ work-related experiences, perceptions of CSR, attitudes, and behavioral intentions toward their firm. Utilizing a sample of 130 retail employees, we find that CSR affects more positively employees low on social cynicism and reduces distrust more so than with cynical employees. Employees exhibiting strong reward for application are less positively affected by CSR, whereas their experiences of other work-related factors are more likely to reduce distrust. Our findings suggest the need for a differentiated view of CSR in the context of employee studies and offer suggestions for future research and management practice.

The role of animal nutrition in designing optimal foods of animal origin as reviewed by the COST Action Feed for Health (FA0802)

This review provides an overview of the main scientific outputs of a network (Action) supported by the European Cooperation in Science and Technology (COST) in the field of animal science, namely the COST Action Feed for Health (FA0802). The main aims of the COST Action Feed for Health (FA0802) were: to develop an integrated and collaborative network of research groups that focuses on the roles of feed and animal nutrition in improving animal wellbeing and also the quality, safety and wholesomeness of human foods of animal origin; to examine the consumer concerns and perceptions as regards livestock production systems. The COST Action Feed for Health has addressed these scientific topics during the last four years. From a practical point of view three main scientific fields of achievement can be identified: feed and animal nutrition; food of animal origin quality and functionality and consumers’ perceptions. Finally, the present paper has the scope to provide new ideas and solutions to a range of issues associated with the modern livestock production system.

The role of big data in governance: a regulatory and legal perspective of analytics in global financial services

This paper discusses how global financial institutions are using big data analytics within their compliance operations. A lot of previous research has focused on the strategic implications of big data, but not much research has considered how such tools are entwined with regulatory breaches and investigations in financial services. Our work covers two in-depth qualitative case studies, each addressing a distinct type of analytics. The first case focuses on analytics which manage everyday compliance breaches and so are expected by managers. The second case focuses on analytics which facilitate investigation and litigation where serious unexpected breaches may have occurred. In doing so, the study focuses on the micro/data to understand how these tools are influencing operational risks and practices. The paper draws from two bodies of literature, the social studies of information systems and finance to guide our analysis and practitioner recommendations. The cases illustrate how technologies are implicated in multijurisdictional challenges and regulatory conflicts at each end of the operational risk spectrum. We find that compliance analytics are both shaping and reporting regulatory matters yet often firms may have difficulties in recruiting individuals with relevant but diverse skill sets. The cases also underscore the increasing need for financial organizations to adopt robust information governance policies and processes to ease future remediation efforts.

Not just social work academics : the involvement of others in the assessment of social work students

University regulations typically assume that the assessment of students is essentially a task for paid academic staff. However, this is a far cry from much of the current literature about assessment in social work education, of which one of the distinguishing features is the not infrequent references to stakeholders beyond the individuals who are to be assessed and the academic staff employed to teach them. This paper reviews some of the recent literature on the involvement of persons other than social work academics, including students, practice teachers and service users, in assessing students studying in social work programmes. Implications for programme providers of using non-academic assessors are explored.

The role of informal groups in organisational knowledge work : understanding an emerging community of practice

Managers and researchers alike have sought new ways to address the challenges of sharing dispersed knowledge in modern business environments. Careful consideration by sharers of receivers’ knowledge needs and behaviours may improve the effectiveness of knowledge sharing. This research examines how sharers react to their perceptions of receivers’ knowledge needs and behaviours when making choices relating to sharing knowledge. The focus of this article is to propose and empirically explore a theoretical framework for a study of the role of the receiver in knowledge sharing — receiver-based theory. Data collected from two case studies highlight a key role played by perceived receiver knowledge needs and behaviours in shaping sharer choices when explicit knowledge is shared. A set of receiver influences on knowledge sharing is provided that highlights key receiver and sharer issues. The paper concludes that companies should develop better ways to connect potential sharers with receivers’ real knowledge needs. Further, the findings suggest that sharing on a need-to-know basis hinders change in organisational power structures, and prevents the integration of isolated pockets of knowledge that may yield new value.

Developing student agency through VET in schools: the role of structured work placements

Using a sample of 446 secondary students who had participated in a vocational education and training in school (VETiS) program, this study compares the experiences and perceptions of students who had undertaken a work placement with those who had not. The study shows that students who had participated in work placement enjoyed the VETiS experience more than those who had not, and that the work placement had assisted them in their decision whether to stay at school or not. A factor analysis of results showed a factor associated with self-confidence about employability, and a factor associated with assistance in achieving specific post-school employment. Students who had completed a work placement were significantly higher on both these factors than students who had not.

These results are consistent with other research in the field, and it is argued that the work placement experience plays a considerable part in developing student agency in the decisions and the journey that they make in their transition from school to work.

The role of a prospective public health intervention study register in building public health evidence: proposal for content and use

Evidence-informed practice is a key component of public health and the focus of much discussion, of which the nature of evidence and how it is best gathered and appraised has formed a large part. Prospective registration of trials is now a key component of rigour and quality in clinical research and has been supported at an international level through the WHO International Clinical Trials Registry Program. This paper discusses the scope and benefits of trial registration in clinical research, including greater transparency and reduced publication bias. It then considers the potential for a Prospective Public Health Intervention Studies Register specific to the needs of public health and aspects to be included in such a register. It is argued that this initiative has the potential to facilitate increased global cooperation and efficiency in the production of high quality evidence and ultimately in improved health outcomes for populations.

The role of peer support in facilitating psychosocial adjustment to chronic illness in adolescence

This article describes a Chronic Illness Peer Support (ChIPS) programme designed to assist young people in their adjustment to life with a chronic medical condition. The ChIPS programme takes a non-categorical approach to participation, recognizing that young people with different medical conditions experience many similar concerns. Support groups are facilitated by a health professional and peer co-leader. Groups meet weekly for 8 weeks and typically include between six and eight young people. Young people can choose to remain involved in broader social, educational and recreational activities following completion of the 8-week programme. We discuss nine psychosocial mechanisms by which peer support groups such as ChIPS might act to improve resilience and well-being among participants. We also discuss some theoretical risks in running support groups for chronically ill young people, which emphasize the importance of training and support of group leaders, including the peer co-leaders. The article concludes with a personal testimony by a ChIPS participant that was prepared for the 2003 Australian and New Zealand Adolescent Health Conference.

Exploring our nation's capital: exploring the role of cultural institutions in the teaching of history and social education in the primary classroom

Explores the role of cultural institutions in the teaching of history and social education in the primary classroom in Australia. Keys to effective teaching and learning of history; Potential of cultural institutions to foster historical interest, relevance, importance and significance; Practicalities of accessing cultural institutions.