Attachés d'administration centrale. Constitution initiale des nouveaux corps . [Instruction du 11 avril 1956 des secrétaires d'Etat au Budget et à la présidence du conseil (Fonction publique) relative à la constitution initiale des nouveaux corps d'attachés d'administration. - Annexes. I. Programme des matières à option "Administration générale" du concours spécial prévu à l'article 23 ; II. Textes de base : Loi du 3 février 1953 et du 3 avril 1955. Décret du 16 décembre 1955 portant règlement d'administration publique relatif au statut particulier des attachés d'administration centrale. III. Organisation et programme du concours normal prévu aux articles 5 et 12 du décret du 16 décembre 1955.]

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Exploring the implementation of a medication adherence programme by community pharmacists: a qualitative study

BACKGROUND: Medication adherence has been identified as an important factor for clinical success. Twenty-four Swiss community pharmacists participated in the implementation of an adherence support programme for patients with hypertension, diabetes mellitus and/or dyslipidemia. The programme combined tailored consultations with patients about medication taking (expected at an average of one intervention per month) and the delivery of each drug in an electronic monitoring system (MEMS6?). OBJECTIVE: To explore pharmacists' perceptions and experiences with implementation of the medication adherence programme and to clarify why only seven patients were enrolled in total. SETTING: Community pharmacies in French-speaking Switzerland. METHOD: Individual in-depth interviews were audio-recorded, with 20 of the pharmacists who participated in the adherence programme. These were transcribed verbatim, coded and thematically analysed. Process quality was ensured by using an audit trail detailing the development of codes and themes; furthermore, each step in the coding and analysis was verified by a second, experienced qualitative researcher. MAIN OUTCOME MEASURE: Community pharmacists' experiences and perceptions of the determining factors influencing the implementation of the adherence programme. RESULTS: Four major barriers were identified: (1) poor communication with patients resulting in insufficient promotion of the programme; (2) insufficient collaboration with physicians; (3) difficulty in integrating the programme into pharmacy organisation; and (4) insufficient pharmacist motivation. This was related to the remuneration perceived as insufficient and to the absence of clear strategic thinking about the pharmacist position in the health care system. One major facilitator of the programme's implementation was pre-existing collaboration with physicians. CONCLUSION: A wide range of barriers was identified. The implementation of medication adherence programmes in Swiss community pharmacies would benefit from an extended training aimed at developing communication and change management skills. Individualised onsite support addressing relevant barriers would also be necessary throughout the implementation process.

Développement d'un programme de formation à l'entretien motivationnel

RESUMELe but de ce travail de thèse est de permettre à un public de professionnels de découvrir à travers des enregistrements et un texte d'accompagnement l'entretien motivationnel, approche qui est utilisée depuis une vingtaine d'années et qui a fait ses preuves dans le domaine des habitudes de vie influençant la santé.L'entretien motivationnel est d'une part un esprit. Au moyen d'une attitude non jugeante et non confrontante, il crée un climat de confiance favorable à une démarche de changement. Le thérapeute installe une relation de partenariat dans laquelle la personne est autonome dans ses décisions. Cette attitude ou esprit de l'entretien motivationnel repose sur quatre principes de bases qui favorisent le changement.L'entretien motivationnel utilise d'autre part des techniques qui visent à soulever l'ambivalence d'une personne face à une habitude de vie et à la résoudre. Il existe des techniques essentielles pour construire la motivation au changement et des techniques pour construire un plan permettant à la personne de s'engager dans le changement. Ces techniques sont illustrées dans les enregistrements et par le texte d'accompagnementCe travail de thèse contient tous les éléments nécessaires pour prendre connaissance de l'esprit et des techniques de l'entretien motivationnel. Il est néanmoins indispensable de participer à des séminaires de formation pratique et de bénéficier de supervisions pour apprendre à utiliser l'entretien motivationnel.

A model for organ donation in switzerland, the latin organ donation programme (lodp); an ongoing successful regional initiative

Background: The 1st Swiss federal Transplant Law was finally enforced in July 2007 with the obligation to promote quality and efficiency in transplant procedures. The LODP was created to develop organ and tissue donation in the Latin area of Switzerland covering seventeen hospitals (29% of the population).Methods: Each of the partner hospitals designated at least one Local Donor Coordinator (LDC), member of the Intensive Care team, trained in the organ donation (OD) process. The principal tasks of the LDC's are the introduction of OD procedures, organisation of educational sessions for hospital staff and execution of the Donor Action programme. The LODP has been operational since July 2009, when training of the LDC's was completed, the web-site and hotline activated and the attendance of Transplant Procurement Coordinators (TPC) during the OD process organised.Results: National and regional guidelines are accessible on the LODP website. The Hospital Attitude Survey obtained a 57% return rate. Many of the staff requested training and sessions are now running in the partner hospitals. The Medical Record Revue revealed an increase in the conversion rate from 3.5% to 4.5%. During the 5 years before creation of LODP the average annual number of utilised donors was 31, an increase of 70%, has since been observed.Conclusion: This clear progression in utilised donors in the past two years can be attributed to the fact that partner hospitals benefit from the various support given (hotline, website and from TPC's). Despite the increase in OD within the LODP the Swiss donation rates remain low, on average 11.9 donors per million population. This successful model should be applied throughout Switzerland, but the crucial point is to obtain financial support.