Changing healthcare: stakeholder perceptions of the burden of chronic disease and the value of teams, measurements and communication.

Canadian healthcare is changing. Over the course of the past decade, the Health Care in Canada Survey (HCIC) has annually measured the reactions of the public and professional stakeholders to many of these change forces. In HCIC 2008, for the first time, the public's perception of their health status and all stakeholders' views of the burden and effective management of chronic diseases were sought. Overall, Canadians perceive themselves as healthy, with 84% of adults reporting good-to-excellent health. However, good health decreased with age as the occurrence of chronic illness rose, from 12% in the age group 18-24 to 65% for the population =65 years. More than 70% of all stakeholders were strongly or somewhat supportive of the implementation of coordinated care, or disease management programs, to improve the care of patients with chronic illnesses. Concordant support was also expressed for key disease management components, including coordinated interventions to improve home, community and self-care; increased wellness promotion; and increased use of clinical measurements and feedback to all stakeholders. However, there were also important areas of non-concordance. For example, the public and doctors consistently expressed less support than other stakeholders for the value of team care, including the use of non-physician professionals to provide patient care; increased patient involvement in decision-making; and the use of electronic health records to facilitate communication. The actual participation in disease management programs averaged 34% for professionals and 25% for the public. We conclude that chronic diseases are common, age-related and burdensome in Canada. Disease management or coordinated intervention often delivered by teams is also relatively common, despite its less-than-universal acceptance by all stakeholders. Further insights are needed, particularly into the variable perceptions of the value and efficacy of team-delivered healthcare and its important components.

Equipes de psychiatrie mobiles pour les trois âges de la vie: l'expérience lausannoise [Psychiatric mobile teams for the three ages of live: the Lausanne experience]

Des équipes mobiles de psychiatrie ont été développées dans les trois âges pour répondre aux besoins de personnes qui devraient bénéficier d'une évaluation ou de soins spécialisés, lorsque ceux-ci doivent avoir lieu à domicile. Pour arriver à ce but, les équipes tissent de forts liens de partenariat dans le réseau, que ce soit avec les proches ou avec les professionnels impliqués. Les principes généraux d'intervention sont semblables entre les âges : une population cible définie, une intervention à domicile au bénéfice également des proches et des soins de proximité, des équipes pluridisciplinaires avec une charge de cas limitée pour garantir leur disponibilité. Les spécificités de chaque âge seront analysées. Mobile teams have been developed for the three ages to meet the needs of people who should receive--but do not access to--a psychiatric assessment or to specialized care. To achieve this goal, the teams built a strong partnership within the social network, both with relatives and professionals involved. The general principles of intervention are similar between the ages: a focused target population, assertive outreach which benefits also relatives and carers, multidisciplinary teams with a limited caseload to ensure availability. The specificities of each age will be analyzed

Gender and family firms: an interdisciplinary approach

This study contributes to developing our understanding of gender and family business, a topic so crucial to recent policies about competitive growth. It does so by providing an interdisciplinary synthesis of some major theoretical debates. It also contributes to this understanding by illuminating the role of women and their participation in the practices of the family and the business. Finally, it explores gender relations and the notion that leadership in family business may take complex forms crafted within constantly changing relationships. Leadership is introduced as a concept that captures the reality of women and men in family firms in a better way than other concepts used by historians or economists like ownership and management.

Gender and family firms: an interdisciplinary approach

This study contributes to developing our understanding of gender and family business, a topic so crucial to recent policies about competitive growth. It does so by providing an interdisciplinary synthesis of some major theoretical debates. It also contributes to this understanding by illuminating the role of women and their participation in the practices of the family and the business. Finally, it explores gender relations and the notion that leadership in family business may take complex forms crafted within constantly changing relationships. Leadership is introduced as a concept that captures the reality of women and men in family firms in a better way than other concepts used by historians or economists like ownership and management.

Anorexie mentale et boutimie: I'expérience vaudoise d'une prise en charge interdisciplinaire [Anorexia and bulimia: the canton of Vaud's experience of an interdisciplinary approach].

As psychiatric disorders attacking the body, anorexia and bulimia may have severe psychological, physical and social consequences, often requiring a long-standing interdisciplinary, coordinated and individualized approach. Recently the canton of Vaud has initiated and developed an interinstitutional structure--between the University Hospital (CHUV) and the hospitals of the Northern region of the canton (eHnv)--for the care of patients suffering from eating disorders. This structure, allowing the above mentioned approach for the treatment of eating disorders, consists of an outpatient facility located in the CHUV and an inpatient unit in the hospital of Saint Loup of the eHnv. Within this structure, the general practitioner plays a crucial role in the prevention of the chronification of these disorders by means of their early detection and management.

Supporting interdisciplinary case studies: development and implementation of a joint learning environment for students in forensic science and criminal law

Scientific reporting and communication is a challenging topic for which traditional study programs do not offer structured learning activities on a regular basis. This paper reports on the development and implementation of a web application and associated learning activities that intend to raise the awareness of reporting and communication issues among students in forensic science and law. The project covers interdisciplinary case studies based on a library of written reports about forensic examinations. Special features of the web framework, in particular a report annotation tool, support the design of various individual and group learning activities that focus on the development of knowledge and competence in dealing with reporting and communication challenges in the students' future areas of professional activity.

Gibbard's expressivism: an interdisciplinary critical analysis

This paper examines key aspects of Allan Gibbard's psychological account of moral activity. Inspired by evolutionary theory, Gibbard paints a naturalistic picture of morality mainly based on two specific types of emotion: guilt and anger. His sentimentalist and expressivist analysis is also based on a particular conception of rationality. I begin by introducing Gibbard's theory before testing some key assumptions underlying his system against recent empirical data and theories. The results cast doubt on some crucial aspects of Gibbard's philosophical theory, namely his reduction of morality to anger and guilt, and his theory of 'normative governance'. Gibbard's particular version of expressivism may be undermined by these doubts.

Iron mining in Goa (India) : an interdisciplinary study

En aquest article es presenten breument els diferents capítols d’un treball interdisciplinari per tal d’entendre el context de prohibició de la mineria de ferro a Goa a finals del 2012 i proporcionar la informació necessària per tal d’orientar i gestionar la presa de decisions sobre l’activitat minera en un futur. Els sis primers capítols consisteixen en l’estudi del medi abiòtic, medi biòtic, fluxos de materials, aspectes socials, aspectes econòmics i finalment aspectes polítics. En canvi, en els dos últims capítols s'avaluen i es gestionen els impactes ambientals de la mineria mitjançant, per una banda, una anàlisi DPSIR i, d'altra banda, es proposen tres escenaris per integrar les diferents variables i fomentar la participació en la presa de decisions. S’ha dut a terme una extensa recerca mitjançant la recopilació de dades, entrevistes i visites a les zones d’estudi d’interès per tal d’entendre el conflicte de la mineria a Goa.