Reconfiguration du réseau de la Patrick sabourté et et des services sociaux au Québec: la place des regroupements intéretablissements

Sommaire: Depuis le début des années 1990, le système de santé québécois, comme celui des autres provinces, subit de profonds changements. lis se concrétisent sous la forme d'une reconfiguration majeure du système lui-meme, des services qu'il dispense et des structures qui le composent. L'article s'interesse a ce dernier aspect, plus particulierement sous l' angle des regroupements interétablissements. II appert que la Loi sur les services de santé et les services sociaux (1991, chap. 42) a bouleversé la configuration structurelle du réseau en forcant l'unification horizontale de plusieurs types d'établissements, tels les centres d'hébergement de soins de longue durée et les centres de réadaptation. Plus récemment, la décentralisation fonctionnelle accrue au profit des régies régionales de la santé et des services sociaux (rrsss), jumelée à l'annonce de compressions budgétaires sans précédent, a donné un second souffle à cette reconfiguration de structures. Une enquete a été menée a l'hiver 1995. Elle révèle qu'à ce moment, en plus des regroupements deja prévus dans la loi, un peu plus de 110 établissements socio-sanitaires, dont 60 centres hospitaliers, étaient également impliqués dans divers projets de regroupements allant de l'entente de services a la fusion. Depuis le printemps 1995, certaines rrsss étudient l' option des intégrations ou des fusions verticales, qui impliquent des établissements de mission différente. Or, une revue de la littérature démontre que l' efficacité et l' efficience de ces options ne sont pas clairement démontrées dans le secteur des soins de santé et qu'il vaudrait mieux envisager des formes moins contraignantes (partenariats, ententes de services, etc.) permettant de s'apprivoiser avant de songer au mariage. Abstract: Since the early 1990s, the Quebec health-care system, as those in other provinces, has undergone major changes. These changes involved a major reconfiguration of the system itself - its services and its structures. This article describes this reconfiguration and focuses on one particular aspect: the integration of services. The Health and Social Services Act, 1991 (c. 42) created havoc in the configuration of the system by imposing horizontal integration of several types of services, such as those of long-term care facilities and rehabilitation centres. More recently, this growing delegation in favour of the Regional Health and Social Services Boards (rhssbs) together with the announcement of unprecedented budget cuts, has led to further restructuring. A survey carried out during the winter of 1995 showed that 120 health-care establishments, including 60 hospitals, were involved in inter-establishment relationship projects, ranging from service agreements to mergers. Since the spring of 1995, some rhssbs have been studying the option of integration or of vertical mergers, i.e., how to integrate facilities with different services. However, a review of the literature shows that the effectiveness and efficiency of these options has not yet been clearly proven in the health-care sector, and that it would be wiser to consider, as a first stage, less constraining relationships (e.g., partnerships, service agreements, etc.) as a way of testing compatibility before getting involved in permanent partnerships.     

Adolescence terminable and interminable: When does adolescence end?

The question of when adolescence ends and young adulthood begins is considered. Throughout, it is addressed in terms of the theory of broad and narrow socialization, which emphasizes the cultural context of development. The question is approached from cognitive, emotional, and behavioral perspectives, then from the perspective of role transitions (such as marriage and parenthood). The idea of an extended path from adolescence to adulthood is discussed, and the concept of emerging adulthood is presented. It is suggested that in most non-Western cultures the entrance to adulthood is socially defined and marked by a social event, usually marriage. In the contemporary West, however, where there is a strong emphasis on independence and individualism, the entrance to adulthood is defined and marked individually. Consequently, it is likely to be based on the achievement of residential and financial independence as well as on the attainment of cognitive self-sufficiency, emotional self-reliance, and behavioral self-control. Thus in the contemporary West the passage from adolescence to young adulthood is a process that is gradual and may take many years.This research was funded partly by an institutional training grant from the National Institute of Mental Health 5T32 MH14668-14, for the Clinical Research Training Program in Adolescence, jointly sponsored by the Department of Psychiatry at Northwestern University and the Committee on Human Development at the University of Chicago.Received Ph.D. from University of Virginia, Research interests include adolescent reckless behavior, adolescents' uses of media, and the transition to adulthood.Research interests include the transition to adulthood and development in young adulthood.     

Body image satisfaction,dieting beliefs,and weight loss behaviors in adolescent girls and boys

Body image and weight loss beliefs and behaviors were assessed in 341 female and 221 male high school students. Estimates of body dissatisfaction varied depending on the measurement strategy used. Despite having similar weight distributions around the expected norm, girls were significantly more dissatisfied with their bodies than boys. Body Mass Index was positively related to body dissatisfaction in girls and boys, while higher exercise levels were related to higher body satisfaction in boys. Nearly two-thirds of girls and boys believed being thinner would have an impact on their lives, but the majority of girls believed this would be positive while the majority of boys believed this would be negative. Thirteen percent of female subjects reported using one or more extreme weight loss behavior at least weekly. Beliefs regarding the effectiveness of different weight loss measures were assessed. Weight loss behaviors in this Australian sample appear similar to comparable U.S. samples.Received Ph.D. from University of Tasmania. Main research interest in body image, weight loss behaviors, and eating disorders.Received Ph.D. from University of Connecticut. Main research interest in body image, eating disorders and weight loss behaviors.Dietitian degree from Melbourne University, Melbourne. Main research interest in eating practices and clinical outcome.M.D. from University of Melbourne, D.P.M. from U.K. FRC Psych. Main research interests in eating disorders.B.B.Sc.(Hons.) received from La Trobe University, Melbourne, B.A. received from University of Minnesota, Duluth. Main research interest in attitudes and attributions.B.A. Received from University of Minnesota, Duluth. Main research interest in adolescence and eating disorders.     

Gender,education and the new christian right

She has written several articles on Evangelicals and the Christian School Movement in the United States and on North American evangelical activity in Guatemala. Her most recent publication is Keeping Them Out of the Hands of Satan: Evangelical Schooling in America.