Le vieillissement des cadres supérieurs de la fonction publique québécoise: y aurat-il une relève?

Sommaire: La fonction publique québécoise compte 2 391 cadres supérieurs. Leur moyenne d'âge est de 48 ans et 63 % d'entre eux ont plus de 45 ans. Parmi ces cadres supérieurs, 90 % seront éligibles à une retraite au cours des prochaines années. Ceci laisse entrevoir une augmentation sans précédent du nombre de départs pour prise de retraite. On craint même une véritable disparition de l'expertise de gestion de la fonction publique québécoise. Selon certaines opinions, cette problématique sera complexifiée par le phénomène de vieillissement du groupe d'employés qui représente traditionnellement la relève des cadres, à savoir, le groupe des professionnels. Une très grande proportion des professionnels àété embauchée massivement, à cause de la croissance rapide de la fonction publique, ce qui explique que leur courbe d'âge suit de près celle des cadres. La présente étude s'intéresse donc à ces deux phénomiènes et montre qu'il y aura effectivement une croissance marquée des départs pour prise de retraite dans le groupe des cadres. Mais en ce qui concerne le remplacement de ces cadres, la demande va évoluer progressivement et le niveau d'augmentation ne sera pas aussi important que prévu. Finalement, quant à la relève, il semble que le bassin de candidats potentiels au sein de la fonction publique soit nettement suffisant en nombre. Abstract: The Quebec civil service comprises 2,391 executive-level officials. Their average age is forty-eight, and 63 per cent are over forty-five. Ninety per cent of those officials will be eligible to retire over the next few years. As a result, there is a potentially unprecedented increase in the number of retirements. Mention is often made of the virtual disappearance of Quebec civil service management expertise which could occur. It is also alleged that this situation will be rendered even more complex by the aging of the employee group from which executive officials have traditionally emerged, i. e., the professionals. A very large proportion of the professionals were hired en masse, when the civil servicc was growing very quickly, which explains why their age distribution curve closely follows that of the executives. This study therefore deals with these two phenomena and shows that there will indeed be a marked increase in retirements within the executive group. However, as regards the replacement of those executives, demand will change gradually and the rate of increase will not be as great as expected. Finally, as regards their replacement, the potential candidate base within the civil service is quite sufficient quantitatively.     

ASSESSING SUBSTANCE ABUSE QUESTIONS IN CHILD CUSTODY EVALUATIONS

Substance use is rampant in contemporary society, but little attention has been paid to it in the context of child custody evaluations (CCEs). This article provides concrete suggestions for integrating issues about substance abuse into a more overarching CCE and discusses specific assessment strategies.     

Malnutrition, a rare form of child abuse: diagnostic criteria

Infantile malnutrition is often difficult to diagnose as it is rarely observed in industrialized countries. It may be associated with physical violence or occur in isolation. The essential clinical sign is height and weight retardation, but malnutrition also causes a variety of internal and bone lesions, which lead to neuropsychological sequelae and death. We report a rare case of death by malnutrition in a female child aged 6 1/2 months. The infant presented height and weight growth retardation and internal lesions related to prolonged protein-energy malnutrition (fat and muscle wasting, thymic atrophy, liver steatosis) resulting in a picture of marasmus or kwashiorkor. We detail the positive and negative criteria that established the diagnosis of abuse, whereas the parents had claimed a simple dietary error.     

Books in review

He is currently on leave and is visiting professor at the University of Maryland-Europe.     

La responsabilisation du patient dans un contexte de télésoins à domicile

Sommaire: La volonté de transformation du système de santé est propice à une recrudescence du discours public sur la responsabilisation du patient. Les technologies d'information et de communication (tic ) sont régulièrement envisagées comme moyens pouvant permettre au patient d'exercer un rôle accru dans la prise en charge des questions de santé. Ce texte vise à cerner le sens de la responsabilisation dans un contexte de télésoins à domicile. L‘étude d'un service de suivi à domicile met en lumière l'un des quatre paradigmes d'interprétation de la responsabilisation du patient: le paradigme professionnel qui est orienté vers l'habilitation en matière de santé. Par une double lecture représentant les approches sociologique et psychologique, cette étude montre les possibilités et les limites d'une technologie de télésoins à domicile par rapport à six principales variables: accès aux connaissances; développement d'une réflexion argumentée; influence sur l'action ou la décision; compétence perçue; contrôle perçu; et intériorisation des buts. Les résultats permettent d'observer le haut niveau d'exigence que représenterait une initiative visant l’émergence de patients informés et compétents. Surtout des patients “experts” dans une vision de la responsabilisation fondée sur la reconnaissance du caractère holistique des connaissances, du principe d'autonomie de pensée et du potentiel d'influence du patient sur une variété de décisions. En conclusion, sont précisées les implications qu'ont ces résultats sur la gestion du système public de santé. Abstract: The willingness to transform the health care system is conducive to a new wave of public discourse on patient empowerment. Information and communications technologies (ict ) are regularly considered as means that allow the patient to exercise increased control in addressing health issues. This text aims at examining this phenomenon within the tele‐homecare context. The study of a follow‐up home‐care service highlights one of the four paradigms of the interpretation of patient empowerment: the professional paradigm that is health empowerment‐oriented. By using both a sociological and a psychological approach, the study identifies the possibilities and limitations of tele‐homecare technology, based on six major variables: access to knowledge, development of critical thinking, personal impact on action or decision, perceived competency, perceived control, and internalization of goals. The results show the high level of requirements needed for an initiative that would produce informed, competent and, most importantly, “expert” patients according to a vision of empowerment based on the recognition of the holistic nature of knowledge, the principle of autonomous thinking, and the patient's potential impact on a variety of decisions. In conclusion, the article defines the implications of these results in terms of the management of the public health system.     

Le Vérificateur général du Québec et la vérification d'optimisation des ressources: évolution et perspectives

Sommaire: Le Vérificateur général du Québec (VGQ) par ses vérifications d'optimisation des ressources (VOR) exerce, une influence croissante sur l'administration publique québécoise. La pertinence et la crédibilité sont les pierres d'assise de ses décisions. Pour être pertinent, le VGQ a adopté l'approche de la déficience appréhendée, qui cible des situations problématiques au lieu de cibler des entités. Tout au cours du processus de vérification, cette approche amène le VGQ à s'assurer que la déficience est réelle, sinon il interrompt la VOR La vérification implique notamment la comparaison de la situation avec une norme. Afin d'être crédible le vérificateur en réalisant une VOR, développe sa norme par une approche d'étalonnage. Nous avons constaté que le VGQ s'adapte à l'évolution de l'administration publique. La nouvelle Loi stir l'administration publique québécoise exige des rapports de performance des entités publiques. Si ces dernière jouent le rôe prévu par la loi, le VGQ devra probablement les certifier. Cette tâche, vu son arnpleur, constituera un véritable défi pour le VGQ. Abstract: The Quebec Auditor General (QAG), through value‐for‐money audits (VFMA), is having a growing impact on the Quebec public administration, with relevance and credibility being the cornerstones of its decisions. To be relevant, the QAG has adopted the “apprehended deficiency” approach that targets problem situations instead of entities. Accordingly, throughout the audit process, the QAG must ensure that the deficiency is real otherwise the VFMA must be terminated. The audit process includes a comparison of the situation against a standard. In addition, to be credible when conducting a VFMA, the auditor must develop a standard by means of benchmarking. We have found that the QAG is adapting to the changes taking place in public administration. Quebec's new Public Administration Act requires performance reports from public entities. If these reports play their statutory role, they will probably need to be certified by the QAG. This task, given its scope, will represent a real challenge for the QAG.     

Towards a relationship with the Mediterranean countries

Fifteen years ago, the European Union (EU) launched a Common European Security and Defence Policy (CSDP). Since then, the CSDP has been the focus of a growing body of political and scholarly evaluations. While most commentators have acknowledged shortfalls in European military capabilities, many remain cautiously optimistic about the CSDP’s future. This article uses economic alliance theory to explain why EU member states have failed, so far, to create a potent common defence policy and to evaluate the policy’s future prospects. It demonstrates, through theoretical, case study-based and statistical analysis, that CSDP is more prone to collective action problems than relevant institutional alternatives, and concludes that the best option for Europeans is to refocus attention fully on cooperation within a NATO framework.     

Assessing programs designed to improve outcomes for children exposed to violence: Results from nine randomized controlled trials

Objectives

The study tests whether participation in interventions offered by a subset of sites from the National Safe Start Promising Approaches for Children Exposed to Violence initiative improved outcomes for children relative to controls.

Methods

The study pools data from the nine Safe Start sites that randomized families to intervention and control groups, using a within-site block randomization strategy based on child age at baseline. Caregiver-reported outcomes, assessed at baseline, 6 and 12 months, included caregiver personal problems, caregiver resource problems, parenting stress, child and caregiver victimization, child trauma symptoms, child behavior problems, and social-emotional competence.

Results

Results revealed no measurable intervention impact in intent-to-treat analyses at either 6- or 12-month post-baseline. In 6-month as-treated analyses, a medium to high intervention dose was associated with improvement on two measures of child social-emotional competence: cooperation and assertion. Overall, there is no reliable evidence of significant site-to-site effect variability, even in the two cases of significant intervention effect.

Conclusions

Since families in both the intervention and control groups received some degree of case management and both groups improved over time, it may be advantageous to explore the potential impacts of crisis and case management separately from mental health interventions. It may be that, on average, children in families whose basic needs are being attended to improve substantially on their own.