A model and typology of collaboration between professionals

Abstract Background: The new forms of organization of healthcare services entail the development of new clinical practices that are grounded in collaboration. Despite recent advances in research on the subject of collaboration, there is still a need for a better understanding of collaborative processes and for conceptual tools to help healthcare professionals develop collaboration amongst themselves in complex systems. This study draws on D'Amour's structuration model of collaboration to analyze healthcare facilities offering perinatal services in four health regions in the province of Quebec. The objectives are to: 1) validate the indicators of the structuration model of collaboration; 2) evaluate interprofessional and interorganizational collaboration in four health regions; and 3) propose a typology of collaboratio

Experiencing food insecurity in childhood: influences on eating habits and body weight in young adulthood

Abstract Objective: To examine how food insecurity in childhood up to adolescence relates to eating habits and weight status in young adulthood. Design: A longitudinal study design was used to derive trajectories of household food insecurity from age 4.5 to 13 years. Multivariable linear and logistical regression analyses were performed to model associations between being at high risk of food insecurity from age 4.5 to 13 years and both dietary and weight outcomes at age 22 years. Setting: A birth cohort study conducted in the Province of Quebec, Canada. Participants: 698 young adults participating in the Québec Longitudinal Study of Child Development. Results: After adjusting for sex, maternal education and immigrant status, household income and type of family, being at high risk (compared to low risk) of food insecurity in childhood up to adolescence was associated with consuming higher quantities of sugar-sweetened beverages (ßadj: 0.64; 95% CI: 0.27-1.00), non-whole-grain cereal products (ßadj: 0.32; 95% CI: 0.07-0.56), and processed meat (ßadj: 0.14; 95% CI: 0.02-0.25), with skipping breakfast (ORadj: 1.97; 95% CI: 1.08-3.53), with eating meals prepared out of home (ORadj: 3.38; 95% CI: 1.52-9.02), with experiencing food insecurity (ORadj: 3.03; 95% CI: 1.91-4.76), and with being obese (ORadj: 2.01; 95% CI: 1.12-3.64), once reaching young adulthood. Conclusion: Growing up in families experiencing food insecurity may negatively influence eating habits and weight status later in life. Our findings reinforce the importance of public-health policies and programs tackling poverty and food insecurity, particularly for families with young children

The effectiveness of scoliosis screening programs: methods for systematic review and expert panel recommendations formulation

Background: Literature on scoliosis screening is vast, however because of the observational nature of available data and methodological flaws, data interpretation is often complex, leading to incomplete and sometimes, somewhat misleading conclusions. The need to propose a set of methods for critical appraisal of the literature about scoliosis screening, a comprehensive summary and rating of the available evidence appeared essential. METHODS: To address these gaps, the study aims were: i) To propose a framework for the assessment of published studies on scoliosis screening effectiveness; ii) To suggest specific questions to be answered on screening effectiveness instead of trying to reach a global position for or against the programs; iii) To contextualize the knowledge through expert panel consultation and meaningful recommendations. The general methodological approach proceeds through the following steps: Elaboration of the conceptual framework; Formulation of the review questions; Identification of the criteria for the review; Selection of the studies; Critical assessment of the studies; Results synthesis; Formulation and grading of recommendations in response to the questions. This plan follows at best GRADE Group (Grades of Recommendation, Assessment, Development and Evaluation) requirements for systematic reviews, assessing quality of evidence and grading the strength of recommendations. CONCLUSIONS: In this article, the methods developed in support of this work are presented since they may be of some interest for similar reviews in scoliosis and orthopaedic fields.Canadian Institutes of Health Research (CIHR) by three means: CIHR Research Operating Grants (2004–2007, 2008–2011); Canada Graduate Scholarships Doctoral Awards (MB) and CIHR MENTOR and AnEIS Strategic training programs doctoral awards (MB)

Modèle des fonctions d'aide un pont entre la théorie et la pratique /

Titre de l'écran-titre (visionné le 3 oct. 2013

The facilitating factors and barriers encountered in the adoption of a humanized birth care approach in a highly specialized university affiliated hospital

<p>Abstract</p> <p>Background</p> <p>Considering the fact that a significant proportion of high-risk pregnancies are currently referred to tertiary level hospitals; and that a large proportion of low obstetric risk women still seek care in these hospitals, it is important to explore the factors that influence the childbirth experience in these hospitals, particularly, the concept of humanized birth care.</p> <p>The aim of this study was to explore the organizational and cultural factors, which act as barriers or facilitators in the provision of humanized obstetrical care in a highly specialized, university-affiliated hospital in Quebec province, in Canada.</p> <p>Methods</p> <p>A single case study design was chosen. The study sample included 17 professionals and administrators from different disciplines, and 157 women who gave birth in the hospital during the study. The data was collected through semi-structured interviews, field notes, participant observations, a self-administered questionnaire, documents, and archives. Both descriptive and qualitative deductive content analyses were performed and ethical considerations were respected.</p> <p>Results</p> <p>Both external and internal dimensions of a highly specialized hospital can facilitate or be a barrier to the humanization of birth care practices in such institutions, whether independently, or altogether. The greatest facilitating factors found were: caring and family- centered model of care, professionals' and administrators' ambient for the provision of humanized birth care besides the medical interventional care which is tailored to improve safety, assurance, and comfort for women and their children, facilities to provide a pain-free birth, companionship and visiting rules, dealing with the patients' spiritual and religious beliefs. The most cited barriers were: the shortage of health care professionals, the lack of sufficient communication among the professionals, the stakeholders' desire for specialization rather than humanization, over estimation of medical performance, finally the training environment of the hospital leading to the presence of too many health care professionals, and consequently, a lack of privacy and continuity of care.</p> <p>Conclusion</p> <p>The argument of medical intervention and technology at birth being an opposing factor to the humanization of birth was not seen to be an issue in the studied highly specialized university affiliated hospital.</p

The Expectations of Low and High Risk Pregnant Women Who Seeking Obstetrical Care in a Highly Specialized Hospital

Background: In the context of a highly specialized hospital, birth care might be is expected to be more medicalized and technocratic for both low and high risk pregnant women.Objective: This study aimed to explore the expectation of low and high risk pregnant women who seeking an obstetrical care in a highly specialized hospital.Methods: A single case study design was chosen for this study. The case under study was a tertiary and university affiliated hospital in Montreal, Canada. The data were collected through semi-structured interviews, field notes, participant observations and self-administered questionnaire. An inductive qualitative content analysis was used.Results: As a whole 157 women were participated in the study. The analysis of data showed that both high and low risk women felt more satisfied with the care they received if they were provided with informed choices, had the right to participate in the decision-making process and were surrounded by competent care providers and obstetric technology. The presence of an attentive care provider during labour who humanly cared for women and her family considered as essential component of birth care by women participant.Conclusion: A birth care provider in a tertiary hospital setting should aim to meet both physiological and psychological aspects of birth care, including respect of the fears, beliefs, values, and needs of women and their families. Integration of competent and caring professionals, as well as the use of obstetric technology, could enhance the level of certainty and assurance in both high-risk and low risk women in a tertiary hospital

A leitura das obras completas em contexto escolar no Quebec

No Quebec, as recentes reformas curriculares testemunham as elevadas exigências quanto ao número de obras completas a serem lidas no período de formação pré-universitária, e dedicam uma grande liberdade aos professores para a seleção dos títulos. Fundamentamo-nos aqui sobre os resultados de uma vasta pesquisa para estabelecer a situação das exigências dos professores em matéria de leitura das obras, das finalidades associadas a esta prática e do corpus escolhido. Os professores do primário e do secundário visam ao desenvolvimento do prazer da leitura; aqueles do colegial, à constituição de uma cultura literária de base: a primeira centra-se na literatura quebequense enquanto a segunda leva em consideração o patrimônio francês

Understanding childbirth practices as an organizational cultural phenomenon: a conceptual framework

Abstract Understanding the main values and beliefs that might promote humanized birth practices in the specialized hospitals requires articulating the theoretical knowledge of the social and cultural characteristics of the childbirth field and the relations between these and the institution. This paper aims to provide a conceptual framework allowing examination of childbirth practices through the lens of an organizational culture theory. A literature review performed to extrapolate the social and cultural factors contribute to birth practices and the factors likely overlap and mutually reinforce one another, instead of complying with the organizational culture of the birth place. The proposed conceptual framework in this paper examined childbirth patterns as an organizational cultural phenomenon in a highly specialized hospital, in Montreal, Canada. Allaire and Firsirotu&apos;s organizational culture theory served as a guide in the development of the framework. We discussed the application of our conceptual model in understanding the influences of organizational culture components in the humanization of birth practices in the highly specialized hospitals and explained how these components configure both the birth practice and women&apos;s choice in highly specialized hospitals. The proposed framework can be used as a tool for understanding the barriers and facilitating factors encountered birth practices in specialized hospitals