Continuity, capture, network: The professional logics of the organization of care

Cooperation in medicine, as in all group activity, is a key problem both for the actors involved and for sociologists. Classical studies in the sociology of health and medicine are moreover of little help in conceptualizing this problem. While arguing against the idea that affiliation with an institutional structure – such as a part of a professional segment or an area of expertise – determines relations between actors, our analysis seeks to move beyond the description of what is presented as being purely contingent. To understand phenomena related to cooperation and conflict, it is possible and worthwhile to distinguish between professionals according to their position in the therapeutic chain and their form of involvement in the strategy of care. Cooperation is based, in particular, on the match between “acquisitive” professionals who feel it is their duty to coordinate medical care and follow-up on a patient throughout the healing process, and other professionals who see their intervention as being limited to one phase in the therapeutic itinerary

La C.E.E : un modele juridique pour une plus grande integration economique en Afrique australe. Volume 1-2

The purpose of this thesis is to answer the following question : Ii the E.E.C. in fact a legal model for greater economic integration in Southern Africa? Part One of the thesis provides a description of the organization of the E.E.C After a brief historical introduction, Section One analyses the Community's main institutions : their composition, their function, and their decision-making mechanisms. The different legal instruments of Community law, the relationship between this law and traditional international law on the one hand and the national law of the member states on the other, the interaction between the Council, the Commission and the European Parliament as well as the financing of the organization are also considered in some detail. Section Two examines some of its most important spheres of activity, namely, free movement of goods, free movement of persons, freedom to provide services, free movement of capital, the rules on competition, regional policy, fiscal harmonization and V.A.T., legal equalization processes and transport. A definition of the internal market and an account of other innovations introduced by the Single European Act in the field of the organization's activities concludes this section on the E.E.C Part Two deals with the principal organizations of economic cooperation in Africa, of which South Africa is not a member, and examines to what extent the African continent has been influenced by this European experience. After a short historical account leading to the existence of these African organizations, each kind of institution in these different organizations is dealt with separately in Section One, particular attention being given to their composition, their functions, and their different legal instruments. This is followed by a study of the law of these organizations and to what extent it differs from the traditional international law, as well as the interaction between the different institutions and the financing of these organizations. Section Two examines the main fields of activity of the organizations studied in this Part, namely, the suppression of customs duties, the common customs tariff, the removal of technical barriers to trade, free movement of persons, freedom to provide services, free movement of capital, transport and communication, natural resources, social and cultural matters, regional policies, industrial development, and other fields of activity. Part Three is divided into three chapters. The first one is the study of the principal instruments of multilateral economic cooperation to which South Africa belongs, that is, the Southern African Customs Union, and Monetary Area and the Economic Community of Southern Africa. The second Chapter presents general comparisons between the institutional structure of the organizations, their fields of activity, as well as the supranationalism which they could eventually enjoy. Finally, the third Chapter consists of conclusions which .are of a more personal note, that is to say, a presentation of an original system based on the study made in this thesis, particularly of the E.E.C., a system which, in my opinion, could be applied to the internal law in South Africa and at the same time could offer a model of economic and political integration in Southern Africa

Un entrepreneur privé de politique publique:La lutte contre l'obésité, entre santé publique et intérêt privé

En prenant le cas de la prévention de l’obésité, le papier contribue à éclairer les recompositions de l’action publique dans le champ de la santé publique en France. L’analyse des mécanismes présidant à l’affirmation d’un opérateur privé dans le champ comme acteur légitime et de premier plan (se développant désormais dans plus de 200 villes) constitue un point d’observation privilégié de l’articulation entre action de l’Etat et action des municipalités d’une part et d’un mode privatisation original de l’action publique d’autre part. Cet acteur ne se laisse pas facilement saisir par les catégories usuelles d’analyse de l’action publique mais correspond davantage à la figure de l’entrepreneur privé, parvenu à s’installer et à agir durablement à la frontière de deux mondes hétérogènes, et même antagonistes à bien des égards, celui de la santé publique et du marché.By studying the case of obesity prevention, this paper aims to shed light on the reorganization of public health policies in France. This analysis of mechanisms by which a private operator establishes itself as a legitimate and leading actor (of a program now present in more than 200 cities) enables an insight into the articulation between policies carried out by the state and the municipalities on one hand, and an original mode of policy privatization on the other hand. This operator does not fit into the usual categories for analysis of policy, but corresponds more to the figure of the private entrepreneur succeeding in creating a durable role for himself on the border of two heterogeneous worlds, which often find themselves in conflict, that of public health and the market

Éléments pour une sociologie de l’entrepreneur-frontière:Genèse et diffusion d’un programme de prévention de l’obésité

Cet article entend apporter une contribution à la littérature sur le rôle des entrepreneurs dans le changement social et institutionnel. Après avoir décrit les figures de « l’entrepreneur-passeur » et de « l’entrepreneur-traducteur », déjà clairement identifiées en sociologie, les auteurs proposent une troisième figure, celle de « l’entrepreneur-frontière », défini tout à la fois comme acteur à la frontière d’univers cloisonnés, objet-frontière et garde-frontière. L’étude de la genèse d’un programme français de prévention de l’obésité infantile conduit à identifier certains de ses promoteurs comme des entrepreneurs-frontières. L’article montre que ces promoteurs ont multiplié les présentations de soi pour se fondre dans un univers institutionnel traversé par de multiples frontières et conflits. Adoptant le point de vue symétrique des partenaires du programme, les auteurs montrent que leur enrôlement a reposé sur une série de projections et d’appropriations sélectives concernant l’identité des promoteurs du programme et les actions développées.This paper aims to contribute to the literature on the role of entrepreneurs in social and institutional change. Having described the types of “intermediary-entrepreneurs” and “translator-entrepreneurs” which have previously been identified in sociology, the authors propose a third type, that of the “boundary-entrepreneur” defined as an actor at the border of closed universes, a boundary-object and a border-guard. The study of the creation of a French programme for the prevention of childhood obesity helps to identify some of its promoters as boundary-entrepreneurs. The paper shows that these promoters have extended their self-presentations to fit into a world of multiple institutional boundaries and conflicts. By adopting the symmetrical point of view of the programme’s partners, the authors show that their recruitment was based on a series of projections and selective appropriations about the identity of the promoters of the programme and the actions that were developed

Gouverner par les labels:Une comparaison des politiques de l'obésité et de la consommation durable

De nombreuses politiques publiques qui visent à réguler, directement ou indirectement, les conduites individuelles ou collectives s’appuient sur le déploiement d’un type d’instrument que nous qualifions de « label ». En prenant pour cas d’étude la comparaison de la politique de la consommation durable et celle de la lutte contre l’obésité, et en nous inspirant de l’analyse des dispositifs de sécurité menée par Foucault (2004), nous proposons de mettre en évidence certaines des caractéristiques essentielles de ce mode de gouvernement. Nous montrons en particulier que celui-ci joue sur la volonté que manifestent les acteurs pour se positionner et se distinguer les uns par rapport aux autres dans un champ concurrentiel donné, afin de les orienter, de manière souple, vers des options que les acteurs de l’action publique considèrent comme collectivement bénéfiques. La logique de ce mode de gouvernement n’est pas la stabilisation d’un standard qui permette l’uniformisation des entités et pratiques d’un champ, mais la création continue de labels toujours plus exigeants dont seule une partie des membres pourra prétendre s’orner