Effets de certaines mesures de la deuxième entente des médecins omnipraticiens sur leur activité dans le cadre du régime d’assurance-maladie

Designed to contribute to an assessment of the effects of the second agreement with general practitioners, the study analyzes the effects produced on the medical practices of general practitioners by pay range of a) the individual income ceiling and b) various types of fee restrictions on supplementary medical procedures provided under the agreement.The methodology used consisted basically in analyzing the variations of selected indicators of professional activity and medical practice among general practitioners by pay range following the implementation of the second agreement. Control groups were used to facilitate the assessment of other factors that may have influenced the variations referred to.The study shows that the income ceiling has resulted in a significant slowdown in the professional activity of general practitioners whose income had been in excess of the income ceiling in the year preceding the agreement. The shorter work period was accompanied by a longer vacation period.From the second part of the study it appears that the implementation of the second agreement has also appreciably reduced differences in medical procedures by pay range. The fee restrictions on supplementary procedures have produced a very considerable drop in the number of supplementary procedures performed by general practitioners in the top pay ranges, whereas in the past such procedures had been particularly prevalent in those pay ranges

How Can Molecular Pharmacology Help Understand the Multiple Actions of Melatonin: 20 Years of Research and Trends

Melatonin actions are so numerous that a naive reader might become suspicious at such wonders. In a systematic way, we would like to summarize the various approaches that led to what is scientifically sounded in terms of molecular pharmacology: where and how melatonin is acting as a molecule, what can be its action as an antioxidant per se, and its side effects at a molecular level not as a drug or in vivo. Finally, the nature of the relationship between melatonin and mitochondria should be decrypted as well. The road we took from 1987 up to now, and particularly after 1995, will be mentioned with special considerations to the receptors from various species and our goals beyond that; the synthesis and catabolism of melatonin and their link to other enzymes; the discovery of the MT3 binding sites, and what’s left to understand on this particularly interesting target; and the search for agonists that occulted part of the potential discovery of true and potent antagonists, a situation quite unique among the G-protein-coupled receptors

Integrated Internet Marketing Communications for the Global Market: An Empirical Examination

Strategy formulation, strategy implementation, and performance of Internet (online) marketing communications (IOMC) by companies when they attempt to target, reach, and communicate with the global market (i.e., both domestic and foreign markets) in order to promote and sell products to the members of that market was the broad phenomenon examined. The specific focus was on the use of a globally integrated marketing communications (GIMC) approach with IOMC and the creation of the global Internet integrated marketing communications (GI-IMC) concept. Relevant theories and theoretical models were identified and leveraged to serve as the theoretical foundation for the general theoretical framework, the research program framework, and/or the hypothesized conceptual model created and/or empirically examined at least partially. They included: industrial organization theory, the resource-based view, and the strategic fit paradigm (environment-strategy coalignment). In addition, various relevant research streams and concepts were described and examined in detail. They included: IOMC, international Internet marketing, integrated marketing communications, GIMC, and Internet integrated marketing communications. The Market Orientation construct was the lone independent variable or construct included in the initial four-construct model empirically examined. There were three stages of data collection: (1) pre-test, (2) pilot test, and (3) main test. A convenience sample of 73 academics or industry practitioners was utilized for the pre-test in order to make modifications to the survey instrument for subsequent rounds of data collection. Samples of qualified industry practitioners were then obtained for the pilot test (n=70) and main test (n=400) from online respondent panels provided by third-party vendors. Results included the creation of two new theoretical constructs (i.e., Global Internet Integrated Marketing Communications and Global Internet Marketing Communications Performance) and the formulation and preliminary validation of their measurement scales (though the hypothesized measurement model lacked discriminant validity, which prevented testing of the hypothesized structural model). In addition, a statistically significant positive relationship was found to exist between the Global Internet Integrated Marketing Communications construct and the Global Internet Marketing Communications Performance construct in a final two-construct model proposed and examined through post-hoc analysis. Implications of this research for researchers and practitioners are provided, as are future research directions

Long wavelenght inner-resonance cut-off frequencies in elastic composite materials

International audienceWe revisit an ancient paper (Auriault and Bonnet, 1985) which points out the existence of cut-off frequencies for long acoustic wavelength in high-contrast elastic composite materials, i.e. when the wavelength is large with respect to the characteristic heterogeneity length. The separation of scales enables the use of the method of multiple scale expansions for periodic structures, a powerful upscaling technique from the heterogeneity scale to the wavelength scale. However, the results remain valid for non-periodic composite materials which show a Representative Elementary Volume (REV). The paper extends the previous investigations to three-component composite materials made of hard inclusions, coated with a soft material, both of arbitrary geometry, and embedded in a connected stiff material. The equivalent macroscopic models are rigorously established as well as their domains of validity. Provided that the stiffness contrast within the soft and the connected stiff materials is of the order of the squared separation of scales parameter, it is demonstrated (i) that the propagation of long wave may coincide with the resonance frequencies of the hard inclusions/soft material system and (ii) that the macroscopic model presents a series of cut-off frequencies given by an eigenvalue problem for the resonating domain in the cell. These results are illustrated in the case of stratified composites and the possible microstructures of heterogeneous media in which the inner dynamics phenomena may occur are discussed

Waves in bubbly liquids with phase change

International audienceIn a previous paper (C. Boutin, J.-L. Auriault, Acoustics of a bubbly fluid at large bubble concentration, Eur. J. Mech. B/Fluids, 12(3) (1993) 367-399), the homogenization technique was used to investigate how acoustic waves propagate in a bubbly fluid at finite concentration. Three different equivalent macroscopic behaviours were shown to exist, for "large"-, "medium"- and "small"-size bubble systems, respectively. In the present paper, we extend the analysis by taking into consideration possible phase change effects. We show that phase change effects are negligible in the case of large-size bubbles, whereas they strongly modify the medium-size bubble system behaviour. For small-size bubbles capillarity dominates the process

Acoustique d'un fluide au voisinage du point d'ébullition

International audienceDans une étude précédente (Boutin et Auriault 1993), la propagation d'ondes acoustiques dans un fluide à bulles en concentration finie était analysée au moyen de la méthode des échelles multiples. Trois comportements différents étaient mis en évidence suivant la taille des bulles, grande, moyenne ou petite. Dans la présente note, nous étendons cette étude par la prise en compte d'un possible changement de phase. Nous montrons que les effets de celui-ci sont négligeables dans le cas de grandes bulles, et modifient fortement le comportement des bulles moyennes en diminuant de plusieurs orders de grandeur la rigidité effective. Pour les petites bulles la capillarité devient le phénomène prépondérent

Les facultés d’éducation des universités traditionnelles et les universités du troisième âge : un modèle de partenariat

Le présent article porte sur un modèle de partenariat que pourraient établir les universités du troisième âge avec les facultés d’éducation des universités, dans le dessein d’offrir aux personnes concernées un meilleur service. La poursuite d’études universitaires représente une voie porteuse, particulièrement si elle se situe dans le cadre des facultés d’éducation et en lien avec les universités du troisième âge. Les auteurs présentent ici un modèle de partenariat entre ces deux instances, inspiré d’une approche pédagogique expérimentée dans de nombreux domaines socio-éducatifs. Ce modèle délimite les rôles des professeurs, formateurs, superviseurs et étudiants dont la mission est, notamment, de créer les conditions d’une bonne coopération entre les instances concernées afin de les rapprocher le plus possible et de leur assurer un fonctionnement maximal. Cet article devrait, en outre, contribuer à mieux cerner la question de l’identité professionnelle des futurs intervenants auprès des personnes du troisième âge, en indiquant comment ils peuvent accéder à une formation théorique et à une formation pratique intégrée et cohérente.This article examines the partnership model proposed between “third age”/senior citizen universities and universities’ faculties of education with the aim of offering improved services to all involved. The pursuit of university level studies represents advantages specifically within the frame of faculties of education as linked with those developed for senior citizens. The authors present a model of partnership between these two, being inspired by a pedagogical approach implemented in a number of socio-educational domains. This model delineates the roles of teachers, trainers, supervisors, and students whose objective is specifically to create conditions for co-operation between these instances in order to bring these students together and to insure an efficient operation. This article aims therefore to contribute to clarify the question of the professional identity of future teachers working with seniors, specifically by showing how to develop theoretical and practical training that is both integrated and coherent.Se trata en el presente artículo de un modelo de cooperación que podrían establecer las universidades de la tercera edad con las facultades de educación de las universidades, con el objetivo de ofrecer a las personas interesadas un mejor servicio. Emprender estudios universitarios representa una vía prometedora, en particular si se ubica en el marco de las facultades de educación en relación con las universidades de la tercera edad. Los autores presentan a continuación un modelo de cooperación entre estas dos instancias, inspirado de un enfoque pedagógico experimentado en varias áreas socio-educativas. Este modelo delimita los papeles de los profesores, formadores, supervisores y estudiantes cuya misión es particularmente de crear las condiciones de una buena cooperación entre las instancias interesadas a fin de acercarles lo más posible y asegurarles un funcionamiento máximo. Este artículo debería, además, contribuir a delimitar mejor el tema de la identidad profesional de los futuros participantes con las personas de la tercera edad, indicando cómo pueden acceder a una formación teórica y a una formación práctica integrada y coherente