Où se situent les associations ? Les enjeux des frontières poreuses

Dans cet article, nous explorons dans un premier temps les principales approches conceptuelles qui englobent le phénomène associatif depuis plus de deux décennies : secteur non marchand, économie sociale, entreprise sociale et entrepreneuriat social. Notre analyse conduit tout d’abord à observer que ces approches évoluent dans le temps : elles reflètent des pratiques en vigueur et – dans un effet retour – conduisent à rendre ces pratiques légitimes. L’analyse permet aussi de remarquer que l’évolution conduit à un phénomène de « blurring boundaries », où les frontières entre catégories d’acteurs économiques semblent progressivement s’estomper. Cet estompement met en péril la reconnaissance a priori des spécificités de chaque type d’organisation, en ce compris la reconnaissance des spécificités associatives. Aujourd’hui, les rôles ne sont plus autant qu’avant attribués sur une base organisationnelle claire. Dans de nombreux esprits, toutes les organisations semblent légitimes pour jouer tous les rôles. Lorsque les organisations entendent se profiler dans des activités qui comportent des dimensions sociales importantes, on leur demande de démontrer leur utilité sociale ou leur impact social. Aussi, dans un second temps, nous rappelons toute la complexité de l’évaluation de l’impact et nous mettons le lecteur en garde par rapport aux outils qui visent à appréhender l’impact comme un retour social sur investissement. Nous terminons en énonçant quels sont, selon nous, les enjeux sous-jacents à l’émergence de la question de l’impact, en particulier dans un contexte où les frontières sont devenues poreuses.Peer reviewe

Que produit l'entreprise d'économie sociale

Peer reviewe

Understanding the clinical profile of patients with frozen shoulder: a longitudinal multicentre observational study

Introduction There is a large diversity in the clinical presentation of frozen shoulder (FS) and the clinical outcome is not always satisfactory. The aim of the current study was to examine to what extent range of motion (ROM) limitation, metabolic factors (diabetes mellitus and thyroid disorders), autonomic symptoms and pain sensitivity may contribute to the prognosis in terms of shoulder pain and disability and quality of life in patients with FS. Methods Patients with stage 1 or 2 FS were longitudinally followed-up during 9 months after baseline assessment. They completed six questionnaires and underwent quantitative sensory testing (pressure pain thresholds, temporal summation and conditioned pain modulation) and ROM assessment. Results One hundred and forty-nine patients with FS were initially recruited and 121 completed at least one follow-up measurement. Shoulder pain and disability improved over time and diabetes mellitus was found to be a prognostic factor for final outcome. Several domains of quality of life also improved over time and external rotation ROM, diabetes mellitus, thyroid disorder and autonomic symptoms were found to be prognostic factors for final outcome. These prognostic factors explained 2.5%–6.3% of the final outcome of shoulder pain and disability and quality of life. Discussion and conclusion In patients with FS, prognostic variables were able to predict different outcomes, indicating that outcomes in this population can be variable-dependent. Other variables not explored in this study might contribute to the prognosis of patients with FS, which should be investigated in future research. In clinical practice, baseline assessment of prognostic factors and focusing on a more holistic approach might be useful to inform healthcare practitioners about progression of patients with FS during a 9-month period

Le Secteur Associatif en Belgique: Une Analyse Quantitative et Qualitative

The book is divided in three parts. The first deals with the problem of defining the third sector in Belgium; the second part presents a quantitative analysis of the sector, and the third chapter provides a detailed analysis of the employment in the sector. The appendix includes interviews to representatives of non-profit organisations about the management of the organisations

Forum: On the limited utility of KAP-style survey data in the practical epidemiology of AIDS

This issue of Forum presents a debate on Herbert L. Smith’s, ‘On the limited utility of KAP-style survey data in the practical epidemiology of AIDS, with reference to the AIDS epidemic in Chile’, Health Transition Review 3,1,1993. His response to issues raised in this debate will appear in Health Transition Review 4,1,1994

Ganciclovir/valganciclovir prophylaxis decreases cytomegalovirus-related events and bronchiolitis obliterans syndrome after lung transplantation

BACKGROUND: Until recently, cytomegalovirus (CMV) infection represented a major threat to lung transplant recipients. Preliminary studies have shown that antiviral prophylaxis might improve the outcome for these patients. METHODS: We extended our initial pilot trial of prolonged prophylaxis with either oral ganciclovir (1 g 3 times per day) or valganciclovir (450 mg twice per day). The trial included 96 patients who were at risk for CMV-related events. RESULTS: CMV prophylaxis resulted in a significant decrease in CMV-related events (i.e., active infection and disease), from 75% in a control group and for 274 cases from the literature who did not receive prophylaxis to a cumulative incidence of 27% (P < .001). Only 11% of the prophylaxis recipients experienced CMV disease (P = .002). Moreover, at 5 years, there was a significant decrease in the rate of bronchiolitis obliterans syndrome, from 60% to 43% (P = .002), and an improved rate of survival, from 47% to 73% (P= .036), irrespective of the immunosuppressive regimen received. CMV strains with UL97 mutations were recovered from 7 of 12 analyzed cases, but the presence of this mutation had no impact on the severity of CMV disease. CONCLUSIONS: A regimen of prolonged ganciclovir or valganciclovir prophylaxis decreased the rate of active CMV infection and disease, reduced the incidence of bronchiolitis obliterans syndrome, and improved the survival rate. Drug-resistant CMV strains may occur, but such strains appeared to have no impact on the outcome of CMV-related events

Ganciclovir/Valganciclovir Prophylaxis Decreases Cytomegalovirus-Related Events and Bronchiolitis Obliterans Syndrome after Lung Transplantation

Background. Until recently, cytomegalovirus (CMV) infection represented a major threat to lung transplant recipients. Preliminary studies have shown that antiviral prophylaxis might improve the outcome for these patients. Methods. We extended our initial pilot trial of prolonged prophylaxis with either oral ganciclovir (1 g 3 times per day) or valganciclovir (450 mg twice per day). The trial included 96 patients who were at risk for CMV-related events. Results. CMV prophylaxis resulted in a significant decrease in CMV-related events (i.e., active infection and disease), from 75% in a control group and for 274 cases from the literature who did not receive prophylaxis to a cumulative incidence of 27% (P<.001). Only 11% of the prophylaxis recipients experienced CMV disease (P<.001). Moreover, at 5 years, there was a significant decrease in the rate of bronchiolitis obliterans syndrome, from 60% to 43% (P=.002), and an improved rate of survival, from 47% to 73% (P=.036), irrespective of the immunosuppressive regimen received. CMV strains with UL97 mutations were recovered from 7 of 12 analyzed cases, but the presence of this mutation had no impact on the severity of CMV disease. Conclusions. A regimen of prolonged ganciclovir or valganciclovir prophylaxis decreased the rate of active CMV infection and disease, reduced the incidence of bronchiolitis obliterans syndrome, and improved the survival rate. Drug-resistant CMV strains may occur, but such strains appeared to have no impact on the outcome of CMV-related event

Que produit l'entreprise sociale ?

peer reviewedThis chapter gives a deep understanding of various notions in the specific contexte of social enterprises : output, outcomes, impact

The result of acute induced psychosocial stress on pain sensitivity and modulation in healthy people

Background: Pain can be influenced by several factors, including stress. Stress can have various reactions on pain. These reactions are influenced by several internal factors such as gender, age, and experience with stress or pain. Objectives: To determine the effect of acute stress on mechanical hyperalgesia (with pressure pain thresholds [PPT]), endogenous pain facilitation (measured by temporal summation [TS]), and inhibition (measured by conditioned pain modulation [CPM]) in healthy people and to determine which factors are responsible for this stress result. Study Design: Pre-posttest design. Setting: Healthy volunteers from Belgium. Methods: One hundred and one healthy pain-free patients underwent a modified Trier Social Stress Test. Prior and following the stress manipulation, PPT, TS, and CPM efficacy were determined in the mm. trapezius and quadriceps and overall. Furthermore, possible explanatory factors, such as fear of pain, pain catastrophizing, pain hypervigilance, and daily activity levels, were assessed using questionnaires. Results: We found a significant stress result on widespread pain sensitivity, with an increase of PPT (P 0.05), and a decrease in CPM efficacy (P < 0.001). Factors associated with the stress result were age, previous surgery, attentional focus on the conditioning stimulus during CPM, fear of pain, and daily activity levels. Limitations: The efficacy of the stress manipulation was not examined, and the lack of a control group prevented to examine a real stress-effect. Furthermore, no physiologic parameters were measured as possibly influencing internal factors for the stress-result. Conclusions: The increase in PPT was not a clinically significant change, whereas the decrease in CPM was meaningful. None of the factors predicted the stress result in all experimental pain measurements, and the predictions that were observed only explained a small proportion of the observed effects