Igneous Rock Associations 9. Ophiolites 1: From the Beginning to Modern Times

This paper on ophiolites is the first of four that will appear in Geoscience Canada; it reviews a fascinating history dating back to the very first, glorious days of field mapping in the western Alps in the 1800s. Originally used to describe serpentinites, the term ophiolite progressively evolved to designate a field association (rock clan) of peridotites, gabbros, and radiolarites. Early on, the deep ocean origin of this association was recognized. Recognition of the ophiolitic rock clan in North America was late, due to conflicts among field geologists, experimental petrologists, and marine geologists. The advent of plate tectonic theory helped put the ophiolitic rock clan in the right geodynamic context with respect to mountain belts. Also, the clan was expanded to include pillow lavas, sheeted dikes, abyssal sedimentary rocks, and other metamorphic units. Starting in 1957, it was clear that the basal peridotites were partly derived from the upper mantle and some others derived by crystal fractionation processes, as defined by Bowen. This basal peridotite and the rest of the rock clan constituted the so-called Penrose-type stratigraphy as defined in 1972. Since then, countless studies have shown that ophiolites are transported sheets, a concept fitting plate tectonic theory and the Wilson cycle. Still debated is the geodynamic significance of ophiolites. Are they produced in large ocean basins at mid-ocean ridges or in more confined settings like forearcs, arcs or back-arc basins close to continental margins? Decades of research have shown that Penrose-type ophiolitic sequences can be produced in a variety of geodynamic settings and with complex geochemical attributes. This new approach led to the possibility that ophiolites could be present throughout the geological column and particularly in Precambrian terrains. Originally thought to begin in Neoproterozoic time, ophiolite sequences are now thought to be found in the Archean but those older than 1 Ga have different stratigraphy and geo-chemical compositions. However, these differences are currently matters of debate. The new concept of Precambrian ophiolites might shed light on the early mechanisms controlling the mobile parts of the Earth. SOMMAIRE Dans ce premier article de quatre des « Igneous Rock Associations 9 »de Geo-science Canada sur les ophiolites on découvre une histoire fascinante qui remonte aux temps glorieux des premiers levés géologiques dans les Alpes occidentales au XIXème siècle. D’abord utilisé pour décrire principalement les serpentinites, le terme ophiolite a progressivement évolué pour désigner une association géologique de terrain comprenant des péridotites, des gabbros et des radiolarites dont on a perçu très tôt leur origine marine profonde. Le terme ophiolite a mis beau-coup de temps avant d’être introduit dans la littérature nord-américaine pour cause de mésentente idéologique entre les géologues de terrain, les expérimentalistes et les géologues marins. La croissance rapide des données marines qui ont conduit à l’énoncé de la théorie des plaques a permis de replacer géodynamiquement cet ensemble lithologique auquel on a associé depuis les laves en coussins, les complexes filoniens, les sédiments abyssaux et autres lithologies métamorphiques dérivées. Il devenait clair à partir de 1957 que les péridotites basales originaient du manteau. La partie crustale supérieure des ophiolites équivalait à une séquence se formant selon les règles de la cristallisation fractionnée énoncées par Bowen et surmontée de laves sous-marines elles-mêmes coiffées de sédiments abyssaux. C’est la stratigraphie de type Penrose définie en 1972. Depuis, les nombreux travaux de recherche sur les ophiolites ont montré que ces séquences étaient transportées appuyant du même coup la théorie de la tectonique des plaques et le fameux cycle de Wilson. Les ophiolites sont toujours sujettes à controverses quant à leur signification géodynamique. Proviennent-elles de grands bassins océaniques et formées en contexte de dorsales en expansion ou bien, de bassins plus restreints en marge des continents où des dispositifs en expansion comme les avant-arcs, les arcs et les bassins arrière-arcs peuvent générer une stratigraphie de type Penrose et expliquer leur complexe composition géochimique? Cette vision plus large de la formation des ophiolites a permis que les ophiolites soient reconnues dans des ensembles lithologiques de plus en plus anciens du Protérozoïque supérieur puis progressivement jusqu’à l’Archéen. Les séquences plus anciennes que 1 Ga sont distinctes en ce qui a trait à leur stratigraphie interne et leur composition géochimique. La signification de ces différences fait l’objet d’un débat contemporain. Les séries ophiolitiques précambriennes pour-raient nous en apprendre beaucoup sur les mécanismes et le fonctionnement des premières parties mobiles terrestres

Monitoring the degree of implementation of an integrated delivery system

INTRODUCTION: The aim of the study was to develop a method to measure the implementation of specific components of an Integrated Service Delivery system for the frail elderly. The system includes six mechanisms and tools: (1) coordination of all organizations involved in delivering health and social services, (2) a single entry point, (3) case management, (4) a single assessment tool with a case-mix classification system, (5) an individualized service plan, and (6) a computerized clinical chart. METHOD: Focus groups of researchers, clinicians, managers and policy-makers identified quantitative indicators for each component. The six components were weighted according to their relative importance in order to generate a total score. Data were collected every six months over 30 months to establish the implementation degree in the three experimental areas: Sherbrooke, Granit and Coaticook in the Province of Quebec, Canada. RESULTS: After 30 months, coordination is the most developed component in the three experimental areas. Overall, in July 2003, the Integrated Service Delivery system was implemented at the rate of 73%, 71% and 70% in Sherbrooke, Granit and Coaticook, respectively. DISCUSSION: This type of quantitative assessment provides data for managers and researchers to monitor the implementation. Moreover, when there is an outcome study, the results of the outcome study can be correlated with the degree of implementation, thus allowing for dose-response analyzes and helping to decrease the “black box” effect

PRISMA: a new model of integrated service delivery for the frail older people in Canada

PURPOSE: PRISMA is an innovative co-ordination-type Integrated Service Delivery System developed to improve continuity and increase the efficacy and efficiency of services, especially for older and disabled populations. DESCRIPTION: The mechanisms and tools developed and implemented by PRISMA include: (1) co-ordination between decision-makers and managers, (2) a single entry point, (3) a case management process, (4) individualised service plans, (5) a single assessment instrument based on the clients' functional autonomy, and (6) a computerised clinical chart for communicating between institutions for client monitoring purposes. PRELIMINARY RESULTS: The efficacy of this model has been tested in a pilot project that showed a decreased incidence of functional decline, a decreased burden for caregivers and a smaller proportion of older people wishing to be institutionalised. CONCLUSION: The on-going implementation and effectiveness study will show evidence of its real value and its impact on clienteles and cost

The effectiveness of the PRISMA integrated service delivery network: preliminary report on methods and baseline data

Purpose: The PRISMA study analyzes an innovative coordination-type integrated service delivery (ISD) system developed to improve continuity and increase the effectiveness and efficiency of services, especially for older and disabled populations. The objective of the PRISMA study is to evaluate the effectiveness of this system to improve health, empowerment and satisfaction of frail older people, modify their health and social services utilization, without increasing the burden of informal caregivers. The objective of this paper is to present the methodology and give baseline data on the study participants. <br><br> Methods: A quasi-experimental study with pre-test, multiple post-tests, and a comparison group was used to evaluate the impact of PRISMA ISD. Elders at risk of functional decline (501 experimental, 419 control) participated in the study. <br><br> Results: At entry, the two groups were comparable for most variables. Over the first year, when the implementation rate was low (32%), participants from the control group used fewer services than those from the experimental group. After the first year, no significant statistical difference was observed for functional decline and changes in the other outcome variables. <br><br> Conclusion: This first year must be considered a baseline year, showing the situation without significant implementation of PRISMA ISD systems. Results for the following years will have to be examined with consideration of these baseline results

The individualized service plan as a clinical integration tool: qualitative analysis in the Quebec PRISMA experiment

Introduction: One aspect of clinical integration involves case managers' tools and particularly the individualized service plan. Methods: We examined individualized service plan content and use in the PRISMA experiment. We analyzed 50 charts, and conducted and recorded interviews regarding individualized service plan use with all the case managers concerned (n=13). Results: Delays between starting case management and writing the individualized service plan were long and varied (0–596 days, mean: 117 days). During the interviews, the individualized service plan was described as the ‘last step’ once the active planning phase was over. The reasons for formulating plans were mainly administrative. From a clinical viewpoint, individualized service plans were used as memoranda and not to describe services (842 interventions not mentioned in the plans) or needs (694 active problems not mentioned). Case managers felt uncomfortable with the individualized planning task and expected a tool more adapted to their needs. Conclusion: Although a majority of the case managers' charts contained an individualized service plan, implementation of this tool seems tenuous. Because of the discrepancy between the potential usefulness expected by case managers and their actual use, a working committee was created to develop proposals for modifying the instrument

Développement d’un cours francophone en ligne sur les politiques publiques en santé : une collaboration internationale

Objectif : Présenter le processus et les défis du développement d’un cours en ligne sur les politiques publiques en santé, conçu en collaboration internationale selon une approche par compétences. Méthodes : Cinq experts de santé publique épaulés d’un expert en technologie éducative onttravaillé à l’élaboration du cours en adoptant une démarche rigoureuse : analyse des besoins, élaboration des cibles et des compétences visées, développement d’un scénario pédagogique comportant pour chaque module la cible visée, les éléments de contenu, la méthode d’enseignement, les activités d’apprentissage, le matériel à identifier ou à développer et les responsabilités et tâches impliquées. Résultats : Le cours d’études supérieures de deux crédits (90 heures de travail) comprend six modules dont un module d’intégration. Les modules débutent pardes étudesde cas variées : loi sur le tabac (paquet neutre), sites d’injection supervisée, logement, réseaux intégrés de services pour personnes âgées en perte d’autonomie, programme de prévention pour les futures mères en milieux défavorisés, port obligatoire du casque de vélo. Les modules 1, 3, 4 et 5 visent l’apprentissage des différentes étapes du développement des politiques publiques : émergence, formulation et adoption, mise en œuvre et évaluation. Le module 2 porte sur l’importance des valeurs et des idéologies dans les politiques publiques. Le module d’intégration permet aux étudiants d’appliquer les connaissances acquises et aborde le rôle des expertsdans lespolitiquespubliques etles considérations éthiques. Conclusion : Le cours est intégré aux programmes d’études supérieures des universités participantes et permet à des étudiants de suivre à distance une formation innovante.Objective: To present the process and challenges of developing an online competency-based course on public health policy using a collaborative international approach. methods: Five public health experts, supported by an expert in educational technology, adopted a rigorous approach to the development of the course: a needs analysis, identification of objectives and competencies, development of a pedagogical scenario for each module and target, choice of teaching methods and learning activities, materialto be identified or developed, and the responsibilities and tasks involved. results: The 2-credit (90-hour) graduate course consists of six modules including an integration module. The modules start with a variety of case studies: tobacco law (neutral packaging), supervised injection sites, housing, integrated servicesfor the frail elderly, a prevention programme for mothersfrom disadvantaged backgrounds, and the obligatory use of bicycle helmets. In modules 1, 3, 4 and 5, students learn about different stages of the public policy development process: emergence, formulation and adoption, implementation and evaluation. Module 2 focuses on the importance of values and ideologies in public policy. The integration module allows the students to apply the knowledge learned and addresses the role of experts in public policy and ethical considerations. Conclusion: The course has been integrated into the graduate programmes of the participating universities and allows students to follow, at a distance, an innovative training programme