Les jeux en ligne dans le marché intérieur : Les effets sur les politiques nationales et les stratégies des entreprises des libertés d'établissement et de prestation de services

peer reviewe

Using and Reporting the Delphi Method for Selecting Healthcare Quality Indicators: A Systematic Review

OBJECTIVE: Delphi technique is a structured process commonly used to developed healthcare quality indicators, but there is a little recommendation for researchers who wish to use it. This study aimed 1) to describe reporting of the Delphi method to develop quality indicators, 2) to discuss specific methodological skills for quality indicators selection 3) to give guidance about this practice. METHODOLOGY AND MAIN FINDING: Three electronic data bases were searched over a 30 years period (1978-2009). All articles that used the Delphi method to select quality indicators were identified. A standardized data extraction form was developed. Four domains (questionnaire preparation, expert panel, progress of the survey and Delphi results) were assessed. Of 80 included studies, quality of reporting varied significantly between items (9% for year's number of experience of the experts to 98% for the type of Delphi used). Reporting of methodological aspects needed to evaluate the reliability of the survey was insufficient: only 39% (31/80) of studies reported response rates for all rounds, 60% (48/80) that feedback was given between rounds, 77% (62/80) the method used to achieve consensus and 57% (48/80) listed quality indicators selected at the end of the survey. A modified Delphi procedure was used in 49/78 (63%) with a physical meeting of the panel members, usually between Delphi rounds. Median number of panel members was 17(Q1:11; Q3:31). In 40/70 (57%) studies, the panel included multiple stakeholders, who were healthcare professionals in 95% (38/40) of cases. Among 75 studies describing criteria to select quality indicators, 28 (37%) used validity and 17(23%) feasibility. CONCLUSION: The use and reporting of the Delphi method for quality indicators selection need to be improved. We provide some guidance to the investigators to improve the using and reporting of the method in future surveys

Catch-Up Growth Following Fetal Growth Restriction Promotes Rapid Restoration of Fat Mass but Without Metabolic Consequences at One Year of Age

BACKGROUND: Fetal growth restriction (FGR) followed by rapid weight gain during early life has been suggested to be the initial sequence promoting central adiposity and insulin resistance. However, the link between fetal and early postnatal growth and the associated anthropometric and metabolic changes have been poorly studied. METHODOLOGY/PRINCIPAL FINDINGS: Over the first year of post-natal life, changes in body mass index, skinfold thickness and hormonal concentrations were prospectively monitored in 94 infants in whom the fetal growth velocity had previously been measured using a repeated standardized procedure of ultrasound fetal measurements. 45 infants, thinner at birth, had experienced previous FGR (FGR+) regardless of birth weight. Growth pattern in the first four months of life was characterized by greater change in BMI z-score in FGR+ (+1.26+/-1.2 vs +0.58 +/-1.17 SD in FGR-) resulting in the restoration of BMI and of fat mass to values similar to FGR-, independently of caloric intakes. Growth velocity after 4 months was similar and BMI z-score and fat mass remained similar at 12 months of age. At both time-points, fetal growth velocity was an independent predictor of fat mass in FGR+. At one year, fasting insulin levels were not different but leptin was significantly higher in the FGR+ (4.43+/-1.41 vs 2.63+/-1 ng/ml in FGR-). CONCLUSION: Early catch-up growth is related to the fetal growth pattern itself, irrespective of birth weight, and is associated with higher insulin sensitivity and lower leptin levels after birth. Catch-up growth promotes the restoration of body size and fat stores without detrimental consequences at one year of age on body composition or metabolic profile. The higher leptin concentration at one year may reflect a positive energy balance in children who previously faced fetal growth restriction

Understanding and preventing recurring errors in strategic decision processes : a Behavioral Strategy approach

Les erreurs récurrentes et systématiques dans les processus de décision stratégique sont fréquentes ; et les théories actuelles des organisations sont insuffisantes pour les expliquer. La « Behavioral Strategy » suggère de lier ces erreurs à la psychologie des décideurs, et notamment à leurs biais cognitifs. Toutefois, cette vision suppose de connecter le niveau d’analyse de l’individu et celui de l’organisation. Nous proposons pour ce faire un niveau « méso », la routine de choix stratégique (RCS), où interagissent la psychologie des décideurs et les décisions stratégiques. Après avoir distingué trois types de RCS, nous formulons des hypothèses d’intervention sur celles-ci visant à prévenir les erreurs stratégiques. Nous illustrons ces hypothèses par six cas pratiques, en testons certaines par une étude quantitative, et analysons les préférences qui conduisent les dirigeants à les adopter ou non. Nous concluons en discutant les implications théoriques et pratiques de notre démarche.Many types of strategic decisions result in recurring, systematic errors. Extant theories of organizations are insufficient to account for this phenomenon. Behavioral Strategy suggests that an explanation may be found in the psychology of decision makers, and particularly in their cognitive biases. This, however, calls for a link between individual-level cognition and affects, and organization-level choices. We propose “Strategic Choice Routines” as a middle level of analysis to bridge this gap, and identify three broad types of Strategic Choice Routines.This leads us to formulate hypotheses on how Strategic Choice Routines can be modified to minimize strategic errors. We illustrate these hypotheses through case studies; test some of them quantitatively; and analyze preferences that drive their adoption by executives. Finally, we discuss theoretical and managerial implications

Comprendre et prévenir l’erreur récurrente dans les processus de décision stratégique : l’apport de la Behavioral Strategy

Many types of strategic decisions result in recurring, systematic errors. Extant theories of organizations are insufficient to account for this phenomenon. Behavioral Strategy suggests that an explanation may be found in the psychology of decision makers, and particularly in their cognitive biases. This, however, calls for a link between individual-level cognition and affects, and organization-level choices. We propose “Strategic Choice Routines” as a middle level of analysis to bridge this gap, and identify three broad types of Strategic Choice Routines.This leads us to formulate hypotheses on how Strategic Choice Routines can be modified to minimize strategic errors. We illustrate these hypotheses through case studies; test some of them quantitatively; and analyze preferences that drive their adoption by executives. Finally, we discuss theoretical and managerial implications.Les erreurs récurrentes et systématiques dans les processus de décision stratégique sont fréquentes ; et les théories actuelles des organisations sont insuffisantes pour les expliquer. La « Behavioral Strategy » suggère de lier ces erreurs à la psychologie des décideurs, et notamment à leurs biais cognitifs. Toutefois, cette vision suppose de connecter le niveau d’analyse de l’individu et celui de l’organisation. Nous proposons pour ce faire un niveau « méso », la routine de choix stratégique (RCS), où interagissent la psychologie des décideurs et les décisions stratégiques. Après avoir distingué trois types de RCS, nous formulons des hypothèses d’intervention sur celles-ci visant à prévenir les erreurs stratégiques. Nous illustrons ces hypothèses par six cas pratiques, en testons certaines par une étude quantitative, et analysons les préférences qui conduisent les dirigeants à les adopter ou non. Nous concluons en discutant les implications théoriques et pratiques de notre démarche

You're about to make a terrible mistake!: how biases distort decision-making and what you can do to fight them

A practical, lively, and research-based tour of nine common business decision-making traps - and tools for avoiding them - from a professor of strategic thinking

Information de la femme enceinte dans la pratique de la médecine générale

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Hémorragies graves du post-partum (expérience à la maternité de l'Hôpital Robert Debré entre 1992 et 1998)

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

L' Accouchement par le siège, expérience de la maternité universitaire de l'hôpital Robert Debré à propos de 752 patientes

PARIS5-BU Méd.Cochin (751142101) / SudocPARIS-BIUM (751062103) / SudocCentre Technique Livre Ens. Sup. (774682301) / SudocSudocFranceF

Mode et terme optimal d accouchement des grossesses gémellaires bichoriales biamniotiques (revue de la littérature et étude rétrospective à l hôpital Robert Debré)

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF