Quantity, Quality, and Relevance: Central Bank Research, 1990-2003

The authors document the research output of 34 central banks from 1990 to 2003, and use proxies of research inputs to measure the research productivity of central banks over this period. Results are obtained with and without controlling for quality and for policy relevance. The authors find that, overall, central banks have been hiring more researchers and publishing more research since 1990, with the United States accounting for more than half of all published central bank research output, although the European Central Bank is rapidly establishing itself as an important research centre. When controlling for research quality and relevance, the authors generally find that there is no clear relationship between the size of an institution and its productivity. They also find preliminary evidence of positive correlations between the policy relevance and the scientific quality of central bank research. There is only very weak evidence of a positive correlation between the quantity of external partnerships and the productivity of researchers in central banks.Central bank research

Les effets juridiques de l'urgence sur la responsabilité médicale et hospitalière

Notre analyse des règles de droit référant à la notion d’urgence nous a permis de constater que l’urgence constitue en responsabilité médicale et hospitalière un régime sui generis soumis à ses propres règles lesquelles ont un caractère dérogatoire aux règles généralement applicables en d’autres circonstances. À défaut de définition claire de la notion d’urgence dans la législation, nous consacrons notre premier chapitre à la définition que doit recevoir l’urgence en responsabilité médicale et hospitalière (chapitre 1). Nous analyserons ensuite l’impact des situations d’urgence en responsabilité médicale et hospitalière qui comporte quatre (4) effets juridiques, dont plus particulièrement: l’obligation d’agir (chapitre 2), l’atténuation de l’obligation d’obtenir un consentement (chapitre 3) ; les écarts aux règles d’exécution de soins (chapitre 4) et l’atténuation de l’obligation de confidentialité (chapitre 5).Abstract : Based on my analysis of the legal rules regarding the notion of "emergency", I have concluded that emergencies constitute a sui generis regime in medical and hospital liability. This regime is governed by its own set of rules that derogate from the rules that generally apply in other circumstances. Given the lack of a clear legislative definition of "emergency", I have devoted my first chapter to defining this concept in medical and hospital liability (Chapter 1). The subsequent chapters contain an analysis of the four (4) effects of emergency situations in medical and hospital liability: the duty to act (Chapter 2), the relaxation of the rules regarding consent (Chapter 3), deviations from the rules regarding treatment (Chapter 4) and the relaxation of the rules regarding confidentiality (Chapter 5)

Caractérisation de la toxicocinétique des trihalométhanes et des acides chloroacétiques administrés sous forme de mélanges chez le rat

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal

A physician-physiotherapist collaborative model in a family medicine teaching clinic

Persons with musculoskeletal disorders frequently seek care in family medicine clinics. However, musculoskeletal education provided in medical schools is often considered insufficient. The implementation of a collaborative model that integrates physiotherapists into teaching clinics may benefit the musculoskeletal training of medical residents. This paper describes a model developed in a family medicine teaching clinic by examining the interprofessional educational and collaborative activities implemented in this model. The model allowed to provide physiotherapy services, involve the physiotherapist in the training of family medicine residents and enhance interprofessional collaboration, particularly for the management of persons with musculoskeletal disorders._____Les personnes ayant des troubles musculosquelettiques consultent fréquemment en cliniques de médecine de famille. Cependant, l’enseignement musculosquelettique dispensé dans les programmes de médecine est souvent considéré comme insuffisant. L’implantation d’un modèle de collaboration qui intègre les physiothérapeutes aux cliniques d’enseignement pourrait améliorer la formation des médecins résidents. Cet article décrit un modèle développé dans une clinique d’enseignement en médecine familiale en examinant les activités interprofessionnelles d’éducation et de collaboration implantées dans ce modèle. Le modèle a permis d’offrir des services de physiothérapie, d’impliquer le physiothérapeute dans la formation des médecins résidents et d’améliorer la collaboration interprofessionnelle, particulièrement pour la prise en charge des personnes ayant des troubles musculosquelettiques

Supporting early academic family medicine careers with the clinician scholar enhanced-skills program

Context: The Clinician Scholar Program (CSP) is an enhanced-skills (R3) residency program to train clinician researchers/educators/leaders for academic family practice. This article intends to share Laval University’s CSP development and evaluation strategy, and provide recommendations for similar innovations in other disciplines/settings. Methods This article uses Kern’s model to present the program development, and a program-oriented approach for program evaluation, carried from 2011 to 2017 using descriptive data. Questionnaires, reflexive texts and an Objective Structured Teaching Exam supported data collection. Results 7 CSP graduates and 14 controls participated in the program evaluation. Residents were highly satisfied with the program, nevertheless suggested allowing training later in career. The CSP enriched knowledge, skills and attitudes about academic practice. CSP increased residents’ entrustment level about academic competencies. All graduates joined an academic practice within five years of program completion. Conclusions Key recommendations to implement similar programs include academic medicine core training, project-based learning with learner-centered objectives, relevant and authentic learning and assessment, and multi-level program evaluation approach. Programs should consider concomitant graduate studies and opportunity to offer such training after a few years of clinical practice to meet other needs at a timely stage of career

Gouvernance des clubs de football professionnels : Entre régulation et contrainte budgétaire

En analysant le comportement individuel des clubs, cette contribution en propose une typologie fondée sur leur niveau de contrainte budgétaire, induite par la capacité de leurs actionnaires à financer les pertes réalisées. Il est ainsi possible de conclure que seul un très petit nombre de clubs évoluent dans le cadre d’une contrainte budgétaire « lâche » (CBL) caractéristique d’une « mauvaise » gouvernance (Andreff, 2009). Cette recherche permet aussi de montrer que les clubs adaptent leur comportement aux exigences de la régulation sectorielle auxquels ils sont soumis, transférant de fait à cette dernière, une part de responsabilité dans la gouvernance de ces organisations. By analysing clubs’ individual behaviour, this research suggests a typology based on their level of budget constraint, induced by the capacity of their shareholders to fund losses. It is thus possible to conclude that only a very small number of clubs operate under a “soft” budget constraint (SBC) characterising a “bad” governance (Andreff, 2009). This research also enables to show that clubs adapt their behaviour to the requirements of the sectorial regulation that applies to them, transferring to the latter a share of responsibility in the governance of these organisations

Severe Asthma Standard-of-Care Background Medication Reduction With Benralizumab: ANDHI in Practice Substudy

Background: The phase IIIb, randomized, parallel-group, placebo-controlled ANDHI double-blind (DB) study extended understanding of the efficacy of benralizumab for patients with severe eosinophilic asthma. Patients from ANDHI DB could join the 56-week ANDHI in Practice (IP) single-arm, open-label extension substudy. Objective: Assess potential for standard-of-care background medication reductions while maintaining asthma control with benralizumab. Methods: Following ANDHI DB completion, eligible adults were enrolled in ANDHI IP. After an 8-week run-in with benralizumab, there were 5 visits to potentially reduce background asthma medications for patients achieving and maintaining protocol-defined asthma control with benralizumab. Main outcome measures for non-oral corticosteroid (OCS)-dependent patients were the proportions with at least 1 background medication reduction (ie, lower inhaled corticosteroid dose, background medication discontinuation) and the number of adapted Global Initiative for Asthma (GINA) step reductions at end of treatment (EOT). Main outcomes for OCS-dependent patients were reductions in daily OCS dosage and proportion achieving OCS dosage of 5 mg or lower at EOT. Results: For non-OCS-dependent patients, 53.3% (n = 208 of 390) achieved at least 1 background medication reduction, increasing to 72.6% (n = 130 of 179) for patients who maintained protocol-defined asthma control at EOT. A total of 41.9% (n = 163 of 389) achieved at least 1 adapted GINA step reduction, increasing to 61.8% (n = 110 of 178) for patients with protocol-defined EOT asthma control. At ANDHI IP baseline, OCS dosages were 5 mg or lower for 40.4% (n = 40 of 99) of OCS-dependent patients. Of OCS-dependent patients, 50.5% (n = 50 of 99) eliminated OCS and 74.7% (n = 74 of 99) achieved dosages of 5 mg or lower at EOT. Conclusions: These findings demonstrate benralizumab's ability to improve asthma control, thereby allowing background medication reduction

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms