Yves Couturier

Analysis of case management programs for patients with dementia: A systematic review

People suffering from dementia are particularly vulnerable to the gaps between the health and social service systems. Case management is a professional field that seeks to fill in these gaps and remedy this fragmentation.

Biodegradation study of a starch and poly(lactic acid) co-extruded material in liquid, composting and inert mineral media

Abstract The biodegradation of a co-extruded starch/poly(lactic acid) polymeric film was studied in liquid, inert solid and composting media. Main mechanical properties of this film were Youngs modulus: 2340 MPa , elongation at break: 50%, contact angle: 118°. Mineralization of the materials carbon content was followed using the appropriate experimental methods of the International Standard Organisation. Whatever be the biodegradation medium used, the percentage of mineralization was better than the required 60% value for the definition of a biodegradable material. Moreover, repartitioning of the materials carbon between the various degradation products produced was quantified throughout the duration of experimental runs. The presence of starch was found to facilitate biodegradation of the polylactic component, especially in liquid media.

The interdisciplinary condition of work in relational professions of the health and social care field: a theoretical standpoint.

The best-known theories on interdisciplinarity in the health and social care field seek to identify personal characteristics and organizational predispositions favourable to interprofessionnal collaboration. This paper proposes a reversal of this positioning through the theorization of interdisciplinarity in the health and social care field as a condition of the work of its professionals rather than one of their peculiar attributes. To achieve this reversal, we set out the epistemological foundations of the current debate on interdisciplinarity.

Enzymatic degradation and deacetylation of native and acetylated starch-based extruded blends

Blends including natural starch and acetylated starch (with a substitution degree of 1.5) have been extruded to obtain an innovative packaging material. The influence of extrusion on the biodegradability of the blends was studied for several acetylated-to-raw starch ratios, by colourimetry (measure of reducing sugars) and chromatographic analysis (determination of the amounts of degradation products). The action of a single α-amylase (Termamyl LS 120 from Bacillus licheniformis) solely led to the degradation of unmodified parts of the starch. In order to increase the biodegradation rate of starch, the hydrolysis of acetylated groups was performed thanks to various acetyleterases, one coming from Sigma and the other one originating from the viscozyme. These acetylesterases will be refered to as Sigma acetylesterase (Sac) and Viscozyme acetylesterase (Vac), respectively. For identical percentages of ethanoic acid released, it appears that the biodegradation obtained after action of the α-amylase is more pronounced when the Sigma acetylesterase was utilized in a first step, because the biodegradation rate increased from 10 to 15%. The main degradation products are dp2 and dp5. Thus, the present work presents the degradation behaviour of a new packaging material, even at high acetylation value, provided the acetylesterase employed leads to a deacetylation compatible with the α-amylase.

Comparative Biodegradation Study of Starch- and Polylactic Acid-Based Materials

The degradation of starch- and polylactic acid-based plastic films by microorganisms extracted from compost was studied in a liquid medium. The various degradation products produced were measured throughout the duration of the experiment, and total carbon balances were estimated. For an easily biodegradable material, the evolution of the way carbon repartitioned between different degradation products was quite similar whatever the experimental condition or the type of substrate. On the other hand, for a resistant material exposed to these microorganisms, the nature of the biodegradation depended strongly on the experimental conditions. In the latter case, a differential scanning calorimetry analysis confirmed the importance of the applied norm on the state of the residual material. The consequences for improved methods of estimation of biodegradability of these materials are discussed.

Schools’ capacity to absorb a Healthy School approach into their operations: Insights from a realist evaluation

Purpose – The purpose of this paper is to understand how a Canadian intervention based on a professional development (PD) model did or did not influence schools’ capacities to absorb a Healthy School (HS) approach into their operations. This study is the second part of a research project: previously published results regarding this research provided a detailed description of the PD model and highlighted the relevance and effectiveness of PD in improving actors’ HS-related knowledge and practices. The present paper focuses on the organizational impact of such PD intervention. Design/methodology/approach – The design was based on a realist evaluation approach, which helps to elicit a theory explaining how an intervention leads to particular outcomes. A multi-site case study of three schools with pre- (T 0) and post- (T 1) intervention comparison was adopted. Multiple qualitative methods were used to capture how the changes were achieved by collecting data from various stakeholders involved in the interventi...

Comparison of mineralization of starch in liquid, inert solid and compost media according to ASTM and CEN norms for the composting of packaging materials

Mineralization percentages of ground starch-based films are similar (68–72%), whatever the degradation medium and the norm used, with standard deviations less than 8%. Vermiculite, an inert solid medium, shows an intermediary behaviour, between liquid and compost media. Consequently, this support is suitable for further degradation studies, including the determination of carbon balances.

Explaining the success or failure of quality improvement initiatives in long-term care organizations from a dynamic perspective.

The purpose of this study was to better understand why change initiatives succeed or fail in long-term care organizations. Four case studies from Québec, Canada were contrasted retrospectively. A constipation and restraints program succeeded, while an incontinence and falls program failed. Successful programs were distinguished by the use of a change strategy that combined “let-it happen,” “help-it happen,” and “make-it happen” interventions to create senses of urgency, solidarity, intensity, and accumulation. These four active ingredients of the successful change strategies propelled their respective change processes forward to completion. This paper provides concrete examples of successful and unsuccessful combinations of “let-it happen,” “help-it happen,” and “make-it happen” change management interventions. Change managers (CM) can draw upon these examples to best tailor and energize change management strategies in their own organizations.

Aerobic Biodegradation of Extruded Polymer Blends with Native Starch as Major Component

The aerobic biodegradation of extruded blends containing native starch and an acetylated compound (starch or cellulose) was studied with the Bacillus amyloliquefaciens strain and also with the Biolen mixture known for its amylolytic activity. In the presented experiments, the rate of biodegradation is related to the percentage of acetylated compound in the blend. In fact, if the blend hydrolysis is facilitated by the amorphous state of the substrate, the inhibitory action of the acetyl group content is the major factor responsible of the weak hydrolysis. For instance, the conversion of the carbon material into CO 2 decreases strongly from 39% (native starch alone) to 7% (equimolar blend of starch and acetylated compound). All the other parameters used to estimate the hydrolysis extent (as the production of reducing sugars or acetic acid release) lead to the same conclusion.

Implementing Community Based Primary Healthcare for Older Adults with Complex Needs in Quebec, Ontario and New-Zealand: Describing Nine Cases

The aim of this paper is to set the foundation for subsequent empirical studies of the “Implementing models of primary care for older adults with complex needs” project, by introducing and presenting a brief descriptive comparison of the nine case studies in Quebec, Ontario and New Zealand. Each case is described based on key dimensions of Rainbow model of Valentijn and al (2013) with a focus on “meso level” integration. Meso level integration is represented by organizational and professional elements of the Rainbow Model, which are of particular interest in our nine case studies. Each of the three cases in Ontario and three in New Zealand are different and described separately. In Quebec, a local health services network model is presented across the three cases studied with variations in the way it is implemented. The three cases selected in the three jurisdictions under study were not chosen to be representative of wider practice within each country, but rather represent interesting and unique models of community-based primary healthcare integration. Similarities and variations in the integrated care models, context and dimension of integration offer insights regarding core component of integration of services, offering a foundational understanding of the cases on which future analysis will be based.