Search

Faced with territorial reorganization and increased competition between territories, rural towns appear particularly weakened. We question their ability to rebound and the importance of certain local resources for the return of productive economic activities. Based on the qualitative analysis of a project for the transformation of organic agri-food products, a private initiative project which "landed" in a small rural town in Vienne, we verify the advantages of the small rural town and confirm the importance land resources (at low cost and quality) and the immediate physical proximity between the actors in the emergence of activities in these territories. We also underline their insufficient nature, the construction of a proximity necessary for good governance and a territorial anchoring of the project appearing essential.

This paper aims to understand the dynamics of a scientific network of researchers by observing their individual publishing activity. Empirically, we propose to reconstruct the personal network of five emeritus chemists attached to the University of Poitiers and to identify the moments when their relations with a co-author emerge and when those relations are weakened or strengthened. This exploratory and comprehensive study is based on an original methodology combining quantitative and qualitative materials: while publication data provide exhaustive information on the researchers’ co-authorship, CVs and semi-structured interviews with the protagonists allow for a detailed analysis of the dynamics of their relations as their careers unfold.

The covid-19 crisis highlighted the weaknesses of the French food system to supply food to the consumers during the lockdown. The article questions the regulatory crisis in the agri-food sector through the issue of food and proximate short food supply chains (PSFSC). From an institutionalist perspective when analyzing the link between crises and innovation, this crisis can be seen as a driver for change in the way the food system is regulated, by providing a favorable context for practices that offer alternatives. Starting from the identification of the multiple initiatives developed during the lockdown, we present a first analysis of the potential changes in the food system relative to the crisis, in particular by questioning their sustainability. The potential for transformation of the food system most often highlighted by standard economic literature is a matter of consumer choice. However, the high degree of interest for local products does not seem to be continuing. We defend here the following thesis: one should rather look at the supply side and its institutional structures to understand the main obstacles to the transformation of the food system after the crisis. CCPs can be quickly envisioned as short-term solutions to crises in the agri-food sector, but instead we propose to shift the issue to the potential for transformation of the food system by PSFSCs. We are thus highlighting a series of issues that could be the subject for future research to better understand the processes of reconfiguration of the food system.

If the researches about short food supply chain give interesting knowledge, the empirical validation of their durability is even necessary given the lack of available data on the subject. The paper seeks to contribute to this literature by providing a unique methodological framework based on a mixed-method analysis to apprehend the three pillars of sustainable development, taking into account its systemic nature. This framework is then tested empirically over twenty farms in short circuits: the combination of the collection of materials both quantitative and qualitative allows us to qualify and to give precisions about the sustainability of short circuits.

Abstract Background Remote Patient Monitoring Systems (RPMS) based on e-health, Nurse Navigators (NNs) and patient engagement can improve patient follow-up and have a positive impact on quality of care (by limiting adverse events) and costs (by reducing readmissions). However, the extent of this impact depends on effective implementation which is often restricted. This is partly due to the lack of attention paid to the RPMS design phase prior to implementation. The content of the RPMS can be carefully designed at this stage and various obstacles anticipated. Our aim was to report on an RPMS design case to provide insights into the methodology required in order to manage this phase. Methods This study was carried out at Gustave Roussy, a comprehensive cancer centre, in France. A multidisciplinary team coordinated the CAPRI RPMS design process (2013–2015) that later produced positive outcomes. Data were collected during eight studies conducted according to the Medical Research Council (MRC) framework. This project was approved by the French National Data Protection Authorities. Results Based on the study results, the multidisciplinary team defined strategies for resolving obstacles prior to the implementation of CAPRI. Consequently, the final CAPRI design includes a web app with two interfaces (patient and health care professionals) and two NNs. The NNs provide regular follow-up via telephone or email to manage patients’ symptoms and toxicity, treatment compliance and care packages. Patients contact the NNs via a secure messaging system. Eighty clinical decision support tools enable NNs to prioritise and decide on the course of action to be taken. Conclusion In our experience, the RPMS design process and, more generally, that of any complex intervention programme, is an important phase that requires a sound methodological basis. This study is also consistent with the notion that an RPMS is more than a technological innovation. This is indeed an organizational innovation, and principles identified during the design phase can help in the effective use of a RPMS (e.g. locating NNs if possible within the care organization; recruiting NNs with clinical and managerial skills; defining algorithms for clinical decision support tools for assessment, but also for patient decision and orientation).

CONTEXT:The strategy of publicly reporting quality indicators is being widely promoted through public policies as a way to make health care delivery more efficient. OBJECTIVE:To assess general practitioners' (GPs) use of the comparative hospital quality indicators made available by public services and the media, as well as GPs' perceptions of their qualities and usefulness. METHOD:A telephone survey of a random sample representing all self-employed GPs in private practice in France. RESULTS:A large majority (84.1%-88.5%) of respondents (n = 503; response rate of 56%) reported that they never used public comparative indicators, available in the mass media or on government and non-government Internet sites, to influence their patients' hospital choices. The vast majority of GPs rely mostly on traditional sources of information when choosing a hospital. At the same time, this study highlights favourable opinions shared by a large proportion of GPs regarding several aspects of hospital quality indicators, such as their good qualities and usefulness for other purposes. In sum, the results show that GPs make very limited use of hospital quality indicators based on a consumer choice paradigm but, at the same time, see them as useful in ways corresponding more to the usual professional paradigms, including as a means to improve quality of care.