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The issue of local practices to survive developed by local communities living around protected areas in the Democratic Republic of Congo is based on two different logics that are irreconcilable. In the first case, the country is pursuing a nature conservation policy without ensuring a minimum of attention for local development. In the second case, the lack of alternative economic activities to survive leads local communities to have to exploit natural resources. This study analyses the survival activities of local communities living around the Man and the Biosphere Reserve of Yangambi, as a response to the failure of the State. The analysis is based on the triangulation of data sources from focus group discussions, historical archives and semi-structured interviews. The investigations reveal a wide range of activities including agriculture, fishing, hunting, mining, forestry and the exploitation of other non-timber forest products. The gains of local community development initiatives from the late colonial Belgian Congo period were not consolidated by the postcolonial State which abandoned them due to its own failures. The direct or indirect involvement of public authorities in these activities makes enforcement difficult.

Keywords: cristallisation, gouvernance, faillite de l'État, pratiques locales de survie, réserve de biosphère, Yangambi, RDC, crystallization, governance, failure of the State, practical local survival, biosphere reserve, Yangambi, DRC

This article draws on the proposals of recent academic researches regarding the relevance of a renewed reflection on the contingent specificity of the SME as an object of analysis. Using a series of eloquent empirical observations made in the field of biotechnology firms in Quebec (Canada) – namely, that most firms in this market are less than 10 years old, and 43 percent of biotech firms have less than 10 employees – as its starting point, this article attempts to answer the following research question : Do biotechnology VSEs constitute a separate species and/or are they unique of their kind, resembling the “organized” type of very small enterprises evoked by Marchesnay (2003) ?This article is organized in three parts. In the first, the authors propose a theoretical framework that attempts to identify VSEs according to “what they do.” This section is based mainly on a review of the literature on the contemporary criteria used to define small enterprises and on the concept of the business model. Secondly, the authors outline the methodology of multi-factorial analysis and cluster analysis used to observe, by induction, the different behaviours of very small enterprises in the bio-industry cluster in Quebec. They then proceed to propose a framework for the analysis of these firms' contingent specificity. This article proposes an empirical validation of the specificity of “organized”, “world-class” VSEs as well as of Torrès' argument (1997) regarding the manifestation of a significant denaturation trend, while adding previously neglected components to the continuum of prevailing criteria defining the VSE. At the methodological level, the use of the five components of a business model in the age of innovation without borders proves effective in identifying the diversity within this specificity by revealing four main types of biotechnology VSEs : discoverers, toolmakers, specialized suppliers and generic suppliers of biotechnology products and services. This empirical study thus establishes VSEs as both specific VSE-forms (in relation to the species), and as special VSE-forms (unique of their kind : the organized VSE).

Keywords: Modèles d'affaires, Biotechnologie, TPE, PME, Spécificité, Haute technologie, Gouvernance, Innovation ouverte, Réseau de valeur

The use of a self-reported measurement tool to identify emotional and behavioral problems would contribute to the valid assessment of adaptative difficulties among Indigenous children. However, without proper validation in a particular socio-cultural context, the use of psychological tests may lead to inaccurate interpretations (AERA et al., 2014). The Dominic Interactive (Valla, 2008) screens for seven common mental health problems in children and has shown promise in terms of being a valid measure for Indigenous children (Garneau et al., 2020). The psychometric properties of the Dominic Interactive are examined in 195 Innu children in Quebec. This study reports indices of temporal stability (test-retest reliability) and validity of the Dominic Interactive scale scores interpretations. Associations between test scores and other variables, such as the ASEBA-Teacher Report Form (TRF) scores (Achenbach et Rescorla, 2001), the reception of psychosocial or educational services, and child gender were examined. Results show satisfactory temporal stability for the seven Dominic Interactive scale scores among Innu children. Correlations between Dominic Interactive scale scores and ASEBA-TRF scale scores suggest that Innu children are reporting valid information about their anxious, depressed, oppositional, behavioral, and attentional symptoms. However, Dominic Interactive scores were poorly associated with the reception of psychosocial or educational services. Data suggest Innu girls participating in this study were less likely to be referred for services. Potential clinical applications of these results are discussed.

Keywords: évaluation, santé mentale, enfants, Premières Nations, qualités psychométriques, Assessment, Mental Health, Children, First Nations, Psychometrics

The emergence of pathogens in water intended for human consumption is a major concern in terms of the public health industry and the public authorities concerned. Among these pathogens, some are of faecal origin (Cryptosporidium, Campylobacter, or rotavirus), while others live in the natural environment (Legionella, Pseudomonas, Aeromonas or mycobacteria). In order to establish a risk analysis related to the presence of these pathogens, it is important to increase our knowledge on the ecology of these microorganisms and to develop analytical tools to achieve better health monitoring. Therefore, the microbial ecology of drinking water distribution networks must be studied in detail, especially with respect to the properties and physiological diversity of the microbial species present, in order to better understand the interactions between species commonly encountered and those that are pathogens.

Keywords: réseau de distribution, eau potable, écologie microbienne, biologie moléculaire, distribution network, drinking water, microbial ecology, molecular biology

In the United States, "Health Maintenance Organisations" (HMO) undertookto master the growth of the costs of the health. Numerous patients complainedabout the quality of the care under this regime and about limitations that HMOimposed on them, in particular in access to care. To the quality care issues underthis regime added the anxieties conceming patients' satisfaction. Has the formerdegraded under the regime HMO? On this subject, numerous studies compare thesatisfaction of the patients under the regime HMO to that of the patients in thetraditional System with "Fee-For-Service payment" (FFS). They also concern thevulnerable patients, such as the old or deprived persons, illustrating how difficultit is to measure of quality.

Keywords: Managed Care, HMO, patients, satisfaction, assurance, Managed Care, HMO, patients, satisfaction, insurance

The article depicts the evolution of Managed Care. A first part describes and evaluatesthe Managed Care experience in the U S. After a review of the major events thatled to Managed Care in the U.S., the paper expands on cost-control mechanisms,changes in the medical practice and their impact on patient's health. In the secondpart, the article proposes a theoretical interpretation of the development of HMOsbased on the cost transaction theory, and uses the W.H.O evaluation grid to outlinethe orientations of the U.S. health care system.

Keywords: HMO, soins gérés, mécanismes de contrôle des coûts, théorie des coûts de transaction, Managed Care, HMO, Cost-Control mechanism, cost transaction theory, Managed Care

Background: The rise in mental health- and addiction (MHA)-related emergency department (ED) visits has been recognized as a contributing factor to ED crises and increasing healthcare costs. While prior research has centred largely on patients’ perspectives, limited attention has been given to healthcare providers’ (HCPs’) insights. This study specifically explores HCPs’ perceptions of why patients with MHA issues frequently present to EDs.Methods: In this qualitative research, data collection involved semi-structured individual interviews. Thematic analysis approach was utilized in data analysis.Results: Six HCPs from diverse disciplines participated in this qualitative study. Four major themes emerged from the data analysis: (a) social determinants of mental health (a housing crisis and financial problems); (b) structural barriers (overstimulation and not a priority in ED, inadequate knowledge and training among HCPs, lack of withdrawal management facilities, stigma from HCPs, shortages of HCPs); (c) suggestions for prevention (more funding/ resources and early childhood education); and (d) HCPs’ response to working with patients (making a difference and rewarding).Conclusions: The study found that HCPs perceived low socioeconomic status and the limited availability of community mental health services and resources as key factors that contribute to frequent MHA-related ED visits. To understand the complex needs of individuals with MHA disorders better, all levels of government, community organizations, and HCPs, especially nurses, should collaborate to develop and implement effective interventions aimed at reducing frequent ED visits or returns related to MHA issues.

Keywords: Emergency department, Service des urgences, mental health and addiction, santé mentale et toxicomanie, visites fréquentes, frequent visits, prestataires de soins de santé, healthcare providers

The article surveys the history of South Asian literature and epigraphy for reliable evidence regarding the existence of early hospitals.  It explores the reasons that may account for the exclusion of South Asian data from international scholarship on the history of hospitals.  The widely-repeated idea that King Aśoka built hospitals is refuted.  Nevertheless, hospitals may be very early in India.  It is suggested that scholarly medical literature on the building and equipping of a hospital was transmitted to Baghdad in the late eighth century and influenced the construction of early Islamic hospitals.

Keywords: history of medicine, history of hospitals, South Asia, India, Sanskrit, Āyurveda