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International audience; Abstract Background Improving health system performance depends on the quality of health policy implementation at the local level. However, in general, the attention of researchers is mainly directed towards issues of health policy design and evaluation rather than implementation at the local level. The management of the COVID-19 crisis, especially in Europe, has particularly highlighted the complexity of implementing health policies, decided at the national or supranational level, at the local level. Methods We conducted 23 semi-structured interviews with the main stakeholders in the management of the COVID-19 crisis in the second largest French region in order to identify the different actors and modes of coordination of the local implementation of health policies that this crisis management illustrates in a very visible way. Our methodology is complemented by a content analysis of the main guidelines and decisions related to this implementation. Results The analysis of these data allows us to identify three levels of implementation of health policies at the local level (administrative, organizational and operational). Interviews also reveal the existence of different types of coordination specific to each of these levels of local implementation of health policies. These results then make it possible to identify important managerial avenues for promoting global coordination of these three levels of implementation. Conclusions Although research on health services emphasizes the existence of several levels of local implementation of health policies, it offers little in the way of definition or characterization of these levels. The identification in this study of the three levels of local implementation of health policies and their specific forms of coordination contribute to a more precise characterization of this implementation in order to promote, in practice, its global coordination.

International audience

International audience

BackgroundPolitical and managerial reforms affect the health sector by translating into governance tensions. As identified in the public management literature, these tensions come from the diffusion of management principles and practices from the business world. These tensions manifest at four levels: institutional, organisational, managerial and instrumental. The aim of this research is to understand how these tensions are expressed in healthcare organisations of different status.MethodsWe conduct a contrasting case study exploring the cases of two French healthcare organisations, one private for-profit (clinic) and one public not-for-profit (cancer treatment centre). Our analyses are mainly based on the content analysis of 32 semi-structured interviews conducted with staff (nurses, doctors, management and administrative staff) of these two organisations.ResultsOur results show that these tensions can be distinguished into three categories (tensions on professional values, standards and practices) which are expressed differently depending on the type of healthcare organisation and its main management characteristics.ConclusionsUnexpectedly, in the for-profit organisation, the most intense tensions concern professional standards, whereas they concern professional practices in the not-for-profit organisation. These analyses can help guide policy makers and healthcare managers to better integrate these tensions into their political and managerial decisions.

International audience

International audience

International audience

International audience; Cet article examine dans quelles mesures des pratiques de bricolage peuvent s'exprimer dans la Gestion des Ressources Humaines (GRH) des organisations. Le bricolage dans les organisations est défini comme la manière de faire face à de nouvelles problèmes ou opportunités avec les « moyens du bord ». Dans le domaine de la Gestion des Ressources Humaines (GRH), les pratiques de bricolage sont peu identifiées. Nous analysons ces pratiques de bricolage à travers l'étude de cas de la gestion de l'absentéisme de courte durée d'un Centre Hospitalier Universitaire (CHU) français, avant et pendant la crise de la Covid-19. A partir de la proposition d'un cadre d'analyse des dynamiques du bricolage dans les organisations, les résulats de cette étude identifient, dans cet établissement, pour gérer cet absentéisme, trois principales formes de bricolage (individuel, collectif familier, collectif conventionnel) et deux dynamiques d'évolution de ce bricolage (dynamiques des objectifs et de mise en oeuvre), observées durant la crise de la Covid-19.

International audience; Organisational innovation in the health sector has until now been the result of top-down approaches driven by the supervisory authorities and has mainly concerned the meso level. In a context where hospitals are under severe pressure on resources, particularly human resources, the ability of staff, particularly nurses, to produce managerial innovation is a promise and a little-explored avenue for transforming practices in these complex structures. This requires the empowerment of these staff members, who have long been relegated to the rank of simple executors. Through the analysis of the discourse of 19 hospital staff (10 nurses and 9 managers from the nursing sector) working in three French hospitals, we identify some markers of local organisational innovations and a nursing leadership that has yet to be built due to a lack of empowerment.; I L'innovation organisationnelle dans le secteur de la santé était jusqu'alors le résultat de démarches top down impulsées par les autorités de tutelle et concerne essentiellement un niveau méso. Dans un contexte où l'hôpital connait de fortes tensions sur les ressources, en particulier humaines, la capacité des personnels, en particulier infirmier, à produire une innovation managériale constitue une promesse et une voie encore peu explorée de transformation des pratiques dans ces structures complexes. Celle-ci exige un empowerment de ces personnels longtemps relégués au rang de simples exécutants. A travers l'analyse du discours de 19 personnels hospitaliers (10 infirmiers et 9 managers issus de la filière infirmière) exerçant leurs fonctions dans trois hôpitaux, nous identifions des marqueurs d'innovations organisationnelles locales et un leadership infirmier qui reste à construire faute d'un empowerment suffisant.

International audience; With highly variable types of coronavirus disease 2019 (COVID-19) symptoms in both severity and duration, there is today an important need for early, individualized, and multidisciplinary strategies of rehabilitation. Some patients present persistent affections of the respiratory function, digestive system, cardiovascular function, locomotor system, mental health, sleep, nervous system, immune system, taste, smell, metabolism, inflammation, and skin. In this context, we highlight here that hydrothermal centers should be considered today as medically and economically relevant alternatives to face the urgent need for interventions among COVID-19 patients. We raise the potential benefits of hydrotherapy programs already existing which combine alternative medicine with respiratory care, physical activity, nutritional advice, psychological support, and physiotherapy, in relaxing environments and under medical supervision. Beyond the virtues of thermal waters, many studies reported medical benefits of natural mineral waters through compressing, buoyancy, resistance, temperature changes, hydrostatic pressure, inhalations, or drinking. Thermal institutions might offer individualized follow-up helping to unclog hospitals while ensuring the continuity of health care for the different clinical manifestations of COVID-19 in both post-acute and chronic COVID-19 patients. Our present review underlines the need to further explore the medical effectiveness, clinical and territorial feasibility, and medico-economic impacts of the implementation of post-COVID-19 patient management in hydrotherapeutic establishments.

Patients' adoption of electronic health records (EHRs) varies substantially. Although some countries, such as Estonia and Denmark, are sufficiently advanced in terms of EHR generalisation, others, such as France, are figuring out how to implement and disseminate EHRs. These governments must respond to patients' disparities to achieve the expected performance for healthcare systems and improve the quality of care delivery. This study investigates patients' perceived benefits and privacy concerns related to EHRs to develop a typology of patients, identify the characteristics of different clusters and propose practical measures for public policy-makers.We conducted a cross-sectional study using online questionnaires.An online quantitative survey was carried out in France. The final sample of EHR non-users (N = 1076) was fitted to be representative of the French population by age and gender, region and socioprofessional status. Hierarchical and non-hierarchical cluster analyses were performed. Several robustness check analyses were also performed.Cluster analyses identified four patient clusters: the worried, who show the highest mean privacy concern and risk levels related to health data disclosure; the ready adopters, who lack privacy concerns and risk and are the most motivated by EHR benefits; the concerned adopters, who express far fewer privacy concerns and perceive EHR benefits more favourably than the worried adopters; and the balanced adopters, who are relatively similar to the ready adopters in their EHR motives and are still concerned about their health data, suggesting a segment that is easier to convince. Comparing clusters regarding the intentions to create EHRs and willingness to disclose health data confirms that ready adopters, followed by balanced adopters, are more likely to create an EHR and disclose health data. The concerned adopters and, finally, the worried exhibit the lowest intentions for EHR creation and data disclosure.The results provide meaningful insights into patient profiles and expectations. The findings underscore the need to implement targeting policies for each cluster and design concrete solutions for improving EHR performance.

Rationale Health digitalization raises important challenges for personal health-data management. Particularly, the advantages underlying the implementation of Electronic Health Record (EHR) remain limited in many countries due to patients’ privacy concerns. Objective Drawing on the privacy calculus theory, the objective of this research is to introduce personal health concerns and trust in healthcare providers as new predictors, beyond the constituent variables of the privacy calculus model - the perceived benefits and risk. We propose and test a conceptual model that investigates simultaneously the effects of these four variables on patients' privacy concerns and intention to share personal health-data on EHR. Method A cross-sectional study using an on online survey was administered from December 2019 to February 2020 in France to both users and non-users of EHR. A structural equation modelling was used to assess the reliability and validity of the measurement as well as to test the research hypotheses. Results The results confirm the positive effects of personal health concerns and trust in healthcare providers on (a) the intention to create an EHR and (b) to share personal health-data. In the same vein, we do not find any significant effect of patients' privacy concerns on the intention to create an EHR and intention to share personal health-data. Furthermore, the patients’ perceived benefits outweigh the perceived risks for EHR using. Conclusions This research provides a more holistic understanding of patients’ privacy concerns. Particularly, we highlight the key role of personal health concerns and trust in healthcare providers with the intention to create an EHR and to share personal health data. Empirical evidence underlines the importance to involve all the stakeholders in the implementation process. Findings are discussed according to existing literature and practical guidelines are suggested to the health policymakers and healthcare providers.

International audience; Virtual assistants are increasingly common on commercial websites. In view of the benefits they offer to businesses for improving navigation and interaction with the consumers, researchers and practitioners agree on the value of providing them with anthropomorphic characteristics. This study focuses on the effect of the voice of the virtual assistant. Although there are some studies of human–computer interaction in this field, there is no work that addresses the topic from a marketing perspective and compares the effect of a human voice versus a synthetic voice. Our findings show that consumers who interact with a virtual assistant with a human voice have a stronger impression of social presence than those interacting with a virtual assistant with a synthetic voice. The human voice also builds trust in the virtual assistant and generates stronger behavioural intentions.

International audience; The first emergency was to receive and treat COVID-19 patients in their acute phase; today, there is a clear need to propose appropriate post-acute rehabilitation programs. The aim of this research was to systematically review the effects of physical activity programs in the recovery of post-COVID-19 patients. The literature search followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, was registered in the PROSPERO database (CRD42022289219), and was conducted between August and December 2021. A total of 35 studies out of the 1528 initially identified were finally included in the analysis. The systematic review clearly showed the health benefits of rehabilitation including physical activity in post-COVID-19 recovery, regardless of exercise modalities. These positive results were even observed using minor muscle re-mobilization for severe cases (i.e., postural changes, few steps—2 times/day) or using low volumes of exercise for mild-to-moderate cases (i.e., 120 min/week). A total of 97% of the 29 studies that performed statistical analyses demonstrated a significant increase in at least one parameter of functional capacity, and 96% of the 26 studies that statistically investigated the effects on the quality of life, mental health, and general state reported improvements. Yet, most of the studies were retrospective, uncontrolled, and enrolled aged people with comorbidities presented in severe forms of COVID-19. Physical activity programs, in addition to their high heterogeneity, remained poorly described in 83% of the studies and were part of a multidisciplinary program for 89% of the studies. Despite promising results, there is today a real need for prospective well-designed studies specifically assessing the effects of physical activity. In addition, it might appear relevant to propose standardized programs further considering the main characteristics of patients such as age, comorbidities, or the severity of COVID-19.

International audience

There is an important literature focused on profit warnings and its impact on stock returns. We provide evidence from Moroccan stock market which aims to become an African financial hub. Despite this practical improvement, academic researches that focused on this market are scarce and our study is a first investigation in this context. Using the event study methodology and a sample of companies listed in Casablanca Stock Exchange, we examined whether the effect of qualitative warning is more negative compared to quantitative warnings in a short event window. Our empirical findings show that the average abnormal return on the date of announcement is negative and statistically significant. The magnitude of this negative abnormal return is greater for qualitative warnings than quantitative ones.

International audience; In a context where cancer is the leading cause of death in France, there is a real interest in identifying the perception that patients have of their care path in order to improve the perceived quality of their experience. It could ultimately help to act positively on the acceptance by the patient of a difficult situation to live and now considered as chronic. Based on an analysis of 956 speeches of breast cancer patients posted on a discussion forum, the aim of this research is to reconstruct the path experienced by patients in their experience of the disease. This contribution explores the three key stages in the pathway of these patients. It highlights a myriad of critical touch points leading to an alteration in the perception of care on which the institutions need to pay special attention. This research also highlights two important extra-pathway stages: the pre-pathway stage and the post-pathway stage.

International audience; Les conseillers virtuels se sont fortement démocratisés sur les sites marchands. Compte tenu des bénéfices qu’ils offrent aux entreprises pour améliorer la navigation et l’interaction avec le consommateur, chercheurs et praticiens s’accordent sur l’intérêt de les doter de caractéristiques anthropomorphiques. Cette recherche s’intéresse particulièrement à l’effet de la voix du conseiller virtuel. Bien qu’il existe quelques recherches en interaction homme-machine sur la question, il n’existe pas de travaux traitant le sujet d’un point de vue marketing et comparant l’effet d’une voix humaine vs une voix de synthèse. Les résultats montrent que les consommateurs qui ont interagi avec un conseiller virtuel doté d’une voix humaine éprouvent un sentiment de présence sociale plus fort que ceux interagissant avec un conseiller doté d’une voix de synthèse. La voix humaine permet également de susciter plus de confiance envers le conseiller virtuel et de générer de meilleures intentions comportementales.

EAN : 9782200932015; Les analyses de la proximité ont 25 ans. L’entreprise confidentielle du début, lancée par six économistes en mal d’ouverture et de reconnaissance, s’est transformée en aventure collective intense, puis en un champ de recherche aujourd’hui internationalement reconnu, avec ses principes analytiques, son itinéraire méthodologique, ses champs d’application privilégiés et ses auteurs phares. 25 ans plus tard, après les poussées de croissance et la crise d’adolescence, la question se pose de la pérennité de cette approche, mais aussi de sa banalisation et de sa capacité à se renouveler dans le monde des sciences régionales.

EAN : 9782200932015; Les analyses de la proximité ont 25 ans. L’entreprise confidentielle du début, lancée par six économistes en mal d’ouverture et de reconnaissance, s’est transformée en aventure collective intense, puis en un champ de recherche aujourd’hui internationalement reconnu, avec ses principes analytiques, son itinéraire méthodologique, ses champs d’application privilégiés et ses auteurs phares. 25 ans plus tard, après les poussées de croissance et la crise d’adolescence, la question se pose de la pérennité de cette approche, mais aussi de sa banalisation et de sa capacité à se renouveler dans le monde des sciences régionales.

EAN : 9782200932015; Les analyses de la proximité ont 25 ans. L’entreprise confidentielle du début, lancée par six économistes en mal d’ouverture et de reconnaissance, s’est transformée en aventure collective intense, puis en un champ de recherche aujourd’hui internationalement reconnu, avec ses principes analytiques, son itinéraire méthodologique, ses champs d’application privilégiés et ses auteurs phares. 25 ans plus tard, après les poussées de croissance et la crise d’adolescence, la question se pose de la pérennité de cette approche, mais aussi de sa banalisation et de sa capacité à se renouveler dans le monde des sciences régionales.

Apres 25 annees de recherche, la question se pose de la perennite de l’approche de la proximite, mais aussi de sa banalisation et de sa capacite a se renouveler dans le monde des sciences regionales, compte tenu de son impact dans differentes disciplines des sciences sociales. Cet article a pour objet de faire un retour sur ces 25 annees d’analyses, afin d’eclairer les raisons de la reussite de ce programme de recherche, de faire le bilan de ses acquis mais aussi de ses echecs et de revenir sur le chemin parcouru, ses avenues et ses bifurcations. Nous commencons par expliciter les enjeux theoriques, societaux et academiques a la base de la naissance de l’Ecole de la Proximite (I), avant de presenter les principaux resultats d’ordre analytique, avec leurs limites et leurs surprises (II), puis les acquis en termes academiques et societaux (III), pour aborder enfin les angles morts du programme de recherche et le travail restant encore a realiser (IV). Nous concluons par quelques interrogations sur l’avenir de ce courant de pensee et sa capacite a se renouveler dans un environnement soumis a de profondes mutations dans le monde reel comme dans le monde des idees.

International audience; This paper examines the effect of earnings management on debt maturity and how this relation is influenced by institutional environment. The sample is from 17 European countries of STOXX Europe 600 Index over the 2006-2014 period. We find that firms with high earnings management activities, both discretionary accruals and real earnings management, are associated with less long-term debt. More importantly, we observe that the negative link between earnings management and long-term debt holds only in countries with weak creditor rights. This suggests that high creditor protection tends to compensate for the weakness of borrowers’ financial reporting quality.; Cet article examine l’effet de la gestion des résultats sur la maturité de la dette et comment cette relation est influencée par l’environnement institutionnel. L’échantillon est issu de 17 pays européens de l’indice STOXX Europe 600 sur la période 2006-2014. Nos résultats montrent que la gestion des résultats, aussi bien par les accruals discrétionnaires que par la gestion réelle, a un effet négatif sur la dette à long terme. Plus important encore, nous observons que le lien négatif entre la gestion des résultats et la dette à long terme ne tient que dans les pays à faible protection des créanciers. Ce résultat suggère que la bonne protection des créanciers tend à compenser la faiblesse de la qualité de l’information financière des emprunteurs.

L’objectif de cette etude est de mettre a jour les caracteristiques des agents virtuels qui influencent la confiance que les internautes eprouvent a leur egard. A partir d’une etude qualitative menee aupres de 32 internautes, 12 dimensions ont ete recensees. Certaines relevent des caracteristiques techniques des agents tandis que d’autres concernent leur anthropomorphisme. Chacune d’entre elles exerce une influence specifique sur l’une des trois dimensions de la confiance envers les agents (credibilite, integrite et bienveillance).