Zeitschriftenartikel zum Thema „OSLC Client“

The National Institute for Alcohol and Drug Research (SIFA) has completed the first nationwide survey of drug abusers in treatment in Norway. Experiences from the study have contributed to the creation and initial implementation of a monitoring system for treatment demands and treatment measures in the country. This article presents the approach and methods used in the SIFA study. It provides an overview of the material and focusses on describing clients from long-term residential and outpatient treatment modalities. The results are presented within seven areas: socio-demographics, substance abuse, mental health and significant problems, risk behaviour, social functioning, social network, and biographical data on childhood/adolescence. These areas are analysed by the variables of gender, age, urban Oslo/outside Oslo clients, and client populations from residential/outpatient treatment. The authors reflect upon the prospects opened by such comprehensive documentation concerning preventive strategies, planning of treatment, and further research in Norway.

Maternal and Newborn Health is a priority as the main indicator in health. During the pregnancy period until the puerperium it is estimated that as many as 15% can experience life-threatening complications of the mother and baby. However, this death is considered to be prevented through the provision of comprehensive care that can be done with the One Student One Client (OSOC) approach, which is an activity that exists between low-risk pregnant women and midwife students during pregnancy up to 6 weeks post delivery. Objective: This study aims to assess the relationship of comprehensive midwifery care with the One Student One Client (OSOC) approach to birth outcomes (gestational age at delivery, prolonged labor and asphyxia) Method: This study is a retrospective cohort study, using secondary data from medical record documentation Results: Comprehensive midwifery care with the OSOC approach was associated with the occurrence of prolonged labor p value 0.046 (RR 95% CI; 3.2 (1.08-9.74), asphyxia with p value 0.037 (RR 95% CI; 2.57 1.12-6.50) Conclusion: The OSOC method can be used in comprehensive midwifery care for all mothers and babies from pregnancy up to 6 weeks post delivery in an effort to improve birth outcomes.

Background: Labor is an event and experience in a woman's life. After giving birth, a mother experiences a postpartum period or puerperal period that is a recovery period. Uncomfortable feeling can cause anxiety, especially in primiparous mothers. Therefore, not to have an impact rise in stress, even untill postpartum depression, a midwife as a spearhead of provider maternal health care must be able to reduce the anxiety which experiences of postpartum mothers, especially primiparous through assistance ‘OSOC’ methods. Objective: To determine the effect of the application of the OSOC assistance maternity service model toward anxiety among primiparous mothers in the postpartum period at Kendal District Health Center. Research Methods: Quantitative data analysis was used to assess the anxiety of postpartum primiparous mothers with the intervention group and the control group, a type of Quasi Experiment research with a non-equivalent control group design. The subjects of this research was divided into two groups, they were intervention groups and control groups. In the intervention group, it was given in the form of providing OSOC assistance in the postpartum period, while the control group was given conventional puerperal care. The research at Kendal District Health Center in May-October 2019. Results: There was a significant difference between anxiety in primiparous postpartum mothers with OSOC conventional assistance, and the magnitude of the effect of mentoring pregnant women with OSOC on anxiety by 7.804. Conclusions: There was a significant difference between anxiety in primiparous postpartum mothers with OSOC and conventional assistance.

Abstract Background The human amylase gene (AMY1) has a broad copy number (CN) variation that may associate with body mass index. Methods Deoxyribonucleic acid was extracted from urine (n = 74) and serum (n = 6) samples (Protein, Fiber and Metabolic Syndrome [ProFiMet] cohort), and buccal (n = 17) samples (Oral Starch Challenge [OSC] cohort), and assessed for AMY1 CN by droplet digital polymerase chain reaction. The association of AMY1 CN with comprehensive markers of metabolic status (ProFiMet cohort) were analyzed with Pearson’s correlation coefficient (CC). For the healthy, euglycemic OSC cohort, glycemic response to OSC was analyzed with independent sample t-tests (subgroups: high AMY1 CN 9–12, n = 10; low AMY1 CN 4–6, n = 7). Results There were significant inverse correlations of AMY1 CN with total visceral fat volume (CC -0.33; P = 0.004) and positive correlations of AMY1 CN with oral glucose insulin sensitivity score (derived from an oral glucose tolerance test, CC 0.26; P = 0.02), serum HDL-cholesterol (CC 0.325; P = 0.003), and serum adiponectin (CC 0.249; P = 0.026). Linear regression multivariate analysis (adiponectin as dependent variable), showed independent association of adiponectin with AMY1 CN (Beta = 0.29; P = 0.03). There were no significant associations between AMY1 CN and clamp-derived M-value, homeostasis model assessment of insulin resistance (IR), hepatic endogenous glucose production, fecal floral signature, or macronutrient dietary preference. Delta (mean) change in blood glucose concentration (fasting to 30-minutes post-OSC) was significantly greater in the high versus low AMY1 CN subgroups (mean 1.7 mmol/l [SEM 0.6] vs 0.9 mmol/l [SEM 0.9], respectively; P = 0.016). Conclusions High AMY1 CN associates with a favorable metabolic profile (lower visceral fat volume, higher serum adiponectin, enhanced glucose absorption following oral glucose, and OSC), but not with whole-body or hepatic IR.

Pengetahuan ibu tentang gizi balita memberikan kontribusi dalam perilaku ibu memberikan makanan pada balita. Sampai saat ini Indonesia masih mengalami masalah gizi ganda. Pemerintah Kabupaten Pringsewu membuat program kesehatan dengan melibatkan mahasiswa untuk penangan masalah kesehatan yang dikenal dengan One Student One Client (OSOC). Salah satu program OSOC adalah dengan memberikan edukasi konseling kepada ibu balita secara door to door ke rumah ibu. Tujuan pengabdian ini adalah untuk memfasilitasi mahasiswa dalam memberikan edukasi dan meningkatkan pengetahuan ibu tentang gizi balita. Metode yang diberikan menggunakan konseling dengan media buku KIA. Hasil pengabdian didapatkan pada akhir pengabdian seluruh ibu memiliki pengetahuan baik 100%. Peningkatan pengetahuan ini karena ibu balita didampingi secara intensif oleh mahasiswa bidan dalam memberikan konseling, ibu lebih fokus pada saat edukasi dan dapat menemukan solusi masalah gizi pada balita. Diharapkan program ini terus berlanjut dan dapat memfasilitasi mahasiswa dan masyarakat untuk mengentaskan masalah kesehatan.

ABSTRACTLyme disease in the United States is caused byBorrelia burgdorferisensu stricto, which is transmitted to mammals by infected ticks.Borreliaspirochetes differentially express immunogenic outer surface proteins (Osp). Our aim was to evaluate antibody responses to Osp antigens to aid the diagnosis of early infection and the management of Lyme disease. We analyzed antibody responses during the first 3 months after the experimental infection of dogs using a novel multiplex assay. Results were compared to those obtained with two commercial assays detecting C6 antigen. Multiplex analysis identified antibodies to OspC and C6 as early as 3 weeks postinfection (p.i.) and those to OspF by 5 weeks p.i. Antibodies to C6 and OspF increased throughout the study, while antibodies to OspC peaked between 7 and 11 weeks p.i. and declined thereafter. A short-term antibody response to OspA was observed in 3/8 experimentally infected dogs on day 21 p.i. Quant C6 enzyme-linked immunosorbent assay (ELISA) results matched multiplex results during the first 7 weeks p.i.; however, antibody levels subsequently declined by up to 29%. Immune responses then were analyzed in sera from 125 client-owned dogs and revealed high agreement between antibodies to OspF and C6 as robust markers for infection. Results from canine patient sera supported that OspC is an early infection marker and antibodies to OspC decline over time. The onset and decline of antibody responses toB. burgdorferiOsp antigens and C6 reflect their differential expression during infection. They provide valuable tools to determine the stage of infection, treatment outcomes, and vaccination status in dogs.

Background: There is little longitudinal research concerning the number and length of different inpatient and outpatient treatment episodes among drug abusers. Most studies follow clients through one or a few treatment episodes and over short time-periods only. Design: Two-hundred Norwegian drug abusers (31 % females, mean age 27.5 year), who consecutively applied for treatment at Phoenix House, Oslo, were personally followed up on average 5 years after the first evaluation. Material: The material consists of 139 drug abusers, 79 % of the original 200 (12 % deceased). Method: Both at first and second evaluation all were interviewed with a structured research interview schedule covering sociodemographic data, substance abuse, legal problems, social adjustment, personality disorder (MCMI), nervous symptoms (SCL-90) and all kinds of treatment received, both number and length of treatment episodes. Results: All except six persons had at least one inpatient treatment stay during the observation period. Average time was 17.6 months in inpatient treatment and 26.0 months in outpatient settings. This means that during 73 % of the observation time the subjects took part in some kind of treatment. Subjects with many inpatient stays had a shorter drug career before the first evaluation. Subjects with few and long inpatient stays were in a somewhat better situation at follow-up, while subjects with manyand short inpatient stays had more alcohol problems but shorter drug careers. Conclusion: Frequency or duration of treatment episodes is not related to client characteristics. It is not the availability of treatment that is lacking but rather treatment effects.

The objective of the research is to analyze the success story of the Salatiga City and Semarang City in the best three achievements and position in Human Development Index in the Central Java Province 2013-2015, what kinds of policy learned can be taken. The research uses qualitative model with several informants as sources of primary data. The data is taken by interviewing with some informants, such as: Local Government Health Service of Salatiga City and Semarang City, Local Government Educational Service of Salatiga City and Semarang City, Regional body for planning and development (Bappeda) of Salatiga City and Semarang City. Triangulation method is the best way to eliminate the fact contruction differences in the context of a certain study when collecting the data about the events and relationships of the various views. Through this technique the researchers also compared the findings with a variety of sources. The study found, firstly, in the health sector, Salatiga City have mainly program, that is improve and practice OSOC (One Student One Client) program, the program focuses in pregnant women with highly risk, OSOC program involve the local government, the obsgins doctor and student of university (especially health academy student), after recoding the pregnant women with highly risk and then become the student client. Meanwhile Semarang City improves and practice EMAS (Emerging Maternal and Neonatal Survival) program based on cooperation with USAID. As we know that the maternal and neonatal mortality is important aspect of Human Development Index. Secondly: in education sector, Salatiga City and Semarang City improve and practice Local Student Operational Aid (BOSDA) and Poor Student Aid for basic and junior school student, that program can increase the educational partisipation rate.

Maternal mortality rate (MMR) and infant mortality rate (IMR) are one of the main indicators of a country's health status. MMR in Semarang was increasing since 2013 (107.95 per 100,000 live birth) become (128.05 per 100,000 live birth) in 2015. Various efforts have been made to handle the increase in maternal mortality rate in Semarang, one of them is OSOC program to accompany pregnant women. However, its implementation has not run optimally and encounters several obstacles. The purpose of the research was to analyze the input, process, and output aspects of the One Student One Client Program to accompany pregnant women by Nursing Students in Semarang. This was qualitative research with descriptive explorative approach through in-depth interview and focus of group discussion. The main informants were; Head of Health Section of Central Java Provincial Health Office and triangulation informant; 2 Heads of Public health services and 2 nurses / midwife coordinator, 2 Head of study program, 2 field supervisors, 14 nursing students and 7 pregnant women / postpartum. Data processed and analysed by content analysis method. The result showed that the input aspect: which was human resources, had been sufficient, but insufficient in funds, infrastructure facilities only in the form of modules, the policy had not been written and there was no memorandum of understanding / MoU between the health office and educational institutions.

The ‘comprovisation’ (Dudas 2010) of electroacoustic music in an affective manner through Internet2, using a directed dramaturgy approach, poses unique scoring problems. Building on prior work (Whalley 2009, 2012c), GNMISS (Graphic Networked Music Interactive Scoring System) was developed to address this. The system has four visual layers that illustrate the structure of works, represented on a circle with parts for each player. One layer maps emotions to colours based on associated words as a primary basis for gesture and timbre representation. A second layer gives musical motives and frequency information for participants to follow. A third allows for more detailed indications of gesture and sound archetypes through representative symbols. Finally, an inside layer represents macro key centres. For timing, the circle score turns in clock time with the current playing position always at noon, and a central metronome shows speed independent of clock time. Technically, client programs sit on distributed machines across the Internet, with data being coordinated by an OSC Server. Distributed scores can be built by a composer or by a team, and all content can be altered simultaneously across client machines. Two works are discussed as initial examples of its implementation: Sensai na Chikai and SymbolAct.

<p>The area covered by the Clinic must be one of the largest and most remote in the world. It covers the whole of northern Norway from Bodo in the south to Kirkenes near the Russian border, and includes the “counties” of Nordland, Troms and Finnmark. All of it lies within the Arctic Circle, which brings special challenges from the climate and thinly spread population. The permanent base is in Tromso, in offices behind the port loaned from Tromso University. From there student volunteers travel to visit most communes in the area, including Norwegian Lapland. Volunteers attempt to visit clients in each major commune at least twice a year, (cases came from 78 communes in 2003), either upon request, or by advertising a clinic session in the local commune building. Sessions in 28 major communes outside Tromso were held in 2003.</p><p><br />The clinic is one of five similar clinics covering the whole of Norway, all founded upon operational and management principles pioneered by law students at Oslo University in the early 1970s. The Oslo JussBuss (literally the “law bus”) has passed into Norwegian legal legend.</p>

With the current skills shortage in the engineering profession and the need for more experienced engineers, it is important for Australian engineering companies to not only rely on importing skilled engineers from overseas to fulfil current day demands, but also to focus on developing young Australian engineers for the future. Aker Solutions Australia has implemented a training and development program for its employees by seconding them into the head office in Oslo, Norway for both technical and personal development. The program provides many positive outcomes for both the company and the employees including: knowledge transfer and alignment between the international offices, developing and improving the talent of Australian engineers, improving communications between the offices and providing the Oslo office with much needed resources. The program was initiated in 2006 and so far nine employees have been sent across the globe for training. In this time the employees have had the opportunity to work on new technological developments in gas processing, advanced concept development studies and large scale engineering, procurement and construction (EPC) projects. Working internationally has also provided Australian engineers with a chance to interact with a number of skilled people from diverse backgrounds, learn new languages and embrace different cultures. The program to date has had much success, with both clients and the Aker Solutions office in Norway requesting continuation of the Australian engineers’ services while one of the engineers—Jacqui Driver—won best paper at the 2007 APPEA conference for her work in Oslo on novel offshore LNG solutions.

Abstract Context Cholesteryl ester transfer protein (CETP) regulates high-density lipoprotein (HDL) cholesterol levels and interaction between glucose, and HDL metabolism is central in the development of diabetes. Objective We hypothesized that CETP levels would be regulated in diabetic pregnancies. We tested the hypothesis by evaluating CETP activity measured multiple times during pregnancy and at 5 years’ follow-up in a prospective cohort (STORK) and investigated its association with gestational diabetes mellitus (GDM) during pregnancy or development of prediabetes 5 years after pregnancy. We also evaluated the strongest correlation of CETP activity among measures of adipocity and glucose metabolism, lipoproteins, adipokines, and monocyte/macrophage activation markers. Design A population-based longitudinal cohort study was conducted from 2001 to 2013. Setting The study setting was Oslo University Hospital. Patients or Other Participants A total of 300 women during pregnancy and at 5 years postpartum participated in this study. Main Outcome Measures CETP activity was measured at 14 to 16, 22 to 24, 30 to 32, and 36 to 38 weeks’ gestation, and at 5 years’ follow-up. Results We found higher CETP activity in pregnancy in women developing prediabetes but no association with GDM. CETP activity decreased throughout pregnancy and remained low at follow-up. High CETP activity was associated with sCD14 levels, in particular in women who developed prediabetes. These data show that enhanced CETP activity during pregnancy is associated with systemic indices of monocyte/macrophage activation, in particular in women who develop prediabetes later in life. Conclusions CETP activity during pregnancy identifies women at risk for later diabetes development.

Abstract Context Lifestyle interventions have not efficaciously reduced complications caused by maternal weight on fetal growth, requiring insight into explanatory mediators. Objective We hypothesized that maternal mediators, including adiponectin, leptin, insulin, and glucose, mediate effects of pregestational BMI (pBMI) and gestational weight gain (GWG) on birthweight and neonatal fat mass percentage (FM%) through placental weight and fetal mediators, including insulin levels (Ifv) and venous-arterial glucose difference (ΔGfva). Hypothesized confounders were maternal age, gestational age, and parity. Methods A cross-sectional study of healthy mother-offspring-pairs (n = 165) applying the 4-vessel in vivo sampling method at Oslo University Hospital, Norway. We obtained pBMI, GWG, birthweight, and placental weight. FM% was available and calculated for a subcohort (n = 84). We measured circulating levels of adiponectin, leptin, glucose, and insulin and performed path analysis and traditional mediation analyses based on linear regression models. Results The total effect of pBMI and GWG on newborn size was estimated to be 30 g (range, 16-45 g) birthweight and 0.17 FM% (range, 0.04-0.29 FM%) per kg∙m–2 pBMI and 31 g (range, 18-44 g) and 0.24 FM% (range, 0.10-0.37 FM%) per kg GWG. The placental weight was the main mediator, mediating 25-g birthweight and 0.11 FM% per kg∙m–2 pBMI and 25-g birthweight and 0.13 FM% per kg GWG. The maternal mediators mediated a smaller part of the effect of pBMI (3.8-g birthweight and 0.023 FM% per kg∙m–2 pBMI) but not GWG. Conclusion Placental weight was the main mediator linking pBMI and GWG to birthweight and FM%. The effect of pBMI, but not GWG, on birthweight and FM%, was also mediated via the maternal and fetal mediators.

Feline oral squamous cell carcinoma (FOSCC) is a common and naturally occurring condition that recapitulates many features of human head and neck cancer (HNC). In both species, there is need for improved strategies to reduce pain caused by HNC and its treatment. Research to benefit both species could be conducted using pet cats as a comparative model, but this prospect is limited by lack of validated methods for quantifying FOSCC-associated pain. A prospective non-randomized pilot study was performed for initial validation of: (1) a pet owner administered quality of life questionnaire and visual assessment scoring tool (FORQ/CLIENT); (2) a clinician assessment questionnaire (UFEPS/VET); (3) electronic von Frey testing [EVF]; and (4) Cochet-Bonnet (COBO) aesthesiometry. To assess intra-rater reliability, discriminatory ability, and responsiveness of each assay, 6 cats with sublingual SCC and 16 healthy control cats were enrolled. The intra-rater reliability was moderate-to-good for the clinical metrology instruments and EVF (intraclass correlation coefficient [ICC] ≥ 0.68), but poor for COBO (ICC = 0.21). FORQ/CLIENT scores were higher (worse quality of life) in FOSCC cats vs healthy controls. The internal reliability of FORQ/CLIENT scoring was high (Cronbach α = 0.92); sensitivity and specificity were excellent (100% when using cut-offs determined using receiver operating characteristic [ROC] curves). For the FORQ/CLIENT, there was strong and inverse correlation between scores from the questions and visual assessment (r = − 0.77, r2 = 0.6, P < 0.0001). For the UFEPS/VET, Cronbach’s α was 0.74 (high reliability). Sensitivity and specificity were 100% and 94%, respectively, when using a cut-off score (3.5) based on ROC curves (Youden index of 0.94). Total UFEPS/VET scores were positively correlated with FORQ/CLIENT scores (r2 = 0.72, P < 0.0001). Sensitivity of EVF and COBO ranged from 83 to 100% and specificity ranged from 56 to 94%. Cats with cancer were more sensitive around the face (lower response thresholds) and on the cornea (longer filament lengths) than control animals (P < 0.03). Reduced pressure response thresholds were also observed at a distant site (P = 0.0002) in cancer cats. After giving buprenorphine, EVF pressure response thresholds increased (P = 0.04) near the mandible of cats with OSCC; the length of filament required to elicit a response in the COBO assay also improved (shortened; P = 0.017). Based on these preliminary assessments, the assays described herein had reasonable inter-rater reliability, and they were able to both discriminate between cats with and without oral cancer, and respond in a predictable manner to analgesic therapy. In cats with tongue cancer, there was evidence for regional peripheral sensitization, and widespread somatosensory sensitization. These results provide a basis for multi-dimensional assessments of pain and sensitivity in cats with oral SCC.

<p><strong>Caregivers awareness of sexuality</strong><em><br />This study deals with the results from two focus group interviews with 13 students from education in "Sexology and Disability" by Oslo and Akershus University College (HIOA). The purpose of this study was to highlight the experiences and perceptions of employees in their work with the theme of sexuality.<br />Findings from the study show that it is still difficult to talk openly about people with developmental disabilities and their sexuality. Many see it as a taboo area. The study shows that both the caregiver and care recipient are in need of training. Staff working with the theme of sexuality may feel stigmatized by colleagues. They get little support from managers and colleagues.<br />Management must ensure good care for the client. The study indicates that employees should have knowledge and methods to meet the challenges of sexual education and prevent abuse.</em></p>

MCJ2K (Motion-Compensated JPEG2000) is a video codec based on MCTF (Motion- Compensated Temporal Filtering) and J2K (JPEG2000). MCTF analyzes a sequence of images, generating a collection of temporal sub-bands, which are compressed with J2K. The R/D (Rate-Distortion) performance in MCJ2K is better than the MJ2K (Motion JPEG2000) extension, especially if there is a high level of temporal redundancy. MCJ2K codestreams can be served by standard JPIP (J2K Interactive Protocol) servers, thanks to the use of only J2K standard file formats. In bandwidth-constrained scenarios, an important issue in MCJ2K is determining the amount of data of each temporal sub-band that must be transmitted to maximize the quality of the reconstructions at the client side. To solve this problem, we have proposed two rate-allocation algorithms which provide reconstructions that are progressive in quality. The first, OSLA (Optimized Sub-band Layers Allocation), determines the best progression of quality layers, but is computationally expensive. The second, ESLA (Estimated-Slope sub-band Layers Allocation), is sub-optimal in most cases, but much faster and more convenient for real-time streaming scenarios. An experimental comparison shows that even when a straightforward motion compensation scheme is used, the R/D performance of MCJ2K competitive is compared not only to MJ2K, but also with respect to other standard scalable video codecs.

<p>The article reflects on the relationship between landscape architects, influential clients, and public involvement in Ekeberg, a publicly owned area of Oslo, where significant changes have taken place since the beginning of World War II. “Ekebergparken” was established as a public sculpture park in 2013. The park is funded entirely by private funds owned by the investor Christian Ringnes. The plans for the park sparked a public debate about private investor influence over public space, and protesters organized demonstrations against the establishment. After the opening of the park, the opposition has subsided, and criticism has been replaced by praise and recognition. Inside the park, there are remains of an honorary cemetery established by the German occupying forces in 1940. An honorary tribunal set up by the Association of Norwegian landscape architects condemned the Norwegian landscape architects who designed the cemetery for Germans after the war ended in 1945. The development of the park in both cases raises questions of democratic control over public space and ethical frames for landscape architects’ work. The two examples in this article show that understanding or lack of understanding of the political context landscape architects are working in, can result in their work subsequently receiving wide recognition in one case, and is characterized as a democratic failure in the other.</p>

Members of civil society are increasingly decrying what they identify as an insidious trend whereby the government is targeting organizations whose mandates run contrary to the federal government’s political and economic agendas and creating a chill around public policy and advocacy work. The media as well as civil society organizations [CSOs] themselves have documented government attempts to undermine and stifle the voices of dissenting organizations, ranging from rhetorical attacks to the withdrawal of funding for ambiguous reasons. The climate of resentment and suspicion between civil society actors and the government is detrimental for safeguarding the tradition of accountability and transparency in Canada’s democratic institutions. Amidst this turbulent environment, this paper examines the often-made claim by CSO leaders in Canada that public funding is a necessary requirement for a strong civil society, with the aim of challenging and mobilizing the civil society community to not only survive but to reinvigorate its engagement to further social justice in this changing social and economic landscape. We argue that discussions of the state of civil society in Canada focus disproportionately on the question of funding and relationship-building with the government and expose the unforeseen consequences of this trade-off for CSOs, their members, and constituent communities. We close by introducing the potential of a new paradigm of “principled engagement” that would allow Canadian CSOs to thrive as sustainable, adaptable social justice advocates in coming years. Les membres de la société civile décrient de plus en plus ce qu’ils appellent la tendance insidieuse du gouvernement à cibler les organisations dont les mandats vont à l’encontre de ses programmes politiques et économiques et à freiner le travail de représentation et de plaidoyer lié aux politiques publiques. Tant les médias que les organisations de la société civile [OSC] ont déploré les tentatives du gouvernement de faire taire les voix d’organisations dissidentes, que ce soit par des attaques rhétoriques ou par le retrait du financement pour des raisons ambiguës. Le climat de ressentiment et de doute qui règne entre les intervenants de la société civile et le gouvernement nuit au maintien de l’imputabilité et de la transparence qui caractérisent depuis longtemps les institutions démocratiques canadiennes. Dans ce contexte de turbulence, les auteurs de ce texte répondent aux dirigeants des OSC du Canada qui ne cessent de répéter qu’une société civile forte a besoin à tout prix de fonds publics afin de mobiliser ses intervenants et de les encourager non seulement à survivre, mais également à réitérer leur engagement à promouvoir la justice sociale dans ce climat socio-économique changeant. Nous affirmons quant à nous que la société civile du Canada accorde trop d’importance à la question du financement et de l’établissement de relations avec le gouvernement et nous évoquons l’émergence possible d’un nouveau paradigme selon lequel les OSC canadiennes pourraient s’imposer comme des représentants de la justice sociale solides et capables de s’adapter aux changements au cours des années à venir.

In the Nordic countries, prevention of radicalization and violent extremism is based on an existing crime prevention collaboration. The core tenet of crime prevention approaches is that early radicalization prevention is best organized as a joint effort, where individual cases are assessed holistically and relevant information shared. This presentation is based on Nordic comparative research that provides a critical analysis of policies, perceptions, and practices regarding multiagency approaches. At the city level, we systematically explore how core components of a Nordic governance model contribute to and might be preconditions for effective multiagency collaboration and secure societies. Variations in these city-level approaches lead to an important question: do these various multiagency approaches to countering violent extremisms and radicalization constitute a unified model? The project provides an informed platform for spreading Nordic experiences and models of governance to other countries in the area of radicalization prevention and countering violent extremism. The multiagency collaboration in Nordic cities tends to be composed of a smaller number of professionals, e.g., three to eight, representing social and health services, a coordinator, and the police. Their positions vary; some represent leadership in the municipality, others are positioned at more mid-level management, and others are frontline professionals handling clients on a daily basis. The origin of these collaborative efforts is based on the School, Social and health services, and Police framework (SSP) in Denmark, Norway, and the Ankkuri group in Finland. We assert that future efforts can also be more need-based, comprising municipal/local initiatives with an element of the guiding national policies, and include the legal frameworks to guide professionals on ethical issues like confidentiality. This presentation is part of a larger project entitled “Nordic Multiagency Approaches to Handling Extremism: Policies, Perceptions, and Practices”, led by professor and center director Tore Bjørgo (University of Oslo) and is funded by NordForsk (Nordic Council of Minister), 2018–2021.

A Review of: Kolstad, A. (2017). Students’ learning outcomes from cross-collaborative supervision in information seeking processes during work placements. Nordic Journal of Information Literacy in Higher Education, 9(1), 2-20. https://doi.org/10.15845/noril.v9i1.231 Abstract Objective – To analyze the effect of collaborative interdisciplinary teaching and supervision using physical and digital tools on students’ information literacy (IL) and evidence based practice (EBP) abilities. Design – Qualitative and quantitative text analysis. Setting – Learning Centre at Oslo University College and student work placements in Oslo, Norway. Subjects – Approximately 400 students enrolled in the undergraduate nursing degree programme. Methods – The author is a librarian and project manager of the Langerud project, an initiative wherein nursing students were jointly trained and supervised by nurse educators, nurse supervisors, and librarians in preparation for and during work placements over an eight-week period. In this role, the librarian author collected 36 student group assignments, 285 blog/wiki comments from students, nurse educators, nurse supervisors, and librarians, and 102 individual student logs written during six work placements between Spring 2010 and Spring 2012, which were posted in a learning management system (LMS), as well as in an evaluation form from Spring 2010. The unstructured text is analyzed according to how the students fulfilled the learning outcome of integrating steps zero to four of the seven-step EBP model: (1) Cultivate a spirit of inquiry; (2) Ask clinical questions in the PICO format; (3) Search for the best evidence; (4) Critically appraise the evidence; and (5) Integrate the evidence with clinical expertise and patient preferences and values. The logs are also analyzed quantitatively to measure if and how many students combined the three aspects of EBP - defined as being the practitioner’s individual expertise, best research evidence, and client values and expectations. Lastly, the author seeks to evaluate the role of the LMS as a mediating tool. Main Results – The author found that the majority (83%) of students successfully met the learning outcome, particularly for steps 1, 2, and 5. For step three, the author observed that some students did not apply PICO in the information-seeking process and were thus not sufficiently thorough in their searching. For step four, the author found that most students failed to demonstrate critical appraisal of the evidence and that many struggled to find up-to-date research findings. The author noted that the results for both steps three and four could be attributed to the students finding international databases and English-language research articles too challenging, given the language barrier. The author’s analysis of the logs reveals that two-thirds of the students combined the 3 aspects of EBP and that 39% described 1 or 2 aspects, of which most described user-based knowledge and experience-based knowledge. One department produced twice as many log entries as the other seven departments; in this department, students were able to choose what aspect of EBP to focus on and the librarian had a co-teaching role in that learning group. Overall, 60% of all students described research-based knowledge, which increased over time from 46% in Spring 2011, to 60% in Autumn 2011, and 83% in Spring 2012. On the evaluation form from Spring 2010, most students rated the supervision by and satisfaction with the nurse educator, nurse supervisor, and librarian as good, very good, or excellent, and many commented that the LMS was a useful learning platform. Conclusion – The author concludes that the project had a positive impact on students’ preparedness for work placements and that the early educational intervention improved IL and EBP competencies. Furthermore, the working relationship between the Nursing Department and Library was strengthened. After the Langerud project ended, the curriculum was revised to add more searching for research-based information in written assignments. Additionally, a lecture on EBP was developed based on real-life experiences from the project and delivered collaboratively by the project’s manager, a nurse educator, and a librarian.

Background: This research aimed to identify the effectiveness of One Nursing Student One Client (OSOC) Assistance in decreasing high-risk pregnancy as an effort to accelerate the decline in maternal and infant mortality rates.Methods: The research design employed the post test-only control group design method, where the high-risk pregnant women are accompanied by one student one client. After supervision has been completed, the results were then compared with the control group that has been given high-risk leaflet prevention for pregnant women. Mann Whitney Test is used to test the difference statistically.Results: The results of high-risk statistical analysis of hypertension obtained results p = 0.000 (P <0.05), anemia p = 0.001 (P <0.05), swollen extremity p = 0.040 (P <0.05) which means there is a very significant different average value of high-risk pregnancy between the control group and the experimental group. This indicates that OSOC counseling is effective in reducing high-risk pregnancies of positive urine protein to negative urine protein in Blora City Community Health Center compared with leaflets to control groups. Further, counseling at high risk of swollen extremity was obtained p = 0. 114 (P> 0.05) which mean there was no difference of the mean value of high pregnancy risk of swollen extremity between the control and experiment group.Conclusion: One nursing student one client assistance is effective in reducing high-risk of the third trimester pregnancy women suffering from hypertension, anemia and positive urine proteins. K eywords: mentoring one nursing student one client, high-risk pregnancy

Metastasis, a powerful prognostic indicator of oral squamous cell carcinoma (OSCC), is chiefly responsible for poor cancer outcomes. Despite an increasing number of studies examining the mechanisms underlying poor outcomes, the development of potent strategies is hindered by insufficient characterization of the crucial regulators. Long noncoding RNAs (lncRNAs) have recently been gaining interest as significant modulators of OSCC metastasis; however, the detailed mechanisms underlying lncRNA-mediated OSCC metastasis remain relatively uncharacterized. Here, we identified a novel alternative splice variant of oral cancer overexpressed 1 ( ORAOV1), named as ORAOV1-B, which was subsequently validated as an lncRNA and correlated with OSCC lymph node metastasis; significantly increased invasion and migration were observed in ORAOV1-B–overexpressing OSCC cells. RNA pulldown and mass spectrometry identified Hsp90 as a direct target of ORAOV1-B, and cDNA microarrays suggested TNFα as a potential downstream target of ORAOV1-B. ORAOV1-B was shown to directly bind to and stabilize Hsp90, which maintains the function of client proteins, receptor-interaction protein, and IκB kinase beta, thus activating the NF-κB pathway and inducing TNFα. Additionally, TNFα reciprocally enhanced p-NF-κB-p65 and the downstream epithelial-mesenchymal transition. ORAOV1-B effects were reversed by a TNFα inhibitor, demonstrating that TNFα is essential for ORAOV1-B–regulated metastatic ability. Consistent epithelial-mesenchymal transition in the ORAOV1-B group was demonstrated via an orthotopic model. In the metastatic model, ORAOV1-B significantly contributed to OSCC-related lung metastasis. In summary, the novel splice variant ORAOV1-B is an lncRNA, which significantly potentiates OSCC invasion and metastasis by binding to Hsp90 and activating the NF-κB-TNFα loop. These findings demonstrate the versatile role of ORAOV1 family members and the significance of genes located within 11q13 in promoting OSCC. ORAOV1-B might serve as an attractive OSCC metastasis intervention target.

Purpose This paper aims to study the relationship between the knowledge exchanged during client interactions and innovation in knowledge-intensive business services (KIBS) enterprises. It adapts the concept of absorptive capacity, i.e. the ability of the firm to successfully deal with external knowledge, to the case of client knowledge being absorbed with the support of information and communication technologies and explores whether its three main dimensions (acquisition, assimilation and application of client knowledge) are significant enablers of KIBS’ innovation propensity. Design/methodology/approach An empirical analysis is based on a dataset of 417 Russian KIBS companies collected in 2019 following the recommendations suggested in the new edition of Oslo Manual. To examine the relationship between the three-client knowledge absorptive capacity dimensions and implementation of different types of innovation by KIBS, the study applies linear ordinary least squares and logistic regression methods. Findings The results show that acquisition of client knowledge through the wide number of digital channels, assimilation of such knowledge boosted by its codification through a digital customer relationship management (CRM) system and application of client knowledge across different functional areas are positively associated with both product and business process innovations in KIBS. Originality/value The paper proposes that KIBS should develop and sustain the strong internal capacity to absorb knowledge through routine day-to-day client interactions as a part of their knowledge management systems. The results also indicate that application of digital communication tools and CRM systems are beneficial for KIBS and increases their propensity to innovate.

Maternal Mortality Ratein the Central Java in 2012-2014 has significantly increased in 2012: 675 of cases, 2013: 668 of cases, 2014: 711 of cases, while in 2015 and 2016 decreased: 2015: 619 of cases and 2016: 602 of cases. One Student One Client Program (OSOC) is a program launched by the Governmentof Central Java Provinceas an effort to decrease The Rate of Maternal Mortality in Central Java.The targets and outcomes of this activity are scientific publications and journals continuously also midwifery care process to the mother; pregnant, childbirth, childbirth, birth control and newborn care.The cooperation between healths professional in midwifery process later can contribute in decreasing Maternal Mortality Rate.The method used is direct learning experience in the community. Each learner will get one client (pregnant mother) through a midwife coordinator in Work Area of Puskesmas Sidoharjo to achieve one student one client.The techniques of data collection are forms of; pregnancy midwifery care , delivery, puerper, new baby born and KB. This accompaniment was carried out for 5 months from April - August 2017 in the working area of Puskesmas of Sidoharjo.The result of this are the majority of pregnant mothers can be through pregnancy with healthy and the increase of awareness and knowledge of pregnant women.

PurposeResearch into the relationship between entrepreneurial ecosystems and sustainability has deepened in terms of both quantity and quality even while still remaining a fragmented and divergent field. Hence, the purpose of this study is to put forward empirical evidence to advance the literature on the relationship between entrepreneurial ecosystems and sustainability. To this end, the authors furthermore identify and highlight a future research agenda.Design/methodology/approachThe source of the empirical analysis in this article stems from the Community Innovation Survey, the leading statistical inquiry of innovation in companies carried out by Eurostat based upon the conceptual framework set out in the Oslo Manual. For modelling the variables, the authors applied binary regression based on logistic distribution.FindingsThe results of the research demonstrated how all of the variables considered for entrepreneurial ecosystems (co-operation with suppliers, co-operation with clients or customers, co-operation with universities; co-operation with government, public or private research institutes) return positive impacts on national sustainabilityResearch limitations/implicationsDespite the data spanning only the nine countries in the database, the results enable insights into the theory as the results serve to strengthen already existing considerations on the positive effects of entrepreneurial ecosystems for the sustainability of countries.Practical implicationsThe results of the research may generate important implications for company policy formulation. The identification of the relevance of the different actors in entrepreneurial ecosystems and their impact on sustainability may assist firms and policymakers to identify the leading actors and the resources necessary to sustaining their activities and thereby correspondingly establishing their priorities.Originality/valueThe research (1) both deepens the prevailing knowledge on this theme and fills a gap encountered in the existing literature; (2) in practical terms, for managers, entrepreneurs and politicians to better grasp how entrepreneurship constitutes a systemic phenomenon and these systems require approaching in terms of their impacts and greater contributions to obtaining sustainability.

Les Nations Unies ont proclamé l’année 2005 "Année Internationale du Microcrédit". A cette occasion, la Plate-forme belge de la microfinance et la Coopération belge au développement (DGCD) organisent les 3 et 4 mars un séminaire de réflexion sur la microfinance. Dans le dernier numéro de Regards économiques, Valérie de Briey, qui est responsable de recherches au Cerisis, membre de la plate-forme belge de microfinance et du GRAP-OSC (CUD-DGCD), dresse un large panorama du rôle et des missions de la microfinance dans les pays en développement. Elle présente également les questions importantes qui seront débattues lors du séminaire des 3 et 4 mars. Ce communiqué résume les principaux points de son étude. De tous temps, de nombreuses activités de taille très réduite (qualifiées habituellement de micro-entreprises) se sont développées dans les pays du Sud, bien souvent partiellement ou totalement en marge des règles législatives et administratives, pour permettre aux populations pauvres de subsister. Celles-ci regroupent des activités aussi diverses que marchands ambulants, petits artisans, kiosques à journaux, taxis, vendeurs de rue, bazars, etc. Parmi les multiples contraintes auxquelles sont confrontées les micro-entreprises, la difficulté d’accès à des sources de financement extérieures représente encore aujourd’hui une entrave principale à leur bon développement. Elles ont en effet besoin d'un capital suffisant pour financer leurs équipements, leurs achats de fournitures, de matières premières, etc. Or, ce capital leur a longtemps fait défaut car les petites sommes demandées par ces micro-entrepreneurs, l’absence de garantir à offrir et bien souvent la nature risquée du projet rebutaient les banques commerciales traditionnelles. C’est pourquoi différents intermédiaires financiers spécialisés dans l’attention à ce type de clientèle ont vu le jour. Ces intermédiaires sont souvent qualifiés d’ «institutions de microfinance» (IMF). Leur rôle consiste à offrir des services financiers de base (épargne, crédit, assurance, transfert de fonds, etc.), aux montants réduits, à des populations pauvres afin de leur donner la possibilité d’investir et de se prémunir en cas de coups durs (conditions climatiques défavorables à la production, dépenses imprévues liées à une maladie ou à la perte de biens, etc.). Par ailleurs, la microfinance favorise également des retombées positives sur la famille en général : amélioration des conditions de vie, valorisation de l’auto-estime, financement de la scolarisation, des soins de santé, etc.). Il a cependant fallu attendre les années quatre-vingt pour que ce secteur soit véritablement reconnu comme générateur de revenus et créateur d’emplois. Depuis lors, il fait l’objet d’une attention toute particulière de la part tant des praticiens du développement, des politiciens que des chercheurs universitaires. Aujourd’hui, la micro-finance fait partie intégrante des politiques de développement des pays pauvres. En 1998 déjà, l’Assemblée Générale des Nations Unies avait proclamé l’année 2005 l’Année Internationale du micro-crédit pour marquer l’importance de cet instrument pour éradiquer la pauvreté. Son objectif à l’époque était de réduire de moitié les populations pauvres qui vivent sous le seuil de pauvreté d’ici 2015 (Objectifs de Développement pour le Millénaire). Depuis les expériences pionnières jusqu’à sa forte médiatisation de nos jours, le champ de la microfinance a fortement évolué. Il existe une pluralité d’institutions de microfinance faisant appel à des statuts juridiques différents (fondations, coopératives d’épargne et de crédit, institutions publiques, sociétés anonymes, etc.) dont les modes de fonctionnement et les objectifs diffèrent fortement. Les IMF sont aujourd’hui largement tributaires d’un discours néo-libéral prônant l’absolutisation du marché et l’adoption d’une démarche commerciale. Pour des institutions telles que Banque Mondiale ou les Nations Unies, il faut en effet parvenir à la construction de «marchés financiers intégrants» afin de mettre en place des systèmes de microfinance pérennes et qui touchent un grand nombre de populations pauvres. Elles préconisent dès lors l’institutionnalisation des programmes de microfinance, autrement dit, la mise en place d’institutions de microfinance rentables, répondant aux lois des marchés financiers concurrentiels et faisant appel à un mode de gouvernance efficace. Pour ces organismes en effet, les institutions à vocation sociale (de type ONG) sont la plupart du temps fragiles, tributaires des subsides en provenance des bailleurs de fonds et disposent d’une capacité limitée à faire face à la demande massive de microcrédits. D’autres personnes au contraire, principalement des acteurs de terrain soucieux de rester au service des plus démunis, s’interrogent sur les dérives potentielles de l’adoption d’une telle démarche et craignent que la poursuite de but de lucre conduise à l’écartement d’une clientèle plus défavorisée afin de satisfaire les critères de rentabilité propres aux marchés financiers. Elles réclament notamment le maintien de subsides. Cette opposition entre ces deux visions de la microfinance constitue ce que Morduch (1998) a qualifié de "microfinance schism". Ce schisme est également marqué par les méthodes d’évaluation auxquelles recourent les partisans de chacune des deux approches (études d’impact, instruments de rating, etc.). Plus qu’antagonistes, ces deux visions de la microfinance sont, selon Valérie de Briey, complémentaires. La pertinence de l’une ou l’autre doit s’évaluer au regard des acteurs en présence, de la cible poursuivie, de la densité de population, de la technologie disponible, du contexte économique, institutionnel, etc. La pérennité d’une IMF ne pourra en effet être atteinte que dans la mesure où l’institution peut opérer à grande échelle et avoir un volume d’activité tel que le point d’équilibre puisse être atteint. Il est donc par exemple nécessaire que la densité de la population soit suffisamment importante pour toucher un grand nombre d’emprunteurs. Par ailleurs, l’IMF doit également disposer d’une technologie appropriée pour évaluer rapidement les demandes de crédit et maintenir à jour l’information commerciale et financière. Sans ces conditions, la productivité des membres internes à l’IMF ne pourra pas être suffisante et la croissance du portefeuille assurée. Par ailleurs, dans le choix de l’approche dans laquelle doit s’inscrire l’IMF, il importe également selon Valérie de Briey de se pencher sur le degré de précarité de la cible visée. Certaines institutions, soucieuses de veiller à la rentabilité de leurs opérations de prêts, excluent en effet de leurs clients, certains secteurs d’activité jugés comme trop risqués (citons en autres les conducteurs de taxi) et mettent des conditions d’accès telles que de nombreux micro-entrepreneurs se trouvent hors des conditions d’accès (comme par exemple l’ancienneté minimale exigée ou le degré de formalisation de la micro-entreprise). Il y a donc place dans certaines zones géographiques pour la coexistence d’IMF différenciées (par exemple des sociétés anonymes adoptant une logique de rentabilité et des ONG adoptant une logique de développement de populations pauvres). Il est donc nécessaire, conclut l’auteur, que les limites du discours dominant orienté sur une approche de marchés soient reconnues et que les bailleurs de fonds adoptent une attitude différenciée selon les intermédiaires financiers considérés, et le contexte économique, social et institutionnel du pays dans lequel ces intermédiaires opèrent. Il faudrait en outre que les bailleurs de fonds adoptent des critères d’évaluation des IMF en cohérence avec la mission poursuivie par l’institution d’appui et ses valeurs fondatrices. Plus qu’antagonistes, les différentes méthodes d’évaluation proposées dans le champ de la microfinance sont, de l’avis de Valérie de Briey, elles aussi complémentaires. Leur utilité dépend tout à la fois de la mission de l’IMF (à vocation sociale ou financière), de la ou des personnes qui évaluent (bailleurs de fonds, membres internes, etc.), de la perspective adoptée (du point de vue des clients, des bailleurs de fonds, de l’institution, etc.) et des moyens dont disposent les évaluateurs. L’important est que les personnes en présence s’accordent sur l’objet de l’évaluation. L’auteur anticipe ainsi sur certaines questions qui seront débattues lors d’un séminaire de réflexion organisé par la plate-forme belge de Microfinance et la DGCD les 3 et 4 mars au Palais d’Egmont à Bruxelles à l’occasion de l’année 2005 proclamée «Année Internationale du Microcrédit» par les Nations Unies.

Les Nations Unies ont proclamé l’année 2005 "Année Internationale du Microcrédit". A cette occasion, la Plate-forme belge de la microfinance et la Coopération belge au développement (DGCD) organisent les 3 et 4 mars un séminaire de réflexion sur la microfinance. Dans le dernier numéro de Regards économiques, Valérie de Briey, qui est responsable de recherches au Cerisis, membre de la plate-forme belge de microfinance et du GRAP-OSC (CUD-DGCD), dresse un large panorama du rôle et des missions de la microfinance dans les pays en développement. Elle présente également les questions importantes qui seront débattues lors du séminaire des 3 et 4 mars. Ce communiqué résume les principaux points de son étude. De tous temps, de nombreuses activités de taille très réduite (qualifiées habituellement de micro-entreprises) se sont développées dans les pays du Sud, bien souvent partiellement ou totalement en marge des règles législatives et administratives, pour permettre aux populations pauvres de subsister. Celles-ci regroupent des activités aussi diverses que marchands ambulants, petits artisans, kiosques à journaux, taxis, vendeurs de rue, bazars, etc. Parmi les multiples contraintes auxquelles sont confrontées les micro-entreprises, la difficulté d’accès à des sources de financement extérieures représente encore aujourd’hui une entrave principale à leur bon développement. Elles ont en effet besoin d'un capital suffisant pour financer leurs équipements, leurs achats de fournitures, de matières premières, etc. Or, ce capital leur a longtemps fait défaut car les petites sommes demandées par ces micro-entrepreneurs, l’absence de garantir à offrir et bien souvent la nature risquée du projet rebutaient les banques commerciales traditionnelles. C’est pourquoi différents intermédiaires financiers spécialisés dans l’attention à ce type de clientèle ont vu le jour. Ces intermédiaires sont souvent qualifiés d’ «institutions de microfinance» (IMF). Leur rôle consiste à offrir des services financiers de base (épargne, crédit, assurance, transfert de fonds, etc.), aux montants réduits, à des populations pauvres afin de leur donner la possibilité d’investir et de se prémunir en cas de coups durs (conditions climatiques défavorables à la production, dépenses imprévues liées à une maladie ou à la perte de biens, etc.). Par ailleurs, la microfinance favorise également des retombées positives sur la famille en général : amélioration des conditions de vie, valorisation de l’auto-estime, financement de la scolarisation, des soins de santé, etc.). Il a cependant fallu attendre les années quatre-vingt pour que ce secteur soit véritablement reconnu comme générateur de revenus et créateur d’emplois. Depuis lors, il fait l’objet d’une attention toute particulière de la part tant des praticiens du développement, des politiciens que des chercheurs universitaires. Aujourd’hui, la micro-finance fait partie intégrante des politiques de développement des pays pauvres. En 1998 déjà, l’Assemblée Générale des Nations Unies avait proclamé l’année 2005 l’Année Internationale du micro-crédit pour marquer l’importance de cet instrument pour éradiquer la pauvreté. Son objectif à l’époque était de réduire de moitié les populations pauvres qui vivent sous le seuil de pauvreté d’ici 2015 (Objectifs de Développement pour le Millénaire). Depuis les expériences pionnières jusqu’à sa forte médiatisation de nos jours, le champ de la microfinance a fortement évolué. Il existe une pluralité d’institutions de microfinance faisant appel à des statuts juridiques différents (fondations, coopératives d’épargne et de crédit, institutions publiques, sociétés anonymes, etc.) dont les modes de fonctionnement et les objectifs diffèrent fortement. Les IMF sont aujourd’hui largement tributaires d’un discours néo-libéral prônant l’absolutisation du marché et l’adoption d’une démarche commerciale. Pour des institutions telles que Banque Mondiale ou les Nations Unies, il faut en effet parvenir à la construction de «marchés financiers intégrants» afin de mettre en place des systèmes de microfinance pérennes et qui touchent un grand nombre de populations pauvres. Elles préconisent dès lors l’institutionnalisation des programmes de microfinance, autrement dit, la mise en place d’institutions de microfinance rentables, répondant aux lois des marchés financiers concurrentiels et faisant appel à un mode de gouvernance efficace. Pour ces organismes en effet, les institutions à vocation sociale (de type ONG) sont la plupart du temps fragiles, tributaires des subsides en provenance des bailleurs de fonds et disposent d’une capacité limitée à faire face à la demande massive de microcrédits. D’autres personnes au contraire, principalement des acteurs de terrain soucieux de rester au service des plus démunis, s’interrogent sur les dérives potentielles de l’adoption d’une telle démarche et craignent que la poursuite de but de lucre conduise à l’écartement d’une clientèle plus défavorisée afin de satisfaire les critères de rentabilité propres aux marchés financiers. Elles réclament notamment le maintien de subsides. Cette opposition entre ces deux visions de la microfinance constitue ce que Morduch (1998) a qualifié de "microfinance schism". Ce schisme est également marqué par les méthodes d’évaluation auxquelles recourent les partisans de chacune des deux approches (études d’impact, instruments de rating, etc.). Plus qu’antagonistes, ces deux visions de la microfinance sont, selon Valérie de Briey, complémentaires. La pertinence de l’une ou l’autre doit s’évaluer au regard des acteurs en présence, de la cible poursuivie, de la densité de population, de la technologie disponible, du contexte économique, institutionnel, etc. La pérennité d’une IMF ne pourra en effet être atteinte que dans la mesure où l’institution peut opérer à grande échelle et avoir un volume d’activité tel que le point d’équilibre puisse être atteint. Il est donc par exemple nécessaire que la densité de la population soit suffisamment importante pour toucher un grand nombre d’emprunteurs. Par ailleurs, l’IMF doit également disposer d’une technologie appropriée pour évaluer rapidement les demandes de crédit et maintenir à jour l’information commerciale et financière. Sans ces conditions, la productivité des membres internes à l’IMF ne pourra pas être suffisante et la croissance du portefeuille assurée. Par ailleurs, dans le choix de l’approche dans laquelle doit s’inscrire l’IMF, il importe également selon Valérie de Briey de se pencher sur le degré de précarité de la cible visée. Certaines institutions, soucieuses de veiller à la rentabilité de leurs opérations de prêts, excluent en effet de leurs clients, certains secteurs d’activité jugés comme trop risqués (citons en autres les conducteurs de taxi) et mettent des conditions d’accès telles que de nombreux micro-entrepreneurs se trouvent hors des conditions d’accès (comme par exemple l’ancienneté minimale exigée ou le degré de formalisation de la micro-entreprise). Il y a donc place dans certaines zones géographiques pour la coexistence d’IMF différenciées (par exemple des sociétés anonymes adoptant une logique de rentabilité et des ONG adoptant une logique de développement de populations pauvres). Il est donc nécessaire, conclut l’auteur, que les limites du discours dominant orienté sur une approche de marchés soient reconnues et que les bailleurs de fonds adoptent une attitude différenciée selon les intermédiaires financiers considérés, et le contexte économique, social et institutionnel du pays dans lequel ces intermédiaires opèrent. Il faudrait en outre que les bailleurs de fonds adoptent des critères d’évaluation des IMF en cohérence avec la mission poursuivie par l’institution d’appui et ses valeurs fondatrices. Plus qu’antagonistes, les différentes méthodes d’évaluation proposées dans le champ de la microfinance sont, de l’avis de Valérie de Briey, elles aussi complémentaires. Leur utilité dépend tout à la fois de la mission de l’IMF (à vocation sociale ou financière), de la ou des personnes qui évaluent (bailleurs de fonds, membres internes, etc.), de la perspective adoptée (du point de vue des clients, des bailleurs de fonds, de l’institution, etc.) et des moyens dont disposent les évaluateurs. L’important est que les personnes en présence s’accordent sur l’objet de l’évaluation. L’auteur anticipe ainsi sur certaines questions qui seront débattues lors d’un séminaire de réflexion organisé par la plate-forme belge de Microfinance et la DGCD les 3 et 4 mars au Palais d’Egmont à Bruxelles à l’occasion de l’année 2005 proclamée «Année Internationale du Microcrédit» par les Nations Unies.