Heavy metal concentrations in drinking water sources in two mining districts in Ghana.

- In Ghana, mining of minerals at small-scale and large-scale is widespread across many districts, leading to significant heavy metal pollution in the environment. In this study, the concentrations of iron (Fe), manganese (Mn), arsenic (As), and mercury (Hg) in the different drinking water samples collected from households, institutions, water points and surface water in two mining districts namely the Wassa East and Asutifi North were analyzed. The water types collected included boreholes, wells, piped water into yards, public standpipes, rainwater, sachet water, and surface water. The results indicated that the levels of Fe and Mn were higher than As and Hg in all the drinking water samples. The levels of As and Hg in drinking water from households and institutions were higher in the Wassa East district compared to the Asutifi North district. However, the metal levels at water points were similar in both districts. In surface water, Fe levels were higher in the Wassa East district compared to the Asutifi North district with median values of 1243 µg/L and 860 µg/L for the Wassa East and Asutifi North districts, respectively. In contrast, the Mn levels were higher in the Asutifi North district than the Wassa East district with median values of 9.5 µg/L and 90 µg/L for Wassa East and Asutifi North districts, respectively. All the metals (Mn, As, and Hg) studied except Fe were within the recommended WHO level. The Heavy Metal Pollution Index (HPI) values for the different water types in households, institutions and water points were all below the critical limit of 100. The Water Quality Index (WQI) indicates that the boreholes, piped water into yards, and public standpipes in both districts were classified as excellent or good, making them suitable for drinking. However, the wells and surface water in both districts were classified as very poor and unfit for drinking, respectively.

Clinical territories.

The author reflects on the extension of the psychoanalytic clinic, showing how ideas, studies and discussions built up over several years have led various Latin American groups to put their thinking into action, by allowing themselves to be penetrated by issues of the city and directly relate to diverse territories. These studies have shown how psychoanalytic actions can take place in various types of encounter between subjectivities, highlighting their challenges as well as their effectiveness and power.

Trauma-informed training as a means of stabilizing the negative impact of stressful and destructive factors of war on the inner world of future specialists.

OBJECTIVE: Aim: To determine the conditions for the implementation of trauma-informed training as a means of stabilizing the negative impact of stressful and destructive factors of war on the inner world of future specialists. PATIENTS AND METHODS: Materials and Methods: 1,100 students studying in the conditions of martial law took part in the experimental work. RESULTS: Results: As a result of the negative impact of the stressful and destructive factors of the war on the inner world, the future specialists the following manifestations of the deterioration of the health were established: depression (99%), sudden change of mood (92%), worsening of well-being during sudden changes in the weather (66%), irritability (52%), aggressiveness (11%), anger (7%). It was found that future specialists wanted to postpone completing the educational task until later, as they perceived it as very difficult (79%). CONCLUSION: Conclusions: The conditions for the implementation of trauma-informed studying were formulated as a means of stabilizing the negative impact of stressful and destructive factors of war on the inner world of future specialists. 1. During the organization of learning, teachers take into account the fact that psycho-traumas, which are caused by stressful and destructive factors of war, disturb students until they experience them. 2. Teachers take into account the traumatic experience of future specialists. 3. The teachers' actions aim to restore future professionals' sense of security, reestablish contact with other study participants, and regain control over their own lives and studies.

[The attitude of foreign students to healthy life-style and confidence to modern medicine as exemplified by students of Kursk].

The article investigates attitude of foreign students to health and a healthy lifestyle. The main practices of maintenance of health and healthy lifestyle are analyzed. The opinions of foreign students related to their health and their modes of dealing with stress in new social cultural conditions are considered. The results of sociological survey carried out in January 2024 covering students of the Kursk State Medical University - foreign students who arrived to receive higher education were chosen as the analysis base. The study established that foreign students more often associate healthy lifestyle with maintenance of mental health, healthy diet and domestic hygiene. At that, considering medicine and physician visits, percentage of respondents attributing these aspects to healthy lifestyle and themselves applying to medical workers is far lower than those giving up bad habits and maintain hygiene. The conclusion is made that it is necessary to increase awareness of foreign students about their rights to receive qualified medical care that will serve as factor increasing confidence in medical institutions and physicians.

The Family and Pregnancy Pop-Up Village: Developing a one-stop shop of services to reduce pregnancy care-related inequities in San Francisco.

INTRODUCTION: Centering affected individuals and forming equitable institutional-community partnerships are necessary to meaningfully transform care delivery systems. We describe our use of the PRECEDE-PROCEED framework to design, plan, and implement a novel care delivery system to address perinatal inequities in San Francisco. METHODS: Community engagement (PRECEDE phases 1-2) informed the "Pregnancy Village" prototype, which would unite key organizations to deliver valuable services alongside one another, as a recurring "one-stop-shop" community-based event, delivered in an uplifting, celebratory, and healing environment. Semi-structured interviews with key partners identified participation facilitators and barriers (PRECEDE phases 3-4) and findings informed our implementation roadmap. We measured feasibility through the number of events successfully produced and attended, and organizational engagement through meeting attendance and surveys. RESULTS: The goals of Pregnancy Village resonated with key partners. Most organizations identified resource constraints and other participation barriers; all committed to the requested 12-month pilot. During its first year, 10 pilot events were held with consistent organizational participation and high provider engagement. CONCLUSION: Through deep engagement and equitable partnerships between community and institutional stakeholders, novel systems of care delivery can be implemented to better meet comprehensive community needs.

Human rights among Korean dental hygiene students in hospital clinical practice.

BACKGROUND: The human rights of dental hygiene students should be guaranteed during practice at medical institutions for their mental and physical health as well as professionalism, for patient safety. Safe and well guaranteed clinicians can perform their work in a more stable way. This study investigated the human rights circumstances of dental hygiene students during their hospital clinical practice at dental institutions. METHODS: This study used a cross-sectional survey design. Convenience sampling was conducted on 121 third- and fourth-year dental hygiene students from universities in Seoul, Gyeonggi, and Gangwon. The survey used the Human Rights Indicators for Dental Hygiene Students to investigate the rights to safety, equality, and personality to understand participants' experiences of guaranteed fundamental rights. Data were collected from October 31 to November 8, 2019. A chi-square test was used to assess differences in experience according to general characteristics. RESULTS: During dental hygiene practice at dental institutions, less than 50% of students felt safe. When human rights violations occurred in dental institutions, only 42.4% of students received guidance on response measures from their universities. While 72.1% of students who practiced at dental university hospitals were given information on first aid supplies (facilities) within dental institutions, only approximately 45% of students who practiced at lower-scale dental institutions were given this information (p < 0.05). Regarding equality rights, only 52.5% of trainees reported that they had received equal treatment from healthcare workers during hospital clinical practice. CONCLUSIONS: During dental practice at dental institutions, Korean dental hygiene students confirmed that human rights (including safety rights, equality rights, and personality rights) were guaranteed to varying degrees. Dental hygiene students' rights during hospital clinical practice in dental institutions should be guaranteed across institutions regardless of their scale. This is necessary for dental hygiene students' human rights and safe policies and guidelines in dental institution clinical practice and regular monitoring systems.

Importance of Understanding Minority-Serving Institutional Designations and Associated Abbreviations in Contemporary US Higher Education.

Prefixes and suffixes in pharmacy might suggest a drug class, generation, or mechanism of action. As pharmacy educators, we also use an alphabet soup of acronyms and abbreviations to describe board certifications or professional organizations and our affiliation to them. Although we may be experts in nomenclature and abbreviations related to health professions education, sometimes, we also have to remind ourselves to be humble and embrace a learning mindset relative to the abbreviations and naming conventions used more broadly in higher education and in other fields. This article discusses the use of abbreviations in minority-serving institutions as well as the financial, historical, and political implications surrounding their names and definitions. The need to appreciate institutional designations and what they represent is not unique to minority-serving institutions or solely the responsibility of personnel who lead diversity, equity, inclusion, and accessibility efforts. Appreciating what institution designations mean is a logical first step toward discovering and acting upon the possibilities to facilitate and support the success of all learners recruited into the pharmacy profession.

Application of Machine Learning for Automating Behavioral Tracking of Captive Bornean Orangutans (Pongo Pygmaeus).

This article applies object detection to CCTV video material to investigate the potential of using machine learning to automate behavior tracking. This study includes video tapings of two captive Bornean orangutans and their behavior. From a 2 min training video containing the selected behaviors, 334 images were extracted and labeled using Rectlabel. The labeled training material was used to construct an object detection model using Create ML. The use of object detection was shown to have potential for automating tracking, especially of locomotion, whilst filtering out false positives. Potential improvements regarding this tool are addressed, and future implementation should take these into consideration. These improvements include using adequately diverse training material and limiting iterations to avoid overfitting the model.

Psych Unit Gangs: An Autoethnography.

The stigma against people with mental illness is a well-worn subject; however, stigma between groups of people with different mental illnesses is rarely discussed. Within the context of a psychiatric hospital, hierarchies form among patients based on symptomatology and diagnosis. In this perspectives piece, I explore, how, in my experiences with being on the bottom of this hierarchy as a person with a schizophrenia-spectrum psychotic illness in a psychiatric hospital. I, and my fellow "psychotics," were stigmatized and outcasted by other groups of individuals who were diagnosed with mental illnesses that are considered less serious than psychosis. I explore how one stigmatized, outcasted group (people with substance use and mood disorders) construct power relationships over an even more highly stigmatized, marginalized group (people with psychotic disorders). Utilizing Goffmanian and Tajfel theories, the perspective explores stigma within a total institution, and the formation of in-groups and out-groups. I explore how people, upon entering the psychiatric hospital unit, know almost immediately whether they belong to the dominant group or the subordinate group, and I conclude with recommendations to reduce the stigma of psychotic disorders within popular culture.

Challenges to the operation of Brazilian LTCIs and changes in oversight.

BACKGROUND: Despite 18 years since health surveillance regulations were promulgated in Brazil to govern Long-Term Care Institutions for Older Adults (LTCIs), many institutions fail to comply with the Differentiated Regime for Public Procurement (Resolution No. 502/2021) due to structural and operational conditions. This study aimed to investigate Brazilian LTCI managers' understanding of challenges that significantly impact institutional operation and gather suggestions for enhancing RDC No. 502/21. METHODS: A cross-sectional, exploratory, and qualitative study was conducted, involving 90 managers or technical supervisors from Brazilian LTCIs. Data were collected using a self-administered Google Forms instrument and analyzed through Thematic Analysis based on the Organizing for Quality (OQ) framework. RESULTS: The most impactful challenges for LTCIs were healthcare, financing, human resources, relationship with oversight bodies, and family members. DISCUSSION: Proposed improvements for RDC No. 502/21 included enhanced professional training, infrastructure revision, increased financial support from the state, realistic oversight/regulations, and tailored monitoring approaches. CONCLUSION: LTCIs in Brazil face numerous challenges, and the suggested improvements aim to adapt regulations to institutional realities. However, considering the regulations' variability and purposes, further investigation is warranted.

Distribution of licensed acupuncturists and educational institutions in the United States at the start of 2023, during the late stage of the COVID-19 pandemic.

This study was conducted to identify the number and density of active licensed acupuncturists (LAcs), as well as the number of accredited schools in acupuncture and Oriental medicine (AOM), as of January 1, 2023, in the United States (U.S.). The number of active LAcs as of January 1, 2023 was 34,524, potentially 33,364 after removing license duplication in multiple states, among which the largest three states were California (with 7317 LAcs [21.19% of the total]), New York (5024 [14.55%]) and Florida (2644 [7.66%]). The total number of LAcs decreased by 8.87% from 2018, and fell short of our projected number of LAcs in 2023 by 9037, or 20.75%. The overall LAc density in the U.S.-measured as the number of LAcs per 100,000 population-was 10.36, less than in 2018. There were 56 active, accredited AOM schools which offered a total of 147 programs (121 at the level necessary for licensing [entry-level], 12 for an advanced practicing degree [advanced-level], and 14 for certifications). Broken down further, offerings included 50 master's degrees in acupuncture, 40 master's degrees in Oriental medicine, 31 entry-level doctorate degrees (10 in acupuncture and 21 in acupuncture plus Chinese herbal medicine), and 12 advanced-level doctorate degrees in AOM. The certification programs included one in East-Asian Medical Bodywork and 13 in CHM. Among these schools in 2023, institutions in the West and East Coast states comprised 67.86% (decreased from 77.42% in 2018) of the national total. California, Florida and Illinois represented 39.29%. There were 48 jurisdictions with acupuncture practice laws in place. The data suggests that the acupuncture profession in the U.S. has been significantly impacted during the coronavirus disease 2019 pandemic. Please cite this article as: Fan AY, He DG, Sangraula A, Alemi SF, Matecki A. Distribution of licensed acupuncturists and educational institutions in the United States at the start of 2023, during the late stage of the COVID-19 pandemic. J Integr Med. 2024; Epub ahead of print.

Love yourself as a therapist, doubt yourself as an institution? Therapist and institution effects on outcome, treatment length, and dropout.

OBJECTIVE: Research suggests that some therapists achieve better outcomes than others. However, an overlooked area of study is how institution differences impact patient outcomes independent of therapist variance. This study aimed to examine the role of institution and therapist differences in adult outpatient psychotherapy. METHOD: The study included 1428 patients who were treated by 196 therapists at 10 clinics. Two- and three-level hierarchical linear regression models were employed to investigate the effects of therapists and institutions on three dependent patient variables: (1) symptom change, (2) treatment duration, and (3) dropout. Level three explanatory variables were tested. RESULTS: The results showed that therapist effects (TE) were significant for all three types of treatment outcome (7.8%-18.2%). When a third level (institution) was added to the model, the differences between therapists decreased, and significant institution effects (IE) were found: 6.3% for symptom change, 10.6% for treatment duration, and 6.5% for dropout. The exploratory analyses found no predictors able to explain the systematic variation at the institution level. DISCUSSION: TE on psychotherapy outcomes remain a relevant factor but may have been overestimated in previous studies due to not properly distinguishing them from differences at the institution level.

Economic policy uncertainty and financial system efficiency.

Economic policy uncertainty (EPU) adversely affects financial system functioning with potentially critical repercussions for economies and corporations worldwide. Financial system efficiency (FSE) has a vital influence on fostering optimal economic growth and development; however, the impact of EPU on FSE remains under-explored. This study investigates the effect of EPU on FSE along with its components financial institution efficiency (FIE) and financial market efficiency (FME). Using data from 22 countries over a 20-year period (2002-2021), our analysis reveals a significant negative effect of EPU on FSE, FIE and FME. Notably, our split-sample analysis highlights the accentuated adverse effects of EPU in high-EPU regimes, emphasising the importance of vigilance during periods of elevated policy uncertainty. We conduct a series of sensitivity tests, including alternative measures of EPU, FSE, FIE and FME, and apply two-stage least squares and two-step dynamic system generalised method of moments estimators and introduce additional control variables. These tests consistently reaffirm the core conclusions of our study. Finally, we discuss the implications of our findings for policymakers.

Sustainability in radiography education: A case study of a tertiary institution in Zimbabwe.

INTRODUCTION: To equip radiographers to tackle the negative impacts of climate change, it is crucial to offer in-depth education on planetary health and sustainability. This study aimed to use a tertiary institution in Zimbabwe as a case study to assess radiography students' views on the integration of sustainability into their curriculum. METHODS: A quantitative cross-sectional study using a questionnaire took place at a tertiary institution in Harare, Zimbabwe, where students were sampled consecutively. Categorical variables were described using frequencies and percentages. Data analysis was carried out using Stata 13.1. RESULTS: A total of 96 out of 111 students participated, with an 86% response rate. The majority of students believed in the importance of environmentally friendly radiography practices (90.62%) and felt that sustainability is crucial for better patient care. While sustainability teaching was acknowledged in the curriculum, many students were not confident about the topic in exams. There was no consensus on the preferred methods of teaching sustainability. University lecturers specializing in climate-related fields were seen as the most suitable teachers for sustainability education. CONCLUSIONS: The curriculum reflects efforts in sustainability education, but student confidence and awareness of climate-focused research units require improvement. Continuous education is crucial to link sustainability awareness with practical implications in radiography. Future studies should investigate tailored teaching methods to engage students effectively in sustainable radiography practices. IMPLICATIONS FOR PRACTICE: The findings highlight the importance of ongoing education and awareness campaigns to address the disconnect between understanding the importance of sustainability and implementing it effectively in radiography practice.

Cervical cancer awareness, perception, and attitude among tertiary health institution students in northeastern Nigeria.

Background: The devastating scourge of cervical cancer in Africa is largely due to the absence of preventive interventions, driven by low awareness and poor perception of the disease in the continent. This work is a preliminary effort toward understanding key social drivers promoting this disease in our immediate environment with a view to mitigating it. Method: Female students of two tertiary health institutions in Azare, northeastern Nigeria, were approached to participate in this cross-sectional descriptive study. A structured self-administered questionnaire was administered to consenting participants and covered questions on their socio-demographics, awareness, perception, and attitude about/toward cervical cancer and its prevention. The responses were scrutinized for coherency and categorized into themes using summary statistics, while a chi-square test was used to determine the association between awareness of cervical cancer and participant age, marital status, religion, screening uptake, and willingness to undergo screen. Results: Awareness of cervical cancer was recorded among 174/230 (75.7%) respondents who enrolled in this study; 117 (67.2%) knew that it was preventable, but only three (1.3%) respondents had undergone screening. Among the aware participants, 91 (52.3%) and 131 (75.3%) knew that sexual intercourse and multiple sexual partners are risk factors for the disease, respectively. In contrast, knowledge of the etiology was poor; 82 (47.1%) respondents who knew it was preventable had heard about human papillomavirus (HPV), while 72 (41.4%) knew that HPV causes cervical cancer. Most (78%) of the participants expressed willingness to take a human papillomavirus vaccine or undergo screening (84.6%) if made available to them. Awareness was significantly associated with participants' age (p = 0.022) and willingness to undergo screening (p = 0.016). Conclusion: This study revealed discordance between awareness and knowledge about cervical cancer. Educational initiatives reflective of population perception/knowledge of cervical cancer are needed to mitigate the rising incidence of this disease, especially among female healthcare providers.

Experiences of pregnant and parenting students at a university in Gauteng province.

Background: Pregnancy and parenting in tertiary institutions is a worldwide concern. The number of pregnancies among tertiary students is increasing globally. About 16 million young women between the ages of 15 years and 19 years around the world became mothers and two million girls under the age of 15 years are reported to be pregnant every year. South African universities continue to report high rates of student pregnancies, and are looking for solutions to the crisis that female students are facing. Aim: The purpose of the study was to explore the experiences of pregnant and parenting students. Setting: At a university in Gauteng province, South Africa. Methods: A qualitative, exploratory and descriptive design was used in a study that was conducted at a university in Gauteng province, South Africa. Undergraduate pregnant and parenting students were sampled purposively, and the sample size was 15 participants. Semi-structured interviews were used to collect data and data were analysed using thematic analysis. Results: The findings of the study produced four themes, namely emotional experience during pregnancy, academic challenges during parenting, experiences during antenatal care, and students' resilience during pregnancy and parenting. Conclusion: Pregnant and parenting students require emotional, academic and social support from the university and other stakeholders. The university should offer on-campus medical services such as antenatal care and provide academic support for pregnant and parenting students to help them achieve their academic objectives. Contribution: This study highlights the importance of developing support programmes that focus on pregnant and parenting students in universities.

Nurses' practice of metabolic monitoring for patients on antipsychotics in Lesotho.

Background: Severe mental illness is associated with higher physical health morbidities and reduced life expectancy, with an estimated 14.3% of global deaths attributed to mental disorders. Antipsychotic medications (APs) used in treatment contribute to physical health issues, including metabolic and cardiovascular effects. Aim: The aim of this study was to assess nurses' practices regarding metabolic monitoring for patients prescribed antipsychotic medications at Mohlomi Hospital in Lesotho. Setting: The study was conducted at Mohlomi Hospital, the primary psychiatric facility in Lesotho. Methods: Using a cross-sectional design, 44 nurses from Mohlomi Hospital participated in the study. A structured questionnaire assessed nurses' metabolic monitoring practices. Results: Most of the respondents were female (n = 30, 75%), and minority were male (n = 10, 25%). The academic qualifications of respondents were distributed as follows: 40% (16) held a nursing assistant certificate and 22.5% (9) held an advanced nursing diploma, among others. The average age of all respondents was 39.05 (s.d. 8.9), with an average of 8 years of experience in psychiatry (s.d. 7.6). The overall rate of nurses' practices of metabolic monitoring for patients taking antipsychotic medications showed variability, with a mean score of 2.83 (s.d. 0.524). However, only 20% performed ECG tests, 22.5% measured blood pressure, 27.5% tested for glucose abnormalities and 17.5% conducted lipid profile testing. Conclusion: Results revealed a significant gap in the practice of metabolic monitoring among nurses with various aspects of metabolic monitoring, not being adequately monitored. Contribution: The study's findings shall inform policy and guidelines for monitoring patients on antipsychotic medications while guiding future research.

Before and during COVID-19: the roles of transformational leadership, organizational culture and work-life balance in healthcare.

PURPOSE: This research aims to investigate the role of transformational leadership and organizational culture - encompassing Clan, Adhocracy, Hierarchical and Market Cultures - in the context of work-life balance for healthcare workers. It aims to present a comparison of observations made pre and mid-pandemic. DESIGN/METHODOLOGY/APPROACH: A structured questionnaire was utilized to collect data from a varied sample of 355 employees (258 before and 97 during the pandemic) representing multiple sectors and positions within a hospital. The interpretation of the data was accomplished using Partial Least Squares Structural Equation Modeling (PLS-SEM). FINDINGS: Findings reveal that prior to the pandemic, transformational leadership significantly influenced all forms of organizational culture perceptions, with a strong influence on Clan Culture. Clan Culture displayed a consistent positive correlation with WLB both before and during the pandemic. During the pandemic, Market Culture exhibited a negative effect on WLB and Adhocracy Culture demonstrated a positive effect, impacts which were absent before the pandemic. Transformational leadership had a positive impact on WLB before the pandemic, but no discernible effect during the pandemic was observed. ORIGINALITY/VALUE: The results indicate that the dynamics between transformational leadership, organizational culture and work-life balance are susceptible to alterations in the face of external crisis events. This study offers a unique exploration of these dynamics in the healthcare sector during the ongoing global pandemic.

Trust in Acquaintances, Strangers and Institutions among Individuals of Different Socioeconomic Statuses during Public Health Emergencies: The Moderation of Family Structure and Policy Perception.

Trust plays a crucial role in effectively responding to public health emergencies. Drawing on COVID-19 survey data conducted in Hubei, China, during August 2020 with a sample size of 5494, this study investigated the influence of individuals' socioeconomic status on trust in acquaintances, strangers and institutions, and how this relationship is moderated by epidemic prevention, policy perception and family structure. The findings showed that individuals with higher socioeconomic status tend to have higher levels of trust. Those with higher income but being married demonstrate higher trust. When perceiving epidemic prevention policies as stringent, those with higher income display increased trust in acquaintances and institutions; similarly, those with lower education levels exhibit heightened trust in acquaintances and strangers. Individuals working in social organizations express higher trust in strangers; however, their trust is compromised under stringent epidemic prevention policies due to potentially heavier work burdens.

Can therapeutic reassessment in ODF be based on management principles? / La réévaluation thérapeutique en ODF peut-elle s'appuyer sur les principes du management ?

Introduction: Re-evaluation of therapy is sometimes necessary during treatment. Rarely planned or desired, it is legitimate to look for a way to avoid it while carrying out the correction of the dysmorphosis as initially envisaged. Can the introduction of management into the therapeutic process, and particularly the principle of the feedback loop, make it possible to eliminate any therapeutic re-evaluation? Materials and Methods: After having defined management, cybernetics and the feedback loop as well as the framework for their application, we will look for ways to apply them to the dento-maxillo-facial orthopedics and will then study through historical practice the specific foundations of management and cybernetics in order to be able to conclude that these means are well adapted to our practice. We will rely on a set of historical, sociological and anthropological sources. Conclusions: Management is unsuitable for eliminating the need for therapeutic re-evaluation because, through the deployment of the organizational mode which is consubstantial with it, it is opposed to the institutional order of which any therapeutic approach is a part.

Introduction: La réévaluation de la thérapeutique est parfois nécessaire en cours de traitement ; rarement prévue, ni désirée, il est légitime de chercher un moyen de s'y soustraire tout en menant à bien la correction de la dysmorphose telle qu'initialement envisagée. L'introduction du management dans le processus thérapeutique, et en particulier le principe de la boucle de rétroaction, peut-il permettre de supprimer toute réévaluation thérapeutique ? Matériels et méthodes: Après avoir défini le management, la cybernétique et la boucle de rétroaction, ainsi que le cadre de leur application, nous chercherons les moyens de les appliquer à l'orthopédie dento-maxillo-faciale, puis nous étudierons à travers la pratique historique les fondements propres du management et de la cybernétique afin de pouvoir conclure à la bonne adaptation de ces moyens avec les fins de notre pratique. Nous nous appuierons sur un ensemble de sources historiques, sociologiques et anthropologiques. Conclusion: Le management est impropre à supprimer la nécessité de la réévaluation thérapeutique car, de par le déploiement du mode organisationnel qui lui est consubstantiel, il s'oppose à l'ordre institutionnel dont fait partie toute démarche thérapeutique.