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[Table des matières] 1. Généralités : Politique et objectifs qualité - Cadre général - Responsabilité des directeurs d'établissements - Système d'information - Financement. 2. Organisation du Programme Qualité : Organisation générale - Revue de direction. 3. Procédures : Procédure d'élaboration et de sélection des projets (avec demande de financement;avec demande de soutien technique; pour information; appel d'offres) - Procédure de suivi. 4. Annexes : Contrat pour la réalisation d'un projet qualité : pour information, sans soutien - avec demande de soutien technique - avec demande de soutien financier. Ce document à usage interne définit la politique "qualité" et décrit l'ensemble des dispositions générales prises en matière de qualité pour la période 97-98.

A new pattern of public & social protection of the elderly emerged during the 1990's in France: the close protection pattern. This pattern is both based on hospice care & hospital care. This double model of social & medical care is reserved for the lower classes & the lower middle classes. When the process of institutionalization occurs, their way of life is transformed because they are no longer allowed to decide by themselves about either their daily way of life or the way of ending their life. Old people who have been professionally assessed as ill, frail & dependent are taken charge of within a socio-familial & professional network. This network is organized in such a way as to ensure the other aspects of the existence of the elderly, while taking charge of all or part of their socio-economic, medical & affective care. Therefore when these people start ageing, their socio-political status changes & their identity becomes "palliative," because they are entering the career of the elderly which is characterized by the deprivation of their citizenship & their personal human rights & freedoms. Thus they have to "learn the job" & their family equally so, because together they constitute a many-sided & "collective person," who needs both medical care & socioeconomic support until the end of the institutionalized person's life. Adapted from the source document.

In this paper, we have studied the "Hospice de la Maternité", created in 1795 to replace the "Office des accouchées" of the Paris "Hôtel-Dieu". Our objectives were, first to conduct a demographic study of the pregnant women coming to the maternity and second, to evaluate the patterns of maternal mortality. Our data are constituted of individual medical reports between 1815 and 1826. 4 086 women issued from a quest at the letter B have been observed. Because of the relative low number of deaths in this population (192), we decided to investigate four other years (1817, 1818, 1819 and 1821), where the deaths were exhaustively recorded.
Unweded mothers represented 80,4 %of the population and their mean age was 25, whereas married women were more than 30 years old. Nearly all these women came from the working class, especially three sectors, sewing (35,4 %), servants (31,8 %) and workers (20 %). More than three quarter dwelled in Paris ; among them, less than 20 % were born in the city.
Mortinatality was very high, it reached 6 %. Forsaking was more prominent for unweded women (81,7 %) than for married mothers (58,3 %). The stay at the Maternity was rather long, mean 23 days. Maternai mortality was high, 47 for thousand, but we noted important fluctuations amongst years and seasons.
The demographic analysis of the population showed that the Maternity appears as a transition structure between the ancient "hospices" and the modem hospital. The poor economic and physiological status of women explained that, despite the noticeable improvement in cares, the mortality rate will remain elevated during all the century, and even increase.

Intro -- À propos de Collection XIX -- Titre -- PRÉFACE -- CHAPITRE PREMIER - LA PLACE DE L'ASSOCIATION DES IDÉES DANS LES PROCESSUS PSYCHIQUES -- CHAPITRE II - L'ASSOCIATION DES IDÉES A L'ÉTAT NORMAL -- CHAPITRE III - LES SYMPTOMES DE LA MANIE -- CHAPITRE IV - L'INCOHÉRENCE DES MANIAQUES -- CHAPITRE V - L'ASSOCIATION DES IDÉES DANS L'ÉTAT MANIAQUE -- Interrogatoire de l'auteur -- Tamb..., femme, 23 ans. Service de M. le Professeur Joffroy -- Malade Pap..., femme. Service de M. Deny. - Hospice de la Salpétrière -- Malade Hug..., homme. - Service du Professeur Joffroy -- Malade Car..., femme. - Service du Professeur Joffroy -- Malade Sch..., homme. - Service du Professeur Joffroy -- Malade Ham,. femme, 47 ans. - Service du docteur Deny à la Salpétrière -- Malade Lebl..., marchande des quatre-saisons. - Service du docteur Magnan, à Ste-Anne -- CHAPITRE VI - LES CAUSES DE L'INCOHÉRENCE MANIAQUE -- CHAPITRE VII - L'ASSOCIATION DES IDÉES CHEZ LES DÉBILES. - LA COHÉRENCE INCOMPLÈTE -- Malade Dub... Service du Professeur Joffroy -- Malade Lé... Service du Professeur Joffroy -- Interrogatoire de Lé... -- Malade Rou... - Service du Professeur Joffroy -- Malade Bri... - Service du Professeur Joffroy -- RÉSUMÉ ET CONCLUSION -- TABLE ALPHABÉTIQUE DES AUTEURS CITÉS -- Note au lecteur -- Page de titre de l'édition imprimée -- Copyright