Dissertations / Theses on the topic 'Adultes – Santé et hygiène'
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Bélanger-Gravel, Ariane. "La promotion d'un mode de vie actif chez les adultes présentant un surplus de poids." Thesis, Université Laval, 2012. http://www.theses.ulaval.ca/2012/29154/29154.pdf.
Eboko, Fred. "Pouvoirs, jeunesses et sida au Cameroun : politique publique, dynamiques sociales et contructions des sujets." Bordeaux 4, 2002. http://www.theses.fr/2002BOR40039.
Delannet, Marie-Thérèse. "Education des adultes vieillissants : Corps, vécu du temps présent et intégration sociale : enquête sur les clubs de retraités du Calvados." Caen, 1998. http://www.theses.fr/1998CAEN1257.
In the 70's, Simone de Beauvoir's writings on old age made the french society aware of the living conditions of the old. Thirty years later, although people generally live longer and have more money when they have retired, has their status really got better ? Such a question leads us to examine the importance of human body in our society. The body models set up by the different powers through the ages, can be seen in representational art. They persist in our modern society. Considering the influence of social models, increasing urbanisation, the hold of free market over science and technology connected with health and physical fitness, we need to redefine the body, which leads to the conception of ageing. A survey conducted on retired people's physical activities in the clubs of calvados confirms the routine and the narrowing acquaintanceship which often go with old age. The study of some effects of those activities show that they should be integrated in a constant process of adults'education
Bergeron, Amélie. "Caractérisation de l’apport en sucres libres et naturellement présents dans la population adulte québécoise, et leur association avec des marqueurs de santé cardiométabolique." Master's thesis, Université Laval, 2020. http://hdl.handle.net/20.500.11794/66707.
The direct or indirect effect of the consumption of free sugars on cardiometabolic health is a controversial and complex topic. In recent years, interest in this nutrient has increased. There are two main types of sugars (free sugars, as opposed to naturally occurring sugars; referring to whether or not they are extracted from their original food matrix), which appear not to be associated in the same way with health variables. Since there is no chemical method to distinguish free sugars from naturally occurring sugars, only the total sugar content is generally found on nutrition facts labels and in nutrient databases. Manual differentiation of total sugars must therefore be made in order to characterize the intake of free and naturally occurring sugars in populations and to compare it with current dietary recommendations. Our work has made it possible to characterize these intakes in the Quebec adult population for the first time. Once free and naturally occurring sugars were differentiated, we were able to study the associations of sugar consumption by type (free or naturally occurring) and by source (liquid (beverages) or solid (foods)) with cardiometabolic health markers. Our work, although based on cross-sectional observational data and from which we cannot therefore draw causal relationships, is part of an emerging literature that is relatively sparse, controversial, and deserves a nuanced approach. This master’s thesis presents the work I did on sugar during my master's project, its importance, as well as what its repercussions suggest for improving public health strategies about sugar consumption, more generally, and sugar-sweetened beverages, more specifically.
Omorou, Abdou-Moutawakirou Yacoubou. "Activité physique et sédentarité de l'adolescent et de l'adulte : facteurs associés, impact sur la santé, efficacité d'une intervention." Thesis, Université de Lorraine, 2015. http://www.theses.fr/2015LORR0198/document.
Background: Relationships between physical activity (PA), sedentary behaviour (SB) and health have been usually investigated independently. However, taking into account these two components simultaneously is an essential requirement to understand their health effects. Objectives: To investigate the relationships between PA, SB and health in French population (adolescents and adults). This aim can be divided in 3 different research headings: (1) identification of the correlates of PA and SB, (2) measurement of the health impact of PA and SB, (3) evaluation of the effectiveness of intervention aimed to improve PA and SB. Methods: We used data from different survey and studies carried out in French general or specific population. The PRALIMAP trial (PRomotion de l'ALImentation et de l'Activité Physique) in adolescents, the SUVIMAX trial (SUpplémentation en VItamines et Minéraux Anti-oXydants) in adults and the health Barometer Surveys (2005 and 2008) in general population. For the heading 1 we investigated the socio-demographic and economic correlates of PA and SB. For the heading 2 we analyzed the common and specific effects of PA and SB on health, especially health-related quality of life (HRQoL) and overweight prevalence. For the heading 3 we assessed the effectiveness of intervention on PA and SB change and its relationship with overweight reduction. Results: PA and SB were highly correlates to socio-economic characteristics in both adolescents and adults. In bidirectional analyses taking into account the domains of PA and SB, we yielded that PA and SB could be both causes and consequences of HRQoL. Intervention (PRALIMAP) was effective in improving PA and SB and this improvement partly mediated the weight reduction. Conclusion: The results of this work emphases the importance of PA and SB as health determinants whatever the life period (adolescents and adults) particularly in terms of weight reduction and HRQoL improvement
Djossa, Adoun Medetongnon Alfred Serge. "Les technologies de l'information et de la télécommunication (TIC) pour la promotion de la santé sexuelle et reproductive (SSR) au sein des jeunes des Premières Nations du Québec : faisabilité et pistes d'intervention." Doctoral thesis, Université Laval, 2016. http://hdl.handle.net/20.500.11794/26815.
The distribution of sexually transmitted infections (STIs) and HIV / AIDS prevalence in Canada presents large inequalities between different socio-cultural groups. Aboriginal people are, among the population, which pay the heaviest price. The First Nations of Quebec and Labrador Health and Social Services Commission (FNQLHSSC) has identified sexually transmitted infections, including HIV/AIDS, as a priority health issue. The Aboriginal Strategy on HIV / AIDS estimates that to be effective, interventions to prevent HIV / AIDS must target various groups, among which Aboriginal youth is a particular target. In this sense, the familiarity of the younger generation with technology positions especially the use of information and communications technology (ICT) as a highly promising avenue for HIV / AIDS prevention among adolescents and young adults. We conducted a knowledge synthesis in this innovative field following the methodology suggested by the Cochrane Collaboration to highlight the effectiveness and the adoption factors of interventions using ICT for the prevention of STIs/HIV/AIDS and for the promotion of sexual and reproductive health among adolescents and young adults. The results of this systematic review were used to develop and conduct, in partnership with the FNQLHSSC, a research project aiming at studying the feasibility of interventions using information and communication technologies (ICT) to promote sexual health among adolescents and young adults of Quebec First Nations (FN) communities. As a complement to this feasibility evaluation, a study was conducted in order to formulate exhaustive recommendations for the development of evidence-based interventions that also take into account the characteristics of the target population. This study aimed to identify the factors underlying condom use among 13-18 year olds from FN communities of Quebec. We discussed in this thesis the results of those studies, as well as various issues of our research partnership with the FN stakeholders who participated in our project. The practical implications of our results, in terms of research and intervention, are to be discussed with our main partner, the FNQLHSSC, in order to maximize benefits for the populations of PN.
Drescher, Olivia. "Gene-environment study on PON1 serum activity and methylmercury exposure among Indian Cree adults." Thesis, Université Laval, 2011. http://www.theses.ulaval.ca/2011/28685/28685.pdf.
Morcel, Jules. "Identification de paramètres nutritionnels, d’activité physique et de condition physique à l’adolescence impactant le risque cardiovasculaire à l’âge adulte." Electronic Thesis or Diss., Université de Lille (2022-....), 2023. https://pepite-depot.univ-lille.fr/ToutIDP/EDBSL/2023/2023ULILS069.pdf.
Introduction: Cardiovascular disease is the world's leading cause of death and is mostly caused by the formation of atherogenic plaques. These plaques appear during adolescence, and their growth depends on numerous risk factors, both non-modifiable (age, gender) and modifiable (lipid profile, blood pressure, glycemia, smoking, body mass index). Nutrition, physical activity and fitness are complex elements that have been shown to have a significant impact on modifiable risk factors in mostly cross-sectional studies.Material & Methods: The aim of this study is to identify, in a longitudinal way, parameters of nutrition, physical activity and physical fitness in adolescence that have an impact on adult cardiovascular risk. These analyses are based on data from the HELENA and BELINDA studies. The HELENA study (2006 - 2007) included 3528 adolescents aged from 12.5 to 17.5 years in 10 European countries, and collected extensive nutritional, physical activity, fitness, anthropometric and biological data. The BELINDA study (2016 - 2020) is a nested cohort that repeated the same analyses, a decade later, in 232 subjects from 4 centers (Ghent, Lille, Roma and Zaragoza). Parameters of interest were identified based on bibliographic resources and data available from these two cohorts. Their impact on cardiovascular risk was assessed by a multivariate statistical analysis. Cardiovascular risk was assessed according to modifiable cardiovascular risk factors and the PDAY (Pathobiological Determinants for Atherosclerosis in Youth) cardiovascular risk score. The parameters identified as most relevant for their potential to predict cardiovascular risk will be the target of more specific studies.Results: The literature analysis identified 13 parameters of interest, including 8 for nutrition, 2 for physical activity and 3 for fitness. Adherence to the diet quality index, planetary health diet index, dietary knowledge and cardiorespiratory fitness were the parameters identified as cardioprotective, in contrary to consumption of ultra-processed foods and upper body muscular strength. An extensive analysis of dietary knowledge highlighted its beneficial long-term impact on adults' blood pressure and dietary behaviour.Discussion: The diet quality index, the planetary health diet index, dietary knowledge, consumption of ultra-processed foods, cardiorespiratory fitness and upper body muscular strength in adolescence have all been shown to have a significant impact on cardiovascular risk in adulthood. Early approaches using these tools therefore seem relevant for identifying clusters of populations at-risk and preventing cardiovascular risk from an early age
Lamy, Leandre. "Évaluation des effets d'un programme de mentorat par les pairs sur la pratique d'activité physique et la condition physique de jeunes adultes au collégial." Master's thesis, Université Laval, 2021. http://hdl.handle.net/20.500.11794/68629.
The actual portrait of the health behaviours of young adults reveals alarming data about the physical activity level (Colley, Garriguet, Janssen, Craig, Clarke & Tremblay, 2011). To help them adopt increase their physical activity level, it seems appropriate to set up interventions that mobilize the action of their peers (Canadian Institute for Research on Fitness and Lifestyle, 2014; 2015). They seem to give them special importance when the time comes to adopt healthy lifestyle habits (DuBois & Karcher, 2014). Therefore, peer mentoring seems a promising avenue. Although the characteristics of this type of intervention have been documented in the literature, few studies have evaluated its effects in mentees (Sallis, Calfas, Nichols, Sarkin, Johnson, Caparosa, Thomson & Alcaraz, 1999; Boyle, Mattern, Lassister & Ritzler, 2011) and even fewer have done so with mentors (Lubans, Morgan, Aguiar & Callister, 2011). From this perspective, the present study had two objectives: 1) to evaluate the effects of a peer mentoring program in college settings on the practice of physical activity, physical condition, eating behaviours, consumption of fruits and vegetables. and the sense of personal effectiveness of mentees and mentors; 2) explore the moderating role of gender and participants' initial level of physical activity on the effects of the program. These objectives were investigated using a study with a quasi-experimental design using 104 young adults (mentors n = 38, non-mentors n = 33, mentees n = 21 and non-mentees n = 12). Questionnaires as well as physical tests made it possible to measure the main variables. The covariance analyzes show that at the end of the intervention, mentees adopted fewer behaviours aimed at gaining weight than non-mentees, while mentors adopted fewer behaviours aimed at losing weight than non-mentors. In addition, moderation analyzes reveal effects in men regardless of their initial level of physical activity but not in women. In fact, 1) mentee men exhibit better estimated maximal volume of oxygen consumption (VO₂ max) than non-mentee men, 2) male mentors show a lower body mass index (BMI) than non-mentor men and 3) male mentors report more behaviours aimed at gaining weight than non-mentor men. However, although our results suggest these effects, it seems essential to us to interpret them with caution due to some methodological limitations, in particular the small sampling. We often see them as tendencies to take in count for future research. However, our results suggest that we must consider sex of participants when time comes to orient, implement, and operationalize mentoring programs, particularly for the mentors.
Zakhem, Eddy. "Relations entre le niveau de performance physique, le niveau d'activité physique usuel, les apports nutritionnels, les caractéristiques anthropométriques, le sommeil et les paramètres osseux chez les jeunes adultes sains." Thesis, Littoral, 2015. http://www.theses.fr/2015DUNK0417.
The aim of this study was to investigate the relations between physical performance level, physical activity level, nutritional intakes, anthropometrical characteristics and sleep on the one hand and bone mineral density, hip geometric indices and trabecular bone score (TBS) on the other hand in young Lebanese and French subjects aged to 18 to 35 years. In a first step, we led 10 preliminary studies in young Lebanese adults. These studies have shown that body weight, lean mass, high-impact physical activity practice, maximal strength and muscular power are positive determinants of bone mineral density, and that high-impact physical activity practice positively influences TBS values, geometric indices of hip bone strength (cross-sectional area (CSA) and section modulus (Z)) and femoral neck strength indices (Bending strength index (BSI), compressive strength index (CSI) and impact strength index (ISI)). These preliminary studies have also shown positive correlations between nutritional intakes (daily calcium intakes and daily protein intakes) and BMD values in young Lebanese men. Finally, one of these preliminary studies has shown that sleep quality is associated with a greater BMD in young men. In a second step, we led a study on 535 young French adults (342 women and 193 men) to explore the relations between physical performance level, physical activity level, nutritional intakes, anthropometrical characteristics and sleep on the one hand and BUA (Broadband ultrasound attenuation) values on the other hand. This study has showed that anthropometric characteristics (body weight, body mass index, waist circumference and hip circumference) are positively correlated to BUA values in women but not in men. On the other hand, we have noted a tendency of positive relation between vertical jump performance and BUA values in men. In conclusion, this thesis has defined an important number of factors significantly correlated to BUA, BMD, hip geometric indices and TBS and therefore permitted to identify new relations between health determinants and bone parameters in young adults
Robert, Sarah. "Santé et recours aux soins des jeunes en insertion socio-professionnelle : une recherche interventionnelle multicentrique Santé et recours aux soins des jeunes en insertion âgés de 18 à 25 ans suivis en mission locale Effects of systematically offered social and preventive medicine consultation on training and health attitudes of young people not in employment, education or training (NEETs) : an interventional study in France." Thesis, Sorbonne université, 2020. http://www.theses.fr/2020SORUS038.
In France, ‘‘Missions locales’’ are public assistance sites for young people aged 16–25 years who are not in employment, in education or training (NEET). More than 1.4 million NEETs – i.e. ten to fifteen percent of the youth – participate in these sites each year. The main goal of ‘‘Missions locales’’ is to enhance both professional and social insertion – since education, employment, housing and health issues are inseperable. Several international studies have shown that NEETs have poor health status. In France, there were very few quantitative studies on this topic until the PRESAJE survey in 2011, which took place in five ‘’Missions locales’’. Based on data from this survey, we showed that the overall social profile of the NEET population was diverse, with more difficult living conditions than in the general population. Health-related vulnerability factors identified were: low education level; social isolation; insufficient health insurance; low self-esteem; and, low level of trust in institutions. Some of their health indicators were remarkably poor compared to other youth of the same age: more often, they had chronic disease, were overweight or obese, and their mental health status was poor. Despite their poor health, NEETs had less access to health care than the youth of the same age in the general population. This work also has highlighted the importance of having health sites inside ‘‘Missions locales’’. Social and preventive medicine consultations that are fully integrated into the social services for NEETs have an impact on their access to training (and we hope subsequently on their employment), and contribute to changing some of their health-related behaviours
Sourdet, Sandrine. "« De la dépendance à la fin de vie du sujet âgé : évènements iatrogènes et prévention »." Thesis, Toulouse 3, 2020. http://www.theses.fr/2020TOU30237.
Hospitalization, functional decline, institutionalization and ultimately death, are common and serious risks in the elderly population. More than 1.2 million older adults in France experience disability. Disability can be explained by two leading causes: chronic diseases and hospitalizations. In older patients, hospitalization associated disability can be triggered by the acute illness that requires hospitalization, but also by inappropriate health care management, and iatrogenic events. We demonstrated that hospitalization associated disability was high in older hospitalized patients, and often explained by iatrogenic events that could be preventable. Previous studies have reported a high risk of functional decline in older patients with cancer. In this population, functional decline can be explained by the impact of the cancer itself, but also adverse effects of the oncologic treatment. To prevent treatment-related complications and assess the appropriateness of the oncologic treatment, a comprehensive geriatric assessment (CGA) is recommended in oncology practice. We aimed to identify domains of CGA that could influence treatment decision in older patients with cancer. Institutionalization is a common outcome in disabled older adults. Nearly 600 000 older adults live in nursing home in France, and 90 000 residents die in nursing home each year. The management of pain and uncomfortable symptoms is a priority in end of life residents. An optimal palliative care management involves optimization of drug prescriptions, including the prescription of symptom-oriented drug therapy but also the limitation of adverse drug events. We assessed drug prescriptions in end of life residents in nursing home, including inappropriate drug prescriptions
Bauret, Michel. "Hygiène et santé publiques à Bordeaux (1870 -1914)." Bordeaux 3, 1994. http://www.theses.fr/1994BOR30061.
This study defines local authority initiatives in public health and hygiene in a french provincial city. It shows the use of nascent administrative technology by the town hall, which employed increasing financial means and equiped itself with functionnal, structured services, led by competent civil servants. Thus the city of bordeaux adopted and applied the hygienic sanitation themes born of the "pasteur revolution" and spread by the local hygienist movement, guided by several highly actives personalities. Moreover, municipal activity was assisted by a permanent political consensus and an absence of partisan divisions, since the elected council took over the legacy of former assemblies. During the 1880's and 1890's, the city installed a modern system of hygienic sanitation management, directed first of all at sanitation improvement and then at disease prevention. Thus, successfully and discreetly, the biological safety of the local population was taken care of, a testimony to the vigour of french municipalism, which took on new responsabilities as early as the end of the nineteenth century
Hélardot, Valentine. "Santé ou travail ? : les expériences sociales de la santé et de la précarisation du travail." Toulouse 2, 2005. https://halshs.archives-ouvertes.fr/halshs-00471343.
The objective of this study is to understand how health and work are interwoven in employees' social experience, in the context of the casualisation of work and of changes in work organisation. Three levels of enquiry were used to investigate various aspects of the social construction of the links between health, work and casualisation. 50 telephone interviews with occupational doctors were carried out in order to analyze their representations and practices, and to recruit 200 employees who have answered a questionnaire. The statistical enquiry shows the variety of both health and work experiences. Finally, 30 detailed interviews with employees were carried out in order to cross examine their experiences of work and health. The biographical approach makes it possible to understand how the interweaving between work and health is perceived and reconstructed by the employees at different moments in the course of their lives
Goncalves, Davi. "L'éducation du travailleur en santé professionnelle : [ la situation des travailleurs brésiliens." Paris 8, 1997. http://www.theses.fr/1997PA081384.
This is a diagnostic essay of education applied to the prevention of illness and work-related accidents in brazil. The study analyses the role which the economic, educational, anthropological and philosophical undercurrents of brazil's social structure play on the subject. Formal education was used by the ruling classes as a tool to create a trained labour force, not citizens. The worker education in professional health is a by-product, based on making profits. The dynamic chain of these events are: 1. The government tries to convince employers that so-called preventive measures can increase productivity. 2. But the employers see no growth. So they don't invest in teaching employees about prevention. 3. The number of accidents and work-related illnesses continue to rise. 4. The government and the employers blame the workers. 5. The workers defend themselves psychologically and succumb to the traditional notion of the destiny, predestination, spiritual forces or will of god. The author explicits this chain of ideas and facts : the influences of catholicism, protestantism, spiritism, beliefs of indigenous peoples and of africans lead the brazilians to have a dualistic interactive world view. It's this world view that underlies the worker's interpretation of the facts related his work-related accidents and illness. The research showed that two symbiotic features helped to create a pseudo conscience among workers. First of all, the official pedagogical material on prevention convinces the workers of their own exclusive responsibility for work-related health problems (illnesses and accidents). Secondly, workers find some comfort behind their hypostasis of the situation. They attribute their unhappiness to uncontrollable spiritual forces and a predetermined destiny
Berut-Bersier, Evelyne. "L' enfant et la santé : les institutions spécifiques de protection de la santé des enfants." Aix-Marseille 3, 2007. http://www.theses.fr/2007AIX32001.
The evolution of the child’s rights in the field of health, in France, is charaterized by the passage from the right to the prevention of death to the right to the protection of health in a more recent objective of promoting his health. Nowadays, both the protection and the promotion of the chidren’s and teenagers’ health are ensured by two specific institutions : mother and infant welfare (MIW) and the mission of promotion for pupils’health. . MIW, which ensures the preventive assumption of responsability of the health of all children up to six years old, proves to be always indispensable nowadays. However it must be more recognized in order to allow equality, efficienc quality on its own territory. Scholl health, supposed to take over MIW, through the mission of promotion of health in favour of pupils doesn’t intend for all children not either for all those which are provided with schooling. Indeed, only those sent to state schools are concerned, contrary to the provisions of the text which organizes it. Nevertheless school health proves to be unable to meet the needs for the children and teenagers provided with schooling in the absence of a real will other than expressed in the circulars. It becomes urgent that an overall and national policy of health in the field of children’s health determines priorities and brings the necessary to their implementation
Cartierre, Nathalie. "Approche bioécologique de la santé des adolescents : filles et garçons en situation de désaffiliation contextuelle." Lille 3, 2009. http://www.theses.fr/2009LIL30039.
In this thesis, the adolescents' health behaviors are discussed in terms of transactions that take place within three different life contexts : family, school and peers. The unit of analysis relies on the concept of affiliation presented in the literature as a basic need of psychological functioning. Both its contextualization and its operationalization led to the creation of the Contextual Connection Scale for Adolescents (CCSA). The contextual connection is sensitive to three sources of variability that caracterize the developmental system : sex, age and context. Its fundamental character is attested by the systematic links established with health behaviors. Specifically, disconnected adolescents' health scores are the most unfavourable ones. The situation of double disconnection - to family and to school - is particularly deleterious. In addition, the amplification of the risks that is found in the double disconnection results for girls in an extension of the manifestations of ill-being which also includes negative behaviors more typically masculine. The reverse is not found for boys. The connection and disconnection appear to be mains markers of the processes of self-regulation that are involved in health behaviors
Dias, Marisa. "Santé et travail : le principe de précaution." Paris 8, 2005. http://www.theses.fr/2005PA082591.
Besson, Rachel. "La santé publique à l'école : approche anthropologique autour de l'expérience des infirmières scolaires." Bordeaux 2, 2003. http://www.theses.fr/2003BOR21058.
How can a welfare policy be implemented in the French school system ? How can this institution, in its missions as well as in its working, take into account the attention brought on health and on the pupil's body ? A study realised on school nurses of the Gironde "Department" sheds light on the implementation of welfare measures. The nurses' professional experience in the education system conduces this work. Their experience affords the comprehension of the way the nurses have to rebuild their professional identity when they take part in this institution. Their daily work induces them to articulate their practices of medical care round the pupil's attention and comprehension. The infirmary becomes a preferential scene where pupils can come and speak of themselves and their sufferings. The health education, that is another aspect of their job, highlights all the little arrangements they have to do in order to work out their missions. In this context, the AIDS prevention, that is used as an illustrating example, hasn't got a real place in their daily experience. If the daily and institutional context is one of the major causes of nurses' desinvolvement, the AIDS's prevention, because it means talking about sexuality and death, reveals other limits
Paunescu, Alexandra-Cristina. "Les composés dioxin-like mesurés par DR-CALUX et les paramètres osseux évalués par ultrasonographie chez les femmes cries et inuites du Nord-du-Québec et du Groenland." Doctoral thesis, Université Laval, 2012. http://hdl.handle.net/20.500.11794/23609.
Baron, Marie. "Vieillissement en bonne santé dans l'Inuit Nunangat : vers un modèle géographique des déterminants sociaux de la santé." Doctoral thesis, Université Laval, 2019. http://hdl.handle.net/20.500.11794/67219.
Background: The aging of the Inuit population is a new phenomenon creating new and unique social and health challenges across the Arctic. There is relatively limited evidence about the health profile and the social determinants of health (SDH) for Inuit elders. The definition of Inuit health is holistic, and is anchored in a geographical dimension such that health is created through interactions between people and the land. This geographic dimension is central to understand the role of SDH in supporting healthy aging, yet are seldom included in Inuit SDH models. The overall aim of my doctoral thesis is to conceptualize and operationalize a model of the sociogeographic determinants supporting healthy aging in Inuit communities. This model is built in coherence with Inuit’s definition of health which is The thesis follows three research objectives: 1) to conceptualize, operationalize and validate the concept of health for older Inuit aged 50 years and over; 2) to identify social determinants of health (SDH) at the individual, housing, and community levels associated with healthy aging; and 3) to explore the geographical dimension of the mechanisms connecting the social determinants to healthy aging. Methods: This thesis employs a mixed-methods exploratory and explanatory research design. Qualitative data used to conceptualize the definition of health for Inuit elders were retrieved from workshops conducted in two Nunavik communities in 2016. Using quantitative data from the 2006 Aboriginal Peoples Survey (APS) (n = 850 Inuit ≥ 50 years), latent class analyses was then used to operationalize the definition of health into a holistic indicator health. Associations between this indicator and selected SDH at the individual, housing and community scales were modelled using multinomial regressions. To further explore the geographical dimension of the SDH, and to understand the mechanisms linking the SDH to health, in-depth interviews and one focus groups with 20 participants aged 50 to 86 were conducted in Baker Lake, Nunavut. Thematic analyses were conducted on the data. Results: Health was defined along eight concepts: overall health, physical limitations, mental health, spirituality, health behaviours, speaking Inuktitut, having positive relationships, and affection. A three-category holistic health indicator was created from the latent class analysis: participants in “good health” for all indicators, those with an “intermediate health” profile, and participants in “poor health” for most indicators. Associations between the holistic health indicator and SDH at individual, housing and community scales were different for the three health profiles. Compared to those with a poorer health profile, older adults with a good health profile were more likely to have strong family ties in the community and to participate in social activities. Older adults with an intermediate health profile were more likely to live in a community with a higher socio-economic status, to live in better housing conditions. In comparison to older adults with a poorer health profile, those with good or intermediate health profiles were more likely to have engaged in land-based activities in the past year. The geographic mechanisms linking the SDH to healthy aging emerged through interviews and focus group with elders in Baker Lake. Family and community activities promoted positive social relationships and symbolic connections to the land, including the sharing of traditional food. Housing conditions and community services adapted for elders’ health offered the possibility to age in place, i.e., in one’s home and community. Adapted transportation and information systems were identified as facilitating factors to access resources supportive for health at the residential, community and environmental levels. Conclusion. The geographic dimension of SDH conceptualized and operationalized in this thesis is important to understand how sociogeographic determinants influence the health of Inuit elders. This type of information is needed to guide the formulation and implementation of social and public health policies and programs to support healthy aging across Inuit communities
Monnier-Benoit, Gaëlle. "Cosmétique et hygiène du corps : théories, pratiques et représentations (XIIe-XVe siècle)." Mémoire, Université de Sherbrooke, 2018. http://hdl.handle.net/11143/11949.
Rennuit, Rosquet Suzanne. "Gymnastique de pause en entreprise : à propos de deux expériences dans le secteur tertiaire." Nantes, 1985. http://www.theses.fr/1985NANT3412.
Saada, Fatiha. "Représentations sociales de la santé et de la maladie chez des travailleurs marocains en France et au Maroc." Nancy 2, 1996. http://www.theses.fr/1996NAN21027.
The proposed study investigates the social representations of the health and illness in 1000 Moroccan workers: 500 migrants living in France and 500 living in morocco. They have answered a same survey questionnaire and the data were analyzed by computer. Both groups define the concept of "good" or "bad" health through factors such as physical aspect, psycho-sociological status, and cultural values in how to face or prevent illness; religious beliefs and socio-economic conditions. They conceive the health as a balance between the individual and social environment. They also mentioned the psycho-social stress due to hard conditions at work and in daily life. The group living in France are more aware and better informed on how to keep themselves healthy than the group staying in morocco; this is certainly due to the availability, the access and efficiency of the French health care system and to the general medical information conveyed around. However, the France group complained strongly against the solitude and exile from their relatives and friends and original habits, which they may feel as a potential cause of disease. Globally, it seems that any group of population represents or perceives its health status in terms of its social environment and of its social reality of daily life
Roques, Claude. "La santé en Polynésie française." Montpellier 1, 1990. http://www.theses.fr/1990MON11120.
Deschênes, Saint-Pierre Béatrice. "Activité physique et structure artérielle carotidienne chez de jeunes adultes apparemment en santé." Master's thesis, Université Laval, 2014. http://hdl.handle.net/20.500.11794/26342.
Physical activity is a protective factor against cardiovascular (CV) events; this evidence has been established by the data of large epidemiological cohort studies over 30 years ago. However, since physical activity modifies favourably several cardiovascular risk factors (hypertension, dyslipidemia, diabetes, obesity), evidence is still missing to determine if this association, between physical activity and cardiovascular risk, is independent from the exercise-induced modifications in metabolic parameters. Our study evaluated, in young adults devoid of cardiovascular risk factors, the differences between sedentary and active individuals in arterial wall structure (a surrogate marker of cardiovascular risk). Our results suggest that apparently healthy young adults have a similar atherosclerosis burden whether active or sedentary.
Milly, Bruno. "Professions et prison : soigner et enseigner en prison : un regard sociologique croisé sur le fonctionnement de la prison et sur les professions de la santé et de l'enseignement intervenant dans ce milieu." Lyon 2, 2000. http://www.theses.fr/2000LYO20004.
Bastide, Victor. "Facteurs de pronostic des jumeaux : expérience du CHU de Montpellier entre le 01.01.1986 et le 31.12.1990." Montpellier 1, 1993. http://www.theses.fr/1993MON11038.
Renteux, Elisabeth. "Exposition et effets du tabagisme passif pour la santé des non-fumeurs." Paris 5, 1991. http://www.theses.fr/1991PA05P077.
Rayssac, Philippe Daniel Françis. "Sport et grossesse." Bordeaux 2, 1990. http://www.theses.fr/1990BOR25015.
Simon, Valérie. "Odontologie et univers carcéral." Bordeaux 2, 1992. http://www.theses.fr/1992BOR20046.
Theodose, Christian. "Les actions d'éducation pour la santé et les enquêtes de santé en milieu scolaire : analyse des difficultés rencontrées." Montpellier 1, 1995. http://www.theses.fr/1995MON11081.
Gabard, Anne. "Notre santé au risque de notre histoire." Thesis, Nantes, 2017. http://www.theses.fr/2017NANT2024/document.
What led me to work on this thesis was a growing amazement over my 40 years of practice as a gynecologist. What a strange discrepancy between the undeniable and spectacular achievements of modern medicine in our western world, and, at the same time, the great number of pathologies that are unaccounted for by the same medicine ! The latter failing to give any answer to the legitime and fundamental questions that every one will ask when a disease is diagnosed, among which : « why me ? » Through trying to have a transversal approach of knowledge, we were able to legitimate the consideration of the complex patient, for whom body and spirit are held together in an incompressible unity. This path of reflection, taking into account the complex patient in his entire reality led us to a hermeneutic approach that gives meaning, a meaning out of the field of science. Such a reflection enables us to understand that disease expresses in a unified language the physical and mental processes. Our diseases have a meaning in the heart of our lives. They are a signal that warns of a loss of harmony with our own selves, with our environment, and of the need to find a new balance when it is still possible. Our health is not predetermined ; our knowledge, our comprehension, our ability to act, allow us some freedom to be actors. Even though we are bound by constraints within our lineage, our environment, and subject to the unavoidable limits of longevity. We are part of a much larger whole, and, thanks to our total involvement in it, and to our capacity to act, we are able to have a local action for ourselves, and a more general action which will impact the fields with which we interfere. Our organised complex unity is based on exchanges of matter, energy, and above all, information, with the universe that builds and surrounds us. The primordial reality that some will name energy, others information, could be love. Love would be the ultimate reality
Bationo, Bouma Fernand. "Santé publique, hygiène et société (s) au Burkina Faso : soins de santé maternelle et infantile et comportements socio-thérapeutiques des Lyela dans la province du Sanguié." Lille 1, 1993. http://www.theses.fr/1993LIL1A001.
Gharbi, Ikbal. "La représentation de la maladie et de la santé et les médecines traditionnelles chez la communauté tunisienne en France." Paris 5, 1992. http://www.theses.fr/1992PA05H047.
The study of the representation of the illness and the health in the same way as the course to traditional medicines among Tunisian in France, permit to analyze some speeches and modes of interpretation that may be as well as profane, traditional and scientific face to biological objective entite : the illness and the health the migratory problematic amid search permit to study the courses of adaptation that the Tunisian community in France can use. Therefore, we attemps to analyze the factuel sociodemographical elements and the different attitudes and opinions. Through these attitudes among the illness and by different therapeutical recourses that are being verified the self-representation and the process of structuration of collective identity of Tunisian immigrants in France
Beaulière, Arnousse. "Pauvreté et santé en Haïti." Bordeaux 4, 2005. http://www.theses.fr/2005BOR40002.
Mignot, Fabrice. "Santé et intégration nationale au Laos." Paris 4, 2002. http://www.theses.fr/2002PA040119.
The Thai Lao lords and the bouddhist monks have a cultural space emerged in the lowlands of the center of Indochina since the XIVth century, especially by spreading health conceptions and practices. French occupant, the kingdom of Laos and the communist regime have continued to develop this territory first by building modern health facilities along a national road parallel to the Mekong River. In 13 villages of 4 multiethnic sites settled along that road health resources and risks of diseases reveal the limits of the integration by the Nation-State of the highlanders relocated in the plains and the valleys. If any traditionnal health practices bring ethnic groups together, some deep factors of differentiation, as movements, water and malaria, lie
Teixeira, Maria. "Changement social et contre-sorcellerie féminine chez les Manjak de Canchungo émigrés à Ziguinchor : les réponses du Bëpene et du Kasara : Guinée-Bissau / Sénégal." Paris, EHESS, 1996. http://www.theses.fr/1996EHES0076.
In the northwest of Guinea-Bissau the Manjak territory is divided in several Manjak kingdoms. Some members of this ethnic group have hive off in Guinea-Bissau, towards neigbouring countries and Europe. Women from Canchungo kingdom have acquired power and an increasing authority in the magical and religious sphere of the antisorcery. Today, the offices of Napene and Namana (diviners-healers specialized in struggle against witchcraft or sorcery), left vacant by men particularly assumed by women. Their abilities are not limited to problems classified as strictly feminine. In others kingdoms, like qualequisse, the same offices are forbidden to women. We have presented ancient and current social structures, the dynamic universe of the animist religion and the position of the anti-sorcery priestesses. A Namana of the Kasara cult is named in her office after an election by trance. The shrine gathers several priestesses and a community of women members of the cult. For a Napene of the Bepene worship, the designation and the installation occur after an election by illness followed by an initiation. In her shrine the priestess officiate alone. The priestesses capacity to oppose to a diversified and an increasing sorcery is analysed through divinatory and therapeutic rituals. The diviners-healers have to face unprecedented problems. By their flexibility in the interpretation of the symbolic and cognitive system. The officiants reajust the Manjak community and it's members to an unfinished and ephemeral world, which balances between chaos and order
De, Souza Givanilda Aquino. "Faible présence de la population démunie dans les centres de santé : quelques aspects socio-économiques et culturels : une recherche participative développée au Brésil." Nancy 2, 1992. http://www.theses.fr/1992NAN21016.
Barlagiannis, Athanasios. "Hygiène publique et construction de l'Etat grec, 1833-1845 : la police sanitaire et l'ordre public de la santé." Thesis, Paris, EHESS, 2017. http://www.theses.fr/2017EHES0044.
This study is about the organization of public hygiene in the kingdom of Greece between 1833, when prince Otto of Bavaria ascends to the throne, and 1845, when the political and epidemiological frontiers of the kingdom are traced by a complete system of lazarettos and sanitary offices. We will firstly analyze the structures of sanitary prevention in the interior of the country (vaccinators, public health doctors, municipal doctors) as well as at its frontiers, and then we will focus on the measures against contagious diseases (such as the plague and smallpox) and against miasmas. We are also interested in examining the main diseases that determine the mortality of the period under scrutiny and the medical theories that explain the applicable sanitary measures. At the same time, we will review some of the aspects of the classical distinction of Erwin Ackerknecht between contagionism and miasmatic theory. Finally, we will study the difficult formation of an official group of medical professionals. The interest in public hygiene imposes the study of the biological construction of the state and, subsequently, of the state itself. Public hygiene defines the threats which it tries to prevent, and it creates and secures the collectivity. In the Police State of the cameralist king Otto, these developments are controlled by the bureaucracy, the administration, the public force and the science of medical police. Its purpose is to construct and order the public space, the space of state action, which is natural as well as social. This action of ordering imposes the centralization of health and at the same time it normalizes the natural elements and the social forces so that they can coordinate without resistance; in other words, the action of ordering pacifies. Medical police controls these processes by reconfiguring the ties that bind individuals with each other and with the geography, the nature and their diseases
Turmel, Julie. "La santé cardiorespiratoires de l'athlète d'élite : principales pathologies et mécanismes de développement." Doctoral thesis, Université Laval, 2011. http://hdl.handle.net/20.500.11794/28394.
The high prevalence of cardiorespiratory problems in athletes reported in the literature and observed in our clinical practice, as well as the importance of cardiovascular screening in athletes lead us to evaluate the prevalence of different cardiorespiratory condition in endurance athletes of Quebec and Chaudiere-Appalaches area. Our studies allowed to assess the effect of intense training and environmental factors on respiratory and cardiovascular function in high level athletes as well as analyzed some mechanisms that could explain these particular cardiorespiratory conditions. Our results mainly showed a high prevalence of exercise-induced asthma, post-exercise cough in winter endurance athletes, and few cardiac abnormalities, such as arterial hypertension at rest and during exercise. Following a literature review on the effects of cold air on lung function of athletes practicing winter sports, we have evaluated whether there was a seasonal variation in the airway responsiveness and airway inflammation which could explain the frequent respiratory symptoms that are reported by these athletes. Our results suggest that there is no seasonal variation in airway responsiveness or airway inflammation in these athletes. However, a significant decrease in lung function was observed during the winter compared to summer and fall time. It seems to be associated with epithelial damage which was significantly higher in the winter time. Post-exercise cough being the symptom most frequently reported by endurance athletes practicing winter sports, we assessed whether the cough reflex could be increased by the inhalation of large volumes of cold air during winter time in these athletes. Our results showed that athletes had more post-exercise cough (1 hour after and up to 8 hours after exercise) than control subjects. However, we have not observed an increase in the cough reflex during the winter season. This has therefore led us to assess whether there were differences in resting and exercise blood pressure, heart rate variability and lipid profile between a resting period and a training period in a group of athletes. Our results suggest that heart rate variability and exercise blood pressure are increased during training period. In addition, athletes with an hypertensive response to exercise have higher resting blood pressure but within normal limits, as well as lowered values of protective factors of lipid profile (decrease in HDL) than those with a exercise normotensive response.
Denis, Annabelle. "Fonctionnement cérébral et cognitif chez de jeunes adultes nés prématurément." Doctoral thesis, Université Laval, 2017. http://hdl.handle.net/20.500.11794/28122.
The advent of technology in neonatal care units has increased the survival rate of premature infants. However, there is still room to better understand the deleterious impacts of prematurity on the brain and cognition over lifespan, including the early adulthood that has poorly been studied to date. This thesis tested the mechanism of interhemispheric inhibition by the ipsilateral silent period (iSP) (reflecting the integrity of callosal function) and intracortical inhibition (ICI reflecting synaptic organization for planning the action) along with the cognitive function in young adults born prematurely (PT). A group of young adults born prematurely (PT, ≤ 33 weeks gestation) were compared to a group of young adults born at term (Term> 37 weeks of gestation, matched for age and education). iSP and ICI were tested with transcranial magnetic stimulation of the primary motor cortex of hand. As compared to the term group, the study 1 showed that PT had fewer occurrences of iSP (p < 0.0001), longer iSP latency (interhemispheric transfer, p=0.004) and shorter iSP duration (p < 0.0001). In study 2, less excitability in the nondominant hemisphere (p=0.001), and less ICI (37.5% in PT group vs. 100% in terms) was observed. This suboptimal regulation between hemispheres and intracortical motor function was parallelled by difficulties to sustain attention in PT as assessed by neuropsychological testing in the 3rd study. This thesis suggests that brain function known to be impaired in PT children and adolescents remained suboptimal at early adulthood and may explain some minor cognitive impairments detected. These brain indicators of a long-term influence of prematurity should be used earlier to test the efficacity of rehab programs on modules recognized to be specifically impaired in adulthood.
Berche, Thierry. "Un projet de santé en pays Dogon : enjeux de pouvoirs et stratégies : 1987-1992." Paris, EHESS, 1994. http://www.theses.fr/1994EHES0021.
This work is focused on actors-strategies in round an health development project as part of cooperation between mali and germany in the district of bandiagara. It begins by placing this project in the ethnological context and historical specificities of the health institutions in mali. And historical specificities of the health institutions in mali. Then the processes of implementation of this primary health care project are explained as well as their intitutional, financial and professional logics. Lastly the autor describes the logics and strategies of four actorsgroups or "strategic groups" : the "clientele", the administrative authorities, the network of health centers, and the project-organization. Their struggles do operating the specific political field of this project. The work ends with a thought about the trade and vocation of anthropologist in developement operation
De, Larochellière Élianne. "Topographie du tissu adipeux et profil de risque cardiométabolique des jeunes adultes apparemment en santé." Master's thesis, Université Laval, 2012. http://hdl.handle.net/20.500.11794/25968.
Les jeunes adultes apparemment en santé, chez qui la prévalence d’athérosclérose asymptomatique est étonnamment élevée, devraient pouvoir bénéficier de stratégies préventives efficaces en matière de santé cardiométabolique. Notre étude a examiné la pertinence et la façon d’évaluer l’adiposité régionale chez les jeunes adultes apparemment en santé en mesurant les associations qui existent entre les différents tissus adipeux (sous-cutané abdominal, viscéral abdominal et épicardique) et les marqueurs du profil de risque cardiométabolique, ainsi que les associations qui existent entre les différents tissus adipeux et les mesures anthropométriques (indice de masse corporelle, tour de taille et ratio taille/hanche). Nos résultats suggèrent la pertinence d’évaluer spécifiquement les quantités de tissu adipeux viscéral abdominal et épicardique chez les jeunes adultes apparemment en santé. Notre étude a également déterminé qu’en plus de simplement calculer l’indice de masse corporelle, mesurer le tour de taille chez les jeunes adultes apparemment en santé permet de mieux discriminer les individus avec une accumulation de tissu adipeux viscéral et épicardique augmentée.
Heyraud-Lemaître, Chantal. "Autoformation et pratique réflexive : le cas des adultes à l'Ecole Nationale de la Santé Publique." Tours, 2002. http://www.theses.fr/2002TOUR2001.
Franckel, Aurélien. "Les comportements de recours aux soins en milieu rural au Sénégal : le cas des enfants fébriles à Niakhar." Paris 10, 2004. https://tel.archives-ouvertes.fr/tel-00195109.
Malaria is a serious infectious disease which claims more than a million lives each year and which strikes 80% of African children. This situation is partly due to sanitary and social factors. This thesis deals focuses on the different ways to heal children with a fever, in Senegal. The results show that children are mainly tended at home while very few people resort to sanitary structures, that people wait a long time before taking their children and that they do not follow the prescriptions so well. However, people tend to be pragmatic in their responses as they are faced with deficient biomedical care. The child's health is taken care of on a collective basis, in which each member of the family cell as a specific role to play. The way people resort to medical care varies according to numerous elements, among which illness characteristics, the morphology of the family cell and contextual parameters
Coelho, Carlos Manuel. "Pollution atmosphérique intérieure : campagne de mesures dans six logements occupés par des personnes âgées, relation entre qualité de l'air et symptômes déclarés." Paris 13, 2004. http://www.theses.fr/2004PA132023.
The objective was to analyse the indoor air quality in dwellings occupied by old people and to correlate pollutants with life habits and health statement. A sociological survey on 96 elderly people living in social housing was firstly undertaken in order to determine risk factors responsible of poor health. Then measurements of several pollutants were carried out in six typical dwellings. Results were analyzed at the light of activities and reported symptoms. Besides discomfort due to CO2 accumulation, several pollutants with levels near or over guidelines were identified in particular particulate matter under 1 um, airborne microbiological counts and permanent TVOC levels. Dust was at the origin of cough, eyes and throat irritations and flows of the nose, fungi and bacteria seems to be responsible of skin irritations, digestive disorders, sneezes and rhinitis. However, most of symptoms appeared after 10 hours of exposure time for people of all ages
Laurent, Jean-François. "Pathologie des pilotes d'hélicoptères." Université Louis Pasteur (Strasbourg) (1971-2008), 1985. http://www.theses.fr/1985STR1M103.
Perozzo, Cristina, and Cristina Perozzo. "Perturbations du sommeil, du fonctionnement diurne et de la qualité de vie associées à l'insomnie comorbide à un trouble psychiatrique ou médical." Doctoral thesis, Université Laval, 2016. http://hdl.handle.net/20.500.11794/27405.
Cette thèse visait à comparer les perturbations du sommeil, du fonctionnement diurne et de la qualité de vie associées à l’insomnie comorbide à un trouble psychiatrique ou médical à celles de l’insomnie seule. En premier lieu, une revue de littérature sur les perturbations du sommeil et du fonctionnement diurne caractérisant l’insomnie comorbide, comparativement à l’insomnie seule, a été effectuée. Celle-ci incluait 38 études et a révélé que l’insomnie comorbide à un trouble psychiatrique n’était pas associée à des perturbations du sommeil subjectives plus sévères que l’insomnie seule, mais qu’elle était liée à une variabilité internuits du sommeil plus importante. L’insomnie comorbide à un trouble dépressif comportait une proportion plus élevée de sommeil paradoxal et moins d’activité électroencéphalographique à hautes fréquences au cours de la nuit que l’insomnie seule. L’insomnie comorbide à un trouble psychiatrique (principalement dépressif) était liée à une utilisation accrue des soins de santé et à des perturbations plus sévères de l’humeur, de la cognition et des tâches quotidiennes. Peu de différences sur le plan du sommeil ont été observées entre l’insomnie avec et l’insomnie sans douleur chronique comorbide. La fréquence et la sévérité des perturbations de l’humeur ainsi que les risques d’absentéisme et d’invalidité au travail étaient plus élevés lorsque l’insomnie était accompagnée de douleur. Parmi les recherches recensées, la plupart portaient sur l’insomnie comorbide à un trouble dépressif ou à une condition douloureuse. Un nombre limité d’études a exploré la comorbidité médicale et celles qui ont évalué les perturbations objectives du sommeil dans l’insomnie avec et sans comorbidité psychiatrique ont obtenu des résultats mitigés. Plusieurs études comportaient des limites méthodologiques majeures, telles que l’utilisation de critères distincts afin de définir l’insomnie dans différents groupes au sein d’une même étude et le manque de contrôle des effets confondants d’autres troubles comorbides et de médicaments prescrits. Tenant compte de ces limites, une étude empirique visant à comparer les perturbations du sommeil, du fonctionnement diurne et de la qualité de vie qui caractérisent l’insomnie comorbide à un trouble psychiatrique et l’insomnie comorbide à un trouble médical à celles de l’insomnie seule a été réalisée. L’échantillon était composé de 84 adultes, répartis en cinq groupes : insomnie seule (INS; n = 22), insomnie comorbide à un trouble psychiatrique (INS+PSY; n = 16), insomnie comorbide à un trouble médical (INS+MED; n = 14), bons dormeurs avec un trouble médical (BD+MED; n = 17) et bons dormeurs en santé (n = 15). Des analyses multivariées suivies de corrélations canoniques pour des contrastes planifiés ont révélé que le groupe INS+PSY rapportait un sommeil non réparateur un plus grand nombre de nuits par semaine et des atteintes diurnes plus sévères (motivation, fatigue physique, fonctionnement physique et occupationnel, impacts de l’insomnie) que le groupe INS. Selon des agendas du sommeil, les participants du groupe INS+MED dormaient moins longtemps et se réveillaient plus souvent la nuit que ceux du groupe INS. Ces premiers étaient aussi moins productifs au travail. Comparativement aux BD+MED, le groupe INS+MED était plus déprimé et fatigué et avait un fonctionnement occupationnel plus perturbé, alors que le groupe INS avait un meilleur fonctionnement physique, mais plus de symptômes dépressifs, un niveau de fatigue plus élevé et moins de vitalité. Les résultats de la thèse suggèrent que la nature des difficultés de sommeil dans l’insomnie comorbide à un trouble dépressif et l’insomnie seule pourrait différer et que l’insomnie comorbide à un trouble psychiatrique est caractérisée par des perturbations du fonctionnement diurne plus sévères, comparativement à l’insomnie seule. L’insomnie comorbide à un trouble médical est liée à un sommeil plus fragmenté et de courte durée et à plus de difficultés sur les plans de l’humeur et du fonctionnement occupationnel que l’insomnie seule. Ces observations soulèvent les possibilités que l’insomnie comorbide à un trouble psychiatrique soit un sous-type d’insomnie distinct de l’insomnie seule et que la comorbidité d’un trouble psychiatrique favorise le maintien de l’insomnie par le biais de processus cognitifs et comportementaux transdiagnostiques (p. ex., mode de pensée répétitif). Les résultats appuient la pertinence d’adapter les interventions pour l’insomnie chez les personnes qui ont un autre trouble, notamment psychiatrique, afin de les aider à surmonter le fardeau d’un double diagnostic et de leur assurer un meilleur sommeil et bien-être.
This thesis aimed to compare the disturbances in sleep, daytime functioning, and quality of life associated with insomnia with a comorbid psychiatric or medical disorder to those of insomnia alone. First, a review of the literature on the sleep disturbances and daytime impairments characterizing comorbid insomnia as compared to insomnia alone was conducted. The review included 38 studies and revealed that insomnia with a comorbid psychiatric disorder was not associated with more severe subjective sleep disturbances than insomnia alone, but that it was related to increased night-to-night sleep variability. Insomnia comorbid with a depressive disorder involved a higher proportion of rapid eye movement (REM) sleep and less high frequency electroencephalographic activity during the night than insomnia alone. Insomnia with a comorbid psychiatric (mainly depressive) disorder was linked to higher health care use and more severe daytime impairments in mood, cognition, and ability to complete daily activities. Few differences in sleep were observed between insomnia with and insomnia without comorbid chronic pain. The rate and severity of mood disturbances and risks of sick leave and disability were higher when insomnia was accompanied by pain. Among reviewed studies, most investigated insomnia with a comorbid depressive disorder or painful condition. A limited number explored medical comorbidity and those that compared objective sleep disturbances in insomnia with and without a comorbid psychiatric disorder yielded inconclusive results. Many studies had major methodological limitations, including the use of different criteria to define insomnia for subgroups within a same study and the lack of control for the confounding effects of other comorbid disorders and prescribed medications. Considering these limitations, an empirical study comparing the sleep disturbances and daytime impairments characterizing insomnia with a comorbid psychiatric disorder and insomnia with a comorbid medical disorder to those of insomnia alone was conducted. The sample included 84 adults, divided into five groups: insomnia alone (INS; n = 22), insomnia comorbid with a psychiatric disorder (INS+PSY; n = 16), insomnia comorbid with a medical disorder (INS+MED; n = 14), good sleepers with a medical disorder (GS+MED; n = 17), and healthy good sleepers (n = 15). Multivariate analyses followed by canonical correlations for a priori contrasts revealed the INS+PSY group reported more nights of nonrestorative sleep and more severe daytime impairments (motivation, physical fatigue, physical and occupational functioning, insomnia-related consequences) than the INS group. According to sleep diaries, participants in the INS+MED group had shorter nights of sleep and more nighttime awakenings than those in the INS group. The former were also less productive at work. Compared to GS+MED, the INS+MED group was more depressed and fatigued, and had poorer occupational functioning, while the INS group had better physical functioning, but more severe depressive symptoms, higher levels of fatigue, and less vitality. Results of the thesis suggest that the nature of sleep complaints differs in insomnia with and without a comorbid depressive disorder and that insomnia with a comorbid psychiatric disorder is characterized by more severe daytime deficits compared to insomnia alone. Insomnia with a comorbid medical disorder was associated with a shorter and more fragmented sleep, and with more impairments in mood and role functioning than insomnia alone. Findings raise the possibilities that insomnia with a comorbid psychiatric disorder is distinct from insomnia alone and that psychiatric comorbidity contributes to the maintenance of insomnia via transdiagnostic cognitive and behavioral processes (e.g., repetitive thinking). Results support the relevance of adapting interventions for insomnia among persons with another disorder, notably a psychiatric disorder, to help them overcome the burden of a dual diagnosis and insure improved sleep and well-being.
This thesis aimed to compare the disturbances in sleep, daytime functioning, and quality of life associated with insomnia with a comorbid psychiatric or medical disorder to those of insomnia alone. First, a review of the literature on the sleep disturbances and daytime impairments characterizing comorbid insomnia as compared to insomnia alone was conducted. The review included 38 studies and revealed that insomnia with a comorbid psychiatric disorder was not associated with more severe subjective sleep disturbances than insomnia alone, but that it was related to increased night-to-night sleep variability. Insomnia comorbid with a depressive disorder involved a higher proportion of rapid eye movement (REM) sleep and less high frequency electroencephalographic activity during the night than insomnia alone. Insomnia with a comorbid psychiatric (mainly depressive) disorder was linked to higher health care use and more severe daytime impairments in mood, cognition, and ability to complete daily activities. Few differences in sleep were observed between insomnia with and insomnia without comorbid chronic pain. The rate and severity of mood disturbances and risks of sick leave and disability were higher when insomnia was accompanied by pain. Among reviewed studies, most investigated insomnia with a comorbid depressive disorder or painful condition. A limited number explored medical comorbidity and those that compared objective sleep disturbances in insomnia with and without a comorbid psychiatric disorder yielded inconclusive results. Many studies had major methodological limitations, including the use of different criteria to define insomnia for subgroups within a same study and the lack of control for the confounding effects of other comorbid disorders and prescribed medications. Considering these limitations, an empirical study comparing the sleep disturbances and daytime impairments characterizing insomnia with a comorbid psychiatric disorder and insomnia with a comorbid medical disorder to those of insomnia alone was conducted. The sample included 84 adults, divided into five groups: insomnia alone (INS; n = 22), insomnia comorbid with a psychiatric disorder (INS+PSY; n = 16), insomnia comorbid with a medical disorder (INS+MED; n = 14), good sleepers with a medical disorder (GS+MED; n = 17), and healthy good sleepers (n = 15). Multivariate analyses followed by canonical correlations for a priori contrasts revealed the INS+PSY group reported more nights of nonrestorative sleep and more severe daytime impairments (motivation, physical fatigue, physical and occupational functioning, insomnia-related consequences) than the INS group. According to sleep diaries, participants in the INS+MED group had shorter nights of sleep and more nighttime awakenings than those in the INS group. The former were also less productive at work. Compared to GS+MED, the INS+MED group was more depressed and fatigued, and had poorer occupational functioning, while the INS group had better physical functioning, but more severe depressive symptoms, higher levels of fatigue, and less vitality. Results of the thesis suggest that the nature of sleep complaints differs in insomnia with and without a comorbid depressive disorder and that insomnia with a comorbid psychiatric disorder is characterized by more severe daytime deficits compared to insomnia alone. Insomnia with a comorbid medical disorder was associated with a shorter and more fragmented sleep, and with more impairments in mood and role functioning than insomnia alone. Findings raise the possibilities that insomnia with a comorbid psychiatric disorder is distinct from insomnia alone and that psychiatric comorbidity contributes to the maintenance of insomnia via transdiagnostic cognitive and behavioral processes (e.g., repetitive thinking). Results support the relevance of adapting interventions for insomnia among persons with another disorder, notably a psychiatric disorder, to help them overcome the burden of a dual diagnosis and insure improved sleep and well-being.
Menai, Mehdi. "Activité physique, transport actif et sédentarité : facteurs individuels associés et conséquences sur la santé chez les adultes français." Thesis, Sorbonne Paris Cité, 2015. http://www.theses.fr/2015USPCD017/document.
Physical activity is a protective factor for common chronic diseases, while sedentary behavioris a risk factor. Among the different domains of habitual physical activity, active transportation (walking, cycling) is a topic of growing interest. A better understanding of the determinants and health effects of physical activity and sedentary lifestyles is essential to develop public health interventions targeted for at-risk populations. The objectives of this thesis were to investigate some individual factors associated with specific domains of walking and cycling, and to explore the relationship of specific areas of sedentary lifestyle with health outcomes, taking into account the effects of habitual physical activity. We measured physical activity and sedentary behavior cross-sectionally with questionnaire in the NutriNet-Santé French adults cohort (n = 39,295 subjects) and longitudinally in the SU.VI.MAX cohort (n =2,841). Our results indicate that the different domains of walking (commuting, leisure andutility) and their relationships with individual factors are not homogeneous, that during the transition to retirement the decrease in occupational physical activity was not offset by newly developed behaviors, and finally that specific physical activity and sedentary lifestyles could affect cardiometabolic risk factors and excessive daytime sleepiness. These results should contribute to a better understanding of the health behaviors of the French population, in order to better target preventive and health promotion interventions