Dissertations / Theses on the topic 'Santé de l'adolescent'
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Duong, Dinh Cong. "Santé des adolescents à Hochiminh-ville(Vietnam)." Nancy 1, 2001. http://www.theses.fr/2001NAN11319.
De, Spiegelaere Myriam. "Prévention et inégalités sociales de santé chez l'enfant et l'adolescent." Doctoral thesis, Universite Libre de Bruxelles, 1999. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/211965.
Esterle, Laure. "Facteurs nutritionnels et génétiques associés à la santé osseuse chez l'enfant et l'adolescent en bonne santé." Paris 5, 2009. http://www.theses.fr/2009PA05T044.
Childhood and adolescence are critical periods for bone mineralization. I have shown that lumbar spine mineralization during adolescence was associated with milk intakes more than other sources of dietary calcium. Polymorphism associated with hypolactasia was not correlated to lumbar spine bone mass accrual during adolescence. In contrast, the -1012 polymorphism in VDRp influence of the association between lumbar spine mineralization and milk intakes. Girls carry G / A and G / G -1012 variants in VDRp (70% of European population) need higher milk intakes than those with bearing a A/A genotype, major variant in African and Asians populations. Bone deformities and biological signs of vitamin D deficiency were observed in children and adolescents with levels of 25 - (OH) D <30 nmol / L, especially in those with low milk / calcium intakes
Aounallah-Skhiri, Hajer. "Mode de vie et santé de l'adolescent en Tunisie dans un contexte de transition épidémiologique." Paris 6, 2010. http://www.theses.fr/2010PA066108.
Lagouanelle-Simeoni, Marie-Claude. "Conceptualisation et validation d'une échelle de mesure de qualité de vie liée à la santé chez l'adolescent." Aix-Marseille 2, 2001. http://theses.univ-amu.fr.lama.univ-amu.fr/2001AIX20676.pdf.
Chollet-Vatin, Myriam. "Former pour mieux éduquer pour la santé : dispositifs de formation continue en sexologie de l'adolescent en Guadeloupe." Thesis, Paris Est, 2010. http://www.theses.fr/2010PEST0024.
The gist of this research is undertanding the influence of continuing education training programs calling upon the analysis of practice, aiming at promoting health and developing the professionalism of people who work with teenagers in various fields and their capacity for empowerment. Our investigations, conducted in Guadeloupe, focused on conceiving and implementing a session to obtain a university diploma in teenage sexology. Various types of data were analyzed : training logbook, researching professionnals‟ requests and previous training, recording analyses workshops on practice (GEASE), group projects drafted by students, on health education actions.The results of our study have revealed that continuing education programs based on the analysis of real life situations, experienced by participants, help train reflexive practitioners. Our research has alsohelped underline that training programs conceived as health promotion programs lead health educators to adopt the same conception in their practice
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
Speyer, Elodie. "Activité physique et qualité de vie liée à la santé de l'enfant et de l'adolescent : approche en population générale et en milieu hospitalier." Thesis, Nancy 1, 2010. http://www.theses.fr/2010NAN10104/document.
Context. Several epidemiological studies were interested in the relation between physical activity (PA), adapted or not, and health-related quality of life in general population or on subjects with chronic pathology. However, the studies were mainly led in adult population and a few have study this relation when PA is practiced in a particular condition such as a hospitalization course. Objective. The general objective was to contribute to knowledge on the association between PA and HRQoL among children and adolescents in general population and in hospital environment.Method. We answered to this general objective by way of 3 research program. First at all, with the inclusion data of REGUL'APS program (September 2005), cluster randomized trial in school children (2nd to 5th grade). Since with the APOP data, cross-over randomized trial, with children 5-18 years-old, hospitalized and treated for a cancer in the paediatric haematology and oncology department of Nancy University Hospital Center. Finally, we set up the Activ'Hop trial, which extend the population to others paediatrics departments of Nancy University Hospital, such as paediatrics and orthopaedic surgery/burned.Results. Our results showed that a PA level is associated with a better HRQoL among school children and adolescents. Boys had a better HRQoL when they practiced a higher PA variety. The APOP results showed that APA during hospitalization for children with cancer was associated with better HRQoL for most of the HRQoL psychological and physical dimensions. The Activ?Hop trial is recruiting, but his placement is presented and discussed in the manuscript. Conclusion. In this thesis work, we have confirmed the short-term positive effect of a PA?s practice on the children HRQoL, in general population but also in a hospital environment. Hence, it is necessary to maintain or increase the PA's resources to make children more active and whatever their health?s status and/or life conditions
Manneville, Florian. "Comportement alimentaire, activité physique, sédentarité et inégalités sociales de santé à l’adolescence." Thesis, Université de Lorraine, 2020. http://www.theses.fr/2020LORR0128.
Background: During adolescence, the higher the socio-economic status (SES), the better the health status is and reflects the existence of social inequalities in health. These inequalities could be explained by the unequal distribution of lifestyles such as physical activity (PA), sedentary behaviour (SB) and dietary behaviour (DB) according to adolescents’ SES. The associations between lifestyles and social inequalities in health are unclear among adolescents. Objectives: This thesis aimed to analyze the associations between lifestyles and social inequalities in health during adolescence through three objectives: 1) to describe lifestyles and their distribution according to adolescents’ SES, 2) to evaluate the effectiveness of a public health intervention on the reduction of social inequalities in health among adolescents, and 3) to measure and quantify the mediating effects of lifestyles on social inequalities in health among adolescents. Methods: To address these objectives, data from two trials aimed at preventing overweight and obesity among adolescents were used: PRALIMAP (PRomotion de l’ALImentation et de l’Activité Physique) and PRALIMAP-INES (PRALIMAP-INEgalités de Santé). PA, SB were measured using the International Physical Activity Questionnaire and DB using a food frequency questionnaire. SES was defined using the Social Position Index of Students and the Family Affluence Scale. Statistical analyses included linear, mixed and logistic regression models and an analysis of latent transitions. Results: Low SES adolescents had lower levels of PA and less adapted DB than high SES ones. Overall, DB was not associated with adolescents’ SES. Social inequalities in weight and quality of life were highlighted. There was no evidence that a universal intervention could reduce social inequalities in weight. Mediating effects of behaviours in the association between SES and health status were suggested. Conclusions: These results underline the importance of taking SES into account in order to reduce social inequalities in health among adolescents. Behaviours appear to be important levers to reduce social inequalities in health
Vasile, Jennifer. "Crise de l'autorité et processus de radicalisation chez des adolescents et post- adolescents en France." Electronic Thesis or Diss., Bourgogne Franche-Comté, 2023. http://www.theses.fr/2023UBFCH041.
This doctoral thesis focuses on the psychological and identity trajectories of adolescents and post-adolescents affected by the phenomenon of radicalization.The main objective of this thesis is to refine and broaden our understanding of the complex dynamics and individual and collective vulnerabilities that underlie the phenomenon of radicalization among adolescents and post-adolescents. The research is based on a psychodynamic approach that seeks to explore both individual and contextual aspects, shedding light on the multidimensional complexity of radicalization.The research methodology integrates three distinct qualitative studies to gather diverse perspectives. All studies were conducted using semi-structured interviews. The first study includes a thematic analysis of the trajectories of young individuals affected by the radicalization phenomenon and their families' perspectives on it. The second study focuses on the thematic analysis of the discourse of professionals confronted with the phenomenon of radicalization in their daily work. This study aims to enhance the overall understanding of radicalization. The last study reports an in-depth case study analysis of the journey of a young individual affected by radicalization. This study allows a more precise exploration of the underlying psychological, social, and identity dynamics, providing insights into the unseen forces that can push an individual towards radical paths.The results of this research show a link between the crisis of authority and the phenomenon of radicalization. They highlight that the radicalization of adolescents and post-adolescents goes beyond mere adherence to an extreme ideology; it is also a revealing symptom of deep vulnerabilities. These vulnerabilities are tied to societal, familial, and individual dynamics characterized by a symbolic deficiency and a crisis of authority.The findings emphasize the need to rethink the structures of authority, taking into account the impact of transgenerational traumas and prompting deep reflection on the potential influence of media in the alienation of young people. It is a call for empathy, ethics, humanity, dialogue, and a critical and constructive analysis of the unseen forces shaping young people's identification in our hypermodern society
Iosifyan, Marina. "Analyse interculturelle de la valeur de santé chez les adolescents atteints d'asthme." Thesis, Sorbonne Paris Cité, 2015. http://www.theses.fr/2015USPCB223/document.
This thesis aims to help better understand the role of values, attitudes and coping strategies in health behaviors alongside with anxiety/depression symptoms among Russian and French adolescents with asthma. Mediation analysis was employed to study the associations between values (health value, value of exciting life) and health behaviors (preventive and risk behaviors) through affective (explicit and implicit) and cognitive (explicit) attitudes among adolescents suffering from asthma and healthy adolescents (N = 200). Mediation analysis has also been used to reveal the associations between values and anxiety/depression symptoms through coping strategies. Qualitative study based on anthropological research methodology were applied to study the phenomenology of asthma and health among Russian and French adolescents (N = 20). The study confirmed that values are associated with health behaviors through affective and cognitive attitudes. In valuing health or exciting life, adolescents use coping strategies specific to asthma which influence the symptoms of anxiety and depression. Inclusion of the above values in educational programs makes it possible to promote healthy behaviors and ameliorate the quality of life among adolescents with asthma
Brossard, Baptiste. "Les conditions sociales de l'automutilation juvenile : une approche sociologique." Paris, EHESS, 2011. http://www.theses.fr/2011EHES0034.
Thesis proposes a sociological approach to self-injury practices, a matter which is traditionally studied by psychology. This practice is defined as deliberate and repetitive self-inflicted injury, which is socially stigmatized and performed in order to relieve oneself of some kind of malaise this is done without any conscious suicidal, sexual or esthetical intentions. The empirical material is mostly composed of repeated in depth interviews with adolescents and young adults who were recruited in online forums and mental health establishments. Following a methodological discussion on the particularities of these fields of investigation, the analysis is presented around two main lines. First, I provide a concrete description of how self-injury occurs in regard to the life trajectories of the affected individuals, the everyday occurrence of this behavior, and the practical modalities of such acts. Second, the search for some "social conditions" of self-injury is the crux of the analysis. Individual case studies elaborate the three dimensions of self-harming practices -secrecy, deviance and self-aggressivity -which contribute to its effectiveness and relative choice. This perspective leads to a sociological interpretation where self-injury is considered in light of the social positions into families of the subjects, the issue being crucial in their school lives, their social belonging, as well as in their corporeal experiences and gender identities. This thesis provides a reflection on the social circumstances which facilitate the recourse to self -injury. It leads to an examination of such practices as a technique of self-control
Bernady, Alain. "Asthme de l'adolescent : comportement des adolescents face à la crise d'asthme et retentissements de la maladie asthmatique dans leur vie de tous les jours." Bordeaux 2, 1997. http://www.theses.fr/1997BOR23080.
Bradshaw, Joanne. "L'incidence de la dépression chez les adolescentes mésadaptées socio-affectives d'un centre d'accueil." Master's thesis, Université Laval, 1989. http://hdl.handle.net/20.500.11794/29453.
Gansel, Yannis. "Le souci des adolescents : traiter une vulnérabilité dangereuse." Paris, EHESS, 2016. https://hal.archives-ouvertes.fr/tel-01338533.
The clinical category of "difficult" adolescents has become ubiquitous in public action in France since the early 2000s. In this thesis, we explore this success as a case-study for contemporary changes in the social treatment of youth deviancy. We use two sets of empirical data: genealogical analysis drawn from a documentary corpus and ethnographic fieldwork conducted in an inter-professional network designed to treat difficult adolescents. We produce a clinical anthropology of mental health, relying on a framework based upon social constructivism tempered with interactionism and pragmatism. The category of difficult adolescents is organised by clinical expertise on subjectivity, inspired b\ psychoanalysis while distancing itself from psychiatry. It allows professionals in charge of youth to define, publicise and solve an emerging problem: new uncertainties in the public management of violent and deviant youth. It depicts a residual, interstitial population, located between the various institutions treating youth deviancy. Such a margin is fostered by the specialisation of these institutions and by the poor coordination capacities of local authorities and policy makers. This category operates by an extreme biographical personalisation. It reassigns adolescents to a profile of institutional treatment and makes professional intervention: meaningful. It coordinates various institutions, while preserving their specialisation. It solves the anomic dilemma of vulnerability versus dangerousness, protection versus autonomy, and care versus control. This clinical expertise has a unique ability in building consensus, insuring a pervasive and coercive moral authority. However, the ethical and social stakes in the care-givers' trouble and the cultural and political relativity of violence fall beyond this clinical scope. Thus clinical expertise performs care, which is both an affective experience and an attitude, embodying contemporary forms of public action
Vallata, Amandine. "Des déterminants individuels et collectifs du sevrage tabagique au développement d’une intervention de santé publique chez les adolescents." Thesis, Bordeaux, 2020. http://www.theses.fr/2020BORD0235.
The leading cause of preventable death in France and worldwide is smoking. Most adult smokers began smoking in adolescence, and the age of daily smoking among adolescents is 15.1 years. Social inequalities have been observed according to the educational pathway of young people, with those in vocational streams (in high schools or in apprentice training centers) showing a much higher prevalence of daily smoking (33% and 47% respectively) compared to their counterparts in the general stream (22%). A smoking cessation program targeting adolescents in apprenticeships, TABADO, was developed and evaluated in France in vocational schools, in the Lorraine region in 2007-2009. The 12-month evaluation showed a quit rate twice as high in schools that had benefited from TABADO compared to control schools. However, the evaluation of this type of intervention cannot be limited to the assessment of efficacy. Indeed, these interventions are considered as complex, due to the influence of contextual and organizational factors on outcomes. Moreover, from a pragmatic point of view, the objective of decision-makers and public health professionals is to be able to replicate and implement evidence-based programs in real-world conditions. In particular, the National Cancer Institute has decided to scale-up TABADO at the national level, and to extend it to vocational high schools. The challenge is then no longer to understand if an intervention "works", but also why and how it works. To date, TABADO research has not benefited from this type of evaluation. The main objective of this PhD is thus to understand the processes and mechanisms explaining the effects of the TABADO intervention, in order to propose an optimized version, applicable in real-world conditions and to adolescents in vocational high schools. This will involve developing the program theory, in accordance with the principles of Pawson’s and Tiley’s realist evaluation. The methods were: 1) conducting a systematic literature review to identify individual and collective predictors of smoking cessation in adolescents, 2) conducting a multiple-case study of the TABADO program (n=10) to identify factors and mechanisms favoring/hindering the enrollment and retention of student smokers in the program, across the diversity of implementation contexts. The literature review identified 63 predictors of smoking cessation among adolescents. Half of these predictors were social influences and psychosocial factors (Article 1). In terms of research, the development of the program theory highlighted the main mechanisms (here in realist terms, i.e. the reasoning of adolescent smokers) explaining the behaviors of young smokers with regard to the TABADO program, and the required conditions to activate these mechanisms (Article 2). From a pragmatic point of view, the multiple-case study highlighted the need and the way to integrate TABADO into a global strategy rather than considering it as an independent intervention, leading to the creation of TABADO 2 (Article 3). Numerous recommendations for field agents have been produced and have been put in a practical guide, now distributed by Santé Publique France, to support the national scaling-up of this program (TABADO 2 Guide). This PhD work thus met a dual research/field objective: it explained how a smoking cessation program can produce an effect in adolescents, and it proposed a new version of TABADO, which has been improved and adapted for real-world conditions, supporting the national scaling-up
Dupas, Pascaline. "Informations, incitations et comportements de santé : trois essais en économie du développement." Paris, EHESS, 2006. http://www.theses.fr/2006EHES0014.
This thesis uses evidence from four programs implemented in Kenya to identify types of informations and incentives that can increase preventive health behaviors. We find that teenagers are responsive to information on relative risks, thus providing information on the distribution of HIV prevalence disaggregated by gender and age group can have a much larger impact that simply providing teenagers with information on the average prevalence. We also find that reducing the cost of education generates effective incentives for teenagers to avoid teen pregnancy or marriage, and thus can have the triple benefit of increasing educational attainments, reducing the spread of sexually transmitted diseases, and reducing the incidence of teenage pregnancy. Last, we find that conditional in-kind subesidies (in the form of mosquito nets given to pregnant women enrolling for prenatal care) can be used effectively to overcome private inertia in the take-up of public health services, including HIV testing
Tran, Phuong Lien. "Promotion de la santé sexuelle et de la vaccination contre le papillomavirus en collège à La Réunion." Electronic Thesis or Diss., La Réunion, 2022. http://www.theses.fr/2022LARE0034.
In Reunion Island, cervical cancer is the third leading cause of cancer in women. Primary prevention is based on vaccination against papillomavirus (HPV). A study on cervical smears and biopsies in Reunion showed that the most frequent HPV on the island were HPV 16, 31, 51, 52, mostly contained in the nonavalent HPV vaccine (Gardasil 9). Thus 96.8% of lesions could have been prevented by the vaccine. However, in Reunion Island, the coverage rate is low (12.2%). The main obstacles found among mothers of adolescents and general practitioners were lack of information and vaccine mistrust. The objective of the study was to evaluate the impact of a health promotion program on HPV vaccination coverage. In this prospective, controlled superiority interventional study, a promotion program took place in a middle school, which was compared to a control school where no specific intervention was planned, during 2020-2021 school year, in the south of Reunion Island. The program combined: information for students (lectures, personalized information in the school yard, public health campaign created by students), parents, general practitioners, free vaccination at school (in a "health bus" parked in the school yard) with the nonavalent HPV vaccine. At the end of school year, vaccination coverage was significantly increased in the school where the intervention took place. The most effective communication method to raise acceptability of vaccination among students was the participatory method, where students were actors in the creation of a public health campaign. However, the low participation rate in vaccination campaigns could be explained by the fear of serious adverse effects due to lack of information and knowledge, mistrust, and the taboo related to sexuality and pregnancy among adolescents, depriving children of a dialogue with their parents on the subject. Implementation of a health promotion program and free vaccination in schools increased vaccination coverage. These results are promising and are a stepping stone towards the extension of this program to the entire island of Reunion; and hopefully someday the burden of cervical cancer may be reduced
Jourdan, Matthieu. "Santé et bien-être des adolescents : conceptions et pratiques déclarées des professionnels et des adolescents." Thesis, Clermont-Ferrand 2, 2015. http://www.theses.fr/2015CLF20017/document.
This research work takes place in the Department of Allier in Auvergne in Central France. Through two projects - the first aims to reduce social inequalities in health of a territory, the second aims to involve schools in a reflection on the health promotion - we are trying to determine the relationships there may be between the conceptions and declared practices of middle school students with the conceptions and the practices of professionals of a territory on issues of health and well-being of adolescents. To explore this topic, we rely on two collections of data. The first consists of 49 semi-structured interviews with respect to conceptions and practices of professionals with regard to questions of health and well-being of adolescents. The second, based on 1170 questionnaires filled in by school boys and girls, deals with conceptions and declared practices that adolescents have on their health and their well-being. The review of systems of conceptions of various professionals in relation to the concepts and practices of adolescents allow us to think that the training of professionals on the issues of health, health education and health promotion should enable stakeholders to better understand the complexity of their public about health and well-being issues; better take account of the different dimensions of health by promoting the development of life-skills and the empowerment of the adolescents and the quality of peer relationships. Then, issues concerning how does stakeholders take into account environment of adolescents, including family, should be improved
Houbre, Barbara Elisabeth. "Violence en contexte scolaire : le cas du bullying : approches psychosociales et clinique." Metz, 2006. http://www.theses.fr/2006METZ026L.
Bullying is a phenomenon that has not been much studied in France until now. This concept can be defined as a whole of negative a ctions physical, verbal or relational), repeated and lasting in time, coming from one (or several) student(a) and directed toward one (orther students). Five studies based on transversal, longitudinal or crossed methodologies let us observe this phenomenon, through its sociopsychological and clinical aspects. Results show that the identity, the efficiency of coping strategies and the physical health of students involved in bullying tends to decrease. However, the expiession of these dimensions varies if the student is a victim, a bully, or a bully-victim. Thus, victims and bully-victims tend to be more directly concemed by those problems than bullies are. Moreover, in the worst cases, bullying seems to generate post-traumatic stress disorders bundled with identity troubles and shattered fundamental assumptions which the student have about himself and the external world. Additionally, students involved in bullying seem to show elements of narcissistic and sexual identifications troubles as well as inadequat educational practices. Ln the case of bullies and bully-victim, we can more pecifically observe a deficient mentalization. Based on those different results, we suggest several applied perspectives in terms of prevention and therapeutic handling
Roche, Johanna. "Le sommeil, ses troubles et la santé cardio-métabolique d'adolescents obèses : effets d'une prise en charge associant exercice physique et modification des habitudes alimentaires." Thesis, Bourgogne Franche-Comté, 2018. http://www.theses.fr/2018UBFCE010.
Sleep, through its restorative functions, is essential for life. However, lifestyle modifications, sedentary and unhealthy feeding behaviors trigger sleep curtailment and sleep disruption, leading together to weight gain. Obesity is usually associated with obstructive sleep apnea (OSA), and these two diseases both induce metabolic dysfunctions and low-grade systemic inflammation. To the best of our knowledge, no study has assessed the effects of exercise reconditioning and modified food habits on these parameters. The purpose of this work was to assess and compare, from an ancillary study, polysomnographic variables between obese adolescents and normal-weight (NW) controls. In the main study, the effects of a 9-month program (exercise reconditioning, adapted physical activities and modified food habits) on sleep architecture, sleep duration, OSA, biological factors (inflammatory, hormonal, carbohydrates and lipid profiles) and physiological adaptations at exercise were assessed, in order to a better understanding of the roles of cardiorespiratory fitness and sleep disorders on cardio-metabolic health. Thirty-two obese adolescents (age: 14.6 years, BMI z-score: 4.7) were recruited. Every parameters were assessed at admission and post-intervention. Short sleep duration and a high prevalence of OSA (58%) were observed at admission in obese adolescents despite a satisfying sleep architecture, compared with NW controls. Post-intervention, weight loss (11kg) and improved parameters of physiological adaptations at exercise (MAP, VE, VO2peak) were found in every subject and OSA was normalized in 46% of them. Sleep quantity and sleep quality were improved. Decreased C-reactive protein (6.78 vs 10.98 mg/l) and leptin concentrations, and increased adiponectin levels were found, and cardio-metabolic risk (CMR) was decreased. At admission, obesity explains by itself the systemic inflammation whereas the decrease in inflammation, post-intervention, is explained by enhanced cardiorespiratory fitness related to fat-free mass, after controlling for sex, weight loss, change in sleep duration and OSA. Prevention of OSA and metabolic dysfunctions by chronic exercise should be an integral part of the obesity management in youths in order to decrease the risk of cardiovascular morbi-mortality in adulthood
Pepin, Camille. "Surpeuplement des logements en lien avec la détresse psychologique chez les adolescents inuit du Nunavik : un suivi longitudinal." Doctoral thesis, Université Laval, 2019. http://hdl.handle.net/20.500.11794/37233.
About half of Nunavik Inuit live in overcrowded households compared to 6% of the general Canadian population. Inuit adolescents are also more at risk of suffering from psychological distress than their Canadian peers. Living in overcrowded households is associated with greater risks of suffering from mental health problems for Canadian adolescents. However, no empirical and longitudinal study has examined the impact of living in an overcrowded household during childhood on psychological distress at adolescence for Inuit. The objective of the present work is to examine the hypothesized relationship between household overcrowding at childhood and psychological distress during adolescence among Nunavik Inuit, as well as the hypothesized relationship between these phenomena when they are both measure at adolescence. It will also examine if this relationship is moderated by sex. Recruited as part of the Nunavik Child Development Study, 220 participants were met when they were 11 years old in average, and then when they were 18 years old in average. Household overcrowding was assessed using the people per room ratio. Psychological distress symptoms were operationalized at adolescence using depressive symptoms and suicidal thoughts. The results did not show that childhood household crowding had a longterm effect on psychological distress, nor effect moderation by sex. Despite these results, household crowding could be a risk factor when in interaction with other elements related housing conditions or with poverty, or could be experienced as a difficulty for adolescents on other aspects than depressive symptoms and suicidal thoughts.
Rebière, Denis. "Approche du trauma psychique à l’hôpital pédiatrique : effroi, sidération, élaboration du trauma." Thesis, Rennes 2, 2014. http://www.theses.fr/2014REN20009/document.
The traumatism is historically a central notion in the field of the surgical medicine. With the claimss of victims' associations, it becomes a psychiatric syndrome. The psychoanalysis will endeavour throughout the last century to describe its functioning. It puts at the day order the responsibility of each traumatized subject in what happens to him. The event comes to reactivate a psychopathological process whose existence would be previous to the traumatic accident. But the general problem of the psychic traumatisme and of its interpretation (performance) still remains a reality nowadays. This clinical research, conducted among children and adolescents sick ( pediatric services) or wounded (pediatric surgery services), generalizes the psychopathology of the traumatism in the domain of pediatric somatic affections. It establishes a difference between a clinic of the dread and a clinic of anguish. The dread (or terror) associated with a mechanisme of sideration, rather occurs in the domain of corporal wounds, the anguish articulated with the repression is rather concerned after the annoncment of a serious disease, such as cancer
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
Maillard, Isabelle. "L'adolescence au prisme de la santé mentale : la recomposition des modes d'action en psychiatrie infanto-juvénile de secteur." Paris 5, 2008. http://www.theses.fr/2008PA05H100.
In less than one half-century, french psychiatry has undergone deep institutionnals transformations. The vertical logic which characterized the closed institution has become horizontal with the multiplication of services in the community. In the last fifteen years, mental health and psychic suffering in teenagers have become major social issues. To adress them, new public policies were designed which redefine psychiatry's perimeter of action. The aim of this thesis is to analyse these transformations in France, where very few studies by social sciences exist. The hypothesis is that mental health operates a reconfiguration of action in psychiatry. It is examined through the analysis of national and local public policies, of the lines of tensions that they create among professionals, and of how they reframe action and its modes
Lindo, Oscar Josué. "Grossesses à l'adolescence : une analyse organisationnelle des services de santé et d'éducation offerte aux adolescentes dans la municipalité de Plato en Colombie." Master's thesis, Université Laval, 2015. http://hdl.handle.net/20.500.11794/32627.
x201512\u En Colombia y en otros países en desarrollo, se ha venido observando un aumento en la tasa de embarazo adolescente con una tendencia ascendente en las últimas décadas. La causa del fenómeno ha sido analizada desde diferentes perspectivas: la globalización y el modernismo, las tendencias socioculturales, los cambios de comportamiento en la adolescencia, los mensajes inapropiados sobre la sexualidad a través de los medios de comunicación, la escasa educación impartida en el tema de la salud sexual y reproductiva (SSR), el ambiente familiar disfuncional, etc. Colombia, un país con recursos económicos limitados, el fenómeno del embarazo adolescente es un factor resultante de los niveles de pobreza y, además contribuye en el incremento de las tasas de mortalidad materna e infantil, la deserción escolar, los abortos clandestinos, entre otras consecuencias. El presente estudio descriptivo eminentemente cualitativo pretende explorar y analizar la problemática desde la perspectiva de la organización de los sistemas, particularmente de los sistemas de salud y educación como un factor determinante que favorece o no la alta incidencia de embarazos en mujeres adolescentes del municipio de Plato-Magdalena. Para estudiar el fenómeno, tomamos como referencia el marco conceptual de los factores determinantes de la salud desarrollado por el Ministerio de Servicios Sociales y de Salud de Québec (MSSSQ, 2010). La entrevista, los grupos de discusión y la revisión de la literatura fueron las técnicas privilegiadas que en el estudio nos permitieron recaudar la información necesaria para su interpretación y análisis. Estas nos posibilitaron contar con el material suficiente para encontrar los diferentes elementos claves que dentro de la organización de los sistemas estudiados favorecen o desfavorecen el embarazo adolescente en Plato-Magdalena. Al final del estudio, el análisis realizado revela claramente la importancia de la organización de servicios como coadyuvante del problema e identifica los factores de riesgo sobre los cuales se podría influir para disminuir el número de casos de embarazos en la población de mujeres adolescentes. Los resultados de este estudio contribuirán seguramente a mejorar los conocimientos en lo concerniente a la organización y oferta de servicios para jóvenes adolescentes, concretamente los servicios de salud y educación. La efectiva organización de éstos se perfila como una estrategia de primer orden a considerar en la resolución del problema. Las recomendaciones presentadas al final, partiendo de la realidad sobre el terreno permitirán a las autoridades una inversión inteligente de los recursos disponibles para impactar positivamente los indicadores actuales de salud sexual y reproductiva de la población de adolescentes del municipio.
Québec Université Laval, Bibliothèque 2018
Yazbeck, Myra. "Three essays in health economics." Thesis, Université Laval, 2011. http://www.theses.ulaval.ca/2011/28786/28786.pdf.
Botton, Jérémie. "Croissances staturale et pondérale jusqu'à cinq ans : relations avec la composition corporelle et les paramètres cardiométaboliques à l'adolescence. Etude Fleurbaix Laventie Ville Santé II." Paris 11, 2008. https://tel.archives-ouvertes.fr/tel-01755570.
Jiménez, Molina Álvaro. "L'adolescence mutilée : grammaires de la souffrance au Chili et en France." Thesis, Sorbonne Paris Cité, 2018. http://www.theses.fr/2018USPCB172.
Since the late 20th century, self-injurious practices (scratching, cutting and burning of body tissue) among adolescents have become a major problem for mental health institutions and professionals. Adolescents who self-injure themselves have become a contemporary figure of the suffering subject. Several psycho-medical studies have provided an analysis of the reasons for this practice and the problems associated with it (impulsivity, depression, suicidal behaviour, etc.). However, little importance was attached to the lived experience and ordinary life of adolescents, the language they use to describe their suffering, as well as the representations of health professionals and their care practices. The purpose of this thesis is to study the subjective and sociocultural dimensions of deliberate self-injury in adolescence. What are the main changes in taxonomies and etiological explanations of self-harm? What does it mean for adolescents and how is it experienced in their daily lives? What are the representations, attitudes and practices of mental health professionals regarding these phenomena? To answer these questions, this study is based on an analysis of secondary literature and an ethnographic work, conducted by observation and interview, in mental health institutions in Santiago (Chile) and Paris (France), among adolescents aged 12 to 19 (n=40) and health professionals (n=51). The different levels of analysis make it possible to highlight how the "corte" [cutting] or "scarification" has become a possible practice for adolescents, its social uses and the particular emotional tone associated with it in each society ("rabia" [anger] in Chile and "angoisse" [anguish] in France). While self-injury is a form of emotional regulation, adolescents' narratives show that it is simultaneously a form of social regulation, a paradoxical self-care strategy that restores continuity to ordinary life at times when the individual is confronted with an experience of loss of control and a crisis of agency. The study also shows the differences in emphasis between a familyist perspective that understand this behaviour as a symptom of a "dysfunctional family" (Chile) and a perspective that understand it as a form of "passage à l'acte" that reflects the excesses of "état limites" (France). Based on a description of care practices, it analyses the cultural logics of therapeutic rituals and the main difficulties for the institutional management of adolescent self-harm. Based on a comparative perspective of singularization by contrast, the study highlights the links between a system of collective representations, values and beliefs, and a grammar of suffering that regulates how emotions and malaise are expressed, qualified and treated in two individualistic societies
Desde finales del siglo XX, las prácticas auto-lesivas (cortarse o quemarse el tejido corporal) entre los adolescentes se han convertido en un problema importante para las instituciones y los profesionales de la salud mental. Los adolescentes que se autolesionan intencionalmente han adquirido una gran visibilidad social y se han transformado en una de las figuras contemporáneas del sujeto sufriente. Diversos estudios psico-médicos han proporcionado un análisis de las razones de esta práctica y de los problemas asociados a ella (impulsividad, depresión, comportamiento suicida, etc.). Sin embargo, en estos estudios se ha dado poca importancia a la experiencia subjetiva y a la vida cotidiana de los adolescentes, al lenguaje que utilizan para describir su sufrimiento, así como a las representaciones de los profesionales de la salud y sus prácticas de cuidado. El propósito de esta tesis es estudiar las dimensiones subjetivas y socioculturales de las prácticas auto-lesivas en la adolescencia. ¿Cuáles son los principales cambios en las taxonomías y las explicaciones etiológicas de la autolesión? ¿Qué sentidos le atribuyen los adolescentes y cómo se experimenta en su vida cotidiana? ¿Cuáles son las representaciones, actitudes y prácticas de los profesionales de la salud mental respecto a estos fenómenos? Para responder a estas preguntas, esta tesis se basa en un análisis de literatura secundaria y un estudio etnográfico, realizado mediante observación y entrevistas, en instituciones de salud mental de Santiago (Chile) y París (Francia), entre adolescentes de 12 a 19 años (n=40) y profesionales de la salud (n=51). Los diferentes niveles de análisis permiten mostrar cómo el "corte" o la "scarification" se ha convertido en una práctica posible para los adolescentes, sus usos sociales y el tipo particular de tono emocional asociado a esta práctica en cada sociedad ("rabia" en Chile y "angoisse" [angustia] en Francia). Si bien la autolesión aparece como una forma de regulación emocional, los relatos de los adolescentes muestran que se trata simultáneamente de una forma de regulación social, una estrategia paradójica de autocuidado que restaura la continuidad de la vida ordinaria en momentos en que el individuo se enfrenta a una sensación de pérdida de control y a una experiencia de crisis de la capacidad de acción. La tesis muestra además las diferencias de énfasis entre una perspectiva familiarista que interpreta este comportamiento como síntoma de una "familia disfuncional" (Chile) y una que lo interpreta como una forma de "paso al acto" que refleja los excesos de los "estados fronterizos" (Francia). A partir de una descripción de las prácticas terapéuticas y de cuidado, se analizan también las lógicas culturales de los rituales terapéuticos y las principales dificultades para la gestión institucional de la autolesión. La perspectiva comparativa de singularización por contraste que asume este estudio permite subrayar los vínculos entre los sistemas de representaciones colectivas, valores y creencias, y una gramática del sufrimiento que regula cómo se expresan, califican y tratan las emociones y las diversas formas de malestar en dos sociedades individualistas
Rivest, Lyne. "Effet du programme Gestion des buts personnels sur la santé mentale des femmes ayant été victimes d'agressions à caractère sexuel dans l'enfance ou à l'adolescence." Thèse, Université du Québec à Trois-Rivières, 2008. http://depot-e.uqtr.ca/1328/1/030093581.pdf.
Le, Dantec Véronica, and JEROME MACAIGNE. "La perception de la contraception orale chez l'adolescente : enquete realisee aupres de 646 jeunes filles, dans le cadre du centre d'examens de sante de l'institut pasteur de lille." Lille 2, 1993. http://www.theses.fr/1993LIL2M353.
Fonte, David. "Processus et enjeux psychosociaux associés au développement des compétences psychosociales : une investigation en éducation thérapeutique du patient." Thesis, Aix-Marseille, 2017. http://www.theses.fr/2017AIXM0292.
Based on a psychosocial approach to the therapeutic situation, this thesis examines the psychosocial processes and issues involved in the development of psychosocial skills in the context of the therapeutic education of type 1 diabetic patients. Following the limitations identified by our systematic review (N = 60 articles), we conducted a qualitative research with diabetic adolescents (N = 28) in order to better understand their needs in terms of psychosocial skills. This work led us to identify three research perspectives that we carried out using different methodological strategies: an experimental study (N = 102) and a transversal study (N = 261) with diabetic adults; a prospective study to following the evolution of the sociocognitive profile of adolescents with diabetes (N = 24); and a qualitative study using ten focus groups of adolescents with diabetes (N = 26), parents (N = 9) and health professionals (N = 11). The articulation of these studies shows that psychosocial skills are regulated by psychosocial processes that are at stake in the dynamic context of the therapeutic relationship. These skills are part of a system of actions and interpretations socially shaped by therapeutic and relational issues as well as by a social symbolism. Their development seems to be determined by the social status and identity of the actors, their motivations and expectations, and by the representation of others mobilized to build the climate of the therapeutic relationship
Terrasson, Johanna. "Perception du diabète de type 1 auto- et hétéro-évaluée par les adolescents et leurs parents : analyse des liens avec leur qualité de vie, la gestion familiale de la maladie et le contrôle métabolique." Thesis, Rennes 2, 2019. http://www.theses.fr/2019REN20018/document.
This thesis focuses on a population of adolescents with type 1 diabetes and their parents. It examines the influence of adolescents’ and their parents’ perceptions of type 1 diabetes, on their respective adjustments to the disease. First, we present the characteristics of type 1 diabetes, its specificities in adolescence, and two criteria used to examine adjustment to the disease : metabolic control and quality of life. After having defined the notion of illness perception and describing its influences on adjustment, the role of family members' perception is examined. A study of illness perception in the family through self- and hetero-evaluation is then presented. The two lines of research aim to highlight the existence of potential interpretations of the family members’ perceptions and analyze their influence on adjustment to the illness. The first two studies highlight the impact of type 1 diabetes' perception, both self- and hetero-evaluation, by adolescents and their parents on their adjustment. The last study reports, using a qualitative approach, the links between illness perception in the family and adolescents' quality of life, in light of family diabetes management. In conclusion, our studies provide further support the need to study the illness perception in the family through the prism of interpersonal perception and meta-perception. Finally, the limits of this work and research and applied perspectives are discussed
Nsakala, Vodiena Gabriel. "Communication stratégique pour améliorer la double prévention des IST / VIH / SIDA et des grossesses non désirées chez les adolescents à Kinshasa, RDC: enjeux et perspectives de l'éducation sexuelle participative." Doctoral thesis, Universite Libre de Bruxelles, 2014. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209308.
Dans le présent travail de recherche, nous présentons un cadre d’analyse, de planification et de mise en œuvre d’une recherche-action portant sur l’apport de l’éducation sexuelle participative comme démarche de la communication stratégique, et ses effets sur le public d’adolescents en milieu scolaire. Le but ultime étant de proposer une meilleure alternative à l’amélioration de la double prévention des IST/VIH/SIDA et des grossesses non désirées chez les adolescents scolarisés de 15-19 ans à Kinshasa, RDC.
Les principaux objectifs fixés à la présente recherche étaient :i) d’évaluer l’ampleur de la situation épidémiologique et sociale liée à la santé de reproduction y compris la prévention du VIH/SIDA chez les jeunes adolescents (15-19 ans) ;ii) d’identifier les besoins ainsi que les préoccupations spécifiques des adolescents et jeunes notamment en terme de vie sexuelle et affective ;iii) de projeter les axes de communication stratégiques susceptibles d’influencer positivement les comportements en vue d’améliorer la prévention des IST/VIH/SIDA et des grossesses précoces des adolescents et jeunes en milieu urbain ;iv) de construire sur base des observations et analyses précédentes, une approche de communication stratégique fondée sur l’éducation sexuelle participative; iv) et mesurer au point de vue cognitif et comportemental, l’écart attribuable à l’éducation sexuelle sur l’amélioration des connaissances, des attitudes et des pratiques favorables à la double prévention des IST/VIH/SIDA et des grossesses précoces chez les adolescents de 15-19 ans en milieu urbain de la RDC.
Réalisée dans une perspective de la promotion de la santé, son cadre théorique chemine avec celui de l’évidence des liens entre les IST/VIH/SIDA et la santé sexuelle et de reproduction. La combinaison du modèle d’analyse PRECEDE avec l’outil de planification PROCESSUS-P, a servi de fil conducteur de ce travail.
Cette étude confronte également la théorie de la communication avec les modèles de changement de comportement. En effet, les messages sur la sexualité émis par un émetteur, permettent à l’individu qui les reçoit, de se persuader à amorcer le changement de comportement qui passe par différents étapes. Mais au delà de la volonté individuelle, les relations de sexualité se vivent dans une interaction sociale dont il faudra tenir compte.
La construction de cette recherche a fait appel aux disciplines des sciences sociales, comportementales, de l’éducation, et de l’épidémiologie.
Nous avons combiné quatre approches différentes pour cerner nos hypothèses de recherche :i) la revue documentaire, ii) l’approche socio-anthropologique (qualitative) par des focus groups, entretiens semi dirigés, observations directes, iii) l’approche socio-épidémiologique (quantitative) par des enquêtes transversales et iv) l’approche opérationnelle par l’introduction d’une approche innovante utilisant le téléphone et la radio comme moyen pour identifier et orienter des messages à diffuser en milieu scolaire sur la prévention des IST/VIH/SIDA et les grossesses précoces.
Ce travail propose deux formats de résultats :les articles publiés ou en cours de l’être et les résultats complémentaires synthétisés dans différents tableaux.
Les articles abordent successivement :i) le profil de risque et de vulnérabilité lié au VIH/SIDA et à la santé des adolescents ;ii) la perception des adolescents en matière de santé sexuelle et reproductive ;iii) l’ analyse de l’intégration de l’éducation sexuelle dans les médias ;iv) l’utilisation du téléphone portable et de la radio pour identifier les préoccupations sexuelles des adolescents, v) les déterminants associés à la pratique de la double prévention des IST/VIH/SIDA et des grossesses précoces et vi) les effets cognitifs et comportementaux de l’éducation sexuelle participative sur la double prévention des IST/VIH/SIDA et des grossesses précoces en milieu scolaire de Kinshasa.
Les données synthétisées dans différents tableaux rendent compte de l’analyse de la réponse nationale sur la santé de la reproduction des adolescents et des différents aspects du cadre théorique d’analyse et de planification d’une communication stratégique pour la prévention des IST/VIH/SIDA et des grossesses précoces.
L’ensemble des résultats de cette recherche peut se résumer en dix points importants ci-après :
1.\
Doctorat en Sciences de la santé publique
info:eu-repo/semantics/nonPublished
Moreau, Anne-Marie. "La gestion de la carie interproximale et occlusale chez l'enfant et l'adolescent." Thesis, 2020. http://hdl.handle.net/1866/24441.
Objectives: The main objective of the research was to assess the management of interproximal and occlusal caries in children and adolescents by Canadian dentists to assess compliance with the new international recommendations on dental caries management. To do this, the restorative threshold, the restoration techniques materials were evaluated. The secondary objective was to assess whether there was a difference between the treatments performed by dentists according to different sociodemographic data, such as their province of practice, their graduation year and University, and their degree of specialization. A comparison was also made analyzing their age, their gender and their frequency of treatment in a pediatric population. Method: An electronic survey was created with REDCap protected server and was sent by email to members of various Canadian provincial regulatory bodies. This survey included 11 questions on the demographic factors of the respondent. The responding dentist was then exposed to 3 clinical situations on dental caries in children and adolescents. Results: Seven hundred and two completed surveys were included in the statistical analysis. For interproximal carious lesions limited to the enamel, 442 (62.6%) responded treating by surgical removal for a permanent molar and 502 (70.9%) responded doing the same for a primary tooth. For occlusal carious lesions, those numbers were 300 dentists (43.2%) for a permanent molar and 269 dentists (38.4%) for a primary molar. The majority of dentists used conservative techniques such as a box-slot preparation for permanent teeth (58.3%) and restored primary and permanent molars with composite resin. The age, year of graduation, gender, province of graduation and of practice appear to have a statistically significant impact on the restorative threshold. Conclusion: Results show that many of the responding Canadian dentists would treat carious lesions, particularly interproximal lesions, more aggressively than the new recommendations for management of dental caries.
Nault, Marie-Lyne. "Prédiction de l'évolution de la scoliose idiopathique de l'adolescent à l'aide des paramètres tridimensionnels du rachis." Thèse, 2012. http://hdl.handle.net/1866/10451.
Prediction of curve progression remains a challenge for the clinicians at the first visit for a patient with adolescent idiopathic scoliosis. Prediction of progression is based on curve type, curve magnitude and skeletal or chronological age. The failure to accurately predict the risk of progression can lead to inadequate treatment, as well as unnecessary medical visits and radiographs. Three-dimensional evaluation is currently more popular in the scoliosis research community either for classification or treatment planning. The global objective of this thesis was to develop a predictive model of the final Cobb angle in adolescent idiopathic scoliosis based on 3D spine parameters and on skeletal age, curve type and curve magnitude. The first study was to develop a skeletal maturity system based on ossification of iliac apophysis and triradiate cartilage status, two details available on routine radiographs. A 3 stages system was develop with the second stage being associated to the rapid acceleration phase of the deformation. The second stage corresponds to a closed triradiate cartilage and a maximum of 1/3 of the iliac apophysis ossification. The second study was a retrospective case control study. It showed the potential for 3D parameters to help predict the evolution. 3D spinal parameters at first visit of a group of patient eventually treated with surgery and a group who had no progression revealed statistical differences for: mean 3D wedging of the apical disks, lower junctional vertebral axial rotation, torsion and T6 and whole spine height/width ratio were all significantly affected. The last study was a prospective cohort study based on an adolescent idiopathic scoliosis group followed from first visit to skeletal maturity. A general linear model was developed based on 3D spinal parameters and on curve type, Cobb angle at first visit and with the 3 stages skeletal maturity system developed in the first study. The predictive model obtained has a determination coefficient of 0,715. Included 3D parameters predictors were: the angle of the plane of maximal curvature, the 3D wedging of T3-T4, T8-T9 and T11-T12 disks, and the sum of 3D wedging of all thoracic and lumbar disks. The predictive model developed reinforced the importance of considering adolescent idiopathic scoliosis in a three-‐dimensional point of view. This model will also optimise the prediction of evolution at first visit.
"La santé à l'adolescence: un processus d'internalisation lié à la structure familiale." Université catholique de Louvain, 2002. http://edoc.bib.ucl.ac.be:81/ETD-db/collection/available/BelnUcetd-12172002-161634/.
Shen, Jesse. "Une nouvelle méthode pour estimer la torsion géométrique en scoliose idiopathique de l’adolescent." Thèse, 2014. http://hdl.handle.net/1866/13877.
Adolescent idiopathic scoliosis (AIS) is a three dimensional (3D) deformity of the spine. For most patients, no surgical intervention is required. However, for patients with severe deformities, surgery is often recommended. Postero-anterior (PA) and antero-posterior (AP) x-rays are the most common modality for viewing and evaluating this deformity. From this imaging modality, clinical indices such as the Cobb angle can quantify and evaluate the severity of AIS. Clinical decision making is often based on this descriptor. However, the descriptors based on spinal radiographies are two- dimensional (2D) by nature. Therefore, they do not fully describe the deformity in AIS due to its three-dimensional (3D) nature. Poncet et al. have studied and presented geometric torsion as a 3D descriptor of AIS. This index measures a curve’s tendency to twist out of a plane. However, the method presented in their study is susceptible to errors from an imperfect 3D spinal reconstruction due to the local approach taken and is presented in a qualitative fashion. Hence, the objective of this study is to evaluate a new method of estimating geometric torsion in AIS employing parametric curve fitting techniques based on local arc-length approximations. The first study attempts to evaluate the sensitivity of the presented method of estimating geometric torsion against noisy data or 3D reconstruction errors. Two clinical studies will then present this descriptor as a quantitative measurement of AIS and will attempt to identify potential new sub-groups and demonstrate the clinical relevance of these new sub-groups. vi The first study evaluated the robustness of the new method in estimating geometric torsion in the presence of reconstruction errors. This study demonstrated that the new method is robust to 3D spinal reconstruction errors and achieves quantitative measures in a global fashion. The second study evaluated this new method of estimating geometric torsion in patients with Lenke type 1 deformities. This study identified two sub-groups based on torsion values, a high torsion and a low torsion group. These two sub-groups showed differences in the orientation of the planes of maximum deformity (PMC) in the thoraco-lumbar segment of the spine with the high torsion group having greater values. The last study evaluated the surgical results of patients with Lenke type 1 deformities having been sub-classified in high and low torsion groups. This study showed differences in TLL PMC with the high torsion group of patients having higher values pre and post-operatively, These studies present a novel method of estimating geometric torsion in AIS and present this 3D descriptor quantitatively. They have demonstrated the existence of new sub-groups within current classification systems that were previously undetected and have shown the clinical relevance of this new method of estimating geometric torsion in AIS. This project contributes towards the development of new 3D indices for AIS and opens the door to potential new 3D classifications.
Huynh, Christophe. "Étude exploratoire et comparative du trouble bipolaire et du trouble de personnalité limite à l'adolescence." Thèse, 2008. http://hdl.handle.net/1866/2693.
Presently, differential diagnosis between bipolar disorder (BD) and borderline personality disorder (BPD) in adolescents remains difficult and affects therapeutic choices. This master’s thesis reviews current scientific literature, both in adults and adolescents. It examines feasibility and presents results of a study on clinical dimensions and endophenotypes in adolescent BD and BPD. Seven BD and eight BPD adolescents (12-17 years old) were evaluated by self-reported questionnaires for clinical variables (affective instability, impulsivity, hostility and temperament) and by actigraphy and sleep diary for sleep-wake circadian rhythm. No significant difference was found between BD and BPD for the clinical variables. BD adolescents wore actigraphic device for 9.9 days and completed the sleep diary for 5.7 days on average; for BPD subjects, the numbers were respectively 9.8 days and 8.9 days. Compared to BPD, BD patients had longer active interval (p=0.035), tended to sleep longer, and had more intradaily variability (p=0.04). Subjective data (sleep diary) and objective data (actigraphy) did not significantly differ on sleep onset latency, last awakening duration and total sleep time, which suggested that BD and BPD adolescents had a good estimate of their sleep patterns. Literature review showed a dearth of research done on adolescent BD and BPD. Feasibility of this study was verified, since data was successfully collected. Research on these variables should continue, so differential diagnosis can be done in adolescent BD and BPD.
Théroux, Jean. "Prévalence, mesures et méthodes alternatives de traitement de la douleur dorsale chez les adolescents ayant une scoliose idiopathique." Thèse, 2017. http://hdl.handle.net/1866/19330.
Adolescent idiopathic scoliosis is a three-dimensional spinal deformity. This pathology is the most common spinal deviation encountered in adolescents and has been thoroughly researched over the past few decades regarding its aetiological factors, its risk of progression and management. It is now commonly accepted that the aetiology of adolescent idiopathic scoliosis is multifactorial and includes, among other things, genetic, hormonal, mechanic, and neuromuscular factors. Though predicting which deviation will progress remain challenging, certain factors such as the age of the patient at presentation, its gender, bone maturity (Risser sign), menarchal status, and the severity of the spinal deformity are now widely accepted as factors that may provide some guidance to estimate this probability. Adolescent idiopathic scoliosis has often been considered as a non-painful pathology, and this is perhaps why researchers have failed to assess back pain in this population more systematically. Only a few studies have been published over the last two decades on this subject. Among those studies, inclusion criteria are widely heterogeneous, as is the working definition of back pain, how the prevalence period was estimated, and which outcome measure was relied upon to assess back pain in this population. Because of this, the determination of back pain prevalence in scoliosis patients remains challenging. Considering the relationship between adolescent and adult spinal pain, and the high societal cost associated with this condition, it would be appropriate to obtain a clearer picture of this condition in this population. v The primary objectives of this thesis were to (objectif 1) update the current knowledge of back pain prevalence in adolescent idiopathic scoliosis patients, to (objectif 2) ascertain if a relationship was present between the severity and localisation of the scoliosis and the back pain, too (objectif 3) reassess the psychometric properties of the SRS-22fv questionnaire, and to (objectif 4) explore an alternative back pain management for those patients. The first retrospective study included in this thesis assessed back pain prevalence in 300 adolescent idiopathic scoliosis patients. It also looked at how pain was reported and if pain management was recommended for patients reporting back pain. This study confirmed that back pain was a prevalent condition in this population and that in the vast majority of those reporting back pain, there was no kind of management recommended. The second prospective study assessed back pain prevalence in more than 500 adolescent idiopathic scoliosis patients. Point prevalence of back pain was close to 68 %. For the thoracic and lumbar regions, the pain was positively associated with the severity of the scoliosis and bracing, prescribed to stabilise or prevent the curve progression, had a protective effect. Data collected in the previous study were employed to validate the most commonly utilised outcome measure in adolescent idiopathic scoliosis, the SRS-22. The SRS-22 is a measurement instrument used to ascertain the quality of life and pain in scoliotic patients. The third article includes a report on analyses done regarding the validation of the SRS- 22fv. Complete data were available for 352 adolescents. The study demonstrated that a briefer version (18 items) had a better internal consistency and explained a greater proportion of the variance thus 63,3 % instead of 47,4 % for the SRS-22fv. vi The last study included in this thesis looked at an alternative treatment for the management scoliotic patients with or without back pain. This modality of spinal manipulation is a treatment that healthy adolescents commonly utilised. However, it was found that the rate of utilisation remains unclear within adolescent idiopathic scoliosis patients. A literature review revealed the need to have better-designed studies to assess the efficacy of spinal manipulation in this population adequately. The acquired knowledge throughout this thesis leads us to a better comprehension and understanding of back pain in adolescent idiopathic scoliosis patients. Back pain appears to be more prevalent than initially estimated and a relationship seems to be present between the level of pain intensity and the scoliosis localisation and severity in patients suffering from this pathology.
Ramsay, Joyce. "L’asymétrie mammaire chez les adolescentes présentant une scoliose idiopathique." Thèse, 2013. http://hdl.handle.net/1866/11838.
Adolescent idiopathic scoliosis (AIS) is a complex tridimensional deformation of the spine affecting primarily girls. The progressive course is mostly aesthetic with, in particular, a resulting rib cage deformity. Breast asymmetry is a frequent concern expressed by these girls. Defined as a difference in shape, position or volume of the breasts or the nipple complex, breast asymmetry is common in women but usually minor and not visible. It remains unknown in the literature if breast asymmetry is more frequent in scoliotics. Moreover, very few studies have evaluated the relationship between scoliosis and breast asymmetry. It is commonly believed that it is not the breasts that are asymmetric, but rather the trunk rotation giving this perception. The breasts represent one of the most challenging organs to measure due to their great variability. Many measuring methods have been described. Magnetic resonance imaging (MRI) is considered the most precise tool to define the mammary gland and its delimitation on the rib cage. This study aims at measuring objectively breast asymmetry, as described by a volume difference between the breasts, in a cohort of young girls presenting with significant AIS, using the MRI as a measuring tool. Then, an automated measuring method, applied on the 3D surface topography, is proposed. The results obtained with this method are confronted to those of the MRI. The influence of posture on breast volume is also examined from the two different modalities. To achieve these objectives, a cohort of 30 scoliotic patients was enrolled on the basis of their thoracic curvature and their bone and breast maturity. Two torso imaging were performed: 3D surface topography and MRI. Initially, the sommation of segmented images acquired by MRI enabled us to measure very precisely breast volume. The statistically significant mean breast asymmetry was found to be 8.32%. 66.6% of the patients presented an asymmetry ≥ 5%. A weak positive non-significant correlation exists between breast volumes and Cobb angle as well as thoracic gibbosity. Thereafter, an automated measuring method, developed from the numeric environment Matlab, is applied directly on the 3D reconstructions. In short, it consists in identifying the breasts contours to excise them in order to expose the rib cage, then subtracting from the complete thorax, the thorax without breasts to determine the breast volumes. The breast volumes acquired by the automated method are, as expected, smaller than those obtained with MRI. A strong correlation is established between breast volumes obtained from the two different techniques. Although statistically significant, breast asymmetries (r= 0.614, p< .001) are not as strongly correlated therebetween as are breast volumes. The right breast (r=0.805) presents a higher correlation than the left breast (r=0.747). Finally, the influence of posture is studied from the meshes obtained from MRI (prone) and 3D surface topography (standing position). Excellent correlations are confirmed between breast volumes; r= 0.896 and r= 0.939, respectively for the left and right breast volumes. This project enabled us to demonstrate, for the first time, that it is possible to measure breast volume objectively and accurately in a cohort of scoliotic patients. As a result of the anatomic landmarks precision, the MRI allowed us to revisit a common belief in the scoliosis community, which states that breast asymmetry expressed by patients, is in fact a perception. These new data will help us counsel our young girls with AIS, regarding their concerns with the asymmetry of their breasts. We have confirmed that the automated measuring method is clinically feasible and could be used to predict MRI volumes. Furthermore, it is the first breast volumetric measuring tool completely automatic, to our knowledge. Also, the breast volumes obtained in standing and in prone are comparable.