Dissertations / Theses on the topic 'Sciences de la santé – Technique – analyse'
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Maurincomme, Eric. "Analyse et segmentation d'images echographiques endovasculaires." Lyon, INSA, 1994. http://www.theses.fr/1994ISAL0087.
Full textIntravascular ultrasound (IVUS) is a new diagnostic imaging tool delivering real-time images of the arterial wall to the clinician. The information it provides being unique, its use is becoming more and more widespread. However, it has two limitating factors: the image interpretation, that requires a learning phase, and the absence of quantitative information, hence yielding a large inter-observer variability. The aim of this dissertation is to remedy these two limits. First, fundamentals of cardiac physiology are recalled; then the different steps of image formation are analyzed, based on the principles of ultrasound. The characteristics of IVUS images are singled out, and their artifacts are described. The information that may correctly be extracted is summarized and is used as a guideline for the next phase. In a second part, an automatic quantification technique is designed, tested, and assessed. The mathematical and physical basis for active contour models, or snakes, is recalled. Then, after exposing the drawbacks of standard snakes, our new technique, called ADDER (Adaptive Damping Dependent on Echography Regions), is introduced and compared to standard techniques. Finally, an in vitro study is conducted on over fifty normal and pathological arterial segments, and the contours obtained by automatic quantification using AD DER are compared to the orres obtained manually by cardiologists familiar to intravascular ultrasound imaging. The results for the lumen area are compared using linear regression, and the morphometric variations between contours are analyzed by the centerline method
Cury, Alexandre. "Techniques d'anormalité appliquées à la surveillance de santé structurale." Phd thesis, Université Paris-Est, 2010. http://tel.archives-ouvertes.fr/tel-00581772.
Full textRiffaud, Laurent. "Enregistrement des procédures chirurgicales crâniennes et rachidiennes, et analyse des " workflows " pour l'étude du processus chirurgical." Phd thesis, Université Rennes 1, 2012. http://tel.archives-ouvertes.fr/tel-00737144.
Full textJacqueline, Sophie. "Éthique de l'étude des objets d'arts extra- européens : intérêts et limites de l'utilisation de l'imagerie médicale." Electronic Thesis or Diss., université Paris-Saclay, 2024. http://www.theses.fr/2024UPASR025.
Full textOur research examines the ethical considerations involved in the study of extra-European art objects, specifically those from African, Oceanic, and South American origins, through the lens of macroscopic examination and medical imaging. We focus particularly on the merits and limitations of these techniques. There is a little large-scale of scientific research employing medical imaging to thoroughly explore the ethical dimensions associated with these objects throughout their lifecycle.This study includes a literature review on the introduction of extra-European objects into French collections and the evolving roles these objects have assumed, transitioning from curiosities to ethnographic artifacts and, to art objects. By integrating insights from anthropology, medical imaging, and legal studies, our research involves a detailed macroscopic and medical imaging analysis of over 150 objects from Africa, Asia, Oceania, and South America, housed at the musée du quai Branly-Jacques Chirac as well as in private collections. This analysis not only elucidates the benefits and constraints of such studies but also underscores the critical importance of addressing ethical considerations at every stage of the object's lifecycle, including collection, exhibition, sale, and restoration.Our findings provide a comprehensive overview of current practices at various stages in the life of these objects and propose new ethical guidelines for museum practices. Drawing parallels with the treatment of Catholic cult objects, we suggest that in an era where demands for the repatriation of extra-European objects are growing, it is essential to more actively involve the originating communities in the decision-making processes. We advocate for the establishment of multidisciplinary and inclusive ethics committees to ensure that diverse perspectives, practices, and beliefs are respected
Sarlon, Emmanuelle. "Stratégies palliatives à la non-randomisation en santé mentale : score de propension et techniques d'ajustement apparentées. Méthodologie appliquée à la prise en compte des facteurs de confusion dans le cas de la schizophrénie." Phd thesis, Université Paris Sud - Paris XI, 2014. http://tel.archives-ouvertes.fr/tel-00934619.
Full textGhemraoui, Rima. "Méthodologie de conception innovante intégrant la sécurité des utilisateurs : application aux liaisons tracteur-outils." Phd thesis, École normale supérieure de Cachan - ENS Cachan, 2009. http://tel.archives-ouvertes.fr/tel-00506040.
Full textHeyer, Laurent. "L'interaction patient-ventilateur : application technique d'une analyse biologique." Phd thesis, Université Joseph Fourier (Grenoble ; 1971-2015), 2009. http://www.theses.fr/2009GRE10184.
Full textOptimal Patient/Ventilator Interactions (PVI) is a determinant factor for pressure support therapy. We studied the hybrid system {Patient, Ventilator} in order to develop a clinical tool for PVI monitoring. In the first part, we described IPV as the expression of a local communication in a biological network. PVI reflect the communication process trough the respiratory system between a biological oscillator and a mechanical oscillator. This biological approach allows application of Shannon theory for the development of a de-synchronization score and the definition of an appropriate inspiratory muscle effort detector. For this purpose, we developed an automatic non-invasive detector based on a robust muscular pressure estimates continuously assessed with the help of passive mechanical respiratory models updated cycle by cycle. In the second part, we assessed these developments in patients under pressure support ventilation. The de-synchronization score was increased as the transmission channel was altered by additional noise or as the information source, the inspiratory effort, was decreased. An automatic titration of IPV by a de-synchronization score that assess channel transmission efficiency or by an inspiratory muscle effort detector that assess message generator efficiency might be helpful for respiratory function monitoring in patients under pressure support
Lancelot, Brigitte. "La gestion automatisée des réseaux d'assainissement : analyse d'un processus d'innovation technique." Phd thesis, Ecole Nationale des Ponts et Chaussées, 1985. http://tel.archives-ouvertes.fr/tel-00523044.
Full textCardot, Jean-pierre. "Formateurs d'enseignants et éducation à la santé : analyse des représentations et identité professionnelle." Phd thesis, Université Blaise Pascal - Clermont-Ferrand II, 2011. http://tel.archives-ouvertes.fr/tel-00751865.
Full textZHANG, Yuxiang. "Contrôle de santé des matériaux et structures par analyse de la coda ultrasonore." Phd thesis, Université du Maine, 2013. http://tel.archives-ouvertes.fr/tel-00971691.
Full textRomainville, Michel. "Les routes africaines de l'aluminium: Analyse d'un phénomène de diffusion technique en Afrique subsaharienne." Doctoral thesis, Universite Libre de Bruxelles, 2016. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/232355.
Full textDoctorat en Sciences politiques et sociales
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Ondoua, Pius. "Positivisme scientifique et positivisme idéologique : une analyse épistémo-politique du fétichisme de la science." Toulouse 2, 1989. http://www.theses.fr/1989TOU20019.
Full textScience cannot be considered as a pure and unitary scheme (because it is fundamentally technoscience) ; technoscience cannot be separated from the historical individual, its direct pruducer, nor from the society, its indirect producer. Subjective, social and political aims are inherent to technoscience, aims of absolute domination of nature, man and society. Therefore, at the epistemological level, analytic model which intends to be the only model of any science, must be criticized; at the political level, structure of reality which indefinitely reproduces technoscientific development and its logic must be transformed, and at the ethical and axiological level human individual has to be considered as an absolute value, giving their aims to technoscience and history
Gourvenec, Magnet Annick. "Etude diachronique de l'article de recherche scientifique en anglais : le cas de la nutrition : analyse discursive de la construction de l'article : analyse linguistique des phénomènesde cohésion du texte." Dijon, 2000. http://www.theses.fr/2000DIJOL003.
Full textLafond, Caroline. "Analyse et optimisation des performances de la technique VMAT pour son utilisation en radiothérapie." Phd thesis, Université Rennes 1, 2013. http://tel.archives-ouvertes.fr/tel-00980181.
Full textCharaudeau, Ségolène. "Réseaux de mouvements dans les modèles épidémiologiques: intégration, analyse et application aux mouvements de navette en France." Phd thesis, Université Paris-Diderot - Paris VII, 2013. http://tel.archives-ouvertes.fr/tel-00934932.
Full textLoubatan, Tabo Augustin. "Analyse économique des comportements de prévention face aux risques de santé." Phd thesis, Université René Descartes - Paris V, 2013. http://tel.archives-ouvertes.fr/tel-00949540.
Full textNarbonne-Nguyen, The Tich Valérie. "Analyse de plusieurs marqueurs moléculaires de mycobactéries : applications épidemiologiques (doctorat : sciences de la vie et de la santé)." Brest, 2000. http://www.theses.fr/2000BRES3102.
Full textAlmeida, Edmar Luiz Fagundes de. "Une analyse évolutionniste du changement dans la technologie des moteurs électriques." Grenoble 2, 1999. http://www.theses.fr/1999GRE21023.
Full textRichard, Sébastien. "Le Nanomonde des chercheurs : analyse des pratiques et des discours sur l'instrumentation en nanotechnologies." Paris 1, 2013. http://www.theses.fr/2013PA010559.
Full textBrejon, Paul. "Les logiciels d'energetique des batiments : developpement, evaluation technique, illustrations." Paris, ENMP, 1988. http://www.theses.fr/1988ENMP0110.
Full textCouture, Ménard Marie-Eve. "Les collaborations public-privé en santé publique au Canada et la responsabilité publique des acteurs participants: une analyse juridique d'un phénomène émergent." Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=121394.
Full textNotre thèse pénètre l'univers complexe et parfois opaque des collaborations établies entre des acteurs publics et privés dans le domaine de la santé publique au Canada. Elle examine les structures et les modalités de quatre collaborations public-privé s'opérant au niveau fédéral, au Québec et en Colombie-Britannique et démontre de quelle manière le droit met en œuvre la responsabilité publique des acteurs participants vis-à-vis de trois forums: les représentants élus de la population, le vérificateur général et les citoyens. En prenant appui sur ces exemples, nous nous attardons aux défis pressentis que pose le modèle émergent de la gouvernance collaborative dans l'application d'un concept essentiel à la démocratie, celui de responsabilité publique. Notre analyse met au jour les apports mais également les déficiences du droit à cet égard et ce, en distinguant les contributions respectives des normes juridiques strictement étatiques et des normes juridiques élaborées conjointement par les partenaires publics et privés des collaborations. Nous concluons finalement qu'un écart existe entre l'engouement pour les collaborations public-privé en santé publique et l'importance accordée à cette manière d'exercer le pouvoir au sein des normes juridiques prévoyant la responsabilité publique des acteurs participants. Cet écart pourrait, selon nous, être symptomatique d'une difficulté ou d'un retard du droit à s'adapter à ce modèle émergent de gouvernance.
Hammami, Sondes. "Aide à la décision dans le pilotage des flux matériels et patients d'un plateau médico-technique." Phd thesis, Grenoble INPG, 2006. http://tel.archives-ouvertes.fr/tel-00168328.
Full textBabou, Igor. "Science, télévision et rationalité : analyse du discours télévisuel à propos du cerveau." Paris 7, 1999. http://www.theses.fr/1999PA070092.
Full textJanvier, Céline. "Recherche d'indicateurs de la santé des sols." Phd thesis, INAPG (AgroParisTech), 2007. http://pastel.archives-ouvertes.fr/pastel-00003443.
Full textBizzoni-Previeux, Caroline. "Les partenariats en éducation à la santé à l'école primaire : analyse comparée entre le Québec et la France." Phd thesis, Université Blaise Pascal - Clermont-Ferrand II, 2010. http://tel.archives-ouvertes.fr/tel-00808459.
Full textPaclet, Florent. "Analyse biomécanique des transferts tendineux de la main (technique Tsugé) Modélisation des tensions Suivi longitudinal des patients." Phd thesis, Université de Grenoble, 2010. http://tel.archives-ouvertes.fr/tel-00566821.
Full textDelavigne, Valérie. "Les mots du nucléaire : contribution socioterminologique à une analyse des discours de vulgarisation." Rouen, 2001. http://www.theses.fr/2001ROUEL412.
Full textThe author draws the evolution of the conception of scientific popularization and the linguistic analysis which have been put forward for it. Then, she makes out an overview of the different discursive communities around nuclear energy exploitation. These communities are driven to use "terms" with different uses. Therefore, the author is induced to consider the matter of the terminological unity, an imperfectly defined notion, and to put forward the theoretical and methodological tools aimed at singling out those terms and to understand their function in popularisation discourses. A discourse analysis around a few key terms (risk, safety, security, accident, incident, waste) shows how the different speakers take over these terms. After that, the author scrutinises some discursive ways to popularise, studying particularly the role of autonymy. .
Havard, Sabrina. "Contribution de la pollution atmosphérique aux inégalités socio-spatiales de santé : analyse écologique du risque d'infarctus du myocarde dans l'agglomération de Strasbourg." Phd thesis, Rennes 1, 2008. http://www.theses.fr/2008REN1B120.
Full textHavard, Sabrina. "Contribution de la Pollution Atmosphérique aux Inégalités Socio-Spatiales de Santé :Analyse Écologique du Risque d'Infarctus du Myocarde dans l'Agglomération de Strasbourg." Phd thesis, Université Rennes 1, 2008. http://tel.archives-ouvertes.fr/tel-00362785.
Full textCette étude a été conduite dans la Communauté Urbaine de Strasbourg (CUS, Bas-Rhin) à l'échelle du quartier de résidence (IRIS). Les infarctus du myocarde survenus parmi la population âgée de 35 à 74 ans entre le 1er janvier 2000 et le 31 décembre 2003 (n = 1193) ont été recueillis auprès du registre bas-rhinois des cardiopathies ischémiques. Les concentrations horaires de pollution atmosphérique (NO2, PM10, O3 et CO) ont été modélisées par IRIS à l'aide du modèle ADMS Urban. Le niveau socio-économique des IRIS a été estimé à l'aide d'un indice de défaveur construit par analyse en composantes principales à partir des données du recensement.
Nous avons tout d'abord cherché à évaluer le degré d'injustice environnementale qui prévalait sur notre zone d'étude afin de vérifier l'hypothèse d'un différentiel d'exposition à la pollution atmosphérique selon le niveau socio-économique des IRIS. Notre analyse de régression spatiale a démontré l'existence d'inégalités socio-économiques dans l'exposition à la pollution atmosphérique ; les quartiers de défaveur moyenne, localisés aux abords des principales infrastructures routières entourant le centre urbain, étaient les plus exposés à la pollution liée au trafic.
Nous nous sommes ensuite intéressés à examiner l'association entre le niveau socio-économique des IRIS et la survenue de l'infarctus du myocarde afin de vérifier l'hypothèse d'inégalités sociales de santé sur notre zone d'étude. Notre analyse bayésienne a montré l'existence de forts gradients socio-économiques du risque d'infarctus du myocarde chez les hommes et les femmes et mis en exergue une vulnérabilité particulière des femmes vivant dans les quartiers les plus défavorisés.
Nous avons finalement exploré la contribution de la pollution atmosphérique aux inégalités sociales de santé en examinant si le niveau socio-économique des IRIS modifiait les effets de la pollution atmosphérique sur le risque d'infarctus du myocarde. Notre analyse cas-croisés a révélé un effet plus élevé de la pollution particulaire chez les individus vivant dans les quartiers défavorisés, en particulier les femmes âgées de 55 à 74 ans. Ces résultats, au vu de ceux précédemment rapportés, semblent s'expliquer davantage par un différentiel de sensibilité que par un différentiel d'exposition. La recherche des mécanismes responsables de cette sensibilité exacerbée nécessite d'être poursuivie dans de futurs travaux afin que des actions de santé publique efficaces puissent être mises en œuvre pour protéger ces populations vulnérables.
Raynaud, Joy. "L'accès aux soins : des perceptions du territoire aux initiatives des acteurs : concepts, mesures et enquêtes pour une analyse géographique de l'organisation et du développement d'une offre de soins durable." Phd thesis, Université Paul Valéry - Montpellier III, 2013. http://tel.archives-ouvertes.fr/tel-00967067.
Full textAmsellem-Mainguy, Yaëlle. "Contraception d'urgence. Analyse sociologique des pratiques contraceptives de jeunes femmes." Phd thesis, Université René Descartes - Paris V, 2007. http://tel.archives-ouvertes.fr/tel-00903733.
Full textBoisson, Véronique. "Test de type-log rank pour l'évolution de la qualité de vie liée à la santé." Phd thesis, Université Pierre et Marie Curie - Paris VI, 2008. http://tel.archives-ouvertes.fr/tel-00356750.
Full textGénéralement lors de ces études, des questionnaires de QdV sont donnés à remplir aux patients permettant de calculer leur score de QdV. L'évolution de QdV se traduit par le concept de dégradation de QdV. Un taux critique x de dégradation de QdV peut être fixé. Les patients sont considérés comme dégradés si leur score de QdV est supérieur à x. Nous étendons la statistique du score de vraisemblance partielle afin de prendre en compte un taux x de dégradation de QdV préalablement fixé et montrons que le vecteur du processus de score normalisé converge vers un processus gaussien centré. Le taux x de dégradation de QdV est ensuite supposé variable. A l'aide de la théorie des processus empiriques nous prouvons la convergence en distribution de la statistique du score normalisé vers un processus gaussien. Ces travaux ont permis de construire, lorsque le taux x de dégradation de QdV est variable, un test de type log-rank permettant de comparer l'évolution longitudinale de la dégradation de QdV pour deux goupes de patients.
Des simulations et une application à une cohorte de patients infectés par le VIH sont présentées.
Gélinas, Colette. "Analyse des besoins de formation des étudiantes en sciences de la santé (sciences infirmières), formation initiale, de l'Université Laval dans le domaine de l'informatique appliquée aux soins infirmiers." Master's thesis, Université Laval, 1989. http://hdl.handle.net/20.500.11794/29392.
Full textHébert, Marc. "Analyse des besoins en formation des enseignants cliniques en physiothérapie du programme de baccalauréat en sciences de la santé (physiothérapie) de l'Université Laval." Master's thesis, Université Laval, 1986. http://hdl.handle.net/20.500.11794/29203.
Full textPerrichot, Régine. "Analyse moléculaire du gène PKD1 impliqué dans la transmission de la polykystose rénale autosomique dominante (doctorat : sciences de la vie et de la santé)." Brest, 2000. http://www.theses.fr/2000BRES3101.
Full textGrolier, Jacques. "Analyse micro-economique du financement des etablissements publics de sante en france. De l'observation a la proposition d'outils quantitatifs d'optimisation." Rennes 1, 1997. http://www.theses.fr/1997REN11018.
Full textThe financing of french public hospitals has been essentially based on a search for macroeconomic equilibrium. The shift from day rate to overall bud- get and finally pathology based reimbursement with restricting budget reflects the determination to limit health expenditure (1). Confrontied with budgets which are becoming more and more restricting, the managers of public hospi- tals have used the advantage in wich assymetric information over their financing sources to fund their discretionary budgets and gain some flexibility, as a result of moral hasard and adverse selection. These budgets allow them to finance hospital equipment, lessen the impact of budget limita- tions and contribute to more efficient, although non-standard, management practices (2). Hospital economist helped build up these " unattached " finan- cial funds by adapting for-profit optimisation tolls to not for profit hospitals. The role played by hospital economists is further reinforced by the order of april 1996 which can turn the discretionary budget into an indicator of mana- gement performance through the use of incintative contracts. Moving the dis- cretionary budget from opacity to transparency can be the mainspring for health expenditure limitation based on medical and not on accounting deci- sions (3)
Berruecos, Villalobos Maria de Lourdes. "Le clonage : une analyse sémiolinguistique du discours de vulgarisation scientifique au Mexique." Paris 13, 2004. http://www.theses.fr/2004PA131023.
Full textThis research project presents an analysis of the discourse of popular science in Mexico and is globally base on the semiolinguistic analysis of discourse, discourse analyses of popular science, on critical sociological studies of popular science, and on the theory of social representations. The first part looks at the problems and at what is at stake in the popularization of science, the relation between the discourse of popular science and scientific discourse, and defines concepts. The second part is organized in various chapters. The first describes the corpus. The second, dedicated to the enunciation, shows that the identity of the popularizer is constructed through the interpellation of the intended readers. The scientist has a specific, professional identity. The ethos of the scientist is that of the author; that of the specialized popularizer is one of objectivity; the scientific journalist plays a weak role as intermediary. The audience is characterized by subjectivity. The tiers (the third) is an essential constituent of the meaning. The chapter on narration shows that description occupies a fundamental place, followed in importance by reported discourse and lastly by the narratives themselves. The chapter on argumentation defines its macrostructure and shows that conjunction and restriction are found at de centre of the logical-semantic operations. Explication plays an important didactic role and the most significant explicative reformulations are those of designation, denomination, and definition. A final chapter completes the analysis with a study of the social representations found in the corpus and shows a bi-polar structure in the discourse that permits anchorage and the integration of the representations in the value system of the group
Nagels, Marc. "Analyse de l’activité et développement de l’auto-efficacité : Contribution à une théorie agentique de la formation des compétences critiques des cadres et dirigeants de la santé publique." Paris 10, 2008. http://www.theses.fr/2008PA100050.
Full textThe aim of this research was to measure the contribution of activity analysis to the development of self-efficacy in the workplace. Our population was comprised of public health executives and managers in training at the French School of Public Health. The research question focused on how to articulate the notion of critical competencies, notoriously difficult to acquire, with cognitive theory and the theory of conceptualization in action. These different but complementary theoretical approaches lead to the idea that activity analysis and agency may contribute explicitly to establishing a model of critical competencies training. Three sources of information data have been exploited. The first characterizes critical competencies in the field of public health management. The second results from measures of the level of job-related self efficacy (697 trainees from the EHESP). The third demonstrates how a system of activity analysis pertaining to managerial decision-making contributes to an increase in self efficacy. This result is particularly significant for those trainees with an initially low level of self efficacy. These results indicate that in all cases in which an increase in self efficacy has occurred, irrespective of whether the individuals concerned have benefited or not from established modes of training, activity analysis or self-conducted activity analysis has been the most determining factor in promoting an increase in self efficacy. Thus, this research strengthens the hypothesis that activity analysis and agency represent two major conditions for the formation of critical competencies, i. E. Of effective adaptation of the professional to his work environment
Zirmi, Omar. "Analyse de fabricabilité en conception de gammes d'usinage pour l'aéronautique." Phd thesis, Grenoble INPG, 2006. http://tel.archives-ouvertes.fr/tel-00278101.
Full textSeror, Valérie. "L'évaluation économique des politiques de prévention dans le domaine de la santé : l'exemple du dépistage prénatal." Paris 1, 1992. http://www.theses.fr/1992PA010051.
Full textThe issue of an optimal allocation of collective ressources for health prevention primary prevention (in order to induce changing behaviours) and secondary prevention (in order to early treat according to a classical distinction of the w. H. O. , is in the heart of the economic matter in drawing up public policies. Choices in health policies are a matter of the social rentability criterium ; i. E. The benefit which is expected by the collectivity, compared to efforts necessitated and ressources consumed. Economic measurement raises methodological difficulties, more stressed when applied to health. These issues are illustrated in two particuliar contexts : genetical handicap prevention and prevention of perinatal transmission of aids. The terms raised in social debates make clear that the approach applied to health will find its legitimacy in its ability to make explicit the multiple choices according to values and social preferences, often refered to as esthical choices, and which are used as reference for tutelary decisions. The thesis upheld is that a normative approach of public economics may help to this clarification
Dabo, David. "Impact environnemental des mâchefers d'incinération d'ordures ménagères (MIOM) valorisés en technique routière : caractérisation, expérimentations multi-échelles et modélisation hydro-géochimique." Phd thesis, École Nationale Supérieure des Mines de Paris, 2008. http://pastel.archives-ouvertes.fr/pastel-00005052.
Full textGrivel, Luc. "L'hypertexte comme mode d'exploitation des résultats d'outils et méthodes d'analyse de l'information scientifique et technique." Aix-Marseille 3, 2000. http://www.theses.fr/2000AIX30016.
Full textGiordano, Florent. "La géographie (dés)organisante : savoirs, pouvoirs, normes : analyse interprétative du dispositif de gestion de la santé en région Centre-Val de Loire." Thesis, Tours, 2017. http://www.theses.fr/2017TOUR1010/document.
Full textThe main question of this thesis can be formulated as follows: How can discourses, norms and spatial practices, in the context of inter-organisational relations, produce good spatial conduct of agents in a relation of delegation? Rooted in strategic management, our theoretical framework mobilise approaches from the domain of geography and the Foucauldian notion of dispositif. The methodology we used is based on a unique case study: the health system in the region of Centre-Valde- Loire. The analysis of the empirical material shows the creation of an inter-organisational self-regulation chain, enabling the dissemination of this dispositif based on three types of space (absolute, relative and relational) by giving the illusion to each one of these links that he is responsible for his actions. We also highlight the independent nature of the dispositif that can create room for manoeuvre for actors as well as results that are sometimes counter-productive with regard to the original policies of the mandator
Djemaci, Brahim. "La gestion des déchets municipaux en Algérie : Analyse prospective et éléments d'efficacité." Phd thesis, Université de Rouen, 2012. http://tel.archives-ouvertes.fr/tel-00804063.
Full textAloui, Saber. "Contribution à la modélisation et l'analyse du risque dans une organisation de santé au moyen d'une approche système." Phd thesis, École Nationale Supérieure des Mines de Paris, 2007. http://tel.archives-ouvertes.fr/tel-00204007.
Full textUn Centre Hospitalier (CH) est considéré comme une entreprise de service particulière nécessitant des outils d'aide au pilotage spécifiques. La mission essentielle est effectivement d'assurer la sécurité du patient et la qualité des soins liés à tout acte médical. Cette mission est soumise à des contraintes toujours plus strictes d'ordre médical, éthique, social, financier, légal ou même politique. De ce fait, il est aisé de constater que l'organisation d'un CH s'inspire désormais de plus en plus des organisations industrielles recentrées autour de la notion de client. Le pilotage doit donc prendre en compte toutes ces contraintes et la nature même du client qu'est le patient. Ce travail de recherche consiste à exploiter les concepts, méthodes et outils de la Modélisation d'Entreprise et de l'Ingénierie Système, pour les appliquer à la maîtrise des risques dans le milieu hospitalier, et en particulier au Circuit du Médicament. Ce travail vise plusieurs objectifs:
- il s'agit de représenter le système sociotechnique complexe hôpital avec ses particularités, différentes vues et niveaux de détail de modélisation.
- ensuite, il s'agit de vérifier les modèles dans un but d'analyse des risques.
Joël, Idt. "LE PILOTAGE DES PROJETS D'AMÉNAGEMENT URBAIN : ENTRE TECHNIQUE ET POLITIQUE Une analyse basée sur les cas de Paris, Lille, et Chartres." Phd thesis, Université Paris VIII Vincennes-Saint Denis, 2009. http://tel.archives-ouvertes.fr/tel-00468424.
Full textDujols, Pierre. "Analyse des énoncés médicaux en langage naturel : vers un prototype d'indexation automatique." Montpellier 2, 1990. http://www.theses.fr/1990MON20008.
Full textLandry, Marilyne. "Les effets secondaires cognitifs de l’électroconvulsivothérapie dans le traitement de pathologies psychiatriques : revue systématique et méta-analyse des impacts cognitifs des techniques modernes en électroconvulsivothérapie." Thèse, 2019. http://hdl.handle.net/1866/23665.
Full textElectroconvulsive therapy (ECT) remains one of the most effective treatments for major depressive disorder but remains highly stigmatised. Fear of cognitive side effects limit its use, even after numerous improvements of the ECT techniques since its discovery in 1938. Uncertainties persist regarding the best cognitive tests to be included in ECT clinical follow-up, as there are only few systematised data of the cognitive impact of modern ECT techniques. The current study is a systematic review of the most frequent cognitive side effects following ECT and a review of the cognitive tests used in clinical follow up. A total of 91 studies published from 2000, with an aggregated sample of 3762 individuals were included. Standardized cognitive tests were separated into 10 different cognitive domains for analysis. Comparisons between cognitive measures included pre-ECT baseline with post-ECT cognitive measures at three times: immediate effects (within 24h post-ECT), subacute (within one month post-ECT), and long-term (more than one month post-ECT). Although studies showed high heterogeneity, Hedges’ g revealed small to medium effect sizes for short-term effects post-ECT, with individuals presenting a decrease in autobiographical memory, verbal fluency, and verbal memory. The impact on verbal fluency showed an inverse correlation with age, being significantly greater in younger adults. Conversely, executive functions improved significantly post-ECT. Long-term effects showed an improvement on almost all cognitive domains. According to the literature, the Mini-Mental State Examination is the most common screening test used in ECT, but its clinical utility is extremely limited to track post-ECT cognitive changes.
LeClair, Cédée-Anne. "Représentations sociales du diabète chez des jeunes francophones en milieu scolaire au Nouveau-Brunswick." Thèse, 2009. http://hdl.handle.net/1866/5112.
Full textThe purpose of this study is to describe healthy francophone adolescents’ social representations of diabetes. This study stems from a partnership, initiated between the University of Moncton and various college and community organizations in New Brunswick, which identified the importance of intervening among young francophone students to prevent diabetes. The theory of social representations is the conceptual framework used to describe adolescents’ vision about diabetes, its origin and factors associated with its prevention. To our knowledge, this study is the first to examine the concept of diabetes among adolescents without diabetes. Principal hypothesis: given that the experience adolescents have with diabetes is limited to their social environment and given that they have difficulty in defining the concepts of health and disease, they will not be able to describe diabetes in an in depth fashion. Focus groups, which included an activity using the Free Association technique, were conducted, between November and December 2005, with adolescents in grade 5, 8 and 10, recruited in four francophone schools in New Brunswick (Districts 1 and 11). Students’ responses, obtained during the focus groups and the Free Association activity, were classified into categories and sub-categories (content analysis); Chi-square and Fisher Exact tests were used to determine differences between sex and grade levels. One hundred and thirty adolescents (70 girls and 60 boys) in grade 5 (n=44), 8 (n=46) and 10 (n=40) participated in 19 focus group discussions. During the Free Association activity, the categories most frequently mentioned were: sugar (cited by 66% of participants), treatment (48%), nature of diabetes (45%), nutrition (41%), blood (38%), complications (18%), physiological manifestations (11%), obesity (6%), and physical activity (6%). No significant differences were observed between boys and girls but students in grade 10 were more likely to cite the categories of ‘treatment’, ‘blood’ and ‘obesity’. During the focus group discussions, adolescents described diabetes as a disease (13/19 groups) related to sugar (15/19 groups) and blood (13/19 groups). However, only a few groups discussed, in detail, the nature of diabetes (e.g.: role of insulin and pancreas), the types of diabetes (type 1 and 2), and the symptoms and complications of diabetes. They also cited what individuals with diabetes should do to treat their disease (e.g.: eat well: 18 groups; have injections: 17 groups; take pills: 5 groups; and be physically active: 5 groups), but they did not discuss the strategies to manage these behaviours. Representations of diabetes related to the origin of the disease included heredity and age (13/19 groups), obesity and nutrition (12/19 groups) and physical activity (13/19 groups). In half of the groups, adolescents mentioned feeling at risk for diabetes; girls more likely than boys. Thirteen groups referred to behaviours which they had observed among diabetics they knew, demonstrating the importance of the social environment in their representations. The results of this study support the hypothesis that adolescents are limited in their description of diabetes with respect to its definition, origins and prevention. These results provide direction for health professionals in identifying the content and strategies that should be included in diabetes prevention programs for youth.
Martin-Lemoyne, Valérie. "Effets de l’utilisation d’un chien d’assistance sur les efforts aux membres supérieurs lors de la montée d’une pente en fauteuil roulant chez les individus ayant une lésion médullaire." Thèse, 2014. http://hdl.handle.net/1866/12121.
Full textProblematic. The use of a mobility assistance dog (ADMob) represents an innovative option to preserve upper limb (U/Ls) integrity in manual wheelchair (MWC) user population. No biomechanical studies have quantified the effects of ADMob on U/Ls efforts when climbing an incline. Objective. This quasi-experimental study compares the U/Ls efforts when climbing an incline with and without the assistance of an ADMob for MWC traction. Methodology. Ten participants with spinal cord injury (SCI) using a MWC and owning an ADMob climbed an incline 3 times with and without the use of an ADMob. The forces applied to the handrims, captured with instrumented wheel and movements of the MWC and the U/Ls, recorded with a three-dimensional motion analysis system, were used to measure the U/Ls mechanical efforts. Simultaneously, the electromyographic (EMG) activity of the pectoralis major muscle, anterior deltoid, biceps and triceps were recorded during the tasks and normalized with its maximum value to measure the U/Ls muscular efforts. Results. Typically, ADMob significantly reduces the mean and peak values of the total force applied to the rings and the tangential component, the mean and peak values of flexion, internal rotation and adduction net joint moments at the shoulder and the mean and peak values of muscular utilization ratio of anterior deltoid, pectoralis major, biceps and triceps. Conclusion. The assistance of an ADMob for MWC traction when climbing an incline reduces the effort to U/Ls among MWC users with a SCI.