Tesis sobre el tema "Indicateur d'état de santé"
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Hervé, de Beaulieu Martin. "Identification et pronostics de l’état de santé des systèmes non linéaires par apprentissage profond. Application à la maintenance prévisionnelle des avions d’affaires". Electronic Thesis or Diss., Université de Lorraine, 2023. http://www.theses.fr/2023LORR0227.
Texto completoState-of-Health prognostics is a major challenge in the predictive maintenance domain, and has been the subject of numerous studies in recent years, with particular emphasis on the use of Artificial Intelligence (AI) to improve prediction performance. However, few realistic approaches have been proposed so far that take into account the real industrial constraints, and in particular the lack of data under degradation. The aim of this PhD work is to propose an AI-based prognostics approach as realistic as possible, addressing in particular the problem of the absence of degradation data, and leveraging the available a priori knowledge. A global prognostics approach in the absence of measured degradation data is proposed. It is divided into three main stages. First of all, a hybrid data augmentation phase based on system identification coupled with the injection of a physics-based degradation model is used to generate both nominal data and degradation data. Next, an unsupervised Health Index (HI) extraction method, using the reconstruction error of an autoencoder, is used to obtain a HI from the sensor data collected on the system. Finally, a long-term HI prediction process leads to Remaining Useful Life (RUL) predictions. Some stages are first validated on an academic dataset (C-MAPSS), then the overall method is applied to a real industrial case thanks to a partnership with Dassault Aviation. The research conducted highlights the need for approaches that are realistic from an industrial point of view, taking account of real-life constraints, and the results obtained open up new opportunities for the practical use of AI in predictive maintenance
Boillereaux, Lionel. "Estimation d'état de procédés non-linéaires : méthode à horizon glissant avec indicateur de qualité". Grenoble INPG, 1996. http://www.theses.fr/1996INPG0087.
Texto completoLeffondré, Karen. "Association entre une durée de survie et une variable catégorielle ordonnée". Paris 11, 1999. http://www.theses.fr/1999PA11T024.
Texto completoSaib, Mahdi-Salim. "Construction d'une méthode de caractérisation des inégalités territoriales, environnementales et sociales de santé". Thesis, Amiens, 2015. http://www.theses.fr/2015AMIE0003/document.
Texto completoThe objective of this thesis is to explore spatial indicator crossing-analysis techniques in order to characterize the accumulation and the interrelations of the territorial, environmental and social health (TESHI).This analysis implies to set up integrated approaches based on data representativeness, techniques adapted to specificities of aggregated data, and relevant modeling of the characterized phenomena. A specific aspect of this work is the development of a tool allowing the integration of spatial phenomena at different levels (local, regional and loco-regional). In this project, a pilot study is presented on the Picardy region. The tool has been tested for the analysis of TESHI, thus validating the methodology feasibility and the adaptation of approaches implemented while providing additional keys of interpretation to the relative limits of direct appropriation of the results by the managers
Blais, Jocelyne. "Le caring comme indicateur en évaluation de la qualité des soins infirmiers en santé communautaire". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ38736.pdf.
Texto completoBennia, Fatiha. "Le risque cardiovasculaire : l'environnement de diffusion des facteurs de risque modifiables". Thesis, Aix-Marseille, 2015. http://www.theses.fr/2015AIXM5060/document.
Texto completoHealth is a dynamic and multifactor construction which has both an individual and a social dimension. The latter may have a direct or indirect effect on the behaviour of individuals and their life choices. The Framingham study has revealed that cardiovascular risk is multifactorial and, as such, its estimate should be global. However, the assessment of global cardiovascular risk methods do not take into account the living environment of individuals, which would factor the development of modifiable risk factors. Through this work, we highlight the characteristics of the environment of dissemination of modifiable cardiovascular risk factors: metabolic and behavioural. Since decades, the North region of France has, for cardiovascular diseases, a high level of global and premature mortality. We are asked about the determinants of the situation of this region, by comparing it to other French regions and by exploring the link between a high cardiovascular risk and an unfavourable economic situation. Thus, we are interested in the link between the distribution of cardiovascular risk and the distribution of income, using normative criteria based on the concept of expected social dominance in terms of poverty. Shedding a light on factors favouring the occurrence of cardiovascular problems and analyzing the knowledge about the individual’s life environment allows a better understanding of the mechanisms of diffusion of the modifiable risk factors, with a double objective to lower the incidence and prevalence of cardiovascular diseases and to reduce the social inequalities in health
Juglaret, Frédéric. "Indicateurs et tableaux de bord pour la prévention des risques en santé-sécurité au travail". Phd thesis, Ecole Nationale Supérieure des Mines de Paris, 2012. http://pastel.archives-ouvertes.fr/pastel-00819109.
Texto completoLafortune, Louise. "Evolution des profils d'état de santé et utilisation des services sociosanitaires chez les personnes âgées". Paris 11, 2009. http://www.theses.fr/2009PA11T014.
Texto completoQuénel, Philippe. "La surveillance épidémiologique des épidémies de grippe : validation d'un critère d'alerte épidémique". Paris 11, 1993. http://www.theses.fr/1993PA11T005.
Texto completoBeauger, Davy. "Le retransqol : une échelle de mesure de la qualité de vie spécifique aux patients porteurs d'un greffon rénal fonctionnel. : Développement, adaptation et application". Thesis, Aix-Marseille, 2014. http://www.theses.fr/2014AIXM5057.
Texto completoThe inclusion of the concept of quality of life (QOL) is indicative of a profound change in the way of practicing medicine, particularly in the field of nephrology for patients with end stage renal disease (ESRD). Given the prevalence, incidence and mortality of this disease in France, it seemed important, even essential, to measure properly, appropriately and consistently, the QOL of patients with ESRD. Health related quality of life (HRQOL) is therefore an important indicator of results to evaluate the consequences of this disease, the effect of medical procedures, treatment effects, or the impact of health policies.In 2007, after a study of literature concerning the assessment of QOL's scales of patients with ESRD, it was revealed a certain lack, quantitative or qualitative, of specific questionnaires for measuring QOL for ESRD patients validated in French, especially for patients with a functioning kidney transplant.In 2008, a specific scale has been developed and validated to measure the QOL of renal transplant recipients: the ReTransQol (Renal Transplant Quality of life questionnaire). After 5 years of use and application of ReTransQol in different national studies, this tool has been improved and a new version was created: the ReTransQol V2 (or RTQ V2). After lots of analysis, this scale has currently good psychometric properties and has been validated in various populations. The RTQ V2 is also used in international studies (Brazil, Germany, Canada ...), and a cross-cultural validation of the scale is planned.The ReTransQol V2 is a specific tool to assess the HRQOL and is suitable for a routine use among renal transplant recipients
Fuchs, Rosalie. "Modélisation de la chlorophylle de surface du lagon de Nouvelle Calédonie comme indicateur de l'état de santé de zones récifales côtières". Thesis, Aix-Marseille, 2013. http://www.theses.fr/2013AIXM4009.
Texto completoIn view of increasing environmental awareness and biodiversity conservation, understanding the main forcing mechanism driving biogeochemical cycles in coral reefs and lagoon coastal areas is a priority. We used a 3D coupled 'on-line' physical-biogeochemical model on the New Caledonia lagoon : a hot spot of biodiversity under several forcing from climate to human origin.Interactions between land and lagoon were investigated through the study of an extreme event La Niña (2008) that caused heavy rainfalls and large organic and inorganic inputs in the lagoon.Model results provided a synoptic view of the lagoon biogeochemical-physical response, highlighting that the whole lagoon was impacted by river inputs and stronger hydrodynamics were the chlorophyll-a concentration was almost double.The complex interaction between the ocean and the lagoon was investigated through the modeling of the South Western (SW) wind-driven upwelling. Four austral summers (2005-2008) were simulated and results were found to be in good agreement with measured data reported in previous publications, highlighting that upwelling processes represent strong drivers of the primary production in the SW of NC. A Lagrangian transport analysis showed that oceanic upwelled waters were able to reach the South West lagoon under certain conditions, representing an important issue for larvae recruitment and lagoon enrichment. The 3D coupled on-line biogeochemical-physical model was a robust tool to study such complex and highly variable environment. It could represent a support for decision makers to manage coastal areas as well as for scientists to plan sampling strategy or to analyse cruise data
Dolivet, Nicolas. "Etude des besoins et des offres de santé du quartier de Villeneuve les Salines, commune de La Rochelle : détermination des indicateurs de santé". Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M217.
Texto completoCoron, Eddy. "Diagnostic d'état de santé des batteries au lithium utilisées dans les véhicules électriques et destinées à des applications en seconde vie". Thesis, Université Grenoble Alpes, 2021. http://www.theses.fr/2021GRALI017.
Texto completoRecent improvements in the properties of lithium-ion batteries, including their cyclability and specific capacity, have enabled the electrification of the vehicle fleet to begin. With few years, this development generates a large stock of used batteries. Along with their recycling, their reuse in a second life is of economic interest and can participate in the integration of intermittent energies into the electrical network. In this thesis work, the influence of the first life on the viability of the second life of Li-ion batteries is studied. Distinct degradation mechanisms are deliberately generated, by imposing different aging protocols on two types of 18650 cells. At the end of this first artificial life, various non-destructive diagnostic tools (impedance spectroscopy, resistance measurements, differential voltage analysis) are subjected to electrochemical characterisations of the electrodes in order to evaluate their accuracy. Some of these cells are then subjected to a second life, a reduced rate cycling protocol in the case of this study. Regardless of the first life, we observe that the generation of lithium plating affects the batteries during their second life. However, depending on the degradation caused in the first life, the kinetics of the appearance of plating are modified. The measurement of the internal resistance of batteries appears to be a first tool, easy-to-implement, for the prognosis of their second life. Depending on the type of cell used and the second life application chosen, the charging rate and the maximum voltage limit must be in line with the internal resistance measurement of the used cells. The importance of the state of health of cells, that is to say their residual capacity, also appears important and tools for rapid estimation of this are proposed, from capacity measurements on fractions of the cell voltage curve. Finally, after the issue of second life longevity, that of the safety of these batteries is assessed, revealing the deleterious impact of lithium plating and pointing out the need for effective thermal management
Lapostolle, Annabelle. "Pertinence et conditions de production d'un indicateur estimant la charge de morbidité : Utilisation des années de vie sur l'incapacité pour décrire la santé en France". Paris 11, 2008. http://www.theses.fr/2008PA11T090.
Texto completoFouquet, Natacha. "Quel indicateur pertinent pour la surveillance épidémiologique et la prévention des troubles musculo-squelettiques en lien avec le travail ? : application à la lombalgie". Thesis, Angers, 2016. http://www.theses.fr/2016ANGE0044/document.
Texto completoThis thesis proposes to review the available indicators for the epidemiological surveillance of work-related low back pain, including compensation data of occupational diseases and data from the pilot surveillance system for musculoskeletal disorders in the Pays de la Loire region.The proportion of cases of lumbar disc surgery (used as sentinel event of low back pain) attributable to occupational activity was particularly high among blue-collar workers of both genders and lower-grade female white-collar workers. Low back pain is a complex phenomenon and cannot be monitored using a single indicator. Compensation data, despite their limitations, give results comparable to other data sources and don’t require specific gathering. Cohorts’ data, based on a standardized questionnaire, are necessary for international comparisons. Finally, surgical data from private and public hospitals databases provide the finest information, if they are completed with occupational data. However, this is a mixed indicator of morbidity and care. It shows large local disparities in a region, encouraging the development of differentiated prevention programs.In addition to these three indicators, it would be interesting to add a disability or incapacity indicator in the surveillance system to better target prevention programs according to occupational exclusion which is an important dimension in terms of social impact for people and cost for the society
Cambois, Emmanuelle. "Calcul d'espérances de vie sans incapacité selon le statut social dans la population masculine française, 1980-1991 : un indicateur de l'évolution des inégalités sociales de santé". Paris, Institut d'études politiques, 1999. http://www.theses.fr/1999IEPP0003.
Texto completoLelong, Audrey. "Mise en place de stratégies d'évaluation des pratiques et des programmes de santé à travers une informatique distribuée". Thesis, Clermont-Ferrand 1, 2015. http://www.theses.fr/2015CLF1MM13/document.
Texto completoThis thesis is part of a project named GINSENG. This project is part of an experimental development for a light grid infrastructure dedicated to e-health and epidemiology. This network aims to collect distributed medical data in order to perform original data analysis thanks to the innovative technologies of grid computing. This project includes the following research areas: medical informatics, epidemiology joined with a socio-economic modeling. This network aims to federate distributed and existing medical databases, particularly cytopathologic data, to make them available to regional and national epidemiologic structures. Thanks to the distributed architecture of the grid, the network should become interoperable with any medical center which would need those medical data.Thanks to GINSENG, this thesis brings quality improvement strategies and its evaluation. A first work concerns the quality of survey design to estimate the indicators of patient record keeping. It plans to exploit some functionalities of GINSENG to increase required sample size to obtain a better estimate. A second work concerns the impact of social deprivation (measured by EPICES score) on access to healthcare for pregnant women and living in rural area. We want to characterize the link between social deprivation and adverse perinatal outcomes. We discuss the possibility to integrate the EPICES score in health care institution. The last work deals with the comparison between organized screening and individual screening. Socio demographic, clinical and prognostic characteristics are analyzed from SIPATH (laboratory), ARDOC and ABIDEC (screening sites) databases. These applications illustrate benefits of using GINSENG
Tchéré, séka Iphigénie marie-laure. "Surveillance de la santé bucco-dentaire en Afrique : recommandations méthodologiques pour le recueil standard d’informations". Thesis, Lyon 1, 2009. http://www.theses.fr/2009LYO10278.
Texto completoThis work is a contribution to the activities of the World Health Organization relative to the implementation and the distribution of standard tools in the African countries to reach an efficient integration of the essential oral health indicators in surveillance in African countries. These essentials indicators fit into the objectives of the new millennium and exceed the idea according to which " the social problems have to be developed in an isolated way. To be in phase with this new paradigm, African countries have to face these new approaches which require that efforts be realized in all development sectors. Twenty two indicators recommended by the World Health Organization for the African region give opportunities to improve oral health activities on the national level and develop an integrated community approach which is the more operational for surveillance and prevention of oral diseases. The collect of the indicators in Ivory Coast motivates this study, which results are recorded in this document. The findings are the result of many years of research and practice related to the implementation and development of oral health activities in Côte d'Ivoire. Two questionnaires were evaluated and measure respectively oral health indicators for general population, and for children and teenagers. Analyses conclude in relatively good psychometrics properties, but imply the taking account of many recommendations which aim to increase the validity and the feasibility of these questionnaires in the context of the Côte d'Ivoire. Their generalization in the African region requires future researches in a way of their optimization in an integrated operational community based-approach, and a redefinition of the role of local actors in sanitary district
Daniau, Côme. "Surveillance épidémiologique fondée sur des indicateurs de santé déclarée : pertinence et faisabilité d’un dispositif à l’échelle locale en santé environnement". Thesis, Paris, CNAM, 2014. http://www.theses.fr/2014CNAM0923/document.
Texto completoThis work presents an innovative epidemiological surveillance system in environmental health based on self-reported health indicators, closer to the complaints of the local population leaving around a source of environmental pollution: symptoms and loss of the quality of life. This approach is built up from a conceptual framework based on the psychometric theory and the transactional model of stress. A field application of this approach was carried out the population neighboring (n=1 495) the chemical industrial area of Salindres, Gard. This study verifies that self-reported health indicators measured with MOS SF-36 and SCL-90-R can be used to study populations exposed to multifactorial environmental risks. This study confirms that these indicators are relevant and sensitive when applied to environmental risk factors referring to the cognitive representations of risks, such as the sensorial perception of stimuli emitted by the industries. This work shows, besides, that the availability of national references for these indicators confers interpretability to these indicators, an essential quality criterion. This work discusses qualitatively the acceptability of measuring indicators of self-reported health in the population, proposes recommendations on communication for the setting of that kind of approach, and opens up avenues on management orientations
Hui, Yi. "Development and experimental validation of vibration based damage indicator on a specific twin-wall sandwich structure". Thesis, Lyon, 2018. http://www.theses.fr/2018LYSEC032.
Texto completoStructural health monitoring (SHM) has attracted much attention in many engineering fields like civil, aeronautic, mechanical industry, etc. since it is important to monitor the healthy condition of the operational structure in order to avoid unpredicted structural failure which may have severe consequences. The four-level damage identification process: existence, localization, severity and prediction of damage evolution, can be partly realized if a suitable indicator is chosen. It exists different damage indicators whose application range of frequency spans from vibrational response at low frequencies to the ultrasonic regimes in the mega hertz range.The sandwich structures are widely used in various engineering applications due to its exceptionally high flexural stiffness-to-weight ratio compared to monocoque structures. In this thesis a specified twin-wall sandwich structure in polypropylene was studied and vibration-based indicators were designed by taking use of its relative high damping and propagation directivity characteristics. Numerical investigations on different damage scenarios (i.e., different types of defect and their combinations) and an associated discussion on the range of application were first carried out. Experimental configuration was easily realized with the help of a scanning laser doppler vibrometer (SLDV). Defect was successfully detected by the proposed indicators
Caunday, Olivia. "Evaluation de la qualité des soins : approche par indicateur dans les centres européens de greffe de cellules souches hématopoïétiques accrédités JACIE". Thesis, Université de Lorraine, 2012. http://www.theses.fr/2012LORR0016/document.
Texto completoJACIE relies on transplant programs voluntarily applying for accreditation: it is important to understand that programs, rather than centres, apply meaning that all three infrastructures and teams (cell collection, cell processing and patient care unit) jointly engage in the accreditation process. The purpose of JACIE standards is to ensure a minimal level of quality, and harmonize laboratory and clinical practices in the field of onco-hematology. Implementation and follow-up of indicators do not necessarily reflect on quality and safety of patient care. The first aim of this study is to identify indicators set in place by the programs and to assess how their measure could be translated in qualitative benefit or quantitative benefit for the patient or the hospital. A survey was launched to 82 programs that were holding a valid accreditation, starting with French centres, and then extending to accredited programs in other European countries. Quality indicator is a tool for assessing healthcare delivery and indicator approach is commonly employed for risk management in healthcare systems. Thus, the second aim of this study is to understand whether a method was used to implement efficiently the indicators and to evaluate if all the HSCT processes are monitored
Mouelhi, Yosra. "Analyse de la qualité de vie dans une cohorte de patients transplantés rénaux". Thesis, Aix-Marseille, 2018. http://www.theses.fr/2018AIXM0462/document.
Texto completoKidney transplant is the best treatment for chronic end-stage renal failure. The quality of life of the patient plays a vital role in the success of the transplantation. In this context, our objective was to analyze the quality of life in a cohort of kidney transplanted patients in France. As a first step, we analyzed the quality of life of patients at the time of their inclusion in the study in order to determine the factors associated with the quality of life. Socio-demographic and clinical characteristics known in literature were found and new psycho-social variables were identified. This work then led us to analyze the profile of patients using the Internet and social networks: nearly 80% of the patients use Internet and the majority need an informative support. We were able to show, in a second time, a weak concordance of the evolution of the state of health of the patient from the patient and the doctor point of view. Finally, to interpret the quality of life scores in this cohort, we calculated the minimal clinically significant difference, by the ROC curve method and using the change in health status from the patient's point of view as a criteria for change. This analysis showed that the quality of life of these patients is not related to the patient's state of health, and no clinical changes could be detected for the quality of life scores of the two questionnaires. This thesis provides an in-depth analysis of the quality of life of French kidney transplanted patients
Drabo, Alassane. "SANTE, ENVIRONNEMENT ET DEVELOPPEMENT ECONOMIQUE". Phd thesis, Université d'Auvergne - Clermont-Ferrand I, 2011. http://tel.archives-ouvertes.fr/tel-00721112.
Texto completoRenaudineau, Hugues. "Hybrid Renewable Energy Sourced System : Energy Management & Self-Diagnosis". Thesis, Université de Lorraine, 2013. http://www.theses.fr/2013LORR0336/document.
Texto completoThis thesis interested on developing a stand-alone photovoltaic system with self-diagnosis possibility. A specific structure has been proposed consisting in a DC hybridization of photovoltaic sources, a Lithium-based battery and supercapacitors. Dynamics models of the boost converter and the current-fed dual-bridge DC-DC converter are proposed and an efficient state observer is proposed to estimate the models equivalent losses' parameters online. It is shown that the estimated parameters can be used in the energy management scheme, with in particular optimisation of the efficiency of paralleled structures. The photovoltaic source optimization is also studied with special attention on shading phenomenon and design of MPPT technique especially on the case of distributed series architecture. Through a specific hybridization structure, State-Of-Health estimation is tested on Li-ion and LiFePO4 batteries. It is shown that the isolated coupled-inductors Cuk converter is very efficient for battery estimation through current injection. Finally, a global energy management scheme is proposed, and the developed stand-alone photovoltaic system is validated to operate as supposed
Nasser, Ali Djambae. "Accès aux soins et gestion des flux migratoires". Thesis, Normandie, 2018. http://www.theses.fr/2018NORMR050.
Texto completoMayotte a French overseas department since 2011, is part of the comorian archipelago from which it was separated from the State of Union of the Comoros islands since 1975. The introduction of a visa in 1995 and the order n° 2002-688 delivered on 12 july 2004 and entered into force on April 1st 2005 with regard to the extension of social security in Mayotte exclude the foreign sick from Mayotte's health system. This leads to a process of medical evacuation following an illegal immigration way that causes shipwrecks and the violation of the patient's rights. The attraction of Mayotte and Mainland France for disadvantaged populations lead to conflict situations and competition in the access to health and social protection. Mayotte's disadvantaged populations, who are struggling to catch up with the mainland, do not get along with that competition. At the same time the illegal immigrants living clandestinely and with the threat of expulsion are facing difficulties to assert their right to health care and to benefit from social system assistance. Obstacles are numerous and most of the time considerable, mainly because of discrimination, because of their judicial status, of disparity in their social and economical difficulties and because of their generaly very hard living conditions. The control of migratory flow and the fight against illegal immigrant remain the top priorities of the French government policy as far as immigration is concerned. The singularity of the situation in the department of Mayotte and the huge migratory flows that have been observed led healthcare authorities to handle migratory movements related to illegal medical evacuations. France has a healthcare policy and continues to support the Union of Comoros in the effort to improve healthcare access and quality, through support programs to health sector. These programs aim at improving the health of mothers and children, mainly in reducing maternal mortality. Through its organisation AFD, France aims at supporting health ministry in elaborating and implementing public policies and helping comorian state to put in place regulatory mechanisms of a private service within public sector and to reform the national pharmacy. This work focus on the issues related to the right to social protection and the health law for foreigners on the national territory, in mainland France and in Mayotte as well. Diversity of national laws applicable in Mayotte is a significant barrier to local devices in terms of medical and social assistance. It is necessary to seek legal solutions related to standardization of this health and social law in order to better the healthcare system. During our field research we observed that local devices such as the "pink warrant" and the "good AGD" are not at all equivalent to the national devices (AME and CMUc)
Renaudineau, Hugues. "Hybrid Renewable Energy Sourced System : Energy Management & Self-Diagnosis". Electronic Thesis or Diss., Université de Lorraine, 2013. http://www.theses.fr/2013LORR0336.
Texto completoThis thesis interested on developing a stand-alone photovoltaic system with self-diagnosis possibility. A specific structure has been proposed consisting in a DC hybridization of photovoltaic sources, a Lithium-based battery and supercapacitors. Dynamics models of the boost converter and the current-fed dual-bridge DC-DC converter are proposed and an efficient state observer is proposed to estimate the models equivalent losses' parameters online. It is shown that the estimated parameters can be used in the energy management scheme, with in particular optimisation of the efficiency of paralleled structures. The photovoltaic source optimization is also studied with special attention on shading phenomenon and design of MPPT technique especially on the case of distributed series architecture. Through a specific hybridization structure, State-Of-Health estimation is tested on Li-ion and LiFePO4 batteries. It is shown that the isolated coupled-inductors Cuk converter is very efficient for battery estimation through current injection. Finally, a global energy management scheme is proposed, and the developed stand-alone photovoltaic system is validated to operate as supposed
Oliveira, Jean-Philippe de. "Communication publique et formes de gouvernabilité contemporaines de l'Etat : le cas de l'homosexualité dans les campagnes de prévention du sida en France (1987-2007)". Phd thesis, Université de Grenoble, 2012. http://tel.archives-ouvertes.fr/tel-00905882.
Texto completoDrabo, Alassane. "Health, environment and economic development". Thesis, Clermont-Ferrand 1, 2011. http://www.theses.fr/2011CLF10376/document.
Texto completoThis dissertation investigates theoretically and empirically the interrelationships among population’s health,environmental degradation and economic development, its consequences for developing countries, and someeffective policy responses. The first part explores the association between health, environment, and inequalities. Itfirstly analyzes whether environmental degradation could be considered as an additional channel through whichincome inequality affects infant and child mortality (chapter 2). Theoretical and empirical investigations show thatincome inequality affects negatively air and water quality, and this in turn worsens population’s health. Therefore,environmental degradation is an important channel through which income inequality affects population health. Then,it is shown that sulphur dioxide emission (SO2) and particulate matter (PM10) are in part responsible for the largedisparities in infant and child mortalities between and within developing countries (chapter 3). In addition, we foundthat democratic institutions play the role of social protection by mitigating this effect for the poorest income classesand reducing the health inequality it provokes. The second part is devoted to the link among health, environment,and economic growth. The effect of health (global burden of disease, communicable disease, and malaria) oneconomic growth is assessed in Chapter 4. This chapter shows that health indicators, when correctly measured by thegap between current health status and an ideal health situation where the entire population lives to an advanced age,free of disease and disability, and when accurately instrumented have significant impact on economic performance.The consequences of these interrelationships on the convergence of poor countries towards their steady state aretheoretically and empirically investigated in the last Chapter (chapter 5). It is found that environment degradationreduces the ability of poor countries to reach their own steady state, reinforcing our argument according to whichenvironment quality improvement plays a considerable role in economic convergence process. Moreover, thedegradation of air and water quality affects negatively economic performance, and health status remains an importantchannel through which environment degradation affects economic growth even if it is not alone. The EnvironmentalKuznets Curve (EKC) hypothesis is also verified
Khelif, Racha. "Estimation du RUL par des approches basées sur l'expérience : de la donnée vers la connaissance". Thesis, Besançon, 2015. http://www.theses.fr/2015BESA2019/document.
Texto completoOur thesis work is concerned with the development of experience based approachesfor criticalcomponent prognostics and Remaining Useful Life (RUL) estimation. This choice allows us to avoidthe problematic issue of setting a failure threshold.Our work was based on Case Based Reasoning (CBR) to track the health status of a new componentand predict its RUL. An Instance Based Learning (IBL) approach was first developed offering twoexperience formalizations. The first is a supervised method that takes into account the status of thecomponent and produces health indicators. The second is an unsupervised method that fuses thesensory data into degradation trajectories.The approach was then evolved by integrating knowledge. Knowledge is extracted from the sensorydata and is of two types: temporal that completes the modeling of instances and frequential that,along with the similarity measure refine the retrieval phase. The latter is based on two similaritymeasures: a weighted one between fixed parallel windows and a weighted similarity with temporalprojection through sliding windows which allow actual health status identification.Another data-driven technique was tested. This one is developed from features extracted from theexperiences that can be either mono or multi-dimensional. These features are modeled by a SupportVector Regression (SVR) algorithm. The developed approaches were assessed on two types ofcritical components: turbofans and ”Li-ion” batteries. The obtained results are interesting but theydepend on the type of the treated data
Wang, Chu. "Deep learning-based prognostics for fuel cells under variable load operating conditions". Electronic Thesis or Diss., Aix-Marseille, 2022. http://www.theses.fr/2022AIXM0530.
Texto completoProton exchange membrane fuel cell (PEMFC) systems are suitable for various transportation applications thanks to their compact structure, high power density, low start/running temperature, and zero carbon emissions. High cost and lack of durability of PEMFC are still the core factors limiting their large-scale commercialization. In transportation applications, the deterioration of PEMFCs is aggravated by variable load conditions, resulting in a decrease in their Remaining Useful Life (RUL). Prognostics and health management (PHM) is an effective tool to forecast potential system risks, manage system control/maintenance schedules, improve system safety and reliability, extend system life, and reduce operation/maintenance costs. Prognostics is an important foundation and key support for PHM, and its core tasks include health indicator extraction, degradation trend prediction, and RUL estimation. The long-term degradation characteristics of PEMFC are concealed in variable load conditions, which increases the difficulty of health indicator extraction, reduces the accuracy of degradation prediction, and inhibits the reliability of life estimation. In view of this, the thesis work starts from modeling the degradation behavior of PEMFC under variable load conditions and carries out research work on health indicator extraction, short/long-term degradation trend prediction, RUL estimation and reliability evaluation
Kacki, Sacha. "Influence de l’état sanitaire des populations anciennes sur la mortalité en temps de peste : contribution à la paléoépidémiologie". Thesis, Bordeaux, 2016. http://www.theses.fr/2016BORD0058/document.
Texto completoFrom the 6th century onwards, plague caused recurring mortality crises in the Western world. Such epidemics hadprofound biological, cultural, economic and political impacts on European societies. Some aspects of the history ofplague epidemics are currently well known, but many questions remain unanswered, such as the preciseepidemiological pattern of the disease in ancient times. It is unclear whether plague killed people indiscriminately orwhether this disease was selective with respect to age, sex and health. This research contributes to this debate.It consists of an anthropological and paleopathological study of skeletal remains of 1090 individuals, including plaguevictims from four medieval and post-medieval burial grounds, and individuals from two parochial cemeteries in useduring periods of normal mortality. Results from the four plague-related assemblages reveal a peculiar demographicsignature. Age and sex distribution differs clearly from what is expected in non-epidemic periods, when it is shown tocorrespond closely to the demographic structure of the living population. Moreover, the study of various non-specificskeletal stress markers shows that plague victims were in a better health before they passed away than people who diedin non-epidemic periods. The results demonstrate that individuals who suffered stress and disease had a reducedchance of survival in non-epidemic periods, whereas they were not at a higher risk to die during plague epidemics.This study provides evidence that plague was not selective, and that it killed regardless of sex, age, and pre-existing health
Veillette, François. "Étude de différents indicateurs biologiques chez l'esturgeon jaune (Acipenser fulvescens) du Québec". Mémoire, 2007. http://www.archipel.uqam.ca/4761/1/M9778.pdf.
Texto completoTanguay, Nancy. "Exploration du savoir écologique traditionnel atikamekw au sujet de la santé des animaux et de la sélection des prises dans un contexte de choix alimentaires". Mémoire, 2010. http://www.archipel.uqam.ca/3604/1/M11591.pdf.
Texto completoLafortune, Louise. "Évolution des profils d'état de santé et utilisation des services sociosanitaires chez les personnes âgées". Thèse, 2009. http://hdl.handle.net/1866/2855.
Texto completoAbstract This thesis aims to study the relationship between the typically heterogeneous needs of community-living elderly and their consequent utilization of health and social services. Inspired by the concept of frailty, the approach consisted in modeling the heterogeneity – by latent class analysis (LCA) – to group individuals into homogenous categories of health status, each representing a constellation of health problems. Applied to the data collected for the demonstration project of the system of integrated services for frail elderly (SIPA), LCA revealed four health state profiles that distinguish the physical and cognitive dimensions of health and capture severity along the disability dimension (Article 1). Transition analyses over 1 year and 22 months showed differentiated and gender-specific patterns of transition probabilities, confirming the sensitivity of the profiles to change in health status. The profiles are stable over time and robust to mortality and lost to follow-up attrition. Relationships between the profiles, sociodemographic characteristics and distal outcomes, such as mortality and institutionalization, confirm the classification’s validity. These profiles were then used in two-part econometric models to study access and costs of several measures of publicly funded services (Article 2). Our results show the profiles are able to identify distinct configurations of service utilization and costs in substantially meaningful subgroups of the frail elderly population. What is important here is that the health state profiles are sensitive to differences, and changes, in available patterns of care in a specific milieu. These differences reveal choices of target groups by local authorities in delivering institutional and community-based services. Finally, a fine analysis of these differences was performed for the costly period preceding death to establish whether the high end-of-life costs affect all elderly homogenously irrespective of the severity of their health state (Article 3). A comparative analysis revealed that survivors’ and decedents’ costs of care trends according to health status go in opposite directions. Severely disabled survivors cost significantly more compared to their relatively healthy counterparts. In contrast, the highest end-of-life costs – driven by acute hospitalizations – belong to the relatively healthy, independent of age. Among survivors and among decedents, the oldest old (85+) cost significantly less compared to younger age groups. Combined, these results support the notion of a compression of costs due to morbidity in the oldest old decedents. The originality of this thesis rests on the fact that few very few studies attempted to model heterogeneity in health status with the goal of estimating its effect on patterns of service utilization. Moreover, in light of the shift towards community-based care as a response to economic pressures and population aging, our work is the first to describe the relationship between health status and end-of-life care in frail community-living elderly.
Réalisé en cotutelle avec l'Université de Paris-Sud
Tanguay, Florence. "L'étude des inégalités dans la distribution des besoins de santé des ménages au Kerala (Inde)". Thèse, 2006. http://hdl.handle.net/1866/17107.
Texto completoBenoit, Martin. "Analyse des perceptions de la santé et de l'environnement chez une communauté innue du Labrador en vue de l'élaboration future d'indicateurs de santé environnementale adaptés". Mémoire, 2009. http://www.archipel.uqam.ca/2127/1/M10871.pdf.
Texto completoTchéré, séka Iphigénie marie-Laure. "Surveillance de la santé bucco-dentaire en Afrique : recommandations méthodologiques pour le recueil standard d’informations". Thesis, 2009. http://www.theses.fr/2009LYO10278.
Texto completoThis work is a contribution to the activities of the World Health Organization relative to the implementation and the distribution of standard tools in the African countries to reach an efficient integration of the essential oral health indicators in surveillance in African countries. These essentials indicators fit into the objectives of the new millennium and exceed the idea according to which " the social problems have to be developed in an isolated way. To be in phase with this new paradigm, African countries have to face these new approaches which require that efforts be realized in all development sectors. Twenty two indicators recommended by the World Health Organization for the African region give opportunities to improve oral health activities on the national level and develop an integrated community approach which is the more operational for surveillance and prevention of oral diseases. The collect of the indicators in Ivory Coast motivates this study, which results are recorded in this document. The findings are the result of many years of research and practice related to the implementation and development of oral health activities in Côte d'Ivoire. Two questionnaires were evaluated and measure respectively oral health indicators for general population, and for children and teenagers. Analyses conclude in relatively good psychometrics properties, but imply the taking account of many recommendations which aim to increase the validity and the feasibility of these questionnaires in the context of the Côte d'Ivoire. Their generalization in the African region requires future researches in a way of their optimization in an integrated operational community based-approach, and a redefinition of the role of local actors in sanitary district
Rafik, Hajrya. "Contrôle santé des structures composites : approche expérimentale et statistique". Phd thesis, 2012. http://pastel.archives-ouvertes.fr/pastel-00727638.
Texto completoLadeira, Agostinho Tiago Gomes Lage. "Avaliação da performance numa organização de saúde: o caso da Clínica de Santo António". Master's thesis, 2009. http://hdl.handle.net/10071/1694.
Texto completoIn most organizations today is not only necessary to meet the functional objectives – effectiveness – to ensure their survival in the medium and long term, but also it is necessary that these objectives are met, with the smallest possible allocation of resources – efficiency. Therefore, the overall performance is one of the major focuses of attention for the manager, in both public and private sectors and even in the social sector. In the health sector, the aim of improving the performance has led to radical changes, particularly in the public sector, first with the introduction of managers on the management board and then with the turning of hospitals into enterprises. Based on these assumptions and with the aim of improving of the health organizations performance, we developed a global Balanced Scorecard (BSC) for the “Clínica de Santo António” (CLISA), able to evaluate the performance in the four perspectives proposed by Kaplan and Norton: financial, customers, internal processes and, learning and growth. Through the case study approach we started by clarifying the CLISA strategies guidelines, defining its Vision, Mission and Organizational Values in order to identify the strategic issues, set strategic objectives and select performance indicators for each perspective, ensuring its alignment. At this stage of development of the BSC, we focused on the selection of competent indicators to evaluate specifically this private health company’s activity. Finally we draw the Strategic Map, in which the main cause-effect relationships between the various perspectives of the Balanced Scorecard are stated.
À la généralité des organisations actuelles il ne suffit pas d’atteindre les objectifs fonctionnels – efficace – pour assurer leur survivance à moyen et à long terme, il faut que ces objectifs soient accomplis, avec la moindre affectation possible de recours – efficience. Pour cette raison, l’accomplissement global – performance – c’est un des principaux centres d’attention du gérant, soit dans le secteur public, soit dans le privé et même dans le secteur social. Dans le secteur de la santé, l’objectif d’améliorer la performance a conduit à des changements radicaux, particulièrement dans le secteur public, d’abord avec l’introduction des gérants dans les conseils d’administration, après avec la transformation des hôpitaux en des entreprises. En partant de ces présuppositions et avec l’objectif de contribuer à l’amélioration de la performance des organisations de santé, on a développé un Balanced Scorecard (BSC) global pour la Clinique de Santo António (CLISA), capable d’évaluer la performance dans les quatre perspectives proposées par Kaplan et Norton: financière, clients, procédés internes et, apprentissage et croissance. A travers la méthode d’étude de cas, on a commencé par clarifier les orientations stratégiques de la CLISA, en définissant sa Vision, sa Mission et ses Valeurs organisationnels, pour ensuite identifier les thèmes stratégiques, définir les objectifs stratégiques et sélectionner les indicateurs de performance pour chaque perspective, en garantissant son alignement. Dans cette phase du développement du BSC, on s’est préoccupé à sélectionner des indicateurs compétents pour évaluer spécifiquement l’activité de cette entreprise privé de santé. Finalement, on a dessiné une Carte Stratégique où sont présentés les principaux rapports de cause- effet entre les différentes perspectives du Balanced Scorecard.
Duhoux, Arnaud. "Des soins de qualité pour la dépression en première ligne : une contribution à l’amélioration de l’état de santé de la population québécoise". Thèse, 2013. http://hdl.handle.net/1866/10760.
Texto completoBackground Numerous studies, using a variety of quality indicators, highlight an important gap in the quality of care for depression in primary care. Few of these studies examined factors associated with receiving adequate treatment, particularly with a simultaneous consideration of individual and organizational characteristics. The association between adequate treatment for a Major Depressive Episode (MDE) and improvements in depressive symptoms is not well established in naturalistic practice conditions. The objectives of this study were to i) systematically review indicators used to measure the quality of depression treatment in primary care, ii) estimate the proportion of primary care patients with a MDE who receive adequate treatment, iii) examine the individual and organizational characteristics associated with the receipt of minimally adequate treatment for depression, iv) examine the association between receiving minimally adequate treatment for MDE (i.e. according to clinical guidelines) in the previous 12 months and evolution of depressive symptoms at 6 and 12 months. Methods The literature on the quality of depression treatment was reviewed using a set of keywords (depression, depressive disorder, quality, treatment, indicator, adequacy, adherence, concordance, clinical guideline and guideline) and « 360search », a federated search engine. Data were obtained from a cohort study including 915 adults consulting a general practitioner (GP), regardless of the motive of consultation, meeting DSM-IV criteria for previous-year MDE, and nested within 65 primary care clinics in Quebec, Canada. Multilevel analyses were conducted. Results Though mostly based on recommendations from clinical practice guidelines, a great variety of indicators were observed. Most studies used rudimentary indicators to measure the quality of depression treatment, especially for psychotherapy. Studies also differed greatly with respect to the methods used, thus limiting the comparability of results. However, whatever the chosen method, most studies reveal that a large proportion of people with depression do not receive minimally adequate treatment in primary care settings. In our sample, adherence to guidelines was high (> 75 %) for one third of the quality indicators that were measured but was low (< 60 %) for nearly half of the measures. Just over half of the sample (52.2 %) received at least one minimally adequate treatment for depression. At the individual level, young adults (18-24) et older people (>65) had a lower probability of receiving at least one minimally adequate treatment. This probability was higher for people with a family physician, a supplementary insurance coverage, a comorbid anxiety disorder and a more severe depression. At the clinic level, the availability of psychotherapy on-site, the use of treatment algorithms, and the mode of remuneration perceived as adequate were associated with more adequate treatment. Results also showed that i) receiving at least one minimally adequate treatment for depression was associated with greater improvements in depression symptoms at 6 and at 12 months; ii) adequate pharmacotherapy and adequate psychotherapy were both associated with greater improvements in depression symptoms, and iii) the association between adequate treatment and improvement in depression symptoms varied as a function of severity of symptoms at the time of inclusion in the cohort with worse symptoms at the time of inclusion being associated with greater reductions at 6 and 12 months. Conclusions Our findings suggest that interventions are needed to increase the quality of depression treatment in primary care. These interventions should target specific populations (i.e. the younger adults and the elderly), enhance accessibility to psychotherapy and to a regular family physician, and support primary care physicians in their clinical practice with patients suffering from depression in different ways such as developing knowledge to treat depression and adapting mode of remuneration. This study also shows that adequate treatment for depression is associated with improvements in depressive symptoms in naturalistic primary care practice conditions.
Khanji, Cynthia. "Évaluation de la qualité des soins et des services préventifs cardiovasculaires en première ligne". Thèse, 2018. http://hdl.handle.net/1866/21822.
Texto completoDufour, Émilie. "Mesure et validation d'indicateurs de performance des services infirmiers en première ligne : utilisation d'un cas traceur en soins de plaies". Thèse, 2017. http://hdl.handle.net/1866/19450.
Texto completoBetter use of nursing resources is a promising avenue for improving the performance of primary care services. Measuring the performance of nursing services is a central component in improving their organization and the quality of care delivered in this sector. The aim of this study was to measure and validate primary care nursing performance indicators from a tracer case in wound care and to assess the reliability of clinical-administrative data used to measure indicators from clinical records. This study adopted a correlational longitudinal design. Data were collected over a one-year period in a Local community services centre (CLSC) using clinical-administrative data contained in the I-CLSC electronic database. The episode of care was the unit of analysis. Eight indicators were measured, including five process indicators: 1) nursing follow-up; 2) relational continuity; 3) teaching; 4) initial assessment; and 5) consultation with a specialized nurse, and three outcome indicators: 1) frequency; 2) duration; and 3) intensity. Measurement and validation objectives were performed using a sample of 482 episodes of wound care lasting more than seven days. The reliability study was based on a sub-sample of 107 episodes. Descriptive and correlational analyzes were performed. Validation results demonstrated very strong associations between nursing follow-up and continuity indicators and the three outcome indicators. Reliability results demonstrated a high concordance between clinical records and clinical-administrative data for six of the eight indicators. In conclusion, valid and relevant process indicators in primary care nursing can be measured on a regular basis by managers using reliable and easily accessible clinical-administrative data.
Bolduc, Jolianne. "Évaluation des liens entre la composition des équipes de soins infirmiers et la qualité et sécurité des soins dans des unités de soins critiques". Thèse, 2018. http://hdl.handle.net/1866/21612.
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