Дисертації з теми "Centres de santé – Sociologie"
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De, Souza Givanilda Aquino. "Faible présence de la population démunie dans les centres de santé : quelques aspects socio-économiques et culturels : une recherche participative développée au Brésil." Nancy 2, 1992. http://www.theses.fr/1992NAN21016.
Joubert, Lucas. "Les médecins de ville en centre de santé : salarisation d ’une profession libérale." Electronic Thesis or Diss., Paris, EHESS, 2023. http://www.theses.fr/2023EHES0186.
This research delves into the process of salarization within the medical profession in health centers. It pertains to the broader issue of salarization in liberal professions, which presents a relative contradiction considering the characteristics of employment (its legal subordination) and the legal framework of independent work associated with certain professional groups. The analysis focuses on the various regulatory modalities governing the practice of medicine in health centers: professional, public, and salaried. Fluctuations in public regulation, exemplified by the numerus clausus, highlight contradictions in managing healthcare supply, balancing public spending control, professional group interests, and responding to the needs of the population. The mechanisms of salarization are situated along the dividing lines between central and local public action, private and public spheres, profit-driven and non-profit sectors, and liberal and salaried practices. In parallel with the trend of liberal physicians consolidating into multi-professional ambulatory healthcare organizations, salaried physicians in health centers, although historically confined to the peripheries of the healthcare system, have the potential to influence the restructuring of medical care offerings. The proposed analysis of this salarization intersects with the sociology of professional groups, professional trajectories, public action, and employment. Following the examination of the establishment of the salaried segment of proximity medicine (interest groups, institutionalization) in the first part, the thesis reports on the hybridization of public action in its territorial dimension in the second part (medical distribution, local rebalancing). This hybridization aligns with a diversification of medical practice modes in the third part, assuming physicians use the plasticity of wage employment
Beurdeley, Didier. "Carie dentaire et facteurs socio-culturels : éléments d'enquête épidémiologique sur une population d'âge déterminé au Centre de Sélection n° 1 de Vincennes." Paris 7, 1985. http://www.theses.fr/1985PA07F117.
Amoric, Michel. "Eléments épidémiologiques et sociaux dans les malocclusions d'une population d'age et de sexe déterminés : appelés au centre de sélection, 1ere région militaire, Vincennes." Paris 7, 1985. http://www.theses.fr/1985PA07F017.
Uribelarrea, Gabriel. "Le souci des patients sans abri. : Enquêter sur la relation de soins entre le monde médical et le monde de l'assistance." Thesis, Lyon, 2020. http://www.theses.fr/2020LYSES012.
This thesis focuses on access to care for the homeless. After a methodological chapter returns to the interests of a cooperative ethnography, the analysis unfolds in two parts. The first shows how access to care has been structured since the 1990s between the medical and assistance worlds. Then, based on a fieldwork in a hospital outreach to this public, it documents the practices of the nurses of this team who assume a third party role. On the one hand, they seek to remove the "homeless label" that may be assigned to these patients by the professionals of the medical world by presenting them, to the latter, as singular persons. On the other hand, they are trying to reattach them in collectives of care, each member of which represents a potential support to act on care. The second part extends this analysis of collectives of care, based on an ethnography in a nursing home. In this environment, patients rely on dense networks, made up of professionals and other patients. Their attachments to animals and alcohol, which are judged on their "quality of care", can also constitute catches. However, a double fragility emerges: not all care can be carried out in this environment and patients are not supposed to stay there indefinitely. Thus, the thesis contributes to an analysis of the forms of imbrication between inhabiting and (self) care. Also, it opens up a reflection on the achievment of care based on an "ecology of capabilities"
Imbaud, Claire. "Influence des technologies de santé dans les parcours de soins des personnes âgées : quel plateau médico-technique ? : éléments de réponse par l’analyse des données de santé." Thesis, Compiègne, 2017. http://www.theses.fr/2017COMP2380/document.
This work questions the answer to be given in terms of organization of the health technical offer and its fair distribution in the territories especially for the elderly patients with multimorbidities. It is based on the assumption that there is space for a concept of small multi-disciplinary outpatient health facilities, with a small health-technical platform, which would help to streamline and optimize care pathways. The method consisted on the one hand to study in Germany smaller community interdisciplinary health care center (the MVZ) in operation for a longer time than the the French multidisciplinary médical care centers. And on the other hand it analyzed the national heath data to reveal both the existence of comorbidités related groups and homogeneous care pathways related groups. The results are positive, both in network science analysis and in the automation of representations of complex care pathways. They made it possible to create representative patterns of groups, to characterize the consumption of care, in terms of medical devices and human resources, to quantify the cumulative distances traveled and the costs accumulated by patients according to their place of residence and the health institutions to which they are sent. We get addition elements for the definition and labeling of small community health centers, satellite of larger hospitals. This work represents a particularly useful step, both conceptual and practical, for complex health data studies of elderly
Choquet, Julien. "Métiers à vendre : Rationalisations du travail et désillusions professionnelles dans les grands réseaux d’enseignes du commerce et des services d’un centre commercial." Paris 10, 2011. http://www.theses.fr/2011PA100100.
The history of the French shopping centers reveals the hegemonic character of the rationality which presses on their spatial, trade and economic organization. Their economic model is one of mass consumption. The shops and services which they shelter cannot escape it so that a sociology of work which takes them for object cannot ignore the industrial character of their work organization. The biographical interviews and observations conducted in the different shops of a large French shopping center remind it. These establishments share the same organizational basis articulating deskilling of work and rationalization of the working time. These precepts continually reconfigure the activity of employees who are witnessing the transformation of their job, the decrease of their autonomy or the impoverishment and the intensification of their work. It is in the light of these evolutions that one can understand the toughness of a work they can no longer dominate. The means provided to them are no longer adequate to contain the flows of customers and goods or to maintain the cordiality of their exchanges with the customers. The urgency is spreading and overflow situations are increasing, which generates exhaustion and stress. These disadvantages are manifested mainly in the private sphere and in a way which varies according to the social situation of the employees. However, beyond these disparities, they all show a concern about the future of their work, the meaning and the position that it gives them around the feeling, widely shared, that it has become dehumanized
N'detibaye, Assah. "Fréquentation des centres de santé en milieu rural tchadien : analyse comparative des centres de santé du District sanitaire de Bousso dans le Chari-Baguirmi." Bordeaux 2, 2004. http://www.theses.fr/2004BOR21125.
Based on the alarming observation, it made and through the Alma-Ata Declaration, the WHO as made states agree upon carrying out the Primary Health strategy so as to reduce the gap that prevails between the fortunate and the unfortunate ones. Chad adhered to this programme through a National Politic Letter witch predicts a health development at the very heart of neighbouring districts, through a self-reliance health programme to be carried out by the communities themselves. But the implementation of this strategy seems to be at a standstill in the district of Bousso where visits to health centres are subject to many parameters. This situation gave birth to a dichotomic perception of health facilities by the health agents themselves and the population, private training having a better representation than public training. This situation required the making up of a new strategy whose objectives, labelled as "Bamako Initiative" aim at strengthhening the previous one through an intense community participation. Hence the setting up of health committees, bodies in charge of the advancement of this participation. But given the stakes behind these committees, one is likely to believe that these committees will deviate from their primary assignment, the joint-management of the health system
Zerbo, Roger. "Dynamiques sociales des comportements de santé au Burkina Faso: approche anthropologique de la prise en charge de la tuberculose dans la région du plateau central." Doctoral thesis, Universite Libre de Bruxelles, 2011. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209842.
Doctorat en Sciences politiques et sociales
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Bourret, Pascale. "Connaissance médicale et sociologie de la santé : problématique d'une nécessité." Aix-Marseille 1, 1986. http://www.theses.fr/1986AIX10004.
In this work we try to answer the general question : how to build medical knowledge as a sociological object ? in the first part we make a review of medical sociology from its origins up to its recent reshaping as a sociology of health. Looking at the main currents (functionalist, professional, marxist and phenomenological and interactionist) we point out the central questions of each of these approaches, but give a greater importance to a broad criticism towards the construction of the object as well as towards the unquestionned assumptions in the field. This review shows that all these approaches agree on the way they deal with medical knowledge since they fail to build it as an object. In the second part we outline a possible way to build this unexisting object. This attempt appears necessary first on a methodological point of view (to call into question traditional presuppositions), and also on regards our hypothesis upon the centrality of the epistemological dimension of the medical process. Adopting an approach which is both constructivist and anti-positivist as well as critical towards the tendancy to avoid any questioning on the content of science itself which is common to the sociology of knowledge and to the sociology of science, our thesis develops three main assertions : knowledge as a work, knowledge as a production, knowledge as a social relationship. We question the separation between theory and practice and view knowledge not only as a cognitive pratice but mainly as the result of practices based on the appropriationby the means of professionalisation- of collective capacities ; and these pratices produce and inscribe social divisions and relationships which express societal projects. In the third part we sketch some possible ways of research from medical genetics, more particularly on prenatal diagnosis
Fernandez, Guillaume. "Famille et santé : analyse de l'activité de santé dans la vie quotidienne des femmes." Toulouse 2, 2001. http://www.theses.fr/2001TOU20060.
Abstract. The sociological study of the activity of health of the women in the family makes necessary to emancipate from finalist presupposition often introduced to characterize these practices. The hypothesis of this research is as follow : the women produce a specific form of activity of health integrated in logics of everyday life which, without being finalized a priori for health, direct and control the dynamic of life of family. First statistical data (N = 195) shows three groups of women ; each one of them has a specific way of control of their family life and health. A first group, of lower-class women, is more often in situation where the familial incorporated pattern does not constitute an operational model regarding the situation experienced. A second group of women belonging to the rich class, acts in situations where the group's dynamic of life is formulated in a more consensual way, within an internal or external frame concerning the family. Finally, a third group characterized of diversified social profiles is engaged in a familial relational process by which the women reformulate in a recurring way, a dynamic of life less standardized and less integrated. Subsequently, a corpus of interviews (N = 41) makes it possible to locate these types of activities in biographical courses and to understand the relationship which these people builds between the activities of the everyday life and health. This reveals that the integration of family's way of life in a social frame, which provides norms and rules valid of life, and the insertion of women in a social role conformed to this frame, are the two dimensions, by which a control of group's dynamics of life and health is formulated
Mayol, Séverine. "Devenir un bon pauvre : Analyse genrée de la prise en charge des personnes sans domicile." Thesis, Paris 5, 2012. http://www.theses.fr/2012PA05H015.
Piérart, Julien. "Les mondes locaux de la santé publique." Université catholique de Louvain, 2004. http://edoc.bib.ucl.ac.be:81/ETD-db/collection/available/BelnUcetd-12202004-170747/.
Lesimple, Sophie. "Une cure thermale à Avène : Santé et beauté." Aix-Marseille 2, 1993. http://www.theses.fr/1993AIX22620.
Savary, Véronique. "Approche sociale des problèmes de santé infantile en Kroumirie(Tunisie)." Nantes, 1985. http://www.theses.fr/1985NANT3490.
Etienne, Jean-Michel. "Les inégalités sociales de santé : implications de politique économique." Paris 2, 2009. http://www.theses.fr/2009PA020005.
Dabrion, Marlyne. "La santé communautaire : mythe ou réalité ? : le cas de la Guadeloupe." Paris 5, 1995. http://www.theses.fr/1995PA05H068.
The "socio-anthropological" investigation intends to find out the Guadeloupian images about health in itself, the reached health types being : - community view -hedonist view or -other a sample survey has been held over 785 persons with a set of 29 close-up questions. The study of health in Guadeloupe through this inquiry shows out a patchwork concerning the different levels of society : man, family, friends, neighborhood, district, borough, it shows out diverse characters. Clos-up observations prove or don't prove a split between apriorism and sanitary image. Contrary to common ideology health at the subspace levels : man, family, neighborhood. A partially community subspace formed by the entity the friends. The adjustment between health policy and health image will take into account these results. Beside from the comparison with the Dominican Republic it must be remembered : -one side, it's a small state which has sad records of bad health indexes, with a knowledge of community approach but without any financial means. - on the other side, a French district with health indexes close to the average French national level but with no community approach
Sauret, Jean-Marc. "Contribution à une sociologie du management : Le cas des centres de tri de la poste." Paris 5, 2000. http://www.theses.fr/2000PA05H047.
Tardieu, Émilie. "Soutenir l'équité en santé dans les actions de santé publique : conditions d'utilisation d'un outil visant à la prise en compte des inégalités sociales de santé." Master's thesis, Université Laval, 2015. http://hdl.handle.net/20.500.11794/26465.
David, Pierre-Marie. "Le traitement de l'oubli : épreuve de l'incorporation des antirétroviraux : et temporalités des traitements du sida en Centrafrique." Thèse, Lyon 1, 2013. http://hdl.handle.net/1866/10559.
This thesis proposes an ethnographic description and a sociological analysis of the arrival of antiretroviral (ARV) in Bangui. It highlights the encounter between an international program with an unprecedented scale and a local society hardly hit by the HIV infection. The qualitative approach, based on three years of fieldwork from 2005 to 2011, aims at answering the following question: what are ARVs really the incorporation of? Treatment programs represent a therapeutic power that is structured as a « politics of life » linking medicines, NGOs and postcolonial history. The distance between the claims and the realities of therapeutic power explains the ambivalence felt in the biological and social inclusion though ARVs. Eventually, we observe that the therapeutic power in the Central African social context is less characterized by exclusive biomedical forms of subjectivity than by a fragmented process of individuation based on flexible, demonstrative and forgetful biomedical practices It appears then increasingly clear that international programs for the treatment of HIV infection contribute to produce oblivion or more precisely write oblivion with "scriptural practices", which is to say the oblivion of individual stories embedded in insurmountable social inequality, but also the omission of a longer history which shows that HIV infection is the incorporation of a colonial past. Taking time to recognize these temporalities of treatment then appears increasingly necessary to build a present that empowers, rather than repeats.
Réalisé en co-tutelle avec le laboratoire Santé-Individu-Société, Ecole doctorale Interdisciplinaire Sciences et Santé, Université de Lyon, avec l'obtention du grade de docteur en sociologie.
Nédélec, Françoise. "Sida et vie quotidienne : approche anthropologique et sociologique des aspects relationnels et affectifs." Paris 5, 1992. http://www.theses.fr/1992PA05H082.
This study, adopting a close approach through the individual life-stories of people directly affected by the HIV virus, is an attempt to understand now only react and cope with this situation in their everyday lives. To what extent does one announcement of a threat modify their everyday lives? What sort of problems arise? What changes are gradually taking place as the disease develops. The first part describes a few major typologies on which our work is based; the second is made up of three chapters: the announcement of a seropositive diagnosis, a silent evolution, and the passage to full blown AIDS. Our purpose has been to differentiate the diverse aspects of experience and to find out how social interactions influence emotional and interpersonal life. The third part we have tried to bring out the anthropological forms that are predominant and the ones that are built up to face this ordeal. This reality characterized by a high dependence on the surrounding word, is made up of social exclusion and community links in which a certain view of life is rooted
Ferrand-Nagel, Sabine. "De l'accès aux soins au mode de production alternatif : les centres de santé dans le redéploiement de la médecine de ville." Paris 1, 1990. http://www.theses.fr/1990PA010037.
In a context of liberal medicine crisis and health ependiture regulation, health centers seem alernative structures. Heterogeneous and few, unequally distributed on the french territory, they locally may be real competitors for liberal doctros. Their final characteristic, in front of liberal evolutions as group practice which are integrating global medicine and team working, lies in collective management of health, combining professionals, financers and users. Their historical calling, access to health care, did not vanish with the development of a social protection system ; the development of new poverty makes a revival of this theme. A statistical study in the hauts-de-seine department shows a division of the local care market, health centers being preferably serving communes with a high density of workers, unqualified and unelployment ones
BENADDA, MOHAMED. "Aspect politico-economique et sociologique dans la creation d'un service mobile d'urgence et de reanimation (smur) dans le cadre du centre hospitalier general de manosque." Aix-Marseille 2, 1990. http://www.theses.fr/1990AIX20307.
Pangu, Kasa Asila. "La "santé pour tous" d'ici l'an 2000: c'est possible. Expérience de planification et d'implantation des centres de santé dans la zone de Kasongo au Zaïre." Doctoral thesis, Universite Libre de Bruxelles, 1988. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/213405.
Silva, David Alves da. "Le supérieur, l'inférieur et l'égal : sociologie d'un centre social associatif." Paris 10, 2007. http://www.theses.fr/2007PA100075.
This doctoral thesis is based partly on the critical study of the usual approaches, in social sciences, to the hierarchical relations and to relations between equals, and partly on the results of observational fieldwork, carried out in an association-based social centre located in Île-de-France. It consists firstly of the compared analysis of the relationship between inferior and superior and of the relationship between equals. Furthermore, it aims to prove that it is heuristically fruitful to distinguish two modalities of the hierarchical relationship, according to whether the inferior obeys voluntarily (authority) or under constraint (domination), and two modalities of the relationship between equals, according to whether the equals succeed in acting together (power), or do not succeed (absence of power)
Romijn, François. "S’exposer en inquiétude. Le sujet fait et défait avec les médiations nouvelles sur sa santé." Doctoral thesis, Universite Libre de Bruxelles, 2018. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/268731.
This work originates in the observation that individuals are more than ever before involved in contexts where new knowledge about their biological life – produced by the technological and scientific progresses – are directly accessible to them (about their bodies, neurons, genes). Within easy reach, an ever-growing number of objectifying signs and data related to the biological self puts the individuals to test. They are confronted to inquietudes they have to cope with. We are investigating this societal phenomenon in a manner that the very diverse movements allowing the individual to integrate these data can be precised. Building on an anthropological problematic questioning how human beings find arrangements with situations in which they are not only confronted to others but also with objectifying data related to their biological life, the research focuses on the dynamics of individual users integrating the findings made while using three different health-related mediations (the classic medical examination, health-related information on the Internet, health-related direct-to- consumer genomic tests). We adopt a set of complementary sociological tools based on a plural conception of the subject; which do not limit the analysis of the action ‘taking place’ in a situation as guided only by a strategic or a managerial assumption.Through a pragmatic approach of the uneasiness exposed, we shed light on insightful dynamics irreducible to the often expected autonomy of an individual taking decisions informed by a shared knowledge required to participate to public debates. A careful analysis of the subject’s action highlights dynamics that have received little attention with regards to ‘what is worth in a given situation’. Moving from a fieldwork to another, we did not focus on the action’s heterogeneity as much as the way the individual brings together different positions that s/he can hold in order to arrange with these discoveries related to one’s biology. On the three sites investigated, the examination of the subject’s consistence draws the analysis toward the composite nature of the action. Rather than considering the equivocal features and sometimes the outright ambiguity of the conducts as a failure of the analysis, our research effort contributes achieving a better understanding of the pervasiveness of composition in our relationship to our self and the others in the social context related to biology.
Doctorat en Sciences politiques et sociales
info:eu-repo/semantics/nonPublished
Merlaud, Fabien. "La médecine de l'obésité en France : sociologie des engagements experts dans la normalisation de la corpulence." Toulouse 3, 2014. http://thesesups.ups-tlse.fr/2422/.
Focused on the study of the medicine of obesity in France, this thesis seeks to understand how the commitments of the experts transform the standards of the individuals' body size and their health and how they may influence the direction of a nutritional policy. The proposed analysis is based, first, on the study in the time of the setting of the nutrition as a public health problem on the political agenda until the recent emergence of the more specific issue of the obesity. Through the establishment of a nutrition policy called the National Nutrition and Health Program (NNHP), it is mainly the slimming market that finds a great echo for his growing in at least three directions: the production and sale of appetite suppressants, of nutraceuticals, as well as publishing and marketing of diets. The public health argument becomes for all the actors involved in this field a rhetorical device in order to be located on the right side of the border of the "healthy" and the "unhealthy". Given this re-appropriation in the food and pharmaceutical sectors, the very existence of the NNHP and its preventive tools makes debates. Its promoters are exposed to three types of controversies over the status attributed to the obesity and its health consequences, around the prevention devices, and the care devices. To capture these changes, we study, secondly, the developments, knowledge and devices that come to support these experts' judgments. The controversies allow to see existing normative references and at the same time they are the place where other "bets" on the future are made, challenging the epidemic and pathological point of view. Finally, these different designs can lead to discrepancy but also shared findings. The research also proposes to question the boundaries of the medicine of obesity established by the experts who present their interventions unanimously as "multidisciplinary" while there are voices which rise against a medicine which fails to allow people to permanently lose weight
Lapoire, Mireille. "Travail temporaire, marché durable : le travail intérimaire en France." Cachan, Ecole normale supérieure, 2007. http://www.theses.fr/2007DENS0024.
There was a fairly steady increase in temporary agency work (TAW) in France between 1972 and 2004, whereas that work was strictly regulated by rules that remained unchanged. This doctoral thesis aims at accounting for this a priori paradoxical increase. The research is based upon multilevel, strategic and systemic studies. The behaviours of individuals who are involved in the TAW system and in a similar social network were observed : temporary workers, user firms, temporary work agencies, and agents of public services who belong to 8 segments of the labour market connected to 4 sectors - logistics, transportation, architecture and call centres. The contexts of their action, employment, economic and judicial situations were examined within several conceptual frameworks : sociologies of work, employment, market and law, economic and financial analyses. Thus, the legal constraints, the high cost of TAW for workers, users and agencies and the unpredictability of their behaviours, which at first sight seemed to interfère with the development of TAW, were thoroughly analysed ; they can accotait for the way the transactions between these individuals, developed and lasted. These elements turn out to be the very conditions for this collective gaine. More legally bound and controlled than the others, the agencies know how to control their constraints and those of theirs "partners". They also manage to turn them into resources, to make temporary workers and users dependent, even though the latter seem to be a priori free. They finally manage to share out the costs of those transactions. They transfer part of the costs to the 3 main parties of the TAW system and the rest to other parties
Visier, Laurent. "Expérience infirmière et rapports sociaux à l'hôpital : contribution à une sociologie de la santé." Paris, EHESS, 1994. http://www.theses.fr/1994EHES0028.
This theses is a reflection on the sociology of health and hospital from the nurses case. In the first part, a critical historical reading of sociology,is made, from the foundings texts of t. Parsons in the fifties to major present-day contributions dominated by interactionist analyses and sociology of organizations. In the second part, the nursing profession is presented diachronically and synchronically. Three coexisting figures are brought out : the "nun", dominated by religion, the "domestic" by science and technology through the doctor figure, and the industrial worker by a bureaucratic organization. Using the method of "sociological intervention" worked out by a. Touraine, the third part looks into the nursing experience from the relationships with other hospital workers and patients. Contradictory demands managed by the nurses appear to be at the heart of this experience in pieces, while the analysis of the nurses' mobilization still renforces the seeling of an identity crisis in the profession. The conclusion goes back to the sociology of health which touches on the question of the evolution of the health car system from a call to consider the pathient as a subject
Lan, Hing Ting karine. "La délocalisation en action : une analyse des pratiques situées du travail en centres d'appels." Paris, Télécom ParisTech, 2010. http://www.theses.fr/2010ENST0099.
Serving as an interface between the organization and customers/users, call centers are now present in all spheres of economic activity. In order to reduce costs and gain efficiency, this activity is, increasingly, outsourced and offshored. One destination for offshoring is Mauritius, where I conducted my field work and collected video data in two call centers. The sociological analysis presented in this thesis has focused on actual call center work, with a naturalistic and situated approach and from a communicational perspective, inspired by conversation analysis and linguistics. Firstly, it appears that despite a certain degree of repetitiveness and while "talking on the phone" is the main activity of the call centre agent, "work" consists of a series of complex actions, characterized by multi-activity. Collaboration between colleagues – which is often mediated technologically and finely coordinated - is dominating. Then, in a context of "globalization of call center activities ", analyzes show how distance (geographical and cultural) and otherness are managed conversationally. It appears that the distance is not simply "masked"; its invisibility is achieved, that is, made transparent and non-relevant for the task at hand and for the customer. Mutual understanding between Mauritian call center agent and French customer is established and maintained, enabling the efficient delivery of service, sequentially organized around the service request and its delivery
Martin, Elisabeth. "Analyse des conditions d'implantation des centres de santé et de services sociaux (CSSS) : études de cas de l'intégration verticale de la gouvernance des établissements dans deux régions." Doctoral thesis, Université Laval, 2014. http://hdl.handle.net/20.500.11794/24827.
Vertical integration of healthcare organizations is one of various solutions put forward to reorient health systems and services around primary care, but such experiments remain limited. We examined the implementation of Health and Social Services Centres (HSSCs), introduced by the 2003-2004 reform and aimed at merging healthcare facilities in the province of Quebec. Our research objective intends to show how and under what conditions the integration of healthcare organisations’ administrative governance was made possible. Rooted in a political economy analytical framework, six case studies were conducted in territories within two regions (Bas-Saint-Laurent and Chaudière-Appalaches), using documentary analysis and 32 semi-structured interviews. Our results unveil the singularity of experiences across the six territories, the implementation dynamic and strategies being highly influenced by local context. Our key findings are organized around four convergent axes. First, territoriality portrays the institutionalized status of the regional county municipality (RCM) as an historical and contemporary scheme around which health care services are organized. Second, from an institutions’ history perspective, the research brings to light that HSSC’s implementation is more broadly part of an evolutionary and sequential process, made of interconnected phases of often conflicting mergers and other more consensual forms of organizational integration put in place since the 1990s. Third, the axis of organisations and missions reveals how the initial opposition between hospital and community services fell short rapidly, but also that the healthcare institutions’ missions showed resilience and therefore integrated at different paces in each territory. Finally, under the actors axis, the research shows how individuals had a greater impact than groups in the implementation processes. The practices described in our research share a common dynamic of constant tension between two logics: resistance and belonging. These logics generate conflicts which are mediated through negotiation and compromise. This leads to conclude to the political nature of the mergers’ implementation process, given that it meets the definition of politics, in both its objects and its actions modes.
Quinaglia, Silva Erica. "Santé et spiritisme : itinéraires thérapeutiques de la troisième révélation en France et au Brésil." Paris 5, 2011. http://www.theses.fr/2011PA05H020.
This thesis aims to investigate the therapeutic itineraries of the third revelation, or spiritism, in France and Brazil. The investigation is achieved in urban contexts, that is to say Paris and the metropolitan region of Brasília. Spiritism was born as a science and philosophy in France. It was settled as a religion in Brazil. In these both countries, it confronted medicine. According to spiritist representations and practices, both health and disease comprehend, other than bio-psychosocial dimension, the spiritual dimension. This permeates not only religious and scientific questions, but also political, ethical and juridical questions and interrogates the very definition of healing. In this sense, there are several indicators of spiritual diagnostics and treatments’ efficacy. We present reports of healing of patients and narratives of mediums that attend spiritist institutions as well as interviews with physicians, members of medical-spiritist associations, researches in medicine concerning the relationships between health and spirituality and an announcement issued by the Brazilian Medical Federal Council. What do these individuals and groups say about the subject of the present research? How to explain the successful cases? Is it suggestion, placebo effect, symbolic efficacy? What are the divergences and convergences between health and spiritism? These are the itineraries that this thesis attempts to cross. And it is from these paths that we intend to open new perspectives of comprehension of the other and of ourselves
Bonetti, Emmanuelle. "Comment le médicament façonne la maladie : le cas du traitement de l'impuissance et de l'hypercholestérolémie." Paris, Institut d'études politiques, 2006. http://www.theses.fr/2006IEPP0009.
Therapeutics are an essential vector of the social framing of diseases. They participate of the discovery of pathological mechanisms. Therefore, the interactions that take place between clinicians, firms and health authorities frame diseases. In the first place, the development of drugs orientates the research's ways. In the second place, therapeutic modify the division of labour between medical specialities. In the third place, their prescription has an effect on the disease's prevalence
Coussaert, Annie. "Perdre ou gérer la santé : une maladie écran : le diabète insulino-dépendant." Paris 5, 1988. http://www.theses.fr/1988PA05H024.
A culture of health changes in some way the nature of the disease. In training the diabetics to self-control, the competence transfer from diabetologists links lay ideas of health with professional definitions as biological constants. The link is becoming complexe with recent technical progress in daily treatment as in biological estimates of health. A first part of the thesis concerns the history of health in centers of diabetics training. The second part investigates in 320 diabetics the intercorrelation between hemoglobin aic levels and 54 mourning-of-health and management-of-risks attitudes. Factorial analysis shows 3 dialectological micro-culture. In each, interchangeable symbols of health and disease create a double bind in short term and long-term management of self-control. The contradiction between curative ans preventive constraints is worked out by producing ethics of health in associative groups which get together dialectologists and diabetics
Loenzien, Myriam de. "Connaissances, opinions et attitudes relatives au sida en milieu rural africain (Sénégal, Cameroun et Burundi)." Paris 5, 1995. http://www.theses.fr/1995PA05H079.
Martin, Élisabeth. "Analyse des conditions d'implantation des centres de santé et de services sociaux (CSSS) : études de cas de l'intégration verticale de la gouvernance des établissements dans deux régions." Thesis, Université Laval, 2014. http://www.theses.ulaval.ca/2014/30499/30499.pdf.
Vertical integration of healthcare organizations is one of various solutions put forward to reorient health systems and services around primary care, but such experiments remain limited. We examined the implementation of Health and Social Services Centres (HSSCs), introduced by the 2003-2004 reform and aimed at merging healthcare facilities in the province of Quebec. Our research objective intends to show how and under what conditions the integration of healthcare organisations’ administrative governance was made possible. Rooted in a political economy analytical framework, six case studies were conducted in territories within two regions (Bas-Saint-Laurent and Chaudière-Appalaches), using documentary analysis and 32 semi-structured interviews. Our results unveil the singularity of experiences across the six territories, the implementation dynamic and strategies being highly influenced by local context. Our key findings are organized around four convergent axes. First, territoriality portrays the institutionalized status of the regional county municipality (RCM) as an historical and contemporary scheme around which health care services are organized. Second, from an institutions’ history perspective, the research brings to light that HSSC’s implementation is more broadly part of an evolutionary and sequential process, made of interconnected phases of often conflicting mergers and other more consensual forms of organizational integration put in place since the 1990s. Third, the axis of organisations and missions reveals how the initial opposition between hospital and community services fell short rapidly, but also that the healthcare institutions’ missions showed resilience and therefore integrated at different paces in each territory. Finally, under the actors axis, the research shows how individuals had a greater impact than groups in the implementation processes. The practices described in our research share a common dynamic of constant tension between two logics: resistance and belonging. These logics generate conflicts which are mediated through negotiation and compromise. This leads to conclude to the political nature of the mergers’ implementation process, given that it meets the definition of politics, in both its objects and its actions modes.
Bardèche, Nathalie. "Les entreprises de santé à l'épreuve du droit des procédures collectives." Montpellier 1, 2009. http://www.theses.fr/2009MON10046.
Kotobi, Laurence. "Le vaccin et le sadaqeh : étude des représentations de la vaccination infantile en Iran d'aujourd'hui." Paris 5, 1995. http://www.theses.fr/1995PA05H018.
Concern : studying the acceptability of immunization of children in Iran from a qualitative work in the country, between 1991 and 1992, from a determined sample of urban (Teheran) and rural (Hassanabad, near Isfahan) women. "hybrid object", this modern preventive technic of health, relatively unavoidable, has not been dismissed in revolutionnary Iran as subject of an western modernity but as one of a cultural appropriation, legitimating a national identity (the iranized immunization) both towards the country's political autorities than towards iranian women
Gallini, Adeline. "Influence de la sélection des médicaments des centres hospitaliers universitaires sur les prescriptions ambulatoires." Toulouse 3, 2011. http://thesesups.ups-tlse.fr/1515/.
This work aimed to test the existence of the influence of hospital choices of drugs on surrounding general practitioners' prescriptions. A review of the literature showed the paucity of the available data. Three studies, restricted to university hospitals (UH) and 9 competitive pharmacological classes were conducted. The first one described the selection of drugs in UH. The second aimed to detect similar trends in the evolutions of hospital and ambulatory consumptions of drugs. The second was a quasi-experimental study which goal was to quantify the influence of the consumption of drugs in UHs on their surrounding communities (département and catchment area). Our analyses confirmed the influence of hospital drug consumption on drug use in the community. This effect largely varied according to the pharmacological classes
Gottfried, Fabrice. "Vers un outil d'aide à la décision en ingénierie territoriale appliqué à la géolocalisation de centres de santé." Thesis, Strasbourg, 2019. http://www.theses.fr/2019STRAH012.
Everyone knows that our western societies are getting older. Our elderly use also a lot of health care where costs go up and up year after year. Thus, health managers have to face conflicting challenges : how to offer top health protection for all at a reasonable cost for each of us and at an acceptable cost for our local health authorities. A health management that is too rigorous limited to the sole expenditure may undermine intergenerational solidarity by sacrificing the most vulnerable populations. In this way of mind, our aid decision tool could help health managers and politics find alternative solutions to restore some equity, in our case health care accessibility, to ensure sustainable social justice, the cement of all advanced societies. We have tested our tool with 2 territories having very different geographical and demographic characteristics : the densely populated Bas-Rhin region located in the Eastern part of France and the less densely populated region of Estrie located in the South-eastern Province of Quebec (Canada). Our tool may only be part of the solution to these health care costs mentioned above but, its utility and originality are also easily transferable to other possible organizational environments
Chiousse, Sylvie. "Divins thérapeutes - La santé au Brésil revue et corrigée par les orixas." Phd thesis, Ecole des Hautes Etudes en Sciences Sociales (EHESS), 1995. http://tel.archives-ouvertes.fr/tel-00003395.
D'un point de vue plus sociologique, cette étude s'intéresse au système sanitaire brésilien, ses évolutions, et pointe les défaillances du système officiel dans la gestion des soins offerte aux patients.
Analysant les parcours (possibles) du malade (brésilien), les techniques qu'il va choisir d'utiliser pour gérer ses problèmes de santé – en faisant appel ou non aux pratiques thérapeutiques du culte afro-brésilien, il apparaît finalement qu'outre le fait de pouvoir se présenter comme un système de soins complémentaire à la médecine officielle, les pratiques thérapeutiques développées par les garants de ce culte et de cette culture s'affichent souvent et de plus en plus comme une alternative, voire un palliatif efficace face à une gestion officielle de la santé souvent défaillante – où les rejetés de la médecine (par manque de moyens financiers permettant d'y accéder) côtoient les rejetants de cette médecine (qui craignent les infections nosocomiales et autres fonctionnements quotidiens mal assurés).
Bonnet, François. "La production organisée de l'ordre : contrôler des gares et des centres commerciaux à Lyon et à Milan." Paris, Institut d'études politiques, 2006. http://www.theses.fr/2006IEPP0034.
This work addresses the issues of security, social control and focuses on the problem of the production of order in urban spaces sucha as railway stations and shopping centers. Which actors follow which security policies towards which social groups and why ? The answer is based on fieldwork carried out in four sites : two railway stations and two shopping centers in Lyon and Milan. The thesis is therefore organized around three problems. The first problem is that of the actors of the production of order and and the stakes which animate the definition of the security policies and they implement. The second problem is that of the power relationships on each space. The third problem is that of the relationship between the production of order and immigration. In Lyon and Milan, in both shopping centers and both railway stations, the population considered as threatening by the police and commercial stakeholders are invariably the immigrants in Italy and the children of immigrants in France
Schmouth, Marie-Eve. "Les attentes et le rôle performé par les soignés et les soignants dans la relation de soins avec des personnes présentant un problème de santé mentale grave et de toxicomanie." Thesis, Université Laval, 2006. http://www.theses.ulaval.ca/2006/24033/24033.pdf.
Bénamouzig, Daniel. "Essor et développement de l'économie de la santé en France." Paris 4, 2000. http://www.theses.fr/2000PA040269.
Aim, Marie-Anastasie. "De la socialisation sanitaire à la santé comme phénomène représentationnel : socio-construction d'une "évidence"." Thesis, Aix-Marseille, 2018. http://www.theses.fr/2018AIXM0350.
This thesis aims to question the genesis of the “common sense” meanings associated with health per se. Particular attention will be paid to the integration of health systems and socio-cultural systems into the content and processes of this phenomenon. It also explores the relationship between sex/gender and health, the issues of which are still relatively invisible. Motivated by the objectives of this thesis and by the characteristics specific to our research subject, “integrative” socio-representational approaches and pluri-methodological approaches were adopted. Thus, this thesis seeks to study the meanings associated with health while developing a theoretical-methodological reflection on the field of social representations. Nine studies were conducted with various populations. Results enabled to highlight the close link between health education and health for education. In general, participants have health-related knowledge that is both polysemic and polyphasic, and this from childhood. This active learning is the result of real-life experiences and “scientific” knowledge relayed by various actors. Health-related knowledge is embodied in and through the social roles and places that people occupy, particularly in relation to their imposed identities such as sex/gender and age group. At a theoretical-methodological level, this thesis invites us to consider the relevance of using an integrative socio-representational approach to think about complex phenomena as well as the need to articulate characteristics of the methods and characteristics of the research objects studied
Desmarais, Julie. "La planification du traitement auprès des détenus fédéraux incarcérés en centre de traitement psychiatrique : situation du Centre régional de santé mentale de la région du Québec." Thèse, Université de Sherbrooke, 2013. http://hdl.handle.net/11143/6453.
Heritage, Zoë. "La contribution des liens sociaux aux inégalités de santé en France." Thesis, Paris 10, 2010. http://www.theses.fr/2010PA100181/document.
Health inequalities, linked to differences in income or other social status indicators have been identified in France as has occurred for most developed countries. Generally a health gradient is observed. Close social relationships have been associated with good health both at individual and area levels.Investigations using a cross-sectional general population survey complimented by an ecological study at the French departmental level found evidence of social health inequalities. Less than good self-rated health was more likely to be reported people in the lower income, education and professional groups compared to those higher up the social gradient. Departmental mortality was associated to the proportion of manual workers living in the department. People with less social ties reported poorer health after adjusting for age and socioeconomic status. This effect appeared to be slightly more important for men. There was some evidence that social ties may be more important for the health of people on a low income compared to their wealthier counterparts
Galand, Shani. "Quand les centres sociaux et socioculturels accompagnent le vieillissement : enjeux et effets des réponses contemporaines d'un vieillir en santé." Thesis, Nantes, 2019. http://www.theses.fr/2019NANT2036.
This thesis focuses on the contribution of social and socio-cultural centers to social action for the elderly. How do these local actors in the animation of social life, historically taken on by the family, intervene in the care of ageing populations? The study aims to examine how the mechanisms and logics of actions applied by social centers that support this specific public, through the evolution of old age public policies, through the demographic transformations. It is through a field survey conducted among the network of Social and Sociocultural Centers of France (FCSF) and more precisely, among the Social Centers of the Pays de la Loire, that this thesis seeks to demonstrate that these local actors cannot totally escape the dominant patterns of public intervention. A context that leads them to adopt a preventive logic of ageing and "Aging Well" that challenges the principle of action designed for and with the concerned individuals. While social centers help to maintain social representations and contemporary norms of ageing, which can induce undesirable effects, they are also a resource that can be mobilized by the individual during the ageing process. In other words, it is also a question of understanding how and in what ways Social Centres participate in the experiences and pathways of ageing of their members
Anzivino-Viricel, Lucie. "Evaluation des expositions et des effets sur la santé des salariés de deux centres de stockage des ordures ménagères." Chambéry, 2003. http://www.theses.fr/2003CHAMS028.
Health risks related with landfiling municipal solid wastes are largely unknown. In the aim of obtaining more data, a multidisciplinary approach has been developed by the Health and Waste Network and applied to two sites. This original approach consists in : -a chemical and microbiological metrology of sourcves emissions ; -a metrology of selected pollutants and microorganism analysis in the ambiant air at several workplaces, as well as in immediate periphery and close to the first dwellings ;-a survey of health parameters of workers compared to non exposed employees in other commercial or industrial activities. In fact, concentrations of pollutants are low, with the exception of total dusts, manganese and microorganisms. The volatile organic compounds (VOC) are present on the alveola in exploitation, because of the traffic of diesel trucks. The same observation was done for PAHs, which are closed to the urban environement levels. High total dusts levels have been measured (but the levels of alveola were low). Manganese was the more representative metal. Concentrations of microorganisms were high (100 at 1000 times what one recovers in classic environment), with the presence of pollution picks, and characteristic monmorphic bacteria and fungi (Aspergillus and Penicillium). Respiratory symptoms and cutaneous irritation were more often observed among waste landfills workers than among non exposed workers, but no perturbation of the lung function was detected among them. The Stroop test shows a low effect on cognitive functioning in the exposed group. This study brings several elements of knowledge on the ambient air pollution in municipal household waste landfill, and their possible effects on health. It would be necessary to continue the investigations particularly on the sanitary effect of the microbiological pollution
@Exposure and health effects evaluation of workers of two municipal waste landfill
Rod, Julien. "Les conséquences, sur le couple parental, de la prise en charge médicale d’un enfant atteint d’une tumeur maligne : une vie entre parenthèses." Caen, 2016. http://www.theses.fr/2016CAEN1022.
Childhood cancers represent 1% of cancers in the general population with 1500 to 2000 new cases per year. In France, malignant solid tumors are the 3rd most frequent childhood cancer behind leukemias/lymphomas and brain tumors. The two current goals of medical research are to increase effectiveness of treatments as well as to increase safety of treatments in growing individiduals. The origin of this work comes from a need to know the impact of childhood cancer treatments and sequelae on social, professional and family functionning. We included in the study families of children whose cancerous lesion had required surgical treatment at a time of the protocol (excluding leukemia and lymphoma), and for whom the child was still alive at the time of research. Ninety-five families had a child who had been treated for extracerebral solid tumors between 1995 and 2010 in the pediatric oncology unit of Caen University Hospital. Of these, 55 met the inclusion criteria. Our materials consisted of 11 interviews. Interviews were focused on the social and professional situation of the couple during three main periods: before diagnosis, during treatment and after end of treatment. From assumptions, ten major themes were built in order to classify the extracts of the most characteristic verbatim that were recorded during the interviews. Each of these themes was the subject of a careful reading and was reclassified into homogeneous themes by a sense point of view. The benefit of this research is to identify not fully known or previously described problems, but also to highlight areas for reflection to better understand the adventure that will change the child, parents and caregiver staff