Le refus scolaire [School refusal]

Pediatrician are often questioned by school refusal which relies on a wide range of psychopathological features and necessitates specific approaches. This disabling condition remains underestimated and is still increasing. A poor prognosis associated with a prolonged school absence is the common hallmark of school refusals, regardless of its heterogeneity. Its seriousness warrants early identification and prompt intervention by childhood healthcare professionals, teachers and social workers. A specialized treatment is needed, closely linked with families and school. Promising developments come from a functional rather than symptomatic concept of school refusal. They offer tailored interventions which fit the clinical diversity of school refusals. After a brief historical summary and current definitions of school refusal, the authors review the main clinical features and comorbidity before taking up treatment modalities.

Brain Spectrins 240/235 and 240/235E: Differential Expression During Development of Chicken Dorsal Root Ganglia in vivo and in vitro.

Brain spectrin, a membrane-related cytoskeletal protein, exists as two isoforms. Brain spectrin 240/235 is localized preferentially in the perikaryon and axon of neuronal cells and brain spectrin 240/235E is found essentially in the neuronal soma and dendrites and in glia (Riederer et al., 1986, J. Cell Biol., 102, 2088 - 2097). The sensory neurons in dorsal root ganglia, devoid of any dendrites, make a good tool to investigate such differential expression of spectrin isoforms. In this study expression and localization of both brain spectrin isoforms were analysed during early chicken dorsal root ganglia development in vivo and in culture. Both isoforms appeared at embryonic day 6. Brain spectrin 240/235 exhibited a transient increase during embryonic development and was first expressed in ventrolateral neurons. In ganglion cells in situ and in culture this spectrin type showed a somato - axonal distribution pattern. In contrast, brain spectrin 240/235E slightly increased between E6 and E15 and remained practically unchanged. It was localized mainly in smaller neurons of the mediodorsal area as punctate staining in the cytoplasm, was restricted exclusively to the ganglion cell perikarya and was absent from axons both in situ and in culture. This study suggests that brain spectrin 240/235 may contribute towards outgrowth, elongation and maintenance of axonal processes and that brain spectrin 240/235E seems to be exclusively involved in the stabilization of the cytoarchitecture of cell bodies in a selected population of ganglion cells.

Development and fruit yield of strawberry plants as affected by crown diameter and plantlet growing period

The objective of this work was to evaluate the influence of crown diameter and growing period of runner tips in 128 cell-trays on growth and yield of strawberry in the field. Treatments consisted of three classes of runner tip crown diameters, between 2.0 to 3.9 mm; 4.0 to 5.5 mm and 5.6 to 7.0 mm, respectively, and four growing periods in trays, 24; 39; 54 and 69 days, respectively. Higher shoot dry mass of transplants at planting and earlier yield of plants in the field were obtained in transplants grown for 69 days in trays. Larger runner tips lead to more vigorous transplants at planting and plants with higher vegetative growth in the field, with minor impact on yield. Increasing the growing time of runner tips in trays improved early fruit yield and decreased plant vegetative growth in the field.

Traumatismes précoces et réponses de stress, leur association aves la santé mentale, l'attachement et l'ocytocine

Lorsqu'un individu est confronté à une situation stressante, une des réponses les plus saillantes est l'activation de l'axe HPA, caractérisée par le déclenchement d'un taux élevé de glucocorticoïdes dans le sang. De manière générale, cette réponse hormonale est adaptative et elle a pour but la mobilisation des ressources physiques et cognitives de l'individu pour une action spécifique (Axelrod & Reisine, 1984; Chrousos & Gold, 1992; N. M. Kaplan, 1988; McEwen, 2004). Cependant, lorsque une personne est confrontée très tôt dans son développement, et de manière répétée, à des situations de stress, cette réponse physiologique peut s'altérer, devenir inadaptée (Anand, 1993; Bremner et al., 1995; Meaney et al., 1996; Mirescu, Peters, & Gould, 2004; Plotsky & Meaney, 1993; Sapolsky, 2000) et être associée à des troubles cognitifs (McEwen & Sapolsky, 1995) et émotionnels (McEwen, 2000). A l'âge adulte, le résultat de ces altérations psychoneuroendocriniennes se traduit au cours de l'activation de l'axe HPA et elles sont visibles lors de situations de stress moins intenses (Graham, Heim, Goodman, Miller, & Nemeroff, 1999; Mirescu et al., 2004; Stam, Bruijnzeel, & Wiegant, 2000; A. Taylor, Fisk, & Glover, 2000). La dysregulation de l'axe HPA semble représenter un facteur de vulnérabilité lié à des dysfonctionnements psychiques et physiologiques chez les adultes (Heim, Ehlert, & Hellhammer, 2000; Heim & Nemeroff, 1999; Heim, Newport, Mletzko, Miller, & Hemeroff, 2008). Cependant, des facteurs de protection peuvent influencer à leur tour ces vulnérabilités. La littérature, basée sur des études translationnelles (animaux, humains), converge vers le postulat selon lequel la dimension relationnelle apportée par l'environnement est fondamentale dans le développement des vulnérabilités physiologiques et psychiques du sujet. Dans ce sens, les relations d'attachement ont été particulièrement étudiées. A l'âge adulte, par exemple, la qualité des représentations d'attachement semble influencer directement l'expression de gènes impliqués dans les réponses hormonales de stress (Biagini, Pich, Carani, Marrama, & Agnati, 1998; Caldji, Diorio, & Meaney, 2000; Dallman, 2000; De Kloet, Rosenfeld, Van Eekelen, Sutanto, & Levine, 1988; Rincon-Cortes & Sullivan, 2014; Romeo, Tang, & Sullivan, 2009; van Oers, de Kloet, Whelan, & Levine, 1998), illustrant ainsi une perspective épigénétique. Traumatismes précoces et réponses de stress, leur association avec la santé mentale, l'attachement et l'ocytocine Deux objectifs principaux définissent ce travail de doctorat. Le premier est de comprendre comment un événement à portée traumatique, qui a eu lieu pendant la période périnatale, l'enfance ou l'adolescence, peut s'inscrire au niveau physiologique (axe hypotalamico- hypophysaire-surrénalien - axe HPA), au niveau psychopathologique ou encore au niveau de la régulation émotionnelle au cours de l'âge adulte. A ce propos, nous avons évalué les réponses physiologiques (telles que le Cortisol, l'ACTH et l'ocytocine), la présence de psychopathologies (relatives à l'axe I du DSM-IV) et les réponses émotionnelles (telles que la perception au stress) au cours d'une situation de stress de nature psychosociale, induite en laboratoire. Le deuxième objectif de ce travail est de savoir si les représentations d'attachement peuvent médiatiser ces effets, chez des individus exposés à différents événements à portée traumatique. Dans ce but, trois populations ont été considérées. La première est relative à des jeunes adultes nés grands prématurés ; la deuxième, concerne des femmes adultes ayant vécu un ou plusieurs abus sexuels au cours de leur enfance ou de leur adolescence et enfin la troisième est constituée de personnes adultes qui ont survécu à une maladie grave (cancer) pendant leur enfance ou leur adolescence. Enfin, ces trois populations sont comparées à des groupes contrôle. La prise en considération de différents types de traumatismes a permis de relever : premièrement, qu'un événement à portée traumatique de nature différente, peut influencer de manière semblable les structures neuronales, par exemple l'hypocortisolémie ; deuxièmement, qu'un dysfonctionnement de l'axe HPA n'aboutit pas nécessairement à la présence de signes de souffrance mentale ; enfin, des effets protecteurs ont été mis en évidence. Ces facteurs sont sous-tendus, d'un point de vue psychologique, par les représentations d'attachement et, d'un point de vue physiologique, par la sécrétion d'ocytocjne périphérique. Traumatismes précoces et réponses de stress, leur association avec la santé mentale, l'attachement et l'ocytocine -- When an individual is faced by a stressful situation, one of the most notable responses is the activation of the HPA axis, which is characterized by a heightened level of glucocortisoids in the blood. In general, this is an adaptive hormonal response which prepares the individual both physically and cognitively for a specific action (Axelrod & Reisine, 1984; Chrousos & Gold, 1992; N. M. Kaplan, 1988; McEwen, 2004). However, should a person be confronted to stressful situations very early and repeatedly in their development, this physiologic response may be altered and become maladapted (Anand, 1993; Bremner et al., 1995; Meaney et al., 1996; Mirescu et al., 2004; Plotsky & Meaney, 1993; Sapolsky, 2000) which can be associated to emotional (McEwen, 2000) and cognitive disorders(McEwen & Sapolsky, 1995). Throughout adulthood, the result of these psychoneuroendocrine alterations affects the activation of the HPA axis and are noticeable during less intense stressful situations (Graham et al., 1999; Mirescu et al., 2004; Stam et al., 2000; A. Taylor et al., 2000). HPA axis dysregulation appears to represent a factor of vulnerability linked to psychological and physical disorders in adults (Heim, Ehlert, et al., 2000; Heim & Nemeroff, 1999; Heim, Newport, et al., 2008). Nonetheless, these vulnerabilities may be influenced by further protection factors. The literature, based on translational studies (animals and humans), suggests that relationships formed in the context of the individual's environment are fundamental in the development of their physiological and psychological vulnerabilities. Thus, attachment relationships have been particularly studied. In adulthood, for example, the quality of attachment representations appear to influence directly the expression of genes involved in the hormonal responses to stress (Biagini et al., 1998; Caldji et al., 2000; Dallman, 2000; De Kloet et al., 1988; Rincon-Cortes & Sullivan, 2014; Romeo et al., 2009; van Oers et al., 1998). With the goal to study these dimensions, two principal objectives define these doctoral study. The first is to understand how an event considered to be traumatic, which took place during early infancy, infancy, or adolescence, could influence physiology (HPA axis), psychopathology or emotional regulation during adulthood. Therefore we have evaluated the presence of psychopathologies (relative to axis I of the DSM), physiological responses (such as Cortisol, ACTH and oxytocin) and emotional responses (such as perception of stress) throughout a psychosocial stress situation, conducted in a laboratory setting. The second objective of this study is to understand if attachment representations can mediate these effects, in individuals exposed to three different types of traumatic events. Therefore, three populations have been considered. The first is young adults who were born prematurely; the second concerns adult women who have suffered sexual abuse, on one or more occasions, during their childhood or adolescence; finally the third group is constituted of people who have survived a grave childhood illness. These populations were all compared to control groups. The consideration of different types of traumatic events has demonstrated, firstly, that different events which are considered to be traumatic can similarly influence neuronal structures, for example hypocortisolism. Secondly, that an HPA axis disorder does not necessarily lead to the presence of mental signs of distress, as is the case for those born very prematurely. Finally, protective effects were demonstrated, distinctively from a psychological point of view, by attachment representations and furthermore by peripheral oxytocin secretion from a physiological perspective.

Physical layer development in third generation protocol software architecture

Diplomityön tavoitteena oli kehittää kolmannen sukupolven fyysistä protokollakerrosta matkapuhelimen ohjelmistoarkkitehtuurille. Kolmannen sukupolven matkapuhelinjärjestelmät ovat aikaisempia järjestelmiä monimutkaisempia. Ohjelmiston koon ja monimutkaisuuden sekä aikataulujen kiireellisyyden vuoksi on tullut tarve ottaa käyttöön formaaleja menetelmiä ohjelmiston kehitystyöhön. Formaalit kuvauskielet mahdollistavat tarkan, yksiselitteisen ja simuloitavissa olevan järjestelmäkuvauksen muodostamisen. Fyysinen protokollakerros tarjoaa tiedon siirtoa ylemmille protokollakerroksille. Tämän tiedonsiirron hallinta vaatii protokollakerrosten välistä viestinvälitystä. Formaaleja kuvauskieliä käyttämällä voidaan viestinvälityksen toteutusta automatisoida ja siinä tarvittavaa logiikkaa havainnollistaa. Työssä suunniteltiin, toteutettiin ja testattiin ylempien protokollakerrosten kanssa kommunikoivaa osaa fyysisestä protokollakerroksesta. Tuloksena saatiin solunvalintatoiminnallisuuden vaatiman kommunikoinnin ja tilakoneen toteutus ohjelmistoarkkitehtuurissa. Ohjelmistonkehityksen alkuvaiheiden havaittiin olevan fyysisen kerroksen suorituskyvyn kannalta merkittävässä asemassa, koska tällöin viestinvälityksen optimointi on helpointa. Formaalit kuvauskielet eivät ole sellaisenaan täysin soveltuvia tarkoin määritellyn ohjelmistoarkkitehtuurin osien kehitykseen.

Challenges and Means for the Front End Activities of Software Development

The front end of innovation is regarded as one of the most important steps in building new software products or services, and the most significant benefits in software development can be achieved through improvements in the front end activities. Problems in the front end phase have an impact on customer dissatisfaction with delivered software, and on the effectiveness of the entire software development process. When these processes are improved, the likelihood of delivering high quality software and business success increases. This thesis highlights the challenges and problems related to the early phases of software development, and provides new methods and tools for improving performance in the front end activities of software development. The theoretical framework of this study comprises two fields of research. The first section belongs to the field of innovation management, and especially to the management of the early phases of the innovation process, i.e. the front end of innovation. The second section of the framework is closely linked to the processes of software engineering, especially to the early phases of the software development process, i.e. the practice of requirements engineering. Thus, this study extends the theoretical knowledge and discloses the differences and similarities in these two fields of research. In addition, this study opens up a new strand for academic discussion by connecting these research directions. Several qualitative business research methodologies have been utilized in the individual publications to solve the research questions. The theoretical and managerial contribution of the study can be divided into three areas: 1) processes and concepts, 2) challenges and development needs, and 3) means and methods for the front end activities of software development. First, the study discloses the difference and similarities between the concepts of the front end of innovation and requirements engineering, and proposes a new framework for managing the front end of the software innovation process, bringing business and innovation perspectives into software development. Furthermore, the study discloses managerial perceptions of the similarities and differences in the concept of the front end of innovation between the software industry and the traditional industrial sector. Second, the study highlights the challenges and development needs in the front end phase of software development, especially challenges in communication, such as linguistic problems, ineffective communication channels, a communication gap between users/customers and software developers, and participation of multiple persons in software development. Third, the study proposes new group methods for improving the front end activities of software development, especially customer need assessment, and the elicitation of software requirements.

Drivers and barriers of mobile travel and tourism service adoption : a study of individual perceptions and business model development in a travel and tourism context

The Travel and Tourism field is undergoing changes due to the rapid development of information technology and digital services. Online travel has profoundly changed the way travel and tourism organizations interact with their customers. Mobile technology such as mobile services for pocket devices (e.g. mobile phones) has the potential to take this development even further. Nevertheless, many issues have been highlighted since the early days of mobile services development (e.g. the lack of relevance, ease of use of many services). However, the wide adoption of smartphones and the mobile Internet in many countries as well as the formation of so-called ecosystems between vendors of mobile technology indicate that many of these issues have been overcome. Also when looking at the numbers of downloaded applications related to travel in application stores like Google Play, it seems obvious that mobile travel and tourism services are adopted and used by many individuals. However, as business is expected to start booming in the mobile era, many issues have a tendency to be overlooked. Travelers are generally on the go and thus services that work effectively in mobile settings (e.g. during a trip) are essential. Hence, the individuals’ perceived drivers and barriers to use mobile travel and tourism services in on-site or during trip settings seem particularly valuable to understand; thus this is one primary aim of the thesis. We are, however, also interested in understanding different types of mobile travel service users. Individuals may indeed be very different in their propensity to adopt and use technology based innovations (services). Research is also switching more from investigating issues of mobile service development to understanding individuals’ usage patterns of mobile services. But designing new mobile services may be a complex matter from a service provider perspective. Hence, our secondary aim is to provide insights into drivers and barriers of mobile travel and tourism service development from a holistic business model perspective. To accomplish the research objectives seven different studies have been conducted over a time period from 2002 – 2013. The studies are founded on and contribute to theories within diffusion of innovations, technology acceptance, value creation, user experience and business model development. Several different research methods are utilized: surveys, field and laboratory experiments and action research. The findings suggest that a successful mobile travel and tourism service is a service which supports one or several mobile motives (needs) of individuals such as spontaneous needs, time-critical arrangements, efficiency ambitions, mobility related needs (location features) and entertainment needs. The service could be customized to support travelers’ style of traveling (e.g. organized travel or independent travel) and should be easy to use, especially easy to take into use (access, install and learn) during a trip, without causing security concerns and/or financial risks for the user. In fact, the findings suggest that the most prominent barrier to the use of mobile travel and tourism services during a trip is an individual’s perceived financial cost (entry costs and usage costs). It should, however, be noted that regulations are put in place in the EU regarding data roaming prices between European countries and national telecom operators are starting to see ‘international data subscriptions’ as a sales advantage (e.g. Finnish Sonera provides a data subscription in the Baltic and Nordic region at the same price as in Finland), which will enhance the adoption of mobile travel and tourism services also in international contexts. In order to speed up the adoption rate travel service providers could consider e.g. more local initiatives of free Wi-Fi networks, development of services that can be used, at least to some extent, in an offline mode (do not require costly network access during a trip) and cooperation with telecom operators (e.g. lower usage costs for travelers who use specific mobile services or travel with specific vendors). Furthermore, based on a developed framework for user experience of mobile trip arrangements, the results show that a well-designed mobile site and/or native application, which preferably supports integration with other mobile services, is a must for true mobile presence. In fact, travel service providers who want to build a relationship with their customers need to consider a downloadable native application, but in order to be found through the mobile channel and make contact with potential new customers, a mobile website should be available. Moreover, we have made a first attempt with cluster analysis to identify user categories of mobile services in a travel and tourism context. The following four categories were identified: info-seekers, checkers, bookers and all-rounders. For example “all-rounders”, represented primarily by individuals who use their pocket device for almost any of the investigated mobile travel services, constituted primarily of 23 to 50 year old males with high travel frequency and great online experience. The results also indicate that travel service providers will increasingly become multi-channel providers. To manage multiple online channels, closely integrated and hybrid online platforms for different devices, supporting all steps in a traveler process should be considered. It could be useful for travel service providers to focus more on developing browser-based mobile services (HTML5-solutions) than native applications that work only with specific operating systems and for specific devices. Based on an action research study and utilizing a holistic business model framework called STOF we found that HTML5 as an emerging platform, at least for now, has some limitations regarding the development of the user experience and monetizing the application. In fact, a native application store (e.g. Google Play) may be a key mediator in the adoption of mobile travel and tourism services both from a traveler and a service provider perspective. Moreover, it must be remembered that many device and mobile operating system developers want service providers to specifically create services for their platforms and see native applications as a strategic advantage to sell more devices of a certain kind. The mobile telecom industry has moved into a battle of ecosystems where device makers, developers of operating systems and service developers are to some extent forced to choose their development platforms.

The impact of a digital children's literature program on primary students' reading motivation

This qualitative study stemmed from a concern of the perceived decline in students' reading motivation after the early years of schooling, which has been attributed to the disconnect between the media students are accustomed to using outside the classroom and the media they predominantly use within the classroom. This research documented the effectiveness of a digital children's literature program and a postreading multimedia program on eight grade 1 students' reading motivation, word recognition, and comprehension abilities. Eight students were given ten 25-minute sessions with the software program over 15 weeks. Preprogram, interim-program, and postprogram qualitative data were collected from students, teachers, and parents through questionnaires, interviews, standardized reading assessment tools, classroom observations, field notes, and student behaviour observation checklists. Findings are summarized into 3 themes. The motivational aspects and constructivist styles of instruction in the digital reading programs may have contributed to 5 student participants' increased participation in online storybook reading at home. Qualitative data revealed that the digital children's literature program and multimedia postreading activities seemed to have a positive influence on the majority of grade 1 student participants' reading motivation, word recognition, and listening comprehension skills. These findings suggest the promise of multimedia and Internet-based reading software programs in supporting students with reading andlor behavioural difficulties. In keeping with current educational initiatives and efforts, increased use of media literacy practices in the grade 1 curriculum is suggested.

The Family Game: A Parent Education Intervention to Increase Positive Parent-Child Interactions in Parents with Learning Difficulties

Children of parents with learning difficulties (LD) are at risk for a variety of developmental problems including behavioural and psychiatric disorders. However, there are no empirically supported programs to prevent behavioural and psychiatric problems in these children. The purpose of the study was to test the effectiveness of a parenting intervention designed to teach parents with learning difficulties positive child behaviour management strategies. A multiple baseline across skills design was used with two parents, who were taught three skills: 1) clear instructions, 2) recognition of compliance and 3) correction of noncompliance. Training scores improved on each skill and maintained at a 1-month follow-up. Scores on generalization cards were high and showed maintenance, but improvements in parenting skills in the naturalistic environment were low at posttest and follow-up. Increases were seen in child compliance at posttest and 1-month follow-up. Results of pre-post social validity measures were also generally positive.

A Case Study of the "Who is NOBODY?" Project: A Character Development Program for Children with Learning Disabilities

This research study explored a support system for children with learning disabilities. The Learning Disabilities Association of Niagara Region (LDANR) recently expanded its Better Emotional and Social Times (B.E.S.T.) program to incorporate an innovative, character education initiative called the “Who is NOBODY?” program. The objective of this qualitative case study was two-fold. First, the study aimed to support the LDANR in assessing the efficacy of the “Who is NOBODY?” program, providing the LDANR with empirical support for their programs. Second, the study enabled a more in-depth understanding of how to best support children with LD in regards to their social and emotional well-being. The study explored the “Who is NOBODY?” program through three lenses: design, implementation, and experiences of participating children. Three primary themes emerged from these three data lenses: positive character traits, prosocial behaviour, and strong self-efficacy – leading to the promotion of strong character development and self-esteem. Taken together, the “Who is NOBODY?” program was shown to be a successful remediation program for supporting vulnerable children with LD.

Qualité de vie et communication entre soignant et soignée auprès de femmes atteintes de cancer du sein : approche longitudinale

Introduction : De nos jours, les femmes atteintes de cancer du sein peuvent espérer une survie prolongée et un grand nombre d’entre elles peuvent même entrevoir la guérison. Alors que le dépistage précoce et les traitements rigoureux donnent espoir à de plus en plus de femmes, les chercheurs et les cliniciens doivent maintenant se pencher sur la qualité de vie de ces femmes à chaque phase clinique de la trajectoire de soins. Les difficultés physiques, fonctionnelles, psychologiques et sociales avec lesquelles les femmes vivent peuvent compromettre leur qualité de vie, d’où l’intérêt d’évaluer celle-ci. Peu de chercheurs se sont intéressés au changement longitudinal de la qualité de vie de ces femmes aux différents moments de la trajectoire de soins en oncologie : diagnostic, traitement et suivi. De plus, peu se sont demandés si la perception que les femmes ont de leur communication avec les professionnels de la santé influence leur qualité de vie le long de la trajectoire de soins. Objectifs principaux : 1) Décrire l’évolution de la qualité de vie liée à la santé des femmes atteintes de cancer du sein pendant le diagnostic, les traitements de radiothérapie et le suivi; 2) Décrire l’évolution de la perception que les femmes ont de leur communication avec les médecins, les infirmières et les technologues en radio-oncologie au cours des mêmes phases cliniques; 3) Examiner l’évolution de la relation entre la perception que les femmes ont de leur communication avec les professionnels de la santé et leur qualité de vie liée à la santé durant les phases citées précédemment. Méthodes : L’échantillon se composait de 120 femmes atteintes d’un cancer du sein précoce (stades I et II) qui parlaient le français, âgées de plus de 18 ans (55 ans ± 9,5) qui ont eu une chirurgie conservatrice. Les femmes ont complété des questionnaires à la période entourant le diagnostic (en moyenne six semaines après le diagnostic), à mi-chemin de la radiothérapie (en moyenne 27 semaines après le diagnostic) et de trois à quatre mois après la fin de la radiothérapie (en moyenne 48 semaines après le diagnostic). À chaque temps de mesure, elles ont complété six questionnaires d’une durée totale de 60 minutes au centre hospitalier ou à domicile : un sur les données sociodémographiques, un sur les renseignements médicaux, le MOS SSS, le EORTC QLQ-C30/BR23 et le MCCS. Résultats : Les analyses GEE montrent que la qualité de vie liée à la santé des femmes atteintes de cancer du sein change dans le temps. Elle diminue pendant la radiothérapie, sauf pour le fonctionnement émotionnel et cognitif. Les analyses démontrent aussi que certains facteurs cliniques, intrapersonnels et interpersonnels influencent leur qualité de vie. Précisément, plus les femmes avancent en âge et plus elles perçoivent qu’elles ont eu du soutien social le long de la trajectoire de soins, plus leur qualité de vie est meilleure pour les dimensions génériques et spécifiques du fonctionnement. De plus, celles qui présentent une tumeur de stade II et celles qui ont eu de la radiothérapie et l’hormonothérapie ont des scores plus élevés pour certaines dimensions de qualité de vie comparativement à celles dont le cancer se situe au stade I et à celles qui ont eu la chimiothérapie, la radiothérapie et l’hormonothérapie. Les résultats font état également d’une interaction entre le facteur « temps » et un facteur intrapersonnel pour le fonctionnement « rôle » et le fonctionnement sexuel des femmes. La perception que les femmes ont de leur communication avec les médecins et les autres professionnels de la santé change très peu avec le temps. Ainsi, les femmes se perçoivent plus compétentes dans la recherche d’information avec les radio-oncologues pendant la radiothérapie qu’avec les chirurgiens-oncologues au moment du diagnostic. Elles perçoivent aussi la vérification et la recherche d’information par les radio-oncologues pendant la radiothérapie plus satisfaisante que celle des chirurgiens-oncologues lors de l’annonce du diagnostic. Globalement, les femmes perçoivent leur communication avec les radio-oncologues et les chirurgiens-oncologues comme étant meilleure pendant la radiothérapie et au suivi qu’au moment du diagnostic avec les chirurgiens-oncologues. Les analyses GEE montrent aussi que certains facteurs cliniques (nature des traitements), intrapersonnels et interpersonnels (âge, niveau de scolarité et soutien social perçu) sont des facteurs susceptibles d’influencer la façon dont elles perçoivent leur communication avec les professionnels de la santé. Enfin, la perception des femmes quant à leurs compétences de communication à l’égard des médecins et des autres professionnels de la santé explique davantage leur qualité de vie liée à la santé que celle des compétences des professionnels de la santé. Donc, les femmes ont un meilleur score pour le fonctionnement « rôle », émotionnel et elles ont moins d’effets secondaires et de symptômes pendant la radiothérapie et au suivi lorsqu’elles se perçoivent compétentes envers les médecins (chirurgiens-oncologues et radio-oncologues) pour la recherche d’information et l’aspect socio-affectif d’un entretien aux temps précédents. De plus, l’âge des femmes, le soutien social perçu, le stade de la maladie et la nature des traitements ont une influence sur le lien entre leur qualité de vie et leur communication avec les professionnels de la santé. Enfin, une interaction est présente entre le facteur « temps » et un facteur clinique ou intrapersonnel pour les dimensions de qualité de vie suivantes : rôle, émotionnel et fonctionnement sexuel. Conclusion et retombées : Les résultats de la présente thèse soulignent l’importance d’évaluer de façon longitudinale la qualité de vie liée à la santé des femmes atteintes de cancer du sein à différents moments de la trajectoire de soins, particulièrement pendant la radiothérapie, et, pour les intervenants psychosociaux, de s’occuper des jeunes femmes diagnostiquées et de celles qui ne perçoivent pas recevoir un soutien social. Ainsi, de meilleures ressources psychosociales pourront être mises sur pied pour aider ces groupes de femmes. Les résultats montrent également qu’il est essentiel d’informer les chirurgiens-oncologues de l’importance d’établir une communication satisfaisante avec les femmes atteintes de cancer du sein lors de l’annonce du diagnostic afin de favoriser une perception positive par les femmes de leur communication avec les chirurgiens-oncologues. Enfin, les résultats obtenus soulignent les avantages pour les femmes atteintes de cancer du sein d’être proactives et de se sentir compétentes pour la recherche d’information et l’aspect socio-affectif d’une relation avec les chirurgiens-oncologues et les radio-oncologues dans le maintien d’une bonne qualité de vie liée à la santé.

Features of neighbourhood environments associated with obesity and related health behaviours in children: using multiple statistical approaches to identify obesogenic environments

Contexte: L'obésité chez les jeunes représente aujourd’hui un problème de santé publique à l’échelle mondiale. Afin d’identifier des cibles potentielles pour des stratégies populationnelles de prévention, les liens entre les caractéristiques du voisinage, l’obésité chez les jeunes et les habitudes de vie font de plus en plus l’objet d’études. Cependant, la recherche à ce jour comporte plusieurs incohérences. But: L’objectif général de cette thèse est d’étudier la contribution de différentes caractéristiques du voisinage relativement à l’obésité chez les jeunes et les habitudes de vie qui y sont associées. Les objectifs spécifiques consistent à: 1) Examiner les associations entre la présence de différents commerces d’alimentation dans les voisinages résidentiels et scolaires des enfants et leurs habitudes alimentaires; 2) Examiner comment l’exposition à certaines caractéristiques du voisinage résidentiel détermine l’obésité au niveau familial (chez le jeune, la mère et le père), ainsi que l’obésité individuelle pour chaque membre de la famille; 3) Identifier des combinaisons de facteurs de risque individuels, familiaux et du voisinage résidentiel qui prédisent le mieux l’obésité chez les jeunes, et déterminer si ces profils de facteurs de risque prédisent aussi un changement dans l’obésité après un suivi de deux ans. Méthodes: Les données proviennent de l’étude QUALITY, une cohorte québécoise de 630 jeunes, âgés de 8-10 ans au temps 1, avec une histoire d’obésité parentale. Les voisinages de 512 participants habitant la Région métropolitaine de Montréal ont été caractérisés à l’aide de : 1) données spatiales provenant du recensement et de bases de données administratives, calculées pour des zones tampons à partir du réseau routier et centrées sur le lieu de la résidence et de l’école; et 2) des observations menées par des évaluateurs dans le voisinage résidentiel. Les mesures du voisinage étudiées se rapportent aux caractéristiques de l’environnement bâti, social et alimentaire. L’obésité a été estimée aux temps 1 et 2 à l’aide de l’indice de masse corporelle (IMC) calculé à partir du poids et de la taille mesurés. Les habitudes alimentaires ont été mesurées au temps 1 à l'aide de trois rappels alimentaires. Les analyses effectuées comprennent, entres autres, des équations d'estimation généralisées, des régressions multiniveaux et des analyses prédictives basées sur des arbres de décision. Résultats: Les résultats démontrent la présence d’associations avec l’obésité chez les jeunes et les habitudes alimentaires pour certaines caractéristiques du voisinage. En particulier, la présence de dépanneurs et de restaurants-minutes dans le voisinage résidentiel et scolaire est associée avec de moins bonnes habitudes alimentaires. La présence accrue de trafic routier, ainsi qu’un faible niveau de prestige et d’urbanisation dans le voisinage résidentiel sont associés à l’obésité familiale. Enfin, les résultats montrent qu’habiter un voisinage obésogène, caractérisé par une défavorisation socioéconomique, la présence de moins de parcs et de plus de dépanneurs, prédit l'obésité chez les jeunes lorsque combiné à la présence de facteurs de risque individuels et familiaux. Conclusion: Cette thèse contribue aux écrits sur les voisinages et l’obésité chez les jeunes en considérant à la fois l'influence potentielle du voisinage résidentiel et scolaire ainsi que l’influence de l’environnement familial, en utilisant des méthodes objectives pour caractériser le voisinage et en utilisant des méthodes statistiques novatrices. Les résultats appuient en outre la notion que les efforts de prévention de l'obésité doivent cibler les multiples facteurs de risque de l'obésité chez les jeunes dans les environnements bâtis, sociaux et familiaux de ces jeunes.

La villa Montalto et l'idéal rustique de Sixte Quint

Constructed, beginning in 1576 by the architect Domenico Fontana, the Villa Montalto, named after the Cardinal Felice Peretti Montalto, was for a long rime described as having surpassed the splendor of all the villas in Rome. Located to the north of the city in an arid and practically deserted zone, between vineyards, Antique ruins and early Christian churches, the villa occupies a privileged place within the history of urban landscape. Elected pope in 1585, under the name of Sixtus V, Felice made his villa the largest that had ever existed inside of the walls, establishing the upper city of the Monti, the Città Felice, as a new economic and religious center, crystallizing his ambitions for a major territorial reform. By simultaneously focusing on the gardens, the painted decorations, the literature, and the architecture of the villa, but also on its economic and social role, this article proposes an original interpretation of the Villa Montalto, demonstrating the fundamental importance of the imagined landscape in the Rome of Sixtus V. Through the ideal space of his villa, the Pope sought to propose a new model of economic and social development necessary to the reform of the then poor and insalubrious Rome. The ultimate goal was none other than the reestablishment of a Christian Eden on Earth. Sixtus V thus placed himself within the lineage which, since Adam, had attempted through the virtue of agricultural labor, to atone for the original sin.

Econometrics as an Academic Discipline in Higher Education: An Exploratory Study of the Need, Relevance and Significance

Econometrics is a young science. It developed during the twentieth century in the mid-1930’s, primarily after the World War II. Econometrics is the unification of statistical analysis, economic theory and mathematics. The history of econometrics can be traced to the use of statistical and mathematics analysis in economics. The most prominent contributions during the initial period can be seen in the works of Tinbergen and Frisch, and also that of Haavelmo in the 1940's through the mid 1950's. Right from the rudimentary application of statistics to economic data, like the use of laws of error through the development of least squares by Legendre, Laplace, and Gauss, the discipline of econometrics has later on witnessed the applied works done by Edge worth and Mitchell. A very significant mile stone in its evolution has been the work of Tinbergen, Frisch, and Haavelmo in their development of multiple regression and correlation analysis. They used these techniques to test different economic theories using time series data. In spite of the fact that some predictions based on econometric methodology might have gone wrong, the sound scientific nature of the discipline cannot be ignored by anyone. This is reflected in the economic rationale underlying any econometric model, statistical and mathematical reasoning for the various inferences drawn etc. The relevance of econometrics as an academic discipline assumes high significance in the above context. Because of the inter-disciplinary nature of econometrics (which is a unification of Economics, Statistics and Mathematics), the subject can be taught at all these broad areas, not-withstanding the fact that most often Economics students alone are offered this subject as those of other disciplines might not have adequate Economics background to understand the subject. In fact, even for technical courses (like Engineering), business management courses (like MBA), professional accountancy courses etc. econometrics is quite relevant. More relevant is the case of research students of various social sciences, commerce and management. In the ongoing scenario of globalization and economic deregulation, there is the need to give added thrust to the academic discipline of econometrics in higher education, across various social science streams, commerce, management, professional accountancy etc. Accordingly, the analytical ability of the students can be sharpened and their ability to look into the socio-economic problems with a mathematical approach can be improved, and enabling them to derive scientific inferences and solutions to such problems. The utmost significance of hands-own practical training on the use of computer-based econometric packages, especially at the post-graduate and research levels need to be pointed out here. Mere learning of the econometric methodology or the underlying theories alone would not have much practical utility for the students in their future career, whether in academics, industry, or in practice This paper seeks to trace the historical development of econometrics and study the current status of econometrics as an academic discipline in higher education. Besides, the paper looks into the problems faced by the teachers in teaching econometrics, and those of students in learning the subject including effective application of the methodology in real life situations. Accordingly, the paper offers some meaningful suggestions for effective teaching of econometrics in higher education

Social Structural Determinants of Education among Tribes in Kerala

The study is focused on education of tribes particularly the problem of high dropout rate existing among the tribal students at school level. Scheduled Tribe is one of the marginalized communities experiencing high level of educational deprivation. The analysis of the study shows that the extent of deprivation existing among STs of Kerala is much higher compared to that of other communities. The present study covered tribes of three tribal predominant districts of Kerala such as Idukki, Palakkad and Wayanad. Out of the 35 tribal communities in the State, 17 of them are concentrated in these districts. Tribes concentrated in Idukki include Muthuvans, Malai Arayan, Uraly, Mannan and Hill Pulaya. The present study analyzed dropouts situation in tribal areas of Kerala by conducting Field Survey among dropout and non-dropout students at school level. High dropouts among STs persist due to many problems which are of structural in nature. Important problems faced by the tribal students that have been analyzed, this can be classified as economic, social, cultural and institutional. It is found that there exists high correlation between Income and expenditure of the family with the well-being of individuals. Significant economic factors are poverty and financial indebtedness of the family. Some of the common cultural factors of tribes are Nature of Habitation, Difference in Dialect and Medium of Instruction etc. Social factors analyzed in the study are illiteracy of parents, migration of family, family environment, motivation by parents, activities engaged in for helping the family and students’ lack of interest in studies. The analysis showed that all these factors except migration of the family, are affecting the education of tribal students. Apart from social, economic and cultural factors, there are a few institutional factors which will also influence the education of tribal students. Institutional factors analyzed in the study include students’ absenteeism, irregularity of teachers, attitude of non-tribal teachers and non-tribal students, infrastructure facilities and accessibility to school. The study found irregularity of students and accessibility to school as significant factors which determine the dropout of the students.