Darbo tikslas. Įvertinti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių gyvenimo kokybės sąsajas su sveikatos paslaugų prieinamumu Prienų rajone. Uždaviniai. Įvertinti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių klinikinę charakteristiką ir sąsajas su socialiniais – ekonominiais veiksniais. Ištirti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių savarankiško judėjimo ir apsitarnavimo galimybes. Įvertinti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių gydymo įstaigos pasiekiamumo ir aptarnavimo galimybes. Įvertinti sergančiųjų reumatoidiniu artritu gyvenimo kokybės ir skausmo intensyvumo sąsajas su aptarnavimu ir sveikatos priežiūros paslaugų prieinamumo galimybėmis. Tyrimo metodika. Kiekybinis momentinis tyrimas. Anketinė apklausa, naudota SF – 36, DAS 28 ir paruoštas bendrojo pobūdžio klausimynas. Analizuojamosios imties dydis – 67 reumatoidiniu artritu sergantys asmenys. Atsako dažnis – 74,4 proc. Gautiems duomenims apdoroti naudota SPSS 22.0. Rezultatai. Tyrime dalyvavo 61,2 proc. moterų ir 38,8 proc. vyrų. Patenkinamai savo sveikatos būklę dažniau vertino dirbantys respondentai, gyvenantys santuokoje, kaime. Nustatyta, kad sąnarių skausmas dažnai vargina 50,7 proc. respondentų, sąnarių sutinimas – 40,3 proc. tiriamųjų, rytinis sąnarių sustingimas – 34,3 proc. apklaustųjų, sąnarių judesių ribotumas – 52,2 proc. Nedirbantys, gaunantys mažas pajamas respondentai dažniau teigė turintys daugiau sutinusių ir skausmingų sąnarių... [toliau žr. visą tekstą] / Aim of the study. To evaluate the quality of life and its links with accessibility to healthcare services for working age patients with rheumatoid arthritis in Prienai region. Objectives. To evaluate the clinical characteristics and their links to the social - economic factors for working age patients with rheumatoid arthritis. To analize the self-movement and the self-service capabilities for working age patients with rheumatoid arthritis. To evaluate the reach of medical institutions and the service capabilities for working age patients with rheumatoid arthritis. To evaluate the quality of life, the intensity of pain and their links with accessibility to healthcare services for working age patients with rheumatoid arthritis. Methods. Quantitative cross sectional research. The size of the sample under analysis – 67 patients with rheumatoid arthritis. The frequency of the response is 74,4 %. The statistical analysis of data was performed using statistical package SPSS Statistics 22.0. Results. 61,2% women and 38,8% man participated in the study. Working in, living in marriage, living in the village respondents their health evaluated satisfactory more often. The pain of joints more often suffer 50,7% of respondents, the swelling of joints – 40,3%, morning stiffness – 34,3%, limitation of joint movement – 52,2%. The unemployed, with low incomes respondents affirmed about the swollen and the painful joints more often. Respondents living in the village and the employed... [to full text]

Internetbaserad KBT är en behandlingsform som har visat god effekt vid insomni. Vården av personer med insomni skulle dock kunna förbättras av mer kunskap om faktorer som påverkar utfall på lång sikt. Föreliggande studie hade en explorativ ansats och syftet var att identifiera faktorer som kunde predicera behandlingsutfall vid 36-månadersuppföljning (FU36). Därutöver ämnade studien undersöka hur väl data insamlad innan behandlingen kunde predicera behandlingsutfall vid FU36 i jämförelse med data insamlad både innan och efter behandling. Behandlingsutfall definierades som förändring av insomnisymtom och grad av insomnisymtom vid FU36. Totalt inkluderades 203 deltagare från två olika behandlingsstudier, vilka genomgått 9–12 veckors insomnibehandling med eller utan kombinerad depressionsbehandling. Initiala korrelationer undersökte samband mellan prediktorer och utfallsmått, därefter genomfördes regressionsanalyser med de prediktorer som visade signifikanta samband. Resultaten påvisade att det var möjligt att predicera förändring och grad av insomnisymtom vid FU36. Prediktorer från data insamlad innan och efter behandling kunde predicera behandlingsutfall bäst och förklarade 33% av den totala variansen gällande förändring av insomnisymtom tre år efter avslutad behandling. Allvarligare grad av insomni vid behandlingsstart, förändring av insomnisymtom under behandlingen, hög ålder och missnöje vid utvärderingen kunde predicera insomnisymtom tre år efter avslutad behandling. Kliniskt kan detta innebära att patienter som riskerar sämre behandlingseffekt på lång sikt kan få bättre stöd. / Internet-based CBT is a treatment-form that has proved to be effective against insomnia. Treatment of patients with insomnia could benefit from more knowledge about factors that affect long-term outcomes. The present study had an explorative design and the aim was to identify factors that could predict treatment outcomes at 36-month-follow-up (FU36). The study also made a comparison of predictive power regarding treatment outcomes between data gathered before treatment and data gathered both before and after treatment. Treatment outcomes were defined as change in insomnia symtoms and degree of insomnia symtoms at FU36. In total 203 participants were included from two different treatment studies, whom had received 9-12 weeks of insomnia treatment with or without combined treatment for depression. Initial correlations explored relationships between predictors and outcome measures, thereafter multiple regression analyses were done with the predictors that showed significant relationships. The results showed that it was possible to predict change and degree of insomnia symtoms at FU36. Predictors taken from data gathered before and after treatment had the most predictive power and explained 33% of the total variance of the change of insomnia symtoms at FU36. More insomnia symtoms at the beginning of treatment, change of insomnia symtoms during treatment, high age and a dissatisfaction of treatment were factors that were able to predict insomnia symtoms at FU36. / ClinicalTrials.gov Identifier: NCT01663844 New Clinical Applications for Internet-based Cognitive Behavior Therapy for Insomnia and Depression

This diploma thesis deals with the issue of life quality of patients taking home parenteral nutrition. Its intention is to present the achieved life quality scores in the individual domains of physical and mental health in comparison with general population and to point out the differences in what dimensions the life quality of these patients is particularly affected. The theoretical section describes the present situation of the issue of home parenteral nutrition in the CR and the system of the care about the patients. The chapter about indications and contraindications to HPN is elaborated in more detail. The possibilities of the long-term vascular accesses, the care about them are also mentioned here, and particularly the role of a nurse in patient education in transferring parenteral nutrition to the domestic environment. The problems with long-term parenteral nutrition resulting from mechanic, metabolic and septic complications are also outlined. Parenteral nutrition failure is the most serious problem, which is why a chapter on small intestine transplantation as the last resort to save a patient with combined failure of intestine and nutrition is included. The second part of the theoretical section describes the life quality. I wanted to define the nature of this unambiguously graspable a term, determinants affecting life quality are also mentioned here. The possibilities of life quality measurement and assessment and particularly the follow-up use of the obtained data are mostly summarized here. Goals and hypotheses: Two goals were set to meet the main purpose of the thesis: Goal 1: To find whether the life quality of patients on HPN differs from that of the general public. Goal 2: To find the spheres in which the life quality of patients on HPN is mostly affected. A zero hypothesis was set to achieve the goals: Life quality of patients on HPN does not differ from that of the general public. There is no statistically significant difference between men and women. Eight alternative hypotheses to each life quality domain followed: H1: Patients on HPN show lower life quality score compared to the general public in the sphere of physical functions. H2: Patients on HPN show lower life quality score compared to the general public in the sphere of physical roles' limitation. H3: Patients on HPN show lower life quality score compared to the general public in the sphere of emotional roles' limitation. H4: Patients on HPN show lower life quality score compared to the general public in the sphere of emotional limitation of social functions. H5: Patients on HPN show lower life quality score compared to the general public in the sphere of pain. H6: Patients on HPN show lower life quality score compared to the general public in the sphere of general mental health. H7: Patients on HPN show lower life quality score compared to the general public in the sphere of vitality. H8: Patients on HPN show lower life quality score compared to the general public in the sphere of general health perception. A quantitative method of collected data analysis was applied to the research implementation. The research was based on the standardized questionnaire SF-36 supplemented with questions dealing with identification of respondents, time consumption of their treatment and their consequent satisfaction at the beginning. The questionnaire was distributed to patients using home parenteral nutrition in specialized nutrition centres of the Thomayer Faculty Hospital in Prague, Faculty hospitals in Brno and Hradec Králové and also by electronic means through the website of the citizen association Life without Intestine. The obtained data were statistically evaluated and processed into illustrative tables and graphs.Detailed mapping of the problems of life quality and highlighting of the neglected spheres of life quality of patients using HPN are the outputs of the thesis. The results will be presented to the members of the workgroup for HPN within their.

Made available in DSpace on 2016-06-02T20:18:07Z (GMT). No. of bitstreams: 1 TeseMTN.pdf: 1356245 bytes, checksum: 4692923c85348f190f2e10d0be464f6e (MD5) Previous issue date: 2007-02-02 / Financiadora de Estudos e Projetos / The aim this study was to investigate the quality of life among postmenopausal women with and without osteoporosis, sudden or not hip fracture, contribute to better understand about influence of the osteoporosis, hip fracture and institutionalization of the quality of life of the women with osteoporosis. Two studies were carried. The first, to investigate the health-related quality of life (HRQoL) of the post-menopausal women with or without osteoporosis through of the SF-36 and OPAQ questionnaire. Two groups were formed, with 21 volunteers each: Group 1 with women without osteoporosis (64,38 ± 4,24 years); and Group 2 with osteoporotic women (67,81 ± 4,19 years). The components Role Physical and General Health showed significant difference (p <0,05) between the groups, with better score to women without osteoporosis. No other differences were found in the SF-36 questionnaire. In the others 6 components, the values showed by two groups do not were significant difference. This form to conclude that post-menopausal women with osteoporosis and physical active can have a quality of life similar to the postmenopausal women without osteoporosis. In the second study, To investigate the health-related quality of life (HRQoL) of the post-menopausal women with osteoporosis, with or without hip fracture, were formed four groups: Group 1: 16 women without hip fracture and sedentary (67,80 ± 3,93 years); Group 2: 20 women without hip fracture and physical active (67,75 ± 4,29 years); Group 3: 20 women with hip fracture and non-institutionalized (70,65 ± 4,53 years); Group 4: 20 women with hip fracture and institutionalized (77,55 ± 6,8 years). The Results showed that the HRQoL of the post-menopausal women with hip fracture and institutionalized is, in general form, worst than non-institutionalized women with osteoporosis physical active, suggest hip fracture in post-menopausal women with osteoporosis to challenge a deteribration in the health-related quality of life, and the institutionalized of the sudden attack to able to contribute for greater decadence of the quality of life. The results of the ours study showed is possible have a good health-related quality of life after osteoporosis diagnostic, principal don t have hip fractures / Este trabalho teve como objetivo comparar a qualidade de vida de mulheres pós-menopausa com e sem osteoporose, acometidas ou não por fratura proximal de quadril, contribuindo assim para um melhor entendimento sobre a influência da osteoporose, fratura de quadril e institucionalização na percepção da qualidade de vida relacionada à saúde. Foram realizados dois estudos. O primeiro comparou a qualidade de vida relacionada à saúde por meio da aplicação do questionário genérico SF-36 (Medical Outcomes Study 36 Item Short-Form Health Survey) em voluntárias com e sem osteoporose. Foram comparados dois grupos, com 21 voluntárias cada, sendo o Grupo 1 constituído por mulheres sem osteoporose (64,38 ± 4,24 anos); e o Grupo 2 constituído por mulheres com osteoporose (67,81± 4,19 anos). Os componentes Aspectos Físicos e Estado geral da Saúde apresentaram diferenças significativas (p <0,05) entre os grupos, com score melhor para as mulheres sem osteoporose. Nos outros seis componentes, os valores apresentados pelos grupos não foram diferentes significativamente.Desta forma, conclui-se que mulheres pós-menopausa acometidas por osteoporose, mas que praticam atividade física podem ter qualidade de vida semelhante ao de mulheres pós-menopausa sem osteoporose. No segundo estudo, com o objetivo de comparar a qualidade de vida relacionada à saúde de mulheres pósmenopausa com osteoporose, acometidas ou não por fratura de quadril, 76 mulheres pós-menopausa com osteoporose responderam aos questionários SF-36 e ao OPAQ (OSTEOPOROSIS ASSESMENT QUESTIONNAIRE). As comparações foram feitas entre quatro grupos: Grupo 1, 16 mulheres sem fratura de quadril e sedentárias (67,80 ± 3,93 anos); Grupo 2, 20 mulheres sem fratura de quadril e praticantes de atividade física (67,75 ± 4,29 anos); Grupo 3, 20 mulheres com fratura de quadril e não institucionalizadas (70,65 ± 4,53 anos); Grupo 4, 20 mulheres com fratura de quadril e institucionalizadas (77,55 ± 6,8 anos). Os resultados mostram que a Qualidade de Vida relacionada à Saúde de mulheres pós-menopausa acometidas por fraturas de quadril e que residem em instituições é, de modo geral, pior do que a de portadoras de osteoporose que convivem na comunidade e que praticam atividade física, sugerindo que a fratura de quadril em mulheres pós-menopausa acometidas por osteoporose, provoca uma piora na qualidade de vida relacionada à saúde, sendo que a institucionalização dos acometidos pode colaborar para um declínio ainda maior da qualidade de vida. Os resultados de ambos estudos mostram que é possível ter uma boa percepção da Qualidade de Vida relacionada à Saúde mesmo após o diagnóstico de osteoporose, principalmente se for fisicamente ativo e não ter fraturas de quadril

This dissertation concerning the theme "A comparison of the Contact and HRQOL concept in clients of nursing/old people´s homes" consists of a theoretical and practical part. The theoretical part firstly defines in detail the concept of the quality of life and the quality of life related to health (HRQoL ? health related quality of life). It also describes various methods of its evaluation. The next charter deals with the problems of aging and changes which arise with increasing age and are associated with a deteriorating health condition, as well as with situations and circumstances which may reset in a chase in the perception of the quality of life. The dissertation takes a closer look at the stay of elderly in some institutions for the elderly. The theoretical part compares the results obtained from elderly clients in an old people?s home using standardised SF-36 and Contact questionnaires. The SF-36 questionnaire is designed to measure the quality of life related to health and the Contact questionnaire serves to ascertain the frequency of contact between family and friends ant he elderly client. Data from both questionnaires were evaluated statistically and drawn up in the form of tables and graphs. This research showed a reduced perception of the quality of life of clients living in old people?s homes compared with the standard European population. In most domains of the quality of life there was no significant difference between clients with various frequency of contact with family and friends, and no difference was found n the evaluation of the quality of life between men and women.

A multiple cerebrospinal sclerosis is one of the most frequent neurologic diseases affecting individuals in the productive age, more often women. The thesis aims to describe the life quality of patients suffering from multiple sclerosis. To detect whether due to the multiple sclerosis the qualities of life change. If this would be the case then the goal is to reveal which aspects the changes affect. Another objective was to establish whether the life quality of multiple sclerosis patients decreases depending on the period of time since the diagnosis was made, that is on the duration of the disease. The theoretical part of the thesis is dedicated to describing the disease in general, signs, symptoms, prognosis, and treatment. I also deal with defining the term of life quality and its clarification, I also discuss the social-legal problems of the disease. The practical part of the thesis implements both qualitative and quantitative methods. The qualitative method included a semi-standardized interview. The quantitative method incorporated interrogative research using a SF-36 questionnaire about the quality of life conditioned by health. The information detected from the semi-standardized interview (the qualitative part) served as the basis for defining hypotheses for the quantitative part of the thesis. The following hypotheses were defined: H1: ``The quality of life in patients diagnosed with multiple sclerosis is lower than in the general population" and H2: "The quality of life in multiple sclerosis carriers decreases in correlation to the period of time since the diagnosis was made, that is on the duration of the disease.{\crqq} Chapter ``Results{\crqq} contains the established information.

Orientador: Vera Aparecida Madruga / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação Fisica / Made available in DSpace on 2018-08-14T15:22:08Z (GMT). No. of bitstreams: 1 DiGrazia_RenataCristina_D.pdf: 1299085 bytes, checksum: 4cc0c3ffae29b36284e45a1007c24f5a (MD5) Previous issue date: 2009 / Resumo: O presente estudo teve como objetivo analisar e verificar os efeitos do programa de terapia manual (Método Mulligan associado à massagem clássica) nas queixas de dor e na qualidade de vida de mulheres adultas com disfunção da articulação temporomandibular (DTM). Participaram da pesquisa 29 mulheres, com idades entre 28 e 59 anos (média de idade de 47,41 (dp±6,71) anos), encaminhadas pelo serviço odontológico do Centro de saúde da Comunidade da Unicamp (CECOM). Todas as voluntárias apresentavam DTM e foram avaliadas antes e após programa de terapia manual utilizando-se a escala visual-numérica de dor e o questionário de qualidade de vida SF-36. O programa de terapia manual foi realizado no setor de Fisioterapia do Cecom-Unicamp durante 16 semanas, com 02 sessões/semanais de 30 minutos, em dias alternados. Utilizou-se estatística descritiva para analise dos dados da anamnese e o teste de Wilcoxon (software SPSS, V. 13.0), com nível de significância de 5% (p< 0,05) para os dados coletados na escala de dor e no SF36. Os resultados mostraram na analise das respostas obtidas com a escala visual numérica de dor, onde as voluntárias responderam de 0 a 10, qual era o número que representava sua dor naquele momento, sendo encontrados na condição pré-terapia os valores: 5 (17,2%); 6 (3,4%); 7 (20,7%); 8 (31%); 9 (10,3%) e 10 (17,2%). Após a terapia manual pode-se verificar que o nível de dor caiu, ou seja, para o valor 0 (37,9%), para o valor 1 (24,1%) e para o valor 2 (31%). Os resultados obtidos no questionário de Qualidade de Vida SF-36 mostraram diferenças estatisticamente significantes com p<0,05. Concluindo pode-se inferir que o programa envolvendo tratamento fisioterapêutico através da terapia manual mostrou-se eficiente para o grupo de mulheres com DTM, pois antes do tratamento elas apresentavam um nível de dor elevado e após o programa de terapia manual esse valor mostrou-se reduzido, com melhora do quadro álgico. / Abstract: The actual study had the objective to analyze and verify the effects of a manual therapy program (Mulligan Method associated with classical massage) in the pain complaints and in the quality of life of the adults' woman with the temporomandibular joint diseases (TMJ). Participated of the study, 29 woman, aged between 28- 59 years old (mean 47,41 (dp±6,71)), referred by the dental department in the health center of Unicamp community (CECOM). All the volunteers had TMJ disease and were assessed before and after program of manual therapy using the visual numeric scale of pain and the quality of life questionnaire SF-36. The manual therapy program had been realized in the Physical therapy of Cecom-Unicamp, during 16 weeks, with 2 sections/ week with 30 minutes, in alternate days. We used decrypted statistics to analyze the anamneses dates and the Wilcoxon test (SPSS, V.13.0), the level of significance was 5% (p< 0,05) for dates from visual numeric pain scale and SF-36. The results showed in the answers analysis obtained with the visual numeric scale of pain, where the volunteers must have to answer among 0 and 10, how are the number that represents their pain in that moment, and we had been in the beginning of the therapy the values: 5 (17,2%); 6 (3,4%); 7 (20,7%); 8 (31%); 9 (10,3%) e 10 (17,2%). After the manual therapy we verify that the values decreased so much, to value : 0 (37,9%); 1 (24,1%) ; 2 (31%) e 3 ( 6,9%) 0 (37,9%). In relation from the analyses of the results of the Quality of life questionnaire SF-36, these showed significant statistics differences with p< 0,05. Concluding, we could infer that the program evolved physiotherapy treatment through manual therapy was efficient for the arrange TMJ disease woman, before the therapy they had a high pain level and after these value decrease, with grow better of the pain. / Doutorado / Ciencia do Desporto / Doutor em Educação Física

Le déploiement des futurs réacteurs à neutrons rapides, dits de Génération IV, est porteur d'améliorations prometteuses sur le plan de l'utilisation des matières premières et de la gestion des déchets. Elles s'accompagneront d'une transformation majeure du cycle et du développement de nouveaux procédés de recyclage, plus simples et plus efficaces. Une des conséquences de cette évolution est l’augmentation de la quantité de radionucléides à vie longue (RNVL) le carbone 14, l’iode 129 et le chlore 36 dans le combustible irradié, rejets du cycle nucléaire. La maîtrise et la réduction de ces rejets passe d’abord par une meilleure connaissance de la quantité de ces radionucléides dans le combustible, formés pendant son irradiation en réacteur. Ce travail de thèse s’inscrit dans l’objectif d’améliorer la mesure des radionucléides carbone 14, iode 129 et chlore 36 dans l’oxyde irradié, non seulement sur les performances analytiques mais aussi sur la minimisation des volumes de rejets liquides et solides engendrés. Une étude bibliographique a été menée afin d’établir le bilan des méthodes existantes pour la mesure de ces RNVL dans l’oxyde irradié. Les conclusions de cette étude ont orienté ce travail selon trois axes principaux : l’utilisation de l’ozone pour oxyder et désorber le carbone 14 de l’oxyde irradié après sa mise en solution ; la proposition d’une méthode d’extraction sélective du chlore 36 contenu dans l’oxyde irradié ; le développement d’une nouvelle méthode d’analyse alliant une séparation par chromatographie ionique couplée à une détection des émetteurs R par scintillation solide pour les trois RNVL / The deployment of future fast neutron reactors, called Generation IV, carries promising improvements in the use of raw materials and waste management. They will lead to a major transformation of the cycle and the development of new recycling processes which will be simplified and more effective. One consequence of this development is the increase of the amount of long-lived radionuclides in spent fuel nuclear waste: 14 carbon, 129 iodine and 36 chlorine. The control and reduction of these radionuclides begins with a better understanding of the amount of these radionuclides in the spent fuel, generated during irradiation in a reactor. The objective of this work consist in improving the measurement of 14 carbon , 129 iodine and 36 chlorine radionuclides in the irradiated oxide, all in reducing the liquid and solid waste generated. A bibliography study was conducted to evaluate the existing methods for measuring these radionuclides in irradiated oxide. The conclusions of this study have oriented the work in three main ways: the use of ozone to oxidize and desorb 14 carbon of the irradiated oxide after solution treatment; the proposal of a selective extraction method for 36 chlorine contained in the irradiated oxide; the development of a new analytical method combining a separation by ion chromatography coupled with detection of R solid scintillation for the three radionuclides

Ce travail se situe dans le cadre des études sur la gestion des déchets graphites des centrales nucléaires Uranium Naturel Graphite Gaz (UNGG) de première génération. Leur fonctionnement a généré 23000 tonnes de déchets graphites pour lesquels la loi du 28 juin 2006 prévoit un stockage dédié. La gestion à long terme de ces déchets nécessite de prendre en compte deux radionucléides principaux : le ^14C et le ^36Cl, principaux contributeurs de dose sur le long terme. Afin de consolider les données sur l'inventaire de ces radionucléides et de prévoir leur comportement lors de la resaturation en eau du site de stockage, il est nécessaire de disposer de données liées à leur distribution et à leur spéciation dans le graphite avant stockage. Ce travail a été centré sur l'étude du chlore. Il a eu pour objectif de retracer le comportement du 36Cl dans le graphite nucléaire durant “sa vie” en réacteur et, en particulier d'étudier les effets de la température et de la corrosion radiolytique de manière découplée. Nos résultats permettent de déduire qu'il se produit un relâchement rapide du 36Cl d'environ 20% dès les premières heures de fonctionnement du réacteur. Celui-ci est suivi par un relâchement beaucoup plus lent tout au long de la vie du réacteur. Nous avons identifié la présence de deux fractions distinctes de chlore correspondant à des formes chimiques différentes (n'ayant pas la même stabilité thermique) ou à deux localisations du chlore d'accessibilités différentes. Notre etude montre également que la corrosion radiolytique semble promouvoir le relâchement du chlore et cela quelle que soit la dose d'irradiation. La forme chimique du chlore est majoritairement organique. / This work concerns the dismantling of the UNGG reactor which have produced around 23 000 t of graphite wastes that ave to be disposed of according to the Frenche law of June 206. These wastes contain two long-lived radionuclides (^ 14C and ^36Cl) which are the main long term dose contributors. In order to get information about their inventory and their long term behaviour in case of water ingress into the repository, it is necessary to determine their location and speciation in the irradiated graphite after the reactor shutdown. This work concerns the study of ^36Cl. The main objective is to reproduce its behaviour during reactor operation. For that purpose, we have studied the effects of temperature and radiolytic corrosion indepently. Our results show a rapid release of around 20% ^36Cl during the first hours of reactor operation whereas a much slower release occurs afterwards. We have put in evidence two types of chlorine corresponding to two different chemical forms (of different thermal stabilities) or to two locations (of different accessibilities). We have also shown that the radiolytic corrosion seems to enhance chlorine release, whatever the irradiation dose. Moreover, the major chemical form of chlorine is inorganic.

La caractérisation géochimique et isotopique des aquifères du Complexe Terminal (CT) du sud tunisien a été effectuée sur la base d'une approche multi isotopique. Cette étude a mis en évidence la continuité hydrogéologique des aquifères du CT en dépit de la variabilité lithologique latérale des formations aquifères et à travers les grands accidents tectoniques. La minéralisation des eaux est acquise par les processus d’interactions eau / roche, la dissolution des évaporites associés à la précipitation de la calcite. Les teneurs en δ18O et δ2H, montrent un fort contraste entre les eaux du CT. La signature isotopique traduit l’effet de l’évaporation manifesté par un enrichissement en δ18O et δ2H. Le marquage isotopique atteste aussi d’un effet de paléorecharge. En outre, les teneurs en 14C couplées aux teneurs en δ13C, ont soutenu la recharge de la nappe au cours de l’Holocène. Le déséquilibre 234U / 238U a été aussi utilisé. Les eaux du CT ont enregistré des teneurs qui varient de 1.5 à 19.5 ppb et des rapports 234U / 238U qui varient de 1.1 à 3.2. La mise en solution de l’uranium est contrôlée par la dissolution de la matrice aquifère. Cette étude a mis en évidence aussi des conditions oxydantes régnant au sein des aquifères du CT. Ces conditions sont propices au lessivage préférentiel de l’234U et dont l’effet marquant les rapports 234U / 238U qui sont >1. L’étude des teneurs en 36Cl et du rapport 36Cl / Cl montre que leur variation est liée aux processus d’évaporation et de dissolution. Les taux d’évaporation et de dissolution calculés sont > 50% traduisant l’effet marquant de ces deux processus sur la variation des teneurs en chlore des eaux du CT. / The geochemical and isotopic characterization of CT aquifers of southern Tunisia was conducted on the basis of a multi isotopic approach. This study highlighted the hydrogeological continuity of the CT aquifers despite the lateral lithological variability of aquifers and through major tectonic accidents. Groundwater mineralization is controlled by water rock interaction and the dissolution of evaporate minerals associated with the calcite precipitation. The δ18O and δ2H composition, show a strong contrast. The isotopic signature reflects the evaporation effect shown by stable isotope enrichment. Isotopic composition also demonstrates a paleorecharge effect. In addition, the 14C content coupled with the contents δ 13C, supported the groundwater recharge in the Holocene period. 234U / 238U disequilibrium was also used. Results indicate a range in 238U concentration and 234U/238U activity ratios of 1.5 to 19 ppb and 1.1 to 3.2 respectively. Our results show that groundwater geochemistry is ultimately a result of lithologic variations associated with water / rock interaction. Results elucidate also the mixing relationships between the different aquifer horizons.In this study, we used also chlorine-36 (36Cl) as a groundwater tracer. The variation in 36Cl content and 36Cl / Cl ratio is essentially related to both evaporation and dissolution processes. Evaporation and dissolution rates recorded values that exceed 50 % showing the major effect of these processes on the change of chloride contents in CT groundwater.