Thesis (M.S.)--Boston University / This is a study of factors in the initial contact related to families' handling of a treatment plan offered by a child guidance clinic. When a clinic considers cases for treatment plans it is important to know as closely as possible that the family can and will use such help. The needs of the community for the helping services of the clinic as shown, in part, by the waiting lists are a charge to the clinic to offer treatment wisely. The nature of many of the problem situations presented for consideration is such that the decision can be a crucial one in the lives of whole families. Clinics do not offer a simple remedy, but a complex problem-solving process which involves two or more members of the family in a new kind of experience with the combined efforts of the clinic team. Each clinic has objective criteria to consider in making its selection of cases and each has a vital interest in broadening this objective base for a more scientific procedure. This study of factors relating to acceptance of treatment is pertinent to that interest. Two groups of twelve cases presenting similar problems have been compared. One group consists of cases which did not accept treatment when it was offered. The other is a group of cases which accepted and entered into treatment. The application interviews as recorded in the case records were examined by means of a schedule. The schedule was constructed to examine factual data and the attitudes of both parents toward help, toward their child and toward the problem. The information from the two groups was then contrasted in an attempt to identify any significant differences. [TRUNCATED]

La radiothérapie, qui représente un des traitements principaux des cancers, consiste à détruire les cellules tumorales par des radiations. Elle est délivrée sur plusieurs séances et nécessite une précision de plus en plus importante dans la localisation de la tumeur pour ne pas endommager les tissus sains avoisinants par des doses toujours plus élevées. Deux enjeux sont alors cruciaux : le positionnement quotidien du patient et le suivi de sa tumeur si celle-ci est mobile. Dans ce travail, nous abordons ces deux points en proposant tout d'abord un système de repositionnement précis et non irradiant. Ce système est composé de deux caméras temps de vol qui permettent une acquisition surfacique du patient à une fréquence pouvant atteindre les 50 Hz. Nous proposons ensuite une nouvelle approche de traitement prenant en compte les mouvements de la tumeur et des tissus sains tout en gardant à l'esprit que le temps de délivrance de traitement ne doit pas être trop augmenté. Nous combinons alors une irradiation par modulation d'intensité qui protège les tissus non tumoraux avec une irradiation délivrée sur une seule phase respiratoire. La nouveauté consiste ici à reproduire ce schéma sur plusieurs phases afin de stopper l'irradiation un minimum de temps par cycle respiratoire et donc d'achever la délivrance du traitement plus rapidement. Nous terminons par l'évaluation d'un modèle respiratoire créé et appliqué à nos données cliniques qui pourrait, couplé au système et au traitement proposés dans cette thèse, augmenter leurs performances en fournissant des informations anatomiques en temps réel. / Radiation therapy is one of the principal cancer treatments which uses radiations to kill cancerous cells. It is delivered over several days and requires an increasing tumor location accuracy in order irradiate well the tumor while protecting the surrounding healthy tissues. Therefore, we have to deal with two major issues: daily patient positioning and tumor motion management. As a first step, we propose an accurate non irradiant system for patient positioning. This system is composed of two times of flight cameras which acquire the patient surface at a frequency of 50 Hz. Then, we suggest a new treatment method that accounts for tumor and healthy tissue motion without increasing treatment duration. For this purpose, we combine an intensity modulated radiation therapy to the gating technique that delivers radiations on a unique respiratory phase. Our contribution consists on reproducing this scheme on several phases while increasing irradiation time efficiency. Finally, we evaluate a breathing model created and validated on our clinical datasets. This model, if coupled with our previous developments, could improve their accuracy by offering a real-time anatomical motion tracking.