Introduction - Quel est le modèle de suivi à long terme adapté aux attentes et besoins des jeunes adultes guéris d’un cancer dans l’enfance ? Méthode - Cette étude a pour objectif d’évaluer l’impact sur la santé de jeunes adultes guéris d’un cancer pédiatrique d’un modèle de suivi associant auto-questionnaire et consultation médicale. De jeunes adultes ayant eu un cancer entre 1987 et 1992 en Rhône-Alpes-Auvergne ont été vus en consultation médicale et psychologique de Suivi A Long Terme (SALTO), précédée et suivie d’un auto-questionnaire. De plus, la capacité d’adaptation de leur système nerveux autonome (SNA) a été évaluée afin de déterminer les caractéristiques des sujets dont le SNA était altéré. Résultats - 207 jeunes adultes ont rempli un questionnaire pré-consultation et 197 ont déclaré avoir de nombreuses séquelles, en moyenne 3,4 séquelles, ce qui a été confirmé par l’observation médicale faite chez les 150 consultants (2,6 séquelles observées/sujet). Après la consultation, près de 70% des sujets ont modifié leur nombre de séquelles déclarées. Aucune caractéristique particulière n’a pu être clairement mise en évidence quant aux personnes ayant une capacité de régulation du SNA altérée mais une relation significative a été établie entre SNA altéré et observation d’une séquelle cardiovasculaire (P=0,049). Une enquête de satisfaction a montré une opinion très favorable à la consultation SALTO. Environ 80% des sujets présentant un trouble psychiatrique au moment de la consultation ne bénéficiaient d’aucun suivi psychologique.Conclusion - Un suivi à long terme des jeunes adultes guéris d’un cancer dans l’enfance est nécessaire, faisable et répond à une demande réelle / Introduction - What is the model of long-term follow-up adapted to the expectations and needs of youngadults cured of a childhood cancer? Method – The aim of this study was to estimate the impact of a long-term follow-up care (LTFU) associated self-questionnaire and medical consultation, on the health of young adult survivors of childhood cancer. Young adults with childhood cancer between 1987 and 1992 in Rhône-Alpes-Auvergne were seen during a LTFU medical and psychological consultation (SALTO), which was preceded and followed by a self-questionnaire. Furthermore, the capacity of adaptation of their autonomous nervous system (ANS) was estimated to determine the characteristics of the subjects whose ANS was altered. Results - 207 young adults completed a questionnaire before consultation and 197 of them declared having sequalae, on average each self-reported 3.4 late effects, which was confirmed by a medical observation made at 150 consultations (mean 2.6 observed late effects/subject). After the consultation, about 70 % of the subjects modified their number of self-reported late effects. No particular characteristic was clearly highlighted in people with an altered capacity of ANS regulation but a significant relationship was established between altered ANS and cardiovascular complication (P=0,049). A satisfaction survey showed a very favorable opinion about the SALTO consultation. Approximately 80% of the subjects presenting a psychiatric disorder at the time of the consultation had received no psychological follow-up at this time. Conclusion - Long-term follow-up of young adult survivors of a childhood cancer is necessary, feasible and answers a real need

Previous literature on the Europeanization of candidate countries has lacked careful empirical investigations into how the process drives domestic policies to change in line with the EU acquis. Selecting on the least-likely case of Turkey and its refugee and asylum policy, I identify that previous work has assumed that Turkey’s policy shifts have been driven by rationalist cost- benefit calculations of its government. The purpose of this study has been to empirically investigate and trace the mechanisms of Europeanization in the selected case, in order to thereby contribute to knowledge on the process of Europeanization in candidate countries in general, and address to the previous research gap. Given this purpose, I have aimed to produce answers to the research question: how has the EU affected Turkey’s asylum and refugee policy after the declaration of candidacy status? I hypothesize that a rationalist model driven by the EU’s conditionality can indeed explain domestic policy changes in Turkey, but also that an alternative mechanism of socialization has been at play. Tracing the process of Europeanization through secondary sources, the results show that what started with behavioral-adaptation of domestic policy change in alignment with the EU’s laws, norms and demands between 1999 and 2010, between 2011 and 2018 the Turkish asylum and refugee policies started to step away from the push power of the external incentives. Nonetheless, significant domestic policy changes continued, suggesting evidence against the rationalist conditionality model of Europeanization in this period. However, I argue that the results are not strong enough to make the claim Turkey’s domestic policy change was driven by a mechanism of socialization, but rather suggest there has been initiation of a switch between the mechanisms.

This study sought to identify and explore the contributing factors responsible for the rate of high absenteeism, as a result of sick leave, at the South African Police Service (SAPS) Academy in Paarl. The research also explored international best practices in the management of absenteeism in police organizations. Furthermore, and most importantly, the study puts forward a set of recommendations to the management of SAPS regarding improvements that could address absenteeism and, ultimately, improve service delivery. Data was collected by means of a literature study coupled with semi-structured individual interviews. The interviews were conducted with the most diligent members of the group employees of the SAPS Academy in Paarl who had taken the least sick leave during the 2009-2012 leave cycle. A thorough literature review was conducted; this literature study focused on SAPS directives, inter alia, standing orders, regulations, national instructions and national legislation. In addition, national and international literature on absenteeism in the workplace was consulted. The findings of the study illustrate the impact of absenteeism on service delivery at the SAPS Academy, Paarl. It was established that absenteeism impacts on the morale of diligent members and, in turn, creates innumerable challenges for managers. The recommendations made in this study could contribute towards addressing and alleviating the impact of excessive absenteeism on service delivery at the SAPS Academy, Paarl. In addition, these recommendations could contribute towards addressing these matters within the broader SAPS body in and other government organizations, since absenteeism in the workplace is a general phenomenon. / Police Practice / M. Tech. (Policing)

Den Anlass der Dissertation lieferte das nach 1990 festgestellte Mobilitätsverhalten von Industriearbeitern eines Braunkohlenveredelungsbetriebes, die obwohl "Produkt" der modernen, also mobilen Gesellschaft und trotz der offensichtlich bestehenden Perspektivlosigkeit der Situation in der Wirtschaft bzw. in der Region insgesamt nur in geringem Maße zu räumlichen und beruflichen Veränderungen bereit waren. Dieses Phänomen des "Verharrens" stellte den Ausgangspunkt für die Arbeit dar. Die Frage nach den strukturellen Gründen und individuellen Motiven der Besonderheiten im Mobilitätsverhalten der Kohlearbeiter, mündete in der Frage nach dessen Ursprüngen. Das Ziel der Arbeit bestand darin, die räumliche und soziale Immobilität der Bevölkerung nach 1990 zu erklären. Die Arbeit geht von der These aus, dass die in der Region bestehende Struktur der Bevölkerung und der Erwerbstätigen das Resultat umfangreicher Wanderungsprozesse und damit einhergehender sozialer Umschichtungen sind, wobei das gesellschaftliche Ereignis "Industrialisierung" die Mobilitätsprozesse auf besondere Weise prägte. Das spezifische Verhaltens der Industriearbeiter wird in die Darstellung der Entstehung und Entwicklung des Wirtschaftsraumes eingebettet, denn es ist auf das vergangene Wirtschaftsmuster und insbesondere, auf die dort wirkenden Anreizstrukturen und Verhaltensmuster zurückzuführen. Die Arbeit befasst sich, indem sie die Frage der regionalen (Massen)Mobilität selbst, ihre Gründe und Auswirkungen problematisiert, mit einem Defizit bisheriger Untersuchungen zur Mobilität in Industriegesellschaften, denn die sozialen (Spät-)Folgen der hohen Bevölkerungsmobilität während der fordistischen Industrialisierungsphase hat die Forschung bisher kaum wahrgenommen. In diesem Kontext betrachtet, wurde die Wanderung einzelner sozialer Gruppen, obwohl sie zu dieser Zeit bestehende Probleme löste (Ausgleichsfunktion), zu einem neue Probleme schaffendem, sozialem Phänomen. / The occasion for this thesis gave the behave of mobility of coal-workers after the social changes in 1990. Although the workers have been a "product" of the modern society, which is a mobile one, and in spite of the obvious existing lack of perspectives in economy respectively in this region, only some of them were willing to local and professional changes. This phenomenon, I called it "behaviour of waiting", was the starting point of the thesis. The question for the structural reasons and individual motives for the special mobility behaviour of coal-workers lead to the question for its origins. The aim of the thesis is to explain the local and social immobility of people after 1990 ?? The thesis bases on the theory that the structure of population and employed persons in this region is the result of extensive processes of mobility and shifts in social structure connected with it. The social event "industrialization" influenced the mobility processes in a special way. The specific behaviour of industrial workers is embedded in the description of the development of the economic area, because it leads back to the former economic pattern and especially to the stimulating structures and behavioural patterns working there. Discussing the question of regional mobility, its reasons and consequences the thesis deals with a deficit of previous studies concerning mobility and industrial societies. Up to now social (late)consequences of the strong population mobility during the industrialization process weren't hardly realized in the field of research. Considering this context the mobility of individual social groups became a social phenomenon which caused new problems, although it solved problems existing at this time.

A violência sexual caracteriza-se como complexo problema de saúde pública, que pode trazer conseqüências físicas e psicológicas para a saúde da pessoa exposta e vitimada. Em situações de risco, a contaminação pelas Doenças Sexualmente Transmissíveis e a gravidez indesejada podem ser prevenidas por meio da terapêutica quimioprofilática e transtornos emocionais podem ser amenizados mediante orientação psicológica precoce. O seguimento ambulatorial em especialidades, indicado pelo período de seis meses, possibilita verificar se houve eficácia na prevenção efetuada e orientar quanto à promoção à saúde. Com o intuito de conhecer algumas características das vítimas e de seus seguimentos ambulatoriais, avaliaram-se 305 prontuários de pessoas atendidas após violência sexual, em Centro de Referência, entre julho de 2003 a junho de 2004. Encontraram-se pessoas com idades até 77 anos e a mediana situou-se em 13 anos. Houve predomínio de vítimas do sexo feminino (89,2%), e as maiores freqüências foram observadas entre solteiras (49,8%), estudantes (47,2%) e com cor de pele branca (57%). Entre os agressores identificáveis, informados em 75,1% dos atendimentos, tiveram maior representatividade o padrasto (n=35) e o pai (n=31). Indicou-se profilaxia para gravidez em 23,9% dos atendimentos, para Doenças Sexualmente Transmissíveis em 29,5% e, para prevenção do vírus HIV, em 27,9%. Entre os seguimentos ambulatoriais, indicados nas especialidades de infectologia (70,8%) e ginecologia (58,8%), verificaram-se 60,4% de retorno em algum tipo de consulta em infectologia e 40,7%, em ginecologia. Seguimentos com psicólogo foram indicados para 98% das vítimas e destas, 23% passaram em algum tipo de retorno. Frente ao exposto, este estudo aponta para a necessidade de ações e políticas que possibilitem e favoreçam os seguimentos em consulta ambulatorial para vítimas de violência sexual, expostas ao risco de conseqüências à saúde física e psicológica. / Sexual violence is considered to be a complex public health problem which can bring either physical or psychological consequences to the health of the exposed and victimized person. In risky situations, the contamination by Sexually Transmitted Diseases and the non desired pregnancy may be prevented through chemoprophylactic therapeutic and emotional disorders may be reduced with early psychological orientation. The outpatient follow up in specialty, indicated for a six month period, makes it possible to check if the prevention was really effective and to orient towards health promotion. Aiming to learn about the victim features and their outpatient follow up, 305 medical charts have been evaluated. All these people had been attended in Reference Center from July 2003 to June 2004, after suffering sexual violence. People’s age went up to 77 years old and the median was 13 years old. Most victims were female (89,2%) and the highest frequency seemed to be among single (49,8%), students (47,2%) and Caucasian (57%). Among the identifiable aggressors, who had been informed in 75,1% of the cases, the stepfather (n=35) and the father (n=31) were the most representative. Prophylaxis for pregnancy (23,9%), for Sexually Transmitted Diseases (29,5%) and for preventing HIV virus (27,9%) were indicated. Among the outpatient follow up, which had been indicated in infectology (70,8%) and gynecology (58,8%), it has been observed that the outpatients who returned for at least some of the medical appointment were 60,4% in infectology and 40,7% in gynecology. Follow up with psychologists was indicated for 98% of the victims and among these, 23% have returned. Therefore , after all these data, this study aims to show the need of actions and policies which may enable and favor outpatient follow up for sexual violence victims who are exposed to risks, both for their physical and psychological health.

O presente estudo, partindo da premissa de que o processo, assim, como o próprio direito, sofre intensa influência dos valores sociais e das determinantes históricas, políticas e culturais da sociedade em que se insere, tem por escopo analisar a influência das concepções instrumentalista e publicista, do robustecimento de seu conteúdo ético e das demais premissas metodológicas do processo civil atual, na denominada divisão de trabalho entre juiz e das partes em todo o iter procedimental, e, notadamente, na atividade probatória, de sorte a reconhecer, com fundamento no modelo constitucional do processo civil brasileiro, a existência de autênticos deveres das partes e do juiz em matéria de prova e analisar as consequências jurídicas de sua inobservância. / This study, working on the premise that procedural law, as well as law itself, suffers intense influence of social values and societys historical, political and cultural determinants in which it operates, has the scope of analyzing the influence of the instrumentalist and publicist conceptions, the toughening of its ethical content and other methodological premises of the current civil procedure in the denominated division of labor between judge and parties throughout the procedural path, and notably in the evidentiary activity, so as to recognize, based on the constitutional model of the Brazilian civil procedure, the existence of genuine obligations of the parties and the judge regarding evidentiary matter and analyze the legal consequences of their noncompliance.

A violência sexual caracteriza-se como complexo problema de saúde pública, que pode trazer conseqüências físicas e psicológicas para a saúde da pessoa exposta e vitimada. Em situações de risco, a contaminação pelas Doenças Sexualmente Transmissíveis e a gravidez indesejada podem ser prevenidas por meio da terapêutica quimioprofilática e transtornos emocionais podem ser amenizados mediante orientação psicológica precoce. O seguimento ambulatorial em especialidades, indicado pelo período de seis meses, possibilita verificar se houve eficácia na prevenção efetuada e orientar quanto à promoção à saúde. Com o intuito de conhecer algumas características das vítimas e de seus seguimentos ambulatoriais, avaliaram-se 305 prontuários de pessoas atendidas após violência sexual, em Centro de Referência, entre julho de 2003 a junho de 2004. Encontraram-se pessoas com idades até 77 anos e a mediana situou-se em 13 anos. Houve predomínio de vítimas do sexo feminino (89,2%), e as maiores freqüências foram observadas entre solteiras (49,8%), estudantes (47,2%) e com cor de pele branca (57%). Entre os agressores identificáveis, informados em 75,1% dos atendimentos, tiveram maior representatividade o padrasto (n=35) e o pai (n=31). Indicou-se profilaxia para gravidez em 23,9% dos atendimentos, para Doenças Sexualmente Transmissíveis em 29,5% e, para prevenção do vírus HIV, em 27,9%. Entre os seguimentos ambulatoriais, indicados nas especialidades de infectologia (70,8%) e ginecologia (58,8%), verificaram-se 60,4% de retorno em algum tipo de consulta em infectologia e 40,7%, em ginecologia. Seguimentos com psicólogo foram indicados para 98% das vítimas e destas, 23% passaram em algum tipo de retorno. Frente ao exposto, este estudo aponta para a necessidade de ações e políticas que possibilitem e favoreçam os seguimentos em consulta ambulatorial para vítimas de violência sexual, expostas ao risco de conseqüências à saúde física e psicológica. / Sexual violence is considered to be a complex public health problem which can bring either physical or psychological consequences to the health of the exposed and victimized person. In risky situations, the contamination by Sexually Transmitted Diseases and the non desired pregnancy may be prevented through chemoprophylactic therapeutic and emotional disorders may be reduced with early psychological orientation. The outpatient follow up in specialty, indicated for a six month period, makes it possible to check if the prevention was really effective and to orient towards health promotion. Aiming to learn about the victim features and their outpatient follow up, 305 medical charts have been evaluated. All these people had been attended in Reference Center from July 2003 to June 2004, after suffering sexual violence. People’s age went up to 77 years old and the median was 13 years old. Most victims were female (89,2%) and the highest frequency seemed to be among single (49,8%), students (47,2%) and Caucasian (57%). Among the identifiable aggressors, who had been informed in 75,1% of the cases, the stepfather (n=35) and the father (n=31) were the most representative. Prophylaxis for pregnancy (23,9%), for Sexually Transmitted Diseases (29,5%) and for preventing HIV virus (27,9%) were indicated. Among the outpatient follow up, which had been indicated in infectology (70,8%) and gynecology (58,8%), it has been observed that the outpatients who returned for at least some of the medical appointment were 60,4% in infectology and 40,7% in gynecology. Follow up with psychologists was indicated for 98% of the victims and among these, 23% have returned. Therefore , after all these data, this study aims to show the need of actions and policies which may enable and favor outpatient follow up for sexual violence victims who are exposed to risks, both for their physical and psychological health.

The purpose of this article is to review relevant literature on the effect of mild traumatic brain injury (mTBI) and blast injury on the vestibular system. Dizziness and imbalance are common sequelae associated with mTBI, and in some individuals, these symptoms may last for six months or longer. In war-related injuries, mTBI is often associated with blast exposure. The causes of dizziness or imbalance following mTBI and blast injuries have been linked to white matter abnormalities, diffuse axonal injury in the brain, and central and peripheral vestibular system damage. There is some evidence that the otolith organs may be more vulnerable to damage from blast exposure or mTBI than the horizontal semicircular canals. In addition, benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder following head injury that is treated effectively with canalith repositioning therapy. Treatment for (non-BPPV) mTBI-related vestibular dysfunction has focused on the use of vestibular rehabilitation (VR) augmented with additional rehabilitation methods and medication. New treatment approaches may be necessary for effective otolith organ pathway recovery in addition to traditional VR for horizontal semicircular canal (vestibulo-ocular reflex) recovery.

<p>Studies concerning social consequences, gastrointestinal and urinary tract symptoms were conducted in a population-based cohort comprising patients with long-standing type 1 diabetes and matched control persons. Three different questionnaires were sent by mail to diabetic patients and control persons. After a mean duration of 28.7±2.6 years, compared to the controls the diabetic patients showed an almost 10 times higher mortality, a lower employment rate and greater need for welfare benefits. These differences were mainly due to diabetic late complications. Education, housing conditions, life-style, civil state, alcohol and smoking habits were similar in the two groups. The prevalence of gastrointestinal symptoms was significantly higher in the diabetic patients than in the controls, and this was found to be attributable to the female diabetic patients. Female diabetic patients had been treated with antibiotics for urinary tract infections more often than controls, they experienced more social problems than controls in daily life because of urinary tract problems and used clamps to prevent wetting more often than did controls. </p><p>Body composition and bone mineral density were evaluated in parts of the cohort with long-standing type 1 diabetes and control persons in another population-based cohort comprising diabetic females aged 16-19 years with type 1 diabetes since childhood and matched controls. Besides a tendency to reduced abdominal fat mass in diabetic males, no difference was observed in fat mass, muscle mass or bone mineral density between the patients with long-standing type 1 diabetes and controls. Significant correlations were found between insulin dosage and whole body fat mass in diabetic females and between serum cholesterol levels and abdominal fat mass in diabetic males. The female adolescents had a higher body mass index than the controls, and their overweight was shown to consist almost entirely of an increased fat mass. The distribution of fat, expressed as abdominal-to-leg ratio, correlated significantly to HbA1c and daily dosage of insulin. Bone mineral density did not differ between the groups. IGF I was significantly lower both in patients with long-standing type 1 diabetes and in the adolescent diabetic females compared with their matched controls.</p>

Studies concerning social consequences, gastrointestinal and urinary tract symptoms were conducted in a population-based cohort comprising patients with long-standing type 1 diabetes and matched control persons. Three different questionnaires were sent by mail to diabetic patients and control persons. After a mean duration of 28.7±2.6 years, compared to the controls the diabetic patients showed an almost 10 times higher mortality, a lower employment rate and greater need for welfare benefits. These differences were mainly due to diabetic late complications. Education, housing conditions, life-style, civil state, alcohol and smoking habits were similar in the two groups. The prevalence of gastrointestinal symptoms was significantly higher in the diabetic patients than in the controls, and this was found to be attributable to the female diabetic patients. Female diabetic patients had been treated with antibiotics for urinary tract infections more often than controls, they experienced more social problems than controls in daily life because of urinary tract problems and used clamps to prevent wetting more often than did controls. Body composition and bone mineral density were evaluated in parts of the cohort with long-standing type 1 diabetes and control persons in another population-based cohort comprising diabetic females aged 16-19 years with type 1 diabetes since childhood and matched controls. Besides a tendency to reduced abdominal fat mass in diabetic males, no difference was observed in fat mass, muscle mass or bone mineral density between the patients with long-standing type 1 diabetes and controls. Significant correlations were found between insulin dosage and whole body fat mass in diabetic females and between serum cholesterol levels and abdominal fat mass in diabetic males. The female adolescents had a higher body mass index than the controls, and their overweight was shown to consist almost entirely of an increased fat mass. The distribution of fat, expressed as abdominal-to-leg ratio, correlated significantly to HbA1c and daily dosage of insulin. Bone mineral density did not differ between the groups. IGF I was significantly lower both in patients with long-standing type 1 diabetes and in the adolescent diabetic females compared with their matched controls.