Avec l’avancement en âge, les personnes âgées qui vivent à domicile ont besoin du soutien des membres de leur entourage, notamment d’un aidant familial dont le rôle n’est toutefois pas sans conséquence sur sa santé. Les écrits empiriques ont montré que certains aidants sont résilients, c’est-à-dire qu’ils s’adaptent à leur situation et continuent leur développement. Toutefois, aucune étude n’a été effectuée au Liban auprès des aidantes familiales pour expliquer la résilience dans ce contexte et, plus spécifiquement, pour déterminer les facteurs qui pourraient l’influencer. Cette étude à devis corrélationnel de prédiction avait pour but de vérifier certaines des relations postulées par un modèle empirique découlant des écrits, soit la contribution de facteurs personnels (stratégies de coping et auto-efficacité) et de facteurs contextuels (relations familiales, perception du soutien de l’entourage, et sens accordé au « prendre soin »),à la résilience des aidantes familiales libanaises qui prennent soin d’un proche âgé à domicile. L’étude a été effectuée au Liban auprès d’un échantillon de convenance composé de 140 aidantes familiales principales cohabitant à domicile avec un parent âgé de 65 ans et plus ayant une perte d’autonomie fonctionnelle ou cognitive. La collecte des données a été réalisée en arabe en utilisant un guide d’entrevue standardisé regroupant des instruments nord-américains traduits selon la méthode de traduction inversée parallèle, de même qu’une question ouverte portant sur la perception des aidantes de la résilience, soit des facteurs qui les aident à continuer à prendre soin de leur proche âgé tout en continuant à se développer. Une analyse de régression hiérarchique a permis de vérifier la contribution unique des facteurs personnels et contextuels à expliquer la résilience des aidantes familiales, en contrôlant pour l’âge et le niveau de scolarité des aidantes et pour le niveau de perte d’autonomie et la fréquence des comportements dysfonctionnels de leurs parents âgés. Une analyse de contenu a permis de décrire la perception des aidantes eu égard à la résilience. Les résultats ont montré que le modèle empirique, incluant les variables de contrôle explique 54% de la variance de la résilience et que quatre des facteurs considérés, soit les stratégies de coping centrées sur le problème, les stratégies de coping centrées sur les émotions, le sentiment d’auto-efficacité et le sens du « prendre soin » ont une contribution statistiquement significative à la résilience des aidantes. Parmi ces quatre facteurs, le sens du « prendre soin » et le sentiment d’auto-efficacité expliquent davantage de variance, soit 11% et 5% respectivement. L’analyse qualitative du discours des aidantes a montré qu’elles prennent soin de leur proche âgé surtout par souci de réciprocité, mais également parce qu’il s’agit d’un membre de la famille et par respect pour Dieu. Ce sont par ailleurs leurs croyances et la satisfaction liée au prendre soin qui les aident à continuer et à se développer. Cette étude offre une meilleure compréhension du concept de la résilience des aidantes familiales au Liban et de certains facteurs qui en sont des prédicteurs significatifs. Elle offre des pistes pour l’intervention infirmière dans le but de promouvoir la santé de la personne/famille en tant que partenaire de soins. Des recommandations pour la pratique, la formation et la recherche sont proposées. / With the aging process, elderly living at home need the support of their entourage and specifically a family caregiver whose role is not without consequences on his own health. Empirical studies have shown that some caregivers are resilient; they adapt to this situation and pursue their development. However, no study has ever been conducted in Lebanon on family caregivers to explain the resilience in this particular context, and more specifically, to determine the factors that could explain it. The objective of this correlational predictive study was to examine some of the relationships postulated in an empirical model derived from the literature, i.e. the contribution of personal factors (coping strategies and self-efficacy) and contextual factors (family relationships, perceived social support and the meaning in caregiving), to the resilience of Lebanese woman family caregivers who take care of their elderly at home. The study has been conducted in Lebanon with a cohort of 140 female family caregivers living with physically or cognitively impaired relative aged 65 years old or above. The data has been collected in Arabic using a standardized interview guide combining north American instruments translated using the inversed parallel translation method and an open question regarding the caregivers perception of resilience and of the factors that help them pursue their role of caregivers as well as their own development. A hierarchical regression analysis was performed to verify the unique contribution of personal and contextual factors in explaining the caregivers resilience while controlling their age and academic level as well as the level of dependency and frequency of dysfunctional behaviors of their relative. A content analysis was used to describe the caregiver’s perception of resilience. The results have shown that the empirical model, including control variables, explains 54% of the variance and that four of the considered factors: the coping strategies centered on the problem, the coping strategies centered on the emotions, the feeling of self-efficacy and the meaning of caregiving are significant predictors of the caregivers’ resilience. Among these four factors, the meaning in caregiving and the feeling of self-efficacy explain respectively 11% and 5% of the variance. The qualitative analysis of the caregivers’ discourse have revealed that they take care of their elder relative mainly for the sake of reciprocity, but also because it is a family member and as respect for God. Their beliefs and satisfaction toward the caring allow them to continue caring and to pursue their own development. This study provides a better understanding of the Lebanese woman family caregivers resilience concept and of the factors that are significant predictors of it. It offers guidelines to a nursing intervention aimed at promoting the health of the person/family caregivers as care partners. Recommendations for practice, training and research are proposed.

Nous analysons dans cette thèse différents aspects associés à la modélisation des écoulements à surface libre en eaux peu profondes (Shallow Water). Nous étudions tout d’abord le système d’équations de Saint-Venant à deux dimensions et leur résolution par la méthode numérique des volumes finis, en portant une attention particulière sur les aspects hyperboliques et conservatifs. Ces schémas permettent de traiter les équilibres stationnaires, les interfaces sec/mouillé et aussi de modéliser des écoulements subcritique, transcritique et supercritique. Nous présentons ensuite la théorie de la méthode d’assimilation variationnelle de données adaptée à ce type d’écoulement. Son application au travers des études de sensibilité est longuement discutée dans le cadre de l'hydraulique à surface libre. Après cette partie à caractère théorique, la partie tests commence par une qualification de l’ensemble des méthodes numériques qui sont implémentées dans le code DassFlow, développé à l’Université de Toulouse, principalement à l’IMT mais aussi à l’IMFT. Ce code résout les équations Shallow Water par une méthode de volumes finis et est validé par comparaison avec les solutions analytiques pour des cas tests classiques. Ces mêmes résultats sont comparés avec un autre code d’hydraulique à surface libre aux éléments finis en deux dimensions, Telemac 2D. Une particularité notable du code DassFlow est de permettre l’assimilation variationnelle de données grâce au code adjoint permettant le calcul du gradient de la fonction coût. Ce code adjoint a été obtenu en utilisant l'outil de différentiation automatique Tapenade (Inria). Nous testons ensuite sur un cas réel, hydrauliquement complexe, différentes qualités de Modèles Numériques de Terrain (MNT) et de bathymétrie du lit d’une rivière. Ces informations proviennent soit d’une base de données classique type IGN, soit d’informations LIDAR à très haute résolution. La comparaison des influences respectives de la bathymétrie, du maillage et du type de code utilisé, sur la dynamique d’inondation est menée très finement. Enfin nous réalisons des études cartographiques de sensibilité aux paramètres du modèle sur DassFlow. Ces cartes montrent l’influence respective des différents paramètres ou de la localisation des points de mesure virtuels. Cette localisation optimale de ces points est nécessaire pour une future assimilation de données efficiente. / We analyze in this thesis various aspects associated with the modeling of free surface flows in shallow water approximation. We first study the system of Saint-Venant equations in two dimensions and its resolution with the numerical finite volumes method, focusing in particular on aspects hyperbolic and conservative. These schemes can process stationary equilibria, wetdry interfaces and model subcritical, transcritical and supercritical flows. After, we present the variational data assimilation method theory fitted to this kind of flow. Its application through sensitivity studies is fully discussed in the context of free surface water. After this theoretical part, we test the qualification of numerical methods implemented in the code Dassflow, developed at the University of Toulouse, mainly at l'IMT, but also at IMFT. This code solves the Shallow Water equations by finite volume method and is validated by comparison with analytical solutions for standard test cases. These results are compared with another hydraulic free surface flow code using finite elements in two dimensions: Telemac2D. A significant feature of the Dassflow code is to allow variational data assimilation using the adjoint method for calculating the cost function gradient. The adjoint code was obtained using the automatic differentiation tool Tapenade (INRIA). Then, the test is carried on a real hydraulically complex case using different qualities of Digital Elevation Models (DEM) and bathymetry of the river bed. This information are provided by either a conventional database types IGN or a very high resolution LIDAR information. The comparison of the respective influences of bathymetry, mesh size, kind of code used on the dynamics of flooding is very finely explored. Finally we perform sensitivity mapping studies on parameters of the Dassflow model. These maps show the respective influence of different parameters and of the location of virtual measurement points. This optimal location of these points is necessary for an efficient data assimilation in the future.

<div>With increasing focus on large scale planning and allocation of resources for protection against future flood risk, it is necessary to analyze and improve the deficiencies in the conventional flood modeling approach through a better understanding of the interactions between river hydrodynamics and subsurface processes. Recent studies have shown that it is possible to improve the flood inundation modeling and mapping using physically-based integrated models that incorporate observable data through assimilation and simulate hydrologic fluxes using the fundamental laws of conservation of mass at multiple spatiotemporal scales. However, despite the significance of integrated modeling in hydrology, it has received relatively less attention within the context of flood hazard. The overall aim of this dissertation is to study the heterogeneity in complex physical processes that govern the watershed response during flooding and incorporate these effects in integrated models across large scales for improved flood risk estimation. Specifically, this dissertation addresses the following questions: (1) Can physical process incorporation using integrated models improve the characterization of antecedent conditions and increase the accuracy of the watershed response to flood events? (2) What factors need to be considered for characterizing scale-dependent physical processes in integrated models across large watersheds? (3) How can the computational efficiency and process representation be improved for modeling flood events at large scales? (4) Can the applicability of integrated models be improved for capturing the hydrodynamics of unprecedented flood events in complex urban systems?</div><div><br></div><div>To understand the combined effect of surface-subsurface hydrology and hydrodynamics on streamflow generation and subsequent inundation during floods, the first objective incorporates an integrated surface water-groundwater (SW-GW) modeling approach for simulating flood conditions. The results suggest that an integrated model provides a more realistic simulation of flood hydrodynamics for different antecedent soil conditions. Overall, the findings suggest that the current practice of simulating floods which assumes an impervious surface may not be providing realistic estimates of flood inundation, and that an integrated approach incorporating all the hydrologic and hydraulic processes in the river system must be adopted.</div><div><br></div><div>The second objective focuses on providing solutions to better characterize scale-dependent processes in integrated models by comparing two model structures across two spatial scales and analyzing the changes in flood responses. The results indicate that since the characteristic length scales of GW processes are larger than SW processes, the intrinsic scale (or resolution) of GW in integrated models should be coarser when compared to SW. The results also highlight the degradation of streamflow prediction using a single channel roughness when the stream length scales are increased. A distributed channel roughness variable along the stream length improves the modeled basin response. Further, the results highlight the ability of a dimensionless parameter 𝜂1, representing the ratio of the reach length in the study region to maximum length of the single stream draining at that point, for identifying which streams may require a distributed channel roughness.</div><div><br></div><div>The third objective presents a hybrid flood modeling approach that incorporates the advantages of both loosely-coupled (‘downward’) and integrated (‘upward’) modeling approaches by coupling empirically-based and physically-based approaches within a watershed. The computational efficiency and accuracy of the proposed hybrid modeling approach is tested across three watersheds in Indiana using multiple flood events and comparing the results with fully- integrated models. Overall, the hybrid modeling approach results in a performance comparable to a fully-integrated approach but at a much higher computational efficiency, while at the same time, providing objective-oriented flexibility to the modeler.</div><div><br></div><div>The fourth objective presents a physically-based but computationally-efficient approach for modeling unprecedented flood events at large scales in complex urban systems. The application of the proposed approach results in accurate simulation of large scale flood hydrodynamics which is shown using Hurricane Harvey as the test case. The results also suggest that the ability to control the mesh development using the proposed flexible model structure for incorporating important physical and hydraulic features is as important as integration of distributed hydrology and hydrodynamics.</div>

This diploma thesis "Education of Pupils at Jedlička Institute and Schools" contains information about physically disabled pupils. The aim of the diploma thesis was to discover the needs and methods of physically disabled pupils' education. The research was focused on what teaching methods, didactic tools, compensation aids and other means and access to pupils are used by teachers at primary school. The diploma thesis includes an analysis of an asset of Jedlička Institute and Schools. The research uses the following methods: structured interviews with teachers and participant observation at primary school. The theoretical part of the thesis comprises kinds of physical disability, combined disability, Jedlička Institute and Schools and information about education of physically disabled pupils and pupils with combined disability. The practical part of the thesis deals with an interaction between pupils and teachers, with cerebral palsy, teaching methods and pupils' needs. The pupils need a barrier-free environment, compensation aids, support measures, support of their motivation and self-sufficiency. The teachers often explain the school work and ask questions. The pupils have individual education, verbal evaluation, marks, tests, examinations, excursions and various school courses. The teacher...

Avec l’avancement en âge, les personnes âgées qui vivent à domicile ont besoin du soutien des membres de leur entourage, notamment d’un aidant familial dont le rôle n’est toutefois pas sans conséquence sur sa santé. Les écrits empiriques ont montré que certains aidants sont résilients, c’est-à-dire qu’ils s’adaptent à leur situation et continuent leur développement. Toutefois, aucune étude n’a été effectuée au Liban auprès des aidantes familiales pour expliquer la résilience dans ce contexte et, plus spécifiquement, pour déterminer les facteurs qui pourraient l’influencer. Cette étude à devis corrélationnel de prédiction avait pour but de vérifier certaines des relations postulées par un modèle empirique découlant des écrits, soit la contribution de facteurs personnels (stratégies de coping et auto-efficacité) et de facteurs contextuels (relations familiales, perception du soutien de l’entourage, et sens accordé au « prendre soin »),à la résilience des aidantes familiales libanaises qui prennent soin d’un proche âgé à domicile. L’étude a été effectuée au Liban auprès d’un échantillon de convenance composé de 140 aidantes familiales principales cohabitant à domicile avec un parent âgé de 65 ans et plus ayant une perte d’autonomie fonctionnelle ou cognitive. La collecte des données a été réalisée en arabe en utilisant un guide d’entrevue standardisé regroupant des instruments nord-américains traduits selon la méthode de traduction inversée parallèle, de même qu’une question ouverte portant sur la perception des aidantes de la résilience, soit des facteurs qui les aident à continuer à prendre soin de leur proche âgé tout en continuant à se développer. Une analyse de régression hiérarchique a permis de vérifier la contribution unique des facteurs personnels et contextuels à expliquer la résilience des aidantes familiales, en contrôlant pour l’âge et le niveau de scolarité des aidantes et pour le niveau de perte d’autonomie et la fréquence des comportements dysfonctionnels de leurs parents âgés. Une analyse de contenu a permis de décrire la perception des aidantes eu égard à la résilience. Les résultats ont montré que le modèle empirique, incluant les variables de contrôle explique 54% de la variance de la résilience et que quatre des facteurs considérés, soit les stratégies de coping centrées sur le problème, les stratégies de coping centrées sur les émotions, le sentiment d’auto-efficacité et le sens du « prendre soin » ont une contribution statistiquement significative à la résilience des aidantes. Parmi ces quatre facteurs, le sens du « prendre soin » et le sentiment d’auto-efficacité expliquent davantage de variance, soit 11% et 5% respectivement. L’analyse qualitative du discours des aidantes a montré qu’elles prennent soin de leur proche âgé surtout par souci de réciprocité, mais également parce qu’il s’agit d’un membre de la famille et par respect pour Dieu. Ce sont par ailleurs leurs croyances et la satisfaction liée au prendre soin qui les aident à continuer et à se développer. Cette étude offre une meilleure compréhension du concept de la résilience des aidantes familiales au Liban et de certains facteurs qui en sont des prédicteurs significatifs. Elle offre des pistes pour l’intervention infirmière dans le but de promouvoir la santé de la personne/famille en tant que partenaire de soins. Des recommandations pour la pratique, la formation et la recherche sont proposées. / With the aging process, elderly living at home need the support of their entourage and specifically a family caregiver whose role is not without consequences on his own health. Empirical studies have shown that some caregivers are resilient; they adapt to this situation and pursue their development. However, no study has ever been conducted in Lebanon on family caregivers to explain the resilience in this particular context, and more specifically, to determine the factors that could explain it. The objective of this correlational predictive study was to examine some of the relationships postulated in an empirical model derived from the literature, i.e. the contribution of personal factors (coping strategies and self-efficacy) and contextual factors (family relationships, perceived social support and the meaning in caregiving), to the resilience of Lebanese woman family caregivers who take care of their elderly at home. The study has been conducted in Lebanon with a cohort of 140 female family caregivers living with physically or cognitively impaired relative aged 65 years old or above. The data has been collected in Arabic using a standardized interview guide combining north American instruments translated using the inversed parallel translation method and an open question regarding the caregivers perception of resilience and of the factors that help them pursue their role of caregivers as well as their own development. A hierarchical regression analysis was performed to verify the unique contribution of personal and contextual factors in explaining the caregivers resilience while controlling their age and academic level as well as the level of dependency and frequency of dysfunctional behaviors of their relative. A content analysis was used to describe the caregiver’s perception of resilience. The results have shown that the empirical model, including control variables, explains 54% of the variance and that four of the considered factors: the coping strategies centered on the problem, the coping strategies centered on the emotions, the feeling of self-efficacy and the meaning of caregiving are significant predictors of the caregivers’ resilience. Among these four factors, the meaning in caregiving and the feeling of self-efficacy explain respectively 11% and 5% of the variance. The qualitative analysis of the caregivers’ discourse have revealed that they take care of their elder relative mainly for the sake of reciprocity, but also because it is a family member and as respect for God. Their beliefs and satisfaction toward the caring allow them to continue caring and to pursue their own development. This study provides a better understanding of the Lebanese woman family caregivers resilience concept and of the factors that are significant predictors of it. It offers guidelines to a nursing intervention aimed at promoting the health of the person/family caregivers as care partners. Recommendations for practice, training and research are proposed.

Text in Afrikaans with summaries in Afrikaans and English / The child in his middle childhood years are confronted with physical, emotional, psychological and intellectual demands. The support from his parents enables him to make changes by using them as male and female role models. With a physically absent father the child has to face his absence and learn to handle it. The aim of this study was to investigate the child in the middle childhood’s experience of a physically absent father. Semi-structured interviews were conducted with thirteen respondents within the middle childhood years with the aim to explore their perceptions, experiences and how they manage with a physically absent father. The data collected during the empirical study was analyzed and compared with existing literature as a control mechanism. The study was completed with conclusions and recommendations that could be of value during an intervention with children in the middle childhood years experiencing a physically absent father. / Social Work / M.Diac. (Spelterapie)

O estudo epidemiológico transversal randomizado objetivou avaliar condições de saúde bucal nos competidores dos XV Jogos Pan-Americanos (JPA) e III Jogos Parapan-Americanos (JPPA), 2007. Foram enviados convites para 5.662 atletas (JPA) e 1.300 (JPPA). Radiografias panorâmicas digitais (RPD) foram utilizadas para o exame de triagem nos 2 eventos, e nos JPPA, os atletas também foram submetidos à avaliação do sangramento gengival interdental (SI) através de uma versão modificada do Índice de Sangramento Interdental de Eastman (EIBI). Foram obtidas RPDs de 410 atletas dos JPA, média de idade 24,38 (dp5,35), 55% homens; e de 118 dos atletas dos JPPA, média de idade de 32,3 (dp9,53), 77,97% homens. 121 competidores (JPPA) foram avaliados para SI: 78,51% homens, média de idade 32,6(dp9,6), e foram separados em grupos (G), conforme sua deficiência física: GI c/ deficiência visual (DV), com 2 subgrupos: GI-a: DV tardia e GI-c-: DV congênita/precoce; GII- deficiência de membro superior; com 1 subgrupo: GII-t: deficiência/ausência bilateral; GIII- deficiência de membro inferior (grupo controle). As RPDs foram examinadas por 1 examinador com o Kodak Dental Imaging(v6.7). A frequência e a distribuição do SI foram calculadas, e os grupos foram comparados. Resultados da triagem com RPDs, representados por número de observações(média por atleta) JPA//número de observações(média por atleta JPPA: Dentes erupcionados/ hígidos: 9097(22,19)//2451(20,77); Ausentes: 803(1,96 //405(3,43); Não erupcionados ou impactados: 330(0,80)//52(0,44); Parcialmente erupcionados e/ou hígidos: 109(0,27)//20(0,17); Cárie extensa: 261(0,64)//62(0,53); Cárie extensa e lesão periapical: 96(0,23)//50(0,42); Tratamento endodôntico e lesão periapical: 24(0,06)//13(0,11); Restaurados: 2298(5,60)//670(5,68); Imagens radiolúcidas patológicas circunscritas: 23(0,06)//0; Raízes-residuais: 27(0,07)//22(0,19); Implantes:6(0,01)//5(0,04); Dentes anteriores fraturados: 13 (0,03)//3(0,03); Molares bandados: 26(0,06)//11(0,09); Dentes anômalos: 7(0,02)//12(0,10). Resultados para SI: G-I>G-III (p=0.0002);GI-c>GI-a (p=0,042). Homens exibiram > freqüência de SI (3,6%+1,7) que mulheres (0,8%+0,5), p<0,01. Conclusões: Os dados das 2 populações de atletas mostraram que há uma grande variação na saúde bucal entre os indivíduos avaliados. Diversas condições com potencial de influenciar o desempenho esportivo dos atletas foram detectadas através de radiografias panorâmicas digitais, sugerindo que um programa de saúde bucal deve ser incluído como parte da preparação destes indivíduos.A avaliação da frequência e distribuição de sangramento gengival interdental em uma população de atletas que competiu nos III Jogos Parapan-Americanos, revelou que o tipo de deficiência ou limitação física dos competidores é um fator que influencia na saúde gengival desses indivíduos. O planejamento de um programa de saúde bucal para esta população deve ser adaptado às diferentes limitações de cada atleta. / This randomized cross-sectional epidemiological study aimed to assess oral health status of athletes competing at the XV-Pan-American-Games (PAG) and III-Parapan-American-Games (PPAG), 2007). Invitations were sent to 5,662 athletes (PAG), and 1,300 (PPAG). Digital panoramic radiographs (DPRs) were used for screening recruited contestants in both events, and a modified version of Eastman Interdental Bleeding Index (EIBI), for screening interdental gingival bleeding (IB) among athletes at PPAG. DPR were taken from 410 athletes (PAG), mean age 24.38(sd5.35), 55% males; and from 118 contestants (PPAG), mean age 32.3(sd9.53), 77.97% males. At PPAG, 121 contestants were also screened for IB: 78.51% males, mean age 32.6(sd9.6) and were separated in groups according to their physical impairment: GI visually impaired (VI), with 2 subgroups: GI-a- w/ late acquired VI, and GI-c- w/ either congenital or early acquired VI; GII- w/ impaired upper limb; with 1 subgroup: GII-t- with bilateral impairment or absent limbs; GIII, with lower limb impairment (control group). DPR were examined, by a single examiner, with Kodak Dental Imaging Software(v6.7). Groups were compared for frequency and distribution of IB. Results for DPR screenings are presented as: number of observations (average per athlete)for PAG//number of observations (average per athlete) for PPAG.Totally erupted/sound teeth: 9097 (22.19)// 2451(20.77); Absent: 803(1.96)//405(3.43); Nonerupted/ Impacted: 330(0.80)//52(0.44); Partly erupted/sound: 109(0.27)//20 (0.17); Extensive carious lesion: 261(0.64)//62 (0.53); Extensive carious lesion+periapical lesion: 96(0.23)//50 (0.42); Endodontic Treatment+PeriapicalLesion: 24(0.06)//13 (0.11); Restored: 2298 (5.60)//670(5.68); Circunscribed pathological radiolucencies: 23(0.06)//0; Residual roots: 27(0.07)//22 (0.19); Dental Implants: 6(0.01)//5(0.04); Fractures: 13(0.03)//3(0.03); Molars with orthodontic band: 26 (0.06)//11(0.09); Anomalous teeth: 7(0.02)//12(0.1). Results for IB showed statistically significant differences as: GI>GIII (p=0.0002); GI-c>GI-a (p=0.042). Males showed higher frequency of IB (3.6%+1.7) than females (0.8%+0,5), p<0.01. In conclusion: Data of the 2 populations of athletes showed that there is a great variance on the oral health among the evaluated individuals. Several conditions that might have a potencial influence on the performance of the athletes were detected with the aid of digital panoramic radiographs, and this suggests that an oral health program should be included as part of the preparation of those individuals. The evaluation of the frequency and distribution of interdental gingival bleeding in a population of athletes that participated in the III Parapan-American Games, revealed that the kind of physical impairment is a factor that influences the gingival health of these individuals. The planning of an oral health program for this population should be adapted to the different limitations of each athlete.

O estudo epidemiológico transversal randomizado objetivou avaliar condições de saúde bucal nos competidores dos XV Jogos Pan-Americanos (JPA) e III Jogos Parapan-Americanos (JPPA), 2007. Foram enviados convites para 5.662 atletas (JPA) e 1.300 (JPPA). Radiografias panorâmicas digitais (RPD) foram utilizadas para o exame de triagem nos 2 eventos, e nos JPPA, os atletas também foram submetidos à avaliação do sangramento gengival interdental (SI) através de uma versão modificada do Índice de Sangramento Interdental de Eastman (EIBI). Foram obtidas RPDs de 410 atletas dos JPA, média de idade 24,38 (dp5,35), 55% homens; e de 118 dos atletas dos JPPA, média de idade de 32,3 (dp9,53), 77,97% homens. 121 competidores (JPPA) foram avaliados para SI: 78,51% homens, média de idade 32,6(dp9,6), e foram separados em grupos (G), conforme sua deficiência física: GI c/ deficiência visual (DV), com 2 subgrupos: GI-a: DV tardia e GI-c-: DV congênita/precoce; GII- deficiência de membro superior; com 1 subgrupo: GII-t: deficiência/ausência bilateral; GIII- deficiência de membro inferior (grupo controle). As RPDs foram examinadas por 1 examinador com o Kodak Dental Imaging(v6.7). A frequência e a distribuição do SI foram calculadas, e os grupos foram comparados. Resultados da triagem com RPDs, representados por número de observações(média por atleta) JPA//número de observações(média por atleta JPPA: Dentes erupcionados/ hígidos: 9097(22,19)//2451(20,77); Ausentes: 803(1,96 //405(3,43); Não erupcionados ou impactados: 330(0,80)//52(0,44); Parcialmente erupcionados e/ou hígidos: 109(0,27)//20(0,17); Cárie extensa: 261(0,64)//62(0,53); Cárie extensa e lesão periapical: 96(0,23)//50(0,42); Tratamento endodôntico e lesão periapical: 24(0,06)//13(0,11); Restaurados: 2298(5,60)//670(5,68); Imagens radiolúcidas patológicas circunscritas: 23(0,06)//0; Raízes-residuais: 27(0,07)//22(0,19); Implantes:6(0,01)//5(0,04); Dentes anteriores fraturados: 13 (0,03)//3(0,03); Molares bandados: 26(0,06)//11(0,09); Dentes anômalos: 7(0,02)//12(0,10). Resultados para SI: G-I>G-III (p=0.0002);GI-c>GI-a (p=0,042). Homens exibiram > freqüência de SI (3,6%+1,7) que mulheres (0,8%+0,5), p<0,01. Conclusões: Os dados das 2 populações de atletas mostraram que há uma grande variação na saúde bucal entre os indivíduos avaliados. Diversas condições com potencial de influenciar o desempenho esportivo dos atletas foram detectadas através de radiografias panorâmicas digitais, sugerindo que um programa de saúde bucal deve ser incluído como parte da preparação destes indivíduos.A avaliação da frequência e distribuição de sangramento gengival interdental em uma população de atletas que competiu nos III Jogos Parapan-Americanos, revelou que o tipo de deficiência ou limitação física dos competidores é um fator que influencia na saúde gengival desses indivíduos. O planejamento de um programa de saúde bucal para esta população deve ser adaptado às diferentes limitações de cada atleta. / This randomized cross-sectional epidemiological study aimed to assess oral health status of athletes competing at the XV-Pan-American-Games (PAG) and III-Parapan-American-Games (PPAG), 2007). Invitations were sent to 5,662 athletes (PAG), and 1,300 (PPAG). Digital panoramic radiographs (DPRs) were used for screening recruited contestants in both events, and a modified version of Eastman Interdental Bleeding Index (EIBI), for screening interdental gingival bleeding (IB) among athletes at PPAG. DPR were taken from 410 athletes (PAG), mean age 24.38(sd5.35), 55% males; and from 118 contestants (PPAG), mean age 32.3(sd9.53), 77.97% males. At PPAG, 121 contestants were also screened for IB: 78.51% males, mean age 32.6(sd9.6) and were separated in groups according to their physical impairment: GI visually impaired (VI), with 2 subgroups: GI-a- w/ late acquired VI, and GI-c- w/ either congenital or early acquired VI; GII- w/ impaired upper limb; with 1 subgroup: GII-t- with bilateral impairment or absent limbs; GIII, with lower limb impairment (control group). DPR were examined, by a single examiner, with Kodak Dental Imaging Software(v6.7). Groups were compared for frequency and distribution of IB. Results for DPR screenings are presented as: number of observations (average per athlete)for PAG//number of observations (average per athlete) for PPAG.Totally erupted/sound teeth: 9097 (22.19)// 2451(20.77); Absent: 803(1.96)//405(3.43); Nonerupted/ Impacted: 330(0.80)//52(0.44); Partly erupted/sound: 109(0.27)//20 (0.17); Extensive carious lesion: 261(0.64)//62 (0.53); Extensive carious lesion+periapical lesion: 96(0.23)//50 (0.42); Endodontic Treatment+PeriapicalLesion: 24(0.06)//13 (0.11); Restored: 2298 (5.60)//670(5.68); Circunscribed pathological radiolucencies: 23(0.06)//0; Residual roots: 27(0.07)//22 (0.19); Dental Implants: 6(0.01)//5(0.04); Fractures: 13(0.03)//3(0.03); Molars with orthodontic band: 26 (0.06)//11(0.09); Anomalous teeth: 7(0.02)//12(0.1). Results for IB showed statistically significant differences as: GI>GIII (p=0.0002); GI-c>GI-a (p=0.042). Males showed higher frequency of IB (3.6%+1.7) than females (0.8%+0,5), p<0.01. In conclusion: Data of the 2 populations of athletes showed that there is a great variance on the oral health among the evaluated individuals. Several conditions that might have a potencial influence on the performance of the athletes were detected with the aid of digital panoramic radiographs, and this suggests that an oral health program should be included as part of the preparation of those individuals. The evaluation of the frequency and distribution of interdental gingival bleeding in a population of athletes that participated in the III Parapan-American Games, revealed that the kind of physical impairment is a factor that influences the gingival health of these individuals. The planning of an oral health program for this population should be adapted to the different limitations of each athlete.

The diploma thesis is concerned with the spiritual needs of disabled persons. The topic is based on the psychology of personality, characterizes human needs, and defines motivation, values and interests. Basic areas of psychology of religion and religious education follow. The educational view focuses on issues associated with the religiosity of human beings seeking aims for religious education. Further chapters are dedicated to disabled persons, describe basic types of such disability and based on the author´s personal experience they show the specificities of the life of disabled persons. The second part concentrates on meeting the spiritual needs. The thematic area gives rise to the methodological proposal for the didactic opening of the spiritual needs. Several didactic units containing individual lessons for a group of disabled persons form part of the thesis.

Le développement des réseaux séparatifs entraîne le transfert fréquent de polluants urbains vers les milieux récepteurs (plans d’eau, rivières, etc.). La compréhension des processus de production et de lessivage des polluants dans le milieu urbain est pourtant incomplète à l’heure actuelle. Afin de répondre aux questions liées à la gestion des eaux urbaines, l’amélioration des connaissances des processus physiques est nécessaire, tant au niveau des surfaces urbaines que les réseaux d'assainissement. Pour cela, la modélisation du transfert hydrologique des polluants en milieu urbain peut être un outil précieux.Cette thèse a pour objectif de développer et d'analyser des modèles distribués à base physique pour simuler les flux de polluants routiers (Matières En Suspension (MES), Hydrocarbures, Métaux) dans un environnement urbain. Elle s'inscrit dans le cadre du projet ANR "Trafipollu" et bénéficie des résultats expérimentaux mis en œuvre dans ce projet pour la calibration et validation des modèles utilisés. Le travail de thèse s’articule autour de deux échelles de modélisation : l’échelle locale et l’échelle du quartier.A l'échelle locale, le code FullSWOF (volumes finis, schéma numérique d'ordre 2) couplé au modèle d’érosion d'Hairsine and Rose (1992a; 1992b) et des données géographiques très détaillées (résolution spatiale centimétrique) ont été utilisés et adaptés afin d'améliorer nos connaissances des processus physiques du lessivage des polluants sur les surfaces urbaines. La comparaison aux mesures en continu permet d’évaluer la performance d’une modélisation physique pour représenter les variations spatiales et temporelles des processus de transferts des polluants sur les surfaces urbaines. Les analyses des résultats obtenus permettent de constater la prédominance des effets d'arrachement liés à la pluie sur les processus d'entrainement par l'advection sur la majeure partie du bassin versant routier. L’utilisation d’un modèle d’érosion pour modéliser le transport particulaire en zone urbaine est une innovation importante de cette thèse.A l’échelle du quartier, la deuxième étape du travail consiste à coupler séquentiellement le modèle TREX (Velleux, England, et al., 2008) avec le modèle CANOE (Alison, 2005), nommé "TRENOE" plateforme. En changeant différentes options de mise en œuvre et de configurations du modèle, l’adaptation de la précision numérique et l’utilisation de données détaillées d’occupation du sol semblent être les facteurs clés pour une telle modélisation. Par ailleurs, ce couplage a montré des problèmes de fond tels que la modélisation du schéma numérique des flux en surface (seulement dans 4 directions), ainsi que l'utilisation de l'équation USLE pour simuler l'érosion en milieu urbain, ne comprenant pas d’impact des gouttes de pluie pour la modélisation.Pour remédier à ces défauts, la plateforme opensource LISEM-SWMM est développée en couplant le modèle LISEM (De Roo, Wesseling, et al., 1996), modèle d’érosion développé initialement pour le milieu naturel, et le modèle SWMM (Rossman, 2010). Pour la première fois, la modélisation hydrologique s’appuie aussi sur l’utilisation de sorties de modèles atmosphériques pour les dépôts des particules fines (PM10), hydrocarbures et métaux. Les résultats montrent que l’emploi de modèles totalement distribués peut arriver à reproduire de manière très fine les dynamiques des particules, des hydrocarbures et des métaux. Même si à ce stade la plateforme développée nécessite des améliorations pour adapter aux utilisations dans le champ opérationnel, ceci constitue une avancée pour le domaine de modélisation du transfert hydrologique des polluants routiers en milieu urbain / Nowadays, the increasing use of separate stormwater systems causes a frequent transport of urban pollutants into receiving water bodies (lakes, rivers). However, current studies still lack of the knowledge of urban build-up and wash-off processes. In order to address urban management issues, better understanding of physical mechanism is required not only for the urban surfaces, but also for the sewer systems. In this context, the modelling of hydrological transfer of urban pollutants can be a valuable tool.This thesis aims to develop and assess the physically-based and distributed models to simulate the transport of traffic-related pollutants (suspended solids, hydrocarbons, heavy metals) in urban stormwater runoffs. This work is part of the ANR "Trafipollu" project, and benefit from the experimental results for model calibration and validation. The modelling is performed at two scales of the urban environment: at the local scale and at the city district scale.At the local scale of urban environment, the code FullSWOF (second-order finite volume scheme) coupled with Hairsine and Rose model (1992a; 1992b) and detailed monitoring surveys is used to evaluate urban wash-off process. Simulations over different rainfall events represent promising results in reproducing the various dynamics of water flows and particle transfer on the urban surfaces. Spatial analysis of wash-off process reveals that the rainfall-driven impacts are two orders of magnitude higher than flow-drive effects. These findings contribute to a significant improvement in the field of urban wash-off modelling. The application of soil erosion model to the urban context is also an important innovation.At the city district scale, the second step consists of coupling the TREX model (Velleux, England, et al., 2008) and the CANOE model, named "TRENOE" platform. By altering different options of model configurations, the adequate numerical precision and the detailed information of landuse data are identified as the crucial elements for achieving acceptable simulations. Contrarily, the high-resolution topographic data and the common variations of the water flow parameters are not equally significant at the scale of a small urban catchment. Moreover, this coupling showed fundamental problems of the model structure such as the numerical scheme of the overland flow (only 4 directions), and the empirical USLE equations need to be completed by raindrop detachment process.To address these shortcomings, the LISEM - SWMM platform is developed by coupling the open-source LISEM model (De Roo, Wesseling, et al., 1996), which is initially developed for soil erosion simulations, and the SWMM model (Rossman, 2010). For the first time, the hydrological model is also supported by the simulations of atmospheric dry deposits of fine particles (PM10), hydrocarbons and heavy metals. The performance of water flow and TSS simulations are satisfying with the calibrated parameters. Considering the hydrocarbons and heavy metals contents of different particle size classes, simulated event mean concentration of each pollutant is comparable to local in-situ measurements. Although the platform at current stage still needs improvements in order to adapt to the operational applications, the present modelling approach contributes to an innovative technology in the field of modelling of hydrological transfer of the traffic-related pollutants in urban environment