Du fait des récentes avancées thérapeutiques, de plus en plus de jeunes se trouvent actuellement en rémission complète de cancer. Cette période entre les traitements et la guérison est pourtant peu évoquée dans la littérature. Elle s’accompagne assez souvent de séquelles iatrogènes, de difficultés de réinsertion sociale ou de troubles psychopathologiques. (Oeffinger et Wallace, 2006). Cette étude a pour principal objectif d’appréhender l’expérience spécifique de la rémission complète par l’adolescent et ses parents. Notre hypothèse principale est qu’ils connaissent des difficultés psychosociales durant cette période.Notre recherche a été menée auprès de 38 dyades parents- adolescents en rémission complète de cancer hématologique au sein des hôpitaux de Toulouse, Montpellier et Bordeaux. Nous avons évalué les représentations de santé, l’anxiété, les stratégies d’adaptation, les relations familiales, le soutien social perçu, les relations avec le corps médical et la qualité de vie chez l’adolescent et son parent. Nous avons mené des entretiens semi-directifs auprès de l'adolescent ainsi qu'un de ses parents avec un suivi longitudinal au cours de trois temps de la rémission : lors du bilan de fin des traitements, lors de la première visite de rémission, lors de la troisième visite de surveillance. L’adolescent et les parents ont rempli trois questionnaires respectifs: l ’Ok-Ado, le QLACS, et le STAIC pour l’adolescent ; et pour le parent: le GHQ-28, le QSSP et le STAI.Le bilan de fin de traitements est un moment anxiogène pour l’adolescent et ses parents qui ont surtout des représentations négatives de la maladie et des perceptions plus positives de la rémission et du suivi médical. Les représentations de la santé et l’anxiété de l’adolescent varient peu au cours du temps aussi bien pour les adolescents que les parents. Lors de la première visite de surveillance, les adolescents sont en majorité dans le refus de parler de leur maladie, avec une désillusion de la rémission et de la surveillance médicale. Ils connaissent une diminution de leur qualité de vie avec une plus grande insatisfaction vis-à-vis du soutien parental, un repli sur soi et un recours à l’hypervigilance. Des attitudes parentales de surprotection et d’hypervigilance vis-à-vis des adolescents perdurent. Les parents souffrent d’une diminution de leur soutien familial. La troisième visite est marquée par une importante dénégation de la maladie des adolescents qui s’accompagne d’un épuisement émotionnel. Les adolescents et les parents ont des représentations négatives du suivi médical. Les parents sont plus dans le contrôle émotionnel et connaissent une diminution de leur qualité de vie. La dyade évoque plus les troubles physiques à ce stade. Le bilan de fin de traitements semble être un temps propice pour exprimer et évaluer leurs représentations de la maladie, de la rémission, de la santé qui influent sur les niveaux d’anxiété. Nous pouvons souligner un contre- coup pour l’adolescent lors de la première visite de surveillance où il semble prendre conscience des risques de santé. Ce temps est l’occasion pour les parents de s’autoriser à exprimer leur détresse émotionnelle, ce qui améliore leur qualité de vie. Un dispositif de sortie de maladie intégrant la possibilité d’un soutien psychologique pourrait permettre un dépistage et une prise en charge des difficultés post traitements des adolescents et de leur famille. / Due to recent therapeutics progress, more and more young people are now in complete cancer remission. However, this period between treatment and healing is rarely mentioned in the literature. This period often goes with iatrogenic sequelae, rehabilitation difficulties or psychopathological disorders (Oeffinger and Wallace, 206).This study has for main objective to apprehend the specific experience of complete remission for the adolescent and his parents. Our principal hypothesis is that psychological difficulties are important during this period.Our study included 38 dyads (parents-adolescents) with total remission of hematologic cancer from Toulouse, Montpellier and Bordeaux hospitals. We have assessed health representations, anxiety, coping strategies, family relationships, perceived social support, relationships with medical profession and quality of life for the adolescent and his parent. We have led semi-directed interviews with the adolescent and one of his parent on a longitudinal follow-up within three steps of remission: during end treatment check-up, during first remission visit, then for the third monitoring visit. Adolescent and his parents have filled out three questionnaires: the Ok-Ado, the QLACS, and the STAIC for the adolescent; and for the parent: the GHQ-28, the QSSP and the STAI.The consult which take place at the end of treatment is an anxious moment for the adolescent and his parents. Indeed their representations of the disease are negatives, while their representation of the medical follow-up and their remission are more positive. Representations of health and anxiety vary little over time both for adolescents and parents.During the first consult after treatment, majority of adolescents don’t want to talk about their disease. Disillusion about remission and medical follow up are important. They’re facing decrease in quality of life with a major dissatisfaction with parental support, a withdrawal and tendency to increase their vigilance. Parents suffer from a decrease of their family support.During the third visit, denial of the disease is considerable and often associated with moral exhaustion. Adolescents and parents have negative representations of medical follow-up. Parents are more into emotional control and experience a decrease of their quality of life. At this stage, the dyad shows mostly physical disorders.End treatment checkup seems to be the perfect time to evaluate their representations of the disease, of remisssion and health which contribute to anxiety. We can underline repercussions for the adolescent during first surveillance visit where he seems to take conscience about health risks. This consult is the opportunity for the parents to express their emotional distress, which improve their quality of life. A psychological follow-up ending illness organized at the end of treatment would ensure to screen and to take care of the difficulties encountered by the patient and his family.

Syftet med vår undersökning är att belysa praktikers erfarenhet av olika aspekter som är av betydelse för att klienter inom missbruksvård ska kunna vidmakthålla stabil drogfrihet, samt att belysa olika insaster som kan främja drogfrihet. Den metodologiska utgångspunkten är kvalitativ forskningsansats med semistrukturerade intervjuer. För att få svar på frågeställningen har fem verksamma personer inom missbruksvården intervjuats. Resultaten undersöks med utgångspunkt från Prochaska och DiClemente teori om förändringsprocessen plus andra sekundära teorier som identitesutveckling, socialisationsprocessen och stämplingsteorin. Studiens resultat visar att stöd från familjen eller nätverket och hitta en väl fungerade vardagsstruktur kan bidra till att främja en bestående drogfrihet.  Att bygga nya relationer och lyckas skapa en ny accepterad social roll kan vara betydelsefullt för att lyckas förbli stabilt drogfri. Studien visar också att det finns glapp mellan behov och befintligt stöd för de personer som kämpar med att förbli drogfria och att det finns behov att implementera andra nya insatser.

Objective. To examine the natural course of social anxiety disorder (SAD) in the community and to explore predictors for adverse long-term outcomes. Method. A community sample of N=3,021 subjects aged 14-24 was followed-up over 10 years using the DSM-IV/M-CIDI. Persistence of SAD is based on a composite score reflecting the proportion of years affected since onset. Diagnostic stability is the proportion of SAD subjects still affected at follow-up. Results. SAD reveals considerable persistence with more than half of the years observed since onset spent with symptoms. 56.7% of SAD cases revealed stability with at least symptomatic expressions at follow-up; 15.5% met SAD threshold criteria again. 15.1% were completely remitted (no SAD symptoms and no other mental disorders during follow-up). Several clinical features (early onset, generalized subtype, more anxiety cognitions, severe avoidance and impairment, co-occurring panic) and vulnerability characteristics (parental SAD and depression, behavioural inhibition, harm avoidance) predicted higher SAD persistence and -less impressively- diagnostic stability. Conclusion. A persistent course with a considerable degree of fluctuations in symptom severity is characteristic for SAD. Both, consistently meeting full threshold diagnostic criteria and complete remissions are rare. Vulnerability and clinical severity indicators predict poor prognosis and might be helpful markers for intervention needs.

Ausgangspunkt der vorliegenden Arbeit ist die gut belegte Assoziation zwischen mütterlicher Depression und ungünstigen emotionalen und behavioralen Folgen für ihre Kinder. Allerdings sind die Faktoren, die zu der transgenerationalen Übertragung der Depression beitragen, noch nicht geklärt. Ziel dieser Arbeit ist es, zwei möglicherweise dazu beitragende psychologische Faktoren zu untersuchen: (1) Affekterkennung von Gesichtsausdrücken in Mutter-Kind Dyaden und (2) mütterliche emotionale Verfügbarkeit. Dazu wurden drei Studien durchgeführt. Studie I untersucht mittels funktioneller Magnetresonanztomographie (fMRT) unterscheidbare und überlappende Aktivierungsmuster bei gesunden Müttern, während sie fröhliche und traurige Gesichter ihres eigenen Kindes sehen. Studie II verwendet eine Morphing-Aufgabe, um die Affekterkennung in Müttern mit remittierter Depression und ihren Kindern zu untersuchen. In Studie III wird die emotionale Verfügbarkeit von Müttern mit remittierter Depression in einer Verhaltensbeobachtung untersucht. Ergebnisse der Studie I zeigen eine größere Gehirnaktivierung der Mütter bei traurigen eigenen Kindergesichtern in der Amygdala und anterioren Cingulum, hingegen bei fröhlichen im Hippocampus und inferioren Frontalgyrus. Überlappende Aktivierung wurde in der Insula gefunden. Diese Aktivierungsmuster könnten feinfühliges mütterliches Verhalten erleichtern und das Aufrechterhalten der Mutter-Kind Beziehung unterstützen. Ergebnisse von Studie II belegen einen negativen Verarbeitungsbias bei Müttern mit einer remittierten Depression, wobei parallele Veränderungen bei ihren Kindern gefunden wurden. Dies könnte auf einen transgenerationalen Übertragungsprozess hinweisen. Ergebnisse von Studie III zeigen eine verminderte emotionale Verfügbarkeit bei Müttern in Remission, was eine Trait-Eigenschaft darstellen könnte. / Starting point of the present dissertation is the well-established association between maternal depression and adverse emotional and behavioral outcomes in children. The factors contributing to the transgenerational transmission of depression have not been fully elucidated. The aim of this thesis is to investigate two psychological factors that potentially contribute to this transgenerational association: (1) affect recognition of facial expressions in mother-child dyads and (2) maternal emotional availability. Therefore, three studies have been conducted. In study I, functional magnetic resonance imaging (fMRI) is used to measure dissociable and overlapping brain activation in healthy mothers, while they view happy, neutral and sad faces of their own child. By using a morphing task, study II tests the hypothesis that affect recognition is biased in mothers with depression in remission and their children. Study III investigates whether emotional availability is reduced in mothers remitted from depression. Study I revealed greater brain activation in the amygdala and anterior cingulate cortex while mothers viewed sad faces of their own child, whereas greater brain activation was detected in the hippocampus and inferior frontal gyrus in response to happy faces. Conjoint activation was found in the insula. These activations might facilitate sensitive maternal behavior and promote mothers to maintain the mother-child relationship. Findings of study II demonstrate a negative processing bias in mothers with depression in remission, which was paralleled in their children. This finding could possibly point to a process of transgenerational transmission. Results of study III indicate reduced emotional availability in mothers who have remitted from depression, which might represent a trait characteristic of depression.

Background: Childhood asthma has increased worldwide, although recent studies report a prevalence plateau in some western countries. Aims: To investigate the prevalence of asthma and the associated risk factor patterns from ages 7-8 to 11-12 with special emphasis on the hereditary component, and further to study prevalence trends at age 7-8 from 1996 to 2006 and the possible determinants of these trends. Methods: The studies involved two cohorts from Kiruna, Luleå and Piteå: one previously identified cohort of 3430 children age 7-8 followed by yearly questionnaires until age 11-12 with 97% yearly participation. Skin-prick tests for allergic sensitisation were performed at ages 7-8 and 11-12 in subsets of 2148 and 2155 children respectively (88% of invited). In 2006 a new cohort of 7-8-year-olds was identified and examined identically. 2585 (96% of invited) and 1700 (90% of invited) participated in the questionnaire and skin-prick tests, respectively. The questionnaire included questions about symptoms of asthma, allergic rhinitis and eczema, and possible risk factors. Results: In the 1996 cohort, from age 7-8 to 11-12 the prevalence of physician-diagnosed asthma increased (5.7%-7.7%, P<0.01) while current wheeze decreased (11.7%-9.4%, P<0.01), and 34.7% reported ever wheee at ≥one occasion. Remission was 10% of which half relapsed during the study. Remission was significantly lower among sensitised children. The strongest risk factors for current asthma at ages 7-8 and 11-12 were allergic sensitisation (OR 5) and family history of asthma (OR 3). Several other significant risk factors, e.g. respiratory infections, damp house and low birth weight, had lost importance at age 11-12. At age 7-8, parental asthma was a stronger risk factor (OR 3-4) than parental rhinitis or eczema (OR 1.5-2). Sibling asthma had no independent effect. Biparental asthma had a multiplicative effect (OR 10). Maternal and paternal asthma was equally important, regardless of the child’s sex and sensitisation status. From 1996 to 2006 the prevalence of current wheeze and asthma at age 7-8 did not increase (P=0.13, P=0.18), while lifetime prevalence of ever wheeze and physician-diagnosed asthma increased (P<0.01, P=0.01). Symptoms of rhinitis and eczema were unchanged, despite 45% increase (P<0.01) in allergic sensitisation. For current asthma the adjusted population attributable fractions of sensitisation and parental asthma increased (35%-41%, 27%-45%). This was however balanced by decreased exposure to infections, maternal smoking and home dampness, resulting in stable asthma prevalence. Stratification by sex revealed that current wheeze increased in boys (P<0.01) but tended to decrease in girls (P=0.37), seemingly due to symptom persistence in males. Several asthma indices followed this pattern. The boy-to-girl ratio in exposure to all studied risk factors increased, which may explain the sex-specific prevalence trends in wheeze. Conclusions: The prevalence of current asthma and wheeze did not increase statistically significantly. However, the risk factor pattern has changed considerably since 1996, which will presumably affect the clinical features of childhood wheeze in this region. Sex-specific trends in wheeze can be explained by changes in exposure, and trends in risk factors should be explored parallel to prevalence trends.

Introdução: apesar do crescimento exponencial do interesse na pesquisa do zumbido, dos avanços científicos e do aprimoramento das técnicas terapêuticas observados nas duas últimas décadas, ainda é praticamente um consenso o fato da cura ser um objetivo inatingível. A ausência de estudos relativos à total remissão do zumbido e a escassez de discussões sobre o assunto revelam a descrença dos profissionais, o que funciona como reforço negativo para os pacientes que sofrem e almejam a cura. Objetivo: o presente estudo propõe a busca e a entrevista de indivíduos que já alcançaram a remissão total do zumbido para identificar possíveis características comuns do paciente, do zumbido ou do tipo de tratamento realizado. Método: Foram realizadas as seguintes estratégias de busca de participantes: 1) análise de banco de dados; 2) busca pelos parentes de pacientes que mencionam a cura; 3) divulgação da pesquisa em aulas ministradas a profissionais; 4) divulgação na internet. Foram incluídos os seguintes indivíduos: a) de qualquer sexo, idade, escolaridade ou nível socio-econômico; b) que tenham apresentado zumbido diariamente por pelo menos três meses em qualquer época da vida; c) que tenham apresentado remissão total do zumbido por pelo menos 6 meses; d) em casos de reaparecimento do zumbido, este deveria durar no máximo dois dias e ser desencadeado ou associado a algum evento claro. Foram excluídos os indivíduos que não responderam aos nossos contatos após três tentativas e aqueles que se encontravam em grau de habituação ou mascaramento do zumbido, mas que ainda o percebiam Resultados: a amostra final foi de 63 participantes. A idade variou de 14 a 89 anos (Média=52,69; Dp=16,33) e com predomínio do gênero feminino (68,25%). As características mais comuns do zumbido antes da remissão total foram: a) localização bilateral (52,31%); b) percepção diária de sons do tipo tom puro (57,14%); c) média de incômodo na escala visual analógica (0 a 10) de 7,57 e Dp 2,43, sendo 61,9% dos casos com incômodo alto (8 a 10) e apenas 22,22% sem limitação das atividades diárias; d) duração média de 49,07 meses (variância de 5.91), sendo 55,56% de casos crônicos (duração superior a 12 meses) e 44,44% de casos subagudos (duração de 4 a 12 meses). O número de tratamentos realizados até a remissão foi predominantemente de 0 a 2 (58,73%). O tipo de tratamento mais comum responsável pelo sucesso foi medicação (36,51%). Dentre os 57 dos 63 participantes que haviam realizado audiometria tonal, 47,62% tinham limiares normais. O tempo médio de remissão total do zumbido em meses foi de 92,03 (Dp 99,24). Conclusões: os pacientes que alcançaram remissão total do zumbido foram prioritariamente do gênero feminino, com percepção de sons do tipo tom puro, com nota de incômodo alta, audiometria normal bilateral e com poucas tentativas de tratamento. A localização (uni ou bilateral) e o tempo de duração do zumbido (subagudo ou crônico) não influenciaram a obtenção da remissão total. Apesar do incômodo alto e da repercussão na qualidade de vida da maioria dos pacientes, parece haver um subtipo de zumbido mais propenso à remissão total e duradoura com a instituição de um tratamento / Introduction: Despite the exponential growth of interest in tinnitus research, besides scientific advances and improvements in therapeutic techniques observed in last two decades, it is still a consensus that the total remission is an unattainable goal until now. The absence of studies on tinnitus remission and the scarcity of discussions on this subject reveal the practitioners\' disbelief, what represents a negative reinforcement for patients who suffer and seek the cure Objective: the present study proposes to search and interview individuals who have experienced the total remission of tinnitus in order to identify possible common features about patients, tinnitus or treatments. Method: The following strategies to search candidates were used: 1) database analysis; 2) search for the relatives of patients who mention the cure; 3) divulgation of the research in events for health professionals; 4) announcements on the web. The following individuals were included: a) of any gender, age, education or socioeconomic level; b) those who had tinnitus for at least three month period at any time of life; c) those who have presented tinnitus total remission for over 6 months; d) in cases of tinnitus recurrence, this should last no more than two days and had been triggered by some clear event. Subjects who did no respond to at least tree attempts of contact and those found in any degree of habituation or masking of tinnitus were excluded. The final sample was composed of 63 participants. The age varied from 14 to 89 years (mean = 52.69, SD = 16.33), female gender predominated (68.25%). The most common characteristics of tinnitus before remission were: a) bilateral location (52.31%); b) daily perception of a pure tone (57.14%); c) average score at visual analogue scale (0 to 10) of 7.57 and SD 2.49; 61.9% of cases with high discomfort (8 to 10) and only 22.22% without limitation of daily activities; d) average duration of 49.07 months (variance of 5.91), 55.56% of chronic cases (lasting more than 12 months) and 44.44% of subacute cases (duration of 4 to 12 months). The number of treatment attempts needed to reach total remission was 0 to 2 (58.73%). The most common type of treatment was medication (36.51%). Of the 57 participants who had tonal audiometry, 47.62% had normal thresholds. So far, the average duration of the total remission was 92,03 months (SD 99,24). Conclusions: patients who achieved total remission of tinnitus were primarily female, perceiving a tonal type of sound, with a high level of discomfort, with symmetrically normal audiometry and limited treatment attempts. The location (bilateral or unilateral) and duration of tinnitus (subacute or chronic) did not influence total remission. Despite of the severe repercussion on patient\'s quality of life, there seems to be a tinnitus subtype more prone to total and long-term remission after the institution of a certain treatment

Introduction The fundamental concept for modern inflammatory bowel disease (IBD) treatment algorithm is an early induction of mucosal healing and its maintenance. Biological therapies are becoming mainstays of IBD therapy. It is however still unclear if there is a difference between Crohn’s disease (CD) and Ulcerative Colitis (UC) in time from diagnosis to stable maintenance treatment when biological treatment is introduced. Aim To investigate the comparative efficacy of biological agents in CD and UC by studying the time course when biological treatment is introduced. Methods Retrospective study of patients suffering from IBD at Falu Hospital, receiving a new start with biologics between 2015-01-01 and 2016-12-31. Remission rate after 3 months of induction therapy was analyzed. Subsequently, when 6 months passed without active disease, it was considered a stable remission. Results Through database extraction 58 patients were identified. A total of 52 % patients fulfilled the criteria for remission. Of patients with CD 49 % got in remission, whereof 33 % had treatment with infliximab, 48 % adalimumab and 19 % vedolizumab. Of patients with UC 60 % got in remission, whereof 33 % had treatment with infliximab and 67 % with adalimumab. Log rank test showed no significant difference in efficacy of biologics in patients suffering from CD or UC in time from diagnosis respective after initiation with biologics to stable maintenance treatment. ConclusionsIn this study patients with CD and UC responded equally to biological treatment.

Die juvenilen rheumatischen Erkrankungen sind häufiger, als von Laien angenommen wird. In der vorliegenden Studie werden Patienten der Kinderklinik und Polyklinik der Universität Würzburg genauer betrachtet um mögliche Verlaufsparameter retrospektiv auswerten zu können. Es zeigt sich, dass weibliche Patienten als häufiger von JIA-Erkrankungen betroffene länger therapiert wurden als die männlichen Patienten. Dabei erhielten sie länger NSAR und Steroide sowie häufiger MTX. Die Wahrscheinlichkeit eine Remission zu erreichen war im untersuchten Kollektiv nicht per se vom Geschlecht abhängig, jedoch geschätzt nach Kaplan und Meier zu Ungunsten der Mädchen, wie laut Literatur zu erwarten. Nicht bestätigen ließ sich ein negativer Zusammenhang zwischen erhöhten Entzündungswerten zu Beginn der Erkrankung und einer Remission im Verlauf. Weiterhin nicht bestätigen ließ sich eine generell geringere Remissionswahrscheinlichkeit bei Polyarthritis. Als prädiktive Marker für eine häufigere Remission können nach unseren Ergebnissen nun theoretisch das männliche Geschlecht (nach Kaplan und Meier) sowie erhöhte Entzündungswerte zu Beginn der Erkrankung angenommen werden. Wobei eine Remission häufiger auftrat, je schneller nach Krankheitsbeginn der Patient „an der richtigen Adresse“ vorgestellt wurde. / The frequency of juvenile idiopathic arthritis is bigger than most non-professional may expect. This trial analyzes retrospective e.g. the outcome of patients from the children's hospital of the University of Wuerzburg. In our cohort it is seen, that female patients are more often affected with rheumatism and need longer medication with NSAR and steroids, also they need more often MTX. The likelihood to reach remission did not differ between boys and girls at first sight, but rated by Kaplan and Meier the girls come out badly - like other references say, too. In our cohort there was no correlation between high inflammation values at the beginning of the disease and remission at a later time. Also it could not be seen, that children with Polyarthritis reached less often remission in general. Only regarding our data one could use male gender and higher inflammation values at the beginning of the disease as a predictive marker for a more frequent remission at a later time. Whereas the remission appeared more often in children who were presented to the "Specialist" early after the beginning of the disease.

A Constituição Federal de 1988 reconhece na criança e no adolescente sujeitos de direitos em processo de formação da personalidade, condição peculiar e especialíssima que deve ser respeitada, notadamente, quando da atribuição da responsabilidade pelo ato infracional cometido, cuja manifestação e midiatização contribui para um clamor generalizado por um maior rigor punitivo, respaldado pelo \"mito da impunidade\" do menor. Surge, então, o dilema da necessidade de comunicação de uma resposta efetiva e proporcional a este jovem que esteja afinada com a sua condição de pessoa em desenvolvimento, favorecendo a busca por alternativas extraprocessuais capazes de atribuir a responsabilidade devida a estes indivíduos e afastá-los dos efeitos negativos da Justiça convencional. Uma ferramenta já prevista pelo Estatuto da Criança e do Adolescente é o instituto da remissão, por intermédio do qual o processo de apuração do ato infracional será evitado antes do seu início, suspenso ou extinto. Para atender ao dilema de responsabilização do adolescente, porém, o instituto deve comunicar a responsabilidade de maneira efetiva, proporcional e reparadora, de forma a evitar os mesmos efeitos de segregação social e estigma produzidos pela Justiça convencional e garantir a posição social deste indivíduo enquanto sujeito de direitos. / The Brazilian Constitution of 1988 recognizes children and adolescents as subjects of law that are undergoing a process of formation of their personality, a very specific and peculiar condition which must be respected mainly in assigning responsibility for the offenses committed. Manifestations and media interest around these offenses contribute to a generalized outcry for more punitive rigidity, endorsed by the \"myth of impunity\" of minors. The dilemma which arises is one of the need for communicating an effective and proportionate response to this youngster in an adequate way regarding his or her condition as a person in process of developing a personality, promoting the search for alternative solutions capable of assigning responsibility to these individuals while keeping them from the negative effects of conventional justice. A mechanism contained in Brazilian Statute for Children and Adolescents is the institute of remission, by which the prosecution and judgment of crimes committed by minors is avoided before its start, suspended or extinct. In order to meet the dilemma of assigning responsibility, however, this has to be done in an effective, proportionate and restorative way, thus avoiding segregation and stigma as consequences of the conventional justice and ensuring the adolescent\'s social position as subject of law.

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 2009. / Source: Masters Abstracts International, Volume: 47-05, page: 2639. Adviser: Paula A. Holoviak. Includes supplementary digital materials.