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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Learner mobility in Johannesburg-Soweto, South Africa : dimensions and determinants.

De Kadt, Julia Ruth 07 March 2012 (has links)
Many South African school children are known to travel fairly long distances to school each day, in pursuit of the best possible educational opportunities in a schooling system that is known to vary greatly in quality. This thesis documents the dimensions and determinants of the daily, education-related travel of primary school aged children in Johannesburg-Soweto, South Africa. It uses data on a sample of 1428 children drawn from the Birth to Twenty cohort study to provide the first population-based data on the extent of learner mobility in contemporary urban South Africa. Learner mobility is measured in three different ways: firstly by the straight line distance between a child‘s home and his or her school; secondly by whether the child‘s school falls into the same geographical area as his or her home; and thirdly by whether the child attends his or her nearest, grade-appropriate school. The thesis provides clear evidence for extensive mobility using all three of these approaches to measurement. Over 25% of children were found to be travelling more than 5km each way to school and back on a daily basis. Almost 60% of children attended a school outside of the Census 2001 Sub-Place (roughly equivalent to a suburb) in which they lived, and fewer than 20% of children attended the grade-appropriate school nearest to their home. Counter to expectations, these figures were fairly stable over time, suggesting that educational mobility does not increase substantially as children age or transition to high school. Mobile children attended significantly more well-resourced and well-performing schools than their non-mobile peers, and the quality of schools attended increased with distance travelled. This substantiates the assumption that children and families make use of educational mobility to improve the quality of education that they are able to access. The analyses presented in the thesis suggest that two distinct patterns of mobility, with different determinants, are in use in the Johannesburg-Soweto area. The first relates primarily to travel from townships to historically advantaged schools in suburban Johannesburg, and typically requires substantial economic investment and extensive parental involvement. The second form of mobility operates at a more local level, and relates to children and families making choices between a number of relatively local schools. This form of mobility is less resource intensive. Children engaging in the first form of mobility were more likely to attend a particularly advantaged school, and to have a well-educated mother. By contrast, children engaged in the second form of mobility were more likely to live in a disadvantaged area, and come from households with moderate SES levels. iv The findings of this thesis provide important insights into the nature of school choice in South Africa, which have implications for educational policy, and the understanding of the nature of urban poverty as experienced by South African children. They also contribute to the international school choice literature, by providing novel information about the implications of relatively unregulated school choice for educational inequality and segregation in the South African context.
22

Mémoires d’un ministère : Une analyse secondaire de l’enquête orale du Service d’histoire de l’éducation (c.1950-c.2010) / Memories of a Ministry : A secondary analysis of the oral investigation conducted by the French Service d'Histoire de l'Education (c. 1950- c. 2010)

Girault, Bénédicte 08 December 2018 (has links)
De 1991 à 2014, le Service d’Histoire de l’Éducation a mené une enquête orale sur le ministère de l’Éducation nationale depuis la Libération. La perspective était double : cerner le processus de décision du ministère et patrimonialiser la mémoire des cadres de l’institution. De cette entreprise résultent 283 entretiens qui représentent plus de 1100 heures d’enregistrement. À partir de ce corpus, cette thèse explore l’hypothèse que les biais régulièrement décriés des archives orales peuvent devenir une féconde ressource pour les historiens. L’objet central de ce travail est donc la source elle-même, dont la déconstruction doit permettre de comprendre une forme de production mémorielle qui se présente comme au service de l’histoire et des historiens. Faire l’histoire de cette enquête revient d’abord à retracer celle d’un moment historiographique dans les années 1990, à partir de l’analyse critique du projet et des pratiques des enquêteurs. Le dispositif de l’enquête assigne les acteurs à une certaine fonction au sein de l’institution, à partir de laquelle est co-construite une histoire de l’Éducation nationale « d’en haut ». La question est alors de saisir comment, ministère après ministère, s’articulent expériences subjectives et histoire(s) collective(s), entre le temps de l'événement et le moment du témoignage, dans une dialectique continue avec l'histoire de l'éducation en train de s'écrire. Enfin, à l’instar des autres ministères, la période couverte par l’enquête est celle de la conquête de l’État par les administrateurs de profession issus de l’ENA. À l’Éducation nationale, les universitaires et les acteurs venus du terrain sont contraints de céder le pas. En identifiant ces mémoires concurrentielles et leurs dynamiques à partir des discours, des régimes de justification et des ordres de grandeur qui les singularisent, cette thèse entend finalement participer à l’analyse des écologies des professions dans le cadre d’un ministère. / From 1991 to 2014, the French Service d’Histoire de l’Education conducted a large oral investigation into the activities of the Ministère de l’Education Nationale since the end of WWII. Its purpose was twofold: identifying the decision-making processes of the ministry’s officials, and creating an archive from the testimonies of the institution’s executives. From this endeavour came 283 interviews that make up more than 1100 hours of recordings. This doctoral thesis draws on this corpus to explore the hypothesis that the biases commonly attributed to oral archives can turn out to be fertile ground for historians. The recordings themselves therefore form the main object of this work: by deconstructing them, it should be possible to understand how this type of memory-based production may contribute to the writing of history, and be of use to historians. Tracing back the history of this survey first involves delving into the historiographical agenda of the 1990s through the critical analysis of the project and of the interviewers’ practices. The survey was thought out in such a way that its participants were assigned to a specific function in the institution, forming the basis for a top-down, yet collective writing of the Education Nationale’s history. The question is then to grasp how, one ministry after another, personal experiences and shared memory/ies come together between the time of the events and the time when people testified, contributing to a wider dialectic of the history of education as it was being written. Finally, like in the other ministries, the period the survey spans coincides with the domination of the State by professional administrators out of the National School of Administration (ENA), forcing the academics and the professionals within the Education Nationale to step down. By pinpointing these competing recollections and their dynamics through the study of the discourse, the means of justification, and the orders of worth that set them apart, this thesis aims to contribute to the analysis of the ecology of the professions within a ministry.
23

Vårdandets symfoni : Fenomenet vårdrelation i skenet av två världsbilder / The symphony of care : The phenomenon of care relationships as reflected in two perspectives

Chow, Judy January 2013 (has links)
This thesis 'The Symphony of Care' consists of four studies focusing on care relationships between patients and professional caregivers. Care relationships are central to the health process and a fundamental element in caregiving. The term care relationship is widely used in caring science but lacks a clear definition, which can create misunderstanding and can constitute an obstacle when attempting to optimize care relationships. The aim of this thesis is to describe the phenomenon of care relationships in order to add to the body of knowledge in caring science.The main research questions are: • What is a care relationship within the caring science field? • How can a care relationship be optimized to improve its caring function, in order to promote health? The ontological foundation of this thesis is caring science. Phenomenology and Lifeworld theory are used as its epistemological bases. Reflective Lifeworld Research is used as a methodological approach. The four studies were conducted in different contexts and cultures- the first two empirical studies were performed in China and the remaining two, a metasynthesis and a secondary analysis, were carried out in a Swedish context. The results show that care relationships are temporary intentional relationships between a person who needs help and a helper. The purpose of this relationship is to support the patient in his/her dynamic health process, which is unique for each person in different times and contexts. Care relationships are fragile because the patient is vulnerable and the demand on the helper is great. It is an inter-human relationship between equals, which can at the same time be an asymmetric relationship due to the professionalism with the caregiver and the vulnerability with the patient. A care relationship is not independent, but is affected by internal factors such as the two individuals' lifeworlds and external factors such as health policies, organization, economics, health culture and environment. To optimize the effectiveness of caring, the relationship and its surrounding need to be in harmony. The view of care relationships should be broadened to include the external resources in order to optimize their caring potential.
24

Classroomlevel factors affecting mathematics achievement : a comparative study between South Africa and Australia using TIMSS 2003

Kunene, Looksmart Lucky Zamokuhle 24 June 2013 (has links)
The purpose of the study was to explore and compare key classroom level factors affecting mathematics learner achievement for South Africa and Australia. The study focused in the classroom where teaching and learning takes place. This is a secondary analysis of classroom level factors influencing Grade 8 mathematics learner achievement using the Trends in International Mathematics and Science Study (TIMSS) 2003. TIMSS 2003 was chosen because it was the latest international study available to measure trends in mathematics learner achievement, where South Africa had participated. Quantitative research approach was employed and a survey research method was used which seeks, among others, to explore relationships and patterns. Survey research method was suitable to provide data that responded to the research questions. The data collection in South Africa and Australia was conducted in October-December 2002 as both countries are located in the Southern Hemisphere. The sample for South Africa consisted of 255 schools with 100% coverage and stratification done by a total of nine provinces, and language. This resulted in 8952 learners tested across the provinces (Joncas, 2004, p. 212). For Australia, the sample consisted of 207 schools with 100% coverage and stratification done by a total of 8 States and Territories and school type. This resulted in 4791 learners participating in the study. The sample included teachers of learners who were selected to participate in the TIMSS 2003 study for South Africa and Australia. The intended target was teachers of all learners at the end of their eight year of schooling. For each participating school, a single mathematics class was sampled and the mathematics teacher of the selected class was asked to complete a mathematics questionnaire. Mathematics teachers of sampled learners responded to questions about teaching emphasis on the topics in the curriculum frameworks, instructional practices, professional training and education and their views on mathematics. The mathematics teacher questionnaire was designed to take about 45 minutes to complete The main question for this study was “What are the key classroom factors that influence learner performance in mathematics?” The three sub questions for the study were: What key variables on classroom level are related to learner achievement in mathematics for South Africa? What key variables on classroom level are related to learner achievement in mathematics for Australia? How do the classroom level factors in mathematics performance of South Africa compare with classroom level factors in Australia? The conceptual framework for the study stressed classroom level factors including instructional quality, which includes teacher background factors, classroom climate, teaching requirements and mathematics curriculum. The framework describes the factors related to classroom interactions within the comprehensive education system, with regard to inputs – process – outputs – outcomes. The selection of variables for the inclusion in the models was guided by the conceptual framework and extensive preliminary analyses. Preliminary statistical analyses included exploring descriptive statistics, Varimax factor analysis, reliability, correlation analysis and stepwise multiple regression analysis. The results of the study indicate that several specific classroom level factors were associated with the higher levels of mathematics achievement of South Africa and Australia. The results for the final South African model were: age of teacher; years been teaching; outside school day grading tests; outside school day other; and computer shortage were identified to predict learner achievement. For Australia ten classroom factors, namely, teacher perception of school climate; teacher perception of school safety; teacher emphasis on mathematics homework; teacher repeat mathematics limiting factors; homework contribute towards learning; work conditions; unhappy learners; shortage of instructional equipment; geometric shapes; and algebraic functions were identified to predict learner achievement. South Africa has factors like teacher background and outside school activities by the teacher. Australia has factors like classroom climate, work conditions and curriculum quality. In the light of schools effectiveness research and school improvement research, a comparative study like this one would require more than one level (classroom level), two or three levels would have been ideal to draw other variables and enrich the analysis, especially the learner level and school level. School effectiveness places an emphasis on the ability and social background of the learners as factors that shape academic performance / Dissertation (MEd)--University of Pretoria, 2011. / Science, Mathematics and Technology Education / unrestricted
25

Reading between the lines : contributing factors that affect Grade 5 learner reading performance

Van Staden, Surette 24 May 2011 (has links)
This study aims to identify and explain relationships between some major factors associated with successful reading at Grade 5 level in South African primary schools. In South Africa, grave concerns with regards to low levels of student achievement pervade research initiatives and educational debates. Despite considerable investments in educational inputs (such as policy and resources) and processes (such as curriculum provision and teacher support), outcomes (such as student achievement) remain disappointingly low. The South African population is characterized by great diversity and variation. With 11 official languages, current educational policy in South Africa advocates an additive bilingualism model and students in Grade 1 to 3 are taught in their mother tongue. Thereafter, when these students progress to Grade 4, the language of learning and teaching changes to a second language, which in most cases is English. At this key developmental stage students are also expected to advance from learning to read to a stage where they can use reading in order to learn. With this complexity of issues in mind, Hierarchical Linear Modeling (HLM) was used to determine the effect of a number of explanatory variables at learner and school level on reading achievement as outcome variable, while controlling for language using the South African Progress in International Reading Literacy Study (PIRLS) 2006 data. As an international comparative evaluation of reading literacy involving more than 40 countries, PIRLS 2006 was the second, after PIRLS 2001, in a series of planned five-year cycles of assessment to measure trends in children’s reading literacy achievement, policy and practices related to literacy. Grade 5 learners in South African primary schools who participated in PIRLS 2006 were not able to achieve satisfactory levels of reading competence. The gravity of this finding is exacerbated by the fact that these learners were tested in the language in which they had been receiving instruction during the Foundation Phase of schooling. This study found most significant factors associated with reading literacy at learner-level, but this does not mean that the existence of teacher- and school-level factors is not of importance. While some explanatory factors at learner-level can more easily become the target of reading interventions, the higher level effect of the classroom and school are not diminished by this study. Creemers’ Comprehensive Model of Educational Effectiveness was utilized as theoretical point of departure. Creemers’ model was adapted for the purposes of this study to reflect a South African model of reading effectiveness in contrast with Creemers’ original use of it as a model of school effectiveness. Evidence was provided that the conceptual framework was inadequate in identifying factors affecting reading achievement for all South African language groupings. More specifically, the adapted South African reading effectiveness model was only appropriate in explaining reading achievement scores for the Afrikaans and English language groupings than for those from African language groupings. / Thesis (PhD)--University of Pretoria, 2010. / Science, Mathematics and Technology Education / unrestricted
26

Srovnání vybraných ukazatelů herního výkonu u družstev nejvyšší basketbalové soutěže mužů v ČR v období sezón 2000/01 - 2019/20 / Comparison of the selected indicators of team game performance in the highest men's basketball competition in the Czech Republic in the period 2000/01 to 2019/2020

Nedostup, Alexandr January 2021 (has links)
о уbraných ukazatelů herníhо оnu u družstev nejvуšší о оutěže mužů v ČR v о о - Cílem naší diplо о je pоrоvnat, na základě získaných dat оficiálních о у у о оnu u družstev umístěných na druhých, šestých a desátých místech nejvуšší basketbalоvé sоutěži mužů v ČR о о о základní části (о оčníku 2000/01 dо оčníku 2019/2020). о - materiálу bуlу získané z internetоvých stránek Č у rоzdílу ve о о každém ukazateli u stejně umístěných týmů za о о rо у у о о výkоnů každém ukazateli mezi týmу, které se umístilу na druhých, šestých a desátých místech sоuhrn průměrných hо о každém ukazateli za о о šestých a desátých, které následně pо о Klíčо о о о о о о у у
27

Ekonomická krize: mediální obraz a veřejné mínění / Economic Crisis: Media Representation and Public Opinion

Picková, Martina January 2013 (has links)
This thesis deals with the current global recession, its presentation in the media, and the public opinion on the economic situation in the Czech Republic. It is based on the theory of agenda-setting. Content analysis is used to examinate the intensity of attention of two different journals paid to the subject of the recession in the observed period September 2007 - December 2011, with a special focus on December 2008. The objects of the current study are two Czech nation-wide journals: the economic newspaper Hospodářské noviny and the tabloid newspaper Blesk. The study shows that the economic journal presents the recession more intensively, from a more general point of view, and questions the causes of the recession. The tabloid concentrates on the Czech Republic, writes about the recession primarily in the context of non-economical news (especially sport), and does not use the mechanisms typical for tabloids as much as expected. A secondary analysis of the outcomes of public opinion surveys examines the readerships of these journals separately. The economic expectations of the readers of the economic journal correspond with the intensity of attention paid by this journal to the recession, but only in the first half of the analysed period. The expectations of the tabloid readers correspond with...
28

Hédonismus v české společnosti: sonda do vývoje hodnotových orientací v letech 1990 - 2011 / Hedonism in the Czech Society: A Probe into the Development of Value Orientation in 1990 - 2011

Dudíková, Eva January 2013 (has links)
The thesis is focused on values of the Czech society in 1990 - 2011, especially on hedonism value. It uses the method of a secondary analysis of quantitative data. We deal with the presumption that the social transformation which started in 1989, influenced value area as well. Our aim is to answer following questions: 1) Has an emphasis of hedonism in the Czech society changed during the social transformation? If yes, in what way? Can we observe continual rising of this value? 2) What is the influence of socio-demographic variables on hedonism? Is diferentiating influence of these variables on hedonism changing in time? An empirical part of this thesis is anticipated by the theoretical one, which is focused on research of values by social sciences and sociology, deals with questions about value stability and dynamism, presents a model of value dynamism by D. Slejška and draws up some consideration about influence of life circumstances - especially those which are related to the transformation of totalitarian society to freedom society - on the field of values. Keywords values - dynamism of values - hedonism - social transformation - public opinion surveys - secondary analysis of data
29

Prévalence et incidence de la douleur lombaire récurrente au Québec : une perspective administrative / Prevalence and incidence of claims-based recurrent low back pain in Quebec : an administrative perspective

Beaudet, Nicolas January 2014 (has links)
Résumé : La douleur lombaire (DL) est l’une des conditions musculosquelettiques les plus fréquentes et coûteuses au Canada. La prévalence annuelle de DL aigüe varierait de 19 % à 57 %, et un patient sur quatre souffrirait de récurrence dans la même année. La présente étude vise donc à produire une analyse descriptive de l’épidémiologie de la DL récurrente à l’échelle de la population. Une nouvelle approche méthodologique est proposée afin d’optimiser l’identification de vrais cas incidents de DL récurrente à partir d’une analyse secondaire de données administratives. Puisque 10 % des patients ayant de la DL seraient responsables de 80 % des coûts qui y sont associés, nous avons également déterminé la tendance séculaire des coûts d’interventions médicales des patients récurrents incidents entre 2003 et 2008. En utilisant le fichier des services médicaux rémunérés à l’acte de la Régie de l’assurance maladie du Québec, des cohortes prévalentes ont été construites à partir de 401 264 dossiers de patients ayant consulté au moins trois fois pour de la DL entre 1999 et 2008. Onze ans d’historique médical des 81 329 patients de la cohorte de 2007 ont ensuite été analysés afin d’exclure les patients ayant eu des consultations antérieures de DL. Une valeur prédictive positive et un coefficient de Kappa élevés ont permis d’identifier une clairance optimale pour récupérer les cas véritablement incidents. Les coûts de consultations ont ensuite été calculés pour tous les patients incidents de 2003 à 2007 à partir des manuels de facturation. Nous avons observé une prévalence annuelle de la DL récurrente de 1,64 % en 2000 chez les hommes diminuant à 1,33 % en 2007. Cette baisse a majoritairement eu lieu dans le groupe d’âge des 35-59 ans. Les femmes âgées (> 65 ans) étaient 1,4 fois plus à risque de consulter un médecin de manière récurrente que les hommes du même âge. L’incidence annuelle de la DL en 2007 était de 242 par 100 000 personnes. Les hommes de 18 à 34 ans étaient 1,2 fois plus à risque que les femmes de développer un premier épisode récurrent et les personnes âgées 1,9 fois plus à risque que les jeunes. L’incidence annuelle a diminué de 12 % entre 2003 et 2007 pendant que les coûts totaux augmentaient de 1,4 %. La médiane des coûts était la plus élevée chez les femmes âgées et tendait à augmenter dans le temps. Ces analyses secondaires suggèrent de s’intéresser particulièrement à la DL chez les personnes très âgées, et de déterminer si la baisse de fréquence de consultations récurrentes observée dans le temps est liée à une meilleure gestion de la DL ou à un problème d’accessibilité. Les coûts devraient faire l’objet d’un suivi continu pour limiter les hausses. // Abstract : Low back pain (LBP) is one of the most frequent and costly musculoskeletal health conditions in Canada. Annual prevalence was found to vary between 19 % and 57 % and likely one out of four patients experience a LBP recurrence within one year. The body of knowledge on the prevalence of recurrent LBP is still limited. This study sought to present a descriptive analysis on the epidemiology of recurrent LBP in a medical population. A new methodology is also proposed to identify true cases of incident recurrent LBP. Since 10 % of LBP patients have been reported to generate 80 % of the costs, we will sought to determine the secular trend of medical costs for the incident cohorts of 2003 to 2008. Using the Canadian province of Quebec medical administrative physicians’ claims database, 401 264 prevalent claims-based recurrent LBP patients were identified between 1999 to 2008 for having consulted at least three times for LBP in a period of 365 days. The medical history of 81 329 prevalent patients in 2007 was screened for a retrospective period of 11 years. High positive predictive values and Kappa statistics were used to determine the optimal clearance period for capturing true incidence cases among patients with no prior encounters for LBP. Physicians’ claims manuals were then used to apply a price for every intervention provided to LBP incident patients in their index year and follow-up years. We observed a decrease from 1.64 % to 1.33 % in the LBP annual prevalence between 2000 and 2007 for men. This decrease was mostly observed between 35 and 59 years of age. Older women (≥ 65 years) were 1.4 times more at risk to consult a physician for LBP in a recurrent manner than older men. The annual incidence in 2007 of adult claims-based recurrent LBP was 242 per 100 000 persons. Males of 18 to 34 years of age were found 1.2 times more at risk than their counterparts. Altogether, elderlies were 1.9 times more at risk than young adults to consult in a recurrent manner for LBP. The annual incidence decreased by 12 % between 2003 and 2007, while the direct costs increase by 1.4 %. The median cost for consultations was highest for elder women and increasing in time. These secondary analyses emphasize the importance to keep the watch on the elders in regards to LBP, and to determine if the timely decrease in morbidity is related to improvements in LBP management or to a medical accessibility issue. Also, costs will need to be surveyed on a regular basis to limit the impact of future increases.
30

Pr??valence et incidence de la douleur lombaire r??currente au Qu??bec : une perspective administrative

Beaudet, Nicolas January 2014 (has links)
R??sum?? : La douleur lombaire (DL) est l???une des conditions musculosquelettiques les plus fr??quentes et co??teuses au Canada. La pr??valence annuelle de DL aig??e varierait de 19 % ?? 57 %, et un patient sur quatre souffrirait de r??currence dans la m??me ann??e. La pr??sente ??tude vise donc ?? produire une analyse descriptive de l?????pid??miologie de la DL r??currente ?? l?????chelle de la population. Une nouvelle approche m??thodologique est propos??e afin d???optimiser l???identification de vrais cas incidents de DL r??currente ?? partir d???une analyse secondaire de donn??es administratives. Puisque 10 % des patients ayant de la DL seraient responsables de 80 % des co??ts qui y sont associ??s, nous avons ??galement d??termin?? la tendance s??culaire des co??ts d???interventions m??dicales des patients r??currents incidents entre 2003 et 2008. En utilisant le fichier des services m??dicaux r??mun??r??s ?? l???acte de la R??gie de l???assurance maladie du Qu??bec, des cohortes pr??valentes ont ??t?? construites ?? partir de 401 264 dossiers de patients ayant consult?? au moins trois fois pour de la DL entre 1999 et 2008. Onze ans d???historique m??dical des 81 329 patients de la cohorte de 2007 ont ensuite ??t?? analys??s afin d???exclure les patients ayant eu des consultations ant??rieures de DL. Une valeur pr??dictive positive et un coefficient de Kappa ??lev??s ont permis d???identifier une clairance optimale pour r??cup??rer les cas v??ritablement incidents. Les co??ts de consultations ont ensuite ??t?? calcul??s pour tous les patients incidents de 2003 ?? 2007 ?? partir des manuels de facturation. Nous avons observ?? une pr??valence annuelle de la DL r??currente de 1,64 % en 2000 chez les hommes diminuant ?? 1,33 % en 2007. Cette baisse a majoritairement eu lieu dans le groupe d?????ge des 35-59 ans. Les femmes ??g??es (> 65 ans) ??taient 1,4 fois plus ?? risque de consulter un m??decin de mani??re r??currente que les hommes du m??me ??ge. L???incidence annuelle de la DL en 2007 ??tait de 242 par 100 000 personnes. Les hommes de 18 ?? 34 ans ??taient 1,2 fois plus ?? risque que les femmes de d??velopper un premier ??pisode r??current et les personnes ??g??es 1,9 fois plus ?? risque que les jeunes. L???incidence annuelle a diminu?? de 12 % entre 2003 et 2007 pendant que les co??ts totaux augmentaient de 1,4 %. La m??diane des co??ts ??tait la plus ??lev??e chez les femmes ??g??es et tendait ?? augmenter dans le temps. Ces analyses secondaires sugg??rent de s???int??resser particuli??rement ?? la DL chez les personnes tr??s ??g??es, et de d??terminer si la baisse de fr??quence de consultations r??currentes observ??e dans le temps est li??e ?? une meilleure gestion de la DL ou ?? un probl??me d???accessibilit??. Les co??ts devraient faire l???objet d???un suivi continu pour limiter les hausses. // Abstract : Low back pain (LBP) is one of the most frequent and costly musculoskeletal health conditions in Canada. Annual prevalence was found to vary between 19 % and 57 % and likely one out of four patients experience a LBP recurrence within one year. The body of knowledge on the prevalence of recurrent LBP is still limited. This study sought to present a descriptive analysis on the epidemiology of recurrent LBP in a medical population. A new methodology is also proposed to identify true cases of incident recurrent LBP. Since 10 % of LBP patients have been reported to generate 80 % of the costs, we will sought to determine the secular trend of medical costs for the incident cohorts of 2003 to 2008. Using the Canadian province of Quebec medical administrative physicians??? claims database, 401 264 prevalent claims-based recurrent LBP patients were identified between 1999 to 2008 for having consulted at least three times for LBP in a period of 365 days. The medical history of 81 329 prevalent patients in 2007 was screened for a retrospective period of 11 years. High positive predictive values and Kappa statistics were used to determine the optimal clearance period for capturing true incidence cases among patients with no prior encounters for LBP. Physicians??? claims manuals were then used to apply a price for every intervention provided to LBP incident patients in their index year and follow-up years. We observed a decrease from 1.64 % to 1.33 % in the LBP annual prevalence between 2000 and 2007 for men. This decrease was mostly observed between 35 and 59 years of age. Older women (??? 65 years) were 1.4 times more at risk to consult a physician for LBP in a recurrent manner than older men. The annual incidence in 2007 of adult claims-based recurrent LBP was 242 per 100 000 persons. Males of 18 to 34 years of age were found 1.2 times more at risk than their counterparts. Altogether, elderlies were 1.9 times more at risk than young adults to consult in a recurrent manner for LBP. The annual incidence decreased by 12 % between 2003 and 2007, while the direct costs increase by 1.4 %. The median cost for consultations was highest for elder women and increasing in time. These secondary analyses emphasize the importance to keep the watch on the elders in regards to LBP, and to determine if the timely decrease in morbidity is related to improvements in LBP management or to a medical accessibility issue. Also, costs will need to be surveyed on a regular basis to limit the impact of future increases.

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