Lumbopelvic pain, anxiety, physical activity and mode of conception: a prospective cohort study of pregnant women

Objectives Pregnancy-related lumbopelvic pain (LPP) is a frequent condition known to significantly affect women in their daily life. The aetiology of pregnancy-related LPP pain is still not clearly established but the mode of conception has been suggested to contribute to LPP. Anxiety related to fertility treatments may be one of the contributing factors. The primary objectives of this study were to determine the evolution of LPP prevalence and severity, and anxiety throughout pregnancy in women who conceived spontaneously (SP) or after fertility treatments (FT). A further aim was to examine the relationship between pregnancy-related LPP severity and anxiety. The secondary objective was to determine the evolution of physical activity and their correlation with the severity of pregnancy-related LPP. Design Prospective cohort study. Setting Pregnant women were recruited through physicians’ referrals, posters and newspaper advertisements in the local and surrounding communities (hospital, maternity care clinic, prenatal centres, sports centres, local university) in the city of Trois-Rivières, Canada. Participants 59 pregnant women (33 SP and 26 FT) were assessed during the first, second and third trimester of pregnancy.Primary and secondary outcome measures Pregnancy-related LPP prevalence and severity (primary), trait and state anxiety, and physical activity levels (secondary).Results There was no relationship between the mode of conception and the outcome measures. The prevalence and severity of LPP increased over the course of pregnancy (time effect, p<0.0001) whereas trait anxiety decreased from early to mid-pregnancy (time effect, p=0.03). Activity limitations increased throughout pregnancy (time effect, p<0.0001) and physical activity levels decreased (time effect, p<0.0001). The severity of LPP was positively correlated with activity limitations (r=0.51 to 0.55) but negatively with physical activity levels (r=−0.39 to −0.41).Conclusions Maternal health-related factors, such as LPP, anxiety and physical activity, are not different in women who conceived spontaneously or after fertility treatments. The more LPP was severe, the more the women were physically limited and inactive

Représentation et gestion des incertitudes pour le diagnostic par la théorie de Dempster-Shafer : application aux procédés biologiques

La supervision des procédés biologiques utilisés pour la dépollution des eaux usées est une tâche complexe du fait des difficultés d'observation et de modélisation de ces procédés. En conséquence le diagnostic de ces procédés nécessite la prise en compte des incertitudes liées aux mesures et à la compréhension du système. Les travaux présentés dans cette thèse se proposent d'utiliser le cadre théorique du Modèle des Croyances Transférables afin de caractériser les différentes sources d'information portant sur l'état d'un système, de les agréger et ainsi de proposer un état ou un groupe d'états le plus crédible. Une méthode est proposée pour combiner des sources d'information définies sur des ensembles de définition différents, en l'occurrence pour la fusion de relations de diagnostic ; cette méthode permet de détecter le ou les capteurs potentiellement en panne ainsi qu'un conflit entre les sources d'information empêchant le système de conclure. La prise en compte des incertitudes des sources d'information permet d'utiliser des relations de diagnostic basées sur des modèles peu précis tels que les modèles par intervalle. De plus une méthode est proposée pour réaliser le diagnostic de l'état physiologique d'un procédé à partir de l'observation d'un nombre limité de variables. Cette méthode s'appuie sur un corps de règles floues et leur représentation sous forme de fonctions de croyances. La combinaison de ces règles au sein du formalisme des masses de croyance permet d'aboutir à une classification satisfaisante capable d'exhiber la qualité du diagnostic, tout en préservant la modularité du système. Ces méthodes permettent le diagnostic de l'instrumentation et de l'état physiologique d'un procédé biologique. Elles ont été appliquées pour le diagnostic de réacteurs ananérobies au sein du projet IST TELEMAC qui visait à développer des méthodes et des outils pour la télésupervision des procédés de dépollution. Biological process are widely used for wastewater treatment, but their supervision is a complex task because of observation and modelling difficulties. As a consequence their diagnosis needs to take into account uncertainties coming from measurement or from ill known models. The work presented in this thesis is proposing to use the Transferable Belief Model (TBM) formalism in order to characterize all available information sources and their uncertainties and then to aggregate them to be able to propose a state or a group of states highly possible for the process. Firstly a method is proposed to combine information sources defined on different definition sets, here to combine diagnosis relations defined on the sensors of a process ; this method allows one to detect one or several sensors having probably broken down. Uncertainty representation is here precious to use diagnosis relations based on low-precision models like interval models. Moreover another method is proposed to decide the biological state of a process with the observation of a limlited number of variables. This method is based on the representation of a corpus of fuzzy rules by belief functions and their combination. The combination produces good classification and preserves the modularity of the system ; furthermore the classification quality is exhibited. These methods based on the TBM formalism as a diagnosis framework have been applied to diagnose the instrumentation and the physiological state of an anaerobic process. They have been applied within the IST europen project TELEMAC whose goals were to develop methods and tools dedicated to the remote supervision of wastewater treatment plants

Co-construire et diffuser les changements organisationnels dans les territoires : une question d'ingénierie et d'intelligence territoriales.

National audienc

Stratégies d’aménagement et gouvernance territoriale des périphéries d’agglomérations. Une illustration par le cas clermontois

International audienc