Dispositifs et dispositions : les conditions de l'engagement et de la réussite de l'amaigrissement de jeunes adultes obèses

À partir d'une approche qui combine approches " dispositionnalistes " et " interactionnistes ", la thèse analyse les effets d'une " socialisation continue " dans la construction et déconstruction des corps des personnes obèses. Dans une perspective essentiellement qualitative, 80 entretiens biographiques ont été effectués avec 57 personnes majoritairement " ex-obèses " issus de 5 dispositifs de prise en charge (clinique, hôpital, groupe commercial, RéPPOP, cabinet conseil), médicalisés ou non. Ces données sont complétées par des observations ethnographiques pour trois d'entre eux. La présentation des résultats est organisée autour de la trajectoire sociale, corporelle et médicale des enquêtés et de leurs différentes étapes. La thèse met d'abord en évidence la complexité et l'hétérogénéité des habitus en relation avec les types de socialisation alimentaire et corporelle ainsi que leur durabilité. Elle montre ensuite que l'engagement dans l'amaigrissement nécessite la rencontre entre un événement, un processus historique objectif, une situation et des dispositions individuelles particulières. La sortie de l'obésité, quant à elle, suit plusieurs étapes : une " crise biographique ", un " déclic ", une prise de décision, l'utilisation d'une méthode socialement, culturellement et sexuellement pertinente et des configurations familiales ou sociales favorables. Enfin, les effets des dispositifs de prise en charge dépendent finalement de l'orientation thérapeutique privilégiée et de sa mise en œuvre (" sur " ou " avec " le patient), de l'efficacité éprouvée et définie par les patients et des dispositions corporelles de ces derniers. La conversion corporelle réussie implique dans tous les cas un " travail sur soi " et " de soi " construit au cours des processus de socialisation explicite et implicite.According to a perspective which articulates dispositional approaches with interactionist sociology, the thesis analyzes the effects of an "uninterrupted socialization" on the social construction and transformation of the body for young obese adults. From a qualitative point of view, 80 biographical interviews were carried out with 57 "ex-obese" who come from medical (or not) framework care (clinic, hospital, commercial weight-loss group, RéPPOP, consulting firm). These data are completed by ethnographic observations in three of them. The presentation of the results is organized following the social, bodily and medical trajectory and its phasing. Firstly, the thesis points out the complexity and heterogeneity of habitus in connection with food and body socialization as well as its persistence. Then, it shows that the commitment to weight loss requires the combination of an event, an objective historical process, a brain wave, a decision, a method related to social position, cultural capital and gender. Family and social setting are also essential to keep losing weight. Finally, the effects of the programmes depend on therapeutic options and their implementation ("on" or "with" the patient), efficiency tested by the patients and their bodily dispositions. The success of body conversion always requires a "work on oneself" and a "work with himself" during explicit and implicit socialization processes

La lutte contre l’obésité à l’école : entre biopouvoir et individuation

L’école constitue un des lieux d’action privilégiés des politiques publiques dans la lutte contre l’obésité et le surpoids infantile, et plus largement dans l’éducation à la santé. Ainsi, entre injonction et responsabilisation individuelle, l’État français tente, par le biais de l’école, de réguler les comportements alimentaires et corporels, et espère insuffler l’adoption d’un nouveau mode de vie. L’étude montre que les adolescents obèses échappent aux dispositifs disciplinaires en développant des stratégies de contournement, comme dans le cas des anorexiques. Autrement dit, la configuration scolaire ne permet pas à l’adolescent de rompre avec les dispositions familiales antérieures et de provoquer une transformation du rapport au corps.Schools, particularly their health programmes, are the major place for the implementation of public policies to fight obesity and excessive weight among children. By both injunction, and encouragement towards individuals to act responsibly, the French state uses the school to shape behaviour with respect to food and the body, hoping to prompt adoption of a new life-style. This study shows that obese teenagers sidestep the disciplinary measures by developing circumvention strategies, just as anorexics do. The school setting does not allow the teenager to break with earlier family habits, and to generate a transformation of their relationship to their body

Technology-Assisted Rehabilitation of Writing Skills in Parkinson’s Disease: Visual Cueing versus Intelligent Feedback

Recent research showed that visual cueing can have both beneficial and detrimental effects on handwriting of patients with Parkinson’s disease (PD) and healthy controls depending on the circumstances. Hence, using other sensory modalities to deliver cueing or feedback may be a valuable alternative. Therefore, the current study compared the effects of short-term training with either continuous visual cues or intermittent intelligent verbal feedback. Ten PD patients and nine healthy controls were randomly assigned to one of these training modes. To assess transfer of learning, writing performance was assessed in the absence of cueing and feedback on both trained and untrained writing sequences. The feedback pen and a touch-sensitive writing tablet were used for testing. Both training types resulted in improved writing amplitudes for the trained and untrained sequences. In conclusion, these results suggest that the feedback pen is a valuable tool to implement writing training in a tailor-made fashion for people with PD. Future studies should include larger sample sizes and different subgroups of PD for long-term training with the feedback pen

Assessment of the increased calcification of the jaw bone with CT-Scan after dental implant placement

Imaging Science in Dentistry (Imaging Sci Dent; ISD) is a peer reviewed and open access journal providing up to date information dedicated to the radiology and related sciences for oral cavity, jaws, face, and neck.Purpose: The study was performed to evaluate the canges of jaw bone density around the dental implant after placement using computed tomography scan (CT-Scan). \ud Materials and Methods: This prospective study consisted of 30 patients who had lost 1 posterior tooth in maxilla or mandible and installed dental implant. The patients took CT-Scan before and after implant placement. Hounsfield Unit (HU) was measured around the implants and evaluated the difference oh HU before and after implant installation. Results: The mean HU of jawbone was 542.436 HU and 764.94 HU after implant placement, respectively (p<0.05). The means Hus for male were 632.3 HU and 932.2 HU and those for female 478.2 HU and 645.5 HU before and after implant placement, respectively (p<0.05). Also, the jaw bone with lower density needed longer period for implant procedure and the increased cange of HU of jaw bone was less in the cases which needed longer period for integration. \ud Conclusion: CT-Scan could be use to assess the cange of bone density around dental implants. Bone density around dental implant was increased after placement. The increased rate of bone density could be determined by the quality of jaw bone before implant placement

Implicit attitudes towards smoking predict long-term relapse in abstinent smokers

It has previously been argued that implicit attitudes toward substance-related cues drive addictive behavior. Nevertheless, it remains an open question whether behavioral markers of implicit attitude activation can be used to predict long-term relapse. The main objective of this study was to examine the relationship between implicit attitudes toward smoking-related cues and long-term relapse in abstaining smokers. Implicit attitudes toward smoking-related cues were assessed by means of the Implicit Association Test (IAT) and the evaluative priming task (EPT). Both measures were completed by a group of smokers who volunteered to quit smoking (patient group) and a group of nonsmokers (control group). Participants in the patient group completed these measures twice: once prior to smoking cessation and once after smoking cessation. Relapse was assessed by means of short telephone survey, 6 months after completion of the second test session. EPT scores obtained prior to smoking cessation were related to long-term relapse and correlated with self-reported nicotine dependence as well as daily cigarette consumption. In contrast, none of the behavioral outcome measures were found to correlate with the IAT scores. These findings corroborate the idea that implicit attitudes toward substance-related cues are critically involved in long-term relapse. A potential explanation for the divergent findings obtained with the IAT and EPT is provided

Prevalence of BRCA-1 associated protein 1 germline mutation in sporadic malignant pleural mesothelioma cases

OBJECTIVE: 23% of mesothelioma tumor specimens have a mutation in the BRCA1-associated protein 1 (BAP1) gene and germline BAP1 mutations predispose to malignant pleural mesothelioma (MPM). Our aim was to investigate germline BAP1 mutations in sporadic MPM patients. MATERIALS AND METHODS: Exonic DNA from peripheral blood leucocytes of 78 MPM patients was screened for germline BAP1 mutation. RESULTS: One out of 78 patients showed a germline synonymous mutation in exon 11. In all other patients wild-type sequence without any single-nucleotide polymorphisms was detected. CONCLUSIONS: Taking into account previous similar screenings, the prevalence of germline BAP1 mutations in sporadic MPM patients can be estimated around 1-2%, suggesting a minor role of germline BAP1 mutation in the pathogenesis of sporadic MPM

Breath analysis by gas chromatography-mass spectrometry and electronic nose to screen for pleural mesothelioma : a cross-sectional case-control study

Rationale: Malignant pleural mesothelioma (MPM) is mainly caused by previous exposure to asbestos fibers and has a poor prognosis. Due to a long latency period between exposure and diagnosis, MPM incidence is expected to peak between 2020-2025. Screening of asbestos-exposed individuals is believed to improve early detection and hence, MPM management. Recent developments focus on breath analysis for screening since breath contains volatile organic compounds (VOCs) which reflect the cell’s metabolism. Objectives: The goal of this cross-sectional, case-control study is to identify VOCs in exhaled breath of MPM patients with gas chromatography-mass spectrometry (GC-MS) and to assess breath analysis to screen for MPM using an electronic nose (eNose). Methods: Breath and background samples were taken from 64 subjects: 16 healthy controls (HC), 19 asymptomatic former asbestos-exposed (AEx) individuals, 15 patients with benign asbestos-related diseases (ARD) and 14 MPM patients. Samples were analyzed with both GC-MS and eNose. Results: Using GC-MS, AEx individuals were discriminated from MPM patients with 97% accuracy, with diethyl ether, limonene, nonanal, methylcyclopentane and cyclohexane as important VOCs. This was validated by eNose analysis. MPM patients were discriminated from AEx+ARD participants by GC-MS and eNose with 94% and 74% accuracy, respectively. The sensitivity, specificity, positive and negative predictive values were 100%, 91%, 82%, 100% for GC-MS and 82%, 55%, 82%, 55% for eNose, respectively. Conclusion: This study shows accurate discrimination of patients with MPM from asymptomatic asbestos-exposed persons at risk by GC-MS and eNose analysis of exhaled VOCs and provides proof-of-principle of breath analysis for MPM screening