188 resultados para Anticipatory


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"Thèse présentée à la Faculté des études supérieures En vue de l'obtention du grade de Docteur en droit"

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Thomas G. Brown, Ph.D., co-directeur de recherche

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Objectif : Cette thèse a pour objectif de mieux comprendre l’effet du stress sur la douleur aiguë et chronique. Devis expérimental : 16 patients souffrant de douleur chronique lombalgique et 18 sujets contrôles ont participé à une étude d’imagerie par résonance magnétique (IRM) et ont collecté des échantillons de salive afin de quantifier les niveaux d’hormone de stress (i.e. cortisol) la journée de l’étude (réponse réactive) et durant les sept jours consécutifs suivants (réponse basale). Étude 1 : Une première étude a examiné le lien entre les niveaux de cortisol basal, le volume de l’hippocampe et l’activité cérébrale évoquée par la douleur thermique chez des patients souffrant de douleur chronique et les sujets contrôles. Les résultats révèlent que les patients souffrant de douleur chronique avaient des niveaux de cortisol plus élevés que ceux des sujets contrôles. Chez ces patients, un niveau élevé de cortisol était associé à un plus petit volume de l'hippocampe et à davantage d’activation dans le gyrus parahippocampique antérieure (une région impliquée dans l'anxiété anticipatoire et l'apprentissage associatif). De plus, une analyse de médiation a montré que le niveau de cortisol basal et la force de la réponse parahippocampique explique statistiquement l’association négative entre le volume de l'hippocampe et l'intensité de la douleur chronique. Ces résultats suggèrent que l’activité endocrinienne plus élevée chez les patients ayant un plus petit hippocampe modifie le fonctionnement du complexe hippocampique et contribue à l’intensité de la douleur chronique. Étude 2 : La deuxième étude a évalué la contribution de la réponse de stress réactif aux différences interindividuelles dans la perception de la douleur aiguë chez des patients souffrant de douleur chronique et chez des sujets normaux. Les deux groupes ont montré des augmentations significatives du niveau de cortisol en réponse à des stimulations nocives administrées dans un contexte d’IRM suggérant ainsi que la réactivité de l’axe hypothalamo-hypophyso-surrénalien est préservée chez les patients lombalgiques. De plus, les individus présentant une réponse hormonale de stress plus forte ont rapporté moins de douleur et ont montré une réduction de l'activation cérébrale dans le noyau accumbens, dans le cortex cingulaire antérieur (CCA), le cortex somatosensoriel primaire, et l'insula postérieure. Des analyses de médiation ont indiqué que la douleur liée à l'activité du CCA explique statistiquement la relation entre la réponse de stress et le désagrément de la douleur rapportée par les participants. Enfin, des analyses complémentaires ont révélé que le stress réduit la connectivité fonctionnelle entre le CCA et le tronc cérébral pendant la douleur aiguë. Ces résultats indiquent que le stress réactif module la douleur et contribue à la variabilité interindividuelle de l'activité cérébrale et la réponse affective à la douleur. Discussion : Conjointement, ces études suggèrent dans un premier temps que la douleur chronique peut être exacerbée par une réponse physiologique inadéquate de l'organisme exposé à un stress récurrent, et en un second temps, que le CCA contribuerait à l'analgésie induite par le stress. Sur le plan conceptuel, ces études renforcent le point de vue prédominant suggérant que la douleur chronique induit des changements dans les systèmes cérébraux régissant les fonctions motivationnelles et affective de la douleur.

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Die Arbeit behandelt den Vorschlag für eine EU-Verordnung KOM/2000/7/final, 2000/0212(COD) des europäischen Parlaments und des Rates von der Kommission der Europäischen Gemeinschaften als Grundlage einer Marktöffnungsverordnung und welche Veränderungen sich dadurch in Deutschland einstellen werden. Ausschreibungen von Verkehrsleistungen werden zunehmen. Die Ausschreibungsarten werden sich in ländlichen Regionen von denen in Verkehrszentren unterscheiden. In der Region werden sich Bedarfslösungen stärker durchsetzen. Kürzungen von Verkehrsleistungen werden hier stärker ausfallen als in den Zentren und damit zu einem kleineren Leistungsvolumen führen. Aufgrund des geringen Leistungsumfangs gibt es weniger Interessenten. Bei Standardausschreibungen werden deshalb auch häufig die Varianten der beschränkten oder die freihändige Vergabe gewählt. Funktionale Ausschreibungen haben nur eine untergeordnete Bedeutung. In den Verkehrszentren sind die Lose größer und damit für viele Anbieter interessant. Die Verkehrszusatzleistungen sind zudem komplexer. Standardausschreibungen in öffentlicher Vergabeart werden sich hier vermutlich als Norm durchsetzen. Die VOL/A wird sicherlich ihre Bedeutung und ihren dafür notwendigen Regelungsumfang in Deutschland als deutsches oder als europäisches Recht behalten. Ob der empfehlende Charakter der DIN EN 13816 Norm „ÖPNV: Definition, Festlegung von Leistungszielen und Messung der Servicequalität“ erhalten werden kann und nicht als Steuerungselement zur Standardisierung im ÖPNV beitragen wird, ist dabei zu bezweifeln. Durch diese Wettbewerbspflicht wird der Aufgabenträger zum Besteller von Verkehrsleistungen. Damit geht die Verkehrsplanung in die Verantwortung des Aufgabenträgers über und gerät stärker in den Einflussbereich der Politik. Die strategisch abstrakte und die konkrete Verkehrsplanung wachsen für den Normfall der Standardausschreibung zusammen. Die Hoffnung auf eine bessere Netzintegration und eine Standardisierung des ÖPNV Angebots und der ÖPNV Qualität entsteht. Es entwickelt sich dadurch aber auch die Gefahr der Abhängigkeit des Nahverkehrsangebots von der derzeitigen Haushaltslage oder der Interessenlage der Politik. Kontinuität in Angebot und Qualität werden zu erklärten Planungszielen. Der Verkehrsplaner auf der Bestellerseite muss die Planung in Ausschreibungsunterlagen umsetzen. Dies erfordert erweiterte Kompetenzen in den Bereichen Betriebswirtschaft, Logistik, Jura, Informatik und Führungskompetenzen. Ausbildende Institutionen müssen darauf bereits im Vorfeld der Umsetzung reagieren. Durch die zeitliche Verzögerung der Umsetzung der Planung durch die Ausschreibungsschritte sind in der Verkehrsplanung längere Planungsvorlaufzeiten einzukalkulieren. Vorausschauender zu planen, wird dabei wichtiger. Auch eventuelle Fehler in der Planung sind nicht mehr so einfach zu korrigieren. Durch den gestiegenen Einsatz von Technologien in den Fahrzeugen besteht für den Verkehrsplaner dafür häufiger die Möglichkeit, Planungsänderungen auf ihre Wirksamkeit im Hinblick auf Attraktivität für den Fahrgast anhand von den ermittelten Fahrgastzahlen zu kontrollieren. Dasselbe gilt auch für Marketing- und Vertriebsmaßnahmen, wie für die Tarifpolitik. Die Zahlen stehen nicht nur für diese Rückkopplung zur Verfügung, sondern dienen auch als Planungsgrundlage für zukünftige Maßnahmen. Dem Planer stehen konkretere Zahlen für die Planung zur Verfügung. Ein Aspekt, der aufgrund der Sanktionsmaßnahmen bei Ausschreibungen an Bedeutung gewinnen wird, ist die Möglichkeit, Qualität von Verkehrsleistungen möglichst objektiv beurteilen zu können. Praxisrelevante Auswirkungen auf die Verkehrsplanung des öffentlichen Personennahverkehrs ergeben sich hauptsächlich durch die gestiegene Komplexität in der Planung selbst und den dadurch unverzichtbaren gewordenen Einsatz von Computerunterstützung. Die Umsetzung in Ausschreibungsunterlagen der Planung und die Kontrolle stellen neue Elemente im Aufgabenbereich des Verkehrsplaners dar und erfordern damit breiter ausgelegte Kernkompetenzen. Es werden mehr Verkehrsplaner mit breiterer Ausbildung benötigt werden. Diese Arbeit hat aufgezeigt, dass sich mit der Integration des Ausschreibungsgedankens in den Ablauf der Verkehrsplanung eine sprunghafte Entwicklung in der Planungstätigkeit ergeben wird. Aufgrund der in Zukunft steigenden Qualität und Quantität der Planungsgrundlagen und der ebenfalls gestiegenen Ansprüche an die Bewertungsparameter ergeben sich Veränderungen und neue Anforderungen auf diesem Gebiet, die in erster Linie für die Hochschulen und andere ausbildende Einrichtungen, aber auch für die Verkehrsplanung unterstützende Industrie.

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L’objectiu d’aquesta recerca és realitzar un estudi exploratori amb la finalitat d’avaluar l’ansietat percebuda pels estudiants immediatament abans de començar el Pràcticum en centres externs, la contribució de les creences disfuncionals a la percepció d’estrès i ansietat, les expectatives d'autoeficàcia per afrontar els estressors percebuts, les pors i preocupacions principals dels estudiants, així com les seves necessitats de formació específica per afrontar el Pràcticum. Els resultats mostren nivells moderats d’ansietat. Les situacions anticipades com a més estressants són l'intent de suïcidi d’un client, l’atac físic, la confidència sobre la comissió d’un delicte, les afirmacions suïcides per part d’un client i la manifestació d‘ira cap a l’estudiant. Les dades també suggereixen que un 44% de la variància de l’ansietat-Estat és pot explicar a partir de l’efecte conjunt de l’ansietat disposicional i les creences disfuncionals, així com l’existència d’una relació negativa entre l’estrès percebut i les expectatives d'autoeficàcia per afrontar-lo. Als estudiants els preocupa no estar a l’alçada de les expectatives, no rebre suficient atenció i orientació dels seus tutors i no saber donar resposta a les demandes del centre o dels usuaris

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Este es un estudio sobre la estrategia de guerra estadounidense en Medio Oriente basada en el uso sistemático de drones durante el periodo comprendido entre 2009 y 2013. Se busca explicar de qué manera puede considerarse el uso de este tipo de armamento como una práctica basada en la proyección de poder sin mayor vulnerabilidad. Los casos de Pakistán y Yemen son abordados, ya que evidencian las características de las operaciones selectivas por las que ha abogado el Presidente Obama. El estudio se inscribe dentro del realismo ofensivo, haciendo también referencia a sus limitaciones explicativas. Empero, se afirma que las dinámicas y consecuencias de la utilización de drones son intrínsecas a la necesidad estadounidense de combatir actores no estatales mediante prácticas que garanticen su seguridad y pretensiones hegemónicas a pesar de las implicaciones políticas , legales y sociales en las que puede incurrir.

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The degree to which perceived controllability alters the way a stressor is experienced varies greatly among individuals. We used functional magnetic resonance imaging to examine the neural activation associated with individual differences in the impact of perceived controllability on self-reported pain perception. Subjects with greater activation in response to uncontrollable (UC) rather than controllable (C) pain in the pregenual anterior cingulate cortex (pACC), periaqueductal gray (PAG), and posterior insula/SII reported higher levels of pain during the UC versus C conditions. Conversely, subjects with greater activation in the ventral lateral prefrontal cortex (VLPFC) in anticipation of pain in the UC versus C conditions reported less pain in response to UC versus C pain. Activation in the VLPFC was significantly correlated with the acceptance and denial subscales of the COPE inventory [Carver, C. S., Scheier, M. F., & Weintraub, J. K. Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267–283, 1989], supporting the interpretation that this anticipatory activation was associated with an attempt to cope with the emotional impact of uncontrollable pain. A regression model containing the two prefrontal clusters (VLPFC and pACC) predicted 64% of the variance in pain rating difference, with activation in the two additional regions (PAG and insula/SII) predicting almost no additional variance. In addition to supporting the conclusion that the impact of perceived controllability on pain perception varies highly between individuals, these findings suggest that these effects are primarily top-down, driven by processes in regions of the prefrontal cortex previously associated with cognitive modulation of pain and emotion regulation.

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This paper investigates whether and to what extent a wide range of actors in the UK are adapting to climate change, and whether this is evidence of a social transition. We document evidence of over 300 examples of early adopters of adaptation practice to climate change in the UK. These examples span a range of activities from small adjustments (or coping) to building adaptive capacity, implementing actions and creating deeper systemic change in public and private organisations in a range of sectors. We find that adaptation in the UK has been dominated by government initiatives and has principally occurred in the form of research into climate change impacts. These actions within government stimulate a further set of actions at other scales in public agencies, regulatory agencies and regional government (or in the devolved administrations), though with little real evidence of climate change adaptation initiatives trickling down to local government level. The water supply and flood defence sectors, requiring significant investment in large scale infrastructure such as reservoirs and coastal defences, have invested more heavily in identifying potential impacts and adaptations. Economic sectors that are not dependent on large scale infrastructure appear to be investing far less effort and resources in preparing for climate change. We conclude that while the government-driven top-down targeted adaptation approach has generated anticipatory action at low cost, it may also have created enough niche activities to allow for diffusion of new adaptation practices in response to real or perceived climate change. These results have significant implications for how climate policy can be developed to support autonomous adaptors in the UK and other countries.

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In recent years, life event approach has been widely used by governments all over the world for designing and providing web services to citizens through their e-government portals. Despite the wide usage of this approach, there is still a challenge of how to use this approach to design e-government portals in order to automatically provide personalised services to citizens. We propose a conceptual framework for e-government service provision based on life event approach and the use of citizen profile to capture the citizen needs, since the process of finding Web services from a government-to-citizen (G2C) system involves understanding the citizens’ needs and demands, selecting the relevant services, and delivering services that matches the requirements. The proposed framework that incorporates the citizen profile is based on three components that complement each other, namely, anticipatory life events, non-anticipatory life events and recurring services.

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Proactive motion in hand tracking and in finger bending, in which the body motion occurs prior to the reference signal, was reported by the preceding researchers when the target signals were shown to the subjects at relatively high speed or high frequencies. These phenomena indicate that the human sensory-motor system tends to choose an anticipatory mode rather than a reactive mode, when the target motion is relatively fast. The present research was undertaken to study what kind of mode appears in the sensory-motor system when two persons were asked to track the hand position of the partner with each other at various mean tracking frequency. The experimental results showed a transition from a mutual error-correction mode to a synchronization mode occurred in the same region of the tracking frequency with that of the transition from a reactive error-correction mode to a proactive anticipatory mode in the mechanical target tracking experiments. Present research indicated that synchronization of body motion occurred only when both of the pair subjects operated in a proactive anticipatory mode. We also presented mathematical models to explain the behavior of the error-correction mode and the synchronization mode.

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Experientially opening oneself to pain rather than avoiding it is said to reduce the mind's tendency toward avoidance or anxiety which can further exacerbate the experience of pain. This is a central feature of mindfulness-based therapies. Little is known about the neural mechanisms of mindfulness on pain. During a meditation practice similar to mindfulness, functional magnetic resonance imaging was used in expert meditators (> 10,000 h of practice) to dissociate neural activation patterns associated with pain, its anticipation, and habituation. Compared to novices, expert meditators reported equal pain intensity, but less unpleasantness. This difference was associated with enhanced activity in the dorsal anterior insula (aI), and the anterior mid-cingulate (aMCC) the so-called ‘salience network’, for experts during pain. This enhanced activity during pain was associated with reduced baseline activity before pain in these regions and the amygdala for experts only. The reduced baseline activation in left aI correlated with lifetime meditation experience. This pattern of low baseline activity coupled with high response in aIns and aMCC was associated with enhanced neural habituation in amygdala and pain-related regions before painful stimulation and in the pain-related regions during painful stimulation. These findings suggest that cultivating experiential openness down-regulates anticipatory representation of aversive events, and increases the recruitment of attentional resources during pain, which is associated with faster neural habituation.

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This paper investigates whether and to what extent a wide range of actors in the UK are adapting to climate change, and whether this is evidence of a social transition. We document evidence of over 300 examples of early adopters of adaptation practice to climate change in the UK. These examples span a range of activities from small adjustments (or coping), to building adaptive capacity, to implementing actions and to creating deeper systemic change in public and private organisations in a range of sectors. We find that adaptation in the UK has been dominated by government initiatives and has principally occurred in the form of research into climate change impacts. These government initiatives have stimulated a further set of actions at other scales in public agencies, regulatory agencies and regional government (and the devolved administrations), though with little real evidence of climate change adaptation initiatives trickling down to local government level. The sectors requiring significant investment in large scale infrastructure have invested more heavily than those that do not in identifying potential impacts and adaptations. Thus we find a higher level of adaptation activity by the water supply and flood defence sectors. Sectors that are not dependent on large scale infrastructure appear to be investing far less effort and resources in preparing for climate change. We conclude that the UK government-driven top-down targeted adaptation approach has generated anticipatory action at low cost in some areas. We also conclude that these actions may have created enough niche activities to allow for diffusion of new adaptation practices in response to real or perceived climate change. These results have significant implications for how climate policy can be developed to support autonomous adaptors in the UK and other countries.

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Background: Anhedonia, the loss of pleasure in usually enjoyable activities, is a central feature of major depressive disorder (MDD). The aim of the present study was to examine whether young people at a familial risk of depression display signs of anticipatory, motivational or consummatory anhedonia, which would indicate that these deficits may be trait markers for MDD. Methods: The study was completed by 22 participants with a family history of depression (FH+) and 21 controls (HC). Anticipatory anhedonia was assessed by asking participants to rate their anticipated liking of pleasant and unpleasant foods which they imagined tasting when cued with images of the foods. Motivational anhedonia was measured by requiring participants to perform key presses to obtain pleasant chocolate taste rewards or to avoid unpleasant apple tastes. Additionally, physical consummatory anhedonia was examined by instructing participants to rate the pleasantness of the acquired tastes. Moreover, social consummatory anhedonia was investigated by asking participants to make preference-based choices between neutral facial expressions, genuine smiles, and polite smiles. Results: It was found that the FH+ group’s anticipated liking of unpleasant foods was significantly lower than that of the control group. By contrast, no group differences in the pleasantness ratings of the actually experienced tastes or in the amount of performed key presses were observed. However, controls preferred genuine smiles over neutral expressions more often than they preferred polite smiles over neutral expressions, while this pattern was not seen in the FH+ group. Conclusion: These findings suggest that FH+ individuals demonstrate an altered anticipatory response to negative stimuli and show signs of social consummatory anhedonia, which may be trait markers for depression.

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Climate change poses new challenges to cities and new flexible forms of governance are required that are able to take into account the uncertainty and abruptness of changes. The purpose of this paper is to discuss adaptive climate change governance for urban resilience. This paper identifies and reviews three traditions of literature on the idea of transitions and transformations, and assesses to what extent the transitions encompass elements of adaptive governance. This paper uses the open source Urban Transitions Project database to assess how urban experiments take into account principles of adaptive governance. The results show that: the experiments give no explicit information of ecological knowledge; the leadership of cities is primarily from local authorities; and evidence of partnerships and anticipatory or planned adaptation is limited or absent. The analysis shows that neither technological, political nor ecological solutions alone are sufficient to further our understanding of the analytical aspects of transition thinking in urban climate governance. In conclusion, the paper argues that the future research agenda for urban climate governance needs to explore further the links between the three traditions in order to better identify contradictions, complementarities or compatibilities, and what this means in practice for creating and assessing urban experiments.

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Background We have previously shown that the selective serotonergic re-uptake inhibitor, citalopram, reduces the neural response to reward and aversion in healthy volunteers. We suggest that this inhibitory effect might underlie the emotional blunting reported by patients on these medications. Bupropion is a dopaminergic and noradrenergic re-uptake inhibitor and has been suggested to have more therapeutic effects on reward-related deficits. However, how bupropion affects the neural responses to reward and aversion is unclear. Methods 17 healthy volunteers (9 female, 8 male) received 7 days of bupropion (150 mg/day) and 7 days of placebo treatment, in a double-blind crossover design. Our functional Magnetic Resonance Imaging task consisted of 3 phases; an anticipatory phase (pleasant or unpleasant cue), an effort phase (button presses to achieve a pleasant taste or to avoid an unpleasant taste) and a consummatory phase (pleasant or unpleasant tastes). Volunteers also rated wanting, pleasantness and intensity of the tastes. Results Relative to placebo, bupropion increased activity during the anticipation phase in the ventral medial prefrontal cortex (vmPFC) and caudate. During the effort phase, bupropion increased activity in the vmPFC, striatum, dorsal anterior cingulate cortex and primary motor cortex. Bupropion also increased medial orbitofrontal cortex, amygdala and ventral striatum activity during the consummatory phase. Conclusions Our results are the first to show that bupropion can increase neural responses during the anticipation, effort and consummation of rewarding and aversive stimuli. This supports the notion that bupropion might be beneficial for depressed patients with reward-related deficits and blunted affect.