Littérature scientifique sur le sujet « Delire de relation des sensitifs »

ObjectifsRappeler le concept du délire de relation des sensitifs de Kretschmer.MéthodologieÉtude de cas : présenter deux vignettes cliniques avec revue de la littérature.RésultatsLe délire de relation chez les personnalités sensitives (ou paranoïa sensitive de Kretschmer) est une forme dépressive de la paranoïa qui a été décrite par Kretschmer en 1919. Il est défini par le développement progressif d’idées de persécution sur un fond prémorbide sensitif (hyperémotif et hyposthénique). On ne retrouve pas, dans les personnalités qualifiées de sensitives ou sensibles, la surestime de soi ou la quérulence qui caractérisent les autres types de personnalités paranoïaques. Par contre, on y trouve l’orgueil, sens des valeurs et de la morale, vulnérabilité et tendance à intérioriser douloureusement les échecs relationnels et affectifs qu’elles rencontrent. Le délire de Kretschmer se complique généralement d’épisodes dépressifs et anxieux à consonance hypocondriaque, ce qui met à découvert les sentiments d’incapacité et d’échec. L’évolution est aussi moins souvent chronique que dans les autres paranoïas. Toutefois, même après une évolution favorable, les signes sont susceptibles de réapparaître à l’occasion d’une nouvelle déception. Le traitement des délires de relation des sensitifs est encore discuté : pour certains, l’association antidépresseur/neuroleptique s’impose. Pour d’autres, il est légitime de tenter d’abord un traitement antidépresseur seul, il est en revanche rare qu’un traitement neuroleptique seul soit efficace, notamment sur la dimension dépressive. Devant l’appauvrissement conceptuel, nous avons choisi d’illustrer ceci à partir de deux cas cliniques.

L’auteur se propose de revenir sur ce délire bien particulier qu’est le délire de relation des sensitifs (ou paranoïa sensitive), isolé par Kretschmer en 1918. Si le nom de Kretschmer est assez peu cité dans la littérature, les « caractères » sensitifs mis en avant sont pourtant encore souvent repris dans la description de tableaux cliniques de certaines formes de paranoïa, et nous montrerons ainsi que ce délire est bien d’actualité. Après avoir exposé les grandes lignes de la conception kretschmérienne et donc les particularités de la paranoïa sensitive, nous proposons une courte revue de la littérature, la façon dont ce délire fut reçue dans le champ psychanalytique, et nous proposerons enfin en guise d’ouverture un regard lacanien qui permet à certains égards de rapprocher la paranoïa sensitive de la psychose dite « ordinaire ». Cette forme singulière de paranoïa se révèle bien différente du tableau classique dressé en son temps par Kraepelin, éloigné des délires systématisés et extra-ordinaires de type Schreber. Nous aurions affaire ici à des sujets décrits - avant le déclenchement du délire - comme des sujets sensibles, introvertis, timides, hyperémotifs, intériorisant les affects, réfrénant leurs pulsions, s’auto-dévalorisant, susceptibles, mal assurés dans leur relation à la sexualité, etc. Un événement, une « expérience vécue » (Erlebnis), souvent une remarque, un reproche, un regard, va déclencher le délire, comme la goutte d’eau faisant déborder le vase. Pas d’hallucination, pas de grand délire, mais un délire essentiellement de « relation », avec sentiment de persécution, sentiment surtout d’échec, d’insuffisance et d’humiliation, impression de malveillance de l’entourage, interprétations délirantes de menus faits du quotidien, ressentiment, insécurité, auto-dévalorisation. L’ensemble du tableau se situerait donc sur le plan relationnel. On peut dire de la conception de Kretschmer qu’elle rompt avec les conceptions déficitaires; en ce sens on peut la qualifier de psychodynamique. Nous verrons combien les descriptions fines qui ont été faites de ce tableau clinique sont dans le fond assez fréquemment rencontrées en pratique et qu’elles nous poussent à repenser le cadre de la paranoïa.

At the height of the Cold War, spies were more likely to be required to live secret lives in deep undercover. The same held true for corporate and industry spies. Even though government and industry spies may still be required to go out in the field, the digital and big data ages have offered the relative comfort of executing spy operations within one's home or office, offering challenges to detecting, investigating, and controlling espionage. Due to various network means, spies never have to “go out into the cold” – code for going deep undercover. Some of the network conduits discussed are the dark web and deep web and their roles in making covert operations even more secretive than when spies were required to go in the field. Methods of obtaining sensitive information and disabling computer systems are explored as well, including phishing and various means to deliver malware, presented in layman's terms. Once the stuff of science fiction and Hollywood movies, life is very much imitating art, with examples given from famous cyber espionage cases.

The past decade has seen advances in wireless network technologies and an explosive growth in the diversity of portable computing devices such as laptop computers, handheld personal computers, personal digital assistants (PDAs), and smart phones with Internet access. Wireless networking technologies and portable devices enable users to access information in an “anytime, anywhere” fashion. For example, a mobile user (MU) on the highway may query local weather, traffic information, nearby gas stations, next rest areas, or restaurants within 10 miles. Such new demands introduce a new type of services, location-based services (LBS), where certain location constraints (e.g., the user’s current location) are used in the service provision. The idea of queries with location constraints is originally introduced by Imielinski and Badrinath (1992), in which mobile users are likely to query information relating to their current positions, leading to the need for LBS. Such services are also termed as location dependent information services (LDIS) in Lee, Lee, Xu, and Zheng (2002). LBS system is the context sensitive systems in a mobile computing environment that consider the user’s location as a significant and dynamic factor affecting the information and services delivered to the users. The major LBS applications include: • Destination guides with maps, driving directions, and real time prompt • Location-based traffic and weather alerts • Wireless advertising and electronic coupons to nearby mobile devices • Movie, theatre and restaurant location and booking • Store locating applications helping users to find the desired services • Telematics-based roadside assistance (e.g., OnStar from General Motors) • Personal content and messaging (Live Chat with friends) • Mobile Yellow Pages provide local information • Information Services (News, Stocks, Sports) • E911: (Wireless carriers provide wireless callers’ numbers and locations.) Generally, LBS services can be classified into three general categories: telematics LBS, Internet LBS, and wireless LBS (Telc). Telematics LBS is the integration of wireless communications, vehicle monitoring systems, and location devices. Telematics LBS applications include automated vehicle location, fleet tracking, online navigation, and emergency assistance. For example, a trucking company can track all their fleet, proactively warn about traffic ahead, and estimate the arrival time. Commercial LBS providers are beginning to offer important management applications that help direct vehicle fleets and ensure optimal usage of key assets. Telematics LBS is a multibillion dollar service industry and is currently the largest segment of the LBS market (Telc). Internet LBS provide Internet users the services relevant to their specified locations. Because they use a user-specified location instead of the user’s current location, no positioning technology is required. For example, one can find turn-by-turn driving direction from one location to another and search for tour information about the destination. These services are targeting applications with stationary users, relatively powerful computers, and reliable network connections. As a result, Internet LBS support sophisticated services, such as local business searching and comparison, trip planning, online virtual tours, and so forth. Wireless LBS deliver location relevant content to cell phones, PDAs, and other wireless devices. Equipped with automated positioning technologies, MUs can query local weather, nearby traffic information, and local businesses close to them. For example, a user can search neighboring post office or coffer shop from the PDA. The wireless LBS market is currently in a nascent stage, but it will potentially become the largest segment of the LBS market. The deployment of third generation (3G) mobile network, which support handsets that are both mobile and location sensitive, will lead to more wireless LBS subscribers and more useful LBS applications.

Heavy Marine Transport is a well accepted method to move large heavy offshore related floating structures around the world. This type of transport is normally limited to getting from and going to sheltered locations, where loading and discharge operation of these objects are safely carried out in very mild environment. However, there is an increasing demand for loading and discharge at offshore locations; and as these operations are sensitive to environmental criteria, this has consequences for the scheduling issues. Also, with increasing size and weight of offshore structures and the desire to deliver these objects directly to remote offshore location, larger Heavy Transport Vessels are required, which may need to operate in higher sea-states than presently considered safe. These safe conditions are mainly based on long term experience. Assessment of the hydrodynamic behavior of submerged HTVs and cargo in rough seaway, in short Offshore Loading / Discharge, will contribute to extending the scope and operability of HTVs. Also, this investigation will contribute to safety by creating more insight in heavy transport operations. Research and development projects in the past have dealt with many aspects of Offshore Loading/Discharge. Both the basic design (of both HTV and systems) and hydrodynamic behavior are investigated. Problems were encountered in the area of predicting the relative behavior of floating structure above a HTV. Investigations have shown that inaccuracy is mainly caused due to the narrow gap between cargo and HTV. Development of an accurate, quick and cost-effective method for the prediction of hydrodynamic behavior of cargo floating above a HTV is in progress. This paper is presenting theory and limitations of an adapted multi-body diffraction theory. The adapted theory uses different domains in which different solution methods are used. For the flow in the gap between cargo and HTV, a 2D solution is used, whereas for the outside domain standard 3D potential solution is applied. Because of analogy with the single-body floating object in shallow water with narrow gap between body and seafloor, model tests have been performed with different shapes; these shapes are representing typical cargos. The results of the measurements for the different shapes are compared and gap flow phenomenon is explained.

Welding processes induce residual stresses and distortion in the welded joint and the connected components. For manufacturing purpose distortion is the main issue and up to now the problem is handled by post weld corrective actions. Welding residual stress fields are not considered at the design stage in French codes and standards. However, it is well known that residual stresses are likely to increase the risks of fatigue or corrosion and may cause failure in brittle materials. Ferritic parts of large components are post-weld heat treated; allowing disregarding the influence of residuals stresses thanks to their relief. Preventive measures, including mitigation by fine polishing are undertaken in corrosion sensitive zones. The influence of residual stresses on fatigue is more complex to analyze: in low cycle fatigue, residual stresses should be relieved or redistributed after few cycles with plastic straining, and for high cycle fatigue, residual stress effects are accounted for through a mean stress offsett. When considered, residual stress fields are often represented in a very crude manner by a membrane distribution of the most influent stress component through the thickness of the structure. In a less rough way, several codes or fitness-for-purpose guidelines (API [1], British standards [2]) propose residual stress profiles relative to several weld configurations. Nevertheless for a given case, the given profiles may differ significantly for several reasons: the degree of conservatism, the number of covered cases, the embedded margins accounting for uncertainties. Some ill-posed benchmark problems have shown that numerical simulation of residual stresses may deliver very scattered results. AREVA has therefore developed a methodology to validate welding simulations. The scope is limited to fusion welding. The simulations are based on a Thermo-Metallurgical Mechanical model in which the welding energy is represented by an equivalent heat source. This paper presents the actual state of development of this methodology which will be illustrated through 4 examples of residual fields in Dissimilar Metal Welds. Residual stress measurements have been performed for each of the four mock-ups by different techniques. Based on this important experimental and numerical campaign some actions of improvement of the validation methodology are finally listed.

This rapid review focuses on the different variations of discrimination against marginalized groups, with a focus on the effect of intersecting and overlapping inequalities and the different experiences and outcomes they have on the varied groups. It highlights how marginalized groups have been included in interventions addressing issues of discrimination in Pakistan. The review also looks into different change interventions that deliver inclusive outcomes for women, girls and persons with disabilities with a focus on preventing violence against those groups. The review notes that intersecting inequalities have led to different experiences and outcomes relating to discrimination. It states that there is a need to address the different groups facing discrimination in a way that addresses their specified experiences because the effects of discrimination are not the same for every person. The review states that in addressing discrimination for the different groups, programmes should pursue multiple entry points to promote non-discrimination, they should work in multiple sites within and across countries and they should work with multiple partners who play different roles in communities.