Ma double culture d’aménagement (franco-allemande) et le travail pour la mise en place d’un dispositif encourageant l’urbanisme durable, l’innovation et l’excellence environnementale pour les élus bretons, avaient fait de mon questionnement personnel de longue date un sujet d’actualité: Peut-on transposer des méthodes et des expériences extraterritoriales d’une culture à une autre pour dynamiser et faire évoluer la qualité des projets et les approches des acteurs locaux ? La réponse à ce questionnement, déterminant pour ma propre pratique professionnelle, n’existe pasdans la littérature en 2005. Partant de la Région Bretagne, à première vue, le choix du Land de la Saxe s’imposait pour la comparaison à cause d’un jumelage datant de 1995. Après enquête, il s’avère que peu d’actions et projets concrets se sont développés. Cela n’est peut-être pas étonnant compte tenu des caractéristiques territoriales très différentes de la Bretagne et la Saxe (passé très industriel, peu d’agriculture, pas de littoral, de nombreuses grandes villes). En conséquence, le Land du Mecklenburg-Vorpommern avec son littoral étendu, ses nombreuses îles, son économie qui separtage entre l’agriculture et le tourisme, semblait plus intéressant pour la comparaison (et pour un partenariat futur, si mes recherches montreraient l’intérêt réel d’une collaboration autour de l’urbanisme durable). Je suis convaincue de la pertinence de l’échelon régional européen (la « Région » en France et le « Land » en Allemagne) pour initier des politiques publiques et stratégies d’aménagement cohérentes sans perdre le lien avec l’identité territoriale mobilisateur. Un état des lieux des potentialités et freins aux transferts d’expériences introduit ma thèse. Un zoom sur les politiques régionales encadrant les dispositifs novateurs dédiés spécifiquement à l’urbanisme durable et la prospective paysagère (Eco-FAUR et Städtebau- und Dorferneuerungsprogramm) permet de situer ces derniers dans leur contexte. La comparaison de 16 projets exemplaires et récents en Bretagne et en Mecklenburg-Vorpommern m’a permis d’analyser en détail les approches, les méthodes, l’intervention des acteurs, les points forts et faibles des projets. Le face-à-face de ces exemples locaux se structure autour de 8 sujets, actuellement dans les discussions des experts européens de l’urbanisme durable et de la prospective paysagère : la revitalisation des coeurs de villes, le renouvellement urbain, les paysages urbains, le grand paysage et la ville, la nouvelle dynamique rurale, l’urbanisme littoral, le tourisme vert et les extensions urbaines sous forme d’éco-lotissements. Mon analyse et les échanges avec plus de 250 acteurs m’ont amenée d’émettre des conclusions positives (sous conditions) concernant les potentialités d’une coopération renforcée dans les domaines analysés entre deux régions européennes non voisines. Ma thèse de doctorat conclut avec des recommandations pour l’amélioration d’efficience des échanges, car l’intérêt pour des projets innovants, concrets et autour d’un groupe d’acteurs restreint et motivé, s’annonce prometteur / My urban planning dual culture (German and French), the works to implement of a device for encouraging the sustainable urban design, the innovation and the environmental excellence for the Brittany elected representatives, had been my personal questioning a long standing concern: Can we transpose extraterritorial experiences from one culture to another and methods to boost and develop the quality of the projects and the approaches of local actors? The answer to this question, determinant for my own professional practice and my standing concern, does not exist in the literature in 2005. Starting from the Brittany region, at first glance, the choice of the Saxony Land was required for comparison resulting of a twinning since 1995. After investigation, it turns out that only few concrete projects and actions were developed. This is, perhaps, not surprising given the very different territorial characteristics from Britain and Saxony (very industrial past, little agriculture, no coastline, many large cities).. Accordingly, the Mecklenburg-Vorpommern Land with its extensive coastline, its many islands, its economy which is shared between agriculture and tourism, seemed more interesting to compare (and for a future partnership, if my research would showed the real interest of collaboration on sustainable urban design). I am convinced of the relevance of the European regional level (the "region" in France and the "Land" in Germany) to introduce public policies and consistent urban planning strategies without losing the link with the mobilizing territorial identity.A State of art of the potential and limits of the transfer experiences introduced my thesis. A focus on the regional policies give a framework for the innovative devices specifically dedicated to the sustainable urban design and the prospective landscape (Eco-FAUR and Städtebau-und Dorferneuerungsprogramm) to place them in context. Comparison of 16 best and recent projects in Brittany and in Mecklenburg-Vorpommern allowed me to analyze in detail the approaches, methods, the intervention of the actors, the best and weak points of the projects. The face to face of these local examples give a framework on 8 topics currently in the discussions of the prospective and sustainable urban landscape Europeanexperts: the revitalization of the cities centers, the urban renewal, the urban landscapes, the great landscape and the city, the new rural dynamic, urban coastal planning, green tourism and urban eco-subdivisions as extensions. My analysis and exchanges with more than 250 actors led me some positive issues (under conditions) concerning the potential of enhanced cooperation between two non-adjacent European areas. My PhD thesis concludes with recommendations for the improvement of trade efficiency, because the interest for the innovative and concrete projects, and around a limited motivated actors group looks promising / Meine doppelte deutsch-französische Raumplanungskultur und meine Arbeit für Politiker der Bretagne (Aufbau eines Förderprogrammes für nachhaltigen Städtebau, Innovation und hohe Umweltverträglichkeit) machen aus meiner langjährigen persönlichen Fragestellung ein Thema der Aktualität: Kann man Erfahrungen, die auf einer anderen, außerterritorialen Planungskultur aufbauen transferieren, um die Qualität der Projekte und die Herangehensweise der Akteure vor Ort zu „dynamisieren“, zu verbessern ? Die Antwort auf diese Frage existierte im Jahr 2005 nicht in der wissenschaftlichen Literatur. Von der Bretagne ausgehend bot sich eigentlich Sachsen zum Vergleich an, da eine offizielleRegionalpartnerschaft seit 1995 besteht. Bei den Voruntersuchungen stellte sich aber heraus, dass sich sehr wenige Aktionen und konkrete Projekte entwickelt haben. Das ist vielleicht nicht verwunderlich wenn man sich die sehr unterschiedlichen territorialen Charakteristiken der Bretagne und Sachsens (Industriestandort, wenig Landwirtschaft, keine Küste und viele große Städte) vor Augen führt. So schien mir der Vergleich mit Mecklenburg-Vorpommern (ausgedehnte Küste mit Inseln, eine auf Landwirtschaft und Tourismus basierende Wirtschaftsstrukture) viel versprechender, vor allem wenn meine Forschungen ein reelles Interesse für eine Zusammenarbeit im Gebiet des Nachhaltigen Stadtbaus und der Landschaftsentwicklungsplanung aufzeigen sollten. Ich bin überzeugt, dass es der regionale Ansatz (die Region in Frankreich und das Land in Deutschland) ist, der im europäischen Rahmen kohärente Lösungen für lokale Entwicklungsstrategien hervorbringt, weil ein genügend großes Territorium mit der mobilisierenden Identität der Akteure verbunden werden kann. Eine Bestandsanalyse der positiven und negativen Faktoren für einen Erfahrungstransfer führtmeine Dissertation ein. Eine Fokussierung auf die Rahmenbedingungen (globale Regionalpolitik) ermöglicht, die beiden auf nachhaltigen Städtebau- und Landschaftsentwicklungsplanung spezialisierten Programme (Eco-FAUR und Städtebau- und Dorferneuerungsprogramm) einzuordnen. Der Vergleich von 16 innovativen und aktuellen Projekten der Bretagne und Mecklenburg- Vorpommerns gab mir die Möglichkeit, im Detail die Herangehensweisen, Methoden, Beteiligung derAkteure sowie die Stärken und Schwachpunkte der Projekte aufzuzeigen. Die Gegenüberstellung bedient sich 8, die aktuelle Fachdebatte der europäischen Experten in Städtebau und ländlicher Entwicklung anregende, Themen: Innenstadtrevitalisierung, Stadtumbau, Stadtlandschaft, Landschaftsplanung und Stadt, Dynamik des ländlichen Raumes, Küstenbebauung, Ökotourismus, Ökoquartiere. Meine Analyse und der Austausch mit über 250 Akteuren erlauben mir einen optimistische Einschätzung (unter entsprechenden Rahmenbedingungen) der Möglichkeiten der Intensivierungder Zusammenarbeit in den analysierten Gebieten und zwischen nichtbenachbarten europäischen Regionen. Meine Dissertation schließt mit Vorschlägen zur Verbesserung des Erfahrungsaustausches ab, da die Zusammenarbeit von motivierten, kleinen Gruppen von Akteuren mit konkreten, innovativen Projekten, vielversprechend erscheint

Cette thèse d’urbanisme s’est donnée pour objectif de réfléchir à l’avenir des gares métropolitaines françaises et allemandes à horizon 2050. Elle porte une interrogation sur les fondements de la gare comme objet urbain conceptuel (abordé comme un système) et pose comme hypothèse qu’il serait en quelque sorte doté de propriétés autonomes. Parmi ces propriétés, c’est le processus d’expansion et de dialogue sans cesse renouvelé et conflictuel, entre la gare et son tissu urbain environnant, qui guide cette recherche ; notamment dans le rapport qu’il entretient avec l’hypermobilité des métropoles. Pour ce faire, cette thèse convoque quatre terrains d’études : les gares principales de Cologne et de Stuttgart en Allemagne et les gares de Paris-Montparnasse et Lyon-Part-Dieu en France ; et commence par un historique détaillé de leurs évolutions morphologiques, pour dégager une série de variables architectoniques et urbaines. Il procède dans un deuxième temps à une série d’analyse prospective, permettant de juger de l’influence possible des politiques publiques en matière transports et de mobilité, sur l’avenir conceptuel des gares. Cette thèse propose alors le concept de système-gare, pour décrire l’expansion et l’intégration des gares métropolitaines avec leur environnement urbain ; un processus de négociation dialectique qui ne trouve pas sa résolution dans le concept de gare comme lieu de vie/ville. Elle invite alors à penser la gare comme une hétérotopie, et propose une lecture dépolarisée et déhiérarchisée de ces espaces, en introduisant les concepts d’orchestre de gares et de métagare. Cette recherche propose enfin une lecture critique de la « ville numérique » et du concept de « mobilité comme service. » Pour éviter une mise en flux tendus potentiellement dommageables, l’application de ces concepts en gare ne pourra se soustraire à une augmentation simultanée des espaces physiques. / This urban planning thesis aims to reflect on the future of French and German metropolitan stations by 2050. It questions the foundations of the station as a conceptual urban thing (considered as a system) and suggests as a hypothesis that it might somehow have autonomous properties. Among these properties, it is the process of expansion and ever renewed and conflictual dialogue between the station and its surrounding urban fabric which guides this research; particularly its link to metropolises’ hypermobility. To do this, this thesis calls up four study sites: the main stations in Cologne and Stuttgart in Germany, and the Paris-Montparnasse and Lyon-Part-Dieu stations in France; and starts with a detailed history of their morphological evolutions, to identify a series of architectonic and urban variables. In a second stage, it proceeds to a series of prospective analyses, allowing us to evaluate the possible influence of public transport and mobility policies on the conceptual future of stations. This thesis then puts forward the concept of a station-system, to describe the expansion and integration of metropolitan stations within their urban environment; a process of dialectic negotiation which does not resolve itself within the concept of stations as a living/urban space. It therefore invites us to think of stations as a heterotopia, and puts forward a depolarised and dehierarchised reading of these spaces, introducing the concepts of station orchestras and metastations. Finally, this research suggests a critical reading of the “smart city” and the concept of “mobility as a service”. To avoid that stations move to a just-in-time model which could potentially be damaging, the application of these concepts to stations cannot avoid a simultaneous increase of physical spaces. / Diese Doktorarbeit im Bereich der Stadtplanung zielt darauf ab, sich mit der Zukunft der französischen und deutschen Metropol-Großbahnhöfe bis zum Jahr 2050 auseinanderzusetzen. Sie hinterfragt die Grundprinzipien des Bahnhofs als konzeptuelles urbanes Objekt (welchem sich als System angenähert wird) und formuliert die Hypothese, dass der Bahnhof als Objekt oder System in gewisser Weise autonome Eigenschaften hat. Zu diesen Eigenschaften gehört der diese Forschungsarbeit prägende Prozess der Expansion und des ständig erneuerten und konfliktgeladenen Dialogs zwischen Bahnhof und umliegenden städtischen Strukturen. Ein Augenmerk liegt hierbei auf der Beziehung dieses Expansionsprozesses und Dialoges zur Hypermobilität von Ballungsräumen. Zu diesem Zweck beschäftigt sich diese Arbeit mit vier Forschungsgegenständen: den Hauptbahnhöfen Köln und Stuttgart in Deutschland und den Großbahnhöfen Paris-Montparnasse und Lyon-Part-Dieu in Frankreich; und stellt zu Beginn eine detaillierte Geschichte der morphologischen Entwicklung derselben dar, um eine Reihe von architektonischen und urbanen Variablen zu identifizieren. Anschließend werden prospektive Analysen durchgeführt, die es ermöglichen, den möglichen Einfluss der aktuellen und geplanten Verkehrspolitik auf die Zukunft des Konzepts Bahnhof zu bewerten. Sodann wird das Konzept des Bahnhofssystems (système-gare) vorgeschlagen, um die Expansion von Großbahnhöfen und deren Integration in ihr urbanes Umfeld zu beschreiben; ein dialektischer Verhandlungsprozess, der vom Konzept des Bahnhofs als Lebensraum und Stadtraum/-ort nicht hinreichend erfasst wird. Die Arbeit lädt dazu ein, Bahnhöfe als Heterotopien zu betrachten und schlägt eine entpolarisierte und de-hierarchische Lesart dieser Räume vor, indem die Konzepte Bahnhofs- Orchester und Meta-Bahnhof eingeführt werden. Schließlich erfolgt eine Auseinandersetzung mit der “Smart City” und dem Konzept der “Mobilität als Dienstleistung”, die sich insbesondere kritisch mit dem Umstand befasst, dass beide Ansätze den aufgrund der Zunahme des Verkehrs und zur Vermeidung einer potentiell schädlichen Just-in-time Organisation in Bahnhöfen notwendigen Ausbau der Bahnhöfe nicht vermeiden können.

A pervasive real-world memory task is remembering to carry out intended activities at appropriate moments in the future, such as remembering to call one’s mother after returning from work or to hand a message to a colleague when seeing him in the office on the next morning. Such types of tasks are termed prospective memory (PM) tasks (Einstein & McDaniel, 1996). PM has been identified as one of the most frequent everyday memory challenges (e.g., Maylor, 1990), particularly in old age (McDaniel, Einstein, & Rendell, 2008) and an intact PM is considered to be crucial for the maintenance of independent living (Kliegel & Martin, 2003). Therefore, many researchers have focused on the exploration of possible age differences in PM. While age-related deficits were found in standard lab-based PM tasks, age-related benefits occured in naturalistic tasks that are carried out in participants’ everyday lives. This surprising pattern has been called the age-PM-paradox (Rendell & Craik, 2000). It has been supported by a meta-analysis comparing PM age effects found in studies that focused either on lab-based or on naturalistic PM tasks (Henry, MacLeod, Phillips, & Crawford, 2004). However, the mechanisms which are critical in determining the direction of age effects remain poorly delineated. Thus, the overall aim of the research programme presented in the present thesis was to investigate the age-PM-paradox as well as potential cognitive, motivational and emotional mechanisms and processes associated with age-related PM performance. For that purpose, three experimental studies were conducted testing adult age effects in different PM task settings with different task material. Furthermore, several possible underlying mechanisms suggested by the literature on age effects in PM were measured and/ or varied experimentally. The first aim of Study 1 was to cross-validate the age-PM-paradox within a single sample. The second aim was to empirically explore the relative importance of four recently proposed factors (motivation, metacognitive awareness, activity absorption, and control over the task) that may be associated with the direction of age effects inside and outside of the laboratory. For that purpose, 20 young and 20 older adults performed a lab-based and a naturalistic PM task, which were similar in structure and demand. The level of control was experimentally manipulated in both task settings. The remaining possibly influencing factors (motivation, metacognitive awareness, and activity absorption) were assessed via questionnaires in the laboratory and with a daily diary in the field. First, analysing mean level age differences, the paradox was confirmed. Second, exploring possible correlates of the paradox revealed that the level of daily activity absorption (i.e., everyday stress) was the most important mechanism in naturalistic PM performance. Further, high motivation and good metacognitive awareness were associated with age benefits in PM performance in the naturalistic task, while high ongoing activity absorption and low control over the PM cue were related to deficits in lab-based tasks. Thus, Study 1 confirmed the age-PM-paradox within one sample and with carefully matched lab-based and naturalistic tasks. In addition, the results indicate that the relative importance of the suggested factors may vary as a function of setting. While cognitive factors were most influential in the laboratory, motivational and knowledge-based factors were associated with high PM performance in the naturalistic task. The strong association between PM performance in the field and everyday stress highlights the need for future studies exploring the mechanisms underlying this effect. Results from Study 1 suggest that cognitive resources are most influential for PM age effects in the laboratory. Yet, it is not clear, which specific cognitive resources are needed for successful PM performance and if these processes differ between young and older adults. Thus, Study 2 explored the role of executive functions (i.e. shifting, updating and inhibition) as possible developmental mechanisms associated with PM age effects. 170 young and 110 older adults performed a battery of cognitive tests including measures of PM, shifting, updating, inhibition, working memory and speed. A comprehensive set of statistical approaches (e.g. median analyses, structural equation modelling) was used to analyze the possible cognitive correlates in predicting PM performance. First, age effects were confirmed in PM and also obtained in measures of executive control. Moreover, the facets of executive control differently predicted PM performance. Specifically, shifting was the strongest predictor of PM performance in young and older adults as well as for explaining age differences in PM. Thus, Study 2 clarified the role of different facets of controlled attention in age effects in PM and bears important conceptual implications: The results suggest that executive functions are important developmental mechanisms of PM across adulthood beyond working memory and speed. Specifically, shifting appeared to be an essential aspect of cognitive control involved in age-related PM performance. Moreover, examining PM as a latent construct confirmed the convergent and discriminant validity of PM. This demonstrates PM as a separate cognitive construct and suggests that PM is related to, but not identical with, executive control. Study 3 was set out to explore if the amount of cognitive resources needed to successfully perform a PM task in the laboratory can be influenced by the emotionality of the task material. First studies suggested that emotional task material may enhance PM performance in young and older adults by heightening the salience of the task and thereby reducing the need for controlled attention. However, the extent and mechanisms of this effect are still under debate. Therefore, Study 3 explored possible differential effects of PM target cue valence on PM age effects. For that purpose, 45 young and 41 older adults performed a PM task in which emotional valence of the PM cue was manipulated (positive, negative, neutral). Results revealed an interaction indicating that age differences were smaller in both emotional valence conditions compared to the neutral condition. This finding supports an emotionally enhanced memory effect in PM, but only for the older adults as PM performance in young adults was not affected by cue valence. From a conceptual perspective, the results from Study 3 may also contribute to the explanation of the age-PM-paradox, as they suggest that the neutral material usually applied in lab-based studies might overestimate PM age effects. In summary, the present thesis makes an important contribution to the ongoing conceptual debate concerning adult age effects in PM performance assessed in the laboratory versus participants’ everyday lives. Results strongly suggest that mostly different variables may be crucial for understanding PM age deficits in the laboratory and age benefits in naturalistic PM tasks. Successful PM performance in the laboratory seems to require high levels of cognitive resources. The present results suggest that shifting ability is especially relevant in this respect. On a task level the emotionality of the material seems to influence the required amount of cognitive resources as it reduced PM age effects. Everyday stress seems to be particularly important for successful PM performance in the field. Thus, possible future studies should specify the relation between stress and PM as outlined in the general discussion.

Les antidépresseurs figurent parmi les médicaments les plus prescrits dans les pays industrialisés, incluant la France. L’utilisation croissante de ces médicaments dans la population générale suscite de multiples préoccupations quant à leurs effets indésirables sur la santé des populations. Plusieurs travaux de recherche se sont récemment intéressés à l’impact de l’utilisation prolongée de ces médicaments sur le risque cardiométabolique. Toutefois, les résultats produits sont contradictoires, limitées et ne concernaient pas la population Française. L’objectif général de ce travail de thèse consiste donc à étudier, à partir des données de deux grandes cohortes françaises (E3N et D.E.S.I.R.), l’association entre l’utilisation de médicaments antidépresseurs et le risque cardiométabolique, en essayant d’en comprendre les mécanismes sous-jacents. La première étude a montré que l’utilisation d’antidépresseurs était associée à un risque accru de diabète de type II. Cependant, l’association était évidente uniquement chez les femmes qui avaient plus de consultations médicales au cours des douze derniers mois. Les résultats de la seconde étude n’ont montré aucune association entre l’utilisation d’antidépresseurs et les marqueurs physio-biologiques qui caractérisent le diabète tels que : la glycémie à jeun, l’hémoglobine glyquée, la fonction des cellules β et la sensibilité à l’insuline. Enfin la troisième étude de ce travail de thèse a mis en évidence un risque accru de syndrome métabolique chez les utilisateurs d’antidépresseurs même si l’effet semblait se potentialiser chez les hommes uniquement. Les résultats de ces études apportent des éléments en faveur de l’hypothèse d’un biais de détection pour expliquer l’association observée entre utilisation d’antidépresseurs et diabète. Ce travail de thèse a permis de clarifier l’association entre l’utilisation d’antidépresseurs chez l’adulte et le risque cardiométabolique. Les implications scientifiques, cliniques et de santé publique sont discutées. / Antidepressants are among the most frequently prescribed medications in industrialized countries, including France. The increasing use of antidepressants in the general population has led to concerns about their adverse effects on health. Recently, important research work has focused on the impact of the prolonged use of antidepressants on cardiometabolic risk. However, the results produced were conflicting, limited and were not based on French population. The general objective of this thesis is therefore to study, based on data from two large French cohorts (E3N and D.E.S.I.R.), the association between the use of antidepressant drugs and cardiometabolic risk, with the ambition to understand the underlying mechanisms. The first study showed antidepressant medication use to be associated with an increased risk of type II diabetes. However, this association was evident only in women with more medical visits in the last twelve months. The results of the second study shows no association between antidepressant medication use and physio-biological markers that characterize diabetes such as fasting plasma glucose, glycated haemoglobin, β-cell function and insulin sensitivity. Finally, the third study showed an increased risk of metabolic syndrome among users of antidepressants, although the effect was apparent in men only. The results of these studies provide evidence supporting the hypothesis of a detection bias to explain the observed association between antidepressants use and diabetes. This work has helped to clarify the association between the use of antidepressants in adults and cardiometabolic risk. The scientific, clinical and public health implications are discussed.

<strong>Background:</strong> Stroke is a leading cause of disability and premature death in China and blood pressure is widely considered to be a major cause. Despite this, substantial uncertainty remains about the shape and strength of the association between blood pressure and stroke pathological types in China. <strong>Methods:</strong> Information from the China Kadoorie Biobank study (a prospective cohort study of 0.5 million men and women in China recruited during 2004-8) was used to relate usual blood pressure to risk of stroke, by stroke pathological type (cerebral infarction [ischaemic stroke], intracerebral haemorrhage and subarachnoid haemorrhage). Prospective analyses excluded participants with a history of vascular disease recorded at baseline; involved correction for regression dilution bias; used incident stroke events for which the diagnosis involved a head CT or MRI scan; and, assessed for confounding and effect modification by major vascular risk factors. These prospective analyses were informed by a set of prior analyses, including: a description of baseline associations between blood pressure and other vascular risk factors, to identify potential confounders; analyses of resurvey blood pressure data from ~20_000 participants, to assess regression dilution bias; and analyses of stroke follow-up data, involving an adjudication ‘sub-study’ performed specifically as part of this thesis, to evaluate the diagnostic accuracy of incident stroke events (~1000 events were adjudicated). <strong>Results:</strong> During 2.1 million person-years at risk, there were 5783 incident stroke events. At ages 40-79 years, the proportional difference in risk of both cerebral infarction and intracerebral haemorrhage associated with a given absolute difference in usual blood pressure was constant throughout the range of blood pressures examined (SBP 120-170 mm Hg, DBP 70-100 mm Hg). Overall, the strength of association was approximately 1.5-times greater for intracerebral haemorrhage than for the other stroke pathological types: 10 mm Hg higher usual SBP was associated with 82% (95% CI: 76%-89%) higher risk of intracerebral haemorrhage, 47% (44%- 50%) higher risk of cerebral infarction and 52% (35%-71%) higher risk of subarachnoid haemorrhage (the overall mean age at event for each stroke pathological type was ~60 years). For both cerebral infarction and intracerebral haemorrhage, there was strong evidence of major effect modification by age and to a lesser extent by a number of other vascular risk factors. The associations by age were around a third as extreme at age 70-79 years than at 40-49 years. The annual absolute differences in risk associated with a given absolute increase in usual blood pressure, however, were greater at older age. <strong>Conclusions:</strong> In Chinese adults, usual blood pressure was strongly and positively related to risk of all stroke pathological types. The strength of association was greater for intracerebral haemorrhage than other stroke pathological types. For both cerebral infarction and intracerebral haemorrhage, there was evidence of major effect modification by age. The overall effect of blood pressure on stroke risk was much greater than estimated by previous prospective studies in China, particularly for intracerebral haemorrhage.

La problématique générale de la recherche est la suivante : en quoi les pratiques de transmission du métier individuel permettent aux acteurs de co-construire le(s) métier(s) collectif(s) ? Un cadre théorique a été construit à partir du croisement de plusieurs champs disciplinaires : la sociologie et l'histoire pour le métier, le management stratégique pour le transfert intra-organisationnel de connaissances, la gestion des ressources humaines pour le management des compétences au sein des organisations. Ce cadre invite à mettre en avant les caractéristiques du métier au cours du processus de transmission. D'un point de vue méthodologique, l'approche empirique est constituée de trois études de cas enchâssées (Yin, 2003) dans un contexte spécifique : les métiers du bâtiment et des travaux publics. Les analyses révèlent que les individus dans l'exercice de leur métier intègrent quatre champs d'analyse : la mémoire, la recherche, la formation et la rencontre. Ces éléments réunissent à la fois l'importance de la tradition (mémoire) et les évolutions liées aux métiers à travers une dimension prospective(recherche et formation). Le lien entre ces deux dimensions étant effectué via la rencontre, la transmission se réalisant essentiellement par la rencontre.

Implementation intentions have been shown to improve prospective memory performance among a variety of populations. In two studies, the effectiveness of implementation intentions was examined among young and older adults. In Experiment 1 64 young adults were placed into one of four instructional conditions (Read-Only, Imagery, Implementation Intention, Combined) before completing a laboratory-based prospective memory task. Results reveal that prospective memory performance improves under each of the three experimental conditions, but that there is no additional benefit of combining imagery with implementation intentions. In a novel finding, imagery alone produced improvements comparable to implementation intentions. Experiment 2 investigated the effect of implementation intentions among 32 older adults, who were characterized as possessing high- or low-frontal function based on neuropsychological test performance. Implementation intentions improved prospective memory among both groups, regardless of frontal function. The results of these studies suggest that implementation intentions can improve prospective memory among both young and older adults. Importantly, these findings reveal that imagery alone may be an effective means of improving prospective memory. Additionally, that implementation intentions improved prospective memory among older adults, regardless of frontal function, raises important questions about potential mechanisms underlying the effectiveness of implementation intentions.

Background: The highly driven and often excessive exercise seen in eating disorder patients can be defined as a compulsive behaviour, and is often performed for weight control reasons, as well as for mood regulatory purposes. Compulsive exercisers often exercise in a rigid and rule-driven manner and predominantly report no enjoyment from the activity. Importantly, compulsive exercise has negative clinical implications, such as prolonging eating disorder treatment and representing a key factor in eating disorder relapse. However, despite these negative clinical implications and the large percentage of patients that may experience these harmful and detrimental behaviours, the body of literature examining the aetiology of compulsive exercise is relatively scarce and lacks a coherent theoretical underpinning. Objectives: This thesis aimed to provide the first known investigations into the possible correlates and risk factors for compulsive exercise in adolescent boys and girls. Main Findings: The key prospective predictors of compulsive exercise found in this thesis were self-perfectionism and obsessive-compulsiveness for boys. For girls, internal dysfunctional emotion regulation and a perceived media pressure to be thin were the key risk factors for compulsive exercise. Implications: The results from the thesis suggest that psychological factors are important in the development of compulsive exercise in boys, whereas in girls, a combination of dysfunctional emotion regulation and socio-cultural pressure to be thin could lead to the development of compulsive exercise cognitions and attitudes. Further research is needed to replicate and extend these results, although these thesis findings still provide useful empirical evidence to inform prevention and early intervention programmes for compulsive exercise in adolescents.

Due to their prevalence and associated high rehabilitation costs, this thesis aimed to better understand factors influencing the risk of tibial (TSF) and third metatarsal (MT3SF) stress fractures in Royal Marine recruit training. In Study 1, the standard issue combat assault boot and neutral trainer were assessed during running. Running in the boot caused restricted ankle motion, greater forefoot loading, greater ankle stiffness and a more laterally applied horizontal force vector at the instant of peak braking, suggesting that the risk of incurring MT3SF was greater in this condition. In Study 2, bending stresses were modelled along the length of the third metatarsal of five participants, using individual bone geometry and dynamic gait data. Stresses were modelled for running when barefoot, and when shod in the standard issue footwear. Estimated peak bending stresses were significantly greater in the combat assault boot than the gym trainer, predominantly due to increased plantar loading. Individual bone geometry was however dominant in determining peak bending stresses. In Study 3, a large (n=1065) prospective study was conducted to identify differences in baseline characteristics between recruits sustaining a TSF or MT3SF and those who complete training uninjured. Ten TSF and 14 MT3SF cases were compared to 120 uninjured legs. Results suggest that risk of TSF is greater in those recruits with reduced ability to resist loading and attenuate impact during gait. Results for MT3SF suggest that ankle and foot position at touchdown, and the timing and magnitude of forefoot loading, are important factors influencing risk of this injury. The observation of lower age and BMI in both stress fracture groups was linked to lower bone strength and earlier fatigue mechanisms. This thesis has increased the understanding of MT3SF in particular, and provides information on specific factors which may be associated with MT3SF and TSF in RM recruits during basic training.

The aims of the present study were to investigate the association between overweight and cognitive ability and dementia, and to evaluate the usefulness of self-reported body mass index (BMI) in late life and various data sources commonly used in epidemiological studies to identify persons with dementia. Data were drawn from three population-based studies: the Swedish Adoption/Twin Study of Aging (SATSA), Aging in Women and Men: A Longitudinal Study of Gender Differences in Health Behaviour and Health among Elderly (the Gender Study), and the Finnish Lieto Study. In Study I, the agreement between self-reported and measured BMI over time was evaluated among 774 men and women, ages 40 to 88 years at baseline (mean age 63.9) participating in both the questionnaire phase and in-person testing of SATSA. Latent growth curve (LGC) modeling showed a small but significant increase between self-reported and measured BMI (0.02 kg/m2/y) over time, which would probably not affect the results if self-reported BMI were used as a continuous variable in longitudinal research. In Study II, the agreement between dementia diagnoses from various sources and dementia diagnoses set at a consensus conference was evaluated. Among the 498 elderly people ages 70 to 81 at baseline (mean age 74.5) enrolled in the Gender Study, 87 were diagnosed with dementia during an eight-year period. Review of medical records and nurse evaluations yielded the highest sensitivity (0.83 and 0.80, respectively) and a high specificity (0.98 and 0.96), indicating that these sources might be good proxies of dementia, while data extraction from the Swedish Inpatient Discharge Registry underestimated the prevalence of dementia (sensitivity 0.26). In Study III, the association between being overweight in midlife and cognitive ability in late life was examined in SATSA. The 781 participants ages 25 to 63 at baseline (mean age 41.6) in 1963 or 1973 self-reported their height and weight. From 1986 until 2002, they were assessed five times using a cognitive test battery. LGC models showed that people with higher midlife BMI scores had significantly lower cognitive ability and a significantly steeper decline than their thinner counterparts, an association that persisted when those who developed dementia during the study period were excluded from the analysis. This finding indicates that being overweight might affect cognitive ability independently of dementia. In Study IV, the association between BMI and dementia risk in older persons was described among 605 persons without dementia and ages 65 to 92 at baseline (mean age 70.8) in the Lieto Study. Among these, 86 persons were diagnosed with dementia during eight years of follow-up. Cox regression analyses indicated that for each unit increase in BMI score, the risk of dementia decreased 8% (hazard ratio = 0.92, 95% confidence interval = 0.87–0.97) and the association remained significant when individuals who developed dementia during the first four years of follow-up were excluded from the analyses. This result suggests that low BMI scores are present almost a decade before clinical dementia onset.