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Cadre de la recherche : En Belgique, l’euthanasie a été ouverte aux mineurs en février 2014. La demande à mourir doit être formulée par le mineur. Elle doit recevoir l’accord des parents. Elle est réglementée par un processus d’évaluation et d’accompagnement interdisciplinaire pour des situations de souffrance physique constante, insupportable et inapaisable ne présentant aucune autre solution raisonnable dans le contexte d’une affection incurable. Objectifs : Partager les réflexions et recommandations sur l’accompagnement des enfants, de leurs familles et des équipes dans le cadre des demandes d’euthanasie. Elles visent à pointer les éléments que cet accompagnement a en commun avec tout processus de soin, mais également ceux qui le caractérisent proprement. Méthodologie : Dès 2014, l’équipe mobile de soins palliatifs pédiatriques de l’Hôpital Universitaire des Enfants Reine Fabiola (HUDERF) de l’Hôpital Universitaire de Bruxelles (HUB) de l’Université Libre de Bruxelles (ULB) s’est réunie régulièrement de manière interdisciplinaire afin d’examiner et de discuter les différents aspects de la loi. Résultats : Le résultat de ce dialogue ouvre un champ de réflexions et de balises pour assurer un soin adapté et réglementé. Il vise à favoriser l’accompagnement de l’ensemble des personnes mobilisées par l’émergence d’une demande d’euthanasie. Il ne s’agit pas de définir un cadre strict, mais de proposer des repères généralisables et capables d’y assurer un soin dynamique, non linéaire, collaboratif et compréhensif. Conclusions : L’euthanasie est un processus de soin et d’accompagnement allant aux rythmes multiples des personnes dont il a la responsabilité. Les balises de ce cheminement trouvent place à travers une constellation humaine et interdisciplinaire. Contribution : L’euthanasie de mineur en Belgique est une pratique rare, peu étudiée mais jamais anodine. Cet article interroge l’exceptionnelle singularité de ces processus de soin et les ressources interdisciplinaires nécessaires pour l’accompagner. Research framework: In Belgium, euthanasia was made available to minors in February 2014. The request to die must be expressed by the minor and receive parental consent. It is regulated by an interdisciplinary process and support for situations of constant, unbearable and unappeasable physical suffering presenting no other reasonable solution in the context of an incurable condition. Objectives: Share reflections and recommendations on support for children, their families and teams in the context of euthanasia requests. They aim to point out the elements that this support has in common with any care process, but also those that characterize it specifically. Methodology: Since 2014, the pediatric palliative care mobile team of the Queen Fabiola University Children's Hospital (HUDERF) of the Brussels University Hospital (HUB) of the Université Libre de Bruxelles (ULB) has met regularly on an interdisciplinary basis to examine and discuss the various aspects of the law. Results: The outcome of this dialogue opens up a field of reflection and guidelines for ensuring appropriate, regulated care. Its aim is to support all those involved in the emergence of a request for euthanasia. The aim is not to define a strict framework, but to propose generalizable benchmarks capable of ensuring dynamic, non-linear, collaborative and comprehensive care. Conclusions: Euthanasia is a process of care and accompaniment that follows the multiple rhythms of the people for whom it is responsible. A human and interdisciplinary constellation is needed to guide this process. Contribution: Euthanasia of minors in Belgium is a rare practice, little studied but never trivial. This article examines the exceptional singularity of this care process and the interdisciplinary resources needed to support it. Marco de la investigación: En Bélgica, la eutanasia se puso a disposición de los menores en febrero de 2014. La petición de morir debe ser expresada por el menor y recibir el consentimiento paterno. Se regula mediante un proceso interdisciplinar y se apoya en situaciones de sufrimiento físico constante, insoportable e inabordable que no presenten otra solución razonable en el contexto de una enfermedad incurable. Objetivos: Compartir reflexiones y recomendaciones sobre el apoyo a los niños, sus familias y equipos en el contexto de las solicitudes de eutanasia. Pretenden señalar los elementos que este apoyo tiene en común con cualquier proceso asistencial, pero también los que lo caracterizan específicamente. Metodología: Desde 2014, el equipo móvil de cuidados paliativos pediátricos del Hospital Infantil Universitario Reina Fabiola (HUDERF) del Hospital Universitario de Bruselas (HUB) de la Universidad Libre de Bruselas (ULB) se reúne periódicamente de forma interdisciplinar para examinar y debatir los distintos aspectos de la ley. Resultados: El resultado de este diálogo abre un campo de reflexión y directrices para garantizar una asistencia adecuada y regulada. Su objetivo es apoyar a todos los implicados en la aparición de una solicitud de eutanasia. No se trata de definir un marco estricto, sino de proponer puntos de referencia generalizables capaces de garantizar una atención dinámica, no lineal, colaborativa e integral. Conclusiones: La eutanasia es un proceso de atención y acompañamiento que sigue los múltiples ritmos de las personas de las que se responsabiliza. Se necesita una constelación humana e interdisciplinaria para guiar este proceso. Contribución: La eutanasia de menores en Bélgica es una práctica rara, poco estudiada pero nunca trivial. Este artículo examina la singularidad excepcional de este proceso asistencial y los recursos interdisciplinarios necesarios para apoyarlo.

Plus que l’Occident, longtemps partagé entre haine et fascination, l’Inde a l’amour du théâtre, sans doute parce que s’y condense sa vision du monde et de l’être dans le monde. Qu’est le monde en effet et celui, homme ou dieu, qui s’y inscrit fugitivement, sinon la création de la māyā, l’Illusion cosmique ? Sur le tréteau de l’univers, Śiva, le Nitarāja, prince et modèle des acteurs, est le dieu qui joue, souverainement. Théâtre indien, donc, ou plutôt, tant l’objet est divers, ambigu et labile, théâtres indiens, fussent-ils réels ou rêvés, de Java ou du romantisme français. De l’Inde à l’Occident, du passé, mythique ou historique, au présent, les dix-huit textes de ce volume voudraient, multipliant les points de vue, rendre compte de ce pluriel. Philologie, analyse littéraire, histoire, sociologie, ethnologie, témoignage de praticiens, poésie même : les approches sont nombreuses, et font leur place à la scène du rituel, comme à la réflexion esthétique et philosophique. Impossible en effet d’ignorer la question fondamentale : celle des rapports du théâtre et de la réalité, avec pour corollaire les raisonnements sur les registres d’incarnation — la figuration théâtrale et la possession —, lesquels, loin de circonscrire fermement les domaines du théâtre et du rituel, contribueraient plutôt à en brouiller les contours puisque la possession elle-même est susceptible d’être jouée. De ces glissements et recouvrements incessants naît un trouble qui est peut-être aussi la condition du plaisir esthétique comme celle de l’accès, au-delà de l’apparence, à une réalité plus haute. L’illusion est la fin du théâtre et sa vérité, son enjeu. Le rideau, « cette toile qui sépare du mystère », comme dit Mallarmé, en est, avant l’acteur même, le premier signe.

Myriades d’oiseaux dont le dessin, le plumage ou l’allure flatte les sensations de l’esthète arrêté devant les volières regorgeant de turacos de Hartlaub, de caucase-soleils, de lophophores couronnés et de spermètes à capuchon... Quand l’œil s’égare à suivre le sélasphore roux, le tichodrome, le tinamou huppé, le bec-croisé des sapins, ou le colibri xiphophore voletant d’une aile espiègle autour du bec informe du pétrel fulmar, parmi tant d’espèces où l’harmonie des formes le dispute à la plu...

Paediatric intensive care is born 40 years ago. It has been shown that admission of critically ill children in intensive care (ICU) where no paediatric intensivists worked increased significantly the mortality and the length of stay. The recognition of Paediatric Intensive Care (PICU) does not exist in Belgium and children are admitted in both adult and paediatric intensive care units. It is mandatory to recognise the PICU specificity and the usefulness of a fellowship in paediatric intensive care. Development of molecular biology and genetics will permit in the near future to understand reversible and irreversible cellular processes of the majority of problems responsible for mortality in critical care and to allow the development of new diagnostic and therapeutic techniques. Rapid development of information will permit the creation of multicenter databases including all PICU's data. The final goal is an intelligent tool for making decision process. Telemedecine is born which permits a virtual consultation of the patient. Technological progress must not impair the wellbeing of the child and its family. The PICU of the future must be "parents admitted". PICU profile is progressively changing, the way of taking care of the critically ill child and its family is also changing and improving. An ethical reflexion among the health care providers' team and a dialogue with parents will blossom.

Dissertação apresentada para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Terminologia Com esta investigação, aplicámos conhecimentos terminológicos no âmbito do ensino do Francês Língua Estrangeira I e II, fundamentando esta escolha com a relação existente entre o domínio do ambiente e os documentos oficiais de orientação para o ensino/aprendizagem do Francês Língua Estrangeira, nomeadamente salientando a ligação entre os pontos mais pertinentes do Quadro Europeu Comum de Referência para as Línguas e os conteúdos dos Programas de Francês LE I e II. A partir de um corpus actual recolhido e tratado criteriosamente por nós, propomos a concepção de uma base de dados terminológica, para fins didácticos no Ensino de Francês Língua Estrangeira I e II, na qual podemos encontrar unidades terminológicas nominais complexas e/ou colocações terminológicas do domínio do ambiente e que poderá servir para a formação inicial e/ou ao longo da vida para o público-alvo: professores e alunos interessados. Para criar esta base de dados relacional, concebemos uma base de dados documental, uma terminológica, uma textual e finalmente a base de dados de recursos terminodidácticos, usando para isso os nossos conhecimentos do Sistema de Gestão de Base de Dados, o que nos proporcionou bastante satisfação. Nesta dissertação, descrevemos todas as etapas e escolhas necessárias para atingir o objectivo máximo: criar esta ferramenta original e cientificamente de qualidade, simultaneamente motivadora para o ensino/aprendizagem, interactiva e evolutiva, levando o seu utilizador a uma maior consciência e quiçá – a boas práticas de “ecocidadania”

International audience; Résumé : Le projet de recherche interuniversitaire AGORA a permis d'investiguer huit cas contrastés d'usage des forums dans l'enseignement supérieur à travers une triangulation de méthodes combinant analyse des traces externes, analyse de contenu et entrevues. Dans le présent article, nous investigons trois grandes questions : (1) les discussions au sein des forums portent-ils effectivement sur le cours ?; (2) quelle est la part respective des échanges pédagogico-intellectuels, socio-affectifs et technico-organisationnels au sein des forums chez les étudiants et chez les agents d'encadrement ?; (3) quelle perception les étudiants ont-ils de l'apport des forums sur ces trois plans ? Nos résultats indiquent que les forums, en raison des différentes formes de soutien dont ils peuvent être les vecteurs, sont un outil potentiellement utile à mobiliser pour faciliter la transition secondaire-université. Mots-clés : forum de discussion -formation hybride -apprentissage collaboratif -apprentissage coopératif -analyse de contenu -pédagogie universitaire -scénario pédagogique – tutorat

Sur base d’une enquête socio-anthropologique menée à Kinshasa sur les obstacles et motivations au don de sang bénévole en RDC dans le cadre d’un programme de coopération au développement, cette contribution s’attache à illustrer une réflexion sur la place et le rôle d’une chercheuse vis-à-vis des populations qui participent à son étude. La première partie de cet article présente les méthodes de recherche privilégiées en fonction du cadre de travail auquel la chercheuse est confrontée; ensuite, les différentes étapes de cette enquête sont développées, ainsi que les difficultés et les solutions mises en œuvre. La deuxième partie se veut une réflexion critique sur la place et le rôle d’une chercheuse. Sur base de la façon de se présenter aux différents acteurs concernés et de leur propre perception du contexte, le statut de la chercheuse est constamment redéfini, renégocié en fonction des logiques et des stratégies de chaque acteur ou groupe d’acteurs impliqués dans la question de la promotion du don de sang bénévole. This article is based on a socio-anthropological study carried out in Kinshasa on the obstacles to and motivations for voluntary blood donations. The research took place in the framework of a development cooperation programme. The objective of this article is to reflect on the place and role of a researcher vis-à-vis the people participating in the study. The first part presents the research methods and the ways they are embedded in the work context. Next, the different steps of the study are outlined, along with obstacles and resolution strategies. The second part presents a critical reflection on the role of the researcher focussing on how she presents herself to actors involved in the project and how their perception of the context influences results. Experience proves that the status of the researcher has to be constantly redefined and renegotiated in relation to the logics and strategies of each actor or group of actors involved in the issue of promoting voluntary blood donations.

Invasive ventilation in status asthmaticus is associated with an increased mortality and morbidity. To avoid intubation associated complications, non-invasive bi-level ventilation is often used in adults and children. We report the clinical history of an 11-month old infant, which encountered intubation criteria but was treated successfully by full-face mask non-invasive bi-level ventilation. Despite difficulties in application due to young age and lack of age related material, non-invasive bi-level ventilation is a good tool in the treatment of children with status asthmaticus.

The antegrade scrotal sclerotherapy is a minimally invasive surgical technique in the treatment of the varicocele. Through a small scrotal incision a straight vein merging in the spermatic vein is isolated and cannulated. An antegrade phlebography is performed and ethoxysclerol is injected in the vein. We have performed this technique in 35 patients with a follow-up of at least 3 months. All patients except one (97%) show no more varicocele. This technique has a low morbidity, is cheap and as effective as the other treatment modalities. The antegrade sclerotherapy is competitive to the retrograde embolisation and has the advantage that the treatment can be performed in all cases, even in cases of recidive.

A review of the literature concerning the very rare anti-PP1Pk isoimmunisation with a personal case.Anti-PP1k antibody gives rise to the high risk of abortion in the first and the second trimester (in a different series the risk is 50-70%). A 19-year-old patient who had this antibody was helped by a plasmaphoresis repeatedly between the 6th and the 25th week of pregnancy. Cordocentesis was carried out to estimate fetal haemoglobin from the 25th week onwards. A set caesarean section was carried out at 36 weeks because of intrauterine growth retardation and the development of fetal anaemia.The authors suggest research based on the known immunohaematological factors concerned with this isoimmunisation and on the main treatments available (plasmaphoresis, cordocentesis, and delivery at a set time).Until now there have been very few cases and only four similar cases to ours have been reported in the literature. That is why it is so difficult to suggest a well defined strategy for treating these patients.

The authors report a case of severe post-transfusion anti-Duffy (Fya) allo-immunization which required a treatment of four intrauterine exchange transfusions. The child was born at 32 weeks of amenorrhoea and he benefited from an exchange perfusion at birth. The outcome was fully satisfactory. On the basis of this case, the authors present a review of immuno-haematology concerning the Duffy system. This system holds fourth rank, after the ABO, rhesus and Kell systems, on the clinical importance scale of group systems. It concerns two alleles, Fya and Fyb, located on the first chromosome. The anti-Duffy antibodies are IgG immune antibodies; they may be responsible for haemolytic accidents, sometimes lethal, during transfusions, and they are an occasional cause of haemolytic disease of the newborn. A review of the literature yielded only 25 cases of haemolytic disease of the newborn, thereby showing that this allo-immunization is very rare, and it demonstrated its potential danger. Finally, the authors present the therapeutic methods used to treat the haemolytic disease of the newborn caused by anti-Duffy antibodies. Plasmapheresis and intrauterine exchange perfusion have dramatically improved the prognosis of this disease.

The authors analyse a series of 23 multiple pregnancies (19 triplet pregnancies, 3 quadruplets and 1 quintuplet). The first objective is to fight prematurity. Over and above all use of drugs as tocolytics (beta-mimetic drugs and progesterone) should routinely be advised and as soon as there is any threat of premature labour hospitalisation is needed. Twenty one of the 23 patients had prophylactic cerclage (Shirodkar's stitch). In 77% of the cases respiratory distress in the newborn was avoided by using cortico-therapy. Vaginal delivery can be carried out under certain conditions in triplet pregnancies. If certain precautions are taken there does not seem to be any immediate difference in the post delivery period of these children if they are born vaginally or by caesarean. Perinatal mortality is raised (at 5.6% for triplets and 58.3% for quadruplets). The psychological implications of these pregnancies are important. Problems appear as soon as the diagnosis is made and continue for years afterwards. On the social level, help given by the social services are usually inadequate. If the couples belong to the National Association for Mutual Aid of Parents of Children of Multiple Births, a system of mutual support is available. We recommend that these pregnancies should be looked after by several disciplines. These consist not only of obstetricians, paediatricians, anaesthetists, those who resuscitate together, but also psychologists, dietitians, social workers, community workers and physiotherapists.

Virulence-associated plasmids pLT2, pIP1350, pIP1360 and pIP1370 coded for the fi+ character. These plasmids did not code for the synthesis of classical adhesins, aerobactin or colicins. Nor did they mediate resistance to the metals Hg, Te, As, Cd or flavomycin. Plasmids pLT2, pIP1350 and pIP1370 contained DNA sequences homologous to the incFIIA and incFIB replicons. Plasmid pIP1360 contained a single sequence homologous to incFIIA replicon.

info:eu-repo/semantics/published

Virulence-associated plasmids pLT2, pIP1350, pIP1360 and pIP1370 coded for the fi+ character. These plasmids did not code for the synthesis of classical adhesins, aerobactin or colicins. Nor did they mediate resistance to the metals Hg, Te, As, Cd or flavomycin. Plasmids pLT2, pIP1350 and pIP1370 contained DNA sequences homologous to the incFIIA and incFIB replicons. Plasmid pIP1360 contained a single sequence homologous to incFIIA replicon., info:eu-repo/semantics/published

info:eu-repo/semantics/published

If the topic of depression in pediatric palliative care is often evoked in the clinical setting, few studies have been published. We have, in our multidisciplinary team, write a protocol of care for depression in children in palliative care and we need to focus in that complex questioning: how to define and diagnose depression among children in pediatric palliative care and how to manage it. The articulation of the different professionals in a real interdisciplinary is essential so that each point of view can be expressed, heard and discussed in a respectful and open environment. We need to be able to anticipate, identify and manage the clinical depression in a multidisciplinary manner, resisting to the temptation to automatically medicalized the psychic suffering of the child, while calling upon the child psychiatrist, when and if necessary. It is crucial, while offering support to the child and the family, to be able to tolerate the adaptive depression and to resist to the utopian idea of a “beautiful death”., SCOPUS: ar.j, info:eu-repo/semantics/published