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Christian Hervé - One of the best experts on this subject based on the ideXlab platform.

  • Decisions concerning potentially life-sustaining treatments in paediatric nephrology: a multicentre study in French-Speaking Countries.
    Nephrology Dialysis Transplantation, 2004
    Co-Authors: Isabelle Fauriel, Luc Montuclard, Ingrid Callies, Irène François, Grégoire Moutel, Marie Laure Moutard, Pierre Cochat, Nathalie Duchange, Christian Hervé
    Abstract:

    BACKGROUND: Few studies have looked at how decisions are made to withhold or to withdraw potentially life-sustaining treatments (LST) in paediatric nephrology. The aim of this work was to evaluate such practices in all nephrology centres in French-Speaking European Countries, so that guidelines could be discussed and drawn up by professionals. METHODS: We used semi-directed interviews to question health care professionals prospectively. We also retrospectively analysed the medical files of all children (n = 50) for whom a decision to withhold or to withdraw LST had been made in the last 5 years. The doctors (n = 31) who had been involved in the decision-making process were interviewed. RESULTS: All 31 of the French-Speaking paediatric nephrology centres in Europe were included in this study. Of these, 18 had made decisions in the previous 5 years about withholding or withdrawing LST. Resultant quality of life, based on long-term living conditions, was the principal criterion used to make the decisions. Relational aspects of life and the child's prognosis were also considered. The decision-making processes were not always collective, even though interactions between doctors and the rest of the medical team seemed to be key elements to them. The parents' involvement in the decision-making process differed between centres. CONCLUSIONS: The criteria used to decide whether to withhold or to withdraw LST are not standardized, and no specific guidelines exist.

L. Paquette - One of the best experts on this subject based on the ideXlab platform.

Axel Augé - One of the best experts on this subject based on the ideXlab platform.

  • Security and defense sector reforms in Sub-Saharan Africa. Towards the institutionalization of governance in the security sector
    Afrique contemporaine, 2006
    Co-Authors: Axel Augé
    Abstract:

    New security realities since the end of the 1990s have led to the structural and organizational transformation of armies worldwide. The military has been entrusted with new responsibilities and performs conventional duties differently. Beyond geopolitical developments that prompted African Countries to reform their security policies, a renewed interest in analyzing these reforms is driven by the key role that security and defense institutions play in good governance in Sub-Saharan African Countries. This paper provides an assessment of reforms being implemented in French-Speaking Countries in Sub-Saharan Africa. It shows how security reforms, although limited, reflect the institutionalization of security and defense governance in West and Central Africa.

Isabelle Fauriel - One of the best experts on this subject based on the ideXlab platform.

  • Decisions concerning potentially life-sustaining treatments in paediatric nephrology: a multicentre study in French-Speaking Countries.
    Nephrology Dialysis Transplantation, 2004
    Co-Authors: Isabelle Fauriel, Luc Montuclard, Ingrid Callies, Irène François, Grégoire Moutel, Marie Laure Moutard, Pierre Cochat, Nathalie Duchange, Christian Hervé
    Abstract:

    BACKGROUND: Few studies have looked at how decisions are made to withhold or to withdraw potentially life-sustaining treatments (LST) in paediatric nephrology. The aim of this work was to evaluate such practices in all nephrology centres in French-Speaking European Countries, so that guidelines could be discussed and drawn up by professionals. METHODS: We used semi-directed interviews to question health care professionals prospectively. We also retrospectively analysed the medical files of all children (n = 50) for whom a decision to withhold or to withdraw LST had been made in the last 5 years. The doctors (n = 31) who had been involved in the decision-making process were interviewed. RESULTS: All 31 of the French-Speaking paediatric nephrology centres in Europe were included in this study. Of these, 18 had made decisions in the previous 5 years about withholding or withdrawing LST. Resultant quality of life, based on long-term living conditions, was the principal criterion used to make the decisions. Relational aspects of life and the child's prognosis were also considered. The decision-making processes were not always collective, even though interactions between doctors and the rest of the medical team seemed to be key elements to them. The parents' involvement in the decision-making process differed between centres. CONCLUSIONS: The criteria used to decide whether to withhold or to withdraw LST are not standardized, and no specific guidelines exist.

Alain Fayolle - One of the best experts on this subject based on the ideXlab platform.