Diarrhées aiguës: propositions de prise en charge ambulatoire [Acute diarrhea: proposal for outpatient management]

Dans la majorité des cas, les diarrhées aiguës sont bénignes et d'évolution spontanément favorable. Il faut cependant savoir reconnaître les situations pouvant mener à des complications, en l'occurrence identifier les diarrhées invasives, inflammatoires, caractérisées par la présence de fièvre, de douleurs abdominales, de ténesmes, de mucus et, ou de sang dans les selles. Celles-ci sont à distinguer des diarrhées sécrétoires, non invasives, non inflammatoires, sans fièvre, généralement aqueuses et volumineuses. En cas de doute diagnostique, l'identification de leucocytes par microscopie ou test à la lactoferrine dans les selles permet d'évoquer une gastroentérite invasive. Les indications à une antibiothérapie empirique dans l'attente du résultat de la coproculture sont la présence d'un syndrome dysentérique (T > 38°C, > 6 selles/24 heures, douleurs abdominales, diarrhées mucopurulentes), l'âge avancé, des comorbidités significatives, une immunosuppression et la présence d'une prothèse endovasculaire. In the majority of the cases, an acute diarrhea is mild and of spontaneously favorable evolution. It is however necessary to know how to recognize the situations being able to lead to complications, in particular to identify the invasive, inflammatory diarrheas, characterized by the presence of fever, abdominal pains, mucus and\or blood. The identification of leukocytes by microscopy or lactoferrine test is helpful. Empiric quinolones treatment is recommended in the presence of dysenteric syndrome (T > 38 degrees C, > 6 stods/24 h 00, abdominal pain muco-purulent diarrhea), advanced age, significant comorbidities, immunosuppression or presence of an endovascular prothesis

Proposal for Construction of Brock’s Monument, Queenston, newspaper fragment, 1824

Brock’s Monument is owned by Parks Canada and maintained by the Niagara Parks Commission in collaboration with the Friends of Fort George and Niagara National Historic Sites. It is located in Queenston Heights Park atop the Niagara Escarpment. On March 14, 1815, Parliament passed an act to erect a monument to the memory of General Isaac Brock. A design by engineer Francis Hall was selected. He envisioned a 135 ft. tall Tuscan column, made out of stone with a winding staircase inside. By the spring of 1824, work had begun on the monument. In June of that year, the cornerstone was laid and William Lyon Mackenzie was in attendance at the ceremony. It was on October 13th, 1824 (the anniversary of Brock’s death) that 6000 people traveled to Queenston to inter the remains of Brock and Lieutenant-Colonel Macdonell. This was the second burial for both. After 3 years the tower had reached 135 feet, but there was no inscription at the base, the fence around the observation deck had not been installed and there was no statue of Brock. Hall submitted a plan to finish the statue, but he was turned down and a simple ornament was placed where the Brock statue should have been. A massive blast of gunpowder destroyed the monument in 1840. It is alleged that an American sympathizer with the Upper Canada Rebellion set off the blast. Brock and Macdonell’s bodies were reburied in the Hamilton Family Cemetery in Queenston. The present monument was rebuilt in 1853. William Thomas (designer of St. Michael’s Cathedral in Toronto) was the architect. Brock and Macdonell were once again laid to rest in separate vaults at the statue. In 1968, Brock’s Monument was declared a national historical site. In 2005, it was closed to the public due to safety concerns, but it reopened in 2010. Source: http://www.thecanadianencyclopedia.com/articles/brocks-monument-queenston-heights

Letter of request to Charles Stuart from S.D. Woodruff for payment for expenses for surveying the macadamized road from Port Robinson to Hurst’s Bridge

Letter of request to Charles Stuart from S.D. Woodruff for payment for expenses for surveying the macadamized road from Port Robinson to Hurst’s Bridge, July 4, 1855.

Letter (unsigned) to George H. Gillespie regarding Col. Clark’s proposal regarding timber in Long Point

Letter (unsigned) to George H. Gillespie regarding Col. Clark’s proposal regarding timber in Long Point. The writer [S.D. Woodruff] makes the argument that the point was purchased as a sporting preserve so it is desirable not to take the timber off the land, Aug. 5, 1868.

Letter to S.D. Woodruff from George H. Gillespie stating that Col. Clark has withdrawn his proposal about timber on the point

Letter to S.D. Woodruff from George H. Gillespie stating that Col. Clark has withdrawn his proposal about timber on the point. “Please send your views”, Aug. 10, 1868.

Estimate which has been taken at Mr. Cook’s request and signed by Fred Holmes

Estimate which has been taken at Mr. Cook’s request and signed by Fred Holmes, Nov. 5, 1855.

Letter from Brush Brothers of Buffalo, New York for delivery of bricks and request for remittance

Letter from Brush Brothers of Buffalo, New York for delivery of bricks and request for remittance. This was signed in receipt of materials by S.D. Woodruff on Sept. 10, 1874, Sept. 8, 1875.

NGO Duties in Relation to Human Rights. A Closer Look at One Proposal

This paper investigates the moral duties that human rights NGOs, such as Amnesty International, and development NGOs, such as Oxfam, have in relation to human rights – especially in relation to the human right to a decent standard of living. The mentioned NGOs are powerful new agents on the global scene, and according to many they might be duty-bearers in relation to human rights. However, until now their moral duties have hardly been investigated. The present paper investigates NGO duties in relation to human rights by looking in particular to a moral theory recently proposed by Leif Wenar, a theory which has some similarities to utilitarianism. In applying this theory, a case for human-rights duties of NGOs is developed mainly by considering the indispensable role that civil society plays in protecting human rights. The paper concludes that, at least, NGOs bear duties with regard to human rights when, as in certain real-life cases, NGO involvement is the only way to achieve acceptable protection against standard threats to certain goods, such as a decent standard of living.

What is reflection? A conceptual analysis of major definitions and a proposal of a five-component definition and model

La réflexion est considérée comme un élément significatif de la pédagogie et de la pratique médicales sans qu’il n’existe de consensus sur sa définition ou sur sa modélisation. Comme la réflexion prend concurremment plusieurs sens, elle est difficile à opérationnaliser. Une définition et un modèle standard sont requis afin d’améliorer le développement d’applications pratiques de la réflexion. Dans ce mémoire, nous identifions, explorons et analysons thématiquement les conceptualisations les plus influentes de la réflexion, et développons de nouveaux modèle et définition. La réflexion est définie comme le processus de s’engager (le « soi » (S)) dans des interactions attentives, critiques, exploratoires et itératives (ACEI) avec ses pensées et ses actions (PA), leurs cadres conceptuels sous-jacents (CC), en visant à les changer et en examinant le changement lui-même (VC). Notre modèle conceptuel comprend les cinq composantes internes de la réflexion et les éléments extrinsèques qui l’influencent.