Processus de résilience chez les jeunes burundais à double appartenance ethnique ayant été victimes des violences interethniques et des conflits de mémoires

Les violences interethniques suivies de la dichotomisation ethnique de la société burundaise ont profondément affectés les jeunes burundais à double appartenance ethnique. Ils ont été contraints à la dislocation familiale, à des exodes répétitifs et à l’exposition de manière récurrente au réel de la mort. La trajectoire de vie de ces derniers a été caractérisée par le manque de reconnaissance qui s’exprimait par de l’ostracisme social, du rejet, de l’humiliation, de la stigmatisation, de la déshumanisation. Ces réactions négatives généraient chez les sujets des sentiments de honte, de culpabilité, d’étrangeté, d’abandon, de trahison et d’insécurité permanente.Se déraciner en rompant les ponts avec leurs régions d’origine a été une stratégie de survie utilisée par les familles mixtes et de leurs enfants pour faire face aux réactions négatives de leur environnement familial et social.Une analyse approfondie à l’aide des catégories conceptualisantes de la trajectoire de vie des jeunes burundais à double appartenance ethnique nous amène à dégager quelques propositions de théorisation ancrée :Les mouvements psychiques de survie induits par les expériences traumatiques extrêmes dont l’endurcissement, la dissociation, le clivage et l’introjection ne permettent pas de sortir des traumatismes. Les jeunes burundais à double appartenance ethnique sont en quête de reconnaissance et utilisent notamment à cette fin les processus psychiques dont l’évitement de la mentalisation, la dépendance affective, la sublimation, le retournement projectif, le retournement-exhibition, l’altruisme, l’humour, l’affiliation et l’oxymoron. Dans cette quête de reconnaissance, l’enclenchement d’un processus de résilience est conditionné par un travail psychique qui se réalise par le fait de s’affilier dans des groupes contenants et de rencontrer des tuteurs de résilience qui sont capables de reconnaître et comprendre leurs souffrances endurées et qui acceptent de leur apporter un réel soutien afin de les surmonter.Ethnic violence followed by ethnic dichotomy of Burundian society has deeply affected the young Burundian with dual ethnicity. They were forced to family dislocation, repetitive exodus and repeatedly exposed to the reality of death. The life trajectory of those children has been characterized by the lack of recognition and this was expressed by social ostracism, rejection, humiliation, stigmatization, dehumanization. These negative reactions generated in subjects feelings of shame, guilt, strangeness, abandonment, betrayal and continued insecurity. Uproot breaking ties with their regions of origin was a survival strategy used by mixed families and their children to deal with negative reactions from their family and social environment.Further analysis using conceptualisant categories of the life trajectory of young Burundian with dual ethnicity leads us to identify some proposals of grounded theory: The psychic survival movements induced by extreme traumatic experiences such as the hardness, dissociation, cleavage and introjection do not help trauma exit.Burundian youth with dual ethnicity are seeking recognition and for this purpose use especially psychic processes including mentalizing avoidance, emotional dependency, sublimation, the projective flipping, flipping-exhibition, altruism, humor, affiliation and oxymoron.In this quest for recognition, the engagement of a resilient process is conditioned by a psychic work that is realized by the affiliation in containers groups and meeting resilience tutors who are able to recognize and understand their pain and suffering and who agree to provide them with real support to overcome their trauma.Doctorat en Sciences psychologiques et de l'éducationinfo:eu-repo/semantics/nonPublishe

Drotrecogin alfa (activated) for severe sepsis: Could we consider a shorter treatment period in patients with a favorable course?

Purpose: The objective of this study was to develop a model to identify patients in whom drotrecogin alfa (activated) (DAA) might be administered for periods shorter than the recommended 96 hours. Methods: We did a retrospective chart review of all 124 patients treated with a standard 96-hour infusion of DAA in a 31-bed department of intensive care. Using a stepwise approach, we identified and combined parameters that could help predict outcomes to achieve the best sensitivity associated with 100% specificity. Results: Twenty-one (17%) of the 124 patients had a favorable outcome (left the intensive care unit within 5 days of DAA initiation); of these, 11 had an increase in arterial pH in the first 24 hours of treatment compared with 22 (21%) of the 103 patients with intermediate (intensive care unit stay >5 days after DAA initiation) or unfavorable (died within 5 days of DAA initiation) outcomes (P = not significant). Eight (72.7%) of these 11 patients and no other patient showed a decrease in sequential organ failure assessment score of at least 50% during the first 24 hours (P < .001). By combining these 2 variables, we could identify, with 100% specificity, 8 of the patients with a favorable outcome (38%) who made a prompt recovery. Conclusions: A simple model based on sequential organ failure assessment score and arterial pH can help identify patients with a rapid favorable course in whom a shorter duration of DAA treatment may be justified. © 2009 Elsevier Inc. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Spatial distribution and predictive factors of antenatal care in Burundi: A spatial and multilevel baseline analysis for the third burundian demographic and health survey.

IntroductionThe use of antenatal care by pregnant women enables them to receive good pregnancy monitoring. This monitoring includes counseling, health instructions, examinations and tests to avoid pregnancy-related complications or death during childbirth. To avoid these complications, the World Health Organization (WHO) recommends at least four antenatal visits. Therefore, this study was conducted to identify predictive factors of antenatal care (ANC) among women aged 15 to 49 years and its spatial distribution in Burundi.MethodsWe used data from the Second Burundi Demographic and Health Survey (DHS). A Spatial analysis of ANC prevalence and Mulitlevel logistic regressions of determinants factors of ANC with a medical doctor were done. The ANC prevalence was mapped by region and by province. In unsampled data points, a cluster based interpolation of ANC prevalence was done using the kernel method with an adaptive window. Predictive factors of ANC were assessed using Mulitlevel logistic regressions. The dependent variable was antenatal care with a medical doctor and the explanatory variables were place of residence, age, education level, religion, marital status of the woman, household wealth index and delivery place of the woman. Data processing and data analysis were done using using Quantum Geographic Information System (QGIS) and R software, version 3. 5. 0.ResultsThe ANC prevalence varied from 0. 0 to 16. 2% with a median of 0. 5%. A highest predicted ANC prevalence was observed at Muyinga and Kirundo provinces' junction. Low prevalence was observed in several locations in all regions and provinces. The woman's education level and delivery place were significantly associated with antenatal care with a medical doctor.ConclusionGlobally, the ANC prevalence is low in Burundi. It varies across the country. There is an intra-regional or intra-provincial heterogeneity in term of ANC prevalence. Woman's education level and delivery place are significantly associated antenatal care. There is a need to consider these ANC disparities and factors in the design and strengthening of existing interventions aimed at increasing ANC visits

A large-bolus injection, but not continuous infusion of sodium selenite improves outcome in peritonitis.

Administration of sodium selenite in septic shock has been associated with apparently conflicting results that may be related to different dosing schedules. Bolus administration, leading to a transient pro-oxidative effect, could limit the inflammatory reaction and improve outcomes. We studied 21 anesthetized, mechanically ventilated, invasively monitored, and fluid-resuscitated sheep. Nine hours after inducing peritonitis by injection of autologous feces, the animals were randomized into three groups: (i) bolus injection (2 mg selenium as selenite, followed by 0.06 microg .kg-1 .h-1, n = 7); (ii) continuous infusion (4 microg .kg-1 .h-1 selenium, n = 7), or (iii) control (n = 7). No vasopressors or antibiotics were administered. All animals were monitored until spontaneous death. Peak plasma selenium values reached 4 to 14 micromol .L-1. Compared with the other groups, sheep given a bolus of sodium selenite had delayed hypotension with better maintained cardiac index, delayed hyperlactatemia, fewer sepsis-induced microvascular alterations, and a prolonged survival time (21.9 [bolus group] vs. 18.4 [continuous group] and 18.3 h [control group], P < 0.05). Hence, in this model of septic shock, the administration of a large bolus of sodium selenite (rather than a continuous administration) resulted in beneficial effects, probably by a transient oxidative effect.Journal Articleinfo:eu-repo/semantics/publishe

Distribution of antenatal care prevalence by province.

Distribution of antenatal care prevalence by province.</p

Additional file 1 of Child stunting prevalence determination at sector level in Rwanda using small area estimation

Additional file 1. This manusrcipt has separate accompying supplementary files