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Les enfants ayant une atteinte neurologique ne sont pas tous en mesure de s'alimenter de manière sécuritaire et suffisante par voie orale pour maintenir un état nutritionnel convenable. L'alimentation par sonde de gastrostomie (ASGS) est une intervention importante et souvent essentielle dans une telle situation. Cependant, bien des parents et des familles ont du mal à prendre la décision de passer à ce type d'alimentation. Le présent point de pratique aborde les raisons courantes qui expliquent ces conflits décisionnels chez les parents et traite des principaux aspects d'une vie sous ASGS. On y présente également un cadre de prise de décision partagée et l'approche de la Classification internationale du fonctionnement, du handicap et de la santé (CIF). On termine par des recommandations pratiques aux cliniciens afin de faire participer les familles au processus décisionnel menant à cette intervention qui change la vie. [ABSTRACT FROM AUTHOR]

We present a study in which we investigated the safety of therapeutic mild hypothermia on the neonatal cardiovascular system. In an attempt to mimic the state of affairs that may follow an hypoxic-ischemic insult, the effect of moderate hypothermia was studied under conditions where cardiovascular integrity was impaired. Newborn piglets where randomized to either receive a thromboxane A2 mimetic or an hypoxic inspiratory gas mixture.  Periods of hypothermia (5 °C below normothermic level) preceded or were combined with those agents in a random manner. Isolated hypothermia decreased cardiac output by 25%, and increased pulmonary vascular resistance by 48%. Mesenteric blood flow and cerebral blood flow decreased by a similar magnitude (21 and 18% respectively). When hypothermia was combined with alveolar hypoxia or thromboxane, the increase in pulmonary vascular resistance (103 and 292% respectively) exceeded the increase produced by the sum of each individual component. In contrast neither hypoxia nor thromboxane potentiates the hypothermia induced decrease in mesenteric blood flow. Ileal mucosal blood flow remained stable for all conditions. We conclude that mild therapeutic hypothermia may be safe in conditions where cardiac function is impaired, but may be more hazardous when severe pulmonary hypertension is present. [Copyright &y& Elsevier]

Novel Polymeric Alloy (NPA) cells are a cellular confinement system with the engineering properties required by international standards for long-term confinement in demanding infrastructure projects. Three-dimensional NPA cells are used as a cover protection system against channel, stream and shoreline erosion caused by flowing water and tractive forces. NPA cells enhance the performance of conventional erosion control materials and dissipate energy from flood, current and wave action for hydraulic and marine structures and are a best available technique for canals, channels, drainage, shorelines, riverbanks, sea-walls, dams and port infrastructure. Soft or hard armor is used to optimize the erosion protection for natural or man-made channels, hydraulic structures and barriers. The surface treatment is dependent upon the geometry, hydraulic, site and environmental conditions along the water course, as well as optimization and cost-efficiencies. For example, sand infill is used for beachfront erosion control, vegetation for riverbank protection, gravel in sites subject to moderate flow velocities and concrete hard-armor in high velocity channels and walls subject to wave action. Reinforcement of load support structures in port applications can use sand, granular or recycled materials. Whereas the suitability of a cellular confinement system is directly dependent on the key attributes of the cell as well as its geometry, cells made of Novel Polymeric Alloy (NPA) have measurable higher tensile strength, resistance to deformation and environmental durability to hydraulic forces and thermal cycling over the project lifespan than conventional HDPE-based soft-cells. This includes high resistance to photochemical degradation – leaching of additives, oxidation and UV light – to preserve confinement for the lifespan of the project. Concrete solutions in non-erodible canals and walls are particularly advantageous with NPA cells. While the cellular mattress eliminates form work for fast construction, NPA cells add high tensile strength to the concrete. The creates a strong yet flexible mattress, which absorbs hydraulic forces and ground movement and resists cracking of the concrete for improved surface durability. Additionally, the high reinforcement factor of the NPA system also enables a reduction in concrete thickness to improve cost-effectiveness and sustainability. These properties also make NPA cells suitable to load support pavements used in marine ports, wharfs, terminals and container yards situated on soft, compressible and saturated soils, using sand for structural infill with no loss in structural stability.

Serial litigants are a well-known phenomenon. This article deals with this phenomenon on two different levels using Israel as a test-case. First, we analyze the impact they have on the judicial system as a whole, and the institutional responses the judicial system uses in order to deal with serial litigants as well as the impact (both positive and negative) such serial litigants have on other litigants. Second, we analyze the personal motives of serial litigants and identify their common denominators, as well as what differentiates them. In this regard the article offers a unique approach by presenting the perspective of serial litigants and the human dimension behind their claims. We then show that serial litigants do not constitute a monolithic group, and suggest that courts have to take the differences between them into account. We further propose the formulation of systemic tools that take into account both the negative and the positive aspects of serial litigants in order to strike a proper balance between the optimal allocation of resources, and the right of access to justice.

While many judicial systems in the Western World are coping with a shortage of judges, the public is not always aware of the overload and its reasons. Our claim is that the reason for this, is the fact that the judicial system preferred to preserve an ideal image of the judiciary and control all information about it, rather than to publicize the judicial overload problem. In this paper, we aim to show that until recently, the issue of “judicial overload” was hidden from the public eye. We deal with the importance and advantageous of presenting the relevant facts to the public. We shall empirically show, that the judicial system has begun to legitimize the exposure of judicial overload to the public. Si bien es cierto que muchos sistemas judiciales del mundo occidental están lidiando con la escasez de jueces, también lo es que el público no siempre es consciente de la sobrecarga de trabajo y de sus razones. Nosotros afirmamos que la razón de ello es que el sistema judicial ha preferido preservar una imagen ideal de la judicatura y controlar toda la información acerca de ella antes que hacer público el problema de la sobrecarga de trabajo de los jueces. En este artículo, pretendemos mostrar que, hasta hace poco, la cuestión de la "sobrecarga de los jueces" ha permanecido oculta a ojos del público. Tratamos el tema de la importancia y la ventaja que supone presentar los hechos relevantes al público, y demostraremos empíricamente que el sistema judicial ha comenzado a aprobar la exposición de la sobrecarga judicial al público. DOWNLOAD THIS PAPER FROM SSRN: http://ssrn.com/abstract=3039584

It has been claimed that Israel has the highest per capital rate of lawyers in the world, resulting in belief that the Israel Bar is overpopulated. The first law colleges, which were established 20 years ago, are newcomers to the production of legal professions. The leadership of the Israel Bar have held the law colleges responsible for Israel’s overpopulation of lawyers and for the legal profession’s decline in prestige. This paper examines whether the perception of overcrowding of the profession is a new “discovery” or rather the recycling of a standard dynamic between professionals and legal education institutions. While this paper focuses specifically on Israel, concern about the overpopulation of the profession has become a central concern in many other jurisdictions. Se ha asegurado que Israel tiene el ratio de abogados per cápita más alto del mundo, lo que hace creer que el Colegio de Abogados de Israel está superpoblado. Las primeras facultades de derecho, que se establecieron hace 20 años, son recién llegados de la producción de abogados. El liderazgo del Colegio de Abogados de Israel ha hecho que las facultades de derecho sean responsables de la superpoblación de abogados en Israel y del descenso del prestigio de la abogacía. Este artículo analiza si la percepción de superpoblación de la profesión es un nuevo “descubrimiento”, o, por el contrario, el reciclaje de una dinámica estándar entre profesionales e instituciones de formación en derecho. Aunque este artículo se centra especialmente en Israel, la superpoblación de la profesión se ha convertido en una preocupación central en muchas otras jurisdicciones.

The main argument of this short essay is that the concept of intellectual, especially the somewhat redundant neologism of public intellectual, is too narrow to guide research on how interventions in public affairs are currently authored, crafted, and operated. Instead, I propose the concept of public interventions to inform a more comprehensive approach that broadens the analytical frame by multiplying relevant agencies, modes and targets of intervention. This approach is inspired by Foucault’s (2000) distinction between the “universal” and “specific” intellectual; Bourdieu’s (Corporatism) replacement of the latter by a “collective intellectual”; and the approach to the public sphere urged by the contributors to Making Things Public (Latour and Weibel).

This paper explores the inter-communal relations in an Ottoman city – 18th century Salonica – against the background of recent studies that highlight the vitality of the urban public space and the ability of different religious and social groups to safeguard their interests vis-à-vis the rulers, to introduce their own agendas and to challenge existing social and physical boundaries. By using the evidence of the sicilt (the records of the şeriat court), I demonstrate the various legal strategies that were adopted by non-Muslims to secure their own interests in the public space: challenging existing boundaries or resisting any intrusion that might endanger their own position. My discussion evolves around three different places of encounter and conflict in Salonica: the prison, the Jewish cemetery and the neighbourhood. Finally, I assess the authorities’ response when facing such challenges: the local authorities often remained aloof when dealing with physical boundaries. However, whenever they suspected that religious boundaries were breached they reacted with vigour.

It has been claimed that Israel has the highest per capital rate of lawyers in the world, resulting in belief that the Israel Bar is overpopulated. The first law colleges, which were established 20 years ago, are newcomers to the production of legal professions. The leadership of the Israel Bar have held the law colleges responsible for Israel’s overpopulation of lawyers and for the legal profession’s decline in prestige. This paper examines whether the perception of overcrowding of the profession is a new “discovery” or rather the recycling of a standard dynamic between professionals and legal education institutions. While this paper focuses specifically on Israel, concern about the overpopulation of the profession has become a central concern in many other jurisdictions. Se ha asegurado que Israel tiene el ratio de abogados per cápita más alto del mundo, lo que hace creer que el Colegio de Abogados de Israel está superpoblado. Las primeras facultades de derecho, que se establecieron hace 20 años, son recién llegados de la producción de abogados. El liderazgo del Colegio de Abogados de Israel ha hecho que las facultades de derecho sean responsables de la superpoblación de abogados en Israel y del descenso del prestigio de la abogacía. Este artículo analiza si la percepción de superpoblación de la profesión es un nuevo “descubrimiento”, o, por el contrario, el reciclaje de una dinámica estándar entre profesionales e instituciones de formación en derecho. Aunque este artículo se centra especialmente en Israel, la superpoblación de la profesión se ha convertido en una preocupación central en muchas otras jurisdicciones. DOWNLOAD THIS PAPER FROM SSRN: http://ssrn.com/abstract=2298419

Background: Cultural differences have been discussed as a potential factor influencing students' perception and motivation towards their studies. At the Sackler Faculty of Medicine, Tel-Aviv University, two separate programs coexist for American and Israeli medical students. Both are taught at the same sites and by the same faculty, thus enabling cultural comparisons. Our aim was to examine the differences of two medical student groups, American and Israeli, regarding their satisfaction with studies, view of the educational workload, and their perceptions of physician characteristics. Methods: During the academic year 2007-2008 we administered an anonymous questionnaire to the two groups immediately after their first clinical clerkship in internal medicine. The response rate was 82% (90 out of 110) for the Israelis and 93% (53 out of 57) for the Americans. Results: Americans, compared to the Israelis, are significantly more satisfied with their medical studies, consider fewer alternatives to future careers in clinical medicine, feel less of a workload, and hold a more positive opinion of physician characteristics. Conclusions: Cultural differences affect students' perception of their studies, mentors and future careers. Medical educators should be sensitive to the effects of students' background which influence academic and professional attitudes and find ways to strengthen their commitment to the profession.