[Clinical care pathway for chronic kidney disease : development and perspectives]. / Le trajet de soins de l'insuffisance rénale chronique : développement et perspectives.

Because of the significant costs related to the treatment of end-stage kidney disease by dialysis, Belgian Health Care Authorities proposed in June 2009 to launch an early multidisciplinary care plan for chronic kidney disease (CKD) patients in the form of a clinical care pathway (CCP) focusing on a combined follow-up by the general practitioner and the nephrologist. The objective was to increase nephro-protection measures, reduce patient morbidity and mortality, and delay admission on dialysis. Our Nephrology Department at Erasme Hospital took the opportunity of CCP to set up workshops on therapy education which promote CKD patients' compliance and autonomy regarding their treatment (" empowerment "). These workshops are conducted by a health professional together with a patient partner recruited by our team according to the model developed by the faculty of medicine at the University of Montreal. This model is based on the patient's valued experience of living with a chronic disease, a knowledge which is complementary to that acquired by any health professional. This patient partnership (PP) may also be implemented in teaching and research. In health care services, patient partners with a resource profile are involved not only in the organization of these services, but also in the development and management of health care political programs. The PP model currently developed in the Nephrology Department is part of the Quality project of our academic hospital and helps to further the co-construction of future health care networks.

Suite aux surcoûts liés au traitement de l'insuffisance rénale chronique (IRC) terminale par la dialyse, l'INAMI a proposé depuis juin 2009 une prise en charge multidisciplinaire précoce du patient IRC sous la forme d'un trajet de soins (TDS) privilégiant le suivi par le médecin généraliste en alternance avec le néphrologue. Le but est d'optimiser les mesures de néphroprotection, de réduire la morbi-mortalité des patients et de retarder leur arrivée en dialyse. Notre service a saisi cette opportunité des TDS de l'IRC pour mettre en place des ateliers d'éducation thérapeutique susceptibles de favoriser l'adhésion et l'autonomie des patients IRC vis-à-vis de leur traitement (" empowerment "). Ces ateliers sont co-animés par un professionnel de santé et un patient partenaire recruté par le service selon le modèle développé à la Faculté de Médecine de l'Université de Montréal. Le partenariat patient (PP) s'appuie sur les savoirs expérientiels reconnus des patients, complémentaires aux savoirs professionnels, issus de la vie avec la maladie et acquis par la pratique des soins et des services de santé. Il peut aussi se développer dans l'enseignement et la recherche. En milieux de soins, il s'agit de patients partenaires au profil ressource, partenaires dans les soins directs, mais aussi dans l'organisation des services, la gouvernance et l'élaboration des politiques de santé. Ce modèle, en cours d'implémentation dans le Service de Néphrologie de l'Hôpital Erasme, fait partie du projet qualité institutionnel et tend vers la co-construction des milieux de soins de demain.

Cryogenic setup for trapped ion quantum computing.

We report on the design of a cryogenic setup for trapped ion quantum computing containing a segmented surface electrode trap. The heat shield of our cryostat is designed to attenuate alternating magnetic field noise, resulting in 120 dB reduction of 50 Hz noise along the magnetic field axis. We combine this efficient magnetic shielding with high optical access required for single ion addressing as well as for efficient state detection by placing two lenses each with numerical aperture 0.23 inside the inner heat shield. The cryostat design incorporates vibration isolation to avoid decoherence of optical qubits due to the motion of the cryostat. We measure vibrations of the cryostat of less than ±20 nm over 2 s. In addition to the cryogenic apparatus, we describe the setup required for an operation with 40Ca+ and 88Sr+ ions. The instability of the laser manipulating the optical qubits in 40Ca+ is characterized by yielding a minimum of its Allan deviation of 2.4 ⋅ 10-15 at 0.33 s. To evaluate the performance of the apparatus, we trapped 40Ca+ ions, obtaining a heating rate of 2.14(16) phonons/s and a Gaussian decay of the Ramsey contrast with a 1/e-time of 18.2(8) ms.