[Efficacy of a pre-dialysis clinic]. / Efficacité d'une clinique d'insuffisance rénale.

For many years now, the population in Quebec, Canada and other countries, counts more and more patients with renal insufficiency and also many more in need of dialysis treatments. In Quebec, there are 34 dialysis centres, mostly set in short term hospital settings. The two most standard treatments are haemodialysis and peritoneal dialysis. Dialysis centres are the most expensive to run and lack sufficient funding. Traditional haemodialysis treatments and their related costs sums up to 85,000 dollars, per patient, yearly. Terminally ill patients with chronic renal insufficiency represent a incompressible practice. If the number of patients keeps growing, at the actual rate, we will face a clientele increasing from 2200 to 5680 by the year 2006. In 1994, the Health and Social Welfare Ministry asked to three socio-sanitary regions to establish a prevention program structured in a way to help prevent and slow renal insufficiencies at every stages of the illness. This article describes this program and presents the results of a research made on the efficacy of these renal insufficiency clinics.

Perceptions of parents' participation in the care of their child undergoing day surgery: pilot-study.

In Canada, more than 100,000 children have procedures in day surgery units. In spite of certain programs designed to prepare those children and their parents for the procedures and events that take place in a hospital, the parents' role during the day stay is not openly and directly approached. Although many pediatric centers recognize the importance of the role of the family in the life of children with health problems, the perceptions of parents with children undergoing day surgery and their role in the hospital have not yet been studied. Therefore, the objective of our study was to describe parents' perceptions regarding their participation in the care of their children in a day surgery. Godin and Kok's (1996) integrated behavior prediction model related to health, which was drawn from Ajzen's theory of planned behavior (1991), was chosen for this research. An interview questionnaire was developed as the measurement instrument. Content analysis was the basis for the analysis of the data gathered through the interview questionnaire. Our article presents the results of this pilot study.

Phase change in amylose-water mixtures as seen by Fourier transform infrared.

The phase content of amylose-water mixtures (0.7/0.3 w/w) has been analyzed by transmission Fourier transform infrared (FTIR) spectroscopy in the 1175-950 cm(-1) region. Spectra are obtained under three different conditions: (a) as a function of temperature (T) from 25 to 97 degrees C; (b) at room temperature (RT), after slow cycles of T; and (c) at RT after quenching. T(max), the maximum temperature in the cycle, ranges from 50 to 120 degrees C. The quality of the seven-band spectra allows for an unambiguous determination of each band area. Unexpectedly, slow cooling after different T(max) brings about wide changes in the spectra while quenching does not. Two jumps in the absorbance are found: one at 70 degrees C and the other above 105 degrees C. Previous work on slow calorimetry of amylose-water mixtures suggests that these temperatures correspond to the beginning and the end of the same physical phenomena that takes place slowly between these two temperatures-namely the dissolution of the strained network phase. The spectra have two distinct regions, the low wavenumber region (1078-950 cm(-1)) and the high wavenumber region (1175-1078 cm(-1)). A distinct gain in the integrated absorbance of the 1175-1078 cm(-1) region at the expanse of that of the 1078-950 cm(-1) region when T(max) increases is interpreted as a change from strained to unstrained environments. A nonequilibrium state between the chains is a strained environment. In light of the (13)C NMR evaluation of the change of molecular order with T, the observed changes of the ir spectra could correspond to a transformation of a network of double helices into freer chains, possibly single helices. The present in-depth analysis of equilibrium or near equilibrium states by FTIR can serve to understand, through in situ spectra, molecular mechanisms during the gelation/crystallization of amylose and other gel-forming polymers.

Experience of teenagers born with cleft lip and/or palate and interventions of the health nurse.

The objective of this study was to describe and understand the experiences of teenagers with cleft lip and/or palate. The human ecology approach of Bronfenbrenner (1979) was chosen as a basis for this study. From this perspective, the living environment of teenagers with cleft lip and/or palate was considered, and as such, qualitative research from an ethnographic standpoint was conducted. The data were collected by semistructured interviews and recorded on magnetic tape. Ten teenagers, between 15 and 17 years of age, were chosen and consulted while undergoing therapeutic treatment and surgery in a cleft lip and/or palate clinic. The results of this study indicate that teenagers born with this congenital malformation experience various physical, functional, or interactional problems throughout their development. To improve this situation, nursing care has been developed to enable the nurse to act within the multidisciplinary team treating cleft lip and/or palate cases, thereby allowing the teenager to develop in an environment that offers a better quality of life.

[Cleft lip and palate: the adolescent and his family]. / Fissure labiopalatine: l'adolescent et sa famille.

Cleft lip or palate: The impact on adolescents and their families. Applying Bronfenbrenner's theory on human development (1979), this article aims to provide a better understanding of the family's impact on adolescents born with a cleft lip or palate. Results focusing on the family microsystem reveal that parents can be either a source of stress or a source of support for their teenager. A description of two teenagers' life experience, when faced with similar problems, highlights the disparity between their journeys. Data indicate the importance of family support in the development of individuals born with a malformation.

Effect of oxidative stress on stability and structure of neurofilament proteins.

Neurofilament proteins are highly phosphorylated molecules in the axonal compartment of the adult nervous system. We report the structural analysis of neurofilament proteins after oxidative damage. SDS-PAGE, immunoblotting, circular dichroism, and Fourier transform infrared spectroscopy were used to investigate the relative sensitivity of neurofilaments to oxidative stress and to identify changes in their molecular organization. An ascorbate-Fe+3-O2 buffer system as well as catechols were used to generate free radicals on a substrate of phosphorylated and dephosphorylated neurofilaments. By Fourier Transform Infrared spectroscopy and circular dichroism, we established that the neurofilament secondary structure is mainly composed of alpha-helices and that after free radical damage of the peptide backbone of neurofilaments, those helices are partly modified into beta-sheet and random coil structures. These characteristic reorganizations of the neurofilament structure after oxidative exposure suggest that free radical activity might play an important role in the biogenesis of the cytoplasmic inclusions found in several neurodegenerative diseases.

[Clinical breast examination]. / L'examen clinique des seins.

This article provides information on breast cancer in women and emphasizes nurses' key role in clinical breast examination. Since women must be shown how to perform proper breast self-examination as a precautionary measure for early cancer detection, it is essential that nurses themselves be able to conduct a quality examination. Following a brief review of the anatomy and physiology of breasts, the manuscript gives instructions on the correct procedure to enable interested nurses to take on independent and interdependent functions in their practice setting. The author also underlines errors to be avoided.

[The adolescent with cleft lip and palate]. / L'adolescent et la fissure labiopalatine.

Research studies afford an in-depth look at the problems experienced by adolescents born with a cleft lip, a cleft palate or cleft lip and palate. If not addressed, their problems can multiply with each successive stage of development. An interdisciplinary team, where the adolescents themselves play an important role, is one of the best means of helping them come to terms with the consequences of the abnormality. The nurse should be a key member of the team. To help adolescents cope with their situation now and in the future, the author promotes a holistic and humanistic approach. Here, she sees nurses creating therapeutic alliances as educators. She recommends that nurses assert themselves more as professionals and as essential resources. Her doctoral thesis proposes a training model to this effect.

[Losing one's father at 20 years of age]. / Perdre son père à 20 ans.

At first intending to describe and understand how all family members experience mourning, three researchers at the Université du Québec à Trois-Rivières found that very few studies have dealt with young men's reactions to the deaths of their fathers. The researchers then conducted a qualitative study, using a phenomenological approach, of this as yet little-explored subject. This study, Le deuil tel qu'expérimenté par les fils lors du décès de leur père (Grieving as experienced by sons on their fathers' death), enabled them to describe and better understand what young men experience on their fathers' death. The father was an important figure in the subjects' lives, and his death was a pivotal experience for each of them. The family structure was shattered and, while each subject's experience was unique, their intense reactions resemble those described by grief theorists. In a detailed discussion of the results of the study, the authors relate these results to theories on grief and youth, and suggest applications in nursing practice.

[When a child is born with a cleft lip and palate]. / Lorsque l'enfant naît avec une fissure labiopalatine.

The child born with cleft lip and palate. Cleft lip, cleft palate and cleft lip and palate are among the most common facial abnormalities. The birth of a child with any of these and the prospect of a schedule of treatments that will continue into late adolescence puts enormous stress on the entire family. Between 1989 and 1994, 160 babies with such malformations were born in Quebec. In a study of eight families from this population, the author examines ways in which they communicate, share tasks, react to difficulties, show interest and solve problems. By means of interviews and three questionnaires, the author determined that the first three months following the birth are the most crucial. During this time, the nurse can help the family through a redefinition of roles brought on by the prospect of numerous medical and surgical procedures. The nurse can also provide the family with emotional and educational support; help them understand and come to terms with the child's malformation, so that the child is fed properly; and help lessen the family's feelings of helplessness. The nurse must ensure that these parents are adequately informed and provide them with additional information about cleft lip, cleft palate and cleft lip and palate. She must be aware of appropriate resources and, whenever possible, refer the families to an organization or a centre specializing in this type of malformation.

Separation of overlapping spectra from evolving systems using factor analysis. 4. Fluorescence spectra of hematoporphyrin IX.

Fluorescence spectra of hematoporphyrin IX (Hp) in water and in aqueous SDS solutions are obtained in the pH range 0.1 to 13 to determine the ionisation state of the molecule as a function of pH. In water, the spectra are complicated by aggregation which is quite severe near pH 4. In aqueous SDS, the aggregation is much less violent. Factor analysis (FA) is used to identify five species in the fluorescence spectra in each series of solutions. The distribution curve of these species as a function of pH is also obtained. By comparing the spectra and the distribution curve of Hp with those of HPPEEA, an ethanolamide derivative of Hp that does not contain the carboxylic groups (Part 3), the species are identified. For Hp in water we have obtained the following species: the dication in two allotropic forms in the pH range 0 to 5; the monocation (with the charge on an imino nitrogen) in the pH range 2 to 7; and the free base in the pH range 3.5 to 13. The monocation observed by the second derivative technique revealed three subspecies. For Hp in aqueous SDS we have obtained the following species; one dication in the pH range 0 to near 4; one monocation (with the charge on an imino nitrogen) in the pH range 0.5 to 9; three free bases (with no charge on the imino nitrogen) in the pH range 4 to 13. Of the latter, one species is the neutral molecule, another is a dianion (with the charges on the carboxylic side chains), and the third one appearing at pH higher than 10 is an allotropic form of the dianion.

Separation of overlapping spectra from evolving systems using factor analysis. 3. Fluorescence spectra of hematoporphyrin IX di-n-propylether diethanolamide.

Fluorescence spectroscopy of hematoporphyrin IX di-n-propylether diethanolamide (HPPEEA) in aqueous solutions, with and without SDS, was obtained in the pH range from 0.1 to 13. At pH greater than 3, HPPEEA in water solutions gives spectra complicated by aggregation whereas in aqueous SDS solutions, the aggregation is greatly reduced. Factor analysis is used to separate the spectra of the individual species from the experimental spectra. Five and four species are identified in pure water and in aqueous SDS solutions, respectively. The predominant species are: two free bases at pH higher than 6; one monocation at pH near 4; and two or one dications at pH lower than 2.5. The intensity signatures are related to the ionic distribution and to the aggregation situation of HPPEEA at different pH.

Protein and chlorophyll in photosystem II probed by infrared spectroscopy.

The infrared spectra of photosystem II (PS II) enriched submembrane fractions isolated from spinach are obtained in water and in heavy water suspension Other spectra are obtained after a photooxidation reaction was performed on PS II to bleach the pigments. The water bands are removed by computer subtraction and the amide bands (A, B, I, II, and III) of the protein are identified. Computer enhancement techniques are used to narrow the bandwidth of the bands that the weak chlorophyll bands, buried in the much stronger protein bands, can be observed. Comparing the spectra of native and photooxidized PS II pr in water and in heavy water, we determine that three polypeptide domains are present in the native material. The first domain, which contains 22% of th is situated in the peripheral region of the PS II system. The polypeptides in this region are unfolded and devoid of chlorophyll. The second domain con of the polypeptides, is more organized, and contains the chlorophylls. The third domain has an alpha-helix configuration, does not contain chlorophyll, a affected by the photooxidation reaction or by the proton/deuteron exchange. Three different types of chlorophyll organisation are identified: two have carbonyl groups non-bonded, differing from one another only in their hydrophobic milieux; the third is weakly bonded to another unidentified group. Other forms of chlorophyll organisation are present but could not be observed because their absorption is buried in the protein amide I band.

Aggregation of chlorophylls in monolayers. VI. Infrared study of the CH stretching bands of chlorophyll a and of chlorophyll b in monolayers.

The CH vibrational stretch bands of chlorophyll (Chl) in monolayers, obtained by the Langmuir-Blodgett technique have been studied by infrared spectroscopy. Compared to a solution or to a multilayer which shows three to four bands, the spectra of Chl a or Chl b molecules in monolayers have revealed more than seven bands, which are assigned to the various CH groups in the molecule. In contrast to solutions or to multilayer samples which give featureless bands, each band of the monolayers is composed of many components which are modified when the system is perturbed either by drying or by hydration techniques. The separation between the components of the CH aliphatic bands is typical of crystalline field splitting and the modification of the intensities of these components is associated with the movement of the phytyl chain of the chlorophyll molecules. The CH aromatic stretch bands have been observed; the displacement and variation of the intensities of these bands are associated with deformation of the porphyrin ring. The CH band of the formyl group on Chl b has also been observed. The displacement and variation of the intensity of this band are related to the association that this group makes with the surrounding molecules and with the displacement of the porphyrin ring.

Aggregation of chlorophylls in monolayers. V. The effect of water on chlorophyll a and chlorophyll b in mono and multilayer arrays.

The nature of the interactions between water molecules and monolayers and multilayers of chlorophyll a (Chl a), and monolayers and multilayers of Chl b. obtained by the Langmuir-Blodgett technique, is examined by infrared spectroscopy. Following deposition of the monolayer or multilayer of Chl a or Chl b onto a plate, repetitive scans showed some modifications in the infrared spectra which are interpreted as a reorganization of the molecules as some water molecules leave the array. Drying the sample further modifies the spectra, which indicates the departure of more tenacious water molecules. Putting the sample in a moist atmosphere does not restore the original spectrum. This is an indication of a nonreversibie reorganization in the chlorophyll array. The spectra of the monolayer of chlorophyll are much more complicated than those of the multilayer, owing to the nonintegrating effect of the monolayer, which reveals the perturbing effect of the different dielectric milieux on each functional group. On the basis of the analysis of the spectra and the information gathered from the surface pressure isotherms, a model is proposed for the monolayer arrangement at the air/water interface which implies two set of dimers of water per molecule of chlorophyll. One pair of dimers constitutes the water of the first kind and is composed of vapor-like dimers. This kind of water is situated between the porphyrin planes of chlorophyll molecules and is easily removed from the monolayer. The second pair of dimers is composed of water of the second and third kinds situated between the Mg atom of the chlorophyll molecules and the water of the subphase. The second kind of water is closest to the Mg atom and is the most difficult one to remove. The third kind of water is closest to the surface and its mobility is intermediate between that of water of the first kind and that of water of the second kind. Comparing the infrared spectra of a freshly prepared monolayers of Chl a with the resonance Raman spectra of intact chloroplasts (M. Lutz, Biochim. Biophys. Acta 460 (1977) 408), we notice great similarities. This is an indication that the model we propose for the monolayer of Chl a could play an important role in the chloroplast.

Aggregation of chlorophylls in monolayers. Part IV. The reorganisation of chlorophyll a in multilayer array.

The nature of the interaction between the chlorophyll a molecules in multilayer arrays obtained by the Langmuir-Blodgett technique is examined by electronic and infrared spectroscopies. Following the deposition of the multilayers, we observed a blue shift with time in the electronic spectra. This effect is monitored by infrared spectroscopy. The intensity of the coordinated ketone band is decreased while the intensity of the free ketone band is increased. These modifications are explained by the reorganization of the chlorophyll a molecules from an organized to a less organized one. The influence of H2O, D2O and SO2 vapors on the chlorophyll a multilayers give some informations on the role of water molecules in the aggregation of chlorophyll a in this ordered system. From these observations, a model is proposed for the multilayer arrangement implying two molecules of water per molecule of chlorophyll a.

Aggregation of chlorophylls in monolayers.

The interaction of dioxane vapor with monolayer and multilayers of chlorophyll has been studied using electronic and infarared spectroscopies. Our results indicate the formation of a complex implying the oxygene of the dioxanc molecules with the magnesiums of adjacent chlorophyll molecules. These results are consistent with the molecular orbital calculations, using the "free electron network" method done by Le Brech, Leblanc and Antippa [Chem. Phys. Letters 26(1974) 37-44].