Physiological role of the putative ammonium transporter RhCG in the mouse.

Ammonium excretion into urine is a major process essential to the regulation of acid-base homeostasis. We have shown that Rh-type proteins, including renal RhCG, belong to the Mep/Amt family of ammonium transporters and promote bi-directional ammonium transport upon heterologous expression in yeast. To study the physiological role of RhCG and to test a potential function in ammonium excretion, we have generated mice bearing an invalidation of the corresponding gene.

[Experience of patients and their families with a palliative care interdisciplinary team]. / Le vécu des patients et des familles face à une équipe interdisciplinaire en soins palliatifs.

This study aims at describing the experience of the patients and their family when they are faced with an interdisciplinary team in palliative care. Are the patients and their family aware of the interdisciplinarity within the team and does this organization meet their expectations? We also went deeper into some themes, i.e. pain treatment, notion of safety and the position of the patients and of his relatives as object or subject of the care. We chose the qualitative approach to answer this question. We interviewed 25 patients and 18 family referents following the method of non directive interview. The method for data processing was double: on the one hand, the constant comparative analysis of GLASER and STRAUSS enabling the emergence of significant categories from the speech of the patients and referents. on the other hand, the structural analysis method of BOURGOIS and NIZET enabling the emergence of meaning structures in the speech, their positive or negative valuation and the definition of quest plans to underline the working strategies of the actors. What could be stressed as a specific reflection subject is the perception of the team and its interdisiplinarity: the latter implies a common project around the patient and his family; it seems that if the will of the teams is indeed an interdisciplinary organization, in the praxis, it is not yet achieved. The pluridisciplinary team organization is taken for granted in most teams, but it is not perceived as such by the patients and the families. The involvement of the patients and of the families is still weak, and they are still sometimes the objects of the care. What we therefore found striking is that the patients and the relatives have a tendency to "justify" their dissatisfactions by invoking constraints to which the team members are subjected, in the hospital as well as at home. At home, the interdisciplinarity is not yet perceived by the subjects and it is striking to see the relatives who wish to "take a break" in their accompaniment of the sick person, even if they feel very guilty and are not very well considered by the care takers. We also noted all what was expressed around the death and the death accompaniment, which raises questions on the role of the team, the limits of this accompaniment and the training of the care takers for this accompaniment. To conclude, this study allowed us to describe an experience rather precisely; we could thus stress the perception by the patients and the families of a team, what, we think, can help the latter in their daily practice but also in a deepened reflection on the interdisciplinarity conditions and the implementation of real team projects, involving the patient and his family.