Implementation of the ars moriendi model in palliative home care: a pilot study

Background: Assessing the spiritual well-being of palliative patients is often perceived as difficult by professional caregivers. Previous research has shown that general practitioners would appreciate a directive for spiritual conversations, if this tool were not too structured and not too religious, and provided it proved to be useful in clinical practice. Aim: To investigate the experiences of professional caregivers and patients with the ars moriendi model as a directive for spiritual conversations in palliative home care. Method: Qualitative semi-structured interview pilot study in Flanders Results: All professional caregivers (n = 7) experienced the ars moriendi model as a useful directive to talk about spirituality at the end of life. They stressed the importance of adjusting the questions to each patient, and of spreading the spiritual conversation over several contacts. The palliative patients (n = 4) appreciated the conversation and advised the caregivers to show an open attitude, to spend enough time on their spiritual well-being, and to follow them in their spiritual process. Both caregivers and patients emphasized the importance of a trusting relationship to establish spiritual conversations. Conclusion: Flemish professional caregivers experienced the ars moriendi model as useful for supporting spiritual conversations, provided that the model is used in a spontaneous and intuitive way, according to the needs of the patient. Palliative patients are stimulated by the questions in the model to think about their spiritual needs and resources. © W. S. Maney & Son Ltd 2013.status: publishe

Extracellular vesicle-derived miRNAs improve stem cell-based therapeutic approaches in muscle wasting conditions

: Skeletal muscle holds an intrinsic capability of growth and regeneration both in physiological conditions and in case of injury. Chronic muscle illnesses, generally caused by genetic and acquired factors, lead to deconditioning of the skeletal muscle structure and function, and are associated with a significant loss in muscle mass. At the same time, progressive muscle wasting is a hallmark of aging. Given the paracrine properties of myogenic stem cells, extracellular vesicle-derived signals have been studied for their potential implication in both the pathogenesis of degenerative neuromuscular diseases and as a possible therapeutic target. In this study, we screened the content of extracellular vesicles from animal models of muscle hypertrophy and muscle wasting associated with chronic disease and aging. Analysis of the transcriptome, protein cargo, and microRNAs (miRNAs) allowed us to identify a hypertrophic miRNA signature amenable for targeting muscle wasting, consisting of miR-1 and miR-208a. We tested this signature among others in vitro on mesoangioblasts (MABs), vessel-associated adult stem cells, and we observed an increase in the efficiency of myogenic differentiation. Furthermore, injections of miRNA-treated MABs in aged mice resulted in an improvement in skeletal muscle features, such as muscle weight, strength, cross-sectional area, and fibrosis compared to controls. Overall, we provide evidence that the extracellular vesicle-derived miRNA signature we identified enhances the myogenic potential of myogenic stem cells