What is spiritual care? Professional perspectives on the concept of spiritual care identified through group concept mapping

Objectives The overall study aim was to synthesise understandings and experiences regarding the concept of spiritual care (SC). More specifically, to identify, organise and prioritise experiences with the way SC is conceived and practised by professionals in research and the clinic.Design Group concept mapping (GCM).Setting The study was conducted within a university setting in Denmark.Participants Researchers, students and clinicians working with SC on a daily basis in the clinic and/or through research participated in brainstorming (n=15), sorting (n=15), rating and validation (n=13).Results Applying GCM, ideas were identified, organised and prioritised online. A total of 192 unique ideas of SC were identified and organised into six clusters. The results were discussed and interpreted at a validation meeting. Based on input from the validation meeting a conceptual model was developed. The model highlights three overall themes: (1) ‘SC as an integral but overlooked aspect of healthcare’ containing the two clusters SC as a part of healthcare and perceived significance; (2) ‘delivering SC’ containing the three clusters quality in attitude and action, relationship and help and support, and finally (3) ‘the role of spirituality’ containing a single cluster.Conclusion Because spirituality is predominantly seen as a fundamental aspect of each individual human being, particularly important during suffering, SC should be an integral aspect of healthcare, although it is challenging to handle. SC involves paying attention to patients’ values and beliefs, requires adequate skills and is realised in a relationship between healthcare professional and patient founded on trust and confidence

Simulation of the coupling between nucleotide binding and transmembrane domains in the ABC transporter BtuCD

AbstractThe nucleotide-induced structural rearrangements in ATP binding cassette (ABC) transporters, leading to substrate translocation, are largely unknown. We have modeled nucleotide binding and release in the vitamin B12 importer BtuCD using perturbed elastic network calculations and biased molecular dynamics simulations. Both models predict that nucleotide release decreases the tilt between the two transmembrane domains and opens the cytoplasmic gate. Nucleotide binding has the opposite effect. The observed coupling may be relevant for all ABC transporters because of the conservation of nucleotide binding domains and the shared role of ATP in ABC transporters. The rearrangements in the cytoplasmic gate region do not provide enough space for B12 to diffuse from the transporter pore into the cytoplasm, which could suggest that peristaltic forces are needed to exclude B12 from the transporter pore