Do oncology outpatients need chaplaincy services?

© Equinox Publishing Ltd 2018. Holistic patient-centred care is the aim of health services in the United Kingdom delivered through the 6Cs. Chaplains can offer aspects of this through compassionate care of the patient, particularly when a person is facing a life-limiting prognosis. This study firstly evaluated patient awareness and use of chaplaincy services in two oncology settings; Inpatient and Outpatient. Outpatients had not previously been offered chaplaincy services. Secondly, the demand and needs for a chaplaincy intervention was investigated with patients who expressed a spiritual or religious belief and had received a chaplaincy visit. Results indicated that half of the patients seen in the first evaluation identified with a spiritual/ religious belief and both Outpatients and Inpatients had a similar demand for chaplaincy visits. Those receiving a chaplaincy visit before being evaluated generally requested further visits. Based on these results we have now established a chaplaincy visiting service in the Outpatient chemotherapy suites to try to match demands

Arabidopsis HDA6 Regulates Locus-Directed Heterochromatin Silencing in Cooperation with MET1

Heterochromatin silencing is pivotal for genome stability in eukaryotes. In Arabidopsis, a plant-specific mechanism called RNA–directed DNA methylation (RdDM) is involved in heterochromatin silencing. Histone deacetylase HDA6 has been identified as a component of such machineries; however, its endogenous targets and the silencing mechanisms have not been analyzed globally. In this study, we investigated the silencing mechanism mediated by HDA6. Genome-wide transcript profiling revealed that the loci silenced by HDA6 carried sequences corresponding to the RDR2-dependent 24-nt siRNAs, however their transcript levels were mostly unaffected in the rdr2 mutant. Strikingly, we observed significant overlap of genes silenced by HDA6 to those by the CG DNA methyltransferase MET1. Furthermore, regardless of dependence on RdDM pathway, HDA6 deficiency resulted in loss of heterochromatic epigenetic marks and aberrant enrichment for euchromatic marks at HDA6 direct targets, along with ectopic expression of these loci. Acetylation levels increased significantly in the hda6 mutant at all of the lysine residues in the H3 and H4 N-tails, except H4K16. Interestingly, we observed two different CG methylation statuses in the hda6 mutant. CG methylation was sustained in the hda6 mutant at some HDA6 target loci that were surrounded by flanking DNA–methylated regions. In contrast, complete loss of CG methylation occurred in the hda6 mutant at the HDA6 target loci that were isolated from flanking DNA methylation. Regardless of CG methylation status, CHG and CHH methylation were lost and transcriptional derepression occurred in the hda6 mutant. Furthermore, we show that HDA6 binds only to its target loci, not the flanking methylated DNA, indicating the profound target specificity of HDA6. We propose that HDA6 regulates locus-directed heterochromatin silencing in cooperation with MET1, possibly recruiting MET1 to specific loci, thus forming the foundation of silent chromatin structure for subsequent non-CG methylation

Stable transmission of reversible modifications: maintenance of epigenetic information through the cell cycle

Even though every cell in a multicellular organism contains the same genes, the differing spatiotemporal expression of these genes determines the eventual phenotype of a cell. This means that each cell type contains a specific epigenetic program that needs to be replicated through cell divisions, along with the genome, in order to maintain cell identity. The stable inheritance of these programs throughout the cell cycle relies on several epigenetic mechanisms. In this review, DNA methylation and histone methylation by specific histone lysine methyltransferases (KMT) and the Polycomb/Trithorax proteins are considered as the primary mediators of epigenetic inheritance. In addition, non-coding RNAs and nuclear organization are implicated in the stable transfer of epigenetic information. Although most epigenetic modifications are reversible in nature, they can be stably maintained by self-recruitment of modifying protein complexes or maintenance of these complexes or structures through the cell cycle

The Chaplain’s Presence and Medical Power:Rethinking Loss in the Hospital System

Book Review. Richard Coble is an associate pastor of congregational care and adult education at Grace Covenant Presbyterian Church and adjunct professor of pastoral care at Lexington Theological Seminary. He worked for nine months in a hospital setting, training as a chaplain under supervision in Clinical Pastoral Education after graduating from his seminary. His book is a closely argued, academic treatise on what he sees as the conflict between chaplaincy and medicine, particularly around issues of end of life care. His book, as he says, is from the point of view of a male, Christian, American chaplain and investigates the role of chaplaincy from that perspective which is a particular view and context

Nurses’ and Nursing Assistants’ Perceptions of Spiritual Healthcare: Spiritual Healthcare Services in Acute Cardiovascular Wards

Abstract: Healthcare chaplains in hospital have a number of roles, many of which may not be known. Whether staff are aware of healthcare provisions and the roles of the spiritual healthcare services will influence the use of these services for patients and, of course, for staff themselves. If staff are not aware of chaplains’ roles this may affect the ability of chaplains to carry out their full range of roles and provide the care needed for patients and staff. We investigated nursing and nursing assistants’ awareness of spiritual healthcare services in a cardio-vascular department, consisting of six wards and an outpatient clinic, in a central London tertiary NHS Trust hospital. Of the 184 members of staff that are nurses or nursing assistants, 78 filled in our questionnaires (42%). These questionnaires provided descriptive quantitative data to gauge awareness of spiritual healthcare services and provide information for which services needed development. By using the questionnaire, we also hoped to raise awareness of the services provided. Keywords

Human embryonic stem cells: a model for human ageing in vitro.

Stem cells have been used to investigate developmental processes and may be used as a therapeutic source of material for regenerative medicine and cancer. Here we propose the use of human embryonic stem cells, which represent a youthful phenotype, as models for experimentally investigating human ageing