32 research outputs found

    Deep silences: a spiritual autoethnography: reclaiming inner space and silence as a locus of the sacred

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    Spiritual matters lie at the heart of a good dying. However, the shape and focus of spiritual care in palliative care has, I believe, shifted away from the original vision of hospice pioneers, such as Cicely Saunders. Assessing the value of spiritual care has become a priority to those who value a ‘scientific’ evidence-based practice. The issue this thesis addresses is whether there is a better ‘artistic’ way to evaluate the care given to dying people. This thesis describes the current landscape of care and then argues for spiritual artistry, as a way to reclaim ‘inner space’ and ‘deep silences’ as sites of sacred encounters. This radical move takes the focus of spiritual care away from both evaluative endeavours and also beyond the alternative meaning-making and narrative models, which are currently offered. I hope to shift the focus towards a relational spirituality in which greater attention is given to spiritual awakenings. Dying and grieving can both be viewed as the space of spiritual quests. The challenge is to discover a new way of seeing these complex and sometimes chaotic spiritual contexts in which important things occur which sometimes are beyond measurement and communication. An innovative methodology, spiritual autoethnography, which integrates creative arts, autoethnography and theology, is chosen to pursue this research. In the process of interrogating the silences enounterered in spiritual care at the end of life new insights and understandings are generated. I illustrate the deep silences that occur in times of trauma, shame, cognitive impairment, betrayal and grief, and how understanding these sheds light on marginalised areas rarely the focus of current models of spiritual care. However, the radically new insights gleaned from this research come from the construction of inner space and deep silences as a locus of the sacred. These heuristic constructs, offer a new framework to shape the role of hospice chaplain, and the delivery of spiritual care. In conclusion, spiritual artistry, founded on a poetics, is presented as enabling chaplains to inhabit ‘inner space’ and ‘deep silences’; to say the unsayable and delight in the gifts that accompany griefs. This new understanding of the role of the hospice chaplain, and of the delivery of spiritual care, benefits all those confronting their mortality and their grief

    Ringed, Bearded, and Ribbon Seal Vocalizations North of Barrow, Alaska: Seasonal Presence and Relationship with Sea Ice

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    The acoustic repertoires of ringed, bearded, and ribbon seals are described, along with their seasonal occurrence and relationship to sea ice concentration. Acoustic recordings were made between September and June over three years (2006 – 09) along the continental slope break in the Chukchi Sea, 120 km north-northwest of Barrow, Alaska. Vocalizations of ringed and bearded seals occurred in winter and during periods of 80% – 100% ice cover but were mostly absent during open water periods. The presence of ringed and bearded seal calls throughout winter and spring suggests that some portion of their population is overwintering. Analysis of the repertoire of ringed and bearded seal calls shows seasonal variation. Ringed seal calls are primarily barks in winter and yelps in spring, while bearded seal moans increase during spring. Ribbon seal calls were detected only in the fall of 2008 during the open water period. The repertoire of known ribbon seal vocalizations was expanded to include three additional calls, and two stereotyped call sequences were common. Retrospective analyses of ringed seal recordings from 1982 and ribbon seal recordings from 1967 showed a high degree of stability in call repertoire across large spatial and temporal scales.Le répertoire acoustique des phoques annelés, des phoques barbus et des phoques à bandes sont décrits, de même que leur présence saisonnière et leur rapport avec la concentration de glace de mer. Des enregistrements acoustiques ont été effectués entre septembre et juin sur une période de trois ans (2006 – 2009), le long de la rupture de la pente continentale, dans la mer des Tchouktches, à 120 km au nord-nord-ouest de Barrow, en Alaska. Les vocalisations de phoques annelés et de phoques barbus étaient présentes pendant l’hiver et pendant les périodes où la concentration de glace était de 80 % à 100 %, mais elles se faisaient rares pendant les périodes d’eau libre. La présence des cris de phoques annelés et de phoques barbus tout au long de l’hiver et du printemps suggère qu’une partie de leur population hiverne. L’analyse du répertoire de cris de phoques annelés et de phoques barbus indique une variation saisonnière. L’hiver, le cri du phoque annelé prend principalement la forme d’aboiements, tandis que le printemps, il prend la forme de glapissements. Les gémissements du phoque barbu s’intensifient au printemps. Le cri des phoques à bandes n’a été capté qu’à l’automne 2008, pendant la période des eaux libres. Le répertoire des vocalisations connues du phoque à bandes a été élargi pour inclure trois autres cris, bien que deux séquences de cris stéréotypées étaient courantes. L’analyse rétrospective des enregistrements de cris de phoques annelés de 1982 et de phoques à bandes de 1967 a laissé entrevoir une grande stabilité du point de vue du répertoire des cris, et ce, sur de vastes échelles spatiales et temporelles

    What are the toxicological effects of mercury in Arctic biota?

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    This review critically evaluates the available mercury (Hg) data in Arctic marine biota and the Inuit population against toxicity threshold values. In particular marine top predators exhibit concentrations of mercury in their tissues and organs that are believed to exceed thresholds for biological effects. Species whose concentrations exceed threshold values include the polar bears (Ursus maritimus), beluga whale (Delphinapterus leucas), pilot whale (Globicephala melas), hooded seal (Cystophora cristata), a few seabird species, and landlocked Arctic char (Salvelinus alpinus). Toothed whales appear to be one of the most vulnerable groups, with high concentrations of mercury recorded in brain tissue with associated signs of neurochemical effects. Evidence of increasing concentrations in mercury in some biota in Arctic Canada and Greenland is therefore a concern with respect to ecosystem health

    REVERBa couples the circadian clock to hepatic glucocorticoid action.

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    The glucocorticoid receptor (GR) is a major drug target in inflammatory disease. However, chronic glucocorticoid (GC) treatment leads to disordered energy metabolism, including increased weight gain, adiposity, and hepatosteatosis - all programs modulated by the circadian clock. We demonstrated that while antiinflammatory GC actions were maintained irrespective of dosing time, the liver was significantly more GC sensitive during the day. Temporal segregation of GC action was underpinned by a physical interaction of GR with the circadian transcription factor REVERBa and co-binding with liver-specific hepatocyte nuclear transcription factors (HNFs) on chromatin. REVERBa promoted efficient GR recruitment to chromatin during the day, acting in part by maintaining histone acetylation, with REVERBa-dependent GC responses providing segregation of carbohydrate and lipid metabolism. Importantly, deletion of Reverba inverted circadian liver GC sensitivity and protected mice from hepatosteatosis induced by chronic GC administration. Our results reveal a mechanism by which the circadian clock acts through REVERBa in liver on elements bound by HNF4A/HNF6 to direct GR action on energy metabolism

    Determinants of anti-PD-1 response and resistance in clear cell renal cell carcinoma

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