In order to accomplish the transition from avascular to vascular growth, solid tumours secrete a diffusible substance known as tumour angiogenesis factor (TAF) into the surrounding tissue. Endothelial cells which form the lining of neighbouring blood vessels respond to this chemotactic stimulus in a well-ordered sequence of events comprising, at minimum, of a degradation of their basement membrane, migration and proliferation. Capillary sprouts are formed which migrate towards the tumour eventually penetrating it and permitting vascular growth to take place. It (...) is during this stage of growth that the insidious process of invasion of surrounding tissues can and does take place. A model mechanism for angiogenesis is presented which includes the diffusion of the TAF into the surrounding host tissue and the response of the endothelial cells to the chemotactic stimulus. Numerical simulations of the model are shown to compare very well with experimental observations. The subsequent vascular growth of the tumour is discussed with regard to a classical reaction-diffusion pre-pattern model. (shrink)

Healthcare ethics committees, physicians, surgeons, nurses, families, and patients themselves are constantly under pressure to make appropriate medically ethical decisions concerning patient care. Various models for healthcare ethics decisions have been proposed throughout the years, but by and large they are focused on making the initial ethical decision. What follows is a proposed model for healthcare ethics that considers the most appropriate decisions before, during, and after any intervention. The Just War Tradition is a model that is thorough in its (...) exploration of the ethics guiding a nation to either engage in or refuse to engage in combatant actions. In recent years, the Just War Tradition has expanded beyond the simple consideration of going to war or not to include how the war is conducted and what the post-war phase would look like ethically. This paper is an exploration of a healthcare ethics decision making model using the tenets of the Just War Tradition as a framework. It discusses the initial consult level of decision making prior to any medical intervention, then goes further in considering the ongoing ethical paradigm during medical intervention and post intervention. Thus, this proposal is a more holistic approach to healthcare ethics decision making that encourages healthcare ethics committees to consider alternate models and ways of processing so that ultimately what is best for patient, family, staff, and the environment is all taken into consideration. (shrink)

Cancer is a complex disease, necessitating research on many different levels; at the subcellular level to identify genes, proteins and signaling pathways associated with the disease; at the cellular level to identify, for example, cell-cell adhesion and communication mechanisms; at the tissue level to investigate disruption of homeostasis and interaction with the tissue of origin or settlement of metastasis; and finally at the systems level to explore its global impact, e.g. through the mechanism of cachexia. Mathematical models have been proposed (...) to identify key mechanisms that underlie dynamics and events at every scale of interest, and increasing effort is now being paid to multi-scale models that bridge the different scales. With more biological data becoming available and with increased interdisciplinary efforts, theoretical models are rendering suitable tools to predict the origin and course of the disease. The ultimate aims of cancer models, however, are to enlighten our concept of the carcinogenesis process and to assist in the designing of treatment protocols that can reduce mortality and improve patient quality of life. Conventional treatment of cancer is surgery combined with radiotherapy or chemotherapy for localized tumors or systemic treatment of advanced cancers, respectively. Although radiation is widely used as treatment, most scheduling is based on empirical knowledge and less on the predictions of sophisticated growth dynamical models of treatment response. Part of the failure to translate modeling research to the clinic may stem from language barriers, exacerbated by often esoteric model renderings with inaccessible parameterization. Here we discuss some ideas for combining tractable dynamical tumor growth models with radiation response models using biologically accessible parameters to provide a more intuitive and exploitable framework for understanding the complexity of radiotherapy treatment and failure. (shrink)

Background and aimsFew Polish hospitals have Hospital Ethics Committee (HECs) and the services are not always adequate. In this situation, the role of HECs, in providing, among others, ethical advice on the discontinuation of persistent therapies, may be taken over by other entities. The aim of our research was to investigate, how often and on what issues hospital chaplains are asked for ethical advice in reaching difficult medical decisions.MethodsA survey of 100 Roman Catholic chaplains was conducted, that is, at least (...) 10% of all chaplains currently working in Polish hospitals.ResultsOf the participants, 29% confirmed receiving requests for advice in making a morally difficult medical decision. Receiving this type of request was not conditional on the place of their service, duration of their pastoral mission or HEC membership. The largest group of chaplains (21%) encounter questions concerning the ethical dilemmas associated with discontinuing persistent therapy. Patients and their families most often raise issues related to the methods of birth control, and the medical staff raise the issue of termination of pregnancy—as reported by 9% and 15% of chaplains, respectively. Most of the chaplains asked for help (79%) experience a deficit of specialist knowledge in the area of medicine or ethics.ConclusionsIn order to improve the quality of ethical consultations in Polish hospitals, in addition to further development of HECs, it is postulated to develop a system for bioethical education of chaplains. (shrink)

Contemporary Nigerian society is in its doldrums as regards the culture of violence and distrust among peoples from various ethnic groups that make-up this nation. To an extent, religio-political reasons are fueling this culture of violence and distrust. The thrust of this paper is that: Christian military chaplains are stakeholders as promoters of peace and mutual co-existence in Nigeria with regard to controlling the culture of violence and disunity. The core of this thesis remains Jesus’ convictions concerning non-resistance to the (...) evil one as documented in the Sermon on the Mount, Matthew 5: 38-42, and His life as the Peace-Builder. Therefore, contemporary Nigerian context calls for Christian military chaplains to be more conscious that being messengers of peace and promoters of peaceful coexistence in our country, they have ethical responsibility to build bridges to harmony. Since Christ (God) is love, the chaplains should rediscover the poetics of testimony as a principle for building and reconstructing paths that lead to mutual co-existence in view of encouraging the reign of justice, unity, and peace in Nigeria. (shrink)

Presents a collection of essays that explore such topics as religion, mysticism, moden educational methods, pseudoscience, Africa, and late colleagues Douglas Adams and Stephen Jay Gould.

All major religions accept that organ donation is an individual choice and the same is true when it comes to donating one's whole body to medical science. While religious groups have ‘official’ views, it is common, given the various denominations and subgroups within a religion, to have deviation from the official message. This paper provides some insight into the views of religious leaders from one local community in the UK on the act of body donation. The paper also demonstrates the (...) importance that the Abrahamic religions place on providing opportunities for remembrance and thanksgiving for those who have died and how this is extended through the services of thanksgiving that are held by medical schools for those who have donated their bodies to medical science. (shrink)

Chaplains often describe their work in health care as “translation” between the world of the patient and the world of hospital medicine. Translators usually work with texts, interpreters with words. However, when chaplains use this metaphor, it describes something other than a discrete task associated with the meaning of words. While medical professionals focus on patients' medical conditions, chaplains seek to read the whole person, asking questions about what people's lives are like outside of the hospital, what they care about (...) most, and where they find joy and support in the world. Chaplains offer a supportive presence that serves to remind patients and caregivers that people are more than just their medical conditions or their current collection of concerns. Some chaplains are skilled at translating patients' experiences and sources of meaning in real time, allowing medical teams to better understand the person they are treating. “Translation” is also defined as metamorphosis. Chaplains provide this sort of translation when they are alone with patients, listening to their deepest concerns, helping them redefine their lives. (shrink)

This article explores the often-disparate commitments the chaplain has made to both the institutional church as well as the hospital system through the lens of the baptismal rite. As baptism is primarily a religious act meant to initiate new members into the Christian faith and a specific community, the chaplain must grapple with the meaning of baptism in the hospital system, a place of crisis and transient community. It is the numinous presence that binds the chaplain’s disparate (...) commitments together in the liminal space between the clinical and ecclesial within which the chaplain exists. The numinous expands the boundaries of institutions often at odds. The chaplain finds meaning and purpose by bearing witness and remaining committed to this numinous presence that binds. (shrink)

Professional chaplains have the unique opportunity to provide spiritual care within institutional settings where other types of pastoral care may not exist. Serving within these institutions presents special challenges, including tension between multiple identities and responsibilities. This tension can create conflict within the Christian chaplain, and confusion as to whom they are ultimately beholden. The first section of the article discusses what I see as the five identity-related tensions a professional chaplain may experience serving in an institution. The (...) second section of the article outlines a Christian theology of calling built on the framework of Covenant Theology and God’s reconciling work of grace. This theology of calling orients the professional identity of the Christian chaplains, rooting them in a clear sense of their responsibilities within their institutional setting. Christian chaplains are beholden first to God and to the calling God places on their life. Proper orientation to that calling equips chaplains to reconcile any cognitive dissonance caused by identity-related tensions, thus opening up a richer spiritual dialogue with God as they live out their kingdom-advancing mission. (shrink)

Kalenychenko T. A. Since the spring of 2014, we can observe the movement of update of military chaplaincy, the emergence of mass volunteering by religious leaders. While Ukraine only continues to develop a new Chaplaincy service, society has already received the first presentation about the priests at the forefront thanks to the work of the Ukrainian media. In this article, author examines the messages about the military chaplaincy of key media and analyzes the way in which the image was formed (...) from the military chaplain to a secular society, and the role it has assumed. (shrink)

Polish hospital chaplaincy, because of the unique political and sociological context in which it finds itself, presents a sort of triple beholdenness. It carries particular loyalties to the state, to Catholic doctrine, and above all, it is called to be faithful to the unique suffering person. In this article, I argue that the biggest challenge for Polish chaplaincy resides within the domain of loyalty to the patient, where the profound and immediate need for robust formation of individual Christian conscience through (...) catechesis is needed. Although hospital chaplaincy’s involvement in catechesis and instructing the faithful might not be clearly evident for the reader, nevertheless I prove my point by bringing a story from my practice as a chaplain in one of Poland’s hospitals. (shrink)

There was a significant monetary cost associated with establishing Catholicism in colonial Western Australia. The bishops and clergy funded the development of the local Catholic Church through donations from European benefactors, offerings from the congregation, and sponsorship from the Colonial and British Governments. As donations from Europe were variable and the resident Catholic population were largely poor, the government grants were the most reliable income for the Diocese of Perth. The government issued grants to support the establishment of congregations, schools, (...) and social welfare institutions. The development of congregations in new settlements was the Catholic Church's core ministry and the government issued stipends to Catholic chaplains to administer spiritual care to settlers and convicts in particular districts. Government grants were based on the census results and the Catholic Church was required to establish local church congregations and recruit clergy, and demonstrate an ability to contribute towards the maintenance of both. From 1852 to 1886, Bishops Joseph Serra, Rosendo Salvado and Martin Griver took charge of establishing congregations, managing clergy and lobbying the governors and other civil officials to fund colonial chaplaincies. The government also expected that the chaplains would promote moral and social order among the ex-convicts transported from Britain. (shrink)

The author, an ordained Lutheran pastor, reflects upon his experiences as chaplain at a small hospital in southwestern Germany (Tropenklinik – Paul Lecher Krankenhaus, Tübingen). Besides its expertise in the treatment of tropical diseases this 100 + bed hospital serves as the referral hospital for terminally ill and dying patients from the local University hospitals and the surrounding area. The experiences at the bedside of such patients with various denominational and religious backgrounds challenged the chaplain to go beyond (...) the confines of any fixed theological system or counseling technique. They made him to discover three essentials as the very basis of such ministry, which he shares in this article. He identifies these as (1) the necessity to realize the situation sober mindedly, (2) the desire to become a companion, and (3) the venture of confident faith, where holding on to any genuine perspective of life is deemed ridiculous. (shrink)

It can be really hard—or really easy—to explain what I do for a living. Chaplains share academic training with clergy, but we complete clinical residencies and work in health care organizations. Our affinities are with the patient and family, but we may also chair the ethics committee or serve on the institutional review board, and we spend a lot of time with staff. We must demonstrate a relationship with an established religious tradition, but we serve patients of all faiths, and (...) of no faith, and seek to protect patients against proselytizing. We provide something that may be called “pastoral” care, “spiritual” care, or just “chaplaincy”—but even among ourselves, we do not always agree about what that thing is. (shrink)

Research has shown that addressing and integrating the existential dimension in treatment settings reduce symptoms like anxiety, depression and substance abuse. Healthcare chaplains are key personnel in this practice. A nationwide, cross-sectional survey influenced by a mixed-methods approach was used to examine the attitudes, practices, understanding and perceptions of mental health professionals, including healthcare chaplains, regarding the value of addressing the existential dimension in treatment programmes. The existential group practice was led by the healthcare chaplains as an integrated part of (...) specialist mental health services. A positive and open attitude towards addressing the existential dimension was identified among the informants. Despite this, a small gap between attitude and practice was reported. Existential, religious and spiritual concerns are reported as part of the existential dimension and as relevant topics to be discussed in specialist mental health services. The findings indicate that the existential group practice could have a positive influence on the co-leaders’ competence to address existential, religious and spiritual concerns; however, this should be further investigated. (shrink)

This article explores the theological themes prevalent in the language of anorexia nervosa by briefly exploring extant literature in the field before reporting on the author’s qualitative fieldwork with Christian women with anorexia nervosa. Sufferers, both those from religious and non-religious backgrounds, often convey their understanding of their illness in theological and moral language, using terms such as ‘sin’ and ‘sacrifice’. The use of theological frameworks on ‘Pro-Ana’ internet forums is also considered. The article concludes by considering the implications of (...) this use of theological language for pastoral and chaplaincy care, and argues that highly skilled mental health chaplains would be of benefit to treatment models for anorexia nervosa and that community church leaders can pay a crucial role in long-lasting recovery, particularly for anorexic women who profess a Christian faith. (shrink)

Gleeson, Damian John In 1924, after a hiatus of a decade, the Australasian Catholic Record was re-established under the driving force of Monsignor John Joseph Nevin, the then vice-president of St Patrick's College, Manly. Mgr Nevin was ACR's principal editor up until 1937 and with the exception of a trip to Ireland and Europe in 1927, he contributed articles and answered questions on topics ranging across canon law, marriage, and moral theology in virtually every quarterly issue of ACR for more (...) than two decades. At Manly, he educated thousands of seminarians for dioceses across New South Wales and beyond, and was the college's president from 1929 to 1942. As such, Mgr Nevin was probably the most formidable Catholic clerical academic in New South Wales in the interwar period, yet we know little of this prodigious writer and intellectual who was a key adviser, not just to the Sydney hierarchy, but to a wide range of bishops. Apart from Dr Kevin Walsh's splendid history of St Patrick's College, Manly, church historians have not sought to consider the significant career of Mgr Nevin and his influence on several generations of clergy and bishops. (shrink)

Southerwood, Terry On 7 May 1820, four days after landing at Sydney, Australia's first Vicar General, Fr Philip Conolly, celebrated Mass for the first time on the soil of this continent. He was assisted by the co-pioneer, Fr John Joseph Therry. This historic liturgical action took place at the house of John Reddington in Pitt Row, later the site of many a dramatic event, Her Majesty's Theatre. At this time both priests were guests of the Davis household in Charlotte Square. (...) The following day, also at Reddington's, Therry offered Mass for the glory of God and in honour of St Michael. (shrink)

In the last two decades, studies on the relationship between spirituality and health have grown significantly in the International literature. In Brazil, the debate on this subject has reached greater visibility since 2009, mainly in the health sciences, with the appearance of the term "spiritual care". In theology, studies on spiritual care in the health care context are still scarce. This paper aims to contribute to the broadening of this reflection. Firstly, spiritual care is approached from scientific publications in Portuguese (...) language. Second, the interdisciplinary spiritual care model is presented as a holistic approach to patient care and consequences of applying a spiritual care model are outlined. The newly defined role of the hospital chaplains, pastoral counselors and spiritual caregivers is also discussed. As a conclusion, the paper mentions the main challenges going along with interdisciplinary spiritual care, especially those concerning the training of health care professionals. (shrink)

There is ongoing debate within the bioethics literature regarding to what extent (if any) it is ethically justifiable for doctors to engage in religious discussion with their patients, in cases where patients cite religious considerations as influencing their medical decision-making. In this paper, we concede that certain forms of religious discussion between doctors and patients are morally permissible (though not necessarily morally obligatory), insofar as patients’ religious beliefs may comprise an important part of their overall wellbeing and can influence their (...) medical decisions. However, we argue that it is not morally permissible for doctors to engage in substantive religious discussion with their patients, beyond simply inquiring about the patient's values (which may include their religious values) or referring patients to a chaplain or religious figure for further discussion. In support of this claim, we put forward two key arguments which have remained relatively unaddressed in the current debate. First, we argue that it is not practical for doctors to engage in substantive religious discussion with patients, and hence it cannot be morally obligatory for them to do so. Second, we argue that, while doctors might have a professional duty to ensure that their patient's religious interests (if any) are addressed, this does not entail that doctors themselves are the ones who should directly address these interests. Along the way, we anticipate and respond to some possible objections to these two key arguments. (shrink)

This paper analyses the role chaplaincy plays in providing religious and spiritual care in the UK’s National Health Service. The approach considers both the current practice of chaplains and also the wider changes in society around beliefs and public service provision. Amid a small but growing literature about spirituality, health and illness, I shall argue that the role of the chaplain is changing and that such change is creating pressures on the identity and performance of the chaplain as (...) a religiously authorised health worker. I shall question whether either orthodox belief or religious belonging have any significant bearing on the patients’ demand for chaplaincy services. Utilising an example of chaplaincy work I shall argue that patient need constitutes the strongest platform for both practice development and an articulated understanding of what chaplains bring to health care. Drawing on a case study the definition and interpretation of spiritual need will be discussed in relation to chaplaincy practice. In conclusion, I shall set out the case for effective research to establish with greater precision the detail of the chaplain’s practice within a state-funded health system. (shrink)

The establishing of the Military Chaplaincy Service of Ukraine is closely related to the fundamental socio-cultural transformations of the entire Ukrainian society, which began in 1991, when Ukraine gained independence. After three revolutions, and especially the Revolution of Dignity in 2013-2014, the people of Ukraine finally chose the path of European integration and their further development in the great family of the civilized world. Gradually, all state and public institutions began to reform their internal structures to approach the standards of (...) European societies. This also affected the armed forces of Ukraine, including and chaplain service. Since 1991, the chaplaincy has gone through several stages in its formation. As early as 2014, before the start of full-scale Russian military aggression against Ukraine, important changes took place in the Military Chaplaincy Service, which brought its internal structure closer to the standards of the armed forces of foreign countries. During the years of work of military chaplains in the combat units of the Armed Forces of Ukraine, experience has been gained that gradually allows us to assess the effectiveness of the mechanisms of activity and management. This article is a scientific reflection of the personal experience of the author, who is serving in the Armed Forces of Ukraine as a military chaplain in one of the combat units. The activity of a military chaplain within the framework of the military chaplaincy of the Armed Forces of Ukraine, and at the same time, in the conditions of the unit's execution of combat missions, gives an opportunity to fix and understand the factors of decreasing the effectiveness of military chaplains. The aim of this study is to determine the institutions and administrative factors of ineffective work of military chaplains and to propose management solutions to overcome them. (shrink)

In Brazil the relationship between religiosity/spirituality and health has been mainly studied by medicine and nursing. There are few studies on the behavior and beliefs of health professionals and chaplains. This study aims to find out how the dimension of religiosity/spirituality is understood and integrated (or not) by health professionals and chaplains in health care in a hospital in Curitiba-PR. The research method is a quantitative survey, cross-sectional and descriptive. The applied instrument consists of a questionnaire with 35 closed questions (...) and 1 semi-structured question. Participants are n = 100 health professionals: nurses, technicians and nursing assistants, psychologists, social workers, physiotherapists, phonoaudiologists, pharmacists, clinical nutritionists and chaplains. The results indicate that most of these professionals believe that religiosity/spirituality affects health outcomes and they believe it is important to be aware of this relationship. However, only few of them report that they integrate spirituality into their care practice as they lack (in) formation on these issues. We conclude that theology can contribute to a theoretical reflection on spirituality and health, and also to the training of these professionals about the subject, in collaboration with other disciplines. (shrink)