Tag: Sweden

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A Sustainable Lifestyle Intervention Among Office Workers: Cluster Randomized Pilot and Feasibility Study

Background: Society faces multiple challenges, including lifestyle diseases and global climate change. Framing health education within sustainable development may enhance motivation for behavior change because proenvironmental behaviors, as well as healthy behaviors, often rely on the same behavior change principles. Combining these perspectives may therefore reinforce health behaviors and climate-friendly choices. Objective: This pilot study aims to explore changes in dietary intake, diet-related carbon footprint, and physical activity among office workers receiving sustainable plus healthy lifestyle (sustainable lifestyle arm) or healthy lifestyle education (healthy lifestyle arm) alone. It also aims to assess the feasibility of the intervention functions, including workshop attendance rate, participants’ dietary goals, social support, and facilitators and barriers to behavior change. Methods: A 2-armed participant-blinded cluster randomized study, including an experimental intervention arm (sustainable lifestyle; n=19) and a control intervention arm (healthy lifestyle; n=14), was conducted in Sweden. The study lasted 8 weeks and included 6 workplace-based workshops and was framed by the behavioral change wheel and the socioecological model. Diet, carbon footprint, and physical activity were assessed using the web-based questionnaires Meal-Q and Active-Q. Attendance rate, individual goals, social support, and facilitators and barriers were assessed using printed questionnaires. Results: The reduction of total diet-related carbon dioxide equivalents (COe) was 0.8 kg and 0.4 kg per day for the sustainable and healthy lifestyle arm, respectively. Also, there was a statistically significant interaction between time and lifestyle when the carbon footprint was expressed as a qualitative aspect of diet, that is, COe kg per 1000 kcal per day (=.05). Moreover, the intake of vitamin C, a marker for fruits and vegetables, increased to 8.0 and 12.5 mg per 1000 kcal per day for the sustainable and healthy lifestyle arms, respectively. In addition, total sedentary time decreased by 0.4 hours per day in the sustainable lifestyle arm, but not in the healthy lifestyle arm. This indicates that the educational workshops in respective arms had different impacts on health behavior over time. Minor differences were found in dietary goals, with the sustainable lifestyle arm setting more goals related to ecological and vegetarian foods. No differences were seen between arms regarding barriers or facilitators. Conclusions: This study suggests that embedding healthy lifestyle recommendations within a sustainable development context may be an efficient way to reduce carbon footprint and increase healthy behavior among office workers. Given the ongoing global epidemic of metabolic diseases, climate change, and environmental degradation, promoting a sustainable lifestyle in a workplace context has the potential to counteract these trends. Trial Registration: ClinicalTrials.gov NCT06698094; https://clinicaltrials.gov/study/NCT06698094
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Exploring Acceptance of a Clinical Workflow Tool in the Swedish Prosthetics and Orthotics Sector: Qualitative Study

Background: The global demand for assistive devices, such as prosthetics and orthotics, is increasing. A shortage of trained professionals contributes to suboptimal care. To improve clinical workflows, the Life Lounge Clinical Workflow (LLCW) has been developed. Understanding user acceptance is essential for ensuring its successful implementation. Objective: This study explored prosthetists and orthotists professionals’ perceptions and acceptance of LLCW, as well as the perceived benefits and challenges associated with its use. Methods: A postdemonstration mixed methods study was conducted using the unified theory of acceptance and use of technology framework, combining Likert-scale summaries with thematic analysis of open-text responses. The study included 18 prosthetists and orthotists professionals working at orthotic and prosthetic clinics across Sweden. After an interactive session about LLCW, feedback was collected via questionnaires. Thematic analysis was used to analyze the data. Results: Participants rated several acceptance-related constructs positively. Performance expectancy and facilitating conditions emerged as the most favorably discussed areas in the qualitative responses. Descriptive ratings showed high mean scores for motivation to use (4.61), management encouragement (4.56), ease of use (4.11), and willingness to use voluntarily (4.11). However, colleagues’ perceptions had a lower mean rating (2.72). Participants highlighted centralized data access, reduced administrative tasks, and improved clinical preparation as key benefits. At the same time, concerns were raised regarding data accuracy, questionnaire length, and the need for structured training before implementation. Conclusions: Participants reported generally positive experiences with LLCW, particularly regarding usability and performance. However, successful implementation requires integration into existing clinical workflows and attention to training and patient engagement. Addressing these elements can support broader adoption and contribute to digital transformation in prosthetics and orthotics care.
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Bibliometric analysis of neurite orientation dispersion and density imaging: research patterns, evolution, and frontier

BackgroundNeurite orientation dispersion and density imaging (NODDI), an emerging diffusion MRI technique for estimating the microstructural pathology of brain tissue in vivo, has attracted significant research interest. However, a systematic bibliometric analysis of this field remains unexamined. This study aims to perform a bibliometric analysis of the NODDI literature to explore the current research landscape, identify emerging trends, and provide insights for future investigations.MethodsNODDI-related publications were retrieved from the Web of Science (WOS) and Scopus databases during the period of 2012 to 2025. CiteSpace, VOSviewer, and Bibliometrix R package were used to generate visualization maps.ResultsA total of 679 publications related to NODDI were identified from WOS, including 653 research articles and 26 review papers. 844 relevant publications were retrieved from the Scopus database. After 2012, the number of publications on NODDI increased rapidly. Sweden demonstrated the highest average citation per paper, while the United States contributed the largest number of publications. University College London was the most productive institution. Hui Zhang was identified as the most prolific author, while Alexander DC achieved the highest average citation count. NeuroImage was recognized as the leading journal in terms of publication frequency. Common keywords included “diffusion magnetic resonance imaging,” “NODDI,” “brain,” and “multiple sclerosis.” Recent studies show the research focus is shifting from methodological development to clinical application, especially in the field of neuropsychiatric disorders, and is being integrated with emerging methodologies such as Mendelian randomization.ConclusionsThis bibliometric analysis highlights potential directions for future NODDI-related research. Future studies may focus on optimizing imaging techniques, investigating neuropsychiatric disorders, and integrating advanced methodologies.
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StockWatch: Trump Order Lifts Psychedelic Drug Shares

Stocks of most publicly traded psychedelic drug developers jumped when President Donald Trump signed Executive Order 14401, directing the FDA and other federal agencies to accelerate research and improve access to psychedelic drugs, citing their potential as promising treatments for serious mental illnesses.

Among its provisions, the order directs the FDA to provide Commissioner’s National Priority Vouchers (CNPVs) to “appropriate” psychedelic drugs that were granted the agency’s Breakthrough Therapy designation and met the voucher program’s criteria. The FDA’s parent agency, the Department of Health and Human Services (HHS), is required to spend at least $50 million through the Advanced Research Projects Agency for Health (ARPA-H) “to support and partner with” state governments that have enacted or are developing programs to advance psychedelic drugs for serious mental illnesses.

“This is an unmet public health need and potentially promising treatments. That’s why there’s a sense of urgency around this, and why we’re doing it now,” FDA Commissioner Martin A. Makary, MD, said at the ceremony where Trump signed the order. “Applications are about to come in, and this is the perfect timing for this announcement.”

At least one analyst agreed that the timing was right for Washington to spur the development of psychedelic drugs.

“Investor mindshare should rise meaningfully ahead of pot’l approvals in 2027–30,” Andrew Tsai, equity analyst with Jefferies, observed in a research note. “As we approach the first pot’l FDA approval of a psychedelic in 2027, President Trump is providing an official stamp of validation to the class in the form of an executive order, reassuring us that the FDA/HHS/White House’s support of psychedelics is real/actionable (not rhetorical).”

Proving correct

Makary said the FDA planned to issue CNPVs to three serotonin 2a agonists, a class that includes LSD and other psychedelic drugs. While he did not reveal specific companies and drugs by name, market watchers immediately speculated that one of the drugs was COMP360 synthetic psilocybin, the lead clinical candidate of Compass Pathways (NASDAQ: CMPS)—speculation that proved correct when COMP360 won a CNPV on Friday.

COMP360 is expected, according to Tsai, to be the first psychedelic drug to win FDA approval in 2027. In February, Compass announced what it called statistically significant and clinically meaningful data from two Phase III trials assessing COMP360 in treatment-resistant depression (TRD), COMP005 (NCT05624268) and COMP006 (NCT05711940). The data showed positive effects for COMP360 within one day, lasting at least through six months after just one or two doses among those who have a clinically meaningful response.

COMP360 is also in Phase II trials for both PTSD and anorexia nervosa.

Compass fueled speculation about an FDA voucher approval by issuing a statement supporting the executive order: “Today’s announcement aligns regulatory urgency with patient need, and we applaud the Administration for taking this important step forward in accelerating access, without compromising rigorous science.”

Investors celebrated with Compass, whose shares soared 42% from $6.66 to $9.46 on April 20, the first trading day after the order signing. Shares yo-yoed the rest of the week, sliding 7.5% to $8.75 Wednesday before rebounding nearly 5% to $9.15 Thursday and rising another roughly 5% to $9.58 Friday on news of the voucher approval. Year-over-year, Compass shares have more than doubled, soaring about 140% from $5.22 on April 24, 2025.

FDA names additional voucher grantees

The FDA indeed issued three CNPVs on Friday—one to Compass as previously mentioned, one to Usona Institute, a nonprofit medical research organization, for psilocybin for major depressive disorder (MDD), and one to Otsuka Pharmaceutical (Tokyo Stock Exchange: 4578) for methylone (TSND-201) for post-traumatic stress disorder (PTSD). Otsuka is acquiring the methylone program as part of its up-to-$1.225 billion ($700 million upfront) purchase of privately held Transcend Therapeutics, announced last month.

Launched in October by Makary, CNPVs are awarded to drug developers whose work is deemed to address a health crisis in the United States, deliver more innovative cures, address unmet public health needs, and increase domestic drug manufacturing as a national security issue. The vouchers entitle companies to reviews of their final applications within a target timeframe of 1–2 months, rather than the current 10–12 months.

“Ultimately, we do not see the FDA’s issuance of the first set of CNPVs as precluding other psychedelic players from also obtaining CNPVs in the future—so we think the FDA’s action today bodes well for the space broadly,” Tsai wrote after the FDA announced the voucher recipients. “Net-net, the macro backdrop for psychedelics is improving.”

That improvement, Tsai added, reflects Trump’s endorsement of psychedelic drugs, a collaborative FDA, and growing interest in the space by big pharma giants such as Johnson & Johnson (NYSE: JNJ), which generated $1.696 billion in 2025 sales and $468 million in first quarter sales from Spravato (esketamine), an NMDA receptor antagonist indicated for treatment-resistent depression (TRD) and depressive symptoms in adults with MDD with acute suicidal ideation or behavior in conjunction with an oral antidepressant.

The voucher decision hardly budged Otsuka shares, which dipped nearly 1% Friday from ¥10,870 ($68.18) to ¥10,810 ($67.80).

However, Compass was one of several psychedelic drug companies to see their shares surge on news of the executive order.

AtaiBeckley (NASDAQ: ATAI), formed last November by the merger of atai Life Sciences and Beckley Psytech, jumped 22% from $4.03 to $4.90 on April 20, then plateaued the rest of the week, finishing Friday at $4.63 and a 15% one-week gain. AtaiBeckley shares year-over-year have more than tripled, rocketing 204% from $1.53 a year ago Friday.

Definium Therapeutics (NASDAQ: DFTX) shares rose 5% over two days, from $22.68 the Friday before Trump signed the order to $23.84 on Tuesday, but gave back all the week’s gain, finishing Friday at $22.48. Long-range investors have fared better, as Definium shares have more than tripled, zooming 249% from $6.43 on April 24, 2025.

GH Research (NASDAQ: GHRS) shares climbed 17% from $18.34 to $21.50 the first day after the executive order, only to drop 6% the rest of the week, closing Friday at $20.25 and settling for a 10% one-week gain. GH’s shares doubled year-over-year, growing 101% from $9.50 a year ago Friday.

Showing volatility

The executive order wasn’t enough to boost shares of Cybin, which operates under the name Helus Pharma (NASDAQ: HELP). Helus showed the most volatility in the days following the order signing, tumbling 12% from $5.61 to $4.93 on April 20. The drop followed Helus’ announcement that its CEO, Michael Cola, stepped down immediately at the request of its board, succeeded by interim CEO Eric So, while the board carries out a search for a permanent chief executive.

“It’s like they can’t give investors a break,” fumed “SamZaki320” on a Reddit chat board. “The only positive is that the executive order sentiment is pushing back against a total disaster. Not that it’s a good thing, other companies are up double digits.”

Helus shares bounced back 17% to $5.77 Wednesday and dipping 0.35% to $5.75 Thursday despite the company announcing two powerhouse additions to its scientific advisory board—Robert Langer, ScD, the David H. Koch Institute professor at MIT and a co-founder of Moderna (NASDAQ: MRNA); and Stephen Brannan, MD, a neuroscience drug development expert with over 20 years of experience designing and implementing clinical programs for psychiatric and neurological disorders. Shares fell 2% Friday, closing at $5.61.

In a statement, interim CEO So lauded Trump’s order: “The Executive Order reflects growing recognition of the urgent need for new treatment options in serious mental health conditions and the importance of advancing innovative therapies through rigorous, research-based development.”

Looking beyond Washington

Yet So acknowledged that Washington alone can’t advance psych drug development beyond what its science can accomplish: “Policy momentum is meaningful, but the future of this field will ultimately be determined by the strength of the clinical evidence and the ability to deliver safe, reliable treatments at scale.”

As did Helus and Compass, Definium also praised the executive order: “We applaud the Administration’s recognition that psychedelic medicines may represent meaningful new treatment options for patients,” Definium CEO Rob Barrow stated. He cited his company’s clinical development program for DT120 (lysergide tartrate) for conditions that include generalized anxiety disorder (GAD) and MDD.

At the ceremony where he signed the executive order, Trump acknowledged being asked to address psych drug development by podcaster Joe Rogan and others, which the president said led to talks with Makary as well as HHS Secretary Robert F. Kennedy Jr., NIH Director Jay Bhattacharya, MD, PhD, and Mehmet Oz, MD, administrator for the Centers for Medicare & Medicaid Services.

“Research has been going on for quite some time. But usually with things like this, nothing ever happens, no matter how the research ends up. We’re changing that,” Trump said. “Why would we wait three or four years to get it done? Or 10 years? Frankly, let’s get it done immediately—and that’s what happened.”

Leaders and laggards

  • Daiichi Sankyo (Tokyo Stock Exchange: 4568) shares slipped 10% from ¥2,790 ($17.50) to ¥2,499 ($15.67) on Friday after the drug developer announced it was delaying the release of its annual earnings results for the fiscal year that ended March 31, from April 27 to May 11,  “as additional time is required to finalize the financial figures.” May 11 is the day when Daiichi Sankyo plans to release its five-year business plan. “The company is currently reviewing the supply plans for its oncology products portfolio and development pipeline in light of rapidly changing business conditions. As a result, additional deliberation is required to reasonably estimate the amount of loss provisions to be recorded in connection with contracts with contract manufacturers,” Daiichi Sankyo added in a statement.
  • Inhibrx Biosciences (NASDAQ: INBX) shares leaped 37% from $84.08 to $115.09 Wednesday after Reuters reported, citing unnamed sources, that Merck & Co. (NYSE: MRK), Merck KGaA (XETRA: MRK), and Ono Pharmaceutical (Tokyo Stock Exchange: 4528) were in talks with Inhibrx for a joint spinoff of two precision-engineered cancer candidates, INBRX-106 and ozekibart (INBRX-109). The treatments could have a combined value of more than $9 billion if their clinical trials prove successful, the report stated. Inhibrx declined to comment, while the other companies cited did not respond to Reuters queries. INBRX-106 is a hexavalent sdAb-based, OX40-targeting candidate being studied as monotherapy and in combination with Merck & Co.’s cancer immunotherapy blockbuster Keytruda® (pembrolizumab). Ozekibart is a tetravalent death receptor 5 (DR5) agonist antibody designed to exploit the tumor-biased cell death induced by DR5 activation. On Tuesday, Inhibrx announced ozekibart showed positive data in a Phase I/II trial (NCT03715933) assessing the drug plus Folfiri in patients with locally advanced or metastatic, unresectable colorectal cancer.
  • Organon (NYSE: OGN) shares surged 31% from $8.60 to $11.26 Friday after the Indian news outlet The Economic Times reported that Sun Pharmaceutical Industries (NSE: SUNPHARMA and BSE: 524715) had submitted a $13 billion offer for the women’s health drug developer spun out of Merck & Co. (NYSE: MRK) in 2021. The deal would be Sun’s largest ever merger-and-acquisition (M&A) deal—if Sun can prevail over at least two other would-be suitors for Organon, German-based private family-owned drug developer Grünenthal, and EQT (Nasdaq Stockholm: EQT), a Swedish-based global investment organization. The latest surge comes two weeks after Organo shares zoomed 28% on an April 10 Economic Times report stating that Sun Pharma had submitted a $12 billion all-cash offer for Organon.
  • Spruce Biosciences (NASDAQ: SPRB) shares tumbled 26% from $69.89 to $51.69 Tuesday after the neurological disorder drug developer priced a $69 million offering of common stock and pre-funded warrants that generated $64.4 million in net proceeds. The offering consisted of 1.15 million shares of common stock priced at $50 per share and pre-funded warrants to purchase 50,000 shares at $49.99 per share. Al shares and pre-funded warrants were sold, and underwriters of the offering exercised in full their option to purchase up to an additional 180,000 shares at the public offering price on Tuesday. “We intend to use the net proceeds from this offering to advance the company’s pre-commercial and launch activities, for planned clinical trials, and for working capital, capital expenditures, and other general corporate purposes,” Spruce stated in its prospectus supplement filed Tuesday. Leerink Partners, Guggenheim Securities, and Oppenheimer & Co. acted as joint book-running managers, while Jones and Craig-Hallum acted as co-managers for the offering.

The post StockWatch: Trump Order Lifts Psychedelic Drug Shares appeared first on GEN – Genetic Engineering and Biotechnology News.

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Epigenetic Mapping in Pancreatic Cells Identifies New Diabetes Target

Researchers at Lund University in Sweden have conducted the first study looking at epigenetic changes associated with type 2 diabetes in alpha and beta pancreatic cells. Published today in Nature Metabolism, their findings show that the ONECUT2 gene plays a key role in the development of type 2 diabetes by altering insulin production. 

“The study shows that many genes central to insulin and glucagon production are regulated by differences in DNA methylation,” says Charlotte Ling, PhD, professor of epigenetics at Lund University and lead author of the study. “It has made it possible, for the first time, to describe detailed, cell-specific epigenetic patterns.”

The number of people living with diabetes is rapidly increasing worldwide, with approximately 95% of cases attributed to type 2 diabetes. This condition develops gradually and is characterized by a reduced ability to use insulin effectively, leading to elevated blood sugar levels. Over time, high blood sugar can lead to a range of complications that significantly impact the patient’s quality of life. 

Lifestyle factors like diet and physical activity are major drivers of this condition; however, genetics can also contribute to the development of type 2 diabetes, increasing the risk for some people over others. While genome- and epigenome-wide studies on diabetes have identified genetic and epigenetic mechanisms involved in type 2 diabetes, previous epigenetics studies had only looked at whole tissues and none had investigated epigenetic changes within specific cell types that are involved in blood sugar regulation. 

Ling’s team focused on alpha and beta pancreatic cells, which secrete insulin and glucagon hormones, respectively, to regulate blood sugar levels. By analyzing hundreds of thousands of cells from 24 people, with and without diabetes, the researchers created the most detailed epigenetics mapping of pancreatic cells to date. This allowed them to discover over 22,000 regions in nearly 8,000 genes that were differentially methylated between alpha and beta cells. 

“Here, for the first time, we show exactly which regions regulate insulin and glucagon production through DNA methylation, which gives us the opportunity to develop future treatments based on epigenetics,” says Ling.    

They then used CRISPR epigenetic editing to alter DNA methylation around the genes encoding for insulin and glucagon, which revealed that levels of the ONECUT2 transcription factor were elevated in beta cells from type 2 diabetes patients. This epigenetic upregulation was found to impair the ability of beta cells to release insulin, which in turn disrupted glucose regulation and reduced energy production within the cell.

Based on their findings, the researchers developed a web tool intended as a comprehensive resource available to researchers investigating the impact of age, sex, and type 2 diabetes on DNA methylation and gene expression in alpha and beta cells. 

“We now want to understand which of these changes can actually be reversed, and whether this can help beta cells regain their function in diabetes,” says Ling. “A key aspect is to see whether the effects of editing DNA methylation can be sustained in the cell over time.” 

The post Epigenetic Mapping in Pancreatic Cells Identifies New Diabetes Target appeared first on Inside Precision Medicine.

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Anemia May Be a Modifiable Risk Factor for Alzheimer’s Disease

Older adults with anemia have significantly higher levels of blood biomarkers for Alzheimer’s disease and a significantly increased risk for the disease itself, particularly when anemia is combined with the presence of the biomarkers, Swedish study data show.

The findings “suggest that anemia may interact with neuropathologic processes, potentially accelerating dementia development,” write Martina Valletta, MD, from Karolinska Institutet and Stockholm University in Sweden, and co-authors in JAMA Network Open.

Their analysis included data for 2282 dementia-free participants (median age, 72 years, 62% women) of the population-based Swedish National Study on Aging and Care in Kungsholmen. Of these, 8.7% had anemia at baseline.

The researchers report that participants with anemia had significantly higher baseline levels of the Alzheimer’s disease blood biomarkers phosphorylated tau 217 (p-tau217; 0.2 vs 0.1 pg/mL), neurofilament light chain (NfL; 36.6 vs 17.0 pg/mL), and glial fibrillary acidic protein (GFAP; 187.8 vs 117.4 pg/mL) relative to individuals with normal hemoglobin levels.

During a mean follow-up of 9.3 years, 362 (15.9%) participants developed dementia, with the incidence significantly higher among those with versus without anemia, at 4.4 and 1.7 cases per 100 person–years, respectively.

After adjustment for multiple potential confounding factors, like age, sex, education level, chronic kidney disease, heart disease, cerebrovascular disease, cancer, weight, iron and vitamin supplementation, and interleukin-6 level, the difference between the two groups corresponded to a significant 1.7-fold higher risk for developing dementia during follow-up among the participants with anemia relative to those with normal hemoglobin levels.

Valletta and colleagues note that the relationship between baseline hemoglobin levels and incident dementia was nonlinear. Specifically, below hemoglobin levels of approximately 14 g/dL dementia risk was inversely associated with hemoglobin level. Above this cutoff, the association plateaued.

In addition, the team found that co-occurrence of low hemoglobin and elevated Alzheimer’s disease blood biomarkers further amplified dementia risk.

For example, compared with participants without anemia and with low NfL, the risk for dementia was a non-significant 1.1-fold higher among those with anemia only, a significant 2.2-fold higher among those with high NfL only, and a significant 3.6-fold higher among participants with both anemia and high NfL.

Elevated dementia risk also occurred when anemia was combined with high p-tau217 or GFAP levels, but no additive interaction was detected for these biomarkers.

In general, the risk associations were stronger in men than women and among participants not carrying APOE ε4 compared with carriers.

The researchers say there are several potential interpretations for their findings, including the possibility that “anemia may reduce brain resilience, thereby lowering the threshold at which neuropathology manifests clinically as dementia.”

They conclude that the study data “suggest anemia is a clinically relevant factor in the context of dementia risk stratification and is possibly a modifiable target in dementia prevention strategies.”

“Future studies should further investigate this possibility and formally assess whether—and which—blood biomarkers mediate the relationship between anemia and dementia development.”

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The conversing military chaplain: time allocation, task salience, and competencies among Swedish military chaplains

Military chaplaincy is an established yet multifaceted practice within military organizations and is exposed to particular stressors such as the use of violence, ethical dilemmas, loss, and existential vulnerability. This study examines how a Swedish normative framework for Military Soul Care (ACCES: advisory role, command and crisis support, ceremonies, education, and soul care conversations) interacts with Swedish military chaplains’ own experiences of what they perceive as most important and meaningful in their mission. The empirical material consists of qualitative questionnaire data collected in 2025 from 50 military chaplains. The material was analyzed using an abductive approach and organized thematically. The results show that conversations constitute the task to which the greatest amount of time is devoted across both main categories of military chaplains, and that conversations are understood broadly, ranging from informal everyday interactions to confidential individual soul care conversations. Various forms of ceremonies and crisis support related to death and grief were experienced as particularly meaningful and reflect a clearly articulated priestly identity. Educational tasks varied between categories, with time constraints and organizational priorities limiting opportunities depending on context. A central finding is that presence within the organization, aimed at building relationships and trust, emerges as a decisive prerequisite and contributes to many chaplains working beyond their contracted hours. The importance of presence is not explicitly articulated in the ACCES framework but rather permeates the mission implicitly. Against the backdrop of a changed security environment, the findings illustrate that ecclesial priestly competencies related to crisis response, death, grief, and funeral expertise constitute a particularly vital resource in situations of crisis and war.