This thesis is based on the stories of the lived experience of two groups of women, the first was a group of women healers, and the second, a group of academic women.Woven through the his-story of women in medicine are two myths-those of Inanna and Isis.The insights that have come from this study will give future women a path to travel to reclaim their past.Both science and scientific medicine are critiqued, and more holistic alternatives as part of this process are offered. The thesis has been constructed with a series of stories to acknowledge the uniqueness of each individual's experience.These stories provide the threads that weave the thesis together and are congruent with both the process of the making of meaning in our lives, and with our journeys toward healing.The study is embedded in both a social and feminist framework and that of depth psychology/mythology. It is based on feminist research methods and cooperative inquiry methodology and uses narrative for the recounting of the experience. It is also a heuristic inquiry that offers constructive critique using reflexive learning and explores the richness of difference in philosophies of healing and the experience of transformation. / Doctor of Philosophy (PhD)

Patients who suffer from severe joint destruction caused by arthritis often undergo total joint arthroplasty (TJA). A major limitation of this treatment and common long-term complication is the development of aseptic loosening of the prosthesis in as many as 20% of patients. The current paradigm to explain aseptic loosening proposes that wear debris generated from the prosthesis initiates a macrophage-mediated inflammatory response by resident macrophages, leading to osteoclast activation and bone resorption at the implant interface. This can then lead to the development of a peri-prosthetic fracture. The principal aim of fracture healing is to restore the bone to its original form and strength. However, this ultimate goal can be altered if the healing is impaired. This impairment may be due to bone disease (osteoporosis) or even the introduction of a foreign material such as PE wear debris that could have migrated from the articulating surface to the fracture site. A standard closed unilateral fracture of the right femur was performed in both normal and oestrogen deficient rats following fixation with a k-wire. Ceridust (PE wear debris) was combined with hyaluronic acid and saline and injected directly into the fracture site. Femurs were assessed using radiographs, histology and immunohistochemistry. Histological analysis revealed that complete remodelling was achieved in all control groups by 6 weeks post-fracture with mechanical strength returning to normal values. The mechanical properties of the fractures were not influenced by the presence of PE wear debris in the dose and timing examined. Histology and immunohistochemistry however, did reveal a local effect of the presence of PE wear debris. The histology adjacent to the PE particles was inferior to the controls but did not manifest itself in a reduction in the mechanical properties except in the oestrogen deficient bone at 6 weeks post-fracture. The levels of MMP-1 and TNF-?? correlated to the presence of PE particles. In this thesis, I have shown the mechanism by which bone remodelling in fracture healing could be retarded due to the presence of PE wear debris, by increased matrix degradation in both normal and oestrogen deficient animals.

Transglutaminase II (TG2) is a complex protein with five different reported activities. Increases in TG2 expression and TGase activity have previously been observed during wound healing in rat studies; however, it has been unclear whether these phenomena were directly involved in the healing process or if they were simply a by-product of it. The aims of this thesis were, thus, to determine if TG2 plays a role in wound healing in vivo and to elucidate the mechanism of any effects TG2 may have at the cellular level. TG2 ablation resulted in delayed wound healing. To gain mechanistic insight into this abnormality, primary fibroblast cultures from TG2-knockout and wildtype mouse embryos were analysed. TG2-null fibroblasts displayed decreased adhesion and integrin signalling during initial stages of adhesion. Intriguingly, TG2-null cells showed faster activation of Rac1 and RhoA in response to adhesion. Long-term adhesion of TG2-null fibroblasts resulted in increased basal phosphorylation of FAK and number of paxillin-stained focal adhesions, enhanced PI3-kinase signalling, faster actin dynamics and altered activation of p44/42 MAPK. These results are indicative of futile cycling of intracellular signalling pathways resulting from reduced focal adhesion turnover in the TG2-knockout fibroblasts. Rescue experiments demonstrated that TG2-mediated effects on cell adhesion occurred in the extracellular environment and that neither GTP-binding nor TGase activity is required for these effects. Results further showed that a ???compact??? conformation of TG2 was not required for this role of TG2. Interestingly, addition of recombinant TG2 to the extracellular environment increased cell spreading of TG2-null cells to a level far greater than that seen in wildtype cells, which did not increase their spreading in response to exogenous TG2. Demonstration of faster activation of the small GTPases in the TG2-null MEFs, and the apparent inhibition of exogenous TG2???s extracellular effects on cell spreading by endogenous protein in the wildtype cells, provide tantalising evidence for a role for intracellular TG2 in regulating activation of the small GTPases to promote efficient fibroblast migration. This work identifies TG2 as a facilitator of efficient wound closure through extracellular effects on integrin-mediated signalling and intracellular effects on activation of the small GTPases.

This thesis examines how narratives of illness become therapeutic narratives. The method is to engage closely with (mainly Australian) texts � literary accounts of illness � in order to identify key elements that effect a healing function (healing is distinguished from cure). Textual analysis is placed in the frame of medical information about the relevant conditions, and theoretical perspectives that provide a cultural and historical setting for illness writing. Bio-medical discourse foregrounds the clinical process of diagnosis, investigation and treatment and relegates the personal meanings of illness to secondary place. The thesis explores ways in which the patient�s account provides an alternative discourse that supplements � and at times challenges � the medical discourse. Illness foregrounds the body, and illness narratives confront the reality of embodied experience. Illness that is chronic or incurable, ageing, physical and mental decline, and the inescapable prospect of death confront the patient with the need to find meaning in experience. Narratives of illness may serve as ventilation, diversion or escape for the patient. They may provide practical help, information and consolation to family and carers, and others who suffer with the condition. These are valuable functions, but I argue that illness writing may embody more powerful therapeutic elements that transform and give meaning to the illness as part of the individual�s life story. Key therapeutic functions identified are perversity, empowerment and transformation. Healing can begin with the empowerment of telling one�s story. Illness stories may challenge the stigma and the subordination associated with disease. They can affirm a sense of belonging and community where illness intersects with other forms of marginalization. Powerful illness narratives are often characterised by perversity, overturning the assumptions of dominant cultural discourses � including those that place authority with the medical practitioner and demand acquiescence from the patient. The most powerful therapeutic narratives transform the story of illness into a new story.

Thesis (M. D. S.)--University of Hong Kong, 2003. / Title proper from title frame. Also available in printed format.

<p>Tendon healing is a slow process and the tendon may not regain its initial mechanical properties after rupture. Mechanical stimuli have shown to have positive effect on tendon healing. This study is the first to investigate the effect of vibration stimuli on healing tendons. Vibration was also compared to treadmill running, which has previously been used for mechanical stimuli.63 female Sprauge-Dawley rats were used. A 3 mm segment was removed from the Achilles tendon and the tendon was left to heal. The animals were subjected to 15 min of daily exercise, vibration or treadmill running or acted as controls without exercise. The study was divided into three experiments. Experiment 1; the animals had full time cage activity and was randomized into running, vibration and control group. Experiment 2; the animals were unloaded and randomized into vibration, running and control group. There was also a control group with full time cage activity in experiment 2. Experiment 3; the animals were unloaded and randomized into vibration and placebo group. 14 days after surgery the animals were killed and mechanical testing of the Achilles tendons was performed. The results showed no significant difference between the groups in experiment 1. Experiment 2 showed that controls with full time cage activity had higher peak load, stiffness and cross sectional area than unloaded running, vibration and control groups. In experiment 3, there was no significant difference between vibration and placebo group. In conclusion, this study shows that vibration, as applied here, does not affect tendon healing.</p>

Tendon healing is a slow process and the tendon may not regain its initial mechanical properties after rupture. Mechanical stimuli have shown to have positive effect on tendon healing. This study is the first to investigate the effect of vibration stimuli on healing tendons. Vibration was also compared to treadmill running, which has previously been used for mechanical stimuli.63 female Sprauge-Dawley rats were used. A 3 mm segment was removed from the Achilles tendon and the tendon was left to heal. The animals were subjected to 15 min of daily exercise, vibration or treadmill running or acted as controls without exercise. The study was divided into three experiments. Experiment 1; the animals had full time cage activity and was randomized into running, vibration and control group. Experiment 2; the animals were unloaded and randomized into vibration, running and control group. There was also a control group with full time cage activity in experiment 2. Experiment 3; the animals were unloaded and randomized into vibration and placebo group. 14 days after surgery the animals were killed and mechanical testing of the Achilles tendons was performed. The results showed no significant difference between the groups in experiment 1. Experiment 2 showed that controls with full time cage activity had higher peak load, stiffness and cross sectional area than unloaded running, vibration and control groups. In experiment 3, there was no significant difference between vibration and placebo group. In conclusion, this study shows that vibration, as applied here, does not affect tendon healing.

The Saulteaux Nation is comprised of 7 major clans the larger of which is the Bear Clan. This thesis examines the holistic philosophy of the Saulteaux world view and the oral teachings of the Bear Clan. The teachings, which emphasize the nature of healing and personal growth, were related by Elder Danny Musqua to myself from within the context of traditional Bear Clan ceremonies and practices. This thesis documents my journey to understand these teachings and in the process to arrive at a deeper understanding of self. This is done within the context of Bear Clan culture and within the context of my relationship with Elder Danny Musqua. This thesis relates my struggle to make meaning of these teachings on a personal level and how these teachings have affected my life.<p> Narrative Inquiry is the methodology employed in this study. Through a reliance on narrative as the research methodology, the oral tradition of the Bear Clan and its traditional methods of knowledge transmission are honoured. The methodology utilized in this study is relatively unstructured in that no formal questioning process is utilized. Instead, it relies upon the relationship between the Elder/teacher and the son/learner in which to transmit knowledge. This process stresses the relationship between Danny and myself and emphasizes trust and respect as important elements of learning. In this relationship, knowledge was transmitted through participation in the sweatlodge, the learning lodge and through conversations with Danny. This approach to research respected the implicit nature of the oral tradition and allowed for me to make meaning of Danny's teachings in their original context and interpret them at a level appropriate for my own personal development.<p> This thesis struggles to define traditional healing and the role that the healer, the one oppressed by illness and the spiritual realm play in the healing process. This thesis may prove valuable in educating and informing those who do not have an understanding of concepts of First Nations' healing. It may also serve as an invitation to all people, Aboriginal and non-Aboriginal, to expand their notions of healing or to search out a similar path in life.

The purpose of the present research was to examine and understand, within a cultural context, the subjective experiences of recovery from child abuse of adults who have not sought the help of mental health professionals. Examining the cultural context of recovery permitted a glance at the environmental climate in which people came to understand, respond, and make sense of their child abuse experiences. To achieve this objective, dominant themes regarding beliefs about recovery were gathered from cultural documents, specifically, popular books on recovery from abuse, and from individual accounts of recovery from abuse. The present study was qualitative in nature and conducted within the framework of an ethnographic inquiry. The data were content analysed for themes of recovery. A comparison of recovery themes in popular books and participant interviews revealed that participants descriptions of their recovery mirrored those described by popular books, with a few exceptions. Factors considered helpful for recovery which emerged from both sources included education/information, relationships (e.g., support and resolution), attending to ones feelings and beliefs about the abuse (e.g, re-experiencing), self-care (e.g., coping with stress), and spirituality. In both popular books and participant stories, value was placed on the survivor looking inward, and differentiating oneself, ones feelings and beliefs, from those of others. This orientation served to delineate clear boundaries from others, and to allow one to assert oneself and to develop an independent view of oneself (Markus & Kitayama, 1991). As such, it reflects Canadian/American cultural values of agency, autonomy, and personal control (Kirsh & Kuiper, 2002). The participants experiences of recovery enabled them to reconstruct their views of themselves, their abusers, and people in general, in a way that enabled them to assert their differences and distinct values from others. Although support was emphasized, its role was confined to helping the participants gain new understanding of their experiences. Their disclosures of abuse experiences to supportive others were guided less by the need to create harmony or to fit in with an in-group, as would be expected in collectivist societies, than it was by the need to assert oneself, ones feelings, and ones needs. Also, participants accounts of recovery illustrated that they were relatively well versed in the use of psychological terms and concepts such as grief, confrontation, self-esteem, and role-models that were common in the popular books. The participants developed new views of themselves which were geared toward developing a more self-enhancing sense of self. These shifts reflect a discourse common in psychology and self-help culture, which directs the individual toward self-actualization, heightened self-esteem, and increased autonomy (Starker, 1989). This study also demonstrated how, through their own personal resourcefulness, people can be agents of their own recovery. Participants accessed unique resources (e.g., participating in sports, parenting, religion) to make sense of their experiences. In some cases, participants focussed more on drawing meaning from these self-enhancing resources than they did on re-experiencing painful memories associated with the abuse. Given the emphasis on re-experiencing trauma in clinical and popular literature, the various routes taken by participants suggest that the process of re-experiencing may be over-emphasized. Further research on recovery, outside of the therapeutic context, may serve to clarify how self-recovery takes place, possibly contributing to a new discourse on recovery.

The purpose of the present research was to examine and understand, within a cultural context, the subjective experiences of recovery from child abuse of adults who have not sought the help of mental health professionals. Examining the cultural context of recovery permitted a glance at the environmental climate in which people came to understand, respond, and make sense of their child abuse experiences. To achieve this objective, dominant themes regarding beliefs about recovery were gathered from cultural documents, specifically, popular books on recovery from abuse, and from individual accounts of recovery from abuse. The present study was qualitative in nature and conducted within the framework of an ethnographic inquiry. The data were content analysed for themes of recovery. A comparison of recovery themes in popular books and participant interviews revealed that participants descriptions of their recovery mirrored those described by popular books, with a few exceptions. Factors considered helpful for recovery which emerged from both sources included education/information, relationships (e.g., support and resolution), attending to ones feelings and beliefs about the abuse (e.g, re-experiencing), self-care (e.g., coping with stress), and spirituality. In both popular books and participant stories, value was placed on the survivor looking inward, and differentiating oneself, ones feelings and beliefs, from those of others. This orientation served to delineate clear boundaries from others, and to allow one to assert oneself and to develop an independent view of oneself (Markus & Kitayama, 1991). As such, it reflects Canadian/American cultural values of agency, autonomy, and personal control (Kirsh & Kuiper, 2002). The participants experiences of recovery enabled them to reconstruct their views of themselves, their abusers, and people in general, in a way that enabled them to assert their differences and distinct values from others. Although support was emphasized, its role was confined to helping the participants gain new understanding of their experiences. Their disclosures of abuse experiences to supportive others were guided less by the need to create harmony or to fit in with an in-group, as would be expected in collectivist societies, than it was by the need to assert oneself, ones feelings, and ones needs. Also, participants accounts of recovery illustrated that they were relatively well versed in the use of psychological terms and concepts such as grief, confrontation, self-esteem, and role-models that were common in the popular books. The participants developed new views of themselves which were geared toward developing a more self-enhancing sense of self. These shifts reflect a discourse common in psychology and self-help culture, which directs the individual toward self-actualization, heightened self-esteem, and increased autonomy (Starker, 1989). This study also demonstrated how, through their own personal resourcefulness, people can be agents of their own recovery. Participants accessed unique resources (e.g., participating in sports, parenting, religion) to make sense of their experiences. In some cases, participants focussed more on drawing meaning from these self-enhancing resources than they did on re-experiencing painful memories associated with the abuse. Given the emphasis on re-experiencing trauma in clinical and popular literature, the various routes taken by participants suggest that the process of re-experiencing may be over-emphasized. Further research on recovery, outside of the therapeutic context, may serve to clarify how self-recovery takes place, possibly contributing to a new discourse on recovery.