Poly(methacrylic acid -co- methyl methacrylate) beads were previously shown to have a therapeutic effect on wound closure through the promotion of angiogenesis. However, it was unclear how this polymer elicited its beneficial properties. The goal of this thesis was to characterize the host response to MAA beads by identifying molecules of interest involved in MAA-mediated angiogenesis (in comparison to poly(methyl methacrylate) beads, PMMA). Using a model of diabetic wound healing and a macrophage-like cell line (dTHP-1), eight molecules of interest were identified in the host response to MAA beads. Gene and/or protein expression analysis showed that MAA beads increased the expression of Shh, IL-1β, IL-6, TNF-α and Spry2, but decreased the expression of CXCL10 and CXCL12, compared to PMMA and no beads. MAA beads also appeared to modulate the expression of OPN. In vivo, the global gene expression of OPN was increased in wounds treated with MAA beads, compared to PMMA and no beads. In contrast, dTHP-1 decreased OPN gene expression compared to PMMA and no beads, but expressed the same amount of secreted OPN, suggesting that the cells decreased the expression of the intracellular isoform of OPN. Interestingly, MAA beads had no effect on the expression of pro-angiogenic growth factors VEGF, bFGF and PDGF-B in vivo or in vitro, suggesting that MAA beads do not induce angiogenesis by simply increasing the expression of pro-angiogenic factors, but use more subtle mechanisms. It was hypothesized that these mechanisms may involve modulation of toll-like receptor signaling in macrophages interacting with the protein layer adsorbed on to MAA beads, in a manner distinct from PMMA beads and no beads. Taken together, the results suggest that MAA beads promote angiogenesis through increased expression of Shh, decreased expression of CXCL10 and modulation of the expression of OPN, but not through increased expression of typical pro-angiogenic growth factors. The resulting vessel-rich “alternative foreign body reaction” has exciting clinical implications as the polymer itself was found to exert a therapeutic effect in the absence of bioactive components or transplanted cells. Understanding the mechanism could lead to new applications for this material and others designed on similar principles.

Traumas such as experiences of military combat, violent personal assault, natural disasters, severe vehicle accidents, being taken as hostage or prisoner, and diagnosis of life threating disease (American Psychiatric Association, 2000) impact every aspect and facet of the lives of trauma survivors including the physical, social, mental, emotional, psychological, and spiritual aspects of well-being. Trauma results in avoidance and dissociation, hyperarousal, and intrusion and constriction (Herman, 1997). Trauma may also lead individuals to anxiety, depression, somatization and cognitive distortions (Briere, 2004), disconnection from their bodies (Ogden el al. 2006; van der Kolk, 2006), and getting stuck in the past (van der Kolk et al., 1996). In leisure contexts, trauma may lead to experiencing avoidance, re-enactment in leisure, and the tendency to isolate and fear emotional and physical intimacy with others (Arai, Griffin, Miatello, & Greig, 2008). The foundation of trauma healing is establishing safety, mourning and reconnection with ordinary life (Herman, 1997), reconnection with the body, and being present (Levine, 2010). While cognitive therapy plays a role in trauma healing, somatic approaches provide additional support to reconnection of body and mind. Somatically-oriented therapies support trauma survivors to acquire a sense of safety and mastery over their bodies and to heal disconnection that results from trauma exposure (van der Kolk, 2003). The promise of interventions integrating body-mind in healing and support various mental health issues are growing and research is showing positive results. There is growing evidence of the role of physically-active leisure in healing trauma (Arai, Mock & Gallant, 2011). Yoga has been supported by a number of studies as a therapeutic intervention for both psychological and physiological conditions associated with trauma (Emerson & Hopper, 2011; Emerson, Sharma, Chaudhry, & Turner, 2009; The Trauma Centre, 2013; van der Kolk, 2012; Ware, 2007) and posttraumatic stress disorder (Descilo et al., 2007; Emerson et al., 2009; van der Kolk, 2012). Yoga originated over 5000 years ago in India and is a holistic and comprehensive system of practice and wellbeing that creates individuality, space, and opening allowing the self to be in the body without judgment. According to Iyengar (2002), yoga lifts up from clutches of pain and sorrow, and enables to live fully, taking a delight in life. The purpose of this phenomenological study was to explore the meanings and experiences of yoga for trauma survivors. Phenomenology attempts to capture participants’ perception of lived experience, plunging deep into the nature of being to embrace a mindful wondering about a project of life, of living, of what it means to live a life (van Manen, 2001). The study engaged thirteen individuals who experienced trauma and had been practicing yoga for at least five years in phenomenological interviews using open and active interview questions. Research questions guiding my study were: What is the nature of the yoga experience? What meanings do people who have experienced trauma make of this experience? What happens in the yoga experience that is healing? The findings emerged in the form of four essences describing the yoga experiences of participants: moving from the darkness of trauma into the light of yoga and living, entering into safe and sacred spaces, letting go into yoga and returning to embodiment of self, and embracing creativity and connection beyond the mat. Through the light that yoga brought into the darkness of the lives of the participants, they realized they are far more than just the trauma they experienced. This light allowed them know and touch the light within, feel safe again, reclaim their connection with self, befriending their bodies while being present in the moment and know the trauma has already happened and they do not have to stay there.

This thesis investigates the difficult reality of children faced with illness, necessitating prolonged hospitalization. It takes a critical position with regard to the current approach to health care in Canada within the institution of the hospital. Through an exploration of environmental and experiential factors of proven importance to the child’s healing process, this thesis seeks to understand the role of architecture in healing. It does not presume that architecture alone has the power to heal, nor does it propose a tabula rasa approach; instead it seeks to explore the possibility of offering a complement to the current health care system, through the exploration of the potential positive physical and psychological impact of place in the healing process. Using Halifax, Nova Scotia, Canada and the IWK Children’s Hospital as a context for investigation, this thesis explores the design of a satellite healthcare building situated in Point Pleasant Park (Halifax), where uninterrupted medical treatment is to be offered, supported by a home-like setting and constant contact with nature.

No description available.

The main objective of this study is to examine the process of healing and recovery by people who have suffered a crisis. Healing concerns not only the physical aspects of a person but also the spiritual. In this regard there is a very close interaction between body and spirit. In the past the individual was to a large extent fragmented; much more emphasis must now be placed on a holistic approach towards illness, excluding however any mystical or occultic attachments. The various terms used in the Bible for healing and salvation make a very important contribution to defining healing; terms such as sozo and therapeuo are important in this regard. The person suffering a crisis has a great need for basic trust in the faithfulness of God. In this regard the following supporting terminology within Scripture presents important insights sterizo, rizomai, bebaioomai, oikodomeo, sthenoo endunamoomai, dunamoo, ischuo, stereoo. For many people in crisis situations, alternative medicine has begun to offer an escape because traditional approaches have not provided for their needs. Aspects with regard to this area has been addressed as well. To a large extent healing takes place when the pastor succeeds in helping a person who has suffered a crisis to function on a higher level than was the case before the crisis. Should the person function on a lower level after the crisis, the implication could be that healing has not occurred. Very often there is also a close relationship between trauma and certain physical symptoms and a number of examples of such cases are presented and discussed. The immune system of the body is affected negatively by stress and trauma. On the other hand, healing is promoted by positive and pleasant circumstances, with the emphasis on the striving towards a specific goal in life. Each crisis could in some way present an opportunity for personal growth. However, it could also be a situation with possible negative consequences; eventually the outcome will depend on a specific decision of the person in crisis. Within the normal long-term relationship between the pastor and the members of his congregation, it should be easy for him, in crisis intervention, to alternate between an insight oriented approach on the one hand and a supportive approach on the other. In cases where it is quite obvious that unresolved past trauma is repeatedly the cause of crisis situations, the pastor's involvement could assist in addressing this problem. 250 case studies of persons who experienced some kind of crisis have been evaluated; from these, fifteen have been selected for discussion in this study. The results indicated the importance of taking into consideration the unique history of each individual - especially with reference to past traumatic experience and crisis. Where the emphasis is put on a responsible self-disclosure when individuals relate their experiences, the indispensable therapeutic value of conversation becomes evident. The decisive importance of prayer in this regard was also pointed out very clearly. Another very important aspect seemed to be the very close relationship between certain traumatic experiences and contact with the occult. The pastor will have to obtain the necessary insight and background to this field in order to be able to assist and guide specific affected individuals effectively. / Thesis (M.A.)-University of Durban-Westville, 1994.

Stress within healthcare environments can be the result of uncertainty, illness, or the environment itself. In order to promote better health outcomes for dialysis users, scientific literature advocates stress reduction within healthcare environments. Dialysis patients are subject to numerous stressors, including the threat of potential losses and lifestyle change. Studies have revealed that patients who suffer from chronic illness perceive different levels of quality of life than those who are considered healthy and because of these lifestyle changes they employ various coping mechanisms when dealing with stress. There is a rising movement to mitigate stress through the use of holistic healing, an approach that addresses a person’s mental, emotional, physical, and spiritual elements to create a total healing environment. In accordance with this growing movement, the intent of this practicum is to create an outpatient centre for Manitoba’s dialysis patients that increases their perceived quality of life. The inquiry process began by questioning dialysis patients and conducting observational research at the Winnipeg Health Sciences Centre. Literature and precedent reviews were conducted, and the design programme was developed. The result of this research-based design proposal is an outpatient hemodialysis centre located within the Winnipeg Health Sciences Centre that helps mitigate stress while patients attempt to cope with lifestyle changes. The resulting design is one that is warm, welcoming, home-like and comfortable, which is supported by the theories explained in the literature review. This environment provides a greater sense of control, creates positive distractions and allows spiritually evoking opportunities to take place for all users of this new facility.

The aim of this study was to investigate the effects of various polysaccharides and their breakdown products on the proliferation and migration of cells involved in wound healing, both in vitro and in vivo, with the ultimate aim of developing a commercially viable collagen dressing containing an active polysaccharide fragment which would stimulate the wound healing response to such a degree that good quality and significantly faster healing would take place. Hyaluronic acid (HA), chondroitin sulphate (CS), heparin, Oxidised Regenerated Cellulose (ORC) and pectin were tested in this study. Some HA fragments and CS fragments significantly stimulated (p<O.05) the proliferation of Bovine Aortic Endothelial (BAEC) cells, although other HA or CS fragments were without effect. All HA and CS fragments tested also had no effect on the migration of L929 cells in the Boyden Chamber assay. Pectin stimulated the proliferation and migration of L929 cells, whereas, ORC 1 and heparin both suppressed proliferation (25% - 45% inhibition) of these cells but stimulated their migration. When injected subcutaneously into Polyvinyl alcohol sponges in the rat wound model at concentrations of 10 and 50J.1g/ml, heparin brought about an increased presence of granulation tissue in the wound after 10 days and 7 days respectively. These results indicate that structurally similar polysaccharides can have profoundly different effects on cell proliferation and migration, and thus have potential therapeutic use in guiding cell movement in wound healing.

No description available.

This Master of Social Work thesis focused on the healing journeys of urban First Nations women who have overcome trauma. The purpose of this research study was to develop a deeper understanding of healing and trauma from an Indigenous perspective. This Master of Social Work thesis created space for Indigenous knowledges so that Indigenous perspectives on the aspects of healing and trauma could be brought forward. At the centre of this created space were the voices of urban First Nations women and their shared stories of healing. This qualitative research study applied Indigenous research methodology, which also included narrative research methodology. In this study, the stories of five First Nations women who reside in an urban centre in Manitoba and who were well into their journeys of healing from trauma were explored. Manitoba First Nations traditional values, practice and protocol guided this thesis project to ensure that this research was conducted ethically and respectfully. The Medicine Wheel was used as a conceptual framework to understand the journeys of healing as well as the trauma experiences of the five women within the context of the life stages of human development. The meta-narratives and life narratives of the women provided accounts of their healing journeys. The findings of this research identified the following three overarching themes: living colonized lives, relationships, and healing paths. Recommendations were outlined for future social work research, practice, and education.

名古屋大学博士学位論文 学位の種類 : 博士(医学)(課程) 学位授与年月日:平成25年3月25日 原真由氏の博士論文として提出された