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.

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This study investigates the procedural techniques, significance and the tangible effects of the laying on of hands in the New Testament. The introductory chapter reviews critically previous contributions to the subject of the laying on of hands in the New Testament and establishes the purpose and delimitations of this study and the methodology used. The next two chapters are devoted to a study of the background of the New Testament practice of the laying on of hands. The investigation is conducted in the Old Testament and contemporary Judaism (Chapter Two) and in the Graeco-Roman and Near-Eastern literature (Chapter Three). Chapters Four through Seven are exegetical, each discussing a particular use of the laying on of hands in the New Testament. Chapter Four examines the function of the gesture in healing. Special attention is given to the inner process of transfer of power through physical contact. A comparative study of Jesus' method of healing with similar practices of his contemporaries challenges the idea that the origin of the healing touch is Hellenistic. The custom of blessing with the laying on of hands, as practised by Jesus, is examined in Chapter Five in terms of origin, significance and the form of the gesture. The next chapter is devoted to the use of the laying on of hands for the reception of the Holy Spirit. In addition to the exegetical analysis of the relevant pericopes, an attempt is made to explain the circumstances which led to the birth of this distinctive Christian practice. Chapter Seven examines the use of the laying on of hands in ordination and commissioning. It discusses the significance of the gesture, argues for the Jewish origin of the Christian rite and opposes the view that in the post-Pauline period charismata are tied to an office and thus institutionalised. In the final section of the thesis, an attempt is made to gauge the possibility of any uniformity in the significance of the various New Testament uses of the laying on of hands.

The aim of this thesis is to assess the nature of African Traditional healing system with special reference to Mpondo culture. It is a case study of the Mpondo people of the Eastern Cape. The focus of the study was on the historical facts, the cultural background, the religious experiences and the traditional healing system of this people. Stimulated by the fact that Mpondo people appear to be a marginalized group, undermined and sometimes sidelined, the research seeks to set the record straight. A lack of documented information about this people is the major contributing factor to their lost identity. This stems from the fact that very little has been written about them. Even when such writings are found, they often contain distorted information. In some books, they are mistakenly represented as amaXhosa or a Xhosa sub-group. They are mostly regarded as having no culture, no language or identity. In terms of language, isiXhosa is taught at schools in Mpondoland. This research is an attempt to raise awareness about the reality of the situation of the Mpondo people. Without this knowledge, the Mpondo people can not regain their lost identity, people-hood, humanity and dignity. Through this knowledge, a dehumanised people can fight for their rights. AmaMpondo need to rediscover the spirit of Africanness, so that they know that they belong to Africa. As T Mbeki puts it, Africa needs to be refounded as a space that is centred neither on the market nor on the fortress, but rather on what geographer Paul Wheatley called, its "ceremonial complex" (Mbeki, T., 20 in Chidester). The Mpondo people were primarily dehumanised by the Cape Colonial government. Precolonial Mpondo culture and its post-colonial history was examined. Dehumanising factors among Mpondo came in the form of labels and insults. Their religion was referred to as "pagan" whilst they were at times called "kaffirs", a Malaysian term meaning a non-believer. Now is the time for the revival of the Mpondo as a people of Africa, 'for a country that frowns on its culture by calling us savage and barbarians is a lost country' (Mutwa, p 22, Sunday Tribune, 16 .July 2000). This research sought to investigate the means and ways of restoring the lost dignity of the Mpondo people. In chapter two and three, a survey of Mpondo culture, their world view their religion and their identification of diseases and their treatment was made. Out of this survey it has been indicated that not all was destroyed by the encroachment of the western civilization. "Christianity and western medicine functioned as a secularising ferment in Africa, dethroned the traditional healer, replacing witchcraft, causation with medical history and introducing modem hygiene" (Jansen G.) Mpondo people still practise and believe in their healing system. This shows that although the foundations have been shaken, the base on which to rebuild its culture is still firm. What is now needed is to resist all forms of cultural expression. Sound reconstruction and reconciliation is the end goal of the research. Cultural reconstruction is the basis for sound reconciliation. Because the forces that be, broke the basis of a reconciled and organised society, there is a need to commence with the reconstruction of the people's culture. Cultural reconstruction becomes central particularly in a country which is threatened by social evils, such as a high crime rate, poverty, incurable or death threatening diseases such as HlV/AIDS and unemployment. Without reconciling the people with their culture and African Traditional Religion, any attempt to solve the above mentioned problems may not be easily achieved. Such a construction should not be confused with what Chidester calls '1:he construction of an inventory of Mrican traditional religion which recalls colonial efforts to create systematic boundaries within which African populations were contained. Enclosed within a stable secure and unchanging religious system" (Chidester 2000 : 15). The point at issue here is the reconstruction of a people's culture, based on its natural dignity. Such reconstruction should aim at the international marketing of the people's culture. The thesis is a pointer to the seriousness of the demand for the speedy reconstruction of religion and medical practice. ''The time is past when western medicine was the much praised vehicle for the propagation of the gospel to foreign cultures - missionaries are the heavy artillery of the missionary army" (Walls 1982 : 22). Healing and African Traditional Religion should be a base of such a reconstruction process. First and foremost, African Traditional Religious researchers who are adherents and practice the religion, should take a lead in such a process. This refers to the people on the ground who must be directly be involved. For, ''the non-western voices have not spoken or intervened in this debate" (Jansen G : 09). This may sound racial or ethnic, but the fact of the matter is that most • of the time, the people on the ground have not as yet surfaced, conscientised and organised as a religious group. What is needed is the democratisation of all cultural councils so that more funds are generated for the development of African Traditional Religion standards. It should be taught at schools. More air time on radio and television stations should also be allocated to African Traditional Religion. As in the rest of sub-Saharan Africa, studies of the recent democratisation wave have so far tended to limit themselves to the role of the churches and to the lesser extent to Islamic communities. ATR has not received the attention it deserves (Schoffieers : 405). The reconstruction of African Traditional Religion and African Traditional Healing systems are the only positive step towards the proper representation of African culture. This will contribute to the recent efforts to positively represent the traditional religious heritages of South Africa. If it is motivated by Christian acculturation or even Africanist revitalization, the process runs the risk of perpetuating the colonial legacy to the extent that it repeats the inventory approached or abstracts the mentality of 'ubuntu' or African humanity, from political, social and economic relations (Chidester : 2000 : 15). Formations such as the NACATR (National Council of African Traditional Religion) and THO (Traditional Healers Organization) are in line with the promotion of African culture based on religion and healing just as the constitution of South Africa demands. ''The primary objects of the commission for the promotion and protection of the rights of cultural religious and linguistic communities are (a) to promote and respect the rights of cultural religious and linguistic communities, (b) to promote and develop peace, friendship, humanity, tolerance, national unity among religious and linguistic communities on the basis of equality, non-discrimination and freedom of association, and (c) to recommend the establishment or recognition in accordance with national legislation of a cultural or other council or councils for a community or communities in South Africa (The Constitution of the Re.public of South Africa 1996 Chapter 9: 101). / Thesis (Ph.D)-University of Durban-Westville, 2001.

Hypothesis: Trimethoprim promotes wound healing, decreases lesion counts and improves quality of life of recessive dystrophic epidermolysis bullosa (RDEB) patients. Objectives: Assess feasibility of conducting a large randomized clinical trial. Determine efficacy of trimethoprim in healing of chronic wounds, decreasing lesion counts and improving quality of life of RDEB patients. Methods: Prospective, randomized, double-blinded, placebo-controlled, cross-over pilot study. Results: Ten patients enrolled in the trial, 7 completed both study periods. Despite showing that all patients improved on trimethoprim and that there was a 41% difference in affected area percent change favoring trimethoprim, the cross-over analysis did not show a significant difference between the drug and placebo (p=0.08). Secondary outcome measures did not achieve statistical significance. Limitations: Small sample size, large variation in wound size and unaccounted confounders. Conclusions: Although patients experienced improvement while on trimethoprim, no statistical significant change was showed when compared to placebo.

Potential targeting of impaired wounds resulting from hyperglycemia using mesenchymal stem cells is a promising approach. We hypothesized that when administered to dermal wounds in hyperglycemic subjects, neonatal mesenchymal stem cells (MSCs) would be more effective than adult mesenchymal cells in accelerating healing. We examined the in vitro impact of various glucose conditions on proliferation and senescence of human umbilical cord perivascular cells (HUCPVCs) and adult bone marrow MSCs (hBM-MSCs). We also investigated the healing potential of both cells in dermal wounds of streptozotocin-induced NOD-scid-gamma (NSG) mice utilizing planimetry and histomorphometry. HUCPVCs showed higher proliferation under normal and hyperglycemic conditions and lower senescence under all conditions compared to hBM-MSCs. Wound closure was better in treated wounds compared to untreated wounds. Disease tolerance varied among mice which affected healing. HUCPVCs still holds a potential over adult MSCs for impaired wounds; yet more studies are needed to recognize their bona fide capacity.

Hypothesis: Trimethoprim promotes wound healing, decreases lesion counts and improves quality of life of recessive dystrophic epidermolysis bullosa (RDEB) patients. Objectives: Assess feasibility of conducting a large randomized clinical trial. Determine efficacy of trimethoprim in healing of chronic wounds, decreasing lesion counts and improving quality of life of RDEB patients. Methods: Prospective, randomized, double-blinded, placebo-controlled, cross-over pilot study. Results: Ten patients enrolled in the trial, 7 completed both study periods. Despite showing that all patients improved on trimethoprim and that there was a 41% difference in affected area percent change favoring trimethoprim, the cross-over analysis did not show a significant difference between the drug and placebo (p=0.08). Secondary outcome measures did not achieve statistical significance. Limitations: Small sample size, large variation in wound size and unaccounted confounders. Conclusions: Although patients experienced improvement while on trimethoprim, no statistical significant change was showed when compared to placebo.

Potential targeting of impaired wounds resulting from hyperglycemia using mesenchymal stem cells is a promising approach. We hypothesized that when administered to dermal wounds in hyperglycemic subjects, neonatal mesenchymal stem cells (MSCs) would be more effective than adult mesenchymal cells in accelerating healing. We examined the in vitro impact of various glucose conditions on proliferation and senescence of human umbilical cord perivascular cells (HUCPVCs) and adult bone marrow MSCs (hBM-MSCs). We also investigated the healing potential of both cells in dermal wounds of streptozotocin-induced NOD-scid-gamma (NSG) mice utilizing planimetry and histomorphometry. HUCPVCs showed higher proliferation under normal and hyperglycemic conditions and lower senescence under all conditions compared to hBM-MSCs. Wound closure was better in treated wounds compared to untreated wounds. Disease tolerance varied among mice which affected healing. HUCPVCs still holds a potential over adult MSCs for impaired wounds; yet more studies are needed to recognize their bona fide capacity.

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.