O tratamento da afecção de disco intervertebral tóraco-lombar com eletroacupuntura tem o objetivo de analgesia e reabilitação motora e sensorial. As melhoras funcionais observadas após lesão medular decorrem de fenômenos de plasticidade sináptica, correspondendo a um mecanismo compensatório e não de reparo estrutural. S100&beta; é considerado um fator neurotrófico glial que pode estar relacionado a estas alterações. Durante o período de fevereiro de 2007 a junho de 2008 foi realizado um estudo clínico prospectivo em cães com extrusão de disco intervertebral (n=10) submetidos à eletroacupuntura (grupo EA) sem o uso de corticosteróides. Foram coletadas amostras de líquido cefalorraquidiano (LCR) destes animais em dois momentos: durante o exame de mielografia e/ou tomografia computadorizada (M1) e após 35.5±21.33 dias de tratamento (M2). Níveis de S100&beta foram investigados no LCR de cães do grupo EA através da técnica de Western blot. LCR de cães sem sinais neurológicos (grupo normal, n=7) foram utilizados para comparação. Para a análise estatística, com nível de significância de 5%, foram utilizadas ANOVA para medidas repetidas e medidas independentes e comparação múltipla de Bonferroni, teste t-Student para a comparação entre duas médias e correlação linear de Pearson para as variáveis quantitativas. Todos os animais do grupo EA, graus de lesão 3 a 5, obtiveram melhora neurológica crescente e significativa (P-valor <0.001) através da Escala Funcional Numérica (EFN) nos M1 e M2 e M3 (momento da última avaliação). O grupo EA foi dividido em grupo A - cães com retorno à locomoção em até 30 dias (6.7±7.89; n=7) e grupo B - após 30 dias (76±17.06; n=3) do tratamento. Níveis de S100&beta; (Média±DP) em cães do grupo A foram superiores no M1 (P-valor=0.0107) em relação ao M2 e grupo normal, mas entre M2 e grupo normal não houve diferença significativa (P-valor=0.423). No entanto, níveis de S100&beta; em cães do grupo B foram superiores no M2 (P-valor=0.039) em relação ao M1 e normal, e não houve diferença significativa entre M1 e grupo normal (P-valor=0.756). Níveis de S100&beta; no M1 não diferiram (P-valor=0.069) entre os grupos A e B. Entretanto, níveis de S100&beta; no M2 em cães do grupo B foram superiores (P-valor=0.032) ao M2 em cães do grupo A. Não houve correlação dos níveis de S100&beta; no M1 com idade (r2=0.2042, P-valor=0.189); peso (r2=0.02634, P-valor=0.654), evolução clínica (r2=0.0062; P-valor=0.828), tempo de retorno à locomoção (r2=0.2522; P-valor=0.139) e extensão da extrusão (r2=0.0345; P-valor=0.607). Níveis de S100&beta; no M1 não apresentaram diferenças significativas entre os graus de lesão 3, 4 e 5 (P- valor=0.931); entre o grupo com escores de compressão extradural 1 e 2 comparado com grupo com escore de compressão 3 (P-valor=0.771); entre grupo de cães com EFN10 (P-valor=0.520) e entre grupo de cães com escores de nº de lesões 1, 2, 3 e 4 (P- valor=0.526). Níveis de S100&beta; no M2 não apresentaram diferenças significativas com a evolução clínica (r2=0.0304; Pvalor=0.629), extensão da extrusão (r2=0.0158; Pvalor=0.729), entretanto houve uma tendência a correlação com o tempo de retorno à locomoção (r2=0.3852; P-valor=0.055). A eletroacupuntura promoveu uma modulação dos níveis de S100&beta; detectados no LCR de cães com extrusão de disco intervertebral tóraco-lombar. A eletroacupuntura induziu aumento de S100&beta; no LCR de cães com recuperação motora tardia sugerindo sua contribuição na plasticidade neural após injúria da medula espinhal devido à extrusão de disco intervertebral. / Electroacupuncture treatment in dogs with thoracolumbar disk disease has the purpose of analgesia, motor and sensorial rehabilitation. The functional improvements observed after spinal cord lesion are resulting of synaptic plasticity. This fact is a result of compensatory mechanisms and not structural repair. S100&beta; is considered a glial neurotrophic factor. It can be involved with these improvements. A prospective clinical study during February 2007 to June 2008 evaluated electroacupuncture (EA) treatment (group EA) in dogs with thoracolumbar disk extrusion (n=10) without corticosteroids. Cerebrospinal fluids (CSF) were collected from these animals in two time points: during the mielography and/or computed tomography (M1) and after 35.5±21.33 (Mean±SD) days after EA treatment (M2). S100&beta; levels in CSF were investigated in dogs of group EA by Western blot. CSF of dogs without neurological signs (group normal; n=7) were used for comparisons. For the statistical analysis, significant level of 5%, ANOVA for repeated and not repeated variables (post-test Bonferroni´s), Student-t test for two variables comparisons and Pearsons linear correlation for quantitative variables, were used. All dogs (group EA) with lesion levels of dysfunction 3 to 5, reached neurological improvements with significant higher scores (P-value<0.001) from a functional numerical score (FNS) at each successive time points (M1; M2; M3 last evaluation). Group EA dogs were divided in group A - dogs with return of ambulation before 30 days (6.7±7.89; n=7) and group B - after 30 days (76±17.06; n=3). S100&beta; levels (Mean±SD) in group A dogs were higher in M1 (P-value=0.0107) than M2 and group normal, and there was not significant difference between M2 and group normal (P-value=0.423). Although, S100&beta; levels in group B dogs were higher in M2 (P-value=0.039) than M1 and group normal, and there was not significant difference between groups B M1 and normal (P-value=0.756). S100&beta; levels in M1 were not different (P-value=0.069) between dogs of group A and B. However, S100&beta; levels at M2 in group B dogs were significantly higher (P-value=0.032) than group A. The S100&beta; levels in M1 have no correlation with age (r2=0.2042; P-value=0.189); weight (r2=0.0263; P-value=0.654), duration of clinical signs (r2=0.0062; P-value=0.828), time of ambulation return (r2=0.2522; P-value=0.139) and extrusion length (r2=0.0345; P-value=0.607). There were no associations between S100&beta; levels at M1 and lesion levels of dysfunction 3, 4 e 5 (Pvalue=0.931); between extradural compression scores 1 and 2 compared with score 3 (Pvalue=0.771); between dogs with FNS10 (Pvalue=0.520) and between group of dogs with number of lesions scores 1, 2, 3 and 4 (Pvalue=0.5262). S100&beta; levels at M2 have no correlation with duration of clinical signs (r2=0.0304; Pvalue=0.629), extrusion length (r2=0.0158; P-value=0.729), however there was a tendency of correlation with time of ambulation return (r2=0.3852; Pvalue=0.055). Electroacupuncture can modulate the S100&beta; levels in CSF of dogs with thoracolumbar disk extrusion. Electroacupuncture up-regulated S100&beta; in CSF of dogs with late motor rehabilitation. This fact suggests its contribution in the neural plasticity after spinal cord lesion due to intervertebral disk extrusion.

En Afrique, la valorisation des pharmacopées traditionnelles constitue bien souvent un moyen d'orienter la recherche vers de nouveaux antipaludéens. Les plantes médicinales antipaludiques peuvent servir de base à la formulation de Médicaments Traditionnels Améliorés (MTA) ou être source de nouvelles molécules antiplasmodiales. Sur la base d'une recherche bibliographique exhaustive, 10 plantes médicinales largement utilisées au Mali dans le traitement du paludisme et des affections hépatiques (ictères) ont été sélectionnées par une approche d'ethnopharmacologie quantitative et évaluées in vitro sur Plasmodium falciparum FcB1, conduisant à la sélection de Terminalia macroptera (Feuilles et Racines). Terminalia macroptera est une espèce largement utilisée au Mali contre le paludisme, la fièvre, les affections hépatiques (ictères) et la plaie. Dans le contexte de mise sur le marché d'un MTA, une monographie botanique a été réalisée sur ces organes de plante afin de définir les normes pharmacopées de la poudre de feuilles et de racines permettant d'éviter les falsifications. Une étude toxicologique in vivo et une étude pharmacologique in vivo (activités antiplasmodiales, antipyrétiques, antalgiques, antiinflammatoires et hépatoprotectrice) ont été réalisées. L'extrait éthanolique des feuilles et des racines ont démontré des propriétés antiplasmodiales in vivo sur des modèles murins de paludisme simple et paludisme sévère des propriétés antipyrétiques, antalgiques, antiinflammatoires et hépatoprotectrices sur modèles murins d'hyperthermie, d'algie, d'inflammation et d'hépatotoxicité, respectivement. Un fractionnement bio-guidé, et une méthode de déréplication ont été réalisés sur les extraits actifs afin d'établir leur profil chimique. Ces résultats vont dans le sens de la validation de l'utilisation traditionnelle de Terminalia macroptera dans le traitement du paludisme et des affections hépatiques, et peuvent servir de base pour l'élaboration d'un médicament traditionnel amélioré au Mali. / In Africa, the promotion of traditional pharmacopoeias is often a means of directing research towards new antimalarial drugs. Anti-malarial medicinal plants can be used as a basis for the formulation of improved traditional medicine (médicament traditionnel amélioré, MTA) or as a source of new antiplasmodial molecules. Based on a comprehensive literature search, 10 medicinal plants widely used in Mali for the treatment of malaria and liver disease (jaundice) were selected by a quantitative ethnopharmacology approach and evaluated in vitro on Plasmodium falciparum FcB1, leading to the selection of Terminalia macroptera (leaves and roots). Terminalia macroptera is a species widely used in Mali against malaria, fever, liver diseases (jaundice) and wound. In the context of the marketing of a Terminalia macroptera based MTA, a botanical monography has been carried out on previously cited plant organs in order to define pharmacopoeia standards for leaf and root powder in order to avoid falsification. An in vivo toxicological study and a pharmacological study in vivo (antiplasmodial, antipyretic, analgesic, anti-inflammatory and hepatoprotective activities) were carried out. Ethanolic extract from leaves and roots demonstrated antiplasmodial properties in vivo on mouse models of simple malaria and severe malaria, antipyretic, analgesic, anti-inflammatory and hepatoprotective properties on mouse models. A bioguided fractionation and a dereplication method were carried out on the active extracts in order to establish their chemical profile. These results support the validation of the traditional use of Terminalia macroptera in the treatment of malaria and liver disease, and may serve as a basis for the development of an improved traditional medicine in Mali.

En occupant un espace social privilégié, la médecine traditionnelle et les diverses pratiques qui y sont liées, sont de moins en moins marginalisées, de plus en plus admises comme ressources et la société leur devient du même coup permissive. La tolérance sociale est relativement forte ». Cette lecture de la situation de la médecine traditionnelle et de sa réception dans la société est celle de l’anthropologue et médecine martiniquais M. Yoyo. Elle évoque la réalité de la médecine créole dans l’espace antillais et dit l’intérêt que lui portent ceux qui en font usage.L’objectif de cette recherche est de poser la question de la transmission du savoir médicinal en contexte martiniquais : transmission des tradipraticiens vers les profanes ; transmission entre professionnels de cette médecine. Autrement dit comment se fait l’apprentissage si apprentissage il y a, de ce savoir traditionnel, jalousement gardé par ceux qui l’exercent ? La dimension magico-religieuse de ce savoir influe-t-elle sur sa transmission ? Quel est le rôle de la famille dans l’éducation et la transmission de ces pratiques ? Quelle est la connaissance profane accessible à tous et que détiennent certaines familles ? Celle-ci répond-elle aux attentes de la médecine traditionnelle et comment les familles procèdent-elles à sa transmission ? Quelle contribution l’institution scolaire apporte-t-elle à la sauvegarde de ce patrimoine ? Ce questionnement nous amène à nous interroger sur les pratiques en matière de médecine des Martiniquais et à considérer la coexistence entre savoir traditionnel et savoir rationnel dit moderne.On ne peut faire l’économie de ces analyses si on veut appréhender de façon objective le problème de la transmission de la médecine créole, de sa sauvegarde par – et pour – les générations montantes, en raison de l’aspect mémoriel de cette pratique thérapeutique mais également en raison de son efficacité et du potentiel important qu’elle représente pour la santé dans les années qui viennent. / By occupying a privileged social space, traditional medicine and the diverses practices related to the field are less and less marginalized, more and more accepted as resources, thus society is gradually becoming more tolerant towards those practices. The social tolerance is relatively strong”. This perception of the present situation of traditional medicine and of its reception in society is proposed by M. Yoyo, French anthropologist and physician from Martinique. It speaks of the reality of traditional medicine in the west Indians context and highlights the positive affects on those who make use of it. The objective of this research is to explore the question of the transmission of medicinal knowledge within the confines of Martinique: transmission by traditionalists towards nonprofessionals as well as transmission among professionals in the fields of medicine. In other words, what learning, if any, still exists of this traditional knowledge faithfully kept by those practiced it? To what extent does the magical-religious experience influence the transmission of this knowledge? What is the role of the family in the education and the transmission of those practices? How much of this profane knowledge is accessible to all and to what extent is it practiced by families? Does the latter respond to the demands of traditional medicine? How do families proceed with the process of transmission. What contribution does the school make towards preserving this tradition ? The above questions provoke reflection on the medicinal practices of the people of Martinique and of the possible coexistence of traditional knowledge and modern or rational knowledge. These questions are inevitable if we want to progress with objectivity in the transmission of Creole medicine and of its preservation for future generations, as a form of safeguarding the memory of this therapeutic practice. However, they also help to focus on the level of its effectiveness and the potential importance that it represents in ensuring a healthy environment in the coming years.

The Tibetan practice of bcud len, or 'extracting the essence', has been for long a neglected aspect of Tibetan medical and spiritual knowledge with scattered evidence and little certainty regarding its origins or the extent of its effective presence, either in the past or at currently. In this study, seventy-three texts have been identified and tabulated. Of these, sixty-seven have been summarised and commented on, and five of these, each representative of one type of the practice, have been translated in full. All but a handful of these texts have not been translated previously. The research findings suggest that, whatever its influences from Indian, Chinese or other medical cultures, bcud len soon evolved into a distinctively Tibetan method of life enhancement, with teachings that emphasise both spiritual and medical aims and the use of indigenous Tibetan remedies, accompanied in some cases by particular rituals. The content of the texts indicates that the term bcud len can be applied legitimately to practices involving ritually empowered pills and elixirs which are ingested, respiratory and yogic exercises, dietary restrictions and rituals involving mantra recitation, visualisation and yab yum union with a consort, in that all these are considered to be means of obtaining 'the essence'. The teachings offer extensive material for those interested in the evolution and contemporary practice of Tibetan medicine, especially its botanical aspects, and for historians of ritual. In particular, the texts provide ample evidence of the lineage tradition in Tibetan religious culture, citing examples of transmissions through gter ma, whereby teachings are preserved in secret to be recovered at a future date by a gter ton or treasure revealer. The final section contains conversations with Tibetan doctors, lamas and contemporary practitioners of bcud len in Asia and the West that complement recent ethnographic studies in the field testifying to the continuing vitality of the tradition.

Made available in DSpace on 2016-01-26T12:51:43Z (GMT). No. of bitstreams: 1 rassen_dissert.pdf: 1247464 bytes, checksum: 68e143195fe25c1bd50b6681db4d40e7 (MD5) Previous issue date: 2001-09-28 / The aim of the present study is to evaluate the result of the knee pain treatment using The Opposite Side Technique from the Traditional Chinese Medicine. Thirty-six patients with unilateral gonalgia were studied. 44.44% (16) with osteoarthrosis, 30.55% (11) with patella femural osteoarthrosis, 11.11% (4) with severe osteoarthrosis, 11.11% (4) with patella chrondomalacy and 2.77% (1) with synovial plica. The patients were divided in two groups: Group I (Acupuncture) were eighteen, who submitted to 20 acupuncture sessions, where it was used points of counter to lateral acupuncture to the affected knee and acupuncture points to the distance according to the Traditional Chinese Medicine and to the acupuncture neurophisiologic action standard to select these points for the treatment, and Group II (Phisiotherapy) also eighteen, who submitted to 20 physiotherapeutic sessions and antiinflamatory non steroid (AINS) medicines. According to the results from the statistical analysis, non-parametric, of the subjective data (the intensity of the described pain, difficulty in walking, in crouching, in going upstairs and downstairs, in running, in jumping, in claudicant motion, in making use of some walking support) as the objective parameters ( the restriction of the flexional moviment and also the one of the knee extension moviment, and the arc moviment) showed good results in all the studied parameters. The most refractory parameters were the objective ones above mentioned. The Jue Yin (Liver) energetic channel of the foot showed to be the most affected (22.22%), followed by the associations of the Jue Yin (Liver) and the Tae Yang (Bladder) energetic channel of the foot (22.22%), the Jue Yin (Liver) and the Yang Ming (Stomach) of the foot (16.66%), and the Jue Yin (Liver) and the Shao Yang (Gall Bladder) of the foot (11.11%), and another associations (16.66%). The false-Yang (52.77%) characteristics of disorders were the predominant in relation to the energetic ones followed by the Yin (33.33%) and the Yang (13.88%) disorders of the patients. / O presente estudo teve a finalidade de avaliar a eficácia da acunputura no pós-operatório das cirurgias artroscópicas no joelho utilizando - se a técnica "ao oposto" da medicina tradicional chinesa. As 36 gonalgias estudadas foram distribuídas conforme a patologia encontrada nas artroscópicas cirúrgicas: 50,0% tinham lesão do menisco medial isolada, 19,44% tinham lesão meniscal associada à artrose de joelho, 11,11% tinham lesão meniscal lateral associada à artrose de joelho, 8,33% tinham lesão meniscal lateral isolada de joelho, 2,77% apresentavam lesão em ambos os menisco associados à artrose de joelho, 2,77% apresentavam condromalácea de patela e 2,77% eram portador de corpo livre. Os pacientes foram dividos em dois grupos. Todos os pacientes do grupo i (acunputura) 18 foram submetidos a 20 sessões de acunputura, utilizando-se pontos de acunputura, utilizando-se pontos de acunputura contra-lateral ao joelho afetado, e os pacientes do grupo ii (fisioterapia), 18, foram submetidos a 20 sessões de fisioterapia, associadas a anti-inflamatórios não esteroídes (aine). Nota de Resumo A análise estatística não paramétrica dos resultados obtidos nos dados subjetivos (intensidade da dor relatada, dificuldade de andar, de agachar, de subir e descer degraus, de correr, de uso de apoio a marcha), como os parâmetros objetivos (limitação do movimento de flexão, extensão, arco de movimento, edema, derrame e trofismo de joelho) evidenciaram bons resultados na maioria dos parâmetros estudados. Embora os resultados fossem semelhantes, a acunputura apresentou melhores resultados do tratamento mais precocemente, enquanto a fisioterapia mais tardiamente.

Thesis (M.Sc. (Biochemistry)) -- University of Limpopo, 2013 / Diabetes mellitus is one of the fast growing chronic metabolic disorders throughout the world. It has become a life threatening disease and health burden. So far it can only be managed with commercial therapeutic agents, proper diet and exercise. People particularly from developing countries use medicinal plants to treat this condition. According to WHO, about 80% of the population in developing countries are dependable on medicinal plants. This prompted many researchers to explore the effectiveness and safety of these plants. In the current study ten medicinal plants were randomly chosen, screened for antidiabetic activity by testing their ability to inhibit α-amylase and α-glucosidase enzymes. The plants were tested using in vitro assays. The finely powdered leaves of each plant were extracted with hexane, chloroform, acetone and ethyl acetate. Phytoconstituents of each plant extracts were analyzed using both qualitative and quantitative methods. All plant extracts tested positive for phenols, flavonoids and all negative for starch. Their compounds were better separated in the TEA mobile system on the TLC plates. All plant extracts had more of total phenolics ranging between 0.1-400 GAE/mg than total flavonoids and condensed tannins. Antioxidant activity of the plant extracts was tested quantitatively at various concentrations using DPPH. Most plant extracts were able to scavenge the radicals produced by DPPH at highest concentration of 2.5 mg/mℓ. Not all plant extracts with the highest number of total phenolics had the highest antioxidant activity. For antidiabetic in vitro assays, plant extracts inhibited various percentages of both α-amylase and α-glucosidase activity at concentrations ranging between 0.019- 2.5 mg/mℓ. The best overall activity against both enzymes was observed in acetone and ethyl acetate plant extracts. Cassia abbreviata and Helinus integrifolius were even more active than acarbose which was used as positive control. These plant extracts inhibited both the enzymes in a dose dependent and non-competitive manner. Seeing that both extracts of C. abbreviata and H. integrifolius were consistent when inhibiting both enzymes, they were further evaluated for their effect on glucose uptake by the C2C12 muscle and H-II-4-E liver cells. All the plant extracts tested were able to increase glucose uptake in the muscle cells. However optimal increase was seen in the liver cells when treated with 250 µg/mℓ of acetone and ethyl acetate extracts of C. abbreviata. The cytotoxicity effects of both acetone and ethyl acetate of C. abbreviata and H. integrifolius was tested using the xCelligence system on RAW 264.7 cells. Different cell indexes were obtained after treating the cells with different concentrations (0.05,0.1 and 0.25 mg/mℓ) of each plant extracts respectively. The system was run for three days but the toxic effects of plant extracts were analyzed for the first ten hours. The results obtained shows that cell index decreased as the concentration of the plant extracts was increased. All the plant extracts were less toxic as compared to positive control, Actinomycin D. The leaves of H. integrifolius were further exhaustively extracted with hexane, dichloromethane, acetone, ethyl acetate and methanol respectively. Since the DCM extracts yielded the highest mass in quantity, it was further used for isolation of active compounds. Column chromatography and bioassay guided fraction led to isolation of a mixture of triterpenes identified as α and β-amyrin. The structure was elucidated using nuclear magnetic resonance technique. The inhibitory capability of the isolated compound against α-amylase enzyme was less than the crude extract which inhibited more than 50% of the activity at a concentration of 1 mg/mℓ.Based on the enzymes assays and cell culture work it can be concluded that C. abbreviata and H. integrifolius species are the best inhibitors of carbohydrate digesting enzymes, and therefore be used to manage postprandial hyperglycemia in the people with type 2 diabetes. However more work still need to be conducted for further isolation of more active compounds.

Thesis (MA. (African Languages)) -- University of Limpopo, 2012 / Ngudo ino yo sengulusa ndeme ya u thusa ṅwana ho sedzwa nḓila ya Tshivenḓa, sa izwi maitele aya a tshi khou ngalangala musalauno. Ngudo iyi yo sumbedza uri u thusiwa hu kha ḓi vha hone naho mathusele a hone o fhambana, sa izwi zwi tshi bva kha thendelano ya muṱa. Ho wanala uri kha muthuso hu shumiswa vhathu vhofhambanaho u fana na vhomaine, vhakegulu, vhafunzi kana ha tou rengwa mishonga ine ya shumiswa kha u thusa ṅwana. Ngudo yo dovha ya sumbedza mvelelo mmbi dza u sa thusa ṅwana na mvelelo mbuya dza u thusa ṅwana.

Thesis (M.Sc. (Biochemistry )) --University of Limpopo, 2007 / Refer to document / The Cannon Collins Trust Fund and the National Research Foundation

This thesis examines the meanings of naturopathy through the experiences of twelve women with refugee backgrounds involved in naturopathic treatment at the Victorian Foundation for Survivors of Torture (Foundation House), a refugee torture and trauma rehabilitation service in Melbourne, Australia. The findings of this research show that the naturopathic encounter provided a transformative and meaningful meeting place for healing, a place in which the women felt at ease and in place.At Foundation House naturopathy has been practised alongside counselling since 1989, two years after the organisation’s inception. The women I interviewed for this project came from diverse sociocultural backgrounds and a wide range of countries including Iraq, Iran, Yemen, Afghanistan, Somalia, Burma and Serbia.The thesis brings together two contemporary fields of practice: Western models of refugee health care and traditional medicine. It argues for the place of non-biomedical approaches in refugee health care in a Western setting. The thesis takes an interdisciplinary approach to theorise the naturopathic encounter. The distinction between holistic and reductionist perspectives on health, illness and the body is underpinned by the theoretical work of medical anthropologists Nancy Scheper-Hughes and Margaret Lock and that of medical sociologist Aaron Antonovsky. A cultural studies perspective, influenced by the work of embodiment scholar Elspeth Probyn is employed to theorise these women’s experiences of the naturopathic encounter.This qualitative study is based on in-depth interviews and draws on grounded theory as an approach to data analysis. Descriptions of respite, renewal, and healing in the naturopathic encounter are cited as the most observable themes emerging from the women’s stories. These themes represent a health-oriented, as opposed to a disease-focused, perspective. Importantly, a health-orientated approach is congruent with the core tenets of naturopathic philosophy. Listening to the body is a crucial therapeutic tool in the naturopathic encounter, where primacy is given to supporting and strengthening health-creating strategies. I argue that this orientation disrupts the existing dominant biomedical approach to refugee health care. I draw on the work of Probyn to theorise the movement from the naturopathic encounter (NE) to the naturopathic meeting place (NMP). Central to this transposition is Probyn’s articulation of the body’s awareness of being in and out of place. This awareness lends itself to an understanding of the connectedness between past and present in the bridge-making that these particular refugee women have engaged in across cultures in the NMP.The thesis addresses an important but often neglected focus in refugee research: the resilience and agency of refugees. This positive aspect of refugee recovery is revealed in the research by theorising the women’s stories through Probyn’s embodiment analysis and cognisance of the ‘everyday’ as a productive and creative process. The research interrupts the ubiquitous image of the ‘disempowered refugee victim’. It highlights the practical wisdom and agency of these particular women that is often overshadowed in the complex resettlement process. It makes a call for further health-orientated research to broaden and deepen our understanding of the refugee experience.

There is increasing concern about hepatitis C virus (HCV) and potential HIV transmission among ethnic Vietnamese injecting drug users (IDUs) in Australia. To date ethnic and cultural differences in vulnerability to blood-borne viruses (BBV) have received little attention and few studies have attempted to explore the role of cultural beliefs and values in influencing injection risk behaviour. This study aimed to systematically explore the cultural beliefs and behavioural practices that appear to place ethnic Vietnamese IDUs at increased risk of BBV infection, identify barriers to this group accessing health and preventive programs, and document antibody HIV and HCV prevalence and associated risk behaviours. The first component of the research consisted of an ethnographic study designed to explore underlying explanatory models of health and illness employed by Vietnamese IDUs and identify cultural influences on risk behaviours and vulnerability to BBVs. These data were subsequently used to inform the development of the instrument used in the second component ??? a cross-sectional survey and collection of capillary blood samples designed to assess risk behaviours and antibody HIV and antibody HCV prevalence. Analysis of data from both components indicates that cultural beliefs and practices influence risk-taking and health-seeking behaviours and suggests pathways through which this influence occurs. Relevant cultural characteristics include those pertaining to spiritual and religious beliefs, the role of the family and traditional Vietnamese family values, cultural scripts of self-control and stoicism, the importance of ???face??? and non-confrontational relationships, trust and obligation, and a reluctance to discuss problems with outsiders. Vulnerability to BBVs is influenced by these cultural characteristics, together with Vietnamese IDUs??? perceptions of risk, knowledge about HIV and HCV, and situational and environmental factors. Main factors contributing to the under-utilisation of health services include the use of self-managed care practices, ambivalence surrounding Western medicine, long waiting times, concerns in relation to confidentiality, stigmatisation of drug use, and limited knowledge of BBVs. The data indicate a need for interventions based on understanding of culturally specific meanings and contexts of health, illness and risk in order to better meet the needs of this vulnerable group.