Definition Of Healing Research Articles

Cancer Patient Perspectives on the Meaning of Healing and the Clinician as a Healer.

The experience of living with cancer is marked by suffering and loss, which creates a need for healing. Understanding what healing means to patients and how clinicians can play a role in the healing process is essential to holistic cancer care. The aim of this study was to explore the perspectives of cancer patients on the meaning and experiences of healing and the qualities of a clinician and the clinician-patient relationship that are healing. A qualitative study was conducted using semi-structured interviews with 14 cancer patients. Participants were asked about their illness experience, definition of healing, qualities of a healer, and relationships with clinicians that were healing. Interview transcripts were coded, and qualitative analysis was conducted to identify major themes. Participants defined the nature of healing as comprising aspects of physical, mental, emotional, and spiritual well-being. Participants described healing as alleviating pain and symptoms; promoting mental strength, emotional comfort, and spiritual connection; restoring and adapting to losses; and improving quality of life. The qualities of a clinician that contributed to a healing relationship included listening, empathy and compassion, understanding patients' values and goals, and caring for the patient as a whole person. Participants viewed healing as physical, psychosocial, and spiritual in nature and an important part of their cancer experience with an emphasis on quality of life. Clinicians played an important role beyond treating the cancer by helping in the healing process through their humanistic qualities and holistic approach to patient care.

Toward a Methodology of Healing: Promoting Radical Healing among Student Survivors through Research

To resist hegemonic campus sexual violence research trends rooted in postpositivist paradigms, I advocate for the centering of healing in research, particularly in the research methodologies that scholars employ. In this article, I invite researchers to (re)consider the purpose of research as a process that actively prioritizes and promotes radical healing among student participants. By envisioning culture as an asset for healing, centering relationality and community, and embodying trauma-informed practices, researchers can employ methodologies that support radical healing among minoritized survivor participants. I describe my conceptualization of a methodology rooted in healing, integrating discussion of my positionality and professional pursuits that have informed my definitions of healing and understandings of the possibilities of a healing methodology. I then share some examples of potential methods that align with a healing methodology, such as thé talks, virtual semi-structured interviews, and photo-elicitation. Through attention to the physical environment and interpersonal context, engaging in contemplative practices, promoting principles of trauma-informed care, and centering relationality, embodying a methodology of healing can foster healing among participants through the very act of engaging in specific methods and the research process. I demonstrate the potential transformative nature of these methods by sharing participant narratives from two critical qualitative studies centering Women and Femme Student Survivors of Color in which I employed these methods. I conclude by illustrating the significance of a healing methodology—its ability to invite higher education scholars to question the very purpose of research and shift to center participant communities as the primary audience of scholarship, ultimately fostering radical healing. By employing a healing methodology, scholars can promote equity and justice for individual participants while working toward broader social change.

Abstract PO-011: CiRCL: A psychosocial program facilitating communication and care to patients, families, and frontline health care teams during COVID-19

Abstract The need for strict social distancing measures preventing visitors on inpatient oncology, ICU, and COVID units during the COVID-19 pandemic has had the unintended consequence of leading to significant psychological and spiritual distress for patients and families and “moral distress” for frontline health care teams tasked with supporting patients who are suffering or dying alone without the support of their loved ones. The trauma of these deaths is sometimes further compounded for families by their inability to provide the final rituals of patients’ faith communities in their last moments, leading to complicated and ongoing grief after the loss. To address these complex psychosocial needs among COVID-19 and advanced cancer oncology patients, and the health care teams caring for them, the Simms/Mann UCLA Center for Integrative Oncology, in collaboration with colleagues at the UCLA Anderson School of Business and a team of diverse faith leaders, developed an innovative digitally mediated program for connection, communication, and care. This program, CiRCL (Caring in Remote Communities of Love), leveraged ZOOM and smartphone recording technology to accomplish the following goals: 1) provide psychological support to family members and friends to facilitate the recording of meaningful personal messages to the patient, including curated playlists of evocative songs from the patient’s life to be played at the bedside; 2) facilitate more meaningful communication between loved ones and frontline workers, including messages of gratitude and support to reduce feelings of isolation and moral distress for frontline workers; and 3) create a liturgical library of recorded ecumenical and faith-based blessings from various traditions, available during illness and at time of dying. Blessings include and encompass the health care teams as well as patients. This program, recently developed and being piloted at UCLA, is intended to extend compassion to all within the health care system during the unique challenges of COVID-19 and, by facilitating connection and support among patients, families, and frontline teams, extend the definition of healing and mitigate the impact of loss and grief for all during the many phases of this pandemic. Citation Format: Kauser Ahmed, Peter Phung, Noah Goldstein, John Glaspy. CiRCL: A psychosocial program facilitating communication and care to patients, families, and frontline health care teams during COVID-19 [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-011.

Protease activity as a prognostic factor for wound healing in venous leg ulcers.

Venous leg ulcers (VLUs) are a common type of complex wound that have a negative impact on people's lives and incur high costs for health services and society. It has been suggested that prolonged high levels of protease activity in the later stages of the healing of chronic wounds may be associated with delayed healing. Protease modulating treatments have been developed which seek to modulate protease activity and thereby promote healing in chronic wounds. To determine whether protease activity is an independent prognostic factor for the healing of venous leg ulcers. In February 2018, we searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid Embase and CINAHL. We included prospective and retrospective longitudinal studies with any follow-up period that recruited people with VLUs and investigated whether protease activity in wound fluid was associated with future healing of VLUs. We included randomised controlled trials (RCTs) analysed as cohort studies, provided interventions were taken into account in the analysis, and case-control studies if there were no available cohort studies. We also included prediction model studies provided they reported separately associations of individual prognostic factors (protease activity) with healing. Studies of any type of protease or combination of proteases were eligible, including proteases from bacteria, and the prognostic factor could be examined as a continuous or categorical variable; any cut-off point was permitted. The primary outcomes were time to healing (survival analysis) and the proportion of people with ulcers completely healed; the secondary outcome was change in ulcer size/rate of wound closure. We extracted unadjusted (simple) and adjusted (multivariable) associations between the prognostic factor and healing. Two review authors independently assessed studies for inclusion at each stage, and undertook data extraction, assessment of risk of bias and GRADE assessment. We collected association statistics where available. No study reported adjusted analyses: instead we collected unadjusted results or calculated association measures from raw data. We calculated risk ratios when both outcome and prognostic factor were dichotomous variables. When the prognostic factor was reported as continuous data and healing outcomes were dichotomous, we either performed regression analysis or analysed the impact of healing on protease levels, analysing as the standardised mean difference. When both prognostic factor and outcome were continuous data, we reported correlation coefficients or calculated them from individual participant data.We displayed all results on forest plots to give an overall visual representation. We planned to conduct meta-analyses where this was appropriate, otherwise we summarised narratively. We included 19 studies comprising 21 cohorts involving 646 participants. Only 11 studies (13 cohorts, 522 participants) had data available for analysis. Of these, five were prospective cohort studies, four were RCTs and two had a type of case-control design. Follow-up time ranged from four to 36 weeks. Studies covered 10 different matrix metalloproteases (MMPs) and two serine proteases (human neutrophil elastase and urokinase-type plasminogen activators). Two studies recorded complete healing as an outcome; other studies recorded partial healing measures. There was clinical and methodological heterogeneity across studies; for example, in the definition of healing, the type of protease and its measurement, the distribution of active and bound protease species, the types of treatment and the reporting of results. Therefore, meta-analysis was not performed. No study had conducted multivariable analyses and all included evidence was of very low certainty because of the lack of adjustment for confounders, the high risk of bias for all studies except one, imprecision around the measures of association and inconsistency in the direction of association. Collectively the research indicated complete uncertainty as to the association between protease activity and VLU healing. This review identified very low validity evidence regarding any association between protease activity and VLU healing and there is complete uncertainty regarding the relationship. The review offers information for both future research and systematic review methodology.

Protease activity as a prognostic factor for wound healing in venous leg ulcers

BACKGROUND Venous leg ulcers (VLUs) are a common type of complex wound that have a negative impact on people's lives and incur high costs for health services and society. It has been suggested that prolonged high levels of protease activity in the later stages of the healing of chronic wounds may be associated with delayed healing. Protease modulating treatments have been developed which seek to modulate protease activity and thereby promote healing in chronic wounds. OBJECTIVES To determine whether protease activity is an independent prognostic factor for the healing of venous leg ulcers. SEARCH METHODS In February 2018, we searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid Embase and CINAHL. SELECTION CRITERIA We included prospective and retrospective longitudinal studies with any follow-up period that recruited people with VLUs and investigated whether protease activity in wound fluid was associated with future healing of VLUs. We included randomised controlled trials (RCTs) analysed as cohort studies, provided interventions were taken into account in the analysis, and case-control studies if there were no available cohort studies. We also included prediction model studies provided they reported separately associations of individual prognostic factors (protease activity) with healing. Studies of any type of protease or combination of proteases were eligible, including proteases from bacteria, and the prognostic factor could be examined as a continuous or categorical variable; any cut-off point was permitted. The primary outcomes were time to healing (survival analysis) and the proportion of people with ulcers completely healed; the secondary outcome was change in ulcer size/rate of wound closure. We extracted unadjusted (simple) and adjusted (multivariable) associations between the prognostic factor and healing. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion at each stage, and undertook data extraction, assessment of risk of bias and GRADE assessment. We collected association statistics where available. No study reported adjusted analyses: instead we collected unadjusted results or calculated association measures from raw data. We calculated risk ratios when both outcome and prognostic factor were dichotomous variables. When the prognostic factor was reported as continuous data and healing outcomes were dichotomous, we either performed regression analysis or analysed the impact of healing on protease levels, analysing as the standardised mean difference. When both prognostic factor and outcome were continuous data, we reported correlation coefficients or calculated them from individual participant data.We displayed all results on forest plots to give an overall visual representation. We planned to conduct meta-analyses where this was appropriate, otherwise we summarised narratively. MAIN RESULTS We included 19 studies comprising 21 cohorts involving 646 participants. Only 11 studies (13 cohorts, 522 participants) had data available for analysis. Of these, five were prospective cohort studies, four were RCTs and two had a type of case-control design. Follow-up time ranged from four to 36 weeks. Studies covered 10 different matrix metalloproteases (MMPs) and two serine proteases (human neutrophil elastase and urokinase-type plasminogen activators). Two studies recorded complete healing as an outcome; other studies recorded partial healing measures. There was clinical and methodological heterogeneity across studies; for example, in the definition of healing, the type of protease and its measurement, the distribution of active and bound protease species, the types of treatment and the reporting of results. Therefore, meta-analysis was not performed. No study had conducted multivariable analyses and all included evidence was of very low certainty because of the lack of adjustment for confounders, the high risk of bias for all studies except one, imprecision around the measures of association and inconsistency in the direction of association. Collectively the research indicated complete uncertainty as to the association between protease activity and VLU healing. AUTHORS' CONCLUSIONS This review identified very low validity evidence regarding any association between protease activity and VLU healing and there is complete uncertainty regarding the relationship. The review offers information for both future research and systematic review methodology.

Definitions of healing and healing interventions across different cultures.

For centuries healing has been embedded in non-Western cultures. Traditional cultures believe that healing is derived from the divine and utilize a holistic approach to healing including the body, mind, and spirit. The community and environment are key elements in individual healing along with herbal remedies and ceremonies. Western cultures have accepted some traditional methods of relaxation and exercise, such as yoga and tai chi. In this paper we will examine some similar themes of traditional practices to better understand traditional patients' healing paradigm and find new tools as practitioners of Western medicine.

동·서양의 치유환경 관점의 차이에 관한 연구

Purpose: The definition of healing and treatment is different between the East and the West. I suppose that the different definitions of them affect the notion of healing environment in two cultural area. Therefore the aim of this study is to consider the different perspective in healing environment between the East and the West. Methods: Relevant literature review around domestic and foreign reference in fields of medicine and architecture has been conducted to consider the purpose. Results: First, the perspective that the cause of disease stems from inside of body approaches the body from standpoint of healing for recovery. Healing is the way to conquer imbalance by entering into a connection with nature around body. The concept of healing could analyze that it come from relevant perspective. Second, the healing environment in the East is the place where the flow of Qi between, human and human, and, human and environment, keep a balance. The notion of healing environment in the East is the filed of relations. In the West, the notion of healing environment is the place where arouse fine emotions through sensory stimulations. Implications: Recently the studies of healing environment focus on deducing sensory stimulation factors scientifically in the perspective of the West. But the healing environment couldn't be possible without the notion of place of relations. In the future, the notion of healing environment as the field of relations in the East has to be concerned.

Acupuncture and vitamin B12 injection for Bell's palsy: no high-quality evidence exists.

OBJECTIVE:To assess the efficacy of acupuncture combined with vitamin B12 acupoint injection versus acupuncture alone to reduce incomplete recovery in patients with Bell’s palsy.DATA RETRIEVAL:A computer-based online retrieval of Medline, Web of Science, CNKI, CBM databases until April 2014 was performed for relevant trials, using the key words “Bell’s palsy or idiopathic facial palsy or facial palsy” and “acupuncture or vitamin B12 or methylcobalamin”.STUDY SELECTION:All randomized controlled trials that compared acupuncture with acupuncture combined with vitamin B12 in patients with Bell’s palsy were included in the meta-analysis. The initial treatment lasted for at least 4 weeks. The outcomes of incomplete facial recovery were monitored. The scoring index varied and the definition of healing was consistent. The combined effect size was calculated by using relative risk (RR) with 95% confidence interval (CI) using the fixed effect model of Review Manager.MAIN OUTCOME MEASURES:Incomplete recovery rates were chosen as the primary outcome.RESULTS:Five studies involving 344 patients were included in the final analysis. Results showed that the incomplete recovery rate of Bell’s palsy patients was 44.50% in the acupuncture combined with vitamin B12 group but 62.57% in the acupuncture alone group. The major acupoints were Taiyang (EX-HN5), Jiache (ST6), Dicang (ST4) and Sibai (ST2). The combined effect size showed that acupuncture combined with vitamin B12 was better than acupuncture alone for the treatment of Bell’s palsy (RR = 0.71, 95%CI: 0.58–0.87; P = 0.001), this result held true when 8 patients lost to follow up in one study were included into the analyses (RR = 0.70, 95%CI: 0.58–0.86; P = 0.0005). In the subgroup analyses, the therapeutic effect in patients of the electroacupuncture subgroup was better than in the non-electroacupuncture subgroup (P = 0.024). There was no significant difference in the incomplete recovery rate by subgroup analysis on drug types and treatment period. Most of the included studies were moderate or low quality, and bias existed.CONCLUSION:In patients with Bell’s palsy, acupuncture combined with vitamin B12 can reduce the risk of incomplete recovery compared with acupuncture alone in our meta-analysis. Because of study bias and methodological limitations, this conclusion is uncertain and the clinical application of acupuncture combined with vitamin B12 requires further exploration.

Salutogenesis: the defining concept for a new healthcare system.

A decade ago, we published several articles that described our definitions of healing and of healing-oriented practice and environments (HOPE) and how they are organized to create an optimal healing environment (OHE) as they apply to healthcare. We also provided a description of the seven domains and their elements that constitute an OHE.1 In the ensuing years, the accumulation of scientific evidence and the changes in healthcare delivery brought on by health reform have reinforced the importance of an OHE as the preferred clinical approach to patient care by individual health practitioners and healthcare institutions. Some elements in our OHE definition have been incorporated into the operations and best practices of several medical institutions and into large systems in their attempts to transform from disease treatment to health and healing.2 However, in our field studies and evaluation of the literature, we have not found a complete prototype of an optimal healing environment that fulfills our definit...

Bringing Zen Home: The Healing Spirit of Japanese Women’s Rituals by Paula Arai (review)

Reviewed by: Bringing Zen Home: The Healing Spirit of Japanese Women’s Rituals by Paula Arai Stephen G. Covell (bio) Bringing Zen Home: The Healing Heart of Japanese Women’s Rituals. By Paula Arai. University of Hawai‘i Press, Honolulu, 2011. xii, 261 pages. $52.00. Bringing Zen Home, Paula Arai’s latest book, builds on her previous work on Buddhist nuns in Japan by turning her focus to female lay practitioners and, in particular, the ways in which they embody the teachings of Zen as a part of their healing regime. The close attention to the details of her subjects’ lives and their approaches to life and practice shed light on this understudied aspect of contemporary Japanese temple Buddhism. The book, however, is not without its flaws. Chapter 1 opens with a personal story about the death of the author’s mother. This story, and the author’s journey in search of healing found within it, both set the tone for all that follows and help us to understand the research methods used and conclusions reached by Arai. It is also in this chapter that the author sets out her definition of healing and ritual. “In a worldview where the interrelatedness of all things is the primary point of reference, healing means to be in harmony with this impermanent web of relationships that constitutes the dynamic universe” (p. 3). And, “Rituals . . . can be a conduit to an intuitive experience of interrelatedness, based on the body, precisely because rituals can induce modes of being that transcend linear and rational logic and facilitate contact with the ineffable” (p. 3). Regarding ritual, Arai goes on to clarify that, for the purpose of this book, ritual concerns the ritualization of daily behavior. This is one of the strong points of the book—its intentional turn away from institutionalized practices and its at times insightful look at the more fluid and personal daily practices of the laity. In subsequent chapters, Arai introduces the lives and actions of her subjects using these definitions of ritual and healing. Chapter 2 traces “the way of healing” within Buddhism. Following her definition of healing above, this chapter is not about overcoming specific physical or psychological illnesses (though they are not excluded) but about “the transformation of habitually deluded ways of looking at the world through the lenses of attachment and aversion” (p. 30). Arai lays out ten principles of healing that she identifies as the core of the healing practices of her subjects: experiencing interrelatedness, living body-mind, engaging in rituals, nurturing the self, enjoying life, creating beauty, cultivating gratitude, accepting reality as it is, expanding perspective, and embodying compassion. These principles become the hermeneutical touchstones for the [End Page 435] chapters that follow. However, one problem that becomes clear in this chapter is the conflict within the book between Arai’s stated aim of understanding her object of study on its own terms and her obvious desire to show that the healing methods employed by her subjects are scientifically legitimate. Arai makes sure to note in the first chapter that her goal is to understand the lives of her subjects and not to explain the “truth” of their healing practices. Be that as it may, in her explanation of nearly all of the ten principles, she cites medical research to prove the effectiveness of the practice. The effort to prove the efficaciousness of the practices continues throughout the book, is distracting, and leads the reader to the conclusion that this is in many ways less a scholarly analysis and more a personal healing journey. If read as such a journey, the book holds many insightful points. Chapter 3 looks at funeral and memorial rituals as a form of healing. One positive outcome of this approach is Arai’s observation that memorials and prayers before the family Buddhist altar must be understood as healing rituals. This serves to expand the more staid view of ancestor veneration as a form of social obligation or solely as a means to aid the dead. On the other hand, Arai’s term “Personal Buddhas,” which she uses as the central theme for the chapter, is highly problematic. Her basic assertion is that...

Fibrin Glue Treatment of Enterocutaneous Fistula in Crohnʼs Disease

Background: Crohn's disease is an auto-immune inflammatory condition that can affect any portion of the gastrointestinal tract from the mouth to the perianal area. Fistulas occur in up to 25% of all Crohn's disease patients. Fibrin glue has been used to treat fistulas refractory to conventional medical therapy to avoid more radical surgical intervention. Case: A 27-year-old male with a 10 year history of Crohn's disease complicated by an enterocutaneous fistula presented with 2 weeks of foul-smelling abdominal drainage. His fistula involved the cecum and had been present for 1 year despite medical therapy. Past medical history was significant for a partial small bowel resection of the terminal ileum & ileocecal valve and perianal fistulas s/p Seton placement. He was on adalimumab, but not continuously due to financial issues. CT of his abdomen and pelvis confirmed the presence of an enterocutaneous fistula without abscess within the region of the cecum. He underwent a colonoscopy with fibrin glue injection and endoclip closure of the enterocutaneous fistula. A colonoscope was passed to the cecum; a small opening was seen which was traversed with the colonoscope. A fistula probe was inserted into the fistula opening on the skin; the probe was visualised with the colonoscope thus confirming the fistula tract. 1ml of fibrin glue was back filled through the fistula tract using an injection catheter. Two endoclips were subsequently applied to the internal portion of the fistula. He was discharged home without adverse events. At follow-up 6 months later, there was no abdominal drainage from the fistula tract. Magnetic resonance enterography confirmed closure of the fistula, without evidence of intra-abdominal abscess or fluid. Discussion: Fibrin glue is a two-component system in which a solution of concentrated fibrinogen and factor XIII is combined with a solution of thrombin and calcium to form a coagulum which is designed to mechanically seal a fistula tract. Instilling fibrin glue into fistulas is a simple and safe procedure which does not preclude the use of other techniques or repeat procedures in the case of failure. Several studies have been published of series of patients treated with fibrin glue and success rates vary from 0% to 80%. This variability can be attributed to the different types of fistulas treated, differences in the definition of healing, variable sample sizes and duration of patient follow-up. Given the low morbidity and relative simplicity of the procedure, it should be considered as an alternative to surgical resection of a persistently draining fistulous tract. More well-designed controlled studies are required to confirm the effectiveness of this emerging treatment.

Expanding the Definition of Healing—Cancer Education in India

Enormous increases are predicted in the global burden of cancer, with the bulk of these cases is expected to occur in low- and middle-income countries like India. This paper outlines the existing scenario of cancer incidence and mortality, health and cancer care facilities, and the status of cancer education in India. Cancer education strategies in tune with future local needs are also discussed with special reference to research related to various aspects of cancer, teaching and training of human resources, and the development of appropriate legislation.

Healing in primary care: a vision shared by patients, physicians, nurses, and clinical staff.

We wanted to understand the views of patients and clinicians on the central concept of healing and to identify major facilitators of and barriers to promoting healing in primary care. We undertook a qualitative analysis of focus group discussions. Participants were drawn from primary care clinics of a large, integrated, health care system in Washington State in 2005. Nine focus groups included 84 participants: 28 patients, 23 primary care physicians (19 family physicians), 20 registered nurses, 11 licensed practical nurses, and 2 medical assistants. Randomly sampled established patients were aged from 21 to 65 years; 71% were female. We found remarkable concordance across focus groups and among types of participants in the definition of healing: Healing is a dynamic process of recovering from a trauma or illness by working toward realistic goals, restoring function, and regaining a personal sense of balance and peace. Healing is a multidimensional process with physical, emotional, and spiritual dimensions. The key themes are as follows: (1) healing is multidimensional and holistic; (2) healing is a process, a journey; (3) the goal of healing is recovery or restoration; (4) healing requires the person to reach a place of personal balance and acceptance; and (5) relationships are essential to healing. Factors that facilitate healing help build relationships, improve communication, and share responsibility between the patient and clinician. Major barriers are logistical factors that limit high-quality time with healing professionals. Patients and health care team members share a vision of healing and agree on ways to enhance the process in primary care.

'Making Tradition': Healing, History and Ethnic Identity among Otjiherero-Speakers in Namibia, c. 1850-1950*

For at least the last century and a half, Otjiherero-speakers in central Namibia have engaged in healing rituals played out around the Holy Fire and involving a resolution of tension through appeal to male patrilineal ancestors. These ceremonies are part of traditions that have increasingly come to define Herero ethnic identity, and that have been deeply affected by the historical developments of the period. The first part of this article traces these changes and their effects on the development of healing within a broader ritual tradition, arguing that the genocide of Herero in 1904 and the burial of Samuel Maharero at Okahandja in 1923 were defining moments in this history. It is possible, I argue, to detect traces of change in healing practices by interweaving this evidence with a broader historical narrative. Healing at the Holy Fire has not, however, been the only source of medical care for Herero, who have also relied on herbal medicine, massage, midwifery and the skills of specialist doctors and diviners (as well as biomedical care), and have frequently crossed putative ethnic boundaries in their search for healing. Oral testimony tends to stress those healing practices that are seen as specifically Herero. Ethnicity must, however, be understood as a historical artefact, not as a natural phenomenon. Thus, the definition of healing around the Holy Fire as the essence of Herero healing is one way in which a specifically Herero identity was constructed in the late nineteenth and early twentieth centuries. On the other hand, 'Herero healing' (in the sense of ritual healing) may not have been the preferred option for many Herero, and choices of healing were made within the context of the dynamics of power played out between ethnic groups in central Namibia. Conversely, the study of indigenous medicine and ritual reveals evidence about the nature of ethnic and regional relations within Namibia, illuminating the dynamics of power and exclusion, and the struggles for the control of resources. These discourses have also, arguably, played a part in shaping the current historiography of Namibia.

Teaching and Learning with the Seventh Generation: The “Inward Bound” Experience

How can a college course for students planning healthcare careers promote compassion in the form of service to others? This article describes a community action learning program in which pre-health students from the University at Albany, State University of New York, worked at a traditional Native American community in upstate New York in return for lessons in Iroquois spirituality, healing, and ecology. Included are citations from educational research, quotes by community residents and students, and a description of the holistic, integrative curriculum in which the community action learning took place. Although a description of a student vision quest is included, this article problematizes the appropriation of Native American traditions, as well as the danger of “great white hope” philanthropy. It suggests that reciprocity between community members and students helped to alleviate these problems, leading to a deepened recognition of compassion and a broader definition of healing of oneself others, and the planet.

Understanding Healing in the Social World of Early Christianity

Healing is a culturally defined and culturally determined phenomenon. Western readers of ancient Mediterranean texts will benefit from a clearer understanding of their own Western understanding of healing and how it differs from the Mediterranean understanding of healing. This article guides the reader through a construction of two culturally different definitions of healing and presents a select list of books that can aid in this and other cross-cultural efforts at interpreting ancient Mediterranean texts.

Science Since Babylon. Derek J. de Solla Price. Yale University Press, New Haven, Conn., 1961. 149 pp. $4.50

The eSCCAN project aims to federate smoking cessation clinics in Europe to share and improve practices. Method: Identification of eSCCAN experts in 26 of the 27 European countries has allowed to organize meetings and internet communication to reach a consensus among the smoking cessation clinics in Europe and to specify their number. Results: The current estimate is that there is about 2500 tobacco cessation clinics in Europe. A minority of them are centers of councelling to stop smoking without the possibility of prescription; a higher number is made of doctors9 offices or paramedics. The vast majority consists of tobacco cessation clinics with several health professionals and all facilities for smoking cessation. Examples of good and bad practices have been described on many topics such as rendez-vous delays, that must be less than 3 weeks for a first appointment. Some definitions have met consensus as the definition of healing, and in particular the period which defines a successful cessation. While waiting to close the debate, the recommendation is to record the cessation at 3, 6 and 12 months, with a particular focus at 6 months. A code and a self-audit in many languages are available on the website for a first evaluation of the activity of the consultations that will enable future improvement. Conclusions: The project provides real rapprochement eSCCAN knowledge to practices for smoking cessation in Europe that support in each country in Europe less than 10% of smokers, but disseminate knowledge and contribute to the assessment for teaching and research.