Wholeness of healing: an innovative Student-Selected Component introducing United Kingdom medical students to the spiritual dimension in healthcare.

Objective: This Student Selected Component (SSC) was designed to equip United Kingdom (UK) medical students to engage in whole-person care. The aim was to explore students' reactions to experiences provided, and consider potential benefits for future clinical practice.

Methods: The SSC was delivered in the workplace. Active learning was encouraged through facilitated discussion with and observation of clinicians, the palliative team, counselling services, hospital chaplaincy and healing ministries; sharing of medical histories by patients; and training in therapeutic communication. Assessment involved reflective journals, literature appraisal, and role-play simulation of the doctor-patient consultation. Module impact was evaluated by analysis of student coursework and a questionnaire.

Results: Students agreed that the content was stimulating, relevant, and enjoyable and that learning outcomes were achieved. They reported greater awareness of the benefit of clinicians engaging in care of the "whole person" rather than "the disease." Contributions of other professions to the healing process were acknowledged, and students felt better equipped for discussion of spiritual issues with patients. Many identified examples of activities which could be incorporated into core teaching to benefit all medical students.

Conclusion: The SSC provided relevant active learning opportunities for medical students to receive training in a whole-person approach to patient care.

'How Soon is Too Soon?:Healing Through Remembering Bulletin (Issue 3), Spring 2007, p. 3

A comment on the process of Commemoration in Northern Ireland

The forgiving tree: a self-healing distributed data structure

We consider the problem of self-healing in peer-to-peer networks that are under repeated attack by an omniscient adversary. We assume that the following process continues for up to n rounds where n is the total number of nodes initially in the network: the adversary deletesan arbitrary node from the network, then the network responds by quickly adding a small number of new edges.

We present a distributed data structure that ensures two key properties. First, the diameter of the network is never more than O(log Delta) times its original diameter, where Delta is the maximum degree of the network initially. We note that for many peer-to-peer systems, Delta is polylogarithmic, so the diameter increase would be a O(loglog n) multiplicative factor. Second, the degree of any node never increases by more than 3 over its original degree. Our data structure is fully distributed, has O(1) latency per round and requires each node to send and receive O(1) messages per round. The data structure requires an initial setup phase that has latency equal to the diameter of the original network, and requires, with high probability, each node v to send O(log n) messages along every edge incident to v. Our approach is orthogonal and complementary to traditional topology-based approaches to defending against attack.

Algorithms for Self-Healing Networks

Many modern networks are \emph{reconfigurable}, in the sense that the topology of the network can be changed by the nodes in the network. For example, peer-to-peer, wireless and ad-hoc networks are reconfigurable. More generally, many social networks, such as a company's organizational chart; infrastructure networks, such as an airline's transportation network; and biological networks, such as the human brain, are also reconfigurable. Modern reconfigurable networks have a complexity unprecedented in the history of engineering, resembling more a dynamic and evolving living animal rather than a structure of steel designed from a blueprint. Unfortunately, our mathematical and algorithmic tools have not yet developed enough to handle this complexity and fully exploit the flexibility of these networks. We believe that it is no longer possible to build networks that are scalable and never have node failures. Instead, these networks should be able to admit small, and maybe, periodic failures and still recover like skin heals from a cut. This process, where the network can recover itself by maintaining key invariants in response to attack by a powerful adversary is what we call \emph{self-healing}. Here, we present several fast and provably good distributed algorithms for self-healing in reconfigurable dynamic networks. Each of these algorithms have different properties, a different set of gaurantees and limitations. We also discuss future directions and theoretical questions we would like to answer. %in the final dissertation that this document is proposed to lead to.

The role of LL-37 in periodontal wound healing

Introduction: As a result of chronic inflammation during periodontal disease the junctional epithelium becomes micro-ulcerated. The inflammatory process is mediated by both bacterial and host cell products. Host defence peptides such as defensins, secretory leucocyte protease inhibitor (SLPI) and the sole human cathelicidin, LL-37, are secreted by both periodontal cells and neutrophils into gingival crevicular fluid (GCF). They have the ability to modulate the immune response in periodontitis and are thought to have a potential role in periodontal wound healing. Objectives: The aims of this study were to determine the role of LL-37 in the production of Interleukin (IL)-8, IL-6, hepatocyte growth factor (HGF) and basic-fibroblast growth factor (bFGF) by gingival fibroblasts. The role of LL-37 in modulating total matrix metalloproteinase (MMP) activity and expression of tissue inhibitors of metalloproteinase (TIMP)-1 and -2 by gingival fibroblasts was also investigated. Methods: Primary gingival fibroblasts were co-cultured with concentrations of LL-37 (1, 5 and 10µg/ml) for 24 hours and their supernatants tested for levels of IL-8 and IL-6, HGF, bFGF, TIMP-1 and TIMP-2 by ELISA. Rates of MMP turnover in the supernatants were tested by fluorogenic assay using fluorescence resonance energy transfer (FRET) peptide substrates. Cytotoxicity was measured by MTT assay. Statistical significance was measured using the independent t-test and p<0.05 was considered significant. Results: LL-37 significantly upregulated levels of IL-8, IL-6, HGF, bFGF and TIMP-1 (p<0.05) in a dose-dependent fashion. LL-37 significantly decreased the total MMP activity (p<0.05). None of the LL-37 concentrations tested were cytotoxic to gingival fibroblasts. Conclusion: These results indicate that LL-37 is involved in periodontal wound healing. LL-37 increased levels of proinflammatory cytokines and increased levels of growth factors involved in re-epithelialisation. LL-37 has the ability to regulate remodelling of the periodontium by controlling MMP overactivity both directly and by stimulating production of inhibitors by gingival fibroblasts.