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PubMed2004

Arts-related activities across U.S. medical schools: a follow-up study.

BACKGROUND: The authors' 2001 survey of the variety of arts-related activities incorporated by U.S. medical schools revealed expansion far beyond the literary arts introduced three decades ago. PURPOSE: A 2002 survey of all U.S. medical schools was designed to assess student involvement in arts-related activities in greater depth. METHODS: Questionnaires were mailed in summer 2002 to all U.S. medical school deans asking about characteristics of arts-related activities, degree and nature of student participation, and if specific outcomes are assessed. RESULTS: The 65% response rate indicates that over half of U.S. medical schools involve the arts in learning activities. Most include literature, visual arts, performing arts, and/or music. Active participation exceeds passive. Electives typically involve 15-18 students. School-based funding predominates. Assessment for increased well-being, clinical skills, and humanism is rare. CONCLUSIONS: Utilization of the arts serves four major functions: (a) enhancement of student well-being, (b) improvement of clinical skills, (c) promotion of humanism, and (d) employment by students as a teaching tool.

Clinical Competence↗
PubMedDate not supplied

[Reception and evaluation of art therapy by patients with neuroses].

The reception of art therapy in neurotic patients as well as artistic training effectivity in patients subjective opinions were studied in 40 patients. The 17 sessions were studied in 40 patients. The 17 sessions of art therapy lasted 10 weeks. Every patient performed two kinds of artistic production with the use of art techniques by the instructor; this gave the total number of 14 art works. During the remaining 3 sessions the art technique was at choice. The result shows the heterogeneity of art therapy evaluation in patients opinions. The fact that patients were very interested in art performance as a form of therapy caused the preference of free choice of art techniques.

Adult↗
PubMed2005

Mutational analysis of proapoptotic ARTS P-loop domain in common human cancers.

Mounting evidence indicates that deregulation of apoptosis is involved in mechanisms of cancer development. ARTS is released from mitochondria into the cytosol during apoptosis, promoting caspase activation by neutralizing the inhibition of inhibitor of apoptotic protein (IAP) on caspases. ARTS contains a P-loop GTP-binding domain, which is essential for the apoptotic function of ARTS. The aim of this study was to ascertain whether a genetic alteration of ARTS gene is involved in the development of human cancers possibly by inactivating the apoptotic function of ART. We analyzed the coding region of the P-loop domain of human ARTS gene for the detection of somatic mutations in 100 gastric carcinomas, 100 non-small cell lung cancers, and 69 hepatocellular carcinomas using a polymerase chain reaction (PCR)-based single strand conformation polymorphism (SSCP). However, there was no mutation in the P-loop coding region in the cancers. The data presented here suggest that ARTS P-loop is not frequently mutated in gastric, lung, and hepatocellular carcinomas, and that apoptosis deregulation in cancers is not dependent on the mutation of ARTS gene.

Apoptosis↗
PubMed1989

Monoclonal antibody studies of creatine kinase. The ART epitope: evidence for an intermediate in protein folding.

Chemical cleavage at cysteine residues with nitrothiocyanobenzoic acid shows that the last 98 amino acids of the 380-amino-acid sequence of chick muscle creatine kinase are sufficient for binding of the monoclonal antibody CK-ART. Removal of the last 30 amino acids by cleavage at methionine residues with CNBr results in loss of CK-ART binding. CK-ART binding is also lost when these C-terminal methionine residues are oxidized to sulphoxide, but binding is regained on reduction. Proteinase K 'nicks' native CK at a single site near the C-terminus and two fragments of 327 amino acides and 53 amino acids can be separated by subsequent SDS or urea treatment. CK-ART still binds normally to 'nicked' CK, which is enzymically inactive. After treatment with either urea (in a competition enzyme-linked immunosorbent assay) or SDS (on Western blots), however, CK-ART binds to neither of the two fragments, although these treatments do not affect binding to intact CK. This suggests that parts of both CK fragments contribute to the CK-ART epitope. CK-ART is both species- and isoenzyme-specific, binding only to chick M-CK. The only C-terminal regions containing chick-specific sequences are residues 300-312 and residues 368-371, the latter group being close to the essential methionine residues. We suggest that one, or possibly both, of these regions is involved in forming the conformational epitope on the surface of the CK molecule which CK-ART recognizes. Native CK is resistant to trypsin digestion. The C-terminal half of urea-treated and partly-refolded CK is also resistant to trypsin digestion, whereas the N-terminal half is readily digested. The results suggest a C-terminal region which can refold more rapidly than the rest of the CK molecule and provide evidence for an intermediate in CK refolding.

Amino Acid Sequence↗
PubMed2001

Automated responsiveness test (ART) predicts loss of consciousness and adverse physiologic responses during propofol conscious sedation.

BACKGROUND: The authors evaluated a device designed to provide conscious sedation with propofol (propofol-air), or propofol combined with 50% nitrous oxide (N2O; propofol-N2O). An element of this device is the automated responsiveness test (ART), a method for confirming that patients remain conscious. The authors tested the hypotheses that the ART predicts loss of consciousness and that failure to respond to the ART precedes sedation-induced respiratory or hemodynamic toxicity. METHODS: The protocol consisted of sequential 15-min cycles in 20 volunteers. After a 15-min control period, propofol was infused to an initial target effect-site concentration of 0.0 microg/ml with N2O or 1.5 microg/ml with air. Subsequently, the propofol target effect-site concentration was increased by a designated increment (0.25 and 0.5 microg/ml) and the process repeated. This sequence was continued until loss of consciousness, as defined by an Observer's Assessment of Alertness/Sedation (OAA/S) score of 10/20 or less, or until an adverse physiologic event was detected. RESULTS: The OAA/S score at which only 50% of the volunteers were able to respond to the ART (P50) during propofol-N2O was 11.1 of 20 (95% confidence interval [CI]: 10.6-11.8); the analogous P50 was 11.8 of 20 (95% CI: 11.4-12.3) with propofol-air. Failure to respond to the ART occurred at a plasma propofol concentration of 0.7 +/- 0.6 microg/ml with propofol-N2O and 1.6 +/- 0.6 microg/ml with propofol-air, whereas loss of consciousness occurred at 1.2 +/- 0.8 microg/ml and 1.9 +/- 0.7 microg/ml, respectively. There were no false-normal ART responses. CONCLUSION: The ART can guide individual titration of propofol because failure to respond to responsiveness testing precedes loss of consciousness and is not susceptible to false-normal responses. The use of N2O with propofol for conscious sedation decreases the predictive accuracy of the ART.

Adult↗
PubMed2005

The two-year impact of first generation protease inhibitor based antiretroviral therapy (PI-ART) on health-related quality of life.

BACKGROUND: Protease inhibitor based antiretroviral therapy (PI-ART) was introduced in 1996 and has greatly reduced the incidence of HIV-related morbidity and mortality in the industrialised world. PI-ART would thus be expected to have a positive effect on health-related quality of life (HRQL). On the other hand, HRQL might be negatively affected by strict adherence requirements as well as by short and long-term adverse effects. The aim of this study was to assess the influence of two years of first generation PI-ART on HRQL in patients with a relatively advanced state of HIV-infection. Furthermore, we wanted to investigate the relation between developments in HRQL and viral response, self-reported adherence and subjective experience of adverse effects in patients with PI-ART. METHODS: HRQL was measured by the Swedish Health-Related Quality of Life Questionnaire (SWED-QUAL). Sixty-three items from the SWED-QUAL forms two single-item and 11 multi-item dimension scales. For this study, two summary SWED-QUAL scores (physical HRQL composite score and emotional HRQL composite score) were created through a data reduction procedure. At the 2-year follow-up measurement (see below), items were added to measure adherence and subjective experience of adverse effects. Demographic and medical data were obtained from specific items in the questionnaires and from the medical files. Seventy-two patients who were among the first to receive PI-ART (indinavir or ritonavir based) responded to the questionnaire before the start of PI-ART. Of these, 54 responded to the same instrument after two years of treatment (13 had died, four had changed clinic and one did not receive the questionnaire). RESULTS: The main findings were that the emotional HRQL deteriorated during two years of PI-ART, while the physical HRQL remained stable. Multiple linear regression analyses showed that experience of adverse effects contributed most to the deterioration of emotional HRQL. CONCLUSION: In this sample of patients with relatively advanced state of HIV-infection, our data suggested that a negative development of physical HRQL had been interrupted by the treatment and that the emotional dimension of HRQL deteriorated during two years after start of PI-ART. Subjective experience of adverse effects made a major contribution to the decrease in emotional HRQL. The results underline the importance of including HRQL measures in the evaluation of new life prolonging therapies.

Adult↗
PubMed2005

Androgen receptor mutations identified in prostate cancer and androgen insensitivity syndrome display aberrant ART-27 coactivator function.

The transcriptional activity of the androgen receptor (AR) is modulated by interactions with coregulatory molecules. It has been proposed that aberrant interactions between AR and its coregulators may contribute to diseases related to AR activity, such as prostate cancer and androgen insensitivity syndrome (AIS); however, evidence linking abnormal receptor-cofactor interactions to disease is scant. ART-27 is a recently identified AR N-terminal coactivator that is associated with AR-mediated growth inhibition. Here we analyze a number of naturally occurring AR mutations identified in prostate cancer and AIS for their ability to affect AR response to ART-27. Although the vast majority of AR mutations appeared capable of increased activation in response to ART-27, an AR mutation identified in prostate cancer (AR P340L) and AIS (AR E2K) show reduced transcriptional responses to ART-27, whereas their response to the p160 class of coactivators was not diminished. Relative to the wild-type receptor, less ART-27 protein associated with the AR E2K substitution, consistent with reduced transcriptional response. Surprisingly, more ART-27 associated with AR P340L, despite the fact that the mutation decreased transcriptional activation in response to ART-27. Our findings suggest that aberrant AR-coactivator association interferes with normal ART-27 coactivator function, resulting in suppression of AR activity, and may contribute to the pathogenesis of diseases related to alterations in AR activity, such as prostate cancer and AIS.

Amino Acid Substitution↗
PubMed2002

Comparative cost of ART and conventional treatment within a dental school clinic.

BACKGROUND: The changing oral health needs in South Africa require that both the teaching and clinical techniques of atraumatic restorative treatment (ART) form a part of the restorative undergraduate curriculum. OBJECTIVE: This study was undertaken to establish and compare the estimated costing of an amalgam, composite resin and ART restoration within the Board of Health Funders (BHF) recommended scale of benefits at the School of Oral Health Sciences Oral and Dental Hospital, University of the Witwatersrand (SOHS). METHODS: Fixed and variable costs were calculated by pricing items and equipment used in each procedure. The output values were established according to the recommended scale of benefits (BHF, 1999). This enabled the calculation of contribution margins and net income for each of the three restorations. RESULTS: The annual capital cost for the ART approach is approximately 50% of the other two options (e.g. per multiple surface restoration ART = R1.58; amalgam and composite resin restorative procedures: R3.12 and R3.10 respectively), despite the fact that ART restorations are rendered in a modern dental setting. CONCLUSIONS: Our study shows that implementation of the ART approach within the clinic setting of the SOHS can be accomplished without additional cost. Furthermore ART can be performed as an economically viable alternative to conventional treatment procedures within the clinic setting. The study represents a first step towards determining the cost efficiency of implementing ART as a pragmatic and cost-effective restorative option within the SOHS, University of the Witwatersrand.

Capital Expenditures↗
PubMed2003

[Atraumatic Restorative Treatment (ART). A special tissue preservative and patient-friendly approach].

The number of studies investigating aspects of the ART-approach has increased in recent years. This tissue preservative treatment concept appears to be less painful and is, therefore, more patient-friendly than conventional treatments. The investigations so far have shown that the ART-approach is indicated for treating single-surface cavities in both primary and permanent dentitions. There appears to be no difference in survival results between single-surface ART restorations and comparable amalgam restorations in the permanent dentition after 3 years. ART sealants using high-viscosity glass-ionomers seem to be retained longer than ART sealants using low-viscosity glass-ionomers after 3 years. The surface wear of ART restorations using high-viscosity glass-ionomers after two years is low. It can be concluded that the ART approach is beneficial in improving the oral health of many people, not only in developing but also in more advanced countries. The full benefit of the ART-approach is not yet known.

Dental Caries↗
PubMed2004

Dementia as a window to the neurology of art.

Art is an expression of neurological function and how it organizes and interprets perception. Recent reports of changes in art performance among patients with frontotemporal dementia have provided an unexpected window to the neurology of art. They confirm that visual art is predominantly in the right hemisphere and suggest a neuroanatomical schema for artistic creativity. The right parietal region is critical for the visuospatial prerequisites of art, and the right temporal lobe integrates and interprets these percepts. The right temporal lobe appears necessary for extracting and exaggerating the essential features of an artistic composition. In contrast, the left parietal region and the left temporal lobe have inhibitory effects on artistic expression through attention to visuospatial detail and semantic labeling, respectively. Frontal-executive functions are also required for artistic expression, particularly right dorsolateral frontal initiation of a network for novelty-seeking behavior. Further study of art in dementia can profitably evaluate this proposed schema for the mechanisms of art in the brain.

Art↗
PubMed1992

Occupational and environmental hazards in art.

Artists and craftspeople, art teachers, hobbyists, and children often use art materials containing toxic chemicals without suitable precautions and often without the knowledge that their art materials are hazardous. The Center for Safety in the Arts, a national clearinghouse for research and education on hazards in the visual and performing arts, answers telephoned and written inquiries on art hazards, distributes publications, publishes a newsletter, and offers educational programs and consultative services to arts organizations.

Environmental Exposure↗
PubMed2000

Nursing education at an art gallery.

PURPOSE: To introduce an experiential teaching-learning method in nursing education based on art gallery visits. Works of art communicate a broad spectrum of human experiences and thoughts, and can be useful when studying interpersonal relations. DESIGN: Theoretical framework on experiential learning was based on writings of Dewey and Burnard. Data were collected from nursing students (N = 206) at a university college of health sciences in Sweden during a 3-year period, 1995-1998. METHOD: The pedagogical approach was experiential and based on three phases: observation, conceptualisation, and reflection. When students visited the art gallery, they were encouraged to look for metaphoric expressions of interpersonal relations. Students were asked to interpret the art, report findings to fellow-students, and evaluate the program. FINDINGS: Studying works of art was a powerful teaching-learning method for understanding interpersonal relations. Students related interpretations of a work of art to interpersonal relations in nursing. CONCLUSIONS: Nursing students' observations and understanding of interpersonal relations were enhanced by the art gallery program.

Art↗
PubMed2006

Arts in health: the value of evaluation.

This article aims to discuss a number of different approaches to the evaluation of the value of implementing arts projects and arts programmes, presenting the evidence of their impact when implemented either in community settings or within a healthcare environment. It focuses on the evidence provided by quantitative research and also discusses the merits of applying qualitative research, outlining their different approach of collecting, interpreting and analysing the data. A brief consideration is also given to the arguments underpinning the introduction of humanities and arts in medical and nursing education and training, an approach that promotes personal development and, most importantly, encourages the health practitioner to become more humane, understanding and sympathetic in their everyday practice. It also renders them more amenable to the introduction of art in the healthcare environment. The article concludes that the value of evaluating the effect of the arts in healthcare resides in providing to all involved in designing, implementation and funding, the knowledge of what, when and how to introduce different art forms to achieve the most effective results. Evaluations produce evidence of the impact of different art forms in encouraging beneficial clinical outcomes in patients, in enhancing the quality of healthcare services and in improving working conditions and job satisfaction.

Art↗
PubMed2006

Establishing common ground in community-based arts in health.

This article originates in current research into community-based arts in health. Arts in health is now a diverse field of practice, and community-based arts in health interventions have extended the work beyond healthcare settings into public health. Examples of this work can now be found internationally in different health systems and cultural contexts. The paper argues that researchers need to understand the processes through which community-based arts in health projects evolve, and how they work holistically in their attempt to produce therapeutic and social benefits for both individuals and communities, and to connect with a cultural base in healthcare services themselves. A development model that might be adapted to assist in analysing this is the World Health Organisation Quality of Life Index (WHOQOL). Issues raised in the paper around community engagement, healthy choice and self-esteem are then illustrated in case examples of community-based arts in health practice in South Africa and England; namely the DramAide and Siyazama projects in KwaZulu-Natal, and Looking Well Healthy Living Centre in North Yorkshire. In South Africa there are arts and media projects attempting to raise awareness about HIV/AIDS through mass messaging, but they also recognize that they lack models of longer-term community engagement. Looking Well by contrast addresses health issues identified by the community itself in ways that are personal, empathic and domesticated. But there are also similarities among these projects in their aims to generate a range of social, educational and economic benefits within a community-health framework, and they are successfully regenerating traditional cultural forms to create public participation in health promotion. Process evaluation may provide a framework in which community-based arts in health projects, especially if they are networked together to share practice and thinking, can assess their ability to address health inequalities and focus better on health outcomes.

Art↗
PubMed1989

Many ways to grow: creative art therapies.

So often, the prevailing thought surrounding treatment is that to be effective the treatment must be serious in tone. Yet, when you ask creative art therapists to describe their work, more often than not they will say that the ability to mix enjoyment with clinical technique is the "secret of our success." Again and again, recalcitrant, angry, underfocused, lethargic, and delayed children spring to life within an arts therapy session. Whether the modality used is music, dance, or the visual arts, children find in it the pleasure, stimulation, fun, and communication that may be missing from other aspects of their world. The creative art therapist helps a child by presenting the two-pronged approach of using the art form to foster mastery while allowing it to be a metaphor for ideas and concerns. Thus, both the process of "making something" and the symbols within the content are simultaneously providing therapeutic acid. Most exciting is the ability of the creative art therapist to unlock the child's inner world and bring new vitality to children and families alike. The creative art therapies are an important and unique tool among the constellation of health services.

Art Therapy↗
PubMedDate not supplied

Elements of the art of practice in mental health.

OBJECTIVE: This qualitative study explored elements of artful practice of therapists practicing in mental health treatment settings. METHOD: In-depth interviews were conducted with three occupational therapists practicing in mental health who were considered exemplars of artful practice. Themes pertaining to their perspectives and approaches to practice were synthesized from interview data. RESULTS: The prevailing themes--therapeutic work as a vehicle for healing, collaborative guidance, and the Zen of therapy--are seen as elements forged by the therapist's compassion and unique personal style into a dynamic therapist-client interplay that creates a space for growth and healing to occur. Results affirmed the view of the art of practice in mental health as an intricate interplay of personal traits, interpersonal skills, and skilled use of meaningful activities within the context of a client's environment. CONCLUSION: The art of practice is a fluid, experiential process that takes place on a developmental continuum. The therapist's inner awareness of the subtlety of a multilayered healing process is an important basis of artful practice. One's practice art can be informed by knowledge of specific elements that contribute to artful practice and can be developed through education, self-reflection, personal growth, and the maturation process.

Art Therapy↗
PubMed2000

An innovative art therapy program for cancer patients.

Art therapy is a healing art intended to integrate physical, emotional, and spiritual care by facilitating creative ways for patients to respond to their cancer experience. A new art therapy program was designed to provide cancer patients with opportunities to learn about the McMichael Canadian Art Collection and to explore personal feelings about their cancer experience through combined gallery and studio components. The role of the facilitator was to assist in the interpretation of a participant's drawing in order to reveal meaning in the art. This paper presents patients' perspectives about the new art therapy program. Content analysis of participant feedback provided information about the structure, process, and outcomes of the program. Evaluation of the art therapy/museum education program demonstrated many benefits for cancer patients including support, psychological strength, and new insights about their cancer experience.

Adaptation, Psychological↗
PubMed1994

Art therapy with the frail elderly.

The use of art engages frail oder persons in a unique way. Art therapists recognize the creative source in the elderly and strive to involve them in the creative process. The art therapist combines the media of the visual artist with assistance in art skills to enable the older person to make meaningful expressions of emotion despite deteriorating functional ability. Supportive and therapeutic art interventions augment the skills and assets that many older persons retain. Effective art therapy sessions may be brought to older persons in their homes or in the day programs they attend. Through art therapy, the frail elderly learn new ways to express and interpret life situations, to communicate perspectives and respond to the difficulties before them.

Aged↗