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A dialectical examination of nursing art.

Literature relevant to the art of nursing is immensely diverse and fragmented. This state is problematic in that progress in understanding nursing art cannot be made until the subject of nursing art is clearly delineated. In light of the need for conceptual clarity regarding nursing art, a dialectical study was undertaken to identify the distinct conceptions of nursing art that are represented in the nursing literature. The examined discourse was that contained in the works of 41 nursing scholars published between 1860 and 1992. The analysis revealed five distinct conceptualizations that can be identified as the art of (1) grasping meaning in patient encounters, (2) establishing a meaningful connection with the patient, (3) skillfully performing nursing activities, (4) rationally determining an appropriate course of nursing action, and (5) morally conducting one's nursing practice.

Humans↗

Modified ART 2A growing network capable of generating a fixed number of nodes.

This paper introduces the Adaptive Resonance Theory under Constraint (ART-C 2A) learning paradigm based on ART 2A, which is capable of generating a user-defined number of recognition nodes through online estimation of an appropriate vigilance threshold. Empirical experiments compare the cluster validity and the learning efficiency of ART-C 2A with those of ART 2A, as well as three closely related clustering methods, namely online K-Means, batch K-Means, and SOM, in a quantitative manner. Besides retaining the online cluster creation capability of ART 2A, ART-C 2A gives the alternative clustering solution, which allows a direct control on the number of output clusters generated by the self-organizing process.

Cluster Analysis↗

Phase I study of a novel recombinant human soluble thrombomodulin, ART-123.

BACKGROUND: Anticoagulants are often given for extended periods of time to patients at high risk for venous thromboembolism, such as after orthopedic surgery. Daily subcutaneous (sc) injections can be inconvenient to the patient. A long-acting anticoagulant requiring less frequent dosing could make treatment more acceptable. Thrombomodulin is a natural anticoagulant that activates protein C, which leads to inactivation of factor (F)Va and FVIIIa and decreased thrombin formation. Recombinant human thrombomodulin is a novel anticoagulant with a long half-life in animal models. METHODS AND RESULTS: This phase I study examined pharmacokinetics, pharmacodynamics, and safety of recombinant human soluble thrombomodulin (ART-123) after administration of doses between 0.02 and 0.06 mg kg(-1) body weight intravenously (iv), and between 0.02 and 0.45 mg kg(-1) sc in 55 healthy volunteers. The plasma half-life was 2-3 days after sc injection of various single doses. Plasma ART-123 levels estimated to be needed for prevention of thrombus formation in humans were maintained for at least 6 days after single sc injection of 0.30 and 0.45 mg kg(-1) ART-123. Antithrombotic activity with these doses was demonstrated by achieving prothrombinase inhibition of more than 80% for more than 6 days after administration. No major bleeding occurred. Pharmacodynamic modeling revealed that adequate antithrombotic ART-123 levels can be achieved for 6 days with one dose of 0.45 mg kg(-1) ART-123, and for 12 days with 2 doses of 0.30 mg kg(-1), given 5 days apart. CONCLUSIONS: Recombinant human soluble thrombomodulin (ART-123) has a long half-life after sc injection and is well tolerated, making it a suitable agent to be tested in clinical thromboprophylaxis trials.

Adult↗

Efficacy and safety of recombinant human soluble thrombomodulin (ART-123) in disseminated intravascular coagulation: results of a phase III, randomized, double-blind clinical trial.

BACKGROUND: Soluble thrombomodulin is a promising therapeutic natural anticoagulant that is comparable to antithrombin, tissue factor pathway inhibitor and activated protein C. OBJECTIVES: We conducted a multicenter, double-blind, randomized, parallel-group trial to compare the efficacy and safety of recombinant human soluble thrombomodulin (ART-123) to those of low-dose heparin for the treatment of disseminated intravascular coagulation (DIC) associated with hematologic malignancy or infection. METHODS: DIC patients (n = 234) were assigned to receive ART-123 (0.06 mg kg(-1) for 30 min, once daily) or heparin sodium (8 U kg(-1) h(-1) for 24 h) for 6 days, using a double-dummy method. The primary efficacy endpoint was DIC resolution rate. The secondary endpoints included clinical course of bleeding symptoms and mortality rate at 28 days. RESULTS: DIC was resolved in 66.1% of the ART-123 group, as compared with 49.9% of the heparin group [difference 16.2%; 95% confidence interval (CI) 3.3-29.1]. Patients in the ART-123 group also showed more marked improvement in clinical course of bleeding symptoms (P = 0.0271). The incidence of bleeding-related adverse events up to 7 days after the start of infusion was lower in the ART-123 group than in the heparin group (43.1% vs. 56.5%, P = 0.0487). CONCLUSIONS: When compared with heparin therapy, ART-123 therapy more significantly improves DIC and alleviates bleeding symptoms in DIC patients.

Aged↗

Painting the future for ART.

The objective of this paper is to review recent research and developments with respect to the atraumatic restorative treatment (ART) approach and to outline future areas of research and development. Areas identified as requiring further investigation include the evaluation of: ART restorations for longer than 3 years duration using recognised evaluation criteria, multi-surface ART restorations, ART restorations in primary teeth and ART sealants. In addition, the possibility and potential dangers of caries remaining after cavity cleaning with hand instruments must be investigated and the findings balanced against the known damage to sound tooth tissue caused by more routine cavity preparation techniques. New bioactive restorative materials which offer the possibility of healing dentinal caries lesions should be developed and evaluated. Finally, behavioural and educational aspects of the ART approach should be investigated.

Cariostatic Agents↗

The arts in the lives of Australian veterinarians: a preliminary survey.

OBJECTIVE: To assess the role of the arts in the lives of those veterinary students and veterinarians who could be found to be active in one or more of the arts. PROCEDURE: Veterinary students and veterinarians active in the arts were sought by advertisement and personal contact. Respondents each completed a questionnaire, which was analysed using SAS. RESULTS: Of the 55 respondents (43 veterinarians; 12 students), 73% were involved in music, 31% in theatre, 27% in writing and 15% art, but for more than 80% this occupied no more than 10 hours/week, about one quarter of the time for veterinary work. Although most would like to spend more time on the artistic activity, this was generally limited by the need to earn an income from veterinary work. Music and drama provided satisfaction, variety, and relaxation while catering to creative needs. A creative outlet and satisfaction was very important for writers as well, but they also valued the intellectual stimulation. A complex relationship existed between the artistic and the veterinary activities, but the nature of this relationship varied both between type of artistic activity, and the person concerned. CONCLUSIONS: Veterinary science and the arts can complement one another with each making important contributions to the person and the artistic field involved, even though limitations of time for the arts may cause frustration.

Adult↗

Expression of the art gene protein of human T-lymphotropic virus type III (HTLV-III/LAV) in bacteria.

Human T-lymphotropic virus type III (HTLV-III/LAV or HIV) contains a gene designated art (anti-repressor transactivator). Here, we report the expression of the art gene product in bacteria and show that the 20-kilodalton (kDa) bacterially expressed art protein is recognized by serum of a patient. The bacterially synthesized art protein competed in an immunological reaction with a 20-kDa protein produced in HTLV-III/LAV-infected lymphocytes. Antiserum to a synthetic oligopeptide corresponding to a sequence in the second exon of the art gene also precipitated the 20-kDa protein in HTLV-III/LAV-infected cells. These results demonstrate that the 20-kDa art gene product is expressed in cell lines that produce HTLV-III/LAV virions.

Amino Acid Sequence↗

Clinical evaluation of the ART approach and materials in peri-urban farm schools of the Johannesburg area.

In this study, 1,325 school children from 7 farm schools were examined. Their mean age (+/- SD) was 10.5 +/- 3.0 (range 6-11) years. At baseline, the mean DMFT score was 1.1 +/- 1.7 and 36.4% of the children had caries. The prevalence of fluorosis among the children was 12.6%. Curative treatment was offered to all the children. A total of 113 children (8.5%) with one-surface cavities on permanent teeth and without fluorosis were treated using the atraumatic restorative treatment (ART) approach. A total number of 163 cavities were included in the study, of which 82 were treated with Fuji IX glass-ionomer cement and 81 with Ketac-MOLAR (hand mix). One year after treatment, restoration and sealant parts of ART fillings were examined. Caries status was also determined. The placing of the ART fillings and their evaluation were performed by different practitioners. A total number of 108 restorations (58 with Fuji IX, 50 with Ketac-MOLAR) were evaluated. Results of ART fillings showed a survival rate of 93.1% with Fuji and 94.0% with Ketac-MOLAR. Retention of the sealant parts of ART fillings was observed in 81% of restorations with Fuji IX and 76% with Ketac-MOLAR, not connected to the filled cavity. Caries was absent on all teeth restored with Fuji IX and noted in only one tooth restored with Ketac-MOLAR, not connected to the filled cavity. The retention rate after a 12-month period was acceptable and ART approach proved to be an appropriate technique for restoring teeth in this population group. There were no statistically significant differences between the survival rates of the two glass-ionomer restorative materials (P > 0.05).

Child↗

[Nursing as an art].

It is more important now than ever to define the goals of nursing by using an aesthetic approach. In every day practice the nurse must explore and adopt these functions, which constitute the essence of nursing as an art. The aim of this paper is to firstly explore the notion of nursing as an art, underpinned by the philosophy of art and to secondly discuss the hidden connections and the criteria for nursing seen or thought to be an art. In this paper, the aesthetic values have been used to depict and to expose the invisible qualities of nursing. Through the written text the attempt to explore the nature of nursing by an aesthetic approach, reveals that the essence of nursing is constituted by the same origins, which define the essence of art. This exploration of the literature led to the recognition of the quality of imitation as an attempt of the artist to awaken individuals to understand what a piece of art represents. Respectively, a nurse by represents a picture of wholeness for the health, attempt to stimulate patient to move forwards regaining control and achieving the state of well-being. The search of the expression as one of the sources of the aesthetic values has brought to the surface that nursing is expressed as a whole of unique functions containing love, advocacy, calmness, care and empathy. The exploration of the combination of the elements, their articulation or their structure exposes the beauty itself. The beauty of a statue as Venus of Milo as well as, in terms of nursing, the beauty of caring as the heart of nursing. However it is difficult to capture the totality of nursing in this paper, which attempts more to portray this beauty of nursing rather than to seek for a clear answer of what nursing is.

Nursing↗

[Visual art, creativity and dementia].

BACKGROUND: Visual art is an expression of neurological function and how it organizes and interprets perception. The art is predominantly in the right hemisphere, in contrast, the left side, have inhibitory effects on artistic expression. In normal subjects, inhibitory and excitatory mechanisms could interact in a complex harmony, reflecting a paradoxical functional facilitation. Brain diseases such as dementia could change this harmony and then, alter the artistic abilities. OBJECTIVE: Evaluate the art expression in the degenerative diseases. PATIENTS AND METHODS: Artistic abilities of 3 painters with degenerative diseases were assessment. RESULTS: Patient 1: A 83 - year old right handed female, diagnosis: Alzheimer's disease. Artistic description: low productivity, simplified versions of earlier and alteration of the visuospatial organization. Patient 2: A 78-year-old right handed female, diagnosis: Primary Progressive Aphasia (PPA); Artistic description: oversimplified drawings which maintaining overall spatial organization, without impair artistic skills. Patient 3: A 68 year-old right handed woman, diagnosis: Fronto-Temporal Dementia (FTD). Artistic description: Increased artistic activity, originality, freedom, utilization of intense colours with perseverative and repetitive copying of similar paintings of her own work. CONCLUSIONS: Visual art in Alzheimer's disease is a consequence of visuospatial and constructive disabilities. In contrast, the conservation of this cognitive functions and left asymmetrical involved, in FTD and PPA respectively, suggest artistic preservation, independently of the language injury. The disproportionate functional prevalence of the right over the left could lead to a release of novelty - seeking in art and can contribute to emergent creativity. These observations suggest an organization for art in the brain and proposed bases for further investigations in dementias.

Aged↗

Survival of self-etch adhesive Class II composite restorations using ART and conventional cavity preparations in primary molars.

PURPOSE: To test the null-hypothesis that there was no difference in the survival percentages of Class II composite restorations in primary teeth produced through either ART or conventional approaches after 2 years. METHODS: 157 children with 325 Class II cavitated dentin lesions were included in a split-mouth study design. A computer program randomly assigned cavitated dentin lesions to treatment groups stratified for gender, operator, upper/lower jaw and left/right side of the mouth. Three operators placed resin composite (Pertac II) restorations using a self-etch adhesive (Prompt L-Pop). Two independent examiners evaluated the restorations after 0.5, 1 and 2 years using the modified Ryge criteria. A modification of the actuarial survival method was applied to estimate survival percentages. RESULTS: There was no statistically significant difference (P > 0.05) observed between the cumulative survival percentages of Class II composite restorations in primary teeth produced by the two approaches after 2 years (ART: 34.9% +/- 4.7%; conventional: 35.1% +/- 4.7%). The cumulative survival percentages of ART and conventional Class II restorations of one of the operators were lower than for ART restorations of the other two operators and for conventional restorations of one of the operators (P < or = 0.001). The main reason for Class II composite restorations to fail over the 2-year period was complete loss of retention; ART: 75%; conventional: 77%. The null-hypothesis was accepted as there was no difference in the cumulative survival percentages of ART and conventional Class II composite restorations in primary teeth after 2 years. It appears that the low survival results obtained may have been caused by poor bonding of the self-etch adhesive.

Acid Etching, Dental↗

Alexander of Aphrodisias on medicine as a stochastic art.

Medical practice in antiquity was conspicuous for its failures, which seriously challenged medicine's status as an art. Ancient philosophers and doctors tried to explain how a whole group of arts including medicine, the so-called stochastic arts, was characterised by the fact that even the most competent exercise of the art could not guarantee a successful outcome. This paper focuses on Alexander of Aphrodisias' (second century AD) explanation and compares it to some other ancient views, in particular to Galen's. The central feature of Alexander's suggestion is a distinction between the end of an art and its function. In the case of medicine end and function do not coincide; for the end is to heal the patient, whereas the function consists solely in doing artfully what is possible to attain the end.

Greece, Ancient↗

An atraumatic restorative treatment (ART) technique: evaluation after one year.

Extraction is the most common dental treatment provided for people in rural and suburban areas in many less-industrialised countries. By comparison, restorative care is rarely provided. In order to improve such situations, a treatment technique has been developed based only on hand excavation of carious lesions and using glass-ionomer cement as a filling material and a sealant. This Atraumatic Restorative Treatment (ART) technique follows the concept of minimal intervention and does not require electrically driven equipment. This paper reports on the longevity of fillings and sealants placed using the technique under field conditions in rural Thailand. Dental caries was treated using the ART technique in one village, whilst the population in a second village received restorative care (amalgam fillings) through mobile dental units. A third village was the control. After one year, 79 per cent of single surface ART fillings and 55 per cent of ART fillings of greater than one surface placed in deciduous teeth were judged successful. The success rate of ART fillings in the permanent dentition (mainly single surface fillings) was 93 per cent and the retention rate for sealants was 78 per cent. Children were pleased at having received treatment by this technique and showed little fear. The ART technique is a promising caries treatment procedure for use in rural and sub-urban areas in less-industrialised countries.

Child↗

Urinary malondialdehyde and 8-hydroxydeoxyguanosine as potential markers of oxidative stress in industrial art glass workers.

Previous epidemiological studies have indicated that industrial art glass workers have increased mortality risks for certain types of cancer and for cardio- and cerebrovascular disease. To test the hypothesis that increased oxidative stress might contribute to these increased mortality risks, the urinary levels of the lipid peroxidation product, malondialdehyde (MDA), and the oxidative DNA adduct, 8-hydroxydeoxyguanosine (8OHdG) were determined in 343 workers (230 men and 113 women) from the art glass industry in the southeast of Sweden. Of the study subjects, 199 (181 men and 18 women) were engaged in the process of glass production and were regarded as exposed, whereas the remainders performed clerical, warehouse and other service work and were regarded as unexposed. One hundred and sixteen were smokers (75 men and 41 women) and 215 were non-smokers (142 men and 73 women). The findings indicate that (a) exposure to industrial art glass work per se does not cause any major oxidative stress as measured by urinary levels of MDA and 8OHdG, (b) the effects from smoking per se are limited to increased lipid peroxidation among men, and (c) joint exposure to industrial art glass work and smoking may cause increased lipid peroxidation among men and increased DNA hydroxylation among both men and women. While these findings provide no evidence for increased oxidative stress due to industrial art glass work per se, the increased 8OHdG excretion, in workers who smoke may be associated with a higher risk of developing free radical-dependent degenerative diseases including cancer.

8-Hydroxy-2'-Deoxyguanosine↗

Art therapy: Using the creative process for healing and hope among African American older adults.

This article provides an introduction to the field of art therapy and the potential it can offer to address the emotional needs of the frail elderly. Two case studies are discussed, and examples of artwork are provided. The case studies and artwork were created under the guidance of an art therapist at a Program of All-Inclusive Care for the Elderly (PACE) site in an urban African American community. This article explores how art making addresses the specific developmental tasks of the elderly in a culturally competent manner. Included are practical considerations in the choice of art media and directives for working with elderly clients, as well as resources for further information on the use of art in therapy.

Activities of Daily Living↗

Pediatric martial arts injuries presenting to Emergency Departments, United States 1990-2003.

Although an estimated 6.5 million United States (US) children aged 6-17 practiced a martial art in 2004, there have been no nationally representative studies comparing pediatric injuries among the three most popular disciplines, karate, taekwondo, and judo. Describe pediatric martial arts injuries presenting to a representative sample of US Emergency Departments (EDs) from 1990 to 2003. We reviewed all martial arts injuries captured by the US Consumer Product Safety Commission's (CPSC), National Electronic Injury Surveillance System (NEISS). An estimated 128,400 children </=17 years were treated in US EDs for martial arts-related injuries from 1990 to 2003. Injured tended to be male (73.0%) and had a mean age of 12.1 years. Most injuries were attributed to karate (79.5%). The most common mechanism of injury was being kicked (25.6%), followed by falling (20.6%) and kicking (18.0%). The majority of injuries occurred to the lower leg/foot/ankle (30.1%) and hand/wrist (24.5%). The most common injury diagnoses were sprains/strains (29.3%), contusions/abrasions (27.8%), and fractures (24.6%). Participants in judo sustained significantly higher proportions of shoulder/upper arm injuries than karate (IPR=4.31, 95% CI: 2.84-6.55) or taekwondo (IPR=9.75, 95% CI: 3.53-26.91) participants. There were also higher proportions of neck injuries sustained by judo participants compared to karate (IPR=4.73, 95% CI: 1.91-11.70) or taekwondo (IPR=4.17, 95% CI: 1.02-17.06) participants. Pediatric martial arts injuries differ by discipline. Understanding these injury patterns can assist with the development of discipline-specific preventive interventions.

Adolescent↗

Art, dance, and music therapy.

Art, dance, and music therapy are a significant part of complementary medicine in the twenty-first century. These creative arts therapies contribute to all areas of health care and are present in treatments for most psychologic and physiologic illnesses. Although the current body of solid research is small compared with that of more traditional medical specialties, the arts therapies are now validating their research through more controlled experimental and descriptive studies. The arts therapies also contribute significantly to the humanization and comfort of modern health care institutions by relieving stress, anxiety, and pain of patients and caregivers. Arts therapies will greatly expand their role in the health care practices of this country in the twenty-first century.

Adult↗

A communication tool for cancer patients with pain: the art therapy technique of the body outline.

OBJECTIVE: The multidimensional aspect of pain suggests the use of multimodal interventions. The Memorial Sloan-Kettering Cancer Center has recently utilized the art therapy modality to help patients communicate the painful side of their illness in such a way that they can feel understood and respected. In this paper we describe a simple innovative art therapy intervention that we have developed within the Art Therapy Service in the Psychiatric Department of Memorial Sloan-Kettering Cancer Center. METHOD: The patients work with a Body Outline as a starting template, together with the art therapist, in sessions lasting approximately 45 minutes. They are encouraged to fill the space inside and outside the Body Outline. They can use colored pastels, markers, or watercolor or cut out images for a collage. RESULTS: Seventy hospitalized adult cancer patients, 60 women and 10 men, used this intervention between January 1999 and May 2000. We have analyzed the variety of responses from the 70 patients, and three main groups have emerged, which have focused on the following issues: (1) visualization of physical pain, (2) communication of emotions, and (3) search for meaning/spirituality. SIGNIFICANCE OF RESULTS: The results suggest that because of its abstract symbolic feature, the Body Outline is a very flexible therapeutic intervention. It must be offered within the relationship with the art therapist, and it may fulfill quite a variety of expressive needs, from the description of physical pain to the elaboration of spiritual longings.

Adult↗