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Comfort as process and product, merged in holistic nursing art.

Although many scholars discuss nursing as an art and science, the practice of nursing art remains unspecified and elusive, especially to learners. Nursing art is the esthetic use by nurses of scientific and humanistic principles of care applied creatively within specific contexts of care. One form of nursing art is called comfort care. Comfort care entails the process of comforting actions and the product of enhanced comfort, both of which have been described in separate programs of research. Because the process of comfort includes the product of comfort, the construct of comfort care designates a necessary merger between the programs of research. A template is presented that guides the practice of comfort care within a context of holistic nursing art.

Aged↗

Memories in the making: outcome-based evaluation of an art program for individuals with dementing illnesses.

The author presents the results of a pilot project, an outcomes-based evaluation of Memories in the Making: An art program for individuals with dementing illnesses. Sponsored by the Greater Cincinnati Chapter of the Alzheimer's Association and implemented at adult day and nursing home sites, participants in the weekly art program use paints to express themselves by creating colorful visual images on paper or fabric. The individuals experienced pleasurable, sustained activity while engaged in making art. Utilizing M.P. Lawton's conceptualization of psychological well-being as a framework, chapter staff developed an observational instrument, which measured objective and subjective indicators of the affect state and self-esteem of 41 participants in the art program. Overall, preliminary data suggests that participation in the weekly sessions contributed to the individuals' sense of well-being. However, more rigorous study is warranted using comparison groups to determine if indeed an enhanced sense of well-being can be attributed with certainty to the intervention of the Memories in the Making art program.

Adaptation, Psychological↗

Online exclusive: art intervention with family caregivers and patients with cancer.

PURPOSE/OBJECTIVES: To describe the implementation and preliminary evaluation of an art intervention at the bedsides of patients with cancer and their family caregivers. DATA SOURCES: Field notes from ongoing encounters with family caregivers and patients with cancer, research literature, and descriptions of other programs. DATA SYNTHESIS: An "Art Infusion" intervention was developed and offered to family caregivers and patients with cancer during treatment at a comprehensive cancer center. Training of interventionists, timing and delivery of the intervention, and the availability of art activity choices were key factors in the intervention's success. CONCLUSIONS: Family caregivers and patients with cancer are interested in and responsive to art interventions. Additional research is needed to quantify the effects. IMPLICATIONS FOR NURSING: Art interventions enhanced and extended the scope of care for family caregivers and patients with cancer. Nurses are in key positions to establish, supervise, and promote such interventions.

Art Therapy↗

Art experience and hospitalized children.

This paper explores the utility of the art experience in helping children cope with the stressful situation of hospitalization. A brief historical overview of the developments in this field is presented. In the art experience, similar aspects of the activity of play are expanded. They are: (a) the use of metaphorical thinking, (b) the use of concrete, sensuous materials, and (c) the use of physical activity. These are described and the creative process is suggested as an alternative mode of thought. The possibilities of using the art experience with children under stress are presented, as well as the description of the benefits of the art object to both staff and child. The benefits of the art experience as a safe place for expression of unacceptable feelings and fantasies and for the facilitation of communication between child and staff are also suggested.

Art Therapy↗

The staging of a hospice arts and crafts exhibition in the UK.

The use of arts in hospices is now well established. However, the voluntary nature of much hospice work in England encourages most regular creative activities to be provided by volunteers with minimal financial support. This article looks at how a successful arts and crafts exhibition for a hospice community was staged by a volunteer arts worker, helped by art and design students from the local university. It was not intended that the exhibition should be a research project; however, it became clear that to learn more about arts practice within a hospice environment, it would need to be appraised in some way. The project leader (and author) adopted an approach which reflected on the responses of people involved in the preparation and staging of the exhibition.

Art↗

Study of Graves design Judgment Test and Barron-Welsh Revised Art Scale.

Previous research suggests that scores on both the Graves Design Judgment Test and the Barron-Welsh Revised Art Scale correlate with education in art and with aspects of creativity but have little validity with respect to artistic performance. With a heterogeneous group of 48, the Graves test correlated significantly with fine-arts education, interest in the arts, artistic achievement, and creative independence. The Barron-Welsh scale correlated significantly with only fine-arts education in a similar group of 47.

Achievement↗

Perceived vulnerability and control of martial arts and physical fitness students.

Anecdotal reports and limited research suggest that enrolling in self-defense courses can enhance feelings of control and reduce feelings of vulnerability; however, much self-defense is taught in the context of martial arts courses. To assess the effects of martial arts courses on perceptions of vulnerability and control, 83 students in physical fitness and 59 students in martial arts courses at 10 randomly chosen large universities responded to questionnaires. Martial arts students scored lower on control, higher on vulnerability, and higher on perceived likelihood of being injured than fitness students while enrolled in their courses. A year later, regardless of whether they had continued training, they scored higher on control and lower on vulnerability. Neither gender nor prior history of assault was related to responses. Enrolling in martial arts courses may not enhance people's feelings of control, at least in the initial stages of training.

Adult↗

The marriage of art and science in health care.

This paper invites the reader to consider the marriage of art and science as antidote to much epidemic disease, for our greater personal and societal health. The history of arts medicine is reviewed, identifying its persisting although often tenuous link with health care from pre-history to the present. The author describes his personal encounter with art at the bedside, and how it led to his establishing a comprehensive artist-in-residence program at his university hospital. The scientific evidence underscoring the efficacy of art-making for physical and psychological health are outlined, together with the physiological and biochemical data. The author describes his own program, and offers examples of healing art in action.

Delivery of Health Care↗

Art therapy with family caregivers of patients with cancer.

Walsh et al.'s (2004) study supported art therapy to reduce stress, decrease anxiety, and increase positive emotions. The results of this study can be used to support the group's utilization project to promote and educate nurses about the importance of creative arts programs with patients and family members and ways to help establish a creative arts program. One suggestion for future research would be to determine whether the severity of the illness of the patient plays a role in the effectiveness of the art therapy intervention. One feasibility issue for implementing art therapy in hospitals would be the cost of the materials, such as paper, watercolors, markers, and fabrics.

Adaptation, Psychological↗

The therapeutic nature of art in self reparation.

While psychoanalysts have extensively explored the interplay between art and artist, few have examined the functions of art for the patient-participant observer or patient-producer. Art references made by patients during therapy can be reparative to the damaged self. Klein's concept of reparation to the object is expanded upon in order to understand the ways in which the patient makes reparation to his self. This paper focuses on two specific reparative functions (Oxford Dictionary, 1926) that the art source brings to bear on the patient's self: (1) "the restoration or renewal of a thing or part." As the patient reparatively integrates repressed impulses and/or the grandiose self, he comes to experience himself in a renewed way as a whole object who is better able to regulate his self-esteem. (2) "the restoration of a person." Once the patient develops the capacity to maintain a more-or-less stable self and object representation, he may then be ready to reparatively adapt to higher order transformations of self involved in creativity. This paper attempts to demonstrate that the analyst, sensitized to the reparative possibilities inherent in art sources, can therapeutically utilize this material both to facilitate the removal of resistances and to help the patient developmentally attain and maintain a well-regulated, adaptive self.

Adult↗

The failed and the inadvertent: art history and the concept of the unconscious.

The history of art-historical responses to psychoanalysis has yet to be written. Art historians have imported a wide variety of psychoanalytic concepts, and psychoanalysis continues to be a major interpretive resource for the discipline of art history. But beyond the core of art-historical texts that are directly and explicitly influenced by psychoanalysis is a much larger, and I think more important, class of texts that do not cite psychoanalytic concepts, but would nevertheless not be possible without psychoanalysis and especially the fundamental concept of the unconscious. This paper examines the ways that the idea (or notion) of the unconscious affects current thinking about the control artists have over their works; I argue that, in this more general sense, psychoanalysis has tended to help art historians to take away artists' control and awareness of their own work, replacing it with the model of artists as workers largely unaware of what they do. Against this I argue that artists who are imagined to 'preside over their work with their eyes open' can be more interesting subjects, both historically and psychologically.

Art↗

Development of an art program on a bone marrow transplant unit.

This article describes a project created as part of the Arts in Medicine program at Shands Hospital at the University of Florida. The overall mission is to identify and develop connections between the creative arts and the healing arts that will improve the physical, mental, emotional, and spiritual health of our community. The immediate aim of this project is to facilitate the development of similar programs on other clinical units and in other hospitals. The key component is the inclusion of professional artists as artists in residence in an intensive care unit setting. Their primary function is to conduct creative arts workshops and to work one on one to facilitate the use of art as a therapeutic intervention with patients, families, and health caregivers. This pilot program is being conducted on the Bone Marrow Transplant Unit and is exploring the links between nurses, physicians, artists, patients, and families in the creative process. The nurse's role has proved to be that of facilitator and advocate, directly incorporating the artist's interactive process into the daily activities of patients and families. The artists have designed and implemented each creative project and acted as consultants in how to incorporate it. The basic assumption is that every individual is a natural artist. We believe that creating opportunities for everyone to explore the possibilities of artistic expression without judgment or criticism can lead to greater self-awareness and self-esteem and can release our innate creative energy. We hypothesize that this energy can be directed as a potent force into our physical, mental, and spiritual healing.

Art Therapy↗

A review of atraumatic restorative treatment (ART).

The purpose of this paper was to critically analyse the results obtained with the Atraumatic Restorative Treatment (ART) technique. The ART approach involves the excavation of cavitated carious lesions with hand instruments and restoration of the cavities and associated pits and fissures with a glass ionomer restorative material. The clinical trial outcomes involving ART include retention rates, cost effectiveness, operative sensitivity, and the effect of personnel with different educational backgrounds involved in this alternative operative treatment. Comparative studies involving permanent and deciduous teeth using amalgam and glass ionomer sealants have also been included in the same projects. Specially defined clinical criteria have been used to evaluate the results. ART offers an opportunity for restorative dental treatment under field conditions where no electricity is available. Three-year data have been published, but long term studies using relevant comparison alternatives are lacking. ART has so far been largely employed on populations with a low DMFT. The technique should also be applied to high risk patients with rampant caries before the maximal benefit of the treatment can be ascertained.

Clinical Trials as Topic↗

Development and psychometric validation of a new patient satisfaction instrument: the osteoARthritis Treatment Satisfaction (ARTS) questionnaire.

Given the increasing interest in treatment satisfaction research and the lack of a specific questionnaire in osteoarthritis (OA), we developed and explored the psychometric properties of the osteoARthritis Treatment Satisfaction (ARTS) questionnaire. The ARTS questionnaire which consists of 18 items was developed in French following the analysis of semi-structured interviews performed among 20 OA participants, five rheumatologists and five general practitioners. Psychometric properties were assessed in France on a cross-sectional sample of 797 OA participants and test-retest reliability was evaluated in an independent sample of 111 clinically stable OA participants who filled-in the questionnaire within a 7.7 (+/- 3.1) day interval. Using principal component analysis, four scales were identified: Treatment advantages (seven items), Treatment convenience (three items), Treatment confidence (two items) and Satisfaction with physician (six items). Item convergent and item discriminant validity were satisfactory. Internal consistency provided evidence of reliability and lack of redundancy (Cronbach's alphas ranged from 0.66 to 0.86). Test-retest reliability was acceptable for two out of four scales (intraclass correlations coefficients (ICC) ranged from 0.61 to 0.75). Significant between groups differences were found on the ARTS scales, demonstrating the known groups validity of the ARTS questionnaire. The responsiveness of the ARTS is still to be documented.

Aged↗

Sulfated pentagalloyl glucose (Y-ART-3) inhibits HIV replication and cytopathic effects in vitro, and reduces HIV infection in hu-PBL-SCID mice.

To evaluate the efficacy of Y-ART-3 as an antiviral drug for HIV infections, its anti-HIV activity was assessed in vitro in cell culture systems and in vivo in hu-PBL-SCID mice. The results indicated that Y-ART-3 invariably inhibited not only HIV-1, but also HIV-2 and SIV strains. Its mechanism of action is ascribed to inhibition of viral adsorption to CD4-positive cells. In an in vivo study, human Ig- and CD4-positive cells were detected at similar levels in Y-ART-3-treated hu-PBL-SCID mice that were infected with HIV, and in PBS-treated control hu-PBL SCID mice that were not infected with HIV. If HIV positivity was calculated using the number of tests in which HIV was detected (i.e. PCR, and p24 from co-cultures of spleen and peritoneal wash cells), a significant effect of Y-ART-3 at a dose of 4 mg/kg was noted. Therefore, Y-ART-3 may be considered to be a potent and effective anti-HIV compound.

Animals↗

High rates of embryonic loss, yet high incidence of multiple births in human ART: is this paradoxical?

Humans have low natural fecundity, as the probability of establishing a viable conception in any one menstrual cycle is 20-25% for a healthy, fertile couple. There are numerous underlying causes for this low rate of human fertility, not the least of which are intrinsic abnormalities within the oocyte and/or embryo, which likely account for greater than 50% of failed conceptions. During assisted reproduction technology (ART) interventions, controlled ovarian stimulation is used to obtain several oocytes in attempts to increase the likelihood of having at least one developmentally competent embryo available for transfer. However, current techniques for identifying the competent embryo(s) are by no means perfect. These limitations, coupled with pressures to maximize the chance of pregnancy, typically result in the transfer of multiple embryos. Not surprisingly, this practice has resulted in an unacceptably high rate of multiple pregnancies arising from ART. During the last few years, concerted efforts have focused on reducing these rates. Programs for ART are developing patient-specific policies, restricting the number of embryos to transfer. In addition, strategies are being adopted to improve the accuracy for selecting viable embryos for transfer. One such strategy involves further refinement of morphological criteria associated with improved viability by considering, for example, pronuclei disposition, nucleolar organization, and identification of the fast-cleaving embryos with only mononucleate blastomeres. Another strategy employs pre-implantation genetic diagnosis (PGD) whereby a biopsied blastomere is tested for ploidy using fluorescence in situ hybridization (FISH). A final strategy involves extending the duration of culture to the blastocyst stage, thereby allowing self-selection of those embryos capable of proceeding to blastulation and exclusion of those less viable embryos that succumb to developmental arrest. Together, these strategies are enabling fewer embryos of higher quality to be transferred. Accordingly, the overall pregnancy rate from ART continues to increase, while the rate of triplet and higher order multiple births continues to decline. Nevertheless, the high incidence of intrinsic developmental anomalies in human oocytes inevitably will continue to result in a high degree of embryonic loss in ART.

Adult↗

3D reconstruction in electron microscopy using ART with smooth spherically symmetric volume elements (blobs).

Algebraic reconstruction techniques (ART) are iterative procedures for solving systems of linear equations. They have been used in tomography to recover objects from their projections. In this work we apply an ART approach in which the basis functions used to describe the objects are not based on voxels, but are much smoother functions named "blobs". The data collection studied in this work follows the so-called "conical tilt geometry" that is commonly used in many applications of three-dimensional electron microscopy of biological macromolecules. The performance of ART with blobs is carefully compared with a currently well-known three dimensional (3D) reconstruction algorithm (weighted back projection) using a methodology which assigns a level of statistical significance to a claim of relative superiority of one algorithm over another for a particular task. The conclusion we reach is that ART with blobs produces high-quality reconstructions and is, in particular, superior to weighted backprojection in recovering features along the "vertical" direction. For the exact implementation recommended in this paper, the computational costs of ART are almost an order of magnitude smaller than those of WBP.

Image Processing, Computer-Assisted↗

Adaptive categorization of ART networks in robot behavior learning using game-theoretic formulation.

Adaptive Resonance Theory (ART) networks are employed in robot behavior learning. Two of the difficulties in online robot behavior learning, namely, (1) exponential memory increases with time, (2) difficulty for operators to specify learning tasks accuracy and control learning attention before learning. In order to remedy the aforementioned difficulties, an adaptive categorization mechanism is introduced in ART networks for perceptual and action patterns categorization in this paper. A game-theoretic formulation of adaptive categorization for ART networks is proposed for vigilance parameter adaptation for category size control on the categories formed. The proposed vigilance parameter update rule can help improving categorization performance in the aspect of category number stability and solve the problem of selecting initial vigilance parameter prior to pattern categorization in traditional ART networks. Behavior learning using physical robot is conducted to demonstrate the effectiveness of the proposed adaptive categorization mechanism in ART networks.

Algorithms↗