The Role of Art in the Patient Experience: An Evaluation of Art from the Heart at UVM Medical Center

Introduction: The World Health Organization defines health as a state of total physical, mental and social well-being, not just the absence of disease or fragility. Making art in medical settings reduces pain, tiredness, emotional distress and other feelings that negatively affect well-being, while enhancing positive emotions and communication. According to the 2009 “State of the Field Report” by the Society for the Arts in Healthcare, 43-45% of healthcare institutions reported having some form of an art program. Art from the Heart (AFTH) is a program of Burlington City Arts in collaboration with the University of Vermont Medical Center. With the aid of volunteers, AFTH offers pediatric patients and their families the opportunity for a more normalized experience by providing them with time and materials to experience the joys of creativity and imagination. Waiting areas, in-patient hospital rooms, exam rooms and chemotherapy infusion bays become temporary art studios. The purpose of our public health project was to evaluate the presence and impact of AFTH in three pediatric points of care at UVM Medical Center.https://scholarworks.uvm.edu/comphp_gallery/1204/thumbnail.jp

Projector Quantum Monte Carlo Methods for Linear and Non-linear Wavefunction Ansatzes

This thesis is concerned with the development of a Projector Quantum Monte Carlo method for non-linear wavefunction ansatzes and its application to strongly correlated materials. This new approach is partially inspired by a prior application of the Full Configuration Interaction Quantum Monte Carlo (FCIQMC) method to the three-band ($p-d$) Hubbard model. Through repeated stochastic application of a projector FCIQMC projects out a stochastic description of the Full Configuration Interaction (FCI) ground state wavefunction, a linear combination of Slater determinants spanning the full Hilbert space. The study of the $p-d$ Hubbard model demonstrates that the nature of this FCI expansion is profoundly affected by the choice of single-particle basis. In a counterintuitive manner, the effectiveness of a one-particle basis to produce a sparse, compact and rapidly converging FCI expansion is not necessarily paralleled by its ability to describe the physics of the system within a single determinant. The results suggest that with an appropriate basis, single-reference quantum chemical approaches may be able to describe many-body wavefunctions of strongly correlated materials. Furthermore, this thesis presents a reformulation of the projected imaginary time evolution of FCIQMC as a Lagrangian minimisation. This naturally allows for the optimisation of polynomial complex wavefunction ansatzes with a polynomial rather than exponential scaling with system size. The proposed approach blurs the line between traditional Variational and Projector Quantum Monte Carlo approaches whilst involving developments from the field of deep-learning neural networks which can be expressed as a modification of the projector. The ability of the developed approach to sample and optimise arbitrary non-linear wavefunctions is demonstrated with several classes of Tensor Network States all of which involve controlled approximations but still retain systematic improvability towards exactness. Thus, by applying the method to strongly-correlated Hubbard models, as well as $\textit{ab-initio}$ systems, including a fully periodic $\textit{ab-initio}$ graphene sheet, many-body wavefunctions and their one- and two-body static properties are obtained. The proposed approach can handle and simultaneously optimise large numbers of variational parameters, greatly exceeding those of alternative Variational Monte Carlo approaches.EPSRC studentshi

Untersuchungen zur Suppression der IFN-ß-Induktion durch Proteine des Hepatitis A-Virus, unter besonderer Berücksichtigung des HAV/2B-Proteins

Hepatitis A virus antagonizes the innate immune response by inhibition of IRF-3 activation which results in efficient suppression of interferon-β synthesis. This study showed that this ability of the virus is mediated by the viral non-structural proteins 2B and 3ABC. While the processing intermediate 3ABC targets MAVS, 2B might interfere with IRF-3 activation in an indirect manner by associating with intracellular membranes. Deletion of the C-terminal transmembrane domain of 2B results in a loss of function concerning the suppression of IRF 3 activation. In addition to suppression of IRF-3 activation, HAV partially down regulates protein expression which is mediated by the viral non-structural protein 2C. This function of 2C probably depends on its membrane association, too. In the second part of this work could be shown that the suppression of IRF-3 activation and down regulation of protein expression is not due to an adaptation of HAV to growth in cultivated cells because proteins of wildtype viruses show these properties also. These results imply that HAV is able to inhibit IRF-3 activation and partially down regulates protein expression in vivo

Effects of Art from the Heart on Nurse Satisfaction and Patient Well-Being

Introduction. Art programs have been shown to positively affect unit culture, quality of care, and nursing practices. Art interventions improve well-being, reduce stress, and enhance nurse-patient communication. Art from the Heart (AFTH) is an art program that provides art supplies, visual art, and patient About Me pages to patients, families and employees at University of Vermont Medical Center (UVMMC).Objective. Assess the efficacy of AFTH through nursing staff perceptions, understanding, and attitudes toward the program.Methods. Structured interviews were conducted on Baird 4, an adult inpatient ward, at UVMMC. A 19-question survey using Likert scales and short answer formats was administered to nursing staff. Questions assessed perceptions of effects of art on patient anxiety and pain, communication, and job satisfaction. Surveys were analyzed to extract major and minor themes.Results. Twenty-eight interviews were obtained and two major themes emerged: nurse satisfaction and patient well-being. Nursing staff satisfaction minor themes included improved productivity, promoting conversation, and creating a positive influence on the unit. Respondents reported that AFTH helped initiate conversations with patients (100% of respondents) and reduced workday stress (68%). The second major theme, patient well-being, included benefits to patients with dementia, providing comfort, and serving as an outlet or distraction. Utilizing AFTH improved perceived patient mood (100%), health (78.5%), and reduced patient anxiety (89.3%).Conclusions. AFTH provides positive benefits by reducing nursing staff stress and perceived patient anxiety; improving communication, perceived patient mood and health; and creating a sense of community. AFTH should be expanded to the entire 6 Community Agency: Burlington City Arts, Art from the Hearthttps://scholarworks.uvm.edu/comphp_gallery/1240/thumbnail.jp

Effects of Art Intervention on Pediatric Anxiety and Pain in the Medical Setting

Introduction: Hospitalization and illness can be a painful and stressful time for a child. There may be anxiety over procedures and inpatient stays disrupt normal routines. Previous research found that for pre-school aged children, having parents around, having the help of the hospital staff, and playing an active role in alleviating their fears were the most helpful in reducing anxiety. Another study found that visual creative expressions can be meaningful experiences for young adult cancer survivors. Additionally, there is abundant literature on formal art therapy and its favorable effects on children in the hospital, however, there are fewer studies investigating less standardized “art intervention” in the same population. The purpose of our project was to assess whether art intervention reduces anxiety and pain in inpatient and outpatient pediatric patients.https://scholarworks.uvm.edu/comphp_gallery/1224/thumbnail.jp

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Is PiSS Alpha-1 Antitrypsin Deficiency Associated with Disease?

Background. Alpha-1 antitrypsin deficiency (AAT) is an inherited condition that predisposes to lung and/or liver disease. Objective. The current study examined the clinical features of the PiSS genotype. Methods. Nineteen study participants (PiSS) and 29 matched control participants (PiMM) were telephone interviewed using a standardized questionnaire. Demographic features, cigarette smoking, vocation, medication history, and clinical diagnoses were compared. Statistical analysis was performed. Finally, a comprehensive literature review was performed by two investigators. Results. 12/19 (63.2%) study participants reported the presence of lung and/or liver disease compared to 12/29 (41.4%) control participants. There trended toward having a higher frequency of medication allergies in the study population (42.11% versus 20.69%). Conclusions. The PiSS genotype was associated with a similar incidence of obstructive lung disease to controls. Selective bias intrinsic in testing for AAT deficiency and the rarity of the PiSS genotype will make future study of this association dependent on population-based tests

Social dynamics shaping the diffusion of sustainable aquaculture innovations in the Solomon Islands

Sustainably feeding the world's growing population represents one of our most significant challenges. Aquaculture is well positioned to make contributions towards this challenge. Yet, the translation of aquaculture production innovations into benefits for rural communities is constrained by a limited understanding of the social dynamics that influence the adoption of new agricultural practices. In this paper, we investigate the factors that shape the spread of small-scale tilapia aquaculture through rural Solomon Islands. Based on diffusion of innovation theory, we focus on three potentially influential factors: (i) socio-economic characteristics of adopters; (ii) the role of opinion leaders; and (iii) characteristics of the innovation. We find that farmers who were wealthier, older, and had more diverse livelihoods were most likely to be adopters. Opinion leaders facilitated the adoption of tilapia aquaculture, but lacked the capacity to provide fundamental knowledge necessary to realize its potential benefits to food security. The paper argues for more explicit attention to the poorest households and makes the case for a deeper engagement with the broader social and institutional contexts that shape the adoption process. Aquaculture interventions that account for these social dynamics are critical for translating production innovations into sustainable benefits to rural communities

The quality of school wellness policies and energy-balance behaviors of adolescent mothers

INTRODUCTION: In this study, we 1) compared the quality of school wellness policies among schools participating in Moms for a Healthy Balance (BALANCE), a school- and home-based weight loss study conducted with postpartum adolescents in 27 states; and 2) assessed the relationship between policy quality with energy-balance behaviors and body mass index z scores of postpartum adolescents. METHODS: As a part of BALANCE, we collected data on high-calorie food and beverage consumption, minutes spent walking, and height and weight for 647 participants. The School Wellness Policy Coding Tool was used to assess the strength and comprehensiveness of school district wellness policies from 251 schools attended by participating adolescent mothers. RESULTS: Schools averaged low scores for wellness policy comprehensiveness and strength. When compared with participants in schools with the lowest policy comprehensiveness scores, adolescent mothers in schools with the highest scores reported consuming significantly fewer daily calories from sweetened beverages while reporting higher consumption of water (P = .04 and P = .01, respectively). School wellness policy strength was associated with lower BMI z scores among adolescent mothers (P = .01). CONCLUSION: School wellness policies associated with BALANCE may be limited in their ability to promote a healthy school environment. Future studies are needed to evaluate the effect of the strength and comprehensiveness of policy language on energy balance in high-risk postpartum adolescents. Evidence from this work can provide additional guidance to federal or state government in mandating not only policy content, but also systematic evaluation

Use of computed tomography imaging during long-term follow-up of nine feline tuberculosis cases

Case series summary: Feline tuberculosis is an increasingly recognised potential zoonosis of cats. Treatment is challenging and prognosis can vary greatly between cases. Pulmonary infection requires extended courses of antibiotics, but methodologies for sensitively monitoring response to treatment are currently lacking. In this case series, we retrospectively examined the serial computed tomography (CT) findings in nine cats that had been diagnosed with tuberculosis. Changes in pathology (where applicable to tuberculosis) were correlated with the clinical presentation of each of the cats, the treatment protocol, and previous and contemporary diagnostic investigations. This study found that changes in CT findings during the medium- to long-term management of feline tuberculosis were highly variable between cats. The majority of cats had reduced pathology at re-examination during anti-tuberculous therapy, but pathology only resolved in a minority of cases. In some cases recurrence of pathology detected by CT imaging preceded clinical deterioration, allowing for rapid therapeutic intervention. Relevance and novel information: When considered in combination with clinical findings, CT studies can aid in decision making regarding tapering of antibiotic protocols, or reintroduction of therapy in cases of recurrence or reinfection. This series also highlights that, in some cases, persistent abnormalities can be detected by CT, so complete resolution of CT pathology should not always be a goal in the management of feline tuberculosis