Melanie Ambler is an aspiring physician-artist-scientist, interested in the integration of the arts into the medical field. She is a classically-trained cellist and founded two live virtual concert series for patients and care providers in both the United States and France. In 2019, she received a Fulbright Fellowship for study and research in the city of Caen, France. She pursued a master's in Neuroscience at the Université de Caen-Normandie, and performed a research study with the Neuroimaging Lab of Human Memory regarding the ability of patients with clinical amnesia to recognize new melodies or paintings. She is currently a musician on call for the nonprofit Project: Music Heals Us and plays weekly one-on-one virtual concerts for critically ill patients.
Melanie hopes to continuing bridging the arts and medicine during her time at Stanford Medicine by researching promising interventions and then putting them into practice as a care provider.
One Year Later: Family Members of Patients with COVID-19 Experience Persistent Symptoms of PTSD.
Annals of the American Thoracic Society
RATIONALE: Family members of critically ill patients with COVID-19 have described increased symptoms of Post-Traumatic Stress Disorder (PTSD). Little is known about how these symptoms may change over time.OBJECTIVES: We studied changes in PTSD symptoms in family members of critically ill patients with COVID-19 over 12-months.METHODS: This prospective, multi-site observational cohort study recruited participants at 12 hospitals in 5 states. Calls were made to participants at 3-4 months, 6-months, and 12-months post-patient admission to the ICU.RESULTS: There were 955 eligible family members, of whom 330 (53.3% of those reached) consented to participate. Complete longitudinal data was acquired for 115 individuals (34.8% of consented). PTSD symptoms were measured by the Impact of Events Scale-6 (IES-6), with a score of ≥10 identifying significant symptoms. At 3-months, the mean IES-6 score was 11.9±6.1 with 63.6% having significant symptoms, decreasing to 32.9% at one year (mean IES-6 score 7.6±5.0). Three clusters of symptom evolution emerged over time: persistent symptoms (34.8%, n=40), recovered symptoms (33.0%, n=38) and non-development of symptoms (32.2%, n=37). While participants identifying as Hispanic demonstrated initially higher adjusted IES-6 scores (2.57 points higher [95% CI: 1.1, 4.1, p = <0.001]), they also demonstrated a more dramatic improvement in adjusted scores over time (4.7 greater decrease at 12 months [95% CI: 3.2-6.3, p<.001]).CONCLUSIONS: One year later, some family members of patients with COVID-19 continue to experience significant symptoms of PTSD. Further studies are needed to better understand how various differences contribute to increased risk for these symptoms.
View details for DOI 10.1513/AnnalsATS.202209-793OC
View details for PubMedID 36508292
Academic medicine : journal of the Association of American Medical Colleges
View details for DOI 10.1097/ACM.0000000000005038
View details for PubMedID 36255207
Heterogeneity of outcomes for intraoperative music interventions: a scoping review and evidence map
BMJ EVIDENCE-BASED MEDICINE
2021; 26 (3): 116-+
Over the past 30 years, numerous studies have been performed that assess the efficacy of intraoperative music as an adjunctive means to regional and local anaesthesia to improve clinical outcomes. Despite an emerging body of evidence and growing adoption of music in surgical settings, the variety of interventions studied, and the heterogeneity of outcomes and outcome measurement tools applied makes difficult the task of aggregating evidence.This study assesses the state of the field of intraoperative musical interventions by documenting and visualising the breadth of outcomes measured in studies.Scoping review and evidence map.Three electronic databases (PubMed, Embase and a music-focussed research database, RILM (International Music Literature Repository)) were searched for full-text articles published between January 1991 and July 2019. Results from these searches were screened and relevant data was extracted from full-text articles on type of music intervention and type of anaesthesia; outcomes measured were recorded in an evidence map in order to identify the current state of the field and assess for trends in outcome measurements.Music administered to adult patients via headphones or speakers under regional or local sedation in during the intraoperative period.Twenty-one studies with a total of 2283 patients were included. A total of 42 unique outcomes were measured across the 21 studies, with each measuring an average of 6.41±2.63 outcomes. Systolic blood pressure, diastolic blood pressure, heart rate, anxiety, pain, patient satisfaction, respiratory rate and sedation requirements were the most prevalent outcomes reported. Only 15 outcome measures (36%) were used in more than one study, while the remaining 27 outcome measures (64%) were identified in only one study in our review.Our scoping review identifies that almost two-thirds of studies in this field used >1 outcome measure unique to that study (not also used in other studies), which hinders opportunities to aggregate data across studies and meta-analyse evidence. Future studies should provide clear documentation regarding the intervention and consider using valid and reliable outcome tools. Researchers should consider standardisation when appropriate and adopting the use of core outcome sets for conditions where these sets have been developed.
View details for DOI 10.1136/bmjebm-2020-111382
View details for Web of Science ID 000656481900016
View details for PubMedID 32816900
Virtual Concerts at the Bedside of COVID-19 Patients: A Trio of Perspectives
CANADIAN MEDICAL ASSOCIATION JOURNAL
2021; 193 (3): E115-E116
View details for DOI 10.1503/cmaj.201662-f
View details for Web of Science ID 000613619900003
View details for PubMedID 33462155
View details for PubMedCentralID PMC7955814
Virtual bedside concerts for patients with COVID-19: a trio of perspectives
CANADIAN MEDICAL ASSOCIATION JOURNAL
2020; 192 (44): E1370-E1371
View details for DOI 10.1503/cmaj.201662
View details for Web of Science ID 000591671800007
View details for PubMedID 33139428
View details for PubMedCentralID PMC7647490