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The Relational Effects of Mindfulness Training: A Phenomenological Study
Full text linkUsing General Systems Theory (Bertalanffy, 1968) and Phenomenology (Husserl, 1913/1931), this qualitative phenomenological study examined the relational effects of mindfulness training when one partner completed an 8-week, hospital based Mindfulness-Based Stress Reduction program (MBSR, Kabat-Zinn, 1990) within the last 6 months. In a sample of 12 couples, in-depth, semi-structured interviews were conducted with: a) recent MBSR graduates, b) their intimate partners, and c) both members of the couple together. The recent MBSR graduates were novel meditators who had limited previous mindfulness experience before taking the MBSR training and included 7 female and 6 male MBSR graduates. Ten heterosexual couples and 2 same sex couples participated in the study, and the average relationship length was 14.5 years. Over 95% of the participants were White, and 62.5% had graduate degrees. Before the interviews, all couples completed the Revised Dyadic Adjustment Scale (Busby et al., 1995), which indicated that 6 out of 12 couples were relationally distressed. A modified version of the interpretative phenomenological analysis method (Smith et al., 2009) informed the data analysis. The following major themes emerged for the MBSR graduates: 1) awareness of emotional reactivity; 2) creating space and time; 3) making different choices; and 4) humility and moments of connection. Findings confirmed that self-awareness and emotional regulation are not only major outcomes of mindfulness training, but could also be pathways to relationship growth. The intensity and reactivity of intimate partner relationships can offer both opportunities and challenges for MBSR participants trying to integrate mindfulness into their daily lives. Although intimate partners observed improved emotional balance in the graduates, their descriptions of the benefits of MBSR training were diluted compared to the graduates' descriptions. The intimate partners revealed that behavioral shifts in the graduates were emerging, but were limited in scale--suggesting that individual outcomes of MBSR training do not automatically transfer to relationship outcomes. Developing more mindfulness-enhanced couple interventions that prioritize conjoint participation and emphasize relational outcomes may harness the potential relational benefits of mindfulness practice. Future research should focus on the potential differences between distressed and non-distressed couples and include more diverse samples of couples.Ph.D., Couple and Family Therapy -- Drexel University, 201
Epidemiology of HIV-1 and hepatitis virus co-infection: Distribution and pathogenesis in an urban clinic population
Full text linkGiven similar routes of exposure, hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection is common among HIV-positive populations. The long-term impact of these is becoming an important public health concern, given the high rates of co-exposure coupled with increased AIDS-related survival and widespread accessibility of antiretroviral therapy. Using a population drawn from an urban HIV clinic, we investigated prevalence rates of co-exposure, and identified factors associated with co-exposure, sexual transmission of HCV, and HCV viral clearance using a cross-sectional study design on data collected from 2002-11. We also conducted survival analyses using Cox proportional hazards regressions to model the risk of progression to four outcomes (clinical AIDS, all-cause mortality, HIV virologic failure, and decline in CD4 count) based on HBV and HCV status. Among 2,880 HIV-positive subjects, relatively high seroprevalences of HBV (44%), HCV (34%), and HBV/HCV (19%) was observed. Injection drug users (IDUs) had the greatest odds of each co-exposure. Additionally, race, sex, socioeconomic status, older age, and more recent HIV diagnosis were associated with co-exposure. Sexual transmission of HCV was associated with Black race, younger age, and a more recent HIV diagnosis Among subjects with a history of HCV exposure, 13% had evidence of HCV viral clearance; being HBV surface antigen-positive was highly predictive of clearance. In the survival analysis, HBV status negatively affected HIV disease progression, particularly time to clinical AIDS and HIV virologic failure. Additionally, HCV status may be related to faster progression to clinical AIDS and all-cause mortality. Taken together, our findings highlight the burden of viral hepatitis co-infections among HIV-positive individuals, and the need to reduce this burden through routine testing, HBV vaccination, and appropriate therapy. Further research, particularly with a prospective study design, is warranted to fully understand the factors associated with viral hepatitis co-infection among HIV-positive populations. Identification of those more likely to develop chronic HCV infections can inform therapy decisions. Further, given the relatively high rates of HBV and HCV co-infection and the current debate on their impact on HIV disease progression, additional research is needed to further elucidate these relationships.Ph.D., Epidemiology -- Drexel University, 201
A retrospective study on African American experiences of witnessing male to female intimate partner violence (IPV) as low-income youth and the impact on adolescent self-identity and development
Full text linkThis qualitative retrospective study examined lived experiences of African American males and females whom witnessed male to female intimate partner violence (IPV) as low-income youth. Race, class, experience of witnessing IPV, and impact on self-identity and development were explored to gain a more in-depth understanding of the collective meaning of these variables to participants. Few studies in the field of couple and family therapy have focused on IPV, particularly in African Americans (Avis, 1992; Bograd, 1999; McDowell & Jeris, 2004). Thus this study endeavored to contribute to the family therapy literature on IPV and African Americans. Ten African American adult males and females from low-income backgrounds were sampled using semi-structured interviews. Developmental-ecological theory was the theoretical framework for this study and data analysis was conducted utilizing a retrospective integrative phenomenological approach (Giorgi, 1997; Moustakas, 1994; van Manen, 1990). Findings revealed the following: loss of safety; feelings of helplessness though some participants tried to protect their mothers/caregivers despite the danger; growing up quickly and loss of childhood; independence; and issues in adolescence (violence in dating relationships, emotional distress and risky behaviors). Further, participants reported that it was very difficult to be a low-income youth due to their exposure to violence, poverty, and other dangerous situations within the community. Consequently, there was a large impact on participants’ self-identity and development. Participants saw themselves as products of their environment, specifically since they not only had to deal with the structural inequities of being low-income but also African American. Remarkably, participants attributed their resiliency and tenacity to negative experiences and believed they were better individuals because of them.Ph.D., Individual, Couple and Family Therapy -- Drexel University, 201
Examining gender role beliefs and marital satisfaction of Ghanaian immigrant couples in the U.S.A.
Full text linkThe experiences of African immigrants to the United States of America are sparsely represented in the literature. Recent research has focused more on Latinos and Asian ethnic minority populations than on African immigrants. Further, given the paucity of research on this population, it is no surprise the limited literature has ignored important factors such as family relationships and marital issues. Therefore, exploring the relationship between gender role beliefs and marital satisfaction among Ghanaian immigrant couples is necessary to help inform and contribute to the literature in Couple and Family Therapy research particularly for a subgroup living in the United States who has been virtually ignored. Acculturation theory was introduced as a framework to facilitate understanding of the relationship between gender role beliefs of Ghanaian immigrant couples and their level of marital satisfaction in the American culture. This study examined these variables with a correlation predictive design using a cross-sectional survey technique of 77 Ghanaian immigrant adult couples currently residing in the tri-state of area of New Jersey, Delaware and Pennsylvania. It was hypothesized that Ghanaian immigrant couples who have more congruent gender role beliefs would have higher levels of marital satisfaction. The results indicated to the contrary. Husbands were liberal in their gender role beliefs compared to wives; however, the difference was not statistically significant. Future studies could explore covariates such as ethnic background, level of education, and counseling services. These were good correlates of gender role beliefs and marital satisfaction in the study.Ph.D., Couple and Family Therapy -- Drexel University, 201
Rolling Out the Interactive Credits: Evolving the Ending Credits into an Interactive Audience Experience
Full text linkA central purpose of "Rolling Out the Interactive Credits: Evolving the Ending Credits into an Interactive Audience Experience" is to create interactive ending credits that personalize the viewing experience for home movie audiences. While retaining the style of the film, interactive credits will enable viewers to feel more connected to production companies by offering select bonus content. Twenty-first century film consumption patterns are changing, and consumers now desire to watch films at home through Video-On-Demand (VOD), which is an increasingly popular alternative to traditional movie theaters. Furthermore, home viewers often seek to interact with what they watch. Home viewing provides opportunities for movie producers to communicate with audiences in novel ways using new technologies, including the Internet. In this project, the interactive credits were created using web technologies, such as HTML5, JavaScript, PHP, and MySQL. Viewers are able to navigate through the interface to find information about roles, people, pre-production, making of, and backstage material. The interface is designed to integrate the original film credits with a visual design that matches the theme of the film. The bonus material will potentially include production material, interviews with the cast and crew, and general information not available to traditional movie theater audiences. This information is meant to fulfill the viewer's interest in film-enhancing material.M.S., Digital Media -- Drexel University, 201
Association Between Serum 25-Hydroxyvitamin D Concentration And Type 2 Diabetes Mellitus: Interaction By Race/Ethnicity And Mediation By Inflammation
Full text linkDiabetes mellitus affects 25.6 million adults and is the seventh leading cause of death in the United States. Recent evidence indicates that vitamin D may alter glucose metabolism, which suggests it may play a role in reducing risk of prediabetes and type 2 diabetes. Although observational studies support pancreatic β-cell dysfunction and insulin resistance as pathways by which vitamin D influences glucose homeostasis, a mechanism involving systemic inflammation remains obscure. We hypothesized that vitamin D was associated with inflammation, prediabetes, and type 2 diabetes. In the present investigation, we analyzed data from the National Health and Nutrition Examination Survey (NHANES) conducted from 2001-2006 among adults over 20 years of age. We evaluated the association between 25-hydroxyvitamin D [25(OH)D], a serum biomarker of vitamin D status, and prediabetes or type 2 diabetes. In addition, we assessed the association by subgroups of gender and race/ethnicity and evaluated interaction using joint effects. We determined the association between 25(OH)D and three biomarkers of inflammation, including C-reactive protein (CRP), and further assessed mediation by CRP on the association between 25(OH)D and hemoglobin A1c [HbA1c], a biomarker of glucose homeostasis. Using piecewise regression, it was determined that 25(OH)D was inversely associated with CRP when 25(OH)D < 20 ng/mL, but directly associated when 25(OH)D ≥ 20 ng/mL. There was significant interaction by age, gender, race/ethnicity, and abdominal obesity. Furthermore, 25(OH)D was not associated with fibrinogen but inversely associated with homocysteine. Results from path analysis indicate that CRP mediated 14.9% of the association between 25(OH)D and HbA1c in males. We determined that 25(OH)D sufficiency was associated with type 2 diabetes. However, the association was not significant in non-Hispanic Blacks which suggests that 25(OH)D sufficiency as defined by the Institute of Medicine may be inadequate for this subgroup. Our finding that vitamin D may prevent diabetes is consistent with prospective studies which supports a temporal association. Although these findings need to be confirmed in prospective studies and intervention trials, our results may be of large public health value in controlling the current unfavorable diabetes epidemic.Ph.D., Epidemiology -- Drexel University, 201
A Study of Crashes and Injuries along a Multiple Use Trail
Full text linkBackground - Multiple use trails constitute an increasing share of the traffic infrastructure in municipalities and states that seek to encourage alternative transportation by foot and bicycle. Though it is known that trail users can sustain severe traumas, there is little research on the risks associated with multiple use trails and no established standards of design or conduct has been implemented to protect the users of these trails.
Objective - To identify risk and protective factors associated with multiple use trails in terms of individual and group level behaviors and trail design features.
Methods - Crashes and injuries were identified for the Mount Vernon Trail in the George Washington Memorial Parkway by contacting local public safety organizations. Cases were eligible if they crashed or were injured along the length of the trail due to trail use from 2006-2010. Denominator data was collected from in the form of per capita trail use from a set of nine infrared counters maintained by the National Park Service along the length of the trail. Demographic data for trail users was collected from the Virginia Department of Transportation, the Arlington Country Environmental Services Department and the National Park Service. Chi-square tests and t-tests were used to evaluate whether or not differences existed between severely injured and non-severely injured cases and between injured and uninjured trail users. Multivariate analysis was conducted using Poisson Regression.
Results - Severely injured cases have higher percentages of head injuries and fractures (p<0.0001). Elevated risk was found for several geographic risk factors, including: roadway crossings (RR: 3.33 (95% CI: 2.32-4.77)), trail intersections (RR: 2.09 (95% CI: 1.13-3.88)) and surface transitions (RR: 3.27 (95% CI: 2.26-4.72)). Users engaged in activities that were not cycling or pedestrian were at an elevated risk of injury (143.59 (31.19-655.50)).
Conclusion - Multiple use trail managers should seek to implement injury surveillance systems to help tailor their preventative activities, and raise awareness of the potential for injury associated with trail use. Multiple use trail design should seek to avoid features that pose elevated risks to their users.M.P.H., Epidemiology -- Drexel University, 201
Flying forward while looking back: An autoethnography on the journey from intimate partner violence
No full textViolence in intimate relationships is a continuing problem in the United States, and has been found to be heightened in the African American couples. Considering this, it is important to explore what cultural differences exists that can be influential in understanding these differences and in promoting healing for specific populations, particularly when combined with the influence of historical legacies, including the legacy of slavery in the African American experience. This dissertation examines the historical context of Blacks in the United States, discussing how the legacies of slavery and of patriarchy are impactful in Black intimate couples. The method used to explore this phenomenon is autoethnography, allowing the researcher to also act as subject, using a critical race, Africana womanist-informed testimonial narrative to explore the experience of intimate partner violence (IPV) of an African American woman. The narrative explores the relationship from inception until recovery. Findings suggest that while the researcher’s narrative reflected the stages of recovery that Wuest & Merritt-Gray (1999; 2001) term “reclaiming self”, there were particular differences that related to the narrative in context. First, as a teen recovering from IPV, some of the challenges that are present for adult women survivors were not for the researcher. Secondly, although there are similarities for women of all races who recover from abusive relationships, the researcher’s context as an African American suggests a need for specific treatment implications for the population, including a resilience-focused approach. Finally, future research should focus on gaining a better understanding of the process of recovery as it directly relates to the context of African American adolescents.Ph.D., Couple and Family Therapy -- Drexel University, 201
Level of Fit of Two Fracture Fixation Plates to the Radius through Physical and Virtual Analysis
No full textFractures of the radius are commonly treated by open reduction and internal fixation by use of a fracture fixation plate. In doing so, the gap between the underside of the plate and the surface of the bone must be minimized, and contouring time of the plate to the radius shape must also be minimized. It is proposed that plates with an initial precontour to approximate the shape of the radius will best achieve these requirements. To this end, the goal of this study is to evaluate the bending time and the level of fit of precontoured plates versus standard plates in fracture fixation of the radius. Six cadaver arms were obtained, and their radii were extracted and cleaned of soft tissue. Precontoured plates designed by Acumed, LLC, were fitted to the radii before and after additional contouring along with standard industry plates designed by DePuy Synthes. Gap measurements were taken at various points along the plate, and bending times were recorded for the plates that were additionally contoured. This analysis was then repeated virtually as well as physically through use of 3D printed duplicates of the radii. The dorsal precontoured Acumed and Synthes plates were found to fit equally well to the radius, while the volar precontoured Acumed plate does not fit as well as the Synthes plate. Additionally bending both the dorsal and volar Acumed plates provides superior fit over the Synthes plate. Also, no significant differences were found between the measurements of the bone and 3D printed bone, meaning 3D printed bone could be a useful facsimile of real bone for use in surgical planning.M.S., Mechanical Engineering and Mechanics -- Drexel University, 202
Exploring the Effects of an Open Access Mindfulness Course on Online Graduate Student Persistence, Stress, and Mind Wandering: A Mixed Methods Explanatory Sequential Study
No full textAs enrollment in online graduate education increases, retention continues to be problematic for many colleges and universities across the United States. Retention is greatly influenced by persistence or continued enrollment from one term to the next. Non-traditional students, who represent the majority of online graduate student enrollment, have unique issues related to persistence considering they often must juggle the demands of graduate school with work and families. The competing demands can lead to increased levels of perceived stress, which can impact academic performance due to increased mind wandering and decreased attention. Mindfulness is a practice that has been shown in the literature to decrease levels of perceived stress and mind wandering, therefore, the integration of mindfulness practice could have a positive effect on student persistence in online graduate education. The purpose of this explanatory sequential dissertation was to examine relationships between, and factors related to student self-reported perceived stress, mind wandering, and persistence (i.e., degree/ institutional commitment) and to explore the impact of teaching mindfulness to online graduate students. A total of 31 online graduate students completed Module One of an open access course, "Mindfulness and Optimal Performance" and the associated pre- and post-surveys. The pre-and post-surveys included valid and reliable instruments to measure self-reported levels of perceived stress, mind wandering, and persistence. To expand on and clarify the quantitative results, six one-on-one interviews were conducted after the post-survey. Self-report levels of perceived stress and mind wandering were significantly lower after students completed Module One of an open access mindfulness course. Self-reported perceived persistence levels were found to be significantly higher after Module One with students in the first or second quarter of their program, students with little or no mindfulness experience, and students who meditated four or more times a week. Furthermore, students interviewed felt that the course provided excellent foundational information about mindfulness that could be immediately applied, and therefore should be a requirement for all incoming students. Given the findings, the recommendation is for colleges and universities to offer education on mindfulness to all incoming students as a way to support students holistically and provide strategies to help students manage their stress, increase their focus, and potentially increase their persistence to graduation.Ed.D., Educational Leadership and Management -- Drexel University, 202