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Music Improvisation and the Expression of Shadow Elements of the Self: A Review of Literature and Case Studies
No full textThe purpose of this capstone study is to review the literature in regards to how improvisational music therapy addressed a client’s unconscious and the elements of the shadow. The Jungian shadow archetype and relevant concepts will be reviewed and integrated into clinical improvisation. This capstone study will review nine case studies in order to demonstrate how music therapists found manifestations of elements of the shadow archetype in musical improvisations. The anticipated outcome of this capstone project is to derive clinical implications by using the technique of improvised music, to explore the elements of the shadow, and to inspire others to continue exploring these concepts and ideas.M.A., Music Therapy and Counseling -- Drexel University, 201
Priming for Flow States Through Engagement Within Music Therapy Improvisation
No full textThe purpose of this thesis is to develop a method to promote flow states in patients in an inpatient psychiatric hospital through group music making. Relevant literature will be reviewed to inform and provide context for the method. The reviewed literature includes an overview of everyday issues associated with depression on quality of life, common practice in the treatment of depression, an introduction to positive psychotherapy, defining characteristics of flow states, benefits of frequently reaching and sustaining flow states, common music therapy practice, music eliciting flow, and flow within the context of music therapy. With the elements of flow in mind, this method was developed to promote complete immersion during group improvisation in order to exploit the benefits of engagement in the intrinsically rewarding experience that group improvisation can be. These benefits include self-growth, a greater sense of connection with the group or to oneself, and increases in subjective well-being, while accessing individuals’ internal areas of health and strength. Additionally, I reflect on what I learned while developing and implementing the method, and how this experience has influenced who I am as a music therapist.M.A., Music Therapy and Counseling -- Drexel University, 201
The Experience of Body Image in Transgender, Nonbinary, and Gender Nonconforming Adults: A Critical Review of the Literature
No full textThis critical review of the literature examines body-based experiences and body image in transgender, nonbinary, and gender nonconforming adults. This review surveys history, language, biopsychosocial factors, information, and research studies of body-based experiences of people not living as the gender assigned at birth. The review examines how body image affects the body, movement, and sense of self. The specific scope of interest for this literature review is body image, including gender dysphoria, in trans men, trans women, nonbinary persons, gender nonconforming persons, two-spirit persons, genderqueer persons, genderfluid persons, agender persons, bigender persons, persons with an intersex condition, and other genders that vary from the assignment at birth. The review examines how community-based therapy, psychotherapy, creative arts therapies, and dance/movement therapy currently approach clinically treating the trans community. The historical context of pathologizing the act of being transgender, continued advocacy within the community, the evolution of the language originating from within the community, and nationwide dialogue for improved care for transgender persons is examined. A goal for this critical review of the literature is to provide a starting point for continuing informed provider care by examining language, advocacy, and education.M.A., Dance/Movement Therapy and Counseling -- Drexel University, 201
Microbial Characteristics of Chronic Respiratory Disease
No full textRespiratory illness is the third leading medical expense category in the United States. Chronic respiratory conditions were the third leading cause of death in the United States in 2011; there is therefore an urgent need for accurate clinical diagnostics, and deeper understanding of organisms associated with these diseases. This study examines in detail new DNA sequence technology that can be used to identify to the species level essentially all bacterial organisms present in clinical samples. A new bioinformatic pipeline designed specifically to leverage this new long read DNA sequence is introduced: MCSMRT. This new analytical method is validated with both simple, and complex mock communities illustrating this pipeline's sensitivity and specificity capabilities compared to previous efforts using short read technology. The methods are applied to 12 patient's sino-nasal surgery samples, showing the clinical relevance of this diagnostic. In addition, to further illustrate the power of genomic DNA sequence methods, Moraxella catarrhalis, the third leading cause of the chronic respiratory illness otitis media (OM) is characterized at a detailed genomic level. This new analysis examines the supragenome in unprecedented detail, including analysis of community composition, phylogenetic relatedness, virulence factor distribution, horizontal gene transfer, and antibiotic capabilities of 31 clinical isolates.Ph.D., Biomedical Science -- Drexel University, 201
Molecular Mediators of Modality-Dependent Axon Facilitated Axon Regeneration Using Novel Tissue Engineered Nerve Grafts
No full textPeripheral nerve injury (PNI) is increasingly common with over 200,000 peripheral nerve repairs performed every year in the United States. Common causes of PNI include trauma, tumor excision, and iatrogenic injury. The current gold standard for nerve repair is the autologous nerve graft (autograft) wherein a healthy sensory nerve is taken from another part of the body to repair injured nerve. However, only about 40-50% of patients receiving autograft treatment exhibit adequate functional recovery. This is likely due to the differences in sensory versus motor axon guidance. A major developmental mechanism of axon guidance is axon facilitated axon guidance, where a pioneer axon reaches the end target first, followed by the bolus of growing axons that use the pioneer axon as a guide; this is also seen in vitro when motor neurons and sensory neurons are co-cultured. Current nerve repair strategies do not take into consideration modality dependent axon regeneration. To address this, we have utilized the technique of axon stretch-growth to develop tissue engineered nerve grafts (TENGs) consisting of long, aligned axon tracts. We have previously reported the efficacy of TENGs in bridging critical nerve gap lengths. These first generation TENGs were comprised of pure sensory stretch grown axons. Here we expand this technology to include motor and mixed motor-sensory stretch grown axons to better suit different nerve types. Motor and mixed motor-sensory TENGs were fabricated by implementing the technique of forced neuronal aggregation and culturing these motor aggregates in custom-built mechanobioreactors. These stretch grown constructs were then used as a testbed to determine key molecular mediators of axon guidance by analyzing expression levels of specific cell adhesion molecules (CAMs) in sensory and motor TENGs over time and the effect of stretch growth on CAM expression. Lastly, sensory, motor, and mixed motor-sensory TENGs were transplanted into a rat sciatic nerve injury model to determine the regenerative efficacy of these modality specific constructs. Electrophysiological and nerve and muscle morphometry assessments confirmed that inclusion of motor axons into the constructs improved functional regeneration outcomes.Ph.D., Biomedical Engineering -- Drexel University, 201
Pediatric Primary Care Provider Personal Health Records (PHRs) Enterprise Utilization and Practice
No full textBackground Personal Health Records (PHRs) empirical research has overwhelmingly focused on patient and family adoption across care setting, severity of illness, dealing with privacy concerns and overall facilitators and barriers to adoption. PHRs Technology Acceptance is defined as three types of PHR usage.1 These usage types are behavioral intent to use, actual use and proficient use. Providers are the focus of this research, which are less researched for PHR barriers and facilitators, acceptance and adoption. Pediatric primary care providers (PCP) are key in terms of the health and well-being of their patients and families, and results in, the often close relationship developed with parents and children during their formative years and the heavily surrogate population that exists in the pediatric population. Wolcott, et al. determines that a supportive provider relationship has been associated with increased patient compliance, decreased pain, and shortened recovery periods.2 Objectives The objectives of this dissertation study were to investigate the existing literature regarding personal health care records and provider use, utilization and practice. Another objective was to evaluate a newly created PHR Organizational Pediatric PCP PHR Acceptance survey and model (POP3) to identify pathways and mechanisms responsible for pediatric PCP PHR behavioral intent to use and actual use. Finally, a targeted network intervention was investigated to determine what, if any, impact it had on increasing pediatric PCP PHR actual use and utilization and practice. Methods The POP3 survey and model was offered to pediatric providers practicing at 30 urban and suburban primary care practices affiliated with an academic medical center. The POP3 survey and model was based on existing technology acceptance and adoption theory. The survey scored external variables impact on both predictor and outcome variables based on a Likert scale. Demographic variables included age, gender, years of healthcare experience including residency and provider type. Predictor variables were individual, technology, patient and family experience, network and organizational level. The median scores were utilized to analyze any pathways and impact on perceived ease of use (PEOU), perceived benefit of use (PBOU), behavioral intent to use (BITU), and actual use (AU). A network intervention was used to further validate impacts of network level interventions on actual and proficient use. Results The POP3 survey response rate was 45%, with 94 providers attempting to complete or completing the survey. Proficient use (UP) had the highest self-reported median score of all outcome variables. Age and years of experience had a statistically significant impact on BITU. The POP3 model resulted in positive impacts of the four of five external variables on both PEOU and PBOU. The highest results were for PHR patient family experience on PEOU and individual PHR technology use, ([beta]= 0.6, P< 0.001), on PBOU. PEOU has an impact, ([beta]= 0.5, P< 0.001), on PBOU which has been demonstrated in past empirical studies. BITU ([beta]= 0.6, P< 0.001), of all predictor variables had the highest impact of all, meaning if the provider intended to use the PHR, there was a higher impact or potential increase on actual use (AU) in comparison to other predictor variables such as PEOU, PBOU and BITU. The self-scheduling network intervention had a 2.0% absolute and 4.0% relative increase in PHR actual provider use in comparison with the control group. For providers deemed as proficient users, a 38% increase in PHR actual use in the intervention group. Finally, PCP providers identified both patient family and provider PHR interventions that could increase PHR use. Conclusion The POP3 model and the impact of a network intervention were both positively validated by this dissertation research. Individual and network level data were integrated to analysis provider PHR use. Additionally, both objective and subjective data are analyzed in this study. This study allows for comparison of both survey and PHR log data to determine provider PHR actual and proficient use. Future research opportunities include updated the POP3 survey and model to include top interventions identified by participants. Further testing of these new interventions, after policy development is completed and implements by care network and organizational leadership. The research should also be extended to include other ambulatory specialty care network locations and providers as well as including other PCP network office roles such as nurses and patient access staff. A further evaluation of proficient usage post intervention should be conducted with the new interventions identified. Finally, a review and analysis of the implications and effects of both patients and families and providers interventions on provider PHR use.Ph.D., Information Studies -- Drexel University, 201
A Study on the Coordination of Decentralized Supply Chain: Outsourcing Decision Making and Selling under Novel Mechanisms
No full textA decentralized supply chain is a network consists of multiple decision makers including the original equipment manufacturer (OEM), the upstream suppliers, retailers and downstream customers. Each of these entities has different information and incentive towards profit and cost priorities. The structure of decentralized supply chains are prevalent today with two growing trends of the manufacturers’ outsourcing practices and the retailers’ application of novel selling strategies. This dissertation is inspired and has been conducted in two themes under these two trends accordingly, with one focused on the Original Equipment Manufacturers’ (OEM) outsourcing decision making problems and the other on the retailer’s pricing and inventory decision making problems when they are applying newly-emerged selling strategies such as Group Buying selling. Many OEMs are constantly facing issues with limited production capacity and unsatisfied demand from downstream customers. We first explore how the external suppliers’ quality affects the OEM’s outsourcing strategy as well as its down-stream demand. A quality-driven demand function is formulated and imbedded into a finite-horizon model on supplier selection and order allocation decisions. We study a two-period model and find it is optimal for the OEM to select suppliers according to their per unit effective procurement cost in the second period, which is defined as the sum of purchase cost and quality cost, and identify the unimodality of the second period value function. In the numerical example, We find the OEM sometimes is better off by not meeting all the demand, even when the supply pool has enough capacity since the benefit of fulfilling all demand could be offset by the future demand decrease caused by products outsourced from low quality suppliers in the current period. Due to the complexity of the first period problem, We characterize the optimal policy under some special cases when certain conditions are met. We also study the multiple period problem using numerical examples to develop a Demand-Driven Policy and to offer some managerial insights on the outsourcing strategy. The notion of "long term capability" of outsourcing attracts many researcher’s attention recently. Under the similar structure of a decentralized supply chain, We consider a one-OEM-one-supplier case, where the OEM outsources finished products to a contract manufacturer (CM), and the CM, by adopting existing technology, achieves quality improvement through learning-by-doing. Besides the role of upstream partner, the CM also acts like a downstream competitor. We study the OEM’s outsourcing strategy dynamically from both cases when quality competition exists and does not exist by constructing a two-period model and explore the interplay of learning, quality and the OEM’s outsourcing strategy. We identify the condition under which pure outsourcing, partial outsourcing or non-outsourcing outplays the others, where pure outsourcing, partial-outsourcing and non-outsourcing strategies refers to the practice when the OEM outsources all, partial or none of its demand to the CM. Under no quality competition where the CM’s quality improvement does not affect the OEM’s future demand, we find that the OEM would still be better off by applying partial outsourcing strategy when CM’s learning triggers future quality improvement. Even when the wholesale price charged by the CM is higher than its own production cost, the OEM still has the incentive to partial outsourcing as a tradeoff for more future demand. When quality competition exists, the CM charges a price lower than the OEM’s in-house production cost to trigger the OEM to still outsource during the first period. If the CM’s learning rate is fixed, the OEM would tend to switch from pure-outsourcing to partial outsourcing when the competition between these two parties is more fierce. We also conduct numerical studies to provide more managerial insights for practitioners who are looking for outsourcing strategy in consideration of CM’s learning effect. The above two chapters address the OEM’s outsourcing decision making problems which focused on the OEM-CM relationship from the upstream part of a decentralized chain. To draw a more complete picture about how different parties within a supply chain are working and coordinating with each other, we extend our viewpoints from the upstream towards the downstream part of the decentralized chain. In recent years, along with intensified competition and growing level of customer involvements, organization’s operational decision is more interacted with their marketing strategy. Therefore, in the third chapter, we study the retailer’s inventory decision and the supplier’s contract design problem under the effect of the retailer’s marketing strategy to sell through a group buying mechanism. Under group buying strategy, a retailer offers buyers price discount based on buyers’ aggregate purchase quantity. We study the supply chain coordination issue with a supplier and a retailer that uses group mechanisms when selling to customers. It has been demonstrated that a buyback contract can coordinate the supply chain under group buying. We also investigate how its contract terms is affected by the quantity threshold above which group buying deal is activated.Ph.D., Supply Chain Management and Logistics -- Drexel University, 201
An exploration of protective and risk factors that influence the development of resilience among black girls
No full textBlack women's issues and obstacles are more complex than most other races due to historical racism, sexism, and poverty (S. A. Thomas & González-Prendes, 2009). However, cultural expectations of strength in Black women fuel the myth of the strong Black woman that compels women to push for unrealistic levels of self-sacrifice, self-denial, and ensuing emotional distress (Beauboeuf-Lafontant, 2007). The combination of powerlessness and strength presents a problematic paradox for Black women. The purpose of this case study is to explore risk and protective factors within the lives of Black girls who attend a large urban high school and examine how those factors affect the development of resilience. Based on cultural, historical, and societal factors, Black adolescent girls living in an urban environment while attending high schools struggle with the development of resilience. A combination of risk factors (poverty and exposure to violence) and protective factors (self-efficacy, belief system, and support system) are considered when developing resilience. This research addressed the following research questions: (a) How do Black high school girls perceive themselves as resilient? and (b) According to Black high school girls, what are the perceived risk and protective factors that had an impact on the development of their resilience? Through the use of a survey, participants were asked questions regarding resilience in addition to the perceived risk and protective factors. Quantitative data were analyzed using descriptive analysis and Excel to determine significant factors pertaining to resilience. One-to-one interviews were used to gather deeper insight into the risk and protective factors that may influence the development of resilience. Qualitative data were coded using In Vivo and descriptive codes to identify patterns and themes. As a result of this study, the researcher now understands resilience as a social ecological construct. This ecological perspective suggests that, when providing a person with opportunities to realize his or her potential, interventions must involve those mandated to help, such as social workers, nurses, and educators, as well as those expected to provide support, namely the person's family, peers, and community.Ed.D., Educational Leadership and Management -- Drexel University, 201
Integration of Technology into Dance Performance and Its Effectiveness and Impact on Artistic Quality
No full textSociety and technological advancements are progressing at an accelerated pace and dance organizations follow that current through integration of technology into their creative endeavors. When dance companies are inspired to establish relationships with technology to heighten artistic concepts, they go through a creative process requiring distinctive, thought out approaches. This thesis explores how dance organizations effectively incorporate technology in their artistic undertakings and how that impacts the artistic quality of their dance productions. Through a review of literature and research into and interviews with dance companies who emphasize technology, this thesis examines historical and current uses of technology, processes while utilizing technological tools, potential restrictions and adjustments, and the overall influence of technology on those dance companies and their artistic productions. This research discovers that by employing technology into productions, dance companies heighten the senses for artists and audiences, transform the performance spaces and present all-encompassing art presentations. Dance companies must be fully dedicated to the process with which those presentations are formed, with proper reactions to inefficiencies and failures, and ultimately find confidence while utilizing the subject technologies. If dance organizations cannot accept the potential issues, whether it be a descent in artistic integrity or reworkings of concepts, they should not force technology into a piece if it will not heighten the artistic worth. Dance companies who do make this commitment typically employ technology professionals to contribute to these endeavors by collaborating through conceptual discussions, production estimates, and provide in-depth knowledge on how to instrument these ideas into feasible performances. To pursue creative innovation, dance companies enter processes with technology that can be precarious but are ultimately fascinating and rewarding.M.S., Arts Administration -- Drexel University, 201
A Qualitative Case Study: Exploring Parents' Support Needs When An Adolescent With Autism Spectrum Disorder Is Preparing To Transition To Adult Services
No full textAutism spectrum disorder (ASD) is pervasive developmental disorder that impacts an individual's ability to interact appropriately with others. Individuals with an ASD diagnosis struggle with communication impairments and challenging behaviors that cause them to be isolated from others and be reliant on others for daily care. Parents of individuals with a more severe ASD diagnosis assume the responsibilities of managing this life-long disorder. The purpose of this qualitative case study was to explore parents' support needs when an adolescent with a more severe ASD diagnosis is preparing to transition to adult services that provide supported employment and skill training programs. The study population was comprised of parents of adolescents with severe ASD and high school special education team members who work closely with adolescents with severe ASD. This study revealed that educators and policymakers need to create change in order to better support parents of adolescents with more severe ASD. It is necessary for high school special education teams to be sharing critical information with parents about workplace skills, independent living skills, and special education resources. With that information, parents can collaborate with educators to create realistic and stimulating future goals for their adolescents with severe ASD. This collaboration can be supported through the use of a transition team and a strong shift from academic learning to workplace learning.Ed.D., Educational Leadership and Management -- Drexel University, 201