Financial capacity and neuropsychological performance in acquired brain injury (ABI)

Difficulty with financial capacity (i.e., difficulty with efficiently managing one's finances), a common consequence in individuals with moderate to severe brain injury, has been found to affect self-autonomy and limit the individual from fully integrating into the community. Previous studies have found that individuals with brain injury have impaired financial capacity six months post-injury. However, the nature of financial capacity with post-injury periods extending to more than a year has not been studied. Moreover, there is mixed evidence regarding the nature and extent to which different cognitive abilities contribute to financial capacity. Therefore, the current study had three specific aims: (1) To compare the nature of financial capacity in individuals with chronic, moderate to severe acquired brain injury (ABI) with demographically matched controls. (2) To examine the contributions of various cognitive abilities (attention, working memory, executive functions, impulsivity) to financial capacity in the ABI group. (3) To investigate the association between the self-report and informant-report report of financial capacity, in the ABI group. A total of 25 participants with chronic, moderate to severe ABI were recruited from a day-treatment program, and 9 age and education matched-healthy control participants were recruited from the community. All participants were administered a comprehensive battery of neuropsychological tests to measure cognitive abilities and the Financial Competence Assessment Inventory (FCAI) to assess financial capacity. In addition, 22 informants were interviewed using the Third Party Perspective FCAI. Results indicated that the control group outperformed the ABI group on the overall and the different dimensions of financial capacity. In the ABI group, specific cognitive abilities, including attention, working memory, delayed verbal memory, abstract reasoning and impulsivity contributed to different dimensions of financial capacity. However, no associations were found between ABI- and informant-reports of financial capacity suggesting the confounding presence of a combination of cognitive impairments and biases. These findings shed light on the compromised nature of financial management in ABI individuals years after a brain injury, and underscore the importance of focusing on continued monitoring and rehabilitation of this crucial functional ability.Ph.D., Psychology -- Drexel University, 201

Gentrification and the decline of African American arts and culture in Washington, D.C.

The purpose of this this thesis is to investigate and examine the effects of gentrification on the African American arts and culture scene in the city of Washington, D.C. This study seeks to prove that the effects of gentrification contributed heavily to the displacement of the city’s Black population, while simultaneously contributing to the decline of African-American arts and culture in the city, and disturbing the lives and careers of the African-American artists who call Washington, D.C. home. The study discusses gentrification in the general sense, and moves on to discuss gentrification in the city of Washington, D.C. specifically. The thesis covers the various ways in which gentrification has contributed to the removal and attempted eradication of various examples of African American arts and culture in the city, primarily in its visual arts and music sectors, while questioning the authenticity of other attempts to preserve culture that, in many ways, seems appropriated. The thesis also discusses the notion that there are fewer available resources and funding opportunities for artists of color in Washington, D.C., while examining recent demographic changes in the city, primarily in areas that once held a Black majority that are now populated heavily by White residents. The thesis concludes with the idea that gentrification does, in many ways, contribute to the decline of African American culture in the city. A way to combat gentrification is to recognize and include the already established community as part of the revitalization process to ensure that the community does not feel deprived.M.S., Arts Administration -- Drexel University, 201

The Continuum of Premenstrual Symptom Exacerbation in Women With and Without Psychiatric Comorbidities: A Nurses' Health Study

Background: It is widely known that menstrual cycle fluctuations can significantly affect a woman's mood, behavior and quality of life over the course of her reproductive years, largely due to reproductive hormonal variations during the course of the menstrual cycle. In fact, women are twice as likely as men to experience a mood disorder. Approximately 85% percent of women experience some form of premenstrual symptom exacerbation (PME) and the majority experience symptoms, which are severe enough to interfere with their daily activities. Little is known, however, about the differences in symptom severity, stress, quality of life, healthy lifestyle and wellness self-perception among women who experience PME with and without psychiatric comorbidities. In addition, little is known about how psychiatric comorbidities affect severity of PME, stress, quality of life, healthy lifestyle and wellness self-perception. Methods: This study was conducted using a comparative descriptive design to compare premenstrual symptoms, stress, quality of life, healthy lifestyle and wellness self-perception among women experiencing PME and psychiatric comorbidities to women who experience PME without psychiatric comorbidities. Women with PME were recruited from various nursing organizations using secure online surveys. After collection of socio-demographic information, premenstrual symptom severity was measured with the Premenstrual Symptoms Screening Tool (PSST), stress with the Perceived Stress Scale (PSS), quality of life with the Quality of Life Scale (QOLS) and healthy lifestyle and wellness self-perception were assessed using the Healthy Lifestyle Questionnaire (HLQ) & Wellness Self-Perception Scale (WSPS). Data Analysis: The data was cleaned, coded and assessed for outliers and shape of distribution prior to data analysis. Analysis included descriptive statistics to describe key characteristics of the sample, and inferential statistics to test the hypotheses. Results: After controlling for diet, exercise, sleep and caffeine intake, psychiatric comorbidities predicted greater PME symptom severity (β=0.22; T=2.45; P=0.02), higher perceived stress (β=0.25; T=2.61; P=0.01), and lower levels of wellness self-perception (β= -0.30; T= -3.14; P=0.00). Psychiatric comorbidities did not predict quality of life (β= -0.13; T= -1.28; P=0.20) or healthy lifestyle (β= -0.13; T= -1.43; P=0.16). Significance: These findings may inform novel pharmacologic and non-pharmacologic interventions and treatment guidelines to achieve optimal symptom management, reduce stress and improve wellness self-perception among women with PME and psychiatric comorbidities.Dr.N.P., Nursing Practice -- Drexel University, 201

Assessing the Role of Sleep, Grief, Anxiety, and Depression in a Miscarriage Population

Miscarriage occurs at a relatively high rate in women who become pregnant with bereavement, anxiety, and depression as commonly experienced consequences of miscarriage. All of these consequences are connected to sleep disturbance, which to date has been neglected within the field of miscarriage research. Sleep is an important facet of miscarriage to evaluate because it is a modifiable behavior that may be a key component to include in follow-up care. We hypothesized that sleep disturbance would coincide with bereavement, anxiety, and depression not only among women who miscarried, but also among the partners of women who miscarried. It was proposed that sleep disturbance, in general, and insomnia, in specific, would be significantly associated with bereavement, anxiety, and depression. Furthermore, bereavement would account for sleep disturbance while controlling for depression. Eighty-eight women and 67 male partners who have experienced a miscarriage within the last year completed surveys on sleep and mood. Findings showed that both women who miscarried and partners of women who have miscarried experienced elevated sleep disturbance, bereavement, anxiety, and insomnia. Both sleep disturbance and insomnia were found to be associated with anxiety and depression. Women reported significantly more mood and sleep disturbance than partners, with the exception of depression and bereavement. Sleep disturbance was associated with female bereavement levels but not partner levels; insomnia was not related to either female or partner bereavement levels. Bereavement did not significantly predict sleep quality after controlling for depression. Future studies should seek to further clarify the relationships among bereavement and sleep by attempting to provide sleep therapy post miscarriage to see if bereavement is significantly improved against a control group who receives treatment as usual. Using a prospective longitudinal design to follow participants throughout their bereavement process would better assist in understanding for whom, under what context, and during which specific time periods bereavement and sleep are most exacerbated, leading to when treatment may be most helpful.M.S., Psychology -- Drexel University, 201

Role of art in the global climate change movement

The findings presented in this publication suggest that artists and arts administrators have significant roles to play when using the arts to address climate change. Responses from three artists and four scientists during in-depth one-on-one qualitative interviews indicate that the role of art in the global climate change movement is to deepen personal engagement with climate change issues by providing new platforms for deeper reflection and discourse—with or without the intent to catalyze activism. Artists do not need to maintain strict fidelity to climate change data, although there may be an inverse correlation between manipulating climate data and validation of the work to accurately comment on climate change. The contemporary climate change movement requires the integration of artists to respond to the challenges of climate change not merely as buffers between the public and the hard data but to incite a richer and more complex conversation through the cumulative impact of all art that addresses climate change.M.S., Arts Administration -- Drexel University, 201

What are the unique obstacles Black theater experiences in the 21st century and how can they can create a symbiotic relationship with their communities for the potential sustainability of both?

The question set forth in this thesis is, “What are the unique obstacles Black theater experiences in the 21st century and how can they can create a symbiotic relationship with their communities for the potential sustainability of both?” Its purpose is to investigate the root challenges Black theater experiences in achieving sustainability in America, to discern how much American racial turmoil has affected the Black community and therefore Black theater, and to identify methods by which Black theater can reverse engineer a path to a symbiotic relationship with their communities in order to consistently achieve the sustainability of both. This thesis found that Black theaters in America are far less represented than their Eurocentric counterparts. Black theaters memberships within theater industry trade organizations (i.e., League of Resident Theaters and Theater Communications Group) are not reflective of the number of Black theaters operating in America. Black theaters represent approximately 13% of theater community, but less than 2% have memberships in industry groups. Black theaters are also disproportionally less visible than their Eurocentric counterparts. In this era of almost immediate digital access, accessing the existence of or information on theaters for and by the African American Diaspora is nominal at best. The national databases researched for this thesis; League of Resident Theatres, Theater Communications Group, Actors Equity and others, do not either have Black theaters listed within them, or do not signify the existence a theater as a Black theater. Nor is there any empirical data specifically on why this disparity exists in the theater community. However, this thesis found a correlation between the success or failure of the Black communities compared to the success or failure of Eurocentric communities and the success or failure of Black theaters compared to Eurocentric theaters. This disparity of representation of Black theater is a reflection of racial inequality in American culture. When identifying challenges in the Black community I found that systemic racism leads to economic inequality (African American household income in America consistently less than Eurocentric household incomes Figure 6 Figure 7, which ultimately leads to failing communities Figure 4. This same paradigm occurs in Black theater yet manifests slightly differently: Systemic racism leads to economic inequality (individual donor priorities shift to need base reasoning, audience participation from the community dissipates from, in part, lack of funding) which leads to failing communities (Black theaters struggle to earn income through ticket sales and/or programming as their primary constituent suffers). This thesis recommends that Black theaters return to community engagement rather than audience engagement. Engaging into the community, being an integral part of the the functionality of the community, not only can Black theater be able to develop a stable business model but in turn be a catalyst for the sustainability within the community. Recommendations include: (1) Changing the narrative to achieving stability versus success, (1a) Contributed income, mission and vision, and achieving a healthy longevity are how Black theaters can achieve sustainability, (1b) Black theater needs to be mobile, innovative, inclusive and civic minded in order to survive in today’s techno-distracted society, (2) Choose “Community Engagement”. The act of taking a group of people from the same place, purpose, goals or interests, and presenting material that reflects that place, purposes, goals or interests to maintain their attention and interest for a certain amount of time, (3) Civic Engagement using the resources readily available within the arts community designed specifically for the communities Black theater serves, ( i.e. creative placemaking) to further strengthen the organization and in turn the community it serves.M.S., Arts Administration -- Drexel University, 201

A Preliminary Investigation of a Personalized Risk Alert System for Weight Control Lapses

Failures to adhere to dietary recommendations in a weight loss program have been attributed to the notion that short-term violations of behavioral “rules” (e.g., dietary lapses) can often precipitate a return to prior behavior patterns. Existing studies suggest that lapses are caused by a select group of internal and external cues, indicating that they may be predictable. Just-in-time adaptive interventions (JITAI) can utilize mathematical models to learn the way in which triggers predict lapse behavior, and then communicate this knowledge to the individual in the form of momentary alerts to risk. The primary aim of the current study was to develop an initial machine learning model (accuracy > 70%, sensitivity > 70%, and specificity > 50%) capable of predicting lapse behavior in a sample of overweight and obese participants following a standardized weight control diet. Users (n = 12, MBMI = 33.6) were prompted to report on lapses and relevant triggers six quasi-random times per day via personal smartphone for six weeks. Participants reported an average of 3.47 lapses per week (SD = 2.41) and completed an average of 94.64% of prompts. This data was used to build a classification model (using C4.5 WEKA decision trees) to predict dietary lapses. The final model accuracy (.72) met our standards for success while maintaining good sensitivity (.70) and specificity (.72). Significance testing revealed this model predicted lapses better than random chance (p < .01). Further analyses related to data collection procedures, variable selection, and individual-level models are presented below. Results from this project indicate that machine learning holds promise for the real-time prediction of dietary lapse, and the algorithm from this project will be utilized in a JITAI application framework to predict and prevent lapses.M.S., Psychology -- Drexel University, 201

Music Therapy as a Treatment for Children with Autistic Spectrum Disorder

Autism Spectrum Disorder (ASD) is an increasingly prevalent disorder affecting many children in the world today. The impact of autism on a child and their family is significant. This disorder is life changing and its early detection, diagnosis, and treatment is essential for the growth and development of a child affected by ASD. There are several traditional therapies associated with the treatment of ASD in children that include: speech, occupational, applied behavior analysis therapy. Music therapy is not included in the core list of therapies, but is a viable and effective tool to reinforce the concepts taught in the traditional therapy treatments. The purpose of these therapies, including music therapy, is to improve social behaviors, increase focus and attention, increases communication attempts (vocalizations, verbalizations, gestures, and vocabulary), reduce anxiety, and improve body awareness and coordination. Through my findings during this thesis process I have found that music therapy is a viable and effective treatment for autistic children.M.S., Arts Administration -- Drexel University, 201

Shoulder Complex Motion and Coordination Impairments, and the Associated Clinical Factors in Women with a History of Breast Cancer Treatment

Common medical management for breast cancer (BC) most often includes lumpectomy and radiation (LR) or mastectomy and reconstruction (MR). Due to these procedures involving the shoulder, it is not surprising that some women experience shoulder complex motion and coordination problems. However, the long-term effect that BC treatments have on shoulder complex motion and coordination during functional tasks is not well understood. The rationale for impaired shoulder complex motion and coordination among women with BC is that these women frequently experience impairments that are believed to contribute to these problems including soft tissue pain, decreased shoulder complex muscle strength, decreased tissue flexibility, altered resting scapular alignment (RSA), and lymphedema. However, limited research exists to support this notion. Therefore, the aims of this dissertation were 1) determine the effect that breast cancer treatments (LR and MR) have on shoulder complex motion and coordination, 2) identify clinical factors associated with impaired shoulder complex coordination in women with a history of breast cancer treatment. Scapular and humeral kinematic data and clinical measures of pain, RSA, tissue flexibility, strength and lymphedema were collected on 30 women with BC (mean age ± SD = 53.8 ± 10.9 yrs.) and 30 women without BC (mean age ± SD = 52.7 ± 10.8 yrs.). Separate one-way multivariate analysis of variance (MANOVA) were conducted to determine whether differences in shoulder complex motion existed between groups (p < .05). Angle-angle and relative motion graphs were created for 3 scapular and 2 clavicular rotations. Mean curves with 95% minimal detectable change bands (MDCB) were calculated using data from women without BC. Each woman with BC’s curve was individually compared to the mean curve and MDCB. Women with BC were classified as having normal (curve fell within MDCB) or impaired shoulder complex coordination (curve fell outside MDCB). Discriminant analyses were used to identify clinical variables that could classify women as having normal or impaired shoulder complex coordination (p < .05). There were no significant differences in shoulder complex motion between women with and without BC or between those with different medical management (LR, MR). Over 93% of women with BC demonstrated impaired shoulder complex coordination for at least 1 scapular or clavicular rotation. Discriminant analysis revealed that clinical measures of pain, RSA, tissue flexibility, strength, and lymphedema were associated with impaired shoulder complex coordination. Cross-validated classification showed that 43.4% to 73.3% of women were grouped correctly. Failure to find group differences in motion may be due to the fact that women in our study were relatively high functioning and recovered from their medical management. Additionally, the majority of women in our study were previously educated on a home exercise program (73.3%) and attended physical therapy (56.7%). A lack of significant differences in shoulder complex motion between women with and without a BC suggests that the women in our study had sufficient range of motion to accomplish the functional tasks. Although we did not find differences in motion between women with and without BC across functional tasks, the majority women with BC demonstrated impaired shoulder complex coordination. Clinical measures of tissue flexibility (ROM and pectoralis minor length) were associated with impaired shoulder complex coordination across multiple scapular and clavicular rotations.Ph.D., Rehabilitation Sciences -- Drexel University, 201

Attachment, Problem Solving, and Their Role in Relationship Conflicts for Female Perpetrators

Intimate partner violence(IPV) has been associated with both physical and psychological trauma in both men and women. Women appear particularly vulnerable to these negative effects, whether they are the victims of IPV or the assailants. However, existing interventions to reduce IPV have been tested primarily in men, and appear to be less effective for women perpetrators. Two potential intervention targets for IPV that may be particularly salient for women are problem solving strategies and relationship attachment. Ineffective social problem solving and insecure attachment have been found to be significantly correlated with each other, and have each been associated with an increased likelihood of IPV. The present study examines the relationships among social problem solving, attachment style, and IPV perpetration in a sample of female undergraduate students. It is hypothesized that social problem solving will mediate the relationship between a person's attachment style and severity of IPV in a romantic relationship. 126 female Drexel undergraduate student volunteers age 18-25 were administered three questionnaires measuring social problem solving (the Social Problem Solving Inventory- Revised), IPV (the Conflict Tactics Scale 2), and attachment (the Experiences in Close Relationships-Revised). The questionnaires were completed on Drexel's SONA system. A bootstrap confidence interval from SPSS's PROCESS regression analysis, showed that social problem solving partially mediated the relationship between attachment anxiety and IPV but not attachment avoidance.M.S., Psychology -- Drexel University, 201