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Description
In order to cope with the decreasing availability of symphony jobs and collegiate faculty positions, many musicians are starting to pursue less traditional career paths. Also, to combat declining audiences, musicians are exploring ways to cultivate new and enthusiastic listeners through relevant and engaging performances. Due to these challenges, many community-based chamber music ensembles have been formed throughout the United States. These groups not only focus on performing classical music, but serve the needs of their communities as well. The problem, however, is that many musicians have not learned the business skills necessary to create these career opportunities. In this document I discuss the steps ensembles must take to develop sustainable careers. I first analyze how groups build a strong foundation through getting to know their communities and creating core values. I then discuss branding and marketing so ensembles can develop a public image and learn how to publicize themselves. This is followed by an investigation of how ensembles make and organize their money. I then examine the ways groups ensure long-lasting relationships with their communities and within the ensemble. I end by presenting three case studies of professional ensembles to show how groups create and maintain successful careers. Ensembles must develop entrepreneurship skills in addition to cultivating their artistry. These business concepts are crucial to the longevity of chamber groups. Through interviews of successful ensemble members and my own personal experiences in the Tetra String Quartet, I provide a guide for musicians to use when creating a community-based ensemble.
ContributorsDalbey, Jenna (Author) / Landschoot, Thomas (Thesis advisor) / McLin, Katherine (Committee member) / Ryan, Russell (Committee member) / Solis, Theodore (Committee member) / Spring, Robert (Committee member) / Arizona State University (Publisher)
Created2013
Description
American Primitive is a composition written for wind ensemble with an instrumentation of flute, oboe, clarinet, bass clarinet, alto, tenor, and baritone saxophones, trumpet, horn, trombone, euphonium, tuba, piano, and percussion. The piece is approximately twelve minutes in duration and was written September - December 2013. American Primitive is absolute music (i.e. it does not follow a specific narrative) comprising blocks of distinct, contrasting gestures which bookend a central region of delicate textural layering and minimal gestural contrast. Though three gestures (a descending interval followed by a smaller ascending interval, a dynamic swell, and a chordal "chop") were consciously employed throughout, it is the first gesture of the three that creates a sense of unification and overall coherence to the work. Additionally, the work challenges listeners' expectations of traditional wind ensemble music by featuring the trumpet as a quasi-soloist whose material is predominately inspired by transcriptions of jazz solos. This jazz-inspired material is at times mimicked and further developed by the ensemble, also often in a soloistic manner while the trumpet maintains its role throughout. This interplay of dialogue between the "soloists" and the "ensemble" further skews listeners' conceptions of traditional wind ensemble music by featuring almost every instrument in the ensemble. Though the term "American Primitive" is usually associated with the "naïve art" movement, it bears no association to the music presented in this work. Instead, the term refers to the author's own compositional attitudes, education, and aesthetic interests.
ContributorsJandreau, Joshua (Composer) / Rockmaker, Jody D (Thesis advisor) / Rogers, Rodney I (Committee member) / Demars, James R (Committee member) / Arizona State University (Publisher)
Created2014
Description
The treatment of individuals with multiple chronic conditions represents the single largest driver of Medicare costs. The use of prescription drugs is a major component in the treatment/management of chronic disease in the United States. Medication nonadherence, however, is a common problem among older adults and leads to significant morbidity and mortality. Whereas, the problem of medication nonadherence has been a primary focus of research for the last thirty years, much is still unknown about which older adults are most at risk for medication nonadherence, as well as what are effective theory-based interventions to improve a person's medication self-management.
The purpose of this descriptive explanatory study was to better understand the self-management behavior, medication adherence, in a sample of frail urban older adults. The study used a combination of quantitative and qualitative methods to analyze data from a larger twelve-month study of a nurse care coordination intervention. Ryan and Sawin's (2009) Individual and Family Self-Management Theory served as the study's conceptual framework for identifying the context and processes involved in the older adults' medication self-management. Quantitative results found several individual- as well as family-level predictors for medication nonadherence. Qualitative analyses identified three overarching themes to describe the participants' struggles along the multistep process of medication adherence. Additionally, a cultural domain described the need for more information from participants to understand their nonadherence. Integration of the results further increased our understanding of medication-self management in these frail older adults, and offers direction for clinical practice and future research.
The purpose of this descriptive explanatory study was to better understand the self-management behavior, medication adherence, in a sample of frail urban older adults. The study used a combination of quantitative and qualitative methods to analyze data from a larger twelve-month study of a nurse care coordination intervention. Ryan and Sawin's (2009) Individual and Family Self-Management Theory served as the study's conceptual framework for identifying the context and processes involved in the older adults' medication self-management. Quantitative results found several individual- as well as family-level predictors for medication nonadherence. Qualitative analyses identified three overarching themes to describe the participants' struggles along the multistep process of medication adherence. Additionally, a cultural domain described the need for more information from participants to understand their nonadherence. Integration of the results further increased our understanding of medication-self management in these frail older adults, and offers direction for clinical practice and future research.
ContributorsO'Brien, Anne Marie (Author) / Marek, Karen D. (Thesis advisor) / Coon, David W. (Committee member) / Evans, Bronwynne C. (Committee member) / Arizona State University (Publisher)
Created2014
Description
This project is a practical annotated bibliography of original works for oboe trio with the specific instrumentation of two oboes and English horn. Presenting descriptions of 116 readily available oboe trios, this project is intended to promote awareness, accessibility, and performance of compositions within this genre.
The annotated bibliography focuses exclusively on original, published works for two oboes and English horn. Unpublished works, arrangements, works that are out of print and not available through interlibrary loan, or works that feature slightly altered instrumentation are not included.
Entries in this annotated bibliography are listed alphabetically by the last name of the composer. Each entry includes the dates of the composer and a brief biography, followed by the title of the work, composition date, commission, and dedication of the piece. Also included are the names of publishers, the length of the entire piece in minutes and seconds, and an incipit of the first one to eight measures for each movement of the work.
In addition to providing a comprehensive and detailed bibliography of oboe trios, this document traces the history of the oboe trio and includes biographical sketches of each composer cited, allowing readers to place the genre of oboe trios and each individual composition into its historical context. Four appendices at the end include a list of trios arranged alphabetically by composer's last name, chronologically by the date of composition, and by country of origin and a list of publications of Ludwig van Beethoven's oboe trios from the 1940s and earlier.
The annotated bibliography focuses exclusively on original, published works for two oboes and English horn. Unpublished works, arrangements, works that are out of print and not available through interlibrary loan, or works that feature slightly altered instrumentation are not included.
Entries in this annotated bibliography are listed alphabetically by the last name of the composer. Each entry includes the dates of the composer and a brief biography, followed by the title of the work, composition date, commission, and dedication of the piece. Also included are the names of publishers, the length of the entire piece in minutes and seconds, and an incipit of the first one to eight measures for each movement of the work.
In addition to providing a comprehensive and detailed bibliography of oboe trios, this document traces the history of the oboe trio and includes biographical sketches of each composer cited, allowing readers to place the genre of oboe trios and each individual composition into its historical context. Four appendices at the end include a list of trios arranged alphabetically by composer's last name, chronologically by the date of composition, and by country of origin and a list of publications of Ludwig van Beethoven's oboe trios from the 1940s and earlier.
ContributorsSassaman, Melissa Ann (Author) / Schuring, Martin (Thesis advisor) / Buck, Elizabeth (Committee member) / Holbrook, Amy (Committee member) / Hill, Gary (Committee member) / Arizona State University (Publisher)
Created2014
Description
A core principle in multiple national quality improvement strategies is the engagement of chronically ill patients in the creation and execution of their treatment plans. Numerous initiatives are underway to use health information technology (HIT) to support patient engagement however the use of HIT and other factors such as health literacy may be significant barriers to engagement for older adults. This qualitative descriptive study sought to explore the ways that older adults with multi-morbidities engaged with their plan of care. Forty participants were recruited through multiple case sampling from two ambulatory cardiology practices. Participants were English-speaking, without a dementia-related diagnosis, and between the ages of 65 and 86. The older adults in this study performed many behaviors to engage in the plan of care, including acting in ways to support health, managing health-related information, attending routine visits with their doctors, and participating in treatment planning. A subset of patients engaged in active decision-making because of the point they were at in their chronic disease. At that cross roads, they expressed uncertainly over which road to travel. Two factors influenced the engagement of older adults: a relationship with the provider that met the patient's needs, and the distribution of a Meaningful Use clinical summary at the conclusion of the provider visit. Participants described the ways in which the clinical summary helped and hindered their understanding of the care plan.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
ContributorsJiggins Colorafi, Karen (Author) / Lamb, Gerri (Thesis advisor) / Marek, Karen (Committee member) / Greenes, Robert (Committee member) / Evans, Bronwynne (Committee member) / Arizona State University (Publisher)
Created2015
Description
The population of older adults and the percentage of people living in urban areas are both increasing in the U.S. Finding ways to enhance city-dwelling, older adults' social integration, cognitive vitality, and connectedness to nature were conceptualized as critical pathways to maximizing their subjective well-being (SWB) and overall health. Past research has found that gardening is associated with increased social contact and reduced risk of dementia, and that higher levels of social support, cognitive functioning, mindfulness, and connectedness to nature are positively related to various aspects of SWB. The present study was a pilot study to examine the feasibility of conducting a randomized, controlled trial of community gardening and to provide an initial assessment of a new intervention--"Mindful Community Gardening," or mindfulness training in the context of gardening. In addition, this study examined whether community gardening, with or without mindfulness training, enhanced SWB among older adults and increased social support, attention and mindfulness, and connectedness to nature. Fifty community-dwelling adults between the ages of 55 and 79 were randomly assigned to one of three groups: Traditional Community Gardening (TCG), Mindful Community Gardening (MCG), or Wait-List Control. The TCG and MCG arms each consisted of two groups of 7 to 10 participants meeting weekly for nine weeks. TCG involved typical gardening activities undertaken collaboratively. MCG involved the same, but with the addition of guided development of non-judgmental, present-focused awareness. There was a statistically significant increase in different aspects of mindfulness for the TCG and the MCG arms. The interventions did not measurably impact social support, attention, or connectedness to nature in this small, high functioning, pilot sample. Qualitative analysis of interview data from 12 participants in the TCG and MCG groups revealed that both groups helped some participants to better cope with adversity. It was concluded that it is feasible to conduct randomized, controlled trials of community gardening with urban older adults, and considerations for implementing such interventions are delineated.
ContributorsOkvat, Heather Audrey (Author) / Zautra, Alex J. (Thesis advisor) / Davis, Mary C. (Committee member) / Knopf, Richard C. (Committee member) / Okun, Morris A. (Committee member) / Arizona State University (Publisher)
Created2011
Description
Identifying modifiable causes of chronic disease is essential to prepare for the needs of an aging population. Cognitive decline is a precursor to the development of Alzheimer's and other dementing diseases, representing some of the most prevalent and least understood sources of morbidity and mortality associated with aging. To contribute to the literature on cognitive aging, this work focuses on the role of vascular and physical health in the development of cognitive trajectories while accounting for the socioeconomic context where health disparities are developed. The Assets and Health Dynamics among the Oldest-Old study provided a nationally-representative sample of non-institutionalized adults age 65 and over in 1998, with biennial follow-up continuing until 2008. Latent growth models with adjustment for non-random missing data were used to assess vascular, physical, and social predictors of cognitive change. A core aim of this project was examining socioeconomic and racial/ethnic variation in vascular predictors of cognitive trajectories. Results indicated that diabetes and heart problems were directly related to an increased rate of memory decline in whites, where these risk factors were only associated with baseline word-recall for blacks when conditioned on gender and household assets. These results support the vascular hypotheses of cognitive aging and attest to the significance of socioeconomic and racial/ethnic variation in vascular influences on cognitive health. The second substantive portion of this dissertation used parallel process latent growth models to examine the co-development of cognitive and functional health. Initial word-recall scores were consistently associated with later functional limitations, but baseline functional limitations were not consistently associated with later word-recall scores. Gender and household income moderated this relationship, and indicators of lifecourse SES were better equipped to explain variation in initial cognitive and functional status than change in these measures over time. Overall, this work suggests that research examining associations between cognitive decline, chronic disease, and disability must account for the social context where individuals and their health develop. Also, these findings advocate that reducing socioeconomic and racial/ethnic disparities in cognitive health among the aging requires interventions early in the lifecourse, as disparities in cognitive trajectories were solidified prior to late old age.
ContributorsBishop, Nicholas Joseph (Author) / Kronenfeld, Jennie J. (Thesis advisor) / Haas, Steven A. (Committee member) / Eggum, Natalie D. (Committee member) / Arizona State University (Publisher)
Created2011
Description
ABSTRACT Despite significant advancements in drug therapy, cardiovascular disease (CVD) is still the leading cause of death in the United States. Given this, research has begun to seek out alternative approaches to reduce CVD risk. One of these alternative approaches is Vitamin D supplementation. Current research has shown a link between Vitamin D status and CVD risk in both healthy and diseased populations. Among the possible mechanisms is a positive effect of Vitamin D on vascular endothelial function, which can be measured with noninvasive techniques such as flow-mediated dilation (FMD) of conduit vessels using high-resolution ultrasound. This dissertation is comprised of two studies. The first examines whether Vitamin D supplementation can improve FMD in older adults within a time period (two weeks) associated with peak increases in plasma Vitamin D concentrations after a single-dose supplementation. The second examines the effect of Vitamin D supplementation in people with Rheumatoid Arthritis (RA). The reason for looking at an RA population is that CVD is the leading cause of early mortality in people with RA. In the first study 29 Post-Menopausal Women received either 100,000 IU of Vitamin D3 or a Placebo. Their FMD was measured at baseline and 2 weeks after supplementation. After 2 weeks there was a significant increase in FMD in the Vitamin D group (6.19 + 4.87 % to 10.69 + 5.18 %) as compared to the Placebo group (p=.03). In the second study, 11 older adults with RA were given 100,000 IU of Vitamin D or a Placebo. At baseline and one month later their FMD was examined as well as plasma concentrations of Vitamin D and tumor necrosis factor-alpha; (TNF-alpha;). They also filled out a Quality of Life Questionnaire and underwent a submaximal exercise test on the treadmill for estimation of maximum oxygen uptake (VO2max). There was no significant change in FMD in Vitamin D group as compared to the Placebo group (p=.721). Additionally, there was no significant improvement in either plasma Vitamin D or TNF-alpha; in the Vitamin D group. There was however a significant improvement in predicted VO2max from the submaximal exercise test in the group receiving Vitamin D (p=.003). The results of these studies suggest that a single 100,000 IU dose of Vitamin D can enhance FMD within two week in older adults, but that a similar dose may not be sufficient to increase FMD or plasma Vitamin D levels in older adults with RA. A more aggressive supplementation regimen may be required in this patient population.
ContributorsRyan, Dana Meredith (Author) / Gaesser, Glenn A (Thesis advisor) / Rizzo, Warren (Committee member) / Martin, Keith (Committee member) / Larkey, Linda (Committee member) / Chisum, Jack (Committee member) / Arizona State University (Publisher)
Created2012
Enhancing motivation for physical activity to reduce fall risk among community dwelling older adults
Description
Unintentional falls among community dwelling older adults are a common, serious and potentially preventable public health problem. In the United States, the annual incidence of fall related injuries per 100,000 persons was 4,616 in 2001, rising to 5,252 in 2008. The annual incidence of fall related deaths per 100,000 persons was 29.3 in 2000, rising to 41.86 in 2006. Older adults are particularly vulnerable to falls as they age. Potential consequences include fractures, emergency room, hospital and nursing home admissions, dependence, confusion, immobilization, depression, and death. Significant modifiable fall risk factors include muscle weakness, gait problems, and balance problems. While researchers have demonstrated the positive effects of balance and leg-strengthening physical activities, the majority of older adults do not engage in them, and the rate of falls continues to increase. Older adults participate in regular physical activity and fitness activities less often than younger populations; disparities are greater among those who are poor and living in rural communities. While knowledge about causes, risk factors, and efficacious physical activity to prevent falls has grown exponentially in the last several decades, bridging the gap between research and practice continues to be a challenge. As a strategy to address the gap between research and practice, this feasibility study utilized a tested theory, the wellness motivation theory, to address motivation for behavioral change in combination with instruction for physical activities proven to reduce fall risk. The study sample included rural, community dwelling older adults at risk of falls. The study included an innovative mobile computer to measure physical activity behavior and to augment motivational content of the intervention. Specific aims of this feasibility study were to: (a) examine the acceptability, demand, and implementation of the wellness motivation intervention (WMI) as well as the technology augmenting the WMI; and (b) evaluate the efficacy of the WMI to influence awareness of social contextual resources, behavioral change processes, physical activity, and fall risk. The WMI delivered in combination with proven multicomponent balance and strength activities was feasible and effectively increased motivation for behavioral change (social support from friends, awareness of social contextual resources, behavioral change processes) and physical activity behavior, and decreased fall risk among rural, community-dwelling older adults at risk of falls in this study. This study is the first step in a program of research focusing on enhancing motivation for physical activity that reduces falls and frailty among older adults.
ContributorsMcMahon, Siobhan (Author) / Fleury, Julie (Thesis advisor) / Belyea, Michael (Committee member) / Shearer, Nelma (Committee member) / Wyman, Jean (Committee member) / Hekler, Eric (Committee member) / Arizona State University (Publisher)
Created2012
Description
Background: Heart failure is the leading cause of hospitalization in older adults and has the highest 30-day readmission rate of all diagnoses. An estimated 30 to 60 percent of older adults lose some degree of physical function in the course of an acute hospital stay. Few studies have addressed the role of posture and mobility in contributing to, or improving, physical function in older hospitalized adults. No study to date that we are aware of has addressed this in the older heart failure population.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
ContributorsFloegel, Theresa A (Author) / Buman, Matthew P (Thesis advisor) / Hooker, Steven (Committee member) / Dickinson, Jared (Committee member) / DerAnanian, Cheryl (Committee member) / McCarthy, Marianne (Committee member) / Arizona State University (Publisher)
Created2015