Masters of Science in Kinesiology and Health, Miami University, 2020, Kinesiology, Nutrition, and Health

Head Start health and nutrition managers have identified obesity as the top health concern for their preschoolers. Little information exists related to perceived training needs and professional development training opportunities available for HS managers around obesity and related measurements. The purpose of this study is to examine perceptions of obesity-specific professional development training needs and opportunities reported by Ohio Head Start Health and Nutrition program managers. Phenomenology was utilized for this research study. Semi-structured in-depth telephone interviews (n=13) were conducted. Interviews were audio-recorded and transcribed. Open coding of transcripts was conducted by trained qualitative researchers. Significant statements were coded, defined, and organized into themes. Researchers identified five themes. Themes included attending professional health conferences; online food and nutrition-focused training through state and national resources; health-related training through Head Start; and networking as informal education from internal staff. Participants identified a lack of knowledge and training specific to the understanding of BMI, BMI-for-age growth charts, and skills around BMI measurement. There are a number of general health-related trainings from a variety of sources but there is a need for training to improve knowledge and skills specific to BMI and its measurement in preschoolers and the interpretation of BMI for-age growth charts.

Committee: Beth Miller PhD, RD, LD (Advisor); Paul Branscum PhD, RD, FAAHB (Committee Chair); Karly Geller PhD (Committee Chair) Subjects: Health; Nutrition; Preschool Education; Public Health

Doctor of Philosophy, The Ohio State University, 2009, Nursing

Child obesity among school age children is epidemic in the United States (U.S.). A critical review of literature was completed that concluded that Body Mass Index (BMI) screening for early identification and growth surveillance is needed for successful school-based obesity prevention intervention programs. This study used total survey design methods to identify the BMI screening practices of school nurses (SNs) and to identify the facilitating factors and barriers to BMI screening in public elementary schools among school age populations. Focus groups were used to identify current BMI screening practice in terms of facilitating factors and barriers. Survey methods were used to determine the validity of the barriers and facilitating factors identified in the focus groups. An adapted version of the Health People 2010 Determinants of Health Model guided this research.Results from 3 focus groups with SNs (N=25) working in public elementary schools indicated that SN BMI screening practice was conditional to policy, school social and physical environments, risk/protection, and access to quality health care. Themes related to geographic area emerged. All SNs described teachers as the most important facilitating factor. Suburban SNs identified that gym teachers were especially important to their BMI screening process. Urban SNs collectively agreed that trained personnel such as aides would be very helpful for data collection and BMI conversion. Rural SNs were also interested in collaborative work but focused on assisting one another as opposed to hiring assistance. Primary barriers voiced by SNs included lack of privacy, time, and policy. School size and amount of space the SNs had to assess a child were barriers, but for rural SNs this assumed there was a specific area designated as a clinic. For suburban SNs, having space to obtain BMIs located near a gym class was important. Urban SNs focused their concerns primarily on school organization and the logistic of obtaining (open full item for complete abstract)

Committee: Barbara Polivka PhD (Advisor); Rosemary Chaudry PhD (Committee Member); Mary Margaret Gottesman PhD (Committee Member) Subjects: Nursing

Master of Science, The Ohio State University, 2023, Human Ecology: Human Development and Family Science

Objective: This study explored adolescents' mental health and relationship with parents pre-bariatric surgery. Background: Bariatric surgery has been established as the most successful and cost-effective treatment for adult patients with severe obesity. Currently, there is little research around adolescent bariatric surgery and mental health (depression, anxiety, etc.), especially with racial/ethnic minority adolescents. Method: Adolescents' responses to specific items on the BDI-II (sadness, suicidal thoughts, feelings of worthlessness, and changes in appetite) and BASC-3 (anxiety, depression, and self-esteem) were analyzed for associations with their body mass index (BMI) and with parental responses to the BASC-3 for adolescents' interpersonal skills and relationship with parent. Demographic differences on the BDI-II and BASC-3 were also noted. These patients range from ages 12-21 and underwent bariatric surgery from June 2020 to November 2022. Pearson's correlations, independent t-tests, and ANOVA were used. Results: The results of the study reported that parents who had higher t-scores for relationship with their adolescents had adolescents who had lower depression t-scores, lower anxiety t-scores, and higher self-esteem t-scores. Parents who had higher t-scores for their adolescents interpersonal relations had adolescents who had lower depression t-scores, lower anxiety t-scores, and higher self-esteem t-scores. White adolescents had higher depression t-scores than Black and Hispanic adolescents. Black and Hispanic adolescent had higher self-esteem t-scores compared to White adolescents. Conclusions: This study focuses on adolescents' reports of their preoperative depression, anxiety, and self-esteem in association with their presenting BMI. Further research is warranted to assess the longitudinal outcomes of adolescent's mental health and BMI, particularly those of minority populations.

Committee: Ashley Hicks (Committee Member); Keeley Pratt (Advisor) Subjects: Health Sciences; Mental Health; Minority and Ethnic Groups; Therapy

Master of Sciences, Case Western Reserve University, 2022, Biomedical Engineering

Intracortical brain-computer interfaces (iBCIs) have the potential for restoring hand grasping to individuals with chronic tetraplegia by recording neural activity from the grasping network and translating it into motion through an external mechanism, such as a robotic limb or reanimating muscle in a paralyzed arm through functional electrical stimulation. Although human-operated iBCIs have successfully implemented grasping, they do not include any sensory information critical for control feedback and environments with poor visibility. The development of iBCIs utilizing somatosensory signals contained within the grasping network allows for technical and faster error checking in fast pace grasping. Here, we investigated how neural activity in the grasping network (inferior frontal gyrus (IFG)) modulates to somatosensory stimulation in a person with chronic tetraplegia without grasping instructions. This study provides insight into how somatotopic signals are represented in the grasping network and a potential mechanism utilized by IFG to control somatosensory inputs.

Committee: Abidemi Ajiboye PhD (Committee Chair); Kenneth Gustafson PhD (Committee Member); Dawn Taylor PhD (Committee Member) Subjects: Biomedical Engineering; Biomedical Research; Neurosciences

Doctor of Philosophy, The Ohio State University, 2021, Psychology

Pain is widely prevalent across the world, and individuals with excess weight are disproportionally affected by it relative to those with normal weight. Research suggests that obesity is associated with biological indicators of systemic inflammation (e.g., C-reactive protein), which may contribute to pain. Individuals with excess weight, especially women, also are at greater risk of experiencing the emotional pain of weight stigma, which may in turn exacerbate physical pain. Recent studies have shown that brain areas involved in the processing of physical pain (dorsal anterior cingulate cortex, anterior insula) are the same areas associated with emotional pain, and that analgesics (e.g., acetaminophen) used for reducing physical pain may also dampen extremity of emotional responses. However, analgesic effects have not been tested in the context of individuals with excess weight experiencing weight stigmatization. The current study was designed to 1) evaluate the influence of a weight stigma induction and acute dose of acetaminophen on pain, distress, and affect among women with overweight or obesity; and 2) evaluate the relationship between body mass index (BMI) and pain, the degree to which this relationship is mediated by weight stigma, and the degree to which acetaminophen moderate the weight stigma-pain relationship. One hundred sixty women with overweight or obesity (78% Caucasian; average age 41.7±17.4 years; average BMI 32.4±6.4) were recruited from the Columbus and surrounding communities. Prospective participants were screened for eligibility including BMI 25 or greater, female sex, and age 18 years or greater. The sample of eligible participants was stratified by age (18-40 years vs. over 40 years) and BMI (overweight vs. obese) for randomization into one of four study conditions: acetaminophen and weight stigma induction; placebo and weight stigma induction; acetaminophen and control condition; and placebo and control condition. Participants att (open full item for complete abstract)

Committee: Charles Emery (Advisor); Jennifer Cheavens (Committee Member); Baldwin Way (Committee Member) Subjects: Psychology

Bachelor of Science (BS), Ohio University, 0, Translational Health

Cardiovascular disease is the major cause of mortality globally1, and the negative relationship between body mass index (BMI) and cardiovascular risk status is well-established2. The purpose of this study was to examine the relationship between BMI and cardiac disease risk factors in a sample of inhabitants of towns near Lima, Peru. This research hopes to give insight into the degree to which the Peruvian population studied requires an intervention for diet, BMI, and CVD, and how to make such an intervention culturally appropriate. The biomarkers of glycated hemoglobin (HbA1c)3, systolic and diastolic blood pressure (SBP and DBP, respectively)4,5, triglycerides (TG)6,7,8, total cholesterol (TC)9,10, high- and low-density lipoproteins (HDL and LDL, respectively)11,12 were selected because of their reliability in measuring cardiovascular risk13,14. In this observational study, progressively higher BMI was associated with some abnormal cardiometabolic variables, but not with all variables measured in this study, which conflicts with some prior findings. Higher SBP, DBP, TG, and TC/HDL averages were found in this study to a statistically significant degree. This data confirms prior findings when it comes to blood pressure, TG, and TC/HDL ratios, but not for HbA1c, LDL, TC, or HDL. Because of the lack of significant relationship found between BMI group and all cardiometabolic variables, weight stigma may be, or should be, less in the population studied in comparison to populations with a more definitive relationship between BMI group and all variables. Because abnormalities in each of these cardiometabolic variables is linked to CVD, interventions aimed at reducing body weight to control blood pressure, TG, and TC/HDL to ultimately reduce risk of CVD may be beneficial for this population. Further studies are needed to better understand if the absence of significant correlations between BMI group and HbA1c, LDL, TC, and HDL in this study are the result of population g (open full item for complete abstract)

Committee: David Drozek Dr. (Advisor); Cheryl Howe Dr. (Advisor) Subjects: Health Sciences; Medicine

Master of Science, The Ohio State University, 2021, Health and Rehabilitation Sciences

Background: Body mass index (BMI) is considered potentially inaccurate in athletes. Misclassification from BMI measurements can lead to inaccurate assumptions about adiposity. Body fat percentage (BF%) is a better indicator of overall adiposity, especially in athletes. Also, the distribution of adiposity is important to consider for associated health risk concerns. Objective: Determine the frequency that BMI and BF% classifications match in athletes, and analyze adiposity distribution as it relates to these variables. Methods: Data from athletes representing thirty-three collegiate teams who were scanned by sports nutrition were included in the study (n=1,288). Measures included height, weight, age, sex, ethnicity, sport, BMI, BF%, total fat mass, total lean mass, and VAT mass. BMI classifications established by the World Health Organization were used. Cutoff values to classify BF% were consistent with those established by the American College of Sports Medicine. Data were analyzed using SPSS (version 27) and SAS statistical software. Results: Classification categories for BMI and BF% matched for 53.4% of females and 39.3% of males. BMI overestimated BF% in males compared to females. The frequency of BMI category versus BF% category for overweight (49% versus 10.2%) and obesity (22.7% versus 10.6%) for males was different than the comparisons for females (overweight 20.1% versus 38.5%, obesity 1.4% versus 9.3%). Statistical analysis measuring the weighted Kappa value for BMI and BF% categorical matching in total athletes was found to be Kappa = 0.1777 (p<0.0001), indicating a weak relationship beyond what could happen by chance alone. Similarly, weighted Kappa values for both males [Kappa = 0.2701 (p=0.0001)] and females [Kappa = 0.2148 (p=0.0001)] indicated weak relationships. Conclusion: This study demonstrated the limitations of BMI for predicting adiposity and showed that BF% estimates are more useful than BMI. As predicted, BMI overestimated adipo (open full item for complete abstract)

Committee: Jackie Buell PhD (Advisor); Julie Kennel PhD (Committee Member); Laura Schmitt PhD (Committee Member) Subjects: Health Sciences

MS, Kent State University, 2021, College of Education, Health and Human Services / School of Health Sciences

The purpose of this retrospective, nonexperimental study was to compare the consumption of sugar-sweetened beverages (SSBs) by college students in BMI groups (N=209). Data were collected from students enrolled in Science of Human Nutrition at a Midwestern public university. More than half the students were women (73.2%) and freshmen (55.2%). The study involved a demographic survey, a three-day dietary log, and anthropometric measurements for data analysis. Descriptive statistics were used to examine demographics and types of SSBs. Analysis of covariance was used to analyze the association of SSB intake, calories derived from SSBs, and sugar derived from SSBs in students whose body mass index (BMI) classified them as underweight‒normal, overweight, and obese. Significance for the results was set at p-value < 0.05. Although the results revealed no significant differences between SSB consumption and BMI categories, they showed that approximately 65% of students consumed SSBs during the three-day period, suggesting the importance of the study.

Committee: Eun-Jeong (Angie) Ha (Advisor) Subjects: Nutrition

Master of Science, Miami University, 2020, Kinesiology, Nutrition, and Health

Sleep requirements change over the lifespan and as adults age they are likely to experience changes in sleep quality and duration. As the aging population grows, it is necessary to examine how sleep quality and duration may be associated with disease risk in older adults. Therefore, the PURPOSE of this study was to examine how sleep quality and duration from the Pittsburgh Sleep Quality Index (PSQI) are associated with cardiometabolic disease risk, body composition, and physical activity in overweight, older adults. METHODS: In 38 overweight (BMI 27-40), older adults (Age 58 years or older) sleep quality and duration was self-reported upon enrollment in a 24-week diet and/or aerobic exercise weight loss study. This information was compared to cardiometabolic risk factors (blood and lipid profile), body composition (BMI), and physical activity measured objectively (7-day accelerometry) and subjectively (CHAMPS). Partial correlations were run controlling for sex and body mass. CONCLUSION: Our hypothesis was partially supported by our results as greater levels of objectively measured physical activity were associated with better sleep quality and worse sleep quality was associated with higher HbA1c. No correlations were found between sleep duration and measures of cardiometabolic risk, body composition, or physical activity.

Committee: Kyle Timmerman PhD (Advisor); Kevin Ballard PhD (Committee Member); Jay Kimiecik PhD (Committee Member) Subjects: Kinesiology

MS, Kent State University, 0, College of Education, Health and Human Services / School of Health Sciences

The purpose of this study was to determine the differences between nutritional knowledge of mothers of preschoolers and the growth status and dietary intake of preschoolers who attend the Child Development Center at Kent State University for which two hypotheses were stated. The independent variable of this study was knowledge of the mother and the dependent variables was the growth status of the child measured by plotting the child's BMI-for-age and the dietary intake of the child which was assessed by taking a 24-hour food log and by evaluating macronutrient (energy, carbohydrate, protein, total fat, saturated fat) intake of the child. The data was collected by a paper-pen survey. Mothers were asked to fill the first four sections of the survey at the CDC and were given the 24-hour-food log to be filled in at home. Total 29 mothers participated in the survey from which 13 mothers turned in the food log of the child. One-way analysis of variance was used in SPSS version 24.0 to analyze the quantitative data and themes and patterns were formed to analyze the qualitative data. The results indicated that there was no significance found (p>0.05). The overall education level of the mothers was observed to be high with the majority of them having a Masters or a Ph.D. degree, but their nutrition knowledge in general was found to be extremely low. While the current study provided beneficial insights into mother's nutrition knowledge, the results indicated an overall lack of impact of mother's nutrition knowledge on the growth status and dietary intake of the child (p>0.05). Despite previous research supporting the influence of mother's nutrition knowledge on a child's development and dietary intake, this study lacked many positive outcomes previously obtained, indicating that additional research is necessary to assess the impact of mother's nutrition knowledge on growth status and dietary intake of the child.

Committee: Natalie Caine-Bish (Advisor); Karen Lowry Gordon (Committee Member); Emily Baker (Committee Member) Subjects: Nutrition

Master of Science, The Ohio State University, 2020, Dentistry

Objective: The unanticipated difficult airway is challenging to predict and can result in hypoxia or other events that can cause harm to the patient. There is currently not a single measure that can be used to predict an unanticipated difficult airway as many elements play different roles.a As a result, a combination of evaluations have been used to create a composite risk score with which to assess patients.b However, even current predictive models continue to show inaccuracy in identifying difficult cases. This study will compare fat volumes (as determined by computed tomography scan) with the Cormack-Lehane score from a general anesthetic with tracheal intubation that occurred within eight months of the scan. This goal of this study is to determine if submental or anterior neck fat volume is an indicator of difficult intubation. Methods: A total of 145 patients were included in this study. All patients will have previously undergone a tracheal intubation with a recorded Cormack-Lehane score and a neck computed tomography (CT) scan. Patients were divided into two groups dependent upon their Cormack-Lehane score with Group A being normal airway with a score of I or II and Group B being a difficult airway with a score of III or IV. Mallampati scores and intubation technique were also recorded. CT scans were performed on awake patients doing a breath hold in the supine position. The zone of interest being evaluated is the sagittal slice that corresponds from the hard palate to the inferior most tip of the epiglottis. This region is referred to as the neck volume, the area that will encompass all other structures being studied. Specific sub-parameters that will be measured include three dimensional volumes: airway volume, submental fat volume, and anterior neck fat volume. Results: Mallampati and Cormack-Lehane ranked scores were related and were found to be statistically significant, p=0.0035. The receiver operating characteristic (ROC) curve was found to be (open full item for complete abstract)

Committee: Bryant Cornelius DDS (Committee Chair); Sonya Kalim DMD, MDS (Committee Member); Hany Emam BDS, MS (Committee Member) Subjects: Biomedical Engineering; Biomedical Research; Dentistry; Medical Imaging; Medicine; Radiology

Master of Science, The Ohio State University, 2020, Health and Rehabilitation Sciences

Introduction: Cystic fibrosis (CF) is a disorder characterized by disfunction of the cystic fibrosis transmembrane regulator (CFTR) protein which transports chloride and sodium across cell membranes. CFTR dysfunction results in accumulation of mucus throughout the body. Involvement of the gastrointestinal (GI) tract has manifestations including malabsorption of nutrients. This, untreated, results in malnutrition. Normal weight adiposity (NWA), lean mass deficits (LMD), and alterations in fat mass index (FMI) and lean mass index (LMI) have been described in CF. These alterations are multifactorial. Pro-inflammatory cytokines secreted by excess adipose tissue have been thought to contribute to systemic inflammation in CF leading to a decline in clinical outcomes. Physical deconditioning related to declined lean mass can also lead to worsened clinical outcomes. The relationship between body composition, bone density, and clinical outcomes is not fully understood. Methods: This retrospective chart review was conducted at Nationwide Children's Hospital (NCH) in Columbus, Ohio for all patients regularly seen in the CF clinic from 2015-2020, aged 8-18 years with a filed dual energy x-ray absorptiometry (DXA) scan. Data collected included NWA/LMD status, FEV1%, lumbar spine bone mineral density (LS BMD) and height-adjusted LS BMD z-scores, FMI and LMI percentiles, body mass index (BMI) Z-score, and number of hospital admissions. Statistical analysis: Frequency and descriptive statistics, t-tests, and Pearson correlations were used to determine relationships between body composition and clinical outcomes in CF. Results: N=114 patients with CF were enrolled, mean age 12 years, 72 were female. A positive relationship between FMI and LMI percentiles were observed for FEV1% (r: 0.231, r: 0.356, respectively), LS BMD z-scores (r: 0.285; r: 0.416, respectively), and height-adjusted LS BMD z-scores (r: 0.220; r: 0.336, respectively). An inverse relationship between FMI perc (open full item for complete abstract)

Committee: Marcia Nahikian-Nelms (Advisor); Roberts Kristen (Committee Member); Shaikhkhalil Ala (Committee Member); Gemma Susan (Committee Member) Subjects: Health; Nutrition

MS, Kent State University, 2019, College of Education, Health and Human Services / School of Health Sciences

Because obesity and sleep are very complex multifactorial, there is a need to look at the variety of variables like BMI, sleep quality, duration, patterns and cultural impact. This study purpose was compared the differences in sleep duration based on total hours of sleep, quality based on PSQI, and sleep patterns based on weekdays/weekends bedtime shift and sleep hours shift; between 994 undergrad and postgrad students of varying BMI statuses (underweight, normal weight, overweight, and obese) from both universities KSU and KAU. Students who had any of this condition bariatric surgery, eating disorders, Prader-Willi/ Bardet-Biedl syndromes, underactive thyroid (hypothyroidism), pregnancy, less than 18 years old, sleep less than three hours per night, or/and have BMI less than 18 or more than 33 were excluded. A 2x2x4 factorial ANOVA used to analysis sleep quality, duration and patterns; and chi square used to analysis PSQI components. This study found that short sleep duration (P=0.044), and sleep efficiency (P=0.044) were linked to obesity. Moreover, KAU students had shorter sleep duration (P=0.001) with less quality (P=0.001) and higher bedtime shift (P=0.000) than KSU students. Moreover, stress, anxiety, depression, insomnia, and overthinking were the most common sleep troubles at college students. These findings suggest the need for educating college students about sleep in general (number of hours they need, improve sleep quality, and other related advices); besides, learning how to control theses influences (stress, anxiety, insomnia, depression, and overthinking) to enhance their sleep and their overall well-being and avoid future related health issues.

Committee: Natalie Caine-Bish (Advisor); Karen Gordon (Committee Member); Jamie Matthews (Committee Member) Subjects: Gender; Nutrition; Public Health; Public Health Education

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2019, Sociology

During the past twenty years, the United States has experienced increasing prevalence rates of obesity, especially among women of childbearing age. For adolescent girls aged 12 to 19, the obesity prevalence rate has more than doubled since 1994, and it has increased by more than 15% for women aged 20 to 39 during the same time period. Consequently, individuals of prime childbearing age are more likely to be obese than prior generations, which is likely to redefine family formation behaviors. This dissertation examines how obesity is associated with first birth, specifically timing and union status, as well as union formation and dissolution following first birth using data from the 1997-2011 rounds of the National Longitudinal Survey of Youth 1997 (NLSY97). Consistent with the physical maturation hypothesis, I found overweight and obese women experienced a first birth at younger ages compared to normal weight/underweight women. Overweight and obese women were more likely to experience a first birth than their thinner peers, but this association was weaker for minorities than for whites. Consistent with the stigma of obesity perspective, compared to normal weight/underweight women, the odds of a marital first birth were lower for obese women, but only when age a first birth was controlled. However, when economic resources were controlled, the association between obesity and union status at first birth was nonsignificant. Minority women were less likely to experience their first birth in a union, but this association somewhat varied by body weight. The odds of a marital rather than a cohabiting first birth were 68% lower for Black obese women than white normal weight/underweight women. Among women who were single at first birth, obese women had lower odds of forming a cohabiting union following a first birth than normal weight/underweight, but the association became nonsignificant once age at first birth was controlled. The association between BMI and union (open full item for complete abstract)

Committee: I-Fen Lin (Advisor); Kelly Balistreri (Committee Member); Susan L. Brown (Committee Member); Kara Joyner (Committee Member); Dara R. Musher-Eizenman (Committee Member) Subjects: Sociology

Master of Science, The Ohio State University, 2018, Allied Medicine

Approximately 93 million adults and over 13 million children and adolescents across the U.S. are considered overweight or obese.1 Healthcare expenditures are shown to be 81% greater in obese adults versus those of normal-weight.2 Obesity has been linked to several chronic health conditions and severe disease risks. These health concerns include risk for cardiovascular disease, type 2 diabetes, some cancers, and metabolic syndrome.3 The prevalence of type 2 diabetes and hypertension has steadily increased in the United States and the prevalence of metabolic syndrome is estimated at more than 30%.4UUnderstanding the trends in metabolic syndrome and examining those who are at an increased risk for metabolic conditions is paramount.4 Therefore, it is essential that accurate and reliable tools are used and implemented to assess patients at risk for metabolic syndrome. Currently body mass index (BMI), waist circumference (WC), and dual-energy x-ray absorptiometry (DXA) are believed to be appropriate screening measures. Expanding on the work of Hamagawa et al.5, and Suzuki et al.6, this work adds evidence for providing a cost effective, portable, accurate, and non-ionizing approach to assess an individuals' abdominal adiposity. This approach uses diagnostic medical sonography (DMS) as a tool for assessing abdominal adiposity in hopes of this method being adopted to help determine an individual's risk for metabolic conditions. Participants provided several anthropometric measures as well as imaging data, to determine if sonographic measures of abdominal fat could be an accurate screening technique for gauging the risk for heart disease, stroke, and diabetes. Measurements were taken on a GE Logiq i laptop ultrasound unit to indirectly asses the participants' subcutaneous fat and visceral fat. These measures were then compared to corresponding measures of BMI, WC, and DXA (android percent body fat, subscores). Additionally, a mesenteric fat thickness measurement was taken (open full item for complete abstract)

Committee: Kevin Evans (Advisor); Colleen Spees (Committee Member); Randee Hunter (Committee Member) Subjects: Health Care; Medicine; Radiology

Doctor of Psychology (Psy.D.), Xavier University, 2018, Psychology

The present study examined the predictive role of body-related components (i.e., Body Compassion and BMI) and components of the ACT model (i.e., Mindfulness and Experiential Avoidance), in two dimensions of pain (i.e., pain severity [PS] and pain interference [PI]) and quality of life (QOL) in endometrial cancer (EC) survivors. Data were utilized from 82 participants who are members of a national online support group for EC and had completed treatment. Results indicated that the ACT components and body-related components, as a set, predicted PI and QOL but not PS. Experiential avoidance was determined to be an independent predictor of QOL. Negative affect, used as a covariate, independently predicted unique variance in PS, PI, and QOL while age as a covariate was an independent predictor of PI and QOL. Post hoc analyses found statistical differences between obese and non-obese groups within the sample, such that obese EC survivors endorsed higher experiential avoidance, lower mindfulness, and lower body compassion compared to non-obese EC survivors. Results suggest that body-related and ACT components, taken together, may be predictive of PI and QOL while experiential avoidance may contribute uniquely to QOL, rendering it a key target of future intervention for EC survivors post-treatment.

Committee: Christine Dacey Ph.D. (Committee Chair); Abbie Beacham Ph.D. (Committee Member); Renee Zucchero Ph.D. (Committee Member) Subjects: Health; Psychology

Doctor of Philosophy, Case Western Reserve University, 2018, Biomedical Engineering

Functional Electrical Stimulation (FES) is an assistive technology that uses stimulating electrodes to reanimate muscles and restore lost functions to people with tetraplegia. Brain-computer interfaces (BCIs), which decode recorded neural activity into user commands, are an enticing technology for commanding assistive devices because they can extract multiple command signals even in the absence of movement. This work, through the BrainGate2 pilot clinical trial, makes progress towards restoring brain-controlled arm and hand movements after paralysis through three main advancements in the development of a combined FES+BCI system. First, we show that FES stimulation produces electrical artifacts on intracortical recordings that significantly degrades BCI performance, particularly in the case of surface FES. However, we present a novel artifact reduction method, linear regression reference, which extracts meaningful information during both implanted and surface FES periods and fully restores normal BCI performance. Second, we compare two potential interfaces for control of human arm reaching: Cartesian and joint based commands. In a virtual reaching and posture matching task, we analyze neural tuning differences between the conditions and show significantly higher performance when using the standard Cartesian commands. Third, we implement the first BCI control of an implanted FES system for restoring four dimensions of arm and hand movement. We show evidence that neural activity is largely similar between control of real and virtual movements, and demonstrate similar performance in FES tasks compared to virtual training. We make progress towards restoring brain-controlled movement after paralysis through improvements in three components of an FES+BCI system: the signal processing, command interface, and effector. Our work culminates in a demonstration of functional performance through one participant's consistent success in self-initiated activities of dail (open full item for complete abstract)

Committee: A. Bolu Ajiboye PhD (Advisor); Robert Kirsch PhD (Committee Chair); Dawn Taylor PhD (Committee Member); Jonathan Miller MD (Committee Member) Subjects: Biomedical Engineering; Biomedical Research; Rehabilitation

Psy. D., Antioch University, 2016, Antioch Seattle: Clinical Psychology

Rates of overweight and obesity have reached epidemic status in the United States and better understanding and treatment of obesity is vital to our success in ending this national trend. Current understanding of special populations informs us sexual minority women are at a higher risk of overweight and obesity. This study sets out to verify this using a nationally representative sample population in a fixed factor blocked ANOVA, controlling for common confounding variables shown to be strong influences of overweight and obesity. Next, the relationship between self-perceived body size and medically classified body size will be compared across sexual orientation to see if sexual minority women tend to under-assess their body size when compared with medical classification using a Chi-Square analysis. Some results were unexpected; sexual minority women are not significantly more overweight or obese than their heterosexual peers, but they do have a greater tendency to under-assess their body size according to medical standards. Furthering our understanding of the complexities of overweight and obesity will aide in the approaches taken by interdisciplinary healthcare providers in addressing this epidemic for sexual minority women and all other special population groups. This study serves to begin a thoughtful conversation about sexual minority women's health but more research is needed to further this conversation.

Committee: Alejandra Suarez Ph.D. (Committee Chair); Elizabeth Kunchandy Ph.D. (Committee Member); Michael Archer Psy.D. (Committee Member); Jude Bergkamp Psy.D. (Other) Subjects: Gender Studies; Health; Health Care; Psychology; Womens Studies

Doctor of Education (Educational Leadership), Youngstown State University, 2016, Department of Teacher Education and Leadership Studies

Childhood obesity has become a significant public health problem over the past 35 years. According to the Surgeon General report on Childhood Obesity from 2010, obesity that starts in childhood or adolescence creates greater risk for adult health problems such as heart disease, arthritis, stroke, and cancer. The literature shows that childhood obesity increases most rapidly during the early elementary school years. While obesity and its etiology are certainly multifaceted, at best, several studies have linked many social and environmental determinants of health. The research has shown strong links to factors such as socioeconomic status, the community type, and amount of physical activity through organized curriculum, intervention, and recess. The sample was a systematic stratified random sample of Ohio schools that reported their 3rd grade BMI scores for 2009-2010 school year to the Ohio Department of Health. The sample included 25 schools and 1,006 students. Those schools selected were contacted via phone to ask how many minutes per week schools allocated to physical education in grades K-3, and how many minutes per day was allotted for recess in grades K-3. Other data in the data set were the percentage of students receiving free or reduced lunch; the school building academic performance designations were acquired from the Ohio Department of Education. Zero-order Correlations were run for all variables. Those that were significantly correlated to BMI percentile adjusted for age and sex correlations were selected to run sequential multiple linear regression. Those variables were minutes of daily recess in the third grade, children receiving free or reduced lunch and the type of community. There were two sets of regression analyses. The first set was run at the student level. The first model at the student level, with the all three independent variables, resulted in an R2; = 0.011, F(3, 1001) = 3.726, p = 0.011. Model two at the student level, with the (open full item for complete abstract)

Committee: Karen Larwin PhD (Advisor); Sara Michaliszyn PhD (Committee Member); Patrick Spearman PhD (Committee Member); Salvatore Sanders PhD (Committee Member) Subjects: Education Policy; Health Education; Physical Education

PHD, Kent State University, 2016, College of Education, Health and Human Services / School of Foundations, Leadership and Administration

Greek organizations provide outlets for student co-curricular involvement on many college and university campuses across the United States. Sorority membership recruitment is the process through which women seek membership. With a recent focus on values-based recruitment, one should consider how membership decisions are being made. Furthermore, if a woman feels rejected from a sorority, she could potentially feel negative emotions such as anxiety and depression, or even feel the need to depart from the institution. The purpose of this research was to determine if the variables of attractiveness, personality, grade point average, ACT score, involvement, and close friendships could predict acceptance into or rejection from a sorority as well as to determine if rejection from a sorority was related to departure from the institution. Utilizing an ex post facto quantitative design, data was collected from a mid-sized, private institution in the Midwest. The data was analyzed using correlation analysis, multiple regression full versus restricted model comparison, and exploratory factor analysis. The results of this study indicate that women with higher academic scores are more likely to be rejected by a sorority. Additionally, women who are more attractive and have NF personality function-attitude scores, which signify a more feminine, relationship-oriented personality, were more likely to be accepted into a sorority. There was no relationship between rejection and departure when examining the entire sample, however, women with ST personality function-attitudes that were rejected were likely to depart from the institution.

Committee: Mark Kretovics Ph.D (Committee Chair); Susan Iverson Ed.D (Committee Member); Oscar McKnight Ph.D (Committee Member) Subjects: Higher Education; Womens Studies