Doctor of Ministry , Ashland University, 2024, Doctor of Ministry Program

This project discovered the knowledge, attitudes, and actions of Living Word Ministries congregates in Strong, Arkansas, regarding starting a substance abuse recovery ministry. Twenty participants completed a five-point Likert scale survey that was collected and analyzed. The data revealed the three top findings in knowledge and attitudes were the community had many individuals impacted by it, the Bible demanded it, and the pastor supported it. Finally, as it relates to actions, the data revealed that participants are willing to participate in a substance abuse recovery ministry, faith-based social activism and follow the pastor.

Master of Science (M.S.), University of Dayton, 2024, Mechanical Engineering

Injuries to the spinal cord can be debilitating to the function of the upper extremity. Many people with spinal cord injuries (SCIs) undergo rigorous therapies to help preserve range of motion and strength. Task specific training has been shown to offer benefits in upper extremity rehabilitation. In recent years, virtual reality has gained popularity for its ability to offer task specific training in an engaging and immersive environment. This study explores therapeutic virtual reality gaming for people with spinal cord injuries. The first aim of the study is to compare the kinematic performance of individuals with spinal cord injuries to healthy controls. This study's second aim is to characterize the qualities of the movement task, such as movement direction and block position, that generate maximum kinematic responses in the SCI group. Finally, the third study aim is to compare the effects of different movement types on overall kinematic performance. Individuals with spinal cord injuries (n=7) and healthy, age-matched, sex-matched controls (n=7) were asked to play Beat Saber in an immersive virtual reality environment. Participants were equipped with upper extremity motion capture markers, virtual reality trackers, and the virtual reality headset/controllers. Custom levels were created in Beat Saber that had different movement directions (UP, DOWN, IN, OUT) and different block positions (HIGH, LOW, MED, LAT). Trials were composed of either movements with one hand (UNI), movements mirrored about the midline (MIR), or movements in opposing directions about the midline (OPP). Participants completed six randomized trials, repeating each of these movement types twice. Results showed that the joint profiles of the participants with SCIs used less overall shoulder and elbow joint motion to accomplish the tasks, compared to the healthy controls. At the wrist, SCI participants were able to use comparable or greater wrist radial/ulnar deviation than the controls. SCI parti (open full item for complete abstract)

MS, Kent State University, 2024, College of Arts and Sciences / Department of Computer Science

The purpose of this thesis is to develop a series of a game interfaces to help in upper limb rehabilitation for individuals suffering with Parkinson's Disease. Parkinson's Disease affects more than 10 million people worldwide. The games incorporate haptic feedback as a more engaging way of encouraging individuals to perform motor tasks. A haptic stylus pen will be used as the main method of interacting with the game interface and the main means of providing resisting force during the tasks, and the use of a virtual reality headset as a means of making the game experience more engaging and immersive. Validating the usability and efficacy of the game system towards upper limb rehabilitation by using data collected from participants of the prototype using three designed games: fishing, archery, and mining. For data collected with the prototype system, both healthy and Parkinson's Disease participants were asked to complete predefined task sessions and provide the usability ratings using a NASA Task Load Index after the sessions. Participants' skills and efficacy were assessed using task specific data (task completion time, hand motion tracking, task score within time limit, etc.) and were automatically recorded in the system for each session. The collected data will be used to improve or refine the game rehabilitation system and analysis the systems efficacy, usability, and potential for a comparable alternative to traditional Parkinson's rehabilitation. Both healthy and Parkinson's participants data have been analyzed and compared with one another and each other to find meaning full discussions and results to better improve the system and rehabilitation process, such as how haptic feedback has affected user performance for both healthy and Parkinson's Disease participants when it comes to completion times, scores, and movement trajectory. This data will be used as the basis of developing a more refined gaming rehabilitation syst (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2024, Health and Rehabilitation Sciences

Frequently referred to as “immobility harm,” reduced mobilization among hospitalized adults is associated with worse patient outcomes, longer length of stay, and additional costs. Significant systemic barriers contribute to low mobility among hospitalized adults and include lack of staff availability, unclear expectations for both patients and clinical staff, and lack of routine physical function assessment. Consequences of immobility harms are myriad and include mobility-related complications such as falls, hospital-acquired pressure injuries (HAPI), and hospital-associated functional decline (HAFD). Despite being considered mostly preventable, these complications are unfortunately common. The purpose of this dissertation is to address the complexities of mobility-related complications within hospital settings using a multifaceted approach that scrutinizes existing practices, examines physical therapy (PT) intervention strategies, and explores innovative solutions. Using a qualitative approach with a thematic analysis technique, chapter 3 identified several themes regarding the perspectives of acute care physical therapists on fall prevention practice in hospitals. Therapists highlighted that although their practice positively supports multidisciplinary mobility promotion and fall prevention efforts, the practice of PT is not central to fall prevention. Critically, participants described that contextual factors often limit fall prevention-focused PT interventions altogether. Instead, practice choices are influenced by the hospital context as therapists strive to maximize their impact despite identified barriers. Chapter 4 involved a quantitative analysis of 7693 hospital episodes in which patients received at least two PT visits. We developed multivariable logistic regression models to examine the relationship between minutes of PT provided and patient functional improvement and discharge disposition. Increasing PT was positively associated with odds of funct (open full item for complete abstract)

Doctor of Nursing Practice, Mount St. Joseph University , 2024, Department of Nursing

Chronic Obstructive Pulmonary Disease (COPD) remains a significant public health challenge and a leading cause of hospital readmissions in the United States, imposing substantial financial and quality-of-life burdens. Global guidelines have advocated early initiation of pulmonary rehabilitation (PR) as an effective intervention to mitigate these readmissions. This Doctor of Nursing Practice (DNP) project aimed to evaluate the impact of early initiation of PR on the 30-day readmission rates for patients discharged with an acute exacerbation of COPD. A comprehensive evaluation was conducted on a cohort of 129 patients admitted with COPD across four months from October 2023 to January 2024. The project tracked 30-day readmission rates, PR referrals, and PR enrollment rates. These were compared against the same period from the previous year to gauge the effectiveness of the intervention. The initiative included inpatient PR consults, patient education, and scheduled PR intake evaluations post-discharge. Early findings indicate a decrease in the 30-day readmission rates, from an initial readmission rate of 14.71% in October 2023 to 12.82% in January 2024. The observed-over-expected readmission ratios demonstrated improvements, particularly notable in January 2024, with a ratio of 0.70. Additionally, there was a notable increase in PR referrals and significant improvement in staff knowledge about PR, indicating successful implementation of the initiative. The early initiation of PR post-discharge for patients with COPD may contribute to reducing 30-day readmission rates.

Master of Science (M.S.), University of Dayton, 2024, Mechanical Engineering

The average physical therapy clinic lacks the funding and resources to install highly specific movement assessment and rehabilitation tools. Moreover, engagement of patients during rehabilitation is difficult to maintain due to the mundane nature of the routines. Virtual Reality (VR) systems have the capacity to become an all-in-one system that gives an engaging and highly customizable experience for each user. VR also incorporates wearable sensors that allow for tracking the position and orientation of individual segments. This study has two primary aims, the first is to validate that a VR system is capable of upper extremity movement motion capture comparable to the golden standard of infrared motion capture. The second aim is to assess movement task data extracted from a VR game to see if quantification of a cohort with spinal cord injury (SCI) is possible through a simulated task. Two cohorts were included in this study, a group of persons with history of SCI (n=7), and a control group (n=9). Each participant was asked to play a modified commercially available VR game known as BeatSaber. The levels were separated into therapy-based mirrored, opposing, and unilateral tasks. Moreover, each task was defined by its position and orientation relative to the user. Additionally, task color was used to distinguish which hand to perform the task with. Results from the VR system compared to the IR system showed that the overall error between the two systems was on average between 4.2°-8.6° and showed small instantaneous errors with all joint angles being less than 2°. Moreover, the instantaneous error was even lower at peak values reported in the IR system. Results allowed for a comparison of performance data for a combination of seven SCI with seven age and gender matched control groups. Task related data showed that SCI tended to have asymmetrical impact from injury and performed worse compared to the control group.

Master of Science, The Ohio State University, 2024, Mechanical Engineering

Manual wheelchair users are at an increased risk of developing long-term upper body pain or overuse injuries. Improper wheelchair biomechanics can play a role in the likelihood of developing carpal tunnel, shoulder tendinitis, or shoulder rotator cuff injuries. These risks can be mitigated by matching users with proper wheelchairs and improving technique. Analysis of wheelchair propulsion metrics such as stroke frequency, stroke length, and rolling resistance can provide insight into how to prevent biomechanical injury and improve patient outcomes. The SmartWheel was a previous product that, while it performed these functions, was limited in its application due to its high cost, out of date software, and the prohibitive amount of set up required. The SmartHub has been designed as an alternative for collecting wheelchair propulsion data that is intended to be easier to use, less obtrusive, and more cost effective. Previous iterations of the SmartHub required Secure Shell protocol for data logging, protruded from the wheels during attachment, and faced inaccuracies in their trajectory calculations. The current design has improved upon these limitations by replacing the Raspberry Pi with an Arduino microcontroller to transmit accelerometer and gyroscope data over Bluetooth Low Energy. This design also resulted in a large device form factor reduction and permits real time analysis and visualization of recorded data on the connected device. Accuracy of recorded data was increased through the use of dual devices, one of which is attached to the central hub of each wheel. The reduced size and cost of the SmartHub make it an accessible tool for research and clinical environments. This device would be beneficial for wheelchair biomechanical research due to its improved metric calculation capabilities. Quantitative data obtained from the SmartHub could be used in clinical settings to improve current practices and patient health.

Doctor of Philosophy, The Ohio State University, 2024, Health and Rehabilitation Sciences

Musculoskeletal disorders represent a significant global health burden, affecting individuals of all ages and leading to substantial disability. However, beyond physical symptoms, musculoskeletal disorders can also have profound psychological implications, both contributing to or resulting from psychological trauma. Despite the interconnectedness of physical and psychological well-being, there remains a gap in the training and practices of physical therapists (PTs) regarding their responsibility and practice involving their patients' psychological trauma. This dissertation addressed this gap through a multi-project approach aimed at understanding and improving the integration of trauma-informed care (TIC) into musculoskeletal physical therapy practice. The first project focused on developing an evidence-based TIC Toolkit tailored for rehabilitation clinicians, including PTs, providing practical guidance for implementing TIC techniques. The toolkit aimed to enhance clinician confidence and competence in responding to the mental health needs of patients (Chapter 3). The second project investigated the attitudes and practices of PTs concerning TIC. By identifying barriers and facilitators to TIC implementation, these findings laid the groundwork for targeted strategies to overcome obstacles and promote effective integration of TIC into clinical practice (Chapter 4). Building on the insights from the survey, the third project employed in-depth interviews with musculoskeletal PTs. These interviews aimed to provide a deeper understanding of the specific challenges and opportunities in implementing TIC, offering rich contextual insights into current practices and barriers faced by PTs (Chapter 5). This work is the first to our knowledge to specifically address the current practices and opportunities for MSK PTs to integrate TIC into their practice. Collectively, these projects contribute to advancing the field of musculoskeletal physical therapy by addressing the critica (open full item for complete abstract)

Psy. D., Antioch University, 2024, Antioch Seattle: Clinical Psychology

This mixed-methods study explored the quality of life and lived experiences of adult individuals with diagnoses of schizophrenia spectrum disorders residing and receiving treatment on the Social Learning Program (SLP) at Fulton State Hospital, a high-security state forensic facility. Eleven participants completed the WHOQOL-BREF quantitative quality-of-life measure. Ten participants completed in-depth, semi-structured, qualitative interviews. Interviews were transcribed then analysed using Interpretive Phenomenological Analysis. The major themes that emerged included “Working the Program,” “Relationship Dynamics with Self and Others,” “Meaning,” “I've Been Having Breakthroughs,” and “Areas for Improvement in the Program.” Combined, the findings of the present investigation demonstrate the utility of the SLP and highlight the importance of studying the lived experience and quality of life of individuals with diagnoses of schizophrenia spectrum disorders residing in forensic facilities.

Master of Science (MS), Ohio University, 2023, Industrial and Systems Engineering (Engineering and Technology)

Human trafficking (HT) is a form of contemporary slavery that affects individuals in every state of the United States. Despite the existence of government and non-profit rehabilitation services, HT-affected individuals often miss out due to improper resource allocation. To address this issue, we propose an optimization model that efficiently allocates resources to rehabilitate and reintegrate HT-affected individuals where they are most needed. Our strategy uses a Mixed Integer Linear Programming model to optimize the net societal value (NSV) gained from offering support services while considering the three stages of HT-affected people's healing path, including victim, survivor, and thriver. This model determines the optimal type, quantity, and location of services while also integrating HT risk scores that account for the risk of HT in those areas. Our model's efficacy is demonstrated in an Ohio case study, allocating housing, detoxification, and food services across the state's eighty-eight counties and three stages of the healing path of HT-affected individuals. Through Monte Carlo Simulation in the solution approach, uncertain demand is accounted for, leading to improved NSV under such conditions. Moreover, we illustrate the impact of an increased budget, showcasing extended service reach and allocation possibilities. Our work aims to support decision-makers in efficiently allocating resources to rehabilitate and reintegrate HT-affected individuals effectively.

Doctor of Philosophy, University of Toledo, 2023, Exercise Science

Athletic populations commonly suffer from various injuries to the back, hip, and knee. Common risk factors, often in the form of movement patterns or strength deficits, have been identified for injuries that negatively impact sport performance or the ability to participate in sport. These common risk factors may be suggestive of a proximal cause-the lumbopelvic-hip complex (LPHC). The LPHC is the center of the kinetic chain and is important for optimal force generation and distribution to the lower extremity during athletic movements. LPHC stability can be defined as the ability of the trunk to maintain optimal positioning over the pelvis and lower extremity in the presence of perturbations. Additionally, LPHC stability can be considered the combined muscular strength, endurance, and sensorimotor control of the muscles and fascia within the complex. Deficits in LPHC stability have been related to movement patterns that are related to increased injury risk and incidence of injury. The proposed connections between LPHC stability and injury risk prompt recommendations for inclusion of LPHC stability training in injury prevention efforts. To better understand the emphasis that should be placed on LPHC stability training for the purpose of injury prevention or rehabilitation, it is important to further investigate the mechanisms by which LPHC stability relates to injury risk factors, and whether improving LPHC stability results in relevant functional changes. Our population of interest included university club sport athletes who are regularly at risk for injury due to their participation in sport, but represents a more recreational population that commonly do not have access to outside training regimens or clinical interventions. In manuscript 1, we explored the relationships between clinical measures of LPHC stability, trunk kinematics, and the margin of stability during landing tasks. Because the head, arms, and trunks make up 70% of the body's mass, control of trunk m (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2023, Health and Rehabilitation Sciences

Acquired brain injury is a leading cause of death and disability among children and adolescents. Adolescents with ABI experience a variety of impairments across all domains of function in the acute and chronic stages of recovery and are at an increased risk for additional injury. Due to increased physical and cognitive challenges, these adolescents are at greater risk of injury exposure within their home environments. While the home environment is a location of concern for adolescents with ABI after injury and hospital discharge, little research exists focusing on home safety to mitigate injury risk for this population. It is unclear what knowledge and expectations adolescents with ABI and their caregivers have of home safety hazards and concerns prior to hospital discharge. Additionally, it is unclear to what degree and how healthcare providers address home safety for these families prior to hospital discharge. Despite a focus on discharge preparation and home safety among other populations, there is limited research focus on the resources and safety of adolescents with ABI upon re-integration into the home and community. There is an urgent need to understand the home safety concerns of various primary stakeholders for adolescents with ABI. Interactive games and virtual technologies, such as virtual reality (VR) are great tools for intervention and education with adolescents. VR programs are demonstrating emerging evidence for learning due to their properties of customizability, realism, iii engagement, standardization, repeatability, outcome measurement, and safe simulation. Some of these VR programs have been developed for the training of home safety among providers, caregivers, and children. However, little is known about the usefulness, usability, and desirability of these technology for addressing home safety concerns for adolescents with ABI. The primary purpose of this research was twofold: 1) to identify the home safety concerns of providers, caregivers (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2023, Speech and Hearing Science

Two essential components of language are semantics, or the meaning of language, and phonology, or the sounds that make up our words. Researchers have long sought to investigate the neural correlates of semantics and phonology; however, questions remain related to the specific brain regions comprising each network as well as the degree to which these networks coincide. Moreover, patterns of reorganization following injury to these networks in populations such as those with post-stroke aphasia remain unclear. Across three manuscripts, this dissertation addresses these questions, emphasizing the influence of aging on the language networks in the brain as well as reorganization during the process of recovery from post-stroke aphasia. Recent work examining the semantic and phonological networks in the brain has focused on neurologically intact younger adults. Considering many people who experience acquired language impairments are older adults, the first manuscript in this dissertation presents the results of a scoping review addressing the regions comprising the semantic and phonological brain networks in this aging population. The review finds that these brain networks are consistent with the networks of younger adults but may have subtle differences that should be further explored in a full systematic review or meta-analysis. The second manuscript in this dissertation specifically examines the resting-state functional connectivity of the inferior frontal gyrus, a region that has been implicated in both semantic and phonological brain networks and is often damaged in cases of post-stroke aphasia. Compared with younger adults, we again found subtle differences that may be accounted for in part by theories of age-related de-lateralization of the dominant left hemisphere. We next correlated significant resting-state functional connectivity with behavioral tasks targeting semantics and phonology, which did not support theories of semantic specialization at the anterior inf (open full item for complete abstract)

Doctor of Philosophy in Engineering, Cleveland State University, 2023, Washkewicz College of Engineering

People with high tetraplegia rely on caregivers or family members to help them perform activities of daily living (ADLs). Assistive robot devices have the potential to considerably reduce a person's dependence on their caregivers, thus affording them increased economic freedom and functional independence. However, these devices often lack appropriate sensors and intelligence for complex tasks and are often not designed for people who have limited naturally available command options. This dissertation aims 1) to develop an intuitive interface between a robotic assistive device and a person with tetraplegia and 2) to impart intelligence and sensing capabilities to the device to reduce the user's input demand. In Aim 1, we developed a prototype robotic assistance platform for self-feeding consisting of a vision system for food item detection and localization, a robot for carrying out manipulations, and a graphical user interface (GUI) to facilitate bi-directional communication between the human and the system. The system was capable of detecting, localizing, acquiring, and delivering food items to a human user and was controlled via eye movements. In Aim 2, we performed a pilot study in which people with tetraplegia tried out the system and provided their feedback. We recorded success rates and tasks times of the feeding task, conducted standardized quantitative human assessments, and executed qualitative post-study interviews with study participants. We included members of the spinal cord injury community as equal partners in the design process, and their post-study feedback directly guided future development. The results from the pilot study revealed key areas of system improvement as well as critical needs and desires of the spinal cord injury community. In Aim 3, we addressed these needs by upgrading the physical system's sensing and execution capabilities, developing a more intuitive human-robot interaction framework, and presenting a proof-of-concept a (open full item for complete abstract)

Doctor of Philosophy (PhD), Ohio University, 2023, Translational Biomedical Sciences

Anterior cruciate ligament (ACL) rupture is a common and debilitating knee injury occurring in young active populations and can lead to rapid development of osteoarthritis. Most individuals undergo reconstructive surgery to restore the mechanical stability of the joint in an attempt to preserve knee joint health and physical function. Unfortunately, despite reconstructive surgery, individuals demonstrate protracted recovery of postural stability, muscle strength, and other neuromuscular impairments. Rupture of the ACL may be considered a partial deafferentation injury, where the sensory afferents from the joint and ligament are disrupted from the central nervous system. Deafferentation is confounded with pain and joint inflammation, making it difficult to understand what the isolated contribution of joint deafferentation to neuromuscular deficits are. Cross-sectional neuroimaging data suggests that widespread whole brain plasticity occurs after ACL reconstruction (ACL-R). However, the isolated effect of deafferentation to whole brain plasticity or physical performance is unknown. Integrating a novel model for knee joint deafferentation in healthy individuals, our findings suggest that joint afferents may contribute to the resting-state functional connectivity of multisensory integration regions with the whole brain. Additionally, physical function on postural stability in the presence of joint deafferentation may be preserved secondary to differences in resting state functional connectivity. We demonstrate a similar phenomenon in those with ACL-R, where individuals appear to be able to preserve physical function on proprioception and dynamic stability tasks through visual-cognitive 4 function and associated neural activity. Collectively, this work expands the current literature by exploring multisensory integration neuroplasticity after knee joint deafferentation, and associated visual-cognitive compensation strategies. Future work should aim (open full item for complete abstract)

Master of Science, University of Toledo, 2023, Exercise Science

Context: Lesser eccentric hamstring strength is reported to increase hamstring strain injury (HSI) risk. There is conflicting evidence on whether sex influences hamstring strength. Several studies have investigated different contraction modes, but less is reported for eccentric contractions between sexes.1-5 Physical activity levels have been shown to influence eccentric hamstring strength, with higher active individuals demonstrating greater strength.1 However, the interaction of sex and physical activity level has not been investigated for eccentric strength. Objective: Assess the influence of sex and physical activity level on eccentric hamstring strength in healthy college-aged individuals. Design: Descriptive laboratory study. Setting: Laboratory and student recreation center. Patients or Other Participants: 108 healthy, physically active (Tegner Activity Scale 3 to 10) males and females, aged 18-30 years. Main Outcome Measure(s): Normalized peak eccentric torque (Nm/kg), normalized average eccentric torque (Nm/kg), normalized impulse (Ns/kg), Borg Rating of Perceived Exertion (RPE), and repetitions completed (n). Results: Males had greater eccentric hamstring strength than females and high active individuals had greater eccentric hamstring strength compared to low active individuals. When considering sex and activity levels, low active females had the least eccentric hamstring strength and high active males had the greatest eccentric hamstring strength. . High active males demonstrated the greatest eccentric hamstring strength compared to other groups. Conclusions: Physical activity level and sex influence eccentric hamstring strength. Males may have had greater strength due to higher mass and height. Higher active individuals may have had greater strength due to an increase in muscle training. Our data highlight the continued need to establish sex- and physical activity level-specific normative eccentric hamstring strength values. Word Count: 265

Master of Science, University of Toledo, 2023, Exercise Science

Context: Anterior cruciate ligament (ACL) injuries occur every year, with about 175,000 cases undergoing ACL reconstruction (ACLR). Current research shows that patients that undergo ACLR are less likely to return to sport and are more likely to have overall long-term functional deficits. Psychological function also has been shown to be impaired following ACLR, with about 65% of patients citing a psychological reason for not returning to sport. However, the relationship between psychological function and injury risk biomechanics following ACLR is unclear. The purpose of our study was to evaluate the relationships between psychological function and landing biomechanics associated with ACL loading among individuals with ACLR. Methods: A cross-sectional study was used to assess the relationships between psychological function after ACLR and landing biomechanics. Patients completed the Tampa Scale of Kinesiophobia (TSK-11), Veterans RAND 12-Item Health Survey (VR-12), and the Knee Injury and Osteoarthritis Outcome Score (KOOS) prior to arriving to the lab for collection. We used 12 high-speed motion capture cameras and two analog force plates to collect biomechanical outcomes during the Landing Error Scoring System (LESS). iii Results: At IC, higher TSK-11 scores moderately associated with less hip flexion (P= .01, r= - 0.57). Lower KOOS (ADL) scores moderately associated with lower vGRF (P=.01, r = -0.60) Within the first 100ms post-IC, higher TSK-11 scores moderately associated with greater (P= .02, r= -0.52). At peak GRF, higher TSK-11 scores moderately associated with less knee flexion (P =.01, r= 0.56), highly associated with less hip flexion (P <.001, r= -0.72), and moderately associated with greater knee frontal moment (P= .002, r= -0.64). Conclusions: Worse psychological function is associated with injury risk landing biomechanics, and pain-related fear appears to be the largest contributor to injury risk biomechanics during the LESS.

Doctor of Philosophy in Engineering, Cleveland State University, 2022, Washkewicz College of Engineering

Several genetic, developmental and neurological disorders can cause various levels of gait impairment in the pediatric population. Powered lower limb orthoses, or exoskeletons, have recently been used to address gait impairment and afford therapists alternative solutions and strategies for gait therapy. Most exoskeleton research has focused on the adult population while the pediatric population remains underserved. The limitations of current pediatric exoskeletons make them impractical for use in both community and clinical settings. Furthermore, exoskeleton controllers suitable for these environments should promote human volitional control while guiding the subject towards a dynamically stable healthy gait pattern. This dissertation presents the design of a pediatric lower limb exoskeleton and the application of a virtual constraint-based controller on the device. First, a small and lightweight exoskeleton joint actuator capable of delivering the torque and power requirements needed to assist and guide the hip and knee joints was developed. Testing and in-air gait tracking of a model leg in a provisional orthosis demonstrated that the joint actuators were suitable for use in a pediatric exoskeleton. Second, an adjustable exoskeleton frame was designed and fabricated, and a human factors assessment of the fully assembled pediatric lower limb exoskeleton demonstrated that the device was lightweight, comfortable, easily adjustable and suitable for children. Third, a virtual constraint-based controller was applied on an underactuated adult exoskeleton. This initial investigation demonstrated that virtual constraint-based control guided the subject towards a dynamically stable gait in a time-invariant manner, provided greater volitional control to the subject and promoted active participation in the walking exercise. Finally, this dissertation research concluded with the application of a virtual constraint-based controller on the pediatric lower limb exoskeleton in (open full item for complete abstract)

Doctor of Nursing Practice, Mount St. Joseph University , 2023, Department of Nursing

Drug and alcohol abuse that goes untreated leads to tens of thousands of deaths annually and affects the lives of many more people. Assessments serve the purpose of collecting comprehensive information required to develop a treatment plan tailored to meet individual needs. The aim of this project included increasing realms of functioning, the number of meetings attended, and passing drug urine screening. The goal of this project was to integrate the Treatment Effectiveness Assessment (TEA) tool into the operations of the participating organization. For a considerable time, a search for the proper tool that is both efficient and all-encompassing, to evaluate patients' advancement during treatment and recovery has been sought out. In order to enhance the capacity to comprehend patients' progress in treatment from their own point of view, the use of the patient-centered tool that offers notable benefits was used. Substance use disorders can have severe impacts on an individual's physical, emotional, and social well-being, as well as the broader community. Early intervention can help identify and address substance use disorders before they escalate, reducing the risk of long-term harm and improving outcomes for individuals and communities.

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2023, Psychology/Clinical

Stigmatization of people experiencing mental illness remains prevalent in the United States. Social stigma can result in negative outcomes for people with mental illness such as limited access to housing and employment and reduced well-being. Both social contact interventions and art exhibits may reduce stigma towards mental illness, and art making may increase feelings of self-efficacy and belongingness among people with mental illness. The present mixed methods research examined the perspectives of both artists who post their work and potential viewers in online interactions about art and mental illness intended to reduce stigma. Study 1 used qualitative interview methods with artists experiencing mental illness who post publicly about their experiences on Instagram (N = 17). Themes from interviews related broadly to art (History and Identity as an Artist, Art Career, and Art and Mental Health), mental health (Symptoms, External Barriers, Protective Factors, and Treatment), and social media (Benefits and Motivations, Risks, and Online Disclosure). Study 2 consisted of a randomized controlled trial of an asynchronous, online social contact intervention to reduce stigma towards mental illness (N = 318). Groups 1-3 viewed intervention posts created by Study 1 artists about mental illness (art and writing posts, art-only posts, or writing-only posts) and Group 4 viewed matched comparison posts not about mental illness. Study 2 results showed that participants in the intervention groups reported significantly higher mental health awareness, general sympathy, and appreciation for people with mental illness than those in the comparison group. All groups had a significant decrease in prejudice. Participants' perceptions of posts as confusing or compelling mediated the relationship between the type of post and their ratings of state empathy. Implications for the development of cost-effective online interventions to reduce stigma towards mental illness are discus (open full item for complete abstract)