Sinclair School of Nursing

Vicki Conn

Impact of Age, Exercise and the Quality of Life

There are hundreds of journals that publish thousands of articles on a huge array of topics. Which ones do you trust?

Thank goodness there’s a meta-analysis on your topic. Researchers who use this technique do the work for you. Meta-analysis involves combing through the tangled web of research and creating a summary and conclusion regarding the current wisdom on any given subject.

At the School, Professor Vicki Conn is the expert on meta-analysis.And she is putting that expertise to good use by continuing her pursuit of exercise interventions.

“There are so many individual studies out there, and it looks like the findings are contradictory,” she says. “One study looks at self-monitoring, one adds walking with a friend, another adds a reward for exercising. How do you compare these different interventions?”

Conn is dedicated to the impressive improvements to quality of life for the population that exercise equipment and gym marketers largely ignore. Through all her research projects, Conn says with a laugh that “my purpose is to get people who don’t look too good in spandex to exercise anyway.”

Linda Bullock

Curbing Domestic Violence for Baby's Sake

Bolstered by more than $5 million from the National Institutes of Health, Linda Bullock, professor, is working to improve the health of babies in violent homes by testing two different interventions.

Bullock’s previous research examined how stress fuels the urge to smoke among pregnant, low-income women.

Yet she noticed more than one in three of the participants in her study were victims of intimate partner violence (IPV), a major source of stress that contributed to their desire to light up.

The Baby BEEP for Kids study is testing whether the telephone calls delivered during pregnancy and up to two years post-delivery helps women to be better parents as measured by their infants' growth and neurodevelopment.

The other NIH trial is testing an empowerment intervention delivered by public health nurses to women experiencing IPV. They want to know if helping women stay safer will lessen the detrimental effects exposure to violence has on the children.

“I know our nurses are making a difference with the rural low-income women they are working with — making them safer and better mothers,” Bullock says. “The children are benefiting from the interventions.”

Greg Alexander

Creating User-Friendly Technology

Greg Alexander, PhD, RN, assistant professor, is keeping multiple studies and projects afloat. However they all center on his primary area of expertise: technology implementation, design, and its use — individually and in community settings — to better assess health.

He’s explored how technology can assess activity among the elderly.

“We actually created images that were silhouettes of the people exercising, which allowed us to track their range of motion and posture,” Alexander explains.

For health care providers the digital imaging system is useful in assessing patients’ ability to safely use various types of equipment.

Even as Alexander looks at new and innovative ways to use technology for the benefit of older exercisers, he continues to explore the use of technology in nursing homes and assisted-living facilities.

“We’re using sensors to detect changes in residents’ health conditions, especially around certain factors, like changes in medication or after a fall,” he says.

Alexander’s role centers on creating technology that can be both effective and user-friendly.

Cynthia Russell

Tracking Medication Adherance

An associate professor, Cynthia Russell is using a high-tech device to track the medication-taking habits of more than 200 renal transplant recipients.

Each patient in her study, which is funded by a $220,500 grant from the National Institutes of Health, takes anti-rejection medicine from bottles topped with a special cap that contains a computer chip. The chip records each time the cap is removed from the bottle, and Russell downloads the information to her computer.

Without diligent medication management, a transplant patient’s body will treat the new organ as a foreign substance and attack it, destroying the organ and potentially killing the patient.

Russell hopes that her study will uncover patterns or commonalities among patients who fail to take their drugs properly, offering insights that may lead to useful interventions.

“One of the heartwarming things that surprised me is that people are so willing to become involved in order to help other transplant patients and society at large,” Russell says. “They feel they’ve been given a gift and they want to give back. That’s one of the reasons I like research in this field — the people are unique and wonderful.”

Rebecca Johnson

Pets Ease Transition to Nursing Homes

Entering a nursing home is a scary transition for many elderly people. So anything that can help ease the anxiety that comes with such a tremendous lifestyle change is worth exploration.

That’s why Rebecca Johnson is putting new nursing home residents in touch — literally — with dogs.

The Millsap Professor of Gerontological Nursing and Public Policy and associate professor of nursing, Johnson also holds an adjunct appointment with the MU College of Veterinary Medicine and is director of the MU Research Center on Human-Animal Interaction.

Her study on “testing a dog visit protocol with newly admitted nursing home residents” is funded by a $7,500 grant from the MU Research Council.

“I’ve been studying relocation issues since 1992,” she says. “The same things keep happening to people when they enter nursing homes. It’s extremely stressful and just not good for older adults.”

Johnson’s research of how animals can help improve human health continues with a new grant application, currently under review by the National Institutes for Health, in which her successful dog-walking program would be expanded.

Marilyn Rantz

Improving Outcomes for Nursing Homes

The National Institutes of Health awarded Professor Marilyn Rantz more than $3.1 million to continue her ground-breaking work on improving outcomes for nursing home residents.

Rantz is confident nursing home administrators will welcome the opportunity to improve resident outcomes. Not only is it a matter of good care, but it’s a matter of good business, she says, having found that homes with better outcomes are also more cost-effective.

“We can help them learn how this works, and it will save them money,” she says. Rantz attributes this cost-saving phenomenon to the fact homes with outstanding outcomes tend to have less staff turnover, which reduces hiring and training costs.

“Good care leads to better resident function,” she adds. “It’s less expensive to maintain people’s abilities than it is to let people become more frail and then have to provide more care.”

For instance, residents who are encouraged to walk are able to care for themselves better, requiring less nursing care. More independent, healthy residents also decrease supply costs for such things as incontinence products and nutritional supplements.

Eileen Porter

Older Widows Maintaining Independence

Moving to a nursing home or assisted-living facility, no matter how clean, well-run and pleasant, is not the intention of many older women.

Professor Eileen Porter talked with them during her five-year study of “Older Homebound Women’s Experience of Reaching Help Quickly funded by a $1 million grant from the National Institute on Aging. Her study focused on the women’s perspective — a natural but somewhat unusual way to collect data.

Older women, who feel independent despite accepting some help from family, friends, and health-care providers, would prefer not to “bother” others if they need help quickly for health or other emergencies. Some had plans for reaching help, but most had vague ideas or had not thought about it. “Some women whose children lived nearby knew that ‘someone would be by in time’ to check on them.”

Porter’s research teaches valuable lessons. “Ask older people what they would do if they needed help quickly,” she says. “Provide information, but let them come up with answers that suit them.”

Through her data, Porter hopes that others will better understand the unique lives of older women.

Dedre Wipke-Tevis

Healing Chronic Wounds

When Deidre Wipke-Tevis was a young nurse she worked on a vascular surgery floor. For five years, she saw stubborn wounds that resisted healing. She realized that wound-care practices and technology were not changing.

After earning her master’s and doctoral degrees, Wipke-Tevis became interested in venous ulcers.

The most frequent type of leg ulcer, venous ulcers are caused by recurrent blood clots that lead to problems with the venous valves and allows a backflow of blood into the legs.

“If venous ulcers could be more effectively treated, the results would include fewer hospital admissions, lower health care costs and better outcomes for patients who even risk amputation if they don’t respond to standard treatments,” says Wipke-Tevis.

In 2006, the total average cost nationally to heal venous ulcer wavered between $9.75 million and $1.95 billion.

“Once a venous ulcer heals, approximately 60 to 70 percent recur,” she says. “I have cared for some venous ulcer patients who have had the same venous ulcer for nearly 20 years.”

Jane Armer

Women’s Cancer Issues Not Invisible

Jane Armer, PhD, FAAN, RN, professor, studies women who suffer from lymphedema, a localized swelling of the arm or shoulder that may occur as a result of breast cancer treatment.

From personal experience, Armer discovered that lymphedema is both underdiagnosed and undertreated even though this chronic condition  has tremendous impact on a woman’s quality of life.

“As our treatments become more successful, there are more cancer survivors. In the past, we’ve focused on the fact that they are survivors and we have not looked at what they deal with after they survive acute cancer treatments. Now there’s more interest in cancer survivorship issues,” she says.

After establishing current lymphedema incidence rates, Armer plans to research risk factors, risk-reduction activities, and optimal lymphedema management strategies.

“For health professionals, it is important to be aware that lymphedema is an on-going issue,” Armer states. “And we hope that women who have lymphedema become aware that what they experience is of concern and is no longer an invisible condition.”

Patricia Schnitzer

Exploring Children’s Safety

An associate professor specializing in public health and epidemiology, Patricia Schnitzer’s work focuses on the role parental supervision plays in preventing childhood injury.

Parents of children 4 or younger who sought emergency care at University Hospital for an unintentional injury were asked whether they would be willing to participate in the study.

“We framed our questions in light of the challenges inherent in raising young children,” she continues. “We want to hear the parents’ story about what happened and why.”

Schnitzer admits that it’s not possible to completely quantify how well a parent can multitask. However, the degree of distraction based on the activity of the parent at the time of the injury is an important piece of information.

Although she has yet to complete her data analysis, Schnitzer hints supervision alone may not prevent as many childhood injuries as we might think.

“It’s important to look at ways in which we can reduce child injuries,” Schnitzer says. “After all, nurses are important because the injury prevention messages they share with patients do make a difference. Eventually, we hope our work will lead to new interventions and programs that will help inform those messages even better.”