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PHOTO: Spring 08 Mizzou Nursing cover

Spring 08
Vol. 15/ No. 1

Best Practices

Falling for You

Americans are living longer and they desire to live as independently as
possible. A team of Mizzou researchers in nursing and engineering said this independent lifestyle comes with risks, such as debilitating falls.

“Billions of dollars are spent in healthcare costs in regards to treatment of falls,” said Marilyn Rantz, professor at the School. “Our research is targeted to not only detecting falls, but also conducting fall-risk assessment.”

A nearly million dollar grant from the U.S. Administration on Aging is allowing the researchers to create technology used at TigerPlace.

In an effort to accurately portray how seniors fall, the nursing researchers created scenarios for stunt actors to follow. As the actors fell, they evaluated the realism of each fall. The engineering researchers filmed the falls so they could enter the information into a
specialized computer system.

“It's important to have the stunt actors because we need to collect data of people falling,” said Marge Skubic, electrical and computer engineering associate professor at the College of Engineering , “and the falls need to be realistic. This information trains our software programs so we can automatically recognize what these falls look like when they happen in real life.”

This and other “smart home” technologies are being developed to enhance residents' safety and monitor health conditions. However, motion and bed sensors can only verify physical function in general terms.

In another project, Skubic is developing vision-based recognition methods for multi-person environments. The cameras capture images and the computers convert it into silhouettes, thus preserving privacy. This silhouette indicates the difference between lying and falling down thus helping with the concern of a false alarm, Skubic said.

“Alarms need to be accurate, sensitive to the event and not miss an event when it occurs,” Rantz said. “A high rate of false alarms, if we hear it too much, will be ignored.”

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Bioterrorism Training

After a successful first year, the Nursing Outreach and Distance Education office is gearing up for the 2008 National Bioterrorism Hospital Preparedness Program. In partnership with the Missouri Department of Health and Senior Services, NODE handled the training seminars associated with the national grant in both 2007 and now in 2008.

“During the last 15 years, our nation has had to react to incidents that directly involve public-health issues,” Farrah says. “The health care professionals in Missouri have to have a workable plan that individuals know about to deal with a variety of scenarios such as a bombing like we saw in Oklahoma City.”

Using technologies available through the MU TeleHealth Network, last year NODE partnered with rural and urban hospitals, rural health clinics and health departments throughout the state to present six training seminars on four topics.

2008 topics include:

  • ESSENCE
  • Psychological aspects of disaster
  • Multiple casualties
  • Medical response to a dirty bomb
  • Pulmonary agent and chemical exposure
  • Tularemia

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More information or to register

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Creating Understanding

Reducing nursing turnover in long-term care facilities and improving patient care are the goals of the MU Extension Leadership Academy. This nine-month program for nursing directors at skilled-care facilities began in November and runs into July.

“Most registered nurses in long-term care come from a hospital background,” said Shirley Farrah, assistant dean for nursing outreach and distance education at the School. “They don't understand the highly regulated, complex long-term care environment.”

Consequently, many nursing directors leave their position within the first six months, and some stay on the job as short as a week, Farrah said.

What turnover creates:

  • Missouri 's rate is nearly 61 percent – the national average is 50 percent.
  • When a nursing director leaves, the effects ripple through the facility.
  • Nursing staff suffers from the lack of leadership creating more turnover.
  • Quality of care residents receive is diminished.

Currently students meet at MU for the first and last class. In between, they meet monthly via interactive video at sites in Columbia, Kansas City and St. Louis . A grant will support the leadership academy for three years with additional ITV locations added in the upcoming years.

“MU nursing research shows that good facilities have well-prepared nurse leaders who can implement change and sustain it, resulting in better morale, lower mortality rates and fewer inspection citations.”

— Shirley Farrah
assistant dean for nursing outreach and distance education

 

More information or to register

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PHOTO: MarCom Award statueMarCom Awards

Your magazine, “Mizzou Nursing” was among the top recipients of this year's MarCom Awards competition by receiving both a gold statuette in the Educational Institution magazine category and an honorable mention for magazine design. Its research publication, “A Taste for Life” also brought home a gold statuette in the Annual Report design competition.

MarCom Awards announced winners for the 2007 international awards competition that recognizes outstanding creative achievement by marketing and communication professionals. More than 5,000 entries worldwide were entered in this year's competition.

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PHOTO: Nursing Alumni Organization participates in 2007 Homecoming Parade

 

The Nursing Alumni Organization and the Student Nurses Association made their presence known at last year's cold but sunny Homecoming Parade — even if they were the 132th organization out of 136 marching in the Homecoming Parade.

 

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Cotton Candy

PHOTO: Cotton Bowl image by Rob HillAt the end of the day, a bunch of extremely happy black-and-gold fans face an extremely pleasant drive or flight home. Coaches and players get to revel in a season in which they won 12 games, something no Mizzou team has done before. They also get to expect a solid ranking at the end of the season after a marquee bowl victory, BCS or no BCS.

Soft-spoken senior tight end Martin Rucker — who was relatively quiet today but was a force this year — offers some parting words on a season that will go down in history: “This is why I came back … I said the guys in this locker room will be a pretty special team this year, and I wanted to be a part of it.”

Mizzou Wire.com

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GRAPHIC: Battling it Out titleA University of Missouri researcher and expert in divorce and stepfamily
issues says everyone's eyes should be open to the damage that can be
inflicted on children who are caught in a custody war.

GRAPHIC: boxing gloves“Interparental conflict is so damaging for kids,” says Larry Ganong, professor and co-chair of the Department of Human Development and Family Studies (HDFS) in the MU College of Human Environmental Sciences and professor in the Sinclair School of Nursing. “The message
is that parents need to cooperate as much as possible, put the children's needs first, stifle anger and take the high road.”

51 the percent of America 's courts require some type of parental education for adults

12 the number of years the HDFS program
“Focus on Kids” has existed

Parents

  • You don't have to like one another
  • Learn how to put your differences aside for your children's sake
  • Act cordial as you would with a co-worker or a business associate.
  • In this instance, the parent's business is raising a child.
  • It takes two people to make co-parenting a success.

 

“When I teach Focus on Kids classes, I tell them when they interact with their former spouse it will be difficult because that person knows what buttons to push, in fact, the ex-spouse probably installed those buttons,” he said. “It sounds like common sense; but there is a lot of research to support the fact that conflict between parents is more damaging to children than not having their parents in the same household.”

Most Parents

Most parents do a good job of putting their children first.

Those who try hard to do their best slip sometimes “Like a person on a diet grabbing a candy bar once in a while,” Ganong says.

  • Above all, it is important for both parents to be a part of their children's lives.
  • It is extremely important for the other parent to have visitations.
  • Safety is the priority.

 

If a child never sees one parent:

  • a tendency for the child to idealize that parent
  • have a distorted view of that parent because all they hear is negative
  • neither situation is good for kids

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Stretching

The ground has been broken for the second building phase of the School's cooperative efforts at TigerPlace.

The highlight for several faculty members and alums is the construction of the new courtyard. “A group of donors have bought the main courtyard feature – a life-size Bengal tiger – and it will be on loan to TigerPlace during our partnership,” says the School's alumni director and '72 grad Donna Otto. “My husband says I've really got the tiger by the tail this time. It takes two grown men to pick him up.”

A true interdisciplinary effort, the courtyard was designed by horticulture students at the College of Agriculture , Food and Natural Resources. The architect selected the best features from the designs submitted and incorporated them into the final schematic.

The courtyard, along with the tiger and arbor, will be viewable from the current dining area as well as many of the apartments, the new informal club dining room and the new exercise area.

 

New additions:

  • 24 apartments
    • Larger single bedroom units
    • More two-bedroom units
  • New dining area
  • Larger workout/exercise room
  • Theatre
  • Club dining (more informal)
  • Larger bar area with more tables and seating space
  • Courtyard with walkways, arbor, benches and tiger statue (see below)
  • Putting green (optional)
  • Technology hidden in cabinet over refrigerator

 

Tiger facts

  • 7' from tip of nose
    to end of tail
  • 31” tall at shoulder
  • 36” head circumference
  • 44” chest circumference
  • 150 pounds

PHOTO: tiger statue

 

 

 

 

 

TigerPlace

Americare

 

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GRAPHIC: upside down pyramidTurning Administration Upside Down

Academics:

  • Master's program 47th out of 285 national programs
  • Nurse Practitioner program ranked 23rd out of 30 evaluated programs — more than 342 programs nationally
  • 90+ pass rate for first time state board exams
  • 90 percent employment placement rate
  • 80 percent of graduates stay in Missouri
  • implemented the Accelerated BSN option in 2003 and it has quadrupled in size
  • all Master's programs and courses go on-line

Research:

  • Ranked third nationally for faculty scholarly productivity
  • first international research publication housed within the School — Western Journal of Nursing Research 
  • 297 percent on the average national scale for grants per faculty
  • increased interdisciplinary research efforts among the School and other MU disciplines
  • nearly doubled American Academy of Nursing Fellows

Service:

  • Exceeded all goals for the MU For All We Call Mizzou capital campaign
  • brought TigerPlace into physical reality
  • highest participating alumni chapter on campus
  • created award-winning publications

Personal:

  • 29 years at MU
  • 9 years as SON dean

 

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PHOTO: Residential construction

Mid Campus Dorms

For almost 30 years, nursing students walked on green grass and sidewalks just east of the School. Now three four-story residence halls are being constructed in that area as well as the area where the Baker-Park and Gardner-Hyde residence halls once stood.

The Mid Campus Housing complex will be a 527-bed student housing facility that will be connected at the second level with bridges. The three buildings will be arranged to create an internal courtyard for residents' use.

The renovation of Defoe and Graham Halls will run concurrently with construction of the Mid Campus complex. The existing residence halls will be renovated and connected at the north end by a new four-story addition. Including this link, the Defoe/Graham renovation will provide a total of 306 beds. Portions of the interiors of Graham and Defoe will be completely renovated with new walls, doors, ceilings and floor finishes. Bathrooms will be completely reconstructed, and elevators will be added to both halls.

The three new Mid Campus buildings, along with renovated Defoe and Graham halls, will open to students fall semester 2009.

Additional information

 

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Smart Carpet

Nearly one-third of American seniors age 65 and older fall each year, and such falls cause more deaths than any other injury, government statistics show. Harry Tyrer, a MU electrical and computer engineering professor, hopes to create a safer environment for seniors. Tyrer is working with Sinclair School of Nursing to develop a “smart” carpet that would electronically monitor a senior's location and sound an alert due to a fall.

Tyrer and Associate Professor of Nursing Myra Aud's smart carpet project incorporates a new type of sensor that can be printed on thin, flexible sheets using what is known as “organic ink.” Organic ink sensors are not only flexible, but potentially inexpensive making it practical to use them by the thousands on a sensor sheet layered between a room's carpet and carpet pad, according to Tyrer.

Tyrer is developing circuits that will feed the sensor sheet's signals several times a second to a computer for display and electronic analysis. Ideally, a caregiver will be able to see where a person steps on a smart carpet, assess that person's gait and act immediately if the person falls.

“Current floor sensor systems rely on vibration readings that may be easily misinterpreted,” Tyrer said. “I think of the ‘smart carpet' system as a significant improvement and a way for seniors to live both independently and safely longer, providing caregivers or family members an electronic emergency alert system.”

After developing and improving a prototype during the next two years, Tyrer plans to test the smart carpet at TigerPlace and The Bluffs, two senior housing complexes in Columbia . The researchers hope the carpet will register not only falls but changes in gait or behaviors that would serve as red flags for caregivers.

by Vicki Hodder

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Baby Me

A University of Missouri-Columbia nursing professor says doctors and nurses need to improve their efforts to educate women on the benefits of breastfeeding and help them overcome some of the hurdles.

“Breastfeeding is so much better for the baby,” said Kay Libbus, professor in the MU Sinclair School of Nursing. “It is very rare for breastfeeding to be physiologically impossible. Unfortunately, there are many societal glitches.”

Benefits:

  • Faster healing and weight loss for mothers who breastfeed
  • Mothers also report a great sense of bonding with their newborns through breastfeeding.
  • New mothers often look to their own mothers as examples. If a woman's mother breastfed and was successful, a woman is more likely to have positive feelings about breastfeeding and be willing to initiate it, according to Libbus.
  • Greater immunity to allergies and other childhood illnesses for babies.

“We need to be helping moms. Many women don't ask questions because they feel they should naturally know how to breastfeed and that just isn't the case. Every woman should have an opportunity to see a lactation consultant to help them learn easier and better methods for making breastfeeding work,” Libbus said. “Of course, if a woman really doesn't want to breastfeed, she shouldn't feel forced to do so. That isn't good for her mental health.”

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TITLE: Colds and Flus by the Numbers

 

 

Handwashing

Thoroughly washing hands was sound advice established by Florence Nightingale 175 years ago while she attempted to cut down on the fatalities of war.

  • Studies show that 40 to 60 percent of people don't wash their hands after using the restroom and most individuals don't wash long enough.
  • “Use warm water and scrub between your fingers as well as around your fingernails,” Traudes said. “Sing the ‘Alphabet' song or ‘Twinkle, Twinkle Little Star' twice and you know you've scrubbed away the majority of the germs and bacteria.”
  • Pay particular attention to your cuticles and under your nails.
  • Dirt, germs and bacteria gather in the crevices surrounding your nails
  • Keep hangnails trimmed and bandaged to prevent bacteria and viruses from entering your body.
  • Long, polished and artificial nails are more susceptible to harboring bacteria

 

Lotions

  • Keep the skin soft and supple to prevent cracking, which in turn helps keep the bacteria out, points out the nursing lab instructor.

 

Antibacterials

  • Be aware of public surfaces such as public computer keyboards, banisters and handrails and countertops
  • Traudes suggests using a waterless hand sanitizer containing aloe before and after touching public surfaces (aloe offsets the drying effects alcohol-based products have on the skin).
  • Using the sanitizer before reduces germs you spread
  • Using it afterwards not only protects you but limits your contribution to the cycle of infection.

 

PHOTO: Beth TraudesBeth Traudes

After the 2008 May graduation, Beth Traudes will retire as the coordinator of the School's Skills Lab and as an instructor of nursing.

 

 

 

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Crunch Time


IMAGE: treadmillVicki Conn focuses on the impact exercise has on the quality of life for older adults — a population that exercise equipment and gym marketers largely ignore.

You're a doctor or nurse with a clinical question. A good place to look for the answer is in the many scientific journals related to the topic of your interest. There are hundreds of journals that publish thousands of articles on a huge array of topics. Even if you successfully narrow the field to publications related to your question, which ones do you trust?

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

So Conn and a team of researchers are beginning the long and arduous process of locating and examining every study that's been published about exercise and the chronically ill. By conducting a meta-analysis, Conn hopes that trends will emerge, making it easier to formulate definitive conclusions about the best types of exercise programs for this population.

Exercise may be particularly important for managing symptoms and disease progression. For instance, diabetics can control their glucose levels better if they regularly exercise, and people with heart disease decrease their risk of life-threatening episodes by staying in shape.

“There are so many individual studies out there, and it looks like the findings are contradictory. 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? We want to summarize across all the studies more accurately,” she says.

After checking high-profile sources, Conn and her team become detectives hunting down what she refers to as “fugitive literature.” At this point, the team will delve into the murky world of unpublished research and minor journals.

It may not be as thrilling and dangerous as a James Bond chase, but for every article scanned by Conn and her team, many more leads are uncovered in the form of citations that must be found and analyzed.

Once they have completed the statistical analysis of primary findings and calculated the exact numbers associated with intervention effects, they will have a list of interventions that have been proven the most effective for encouraging exercise.

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.”

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PHOTO: golf flagFund the Drive for Nurses Golf Tournament

Thanks to your continued support, the Fund the Drive for Nurses scholarship golf tournament has now generated more than $121,000. The 8th annual event held October 1, 2007 with the live auction generated $25,000. To date, 53 recipients have received more than $23,000 in scholarships from this tournament. Thank you for continuing to support nursing education at MU. Please make plans to join us in 2008.

Women's Division first place: Wendy Evans Sponsored Team — Marilyn Gaeth, Heiddi Davis, Kimi Rother and Rebecca Highland

Men's/Mixed Division first place: Joe Machens Sponsored Team — Kevin Osborne, Danny Myers, Dave Teel and Dave McDonald

Specialty contest winners:
Men's Longest Drive — Jack Cruise
Women's Longest Drive — Linda Dreier
Men's Closest to the Pin — Marty Siddall
Women's Closest to the Pin — Mary Beck

Sponsors: Friends in Memory of Ed McDaniel; Larry and Annette Lueckenotte; Roxanne McDaniel; Denice and Richard Mendenhall; Jack and Donna Smith; Joe Machen's BMW, hole-in-one; Gary and Ginny Evans, lunch; Elite Nurse Staffing, award reception; Nauser Beverage, N.H. Scheppers Distributing and Hy-Vee, beverages; and Travis Ballenger, auctioneer

Tribute to Ed McDaniel: The Ed McDaniel Memorial Men's Longest Drive competition. With the death of Ed McDaniel in March 2007, one of the original Driving Force sponsors, his family and friends honored the man and his passion by dedicating this highly sought after competition in his name.

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Viva Mizzou

GRAPHIC: Student Nurses Week adtop

 


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