Nursing home care quality: A multidimensional theoretical model integrating the views of consumers and providers

Written By: Rantz, M. J., Zwygart-Stauffacher, M., Popejoy, L., Grando, V., Mehr, D., Hicks, L., Conn, V., Wipke-Tevis, D., Porter, R., Bostick, J., & Maas, M.

This exploratory study was undertaken to discover the defining dimensions of nursing home care quality from the viewpoint of consumers of nursing home care. Eleven focus groups were conducted in five Missouri communities. The seven dimensions of the consumer...

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Integrative review of physical activity intervention research with aging adults

Written By: Conn, V., Minor, M., Rantz, M.J., Burks, K., & Pomeroy, S.

This paper reviews randomized, controlled trials (RCTs) that have attempted to increase physical activity behavior by aging adults. A systematic review was necessary because numerous studies target older adults, and previous reviews have addressed a limited range of primary...

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Senior Care: Making a difference in long-term care of older adults

Written By: Marek, K.D., Rantz, M.J., & Porter, R.T.

This article describes the creation of Senior Care , a practice of the University of Missouri Sinclair School of Nursing (MUSSON). Senior Care is a home care agency that specializes in care of frail older...

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Technology and nursing collaboration to help older adults age in place

Written By: Rantz, M.J., Marek, K.D., Aud, M.A., Tyrer, H.W., Skubic, M., Demiris, G., & Hussam, A.A.

This is an account of an active collaboration between Computer Engineering, Health Informatics, and Nursing within an academic health science center to improve the quality of life of older adults as they “age in place.” The Sinclair School of...

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Clinical outcomes of aging in place

Written By: Marek, K., Popejoy, L., Petroski, G., Mehr, D., Rantz, M.J., & Lin, W.

Programs such as Medicaid Home and Community-based Services (HCBS) have provided an alternative to institutionalization through community-based, long-term care services; however, there are limited studies on the clinical outcomes of participants in these programs as compared to nursing home...

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Nurse care coordination in community-based long-term care

Written By: Marek, K.D., Popejoy, L., Petroski, G., & Rantz, M.J.

The purpose of this study was to evaluate the clinical outcomes of a nurse care coordination program for people receiving services from a state-funded home and community-based waiver program called Missouri Care Options (MCO). A quasi-experimental design was used...

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Senior residents’ perceived need of and preferences for “smart home” sensor technologies

Written By: Demiris, G., Hensel, B.K., Skubic, M., & Rantz, M.J.

The goal of meeting the desire of older adults to remain independent in their home setting while controlling healthcare costs has led to the conceptualization of “smart homes.” A smart home is a residence equipped with technology that enhances...

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Use of videophones for distant caregiving: An enriching experience for families and residents in long-term care

Written By: Demiris, G., Parker-Oliver, D., Hensel, B.K., Dickey, G., Rantz, M., & Skubic, M.

The objective of this study was to explore the role of videophone technology in enhancing the distant caregiving experience of and communication between residents of a long-term care facility and their family members. Ten participants – 4 residents of...

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Needing smart home technologies: the perspectives of older adults in continuing care retirement communities

Written By: Courtney, K.L., Demiris, G., Rantz, M.J., & Skubic, M.

At present, the vast majority of older adults reside in the community. Though many older adults live in their own homes, increasing numbers are choosing continuing care retirement communities (CCRCs), which range from independent apartments to assisted living and...

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The relationship of community-based nurse care coordination to costs in the Medicare and Medicaid programs

Written By: Marek, K.D., Adams, S.J., Stetzer, F., Popejoy, L., Petroski, G.F., & Rantz, M.

The purpose of this evaluation was to study the relationship of nurse care coordination (NCC) to the costs of Medicare and Medicaid in a community-based care program called Missouri Care Options (MCO). A retrospective cohort design was used comparing...

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Aging in Place Preserves Seniors’ Independence, Reduces Care Costs

Written By: Martin, Emily

America’s 75 million aging adults soon will face decisions about where and how to live as they age. Current options for long-term care, including nursing homes and assisted-living facilities, are costly and require seniors to move from place to...

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Evolution of an early illness warning system to monitor frail elders in independent living

Written By: Alexander G.L., Rantz M.J., Skubic M., Koopman R., Phillips L., Guevara R.D., & Miller S.

This paper describes the evolution of an early illness warning system used by an interdisciplinary team composed of clinicians and engineers in an independent living facility. The early illness warning system consists of algorithms which analyze resident activity patterns...

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At Complex, University of Missouri Touts ‘Aging in Place’

Written By: Glenn Haas, Jane

One study, just completed, is said to prove the financial benefit as well as the social and personal benefits to aging in place. (2011) Press Release @ St. Louis Post Dispatch

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Passive sensor technology interface to assess elder activity in independent living

Written By: Alexander, G.L., Wakefield, B.J., Rantz, M., Skubic, M., Aud, M., Erdelez, S., & Al Ghenaimi, S.

Background: The effectiveness of clinical information systems to improve nursing and patient outcomes depends on human factors, including system usability, organizational workflow, and user satisfaction. Objective: The aim of this study was to examine to what extent residents, family...

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MU Researchers Use New Video Gaming Technology to Detect Illness, Prevent Falls in Older Adults

Written By: MU News Bureau

Researchers at the University of Missouri and TigerPlace, an independent living community, have been using motion-sensing technology to monitor changes in residents’ health for several years. Now, researchers have found that two devices commonly used for video gaming and...

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Kinect Effect Reaches Into Hospitals, Senior Centers

In the year since Microsoft launched Kinect for Xbox 360, the controller-free device has been adopted and adapted for a growing number of non-gaming uses, many of them in the healthcare field. (2011) Press Release @ Microsoft

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Aging in Place versus nursing home care: comparison of costs to Medicare and Medicaid

Written By: Marek, K.D., Stetzer, F., Adams, S.J., Popejoy, L., & Rantz, M.

The objective of this study was to compare the community-based, long-term care program called Aging in Place (AIP) and nursing home care, in terms of cost to the Medicare and Medicaid programs. A retrospective cohort design was used in...

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MU Sinclair School of Nursing Interdisciplinary Projects Receive Top Honors from the American Academy of Nursing

Raise the Voice Edge Runners are the practical innovators who have led the way in bringing new thinking and new methods to a wide range of health care challenges. Many senior citizens and their families seek to postpone or avoid nursing...

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In-home fall risk assessment and detection sensor system

Written By: Rantz, M.J., Skubic, M., Abbott, C., Galambos, C., Pak, Y., Ho, D.K., Stone, E.E., Rui, L., Back, J., & Miller, S.J.

Falls are a major problem in older adults. A continuous, unobtrusive, environmentally mounted (i.e., embedded into the environment and not worn by the individual), in home monitoring system that automatically detects when falls have occurred or when the risk...

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Influencing Public Policy through Care Coordination Research

Written By: Rantz, M., Popejoy, L., Musterman, K., & Miller, S.J.

The University of Missouri (MU) Sinclair School of Nursing (SSON) stepped up to the challenge of creating a different way of supporting older adults as they age, providing care on their own terms. Working with stakeholders, including consumers, politicians,...

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Automated fall detection with quality improvement “rewind” to reduce falls in hospital rooms

Written By: Rantz, M., Banerjee, T.S., Cattoor, E., Scott, S.D., Skubic, M., & Popescu, M.

The purpose of this study was to test the implementation of a fall detection and “rewind” privacy-protecting technique using the Microsoft® Kinect™ to not only detect but prevent falls from occurring in hospitalized patients. Kinect sensors were placed in...

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Nursing home research: The first international association of gerontology and geriatrics research conference

Written By: Rantz, M.J. & Skubic, M.

The International Association of Gerontology and Geriatrics held its first conference on nursing home research in St Louis, MO, in November 2013. This article provides a summary of the presentations. Rolland, Y., Resnick, B., Katz, P.R., Little, M.O., Ouslander,...

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New Technologies to Help Seniors Age in Place

Written By: Wang, Shirley

Researchers test ways to prevent elderly people from injuring themselves at home. Article @ The Wall Street Journal

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Quantitative gait measurement with pulse-Doppler radar for passive in-home gait assessment

Written By: Wang, F., Skubic, M., Rantz, M., Yardibi, T., & Cuddihy, P.E.

In this paper, we propose a Pulse-Doppler radar system for in-home gait assessment of older adults. A methodology has been developed to extract gait parameters including walking speed and step time using Doppler radar. The gait parameters have been...

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The continued success of registered nurse care coordination in a state evaluation of Aging in Place in senior housing

Written By: Rantz, M., Popejoy, Lori L., Galambos, C., Phillips, L.J., Lane, K.R., Marek, K.D., Hicks, L., Musterman, K., Back, J., Miller, S.J., & Ge, B.

Older adults prefer to age in place, remaining in their home as their health care needs intensify. In a state evaluation of Aging in Place (AIP), the University of Missouri Sinclair School of Nursing and Americare System Inc., developed...

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Because of Nursing Research: Supporting Technologies for Healthy Independent Living

Written By: NIH: NINR

National Institute of Nursing Research (National Institutes of Health) – Because of Nursing Research: Supporting Technologies for Healthy Independent Living

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Doppler radar fall activity detection using the wavelet transform

Written By: Su, B.Y., Ho, K.C., Rantz, M., & Skubic, M.

We propose in this paper the use of Wavelet transform (WT) to detect human falls using a ceiling mounted Doppler range control radar. The radar senses any motions from falls as well as nonfalls due to the Doppler effect....

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Automated health alerts using in-home sensor data for embedded health assessment

Written By: Skubic, M., Guevara, R., & Rantz, M.

We present an example of unobtrusive, continuous monitoring in the home for the purpose of assessing early health changes. Sensors embedded in the environment capture behavior and activity patterns. Changes in patterns are detected as potential signs of changing...

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Reaching for the Gold with Harriet Tramer (radio interview)

Written By: Tramer, Harriet

Listen to Marilyn Rantz’s interview on Harriet Tramer’s May 2015 show. Host Harriet Tramer has long worked as both a journalist and a college instructor. And her experiences have taught her that these two professions definitely share one thing in...

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Technology Helps Seniors Live Safely and Independently at Home

Written By: Chew, Jesslyn

For more than 10 years, two University of Missouri researchers have researched and developed technology to help people age in place safely and independently. The research started at TigerPlace, an independent housing facility in Columbia, which was developed by...

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Automated in-home fall risk assessment and detection sensor system for elders

Written By: Rantz, M., Skubic, M., Abbott, C., Galambos, C., Popescu, M., Keller, J., Stone, E., Back, J., Miller, S.J., & Petroski, G.F.

Falls are a major problem for the elderly leading to injury, disability, and even death. An unobtrusive, in-home sensor system that continuously monitors older adults for fall risk and detects falls could revolutionize fall prevention and care. A fall...

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Paul Pepper: Boone County Museum 25th Anniversary & Sinclair School of Nursing, “Sinclair At Home”

Written By: Pepper, Paul

Paul Pepper: Boone County Museum 25th Anniversary & Sinclair School of Nursing, “Sinclair At Home” Paul Pepper  |  July 6, 2015 Paul Pepper and Chris Campbell talk about the upcoming 25th anniversary celebration of the Walters-Boone County Museum and...

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Foresight – Health Risk Detection System

Written By: ASC Video Production

Foresight – Health Risk Detection System – presented at the 2015 Innovation & Entrepreneurial Recognition Dinner at the University of Missouri. Click here for the video – ASC Video Production

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Enhanced registered nurse care coordination with sensor technology: impact on length of stay and cost in Aging in Place housing

Written By: Rantz, M.J., Lane, K.R., Phillips, L.J., Despins, L.A., Galambos, C., Alexander, G.L., Koopman, R.J., Skubic, M., & Miller, S.J.

When planning the Aging in Place Initiative at TigerPlace, it was envisioned that advances in technology research had the potential to enable early intervention in health changes that could assist in proactive management of health for older adults and...

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Comparing Aging in Place to home health care: impact of nurse care coordination on utilization and costs

Written By: Popejoy. L., Stetzer, F., Hicks, L., Rantz, M.J., Galambos, C., Popescu, M., Khalilia, M.A., & Marek, K.

The goal of this study was to compare utilization and cost outcomes of patients who received long-term care coordination in an Aging in Place program to patients who received care coordination as a routine service in home health care. This...

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Aging in community: developing a more holistic approach to enhance older adults’ well-being

Written By: Davitt, J.K., Madigan, E.A., Rantz, M., & Skemp, L

Public health advances have contributed to increased longevity; however, individuals are more likely to live longer with multiple chronic conditions. The existing health care system primarily focuses on treating disease rather than addressing well-being as a holistic construct that...

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Older adults live independently longer when monitored by care team and technology

Written By: Chew, Jesslyn

Finding ways to help older adults “age in place” has been a focus of researchers at the University of Missouri for more than a decade. Now, a new study shows their work at TigerPlace, an independent living community that...

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Aging in Place: Critical for Seniors to Remain Independent

Written By: Rice, Sheena

EXPERT AVAILABLE: Aging in Place Critical for Seniors to Remain Independent MU Professor Marilyn Rantz credits advanced nurses, technology and coordinated care as means for improving patient care and lowering health care costs COLUMBIA, Mo. – Quality of care...

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Aging in Place: critical for seniors to remain independent

Written By: Rantz, M.

America’s 75 million aging adults soon will face decisions about where and how to live as they age. Current options for long-term care, including nursing homes and assisted-living facilities, are costly and require seniors to move from place to...

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An automatic in-home fall detection system using Doppler radar signatures

Written By: Liu, L., Popescu, M., Skubic, M., Rantz, M., & Cuddihy, P.

One in three elders over the age of 65 falls each year in the United States. This paper describes a non-invasive fall detection system based on a Doppler radar sensor. The developed system has been tested in two environments:...

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Using embedded sensors in independent living to predict gait changes and falls

Written By: Phillips, L. J., Deroche, C., Rantz, M., Alexander, G. L., Skubic, M., Despins, L., Abbott, C., Harris, B. H., Galambos, C., & Koopman, R.

This study explored using Big Data, totaling 66 terabytes over 10 years, captured from sensor systems installed in independent living apartments to predict falls from pre-fall changes in residents’ Kinect-recorded gait parameters. Over a period of 3 to 48...

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Exploring the feasibility and acceptability of sensor monitoring of gait and falls in the homes of persons with Multiple Sclerosis

Written By: Newland, P., Wagner, J.M., Salter, A., Thomas, F.P., Skubic, M., & Rantz, M.

Gait parameters variability and falls are problems for persons with MS and have not been adequately captured in the home. Our goal was to explore the feasibility and acceptability of monitoring of gait and falls in the homes of...

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Exploratory analysis of older adults’ sedentary behavior in the primary living area using Kinect depth data

Written By: Banerjee, T., Yefimova, M., Keller, J., Skubic, M., Woods, D.L., & Rantz, M.

We describe case studies of clinically significant changes in sedentary behavior of older adults captured with a novel computer vision algorithm for depth data. An unobtrusive Microsoft Kinect sensor continuously recorded older adults’ activity in the primary living spaces...

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Estimation of human walking speed by Doppler radar for elderly care

Written By: Rui, L., Chen, S., Ho, K.C., Rantz, M., & Skubic, M.

This paper presents a human walking speed estimation algorithm using a Doppler radar system for in-home passive gait assessment of elderly adults. The Fast Fourier Transform (FFT) has been a common approach to obtain the gait speed estimation. The...

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Assessment of fall characteristics from depth sensor videos

Written By: O’Connor, J.J., Phillips, L.J., Folarinde, B., Alexander, G.L., & Rantz, M.

Falls are a major source of death and disability in older adults; little data, however, are available about the etiology of falls in community-dwelling older adults. Sensor systems installed in independent and assisted living residences of 105 older adults...

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Older adults’ perceptions and preferences of a fall risk assessment system: Exploring stages of acceptance model

Written By: Galambos, C., Back, J., Rantz, M., Jung Sim, J., Skubic, M., & Miller, S.

Aging in place is a preferred and cost-effective living option for older adults. Research indicates that technology can assist with this goal. Information on consumer preferences will help in technology development to assist older adults to age in place....

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Continuous in-home symptom and mobility measures for individuals with Multiple Sclerosis: A case presentation

Written By: Newland, P., Kimutis, A., Salter, A., Flick, L., Thomas, F., Rantz, M., & Skubic, M.

Gait impairment represents one of the most common and disabling symptoms of multiple sclerosis (MS). To identify which temporal or spatial parameters of gait could be used as outcome measures in interventional studies of individuals with MS with different...

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An integrated review of research using clinical decision support to improve advanced directive documentation

Written By: Folarinde, B. & Alexander, G.L.

The Patient Self-determination Act requires that health care institutions inform patients of their right to make health care preferences known through advance directives. However, actual advance directive documentation remains low. This study’s purpose is to identify and analyze research...

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Metrics from in-home sensor data to assess the effect of clinical therapies

Written By: Wallace, R., Abbott, C., Gibson-Horn, C., Rantz, M., & Skubic, M

A set of metrics and a methodology were developed to characterize a subject’s ability to ambulate. These metrics use the movement of the subject’s centroid as detected by an inexpensive depth camera system. The centroid is chosen as it...

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Randomized trial of intelligent sensor system for early illness alerts in senior housing

Written By: Rantz, M., Phillips, L.J., Galambos, C., Lane, K., Alexander, G.L., Despins, L., Koopman, R.J., Skubic, M., Hicks, L., Miller, S., Craver, A., Harris, B., & Deroche, C.B.

Objectives: Measure the clinical effectiveness and cost-effectiveness of using sensor data from an environmentally embedded sensor system for early illness recognition. This sensor system has demonstrated in pilot studies to detect changes in function and in chronic diseases or...

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Radar placement for fall detection: signature and performance

Written By: Su, B.Y., Ho, K.C., Rantz, M.J., & Skubic, M.

Two popular mounting positions of Doppler radar for human fall detection are in the ceiling center and at the torso level. This paper examines the fall signatures observed by a Doppler radar at the two positions and evaluates their...

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Involvement of Advanced Practice Nurse in the management of geriatric conditions: examples from different countries

Written By: Fougère, B., Lagourdette, C., Abele, P., Resnick, B., Rantz, M., Kam Yuk Lai, C., Chen, Q., Moyle, W., Vellas, B., & Morley, J.E.

The increasing demand for healthcare services is placing great strain on healthcare systems throughout the world. Although the older population is increasing worldwide, there is a marked deficit in the number of persons trained in geriatrics. It is now...

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Monitoring the relative blood pressure using a hydraulic bed sensor system

Written By: Su, B.Y., Enayati, M., Skubic, M., Despins, L., Keller, J., Popescu, M., Guidoboni, G., & Rantz, M.

We propose a non-wearable hydraulic bed sensor system that is placed underneath the mattress to estimate the relative systolic blood pressure of a subject, which only differs from the actual blood pressure by a scaling and an offset factor....

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Aging in Place: transitional housing and supported housing models

Written By: Lane, K.R., Galambos, C., Phillips, L.J., Popejoy, L.L., & Rantz, M.

Handbook of Geriatric Assessment, Fifth Edition is a multidisciplinary text that takes a contemporary approach in line with patient- and family-centered care. With contributions from the foremost experts in the field, it contains the latest information on geriatric assessments...

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From detection to prevention and beyond: the future of sensor technology in senior living

Written By: Kilgore, Christine

In an innovative senior living community in Columbia, MO, called Tiger-Place, sensor technology that continually monitors the residents and sends alerts when patterns change is helping nurses and other providers prevent falls and detect early signs of illnesses and...

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Linguistic summarization of in-home sensor data

Written By: Jain, A., Popescu, M., Keller, J., Rantz, M., & Markway, B.

Introduction With the increase in the population of older adults around the world, a significant amount of work has been done on in-home sensor technology to aid the elderly age independently. However, due to the large amounts of data...

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Associations between self-reported symptoms and gait parameters using in home sensors in persons with multiple sclerosis (MS)

Written By: Newland, P., Salter, A., Flach, A., Flick, L., Thomas, F., Gulick, E., Rantz, M., & Skubic, M.

Background and Purpose: Multiple sclerosis (MS) is a progressive neurological disorder, characterized by exacerbations and remissions, often resulting in disability affecting multiple neurological functions. The purpose of this article was (1) to describe the frequencies of self-reported symptoms in...

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A coordinated response to the COVID-19 pandemic in Missouri nursing homes

Written By: Popejoy, L., Vogelsmeier, A., Boren, W., Martin, N., Kist, S, Canada, S., Miller, S.J., & Rantz, M.

In the United States, the first case of the novel coronavirus 2019 (COVID-19) was detected in January 2020 in the state of Washington. By February 2020, COVID-19 was linked to 167 confirmed cases of staff and residents within a...

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Technology for healthy independent living: creating a tailored in-home sensor system for older adults and family caregivers

Written By: Robinson, E.L., Park, G., Lane, K., Skubic, M., & Rantz, M.

Sensing technologies hold enormous potential for early detection of health changes that can dramatically affect the aging experience. In previous work, we developed a health alert system that captures and analyzes in-home sensor data. The purpose of this research...

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Human-centered approaches that integrate sensor technology across the lifespan: opportunities and challenges

Written By: Ward, T., Skubic, M., Rantz, M., & Vorderstrasse, A.

Children, parents, older adults, and caregivers routinely use sensor technology as a source of health information and health monitoring. The purpose of this paper is to describe three exemplars of research that used a human-centered approach to engage participants...

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Tracking personalized functional health in older adults using geriatric assessments

Written By: Mishra, A.K., Skubic, M., Popescu, M., Lane, K., Rantz, M., Despins, L.A., Abbott, C., Keller, J., Robinson, E.L. & Miller, S.

Background: Higher levels of functional health in older adults leads to higher quality of life and improves the ability to age-in-place. Tracking functional health objectively could help clinicians to make decisions for interventions in case of health deterioration. Even...

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Social practices of nurse care coordination using sensor technologies – Challenges with an alert system adoption in assisted living communities for older adults

Written By: Jahnke, I., Riedel, N., Popescu, M., Skubic, M., & Rantz, M.

Objectives: From the view of everyday practices and the socio-technical coordination lens, we analyzed the gap between creators’ intention and the users’ implementation (mainly nursing staff and social workers) of an alert system in assisted living communities. Methods: Qualitative...

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Explainable fall risk prediction in older adults using gait and geriatric assessments

Written By: Mishra, A.K., Skubic, M., Despins, L.A., Popescu, M., Keller, J., Rantz, M., Abbott, C., Enayati, M., Shalini, S., & Miller, S.

Mishra, A.K., Skubic, M., Despins, L.A., Popescu, M., Keller, J., Rantz, M., Abbott, C., Enayati, M., Shalini, S., & Miller, S. (2022). Explainable fall risk prediction in older adults using gait and geriatric assessments. Frontiers Special Issue: Preserving Health:...

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