Technology & Aging

MU researchers taking sensor system from lab to marketplace

Written By: Favignano, Megan

While some go to the doctor once a year, many residents at the TigerPlace assisted living community in southeast Columbia get a virtual checkup every day. Wireless sensor systems installed in about half of the community’s living spaces constantly...

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...

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 Because of Nursing

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. ASC Video Production

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...

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...

Mizzou professor teaches senators about technology to help seniors stay at home

Written By: Howard, Jim (KSMU Ozarks Public Radio)

Technology is extending the amount of time aging Americans can live in the familiar surroundings of their own home, rather than be placed in a care facility. Marjorie Skubic, director of the University of Missouri’s Center for Eldercare and...

Sinclair@Home (KFRU Interview)

Written By: Rantz, M.

Listen to Marilyn Rantz’s KFRU interview on the new program, Sinclair@Home!

MU professor featured by Smart America Expo, Huffington Post

Written By: MU Engineering

Marjorie Skubic, a professor in MU’s Electrical and Computer Engineering Department, participated in the Smart America Expo in June in Washington, D.C.  Skubic also was featured with a story and video produced by the NSF. MU professor featured by...

TigerPlace celebrates 10-year anniversary

Written By: Stice, Alicia

TigerPlace, which celebrated its 10th anniversary yesterday with an open house, is a unique partnership between Americare and the University of Missouri Sinclair School of Nursing. Columbia Daily Tribune

MU Researchers Use Sensors to Monitor Older Adults’ Health, Sync Health Information between Homes and Hospitals

Written By: Jesslyn Chew

Technological advances have provided medical professionals with many devices and systems to collect and analyze patients’ health information, but many of these technologies do not share data with each other. MU News Bureau

New Technologies to Help Seniors Age in Place

Written By: Shirley Wang

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

Aging in Place: Facilitating Choice and Independence

Written By: US Department of Housing and Urban Development

Highlights * A combination of demographic and economic shifts is creating a large and growing need for affordable and age-appropriate housing opportunities. * Most seniors would prefer to age in place; home modifications are critical to this process, but...

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

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...

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

Electronic Health Records Prime Clinicians to Provide Progressive Care to Older Adults

MU researchers are developing an EHR system that encompasses standard health assessments and those obtained through new technologies. The goal is to increase efficiency and accuracy, improve patient outcomes and reduce costs for long-term care. (2010) Press Release @...

MU Using TigerPlace to Develop ‘Aging in Place’ Technology

Written By: Jacob Barker

Marilyn Rantz, a professor at MU’s Sinclair School of Nursing, and Marjorie Skubic, a professor of electrical and computer engineering, lead the university’s interdisciplinary research team. They use inexpensive sensors to monitor residents’ movement and develop programs to analyze...

Seniors Live At Home Longer With Health-Monitoring Technology

University of Missouri researchers are using sensors, computers and communication systems, along with supportive health care services to monitor the health of older adults who are living at home. (2009) Press Release @ Medical News Today

New Solutions to Old Problems: The MU Eldertech Initiative

In 2002, University of Missouri Sinclair School of Nursing Professor Marilyn Rantz came to the MU College of Engineering looking for collaborators and, as she put it, new solutions to old problems. Through years of meetings and proposals, this...

Improving nurse care coordination with technology

Written By: Rantz, M.J., Skubic, M., Alexander, G., Aud, M., Wakefield, B., Koopman, R., & Miller, S.

Technology offers potential solutions to the pending crisis of healthcare for older adults, while healthcare workers are in short supply. Technology can enable remote monitoring of individuals and early detection of potential problems, so that early interventions can help...

The use of bedside electronic medical record (EMR) to improve quality of care in nursing facilities: A qualitative analysis

Written By: Rantz, M.J., Alexander, G., Galambos, C., Flesner, M.K., Vogelsmeier, A., Hicks, L., Scott-Cawiezell, J., Zwygart-Stauffacher, M., & Greenwald, L.

It appears that the implementation and use of a bedside electronic medical record in nursing homes can be a strategy to improve quality of care. Staff like using the bedside electronic medical record and believe it is beneficial. Information...

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...

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...

Automated technology to speed recognition of signs of illness in older adults

Our team has developed a technological innovation that detects changes in health status that indicate impending acute illness or exacerbation of chronic illness before usual assessment methods or self-reports of illness. We successfully used this information in a 1-year...

Towards a passive low-cost in-home gait assessment system for older adults

Written By: Wang, F., Stone, E. Skubic, M., Keller, J., Abbott, C., & Rantz, M.

In this paper, we propose a webcam-based system for in-home gait assessment of older adults. A methodology has been developed to extract gait parameters including walking speed, step time, and step length from a 3-D voxel reconstruction, which is...

Sensor technology to support Aging in Place

Written By: Rantz, M.J., Skubic, M., Miller, S.J., Galambos, C., Alexander, G., Keller, J., & Popescu, M.

Older adults want to age in place at home. Sensor technology has the potential to help by monitoring individuals’ health status, detecting emergency situations, and notifying health care providers. Researchers at the University of Missouri are investigating the impact...

Evaluation of health alerts from an early illness warning system in independent living

Written By: Rantz, M.J., Scott, S.D., Miller, S.J., Skubic, M., Phillips, L., Alexander, G., Koopman, R.J., Musterman, K., & Back, J.

Passive sensor networks were deployed in independent living apartments to monitor older adults in their home environments to detect signs of impending illness and alert clinicians so they can intervene and prevent or delay significant changes in health or...

Older adults’ attitudes towards and perceptions of “smart house” technologies

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

The study aim is to explore the perceptions and expectations of seniors in regard to “smart home” technology installed and operated in their homes with the purpose of improving their quality of life and/or monitoring their health status. Three...

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...

Clinical information systems in nursing homes: an evaluation of initial implementation strategies

Written By: Alexander, G., Rantz, M., Flesner, M., Diekemper, M., & Siem, C.

This article presents qualitative results collected 6 months after implementation of a clinical information system in four nursing homes in the Midwestern USA. Researchers explored initial implementation strategies, discussed employee experiences, and analyzed employee satisfaction. Transcript-based analysis and axial...

Falls, technology, and stunt actors: new approaches to fall detection and fall risk assessment

Written By: Rantz, M.J., Aud, M.A., Alexander, G., Wakefield, B.J., Skubic, M., Luke, R.H., Anderson, D., & Keller, J.M.

Falls are a critical health problem for older adults. One in every 3 people ages 65 or older falls each year, making falls the most common cause of trauma-related injuries and hospitalizations in older adults and the leading cause...

Findings from a participatory evaluation of a smart home application for older adults

Written By: Demiris G., Parker Oliver D., Dickey G., Skubic M., & Rantz M.

The aim of this paper is to present a participatory evaluation of an actual “smart home” project implemented in an independent retirement facility. Using the participatory evaluation process, residents guided the research team through development and implementation of the...

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...

Sensor systems for monitoring functional status in assisted living facility residents

Written By: Alexander, G.L., Rantz, M., Skubic, M., Aud, M.A., Wakefield, B., Florea, E., & Paul, A.

This article provides results of an expert review of data displays for a sensor system used to monitor functional abilities in older adults. The research took place at TigerPlace, an assisted living facility where the sensor system is currently...

A comparison of video-based resident-family communication in a nursing home and a congregate living facility

Written By: Hensel, B., Demiris, G., Parker Oliver, D., & Rantz, M.

Objective: To explore user perceptions of videophone communication in different long-term care settings by comparing interview transcripts of a study involving residents of a congregate living facility (CLF) and family members with findings of a case study involving a...

A smart home application to eldercare: current status and lessons learned

Written By: Skubic, M., Alexander, G., Popescu, M., Rantz, M., & Keller, J.

To address an aging population, we have been investigating sensor networks for monitoring older adults in their homes. In this paper, we report ongoing work in which passive sensor networks have been installed in 17 apartments in an aging...

Developing a comprehensive electronic health record to enhance nurse care coordination, use of technology, and research

Written By: Rantz, M.J., Skubic, M., Alexander, G., Popescu, M., Aud, M., Koopman, R., & Miller, S.

As in acute care, use of health information technology in long-term care holds promise for increased efficiency, better accuracy, reduced costs, and improved outcomes. A comprehensive electronic health record (EHR), which encompasses all health care measures that clinicians want...

Tracking exercise motions of older adults using contours

Written By: Havens, T.C., Alexander, G.L., Abbott, C.C., Keller, J.M., Skubic, M. & Rantz, M.

In this paper we describe the development of a novel markerless motion capture system and explore its use in documenting elder exercise routines in a health club. This system uses image contour tracking and swarm intelligence methods to track...

TigerPlace, a state-academic-private project to revolutionize traditional long term care

Written By: Rantz, M.J., Porter, R., Cheshier, D., Otto, D., Servey, C.H., Johnson, R.A., Skubic, M., Tyrer, H., He, Z., Demiris, G., Lee, J., Alexander, G., & Taylor, G.

The Aging in Place Project at the University of Missouri (MU) required legislation in 1999 and 2001 to be fully realized. An innovative home health agency was initiated by the Sinclair School of Nursing specifically to help older adults...

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...

Linguistic summarization of video for fall detection using voxel person and fuzzy logic

Written By: Anderson D., Luke R.H., Keller J.M., Skubic M., Rantz M. & Aud M.

In this paper, we present a method for recognizing human activity from linguistic summarizations of temporal fuzzy inference curves representing the states of a three-dimensional object called voxel person. A hierarchy of fuzzy logic is used, where the output...

Older adults’ privacy considerations for vision based recognition methods of eldercare applications

Written By: Demiris, G., Parker-Oliver, D., Giger, J., Skubic, M., & Rantz, M.

This study aims to explore older adults’ privacy considerations for technology based monitoring applications in eldercare that use video systems. It specifically aims to introduce alternative vision based tools and identify whether distorting or “anonymizing” captured images affect older...

An analysis of human motion detection systems use during elder exercise routines

Written By: Alexander, G.L., Havens, T.C., Rantz, M., Keller, J., & Abbott, C.C.

Human motion analysis provides motion pattern and body pose estimations. This study integrates computer-vision techniques and explores a markerless human motion analysis system. Using human–computer interaction (HCI) methods and goals, researchers use a computer interface to provide feedback about...

Average in-home gait speed: Investigation of a new metric for mobility and fall risk assessment of elders

Written By: Stone, E., Skubic, M., Rantz, M.J., Abbott, C., & Miller, S.

A study was conducted to assess how a new metric, average in-home gait speed (AIGS), measured using a low-cost, environmentally mounted, continuous monitoring system, compares to a set of traditional physical performance instruments used for mobility and fall risk...

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...

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...

Radar placement for fall detection: signature and performance

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

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...

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...

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....

Nighttime restfulness during daytime dance therapy: an exploratory study with bed sensors

Written By: Krampe, J., Miller, S.J., Echebiri, C., Rantz, M.J., & Skubic, M.

Dance-based therapy has the potential to slow the progression of functional limitations in older adults. The purpose of this study was to explore the feasibility of measuring the impact of dance-based therapy on the nighttime restfulness patterns of older...

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...

Preparing nursing homes for the future of health information exchange

Written By: Alexander, G.L., Rantz, M., Galambos, C. Vogelsmeier, A., Flesner, M., Popejoy, L.L., Mueller, J., Shumate, S., & Elvin, M.

Objective: Our purpose was to describe how we prepared 16 nursing homes (NHs) for health information exchange (HIE) implementation. Background: NH HIE connecting internal and external stakeholders are in their infancy. U.S. initiatives are demonstrating HIE use to increase...

A new paradigm of technology enabled “vital signs” for early detection of health change for older adults

Written By: Rantz, M., Skubic, M., Popescu, M., Galambos, C., Koopman, R.J., Alexander, G.L., Phillips, L.J., Musterman, K., Back, J., & Miller, S.J.

Environmentally embedded (non-wearable) sensor technology is in continuous use in elder housing to monitor a new set of “vital signs” that continuously measure the functional status of older adults, detect potential changes in health or functional status, and alert...

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,...

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...

Are older persons willing to accept and use amplifiers to better understand speech?

Written By: Lane, K., Rantz, M., Rawn, C., & Bien, A.

Hearing loss, the partial or total inability to perceive sound (Bance, 2007), is the third leading chronic illness in older adults, exceeded only by hypertension and arthritis (Hannula, 2011). In nursing homes, the prevalence of hearing loss is staggering, with reports...

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...

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....

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...

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....

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:...

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...

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...

Enhanced RN 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...

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...

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...

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...

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...

An Interdisciplinary Approach to Promote Older Adult Health

Written By: WebsEdgeHealth

An Interdisciplinary Approach to Promote Older Adult Health Over twenty years ago, the University of Missouri formed a broad interdisciplinary team to revolutionize older adult care. Over the years, this team consisted of engineering, nursing, and social work researchers,...

Entrepreneurial program of research and service to improve nursing home care

Written By: Rantz, M., Mehr, D., Hicks, L., Scott-Cawiezell, J., Petroski, G.F., Madsen, R.W., Porter, R., & Zwygart-Stauffacher, M.

This is a methodological article intended to demonstrate the integration of multiple goals, multiple projects with diverse foci, and multiple funding sources to develop an entrepreneurial program of research and service to directly affect and improve the quality of...