Multimedia Telehealth for Persons who are Deaf or Hard of Hearing

Co-Investigator and Evaluation Director: Cheryl Shigaki, Ph.D.

Project Summary

The United States government has invested substantial resources into telehealth as a health care resource. Most of these resources are not accessible to individuals who are deaf or hard of hearing. For example: 1) the audio and video are not synchronized; 2) the video compression often does not allow for multiple sign language users because the video seizes or blurs a lot of the motion; and 3) the audio is “muddy” or indistinct, plus there is no way for users to selectively use and customize the audio.

The study involves investigating real-time speech-driven captioning of a health care provider’s speech, improved video compression to support sign language and speech reading, and allowing users to customize the audio presentation to accommodate speech and hearing loss.

The 5-year, $1.7 million grant is funded by the National Institute on Deafness and Other Communication Disorders. Principal Investigator is Yunxin Zhao, Ph.D., an MU Computer Science professor. Consultant for the grant is Linda Day, Ph.D., a research assistant professor in the Communication Science and Disorders Department in the MU School of Health Professions.

Predicting Positive Outcomes among Cancer Survivors: Individual and Social/Environmental Factors

Principal Investigator: Stephanie Reid-Arndt, Ph.D.
Co-Investigators: Michael Perry, M.D., Jane Armer, Ph.D.
Funding provided by the National Institutes of Health

Project Summary

Cancer survivorship research has yielded important insights into the impact of cancer and associated treatments on such areas as quality of life, emotional functioning, and neuropsychological abilities. However, there are critical gaps in understanding the functional significance of these previously documented effects in terms of community/social and vocational activities, and in determining whether these influences are manifest differently among cancer survivors residing in rural areas.

The present study endeavors to expand upon existing research by evaluating individual and environmental factors that predict community functioning, vocational and financial outcomes, and quality of life among breast cancer survivors. Additionally, the study will elucidate interactions between urban/rural residence and individual and environmental factors on these functional outcomes.

The study will involve evaluating 75 women with a history of adjuvant chemotherapy for breast cancer at 1-, 6-, and 12-months following the completion of their treatment. The data collected will enable us to understand the potentially vital role of neuropsychological, psychological, social/environmental, and medical factors in fostering improved vocational/financial, community functioning and quality of life outcomes.

By identifying factors that predict positive long-term outcomes, this project will begin to address the relative lack of existing research on the experiences of breast cancer survivors living in rural communities. The emphasis on functional outcomes will also be an important extension of extant research. By elucidating factors associated with positive and/or negative outcomes among cancer survivors, this project will serve as a foundation for future intervention programs and future research examining long-term functional outcomes.

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Missouri Arthritis Rehabilitation Research and Training Center (MARRTC), Project 3

Worksite Vocational Rehabilitation Intervention to Improve Employment Outcomes for Persons With Arthritis?

Principal Investigator: Brick Johnstone, Ph.D., A.B.P.P.
The Missouri Arthritis Rehabilitation Research and Training Center was funded by the National Institute on Disability and Rehabilitation Research of the U.S. Department of Education under grant #H133B031120.

Web site: http://marrtc-dev.missouri.edu/research/summaries.html#project3

Project Summary

Arthritis is the leading cause of work-related disability. Consequently, many people with arthritis often are not able to keep long-term, competitive jobs. This results in loss of income and affects physical health and psychological well being.

Vocational rehabilitation programs and technological devices used at the workplace have been shown to dramatically improve employment outcomes for people with arthritis by facilitating their work.

This project seeks to determine what people with arthritis can do to improve their chances for retaining jobs and decreasing the effects of arthritis work-related problems. Specifically, researchers will measure the effects of worksite assessment through educational materials or an on-site work evaluation by an occupational therapist on a person’s job satisfaction, capacity to perform work duties, income, health status, and psychological well-being. The two groups involved in the research will either receive educational information or on-site work visits. The scope of the information will either be through educational materials to develop strategies to compensate or one-to-one contact and an individualized work plan. The strategies will include recommendations for work behaviors, ergonomic and body mechanics considerations, and modifications for job tasks, equipment, and space.

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Intern Training Grant

Principal Investigator: Brick Johnstone, Ph.D., A.B.P.P.
Co-Principal Investigator: Renee Stucky, Ph.D.
Funding provided by the Department of Health and Human Resources, Health Resources and Services Administration (HRSA)

Project Summary

There are an estimated 54 million Americans with disabilities, many who are in need of psychological serves, and particularly in rural areas. Although 32 percent of Missourians (1.7 million people) live in rural counties, there are only 14 board certified rehabilitation/neuropsychologists in the state (only 1 in a rural county). The MU Department of Health Psychology (DHP) is the primary training site in Missouri for rehabilitation/neuropsychologists since 1986. Recently, the Department of Health Psychology has been awarded a three year (9/01/04-8/31/07) training grant from the Department of Health and Human Resources, Health Resources and Services Administration (HRSA), with the primary purpose of improving the health outcomes of persons with disabilities by increasing their access to psychological services in rural areas.

The specific objectives of the training grant are:

• to improve access to quality health care to persons with disabilities in rural Missouri through appropriate preparation of a) rehabilitation psychologists, b) pediatric neuropsychologists and c) adult neuropsychologists;
• improve access to a diverse and culturally competent and sensitive psychology workforce in rural areas by increasing minority interns;
• improve access to a diverse and culturally competent and sensitive psychology workforce in rural areas by providing training to interns in cultural competence, particularly as it relates to persons with disabilities in rural areas.

Interns are trained at Rusk Rehabilitation Center, in Columbia, MO, Missouri Rehabiltiation Center (MRC) in Mt. Vernon, MO, and the Harry S Truman VA Hospital in Columbia, MO. Interns provide services to all age ranges of persons with all types of physical and cognitive disabilities, which is a typically underserved population.

Acquired Loss of Smell Function (Anosmia) After Traumatic Brain Injury (TBI): Does Anosmia Predict Neurobehavioral Difficulties, Rehabilitation Outcome, and Caregiver Strain after TBI  

Principal Investigator: Joseph H. Hinkebein, Ph.D., ABPP
Funded by the School of Health Professions- Rogers S. Williams Fund.

Project Summary

Traumatic Brain Injury (TBI) is a serious health epidemic affecting an estimated one-quarter million Americans every year, and resulting in approximately 73,000 cases of new disability per year. Among the difficulties encountered by TBI survivors, changes in personality and behavioral control are often the most significant. These difficulties are common after TBI because of the exquisite vulnerability of the frontal lobes to damage when the brain suffers trauma. Certain frontal lobe functions are more cognitive in nature and therefore are assessable by traditional neuropsychological testing methods. However, damage to the orbital frontal cortex, critical in emotional and behavioral regulation, is not easily assessed by traditional neuropsychological strategies.

Injury to cranial nerve I (CN-I; the olfactory nerve) is often associated with orbital frontal brain damage given anatomical proximity. Injury to CN-I may therefore be associated with a greater potential for behavioral and emotional disruption. However, CN-I function (i.e., the sensation of smell) is not routinely assessed in the typical neurology or neuropsychology evaluation after TBI.

The primary objective of this research project is to investigate whether the TBI-induced anosmia predicts the occurrence and severity of emotional and behavioral difficulties after TBI. Secondary objectives include exploring whether anosmia is associated with reduced rehabilitation outcome; greater care giver strain in family members of TBI survivors; and less optimal community integration at one year post-injury.

The results of this research could enhance efforts to identify and treat emotional and behavioral difficulties early in the rehabilitation process, and to educate and train family members regarding methods for effectively managing such difficulties.

Intergenerational Day Care Center

Co-Principal Investigators: Cheryl Shigaki, Ph.D., Dick Hessler, Ph.D.
Funding was provided by a private foundation gift

Project Summary

Researchers at MU have received seed funding to develop and demonstrate the feasibility of a university-based intergenerational day care program. Children and seniors served by the program ultimately will be co-located and have the opportunity to participate in multiple daily intergenerational activities. The program will promote optimal early childhood development, healthy aging for seniors, and respite for caregivers, as well as provide a platform for longitudinal study.

In addition to the program itself, the MU center will:

• train future and current intergenerational care providers through academic programs and training institutes;
• develop an international consortium for researchers interested in studying the outcomes of intergenerational care and best practices; and
• advocate for increased public awareness and education for policy makers on the importance of intergenerational programming.