Dear SHP Family,
The last few days have been especially difficult ones for the Mizzou community, and there are surely difficult days ahead. I am proud of the students, faculty, staff, alumni and friends of Mizzou who have the courage to fight for what they believe in, and I’m more confident than ever that the University of Missouri will emerge from these challenging times with a renewed commitment to our core mission and values. There is now an opportunity for each of us to be thoughtful and engaged in the selection process for our new leaders, and the culture change that we expect they will foster at Mizzou. The School of Health Professions joins with many others on campus in redoubling our efforts to create a respectful and inclusive learning environment for all our students, faculty and staff. There is much to be done, and I’m asking each and every one of you to join me in taking action.
Respect is a core value of the university, and it’s one we take seriously at SHP. As health professionals, it is our job to care for patients; moreover, as human beings it’s our duty to respect others without exception. We teach students to respect their patients by understanding their histories and values and how those impact their health care and the decisions they make. For health professionals, respect is not a luxury reserved only for some – it’s fundamental to how we interact with all others, and it’s what sets us apart. I expect everyone who represents SHP in the important work that lies ahead to do so with respect as their first priority.
We, the deans and department chairs of our school, support all members of the SHP family. In SHP you will find a safe place, people who will listen, and respectful conversations. We are working with students and faculty on short- and long-term strategies to improve the diversity of our faculty, staff and student body, and to identify and eliminate systemic biases that exclude or marginalize any member of our family. I invite you to reach out to faculty, advisers, Associate Dean Reid-Arndt or me. You have my word that we are still listening, always learning, and committed to continuing our work toward making Mizzou better.
Kristofer Hagglund, Dean
Janet Farmer, Associate Dean
Stephanie Reid-Arndt, Associate Dean
Kyle Gibson, Department Chair, Physical Therapy
Judith Goodman, Department Chair, Communication Science and Disorders
Glen Heggie, Department Chair, Clinical and Diagnostic Sciences
Rosemary Hogan, Department Chair, Health Sciences
Christina McCrae, Department Chair, Health Psychology
Timothy Wolf, Department Chair, Occupational Therapy
Many of us have been there, whether with a loved one, or alone- in a cold room at a doctor’s office or hospital, sitting on a far from comfortable examination bed awaiting the physician. The visit may have been a quick check-up or a follow-up to discuss test results.
Towards the end of the visit, the physician prompts us to ask any questions we may have regarding our medical report or to select a treatment option for our diagnosis. More often than not, nothing is uttered. Perhaps we feel confident in our understanding of the information communicated. Perhaps we feel rushed because the physician has to swiftly move to the next patient. Or, perhaps we are unsure how to phrase our uncertainties and a communication barrier lies between us and our clinician.
On Thursday, October 29, Dr. Peter Ubel visited MU and spoke on the topic of “Critical Decisions: How You and Your Health Care Provider Can Make the Right Health Choices Together.” The event was part of the School of Health Professions’ Scholarship & Discovery Lecture Series. It was a community conversation based on his most recent book, also titled Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together (2012).
In Critical Decisions, Ubel discusses his research about how to improve communication between patients and health care providers. Patients can use this information to prepare for appointments and consider important questions about their health care. Ubel also discusses a lack of available resources for patients seeking health information and describes how clinicians can develop aides (pamphlets, brochures) and other resources to improve patient comprehension.
Dr. Victoria Shaffer, associate professor of health sciences at the School of Health Professions, is also exploring the topic of how patients and clinicians can work collaboratively to make the right medical choices. “Just having knowledge about a medical condition or treatment options is not enough,” says Shaffer. “Communication and relationship building are also major parts of what will break the barriers between patients and their providers.” She says that research findings have uncovered strategies that health care providers can use to improve the communication of complex information about medical diagnoses and treatment options, including the use of pictographs and other risk communication graphics.
Shaffer recommends individuals prepare to ask questions during their appointments. “Many patients will follow the lead of the doctor, who may or may not prompt for questions after presenting health information. Though it may seem a bit intimidating, patients should not be shy about asking any questions they have,” Shaffer advises. For those instances when an overwhelming amount of unexpected information is presented to a patient, with little time to process and think of questions, individuals should schedule a follow-up appointment.
Dr. Shaffer also suggests patients explore a user-friendly online resource: the Ottawa Patient Decision Aid Inventory. Users can search by illness or health topic and find educational tools to assist in patient decision making. Housed in this virtual repository are tools that communicate information about diseases and their treatment options, employing research on optimal methods of sharing health information.
Solutions for patient-provider communication issues, patient informational needs, longer appointments and different structures for asking additional questions are still being refined. Some health care facilities have moved to an online portal where patients can schedule appointments, receive test results and send private messages to their health care providers. “This method seems convenient, but there is a significant portion of our community for whom that’s not going to be a tool that they can access,” Shaffer notes. “Also, on many occasions, test results are not easily understood without a further explanation and often involve follow-up questions.”
Shaffer believes strides in the right direction to strengthen the partnership and communication between patients and their care providers will continuously be made.
About MU School of Health Professions
The MU School of Health Professions (SHP) is the University of Missouri system’s only school of health professions and the only school of its kind in Missouri to be located on a health sciences campus. Health professions account for more than 60 percent of the total U.S. health care workforce and represent more than half of the fastest growing occupations in the country according to the Bureau for Labor Statistics. With programs in rehabilitation, diagnostic and imaging sciences, graduates of the School of Health Professions fill critical roles in health care.
Nuclear Medicine and Molecular Imaging Week is Celebrated the first full week of October each year.
For Elochukwu Osoego, a 2013 graduate of SHP’s nuclear medicine program, the best way to describe his career as a nuclear medicine technologist is, “there’s never a dull moment!” Nuclear medicine is a specialty of health care that uses radiopharmaceuticals to help diagnose and treat diseases.
Osoego and fellow alum Patrick Griggs (BHS-NM ’13) both now work at MU Health Care. Their jobs involve injecting patients with radiopharmaceuticals that can be traced with specialized cameras and computers to help physicians get a closer look at the molecular structure of a patient.
Osoego described the field of nuclear medicine as very futuristic and constantly evolving, from the discovery of new isotopes to understanding new ways of looking at the body. Brent McHugh, a nuclear pharmacist at Mid America Isotopes and nuclear medicine instructor agrees, but says that while the study of nuclear medicine is highly scientific, students and technologists still have to be focused on patient care.
“When people come in and they look very nervous, we need to remember what we’re doing is about the patient,” Osoego said. McHugh added, “People kind of freak out. We need to be able to calmly talk to patients to get the best outcome.”
Both Osoego and Griggs say the SHP Nuclear Medicine program did a great job of preparing them for both aspects of their jobs. In addition to coursework, students complete fieldwork in a variety of settings, including rotations at Mid-America Isotopes. For four weeks, students get hands-on experience in the preparation and compounding of the radiopharmaceuticals used in the hospitals. “When students are here, they learn the pharmacy aspect of nuclear medicine that they don’t usually get in the hospital,” McHugh said.
Mid America Isotopes also donates materials every year to the program so that students have access to pharmaceuticals and materials that otherwise might not be available in the coursework portion of their studies. Since 2001, the company has given more than $300,000 in support of the program and its students.
Osoego’s advice to students considering a career in nuclear medicine is to remember that the science and technology are cool, but it’s still about serving patients. “Make sure this is what you want: that you want to help people.” For more information about Nuclear Medicine at Mizzou SHP, visit http://shp.missouri.edu/nm/about.php.
MU Adult Day Connection is the recent beneficiary of a $250,000 estate commitment from an anonymous local donor. Though the donor doesn’t want recognition, the goal of the gift was to recognize the work being done at ADC. The gift honors the more than a quarter century of care by students, faculty and staff in ADC and SHP for older adults and adults with disabilities in our community.
For many caregivers, access to high-quality respite health care for their loved ones makes the difference in being able to remain employed or prolong entry in to a nursing home or other long-term care facility. Kristofer Hagglund, dean of the School of Health Professions where ADC is housed said, “ADC is completely self-supported, and never turns people away for an inability to pay for services, so gifts like this, and the support of our community are essential for helping to sustain our mission.”
Jerry Kiesling, director of ADC said, “We are honored and humbled to be recognized with such a generous gift. It’s truly a testament to the staff and students here who are so passionate about serving others.”
Dean Hagglund announced the gift to the staff and participants at ADC with a breakfast celebration. Photos of the announcement and celebration can be found here. The University of Missouri officially launches the One Mizzou: Our Time to Lead fundraising campaign on October 8, 2015.
MU Adult Day Connection is a service of the MU School of Health Professions. Founded in 1989 as a university-community partnership, ADC provides adult day health care for older adults and adults with disabilities. In the past ten years alone, ADC has served more than 600 families with more than 37,000 days of respite care. University of Missouri students from nearly every discipline have logged more than 80,000 clinical and volunteer hours
The School of Health Professions is the University of Missouri system’s only school of health professions and the only school of its kind in Missouri to be located on a health sciences campus. Health professions account for more than 60 percent of the total U.S. health care workforce and represent more than half of the fastest growing occupations in the country according to the Bureau for Labor Statistics. With programs in rehabilitation, diagnostic and imaging sciences, graduates of the School of Health Professions fill critical roles in health care.
New Graduate Certificate in Applied Behavior Analysis Aims to Improve Options for Children with Autism
Beginning in January 2016, graduate students at the University of Missouri will be able to pursue a graduate certificate in Applied Behavior Analysis in the Department of Health Psychology in the School of Health Professions. The first opportunity locally for this kind of certification, current graduate students and practicing professionals with existing graduate degrees can complete the six courses and clinical practicum which prepare them for the Board Certified Behavior Analyst (BCBA) Examination.
In 2015, one in every 68 children is diagnosed with an autism spectrum disorder, and parents and caregivers are seeking evidence-based interventions like those based on Applied Behavior Analysis (ABA). To meet this need, Dr. SungWoo Kahng, PhD, BCBA-D, associate professor of health psychology and behavior analyst at the MU Thompson Center, is heading a Mizzou collaboration to train behavior analysts and prepare them for certification.
ABA-based treatment is becoming the evidence-based standard for autism care. “The demand for this training and certification is increasing as research supports the efficacy of ABA interventions in helping children with autism,” said Dr. Kahng. “As these kinds of training programs become more common, children and families are getting access to better services in more areas.” ABA certification is preferred by insurance companies who pay for treatment, which means BCBAs are in higher demand than ever before.
The Behavior Analyst Certification Board provides rigorous academic and clinical experience standards for programs that prepare students to sit for the certification exam. The combination of coursework and clinical practicum at the MU Thompson Center for Autism and Neurodevelopmental Disorders teach students the conceptual foundations of ABA and how these principles are applied to improve behavior. Students will get real-world experience in early intervention, social skills training and behavioral supports under the supervision of highly experienced board-certified ABA practitioners.
In addition to Dr. Kahng, program faculty include Timothy Lewis, PhD, in the College of Education, Department of Special Education; Kelly Schieltz, PhD, BCBA-D, in the College of Education Department of Educational, School and Counseling Psychology and Casey Clay, PhD, BCBA in the School of Health Professions Department of Health Psychology. Kahng and his colleagues say the certificate program is only the first step. The School of Health Professions plans to roll out a master’s degree in Applied Behavior Analysis in the near future.
Photo Credit: Rebecca Miller, MU Thompson Center for Autism and Neurodevelopmental Disorders.
Story Contact(s): Jesslyn Chew, ChewJ@missouri.edu, (573) 882-8353
COLUMBIA, Mo. – Individuals who blame karma for their poor health have more pain and worse physical and mental health, according to a new study from University of Missouri researchers. Targeted interventions to counteract negative spiritual beliefs could help some individuals decrease pain and improve their overall health, the researchers said.
“In general, the more religious or spiritual you are, the healthier you are, which makes sense,” said Brick Johnstone, a neuropsychologist and professor of health psychology in the MU School of Health Professions. “But for some individuals, even if they have even the smallest degree of negative spirituality – basically, when individuals believe they’re ill because they’ve done something wrong and God is punishing them – their health is worse.”
Johnstone and his colleagues studied nearly 200 individuals to find out how their spiritual beliefs affected their health outcomes. Individuals in the study had a range of health conditions, such as cancer, traumatic brain injury or chronic pain, and others were healthy. The researchers divided the individuals into two groups: a negative spirituality group that consisted of those who reported feeling abandoned or punished by a higher power, and a no negative spirituality group that consisted of people who didn’t feel abandoned or punished by a higher power. Participants answered questions about their emotional and physical health, including physical pain.
Those in the negative spirituality group reported significantly worse pain as well as worse physical and mental health while those with positive spirituality reported better mental health. However, even if individuals reported positive spiritual beliefs, having any degree of negative spiritual belief contributed to poorer health outcomes, the researchers found.
“Previous research has shown that about 10 percent of people have negative spiritual beliefs; for example, believing that if they don’t do something right, God won’t love them,” Johnstone said. “That’s a negative aspect of religion when people believe, ‘God is not supportive of me. What kind of hope do I have?’ However, when people firmly believe God loves and forgives them despite their shortcomings, they had significantly better mental health.”
Individuals with negative spiritual beliefs also reported participating in religious practices less frequently and having lower levels of positive spirituality and forgiveness. Interventions that help combat negative spiritual beliefs and promote positive spiritual beliefs could help some individuals improve their pain and their mental health, Johnstone said.
The study, “Relationships Between Negative Spiritual Beliefs and Health Outcomes for Individuals With Heterogeneous Medical Conditions,” was published in the Journal of Spirituality in Mental Health. MU co-authors included Daniel Cohen from the Department of Religious Studies; Dong Pil Yoon from the School of Social Work; Laura H. Schopp from the Department of Health Psychology; and James Campbell from the Department of Family and Community Medicine. Angela Jones from St. John’s Hospital in Springfield, Missouri, was the lead author, and Guy McCormack from Samuel Merritt College in San Francisco also contributed to the research.
Johnstone recently returned from Oxford University, where he studied the intersection of science and religion. Prior to his time at Oxford, Johnstone completed a nine-month fellowship with seven other scholars at the Center of Theological Inquiry at Princeton University, where he explored religious experience and moral identity. Johnstone recently served as a contributing expert for a Centers for Disease Control and Prevention report, “Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation,” which was presented to Congress.
Swim lessons for many kids can mean endless hours kicking in the pool or facing their fear of the diving board.
The experience for children with autism can be very different. With constant distractions around the pool, and the need for individualized attention, group swim lessons often do not cater to the diverse needs of children with autism.
Five occupational therapy students at the University of Missouri recognized this need and set out to fill it for the Columbia community.
Occupational therapy students Gabrielle Heckman, Caroline Thompson, Hannah Ruzicka, Alexis White, and Anna Lourens spent months creating an adaptive swim program for children with autism.
“Typical swim lessons are very structured and you have to pass specific skills to move on to the next level. That doesn’t necessarily work, especially for kids with autism,” Thompson said.
According to the National Autism Association, 91% of the deaths reported for children with autism in the U.S. in 2009-2011 were from accidental drowning
With these facts in mind, the team set out to focus on water safety along with social participation and exercise.
The group began their research in the spring with the help of Dr. Lisa Mische-Lawson, an associate professor of occupational therapy from University of Kansas. Mische-Lawson started a similar program at KU.
Thompson and Heckman attended training at KU, where they watched instructors do sensory-supported swimming and spoke to parents about their experience.
The pair learned regular swim lessons lacked accommodation for the varying needs of kids with autism, and the environment was full of too many distractions.
The training was just the start of the group’s extensive research on the topic. With guidance and assistance from School of Health Professions occupational therapist Brittney Stevenson and associate clinical professor Lea Ann Lowery, the group continued their research in Columbia. The students surveyed and interviewed parents throughout Columbia and contacted local pools.
After the group found a 100 percent interest in the program, they moved forward using the research to develop a project plan- Swimming and Water Instruction Modifications (SWIM) for Children with Autism Spectrum Disorders (ASD).
The Mizzou recreation center donated all the space and equipment for the two 30-minute swim lessons. The pilot program had four participants with a 2-1 instructor to swimmer ratio.
Prior to the lesson, each child received a visual story to illustrate how the day’s lesson would go.
“Some kids with autism want to know what’s going on, what’s going to happen. They have a lot of anxiety about that, so that saved us time with some kids because they already knew what was going to happen,” Heckman said.
The lesson focused on basic swimming skills from kicking and floating to blowing bubbles.
During the lesson, the students showed the kids a water safety video and held a focus group with the parents to evaluate the progress of the lesson.
After just one swim lesson, the group began to see the effect of their work.
One participant, a 5-year-old boy who had never been in the pool before, gave the group their biggest insight. His mom said, “My son was so proud of himself after he got home, he called all his family to tell them about his fun swim lesson.”
Heckman explains that the pride and excitement the boy felt from the lesson went on to help him use the bathroom for the first time.
“For him to have that sense of achievement and self-worth and have that translate to a new skill – that was huge. If that’s the difference after one lesson, what will he do after a whole session,” Heckman said.
“We always hoped that self-achievement would be an outcome, but never expected something this exceptional,” Thompson said.
Since the success of the first program, the group is now applying for an Autism Speaks grant and working on installing a permanent 8-week program at the Mizzou recreation center.
Jacque Sample, Clinical Instructor for the Missouri Health Professions Consortium Occupational Therapy Assistant Program (MHPC OTA), is the first funded graduate student in the Project Coordinator role for the Association of Schools of Allied Health Professions (ASAHP) Clinical Education Task Force. She began the role on September 1 and will serve through the 2015-2016 school year.
ASAHP is a not-for-profit national professional association for administrators, educators, and others concerned with critical issues affecting allied health education. School of Health Professions Dean Emeritus, Dr. Richard Oliver, serves as president of the organization. The ASAHP Clinical Education Task Force is a collaboration of educators from across different allied health professions working to improve the clinical education of students.
Though Jacque is still learning the ropes of her new role, her responsibilities will include: assisting with coordinating projects, writing summaries for various studies, contributing to the Institutional Review Board (IRB) reviews and submitting proposals, in addition to other administrative duties such as writing, managing internal communication and general organization tasks.
“It is such a great honor to sit at the table with so many brilliant deans from across the country who are coming together to improve the clinical education of our students,” says Jacque. “My experience so far has been an exciting and humbling one.”
One of the task force’s recent projects involves identifying key employers in allied health professions to collaborate with and discuss the student clinical education process. They are hoping to get the American Occupational Therapy Association (AOTA) involved and explore what improvements can be made.
Sample graduated from Mizzou with a Bachelor of Health Science in Occupational Therapy and later returned to pursue and complete her Master of Education in Special Education with an emphasis in Autism degree. Currently, Jacque is enrolled in the occupational therapy doctoral program at Nova Southeastern University in Fort Lauderdale, Florida. Her anticipated graduation date is May 2016.
Whether it’s on the high school football field or a little league baseball diamond, an impact to the head should be taken seriously. The effects of these kinds of injuries can be long term, and health professionals are just beginning to better understand them through ongoing research efforts.
“You have only one brain, so you need to take care of it. It’s not like sending someone back out there with a mild ankle sprain. An injured athlete should be evaluated by an appropriate medical professional,” said Keith Belmore, Assistant Teaching Professor in the MU School of Health Professions Athletic Training program.
According to the Centers for Disease Control and Prevention traumatic brain injury-related hospital visits have increased by 70 percent since 2000.
Fortunately, Belmore said the way professionals identify, treat and manage concussions has progressed in the last few years. When athletic trainers are on the sidelines, they often witness the play or incident that caused the injury, and can help recognize early signs and symptoms.
Immediately following a head injury or impact to the head, health professionals check for symptoms like blurry vision, sensitivity to light and noise, headaches, or dizziness. Following the incident, players and health professionals watch for sleep disturbances, changes to emotional control and trouble concentrating or focusing. All of these can be signs of a concussion.
Concussions don’t always result from a direct blow to the head. Belmore explains that some sport-related contact can have a whiplash effect that can also result in injury to the brain. “The big collision sports like football or ice hockey have received a lot of attention, but kids and athletes can sustain a concussion or head injury in really any sport,” Belmore said. While sports equipment has evolved to prevent many injuries, Belmore said there is no equipment that is concussion proof.
At MU, the athletic training program curriculum does focus on concussions. Clinical preceptors and faculty train students on everything from how to evaluate and initially manage a head injury to how to help facilitate the recovery process during rehabilitation.
“Concussions are a functional injury rather than a structural injury, so it’s not like a fracture where we can use an x-ray to clearly identify the injury. It can be challenging to identify the existence and extent of head injuries and it takes a more comprehensive and interdisciplinary approach,” Belmore said. “Athletic trainers, physicians, neurologists, neuropsychologists and physical therapists should all be working together to effectively diagnose and manage concussions in athletes.”
August 19, 2015, Columbia, Mo: Fall sports are starting back up, but that doesn’t mean fall temperatures are here quite yet.
As players gear up to spend extended hours in the heat, it’s important for both coaches and players to be aware of the dangers of overheating.
Keith Belmore is an assistant teaching professor and the coordinator of clinical education in the Athletic Training Program in the Mizzou School of Health Professions. “Here in Missouri we have hot, humid weather and it’s definitely important to be aware of heat illness and the signs and symptoms that go along with that,” Belmore said.
When athletes are constantly being pushed to give it their all during practice and competition, sometimes it’s hard to determine when enough is enough.
Belmore said athletes can also push themselves past the limit.
“A lot of times athletes want to push through, they want to impress coaches and might feel like if they let up or take a break, they’re going to miss out on playing time,” Belmore said.
But, Belmore said heat-related illnesses are 100 percent preventable with the right systems in place.
Coaches should allow adequate frequency and duration of water breaks during practices. They can also vary the amount of equipment worn with the time of day practice is held to further minimize the potential for injury.
While every athlete’s body varies in how it responds to heat and exercise, Belmore recommends athletes weigh in before and after practice and competition. By noting how much weight was lost, athletes can determine how much fluid weight they need to replace by the next practice.
“Above all else, it’s important to have an emergency action plan in place to ensure rapid response to any injury, whether a heat illness or a head or spine injury. It’s essential to have people who can evaluate an emergency situation, and know that they have a plan to work from,” Belmore said.
Belmore also warns that even in mild conditions athletes can sustain a heat illness without proper precautions. “Communication between players and coaches is key to reducing the risk of heat illness,” Belmore said.
For more information or to schedule an interview, contact Casey Adams at 573-882-0266 or click here to email.