Browsing by Subject "Integration"
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Item Availability of screening and treatment for common mental disorders in HIV clinic settings: data from the global International epidemiology Databases to Evaluate AIDS (IeDEA) Consortium, 2016–2017 and 2020(Wiley, 2023) Parcesepe, Angela M.; Stockton, Melissa; Remch, Molly; Wester, C. William; Bernard, Charlotte; Ross, Jeremy; Haas, Andreas D.; Ajeh, Rogers; Althoff, Keri N.; Enane, Leslie; Pape, William; Minga, Albert; Kwobah, Edith; Tlali, Mpho; Tanuma, Junko; Nsonde, Dominique; Freeman, Aimee; Duda, Stephany N.; Nash, Denis; Lancaster, Kathryn; IeDEA Consortium; Pediatrics, School of MedicineIntroduction: Common mental disorders (CMDs) are highly prevalent among people with HIV. Integrating mental healthcare into HIV care may improve mental health and HIV treatment outcomes. We describe the reported availability of screening and treatment for depression, anxiety and post-traumatic stress disorder (PTSD) at global HIV treatment centres participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) Consortium in 2020 and changes in availability at sites in low- or middle-income countries (LMICs) between 2016/2017 and 2020. Methods: In 2020, 238 sites contributing individual-level data to the IeDEA Consortium and in 2016/2017 a stratified random sample of IeDEA sites in LMICs were eligible to participate in site surveys on the availability of screening and treatment for CMDs. We assessed trends over time for 68 sites across 27 LMICs that participated in both surveys. Results: Among the 238 sites eligible to participate in the 2020 site survey, 227 (95%) participated, and mental health screening and treatment data were available for 223 (98%) sites across 41 countries. A total of 95 sites across 29 LMICs completed the 2016/2017 survey. In 2020, 68% of sites were in urban settings, and 77% were in LMICs. Overall, 50%, 14% and 12% of sites reported screening with a validated instrument for depression, anxiety and PTSD, respectively. Screening plus treatment in the form of counselling was available for depression, anxiety and PTSD at 46%, 13% and 11% of sites, respectively. Screening plus treatment in the form of medication was available for depression, anxiety and PTSD at 36%, 11% and 8% of sites, respectively. Among sites that participated in both surveys, screening for depression was more commonly available in 2020 than 2016/2017 (75% vs. 59%, respectively, p = 0.048). Conclusions: Reported availability of screening for depression increased among this group of IeDEA sites in LMICs between 2016/2017 and 2020. However, substantial gaps persist in the availability of mental healthcare at HIV treatment sites across global settings, particularly in resource-constrained settings. Implementation of sustainable strategies to integrate mental health services into HIV care is needed.Item Fostering Local Health Department and Health System Collaboration Through Case Conferences for At-Risk and Vulnerable Population(American Public Health Association, 2018-05) Vest, Joshua R.; Caine, Virginia; Harris, Lisa E.; Watson, Dennis P.; Menachemi, Nir; Halverson, Paul; Health Policy and Management, School of Public HealthIn case conferences, health care providers work together to identify and address patients' complex social and medical needs. Public health nurses from the local health department joined case conference teams at federally qualified health center primary care sites to foster cross-sector collaboration, integration, and mutual learning. Public health nurse participation resulted in frequent referrals to local health department services, greater awareness of public health capabilities, and potential policy interventions to address social determinants of health.Item Grades K-12 Curriculum Guide for Attucks: The School That Opened A City(WFYI, 2016) Adams, Susan; Bangert, Sara; Bradbury, Kelly; Morton, Crystal; Kandel-Cisco, Brooke; Jackson, Tambra; Murtadha, Khaula; Payne, PatriciaMany challenging social issues (e.g. stereotyping, democracy, racism, cultural difference, integration, segregation, to name only a few) emerge from “Attucks: The School That Opened A City.” Grappling with these issues is central to children’s understanding of society, therefore they are addressed in this elementary, middle, and high school curriculum guide developed in partnership with Butler University, IUPUI and Indianapolis Public Schools.Item Integrated Correlation Analysis of Proteomics and Transcriptomics Data in Alzheimer's Disease(2020-12) Modekurty, Suneeta; Liu, Xiaowen; Wan, Jun; Zheng, JiapingWe wanted to see if there existed any significant correlations between two -omics layers. So, here, we performed a correlation analysis to study the disease. The pipeline building consisted of first performing the differential expression of two datasets (proteomics and transcriptomics) individually. An in-depth analysis of the proteomics data was performed, followed by differential expression analysis of RNA seq data and then a correlational analysis of the differentially expressed proteins (from proteomics data) and genes (from RNA seq data). From our analysis, we found fascinating information about the correlations between proteins and genes in AD. We performed a correlation analysis of AD (N= 84), Control (N = 31), and PSP (N = 85) samples for proteomics data and got 114 differentially expressed proteins (DEPs = 114). The RNA seq data had AD (N = 82), Control (N = 31) and PSP (N = 84) samples which gave us 61 differentially expressed genes (DEGs = 61). A correlation analysis using Spearman’s correlation coefficient method between proteins involved in AD revealed 192 very significant correlations with p-value <= 0.00000000000005. The mean correlation coefficient was quite high (r = 0.52). A correlation analysis using Spearman’s correlation coefficient method between genes involved in AD revealed 208 very significant correlations with p-value <= 0.00000000000005. The mean correlation coefficient was quite high (r = 0.52). A correlation analysis using Spearman’s correlation coefficient method between proteins and genes involved in AD revealed 395 significant correlations with p-value <= 0.0001. The correlation coefficient (quite high of +0.53), which might help in understanding the molecular pathways behind the disease could uncover new prospects of understanding the disease as well as design treatments. We observed that different genes interact with different proteins (correlation coefficient r >= 0.5, p-value < 0.05). We also observed that a single protein interacts with multiple genes, and a single gene is interestingly associated with multiple proteins. The patterns of correlations are also different in that a protein/gene positively correlates with some proteins/genes and negatively with some other proteins/genes. We hope that this observation is quite useful. However, understanding how it works and how they interact with each other needs further assessment at the molecular level.Item Integrating Prevention of Mother-to-Child Transmission of HIV Care into General Maternal Child Health Care in Western Kenya(Global Health and Education Projects, 2021) Berlacher, Michelle; Mercer, Timothy; Apondi, Edith O.; Mwangi, Winfred; Were, Edwin; McHenry, Megan S.; Medicine, School of MedicineBackground: Health systems integration is becoming increasingly important as the global health community transitions from acute, disease-specific health programming to models of care built for chronic diseases, primarily designed to strengthen public-sector health systems. In many countries across sub-Saharan Africa, including Kenya, prevention of mother-to-child transmission of HIV (pMTCT) services are being integrated into the general maternal child health (MCH) clinics. The objective of this study was to evaluate the benefits and challenges for integration of care within a developing health system, through the lens of an evaluative framework. Methods: A framework adapted from the World Health Organization's six critical health systems functions was used to evaluate the integration of pMTCT services with general MCH clinics in western Kenya. Perspectives were collected from key stakeholders, including pMTCT and MCH program leadership and local health providers. The benefits and challenges of integration across each of the health system functions were evaluated to better understand this approach. Results: Key informants in leadership positions and MCH staff shared similar perspectives regarding benefits and challenges of integration. Benefits of integration included convenience for families through streamlining of services and reduced HIV stigma. Concerns and challenges included confidentiality issues related to HIV status, particularly in the context of high-volume, crowded clinical spaces. Conclusion and global health implications: The results from this study highlight areas that need to be addressed to maximize the effectiveness and clinical flow of the pMTCT-MCH integration model. The lessons learned from this integration may be applied to other settings in sub-Saharan Africa attempting to integrate HIV care into the broader public-sector health system.Item Intrinsically disordered proteins play diverse roles in cell signaling(BMC, 2022-02-17) Bondos, Sarah E.; Dunker, A. Keith; Uversky, Vladimir N.; Biochemistry and Molecular Biology, School of MedicineSignaling pathways allow cells to detect and respond to a wide variety of chemical (e.g. Ca2+ or chemokine proteins) and physical stimuli (e.g., sheer stress, light). Together, these pathways form an extensive communication network that regulates basic cell activities and coordinates the function of multiple cells or tissues. The process of cell signaling imposes many demands on the proteins that comprise these pathways, including the abilities to form active and inactive states, and to engage in multiple protein interactions. Furthermore, successful signaling often requires amplifying the signal, regulating or tuning the response to the signal, combining information sourced from multiple pathways, all while ensuring fidelity of the process. This sensitivity, adaptability, and tunability are possible, in part, due to the inclusion of intrinsically disordered regions in many proteins involved in cell signaling. The goal of this collection is to highlight the many roles of intrinsic disorder in cell signaling. Following an overview of resources that can be used to study intrinsically disordered proteins, this review highlights the critical role of intrinsically disordered proteins for signaling in widely diverse organisms (animals, plants, bacteria, fungi), in every category of cell signaling pathway (autocrine, juxtacrine, intracrine, paracrine, and endocrine) and at each stage (ligand, receptor, transducer, effector, terminator) in the cell signaling process. Thus, a cell signaling pathway cannot be fully described without understanding how intrinsically disordered protein regions contribute to its function. The ubiquitous presence of intrinsic disorder in different stages of diverse cell signaling pathways suggest that more mechanisms by which disorder modulates intra- and inter-cell signals remain to be discovered.Item Library Research Guides and the Learning Environment: Go Big or Go Home(2017-04-19) Meiman, Meg; McDonald, Courtney; Lowe, M. Sara; Lee, Yoo YoungIn Fall 2016, librarians at Indiana University Bloomington and Indiana University Purdue University in Indianapolis undertook a pilot project to embed course-specific library research guides directly into Canvas course sites. With help from partners at IU's Information Technology division, we were able to install a software tool that uses metadata to connect course and research guides within the navigation menu of a Canvas course. This increased ability to seamlessly present expert research help, library services, and resources (both subscription-based and open educational content) within a learning ecosystem where students and faculty already operate, presented a wonderful opportunity to make this content discoverable. More importantly, integrating library content and research help directly into the LMS itself has promoted greater collaboration among librarians, students, and faculty, and allowed librarians to create a more customized learning environment for students to enhance their learning experience. In this session we will present results from our eight-month pilot, including faculty and student responses to these learning modules, as well as usage data. We will also discuss how this project enables libraries to provide both a consistent user interface and high-quality scholarly content to all students and faculty. Finally, our project presents a compelling opportunity for a more unified approach to information access needs not only across the entire Indiana University system, but among all Unizin institutions.Item The Impact of Specialty Palliative Care in Pediatric Oncology: A Systematic Review(Elsevier, 2021) Kaye, Erica C.; Weaver, Meaghann S.; DeWitt, Leila Hamzi; Leila Hamzi, Elizabeth; Stevens, Sarah E.; Lukowski, Joe; Shih, Brandon; Zalud, Kristina; Applegarth, Jacob; Wong, Hong-Nei; Baker, Justin N.; Ullrich, Christina K.; AAHPM Research Commttee; Medicine, School of MedicineContext: Children with cancer and their families have complex needs related to symptoms, decision-making, care planning, and psychosocial impact extending across the illness trajectory, which for some includes end of life. Whether specialty pediatric palliative care (SPPC) is associated with improved outcomes for children with cancer and their families is unknown. Objective: We conducted a systematic review following PRISMA guidelines to investigate outcomes associated with SPPC in pediatric oncology with a focus on intervention delivery, collaboration, and alignment with National Quality Forum domains. Methods: We searched PubMed, Embase, Scopus, Web of Science, and CINAHL databases from inception until April 2020 and reviewed references manually. Eligible articles were published in English, involved pediatric patients aged 0-18 years with cancer, and contained original data regarding patient and family illness and end-of-life experiences, including symptom management, communication, decision-making, quality of life, satisfaction, and healthcare utilization. Results: We screened 6682 article abstracts and 82 full-text articles; 32 studies met inclusion criteria, representing 15,635 unique children with cancer and 342 parents. Generally, children with cancer who received SPPC had improved symptom burden, pain control, and quality of life with decreased intensive procedures, increased completion of advance care planning and resuscitation status documentation, and fewer end-of-life intensive care stays with higher likelihood of dying at home. Family impact included satisfaction with SPPC and perception of improved communication. Conclusion: SPPC may improve illness experiences for children with cancer and their families. Multisite studies utilizing comparative effectiveness approaches and validated metrics may support further advancement of the field.