The Arthritis Center at the Indiana School of Medicine (IUMPAC) is comprised of components for (a) research, (b) education, and (c) community programs: The research component supports basic studies on connective tissue biochemistry, control mechanisms in connective tissue metabolism, pathogenesis of osteoarthritis, immunologic tolerance, amyloidosis, the effects of immunologi mediators on muscle physiology, and joint biomechanics. In addition, it encompasses clinical investigations in such areas as post-intestinal bypass arthritis, polymyositis, amyloid disease and hypogammaglobulinemia. The education component augments Rheumatology training of Fellows, house officers, medical students, Allied Health Professionals (AHPs) and patients. Particular emphasis is directed toward improving the training in Rheumatology of house officers who aim ultimately to practice as primary care physicians. A Nurse Educator will serve as a liaison between the Rheumatology Division and the Baccalaureate, Graduate Nurse and Specialist Degree programs in the School of Nursing. A Pediatric Rheumatology Paramedical Team (supervised by an IUMPAC-trained pediatric rheumatlogist) is being established, and education in juvenile rheumatoid arthritis will be emphasized at all levels. The community program will link IUMPAC with private and govermental health organizations. It will evaluate the efficacy of an AHP Team in providing long-term care. The impact of the team approach on function, disease activity and psychosocial adaptation is being assessed. Use of informational-support groups for patients with rheumatoid arthritis, spondylitis and lupus will be expanded and efficacy of the groups assessed. Outreach clinics, staffed by a rheumatologist and AHPs, will be established in communities in which specialized expertise is now lacking. Also, a system for regionalization of health care for children and adolescents with arthritis, utilizing community-based AHPs, (Project COUPLE), is planned.
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