This proposal sets forth a plan for further development of the University of Michigan Multipurpose Arthritis Center (UMAC). Osteoarthritis (OA) is to receive special emphasis in the pilot research area and in a major epidemiologic study. The overall objectives of UMAC continue to include: 1) basic and clinical research dealing with the pathogenesis and treatment of the several rheumatic diseases; 2) continuation of education/training programs for physicians and other health professionals to meet the academic and patient care needs in the field; 3) development of new education programs for specific target groups; 4) expansion of a unique program of community-based education for primary care physicians; and 5) evaluation of each education effort by the best available methodology. Established research programs will be complemented by 9 new pilot research projects that deal with: a new animal model of OA, biochemical mechanisms in OA, new imaging techniques relevant to OA, three different studies of immune cell receptor function, HLA-DR phenotypes in juvenile arthritis, and a virus-induced murine model of polymyositis. Six new educational projects target: teachers in the field of physical education, University students with rheumatoid disease, adults with rheumatoid arthritis, primary care physician trainees, juvenile arthritis patients in the public school setting, and assessment of rheumatoid patients with boutonniere deformities treated by nonsurgical means. In the community programs component a new study of critical factors which determine primary care physician involvement in continuing medical education (CME) in the field of rheumatology is proposed. It will utilize previously collected CME data and also determine how new information reaches the primary care practitioner. The population of Tecumseh, Michigan will be re-examined to measure the incidence, regression, and progression of osteoarthritis and osteoporosis as compared to findings 20 years previously (1962-65). A random probability sample of the entire state of Michigan will also be studied to provide estimates of these two conditions in the general population and to identify possible intervention strategies. These research, education, and community projects will be supported by an Administrative Unit that is integrated into the established organization of the University. A special Tissue Culture Core Unit is proposed for continuation since it supports several of the established research programs within this Center. UMAC has the external support of private and state agencies, as well as the required institutional support, professional, physical, and patient resources to achieve its stated objectives.
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