Perceptions of How Integrated Care Impacts Treatment in Rural Settings

Background: In light of the changing face of health care, it is important that practitioners and researchers begin to think strategically regarding comprehensive and accessible care. The purpose of this research study is to provide a deeper understanding of change among health care providers who work on multidisciplinary teams and the impact on patient outcomes. Methods: This research was designed as an exploratory phenomenological research study. The experience of interest was how providers described changes in care when working in an integrated care context. Eight semistructured in-depth interviews were conducted with physicians, nurse practitioners, social workers, and psychologists from locations in Southern Ohio, Central Maine, and Eastern Tennessee. Data were analyzed using qualitative coding to find patterns with and across participants associated with their perceptions of health integration. Results: Final developed themes described provider perceptions of working in an integrated care environment, and included access to care, interprofessional education, communication between providers. Conclusion: Through interviews and a review of the literature, we have found that as integrated care is employed throughout the country, patients have better health outcomes and providers experience efficient and effective work environments. Providers have adapted to the changing environment of integrative medicine; through this study we see that these changes have been for the benefit of the patients. Patients who disproportionately suffer from a lack of health care resources, such as those in rural areas, may benefit greatly from an integrated care model

Improved annotation of the insect vector of citrus greening disease: Biocuration by a diverse genomics community

The Asian citrus psyllid (Diaphorina citri Kuwayama) is the insect vector of the bacterium Candidatus Liberibacter asiaticus (CLas), the pathogen associated with citrus Huanglongbing (HLB, citrus greening). HLB threatens citrus production worldwide. Suppression or reduction of the insect vector using chemical insecticides has been the primary method to inhibit the spread of citrus greening disease. Accurate structural and functional annotation of the Asian citrus psyllid genome, as well as a clear understanding of the interactions between the insect and CLas, are required for development of new molecular-based HLB control methods. A draft assembly of the D. citri genome has been generated and annotated with automated pipelines. However, knowledge transfer from well-curated reference genomes such as that of Drosophila melanogaster to newly sequenced ones is challenging due to the complexity and diversity of insect genomes. To identify and improve gene models as potential targets for pest control, we manually curated several gene families with a focus on genes that have key functional roles in D. citri biology and CLas interactions. This community effort produced 530 manually curated gene models across developmental, physiological, RNAi regulatory and immunity-related pathways. As previously shown in the pea aphid, RNAi machinery genes putatively involved in the microRNA pathway have been specifically duplicated. A comprehensive transcriptome enabled us to identify a number of gene families that are either missing or misassembled in the draft genome. In order to develop biocuration as a training experience, we included undergraduate and graduate students from multiple institutions, as well as experienced annotators from the insect genomics research community. The resulting gene set (OGS v1.0) combines both automatically predicted and manually curated gene models.Peer reviewedBiochemistry and Molecular BiologyEntomology and Plant Patholog

Building trust in American hospital-community development projects: a scoping review

Although it has become increasingly common for hospitals to engage in development projects aimed at improving the social determinants of health in surrounding communities, scholarly literature examining the establishment of trust between hospitals and communities is sparse. Because of an extensive and complex history of abuse suffered by marginalized populations at the hands of medical institutions, trust building is critical to the pursuit of equitable health outcomes in these communities. A scoping review was conducted to assess the current base of knowledge for building trust between hospital systems and community members. The review identified only 13 relevant articles addressing this topic, centered on six key themes: with whom to form partnerships; how to form partnerships; conceptualizing and defining trust; questions about investment and hiring; effective communication with communities; and, understanding communities