Open Access Journals at IU Indianapolis
Not a member yet
23580 research outputs found
Sort by
Restorative Practices and Disproportionate Discipline of Black Girls: An Intersectional and Ecological Analysis
Get PDFThis mixed-methods study examines the disproportionate discipline of Black girls attending a U.S. high school implementing restorative justice practices. Grounded in ecological systems theory and intersectionality, this study presents overall and within-gender disciplinary outcomes, with qualitative data providing context for these trends. Quantitative analyses, including a relative risk index and Pearson’s chi-square tests, confirm significant overall and within-gender disparities in disciplinary outcomes. Qualitative findings reveal inconsistent discipline practices and classroom management challenges as pathways to inequity, exacerbated by subjective enforcement and punitive measures. The study underscores the need for consistent, equitable application of restorative practices and intentional relationship-building to address the complex interplay of race, gender, and discipline. We posit that school social workers can play a pivotal role in developing intersectional tier-2 restorative practices that center the lived experiences of Black girls to reduce inequitable school discipline outcomes
Introducing Lived Experience Workers Into a Pregnancy Child Protection Intervention: Parent and Staff Experiences
Get PDFPregnancy Family Conferencing is a program to support families with identified child protection risks during the perinatal period. Parents are often cautious about engagement due to mistrust of services and fear of having their babies removed if they discuss their difficulties. Subsequently, the inclusion of lived experience parent supporter roles was piloted to support families with engagement. Little is known about lived experience workers in child protection services and thus this qualitative study explored the experiences and perspectives of families, parent supporters and professionals, and of implementing parent supporter roles into the pregnancy family conferencing program. Inductive thematic analysis identified benefits of lived experience inclusion in child protection processes for parents, families, staff, and services, and highlighted that introducing lived experience positions into systems requires significant reflection, structures, and flexibility to ensure wellbeing and sustainability for those working in the roles. Recommendations are made for other child protection or social work services introducing lived experience roles. The inclusion of lived experience workers into child protection services has enormous potential for improving the experiences of people accessing services, enacting the values of social work, and balancing the inherent power dynamics embedded in practice. However, in introducing such roles into existing systems, there is a role for social workers and other practitioners in advocating for, and leading, the structural changes required to ensure the sustainability of positions and wellbeing of people working in these roles
Spring 2025 Editorial: Navigating the Academy, Educational Processes, and Practice Innovations
Get PDFIn the Spring 2025 issue of Advances in Social Work, we begin with a critical view of standard research practices in the academy. Then we investigate racism, well-being, pedagogy, culture wars, executive coaching, and eco-friendly conferences in social work education. In our section on social work practice, 10 articles address aiding people from a wide range of backgrounds. Authors write about issues for people who are elderly, transgender, incarcerated, marginalized, traumatized, struggling with recovery, considering self-harm, or needing child protection support. Social workers ourselves are the focus of three articles, whether experiencing compassion fatigue, experiencing inequities in clinical supervision, or experiencing challenges in interprofessional teams. Understanding ways to support the profession is valuable as the profession grows and develops
Building Bridges: A Case Study of Peer Support in Enhancing Mental Health for Students at a Hispanic-Serving Institution
Get PDFThe challenge: Addressing the rising mental health needs of university students is an urgent priority for institutions of higher education. Recognizing the scarcity of professional mental health services on campus, this project sought to evaluate the effectiveness of a peer support model in enhancing students’ mental well-being.
Potential consequences: With only three mental health professionals serving approximately 4,000 students, the peer educators provided crucial ancillary support to the Wellness Clinic’s services.
Description: The Peer Support Network (PSN) project was implemented as a proactive initiative grounded in peer support theory to foster a supportive campus culture through open conversations about mental health and coping strategies. Peer educators reviewed and signed informed consent documents and completed training in Youth Mental Health First Aid and Question, Persuade Refer (QPR).
Reflection: During its pilot phase, six trained peer educators engaged with 200 students (almost 5% of the student body) over one semester through classroom presentations, workshops, and information tables. Additionally, through the peer support model we created, one peer educator effectively utilized their training to provide critical support to a peer experiencing suicidal ideation, highlighting the model\u27s potential for addressing mental health crises in real-time
Hammersmith Infant Neurologic Examination (HINE) in the Assessment of Infants with Dysphagia
Get PDFBackground: Over the past several years, significant advancements have been made in the recognition and diagnosis of dysphagia. Intensive therapeutic interventions and diagnostic tools, such as the video fluoroscopic swallow study (VFSS), have been developed to assess and modify swallowing mechanics and ensure safe swallowing to promote growth in children diagnosed with dysphagia. Although there have been significant increases in improving dysphagia, there are minimal tools available to predict the timing of dysphagia resolution. Many children with dysphagia have impaired oromotor function and difficulty in mobilizing and clearing airway secretion. This is partly due to dyscoordination of the muscles involved in swallowing, which has been theorized to be related to reduced muscle tone. The Hammersmith Infant Neurological Examination (HINE) has been specifically designed and optimized to identify differences in motor tone and coordination in infant development. HINE is currently used in the diagnosis and prognosis of infants at risk for developing cerebral palsy (CP).
Methods: In this retrospective study 67 patients were examined using VFSS to assess if a lower HINE score is associated with longer resolution times for aspiration.
Results: Using this data, it was found that a HINE score below or above the CP cutoff score directly correlated with the recommendation of feeding (bottle modifications, thickening of liquid, or tube feeding) (p=0.018). HINE scores were also utilized to demonstrate a linear regression model capable of predicting the approximate duration of dysphagia resolution (p=0.041).
Conclusion: Future research can aim to develop a more comprehensive framework for the resolution of penetration and aspiration associated with dysphagia
Social Determinants of Health Factors Associated with Breast Cancer Screening in Underserved Communities of Northwest Indiana
Get PDFBackground: Despite breast cancer being the second most common type of cancer found in female patients, a large number of female patients have not received a mammogram in the past two years. This disparity is partly due to factors related to social determinants of health. The effects of social determinants of health on positive breast cancer screenings are clearly present in Northwest Indiana, a region containing vastly differing communities with a wide range of income levels and diversity. Nearly two decades of patient data from this area can inform us which social determinants of health are associated with increased risk for breast cancer.
Methods: “Hospital System A”, located in Lake County, Indiana, provided data from 111,564 mammograms from the year 2006 to the end of 2023. These 18 years of data provide patient zip code, age, race, insurance category, and screening results. A proportion of positive screenings was calculated for each group and compared using Chi-Square tests. Census information such as mean household income, race, and age was gathered for each zip code in Northwest Indiana and was tested on proportion of positive screenings by regression analysis.
Results: When comparing zip codes of Northwest Indiana, lower mean household income was associated with higher rates of breast cancer (p-value = 0.0049). Medicare and Medicaid patient groups both had significantly higher rates of breast cancer than private and self-pay groups (p-value = 1.35x10-10, p-value = 0.0032). Race had almost no impact on breast cancer rates.
Potential Impact: Income level has the greatest impact on breast cancer rates. We hypothesize that this relationship may be related to decreased access to care and unhealthy lifestyles because of economic restraints. Additionally, race has little influence on breast cancer rates, which may explain that society may have a greater role in health than individual characteristics
Determining the Therapeutic Effect of Human Neuritin 1 on the Restoration of Degenerated Retinal Ganglion Cells from Glaucoma Patients
Get PDFBackground and Hypothesis: Glaucoma is a group of optic neuropathies that affects approximately 76 million people worldwide. The main risk factor is elevated intraocular pressure (IOP) which predominantly affects retinal ganglion cells (RGC), resulting in cell death and permanent vision loss. Current therapeutics for glaucoma involve reducing IOP and halting progression of disease, but no current treatments can revive degenerated RGCs. Our project aims to evaluate the therapeutic effect of human Neuritin 1 (NRN1) in regenerating and protecting RGC loss in glaucoma. By administering NRN1 to the RGCs in culture, we hope to elucidate the efficacy in helping glaucomatous RGCs recover from cell death.
Project Methods: Immunofluorescence (IF), gene expression, and karyotyping experiments were performed on iPSCs to confirm they were successfully reprogrammed from donor keratocytes. The iPSCs were differentiated to retinal organoids (RO) to generate RGCs in vitro. After around 30 days of differentiation, the ROs were dissociated to isolate RGCs. The RGCs were seeded at one end of three different in vitro collagen scaffolds. The first received no NRN1 treatment, the second received NRN1 at the cell body, and the third received NRN1 at the opposite end. IF was done on RGC-seeded scaffolds with RBPMS and NEFL antibodies to confirm RGC marker expression and neurite growth.
Results: The iPSCs were successfully reprogrammed from donor keratocytes. We successfully generated RGCs from both non-glaucomatous and glaucomatous donor iPSCs. The RGCs effectively integrated within the collagen scaffolds. After NRN1 treatment, non-glaucomatous and glaucomatous RGCs demonstrated differential expression of RGC specific markers.
Conclusions and Potential Impact: Our study demonstrates that NRN1 exhibits a therapeutic effect on glaucomatous RGCs. This study lays the foundation that NRN1 could potentially restore vision in glaucoma patients. Additionally, iPSC-derived RGCs can successfully be obtained from human donor eyes and cultured for future research for testing therapeutics
Metabolic recovery at 12 months postpartum among individuals with glucose intolerance in pregnancy
Get PDFBackground: Gestational diabetes mellitus (GDM) is associated with long-term risk for maternal Type II Diabetes (T2DM). We evaluated β-cell function during pregnancy and at 12 months postpartum in individuals with varying levels of glucose intolerance in pregnancy.
Methods: This is a planned follow-up to the Gestational Diabetes Diagnostic Methods (GDM2) trial, which randomized pregnant individuals to either a 75-gram oral glucose tolerance test (OGTT) with GDM diagnosed with ≥1 abnormal value per IADPSG guidelines, or a 100g OGTT with GDM diagnosed with ≥2 abnormal values per Carpenter-Coustan (CC) criteria. All participants with treated GDM, those with untreated mild glucose intolerance (MGI, one abnormal value on CC criteria), and half of participants with normal glucose tolerance were invited for a follow-up visit at 12 months postpartum where they underwent a 75g OGTT measuring insulin and glucose at all time points. Measures assessed included Stumvoll, Matsuda, and Disposition Indices and other metabolic factors to evaluate insulin sensitivity, resistance, and β-cell function.
Results: In pregnancy and 12-month postpartum visits, the disposition and Matsuda indices demonstrated significantly more insulin resistance among those with MGI and GDM compared to those without GDM (41.0±41.6, 28.7±26.6, 20.0±15.9, p<0.001), whereas the Stumvoll index was similar among groups. The rate of change from pregnancy to postpartum in both the Matsuda and Stumvoll indices were similar across the three groups, indicating individuals were likely returning to their baseline levels of glucose tolerance rather than recovering from a pregnancy-specific metabolic impairment. Although this study was underpowered for this outcome, there was a trend towards higher rates of prediabetes and T2DM in those with MGI and GDM (14.6%, 25.5%, 24%, p=0.09).
Conclusions: Patients with MGI have significant impairments in insulin resistance similar to individuals with treated GDM one year postpartum and should receive follow-up for potential progression to T2DM. 
Implementation of Indiana’s Universal Blood Lead Testing Mandate: Interviews with Primary Care Practices in Michiana
No full textBackground: Disparities in lead exposure and social determinants of health – including housing, environmental conditions, and nutrition security – influence developmental and health outcomes, plus academic achievement and socioeconomic status through generations. Blood lead testing and follow-up care are essential safety nets for children who may already be lead exposed. Although Indiana Department of Health reports that Indiana’s universal testing statute, House Enrolled Act 1313, has facilitated a statewide testing increase in its first year 2023, lack of implementation direction plus data inconsistencies may hinder decision making at local levels. We study the interpretation and implementation of universal testing by health care practices in Michiana, serving legacy cities, including South Bend, with widespread lead-based paint hazards and proximity to lead crises in East Chicago, Indiana and Flint, Michigan.
Methods: Semi-structured interviews were conducted with Michiana key informants selected for their knowledge of the subject through purposive sampling. Frameworks of street-level bureaucracy and WHO’s building blocks of well-functioning health systems guide analysis.
Results: Twelve interviewees spoke of varying testing processes and awareness of the new law. Implementation barriers include ambiguous state guidelines, CHIRP reporting issues, and persistent health inequities in primary care access. Although in-office point-of-care analyzers reduce access barriers, the detection limit of 3.3 mcg/dL bars distinction of lead levels below this threshold. Facilitators include adequately-staffed workforces, communication with local social services (e.g., WIC, Head Start) and schools, and increased funding for families.
Conclusion: Clear implementation directions are needed to improve service delivery of lead testing by practices, while barriers in information systems, leadership and governance, and medical technologies must be addressed to support medical and environmental management of lead-exposed families.
Impact: Gaps in well-child care and health system fragmentation are major barriers to lead testing, necessitating expansion of public health services and collaboration with primary care practices to reach underserved communities.  
Analysis of Cerebral Small Vessel Changes in an APOE4 Knock-In AD Mouse Model
Get PDFIntroduction:
Alzheimer’s disease (AD) is a complex neurodegenerative disorder and the leading cause of dementia worldwide. Recently approved monoclonal antibody therapy has shown increased instances of amyloid-related imaging abnormalities (ARIA) in patients with the APOE4 allele compared to those with the APOE3 allele. Although it is well established that AD adversely affects cerebral vasculature, the differential pathology between alleles is not fully understood. This study aims to explore and quantify the changes of cerebral small vessels in a human APOE4 vs. APOE3 knock-in AD mouse model.
Methods:
Brains were collected from APOE3: APP-SAA and APOE4: APP-SAA mouse cohorts at 8 months. Sectioning and staining were completed with immunofluorescence imaging of beta-amyloid (6E10), blood vessel (CD31), and microglia (Iba1) biomarkers. Vessel density, diameter, signal intensity, and vessel-plaque colocalization were analyzed using NIH Fiji software, and t-tests were performed to compare averages between cohorts.
Results:
Two-tail t tests revealed a vessel density difference of -0.4956±0.4590% (t(8)=1.080;p=0.3118) and a CD31 intensity difference of -269881±169413au (t(8)=1.593;p=0.1498) showing no statistical significance. Further testing showed a vessel diameter difference of -0.4043±0.02431 um (t(700)=16.63;p<0.0001). Additionally, testing showed a plaque-vessel colocalization difference of 16.34±6.307% (t(51)=2.591;p=0.0124). The qualitative assessment showed higher levels of microglial activation, a marker of neuroinflammation, in APOE4: APP-SAA brain samples.
Discussion:
The APOE4 allele is associated with adverse changes in cerebral small vessels in a controlled APOE3 vs. APOE4 APP-SAA model. The observed pathology of increased neuroinflammation, decreased vessel diameter, and heightened amyloid-beta localization to cerebral small vessels may elucidate the mechanisms by which monoclonal antibody therapy targeting plaque removal results in increased pathological side effects related to vessel damage. These findings warrant further studies on vascular changes responding to AD progression across ages and investigations into how this novel model may respond to monoclonal antibody therapy experiments.