Doctoral Dissertation Research: The Role of Socioeconomic and Cultural Variation of Neurotrauma Recovery

博士论文研究：社会经济和文化变异对神经创伤康复的作用

• 批准号: 1756617
• 负责人: Rebecca Seligman
• 金额: $ 0.86万
• 依托单位: Northwestern University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-03-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1756617&HistoricalAwards=false
• 关键词: Doctoral; Dissertation; Research; Role; Socioeconomic

Traumatic Brain Injury (TBI), or neurotrauma, is a disruption in brain function caused by a blow or jolt to the head that can produce a wide range of physical, cognitive, and psychosocial aftereffects. TBI also represents a critical global health issue with high personal, societal, and economic costs to patients, caregivers, and communities as a whole. Although global health officials have recognized TBI as "silent epidemic," public health approaches have seldom paid attention to the specific cultural and socioeconomic circumstances of this injury. In particular, understandings of life after trauma may vary across cultural contexts, with potentially powerful implications for TBI care within and outside clinical settings. This project, which trains a student in the methods of empirical, scientific data collection and analysis, asks how TBI patients and their families engage popular and medical framings about injury, and how societal and medical understandings of brain injury are differentially affected by constraints of public care and new perspectives on mind and brain. In addition to providing funding for the training of a graduate student in anthropology, the project would enhance scientific understanding by broadly disseminating its findings to organizations and institutions invested in ameliorating the social and medical costs associated with traumatic brain injury.In the research supported by this award, doctoral student Livia Garofalo, under the supervision and guidance of Dr. Rebecca Seligman, will investigate how Traumatic Brain Injury is cared for and experienced in a context of high TBI incidence, healthcare shortage, and increased attention towards neurological conditions. Through ethnographic research in public hospitals in the greater Buenos Aires area, the researcher will collect data through participant observation in clinical spaces and semi-structured interviews with patients, caregivers, and medical professionals, and conduct archival and media research. Triangulating this data will provide an assessment of the socioeconomic and political circumstances in which brain injury occurs, as well as the repercussions of neurotrauma at a broader societal level in the Argentine context. Buenos Aires, in particular, provides an apt site to investigate these issues as a large metropolitan area with a high influx of patients, thus providing a model for other dense and highly unequal urban contexts in the United States. Twelve months of ethnographic research will be conducted at two different hospitals with trauma centers, and their surrounding communities. Data will be collected through participant observation, interviews, and case studies and clinical histories, with medical professionals, TBI caregivers and their families, and TBI patients, with appropriate stratification based on age, gender, class, education, and hospital affiliation. Contributing to interdisciplinary conversations between cultural anthropology, science and technology studies, and global health, findings from this research will offer a multi-level anthropological perspective on how TBI incidence is stratified along socioeconomic lines, how emerging notions of "brain health" affect the attention towards brain injury, and how access to care is crucial for marginalized individuals and families to rebuild lives after trauma.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

创伤性脑损伤 (TBI) 或神经外伤是由头部受到打击或摇晃引起的脑功能破坏，可产生广泛的身体、认知和心理社会后遗症。 TBI 也是一个严重的全球健康问题，给患者、护理人员和整个社区带来高昂的个人、社会和经济成本。尽管全球卫生官员将创伤性脑损伤视为“无声的流行病”，但公共卫生方法很少关注这种伤害的具体文化和社会经济环境。特别是，对创伤后生活的理解可能因文化背景而异，这对临床环境内外的 TBI 护理具有潜在的强大影响。该项目对学生进行实证、科学数据收集和分析方法的培训，询问 TBI 患者及其家人如何参与有关损伤的流行和医学框架，以及社会和医学对脑损伤的理解如何受到公共护理的限制和关于精神和大脑的新观点的不同影响。除了为人类学研究生的培训提供资金外，该项目还将通过向投资于改善与创伤性脑损伤相关的社会和医疗成本的组织和机构广泛传播其研究结果来增强科学理解。在该奖项支持的研究中，博士生 Livia Garofalo 在 Rebecca Seligman 博士的监督和指导下，将研究如何在创伤性脑损伤中护理和体验创伤性脑损伤。 TBI 发病率高、医疗保健短缺以及对神经系统疾病的关注日益增加。通过对大布宜诺斯艾利斯地区公立医院的人种学研究，研究人员将通过临床空间的参与观察以及对患者、护理人员和医疗专业人员的半结构化访谈来收集数据，并进行档案和媒体研究。对这些数据进行三角测量将提供对脑损伤发生的社会经济和政治环境的评估，以及神经创伤在阿根廷更广泛社会层面的影响。尤其是布宜诺斯艾利斯，作为一个患者大量涌入的大都市区，提供了一个合适的地点来调查这些问题，从而为美国其他人口稠密且高度不平等的城市环境提供了一个模型。为期十二个月的人种学研究将在两家设有创伤中心的不同医院及其周边社区进行。将通过参与者观察、访谈、案例研究和临床病史收集数据，参与者包括医疗专业人员、TBI 护理人员及其家人以及 TBI 患者，并根据年龄、性别、阶层、教育程度和医院隶属关系进行适当分层。这项研究的结果有助于文化人类学、科学技术研究和全球健康之间的跨学科对话，提供多层次的人类学视角，探讨 TBI 发病率如何按照社会经济路线分层、“大脑健康”的新兴概念如何影响对脑损伤的关注，以及获得护理对于边缘化个人和家庭在创伤后重建生活至关重要。该奖项反映了 通过使用基金会的智力价值和更广泛的影响审查标准进行评估，NSF 的法定使命被认为值得支持。