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Identifying Injury Patterns and Forensic Biomarkers Diagnostic of Physical Elder Abuse

识别老年人身体虐待的伤害模式和法医生物标志物诊断

基本信息

批准号：
10400512
负责人：
Anthony Rosen
金额：
$ 24.06万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-01 至 2022-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10400512
关键词：
Accident and Emergency department Accidental Falls Accidental Injury Accidents Acute Address Adult Aging Area Award Biological Markers Biometry Caring Center for Translational Science Activities Characteristics Child Abuse Classification Clinical Clinical Research Clinical Sciences Collaborations Contusions Core Facility Criminal Justice Data Detection Development Diagnosis Diagnostic radiologic examination Documentation Educational workshop Elder Abuse Elder abuse prevention Elderly Emergency Department evaluation Emergency Department-based Intervention Emergency Medicine Emergency medical service Enrollment Environment Epidemiologic Methods Epidemiology Face Family Fellowship Forearm Injuries Forensic Medicine Forensic Sciences Foundations Fracture Funding Geriatrics Goals Government Agencies Grant Health Health Care Costs Health Personnel Health system Image Injury Intervention Interview Justice Knowledge Laboratories Leadership Left Legal Link Lower Extremity Medical Mental Health Mentors Mentorship Methodology Neck Neurocognitive New York City Nurses Outcome Participant Patients Pattern Photography Physical Examination Physicians Physiological Policy Making Positioning Attribute Presbyterian Church Prevention Prevention Research Protocols documentation Radiology Specialty Reporting Research Research Methodology Research Personnel Research Project Grants Resources Scientist Series Services Standardization System Testing Time Training Trauma United States National Institutes of Health Vulnerable Populations Work Writing abuse neglect abuse victim adjudicate authority base career career development cohort design diagnostic biomarker evidence base experience fall injury falls health assessment improved injured injury prevention innovation interest leadership development legal cases medical schools mortality novel physical abuse prospective psychosocial recruit research and development skills social success

项目摘要

PROJECT SUMMARY/ABSTRACT The over-arching aims of this Beeson K76 application are to identify injury patterns and forensic biomarkers diagnostic of physical elder abuse and launch the academic career of a very promising junior investigator. Candidate: The applicant, Dr. Anthony Rosen, is an Emergency Medicine physician at Weill Cornell Medical College (WCMC) who has demonstrated significant research ability and clinical interest in elder abuse and acute geriatric care. He is the recipient of an NIA GEMSSTAR award, where he partnered with prosecutors’ offices to examine legal case files to describe intriguing patterns of injury in the largest retrospective series of highly adjudicated elder abuse cases ever examined. To conduct this work, Dr. Rosen and colleagues developed a comprehensive classification system for acute geriatric injuries and a protocol for standardized photography of acute injuries. Dr. Rosen’s work has begun to be recognized nationally, as he was an invited participant in the 2015 White House Elder Justice Forum and presented at NIH’s recent elder abuse workshop. He has also pursued a clinical fellowship in Geriatric Emergency Medicine. Dr. Rosen is already trained in research methods and biostatistics, having completed an MPH in epidemiology. Dr. Rosen’s long-term career goals are to improve protection of vulnerable older adults through identification, intervention, and prevention of elder abuse and neglect and become an independent researcher and academic leader in elder abuse and geriatric injury prevention research. He has identified four specific areas where he will benefit from additional critical training during the Beeson Award period: forensic sciences, policy-making, independent grant writing, and leadership skills. For each, in collaboration with his mentors, he has taken advantage of institutional, local, and national didactic resources and opportunities to create an ambitious plan to provide this training and experience. The Beeson K76 award will allow Dr. Rosen to develop these skills, complete the important project he proposes, and continue his promising academic career and leadership development. Mentors/Environment: Dr. Rosen has engaged an extraordinarily strong, committed mentorship team with deep knowledge of elder abuse research and extensive experience in mentoring junior researchers to independence. Dr. Rosen has worked closely for 9 years with his primary mentor, Dr. Mark Lachs, the Chief of Geriatrics for WCMC and the entire NewYork-Presbyterian Health System (NYPHS), who has led multiple R01-funded elder abuse research projects. He has also worked extensively with co-mentor Dr. Karl Pillemer, a leading social scientist in elder abuse research for nearly 30 years. Co-mentor Dr. Terry Fulmer, president of the John A. Hartford Foundation, is a leading nurse researcher with experience prospectively recruiting elder abuse victims from the Emergency Department and has provided pilot data which informs this proposal. Dr. Rosen has also assembled a diverse team of expert collaborators from criminal justice, policy-making, government agencies, injury prevention, and epidemiology methods. The WCMC Division of Emergency Medicine is committed to Dr. Rosen’s success and will provide protected time and resources. In addition, WCMC provides a rich and supportive research and career development environment, which includes the Clinical and Translational Science Center, the Clinical Research Methodology Core Facility, and training courses / seminars in biomedical grant writing, transitioning to research independence, and leadership. Research: The over-arching aim and long-term goal of Dr. Rosen’s research is to: identify injury patterns and forensic biomarkers diagnostic of physical elder abuse. The Specific Aims of this proposal are: (1) to identify injury patterns, physical findings, and other characteristics associated with elder physical abuse by comparing prospectively enrolled victims in comparison with geriatric patients presenting to the ED with accidental falls, (2) to identify laboratory and radiographic results associated with physical elder abuse in comparison with accidental fall injury patients, and (3) to derive a clinical prediction rule (CPR) to assist busy health care providers in more effectively identifying physical elder abuse, an under-recognized phenomenon. By enrolling prospectively and evaluating comprehensively physical abuse victims in the ED, the proposed project addresses the major methodologic limitations in Dr. Rosen’s prior work, the quality and completeness of information in legal files, which were not gathered for research, and the lack of ancillary neuro-cognitive, radiographic, and laboratory testing on victims. Developing a CPR will dramatically increase the utility of the findings for busy clinicians. Subjects will be identified and recruited through partnerships with the New York City Elder Abuse Center (NYCEAC), the New York City Department for the Aging, Adult Protective Services, prosecutors’ offices, and Emergency Medical Services, as well as through ED evaluation. In addition to study enrollment, victims will be assessed and treated by a first-of-its-kind, ED-based multi-disciplinary Vulnerable Elder Protection Team designed by Dr. Rosen and colleagues. He and this team are uniquely able and ideally positioned to conduct this research because of the size and reach of the NYPHS, their leadership in the NYEAC, and their long-term collaboration with agencies serving elder abuse victims locally. This innovative project is likely to greatly improve the ability of health care providers to identify victims of physical elder abuse, who are among the most vulnerable older adults. The long-term goal of this Beeson proposal is to improve protection of these victims and to launch Dr. Rosen’s promising research, academic, and leadership career.

项目概要/摘要 Beeson K76 应用程序的首要目标是识别损伤模式和法医生物标志物诊断身体虐待老人并开启一位非常有前途的初级研究员的学术生涯。候选人：申请人安东尼·罗森博士是威尔康奈尔医疗中心的急诊医学医师学院（WCMC）在虐待老年人和虐待方面表现出显着的研究能力和临床兴趣急性老年护理。他与检察官合作，荣获 NIA GEMSSTAR 奖办公室审查法律案件档案，以描述最大的回顾性系列中有趣的伤害模式曾经审查过经过严格裁决的虐待老年人案件。为了开展这项工作，罗森博士和同事制定了急性老年损伤的综合分类系统和标准化协议急性损伤的摄影。罗森博士的工作已开始在全国范围内得到认可，因为他是受邀的参加 2015 年白宫老年司法论坛，并在 NIH 最近举办的虐待老年人研讨会上发表演讲。他还获得了老年急诊医学的临床奖学金。罗森博士已经接受过以下方面的培训：研究方法和生物统计学，已完成流行病学硕士学位。罗森博士的长期职业生涯目标是通过识别、干预和预防来改善对弱势老年人的保护虐待和忽视老年人问题，成为虐待和忽视老年人问题的独立研究者和学术带头人老年损伤预防研究。他确定了四个具体领域，他将从这些领域中受益比森奖期间的关键培训：法医学、政策制定、独立拨款写作、和领导能力。对于每个人来说，他都与他的导师合作，利用了机构、当地、以及国家教学资源和机会来制定雄心勃勃的计划来提供这种培训和经验。 Beeson K76 奖将使 Rosen 博士能够发展这些技能，完成重要项目他建议并继续他有前途的学术生涯和领导力发展。导师/环境：罗森博士聘请了一支非常强大、忠诚的导师团队对虐待老年人研究的深入了解以及指导初级研究人员的丰富经验独立。 Rosen 博士与他的主要导师 Mark Lachs 博士密切合作了 9 年。 WCMC 和整个纽约长老会卫生系统 (NYPHS) 的老年病学，他领导了多个 R01 资助的虐待老年人研究项目。他还与联合导师 Karl Pillemer 博士进行了广泛的合作。近 30 年来，他一直是虐待老年人研究领域的领先社会科学家。联合导师 Terry Fulmer 博士，总裁约翰·哈特福德基金会 (John A. Hartford Foundation) 是一位领先的护士研究员，具有前瞻性招募老年人的经验来自急诊科的虐待受害者，并提供了为该提案提供信息的试点数据。博士。罗森还组建了一支由来自刑事司法、政策制定、政府机构、伤害预防和流行病学方法。 WCMC 应急部门医学界致力于帮助罗森博士取得成功，并将提供受保护的时间和资源。此外， WCMC 提供丰富且支持性的研究和职业发展环境，其中包括临床和转化科学中心、临床研究方法核心设施和培训生物医学资助写作、向研究独立过渡和领导力方面的课程/研讨会。研究：罗森博士研究的总体目标和长期目标是：识别损伤模式和老年人身体虐待的法医生物标志物诊断。该提案的具体目标是： (1) 确定通过比较与老年人身体虐待相关的伤害模式、身体检查结果和其他特征前瞻性登记的受害者与因意外跌倒而到急诊室就诊的老年患者进行比较， (2) 与老年人身体虐待相关的实验室和放射学结果进行比较意外跌倒受伤患者，以及（3）导出临床预测规则（CPR）以协助繁忙的医疗保健提供者更有效地识别老年人身体虐待这一未被充分认识的现象。通过报名拟议项目对急诊室中的身体虐待受害者进行前瞻性和全面评估解决了 Rosen 博士之前工作中的主要方法学局限性、质量和完整性法律档案中的信息未收集用于研究，并且缺乏辅助神经认知，对受害者进行射线照相和实验室检测。开发心肺复苏术将极大地提高心肺复苏术的效用为忙碌的临床医生提供的发现。受试者将通过与纽约的合作伙伴关系来确定和招募市老年人虐待中心 (NYCEAC)、纽约市老龄化、成人保护服务部、检察官办公室、紧急医疗服务以及急诊室评估。除了学习注册后，受害者将由首个基于 ED 的多学科弱势群体进行评估和治疗老年人保护团队由罗森博士及其同事设计。他和这个团队具有独特的能力和理想的能力由于 NYPHS 的规模和覆盖范围以及他们在 NYEAC，以及他们与当地为老年人虐待受害者提供服务的机构的长期合作。这种创新的该项目可能会大大提高医疗保健提供者识别老年人身体虐待受害者的能力，他们是最脆弱的老年人之一。 Beeson 提案的长期目标是改进保护这些受害者，并开启罗森博士充满希望的研究、学术和领导生涯。

项目成果

期刊论文数量（16）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Developing a tool to assess and monitor institutional readiness to address elder mistreatment in hospital emergency departments.

DOI：
10.1080/08946566.2021.1965930
发表时间：
2021-08
期刊：
JOURNAL OF ELDER ABUSE & NEGLECT
影响因子：
1.9
作者：
Dash, Kim;Breckman, Risa;Lees-Haggerty, Kristin;Elman, Alyssa;Lachs, Mark;Stoeckle, Rebecca Jackson;Fulmer, Terry;Rosen, Tony
通讯作者：
Rosen, Tony

Loneliness before and during the COVID-19 pandemic: A systematic review with meta-analysis.

DOI：
10.1037/amp0001005
发表时间：
2022-07
期刊：
AMERICAN PSYCHOLOGIST
影响因子：
16.4
作者：
Ernst, Mareike;Niederer, Daniel;Werner, Antonia M;Czaja, Sara J;Mikton, Christopher;Ong, Anthony D;Rosen, Tony;Brahler, Elmar;Beutel, Manfred E
通讯作者：
Beutel, Manfred E

Screening for elder mistreatment in emergency departments: current progress and recommendations for next steps.