PROJECT CARE (COCAINE ABUSE IN THE RURAL ENVIRONMENT)

描述：(申请人摘要) 这一竞争性更新的目标是确定产前的影响 暴露在可卡因环境中的后代从 从蹒跚学步到早年的学生时代。这项研究将考虑 可卡因暴露的数量和时间的可能综合影响，其他 药物暴露、照顾者的心理社会功能和 环境对孩子的结果有影响。我们这群人的优势是：1) 在孕妇进入产前护理时登记的受试者 系统，从怀孕到分娩的任何时间，提供一系列产前检查 我们样本中的护理和药物使用；2)收集了关于剂量和药物使用的广泛数据 药物暴露的时间；3)使用 最小化用户错误分类的策略；4)医疗， 神经发育、行为、心理社会和环境数据 从产前到3岁收集，平均随访率为93%；5) 对毒品状况视而不见的审查员对婴儿/儿童的评估；以及6) 可卡因为可卡因且唯一可卡因为可卡因的样本的唯一性 其他非法接触毒品的是大麻。一种致畸动物模型的建立 可卡因的毒性导致了我们的假设，即产前接触可卡因的儿童 在5-7岁之间会表现出特定的神经心理缺陷， 其程度根据暴露的量和持续时间进行修改 环境影响。我们建议继续收集有关 儿童、照顾者和环境。每个孩子都将被盲目评估 5岁和7岁，使用以下领域的测量： 认知/智力；记忆/学习；语言；注意力和其他 执行功能；粗略、精细、视觉/知觉运动；准备和 学业成就和心理社会功能。此外， 照顾者/家庭环境将在家访期间进行评估， 放在每个孩子的评估之前。拟议的研究将提供至关重要的 关于产前接触可卡因的影响的信息，包括 确定可卡因影响的具体结果，澄清 剂量和暴露时间的影响，以及对 交易效应、可卡因暴露和其他风险因素导致 结果随着孩子的发展而变化。

DESCRIPTION: (Applicant's Abstract) The goal of this competitive renewal is to identify the effect of prenatal cocaine exposure on the exposed offspring making the transition from toddlerhood to the early school years. This study will consider the possible combined effects of amount and timing of cocaine exposure, other drug exposure, caregiver psychosocial functioning and the quality of the environment on the child's outcome. Strengths of our cohort are: 1) subjects enrolled at the time pregnant women entered the prenatal care system, anytime from conception to delivery, providing a range of prenatal care and drug use in our sample; 2) extensive data collected on dosage and timing of drug exposures; 3) target and control groups established using a strategy that minimized misclassification of users; 4) medical, neurodevelopmental, behavioral, psychosocial, and environmental data collected prenatally through age 3 with an average follow-up rate of 93%; 5) infant/child assessments made by examiners blinded to drug status; and 6) the uniqueness of a sample whose cocaine of choice is crack and whose only other illegal drug exposure is marijuana. A teratogenic model for the toxicity of cocaine leads to our hypotheses that prenatally exposed children between ages 5-7 will manifest specific neuropsychological deficits, the extent of which are modified by the amount of exposure and ongoing environmental influences. We propose to continue to collect data on the child, caregiver, and environment. Each child will be blindly assessed at ages 5 and 7 using measures of the following domains: Cognition/Intelligence; Memory/Learning; Language; Attention and other Executive Functions; Gross, Fine, Visual/Perceptual Motor; Readiness and School Achievement; and Psychosocial Functioning. In addition, the caregiver/family environment will be evaluated during home visits which take place prior to each child assessment. The proposed study will provide vital information regarding effects of prenatal cocaine exposure, including identification of specific outcomes affected by cocaine, clarification of the effect of dosage and timing of exposure, and description of the transactional effects cocaine exposure and other risk factors contribute to outcomes as the child develops.