Project CARE(Cocaine Abuse in the Rural Environment)

描述（由申请人提供）：本次竞争性续约的目标是 确定产前可卡因暴露对暴露后代的影响 从小学到中学的过渡。本研究 将评估产前服用可卡因的量 暴露，其他药物暴露，照顾者心理社会功能和 环境质量对孩子的影响。我们的团队的优势是： 1)当妇女进入产前护理系统时登记的受试者， 产前护理和药物使用的范围; 2）收集的关于数量和 使用时间; 3）使用一种策略建立的目标和对照组， 最大限度地减少用户的错误分类; 4）来自众多领域的广泛数据 在产前至7岁期间收集感兴趣的数据，平均随访率为 93%的存活队列; 5）对所有儿童进行盲法评估 时间点; 6）选择可卡因为快克的样本的独特性， 他唯一接触过的非法毒品就是大麻混合方面的 可卡因毒性的致畸模型与交易模型 儿童的发展导致我们的假设的完善，产前 10-13岁接触可卡因的儿童会表现出特定的 神经心理、行为和心理社会缺陷， 受到暴露量和持续环境影响的影响。 我们建议继续收集有关儿童、照顾者和环境的数据 在这个周期里，孩子的重要性更大。每个孩子都将 在10岁和12岁时使用以下领域的措施进行盲测： 认知/智力;记忆/学习;语言;注意力和其他 执行功能;行为;学校成绩和功能;以及 心理社会功能将评估护理者/家庭环境 在每次儿童评估之前进行家访。最后， 在整个研究过程中，孩子们将被反复采访， 他们的心理社会功能和发展，他们对压力的感知， 生活事件和支持性活动和关系。拟定研究 将提供关于产前接触可卡因的影响的重要信息， 包括确定受影响的具体结果， 并澄清产前接触量的影响， 持续被动暴露它还将提供对 交易影响可卡因暴露和其他风险因素（以及 可能的保护因素）有助于儿童过渡期的结果 从儿童早期到青春期前。

DESCRIPTION (provided by applicant): The goal of this competitive renewal is to identify the effect of prenatal cocaine exposure on exposed offspring making the transition from elementary school to the middle school years. This study will evaluate the possible combined effects of amount of prenatal 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 when women entered the prenatal care system, providing a range of prenatal care and drug use; 2) extensive data collected on amount and timing of use; 3) target and control groups established using a strategy that minimized misclassification of users; 4) extensive data from numerous domains of interest collected prenatally through age 7, with an average follow-up rate of 93 percent of the surviving cohort; 5) blinded assessments of child at all timepoints; 6) the uniqueness of a sample whose cocaine of choice was crack and whose only other illegal drug exposure was marijuana. Blending aspects of the teratogenic model for the toxicity of cocaine with the transactional model for child development leads to a refinement of our hypotheses that prenatally cocaine-exposed children between the ages of 10-13 will manifest specific neuropsychological, behavioral, and psychosocial deficits, the extent to which are modified by the amount of exposure and on-going environmental influences. We propose to continue to collect data on the child, caregiver, and environment with a heavier emphasis on the child during this cycle. Each child will be blindly assessed at ages 10 and 12 using measures of the following domains: cognition/intelligence; memory/learning; language; attention and other executive functions; behavior; school achievement and functioning; and psychosocial functioning. The caregiver/family environment will be evaluated during home visits which take place prior to each child assessment. Finally, the children will be repeatedly interviewed throughout the study to determine their psychosocial functioning and development, their perception of stressful life events and supportive activities and relationships. The proposed study will provide vital information regarding effects of prenatal cocaine exposure on the developing child, including identification of specific outcomes affected by cocaine and clarification of the effect of amount of prenatal exposure and ongoing passive exposure. It will also provide a description of the transactional effects cocaine exposure and other risk factors (as well as possible protective factors) contribute to outcomes as the child transitions from early childhood to pre-adolescence.