Outcomes of Traumatic Brain Injury

脑外伤的后果

• 批准号: 6903314
• 负责人: HEATHER T. KEENAN
• 金额: $ 9.78万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-01 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6903314
• 关键词: brain injury; child abuse; child behavior; child welfare; clinical research; cognition; computed axial tomography; coping; developmental psychology; disease /disorder etiology; epidemiology; family structure /dynamics; functional ability; health care service availability; human mortality; human subject; infant human (0-1 year); infant mortality; legal /correctional; longitudinal human study; neuropsychological tests; patient oriented research; preschool child (1-5); racial /ethnic difference; socioeconomics; trauma

DESCRIPTION (provided by applicant): This career development proposal is designed to prepare the candidate, currently an Assistant Professor of Social Medicine and Pediatrics, to be an independent clinician-scientist in the area of child abuse research. The applicant has worked closely with Dr. Desmond Runyan - a leader in child abuse research - as her primary sponsor, and has identified Dr. Stephen Hooper as a co-sponsor because of his expertise in neuro-developmental assessment. The training portion of this grant includes supervised work with both sponsors as well as formal courses in epidemiology, the biological basis of childhood exceptionalities, the selection and theoretical background of measurement tools used for pediatric outcome assessment, and responsible conduct of research. This application also benefits from the collaboration, research infrastructure, and supplemental funding of the CDC-sponsored UNC Injury Prevention Research Center, mentors in ethics within Social Medicine, and statewide public health resources including the Office of the Chief Medical Examiner and the State Center for Vital Statistics. The research component is a prospective, longitudinal study of a statewide population of children under age 2 years who have suffered any type of non-penetrating traumatic brain injury (TBI) that is serious enough to warrant observation in an intensive care unit. It is unique in that it will provide the first population based data of inflicted TBI (iTBI) in the United States. The series of proposed studies build on data already collected in a CDC-sponsored study (C. Runyan), linkages with public health data, and data unique to this application that will be gathered by telephone at one and two year follow-up from the injury, and by home visits after the child's third birthday. Study 1 will determine incidence and case fatality rates of non-iTBI and iTBI, as well as compare patterns of injury and initial clinical presentation between the two groups. Study 2 will utilize follow-up calls to the cohort to determine intermediate functional outcomes and non-biologic data about the post-injury family. A model of how non-biologic factors mediate cohort outcomes will be explored. Study 3 will utilize home visits to determine differences in developmental cognitive and behavioral outcomes between children with inflicted and non-inflicted TBI, using standardized neuropsychological tests. Further information will be collected on the child's family including indices of coping and family functioning. The hypothesis is that children with inflicted TBI will fare more poorly than children with non-inflicted TBI partially due to the injury type, and partially due to the post-injury family environment. Preliminary data on a model which encompasses these three studies will be developed. Finally, Study 4 will describe the initial and longitudinal social and legal ramifications for children with iTBI. In addition to publications, data from this mentored research will be used to develop additional, independent research awards.

描述（由申请人提供）：该职业发展提案旨在使目前担任社会医学和儿科助理教授的候选人成为虐待儿童研究领域的独立临床医生科学家。申请人与儿童虐待研究领域的领导者 Desmond Runyan 博士密切合作，作为她的主要资助者，并因其在神经发育评估方面的专业知识而确定 Stephen Hooper 博士为共同资助者。 该赠款的培训部分包括与赞助商的监督工作以及流行病学、儿童异常的生物学基础、用于儿科结果评估的测量工具的选择和理论背景以及负责任的研究行为的正式课程。该应用程序还受益于疾病预防控制中心资助的北卡罗来纳大学伤害预防研究中心的合作、研究基础设施和补充资金、社会医学道德导师以及全州公共卫生资源，包括首席法医办公室和国家生命统计中心。 该研究内容是一项前瞻性纵向研究，对象是全州范围内 2 岁以下的儿童，这些儿童遭受过任何类型的非穿透性脑外伤 (TBI)，且严重程度足以需要在重症监护室进行观察。它的独特之处在于它将提供美国第一个基于人群的 TBI (iTBI) 数据。这一系列拟议的研究建立在疾病预防控制中心资助的一项研究（C. Runyan）中已收集的数据、与公共卫生数据的联系以及本应用程序特有的数据的基础上，这些数据将在受伤后一年和两年的随访中通过电话收集，并在孩子三岁生日后通过家访收集。研究 1 将确定非 iTBI 和 iTBI 的发病率和病死率，并比较两组之间的损伤模式和初始临床表现。研究 2 将利用对队列的后续电话来确定关于受伤后家庭的中间功能结果和非生物学数据。将探索非生物因素如何介导队列结果的模型。研究 3 将利用家访的方式，通过标准化的神经心理学测试，确定患有创伤性脑损伤的儿童和非创伤性脑损伤儿童之间的发育认知和行为结果的差异。将收集有关儿童家庭的进一步信息，包括应对指数和家庭功能。假设是，患有 TBI 的儿童比未患 TBI 的儿童表现更差，部分原因是伤害类型，部分原因是受伤后的家庭环境。将开发包含这三项研究的模型的初步数据。最后，研究 4 将描述 iTBI 儿童的初始和纵向社会和法律影响。除了出版物之外，这项指导研究的数据还将用于制定额外的独立研究奖项。