Mount Sinai Injury Control Research Center (MS-ICRC)

西奈山伤害控制研究中心（MS-ICRC）

• 批准号: 8519082
• 负责人: Wayne A. Gordon
• 金额: $ 79.47万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8519082
• 关键词: Mount; Sinai; Injury; Control; Research

DESCRIPTION (provided by applicant): The Mount Sinai Injury Control and Research Center (MS-ICRC) will continue, in the proposed funding period, to focus on ameliorating the secondary and tertiary conditions that occur after traumatic brain injury (TBI), to address two goals: (1) improving quality of life after TBI and (2) extending the life span of people injured after age 40. We have added an additional emphasis: reducing violence and criminal behavior in youth who are at high risk. The proposed Research Program of the MS-ICRC includes: (1) An investigation of the impact of a behavioral intervention on violence and recidivism amongst youth (with TBI and without) who are on parole. This study "translates" an intervention we developed for an adult TBI population for use with adolescents at-risk for violence, and it comprises the first stud of an intervention for young offenders with TBI. (2) A pilot prospective cohort study of individual who sustained a TBI after age 40, to document health issues and other factors that may contribute to the accelerated aging and pre-mature death that has been documented in TBI survivors. (3) An analysis of a database developed by the Texas juvenile justice system to explore the relationship between TBI (and other health factors) and youth criminality, with a particular focus on violent offenses. This policy research follows extensive outreach by the MS-ICRC to the juvenile justice system in Texas that resulted in their decision to screen their population for TBI (using the MS-ICRC's Brain Injury Screening Questionnaire [BISQ]). (4) The establishment of a longitudinal database of all college athletes at St. John's University in New York City, to document at time of college admission lifetime history of concussion and to then prospectively document concussions sustained during college both on and off the field. Student-athletes will be followed to define the long-term consequences of concussions. This project will be fully manualized for replication in other institutions, to move toward the establishment of a national registry of college sports concussions. (5) A program of exploratory projects, to encourage other researchers to expand their work to address the MS- ICRC's long-term goals. Together, Projects 1 and 3 have strong policy implications for developing system-wide interventions to identify children with TBI at the earliest point possible and for providing subsequent accommodations, i.e., systemic interventions to reduce violence and criminality in young offenders, or school- based interventions to prevent children with TBI from taking the path that often leads from untreated long-term challenges consequent to injury to criminal behavior, homelessness and other forms of social failure. The proposed Outreach Program addresses MS-ICRC goals by building on the output of our current activities (2007-2012) and by weaving the results of proposed activities into outreach, as new "products" are developed and new implications for action emerge. Specifically, three interventions (cognitive behavioral therapy adapted to treat depression post TBI, and the Executive Plus and STEP treatment programs for post-TBI executive dysfunction) have been developed, evaluated and manualized. Planned outreach will focus on broad dissemination and support for adoption of these valuable additions to the TBI treatment arsenal. A second current focus is on screening for "hidden" TBI, through further validation of the BISQ and its adaptation for web-based administration. Outreach in the next five years will stress wider dissemination of the BISQ to screen additional populations, with the goal of effecting changes in policy in schools and in other settings where screening is needed to identify individuals with brain-injury related challenges, so that accommodations can be provided to prevent failure associated with unrecognized injury. Another emphasis is being placed on working with marketing experts to better tailor MS-ICRC outreach to meet the needs of our several constituencies. A new element of MS-ICRC outreach will be a Policy Think Tank, to review evidence based on MS-ICRC research and from the established knowledge base, and then to detail means and strategies to achieve policy change; the first area will be establishing systematic screening for "hidden" TBI. The Training and Education Program will continue to focus on supplying the field with qualified professional injury prevention practitioners and researchers, in the spirit of the training program established in 2007. Formal training will include a 2-year post-doctoral fellowship program and a 1-year pre-doctoral externship. In addition, we will educate service providers through webinars and workshops, symposia and lectures at professional conferences and institutions; we also provide numerous resources for professionals downloadable (gratis) on our website. Recommendations for curricula changes to be incorporated into programs for medical and other professional training will also be developed.

西奈山伤害控制与研究中心（MS-ICRC）将在拟议的资助期内继续专注于改善创伤性脑损伤（TBI）后发生的二级和三级疾病，以实现两个目标：（1）改善TBI后的生活质量和（2）延长40岁后受伤者的寿命。 我们增加了一个额外的重点：减少高危青年的暴力和犯罪行为。红十字国际委员会会员国拟议的研究方案包括：（1）调查行为干预对假释青年（有创伤性脑损伤和无创伤性脑损伤）暴力和累犯的影响。这项研究“翻译”我们开发的成人TBI人群用于青少年暴力风险的干预，它包括TBI青少年罪犯干预的第一个研究。(2)一项针对40岁后持续TBI的个体的前瞻性队列研究，以记录健康问题和其他可能导致TBI幸存者加速老化和过早死亡的因素。(3)对德克萨斯州少年司法系统开发的数据库进行分析，以探讨TBI（和其他健康因素）与青少年犯罪之间的关系，特别关注暴力犯罪。这项政策研究是在红十字国际委员会对德克萨斯州青少年司法系统进行广泛宣传之后进行的，该系统决定对德克萨斯州的青少年进行创伤性脑损伤筛查（使用红十字国际委员会的脑损伤筛查问卷[BISQ]）。(4)在纽约市的圣约翰大学建立一个所有大学运动员的纵向数据库，以记录大学入学时的脑震荡终身史，然后前瞻性地记录大学期间在球场内外持续的脑震荡。学生运动员将被跟踪，以确定脑震荡的长期后果。该项目将完全手工化，以便在其他机构复制，以建立一个全国大学运动脑震荡登记处。(5)探索性项目计划，鼓励其他研究人员扩大工作范围，以实现红十字国际委员会的长期目标。项目1和项目3对制定全系统干预措施，尽早发现创伤性脑损伤儿童，并提供后续照顾，系统性干预措施，以减少青少年犯罪者的暴力和犯罪行为，或以学校为基础的干预措施，以防止TBI儿童走上往往导致未经治疗的长期挑战的道路，从而导致犯罪行为，无家可归和其他形式的社会失败。拟议的“外联方案”旨在实现会员国-红十字国际委员会的各项目标，在我们目前活动（2007-2012年）成果的基础上再接再厉，并随着新“产品”的开发和新的行动影响的出现，将拟议活动的成果融入外联工作。具体来说，已经开发、评估和实施了三种干预措施（适用于治疗TBI后抑郁症的认知行为疗法，以及针对TBI后执行功能障碍的Executive Plus和STEP治疗计划）。计划中的外联活动将侧重于广泛传播和支持采用这些对创伤性脑损伤治疗库有价值的补充。当前的第二个重点是通过进一步验证BISQ及其基于网络的管理的适应性来筛查“隐藏”TBI。未来五年的推广工作将强调更广泛地传播BISQ，以筛查更多的人群，目标是改变学校和其他需要筛查的环境中的政策，以确定患有脑损伤相关挑战的个人，以便提供住宿，以防止与未识别的损伤相关的失败。另一个重点是与营销专家合作，更好地调整红十字国际委员会会员国的外联工作，以满足我们几个支持者的需求。红十字国际委员会与红十字国际委员会合作的一个新内容将是建立一个政策智囊团，以审查基于红十字国际委员会与红十字国际委员会合作的研究和现有知识库的证据，然后详细说明实现政策变革的手段和战略;第一个领域将是建立“隐性”创伤性脑损伤的系统筛查。本着2007年制定的培训方案的精神，培训和教育方案将继续侧重于为该领域提供合格的专业伤害预防从业人员和研究人员。正式培训将包括为期2年的博士后奖学金计划和为期1年的博士前实习。此外，我们将通过网络研讨会和研讨会，研讨会和专业会议和机构的讲座来教育服务提供商;我们还在我们的网站上为专业人士提供了许多可下载的资源（免费）。还将制定关于将课程改革纳入医疗和其他专业培训方案的建议。