Identifying Injury Patterns and Forensic Biomarkers Diagnostic of Physical Elder Abuse

项目总结/摘要 此Beeson K76应用程序的总体目标是识别损伤模式和法医生物标志物 诊断身体虐待老年人，并启动一个非常有前途的初级调查员的学术生涯。 候选人：申请人，安东尼罗森博士，是一个急诊医学医师在威尔康奈尔医疗 学院（WCMC）谁已经表现出显着的研究能力和临床兴趣，在虐待老人和 急性老年病护理。他是NIA GEMSSTAR奖的获得者，在那里他与检察官合作， 办公室审查法律的案件档案，以描述在最大的回顾性系列伤害有趣的模式， 最高级别的虐老案件为了进行这项工作，罗森博士和同事们 制定了一个全面的分类系统，为急性老年人受伤和议定书的标准化 急性损伤的照片。罗森博士的工作已经开始得到全国的认可，因为他是一个邀请 参加2015年白宫老年人司法论坛，并在美国国立卫生研究院最近的虐待老人研讨会上发表演讲。 他还在老年急诊医学方面获得了临床奖学金。罗森博士已经接受过 研究方法和生物统计学，完成了流行病学硕士学位。罗森博士的长期职业生涯 目标是通过识别、干预和预防，改善对弱势老年人的保护， 虐待和忽视老年人，成为虐待老年人问题的独立研究员和学术领导者， 老年人伤害预防研究。他确定了四个具体领域， 在比森奖期间的关键培训：法医科学，决策，独立赠款写作， 和领导能力对于每一个，在与他的导师合作，他利用了机构，地方， 和国家教学资源和机会，制定一项雄心勃勃的计划，提供这种培训， 体验.比森K76奖将允许罗森博士发展这些技能，完成重要的项目 他建议，并继续他有前途的学术生涯和领导力的发展。 导师/环境：罗森博士拥有一支非常强大、忠诚的导师团队， 对虐待老人研究的深入了解和指导初级研究人员的丰富经验， 独立罗森博士与他的主要导师Mark Lachs博士密切合作了9年， 老年医学为WCMC和整个纽约长老会卫生系统（NYPHS），谁领导了多个 R 01资助的虐待老人研究项目。他还与共同导师Karl Pillemer博士进行了广泛的合作， 他是近30年来研究虐待老人问题的社会科学家共同导师特里富尔默博士，总裁 约翰A。哈特福德基金会，是一个领先的护士研究人员与经验前瞻性招募老年人 虐待受害者从急诊部，并提供了试点数据，告知这一建议。博士 罗森还组建了一个由刑事司法、政策制定、 政府机构、伤害预防和流行病学方法。世界养护监测中心应急司 医学致力于罗森博士的成功，并将提供保护的时间和资源。此外，本发明还提供了一种方法， WCMC提供了一个丰富和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 课程/研讨会在生物医学补助金写作，过渡到研究的独立性，和领导。 研究：罗森博士研究的首要目标和长期目标是：确定损伤模式， 法医生物标志物诊断身体虐待老人。该建议的具体目标是：（1）确定 伤害模式，身体发现，和其他特征与老年人身体虐待，通过比较 与因意外福尔斯跌倒到艾德就诊的老年患者相比， (2)确定与身体虐待老年人相关的实验室和放射学结果， 意外跌倒伤害患者，以及（3）导出临床预测规则（CPR）以辅助忙碌的健康护理 提供者更有效地识别身体虐待老年人，这是一种认识不足的现象。通过入组 前瞻性和全面评估身体虐待受害者在艾德，拟议的项目 解决了罗森博士先前工作中的主要方法学限制， 法律的文件中的信息，这些信息不是为了研究而收集的，而且缺乏辅助神经认知， X光片和实验室检测开发心肺复苏术将大大提高 为忙碌的临床医生提供了新的发现。将通过与纽约的伙伴关系确定和征聘受试者。 市老年虐待中心（NYCEAC），纽约市老龄部，成人保护服务， 检察官办公室和紧急医疗服务，以及通过艾德评估。除了学习 注册，受害者将由一个基于ED的多学科弱势群体进行评估和治疗。 由罗森博士及其同事设计的老年人保护小组。他和这支球队是独一无二的， 由于NYPHS的规模和范围，他们在 NYEAC，以及他们与当地为虐待老年人受害者服务的机构的长期合作。这一创新 该项目可能会大大提高卫生保健提供者识别身体虐待老年人受害者的能力， 他们是最脆弱的老年人比森提案的长期目标是改善 保护这些受害者，并启动罗森博士有前途的研究，学术和领导生涯。

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.