Mount Sinai Injury Control Research Center (MS-ICRC)

西奈山伤害控制研究中心（MS-ICRC）

• 批准号: 9119492
• 负责人: Wayne A. Gordon
• 金额: $ 77.35万
• 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 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9119492
• 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.

描述（由申请人提供）：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重点改善创伤性脑损伤（TBI）后出现的二级和三级病症，以实现两个目标：（1）改善TBI后的生活质量；（2）延长40岁以后受伤者的寿命。 我们还增加了一个重点：减少高危青少年的暴力和犯罪行为。 MS-ICRC拟议的研究项目包括： (1) 调查行为干预对假释青少年（无论是否患有脑外伤）的暴力和累犯的影响。这项研究“转化”了我们为成年 TBI 人群开发的一项干预措施，用于有暴力风险的青少年，它是针对患有 TBI 的年轻罪犯的第一个干预措施。 (2) 对 40 岁后遭受 TBI 的个体进行一项试点前瞻性队列研究，以记录 TBI 幸存者中记录的健康问题和其他可能导致加速衰老和过早死亡的因素。 (3) 对德克萨斯州青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MS-ICRC对德克萨斯州青少年司法系统进行广泛宣传之后进行的，该系统最终决定对其人口进行TBI筛查（使用MS-ICRC的脑损伤筛查问卷[BISQ]）。 (4) 建立纽约市圣约翰大学所有大学运动员的纵向数据库，记录大学入学时的终生脑震荡史，然后前瞻性地记录大学期间场内和场外持续的脑震荡。将跟踪学生运动员以确定脑震荡的长期后果。该项目将完全手动化，以便在其他机构复制，以建立国家大学体育脑震荡登记册。 (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 MS-ICRC 的长期目标。项目 1 和项目 3 对制定全系统干预措施以尽早识别患有 TBI 的儿童并提供后续调整具有很强的政策意义，即采取系统性干预措施减少青少年罪犯的暴力和犯罪行为，或采取以学校为基础的干预措施以防止 TBI 儿童走上因伤害、犯罪行为、无家可归和其他形式的社会失败而导致长期挑战而得不到治疗的道路。随着新“产品”的开发和新的行动影响的出现，拟议的外展项目以我们当前活动（2007-2012年）的成果为基础，并将拟议活动的结果融入到外展活动中，以实现MS-ICRC的目标。具体来说，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 治疗方案）已经开发、评估和手册化。计划的外展活动将侧重于广泛传播和支持采用这些有价值的 TBI 治疗手段。当前的第二个重点是通过进一步验证 BISQ 及其对基于网络的管理的适应来筛查“隐藏”TBI。未来五年的外展活动将强调更广泛地传播 BISQ 以筛查更多人群，目标是影响学校和其他需要筛查以确定患有脑损伤相关挑战的环境的政策变化，以便提供便利，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 MS-ICRC 的外展活动，以满足我们多个支持者的需求。 MS-ICRC外展活动的一个新要素将是政策智囊团，负责审查基于MS-ICRC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策略；第一个领域是建立“隐性”TBI 的系统筛查。本着 2007 年制定的培训计划的精神，培训和教育计划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讲习班、研讨会以及专业会议和机构的讲座对服务提供商进行教育；我们还为专业人士提供了大量资源，可在我们的网站上（免费）下载。还将制定将课程变更纳入医疗和其他专业培训计划的建议。