Doctoral Dissertation Research: The Role of Socioeconomic and Cultural Variation of Neurotrauma Recovery

创伤性脑损伤（TBI）或神经创伤，是由头部的打击或震动引起的脑功能中断，可产生广泛的身体，认知和心理社会后遗症。TBI也代表了一个关键的全球健康问题，对患者，护理人员和整个社区造成了很高的个人，社会和经济成本。虽然全球卫生官员已经认识到TBI是一种“无声的流行病”，但公共卫生方法很少关注这种伤害的特定文化和社会经济环境。特别是，对创伤后生活的理解可能因文化背景而异，对临床环境内外的TBI护理具有潜在的强大影响。这个项目，培养学生的经验，科学的数据收集和分析的方法，询问TBI患者及其家属如何参与流行和医疗框架的伤害，以及如何社会和医学的理解脑损伤的差异受到公共护理的限制和对心灵和大脑的新观点的影响。除了为人类学研究生的培训提供资金外，该项目还将通过向投资于改善与创伤性脑损伤相关的社会和医疗成本的组织和机构广泛传播其研究结果来提高科学认识。在该奖项支持的研究中，博士生Livia Garofalo在Rebecca Seligman博士的监督和指导下，将调查如何照顾创伤性脑损伤和经验的背景下，高TBI发病率，医疗保健短缺，并增加对神经系统疾病的关注。通过在大布宜诺斯艾利斯地区的公立医院进行民族志研究，研究人员将通过临床空间的参与观察和与患者，护理人员和医疗专业人员的半结构化访谈收集数据，并进行档案和媒体研究。将这些数据三角化将提供对脑损伤发生的社会经济和政治环境的评估，以及阿根廷背景下更广泛的社会层面上神经创伤的影响。布宜诺斯艾利斯，特别是，提供了一个适当的网站，以调查这些问题作为一个大都市区的大量涌入的病人，从而提供了一个模式，其他密集和高度不平等的城市环境在美国。为期12个月的人种学研究将在两家不同的创伤中心医院及其周围社区进行。将通过参与者观察、访谈、病例研究和临床病史收集数据，包括医疗专业人员、TBI护理人员及其家属和TBI患者，并根据年龄、性别、阶级、教育和医院关系进行适当分层。为文化人类学、科学技术研究和全球健康之间的跨学科对话做出贡献，这项研究的结果将提供一个多层次的人类学视角，探讨TBI发病率如何沿着社会经济线分层，“脑健康”的新兴概念如何影响对脑损伤的关注，以及获得护理对于边缘化个人和家庭在创伤后重建生活至关重要。该奖项反映了NSF的法定使命，并通过使用基金会的学术价值和更广泛的影响评审标准。

Traumatic Brain Injury (TBI), or neurotrauma, is a disruption in brain function caused by a blow or jolt to the head that can produce a wide range of physical, cognitive, and psychosocial aftereffects. TBI also represents a critical global health issue with high personal, societal, and economic costs to patients, caregivers, and communities as a whole. Although global health officials have recognized TBI as "silent epidemic," public health approaches have seldom paid attention to the specific cultural and socioeconomic circumstances of this injury. In particular, understandings of life after trauma may vary across cultural contexts, with potentially powerful implications for TBI care within and outside clinical settings. This project, which trains a student in the methods of empirical, scientific data collection and analysis, asks how TBI patients and their families engage popular and medical framings about injury, and how societal and medical understandings of brain injury are differentially affected by constraints of public care and new perspectives on mind and brain. In addition to providing funding for the training of a graduate student in anthropology, the project would enhance scientific understanding by broadly disseminating its findings to organizations and institutions invested in ameliorating the social and medical costs associated with traumatic brain injury.In the research supported by this award, doctoral student Livia Garofalo, under the supervision and guidance of Dr. Rebecca Seligman, will investigate how Traumatic Brain Injury is cared for and experienced in a context of high TBI incidence, healthcare shortage, and increased attention towards neurological conditions. Through ethnographic research in public hospitals in the greater Buenos Aires area, the researcher will collect data through participant observation in clinical spaces and semi-structured interviews with patients, caregivers, and medical professionals, and conduct archival and media research. Triangulating this data will provide an assessment of the socioeconomic and political circumstances in which brain injury occurs, as well as the repercussions of neurotrauma at a broader societal level in the Argentine context. Buenos Aires, in particular, provides an apt site to investigate these issues as a large metropolitan area with a high influx of patients, thus providing a model for other dense and highly unequal urban contexts in the United States. Twelve months of ethnographic research will be conducted at two different hospitals with trauma centers, and their surrounding communities. Data will be collected through participant observation, interviews, and case studies and clinical histories, with medical professionals, TBI caregivers and their families, and TBI patients, with appropriate stratification based on age, gender, class, education, and hospital affiliation. Contributing to interdisciplinary conversations between cultural anthropology, science and technology studies, and global health, findings from this research will offer a multi-level anthropological perspective on how TBI incidence is stratified along socioeconomic lines, how emerging notions of "brain health" affect the attention towards brain injury, and how access to care is crucial for marginalized individuals and families to rebuild lives after trauma.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.