Project CARE(Cocaine Abuse in the Rural Environment)

描述(由申请人提供)：本次竞赛更新的目标是确定产前接触可卡因对暴露的后代制造的影响 从小学到中学的过渡时期。本研究 将评估产前可卡因用量可能的综合影响 暴露、其他药物暴露、照顾者的心理社会功能和 环境的质量对孩子的结果有影响。我们这批人的优势是： 1)妇女进入产前保健系统时登记的受试者，提供 产前护理和药物使用的范围；2)收集的关于数量和药物使用的广泛数据 使用时机；3)使用以下战略建立的目标和控制组 最大限度地减少用户的错误分类；4)来自多个领域的大量数据 在7岁之前收集的利息，以及平均随访率 93%的幸存队列；5)对儿童的盲目评估 时间点；6)选择可卡因为可卡因的样本的唯一性 他唯一的其他非法毒品接触是大麻。混合的各方面 可卡因致畸模型与可卡因交易模型 儿童发展导致我们的假设在产前得到完善 10-13岁接触可卡因的儿童将表现出特定的 神经心理、行为和心理社会缺陷，其程度 被暴露的量和持续的环境影响所改变。 我们建议继续收集有关儿童、照顾者和环境的数据 在这个循环中更加重视孩子。每个孩子都会是 在10岁和12岁时使用以下领域的测量进行盲目评估： 认知/智力；记忆/学习；语言；注意力和其他 行政职能；行为；学校成绩和运作；以及 心理社会功能。将对照顾者/家庭环境进行评估 在对每个儿童进行评估之前进行的家访期间。最后， 在整个研究过程中，孩子们将被反复采访，以确定 他们的心理社会功能和发展，他们对压力的感知 生活事件、支持性活动和人际关系。建议进行的研究 将提供有关产前可卡因暴露的影响的重要信息 关于发育中儿童的问题，包括确定受影响的具体结果 通过可卡因和澄清产前暴露的量和影响 持续的被动暴露。它还将提供对 交易影响、可卡因暴露和其他风险因素(以及 可能的保护性因素)对儿童过渡的结果有影响 从儿童早期到青春期前。

DESCRIPTION (provided by applicant): The goal of this competitive renewal is to identify the effect of prenatal cocaine exposure on exposed offspring making the transition from elementary school to the middle school years. This study will evaluate the possible combined effects of amount of prenatal cocaine exposure, other drug exposure, caregiver psychosocial functioning and the quality of the environment on the child's outcome. Strengths of our cohort are: 1) subjects enrolled when women entered the prenatal care system, providing a range of prenatal care and drug use; 2) extensive data collected on amount and timing of use; 3) target and control groups established using a strategy that minimized misclassification of users; 4) extensive data from numerous domains of interest collected prenatally through age 7, with an average follow-up rate of 93 percent of the surviving cohort; 5) blinded assessments of child at all timepoints; 6) the uniqueness of a sample whose cocaine of choice was crack and whose only other illegal drug exposure was marijuana. Blending aspects of the teratogenic model for the toxicity of cocaine with the transactional model for child development leads to a refinement of our hypotheses that prenatally cocaine-exposed children between the ages of 10-13 will manifest specific neuropsychological, behavioral, and psychosocial deficits, the extent to which are modified by the amount of exposure and on-going environmental influences. We propose to continue to collect data on the child, caregiver, and environment with a heavier emphasis on the child during this cycle. Each child will be blindly assessed at ages 10 and 12 using measures of the following domains: cognition/intelligence; memory/learning; language; attention and other executive functions; behavior; school achievement and functioning; and psychosocial functioning. The caregiver/family environment will be evaluated during home visits which take place prior to each child assessment. Finally, the children will be repeatedly interviewed throughout the study to determine their psychosocial functioning and development, their perception of stressful life events and supportive activities and relationships. The proposed study will provide vital information regarding effects of prenatal cocaine exposure on the developing child, including identification of specific outcomes affected by cocaine and clarification of the effect of amount of prenatal exposure and ongoing passive exposure. It will also provide a description of the transactional effects cocaine exposure and other risk factors (as well as possible protective factors) contribute to outcomes as the child transitions from early childhood to pre-adolescence.