Yale Drug Abuse, Addiction, and HIV Research Scholars (Yale-DAHRS)

描述(由申请人提供)：迫切需要培养一批训练有素的临床医生学者，以促进与普通医疗机构中药物滥用、成瘾和艾滋病毒预防和治疗相关的生物医学、行为和临床研究的发展。滥用药物的患者更有可能出现在普通医疗机构，如急诊科(ED)、普通医疗初级保健诊所和住院病房、艾滋病毒和青少年健康诊所以及妇女健康中心。这些患者往往出现一系列复杂的急性后果和药物使用的并发症(如中毒、过量用药、戒断、创伤和传染病)以及慢性疾病，如艾滋病毒疾病、肝炎、肺部和心血管疾病。目标：耶鲁大学药物滥用、成瘾和艾滋病毒研究学者计划(DAHRS)提供一个全面的三年博士后、跨学科、有指导的职业发展计划，以改善药物滥用、成瘾和艾滋病毒的医疗结果，整合普通医疗机构(包括ED、初级保健、艾滋病毒、青少年和妇女健康诊所)的预防和治疗。具体地说，耶鲁-DAHRS将：[目标1]培养具有成为独立调查人员的知识、技能和能力的临床科学家，产生具有重大影响的实用价值的发现，以改善患有和处于高血压风险的患者的健康结果。 [目标2]培养未来的领导者，为学者提供领导工具和技能，并创建个性化项目，以确保在领导多学科研究团队研究药物滥用、成瘾和艾滋病毒方面取得成功，并将研究结果落实和整合到普通医疗环境中；以及[目标3]提高药物滥用、成瘾和艾滋病毒研究人员的多样性。向代表中的女性和少数族裔教职员工发表讲话将增强研究人员和研究主题的多样性，在设定研究优先事项方面拓宽视角，增加临床试验的参与度，并扩大知识。耶鲁-DAHRS将与耶鲁大学在药物滥用、艾滋病毒和临床调查方面的既定培训计划协同工作，利用现有的学术基础设施和专业知识确保成功。独一无二的特点包括：(1)跨学科、多样化的学院 在非法和处方药滥用和成瘾、烟草、酒精、艾滋病毒以及疼痛和丙型肝炎等医疗复杂性方面的独立研究人员；(2)与耶鲁大学成熟的、高质量的博士后培训计划的协同；(3)使用临床信息学进行数据收集、数据管理、诊断工具开发和信息传播；以及(4)将公共卫生、信息学、临床流行病学、系统工程和人口学等不同领域与内科、急诊医学、艾滋病毒医学、儿科学、妇产科、精神病学和心理学等传统临床科学相结合；(5)已建立的临床研究实验室，包括耶鲁-纽黑文医院、新英格兰南部的三级护理中心和大纽黑文地区的社区医院，为种族、种族、文化和经济多元化的人群提供服务，退伍军人事务医学中心和社区治疗中心，如APT基金会和联邦合格的健康中心；(6)与现有的研究中心和机构，如艾滋病跨学科研究中心和艾滋病毒问题退伍军人老龄队列。职业发展计划：耶鲁-DAHRS是一个为期三年的研究培训计划，将在第一个资助周期内为专注于普通医疗环境中的药物滥用、成瘾和艾滋病毒的职业生涯培养总共六名临床医生调查人员。学者将获得健康科学硕士学位，将研究方法、统计和设计方面的严格培训与与药物滥用、成瘾和艾滋病毒内容、领导力、拨款撰写和负责任的研究行为有关的研讨会结合起来。考生将完成已发表的导师研究项目(S)，并准备下一职业阶段的申请；即NIH R21、R03、R15、R34机制。来自急诊科和内科的两名主要研究人员拥有丰富的指导经验和独立资助的研究人员，他们的合作和强大的综合实力将推动耶鲁-DAHRS计划。潜在的研究项目：多个研究项目已经为学者培训做好了准备，可以在我们分配的时间框架内完成，例如使用国家大型数据集的二级数据分析，例如VA老龄队列(艾滋病毒)；风险因素，预防和治疗处方药滥用，丁丙诺啡对阿片依赖的办公室治疗，系统评价和荟萃分析，为药物滥用、成瘾和艾滋病毒患者创建成本效益评估模型，包括处方药滥用；调查识别和治疗干预措施和结果中的性别和种族/族裔差异；评估特殊人群(即青少年-老年人、退伍军人、被监禁者、艾滋病毒感染者)的筛查、治疗启动和治疗；提供者和其他创新技术提供的筛查、短期干预和转诊治疗(SBIRT)模式的比较；SBIRT科学在具有急慢性复杂医疗问题的普通医学实践中的有效性和实施。

DESCRIPTION (provided by applicant): There is a critical need to develop a diverse pool of highly trained clinician scholars to foster the development of biomedical, behavioral and clinical research related to drug abuse, addiction, and HIV prevention and treatment in general medical settings. Patients who abuse substances are more likely to be seen in general medical settings such as emergency departments (ED), general medical primary care clinics and inpatient wards, HIV and adolescent health clinics, and women's health centers. These patients often present with a complex array of acute consequences and complications (e.g. intoxication, overdose, withdrawal, trauma and infectious diseases) of substance use as well as chronic conditions such as HIV disease, hepatitis, pulmonary and cardiovascular disease. Objectives: The Yale-Drug Abuse, Addiction, and HIV Research Scholars (DAHRS) program provides a comprehensive three year post-doctorate, interdisciplinary, Mentored Career Development Program to improve drug abuse, addiction, and HIV medical outcomes integrating prevention and treatment in general medical settings including ED, primary care, HIV, adolescent, and women's health clinics. Specifically, Yale-DAHRS will: [Aim 1] Develop clinician scientists with the knowledge, skills, and ability to become independent investigators, generating findings of practical value with significant impact to improve health outcomes of patients with and at risk for drug abuse, addiction, and HIV; [Aim 2] Develop future leaders by providing Scholars with leadership tools and skills and creating individualized programs to ensure success in leading multidisciplinary research teams in studying drug abuse, addiction and HIV, and implementation and integration of research findings into general medical settings; and [Aim 3] Enhance the diversity of drug abuse, addiction, and HIV researchers. Addressing women and minority faculty under representation will enhance the diversity of investigators and research topics, broaden perspectives in setting research priorities, increase clinical trial participation, and expand knowledge. Working synergistically with Yale's established training programs in drug abuse, HIV and clinical investigation, Yale- DAHRS will capitalize on existing academic infrastructure and expertise to ensure success. Unique, features include: (1) An interdisciplinary, diverse faculty of independent researchers in illicit and prescription drug abuse and addiction, tobacco, alcohol, HIV, and medical complexities such as pain and hepatitis C; (2) Synergy with well established, high quality post-doctoral training programs at Yale; (3) The use of clinical informatics for data collection, data management, diagnostic tool development, and information dissemination; and (4) The integration of such diverse fields as public health, informatics, clinical epidemiology, systems engineering and demography with the traditional clinical sciences of internal medicine, emergency medicine, HIV medicine, pediatrics, obstetrics and gynecology, psychiatry, and psychology; (5) Established clinical research laboratories, including the Yale-New Haven Hospital, a tertiary care center for southern New England and a community hospital for the Greater New Haven Area, serving an ethnically, racially, culturally, and economically diverse population, a Veterans Affairs Medical Center and community treatment centers such as the APT Foundation and Federally Qualified Health Centers; (6) Synergies with established research centers and institutes such as the Center for Interdisciplinary Research on AIDS and the Veterans Aging Cohort on HIV. Career Development Plan: Yale-DAHRS is a three year research training program that will prepare a total of six clinician investigators for careers focusing on drug abuse, addiction, and HIV in general medical settings during its first funding cycle. Scholars will earn the Master in Health Sciences degree, combining rigorous training in research methodology, statistics and design with seminars in topics related to drug abuse, addiction, and HIV content, leadership, grant writing and responsible conduct of research. Candidates will complete published mentored research project(s) and prepare an application for the next career step; i.e. NIH R21, R03, R15, R34 mechanism. The collaboration of the multidisciplinary faculty and the combined robust strengths of two principal investigators from Emergency and Internal Medicine, both with extensive experience mentoring and as independent funded investigators will drive the Yale-DAHRS program. Potential Research Projects: Multiple research projects are "shovel ready" for Scholar training and can be completed within our allotted time frame, such as secondary data analysis using national large datasets e.g. VA Aging Cohort (HIV); risk factors, prevention and treatment of prescription drug abuse, office-based treatment of opioid dependence with buprenorphine, systematic reviews and meta-analyses, creation of cost effective evaluation models for patients with drug abuse, addiction and HIV including prescription drug abuse; investigation of gender and racial/ethnic disparities in identification and treatment interventions and outcomes; evaluation of screening, and treatment initiation in special populations (i.e. adolescent-elderly, veterans, incarcerated, HIV); comparison of models of screening, brief intervention and referral to treatment (SBIRT) delivery by providers and other innovative technologies; effectiveness and implementation of SBIRT science in general medicine practice with acute and chronic medical complexities.