Identifying Injury Patterns and Forensic Biomarkers Diagnostic of Physical Elder Abuse

识别老年人身体虐待的伤害模式和法医生物标志物诊断

• 批准号: 10400512
• 负责人: Anthony Rosen
• 金额: $ 24.06万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10400512
• 关键词: Accident and Emergency department; Accidental Falls; Accidental Injury; Accidents; Acute; Address; Adult; Aging; Area; Award; Biological Markers; Biometry; Caring; Center for Translational Science Activities; Characteristics; Child Abuse; Classification; Clinical; Clinical Research; Clinical Sciences; Collaborations; Contusions; Core Facility; Criminal Justice; Data; Detection; Development; Diagnosis; Diagnostic radiologic examination; Documentation; Educational workshop; Elder Abuse; Elder abuse prevention; Elderly; Emergency Department evaluation; Emergency Department-based Intervention; Emergency Medicine; Emergency medical service; Enrollment; Environment; Epidemiologic Methods; Epidemiology; Face; Family; Fellowship; Forearm Injuries; Forensic Medicine; Forensic Sciences; Foundations; Fracture; Funding; Geriatrics; Goals; Government Agencies; Grant; Health; Health Care Costs; Health Personnel; Health system; Image; Injury; Intervention; Interview; Justice; Knowledge; Laboratories; Leadership; Left; Legal; Link; Lower Extremity; Medical; Mental Health; Mentors; Mentorship; Methodology; Neck; Neurocognitive; New York City; Nurses; Outcome; Participant; Patients; Pattern; Photography; Physical Examination; Physicians; Physiological; Policy Making; Positioning Attribute; Presbyterian Church; Prevention; Prevention Research; Protocols documentation; Radiology Specialty; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Resources; Scientist; Series; Services; Standardization; System; Testing; Time; Training; Trauma; United States National Institutes of Health; Vulnerable Populations; Work; Writing; abuse neglect; abuse victim; adjudicate; authority; base; career; career development; cohort; design; diagnostic biomarker; evidence base; experience; fall injury; falls; health assessment; improved; injured; injury prevention; innovation; interest; leadership development; legal cases; medical schools; mortality; novel; physical abuse; prospective; psychosocial; recruit; research and development; skills; social; success

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.

项目摘要/摘要 该比森K76应用程序的整理目标是识别损伤模式和法医生物标志物 诊断身体虐待的诊断并启动了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（Anthony Rosen）博士是威尔·康奈尔（Weill Cornell）医疗的急诊医学 学院（WCMC）表现出对老年虐待老年人的重要研究能力和临床兴趣 急性老年护理。他是Nia Gemsstar奖的获得者，在那里他与检察官合作 办公室检查法律案件文件，以描述最大的回顾性系列中有趣的伤害模式 曾经检查过高度调整的虐待老人案件。为了进行这项工作，Rosen博士及其同事 开发了用于急性老年损伤的综合分类系统和标准化的方案 急性受伤的摄影。罗森博士的工作已经开始在全国范围内得到认可，因为他受到了邀请 参加了2015年白宫老式司法论坛，并在NIH最近的老年虐待讲习班上演讲。 他还聘请了老年急诊医学的临床研究金。罗森博士已经接受过培训 研究方法和生物统计学完成了流行病学的MPH。罗森博士的长期职业 目标是通过识别，干预和预防来改善对弱势老年人的保护 虐待和忽视老年人，成为虐待老人的独立研究员和学术领导者， 老年损伤预防研究。他已经确定了四个特定领域，他将从额外 贝森奖奖期间的重要培训：法医学，政策制定，独立赠款写作， 和领导能力。对于每个人，他与导师合作，都利用了机构，当地的优势 以及国家教学资源和机会，制定雄心勃勃的计划，以提供此培训和 经验。 Beeson K76奖将使Rosen博士能够发展这些技能，完成重要项目 他的建议，并继续他有前途的学术生涯和领导力发展。 导师/环境：罗森博士与一支非常强大，坚定的指导团队与 对虐待老年人研究的深入了解和在心理研究人员方面的丰富经验 独立。罗森博士与他的主要导师马克·拉赫斯（Mark Lachs）博士密切合作了9年。 WCMC的老年医学和整个纽约长主教卫生系统（NYPHS），他领导了多个 R01资助的老年虐待研究项目。他还与Co-Encormor广泛合作Karl Pillemer博士 领先的社会科学家在旧虐待研究中已有近30年的历史。副总裁特里·富尔默（Terry Fulmer）博士 约翰·A·哈特福德基金会（John A. Hartford Foundation）是一位领先的护士研究员 急诊室的虐待恐怖故事，并提供了为该提案提供信息的试点数据。博士 罗森还召集了一个来自刑事司法，政策制定的专家合作者团队 政府机构，预防伤害和流行病学方法。 WCMC紧急部门 医学致力于罗森博士的成功，并将提供受保护的时间和资源。此外， WCMC提供了丰富而支持的研究和职业发展环境，其中包括 临床和转化科学中心，临床研究方法论核心设施以及培训 生物医学赠款写作，向研究独立性过渡和领导力的课程 /半手。 研究：罗森博士的研究的超级目标和长期目标是：确定伤害模式和 法医生物标志物的身体虐待诊断。该提案的具体目的是：（1）确定 通过比较，与老年人身体虐待相关的伤害模式，身体发现和其他特征 与偶然下降的急诊室的老年患者相比，前瞻性侵犯行为， （2）确定与身体虐待相关的实验室和射线照相结果 意外秋季受伤患者，（3）得出临床预测规则（CPR）以协助繁忙的医疗保健 提供者更有效地确定了身体虐待，这是一种未知的现象。通过注册 拟议的项目前瞻性并评估ED中普遍违反身体虐待的行为 解决了罗森博士先前工作的主要方法论限制，质量和完整性 法律文件中没有收集的法律文件中的信息，缺乏辅助神经认知的信息 射线照相和实验室测试。开发CPR将大大增加 繁忙临床医生的发现。通过与纽约的合作伙伴关系，将确定和招募主题 城市老年虐待中心（NYCEAC），纽约市成人保护服务部，成人保护服务部 检察官办公室和紧急医疗服务以及通过ED评估。除了学习 入学，可怕的疫苗接种将由基于ED的基于ED的多学科脆弱性评估和治疗 由Rosen博士及其同事设计的老年保护团队。他和这个团队具有独特的能力，理想的 由于NYPHS的规模和覆盖范围而定位进行这项研究，他们在 Nyeac，以及他们与在当地遭受旧虐待的机构的长期合作。这种创新 项目可能会大大提高卫生保健提供者确定身体虐待的可怕事物的能力， 他们是最脆弱的老年人。这个比森提议的长期目标是改善 保护这些惊奇，并启动罗森博士的承诺研究，学术和领导职业。

项目成果

Developing a tool to assess and monitor institutional readiness to address elder mistreatment in hospital emergency departments.

• DOI: 10.1080/08946566.2021.1965930
• 发表时间: 2021-08
• 期刊: JOURNAL OF ELDER ABUSE & NEGLECT
• 影响因子: 1.9
• 作者: Dash, Kim;Breckman, Risa;Lees-Haggerty, Kristin;Elman, Alyssa;Lachs, Mark;Stoeckle, Rebecca Jackson;Fulmer, Terry;Rosen, Tony
• 通讯作者: Rosen, Tony

Elder abuse prevalence and risk factors: findings from the Canadian Longitudinal Study on Aging.

• DOI: 10.1038/s43587-022-00280-2
• 发表时间: 2022-09
• 期刊: NATURE AGING
• 作者: Burnes, David;Pillemer, Karl;Rosen, Tony;Lachs, Mark S.;McDonald, Lynn
• 通讯作者: McDonald, Lynn

Developing standard data for elder abuse multidisciplinary teams: A critical objective.

• DOI: 10.1080/08946566.2020.1782301
• 发表时间: 2020-08
• 期刊: Journal of elder abuse & neglect
• 影响因子: 1.9
• 作者: Burnes D;Kirchin D;Elman A;Breckman R;Lachs MS;Rosen T
• 通讯作者: Rosen T

Changes in Elder Abuse Risk Factors Reported by Caregivers of Older Adults during the COVID-19 Pandemic.

• DOI: 10.1111/jgs.17009
• 发表时间: 2021-03
• 期刊: Journal of the American Geriatrics Society
• 影响因子: 6.3
• 作者: Makaroun LK;Beach S;Rosen T;Rosland AM
• 通讯作者: Rosland AM

Loneliness before and during the COVID-19 pandemic: A systematic review with meta-analysis.

• DOI: 10.1037/amp0001005
• 发表时间: 2022-07
• 期刊: AMERICAN PSYCHOLOGIST
• 影响因子: 16.4
• 作者: Ernst, Mareike;Niederer, Daniel;Werner, Antonia M;Czaja, Sara J;Mikton, Christopher;Ong, Anthony D;Rosen, Tony;Brahler, Elmar;Beutel, Manfred E
• 通讯作者: Beutel, Manfred E