Improving Recognition of Elder Abuse through Analysis of Highly Adjudicated Cases

通过分析高度判决的案件提高对虐待老年人的认识

基本信息

批准号：
8757750
负责人：
Anthony Rosen
金额：
$ 12.71万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-01 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8757750
关键词：
Accident and Emergency department Accidental Falls Accidental Injury Acute Adult Aging Appointment Award Biological Markers Biometry Caring Case Series Case Study Case-Control Studies Characteristics Clinical Collaborations Control Groups Data Diagnosis Elder Abuse Elder abuse prevention Elderly Emergency Medicine Enrollment Epidemiology Faculty Family Fellowship Forensic Medicine Frequencies Funding Future Geriatrics Goals Gold Grant Health Health Care Costs Health Personnel Injury Institution Judgment Lawyers Medical Records Medical Students Mentors Methodology Methods Morbidity - disease rate New York Outcome Patients Pattern Physicians Physiological Presbyterian Church Prevention Research Reporting Research Research Methodology Research Personnel Research Project Grants Research Support Risk Assessment Series Services Students Time Training Trauma United States National Institutes of Health Wages abuse victim adjudicate authority career court design emergency service responder evidence base experience improved innovation interest maltreatment mortality perpetrators physical abuse public health relevance screening tool violence prevention

项目摘要

DESCRIPTION (provided by applicant): The specific aims for this project are: (1) to comprehensively examine and describe common injury patterns, physical findings, and forensic biomarkers in a series of highly adjudicated cases of physical elder abuse using a mixed methods approach, (2) to conduct a case-control study comparing these injury patterns to those sustained by older adults after an accidental fall, and (3) to design a clinical decision rule to assist health care providers in identifying abuse victims. We will achieve these aims through a unique collaboration with the Elder Abuse Unit (EAU) of the Brooklyn District Attorney's Office. The Brooklyn EAU successfully prosecutes more than 100 cases of physical elder abuse annually and maintains comprehensive files including photographs of injuries, medical records, description of first responder interactions with victim and perpetrator, and court documents. We will closely examine 200 files to comprehensively describe injury patterns as well as characteristics of victims and abusers. This innovative design, using cases of indisputable physical elder abuse, represents an important methodologic advance, as previous research has suffered from insufficient access to a large number of well-characterized elder abuse cases. Given the challenges associated with differentiating elder abuse from accidental injury, we will compare results from these cases to a control group of geriatric patients presenting to the emergency department with accidental falls to identify injury patterns and biomarkers associated with abuse. Ultimately, we plan to derive a clinical decision rule that will assist health care providers in more effectively screening for elder abuse. The applicant, Dr. Anthony Rosen, is an Emergency Medicine physician who has demonstrated significant research and clinical interest in acute geriatric care. He has a successful track record of collaboration in elder maltreatment research with Dr. Mark Lachs, an established NIH-funded researcher, who serves as Geriatrics mentor and co-investigator. Dr. Stephen Hargarten, his Emergency Medicine mentor and a co-investigator, is a pioneer in academic Emergency Medicine and violence prevention research. Having completed an MPH in epidemiology, Dr. Rosen is already trained in research methods and biostatistics. He is a former recipient of the Medical Student Training in Aging Research (MSTAR) grant and has mentored multiple MSTAR student research projects. In addition to his faculty appointment, Dr. Rosen will pursue a Geriatric Emergency Medicine fellowship during the grant period to increase his expertise in caring for older adults. The study proposed can be feasibly completed in two years with the support provided through this R03, particularly because, through funding from his institution, Dr. Rosen will already have salary support for 75% time protected from clinical responsibilities, and all NIA funds awarded will be allocated exclusively to support this research. The long-term goal of this proposal is to develop, implement, and evaluate comprehensive strategies to improve identification and prevention of elder abuse by health care providers and to launch the academic career of a promising junior investigator.

描述（由申请人提供）：该项目的具体目的是：（1）在一系列高度裁定的身体滥用案例中，全面检查和描述常见的伤害模式，身体发现和法医生物标志物，使用混合方法的方法，（2）进行病例对照研究，以进行案例对照研究，以对这些临床的临床临床的规定进行临床，并在意外跌倒后的临床范围内（3）临床，并设计了一项临床，并设计了一名意外的临床（3），并设计了一名（3）的一名（3）（3），并设计了一名（3），并设计了一名（3），并设计了一名（3），并设计了一名（3），并设计了一名（3），并设计了一名（3），并设计了一名（3）的临床。虐待受害者。我们将通过与布鲁克林地方检察官办公室的虐待老人（EAU）的独特合作来实现这些目标。布鲁克林EAU每年成功起诉100例身体虐待，并保留全面的文件，包括伤害照片，病历，与受害者和肇事者的急救人员互动的描述以及法院文件。我们将密切检查200个文件，以全面描述受害者和施虐者的伤害模式以及特征。这种创新的设计使用无可争议的身体虐待案例，代表了重要的方法论，因为先前的研究遭受了大量特征良好的虐待老人案件的访问。鉴于与将虐待老年人与意外伤害区分开来的挑战，我们将将这些病例的结果与对照组的老年患者进行比较，这些患者偶然下降了急诊科，以识别与虐待相关的伤害模式和生物标志物。最终，我们计划得出一项临床决策规则，该规则将帮助医疗保健提供者更有效地筛选虐待老年人。申请人安东尼·罗森（Anthony Rosen）博士是一名急诊医学医师，对急性老年护理表现出了重大研究和临床兴趣。他与已建立的NIH资助的研究员马克·拉赫斯（Mark Lachs）博士（Mark Lachs）博士（Mark Lachs）合作成功，他担任老年医学指导者和共同投资者。他的急诊医学导师，共同投资者Stephen Hargarten博士是学术急诊医学和暴力预防研究的先驱。罗森博士完成了流行病学的MPH，已经接受了研究方法和生物统计学的培训。他曾是老龄化研究（MSTAR）医学生培训的前接受者，并指导了多个MSTAR学生研究项目。除任命外，罗森博士还将在赠款期间攻读老年急诊医学研究金，以增加他在照顾老年人方面的专业知识。提出的研究可以在两年内通过此R03提供的支持可行地完成，特别是因为，通过其机构的资助，Rosen博士将已经为75％的时间提供了支付75％时间的薪水支持，并且将专门分配所有NIA资金以支持这项研究。该提案的长期目标是制定，实施和评估全面的策略，以改善医疗保健提供者对老年人虐待的认同和预防，并启动有前途的初级研究员的学术职业。