Despite research spending on cardiovascular disease, pulmonary disease, dementia, and cancer, there has been relatively little spending on studies of the physical symptoms, psychological distress, and care, family, and social needs of older persons living with serious illness. In this OAIC renewal application we propose a Pilot and Exploratory Studies Core (PESC) that builds upon our Mount Sinai OAIC 2010-14 experience that will accomplish the following aims: 1) support pilot and exploratory studies that will a) examine the relationship of pain and other distressing symptoms to independence, function, and disability; b) develop interventions directed at pain and other distressing symptoms, quality of life, function, and independence for older adults with serious and chronic illness; and c) advance methods for the study of care of older adults with serious illness using non-randomized designs and illness-indexed cohorts as opposed to decedents; 2) support the development of junior faculty by providing a mechanism to obtain mentored, hands-on research training and develop preliminary data in aging and palliative care that will lead to the development of larger federal or foundation funded research projects and career development awards focused on improving care and promoting independence for older adults with serious illness; 3) support senior and mid-level faculty who are conducting a) studies in palliative care and aging and who are embarking on new research projects requiring pilot data; b) palliative care research in younger populations and who would like to expand or shift their research into aging; or c) aging research unrelated to palliative care who would like to refocus their work to fit within the OAIC theme; and 4) foster collaborative research among investigators from different disciplines, specialties, and institutions. The proposed PESC will accomplish these aims by: 1) soliciting and assisting in the development of pilot studies from investigators within and outside the OAIC who are conducting work relevant to its focus; 2) providing a mechanism for review and selection of projects that will support investigator career development; and 3) monitoring the progress of studies and assisting investigators in developing independently funded research from their projects. We will fund standard pilot applications (size: $50-75,000; duration: 1-2 years) due once or twice yearly, and small pilot applications (size: $10-$25K; duration: 1 year) due on a rolling basis, to permit rapid generation of pilot data and rapid response to RFAs. Mount Sinai's faculty and programs in geriatrics, palliative care, health policy, and geropsychiatry, and its affiliations with NPCRC, Bronx VA, Jewish Home, and Visiting Nurse Service investigators, will be a rich source of potential PESC investigators to develop new pilots once initial pilots end.
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