This proposal to support the Mount Sinai Injury Control Research Center (MS-ICRC) is submitted by the Mount Sinai School of Medicine (MSSM), New York City. The lead in this effort has been taken by the Department of Rehabilitation Medicine, drawing in relevant expertise from and participation of other disciplines within MSSM (emergency medicine, community medicine), as well as from other institutions in Region II: Columbia University College of Physicians and Surgeons, JFK Rehabilitation Institute of the University of Medicine and Dentistry of New Jersey and The National Rehabilitation Hospital. The major theme of the MS-ICRC is enhancing quality of life (QOL) of individuals who have experienced traumatic brain injury (TBI). Research will be pursued along three paths: 1) developing better rehabilitation interventions aimed at improve outcomes for individuals with TBI, 2) developing approaches to better identify those individuals with mild TBI who are at risk of long-term disability, and 3) developing a method to identify the long-term needs of individuals with TBI as the basis for documenting disablement and for prioritizing the elements of a secondary injury control agenda aimed at secondary prevention. Five projects, two large and three small, are being proposed: 1) An RCT will be implemented to document the impact of sustained aerobic exercise on the cognitive functioning and mood of individuals with TBI, both those with """"""""mild"""""""" as well as moderate to severe injuries;2) A second RCT will evaluate the impact of a comprehensive day program focused on improving executive functions and attention of participants, with long-term impact on their functioning in the community and on perceived quality of life;3) Patterns of symptoms that emerge after an individual presents with mild TBI within three emergency departments will be tracked over six months, while at the same time evaluating contrasting approaches for educating people about TBI who are discharged home from the ED after experiencing a Wow to the head with altered mental status;4) The Brain Injury Screening Questionnaire will be validated by demonstrating its utility in identifying sensitive and specific patterns of post-TBI symptomatology that is distinguishable from patterns found in persons with other chronic conditions;and 5) The I-CAN, a new method for identifying perceived needs of individuals with TBI, will be evaluated: to provide the basis for documenting service needs over time and for providing systematic input to agencies, such as CDC, indicating the """"""""research agenda"""""""" they would established when asked. In addition, a comprehensive program of training for both professionals and consumers and knowledge translation is incorporated as part of the MS-ICRC. A program for training pre-doctoral researchers is planned, as are efforts to shape curricula within the Mount Sinai School of Medicine to address injury control / prevention objectives. A website, training materials for newly identified individuals with TBI, other consumer-oriented training, as well as professionally-oriented dissemination are all planned as means of effecting tertiary prevention and prevention of secondary disability. Finally, funds will be made available to support seed projects, as a means of bolstering the injury control structure of researchers within Region II. Thus, the results emerging from the, MS- ICRC will be disseminated through extensive knowledge translation activities, particularly in Years 3-5 of the proposed Center.
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