Identify and modify fetal and neonatal antecedents of disease or developmental disabilities which have particular impact on residents of South Carolina establish a new direction for evidence-based investigation at MUSC, establishing long-term relationships with communities and groups of individuals, from which data are collected and outcome studies are conducted defining biological and behavioral aspects of major health issues that impact the state. First Objective:
Catalogue known fetal, neonatal, and infant antecedents of childhood disease and developmental problems that are prevalent in South Carolina. | First Related Strategy - Encourage basic science research to be focused on mechanisms and predictors of disease development, with an emphasis on hypothesis-driven studies to identify both genetic factors (markers of disease, risk factors) and environment factors (which can be changed). | Second Related Strategy - Establish a multidisciplinary, intercollege Institute for Community Health to serve as the umbrella organization which mobilizes resources within the University to focus on health issues within the State. Fund leadership, development, and management positions to facilitate multidisciplinary study of developmental, medical, cognitive, and psychosocial issues that serve as antecedents to illness and disability. | Second Objective:
Develop a long-term community-based, longitudinal cohort study to identify additional or new antecedents. | First Related Strategy - Review relevant programs that may benefit the development of a cohort study (e.g. Southeastern Counties demonstration project for low birth weight infants, Charleston Heart Study). | | Second Related Strategy - Identify groups that have already developed or are presently developing effective community relationships. | Third Related Strategy - Establish a planning team for a creation of a cohort study based in a South Carolina community. Include in their charge the determination of demographic and clinical information to be collected during the cohort study and how it is to be stored, reviewed, utilized, and expanded. The Professional Advisory Committee for the MUSC Institute for Community Health should develop a long-term strategy for development of the cohort and related research and clinical projects. | Fourth Related Strategy - Establish MUSC as a site for the planned National Children's Study (http://www.nichd.nih.gov/despr/cohort/ or ncs@mail.nih.gov). Through the Institute for Community Health, MUSC should apply for formal participation in this study. | Fifth Related Strategy - Evaluate interest in identifying a corporate sponsor to assist with development of an information system sufficient to support the long-term study. | Sixth Related Strategy - Establish the necessary infrastructure to manage and maintain a long-term cohort for clinical and research activities. Seventh Related Strategy - Develop training opportunities and educational programs for students and residents with the longitudinal cohort. | Third Objective:
Initiate multi-disciplinary clinical interventions during the fetal or neonatal period to intervene and modify maladaptive development or genetic and metabolic foundations for disease. | First Related Strategy - Develop an interdisciplinary interest group among all MUSC Colleges and interested community-based programs, charged with exploring available model systems and emphasizing model-building. Second Related Strategy - Establish a multidisciplinary, intercollege Institute for Community Health to serve as the umbrella organization which mobilizes resources within the University to focus on health issues within the State. | Second Related Strategy - Establish a multidisciplinary, intercollege Institute for Community Health to serve as the umbrella organization which mobilizes resources within the University to focus on health issues within the State. | Third Related Strategy - Provide a framework for long-term continuity of care for community-based cohorts, with an emphasis on education and advocacy in modifying antecedents of disease. | | Fourth Related Strategy - Charge the Board of Directors for the Children's Research Institute, integrating ongoing plans for research development with expanded vision of the University in community-based, preventive research. In addition, the Children's Research Institute should create and maintain a roster of clinicians and investigators collaborating on issues related to the prevention or modification of disease in children. |
Considerations:
To be successful, MUSC must develop sufficient credibility with community groups to cultivate effective long-term relationships. It will be extremely important to establish effective rewards for participation in community-based and interdisciplinary research in an institution with a strong departmental structure and traditional academic incentive program. MUSC must capitalize on the existing resources outside MUSC, such as molecular genetics (Greenwood Genetic Center), epidemiology (USC School of Public Health), and other state agencies with strong reputations in order for MUSC to effectively decrease the anticedents of illness in South Carolina. Internally, MUSC must centralize its planning in this area to focus scientific issues and coordinate cohort studies with related clinical and basic science research. As with any long-term cohort study, adequate information technology resources must be established and necessary databases must be maintained. Second Goal- Heatlhy Youth and Development Work Group
Third Goal- Heatlhy Youth and Development Work Group |
