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Nicotine replacement therapy sampling (NRTS) refers to providing all smokers, regardless of interest in quitting, with free samples of over-the-counter NRT. NRTS has been shown to increase quit attempts and abstinence.
We conducted a pilot trial with a goal to establish the feasibility and acceptability of NRTS in a dental clinic, where providing free samples is routine and universal.
Participants (N = 30) completed a baseline survey and were randomized to receive or not receive a 2-week supply of NRT samples (14 mg patches and 4 mg lozenges) in a 3:1 ratio.
We enrolled 30 of 50 potentially eligible patients, of whom 26 completed a 4-week follow-up survey. At follow-up, 61% of the NRT group reported use of the samples and 26% said they used more NRT obtained on their own. In the No NRT group, only one patient reported using NRT. No patients reported past week abstinence, but 43% of the NRT group vs. 29% of the No NRT group reported making a quit attempt lasting longer than 24 h.
The pattern of results suggests that conducting a larger trial would be feasible and that the NRTS intervention was acceptable to dental patients.
Objectives: Research has shown that analyzing intrusion errors generated on verbal learning and memory measures is helpful for distinguishing between the memory disorders associated with Alzheimer’s disease (AD) and other neurological disorders, including Huntington’s disease (HD). Moreover, preliminary evidence suggests that certain clinical populations may be prone to exhibit different types of intrusion errors. Methods: We examined the prevalence of two new California Verbal Learning Test-3 (CVLT-3) intrusion subtypes – across-trial novel intrusions and across/within trial repeated intrusions – in individuals with AD or HD. We hypothesized that the encoding/storage impairment associated with medial-temporal involvement in AD would result in a greater number of novel intrusions on the delayed recall trials of the CVLT-3, whereas the executive dysfunction associated with subcortical-frontal involvement in HD would result in a greater number of repeated intrusions across trials. Results: The AD group generated significantly more across-trial novel intrusions than across/within trial repeated intrusions on the delayed cued-recall trials, whereas the HD group showed the opposite pattern on the delayed free-recall trials. Conclusions: These new intrusion subtypes, combined with traditional memory analyses (e.g., recall versus recognition performance), promise to enhance our ability to distinguish between the memory disorders associated with primarily medial-temporal versus subcortical-frontal involvement.
Distinguishing a disorder of persistent and impairing grief from normative grief allows clinicians to identify this often undetected and disabling condition. As four diagnostic criteria sets for a grief disorder have been proposed, their similarities and differences need to be elucidated.
Participants were family members bereaved by US military service death (N = 1732). We conducted analyses to assess the accuracy of each criteria set in identifying threshold cases (participants who endorsed baseline Inventory of Complicated Grief ⩾30 and Work and Social Adjustment Scale ⩾20) and excluding those below this threshold. We also calculated agreement among criteria sets by varying numbers of required associated symptoms.
All four criteria sets accurately excluded participants below our identified clinical threshold (i.e. correctly excluding 86–96% of those subthreshold), but they varied in identification of threshold cases (i.e. correctly identifying 47–82%). When the number of associated symptoms was held constant, criteria sets performed similarly. Accurate case identification was optimized when one or two associated symptoms were required. When employing optimized symptom numbers, pairwise agreements among criteria became correspondingly ‘very good’ (κ = 0.86–0.96).
The four proposed criteria sets describe a similar condition of persistent and impairing grief, but differ primarily in criteria restrictiveness. Diagnostic guidance for prolonged grief disorder in International Classification of Diseases, 11th Edition (ICD-11) functions well, whereas the criteria put forth in Section III of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are unnecessarily restrictive.
OBJECTIVES/SPECIFIC AIMS: Leadership is an essential and recognized team science competency. To support the development of leadership skills at Mount Sinai, the LEAD (Leadership Emerging in Academic Departments) program, launched in 2016, delivers a structured 12-month blended learning program for junior faculty. The program aims to promote personal and professional leadership capacity, skills and behaviors. Following a competitive application process, 24 participants each year are selected to participate. In its second year, the challenge for the LEAD program leadership is to support alumni in fostering a culture of leadership that extends beyond the 12-month program. In order to promote a leadership community of practice and offer continued support to junior faculty, the LEAD Alumni program aims to bring former LEAD participants together to maintain motivation, share challenges and successes, meet with mentors and role models, and foster an ongoing community of practice that seeks to embed evidenced-based leadership culture at Mount Sinai. METHODS/STUDY POPULATION: The previous two cohorts of LEAD participants were approached to volunteer for the LEAD Alumni Forum working group. Four LEAD alumni came forward to form a self-selected working group. With input from the program leadership, the alumni working group is tasked with organizing regular events that bring the 48 previous LEAD participants together. The events provide the opportunity for individuals with expertise and a passion for leadership to create a supportive environment. This ultimately seeks to increase the transfer and utilization of leadership skills in practice, and promotes a culture of leadership. These alumni events also provide the opportunity for alumni to interact with senior leaders at Mount Sinai, thereby learning from role models within the organization. RESULTS/ANTICIPATED RESULTS: Evaluating learning transfer and culture change is challenging, so a number of proxy measures will provide insight into the success of the Alumni Forum. Firstly, the number of LEAD Capstone projects implemented in practice, and the success of these initiatives, will provide insight into transfer of leadership learning to practice. Secondly, participants will complete a validated survey tool, Leadership Programs Outcome Measure (LPOM), which explores self-reported leadership change at a personal, organizational and community level. Finally, participants will be followed up in the long-term to track promotion, awards, and other formal or informal leadership positions assumed following engagement in the LEAD program and the subsequent LEAD Alumni Forum. DISCUSSION/SIGNIFICANCE OF IMPACT: It is hoped the LEAD Alumni program will enhance the ability of participants to implement leadership knowledge and skills to practice, which may subsequently advance organization and culture change. Fostering a community of practice will further the reach of the LEAD program and as the number of LEAD alumni grows, and the Alumni Forum may provide the supportive environment that allows these individuals to have real impact.
Recently developed direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV) are groundbreaking in their high efficacy across disease genotypes and lack of severe side effects. This study used a cost-of-illness (COI) approach to estimate the net value conferred by one of these novel drug combinations, sofosbuvir and velpatasir (SOF/VEL), recently licensed for generic manufacture in India.
This study considered COI from lifetime earnings lost due to disability and premature death from HCV infection. Risk of death and disability in future years was calculated using a Markov state-transition model with parameters determined from the literature. The future earnings of sampled patients were predicted using an empirical earnings model, with coefficients determined from India Human Development Survey data. Costs to both the patient and secondarily infected individuals were considered.
Preliminary results suggested that curing individuals diagnosed with chronic HCV in India would preserve INR 3.7 million (USD 55,750) in earnings per person. For non-cirrhotic (NC) and compensated cirrhotic (CC) individuals, the expected benefits associated with preventing secondary infections were worth between one and forty-one percent of the value of benefits conferred to the diagnosed individuals (depending on sex and extent of liver damage). Treating decompensated cirrhotic (DC) individuals with DAAs alone offered minimal earnings benefits because these individuals will likely remain disabled and unable to work without a liver transplant. Expected net benefits of treatment were substantial for NC and CC patients, ranging from INR 640,349 (USD 9,531) for NC women to INR 10.7 million (USD 158,968) for CC men. The cost of treatment for DC individuals exceeded the expected earnings benefits.
For average NC and CC individuals, the cost of treatment with SOF/VEL is offset by the benefits of increased future productivity. Increased earnings are not sufficient to offset the cost of treatment for DC individuals, but treatment may still be justified on the basis of the intrinsic value of health improvements and other treatment benefits.
Objectives: The third edition of the California Verbal Learning Test (CVLT-3) includes a new index termed List A versus Novel/Unrelated recognition discriminability (RD) on the Yes/No Recognition trial. Whereas the Total RD index incorporates false positive (FP) errors associated with all distractors (including List B and semantically related items), the new List A versus Novel/Unrelated RD index incorporates only FP errors associated with novel, semantically unrelated distractors. Thus, in minimizing levels of source and semantic interference, the List A versus Novel/Unrelated RD index may yield purer assessments of yes/no recognition memory independent of vulnerability to source memory difficulties or semantic confusion, both of which are often seen in individuals with primarily frontal-system dysfunction (e.g., early Huntington’s disease [HD]). Methods: We compared the performance of individuals with Alzheimer’s disease (AD) and HD in mild and moderate stages of dementia on CVLT-3 indices of Total RD and List A versus Novel/Unrelated RD. Results: Although AD and HD subgroups exhibited deficits on both RD indices relative to healthy comparison groups, those with HD generally outperformed those with AD, and group differences were more robust on List A versus Novel/Unrelated RD than on Total RD. Conclusions: Our findings highlight the clinical utility of the new CVLT-3 List A versus Novel/Unrelated RD index, which (a) maximally assesses yes/no recognition memory independent of source and semantic interference; and (b) provides a greater differentiation between individuals whose memory disorder is primarily at the encoding/storage level (e.g., as in AD) versus at the retrieval level (e.g., as in early HD). (JINS, 2018, 24, 833–841)
be a set of natural numbers. Recent work has suggested a strong link between the additive energy of
(the number of solutions to
) and the metric Poissonian property, which is a fine-scale equidistribution property for dilates of
. There appears to be reasonable evidence to speculate a sharp Khinchin-type threshold, that is, to speculate that the metric Poissonian property should be completely determined by whether or not a certain sum of additive energies is convergent or divergent. In this article, we primarily address the convergence theory, in other words the extent to which having a low additive energy forces a set to be metric Poissonian.
OBJECTIVES/SPECIFIC AIMS: Leadership is an essential and recognized team science competency. Modeled after the successful LEAD (Leadership in Emerging Academic Departments) program at University of Texas Southwestern (UTSW), ConduITS LEAD Program is designed to: (1) provide personal and professional development opportunities for participants; (2) promote organizational change through applied leadership skills; (3) provide a platform for integrating multiple disciplines and fostering interprofessional relationships among investigators and clinicians. METHODS/STUDY POPULATION: The 1-year structured LEAD program curriculum includes monthly interactive seminars covering: personal and situational leadership; unconscious bias; communication and influence; navigating personal conflict; negotiation and networking; selecting and managing the right team; teamwork; financing the academic mission, budgets and business plan development; strategic planning and vision; presentation skills. To foster the development of leadership skills participants engage in Hogan Assessments, individual and peer mentoring from an executive coach and self-directed learning activities and assignments. Completion of an individual Capstone leadership project empowers learners to enact practice change through the implementation of leadership concepts in practice. RESULTS/ANTICIPATED RESULTS: In collaboration with the Office of Academic Enrichment & Development (OADE), the first competitive RFA was issued in November of 2016. In total, 63 applications were received including: gender: 29 M: 34 F; URM: 10; Degrees: M.D. (40); Ph.D. (11); M.D./Ph.D. (6); M.D./M.P.H. (3); M.D./M.S.C.R. (2); PharmD (1); Departments: 19; Institutes/Centers: 12; MSHS: 3 sites. Through a competitive and rigorous application process, 24 junior faculty with evidence of leadership potential and trajectory were chosen to participate. The current cohort of LEAD participants joined in February 2017, and will complete the program in January 2018. Using qualitative and quantitative survey methodology, participants will be evaluated for self-reported change to attitudes, belief, skills and development of new relationships and collaborations. Submitted Capstone projects were mainly focused on implementing situational and personal leadership concepts to practice, with one additionally focused on the use of behavioral interviewing techniques to optimize team building and teamwork. At the time of abstract submission 30% of the cohort has implemented their Capstone project in practice. Participants will be followed-up in 6 months’ time to evaluate the impact of the LEAD program on their practice. Following a second RFA, 24/52 candidates have been selected as our next cohort, and will start in February 2018. DISCUSSION/SIGNIFICANCE OF IMPACT: Leadership is known to be a core component of team science, and the ability to implement leadership into practice may advance personal and professional change. This program addresses the need to empower Junior Faculty to engage in leadership in practice. In addition, this program is able to provide added value to extend the reach of the OADE, promote new individual collaborations and facilitate additional leadership training efforts at our Institution. Future collaborative studies will focus on common outcomes as well as institutional differences between these 2 CTSA institutions.