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OBJECTIVES/GOALS: Despite a disproportionate impact of COVID-19 on minority and under-resourced communities, nearly all COVID-19 resources have only been online in English. A statewide coalition of community and academic partners used community-engaged strategies to provide tailored outreach to diverse populations. METHODS/STUDY POPULATION: The STOP COVID-19 CA statewide team had a workgroup focused on communications. Members of this group represented different sectors, racial/ethnic groups, disciplines, and regions across the state. They had regular meetings to discuss and strategize how to overcome the impact of historic and structural racism on access to COVID-19 resources, including testing, vaccines, and protective equipment. The team also shared regular updates about changes in community concerns and needs as well as new, tailored resources. RESULTS/ANTICIPATED RESULTS: Together, the team has been able to reach diverse populations across the state, including providing information about COVID-19 in multiple languages and formats, from radio to virtual town halls to local health fairs. The multiple sites also increased access to vaccines and testing through trusted community leaders and locations, including church-based locations to bringing vaccines and testing directly to workplaces. These community pop-up vaccination sites have helped to vaccinate large numbers of diverse populations, some of whom were initially unsure about getting the vaccine, which has helped to reduce the gaps in community vaccination rates by race/ethnicity. DISCUSSION/SIGNIFICANCE: This network of community-engaged strategies utilized for rapid COVID-19 response could also be used to for responses to future public health emergencies, addressing chronic diseases (e.g., diabetes, hypertension), or even other complex issues that affect society and health (e.g., climate change).
OBJECTIVES/GOALS: The clinical management of differences of sex development (DSDs) aims to guarantee best practices in medical care while addressing concerns related to non-reversible surgeries. Rhetorical analysis was conducted to study the balance between science policy and patient advocacy related to DSD surgeries as depicted in medical education materials METHODS/STUDY POPULATION: Unrestricted transcripts of two educational videos and text from all chapters of a handbook addressed to medical learners and faculty by the Association of American Medical Colleges (AAMC) were submitted to automated word cloud analysis (NVivo, QSR InternationalÂ®). Words with a weighted percentage > 0.19% from total words of a given source were defined as words of frequent use and were selected for further analysis after exclusion of words as conjunctions, prepositions, pronouns, or conversational fillers. Words sharing noun, adjective and adverb forms were coded and weighed as a single word following the Oxford dictionary. Discrepancies on word selection, exclusion or coding were resolved between four raters. The rhetorical context of most frequent words was identified. RESULTS/ANTICIPATED RESULTS: The word cloud analysis of the video resource intended for medical learners (n=104 words of frequent use) and the video intended for medical faculty (n= 94 words of frequent use) depicts a patient-centered approach (word people’) that is based on expert opinion (word [I] think’). The handbook (n= 998 words of frequent use) makes reiterated reference to patients’; lgbt’; gender’; health’; and caring’ while underscoring health concerns that are unrelated to genital variance (health’; caring’ and medical’). The noun surgery’ did not figure among the most frequent words in spoken language nor in written text even when summing its adjective and adverb forms. DISCUSSION/SIGNIFICANCE: Educational materials by the AAMC on DSDs accentuate patient-centered care within a medical humanism framework. However, the lack of discussion of DSD surgeries is an educational gap that should be addressed by key science policy and patient advocacy stakeholders.
To quantify patient eligibility for cochlear implantation following National Institute for Health and Care Excellence 2019 guidelines (TA566) over five years at our institution, and identify factors influencing patients’ decisions surrounding cochlear implantation referral.
A multi-perspective service evaluation was conducted at a district general hospital, comprising cochlear implantation eligible patients. The main outcome measures were: eligibility numbers for 2014–2019, comparing application of TA566 versus 2009 (TA166) guidelines; and patient interview transcripts and questionnaires.
There was a 259 per cent average increase in cochlear implantation eligibility from 2014 to 2019. Most patients’ thresholds were 80 dB HL or more at 3 kHz and 4 kHz. There are several cochlear implantation barriers, including patient-centred issues (e.g. health-related anxieties, implantation misperceptions) and external barriers (difficulty getting to regional implant centres). Motivating factors for cochlear implantation include improved quality of life and access to local cochlear implantation services.
The TA566 guidelines have increased cochlear implantation eligibility, putting pressure on cochlear implantation centres and referring hospitals. Current referral systems have external and patient-centred implantation barriers. British cochlear implantation delivery may need rethinking to meet increasing populational demands and improve accessibility for those most vulnerable to these barriers.
Religion and spirituality have been scarcely addressed in heritage preservation history, discourse, and practice. More recently, increased interest in the intersections between the study of religion and heritage preservation in both academic studies and institutional initiatives highlight obstacles that the field has yet to overcome theoretically and methodologically. This Element surveys the convergences of religious and heritage traditions. It argues that the critical heritage turn has not adequately considered the legacy of secularism that underpins the history and contemporary practices of heritage preservation. This omission is what has left the field of heritage studies ill-equipped to support the study and management of a heritage of religion broadly construed.
This article examines the ways in which global heritage discourse has operated across the Middle East and North Africa (MENA) region, from an ideological and historical perspective. Ideologically, I consider tensions between heritage preservation practice and religious traditions that share the same landscape or material culture. This discussion, which is relatively marginalized in the heritage literature, has an adverse effect on many attempts by heritage preservationists to mediate or resolve conflicts and contradictions surrounding this type of historic resource. Historically, I revisit the presence and inclusion of experts from the MENA region in the formative years of a global heritage ideology. In this discussion, I juxtapose the relative marginalization of the Middle East and North Africa in global heritage debates against the frequency with which sites and communities across this region are put in the spotlight of religion-driven heritage conflict. Addressing these two forms of (mis)representation, I aim to bring to the foreground the way in which heritage studies is implicated in the constructions of narratives about – not from or by – the MENA region.
El Niño cave, located on the south-eastern border of the Spanish Meseta, hosts a discontinuous sequence including Middle Palaeolithic and Neolithic levels, along with Upper Palaeolithic and Levantine style paintings. It is a key site for understanding human occupations of inland Iberia during the Palaeolithic and early prehistory. This paper summarises the main results of a multidisciplinary project aimed at defining the prehistoric human occupations at the site.
On January 28, 2021, a Special Chamber of the International Tribunal for the Law of the Sea (ITLOS) delivered a judgment in which it rejected preliminary objections raised by the Maldives in arbitral proceedings instituted by Mauritius, concerning the delimitation of the maritime boundary north of the Chagos Archipelago in the Indian Ocean.
The separation of the Chagos Archipelago from Mauritius in 1965, and its setting aside by the UK ‘for defence purposes’,1 was the precursor to a human tragedy. The covert expulsion of the Chagossians from their homeland in the years that followed has been described as ‘unhappy – indeed, in many respects, disgraceful’ (by one of the UK’s most senior judges),2 ‘sordid’ and ‘morally indefensible’ (by a former British Foreign Secretary)3 and ‘shameful and wrong’ (by counsel for the UK in the International Court of Justice (ICJ)).4