Please note, due to essential maintenance online transactions will not be possible between 02:30 and 04:00 BST, on Tuesday 17th September 2019 (22:30-00:00 EDT, 17 Sep, 2019). We apologise for any inconvenience.
To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This study evaluated the efficacy of a family-centered preventive intervention, the Family Check-Up (FCU), delivered as an online, eHealth model to middle school families. To increase accessibility of family-centered prevention in schools, we adapted the evidence-based FCU to an online format, with the goal of providing a model of service delivery that is feasible, given limited staffing and resources in many schools. Building on prior research, we randomly assigned participants to waitlist control (n = 105), FCU Online as a web-based intervention (n = 109), and FCU Online with coaching support (n = 108). We tested the effects of the intervention on multiple outcomes, including parental self-efficacy, child self-regulation, and child behavior, in this registered clinical trial (NCT03060291). Families engaged in the intervention at a high rate (72% completed the FCU assessment) and completed 3-month posttest assessments with good retention (94% retained). Random assignment to the FCU Online with coaching support was associated with reduced emotional problems for children (p = .003, d = −0.32) and improved parental confidence and self-efficacy (p = .018, d = 0.25) when compared with waitlist controls. Risk moderated effects: at-risk youth showed stronger effects than did those with minimal risk. The results have implications for online delivery of family-centered interventions in schools.
OBJECTIVES/SPECIFIC AIMS: The National HIV/AIDS strategy aims to increase retention in care (RIC) to reduce HIV transmission and mortality. Previous studies have evaluated clinic-level interventions such as appointment reminders and peer navigation. However, few studies have investigated the association between multiple clinic-level factors and RIC among PLWH across the United States. We conducted a multi-site cohort study to identify clinic-level factors associated with RIC in the United States from 2010-2016. METHODS/STUDY POPULATION: We included PLWH with at least one HIV primary care visit from 2010-2016 at seven sites of the Center for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS). Individual-level data collected as part of routine clinical care were abstracted from the electronic health record. Clinic-level data were gathered through a survey and included questions on site characteristics (i.e. clinic volume) as well as services available at the site during each year of the study: peer navigation, RIC posters/brochures, laboratory test timing, flexible scheduling, appointment reminder types, and stigma support services defined as intensive HIV education and advocacy regarding support to address stigma at outreach visits. RIC was defined as ≥2 encounters per year, ≥90 days apart, observed until death, administrative censoring (December 31, 2016), or loss to follow-up (no visit for >12 months with no future visits). Poisson panel regression with robust error variance, clustering by site and adjusting for calendar year, age (modeled with a cubic spline), sex, race/ethnicity, and HIV transmission risk factor, was used to estimate incident rate ratios (IRR) with 95% confidence intervals (CI) for RIC. Clustering by site has been shown to absorb for clustering that could occur at the individual level as well. RESULTS/ANTICIPATED RESULTS: Among 21,046 patients contributing 103,348 person-years, 67% of person-years were RIC. Text appointment reminders (IRR = 1.13; 95% CI: 1.03-1.24) and stigma support services (IRR=1.11; 95% CI:1.04-1.19) were significantly associated with RIC. RIC disparities in individual-level patient characteristics were observed even after accounting for clinic-level characteristics. Older patients were more likely to be RIC demonstrated through year comparisons due to the use of a spline; for age 50 years (IRR = 1.07, 95% CI: 1.06-1.08) and 60 years (IRR = 1.15, 95% CI: 1.13-1.17) compared to 45 years. Female PLWH were more likely to be RIC compared to males (IRR = 1.03, 95% CI: 1.02-1.05) and Hispanic PLWH were more likely to be RIC compared to white, non-Hispanic PLWH (IRR = 1.09, 95% CI: 1.05-1.13). Although commonly found to be associated with worse RIC, Black race and injection drug use were not associated with RIC in this population. DISCUSSION/SIGNIFICANCE OF IMPACT: In this multi-site US cohort study from 2010-2016, availability of text appointment reminders and stigma support services at a clinic were associated with approximately 10% higher probability of RIC than at clinics without those services. RIC disparities persisted with respect to individual-level characteristics of age, sex, and race/ethnicity even after accounting for these clinic-level factors. Prospective studies examining the impact of these clinic-level factors and individual-level uptake of these services on RIC are needed.
OBJECTIVES/SPECIFIC AIMS: To establish an effective team of researchers working towards developing and validating prognostic models employing use of image analyses and other numerical metadata to better understand pediatric undernutrition, and to learn how different approaches can be brought together collaboratively and efficiently. METHODS/STUDY POPULATION: Over the past 18 months we have established a transdisciplinary team spanning three countries and the Schools of Medicine, Engineering, Data Science and Global Health. We first identified two team leaders specifically a pediatric physician scientist (SS) and a data scientist/engineer (DB). The leaders worked together to recruit team members, with the understanding that different ideas are encouraged and will be used collaboratively to tackle the problem of pediatric undernutrition. The final data analytic and interpretative core team consisted of four data science students, two PhD students, an undergraduate biology major, a recent medical graduate, and a PhD research scientist. Additional collaborative members included faculty from Biomedical Engineering, the School of Medicine (Pediatrics and Pathology) along with international Global Health faculty from Pakistan and Zambia. We learned early on that it was important to understand what each of the member’s motivation for contributing to the project was along with aligning that motivation with the overall goals of the team. This made us help prioritize team member tasks and streamline ideas. We also incorporated a mechanism of weekly (monthly/bimonthly for global partners) meetings with informal oral presentations which consisted of each member’s current progress, thoughts and concerns, and next experimental goals. This method enabled team leaders to have a 3600 mechanism of feedback. Overall, we assessed the effectiveness of our team by two mechanisms: 1) ongoing team member feedback, including team leaders, and 2) progress of the research project. RESULTS/ANTICIPATED RESULTS: Our feedback has shown that on initial development of the team there was hesitance in communication due to the background diversity of our various member along with different cultural/social expectations. We used ice-breaking methods such as dedicated time for brief introductions, career directions, and life goals for each team member. We subsequently found that with the exception of one, all other team members noted our working environment professional and conducive to productivity. We also learnt from our method of ongoing constant feedback that at times, due to the complexity of different disciplines, some information was lost due to the difference in educational backgrounds. We have now employed new methods to relay information more effectively, with the use of not just sharing literature but also by explaining the content. The progress of our research project has varied over the past 4-6 months. There was a steep learning curve for almost every member, for example all the data science students had never studied anything related to medicine during their education, including minimal if none exposure to the ethics of medical research. Conversely, team members with medical/biology backgrounds had minimal prior exposure to computational modeling, computer engineering and the verbage of communicating mathematical algorithms. While this may have slowed our progress we learned that by asking questions and engaging every member it was easier to delegate tasks effectively. Once our team reached an overall understanding of each member’s goals there was a steady progress in the project, with new results and new methods of analysis being tested every week. DISCUSSION/SIGNIFICANCE OF IMPACT: We expect that our on-going collaboration will result in the development of new and novel modalities to understand and diagnose pediatric undernutrition, and can be used as a model to tackle several other problems. As with many team science projects, credit and authorship are challenges that we are outlining creative strategies for as suggested by International Committee of Medical Journal Editors (ICMJE) and other literature.
From 1565 to 1570, Spain established no fewer than three networks of presidios (fortified military settlements) across portions of its frontier territories in La Florida and New Spain. Juan Pardo's network of six forts, extending from the Atlantic coast over the Appalachian Mountains, was the least successful of these presidio systems, lasting only from late 1566 to early 1568. The failure of Pardo's defensive network has long been attributed to poor planning and an insufficient investment of resources. Yet recent archaeological discoveries at the Berry site in western North Carolina—the location of both the Native American town of Joara and Pardo's first garrison, Fort San Juan—warrants a reappraisal of this interpretation. While previous archaeological research at Berry concentrated on the domestic compound where Pardo's soldiers resided, the location of the fort itself remained unknown. In 2013, the remains of Fort San Juan were finally identified south of the compound, the first of Pardo's interior forts to be discovered by archaeologists. Data from excavations and geophysical surveys suggest that it was a substantial defensive construction. We attribute the failure of Pardo's network to the social geography of the Native South rather than to an insufficient investment of resources.
Music Criticism in France, 1918–1939: Authority, Advocacy, Legacy examines the aesthetic battles, discursive strategies and cultural stakes that animated and informed French music criticism during the interwar period. Drawing on a rich corpus of critical writings and archival documents, the primary goal of its twelve essays is to uncover some of the public debates that emerged around classical music at this time. As such, it provides significant new insights into the period's musical priorities and values while also highlighting some of the challenges confronting this war-bound generation. The book examines the ways in which influential critics played prominent roles in promoting the careers and defending the reputations of both young and established composers. It considers the efforts that critics took to shape the history of France's musical past. Finally, it questions how critics used their professional and social affiliations as a means of better buttressing their own aesthetic and political agendas.
The interwar period in France is often described as problematic, more famous for the deaths of major figures including Claude Debussy, Gabriel Fauré and Camille Saint-Saëns than the achievements of its living composers. Until fairly recently it has been marginalised, in contrast to the ‘golden’ generation of Debussy and his circle on the one hand and the ‘renewal’ of French musical life with Olivier Messiaen on the other. Yet the ‘Années Folles’ are distinctive in several respects. Having inherited the pre-war musical aesthetics of Debussy and Fauré, but also confronted with the iconoclastic works of a new generation (including Les Six) who used the press to reject the aesthetics of its forebears, interwar French music critics were drawn into an acute battle over conservative and progressive musical trends. Whereas critics including Henri Collet (1885–1951), Paul Landormy (1869–1943) and Henry Prunières (1886–1942) energetically supported the works and aesthetic paradigms of the younger generations, figures such as Émile Vuillermoz (1878–1960), Léon Vallas (1879–1956), Dominique Sordet (1889–1946) and Lucien Rebatet (1903–72) frequently denounced the avant-garde and attempted to influence a musical climate for which they felt a fair measure of dissatisfaction. As a result, the period is characterised by often fraught debates around what it meant to be avant-garde and modern.
The French newspaper L'Action française was the official press organ of the political league of the same name, a right-wing, ultranationalist, anti-Semitic movement founded in 1899, which gained notoriety and exercised considerable intellectual influence in the wake of the Dreyfus Affair. The movement's principal ideologue was Charles Maurras, a prolific writer and prominent political figure who maintained his position as editor-in-chief of L'Action française up until the political party's imposed dissolution at the end of the German Occupation of France in 1944. During the 1920s the political influence of Action française waned considerably. Condemned by the Pope in 1926, its political ambitions were severely curtailed as a result of diminished support from its traditional political base of Catholic sympathisers. Its fortunes changed dramatically, however, in the wake of the anti-democratic and violent demonstrations that took place in Paris on 6 February 1934. Primarily instigated by right-wing leagues including the Camelots du Roi, the paramilitary wing of Action française, these riots were the bloodiest civic confrontation to have occurred on French streets since the Commune. Viewed by some historians as a failed coup d’état, the February riots represented an attack on France's democratic and republican institutions and pointed to the swelling influence of militant far-right movements, including Action française, during this period. It ultimately caused the resignation of Prime Minister Édouard Daladier, the downfall of the acting leftist coalition government, and a growing radicalisation on both sides of the political spectrum.
Although a partisan political publication, by the late 1920s L'Action française began to resemble a general-interest daily newspaper with pages devoted to national and international affairs, the economy, sport and culture. This ostensible editorial mainstreaming did not however entail a concomitant whitewashing of its political agenda; indeed, Maurras and his journalists regularly called for the assassination of their political foes from the front pages of the paper, and the venture's financial fortunes were consistently troubled as a result of the legal challenges mounted against it for various cases of defamation. In 1929 a weekly instalment entitled ‘Les Spectacles’ was inaugurated and featured reviews of film, theatre and music that served to complement the publication's traditional critical focus on literature. Similarly to the newspaper's political journalists, contributors to ‘Les Spectacles’ were partisan in their political orientation.
Biomass energy with carbon capture and storage (BECCS) is represented in many integrated assessment models as a keystone technology in delivering the Paris Agreement on climate change. This paper explores six key challenges in relation to large scale BECCS deployment and considers ways to address these challenges. Research needs to consider how BECCS fits in the context of other mitigation approaches, how it can be accommodated within existing policy drivers and goals, identify where it fits within the wider socioeconomic landscape, and ensure that genuine net negative emissions can be delivered on a global scale.
The final rule for the protection of human subjects requires that informed consent be “in language understandable to the subject” and mandates that “the informed consent must be organized in such a way that facilitates comprehension.” This study assessed the readability of Institutional Review Board-approved informed consent forms at our institution, implemented an intervention to improve the readability of consent forms, and measured the first year impact of the intervention.
Readability assessment was conducted on a sample of 217 Institutional Review Board-approved informed consents from 2013 to 2015. A plain language informed consent template was developed and implemented and readability was assessed again after 1 year.
The mean readability of the baseline sample was 10th grade. The mean readability of the post-intervention sample (n=82) was seventh grade.
Providing investigators with a plain language informed consent template and training can promote improved readability of informed consents for research.
In the southeastern United States, growers often double-crop soft red winter wheat with peanut. In some areas, tobacco is also grown as a rotational crop. Pyrasulfotole is a residual POST-applied herbicide used in winter wheat, but information about its effects on rotational crops is limited. Winter wheat planted in autumn 2014 was treated at Feekes stage 1 or 2 with pyrasulfotole at 300 or 600 g ai ha−1. Wheat was terminated by glyphosate at Feekes stage 3 to 4. Peanut was planted via strip tillage, while tobacco was transplanted into prepared beds after minimal soil disturbance. Peanut exhibited no differences in stand establishment, growth, or yield, and tobacco stand, growth, and biomass yields were not different from the nontreated control for any pyrasulfotole rate or treatment timing.