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OBJECTIVES/GOALS: We conducted a review of CTSA websites to understand the current landscape for CRP institutional professional development and training revealed in the CTSA hub websites. METHODS/STUDY POPULATION: We accessed and reviewed 59 currently funded CTSA hub websites for evidence of CRP training opportunities. Parameters reviewed included: 1) opportunities were specified for CRPs versus K and T trainees; 2) mandated training; 3) leveling; 4) delivery methods/resources; 5) public accessibility; 6) unique features. The website reviews informed a REDCap survey sent to the CTSA Administrators (n = 149) and the Coordinator Taskforce (n = 105) listservs to gain additional knowledge of CRP training available at the institution. A subsequent repeat review of the CTSA hub websites will be conducted to determine evolving trends. RESULTS/ANTICIPATED RESULTS: A total of 40 responded to the survey from 59 CTSA hubs. Survey results are being analyzed. Website review data are being tabulated and the subsequent review of websites will be collected in February. Those findings are pending and will include a comparison of prior findings. 42% of CRP hubs list CRP training within the CTSA hub website. Required onboarding training (beyond CITI certificates) is revealed for some hubs (15%). DISCUSSION/SIGNIFICANCE OF IMPACT: On our initial website review less than half of the CTSA hub websites list specific CRP training on their website. Many were hidden behind firewalls and could not be reviewed for content. The REDCap Survey will provide more granular descriptions of programs. Data from a second website review will be collected for comparison. Based on a preliminary re-review of sites, there is a suggestion of increasing CRP workforce development information. CTSAs are well-positioned to be a central hub for promoting educational excellence of the institutional workforce, for medical centers and in other venues where clinical research is performed.
To utilise a community-based participatory approach in the design and implementation of an intervention targeting diet-related health problems on Navajo Nation.
A dual strategy approach of community needs/assets assessment and engagement of cross-sectorial partners in programme design with systematic cyclical feedback for programme modifications.
Navajo Nation, USA.
Navajo families with individuals meeting criteria for programme enrolment. Participant enrolment increased with iterative cycles.
The Navajo Fruit and Vegetable Prescription (FVRx) Programme.
A broad, community-driven and culturally relevant programme design has resulted in a programme able to maintain core programmatic principles, while also allowing for flexible adaptation to changing needs.
In this article we engage in a critical examination of how local authority Housing Solutions staff, newly placed centre stage in preventing homelessness amongst prison leavers in Wales, understand and go about their work. Drawing on Carlen’s concept of ‘imaginary penalities’ and Ugelvik’s notion of ‘legitimation work’ we suggest practice with this group can be ritualistic and underpinned by a focus on prison leavers’ responsibilities over their rights, and public protection over promoting resettlement. In response we advocate for less-punitive justice and housing policies, underpinned by the right to permanent housing for all prison leavers and wherein stable accommodation is understood as the starting point for resettlement. The analysis presented in this article provides insights to how homelessness policies could play out in jurisdictions where more joint working between housing and criminal justice agencies are being pursued and/or preventative approaches to managing homelessness are being considered.
Robert Schumann’s 1853 essay ‘New Paths’ is famous for its prophetic introduction of the young Johannes Brahms to the wider German musical community. In this, his last piece of published criticism, Schumann presented Brahms, then a virtually unknown young composer, as a Messiah-like figure for a nascent musical era, one who would be called to ‘give the highest expression to the times in an ideal manner’ The final sentence of Schumann’s essay has often been overlooked, but it is significant for the glimpse that it offers of the place that he envisioned for Brahms in the future: ‘In every era there presides a secret league of kindred spirits. Draw the circle tighter, you who belong together, that the truth of art may shine ever more clearly, spreading joy and blessings everywhere!’ [see Ch. 31 ‘Germany’].
OBJECTIVES/SPECIFIC AIMS: To translate a behavioral theory–informed, evidence-based, face-to-face health education program into an mHealth lifestyle intervention for African-Americans (AAs). METHODS/STUDY POPULATION: This mixed methods study consisted of 4 phases, using an iterative development process to intervention design with the AA community. In Phase 1, we held focus groups with AA community members and church partners (n=23) to gain insight regarding the needs and preferences of potential app end users. In Phase 2, the interdisciplinary research team synthesized input from Phase 1 for preliminary app design and content development. Phase 3 consisted of a sequential 3-meeting series with the church partners (n=13) for iterative app prototyping (assessment, cultural tailoring, final review). Phase 4 was a single group pilot study among AA church congregants (n=50) to assess app acceptability, usability, and satisfaction. RESULTS/ANTICIPATED RESULTS: Phase 1 focus groups indicated preferences for general and health related apps: multifunctional; high-quality graphics/visuals; evidence-based, yet simple health information; and social networking capability. Phase 2 integrated these preferences into the preliminary app prototype. Feedback from Phase 3 was used to refine the FAITH! App prototype for pilot testing. Phase 4 pilot testing indicated high acceptability, usability, and satisfaction of the FAITH! App. DISCUSSION/SIGNIFICANCE OF IMPACT: This study illustrates the process of using formative and CBPR approaches to design a culturally relevant, mHealth lifestyle intervention to address CV health disparities within the AA community. Given the positive perceptions of the app, our study supports the use of an iterative development process by others interested in implementing an mHealth lifestyle intervention for racial/ethnic minority communities.
We compared interventions to improve urinary catheter care and urine culturing in adult intensive care units of 2 teaching hospitals. Compared to hospital A, hospital B had lower catheter utilization, more compliance with appropriate indications and maintenance, but higher urine culture use and more positive urine cultures per 1,000 patient days.
We examined the prospective associations of objective and subjective measures of stress during pregnancy with infant stress reactivity and regulation, an early-life predictor of psychopathology. In a racially and ethnically diverse low-income sample of 151 mother–infant dyads, maternal reports of stressful life events (SLE) and perceived stress (PS) were collected serially over gestation and the early postpartum period. Infant reactivity and regulation at 6 months of age was assessed via maternal report of temperament (negativity, surgency, and regulation) and infant parasympathetic nervous system physiology (respiratory sinus arrhythmia [RSA]) during the Still Face Paradigm. Regression models predicting infant temperament showed higher maternal prenatal PS predicted lower surgency and self-regulation but not negativity. Regression models predicting infant physiology showed higher numbers of SLE during gestation predicted greater RSA reactivity and weaker recovery. Tests of interactions revealed SLE predicted RSA reactivity only at moderate to high levels of PS. Thus, findings suggest objective and subjective measures of maternal prenatal stress uniquely predict infant behavior and physiology, adjusting for key pre- and postnatal covariates, and advance the limited evidence for such prenatal programming within high-risk populations. Assessing multiple levels of maternal stress and offspring stress reactivity and regulation provides a richer picture of intergenerational transmission of adversity.
Influences of dietary patterns on musculoskeletal health are poorly understood in middle-aged women. This cross-sectional analysis from a cohort of 347 women (aged 36–57 years) aimed to examine associations between dietary patterns and musculoskeletal health outcomes in middle-aged women. Diet was measured by the Cancer Council of Victoria FFQ. Total body bone mineral content (TB BMC), femoral neck and lumbar spine bone density (dual-energy X-ray absorptiometry), lower limbs muscle strength (LMS) and balance tests (timed up and go test, step test, functional reach test (FRT) and lateral reach test) were also measured. Exploratory factor analysis was used to identify dietary patterns and scores for each pattern generated using factor loadings with absolute values ≥0·20. Associations between food pattern scores and musculoskeletal outcomes were assessed using multivariable linear regression. Three dietary patterns were identified: ‘Healthy’ (high consumption of a plant-based diet – vegetables, legumes, fruit, tomatoes, nuts, snacks, garlic, whole grains and low intake of high-fat dairy products), ‘high protein, high fat’ (red meats, poultry, processed meats, potatoes, cruciferous and dark-yellow vegetables, fish, chips, spirits and high-fat dairy products) and ‘Processed foods’ (high intakes of meat pies, hamburgers, beer, sweets, fruit juice, processed meats, snacks, spirits, pizza and low intake of cruciferous vegetables). After adjustment for confounders, Healthy pattern was positively associated with LMS, whereas Processed foods pattern was inversely associated with TB BMC and FRT. The associations were not significant after accounting for multiple comparisons. There were no associations with any other outcomes. These results suggest that maintaining a healthy diet could contribute to bone acquisition, muscle strength and balance in adult life. However, while they provide some support for further investigating dietary strategies for prevention of age-related loss of muscle and deterioration in balance, the exploratory nature of the analyses means that confirmation in longitudinal studies and/or trials with pre-specified hypotheses is needed.
OBJECTIVES/SPECIFIC AIMS: Translational science supports the continuum of activities from early-stage bench research to implementation of discoveries for better and faster treatments to more patients. Past studies have attempted to clarify our understanding of the spectrum of translational research by categorizing the activities into stages ranging from T0 to T4 using explanatory definitions. Unfortunately, this approach is often vague and relies on a process of manual classification and binning of research publications into predetermined categories. This study aims to provide a big-picture analysis of clinical and translational science (CTS) based on an in-depth analysis of the entire corpus of publications resulting from research funded by Clinical and Translational Science Awards (CTSA) U54 awards (through 2016). METHODS/STUDY POPULATION: We harvested bibliographic metadata from all papers that cited any of the U54 award numbers since the inception of the CTSA program to the most recent award announcement. Natural language processing techniques were used to create term co-occurrence networks based on English-language textual data. Relevant and nonrelevant terms were distinguished algorithmically and processed accordingly to provide the clustered visualization. RESULTS/ANTICIPATED RESULTS: With this approach, we uncovered 6 natural clustered areas of emphasis of published CTS research, the evolution of specific concepts through time, and gained a better understanding of their relative impact as demonstrated by citations. We performed additional analyses including discipline-specific impact assessment; identification of categories of excellence relating to both productivity and citations; characteristics of collaborative networks such as organizational, industry, and international collaborations and network dynamics; and resulting global impact of the CTSA program. DISCUSSION/SIGNIFICANCE OF IMPACT: Ultimately we gained a clearer understanding of the CTSA program, its evolution through scholarly publications, and key areas of impact of the program using computational, data-driven evaluation methods.
Training for the clinical research workforce does not sufficiently prepare workers for today’s scientific complexity; deficiencies may be ameliorated with training. The Enhancing Clinical Research Professionals’ Training and Qualifications developed competency standards for principal investigators and clinical research coordinators.
Clinical and Translational Science Awards representatives refined competency statements. Working groups developed assessments, identified training, and highlighted gaps.
Forty-eight competency statements in 8 domains were developed.
Training is primarily investigator focused with few programs for clinical research coordinators. Lack of training is felt in new technologies and data management. There are no standardized assessments of competence.
This paper tracks human–animal entanglements through one particular species, Canis lupus, the wolf, with a view to exploring how this contested predator might be used to unpack normative assumptions about wildlife science, conservation practice and storytelling. The focus of attention here is on Yellowstone National Park and the century-long struggle to eradicate and then restore the wolf based on the shifting rubrics of science and environmental ethics. The ‘wild heart’ of North America and a centre of scientific and popular environmental mythology, Yellowstone presents a useful terrain (both material and contextual) in which to theorize the wolf as an environmental agent and explore its special provenance within an evolving narrative of ecological science. More specifically, the landmark story of restor(y)ation that played out in the national park serves to illuminate the complex web of temporality, narrative and memory that frames our configurations of animal agency. Wiped out in the late nineteenth and early twentieth centuries and ruminated on in the interwar period, the wolf was returned to ancestral haunts in the 1990s (to great fanfare) as a charismatic poster animal for environmental consciousness and a vital ‘missing link’ in the psychological and biotic fabric of the landscape. Ornamented with what conservationist Aldo Leopold famously called a ‘fierce green fire’, the wolf became a carrier animal for Yellowstone's environmental memory, transporting with it the fates of other threatened species and the promise of an enlightened Ecological Age. Beneath this teleological tale of expanding biological knowledge and ethical awakening lies a convoluted (and interesting) story that reveals the sinuous connections between the material and the imagined animal as well as the challenges and the complexities of reading non-human traces.
National Institute for Health and Care Excellence have recommended faecal calprotectin (FC) testing as an option in adults with lower gastrointestinal symptoms for whom specialist investigations are being considered, if cancer is not suspected and it is used to support a diagnosis of inflammatory bowel disease (IBD) or irritable bowel syndrome. York Hospital and Vale of York Clinical Commissioning Group have developed an evidence-based care pathway to support this recommendation for use in primary care. It incorporates a higher FC cut-off value, a ‘traffic light’ system for risk and a clinical management pathway.
To evaluate this care pathway.
The care pathway was introduced into five primary care practices for a period of six months and the clinical outcomes of patients were evaluated. Negative and positive predictive values (NPV and PPV) were calculated. GP feedback of the care pathway was obtained by means of a web-based survey. Comparator gastroenterology activity in a neighbouring trust was obtained.
The care pathway for FC in primary care had a 97% NPV and a 40% PPV. This was better than GP clinical judgement alone and doubled the PPV compared with the standard FC cut-off (<50 mcg/g), without affecting the NPV. In total, 89% of patients with IBD had an FC>250 mcg/g and were diagnosed by ‘straight to test’ colonoscopy within three weeks. The care pathway was considered helpful by GPs and delivered a higher diagnostic yield after secondary care referral (21%) than the conventional comparator pathway (5%).
A care pathway for the use of FC that incorporates a higher cut-off value, a ‘traffic light’ system for risk and supports clinical decision making can be achieved safely and effectively. It maintains the balance between a high NPV and an acceptable PPV. A modified care pathway for the use of FC in primary care is proposed.
Sponge samples were taken by scuba diving from six sites around Sea Lion Island (Sea Lion, Sea Lion Easterly and Brandy Islands), three sites south-east of East Falkland (Motley Island, Green Island and Triste Island) and six sites around Beauchêne Island. Nine new species are described: Iophon roseum sp. nov., Clathria (Microciona) tenebrosa sp. nov., Clathria (Microciona) cheeki sp. nov., Hymedesmia (Hymedesmia) laptikhovskyi sp. nov., Hymedesmia (Hymedesmia) croftsae sp. nov., Myxilla (Ectyomyxilla) beauchênensis sp. nov., Tedania (Tedania) livida sp. nov., Amphilectus fimbriatus sp. nov. and Isodictya cutisanserina sp nov. Additional information is provided on several species recently described from the Falkland Islands and Amphimedon marsei is newly reported. The biogeography of the sponge fauna of the southern Falkland Islands is discussed.