In this article, we present the results of an original study identifying the perceptions of beginning philosophy students at the start of their first introductory course. We surveyed over 1,100 students representing over 40 universities and colleges in the United States regarding their initial perceptions of gender bias, inclusivity, value, understanding, similarities, and enjoyment of philosophy. We analyzed the results based on gender, first-generation status, and student of color status. This work represents the perspectives of a more diverse range of students, reflecting far more first-generation college students (40 percent) and students who identify as people of color (43 percent) than in previous work. Additionally, this study provides novel data as we were able to collect data on the first day of classes, in most cases before students were exposed to syllabi or content that could inform their views about philosophy. Understanding what beginning students think about philosophy before formal exposure to the field might help us to identify concerns, misconceptions, and areas for improvement. Many results are striking, and our project offers insight into the initial perspectives of philosophy students.

Cyclosporiasis results from an infection of the small intestine by Cyclospora parasites after ingestion of contaminated food or water, often leading to gastrointestinal distress. Recent developments in temporally linking genetically related Cyclospora isolates demonstrated effectiveness in supporting epidemiological investigations. We used ‘temporal-genetic clusters’ (TGCs) to investigate reported cyclosporiasis cases in the United States during the 2021 peak-period (1 May – 31 August 2021). Our approach split 655 genotyped isolates into 55 genetic clusters and 31 TGCs. We linked two large multi-state epidemiological clusters (Epidemiologic Cluster 1 [n = 136 cases, 54 genotyped] and Epidemiologic Cluster 2 [n = 42 cases, 15 genotyped]) to consumption of lettuce varieties; however, product traceback did not identify a specific product for either cluster due to the lack of detailed product information. To evaluate the utility of TGCs, we performed a retrospective case study comparing investigation outcomes of outbreaks first detected using epidemiological methods with those of the same outbreaks had TGCs been used to first detect them. Our study results indicate that adjustments to routine epidemiological approaches could link additional cases to epidemiological clusters of cyclosporiasis. Overall, we show that CDC’s integrated genotyping and epidemiological investigations provide valuable insights into cyclosporiasis outbreaks in the United States.

Previous studies indicate that “hesitation” and “skepticism” are important barriers to the development of renewable energy industries in the United States. We examine whether key pecuniary and nonpecuniary characteristics of bioenergy crops underlie the hesitation argument. Based on a stated choice experiment, we find that Midwestern producers appreciate certain crop attributes that are found in switchgrass, but not in conventional crops. We also find that producers would be willing to grow switchgrass-like crops for net margins between $222/acre/year and $247/acre/year in marginal counties. We argue that farmers’ hesitation and skepticism toward bioenergy crops can be overcome.

ABSTRACT IMPACT: We conducted a study to understand how a patient’s report of a new diagnosis compares with what was documented in the electronic medical record, since it is critical to the diagnostic process that the patient both understands and agrees with a new diagnosis. OBJECTIVES/GOALS: We sought feedback on patient’s understanding of their diagnosis and health status follow Emergency Department discharge. We compared patient report of a new diagnosis to documentation in the electronic medical record. METHODS/STUDY POPULATION: To compare patient reported diagnoses to documented diagnoses, we employed a longitudinal cohort study design at 3 of emergency departments in an academic health system in the Mid-Atlantic. Patients consented to complete questionnaires regarding their understanding of their diagnosis and/or follow-up steps and their health status at 2 weeks, 1 month, and 3 months following emergency department discharge. Inclusion criteria: adult ED patients aged 18 and older seen within the last 7 days with one or more of the following common chief complaints: chest pain, upper back pain, abdominal pain, shortness of breath/cough, dizziness, and headache. We compared patient report of a new diagnosis following discharge to documentation in the electronic medical record. RESULTS/ANTICIPATED RESULTS: Of the sample recruited (n=137), the majority were women (66%, n=91), the average age was 42 (SD 16). A third (n=45) were black and 56% (n=76) were white. The majority of participants (84%, n=115) reported that they either understood the diagnosis they received on ED discharge, or were not given a diagnosis but they understood follow-up steps. At two weeks following discharge, 25% of participants (n=36) had a new diagnosis identified after discharge and 33% (n=45) reported that their health status stayed the same or worsened. There was 85% agreement (kappa 0.49) between patient report of a new diagnosis and a new diagnosis identified in the electronic medical record. Only one of the participants who reported a new diagnosis also reported seeking healthcare outside of the health system. DISCUSSION/SIGNIFICANCE OF FINDINGS: Patient report of a new diagnosis following emergency department discharge had moderate agreement with new diagnoses identified in the electronic medical record, and differences in agreement were not explained by outside healthcare visits.

An interested and engaged electorate is widely believed to be an indicator of democratic health. As such, the aggregate level of political interest of an electorate – macrointerest – is an essential commodity in a democracy, and understanding the forces that change macrointerest is important for diagnosing the health of a democracy. Because being interested in politics requires time and effort, the article theorizes that the electorate's level of political interest will be highest when the electorate believes the government cannot be trusted or is performing poorly. To test hypotheses derived from a proposed theory against rival explanations, the study develops a measure of macrointerest using a quarterly time series of aggregated survey items (1973–2014) of political interest. The authors find support for the theory that the electorate responds as reasonable agents when determining how closely to monitor elected officials: interest is positively related to decreases in trust in government.

OBJECTIVES/GOALS: Leveraging Patient’s Experience to improve Diagnosis (LEAPED) is our proposed method of measuring diagnostic error through seeking patient feedback on their understanding of their diagnosis and health status following emergency department discharge. To pilot test LEAPED’s feasibility, we deployed and determined patient uptake of LEAPED. METHODS/STUDY POPULATION: To test LEAPED, we employed a longitudinal cohort study design at emergency departments across one academic health system in the Mid-Atlantic region. Patients consented to complete questionnaires regarding their understanding of their diagnosis and/or follow-up steps and their health status at 2 weeks, 1 month, and 3 months following emergency department discharge. People aged 18 and older who were seen at the emergency department within the past 7 days with at least one chronic condition (hypertension, diabetes, history of stroke, arthritis, cancer, heart disease, osteoporosis, depression, and/or chronic obstructive lung disease) and one or more of the following common chief complaints: chest pain, upper back pain, abdominal pain, shortness of breath/cough, dizziness, and headache were eligible to join the study. RESULTS/ANTICIPATED RESULTS: Of those enrolled (n = 59), 95% (n = 53) responded to the two week post-ED discharge questionnaire (1 and 3-month ongoing). Of the 6 non-responders, 1 had died and 3 were hospitalized at two weeks. The average age was 50 years (SD 16) and 64% were female. Over half of participants (53%) were white and 41% were black. Almost one-third (27%) reported they were not given an explanation of their health problem on leaving the ED, and of those, a third did not have an understanding of what steps to take after leaving the ED. Participants reported a new health problem was identified after ED discharge (19%), worsening health status (12%), and health status stayed the same (16%). DISCUSSION/SIGNIFICANCE OF IMPACT: Patient uptake of LEAPED was high, which suggests that patient-report is a feasible method of evaluating diagnostic decision making and delivery to patients and yields insightful information beyond administrative data. The next steps are to validate the accuracy of patient-reported diagnostic error by comparing with administrative data.

Prospectively acquired Canadian cerebrospinal fluid samples were used to assess the performance characteristics of three ante-mortem tests commonly used to support diagnoses of Creutzfeldt–Jakob disease. The utility of the end-point quaking-induced conversion assay as a test for Creutzfeldt–Jakob disease diagnoses was compared to that of immunoassays designed to detect increased amounts of the surrogate markers 14-3-3γ and hTau. The positive predictive values of the end-point quaking-induced conversion, 14-3-3γ, and hTau tests conducted at the Prion Diseases Section of the Public Health Agency of Canada were 96%, 68%, and 66%, respectively.