Early surgical intervention in infants with complex CHD results in significant disruptions to their respiratory, gastrointestinal, and nervous systems, which are all instrumental to the development of safe and efficient oral feeding skills. Standardised assessments or treatment protocols are not currently available for this unique population, requiring the clinician to rely on knowledge based on neonatal literature. Clinicians need to be skilled at evaluating and analysing these systems to develop an appropriate treatment plan to improve oral feeding skill and safety, while considering post-operative recovery in the infant with complex CHD. Supporting the family to re-establish their parental role during the hospitalisation and upon discharge is critical to reducing parental stress and oral feeding success.

Mate preferences and mating-related behaviours are hypothesised to change over the menstrual cycle to increase reproductive fitness. Recent large-scale studies suggest that previously reported hormone-linked behavioural changes are not robust. The proposal that women's preference for associating with male kin is down-regulated during the ovulatory (high-fertility) phase of the menstrual cycle to reduce inbreeding has not been tested in large samples. Consequently, we investigated the relationship between longitudinal changes in women's steroid hormone levels and their perceptions of faces experimentally manipulated to possess kinship cues (Study 1). Women viewed faces displaying kinship cues as more attractive and trustworthy, but this effect was not related to hormonal proxies of conception risk. Study 2 employed a daily diary approach and found no evidence that women spent less time with kin generally or with male kin specifically during the fertile phase of the menstrual cycle. Thus, neither study found evidence that inbreeding avoidance is up-regulated during the ovulatory phase of the menstrual cycle.

This paper illustrates the potential impacts of climate change on financial markets, focusing on their long-term significance. It uses a top-down modelling tool developed by Ortec Finance in partnership with Cambridge Econometrics that combines climate science with macro-economic and financial effects to examine the possible impacts of three plausible (not extreme) climate pathways. The paper first considers the impact on gross domestic product (GDP), finding that GDP is lower in all three pathways, with the most severe reduction in the Failed Transition Pathway where the Paris Agreement climate targets are not met. The model then translates these GDP impacts into financial market effects. In the Failed Transition Pathway, cumulative global equity returns are approximately 50% lower over the period 2020–2060 than in the climate-uninformed base case. For the other two pathways where the Paris Agreement targets are met, the corresponding figures are 15% and 25% lower returns than in the base case. Results are provided for other asset classes too. These demonstrate that climate change represents a significant market risk, with implications for financial planning, modelling and regulation.

This paper demonstrates how climate scenario analysis can be used for forward-looking assessment of the risks and opportunities for financial institutions, using a case study for a UK defined benefit pension scheme. It uses a top-down modelling tool developed by Ortec Finance in partnership with Cambridge Econometrics to explore the possible impacts of three plausible (not extreme) climate pathways of the scheme’s assets and liabilities. It finds that the funding risks are greater under all three climate pathways than under the climate-uninformed base scenario. In the absence of changes to the investment strategy or recovery plan, the time taken to reach full funding is increased by three to nine years. Given that most models currently used by actuaries do not make explicit adjustments for climate change, these modelled results suggest it is quite likely that pension schemes are systematically underestimating the funding risks they face.

Leveraging elements of game design and theories of human motivation, gamification provides a variety of techniques to engage learners in novel ways. Our Clinical and Translational Science Award created the software platform (Kaizen-Education©) to deliver gamified educational content in 2012. Here, we explore two novel use cases of this platform to provide practical insights for leveraging these methods in educational settings: (1) national training in rigor, reproducibility, and transparency and (2) attainment of learner competency (n = 7) as a gauge of curricular effectiveness across Master of Public Health degree tracks (n = 5). Data were captured in real time during player interaction with Kaizen-Education© to provide descriptive analyses of player engagement in both implementation examples. We then assessed item analysis to assess knowledge gain and competency attainment. We have just begun to leverage the potential for gamification to engage learners, enhance knowledge acquisition, and document completion of training, across various learning environments. We encourage a systematic approach to gamification applying insights from self-determination theory to learners and learning environments, a methodical approach to game design and rigorous analysis after implementation to generate evidence-based insights to maximize educational return for time invested.

There has been an increasing focus in the UK on the support provided to the Armed Forces community, with the publication of the Armed Forces Covenant (2011), the Strategy for our Veterans (2018) and the first ever Office for Veterans’ Affairs (2019). There is also an important body of research – including longitudinal research – focusing on transitions from military to civilian life, much of which is quantitative. At the same time, the UK has witnessed a period of unprecedented welfare reform. However, research focused on veterans’ interactions with the social security system has been largely absent. This article draws on the authors’ experiences of undertaking qualitative longitudinal research (QLR) to address this knowledge gap. We reflect on how QLR was essential in engaging policy makers enabling the research to bridge the two parallel policy worlds of veterans’ support and welfare reform, leading to significant policy and practice impact.

ABSTRACT IMPACT: Recommendations for increasing trainee productivity will be highlighted. OBJECTIVES/GOALS: Using a combination of qualitative (interview) and quantitative (publications tracking) data, we undertook to describe the hurdles and concerns impeding academic accomplishments among T and K awardees at one CTSA hub and to examine whether hurdles at 6 months would predict academic output within one year following completion of the training program. METHODS/STUDY POPULATION: Semi-structured interviews were conducted with 29 trainees (28 TL1 and 8 KL2) 6 months into their training. Interview transcripts were analyzed using Atlas.ti to identify hurdles (factors that had already impeded research progress) and concerns (future challenges anticipated by the trainee). PubMed searches yielded the number of publications within one year of exiting the training program. Frequencies of hurdles and concerns were examined to characterize the factors most likely to impact trainee progress during the first 6 months of their training program. Among 18 trainees who had completed their training, the mean number of publications within one year of exiting the program (identified via verified PubMed searches) was compared across the total number of hurdles reported at 6 months (range = 0 to 3). RESULTS/ANTICIPATED RESULTS: The thematic analysis yielded 19 categories of hurdles and 14 categories of concerns. The top three hurdles were technological challenges (e.g., issues with equipment or data reduction; reported by 63% of trainees), professional competing responsibilities (40%), and navigating collaborations (30%). The top three concerns were future funding (33%), potential as an independent researcher (27%), and institutional context (e.g., departmental structure; 23%). The number of hurdles reported at 6 months significantly predicted number of publications one year post-exit (F (3,14) = 3.14, p < .05). Trainees reporting zero hurdles generated a mean of 8.67 publications; those with 3 hurdles generated a mean of 2.4 publications. DISCUSSION/SIGNIFICANCE OF FINDINGS: Future concerns were completely different from past hurdles, suggesting that the issues impeding research progress are not anticipated. Results suggest trainees would benefit from training related to how to balance competing professional responsibilities and navigate collaborations and that early attention to hurdles may enhance productivity.

Wildlife reintroduction projects often face resistance from local residents who see potential conflicts with the species or lack trust or confidence in the agencies and professionals involved in reintroduction. Yet the linkages between trust, confidence, risk perceptions, attitudes towards the species and local support for its reintroduction are not well known. The Dual-Mode Model of Cooperation and Cognitive Hierarchy Model were theoretical frameworks used to shed light on these linkages by exploring the potential roles trust and confidence play as mediators between risk perceptions and attitudes towards, and support for, reintroduced elk in Tennessee (USA). A mail survey of 1005 residents living in the five-county area surrounding the North Cumberland Elk Restoration Zone assessed resident attitudes and risk perceptions towards the reintroduced elk, trust towards the managing wildlife agency and support for continued conservation efforts. A structural equation model revealed that trust and confidence play positive roles in mitigating risk perceptions and improving support for the reintroduction of elk. The findings confirm the roles public trust and confidence play in wildlife reintroductions and should help agencies work towards building local trust and confidence, minimizing risks, improving attitudes and increasing the chances for successful outcomes for the species and people.

Congenital heart disease (CHD) is the most common birth defect for infants born in the United States, with approximately 36,000 affected infants born annually. While mortality rates for children with CHD have significantly declined, there is a growing population of individuals with CHD living into adulthood prompting the need to optimise long-term development and quality of life. For infants with CHD, pre- and post-surgery, there is an increased risk of developmental challenges and feeding difficulties. Feeding challenges carry profound implications for the quality of life for individuals with CHD and their families as they impact short- and long-term neurodevelopment related to growth and nutrition, sensory regulation, and social-emotional bonding with parents and other caregivers. Oral feeding challenges in children with CHD are often the result of medical complications, delayed transition to oral feeding, reduced stamina, oral feeding refusal, developmental delay, and consequences of the overwhelming intensive care unit (ICU) environment. This article aims to characterise the disruptions in feeding development for infants with CHD and describe neurodevelopmental factors that may contribute to short- and long-term oral feeding difficulties.

Ventenata [Ventenata dubia (Leers) Coss.], an invasive winter annual grass, negatively impacts grassland community composition and function in the Pacific Northwest. Ventenata dubia established in Palouse prairie (PP) and canyon grasslands (CG) of northern Idaho/eastern Washington in the mid-1980s to early 1990s. Understanding and comparing patterns of invasion can elucidate future trends as its range expands. We performed surveys in PP (2012 and 2013) and CG (2018) to assess V. dubia abundance. Specifically, we correlated species richness, Shannon diversity, rank abundance, and indicator species with no, low (<12.5%), and high (>12.5%) V. dubia cover. We used nonmetric multidimensional scaling analysis (NMDS) to visualize species similarities and associations with abiotic variables. In both ecoregions, V. dubia was very common, appearing in nearly 60% of 450 plots. When present, V. dubia cover averaged 26% (±2.3 SE) in PP and 19% (±1.8 SE) in CG. Indigenous plant species richness and diversity were lowest in plots with high V. dubia cover. In CG, this relationship held for nonindigenous species; in PP, nonindigenous plant richness and diversity were higher with high V. dubia cover. Ventenata dubia and other winter annual grasses (Bromus spp., medusahead [Taeniatherum caput-medusae (L.) Nevski]) were moderately associated according to the NMDS analysis. Indicator species analysis showed V. dubia was positively associated with nonindigenous winter annual grasses and negatively associated with indigenous low shrub species. Abiotic factors that explained V. dubia abundance included shallow soils and a south to west aspect. Overall, these findings indicate V. dubia can successfully invade both dry and relatively wet plant communities and is more abundant than other invasive annual grasses. We suggest these findings foreshadow what will happen in sagebrush steppe and Great Plains grasslands, regions where V. dubia recently became established.

OBJECTIVES/GOALS: To evaluate the FAITH! (Fostering African-American Improvement in Total Health) App mHealth lifestyle intervention by using post-intervention feedback obtained from participants in our intervention pilot study. METHODS/STUDY POPULATION: We used qualitative methods (focus groups) to elicit post-intervention feedback. Participants who completed the pilot study were recruited to one of two focus groups. Semi-structured focus groups were conducted to explore participants’ views on the app functionality, utility and satisfaction as well as its impact on healthy lifestyle change. Sessions were audio-recorded, transcribed verbatim and qualitative data were analyzed by systematic text condensation thematic analysis. RESULTS/ANTICIPATED RESULTS: Nine individuals participated (N = 4 and N = 5) in each of the two focus groups. Their mean age was 47.9 years (SD 12.1), 67% were women, and all had at least an education level of some college. Six overarching themes emerged from the data: (1) overall impression, (2) content usefulness (3) formatting, (4) implementation, (5) impact and (6) suggestions for improvement. Underpinning the themes was a high level of agreement that the intervention facilitated healthy behavioral change through cultural tailoring, multimedia education modules and social networking. Among the suggestions for improvement were streamlining of app self-monitoring features, personalization based on individual’s cardiovascular risk and attentiveness to nuanced cultural perspectives. DISCUSSION/SIGNIFICANCE OF IMPACT: This formative evaluation found the FAITH! App mHealth lifestyle intervention had high reported satisfaction and impact on the health-promoting behaviors of African-Americans, thereby improving their overall cardiovascular health. The findings provide further support for the acceptability of mHealth interventions among African-Americans. CONFLICT OF INTEREST DESCRIPTION: None.

Worldwide, early intervention services for young people with recent-onset psychosis have been associated with improvements in outcomes, including reductions in hospitalization, symptoms, and improvements in treatment engagement and work/school participation. States have received federal mental health block grant funding to implement team-based, multi-element, evidence-based early intervention services, now called coordinated specialty care (CSC) in the USA. New York State’s CSC program, OnTrackNY, has grown into a 23-site, statewide network, serving over 1800 individuals since its 2013 inception. A state-supported intermediary organization, OnTrackCentral, has overseen the growth of OnTrackNY. OnTrackNY has been committed to quality improvement since its inception. In 2019, OnTrackNY was awarded a regional hub within the National Institute of Mental Health-sponsored Early Psychosis Intervention Network (EPINET). The participation in the national EPINET initiative reframes and expands OnTrackNY’s quality improvement activities. The national EPINET initiative aims to develop a learning healthcare system (LHS); OnTrackNY’s participation will facilitate the development of infrastructure, including a systematic approach to facilitating stakeholder input and enhancing the data and informatics infrastructure to promote quality improvement. Additionally, this infrastructure will support practice-based research to improve care. The investment of the EPINET network to build regional and national LHSs will accelerate innovations to improve quality of care.