Melanie Fennell’s (1997) seminal cognitive approach to low self-esteem was published in Behavioural and Cognitive Psychotherapy. The current paper proposes a refined model, drawing on social theories, and research with people with socially devalued characteristics. This model emphasises how self-esteem relates to perceptions of one’s value in the eyes of others. It is proposed that core beliefs typical of low self-esteem relate to one’s value in relation to personal adequacy (e.g. having worth or status) and/or to social connection (e.g. being liked, loved, accepted or included). In each of these value domains, beliefs about both the self (e.g. ‘I am a failure’, ‘I am unlovable’) and others (e.g. ‘Others look down on me’, ‘Others don’t care about me’) are considered important. The model suggests that everyone monitors their value but in people with low self-esteem, cognitive biases associated with underlying beliefs occur. In the context of trigger situations, this results in a greater likelihood of negative appraisals of perceived threat to one’s value. Such appraisals activate underlying negative beliefs, resulting in negative mood (e.g. low mood, anxiety, shame, disgust) and other responses that maintain low self-esteem. Responses which can be used excessively or in unhelpful ways include (a) corrective behaviours; (b) compensatory strategies; (c) increased value monitoring; (d) safety-seeking behaviours; (e) rumination; (f) unhelpful mood regulation responses. These responses can adversely impact daily functioning or health, having the counterproductive effect of maintaining negative beliefs about one’s value. Examples are provided for low self-esteem in lesbian, gay and bisexual individuals.

OBJECTIVES/GOALS: To increase the diversity of the health sciences research workforce, students from a variety of backgrounds must have the opportunity to participate in hands-on research experiences that highlight translating science to treating human disease. We developed a mentored translational research program for students from VCU and central Virginia HBCUs. METHODS/STUDY POPULATION: The Wright Regional Center for Clinical and Translational Science collaborated with the existing VCU Honors’ Summer Undergraduate Research Program (HSURP) to expand their summer research experience to URM students from our partner HBCUs. For 10 weeks, students worked with faculty mentors to learn research techniques and engage in research projects. Students also participated in career development sessions like developing a CV and choosing graduate programs, and at the end of HSURP, they shared formal presentations of their research with peers and mentors. HSURP students were provided housing and a stipend, and mentors were provided a stipend. A post-program assessment gathered feedback on research and personal skills gained, the program’s influence on their career goals, and overall experiences with HSURP. RESULTS/ANTICIPATED RESULTS: Nine students, 7 from VCU and 2 from Virginia State University participated in HSURP. Students were rising sophomores, juniors, and seniors, and 5 had previous research experience. Students worked on projects ranging from basic to social behavioral, community-placed research. All students rated the program as good or excellent. Post-program assessments showed all students believed they had a better understanding of ethical responsibilities of researchers, relevance of community-engaged and clinical/translational research, and interpreting journal articles after participating in the program. Four students reported they plan to continue working on their research projects during the academic year, and all students strongly agreed or agreed that HSURP prepared them for graduate or professional schools. DISCUSSION/SIGNIFICANCE: A program that combines hands-on research training and career development opportunities provides a robust research foundation for URM students, which can increase their participation in the translational science workforce. Future program development will include preprogram training modules to better prepare students for research experiences.

Health justice seeks, both conceptually and in practice, to strengthen community engagement and empowerment as an integral means of addressing health disparities. In this essay, we explore the nature of communities and their roles in health care/public health. We propose that an ethical principle of respect for communities is a requisite part of health justice. It is this respect for communities that ethically grounds health justice’s calls for greater community engagement and empowerment. Conceptions of health justice, we claim, will gain ethical power and coherence as this principle is more clearly recognized and further developed.

The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and is characterised by symptoms of either depersonalisation or derealisation, in addition to a diagnosis of post-traumatic stress disorder (PTSD). This systematic review and meta-analysis sought to estimate the point prevalence of current PTSD-DS, and the extent to which method of assessment, demographic and trauma variables moderate this estimate, across different methods of prevalence estimation. Studies included were identified by searching MEDLINE (EBSCO), PsycInfo, CINAHL, Academic Search Complete and PTSDpubs, yielding 49 studies that met the inclusion criteria (N = 8214 participants). A random-effects meta-analysis estimated the prevalence of PTSD-DS as 38.1% (95% CI 31.5–45.0%) across all samples, 45.5% (95% CI 37.7–53.4%) across all diagnosis-based and clinical cut-off samples, 22.8% (95% CI 14.8–32.0%) across all latent class analysis (LCA) and latent profile analysis (LPA) samples and 48.1% (95% CI 35.0–61.3%) across samples which strictly used the DSM-5 PTSD criteria; all as a proportion of those already with a diagnosis of PTSD. All results were characterised by high levels of heterogeneity, limiting generalisability. Moderator analyses mostly failed to identify sources of heterogeneity. PTSD-DS was more prevalent in children compared to adults, and in diagnosis-based and clinical cut-off samples compared to LCA and LPA samples. Risk of bias was not significantly related to prevalence estimates. The implications of these results are discussed further.

Records of abnormal fossil arthropods present important insight into how extinct forms responded to traumatic damage and developmental complications. Trilobites, bearing biomineralized dorsal exoskeletons, have arguably the most well-documented record of abnormalities spanning the Cambrian through the end-Permian. As such, new records of malformed, often injured, trilobites are occasionally identified. To further expand the documentation of abnormal specimens, we describe malformed specimens of Lyriaspis sigillum Whitehouse, 1939, Zacanthoides sp. indet., Asaphiscus wheeleri Meek, 1873, Elrathia kingii (Meek, 1870), and Ogygiocarella debuchii (Brongniart, 1822) from lower Paleozoic deposits. In considering these forms, we propose that they illustrate examples of injuries, and that the majority of these injuries reflect failed predation. We also considered the origin of injuries impacting singular segments, suggesting that these could reflect predation, self-induced damage, or intraspecific interactions during soft-shelled stages. Continued examination of lower Paleozoic trilobite injuries will further the understanding of how trilobites functioned as prey and elucidate how disparate trilobite groups recovered from failed attacks.

Bacillus pumilus SAFR-032, an endospore-forming bacterial strain, was investigated to determine its methylation pattern (methylome) change, compared to ground control, after direct exposure to space conditions onboard the International Space Station (ISS) for 1.5 years. The resulting ISS-flown and non-flown strains were sequenced using the Nanopore MinION and an in-house method and pipeline to identify methylated positions in the genome. Our analysis indicated genomic variants and m6A methylation increased in the ISS-flown SAFR-032. To complement the broader omics investigation and explore phenotypic changes, ISS-flown and non-flown strains were compared in a series of laboratory-based chamber experiments using an X-ray irradiation source (doses applied at 250, 500, 750, 1000 and 1250 Gy); results show a potentially higher survival fraction of ISS-flown DS2 at the two highest exposures. Taken together, results from this study document lasting changes to the genome by methylation, potentially triggered by conditions in spaceflight, with functional consequences for the resistance of bacteria to stressors expected on long-duration missions beyond low Earth orbit.

The present study reports the validity of multiple assessment methods for tracking changes in body composition over time and quantifies the influence of unstandardised pre-assessment procedures. Resistance-trained males underwent 6 weeks of structured resistance training alongside a hyperenergetic diet, with four total body composition evaluations. Pre-intervention, body composition was estimated in standardised (i.e. overnight fasted and rested) and unstandardised (i.e. no control over pre-assessment activities) conditions within a single day. The same assessments were repeated post-intervention, and body composition changes were estimated from all possible combinations of pre-intervention and post-intervention data. Assessment methods included dual-energy X-ray absorptiometry (DXA), air displacement plethysmography, three-dimensional optical imaging, single- and multi-frequency bioelectrical impedance analysis, bioimpedance spectroscopy and multi-component models. Data were analysed using equivalence testing, Bland–Altman analysis, Friedman tests and validity metrics. Most methods demonstrated meaningful errors when unstandardised conditions were present pre- and/or post-intervention, resulting in blunted or exaggerated changes relative to true body composition changes. However, some methods – particularly DXA and select digital anthropometry techniques – were more robust to a lack of standardisation. In standardised conditions, methods exhibiting the highest overall agreement with the four-component model were other multi-component models, select bioimpedance technologies, DXA and select digital anthropometry techniques. Although specific methods varied, the present study broadly demonstrates the importance of controlling and documenting standardisation procedures prior to body composition assessments across distinct assessment technologies, particularly for longitudinal investigations. Additionally, there are meaningful differences in the ability of common methods to track longitudinal body composition changes.

ABSTRACT IMPACT: Our research focuses on determining rural-urban disparities in chronic obstructive pulmonary disease (COPD) management to improve COPD health outcomes in rural areas. OBJECTIVES/GOALS: Several methods exist to distinguish rural from urban areas, but it is not clear which method relates most directly to rural-urban health care disparities. To address this, we compared different measures of rurality to measures of chronic obstructive pulmonary disease (COPD) processes of care among a national sample of veterans. METHODS/STUDY POPULATION: Retrospective analysis of patients with COPD (2016-2019 by ICD-10 codes) using national Veterans Affairs (VA) data. We assessed rurality by: 1) patient’s residential address, 2) assigned primary care clinic address, and 3) drive time from the patient’s residence to closest primary care clinic. Rurality designations of the residential address and primary care clinic address into urban, rural, and highly rural areas are based on the Rural Urban Commuting Area (RUCA) codes. The dependent variables were binary outcomes of: 1) documentation of a pulmonary clinic encounter and 2) evidence of spirometry to confirm the diagnosis of COPD. RESULTS/ANTICIPATED RESULTS: Of 6,765,951 veterans, 1,157,002 (17%) had COPD (Table 1). Although approximately 40% of patients with COPD reside in addresses that are rural and highly rural, a large majority are assigned to primary care clinics in urban areas (82.8%) and reside within 30 minutes to the closest primary care clinic (76.7%) (Table 2). Compared to defining rurality based on patient’s residential address or drive time to closest primary care, defining rurality based on the assigned primary care clinic address was associated with a larger disparity in rates of pulmonary encounter. In contrast, the drive time from the patient’s residence to the closest primary care was the strongest predictor of receipt of spirometry (Figure 1 and Table 3). DISCUSSION/SIGNIFICANCE OF FINDINGS: Estimates of the severity of rural-urban disparities varied based on the definition of rurality used. For two process measures, definitions of rurality based on where the patient received primary care generated more evidence of disparities than definitions based solely on the patient’s residential address.

Over the last year, COVID-19 has emerged as a highly transmissible and lethal infection. As we address this global pandemic, its disproportionate impact on Black, Indigenous, and Latinx communities has served to further magnify the health inequities in access and treatment that persist in our communities. These sobering realities should serve as the impetus for reexamination of the root causes of inequities in our health system. An increased commitment to strategic partnerships between academic and nonacademic health systems, industry, local communities, and policy-makers may serve as the foundation. Here, we examine the impact of the recent COVID-19 pandemic on health care inequities and propose a strategic roadmap for integration of clinical and translational research into our understanding of health inequities.

Our recent exploration into the use of biodegradable metals and surface treatments resulting in sufficient strength for skeletal reconstruction applications has led to the need to test these devices’ cytotoxicity. More specifically, our group has developed a resorbable magnesium alloy, Mg–1.2Zn–0.5Ca–0.5Mn, that can be strengthened by heat treatment and coated with a ceramic layer offering time-certain resorption of a medical device. This in vitro study shows that these treatments do not result in cytotoxicity. Both heat-treated (HT) and HT + ceramic-coated (sol–gel) coupons demonstrated more than 70% viability. Thus, these processing steps are likely to be useful in producing biocompatible, resorbable implants that incorporate our Mg–1.2Zn–0.5Ca–0.5Mn alloy.

This study was undertaken 6–7 months after the 1999 Athens earthquake with the aim of exploring the differences in post-traumatic stress disorder (PTSD), anxiety and depression symptoms between a group of children exposed to earthquake with a group of children not exposed to it, but with both groups potentially exposed to the same levels of post-earthquake adversities. The study included 2037 children, aged 9–17 years, who were assessed with self-completed questionnaires. The directly exposed group (N = 1752) had significantly higher anxiety and PTSD scores than the indirectly exposed group (N = 284), but no significant group differences were found in depression scores. Girls in both groups reported significantly more PTSD, anxiety and depressive symptoms than boys. Younger children reported significantly more PTSD and anxiety symptoms than the older ones. No significant interactions were found between direct exposure to earthquake, age group and gender. The severity of PTSD symptoms was most strongly predicted by greater perceived threat during the earthquake, whereas depression was most strongly predicted by the level of post-earthquake adversity. The severity of anxiety symptoms was most strongly predicted by female gender. These findings are discussed in relation to the need for screening and intervention following earthquake events.