We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save 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 saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.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 saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved 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.
Objectives/Goals: The Translational Science Benefits Model (TSBM) offers a key framework for demonstrating the real-world health outcomes of research. This study uses a mixed-methods approach combined with the TSBM to show how researchers from Case Western Reserve University’s Clinical and Translational Science Collaborative (CTSC) have advanced health equity or improved public health in the USA and globally. Methods/Study Population: Using the TSBM indicators, we surveyed 72 former CTSC KL2 Program trainees and 469 CTSC Pilot Program awardees for documented evidence that their research led to demonstrated health benefits. We used purposive sampling of the survey responses to obtain examples highlighting research that led to advances in health equity as well as international public health improvements. We conducted in-depth interviews with six investigators to assess the populations impacted and the scope of their contributions. For each investigator, we examined how their publications informed both national and international policy. Through this approach, we will present specific case studies highlighting research that led to advances in health equity as well as international examples of public health improvements. Results/Anticipated Results: Among KL2 Scholars, we achieved a 40% response rate (29/72), with 90% (26/29) reporting 86 significant benefits across the four TSBM areas. For Pilot Program awardees, 18.5% responded (87/469), with 40% documenting 136 benefits. Several different types of translational science benefits resulted in improved health and health equity for several diverse national and international beneficiaries, including racial and ethnic minorities (e.g., Blacks, Hispanics), potentially vulnerable populations (e.g., pregnant women, victims of intimate partner violence, individuals on Medicaid, infants), international populations (e.g., people from low-resource countries with genetic disorders or parasitic infections), as well as people from rural areas and professions at high risk of developing cancer. Discussion/Significance of Impact: Leveraging KL2 and Pilot Grant successes, the TSBM shows how research improves public health and health equity for underserved populations. It streamlines outcome reporting, enabling researchers to demonstrate their societal impact while providing funders and policymakers with clear, data-driven evidence of the value of translational science.
OBJECTIVES/GOALS: Burst suppression is a neurophysiological marker associated with severe hypoxic-ischemic injury following cardiac arrest. The goal of this study is to identify the anatomical regions of the brain associated with burst suppression post-cardiac arrest. METHODS/STUDY POPULATION: 86 comatose patients post-cardiac arrest admitted to the neurological-ICU from Massachusetts General Hospital and Brigham and Women’s Hospital were included in this study. EEG data after return of spontaneous circulation were preprocessed and artifact was rejected. Burst segments were extracted for source localization analysis from epochs with burst suppression. Four bursts for each patients were manually selected. The source of the bursts were obtained using the Champagne algorithm and mapped on the Desikan-Killiany atlas. The source for each burst was defined as any region of interest (ROI) with power > = 75th percentile relative to all ROIs. The power of the bursts at each source was correlated with the burden of brain injury measured using apparent diffusion coefficient (ADC) per ROI. RESULTS/ANTICIPATED RESULTS: 48 (56%) patients had burst suppression. 5 (10.4%) of patients with burst suppression were independent at the time of hospital discharge. Preliminary analyses was performed on 6 patients (24 bursts in total). ROI’s determined to be sources in a majority of the burst (>=13) were bilateral superior frontal, rostral middle frontal, parstriangularis precentral, superior parietal, inferior parietal, right post central, superior temporal, lateral occipital, and left middle temporal ROI. A lower mean ADC intensity was associated with a higher EEG power in the bilateral superior frontal (r = -0.80, p < 0.0001; r = -0.677, p < 0.001, respectively), left superior parietal (r = -0.53, p = 0.009), left middle temporal (r = -0.43, p = 0.042) ROI. DISCUSSION/SIGNIFICANCE: The source of bursts in patients post-cardiac arrest experiencing burst suppression is not well defined. This study will improve our understanding of how burst suppression is a measure of cortical injury, how it may relate to the burden of injury found on ADC imaging, and patient outcomes.
The Coca-Cola bottle is among the most famous product packaging in the world. Consumers everywhere instantly recognize the distinctive curvy bottle and understand what it represents. It has been celebrated as a design classic and featured prominently by artists ranging from Norman Rockwell to Andy Warhol. The bottle is not only a cultural icon but also a triumph of branding, its goodwill built up over time by the Coca-Cola Company’s heavy investments in advertising and other forms of marketing.
Adolescent health, development and behaviour lay a foundation for future population health (Patton, et al., 2018; Sawyer, et al., 2012). Adolescence now occupies a greater portion of the life-course. It is commonly framed as the period from 10-24 years of age, moving beyond earlier definitions of 10-19 years (Sawyer, Azzopardi, Wickremarathne, & Patton, 2018). Disadvantage, social inequality and a range of harmful health and social problems often become prominent during adolescence. This chapter explores some of the common health and social problems experienced by adolescents, including internalising and externalising problems, homelessness, substance use, and traditional and cyberbullying perpetration and victimisation. We also discuss some of the contextual factors (herein referred to as risk and protective factors) that may increase or decrease the likelihood of these health and social problems (Hawkins & Weis, 2017). We conclude by discussing some of the public health approaches used by practitioners and researchers to target these health and social problems.
In November 1915, popular Baltimore minister and anti-vice reformer Kenneth G. Murray became enmeshed in scandal after he allegedly attempted to engage in sex with another man at the Y.M.C.A. The revelation of Murray’s alleged queerness became a flashpoint in ongoing contestations over anti-vice reform and the legitimacy of using state power to enforce Christian morality. In the hands of his political opponents, most notably H.L. Mencken, Murray’s apparent homosexuality became a tool for vindicating long-standing assertions that men who campaigned for state-enforced morality were hypocritical and motivated in their activism by sexual and gendered pathologies. In tracing print reactions to Murray’s public exposure, this essay argues that homosexuality proved to be a powerful political weapon against progressive anti-vice campaigning like Murray’s because it was capable of reconciling competing stereotypes of religiously motivated anti-vice reformers as simultaneously overly sexual and impotent, feminized and pathologically masculine. The Murray scandal also opened the door for critiques of muscular Christianity, which made it an early example of how the sexual diagnosis of religious figures and reformers could be used to discredit social and religious activism.
San Francisco (California USA) is a relatively compact city with a population of 884,000 and nine stroke centers within a 47 square mile area. Emergency Medical Services (EMS) transport distances and times are short and there are currently no Mobile Stroke Units (MSUs).
Methods:
This study evaluated EMS activation to computed tomography (CT [EMS-CT]) and EMS activation to thrombolysis (EMS-TPA) times for acute stroke in the first two years after implementation of an emergency department (ED) focused, direct EMS-to-CT protocol entitled “Mission Protocol” (MP) at a safety net hospital in San Francisco and compared performance to published reports from MSUs. The EMS times were abstracted from ambulance records. Geometric means were calculated for MP data and pooled means were similarly calculated from published MSU data.
Results:
From July 2017 through June 2019, a total of 423 patients with suspected stroke were evaluated under the MP, and 166 of these patients were either ultimately diagnosed with ischemic stroke or were treated as a stroke but later diagnosed as a stroke mimic. The EMS and treatment time data were available for 134 of these patients with 61 patients (45.5%) receiving thrombolysis, with mean EMS-CT and EMS-TPA times of 41 minutes (95% CI, 39-43) and 63 minutes (95% CI, 57-70), respectively. The pooled estimates for MSUs suggested a mean EMS-CT time of 35 minutes (95% CI, 27-45) and a mean EMS-TPA time of 48 minutes (95% CI, 39-60). The MSUs achieved faster EMS-CT and EMS-TPA times (P <.0001 for each).
Conclusions:
In a moderate-sized, urban setting with high population density, MP was able to achieve EMS activation to treatment times for stroke thrombolysis that were approximately 15 minutes slower than the published performance of MSUs.
In this study, we evaluated the efficacy, expressed as a mean weight decrease of the whole echinococcal cyst mass, of novel benzimidazole salt formulations in a murine Echinococcus granulosus infection model. BALB/c mice were intraperitoneally infected with protoscoleces of E. granulosus (genotype G1). At 9 months post-infection, treatment with albendazole (ABZ), ricobendazole (RBZ) salt formulations, and RBZ enantiomer salts (R)-(+)-RBZ-Na and (S)-(−)-RBZ-Na formulations were initiated. Drugs were orally applied by gavage at 10 mg kg−1 body weight per day during 30 days. Experimental treatments with benzimidazole sodium salts resulted in a significant reduction of the weight of cysts compared to conventional ABZ treatment, except for the (S)-(−)-RBZ-Na enantiomer formulation. Scanning electron microscopy and histological inspection revealed that treatments impacted not only the structural integrity of the parasite tissue in the germinal layer, but also induced alterations in the laminated layer. Overall, these results demonstrate the improved efficacy of benzimidazole salt formulations compared to conventional ABZ treatment in experimental murine cystic echinococcosis.
This chapter examines how the legal climate around prostitution in Baltimore changed in the wake of the Civil War. Growing fears about vagrancy following emancipation and the triumph of a free labor economy prompted crackdowns on streetwalkers and public sex workers, who found themselves incarcerated in the city’s growing network of carceral institutions. Meanwhile, real estate speculators’ growing disenchantment with brothels as investment properties and pressures from a growing urban middle class that expected the state to act as an active guarantor of their property rights brought challenges to the decades-old regime of toleration around indoor prostitution. Brothels, once regarded as a comparatively benign sexual labor arrangement because they kept illicit sexuality contained and out of sight, came to be firmly defined as threats to private property rights and to the future of the middle class. Authorities began to utilize the precedent set by an 1857 equity decision, Hamilton v. Whitridge, as they moved to crack down on sex workers and evict them from “respectable” neighborhoods. As they did so, they began to create informal red-light districts.
This chapter examines the growth of Baltimore’s casual sex trade in the early republic. At the turn of the nineteenth century, the sex trade in Baltimore emerged as part of the broader, mobile world of coastal and Atlantic commerce and labor and functioned as a survival strategy for women whose existences were governed by seasonal labor patterns and the uncertain rhythms of trade. Sex work was a loosely organized and casual affair that was part of poor women’s economy of makeshifts, and it was neither highly profitable nor spatially separated from the everyday world and social fabric of community life in maritime neighborhoods. Men and women, black and white, enslaved and free, sold and purchased sex in taverns, sailors’ boardinghouses, and local groggeries. They did so at significant legal risk and for little in the way of profit, for prostitution in the early city was little more than a subsistence trade.
This chapter examines the decline of the brothel as a commercial form in the latter decades of the nineteenth century and the recasualization of sex work in the context of women’s changing labor arrangements and the growth of urban leisure culture. Baltimore’s brothels, in keeping with patterns in other US cities, lost their prominence as a sexual labor arrangement as the result of changing land use patterns, new styles of courting, and evolving work and housing arrangements for young laborers. With the rise of new types of urban leisure, young women who sold or traded sex increasingly resorted to concert saloons, dance halls, and amusement parks to solicit men and to furnished room houses to carry out their trysts. Once-taboo forms of sexual exchange became incorporated into the courting and leisure culture of young working people. Brothels, which in many ways reflected an outmoded, domestic model of courtship, had to embrace niche sexual markets in a struggle to compete for labor and customers.
This chapter traces the expansion of Baltimore’s sex trade and the rise of brothel prostitution over the course of the antebellum period. Although prostitution is often called “the world’s oldest profession,” it resembled a “profession” in urban America only after the 1820s, when rapid changes to the structures of labor and increased mobility created both a supply and a demand for sexual labor beyond the structures of maritime neighborhoods. The sex trade’s geographies shifted toward new centers of business and trade, and labor patterns in the trade changed. In keeping with a broader trend of business specialization and capitalist labor practices, Baltimore’s sex trade came increasingly to revolve around brothels where madams dictated aspects of sex workers’ behavior, extracted surplus value from their labor, and commercialized both sex and intimacy to a much greater degree than before. Women involved in the sex trade adapted their ventures to cater to dominant cultural preferences, from the domestication of courting to the embrace of racially exclusionary labor practices.
This chapter traces the expansion of Baltimore’s sex trade during the Civil War and the reactions of civilian and military authorities to its growth. Baltimore was an occupied city and staging ground for Union troops for much of the war, and the presence of thousands of soldiers in and around the city swelled the demand for commercial sex. As the economic hardships that accompanied war drove more women into sex work, Baltimore’s prostitution trade expanded far beyond its antebellum scale. Prostitution drew the attention of military and civil authorities, who were fearful of the potential the brothels had to undermine military discipline, civilian relations, and the health of soldiers. Baltimore’s brothel keepers managed to keep Union officials at bay by cooperating with their efforts to round up errant troops and providing valuable intelligence gathered from their clients, and many managed to make small fortunes by catering to soldiers. However, the attention the war brought to the violence, disorderliness, and disease-spreading potential of the sex trade would have profound long-term consequences for Baltimore’s sex workers and their enterprises.
In December 1921, a twenty-nine-year-old black woman named Adelaine (sometimes spelled Adeline) Payne appeared before the Baltimore City Criminal Court on charges related to prostitution. At the time of her trial, Payne was living on North Dallas Street, a narrow road running up from Fells Point. She rented a house between the Washington Hill and Dunbar neighborhoods, not far from the old Orleans Street vice district. Payne was a divorced, single mother to her four-year-old daughter, Iona. Though she may have been fortunate enough to enjoy some family support, Payne almost certainly struggled with the burdens of raising a young child on only her own earnings. As a black woman living in a city that was increasingly segregated and rife with anti-black racism, she had limited options for well-compensated work, and at the time of the 1920 census she had no legitimate employment. Prostitution, if indeed she participated in it, probably helped her to pay her bills.