Labelling specific psychiatric concerns as ‘niche’ topics relegated to specialty journals obstructs high-quality research and clinical care for these issues. Despite their severity, eating disorders are under-represented in high-impact journals, underfunded, and under-addressed in psychiatric training. We provide recommendations to stimulate broad knowledge dissemination for under-acknowledged, yet severe, psychiatric disorders.

Background: The FIRST Trial is a 5-year study funded by the Agency for Healthcare Research and Quality. Our investigation is situated within a more extensive study to restrict fluoroquinolone antibiotics by requiring providers to obtain authorization from an infectious disease physician before prescribing fluoroquinolones. Our research team is performing a systematic evaluation to identify organizational characteristics and influencers of the fluoroquinolone preprescription authorization implementation process to understand variables that may facilitate or hinder implementation success. Methods: To address this critical gap, we present a qualitative analysis from our ongoing, multisite research project aimed at systematically assessing the adoption of an antimicrobial stewardship intervention in the form of an EHR-integrated best-practice alert (BPA) at each site to identify work system factors that impact uptake and variability in the implementation of the BPA at each location. The evaluation provides a detailed explanation of activities through the implementation process (eg, before implementation, during implementation, and after implementation) to assess how an organization effectively negotiates the phases and transitions, ultimately influencing the impact of the intervention. We have used a contextual determinant framework (CFIR) that has enabled us to perform a systematic and comprehensive exploration and identification of potential explanatory themes or variables to shed light on the complex social phenomenon of implementation. Results: Participants who will be a part of our poster presentation will learn about implementing a BPA, the potential barriers to implementation, and strategies for overcoming these barriers. Stakeholders within our study include site coordinators, medical doctors, nurses, pharmacists, and clinical informaticists. Our analysis synthesizes their experiences implementing and sustaining this evidence-based antimicrobial stewardship intervention. It includes (1) a detailed description of the process of change, (2) work-system factors (eg, inner setting and outer setting) that they believe influenced the success of the intervention, (3) barriers and facilitators (eg, CFIR constructs) within the implementation process; and (4) description of how these could have influenced the outcomes of interest (eg, implementation and intervention effectiveness). Conclusions: Our research is expected to advance patient safety research and initiatives by providing a more robust approach to performing systematic intervention evaluations. By outlining stakeholders’ experiences within our study, implementation leaders within healthcare systems will utilize our findings to aid them in their design and implementation process when designing and implementing similar types of healthcare interventions.

Disclosures: None

Farmers and food entrepreneurs are encouraged to enter direct and intermediated markets for value-added food products, but do not have information that they need to determine whether the markets are financially feasible for their operations. We conduct timed trials in a state-of-the-art regional shared-use food processing facility in the Northeast, and test production costs for two high-quality, safe, value-added frozen products: blueberries and spinach. We combine this with research on capital costs, field research on distribution costs and baseline per-unit revenues, and published research on potential market returns, and assess the conditions under which frozen produce sales can be a good business choice for farmers and food businesses in local and regional food markets. We develop a roadmap and a calculator tool that potential market entrants, extension agents, regional food business centers and other agricultural support providers can modify to reflect local and regional market conditions. The tool can help determine whether entering the frozen produce market is a good fit for a farm or food business. In general, we find that frozen regional blueberries have potential to generate a profitable return for medium-scale farmers with access to a shared-use facility, or farmer aggregators with the ability to invest in their own facilities. Frozen regional spinach is unlikely to generate a profitable return at the regional scale. Our results provide critical information to policy makers regarding the scale of production necessary to justify investments in regional shared-used kitchens. Results also suggest that policy makers should be cautious when encouraging farmers and food businesses to enter value-added markets, as there is significant potential for these markets to under-perform.

This research note seeks to offer some resolution to the theoretical disagreements over how democratization affects civil society, specifically in a transition toward democracy that occurs through pacted settlements of an armed internal conflict. Using a comparative study over time of the labor movement in El Salvador, the authors demonstrate that while unions of the political center and left have weakened since the signing of the Salvadoran Peace Accords, independent labor groups show higher levels of organizing and right-leaning unions have maintained nearly constant levels of organizing. But the labor movement has become atomized because unions have been unable to redefine their once-common political goals to adopt other unified stances in the postwar period. The data show that the unions that have relinquished excessively politicized stances or never claimed them are the ones that survive and sometimes grow in the postwar environment. These findings have implications for the nature of the emerging Salvadoran democracy and the economic well-being of its citizens.

Only a small area of the Australian mainland was glaciated during the Pleistocene, whereas periglacial deposits are far more common, indicating that cold environments were extensive and a major influence on landscape evolution. Here we identify representative low-elevation examples of scree slopes and frost action, together with fans and valley fills, indicating pronounced erosion cycles during the Pleistocene. To date the deposits, we explore approaches using radiocarbon, optically stimulated luminescence, and profile dating using the cosmogenic nuclide 10Be. The radiocarbon and optical ages show that screes, alluvial valley fill, and fans were deposited between 66–13 ka during the coldest part of the last glacial cycle, and within the previous glacial cycle. Exposure dating indicates further landscape erosion cycles back to the mid Pleistocene. Together, the deposits indicate the frost cracking limit was ~1300 m lower at 680 ± 10 m and mean winter temperature was 8.2 ± 0.5°C colder than present. Periglacial conditions probably affected much of southeastern Australia. The treeless and dry conditions resulted in widespread erosion and increased run off. Combined with increased snow storage within catchments, rivers were paradoxically larger, with high seasonal discharge and sediment loads.

Poor connectivity between diverse resource users and complex wider governance networks is a challenge in environmental governance. Organizations that ‘broker’ interactions among these relationships are expected to improve governance outcomes. Here, we used semi-structured interviews and social network analysis to identify actors in positions to broker coral reef-related information to and from resource users and to assess the performance of these brokers. Representatives (n = 262) of actor groups were interviewed, including local and national government, non-governmental organizations (NGOs), community organizations and resource user groups from 12 communities across four Caribbean countries, to map information-sharing networks and to identify brokers. Broker performance was assessed through separate interviews with coral reef resource users (n = 545). The findings show that marine NGOs were the highest-functioning brokers. Where such local-level organizations were absent, government agencies in reef management roles acted as brokers, but their performance was lower. Actors in brokerage positions did not always effectively share information, with broker performance being positively correlated with network brokerage scores. The results further our understanding of the roles of brokers in different governance contexts. Identifying those in brokerage positions and supporting their roles in connecting local resource users to wider governance networks could encourage functional brokerage and enhance reef management outcomes.

OBJECTIVES/GOALS: Aims 1&2: Develop (1) and implement (2) online, guided self-help intervention for ED psychopathology and weight reduction. Aim 3: Follow-up to track remission of ED psychopathology and symptoms and WL maintenance at end of treatment and 6-months. METHODS/STUDY POPULATION: N = 60 college students meeting criteria (clinical/sub-clinical binge-type ED with BMI > 25) will complete a baseline survey and then will be randomized into a condition. Students in the intervention group (n = 30) will be offered 8 weeks of an online, guided self-help intervention for ED and WL. Students in the control group (n = 30) will receive an email message to seek support from Student Health Services. All participants will receive follow-ups 9 weeks and 6 months after baseline. Data analysis will compare Eating Disorder Examination Questionnaire (EDE-Q) scores and WL (change in BMI) at all three time-points. Group comparisons will be assessed via two-way mixed-model ANOVA. RESULTS/ANTICIPATED RESULTS: Recruitment is still ongoing. Data collected by the time of the conference will be presented on the poster. DISCUSSION/SIGNIFICANCE OF IMPACT: Online, guided self-help interventions have been used for WL, as well as for treatment of EDs separately, but no program exists to manage these commonly comorbid conditions concurrently. Thus, this pilot study will examine the effectiveness of combined programs to breach this treatment gap.

We Are All Treaty People is a Canadian play for young audiences (ages eight to twelve) that addresses difficult knowledge, Elders’ story sharing, and contemporary and historical Indigenous–settler relations. This article discusses the contemporary and historical political context of the play and its production, the creation process and its narrative anchors. It argues that through a respectful, Indigenous-led creation process, and structural techniques, the play has the potential to offer hope and healing, and encourage relationships based on knowledge.