This article brings together a transdisciplinary collective of academics to critically explore the impacts of planetary thinking across the higher education sector in settler colonial Australia. Growing out of weekly critical practice dialogues between scholars in the fields of Indigenous studies, education, design, philosophy, geography, art, literary studies, communication, urban research and political science, the authors undertake a pluriversal counter-mapping of the university as a place where many worlds meet. Resisting tendencies towards universalisation which continue to dominate discussions of the planetary, the article proposes a pedagogy which embraces multiple worlds, natures and temporalities to open dynamic potentials for integrating planetary thinking into teaching and learning across the university.

The results of research on the human remains and artefacts recently discovered at Heaning Wood Bone Cave, Cumbria, UK are reported. A programme of radiocarbon dating has established that the human remains include the earliest so far discovered in northern Britain, the ‘Ossick Lass’, which date between 9290 and 8925 cal BC. The cave was used for burial during three phases in prehistory: one individual dating to the Early Mesolithic, four to the Early Neolithic and two to the Early Bronze Age and is thus an important addition to our developing knowledge about the deposition of human remains in caves in north-west Europe at these dates. Genomic analysis has established that all but one of the sampled individuals were biologically female. Osteological and taphonomic analysis shows that, in each phase, the burial practice seems to have been successive inhumation of the recently deceased body into the vertical entrance of the cave. Artefacts associated with the burials include perforated periwinkle shell beads radiocarbon dated to the Early Mesolithic, a small assemblage of worked stone, including diagnostically Early Neolithic pieces, and sherds of Early Bronze Age Collared Urn pottery.

The dedicatory preface to Francisco Balagtas’s 1838 Tagalog poem, Florante at Laura, introduced a new conception of time to Philippine literature by referencing mortality as “búhay ma,i, mapatid,” or “life with a cut.” Mapatid, meaning “cut,” contradictorily has the same root word as the Tagalog word for sibling, kapatid. Zeroing in on the term’s simultaneous connotation of cessation and relation, this essay seeks to better understand the specificity of time’s emergence as an object of representation in Philippine literature through mapatid. It examines Lope K. Santos’s 1906 Tagalog socialist novel, Banaag at Sikat (Soft Glimmers before Dawn), for its omission of a representation of US colonial rule. I argue that this omission is a development of Balagtas’s notion of time and that cutting the historical context of US colonialism allows the novel to criticize colonialism.

Interpersonal Psychotherapy (IPT) is an evidence-based treatment for adolescent depression. However, since it does not work for all adolescents in all settings, more research on its heterogeneous effects is needed. Using a realist approach, we aimed to generate hypotheses about mechanisms and contextual contingencies in adolescent group IPT in Nepal. We analysed 26 transcripts from qualitative interviews with IPT participants aged 13–19, facilitators, supervisors and trainers. We analysed data using the Framework Method. The qualitative analytical framework was based on the VICTORE checklist, a realist tool to explore intervention complexity. Sharing, problem-solving, giving and receiving support, managing emotions and negotiating emerged as mechanisms through which adolescents improved their depression. Participants perceived that girls and older adolescents benefitted most from IPT. Girls had less family support than boys and therefore benefitted most from the group support. Older adolescents found it easier than younger ones to share problems and manage emotions. Adolescents exposed to violence and parental alcoholism struggled to overcome problems without family and school support. We formulated hypotheses on group IPT mechanisms and contextual interpersonal and school-level factors. Research is needed to test these hypotheses to better understand for whom IPT works and in what circumstances.

Background: Central venous catheter (CVC) utilization and central-line associated bloodstream infection (CLABSI) have increased nationwide. Busy providers can easily overlook the recommended practice of daily assessment of the ongoing indication for CVC. Prospective audit and feedback (PAF) is widely used and the gold standard for antibiotic stewardship programs (ASP), but reports involving PAF for device use are scarce. Therefore, we decided to evaluate the usefulness and feasibility of PAF for reducing device utilization and ultimately CLABSI rates at our 528-bed tertiary care hospital. Methods: A PAF-based Central Line Stewardship (CLS) initiative was launched in February 2023, with a team of hospitalists, infectious diseases physicians, health informatics, vascular access nurses, and infection preventionists. On business days, CVC line-lists were exported from the electronic medical record (EMR), into a REDCap (Research Electronic Data Capture) database for team members to evaluate, in real-time, all non-ICU CVCs in place for more >72 hours (Figures 1 and 2). For CVCs eligible for stewardship, CLS members placed Legal-approved note into the patient’s EMR, advising CVC removal or alternative IV access (Figure 3). CVCs continued to be audited until removal or patient discharge. Recommendation outcomes were tracked over the subsequent 72 hours for acceptance. Standardized Utilization Rates (SUR) and Infection Rates (SIR) were calculated and compared using the National Healthcare Safety Network. Results: Between February and August 2023, the CLS team reviewed 861 CVCs, representing 581 unique patient encounters, and made 622 recommendations. Recommendations to remove or replace the CVC represented 23.5% (146) of reviews, and 57% of these CVCs were removed within 3 days. 95% of removed lines had no adverse outcomes and did not require reinsertion. Hospital-wide CVC utilization decreased 18.7% from a SUR of 1.006 in the previous year, to 0.818 during the 7-month pilot period (p < 0 .001). In the 4 months following the pilot period, decreased CVC utilization was sustained with an SUR of 0.797. Non-ICU CLABSI SIR decreased from 1.282 in 2022 to 1.024 in 2023 (p=0.36). Average time physician required for CLS review approximated a 0.4 full-time equivalent a week. The intervention was well received, with requests for expansion to urinary catheters. Conclusion: CLS safely and significantly reduced device-utilization; directly via documentation and recommendation, and indirectly through increased awareness and the Hawthorne Effect. Examples of the “art” of CLS include when to leave a discoverable note and how to determine ongoing need for CVC in a fragile patient.

OBJECTIVES/GOALS: The purpose of this study is to determine critical recovery support factors (SDOH, postpartum and post-discharge continuity of care), to optimize continuity of recovery and to determine the best intervention among postpartum and parenting women for treatment retention. METHODS/STUDY POPULATION: Through a mixed methods approach, we will review retrospective hospital discharge data to identify hospital-based gaps in treatment. We will conduct key informant interviews with postpartum women, treatment providers and stakeholders to broaden understanding of critical recovery factors from lived experiences and test a parent-centered evidence-based intervention for a comprehensive and targeted approach to recovery. RESULTS/ANTICIPATED RESULTS: This research will lead to new understanding of critical maternal recovery support factors for sustaining treatment retention for 6-12 months after childbirth and to improve long term maternal health outcomes. DISCUSSION/SIGNIFICANCE: The recovery journey and postpartum period are challenging and lack specific recovery support evidence. Recovery support and continuity of care protocols are unclear after childbirth. Maternal opioid-related overdose deaths occur 6-12 months after childbirth. Therefore, this study will impact and inform recovery retention strategies.

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is an important cause of healthcare-associated infections with limited treatment options and high mortality. To describe risk factors for mortality, we evaluated characteristics associated with 30-day mortality in patients with CRAB identified through the Emerging Infections Program (EIP). Methods: From January 2012 through December 2017, 8 EIP sites (CO, GA, MD, MN, NM, NY, OR, TN) participated in active, laboratory-, and population-based surveillance for CRAB. An incident case was defined as patient’s first isolation in a 30-day period of A. baumannii complex from sterile sites or urine with resistance to ≥1 carbapenem (excluding ertapenem). Medical records were abstracted. Patients were matched to state vital records to assess mortality within 30 days of incident culture collection. We developed 2 multivariable logistic regression models (1 for sterile site cases and 1 for urine cases) to evaluate characteristics associated with 30-day mortality. Results: We identified 744 patients contributing 863 cases, of which 185 of 863 cases (21.4%) died within 30 days of culture, including 113 of 257 cases (44.0%) isolated from a sterile site and 72 of 606 cases (11.9%) isolated from urine. Among 628 hospitalized cases, death occurred in 159 cases (25.3%). Among hospitalized fatal cases, death occurred after hospital discharge in 27 of 57 urine cases (47.4%) and 21 of 102 cases from sterile sites (20.6%). Among sterile site cases, female sex, intensive care unit (ICU) stay after culture, location in a healthcare facility, including a long-term care facility (LTCF), 3 days before culture, and diagnosis of septic shock were associated with increased odds of death in the model (Fig. 1). In urine cases, age 40–54 or ≥75 years, ICU stay after culture, presence of an indwelling device other than a urinary catheter or central line (eg, endotracheal tube), location in a LTCF 3 days before culture, diagnosis of septic shock, and Charlson comorbidity score ≥3 were associated with increased odds of mortality (Fig. 2). Conclusion: Overall 30-day mortality was high among patients with CRAB, including patients with CRAB isolated from urine. A substantial fraction of mortality occurred after discharge, especially among patients with urine cases. Although there were some differences in characteristics associated with mortality in patients with CRAB isolated from sterile sites versus urine, LTCF exposure and severe illness were associated with mortality in both patient groups. CRAB was associated with major mortality in these patients with evidence of healthcare experience and complex illness. More work is needed to determine whether prevention of CRAB infections would improve outcomes.

Funding: None

Disclosures: None

The following exchange was the result of ongoing informal conversations among thecontributors, who are all, in different ways, interested in the emergent concept of theAnthropocene and the challenges it posed, and the opportunities it provided, forhistorians working on Britain and the world. The conversation began at the end of 2015 andcontinued for about a year.

On August 25, 2017, Hurricane Harvey made landfall near Corpus Christi, Texas. The ensuing unprecedented flooding throughout the Texas coastal region affected millions of individuals.1 The statewide response in Texas included the sheltering of thousands of individuals at considerable distances from their homes. The Dallas area established large-scale general population sheltering as the number of evacuees to the area began to amass. Historically, the Dallas area is one familiar with “mega-sheltering,” beginning with the response to Hurricane Katrina in 2005.2 Through continued efforts and development, the Dallas area had been readying a plan for the largest general population shelter in Texas. (Disaster Med Public Health Preparedness. 2019;13:33–37)

During the 2010/11 boreal winter, a distributed set of backscatter measurements was collected using a ground-based Ku-band (17.2 GHz) scatterometer system at 26 open tundra sites. A standard snow-sampling procedure was completed after each scan to evaluate local variability in snow layering, depth, density and water equivalent (SWE) within the scatterometer field of view. The shallow depths and large basal depth hoar encountered presented an opportunity to evaluate backscatter under a set of previously untested conditions. Strong Ku-band response was found with increasing snow depth and snow water equivalent (SWE). In particular, co-polarized vertical backscatter increased by 0.82 dB for every 1 cm increase in SWE (R 2 = 0.62). While the result indicated strong potential for Ku-band retrieval of shallow snow properties, it did not characterize the influence of sub-scan variability. An enhanced snow-sampling procedure was introduced to generate detailed characterizations of stratigraphy within the scatterometer field of view using near-infrared photography along the length of a 5 m trench. Changes in snow properties along the trench were used to discuss variations in the collocated backscatter response. A pair of contrasting observation sites was used to highlight uncertainties in backscatter response related to short length scale spatial variability in the observed tundra environment.

Reducing the excess nutrient and sediment pollution that is damaging habitat and diminishing recreational experiences in coastal estuaries requires actions by people and communities that are within the boundaries of the watershed but may be far from the resource itself, thus complicating efforts to understand tradeoffs associated with pollution control measures. Such is the case with the Chesapeake Bay, one of the most iconic water resources in the United States. All seven states containing part of the Chesapeake Bay Watershed were required under the Clean Water Act to submit detailed plans to achieve nutrient and sediment pollution reductions. The implementation plans provide information on the location and type of management practices making it possible to project not only water quality improvements in the Chesapeake Bay but also improvements in freshwater lakes throughout the watershed, which provide important ancillary benefits to people bearing the cost of reducing pollution to the Bay but unlikely to benefit directly. This paper reports the results of a benefits study that links the forecasted water quality improvements to ecological endpoints and administers a stated preference survey to estimate use and nonuse value for aesthetic and ecological improvements in the Chesapeake Bay and watershed lakes. Our results show that ancillary benefits and nonuse values account for a substantial proportion of total willingness to pay and would have a significant impact on the net benefits of pollution reduction programs.

We question whether the increasingly popular, radical idea of turning half the Earth into a network of protected areas is either feasible or just. We argue that this Half-Earth plan would have widespread negative consequences for human populations and would not meet its conservation objectives. It offers no agenda for managing biodiversity within a human half of Earth. We call instead for alternative radical action that is both more effective and more equitable, focused directly on the main drivers of biodiversity loss by shifting the global economy from its current foundation in growth while simultaneously redressing inequality.

School belonging is generally regarded as a student's sense of affiliation or connection to his or her school. Anyone who has personally navigated the sometimes torturous terrain of secondary school is able to have some level of direct understanding of the importance that belonging, fitting in, and identifying with a school holds for most people. Educators and practitioners often work with young people who feel that they do not belong to the school community, in which they attend. An absence of belonging can manifest itself in mental health concerns, school attrition, and risk taking behaviours. Opportunities for early intervention through fostering school belonging are born from a greater understanding and awareness of what school belonging is and how it is contextualised and fostered. This special issue aims to place a focus on school belonging and highlight it as a significant social issue of our time.

Background: Increasingly, healthcare decision makers demand quality evidence in a short timeframe to support urgent and emergent decisions related to procurement, clinical practice, and policy. Health technology assessment (HTA) producers are responding by developing innovative approaches to evidence synthesis that can be executed more quickly than traditional systematic review. These approaches, and the broader implications they bring to bear on health decision making and policy development, however, are generally neither well-understood nor well-described. This study intends to contribute to an emerging literature around methodological approaches to rapid review in HTA by outlining those developed and implemented by the Canadian Agency for Drugs and Technologies in Health (CADTH).

Methods: Since 2005, CADTH has developed and implemented a rapid review approach that synthesizes evidence to support informed healthcare decisions and policy. Rapid Response reports are tailored to the identified needs of Canadian health decision makers, representing a range of options with regard to depth, breadth, and time-to-delivery.

Results: Preliminary observations indicate that CADTH's approach to rapid evidence review is generally well-received by Canadian health decision makers; real-world case studies provide pragmatic examples of how health decision makers have used Rapid Response reports to support evidence-informed health decisions across Canada.

Conclusions: Rapid review is becoming an increasingly important approach to evidence synthesis, both within and external to the field of HTA. Transparent reporting of the methods used to develop rapid review products will be critical to the assessment of their relevance, utility and effects in a range of contexts.