Health equity gaps persist across minoritized groups due to systems of oppression affecting health-related social needs such as access to transportation, education and literacy, or food and housing security. Consequently, disparities in the prevalence of multidrug-resistant infections, infectious disease outcomes, and inappropriate antimicrobial use have been reported across minoritized populations. The Joint Commission and Centers for Medicare and Medicaid Services (CMS) have formally acknowledged the importance of integrating health equity-focused initiatives into existing hospital quality improvement (QI) programs. Here, we review documented disparities in antimicrobial stewardship and offer a framework, derived from components of existing health equity and QI tools, to guide clinicians in prioritizing equity in antimicrobial stewardship efforts (EASE).

Objective. The efficacy of individualized, community-based physical activity as an adjunctive smoking cessation treatment to enhance long-term smoking cessation rates was evaluated for the Lifestyle Enhancement Program (LEAP). Methods. The study was a two-arm, parallel-group, randomized controlled trial. All participants (n = 392) received cessation counseling and a nicotine patch and were randomized to physical activity (n = 199; YMCA membership and personalized exercise programming from a health coach) or an equal contact frequency wellness curriculum (n = 193). Physical activity treatment was individualized and flexible (with each participant selecting types of activities and intensity levels and being encouraged to exercise at the YMCA and at home, as well as to use “lifestyle” activity). The primary outcome (biochemically verified prolonged abstinence at 7-weeks (end of treatment) and 6- and 12-months postcessation) and secondary outcomes (7-day point prevalent tobacco abstinence (PPA), total minutes per week of leisure time physical activity and strength training) were assessed at baseline, 7 weeks, 6 months, and 12 months. Results. Prolonged abstinence in the physical activity and wellness groups was 19.6% and 25.4%, respectively, at 7-weeks, 15.1% and 16.6% at 6-months, and 14.1% and 17.1% at 12 months (all between-group P values >0.18). Similarly, PPA rates did not differ significantly between groups at any follow-up. Change from baseline leisure-time activity plus strength training increased significantly in the physical activity group at 7 weeks (P = 0.04). Across treatment groups, an increase in the number of minutes per week in strength training from baseline to 7 weeks predicted prolonged abstinence at 12 months (P ≤ 0.001). Further analyses revealed that social support, fewer years smoked, and less temptation to smoke were associated with prolonged abstinence over 12 months in both groups. Conclusions. Community-based physical activity programming, delivered as adjunctive treatment with behavioral/pharmacological cessation treatment, did not improve long-term quit rates compared to adjunctive wellness counseling plus behavioral/pharmacological cessation treatment. This trial is registered with https://beta.clinicaltrials.gov/study/NCT00403312, registration no. NCT00403312.

The current coronavirus disease (COVID-19) pandemic has placed unprecedented strain on underfunded public health resources in the Southeastern United States. The Memphis, TN, metropolitan region has lacked infrastructure for health data exchange.

This manuscript describes a multidisciplinary initiative to create a community-focused COVID-19 data registry, the Memphis Pandemic Health Informatics System (MEMPHI-SYS). MEMPHI-SYS leverages test result data updated directly from community-based testing sites, as well as a full complement of public health data sets and knowledge-based informatics. It has been guided by relationships with community stakeholders and is managed alongside the largest publicly funded community-based COVID-19 testing response in the Mid-South. MEMPHI-SYS has supported interactive Web-based analytic resources and informs federally funded COVID-19 outreach directed toward neighborhoods most in need of pandemic support.

MEMPHI-SYS provides an instructive case study of how to collaboratively establish the technical scaffolding and human relationships necessary for data-driven, health equity-focused pandemic surveillance, and policy interventions.

Although biological evidence suggests that tea consumption may protect against non-Hodgkin lymphoma (NHL), epidemiological evidence has been unclear. The aim of this study was to examine the association between tea-drinking habits and the risk of NHL in a large nationwide prospective cohort of postmenopausal US women. 68 854 women who were enrolled from 1993 through 1998 in the Women’s Health Initiative Observational Study and responded to year 3 annual follow-up questionnaire comprised the analytic cohort. Newly diagnosed NHL cases after the year 3 visit were confirmed by medical and pathology reports. Multivariable-adjusted Cox proportional hazards models were performed to assess the associations of tea-drinking habits (specifically, the amounts of caffeinated/herbal/decaffeinated tea intake) with the overall risk of NHL and three major subtypes (diffuse large B-cell lymphoma (n 195, 0·3 %), follicular lymphoma (n 128, 0·2 %) and chronic lymphocytic leukaemia/small lymphocytic lymphoma (n 51, 0·1 %)). Among 62 622 participants, a total of 663 (1·1 %) women developed NHL during a median follow-up of 16·51 (sd 6·20) years. Overall, different amounts of type-specific tea intake were not associated with the risk of NHL regardless of its histologic subtypes after adjustment for confounders. Our findings suggest that tea intake at the current consumption level does not influence the risk of NHL, regardless of its histologic types.

OBJECTIVES/GOALS: Learners will:

• Identify social structures that serve as root causes of health disparities

• Critically evaluate the ways in which racism, culture, and power perpetuate disparity

• Use critical reflection to shape their research and advocate for institutional change

METHODS/STUDY POPULATION: The Integrated Translational Health Research Institute of Virginia (iTHRIV) Health Equity curriculum provides a lens for participants to view health disparities, social structures that create and perpetuate disparities, and the path to a more equitable future. This longitudinal workforce curriculum incorporates the principles of critical race theory (CRT), including: race as a social construct, structural determinism, intersectionality, and the social construction of knowledge. Learners gain practical experience through facilitated group discussions and critical reflection of their own work including research question design, recruitment, dissemination, and enhancing the faculty pipeline. RESULTS/ANTICIPATED RESULTS: To measure the impact of the curriculum, we will evaluate learners’ participation in mentoring activities for persons from underrepresented backgrounds; participation in local and national diversity and inclusion efforts; engagement in community-based research; ability to account for implicit bias and power imbalances in their research design, including in recruitment and retention; and share research findings with community members and research participants. Evaluation strategies will include quantitative and qualitative methodologies. DISCUSSION/SIGNIFICANCE OF IMPACT: There is growing recognition of the impact of racism on the development and perpetuation of health disparities. Public health critical race praxis (an adaptation of CRT) is emerging as a theoretical framework to empower researchers to challenge the status quo in order to achieve health equity.

The middle Wisconsinan Gilman Canyon Formation at the Buzzard's Roost type locality in southwestern Nebraska was investigated to document the stratigraphy and to reconstruct the environmental and climate record. The Gilman Canyon Formation was subdivided into three loess units and three soils, with radiocarbon ages constraining it between about 40 ka and 25 ka. Stable carbon isotope ratios, magnetic susceptibility, and carbon content were used to define and characterize soils within both the Gilman Canyon Formation and underlying Illinoian Loveland Loess. At the height of soil development within the Gilman Canyon Formation, climate was supporting C4-dominated grassland, with July temperatures equal to or exceeding those of today. Soil-forming intervals within the Loveland Loess, including the Sangamon Soil, also exhibited relative increases in C4 biomass. Climate, as recorded in the Gilman Canyon Formation, is corroborated by regional proxy data. The formation accumulated during MIS 3, and concurrent soil formation coincided with a summer insolation maximum.

Weed seedbanks have been studied intensively at local scales, but to date, there have been no regional-scale studies of weed seedbank persistence. Empirical and modeling studies indicate that reducing weed seedbank persistence can play an important role in integrated weed management. Annual seedbank persistence of 13 summer annual weed species was studied from 2001 through 2003 at eight locations in the north central United States and one location in the northwestern United States. Effects of seed depth placement, tillage, and abiotic environmental factors on seedbank persistence were examined through regression and multivariate ordinations. All species examined showed a negative relationship between hydrothermal time and seedbank persistence. Seedbank persistence was very similar between the two years of the study for common lambsquarters, giant foxtail, and velvetleaf when data were pooled over location, depth, and tillage. Seedbank persistence of common lambsquarters, giant foxtail, and velvetleaf from October 2001 through 2002 and October 2002 through 2003 was, respectively, 52.3% and 60.0%, 21.3% and 21.8%, and 57.5% and 57.2%. These results demonstrate that robust estimates of seedbank persistence are possible when many observations are averaged over numerous locations. Future studies are needed to develop methods of reducing seedbank persistence, especially for weed species with particularly long-lived seeds.

We present ELSA, a new modular software package, written in C, to analyze and manage spectroscopic data from emission-line objects. In addition to calculating plasma diagnostics and abundances from nebular emission lines, the software provides a number of convenient features including the ability to ingest logs produced by IRAF's splot task, to semi-automatically merge spectra in different wavelength ranges, and to automatically generate various data tables in machine-readable or LaTeX format. ELSA features a highly sophisticated interstellar reddening correction scheme that takes into account temperature and density effects as well as He II contamination of the hydrogen Balmer lines. Abundance calculations are performed using a 5-level atom approximation with recent atomic data, based on R. Henry's ABUN program. Downloading and detailed documentation for all aspects of ELSA are available at the following URL: