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OBJECTIVES/GOALS: To identify factors enabling growing underage consumption of disposable Electronic Nicotine Delivery Systems (ENDS) by understanding young adults’perceptions and patterns of use of disposable ENDS through surveying college students. METHODS/STUDY POPULATION: Disposable ENDS are all-in-one devices with pre-filled nicotine liquid and a built-in battery. Recent data shows increased sales as users, including youth, are switching from pod-based to disposable ENDS. Gaps were identified via a literature review of current survey data revealing unknown information about disposable ENDS. Based on these data gaps, an anonymous survey was developed to gain insight into youth disposable ENDS use. The survey was distributed to college students via social media, university email chains, and flyers with QR codes. Responses were analyzed to identify trends and correlations in disposable ENDS use among college students. The survey was approved by USC IRB, Study ID: UP-22-00023. RESULTS/ANTICIPATED RESULTS: Between March 6 and October 28, 2022, 166 completed survey responses were collected; 158 were students. 80.4% (127/158) of surveys were eligible for analysis with the following criteria: 18-20 years old, under the US legal age to use ENDS. Of respondents aged 18-20, 57.5% (73/127) reported using ENDS at least once. 79.5% (58/73) of underage respondents used disposable ENDS and 72.9% (51/70) reported disposable ENDS as their usual device. 93.0% (53/57) of underage users reported using a flavored product, 56.1% (32/57) reported Flum®as their usual brand, 48.2% (27/56) reported convenience of use as the most attractive aspect of disposable ENDS, and 46.4% (26/56) obtained disposable ENDS from a convenience store. Of all disposable ENDS-using respondents, 98.7% (75/76) used for the first time while under the age of 21. DISCUSSION/SIGNIFICANCE: The survey continues to be open for data collection, with the goal of obtaining additional data. The goal with the additional data will be to create a comprehensive list of identified risk factors influencing underage disposable ENDS use and to suggest specific regulatory and policy reform to better address underage nicotine addiction.
OBJECTIVES/GOALS: To evaluate the clinical trial designs of stimulant medications approved for the treatment of adult Attention-Deficit/Hyperactivity Disorder (ADHD) and identify discrepancies between safety and efficacy outcome measure criteria. METHODS/STUDY POPULATION: There are 24 stimulants currently approved and marketed for the treatment of adult ADHD: 12 amphetamine (AMP)-based and 12 methylphenidate (MPH)-based formulations. A mixed methods review of clinical trials that have evaluated the safety and efficacy of these drugs will be performed using qualitative and quantitative data, including inclusion and exclusion criteria, primary and secondary outcome measures, manufacturer recommendations, and package inserts, as well as FDA recommendations for industry. After compiling a list of clinical trials for each of the 24 drugs, this information will be analyzed for themes and trends in the assessment of safety and efficacy with particular attention paid to differing criteria between individual drugs and/or the two subclasses of prescription stimulants. RESULTS/ANTICIPATED RESULTS: The FDA has published recommendations for ADHD medication clinical trial design, including suggested outcome measures utilizing validated assessment tools. However, the FDA notes that these assessments may be altered to fit study populations and indicate that other primary and secondary endpoint measures may be acceptable. As such, efficacy assessments for these drugs may vary greatly, and the specific criterion selected for each drug’s study population and outcome measures may suggest more specific indications and usage conditions for optimal efficacy. DISCUSSION/SIGNIFICANCE: Regulatory officials consider AMP- and MPH-based stimulants equivalent therapeutic options for the treatment of ADHD. A study of clinical trial criteria reveals that differing mechanisms have been used to evaluate safety and efficacy. This discrepancy may have implications that affect clinical decision-making and patient experiences.
OBJECTIVES/GOALS: To assess the impact of federal regulations and policies relating to disposable Electronic Nicotine Delivery Systems (ENDS) on youth consumption of these products by identifying factors enabling its growing consumption among youth users and its relation to adolescent addiction to nicotine. METHODS/STUDY POPULATION: Disposable ENDS are all-in-one devices with pre-filled nicotine liquid and a built-in battery. Recent data shows increased sales as users, including youth, are switching from pod-based to disposable ENDS. Thus, an understanding of the regulatory landscape for these products will provide insight on how to mitigate youth nicotine addiction. Data from the Centers for Disease Control and Prevention 2021 National Youth Tobacco Survey (NYTS) was analyzed for patterns of adolescent use. FDA statements and actions involving disposable ENDS companies were reviewed to evaluate the current FDA stance. Analyses of both data sets identified factors enabling the growth in sale of disposable ENDS. RESULTS/ANTICIPATED RESULTS: The NYTS reported 53.7% of youth ENDS users report using disposable ENDS and Puff Bar is the leading ENDS device among youth consumers. In March 2021, Puff Bar announced a return to market with “tobacco-free nicotine” after ceasing sales following an FDA warning letter in July 2020. But synthetic nicotine retains the same chemical properties as tobacco-derived nicotine and the same risks for addiction and abuse. The Food and Drug Administration (FDA) maintains synthetic nicotine products will be regulated on a case-to-case basis, suggesting “closed system devices” containing synthetic nicotine may not be regulated as tobacco products. DISCUSSION/SIGNIFICANCE: The growing popularity of disposable ENDS among youth is problematic. Awareness of strategic regulatory defiance (i.e., Puff Bar), will bring light to industry sales tactics. To develop comprehensive data on disposable ENDS use by young adults, an anonymous survey of college students will be conducted.
ABSTRACT IMPACT: This research will aid clinical and policy solutions on lessening the vast health disparities and overall access issues for low-income, type 1 diabetes patients. OBJECTIVES/GOALS: Identify key barriers to accessing continuous glucose monitors (CGMS) and care options for low-socioeconomic status (SES) patients on public insurance. Low-SES patients with type 1 diabetes (T1D) have lower utilization rates of effective diabetes management technologies and worse clinical outcomes. METHODS/STUDY POPULATION: A literature review was conducted to understand the current research landscape for T1D and lead to the identification of potential barriers which included socioeconomic status, low-income, health literacy, and racial/ethnic minority. Clinicaltrials.gov was searched using the keyword ‘type 1 diabetes’ in conjunction with the identified barriers (as well as the keyword ‘barrier’). A follow up review of each state’s Medicaid programs was conducted to analyze cost and access options for CGMs and the overall financial burden of the disease on low-SES T1D patients. States that offered CGM coverage were further analyzed to determine reimbursement rates and actual out-of-pocket cost for patients. RESULTS/ANTICIPATED RESULTS: Of 285 trials identified from Clinicaltrial.gov searches, only seven relevant trials examined barriers and T1D for low-SES patients. Additionally, many of these studies, both in and outside of the clinical trial space, seldom distinguished between type 1 and type 2 diabetes’‘ an important distinction given that T1D has a higher financial burden and a quicker onset of complications. Currently, 39 states offer various insurance coverage through their Medicaid programs, but have clinical restrictions and requirements such as pediatric coverage only or minimum blood glucose requirement checks. Additionally, there is vast variability in reimbursement rates between states ($0-$800). DISCUSSION/SIGNIFICANCE OF FINDINGS: Study results indicate less effective diabetes management for low-SES T1D patients and a need for more intersectional clinical trial research. Differences in state’s Medicaid CGM coverage, expressed in disparate clinical outcomes for these T1D patients, belies financial incentives to health improvements, as annual US T1D costs are $14.4 billion.
THIS book is a team effort, driven by a shared desire to illuminate and celebrate the world's great classical traditions. Its ancestry as a piece of crosscultural musical analysis goes back a thousand years, to the ‘science of music’ of the medieval Arab theorists. Its European precursors include the sixteenthcentury Swiss theologian Jean de Léry, who notated antiphonal singing in Brazil, and the Moldavian polymath Prince Dimitrie Cantemir (1673–1723) who was enslaved by the Ottomans in Istanbul, became a de facto Turkish composer, and created the first notation for Turkish makam; also Captain James Cook, who made detailed descriptions of the music and dance of Pacific islanders in 1784. Meanwhile Chinese music was being admiringly analysed by French Jesuit missionaries – Chinese theorists had beaten their European counterparts in the race to solve the mathematics of equal temperament – and other Frenchmen were investigating the music of the Arab world. While serving on Napoleon Bonaparte's Egyptian campaign, Guillaume-André Villoteau made studies of Arab folk and art music, before going on to contrast those with the music of Greece and Armenia; his theories were then contested by the French composer Francesco Salvador-Daniel, who after a twelve-year musical sojourn in Algeria concluded, among other things, that Arab and Greek modes were one and the same. Long before ‘ethnomusicology’ was born in academe, the game was well established.
In recent years the ethnomusicologists’ findings have been magisterially presented in two great publications: in the ten massive volumes of the Garland Encyclopedia of World Music, and scattered through the twenty-nine volumes of the New Grove Dictionary of Music and Musicians. But our book is, we believe, the first panoptic survey of the world's classical musics (I explain in the Introduction why we have settled on that somewhat contentious adjective). Although much of its information may also be found in Grove and Garland – many of its writers were contributors to, or editors on, those projects – its tight focus permits presentation in a single volume, rather than scattered through a six-foot shelf of tomes.
As editor I am deeply indebted to my writers, who have patiently put their chapters through numerous drafts in pursuit of non-academic accessibility, while in no way traducing their (often very complicated) subject-matter. I must particularly thank Terry Miller, whose resourceful problem-solving assistance has extended far beyond his own signed contributions; also his colleague Andrew Shahriari, for additional information on Persian classical music.
What is classical music? This book answers the question in a manner never before attempted, by presenting the history of fifteen parallel traditions, of which Western classical music is just one. Eachmusic is analysed in terms of its modes, scales, and theory; its instruments, forms, and aesthetic goals; its historical development, golden age, and condition today; and the conventions governing its performance. The writers are leading ethnomusicologists, and their approach is based on the belief that music is best understood in the context of the culture which gave rise to it . By including Mande and Uzbek-Tajik music - plus North American jazz - in addition to the better-known styles of the Middle East, the Indian sub-continent, the Far East, and South-East Asia, this book offers challenging new perspectives on the word 'classical'. It shows the extent to which most classical traditions are underpinned by improvisation, and reveals the cognate origins of seemingly unrelated musics; it reflects the multifarious ways in which colonialism, migration, and new technology have affected musical development, and continue to do today. With specialist language kept to a minimum, it's designed to help both students and general readers to appreciate musical traditions which may be unfamiliar to them, and to encounter the reality which lies behind that lazy adjective 'exotic'.
MICHAEL CHURCH has spent much of his career in newspapers as a literary and arts editor; since 2010 he has been the music and opera critic of The Independent. From 1992 to 2005 he reported on traditional musics all over the world for the BBC World Service; in 2004, Topic Records released a CD of his Kazakh field recordings and, in 2007, two further CDs of his recordings in Georgia and Chechnya.
Contributors: Michael Church, Scott DeVeaux, Ivan Hewett, David W. Hughes, Jonathan Katz, Roderic Knight, Frank Kouwenhoven, Robert Labaree, Scott Marcus, Terry E. Miller, Dwight F.Reynolds, Neil Sorrell, Will Sumits, Richard Widdess, Ameneh Youssefzadeh