Wearable technology and daily diaries offer insights into everyday behaviors that can further health research and treatment globally. However, the use of these methodologies outside of high-income settings has been limited. We conducted two pilot studies that enrolled 60 young women in the urban slums of Kampala, Uganda to understand design considerations associated with using wearable technology and daily diaries in this context. Each participant in the pilot studies was asked to wear a wearable activity tracker and complete daily diary questionnaires for 5 days. Based on our experiences, we identified several lessons that may be beneficial to others interested in implementing wearable technology and daily self-reports in their research and interventions, particularly when working in low-resource contexts. We discuss the importance of designing solutions tailored to the available resources, building validation for the most critical measures, investing in data management efforts and providing transparent and culturally accessible information to participants. Examples from our study are provided. These lessons may reduce the barriers and improve data quality for future researchers and practitioners interested in using these data collection methods globally.

Separation-related behaviours (SRBs) in dogs (Canis familiaris) often indicate poor welfare. Understanding SRB risk factors can aid prevention strategies. We investigated whether early-life experiences and dog-owner interactions affect SRB development. Using a longitudinal study, we conducted exploratory analyses of associations between potential risk factors and SRB occurrence in six month old puppies (n = 145). Dogs were less likely to develop SRBs if owners reported that, at ≤ 16 weeks old, puppies were restricted to crates/rooms overnight and had ≥ 9 h of sleep per night. Puppies with poor house-training at ≤ 16 weeks were more likely to show SRBs, as were those trained using dog treats or novel kibble versus other rewards. Puppies whose owners used more punishment/aversive techniques when responding to ‘bad’ behaviour had increased odds of SRBs at six months versus other puppies. Puppies whose owners reported ‘fussing’ over their dogs at six months in response to ‘bad’ behaviour upon their return, versus those whose owners responded in other ways, were six times more likely to display SRBs. Other factors, including dog breed, sex and source, showed no significant association with SRB occurrence. Thus, SRB development might be prevented by enabling sleep for ≥ 9 h in early life, providing enclosed space overnight, refraining from aversive training of puppies generally, and avoiding fussing over puppies in response to unwanted behaviour following separation. These recommendations derive from correlational longitudinal study results, so analysis of interventional data is required for confirmation regarding effective prevention strategies.

OBJECTIVES/GOALS: We adapted the Serious Illness Care Program (SICP), an evidence-based intervention designed to promote early serious illness conversation, to be delivered via telehealth for older patients with acute myeloid leukemia and myelodysplastic syndromes. The purpose of this study is to assess the feasibility and usability of the adapted intervention. METHODS/STUDY POPULATION: We are conducting a single-arm pilot study of an adapted SICP that is delivered via telehealth for older patients with AML or MDS (>=60 years) and their caregivers (if available). The adapted SICP includes: 1) Patient preparation pamphlet: sent to patient prior the visit with their clinician, 2) Geriatric assessment: completed by study team and provided to clinician prior to their visit with the patient, 3) A 30-60 minute telehealth visit with their primary oncologist or oncology advance practitioner, 4) Serious Illness Conversation Guide (SICG): used by the clinician during the visit to elicit patient values, 5) Family guide: provided to patient following their visit to help patient’s share their values with their family, 6) Electronic medical record note template for clinicians to document their visit the patient. RESULTS/ANTICIPATED RESULTS: We hypothesize that the adapted SICP intervention will be feasible and usable. We will assess feasibility based on retention rate (percent of patients who consent and complete the visit); >80% is considered feasible. Usability will be assessed using the telehealth usability questionnaire; an average score of >5 is considered usable. Other measures include psychological health, advance care planning engagement, quality of life, and disease understanding. We plan to enroll 20 patients in this study. To date, 11 patients have consented to participate, 10 patients have scheduled SICP visits, 9 patients have completed their visits, 7 patients have completed post-intervention qualitative interviews, and 4 patients have completed post-intervention surveys. DISCUSSION/SIGNIFICANCE: The adapted telehealth-based SICP may promote early serious illness conversation, patient-reported outcomes, and end-of-life experience for older patients with AML and MDS. Results from this study will be used to inform development of clinical trials testing the impact of the adapted SICP on patient- and caregiver-reported outcomes.

Long-term sequelae of severe acute respiratory coronavirus-2 (SARS-CoV-2) infection may include increased incidence of diabetes. Here we describe the temporal relationship between new type 2 diabetes and SARS-CoV-2 infection in a nationwide database. We found that while the proportion of newly diagnosed type 2 diabetes increased during the acute period of SARS-CoV-2 infection, the mean proportion of new diabetes cases in the 6 months post-infection was about 83% lower than the 6 months preinfection. These results underscore the need for further investigation to understand the timing of new diabetes after COVID-19, etiology, screening, and treatment strategies.

Sleep is vital for our physical and mental health. Studies have shown that there is a high prevalence of sleep disorders and sleep difficulties amongst adults with intellectual disabilities. Despite this, sleep is often overlooked or its disorders are considered to be difficult to treat in adults with intellectual disabilities. There is a significant amount of research and guidance on management of sleep disorders in the general population. However, the evidence base for sleep disorders in adults with intellectual disabilities is limited. In this review paper, we look at the current evidence base for sleep disorders in adults with an intellectual disability, discuss collaborative working between intellectual disabilities psychiatrists and sleep medicine specialists to manage sleep disorders, and provide recommendations for future directions.

UK universities re-opened in September 2020, amidst the coronavirus epidemic. During the first term, various national social distancing measures were introduced, including banning groups of >6 people and the second lockdown in November; however, outbreaks among university students occurred. We aimed to measure the University of Bristol staff and student contact patterns via an online, longitudinal survey capturing self-reported contacts on the previous day. We investigated the change in contacts associated with COVID-19 guidance periods: post-first lockdown (23/06/2020–03/07/2020), relaxed guidance period (04/07/2020–13/09/2020), ‘rule-of-six’ period (14/09/2020–04/11/2020) and the second lockdown (05/11/2020–25/11/2020). In total, 722 staff (4199 responses) and 738 students (1906 responses) were included in the study. For staff, daily contacts were higher in the relaxed guidance and ‘rule-of-six’ periods than the post-first lockdown and second lockdown. Mean student contacts dropped between the ‘rule-of-six’ and second lockdown periods. For both staff and students, the proportion meeting with groups larger than six dropped between the ‘rule-of-six’ period and the second lockdown period, although was higher for students than for staff. Our results suggest university staff and students responded to national guidance by altering their social contacts. Most contacts during the second lockdown were household contacts. The response in staff and students was similar, suggesting that students can adhere to social distancing guidance while at university. The number of contacts recorded for both staff and students were much lower than those recorded by previous surveys in the UK conducted before the COVID-19 pandemic.

The National Center for Advancing Translational Sciences (NCATS) has defined translation as the process of turning observations into interventions that are adopted, sustained, and improve health. Translation must attend to research and community systems and context at multiple levels, and to key stakeholders. Dissemination and implementation (D&I) sciences are informed by an understanding of the critical role of people and systems in disseminating, adopting, and sustaining innovations within real-world settings. Thus, the D&I sciences provides a set of principles that can guide the translational work of Clinical and Translational Science Award (CTSA) programs from basic research to public health. In this special communication, our cross-domain working group of the CTSA consortium, comprised of experts in methods and processes, workforce development, evaluation, stakeholder engagement, and D&I sciences, share a vision of how CTSAs can enhance translation across the translational spectrum through the integration of D&I sciences into the critical areas of methods and processes, workforce development, and evaluation. We propose a set of recommendations for NCATS national and local leaders that are intended to move D&I sciences out of a position of unfamiliarity and ancillary value and into the core identity of who CTSAs are, how they think, and what they do, to advance translation and health.

Supraglacial ponds and ice cliffs can dramatically enhance ablation rates on debris-covered glaciers. Supraglacial ponds can also coalesce, forming moraine-dammed lakes at risk of glacial lake outburst flood (GLOF). Given Bhutanese glaciers have some of the highest ice loss rates in the Himalaya and GLOF vulnerability is high, we seek to advance our understanding of the spatial distribution and evolution of supraglacial ponds and ice cliffs. Here, we use high-resolution (3 m) Planet Labs satellite imagery to provide the first short-term, high-resolution dataset of supraglacial pond and ice cliff evolution for three glaciers along the Bhutan–Tibet border from 2016 to 2018. A total of 5754 ponds and 2088 ice cliffs were identified. Large intra-annual changes were observed, with ponded area changes and drainage events coinciding with the seasonality of the Indian Summer Monsoon. On average, ~19% of the total number of ponds had a coincident ice cliff. Pond spatial distribution was driven by ice-surface velocities, with higher numbers of ponds found in areas of low velocity (<8 m a−1). Our study provides the first detailed, quantitative investigation of supraglacial ponds and ice cliffs in Bhutan, providing a framework for further monitoring in this understudied, yet important, region of the Himalaya.

The investigation of Islamic archaeology in Ethiopia has until recently been neglected. Excavations at Harlaa, a large urban centre in eastern Ethiopia, are now beginning to redress this lack of research attention. By establishing occupation and material sequences, and by assessing the chronology and material markers of Islamisation, recent work provides important new insight on the presence and role of Muslims and Islamic practice at Harlaa, and in the Horn of Africa more generally. The results challenge previous assumptions of cultural homogeneity, instead indicating the development of cosmopolitanism. They also suggest a possible historical identity for Harlaa: as Hubät/Hobat, the capital of the Hārlā sultanate.