Migrants and refugees face elevated risks for mental health problems but have limited access to services. This study compared two strategies for training and supervising nonspecialists to deliver a scalable psychological intervention, Group Problem Management Plus (gPM+), in northern Colombia. Adult women who reported elevated psychological distress and functional impairment were randomized to receive gPM+ delivered by nonspecialists who received training and supervision by: 1) a psychologist (specialized technical support); or 2) a nonspecialist who had been trained as a trainer/supervisor (nonspecialized technical support). We examined effectiveness and implementation outcomes using a mixed-methods approach. Thirteen nonspecialists were trained as gPM+ facilitators and three were trained-as-trainers. We enrolled 128 women to participate in gPM+ across the two conditions. Intervention attendance was higher in the specialized technical support condition. The nonspecialized technical support condition demonstrated higher fidelity to gPM+ and lower cost of implementation. Other indicators of effectiveness, adoption and implementation were comparable between the two implementation strategies. These results suggest it is feasible to implement mental health interventions, like gPM+, using lower-resource, community-embedded task sharing models, while maintaining safety and fidelity. Further evidence from fully powered trials is needed to make definitive conclusions about the relative cost of these implementation strategies.

This article considers three “unanswered questions” raised by R. (McConnell) v Registrar General for England and Wales (AIRE Centre Intervening) [2020] EWCA Civ. 559, which held that a trans man (with a Gender Recognition Certificate) who gave birth must be registered as “mother” on his child’s birth certificate. This article considers these questions to clearly situate McConnell within the context of the UK’s legal regimes concerning access to fertility treatment, gender recognition and legal parenthood in cases involving assisted reproduction. The article argues that clearly establishing the current legal position will provide the proper context to facilitate any subsequent legal reforms.

This study suggests that there may be considerable difficulties in providing accurate calendar age estimates in the Roman period in Europe, between ca. AD 60 and ca. AD 230, using the radiocarbon calibration datasets that are currently available. Incorporating the potential for systematic offsets between the measured data and the calibration curve using the ΔR approach suggested by Hogg et al. (2019), only marginally mitigates the biases in calendar date estimates observed. At present, it clearly behoves researchers in this period to “caveat emptor” and validate the accuracy of their calibrated radiocarbon dates and chronological models against other sources of dating information.

OBJECTIVES/GOALS: Patients frequently need or desire fat grafting to improve common issues such as implant visibility and contour deformity, often done as a second, staged procedure following immediate reconstruction. This study aimed to identify which patient factors and reconstructive techniques predict the need for revision with AFG after IBBR METHODS/STUDY POPULATION: Patients who underwent IBBR with either tissue expanders or implants following mastectomy from 2017 to 2021 were identified. Demographics, comorbidities, and the postoperative course were reviewed. The primary outcome variable was AFG after the initial reconstruction. Univariate and regression analyses were performed to identify factors predictive of AFG. RESULTS/ANTICIPATED RESULTS: Five-hundred twenty-nine patients were included in our analysis, with 43% having AFG. Univariate regression displayed single-stage reconstruction (OR=0.53, 95% 0.37-0.75) and previous radiation (OR 0.59, 95% 0.35-0.99) negatively predicted the need for AFG, while bilateral breast reconstruction (BBR) was a predictor (OR 2.32, 95% 1.58-3.4). On multivariate analysis, decreasing age and BBR remained predictive of AFG. The odds of AFG decreased by 3% for every one-unit increase in age (95% CI [0.96, 0.99]). Interestingly, neither pre-pectoral breast reconstruction nor specimen weight:implant ratio was associated with increased need for AFG on univariate/multivariate analysis. DISCUSSION/SIGNIFICANCE: Patients requiring AFG were likely younger and had undergone BBR with tissue expanders. Plane of implant did not appear to affect need for AFG. Knowledge of these predictive factors may help plastic surgeons in preoperative counseling before implant-based breast reconstruction.

Radiocarbon data are the most commonly used chronometric measurement technique in archaeology. The introduction of the radiocarbon method offered new potential for independent, internationalized research projects. Today millions of radiocarbon measurements exist globally. However, the many strengths of radiocarbon for research in archaeology have also created an internationally significant challenge in heritage practice. How can we attempt to curate huge volumes of radiocarbon “legacy” data in systematic ways that facilitate interdisciplinary, international research? How can we contend with a dataset that is rapidly scalable, and needs to be kept live—updated, validated, curated, and related to existing national archives and data systems—beyond the timescale of any individual project? In this paper we introduce an international project, “Project Radiocarbon; Big Data, integrated cross-national heritage histories”, working across the historic environment sector in Ireland and the United Kingdom, that is developing a solution to these issues. We argue that we need to think critically about how we classify and curate radiocarbon data, to render them interoperable and findable. Such work requires inter-sector approaches to ensure sustainability and scalability, and to anticipate the increasing value of these data into the future.