Barriers and Opportunities for Sustainable Hand Hygiene Interventions in Rural Liberian Hospitals

Hand hygiene is central to hospital infection control. During the 2014–2016 West Africa Ebola virus disease epidemic in Liberia, gaps in hand hygiene infrastructure and health worker training contributed to hospital-based Ebola transmission. Hand hygiene interventions were undertaken post-Ebola, but many improvements were not sustainable. This study characterizes barriers to, and facilitators of, hand hygiene in rural Liberian hospitals and evaluates readiness for sustainable, locally derived interventions to improve hand hygiene. Research enumerators collected data at all hospitals in Bong and Lofa counties, Liberia, in the period March–May 2020. Enumerators performed standardized spot checks of hand hygiene infrastructure and supplies, structured observations of hand hygiene behavior, and semi-structured key informant interviews for thematic analysis. During spot checks, hospital staff reported that handwashing container water was always available in 89% (n = 42) of hospital wards, piped running water in 23% (n = 11), and soap in 62% (n = 29). Enumerators observed 5% of wall-mounted hand sanitizer dispensers (n = 8) and 95% of pocket-size dispensers (n = 53) to be working. In interviews, hospital staff described willingness to purchase personal hand sanitizer dispensers when hospital-provided supplies were unavailable. Low-cost, sustainable interventions should address supply and infrastructure-related obstacles to hospital hand hygiene improvement

Do children with autism perceive second-order relational features? The case of the Thatcher illusion

Background:This study presents two experiments that investigated whether children with autism were susceptible to the Thatcher illusion. Perception of the Thatcher illusion requires being able to compute second-order configural relations for facial stimuli. Method:In both experiments children with autism were matched for non-verbal and verbal ability with a group of children with moderate (non-specific) mental retardation (MLD) and a group of typically developing children respectively. Participants were asked to detect the ‘unusual’ face in a two-alternative-forced-choice version of the Margaret Thatcher illusion with grey-scale (Experiment 1) and monochrome ‘Mooney’ face images (Experiment 2). In Experiment 1 participants also performed a control task where buildings had been doctored in the same way as the facial stimuli. Results:Children with autism were as susceptible to the Thatcher illusion as both control groups, in terms of accuracy and reaction time to make decisions about which face was unusual. Children with autism performed more accurately than children with MLD in the buildings task. Conclusion:Children with autism are able to compute second-order configural features in faces and exhibit no difference in face processing, relative to appropriate control groups