Facilitators and barriers to engagement with contact tracing during infectious disease outbreaks: A rapid review of the evidence

BACKGROUND: Until a vaccine is developed, a test, trace and isolate strategy is the most effective method of controlling the COVID-19 outbreak. Contact tracing and case isolation are common methods for controlling infectious disease outbreaks. However, the effectiveness of any contact tracing system rests on public engagement. Numerous factors may influence an individual's willingness to engage with a contact tracing system. Understanding these factors has become urgent during the COVID-19 pandemic. OBJECTIVE: To identify facilitators and barriers to uptake of, and engagement with, contact tracing during infectious disease outbreaks. METHOD: A rapid systematic review was conducted to identify papers based on primary research, written in English, and that assessed facilitators, barriers, and other factors associated with the uptake of, and engagement with, a contact tracing system. PRINCIPAL FINDINGS: Four themes were identified as facilitators to the uptake of, and engagement with, contact tracing: collective responsibility; personal benefit; co-production of contact tracing systems; and the perception of the system as efficient, rigorous and reliable. Five themes were identified as barriers to the uptake of, and engagement with, contact tracing: privacy concerns; mistrust and/or apprehension; unmet need for more information and support; fear of stigmatization; and mode-specific challenges. CONCLUSIONS: By focusing on the factors that have been identified, contact tracing services are more likely to get people to engage with them, identify more potentially ill contacts, and reduce transmission

Cost-effectiveness of psychological interventions for children and young people with post-traumatic stress disorder

Background: PTSD in youth may lead to long‐lasting psychological implications, educational difficulties and increased healthcare costs. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost‐effectiveness of a range of psychological interventions for children and young people with PTSD. / Methods: A decision‐analytic model was constructed to compare costs and quality‐adjusted life years (QALYs) of 10 psychological interventions and no treatment for children and young people with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta‐analysis. Other model input parameters were based on published sources, supplemented by expert opinion. / Results: Cognitive therapy for PTSD, a form of individual trauma‐focused cognitive behavioural therapy (TF‐CBT), appeared to be the most cost‐effective intervention for children and young people with PTSD (with a probability of .78 amongst the 11 evaluated options at a cost‐effectiveness threshold of £20,000/QALY), followed by narrative exposure (another form of individual TF‐CBT), play therapy, and other forms of individual TF‐CBT. After excluding cognitive therapy from the analysis, narrative exposure appeared to be the most cost‐effective option with a .40 probability of being cost‐effective amongst the remaining 10 options. EMDR, parent training and group TF‐CBT occupied middle cost‐effectiveness rankings. Family therapy and supportive counselling were less cost‐effective than other active interventions. There was limited evidence for some interventions, in particular cognitive therapy for PTSD and parent training. / Conclusions: Individual forms of TF‐CBT and, to a lesser degree, play therapy appear to be cost‐effective in the treatment of children and young people with PTSD. Family therapy and supportive counselling are unlikely to be cost‐effective relative to other interventions. There is a need for well‐conducted studies that examine the long‐term clinical and cost‐effectiveness of a range of psychological treatments for children and young people with PTSD

Atypical audiovisual speech integration in infants at risk for autism

The language difficulties often seen in individuals with autism might stem from an inability to integrate audiovisual information, a skill important for language development. We investigated whether 9-month-old siblings of older children with autism, who are at an increased risk of developing autism, are able to integrate audiovisual speech cues. We used an eye-tracker to record where infants looked when shown a screen displaying two faces of the same model, where one face is articulating/ba/and the other/ga/, with one face congruent with the syllable sound being presented simultaneously, the other face incongruent. This method was successful in showing that infants at low risk can integrate audiovisual speech: they looked for the same amount of time at the mouths in both the fusible visual/ga/− audio/ba/and the congruent visual/ba/− audio/ba/displays, indicating that the auditory and visual streams fuse into a McGurk-type of syllabic percept in the incongruent condition. It also showed that low-risk infants could perceive a mismatch between auditory and visual cues: they looked longer at the mouth in the mismatched, non-fusible visual/ba/− audio/ga/display compared with the congruent visual/ga/− audio/ga/display, demonstrating that they perceive an uncommon, and therefore interesting, speech-like percept when looking at the incongruent mouth (repeated ANOVA: displays x fusion/mismatch conditions interaction: F(1,16) = 17.153, p = 0.001). The looking behaviour of high-risk infants did not differ according to the type of display, suggesting difficulties in matching auditory and visual information (repeated ANOVA, displays x conditions interaction: F(1,25) = 0.09, p = 0.767), in contrast to low-risk infants (repeated ANOVA: displays x conditions x low/high-risk groups interaction: F(1,41) = 4.466, p = 0.041). In some cases this reduced ability might lead to the poor communication skills characteristic of autism

Perinatal mental ill health - the experiences of women from ethnic minority groups

This study aimed to investigate ethnic minority women’s experiences and opinions of perinatal mental health problems and the provision of perinatal mental health support services. An exploratory survey was undertaken using a questionnaire. Quantitative data were analysed using descriptive statistics and a simple thematic analysis was used for the qualitative data. A total of 51 responses from women of 14 different ethnic minority backgrounds were analysed. Women from minority ethnic groups face barriers to seeking help for perinatal mental ill health as a result of ongoing stigma and the poor attitudes and behaviours of health professionals and inappropriately designed services. Future interventions should focus on providing adequate cultural competency for health care professionals and ensure that all women are able to access culturally appropriate spaces to talk and be listened to within community settings and wider services

No rapid audiovisual recalibration in adults on the autism spectrum

Autism spectrum disorders (ASD) are characterized by difficulties in social cognition, but are also associated with atypicalities in sensory and perceptual processing. Several groups have reported that autistic individuals show reduced integration of socially relevant audiovisual signals, which may contribute to the higher-order social and cognitive difficulties observed in autism. Here we use a newly devised technique to study instantaneous adaptation to audiovisual asynchrony in autism. Autistic and typical participants were presented with sequences of brief visual and auditory stimuli, varying in asynchrony over a wide range, from 512 ms auditory-lead to 512 ms auditory-lag, and judged whether they seemed to be synchronous. Typical adults showed strong adaptation effects, with trials proceeded by an auditory-lead needing more auditory-lead to seem simultaneous, and vice versa. However, autistic observers showed little or no adaptation, although their simultaneity curves were as narrow as the typical adults. This result supports recent Bayesian models that predict reduced adaptation effects in autism. As rapid audiovisual recalibration may be fundamental for the optimisation of speech comprehension, recalibration problems could render language processing more difficult in autistic individuals, hindering social communication

Increased Activity of Cell Surface Peptidases in HeLa Cells Undergoing UV-Induced Apoptosis Is Not Mediated by Caspase 3

We have previously shown that in HeLa cells treated with a variety of agents there is an increase in cell surface peptidase (CSP) activity in those cells undergoing apoptosis. The increase in CSP activity observed in UVB-irradiated cells undergoing apoptosis was unaffected when the cultures were treated with the aminopeptidase inhibitor bestatin, and matrix metalloprotease inhibitor BB3103, but greatly enhanced when treated with the caspase 3 inhibitor-DEVD, and reduced in the presence of the poly(ADP-ribose) polymerase (PARP) inhibitor-3-aminobenzamide (3AB). Neither 3AB nor DEVD had an effect on the gross morphology of the apoptotic cells observed under electron microscopy, nor did they have an effect on phosphatidylserine eversion on the cell membrane, or that of PARP cleavage. All the agents except for DEVD had no effect on the level of caspase 3 activity in the cells. The results suggest that other caspases may cleave PARP in these cells. Both 3AB and DEVD treatment reduced the level of actin cleavage seen in the apoptotic cells. The increase in CSP activity observed in cells undergoing UVB-induced apoptosis appears to involve PARP but not caspase 3

A neural oscillations perspective on phonological development and phonological processing in developmental dyslexia

Children’s ability to reflect upon and manipulate the sounds in words (’phonological awareness’) develops as part of natural language acquisition, supports reading acquisition, and develops further as reading and spelling are learned. Children with developmental dyslexia typically have impairments in phonological awareness. Many developmental factors contribute to individual differences in phonological development. One important source of individual differences may be the child’s sensory/neural processing of the speech signal from an amplitude modulation (~ energy or intensity variation) perspective, which may affect the quality of the sensory/neural representations (’phonological representations’) that support phonological awareness. During speech encoding, brain electrical rhythms (oscillations, rhythmic variations in neural excitability) re-calibrate their temporal activity to be in time with rhythmic energy variations in the speech signal. The accuracy of this neural alignment or ’entrainment’ process is related to speech intelligibility. Recent neural studies demonstrate atypical oscillatory function at slower rates in children with developmental dyslexia. Potential relations with the development of phonological awareness by children with dyslexia are discussed.Medical Research Council, G0400574 and G090237

Sensory theories of developmental dyslexia: three challenges for research.

Recent years have seen the publication of a range of new theories suggesting that the basis of dyslexia might be sensory dysfunction. In this Opinion article, the evidence for and against several prominent sensory theories of dyslexia is closely scrutinized. Contrary to the causal claims being made, my analysis suggests that many proposed sensory deficits might result from the effects of reduced reading experience on the dyslexic brain. I therefore suggest that longitudinal studies of sensory processing, beginning in infancy, are required to successfully identify the neural basis of developmental dyslexia. Such studies could have a powerful impact on remediation.This is the accepted manuscript. The final version is available from NPG at http://www.nature.com/nrn/journal/v16/n1/abs/nrn3836.html

The feasibility of a role for community health workers in integrated mental health care for perinatal depression: a qualitative study from Surabaya, Indonesia.

BACKGROUND: Indonesian maternal health policies state that community health workers (CHWs) are responsible for detection and referral of pregnant women and postpartum mothers who might suffer from mental health problems (task-sharing). The documents have been published for a while, however reports on the implementation are hardly found which possibly resulted from feasibility issue within the health system. AIMS: To examine the feasibility of task-sharing in integrated mental health care to identify perinatal depression in Surabaya, Indonesia. METHODS: Semi-structured interviews were conducted with 62 participants representing four stakeholder groups in primary health care: program managers from the health office and the community, health workers and CHWs, mental health specialists, and service users. Questions on the feasibility were supported by vignettes about perinatal depression. WHO's health systems framework was applied to analyse the data using framework analysis. RESULTS: Findings indicated the policy initiative is feasible to the district health system. A strong basis within the health system for task-sharing in maternal mental health rests on health leadership and governance that open an opportunity for training and supervision, financing, and intersectoral collaboration. The infrastructure and resources in the city provide potential for a continuity of care. Nevertheless, feasibility is challenged by gaps between policy and practices, inadequate support system in technologies and information system, assigning the workforce and strategies to be applied, and the lack of practical guidelines to guide the implementation. CONCLUSION: The health system and resources in Surabaya provide opportunities for task-sharing to detect and refer cases of perinatal depression in an integrated mental health care system. Participation of informal workforce might facilitate in closing the gap in the provision of information on perinatal mental health

Electrophysiological correlates of audio-visual integration of spoken words in typical development and autism spectrum disorder

This thesis examined audio-visual (AV) integration effects in speech processing using event-related potentials (ERP) in healthy adults, adolescents and children. In a further study ERP recordings in adolescent boys with autistic spectrum disorder were compared to matched typically developing boys. ERP effects were examined in three post-stimulus time windows: the N1 time window as a measure of sensitivity to word onset; the P2 as a measure of transition from phonetic to lexical-semantic processing; and the N4 as a measure of semantic processing. Participants were presented with monosyllabic words in four conditions: auditory-only, visualonly, audio-visual with face, and audio-visual with scrambled face. The study reports on the modulation of ERP due to such multimodal interactions between visual and auditory input, its developmental trajectory and evidence for disruption in ASD