In this column, the Editor of the American Journal of Speech-Language Pathology reflects on the value of retrospective record review and considers the design elements that contribute to sound methodology in this format.
After routine mumps immunization programs were implemented in Manitoba in the 1980s, incidence was low, with 0-9 cases of disease annually. In September 2016, a mumps outbreak began in fully vaccinated university students in Winnipeg, Manitoba.We describe the investigation of this province-wide mumps outbreak, which lasted between September 2016 and December 2018. We present the details of public health measures implemented and challenges encountered. Possible contributing factors to the sustained transmission are also provided.Probable and confirmed cases of mumps were investigated by public health departments using the investigation form developed for this outbreak. Confirmed mumps cases were linked to the provincial immunization registry. An outbreak response team planned and implemented control measures across the province.The outbreak began in vaccinated university students in September 2016 and spread across the province. Activity was high and prolonged in the northern remote areas. By the end of 2018, 2,223 cases had been confirmed. All age groups were affected, and incidence was highest among people aged 18-29 years. Two-dose coverage of mumps-containing vaccine in confirmed cases was close to 70%.This prolonged outbreak revealed a large vulnerable population likely resulting from under-vaccination and waning vaccine-induced immunity in the absence of natural boosting from exposure to mumps virus. It is important to maintain high two-dose coverage with mumps-containing vaccines. A third dose of mumps-containing vaccine in future outbreaks may be considered.
Background: From March 2020 to January 2021, Newfoundland and Labrador experienced 408 coronavirus disease 2019 (COVID-19) cases (incidence 78 per 100,000).In February and March 2021, a community outbreak of the B.1.1.7 (Alpha) variant occurred in the Eastern Regional Health Authority.This article describes the epidemiology of this variant of concern outbreak, identifies settings that likely contributed to spread and informs recommendations for public health measures (PHMs).Methods: Provincial surveillance data were linked with case interview data and a school class roster.Descriptive epidemiological methods were used to characterize the outbreak.Secondary attack rates (SAR) were calculated for households and classrooms.Results: This outbreak involved 577 laboratory-confirmed and 38 probable cases.Whole genome sequencing determined cases were B.1.1.7.The median age was 31 years and the highest proportion of cases were in the 15 to 19-year age group (29%); 293 (51%) were female and 140 (24%) were asymptomatic upon identification.Early cases were linked to a high school, sports activities, a restaurant and social gatherings.As the outbreak progressed, cases were associated with household transmission, a daycare, healthcare settings and a workplace.The unadjusted SAR estimate among laboratory-confirmed cases was 24.4% for households and 19.3% for classroom exposures.When adjusted for other potential exposures, SAR estimates were 19.9% for households and 11.3% for classrooms. Conclusion:This outbreak demonstrated how B.1.1.7 spread rapidly through a community with previously low COVID-19 transmission and few preventative PHMs in place.Implementation and compliance with school and community-based PHMs is critical for preventing transmission during outbreaks.
This paper examines the phenomenon of stimulus overselectivity, or overselective attention, as it may impact AAC training and use in individuals with intellectual disabilities. Stimulus overselectivity is defined as an atypical limitation in the number of stimuli or stimulus features within an image that are attended to and subsequently learned. Within AAC, the term stimulus could refer to symbols or line drawings on speech-generating devices, drawings or pictures on low-technology systems, and/or the elements within visual scene displays. In this context, overselective attention may result in unusual or uneven error patterns such as confusion between two symbols that share a single feature, or difficulties with transitioning between different types of hardware. We review some of the ways that overselective attention has been studied behaviorally. We then examine how eye tracking technology allows a glimpse into some of the behavioral characteristics of overselective attention. We describe an intervention approach, differential observing responses, that may reduce or eliminate overselectivity, and we consider this type of intervention as it relates to issues of relevance for AAC.
An abstract is not available for this content so a preview has been provided. As you have access to this content, a full PDF is available via the 'Save PDF' action button.
