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Background/Purpose: Infants with cleft lip and/or palate require special care from birth in order to adapt to the cleft and overcome insufficient suction, difficulties in breastfeeding, insufficient food intake, and malnutrition. Early nutritional intervention, as well as nutritional care and guidance, are extremely important for them to achieve their potential in terms of growth, development, and preparation for surgery. Mothers should receive training and have access to appropriate feeding assistance to optimize their children's nutrition, health, and survival rate. The purpose is to provide feeding assistance by training mothers, using the manuals prepared by our specialized multidisciplinary team. Methods/Description: Planning, preparation and dissemination of instruction/educational manuals that are accessible and easy to understand, by the team of otolaryngologists, pediatricians, nurses, nutritionists, speech-language therapist, dental professionals, and lactation specialists who prepared straightforward and fun manuals that have been used since May 2021, in treatment centers all over Brazil. Results: Breastfeeding Manual: the importance of breast milk;breast physiology, latching;various breastfeeding positions;expressing breast milk manually or using a pump;best nipple for each cleft, breastfeeding position;burping (eructation);types of milk formulas and dilution, hygiene, and preparation techniques. Manual on Introducing Food and Feeding in the Post-Surgical Feeding and Foods: introducing additional foods, food quality and quantity;techniques to offer food;child positioning;food consistency;care after lip surgery (cheiloplasty) and after palate surgery (palatoplasty), such as: raising the crib;using bracelets to prevent the child from touching his/ her mouth and thus hindering the healing process;when to change the food consistency;weaning from the bottle and pacifier, and the use of glasses and spoons;recipes. Manual Guide to Anthropometric Measurements: teaching mothers to check their children's weight, height, head, thoracic, and brachial circumference and to send this information to nutritionists/pediatricians, for monitoring and interventions, as needed. Conclusions: Since the onset of the COVID-19 pandemic, the need to provide training to the parents of patients with cleft has become increasingly evident, so as to provide nutritional care at home needed for the appropriate growth and development of infants, even with less frequent in-person appointments. Considering that cleft babies begin to be submitted to surgical procedures at 3 months old, nutritional care must include growth, development, and preparation for these surgeries. Providing support for the mothers is essential for them to overcome challenges and to adopt best practices in feeding their children. Training them to do that is certainly the best way. This work was supported by Smile Train, Inc.
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This article proposes the characterization and analysis of domestic work in various European economies based on its definition and the clarification of the measurement criteria. Next, an analysis of domestic work is carried out in a selection of European countries, focusing on the trends before and after the arrival of the pandemic. The results allow us to conclude that the southern European countries require a regulatory change that promotes the improvement of working conditions in this sector and that, in turn, respond to the care needs of many households with economic difficulties. © 2022, Universidad de Huelva. All rights reserved.
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OBJECTIVE: Studies about SARS-CoV-2 transmission at school settings have been outbreaks or schools clusters. There are scarce population-based studies has been studied. We aimed at describing SARS-CoV-2 school-related transmission and its relationship with baseline community cumulative incidence rate in the Basque Country after school reopening in order to inform Public Health decision-making. METHODS: We conducted a scholar surveillance population-based study of SARS-CoV-2 transmission from 7 September to 31 October 2020. We calculated percentages of cases in school-age population, secondary attack rates by education level among close contacts and correlation between population's and scholars' incidence rates at municipal level. RESULTS: There were 35,477 SARS-CoV-2 laboratory confirmed cases. Among them, 7.65% happened at school settings. Secondary attack rate at schools ranged from 2.9%, in preschools to 7.1% in high schools;Scholars caused a household and social secondary attack rate from 13% (high scholars) to 23.2% (elementary scholars). We found a low correlation between population's and scholars' incidence rates at municipal level (R2=0.047). CONCLUSIONS: Secondary attack rate at school settings increased as educational level did;conversely, to social and family secondary attack rate, that decreased with higher educational level. School attendance, during a SARS-CoV-2 high transmission period showed feasible and did not rise transmission. These findings happened under strict non-pharmaceutical measures at school settings and proper epidemiological surveillance, including tracing of laboratory confirmed cases of SARS-CoV-2 looking for close contacts, isolation and testing of close contacts during isolation period. The different degree of transmission of the circulating variants in the different periods of the pandemic must also be taken into account.
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Aims Some guidelines suggest to contact patients 14 days after the endoscopic procedure to evaluate their clinicalsituation, aiming to identify nosocomial SARS-CoV-2 infection. Our aim was to assess the clinical usefulness of thisrecommendation in an endoscopy unit during the first wave and the recovery phase of the COVID-19 pandemic. Methods From March 2020 to July 2020 (first wave and recovery phase), every patient undergoing an endoscopicexamination in our unit was contacted by phone 14 days after the procedure to check about the presence of COVID-19-related symptoms and to inquire about any new SARS-CoV-2 infection diagnosis using a predesigned questionnaire. Most ofthe patients had a preprocedure nasopharyngal swab testing for SARS-CoV-2 (PCR), and all procedures were performedusing a full PPE. Results 424 inpatients (A) and 1187 outpatients (B) were included. Their main characteristics are summarized in [table 1].Overall, 211 patients (13.1 %) had symptoms that could be related to COVID-19. However, only two cases of SARS-CoV-2positive PCR were detected (0,12 %), one in each group. The +PCR in group A was during the first wave and the +PCR ingroup B was during the recovery phase. Positive group A patient was detected during her admission because complicationsof a multiple myeloma. Positive group B patient was detected because typical COVID-19 symptoms. No infection inhealthcare workers related to these procedures was detected. Conclusions 1) The rate of SARS-CoV-2 infection in patients undergoing an endoscopic examination is exceedingly loweven during the acceleration phase;2) The practical relevance of a control telephone call 14 days post-procedure isquestionable. (Table Presented).
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A novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak has become a global ongoing pandemic. This pandemic represents a great work risk for all health professionals, it includes dental professionals who are in constant contact with saliva, which represents one of the main routes of transmission of the disease. This is due to the fact that a wide variety of oral tissues and cells are susceptible to infection by SARS-CoV-2 and that they express the ACE2 receptor, which is the main route of entry of the virus into cells, as well as the proteins TMPRSS and furin that contributes to the binding of the virus to the host cells. According to recent studies, some of the oral cells most susceptible to infection by SARS-CoV-2 are the epithelial cells of the salivary glands. This explains the presence of the virus in the saliva of infected patients and provides scientific evidence that supports the use of saliva as a biofluid that offers the opportunity to develop new detection and diagnostic techniques. This is because saliva is much easier to collect compared to nasopharyngeal swab. However, the presence of the virus in saliva, also represents a great source of transmission, since the main form of infection is through microscopic drops that are generated when infected people cough or sneeze. Likewise, health professionals, such as dentists are exposed to contagion through saliva. The objective of this review article is to provide a perspective on the main cells and tissues that can be affected by the virus, the risk of contagion that the presence of the virus in saliva represents for dentists;and the new techniques developed from saliva samples for the diagnosis and surveillance of SARS-CoV-2 infection. This review is expected to contribute to the knowledge of oral health professionals about the risk of saliva in the spread of SARS-CoV-2, but also its advantages as a diagnostic tool for pandemic control. In conclusion, the authors can mention that information that provides more scientific evidence of the mechanisms of infection of the coronavirus in oral cells and tissues is being published continually. This also explains the presence of the virus in the saliva of infected people and the risk of contagion that this means. It also provides scientific evidence of the use of saliva as a biofluid for the detection, diagnosis, monitoring, and control of the spread of the virus.
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Patients infected with the new coronavirus COVID-19 have an increased risk of venous thromboembolic disease (VTEV). The present clinical practice guide of the Spanish Chapter of Phlebology and Lymphology and the Spanish Society of Angiology and Vascular Surgery, aims to give a series of recommendations on prophylaxis and treatment of VTE in patients infected with COVID-19, both at the hospital and outpatient, and advice on their clinical and ultrasound monitoring. It is recommended that all hospitalized patients with COVID-19 infection, whether or not they have associated prothrombotic risk factors, should receive antithrombotic prophylaxis, if there is no contraindication. In the case of outpatients, according to clinical profile and medical history, it is recommended to evaluate thromboprophylaxis with low molecular weight heparin (LMWH), in the absence of contraindication. Given the diagnosis of DVT in a patient with COVID19, both hospitalized and outpatient, anticoagulant treatment with LMWH should be started at therapeutic doses. There are no described pharmacological interactions of HPBMs with the drugs used against COVID19. High levels of D-dimer are a common finding in patients with COVID-19, so this parameter, in isolation, is not indicative for routine Doppler ultrasound. Doppler ultrasound is recommended for a COVID-19 positive patient (with the necessary protective measures), to rule out DVT, only in patients with high clinical suspicion of DVT, and when one of the two clinical situations occurs: High risk of bleeding, or a sudden and unexpected increase in D-dimer levels. ©Copyright 2020 SEACV.
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Europe’s capacity to explore the envisaged pathways that achieve its near- and long-term energy and climate objectives needs to be significantly enhanced. In this perspective, we discuss how this capacity is supported by energy and climate-economy models, and how international modelling teams are organised within structured communication channels and consortia as well as coordinate multi-model analyses to provide robust scientific evidence. Noting the lack of such a dedicated channel for the highly active yet currently fragmented European modelling landscape, we highlight the importance of transparency of modelling capabilities and processes, harmonisation of modelling parameters, disclosure of input and output datasets, interlinkages among models of different geographic granularity, and employment of models that transcend the highly harmonised core of tools used in model inter-comparisons. Finally, drawing from the COVID-19 pandemic, we discuss the need to expand the modelling comfort zone, by exploring extreme scenarios, disruptive innovations, and questions that transcend the energy and climate goals across the sustainability spectrum. A comprehensive and comprehensible multi-model framework offers a real example of “collective” science diplomacy, as an instrument to further support the ambitious goals of the EU Green Deal, in compliance with the EU claim to responsible research.