Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 335
Filter
Add filters

Year range
1.
Topics in Antiviral Medicine ; 30(1 SUPPL):249, 2022.
Article in English | EMBASE | ID: covidwho-1880130

ABSTRACT

Background: COVID-19 infection-associated cognitive and olfaction impairments have an unclear pathogenesis, possibly related to systemic disease severity, hypoxia, or illness-associated anxiety and depression. A biomarker for these neurocognitive changes is lacking. The kynurenine pathway (KP) is an interferon stimulated myeloid cell mediated tryptophan degradation pathway important in immune tolerance, neurotoxicity and vascular injury, that is dysregulated in COVID-19. We hypothesized that neurocognitive impairments were associated with an activated KP. Methods: The current analysis includes COVID-19 patients as part of the ADAPT study, a prospective cohort (St Vincent's Hospital Sydney, Australia). Disease severity was assessed with 18 acute symptoms and hospitalization status. Blood samples were taken 2 months (N=136) and 4 months (N=121) post diagnosis along with cognitive (Cogstate Computerized Battery, CBB;NIH toolbox Odor Identification Test, OIT) and mental health screenings (DMI-10;IESR, SPHERE-34 Psychological subscale grouped into a composite score). KP metabolites (PIC, QUIN, 3HK, 3HAA, AA, KYN, TRP, log for analyses except for TRP) were measured by GC-MS and uHPLC. The CBB and OIT data were demographically-corrected. CBB follow-up data was also corrected for practice effect. Linear mixed effect regression models with time effect (days post diagnosis) tested whether cognition, and olfaction were associated the KP (main and time interaction);while correcting for disease severity, mental health and comorbidities. Results: 136 patients: mean age=46±15;40% females;90% English speaking background;disease severity: 40% mild, 50% moderate, 10% severe/hospitalised;34% treated comorbidities. At 2 months post diagnosis, 16% had cognitive impairment, and 25% had impaired olfaction. Cognitive impairment was more common in those with anosmia (p=.05). At 4 months, 23% had cognition impairment and 20% had impaired olfaction. QUIN (p=.001), 3HAA (p<.0001) increased over the study period, while TRP decreased (p=.02). QUIN level associated with poorer cognitive scores (p=.0007;QUIN (nM) between 800-1000 was most predictive). There was no time∗QUIN interaction. QUIN association to cognition persisted when severe cases were excluded (p<.005). Conclusion: COVID-19 is associated with KP activation, and the latter with cognitive impairment. QUIN was the only biomarker associated with cognitive impairment, and may be useful in monitoring and elucidating COVID-19 neuropathogenesis and treatment.

2.
Stud Health Technol Inform ; 290: 924-928, 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1879429

ABSTRACT

Children with speech sound disorders should attend speech and language therapy and should practice the speech exercises regularly to surpass their speech difficulties. Since doing the speech exercises often may be tedious, there is the need to motivate children to practice them. During the COVID-19 pandemic, speech and language pathologists had the need to adapt their procedures to others with less physical contact. Here, we propose two serious games to motivate children with sigmatism on doing the speech exercises, which can be used at home and during face-to-face and online speech therapy sessions. The games use automatic speech recognition to classify speech productions. Visual and auditory feedback are used to help children understand their performance, and a hint system is used to help them perform the exercises correctly. A dynamic difficulty adjustment system is used to change the level of difficulty according to the child's speech performance in previous trials.


Subject(s)
COVID-19 , Speech Sound Disorder , Child , Humans , Pandemics , Speech , Speech Disorders/therapy , Speech Therapy/methods
3.
Stud Health Technol Inform ; 290: 919-923, 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1879428

ABSTRACT

People with Parkinson's disease (PD) can have dysarthria, a voice disorder that affects speech intelligibility. To fight this disorder people may resort to speech and language therapy. Unfortunately, weekly speech therapy sessions may not be enough, because to achieve and maintain good voice quality, intensive training is required. Additionally, the COVID-19 pandemic brought attention to the need for alternative speech therapy treatments that complement face-to-face appointments. Here, we propose a serious therapy game to improve voice loudness that can be used for intensive therapy or when face-to-face appointments are not possible. The game integrates three voice exercises used in speech therapy sessions for people with PD and aims to provide motivation for patients to perform the exercises on a daily basis. This application evaluates the vocal intensity, vocal frequency and maximum phonation time, offering real-time visual feedback. It also allows pathologists to customize the exercises difficulty to the needs of each patient.


Subject(s)
COVID-19 , Parkinson Disease , Voice , Dysarthria/etiology , Dysarthria/therapy , Humans , Pandemics , Parkinson Disease/complications , Parkinson Disease/therapy , Speech Therapy
4.
7th International Conference on Computing in Engineering and Technology, ICCET 2022 ; 303 SIST:263-276, 2022.
Article in English | Scopus | ID: covidwho-1877799

ABSTRACT

A subset of machine learning is called Deep Learning (DL). Due to its intelligent behavior, it is used in various applications like speech recognition, face recognition, detection of an image, Natural Language Processing (NLP), analysis of video images, etc. Medical image processing is one of the significant area where deep learning network performance is proved outstanding. DL is used in image classification, dimensionality reduction, feature learning, detection, etc. The large volume of image data is processed and analyzed to predict disease is absent/present. In 2019, the COVID-19 virus was detected and started spreading through the community transmission rapidly, and several people lost their lives due to lack of treatment. Almost all hospitals all over the countries were overloaded heavily, and the Medical Health Care System was affected significantly. To fight against such a tough time, many researchers put their efforts day and night into designing effective deep learning models that can accurately speed up the COVID-19 viral diagnosis process. With this knowledge, a review of various deep learning algorithms and techniques for diagnosing Covid-19 cases is presented in this paper. It starts with the introduction of deep learning, its architecture, and different deep learning algorithms used to diagnose COVID-19 cases with key issues and challenges that significantly impact the detection of COVID-19 cases. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

5.
Mobile Information Systems ; 2022, 2022.
Article in English | Scopus | ID: covidwho-1874892

ABSTRACT

Due to the recent increase in non-face-To-face services due to COVID-19, the number of users communicating through messengers or SNS (social networking service) is increasing. As a large amount of data is generated by users, research on recognizing emotions by analyzing user information or opinions is being actively conducted. Conversation data such as SNS is freely created by users, so there is no set format. Due to these characteristics, it is difficult to analyze using AI (artificial intelligence), which leads to a decrease in the performance of the emotion recognition technique. Therefore, a processing method suitable for the characteristics of unstructured data is required. Among the unstructured data, most emotion recognition in Korean conversation recognizes a single emotion by analyzing emotion keywords or vocabulary. However, since multiple emotions exist complexly in a single sentence, research on multilabel emotion recognition is needed. Therefore, in this paper, the characteristics of unstructured conversation data are considered and processed for more accurate emotion recognition. In addition, we propose a multilabel emotion recognition technique that understands the meaning of dialogue and recognizes inherent and complex emotions. A deep learning model was compared and tested as a method to verify the usefulness of the proposed technique. As a result, performance was improved when it was processed in consideration of the characteristics of unstructured conversation data. Also, when the attention model was used, accuracy showed the best performance with 65.9%. The proposed technique can contribute to improving the accuracy and performance of conversational emotion recognition. © 2022 Myungjin Lim et al.

6.
Brain Sci ; 12(5)2022 Apr 29.
Article in English | MEDLINE | ID: covidwho-1875489

ABSTRACT

INTRODUCTION: Due to the changes in the indication range for cochlear implants and the demographic development towards an aging society, more and more people are in receipt of cochlear implants. An implantation requires a close-meshed audiological and logopedic aftercare. Hearing therapy rehabilitation currently requires great personnel effort and is time consuming. Hearing and speech therapy rehabilitation can be supported by digital hearing training programs. However, the apps currently on the market are to a limited degree personalized and structured. Increasing digitalization makes it possible, especially in times of pandemics, to decouple hearing therapy treatment from everyday clinical practice. MATERIAL AND METHODS: For this purpose, an app is in development that provides hearing therapy tailored to the patient. The individual factors that influence hearing outcome are considered. Using intelligent algorithms, the app determines the selection of exercises, the level of difficulty and the speed at which the difficulty is increased. RESULTS: The app works autonomously without being connected to local speech therapists. In addition, the app is able to analyze patient difficulties within the exercises and provides conclusions about the need for technical adjustments. CONCLUSIONS: The presented newly developed app represents a possibility to support, replace, expand and improve the classic outpatient hearing and speech therapy after CI implantation. The way the application works allows it to reach more people and provide a time- and cost-saving alternative to traditional therapy.

7.
2022 CHI Conference on Human Factors in Computing Systems, CHI 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1874707

ABSTRACT

Deaf and Hard-of-Hearing (DHH) users face accessibility challenges during in-person and remote meetings. While emerging use of applications incorporating automatic speech recognition (ASR) is promising, more user-interface and user-experience research is needed. While co-design methods could elucidate designs for such applications, COVID-19 has interrupted in-person research. This study describes a novel methodology for conducting online co-design workshops with 18 DHH and hearing participant pairs to investigate ASR-supported mobile and videoconferencing technologies along two design dimensions: Correcting errors in ASR output and implementing notification systems for influencing speaker behaviors. Our methodological findings include an analysis of communication modalities and strategies participants used, use of an online collaborative whiteboarding tool, and how participants reconciled differences in ideas. Finally, we present guidelines for researchers interested in online DHH co-design methodologies, enabling greater geographically diversity among study participants even beyond the current pandemic. © 2022 ACM.

8.
6th International Conference on Computational Intelligence in Data Mining, ICCIDM 2021 ; 281:137-148, 2022.
Article in English | Scopus | ID: covidwho-1872352

ABSTRACT

Covid-19 pandemic led to remote working and hence resulting in more video conferences among all sectors. Even important international conferences between different nations are being conducted on online video conferencing platforms. Hence, a methodology capable of performing real-time end-to-end speech translation has become a necessity. In this paper, we have proposed a complete pipeline methodology, wherein the real-time video conferencing will become interactive, and it can be used in the educational section for generating videos of instructors from just their images and textual notes. We are using automatic voice translation (AVT), text-to-stream machine translation (MT), and text-to-voice generator for voice cloning and translation in real time. For video generation, we use general adversarial networks (GANs), encoder-decoder, and various other previously implemented generative models. The proposed methodology has been implemented and tested with some raw data and is quite effective for the specified application. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

9.
Education Sciences ; 12(5):302, 2022.
Article in English | ProQuest Central | ID: covidwho-1871959

ABSTRACT

With an increasing demand for telepractice services, the need for telepractice education is more important than ever. In addition to learning how to deliver these services, certain clinical and technological skills learned through telepractice apply more broadly to in-person care. Evaluating students’ abilities to master these skills is necessary to ensure clinical skill competence. We utilized self-efficacy ratings and self-reflections to determine student growth after hands-on telepractice training among nursing, occupational therapy, physical therapy, and speech-language pathology students. Students across disciplines demonstrated growth in all measured skill areas and reported overall increased confidence. Students with less prior telepractice experience reported greater increased confidence in seven measured competency areas than students with more prior telepractice experience. The number of completed sessions at the end of student placements was correlated with increased confidence for one measured skill area. Regardless of whether or not students had prior experience when starting their placement, as the number of telepractice sessions completed increased, thus did students’ confidence levels. The results of this study support telepractice as a viable clinical education tool for student growth and the use of self-efficacy and self-reflection as valuable tools for monitoring the effectiveness of telepractice clinical learning activities.

10.
Social Sciences ; 11(5):184, 2022.
Article in English | ProQuest Central | ID: covidwho-1870723

ABSTRACT

During the last two years, the pandemic has dominated the public attention and debate around the world, centering on socio-economic aspects and having camouflaged other social, cultural and even environmental issues. This study sought to analyze ethno-racial discrimination processes, identifying significant events in Portugal during the period of the current global crisis. We utilized document analysis of national and international reports produced in the last five years, complementing with secondary statistical data and the analysis of online news and users’ comments published in national media during the last two years. The results show that, although there has been a development in Portuguese legislation and in anti-discrimination measures, there has been an increase in racist and xenophobic phenomena in Portugal. Citizens’ perceptions, indicators and reports from official bodies show evidence of discriminatory behavior. Additionally, within this framework, we see a greater political presence of extreme right-wing movements, as well as an increase in hate speech in online news comments. Thus, although there is an awareness of the seriousness of these phenomena, there is an urgent need for actions against racial and ethnic intolerance and greater effective measures for ideological crimes.

11.
Revue Medicale Suisse ; 16(691):835-838, 2020.
Article in French | EMBASE | ID: covidwho-1870376

ABSTRACT

Most patients hospitalized for COVID-19 are aged over 70 years old, and half of those who die are over 83 years old. Older patients do not always present with typical symptoms (fever, cough and dyspnoea) but sometimes are and remain asymptomatic (contact screening), or have aspecific presentations (altered general condition, falls, delirium, unusual fatigue). Rectal swab, which minimizes exposition risk, appears useful in long-term care patients with diarrhea. Older age is associated with worse prognosis, but the analysis should be refined by means of prognostic indexes that account for the heterogeneous health, functional, and cognitive status of the elderly population. Gathering elderly patients’ wishes and assessing their remaining life expectancy allows to anticipate care decisions according to the level of tension in the health system.

12.
B-ENT ; 17(2):62, 2021.
Article in English | EMBASE | ID: covidwho-1869993
13.
Cleft Palate-Craniofacial Journal ; 59(4 SUPPL):99, 2022.
Article in English | EMBASE | ID: covidwho-1868938

ABSTRACT

Background/Purpose: This presentation highlights the benefits and challenges of implementing speech therapy trainings utilizing a train-the-trainer model. Children born with CL+/-P need comprehensive care from a cleft team to ensure that they can meet their highest potential and engage in all aspects of life in their communities. However, in these areas it can be difficult to locate health professionals with the capacity to address cleft palate speech characteristics. As a result, many children speak with these characteristic speech patterns post-palate repair. Research has shown that in low- and middle-income countries (LMICs) a partner hospital model improves the quantity and quality of cleft care services (Purnell, McGrath, & Gosain, 2015). However, there are varying models as to how to structure and build these programs once a partner hospital is established. Limited research has been conducted focusing on the efficacy of speech therapy trainings intended to provide a sustainable impact on these communities. Methods/Description: This poster shares comprehensive data from a survey distributed to training attendees from the past 5 years. Trainings were organized by Smile Train and facilitated by local health professionals who went on to become future trainers. The survey was distributed in August 2020 and consisted of three sections: Personal & Demographic information, Global Impact & Outreach, and Speech Training Feedback. The survey elicited a group of respondents (n=55) who each attended one or more of 14 trainings over a five year span (2015-2020). Authors collected demographic data of respondents, measured respondents' self perception of competency in this area before and after speech therapy trainings, and gathered trainee feedback for future trainings. Results: Surveys were analyzed via SurveyMonkey platform. Researchers analyzed trainee's multiple choice selections, scaled scores, and open-ended responses. Results indicated that trainee confidence in treating those with speech conditions resulting from a CL +/-P significantly increased after the training (on average, trainee confidence was scored a 4/10 before training and improved to 9/10 after training). Further, 56% of trainees have now begun to train other health professionals in their communities. Constructive feedback included the need for continuing education after trainings concluded and the need to address the lack of resources/funding in home countries. Finally, trainees report difficulties in implementing tools acquired from the trainings as a result of the COVID-19 pandemic. Conclusions: Utilization of a train-the-trainer model for speech trainings can provide a lasting, sustainable impact for LIMCs based on respondent feedback. Continued survey distribution is imperative to continuously evaluate the efficacy of these trainings. Further discussion is also needed to determine how trainings can effectively provide tools and education within the constraints of the COVID-19 pandemic.

14.
Cleft Palate-Craniofacial Journal ; 59(4 SUPPL):9, 2022.
Article in English | EMBASE | ID: covidwho-1868937

ABSTRACT

Background/Purpose: Cleft Surgery in our centre is delivered by a single specialist surgeon in a regional Burns and Plastic service. We see 35-45 cleft-affected births per annum and, prior to the COVID-19 pandemic, ran 6 theatre lists per month, conducting 170-180 cleft procedures annually. The pandemic severely hindered elective operating in even tertiary centres, due to the redeployment of theatre staff and resources to manage the emergency care load. Cleft surgery was suspended entirely during the first wave (March-June 2020), before efforts in collaboration with the RCPCH (UK) to conserve the cleft pathway restored it as a priority. Primary palatine reconstruction is recommended at 6-9 months of age to optimise velopharyngeal function and speech proficiency by 5 years (Slater et al 2019). Our service was restarted at 1-2 ad hoc lists a month, which was both insufficient to manage ongoing demands and deal with rising outstanding cases. We faced a major challenge in safely distributing scarce surgical time and capacity across the entire cleft surgical burden. Therefore, we aim to examine our response to these limitations in the face of rising cases and time pressures, illustrating our methods in prioritising cleft procedures. Methods/Description: We reviewed the current literature to determine which of the main cleft procedures were most time critical, and compiled a cleft priority document with a broad evidence basis. Babies with palate involvement were top priority, in light of the strong evidence advocating primary palate repair by 13 months of age (CRANE 2020), after which there is a risk of speech delay (Shaffer et al 2020). Primary lip +/- alveolar involvement were prioritised lower and performed later (∼1 year), as cosmesis during infancy was deemed less detrimental, although there remained the psychological impact on the parent (Grollemund et al 2020). Secondary speech surgery was next, the lack of which can inhibit education and require intensive speech therapy to support patients (Baillie and Sell 2020). This was followed by alveolar bone grafting, ideally performed prior to canine eruption at ∼8-9 years to limit further dental reconstructions (Vandersluis et al 2020). As per national consensus, all adult cleft surgery was suspended to accommodate higher priorities. Focusing on early palate repair helped restart the cleft pathway and prevent functional delay as well as further interventions and schoolage support. However, late lip repair saw a rise in complications - two cases of dehiscence were associated with self-inflicted toddler trauma. This is in addition to the psychosocial implications of cosmesis, including early maternal interactions (Montirosso et al 2011), stigmatisation by peers (Bous et al 2021), and parental anxiety (Bous et al 2020). We recommend isolated lip reconstructions are also undertaken within 9 months. Long-term physical and psychosocial impacts of delay in surgery should guide resource allocation in the event of future operating limitations.

15.
Cleft Palate-Craniofacial Journal ; 59(4 SUPPL):101, 2022.
Article in English | EMBASE | ID: covidwho-1868933

ABSTRACT

Background/Purpose: During the COVID 19 pandemic in Brazil, for a period of six months to a year and by determination of the National Supplementary Health Agency (ANS), elective health procedures were suspended in public and private hospitals, including cleft lip and palate treatment. The measure took into account the high occupancy rates of Intensive Care Unit (ICU) beds in the country and the prevention of contamination. For a condition such as cleft lip and palate, can be harmful to the patient. To report the impacts on cleft lip and palate treatment during the COVID 19 pandemic in Brazil. Methods/Description: Exploratory and descriptive research with 55 accredited cleft lip and palate treatment centers and partners of an international philanthropic institution. Results: Among the of 55 partners centers (100%), 11% provided essentially multidisciplinary outpatient care and 89% provided surgical procedures besides the outpatient care. In the latter, 100% of the surgeries were postponed but, with the support of the International Philanthropic Institution, the 55 centers continued to provide integral care, including nutrition, speech therapy, social service, dentistry and psychological support to the patients through telemedicine. This online working method has saved lives, such as breastfeeding and proper nutritional counseling for mothers of babies born with the malformation. Doctors from these partner centers have treated thousands of patients remotely, providing vital guidance to families, following up with new patients who were waiting for their surgeries. They also received personal protective equipment (PPE) and essential equipment, such as pulse oximeters and non-contact infrared thermometers, so they could continue to care for patients with clefts, protecting against COVID-19. As government restrictions begin to ease around the world, there is a cautious resumption of free cleft lip and palate surgeries and life-saving outpatient follow-ups. Partner centers are developing safe surgery guidelines in accordance with regulations and recommendations from local and global Medical Advisory Boards allowing for continuity of care and a full and productive life for patients. Conclusions: The COVID-19 pandemic postponed the treatment of many children with cleft lip and palate in Brazil, but gave the partner centers the possibility to study in depth the problems relevant to clinical practice. It was in this context that the International Philanthropic Institution promoted online training with the teams, covering the integral care of the cleft patient, from the first consultation to the surgical treatment and multidisciplinary continuity.

16.
Cleft Palate-Craniofacial Journal ; 59(4 SUPPL):58, 2022.
Article in English | EMBASE | ID: covidwho-1868931

ABSTRACT

Background/Purpose: COVID-19 fundamentally changed cleft teams' ability to care for their patients. This study aims to study;1) the effect of COVID-19 on elective surgery timings and outcomes;2) preoperative screening and isolation protocols;3) the impact of operating with personal protective equipment (PPE). Methods/Description: Between the start of the first UK lockdown in March 2020 and April 2021 operative details from 651 cleft procedures performed in eight UK centres were entered into a secure REDCap database. Results: 651 records were entered (59% male, 41% female). 9% patients had a known syndrome. Operations were as follows: cleft palate repair (40%), unilateral cleft lip repair +/- vomer flap (23%), alveolar bone grafting (16%), secondary speech surgery (10%), fistula repair (3.7%), lip revision (1%) and rhinoplasty (1%). 39% of surgical cases were deemed delayed compared to normal protocol timings, with 80% of the delays attributable to COVID. Mean age at initial cleft lip repair was 230 days exceeding a previous representative mean of 137 days as well as breaching the UK national standards for upper age limit of 183 days. Mean age at cleft palate repair was 387 days compared to the UK national standard for upper age limit of 396 days, and previous representative mean of 320 days. 81% of patients undertook some form of pre-operative isolation;47% isolated for two weeks. COVID screening was performed in the 72 hrs prior to surgery in 89% of patients and 13% of parents/carers. Only one patient had a positive test. 69% surgeons wore an FFP3 (N99) mask to operate, and 64% of cases involved difficulty during the operation as a result of the PPE;most commonly communication difficulties (45%). No patients developed COVID in the early post-operative period. Conclusions: This data demonstrates that initial cleft lip and palate repair in the UK has been delayed as a direct result of the COVID-19 pandemic. Secondary surgery has been significantly affected and efforts will need to be made at national level to provide capacity to catch up. Isolation and testing protocols for COVID-19 vary from unit to unit, but appear safe. Routine cleft surgery can safely continuing through the pandemic, as long as appropriate infection control measures are followed and resources allow.

17.
Cleft Palate-Craniofacial Journal ; 59(4 SUPPL):102, 2022.
Article in English | EMBASE | ID: covidwho-1868929

ABSTRACT

Background/Purpose: Comprehensive hands-on clinical training in nasopharyngoscopic evaluation of VP closure for speech has been increasingly difficult for trainees to obtain since the onset of the COVID-19 pandemic. Due to various restrictions in availability of PPE, equipment, and training space, as well as potential risks to providers and trainees, an alternative approach for teaching this important clinical skill was developed. This presentation will describe an innovative approach to nasopharyngoscopy training using simulation. Methods/Description: Training was coordinated through a state-of-the-art Simulator Center with the assistance of vendor technical support. First, a didactic session was led by an experienced craniofacial SLP regarding equipment specifications, speech sampling, imaging rating procedures, patient safety, and universal and COVID-specific precautions. Then, simulator training proceeded using a life-like pediatric patient simulator model to perform mock assessment of velopharyngeal closure for speech. This presentation will include photo and video images of the simulator room, equipment, and demo sessions. Results: Four fellows have completed simulator training (2 surgeons, 2 speech pathologists) at this time. Conclusions: Traditional nasopharyngoscopy training can be adapted using simulation approaches, to provide safe and effective training in the COVID era.

18.
Cleft Palate-Craniofacial Journal ; 59(4 SUPPL):103, 2022.
Article in English | EMBASE | ID: covidwho-1868928

ABSTRACT

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.

19.
Journal of Investigative Medicine ; 70(4):1163, 2022.
Article in English | EMBASE | ID: covidwho-1868768

ABSTRACT

Purpose of Study To identify factors influencing acceptance or refusal of COVID-19 vaccine by parents of children at a university affiliated community healthcare center. The introduction of the COVID-19 vaccine has been crucial in the mitigation of the COVID-19 pandemic. Initially, the vaccine was targeted at healthcare workers and other high-risk adults. Early in the pandemic, studies in adults on vaccine hesitancy noted concerns about the supposed novelty and efficacy of the vaccine. Studies in China and the UK established that most parents were willing to vaccinate their children with the COVID-19 vaccine even though they expressed concerns about safety and efficacy. This study aims to identify potential barriers and uncertainties that parents express when considering vaccinating their children. Methods Used Cross-sectional study using a self-administered questionnaire completed by English and Spanish-speaking parents/guardians requesting acute or well child care for their children less than 18 years of age at a university-affiliated pediatric ambulatory care center from April 2021 to May 2021. Summary of Results 223 subjects, predominantly mothers (90.1%), participated in the study. 49.8% of children were male and 48.4% female. The mean age of all children was 6.79 ± 5.4 years. 74% of the participants identified themselves as Hispanic, 17.9% as African American/Black, and 5.8% as 'mixed'. Concerning vaccinating their children against COVID-19, 23.8% of the respondents, stated 'Yes definitely' to agreeing to give the vaccine to their child, while 37.7% were 'Unsure but leaning towards yes'. 9.9% had 'No opinion', 13.5% were 'Unsure but leaning towards no', and 14.3% stated, 'No, definitely not'. Reasons for vaccine refusal include;uncertainty about vaccine efficacy (46.2%), concerns about hurried vaccine production (31.4%), belief that the child will get sick after vaccination (23.8%) and, being generally opposed to vaccines (4.5%). Conclusions In a largely Hispanic population, majority of parents/guardians were unsure but leaning towards accepting the COVID-19 vaccine for their children. Common reasons for vaccine refusal were concerns for efficacy and the rapid speed of production. This data suggests that specific vaccine education is needed in this community to address the concerns of efficacy, speedy vaccine production, and reactivity after vaccine administration to increase parental acceptance of COVID- 19 vaccine administration in their children.

20.
Journal of Investigative Medicine ; 70(4):1138-1139, 2022.
Article in English | EMBASE | ID: covidwho-1868760

ABSTRACT

Purpose of Study Language exposure is essential for speech and language development in newborns. NICU infants by virtue of their prolonged hospitalizations or multiple complications are more likely exposed to less language. Based on a low rate of reading measured in our NICU, this initiative was designed to target this deficiency. Methods Used A family reading survey used for two-week old infants at home (modified from Before and After Books and Reading Survey and the Stony Brook Family Reading Survey) was adapted for inpatients. The survey, consisting of 22 questions, was given to caretakers of infants in the NICU at >7 days to 2 months' time period. The R.E.A.D. (Read to, Enjoy, And Develop) Your Baby program was developed to promote shared reading and educate parents about the importance of language. The campaign consists of giving baby books to families with an infant in the NICU >7 days and bi-weekly for chronically hospitalized infants. Books were made available by the Reach Out and Read Program and by acquisition using a regional grant fund. Using historical cohorts, the survey was given to parents before and after instituting the R.E.A.D. Your Baby program. Comparisons of proportions of parents reporting reading or verbalizing activity was analyzed using N-1 two proportion test. Summary of Results The initial survey was conducted with 50 families in 2019;the post-intervention survey collection is still ongoing and currently 12 families have participated. Demographic data of caretakers are included in Table 1. One item asked parents to name three favorite activities to do with your baby in the NICU by free text-25.2% (37/150) responses centered about language (talking, singing, or reading) in the pre-phase;41.7% (15/36) provided language responses (p=0.024) in the post-intervention phase. Reading represented 5.3% (8/150) of responses in the pre-phase, whereas it represented 13.9% (5/36) of the responses in the post-phase, p=0.00001. A multiple-choice question later asked do you read to your baby in the NICU? in which 22% (11/50) of parents answered yes in the pre-phase;91.7% (11/12) respondents answered yes in the post-phase, p=0.00000. Conclusions Shared reading was occurring for a minority of infants in our urban-setting NICU before the R.E.A.D. Your Baby campaign. Initially we had aimed to improve the reading rate to 50%. Already in the early stages of surveying postintervention, a remarkable increase has been observed. One confounding factor may be a long interval of time between pre- and post-intervention (which was mostly due to the Covid-19 pandemic);another factor may be higher number of parents with education beyond high school in the post-phase. Beyond exposing infants to language in the NICU, additional benefits of reading together likely include promoting parentinfant bonding, providing parental stress coping techniques, and priming for continued reading at home. (Table Presented).

SELECTION OF CITATIONS
SEARCH DETAIL