Teleducation about Cleft Lip and Palate: An Interdisciplinary Approach in the Promotion of Health

Telemedicine as an Alternative Way to Provide Multidisciplinary Cleft Care During the COVID-19 Pandemic

The current coronavirus pandemic is changing the way healthcare professionals provide services to patients. Healthcare professionals are required to provide quality care while reducing the risk of viral transmission. This pandemic has disrupted the timely multidisciplinary team care for patients with clefts across the globe. Thus, telemedicine has been recognized and accepted by various medical and dental specialists as a viable alternative to face-to-face consultation. In addition, telemedicine incorporating a digital workflow in cleft management will further reduce the risk of viral transmission and enhance the quality of treatment being provided to these patients.

Practice of Telehealth in Otolaryngology: A Scoping Review in the Era of COVID-19

OBJECTIVE

The COVID-19 pandemic has spurred widespread adoption and advancement in telehealth activities, representing a marked change in otolaryngology practice patterns. The present study undertakes a scoping review of research focused on telehealth in otolaryngology (teleotolaryngology) to identify key themes and commonly utilized outcome measures that will assist future development in this growing field.

DATA SOURCES

PubMed, Embase, and Cochrane databases and reference review.

REVIEW METHODS

Per guidelines of the PRISMA Extension for Scoping Reviews, we performed database queries using a comprehensive search strategy developed in collaboration with research librarians at the Columbia University Irving Medical Center. We identified 596 unique references to undergo title and abstract review by 2 independent reviewers, leaving 439 studies for full-text review.

RESULTS

We included 285 studies for extraction of notable findings, leaving 262 unique studies after accounting for content overlap. We identified core outcome measures, including patient and provider satisfaction, costs and benefits, quality of care, feasibility, and access to care. Publication volume increased markedly over time, though only 4% of studies incorporated randomized study group assignment. Using an iterative approach to thematic development, we organized article content across 5 main themes: (1) exploration of teleotolaryngology evolution, (2) role in virtual clinical encounters, (3) applications in interdisciplinary care and educational initiatives, (4) emerging and innovative technologies, and (5) barriers to implementation.

CONCLUSION

This scoping review of teleotolaryngology documents its evolution and identifies current use cases, limitations, and emerging applications, providing a foundation from which to build future studies, inform policy decision making, and facilitate implementation where appropriate.

Global and communicative development skills in preschool children with cleft lip and palate

IMPORTANCE

Cleft lip and palate (CLP) is globally among the most common childhood malformations. This disorder impacts childhood development, including speech and language, and affects children worldwide.

OBJECTIVE

To analyze child development skills (adaptive fine motor, gross motor, personal-social, and language) in preschool children with isolated CLP compared with children without this malformation.

METHODS

The participants included an experimental group of 27 children with isolated CLP and a comparison group of 27 children without CLP aged between 48 and 59 months. The groups were evaluated using two instruments: the Denver Developmental Screening Test II (DDST-II) and the Avaliação do Desenvolvimento da Linguagem (ADL-Language Development Assessment). Data were analyzed by descriptive and inductive analyses, using the Student's t-test and the Mann-Whitney test, at a significance level of P ˂ 0.05.

RESULTS

All children in the comparison group performed within normal standards for their age range in the DDST-II and the ADL. The worst performance in the experimental group was observed in language skills, followed, in declining order, by adaptive fine motor, personal-social, and gross motor as measured by the DDST-II. Children with isolated CLP also performed poorly in receptive, expressive, and global language in the ADL. No statistically significant differences were observed in the experimental group's scores for the ADL and the DDST-II.

INTERPRETATION

Developmental skill levels were below expectations for children of this age with isolated CLP.

Telemedicine in International Cleft Care: A Systematic Review

BACKGROUND

Cleft lip and cleft palate (CLP) are among the world's most common congenital malformation and has a higher prevalence in developing nations due to environmental and genetic factors. Global efforts have been developed in order to prevent and treat the malformation. Telemedicine has been implemented in various humanitarian global missions with success and is currently the primary means of care due to COVID-19.

OBJECTIVE

To assess the benefits and barriers of telehealth in the care of patients with CLP through a global approach.

METHODS

Systematic review of the PubMed and Cochrane Review databases with relevant terms related to telemedicine in cleft lip and palate surgery.

RESULTS

Eight articles fit the inclusion criteria and suggested benefits with the use of telemedicine in regard to education, preoperative, and postoperative care as well as increased access to underserved populations. Barriers included connectivity and accessibility concerns.

CONCLUSION

Telehealth is a beneficial way to evaluate patients with CLP in developing countries with proper care and follow-up to reduce complications and to improve health outcomes.

Development and Evaluation of a Blog about Cleft Lip and Cleft Palate and Hearing

Introduction  Cleft lip and cleft palate can result in impairments in communication, specifically in hearing, making the use of technological resources such as blogs a fundamental guideline for health professionals. Objective  The aim of this study was to prepare and analyze the access to a blog about cleft lip and cleft palate and hearing as a pedagogical tool for health professionals. Methods  The first stage for the development of the blog was the selection of the content that would be addressed and the respective illustrations. The second stage was making the blog available through the WordPress platform, and the third stage included the evaluation of the blog, of the access to the WordPress statistical features, and of the quality of the blog through the Emory questionnaire, which was answered by 75 professionals. Results  The blog, titled "Fissure and Hearing", was developed with the architecture of a digital information environment containing a system of organization, navigation, labeling and search (first stage). The address hosting the blog was: http://fissuraeaudicao.wordpress.com (second stage). The result of the third stage included 56,269 views of the blog from different countries, and Brazil was the country with the highest viewing. Regarding the assessment by the Emory questionnaire, we found that for most of the major issues, the percentages obtained were or equal to 90%, while the analysis of the scales, navigation and structure presented the lowest scores. Conclusion  The blog was developed and enabled greater access to information available on the web about cleft lip and cleft palate and hearing.

Desenvolvimento e aplicação de instrumento administrativo para orientação das pesquisas em telefonoaudiologia

RESUMO Objetivo: desenvolver e aplicar um instrumento para orientação das pesquisas em Telefonoaudiologia e identificar os pontos fortes e fracos destes projetos. Métodos: foi desenvolvido um questionário, abordando quatro competências distintas: administrativa, tecnológica, financeira e de sustentabilidade. Realizou-se a aplicação com 11 docentes que desenvolviam projetos na área de Telefonoaudiologia. Tais dados foram analisados por meio de estatística descritiva e aplicada a Matriz SWOT, que possibilitou identificar os pontos fortes e fracos, bem como o Diagrama de Ishikawa, para identificar os efeitos e causas. Resultados: foram aplicados os questionários e analisados 32 projetos em que os pontos fortes foram: a missão do projeto, a qualidade das informações, os canais de comunicação e os benefícios proporcionados aos usuários, tendo como principais causas a utilização de multimeios específicos, a educação continuada, a quantidade de informações disponibilizadas e o comprometimento do capital humano. Quanto aos pontos fracos, constatou-se a ausência de especialização da mão de obra em determinadas etapas do projeto, a falta de atualização de hardware e software, a exclusão digital de usuários e a obsolescência do projeto, sendo as principais causas concentradas na dificuldade de suporte técnico, profissionais para divulgação e treinamento, estratégias de marketing e a manutenção dos projetos desenvolvidos. Conclusão: foi desenvolvido e aplicado o questionário, sendo identificados os pontos fortes e pontos fracos, estando associados a especialização do capital humano. A maximização do tempo e a atualização dos recursos digitais foram identificados como insumos importantes para ampliar os benefícios dos projetos de Telessaúde, rumo à vantagem competitiva organizacional.