AIM The aim of this retrospective study was to assess the relationship between feedingswallowing difficulties (FSDs) and later language impairments in children.METHOD Retrospective analyses were carried out using the clinical files of 82 children with language impairments from a large urban rehabilitation center. Two subgroups of these children were established: children with motor impairments, referred to as the language impairment with motor impairment ('LI+MI') subgroup (n=23, mean age 4y 6mo, SD 8.7mo), and children without motor impairments, referred to as the language impairment without motor impairment ('LI-MI') subgroup (n=59, mean age 5y, SD 8mo). The prevalence of food selectivity, difficulties in sucking, salivary control issues, and food transition difficulties was extracted. Data were compared with a general population estimate of FSDs.RESULTS FSDs were documented in 62% of the clinical files; 87% of these files were from the LI+MI subgroup and 53% were from the LI-MI subgroup. Among each subgroup of children with language impairments, the prevalence of FSDs was significantly higher than the general population estimate of 20% (LI+MI:v 2 =55.965, df=1, p<0.001; LI-MI: v 2 =32.807, df=1, p<0.001). Furthermore, the prevalence of FSDs was significantly higher in children with language impairments and motor impairments than in those with language impairments but without motor impairments (v 2 =6.936, df=1, p<0.01). Both food transition difficulties (v 2 =14.99, df=1, p<0.001) and salivary control issues (v 2 =5.02, df=1, p=0.02) were more frequent in the LI+MI subgroup than in the LI-MI subgroup. Combinations of two or more FSDs were also more frequent in the LI+MI subgroup than in the LI-MI subgroup (v 2 =4.19, df=1, p=0.04).

Background: The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion from healthcare services, protect healthcare providers, and help them maintain satisfactory quality and safety of care. Remote COVID-19 monitoring platforms emerged as potential solutions.Objective: The purpose of this study was to evaluate the capacity and contribution of two different platforms used to remotely monitor patients with COVID-19 to maintain quality, safety, and patient engagement in care, as well as their acceptability, usefulness, and user-friendliness from the user's perspective. The first platform is focused on telecare phone calls (Telecare-Covid), and the second is a telemonitoring app (CareSimple-Covid).Methods: We performed a cross-sectional study. The data were collected through a phone survey from May to August 2020. Data were analyzed using descriptive statistics and t-test analysis. Participants' responses and comments on open-ended questions were analyzed using content analysis to identify certain issues and challenges and potential avenues for improving the platforms.Results: Fifty one patients participated in the study. Eighteen participants used the CareSimple-Covid platform and 33 participants used the Telecare-Covid platform. Overall, the satisfaction rate for quality and safety of care for the two platforms was 80%. Over 88% of the users on each platform considered the platforms' services to be engaging, useful, user-friendly, and appropriate to their needs. The survey identified a few significant differences in users' perceptions of each platform: empathy toward users and the quality and safety of the care received were rated significantly higher on the CareSimple-Covid platform than on the Telecare-Covid platform. Users appreciated four aspects of these telehealth approaches: (1) the ease of access to services and the availability of care team members; (2) the user-friendliness of the platforms; (3) the continuity of care provided, and (4) the wide range of services delivered. Users identified some technical limitations and raised certain issues, such as the importance of maintaining human contact, data security, and confidentiality. Improvement suggestions include promoting access to connected devices; enhancing communications between institutions, healthcare users, and the public on confidentiality and personal data protection standards; and integrating a participatory approach to telehealth platform development and deployment efforts.Conclusion: This study provides preliminary evidence that the two remote monitoring platforms are well-received by users, with very few significant differences between them concerning users' experiences and views. This type of program could be considered for use in a post-pandemic era and for other post-hospitalization clienteles. To maximize efficiency, the areas for improvement and the issues identified should be addressed with a patient-centered approach.

During the last 20 years, telemedicine has evolved in Quebec despite several barriers. We studied how a university health centre in Montreal implemented a strategy to enhance the use of telemedicine with the deployment of appropriate infrastructures, continuous training, and the use of advanced technologies, before and during the pandemic. COVID-19 accelerated the use of telemedicine by overcoming some pre-existing barriers. However, telemedicine was mainly limited to a distance consultation during the pandemic using telephone calls or videoconference. The future of telemedicine depends on lifting these obstacles. We need to better define telemedicine and in-person medicine to guarantee the quality of medical and professional acts. We propose some strategies to achieve these goals, combining cultural change, continuous training, new technologies to improve quality of care, and a vision of healthcare with telemedicine oriented on value creation.

A significantly higher percentage of histories of FSCs (48%) were found in the files of children with LI when compared with the population estimate (χ2 = 13.741, df = 1, p < .001). Difficulties in food transition (31%) and food selectivity (14%) were the most frequent. Data confirm and extend our previous findings and suggest that a previous history of FSCs may characterize children with LI early in their care delivery pathway.