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Ferraro JJ, Jeffe JS, Seu MY, Aminzada A, Tragos C. Is There a Role for Comfort Care in Neonates With Severe Craniofacial Anomalies? Case Report and Review of Quality-of-Life Literature. Cleft Palate Craniofac J 2024; 61:717-722. [PMID: 36384315 DOI: 10.1177/10556656221138884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
This article aims to determine how quality of life (QoL) is defined and assessed in cases of severe craniofacial anomalies, as well as the impact such considerations may have on the treatment of a neonate with these conditions with respect to palliative neonatal care. Our literature review found insufficient evidence to suggest that craniofacial anomalies result in consistently poor QoL. Based on these findings and in line with the current acceptable standards for the ethical care of neonates, with the exception of rare cases, resuscitative efforts should always be performed on patients with isolated craniofacial anomalies, as demonstrated in the management of this reported patient.
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Affiliation(s)
| | - Jill S Jeffe
- Rush University Medical Center, Chicago, IL, USA
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2
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Payer D, Krimmel M, Reinert S, Koos B, Weise H, Weise C. Oral health-related quality of life in patients with cleft lip and/or palate or Robin sequence. J Orofac Orthop 2024; 85:98-109. [PMID: 35852562 PMCID: PMC10879386 DOI: 10.1007/s00056-022-00414-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 06/19/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To compare the oral health-related quality of life (OHRQoL) in patients with cleft lip and/or palate or Robin sequence versus a healthy control group using the Child Oral Health Impact Profile (COHIP-G19). Factors such as age, gender, and cleft type were considered. METHODS Over an 8-month period, the OHRQoL was surveyed by using the COHIP-G19 questionnaire. Included were patients with a craniofacial disorder (n = 61; average age 11.24 years) and a healthy control group (n = 70, average age 12.63 years) for a total of 131 patients (average age 11.99 years) from the Department of Orthodontics University Hospital Tübingen, Germany. These were divided into two age groups (6-11 years; 12-18 years). RESULTS Statistically, patients with a craniofacial disorder presented a significantly lower OHRQoL than the control group (p = 0.0055). In the craniofacial disorder group, older patients revealed a significantly (p = 0.005) lower OHRQoL than the younger patients. Female patients showed in nearly all groups a better OHRQoL than male patients, but this difference was not statistically significant (p > 0.05). Males with a craniofacial disorder scored significantly lower than males without (p = 0.016); females showed no differences between the groups. Visibility, location, and severity of the craniofacial malformation did not have a significant influence on the OHRQoL. CONCLUSION The occurrence of a craniofacial malformation impacted the OHRQoL especially in older and male affected patients, unrelated to the expression level or localization. An early instruction about oral health, rehabilitation and functional training should be considered in therapy.
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Affiliation(s)
- D Payer
- Department of Orthodontics, University Hospital Tuebingen, Osianderstr. 2-8, 72076, Tuebingen, Germany
| | - M Krimmel
- Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen, Osianderstr. 2-8, 72076, Tuebingen, Germany
| | - S Reinert
- Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen, Osianderstr. 2-8, 72076, Tuebingen, Germany
| | - B Koos
- Department of Orthodontics, University Hospital Tuebingen, Osianderstr. 2-8, 72076, Tuebingen, Germany
| | - H Weise
- Department of Orthodontics, University Hospital Tuebingen, Osianderstr. 2-8, 72076, Tuebingen, Germany
| | - C Weise
- Department of Orthodontics, University Hospital Tuebingen, Osianderstr. 2-8, 72076, Tuebingen, Germany.
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3
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Toriumi DM. Structural Approach to Secondary Repair of the Unilateral Cleft Lip Nasal Deformity. Plast Reconstr Surg 2024; 153:193-201. [PMID: 37189225 DOI: 10.1097/prs.0000000000010687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
SUMMARY Management of the unilateral cleft lip nasal deformity is complex because of the underlying significant asymmetry of the lower lateral cartilages and soft tissues of the nasal base. Suturing and grafting techniques may leave the patient with residual asymmetries of the nasal tip and nostrils. Some of this residual asymmetry may be attributable in part to the anchoring effect of the vestibular skin attachments to the lower lateral cartilages. This article discusses the use of lateral crural release, repositioning, and support with lateral crural strut grafts to manage the nasal tip. The technique involves freeing the vestibular skin from the undersurface of the lateral crura and domes and placement of lateral crural strut grafts with or without amputation of the ipsilateral dome and lateral crura to allow precise resuturing to the caudal septal extension graft. This technique is coupled with the use of a caudal septal extension graft to stabilize the nasal base and provide a strong foundation for the repair. Treatment of the nasal base may require skeletal augmentation to aid in creating symmetry of the alar insertions. Costal cartilage is needed in most cases to provide adequate structural support. Nuances in technique are discussed to help maximize outcomes.
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Affiliation(s)
- Dean M Toriumi
- From the Department of Otolaryngology-Head and Neck Surgery, Section of Facial Plastic and Reconstructive Surgery, Rush University Medical School
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4
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Paganini A, Engström M, Mark H, Persson M. Being Normal yet Different: A Qualitative Study on the Dualistic Experience of Living With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2024; 61:52-60. [PMID: 35979595 PMCID: PMC10676618 DOI: 10.1177/10556656221121037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of the present study was to describe the experiences of young adults living with cleft lip and palate (CLP) and to explore potential gender differences. A descriptive qualitative study was designed involving semi-structured interviews. The interviews were analyzed using qualitative content analysis, as described by Graneheim and Lundman. A total of 9 women and 8 men, aged 22 to 26 years with UCLP. The main theme identified was: the duality of living with a cleft-being normal yet different, and 2 subcategories: "My cleft and me" and "My cleft and the World." The participants described themselves as normal yet different, both in relation to themselves and in relation to others. They also stated that gender norms regarding appearance affected their lives and how they saw the cleft. This study adds to the growing body of qualitative research on CLP. It highlights the dualistic experiences of feeling normal and different at the same time. The interviews indicated that this dualism was based on context and gender, showing the psychological complexity of an individual. The clinical implications of this study emphasizes the need of a person-centered care approach in the cleft care setting where the clinicians are aware of the potential dualistic experience that also may differ over time that individuals with cleft can experience. This can also help clinicians better understand and help patients reduce distress and strengthen positive coping mechanisms.
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Affiliation(s)
- Anna Paganini
- Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Reconstructive Plastic Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - My Engström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hans Mark
- Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Reconstructive Plastic Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martin Persson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
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5
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Sahoo AR, Singh Dheer S, P C M, Goyal P, Sidhu R, Deepalakshmi S. A Questionnaire Study to Assess Patients With Cleft Lip and Palate for Their Oral Health-Related Quality of Life. Cureus 2023; 15:e38712. [PMID: 37292523 PMCID: PMC10246514 DOI: 10.7759/cureus.38712] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 05/04/2023] [Indexed: 06/10/2023] Open
Abstract
AIM The purpose of this survey was to assess the quality of life of patients with cleft lips and palates in relation to their dental health. MATERIALS AND METHODS Between January 2022 and December 2022, 50 people between the age of eight and 15 years who had treatment for cleft lip and/or palate were part of a study. A questionnaire was administered to the subjects, including questions pertaining to their general well-being and dental hygiene. The information was gathered and subjected to statistical analysis through appropriate software, with the outcomes presented in the form of descriptive statistics. RESULT The results of the research showed that those with cleft lip and palate had a significant negative effect on their oral health-related quality of life (OHRQoL). The patients reported having trouble speaking, eating, and smiling, which caused them to feel self-conscious and isolated from other people. Conclusion: The study's findings show that those born with cleft lip and/or palate have far greater challenges in achieving and maintaining optimal oral health and a satisfying quality of life, which has repercussions for their overall health and happiness. The study's results may provide successful strategies for enhancing patients' OHRQoL who have had treatment for cleft lip and/or palate.
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Affiliation(s)
- Amiya Ranjan Sahoo
- Department of Oral and Maxillofacial Surgery, Awadh Dental College and Hospital, Jamshedpur, IND
| | - Shiras Singh Dheer
- Department of Dentistry, Shrimant Rajmata Vijayaraje Scindia Medical College, Shivpuri, IND
| | - Mahesh P C
- Department of Public Health Dentistry, Dayananda Sagar College of Dental Sciences, Bangalore, IND
| | - Pragya Goyal
- Department of Oral Medicine and Radiology, KD Dental College and Hospital, Mathura, IND
| | - Ruhi Sidhu
- Department of Oral Medicine and Radiology, MNDAV Dental College and Hospital, Solan, IND
| | - S Deepalakshmi
- Department of Oral Medicine and Radiology, Seema Dental College and Hospital, Rishikesh, IND
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6
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Jensen ED, Poirier BF, Oliver KJ, Roberts R, Anderson PJ, Jamieson LM. Childhood Experiences and Perspectives of Individuals With Orofacial Clefts: A Qualitative Systematic Review. Cleft Palate Craniofac J 2022:10556656221084542. [PMID: 35254151 DOI: 10.1177/10556656221084542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Children and adolescents with orofacial clefts may experience ongoing psychosocial impacts due to the continuous nature of cleft treatments, facial and dental differences, and speech and hearing difficulties. The aim of this qualitative systematic review was to better understand the experiences of children and adolescents with orofacial clefts. DESIGN A systematic search strategy using PubMed, Embase, Emcare, Scopus, and Web of Science databases was performed to identify relevant qualitative studies evaluating the lived experience of children and adolescents with orofacial clefts from inception through to June 2021. Eligible studies were critically appraised using the Joanna Briggs methodology and a meta-aggregative approach. RESULTS The search identified 2466 studies, with 13 found to meet the inclusion criteria. Extraction of 155 findings resulted in 27 categories, which were meta-aggregated into 7 overarching synthesized findings. These 7 core findings included aspects of child experience and findings that enhanced or impeded child experience at the individual, family, and community levels. CONCLUSIONS Factors that impeded child experience at the individual, family, and community levels were more pronounced than factors that enhanced their experience among children and adolescents with orofacial clefts. Further initiatives are needed to provide support to individuals, families, and school communities to enhance children's experience of orofacial cleft during the formative childhood and adolescent years.
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Affiliation(s)
- Emilija D Jensen
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia.,Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, Australia
| | - Brianna F Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Kelly J Oliver
- Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, Australia
| | - Rachel Roberts
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Peter J Anderson
- Cleft and Craniofacial South Australia, Women's and Children's Hospital, North Adelaide, Australia.,Discipline of Paediatrics, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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Faulkner R, Trenchard S, Taylor C, Murray CD. Experiences of Transition to Secondary School in the United Kingdom for Children With Cleft Lip and/or Palate: A Qualitative Study. CONTINUITY IN EDUCATION 2021; 2:109-120. [PMID: 38774895 PMCID: PMC11104331 DOI: 10.5334/cie.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/22/2021] [Indexed: 05/24/2024]
Abstract
This study explored the secondary school transition experiences of children with cleft lip and/or palate (CL/P). Data were collected via semi-structured interviews and analysed using interpretative phenomenological analysis (IPA). Participants were recruited from a National Health Service (NHS) specialist cleft service covering a large geographical area in the United Kingdom. Six participants with CL/P (aged 11-12 years old) in their first 12 months following transition to secondary school were interviewed. Four themes describe participants' transition experiences: (a) managing and valuing difference: the impact on self-worth and identity; (b) managing and valuing difference within the social context; (c) disclosure and the process of informing others about CL/P; and (d) developing positive peer relationships. Children with CL/P experience several psychosocial challenges during the transition to secondary school. Professionals involved with working with and supporting these children (and their families), such as psychologists, school nurses or wellbeing staff, child psychiatrists, social workers, mental health nurses and paediatricians, should attend to these issues when preparing for this transition in order to foster resilience and adjustment.
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Affiliation(s)
| | - Sian Trenchard
- Royal Manchester Children’s Hospital, Manchester University NHS FT, GB
| | - Catherine Taylor
- Royal Manchester Children’s Hospital, Manchester University NHS FT, GB
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8
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Matsunaka E, Kumagai Y, Ike M, Takano S, Kogo M. Decision-making process to undergo surgery among adolescent patients with cleft lip and/or palate. Jpn J Nurs Sci 2020; 17:e12342. [PMID: 32390343 DOI: 10.1111/jjns.12342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 02/19/2020] [Accepted: 03/29/2020] [Indexed: 12/30/2022]
Abstract
AIM As patients with cleft lip and/or palate grow older, the main decision-making process for treatment is likely to shift from a parent-centered to a patient-centered process. However, many adolescent patients have difficulty in treatment decision-making. This study aimed to clarify the decision-making process regarding undergoing surgery among adolescent patients with cleft lip and/or palate. METHODS Participants were adolescent patients with cleft lip and/or palate aged 14-18 years who were admitted to a hospital in Japan for surgery. Fourteen patients (six boys, eight girls) and their parents agreed to participate in this study. Data were collected in face-to-face semi-structured interviews. Data were analyzed qualitatively with inductive content analysis. RESULTS Fifteen categories were classified into three themes for adolescent patients' decision-making processes regarding undergoing surgery. The three themes were: (a) a doctor's recommendation for surgery, (b) psychological conflict about surgery, and (c) a final decision about surgery. CONCLUSION This study's findings suggest that adolescent patients with cleft lip and/or palate were not adequately involved in the decision-making process before undergoing surgery. Medical staff need to explain other treatment options, the risks and benefits of surgery with materials and methods that adolescent patients can understand as part of "a doctor's recommendation for surgery." Medical staff and parents need to encourage adolescent patients to communicate their preferences and values to reduce patients' "psychological conflict about surgery" and adolescent patients' intentions should be considered in "a final decision about surgery."
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Affiliation(s)
- Eriko Matsunaka
- Department of Nursing, Japanese Red Cross Kyushu International College of Nursing, Fukuoka, Japan
| | - Yukari Kumagai
- Nursing Department, Osaka University Dental Hospital, Osaka, Japan
| | - Miho Ike
- Nursing Department, Osaka University Dental Hospital, Osaka, Japan
| | - Sachiko Takano
- Nursing Department, Osaka University Dental Hospital, Osaka, Japan
| | - Mikihiko Kogo
- Department of Oral and Maxillofacial Surgery 1, Graduate School of Dentistry, Osaka University, Osaka, Japan
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9
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Perillo L, Vitale M, d'Apuzzo F, Isola G, Nucera R, Matarese G. Interdisciplinary approach for a patient with unilateral cleft lip and palate. Am J Orthod Dentofacial Orthop 2018; 153:883-894. [PMID: 29853246 DOI: 10.1016/j.ajodo.2016.12.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 12/01/2016] [Accepted: 12/01/2016] [Indexed: 02/07/2023]
Abstract
The oral rehabilitation of patients with cleft lip and palate is a challenge. The aim of this case report was to underline the importance of a sequential interdisciplinary approach to correct functional problems and improve facial esthetics for a patient with unilateral cleft lip and palate. Few clinical reports have described this treatment in a teenager. The patient, a girl, age 12.6 years, had a complete right cleft lip and palate with a Class II molar tendency and a full Class II canine relationship on the right side, and a full Class II molar relationship with a canine Class I on the left side. Transposed, impacted, and anomalously shaped teeth and crowding added to the patient's problems. Treatment included maxillary expansion and maxillary and mandibular extractions. An interdisciplinary approach was necessary to achieve proper occlusion and better esthetics.
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Affiliation(s)
- Letizia Perillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Maddalena Vitale
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Fabrizia d'Apuzzo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Gaetano Isola
- Section of Orthodontics, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
| | - Riccardo Nucera
- Section of Orthodontics, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Giovanni Matarese
- Section of Orthodontics, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
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10
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Nicholls W, Persson M, Robinson S, Selvey L. Adult Narratives of the Psychosocial Impact of Cleft in a Western Australian Cohort. Cleft Palate Craniofac J 2018; 56:373-382. [PMID: 29652531 DOI: 10.1177/1055665618770184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Living with a cleft condition involves many years of multidisciplinary therapy, treatment, and surgical intervention. This complex process may have both physical and psychosocial long-term impacts. There is limited evidence of the psychosocial impact of cleft on individuals in Australia. AIM To obtain an understanding of the adult patient perception of having a cleft and explore the impact of the condition on their lives. DESIGN Qualitative methodologies at one case study site in Western Australia. POPULATION OF INTEREST Adults with a cleft lip and/or palate (CL/P) who had received treatment at Princess Margaret Hospital, the only treatment center for cleft in Western Australia. METHODOLOGY Individual in-depth semi-structured qualitative interviews were conducted and recorded and transcribed for analysis. RESULTS Fifteen adults with a CL/P. Two main themes were identified: lived experience (with 3 subthemes: normality, support networks, and impacts in later life) and advice to others. The majority of participants reported social rejection and isolation, which occurred mostly at school and in some instances at home, but did not often last into adulthood. The greatest protective factor was the support of family and friends, which if missing during their childhood, was desired and appreciated in adulthood. CONCLUSION Adults with CL/P may require psychosocial support from their cleft team including referral to clinicians in adult services. There is also the need for earlier psychological interventions and social programs to support those with appearance-related social difficulties.
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Affiliation(s)
- Wendy Nicholls
- 1 Dental Department/Cleft Lip and Palate Unit, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Martin Persson
- 2 Centre for Appearance Research, University of West England, Bristol, United Kingdom
| | - Suzanne Robinson
- 3 School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Linda Selvey
- 3 School of Public Health, Curtin University, Perth, Western Australia, Australia
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Borghini A, Despars J, Habersaat S, Turpin H, Monnier M, Ansermet F, Hohlfeld J, Muller-Nix C. ATTACHMENT IN INFANTS WITH CLEFT LIP AND/OR PALATE: MARGINAL SECURITY AND ITS CHANGES OVER TIME. Infant Ment Health J 2018; 39:242-253. [PMID: 29489020 DOI: 10.1002/imhj.21696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study examines the attachment quality and how this changed over time among infants who had cleft lip and palate (CLP), by conducting a prospective longitudinal study addressing the effects of this type of perinatal event on the parent-infant relationship and the emotional development of the infants. At 12 months of age, the Strange Situation Paradigm (SSP; M. Ainsworth, M.C. Blehar, E. Waters, & T. Wall, 1978) was administered to a sample of 38 CLP infants (born between 2003 and 2010) and 17 healthy controls. At 4 years of age, the Attachment Story Completion Task (ASCT; I. Bretherton, D. Ridgeway, & J. Cassidy, 1990) was administered to 32 individuals from the CLP sample and 14 from the control group. As reported in the literature, CLP infants display secure attachment behaviors as frequently as do control infants (55%). However, a more detailed analysis of the attachment scales revealed that CLP infants show more avoidance and less proximity seeking. In addition, a closer examination of the subcategories of attachment styles revealed that most CLP infants (71%) displayed distal attachment strategies such as the B1/B2 or A1/A2 subcategories. At 4 years old, CLP infants clearly displayed more deactivation and less security than did the control sample. Moreover, when detailing the evolution of attachment individually, almost 60% of the CLP children showing distal strategies at 12 months became deactivated or disorganized when they reached 4 years. Indeed, subtle differences in attachment behaviors at 12 months old-which can be considered marginally secure at that age-may reveal attachment vulnerabilities, which seem to be more apparent over the course of development.
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Tierney S, O'Brien K, Harman NL, Sharma RK, Madden C, Callery P. Otitis media with effusion: experiences of children with cleft palate and their parents. Cleft Palate Craniofac J 2018; 52:23-30. [PMID: 24237229 DOI: 10.1597/13-139] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To explore the views of children with cleft palate and their parents about daily life with otitis media with effusion and associated hearing loss. DESIGN A qualitative study. Semistructured interviews were used to collect data from parents. Participatory techniques, including activities on a tablet computer, were used to collect data from children. Framework analysis was applied to interview transcripts. SETTING Two English cleft units. PARTICIPANTS A purposive sample of parents of 37 children aged 0 to 11 years with experience of otitis media with effusion. Their children also took part if aged 6 to 11 years (n = 22). RESULTS Themes related to the following: (1) emotions (frustration, anger, sadness, happiness, anxiety), (2) educational experiences (struggling at school, having to sit at the front of the class, requiring extra support, missing lessons for appointments or due to ear infections), (3) social interactions (isolation, communication, reliance on siblings, participation in activities). CONCLUSIONS A number of areas of interviewees' everyday life were affected by the presence of otitis media with effusion. Parents may need to be forewarned about the possible ongoing nature of this condition and its impact on a child's social and emotional experiences. Children may also benefit from age-appropriate information about otitis media with effusion and its treatment, including information on hearing tests, to help reduce any anxiety.
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13
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Alberconi TF, Siqueira GLC, Sathler R, Kelly KA, Garib DG. Assessment of Orthodontic Burden of Care in Patients With Unilateral Complete Cleft Lip and Palate. Cleft Palate Craniofac J 2017; 55:74-78. [DOI: 10.1177/1055665617718825] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To assess the orthodontic burden of care of patients from a Brazilian rehabilitation center (Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo [HRAC-USP]). Design: Retrospective. Setting: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo. Interventions: One hundred files of unilateral complete cleft lip and palate patients who had consecutively finished orthodontic rehabilitation at HRAC-USP were evaluated from January 2011 to January 2013. The duration of orthodontic treatment, number of visits, kilometers traveled, number of appliances and surgical procedures performed were recorded. The sample was divided into 2 subgroups according to severity the interarch relation (Goslon Yardstick score) at the beginning of orthodontic treatment. Mann-Whitney test was applied for intergroup comparison ( P < .05). Results: For the total sample (n = 100), the mean time of orthodontic treatment was 140.2 months, the mean number of orthodontic appointments was 61.8, the mean number of appliances was 10, the mean number of surgical procedures was 6.2, and the mean distance traveled to attend the center for orthodontic appointments was 38,978.5 km. The subgroup with the most severe malocclusion (Goslon yardsticks scores 4 and 5) showed a longer orthodontic treatment length, greater number of surgical procedures, and longer distance traveled than those presenting Goslon yardstick scores 1, 2, and 3. Conclusion: Patients with greater severity of the initial malocclusion experienced a higher burden of care than patients with less severity of the initial malocclusion. To reduce the burden of care, research and efforts should focus on minimizing maxillary growth deficiency related to primary surgery.
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Affiliation(s)
| | | | - Renata Sathler
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Katherine A. Kelly
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Daniela G. Garib
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
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14
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Stock NM, Ridley M. Young Person and Parent Perspectives on the Impact of Cleft Lip and/or Palate Within an Educational Setting. Cleft Palate Craniofac J 2017; 55:607-614. [PMID: 29554456 DOI: 10.1177/1055665617734991] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: During the school years, a cleft of the lip and/or palate (CL/P) may pose a risk to educational achievement. To further understand this multifaceted association, and to offer suggestions as to how young people’s educational experiences might be improved, qualitative investigation is warranted. Design: Semi-structured telephone interviews were conducted with young people born with CL/P (n = 10; aged 10-16 years) and their parents (n = 10). The resulting data were subjected to inductive thematic analysis. Results: Negative social interactions, cleft-related treatment, the presence of an additional condition, and a lack of appropriate support from teachers was found to influence young people’s educational experience. Methods for promoting diversity, support from clinical teams, facilitation of positive school transitions, implementation of training for teachers, and a holistic approach to the measurement of “success” were suggested by participants as potential ways of improving this experience. Conclusions: The findings of this study point to a need for a range of school-focused interventions, as well as the inclusion of a number of potentially impactful variables within future quantitative research.
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Affiliation(s)
- Nicola Marie Stock
- Centre for Appearance Research and The Cleft Collective, University of the West of England, Bristol, United Kingdom
| | - Matthew Ridley
- Centre for Appearance Research and The Cleft Collective, University of the West of England, Bristol, United Kingdom
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Lateral Ramus Cortical Bone Plate in Alveolar Cleft Osteoplasty with Concomitant Use of Buccal Fat Pad Derived Cells and Autogenous Bone: Phase I Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6560234. [PMID: 29379800 PMCID: PMC5742895 DOI: 10.1155/2017/6560234] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/12/2017] [Indexed: 12/29/2022]
Abstract
Tissue regeneration has become a promising treatment for craniomaxillofacial bone defects such as alveolar clefts. This study sought to assess the efficacy of lateral ramus cortical plate with buccal fat pad derived mesenchymal stem cells (BFSCs) in treatment of human alveolar cleft defects. Ten patients with unilateral anterior maxillary cleft met the inclusion criteria and were assigned to three treatment groups. First group was treated with anterior iliac crest (AIC) bone and a collagen membrane (AIC group), the second group was treated with lateral ramus cortical bone plate (LRCP) with BFSCs mounted on a natural bovine bone mineral (LRCP+BFSC), and the third group was treated with AIC bone, BFSCs cultured on natural bovine bone mineral, and a collagen membrane (AIC+BFSC). The amount of regenerated bone was measured using cone beam computed tomography 6 months postoperatively. AIC group showed the least amount of new bone formation (70 ± 10.40%). LRCP+BFSC group demonstrated defect closure and higher amounts of new bone formation (75 ± 3.5%) but less than AIC+BFSC (82.5 ± 6.45%), suggesting that use of BFSCs within LRCP cage and AIC may enhance bone regeneration in alveolar cleft bone defects; however, the differences were not statistically significant. This clinical trial was registered at clinicaltrial.gov with NCT02859025 identifier.
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Chang CS, Wallace CG, Hsiao YC, Lu TC, Chen SH, Chan FC, Chen PKT, Chen JP, Chang CJ, Noordhoff MS. Patient and parent reported outcome measures in cleft lip and palate patients before and after secondary alveolar bone grafting. Medicine (Baltimore) 2017; 96:e9541. [PMID: 29384973 PMCID: PMC6393063 DOI: 10.1097/md.0000000000009541] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
European and Northern American healthcare authorities increasingly encourage the use of Patient Reported Outcome Measures (PROMs) that complement clinical and laboratory assessments to help holistically evaluate reconstructive outcomes. This is the first study to evaluate PROMs in cleft lip/palate patients who have, or have not, undergone secondary alveolar bone grafting (SABG).A PROMs study was conducted; 40 consecutive consenting cleft lip/palate children between 8 and 14 years old were included. Twenty patients did, and 20 patients did not, have SABG. PROMs scores from children and parents in the 2 groups were compared.Forty patients completed the trial. No significant differences in total score from the Chang Gung Short Form-15 (CGSF-15) were found between children and their parents. Children with SABG reported no more oral-nasal regurgitation than children without SABG, but tended to report more nasal obstruction. There were no statistically significant differences in parent reported outcomes between the 2 groups.Cleft lip/palate patients who underwent SABG reported significantly less nasal regurgitation and more nasal obstruction compared to those patients who did not undergo SABG.
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Affiliation(s)
- Chun-Shin Chang
- Department of Chemical and Materials Engineering, College of Engineering, Chang Gung University
- Craniofacial Research Center, Department of Medical Research, Department of Plastic & Reconstructive Surgery and Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan
| | - Christopher Glenn Wallace
- Craniofacial Research Center, Department of Medical Research, Department of Plastic & Reconstructive Surgery and Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan
| | - Yen-Chang Hsiao
- Craniofacial Research Center, Department of Medical Research, Department of Plastic & Reconstructive Surgery and Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan
| | - Ting-Chen Lu
- Craniofacial Research Center, Department of Medical Research, Department of Plastic & Reconstructive Surgery and Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan
| | - Sue-Huei Chen
- Department of Psychology, National Taiwan University, Taipei
| | - Fuan-Chiang Chan
- Craniofacial Research Center, Department of Medical Research, Department of Plastic & Reconstructive Surgery and Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan
| | - Philip Kuo-Ting Chen
- Craniofacial Research Center, Department of Medical Research, Department of Plastic & Reconstructive Surgery and Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan
| | - Jyh-Ping Chen
- Department of Chemical and Materials Engineering, College of Engineering, Chang Gung University
| | - Chee-Jen Chang
- Graduate Institute of Clinical Medical Sciences, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - M. Samuel Noordhoff
- Craniofacial Research Center, Department of Medical Research, Department of Plastic & Reconstructive Surgery and Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan
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Sundell AL, Törnhage CJ, Marcusson A. A comparison of health-related quality of life in 5- and 10-year-old Swedish children with and without cleft lip and/or palate. Int J Paediatr Dent 2017; 27:238-246. [PMID: 27464906 DOI: 10.1111/ipd.12253] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The current understanding on health-related quality of life (HRQoL) in young Swedish children with cleft lip and/or palate (CL/P) is sparse, and therefore, research on impact of CL/P on HRQoL in children is needed. AIMS To investigate HRQoL in 5- and 10-year-old Swedish children with CL/P in comparison with non-cleft controls. Also to analyse whether there were any differences in HRQoL between children with cleft lip (with or without cleft palate, CL ± P) and cleft palate only (CP) and/or gender differences. DESIGN A total of 137 children with CL/P and 305 non-cleft controls participated. HRQoL was measured with KIDSCREEN-52. RESULTS All children in the study exhibited HRQoL within or above the age-matched reference interval of the method with similar results in both groups; however, in the dimension 'social support and peers', the 10-year-old children with CL/P perceived lower HRQoL than the non-cleft controls, but it did not reach statistical significance. Type of cleft or gender did not influence HRQoL. CONCLUSIONS Both 5- and 10-year-old Swedish children with CL/P had HRQoL in the normal reference interval. Their general life situations were well adjusted to their clefts, but the older children with CL/P felt more excluded and less supported by peers.
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Affiliation(s)
- Anna Lena Sundell
- Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Carl-Johan Törnhage
- Department of Paediatrics, Skaraborg Hospital, Skövde, Sweden.,Sahlgrenska Academy, Gothenburg's University, Gothenburg, Sweden
| | - Agneta Marcusson
- Maxillofacial Unit, Department of Dentofacial Orthopaedics, Linköping University, Linköping, Sweden
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Lauris RDCMC, Capelozza L, Calil LR, Lauris JRP, Janson G, Garib DG. Facial profile esthetics in operated children with bilateral cleft lip and palate. Dental Press J Orthod 2017; 22:41-46. [PMID: 28902248 PMCID: PMC5573009 DOI: 10.1590/2177-6709.22.4.041-046.oar] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 04/18/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE: The aim of this study was to evaluate the facial profile esthetics of rehabilitated children with complete bilateral cleft lip and palate (BCLP), comparing the judgment of professionals related and not related to cleft rehabilitation and laypersons. METHODS: Thirty children in the mixed dentition (24 male; 6 female) with a mean age of 7.8 years were evaluated using facial profile photographs by 25 examiners: 5 orthodontists and 5 plastic surgeons with experience in cleft care, 5 orthodontists and 5 plastic surgeons without experience in oral cleft rehabilitation and 5 graduated laymen. Their facial profiles were classified into esthetically unpleasant (grade 1 to 3), esthetically acceptable (grade 4 to 6), and esthetically pleasant (grade 7 to 9). Intraexaminer and interexaminer errors were evaluated using Spearman correlation coefficient and Kendall's test, respectively. Inter-rater differences were analyzed using Friedman test and Student-Newman-Keuls test for multiple comparisons. RESULTS: Orthodontists dealing with oral clefts rehabilitation considered the majority of the sample as esthetically pleasant. Plastic surgeons of the cleft team and laypersons classified most of the sample as esthetically acceptable. Most of the orthodontists and plastic surgeons not related to cleft care evaluated the facial profile as esthetically unpleasant. The structures associated to unpleasant profiles were the nose, the midface and the upper lip. CONCLUSIONS: The facial profile of children with BCLP was classified as esthetically acceptable by laypersons. Professionals related to cleft rehabilitation were more lenient and those not related to cleft care were stricter to facial esthetics than laypersons.
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Affiliation(s)
| | - Leopoldino Capelozza
- Universidade do Sagrado Coração, Programa de Pós-graduação em Ortodontia, Departamento de Biologia Oral (Bauru/SP, Brasil)
| | - Louise Resti Calil
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brasil)
| | | | - Guilherme Janson
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brasil)
| | - Daniela Gamba Garib
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Departamento de Ortodontia (Bauru/SP, Brasil)
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Abualfaraj R, Daly B, McDonald F, Scambler S. Cleft lip and palate in context: Learning from, and adding to, the sociological literature on long-term conditions. Health (London) 2017; 22:372-388. [DOI: 10.1177/1363459317693409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cleft lip and palate is a common congenital anomaly affecting males and females. While there is psychological research on cleft lip and palate, there is relatively little research exploring the social context of cleft lip and palate and the experiences of living with the condition on a daily basis. Drawing on common themes emerging from sociological work which have explored the experiences of people living with long-term conditions (uncertainty, social relations, self-esteem and self-image and biomedical concerns), we argue that these themes can be used to help elucidate the experiences of people living with cleft lip and palate. Within this framework, the findings of a qualitative study exploring the experiences of people living with cleft lip and palate are presented. The results suggest that all four themes can be found within the accounts of people living with cleft lip and palate, and there are many commonalities between the experiences of these people and those living with other long-term conditions. Conversely there are interesting areas of divergence. Unlike most long-term conditions, cleft lip and palate is not degenerative and treatment means symptoms will reduce over time. This is reflected in narratives around ‘normality’ as the endpoint of the care pathway. In addition, prenatal diagnosis means that the vast majority of participants within this study were born into, and grew up within, the care pathway. This has implications for the way in which cleft lip and palate is understood and the provision of information, relationships with members of the care team over time and the temporal and contextualised impact of cleft lip and palate on social relations and the self.
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Affiliation(s)
| | - Blanaid Daly
- Dublin Dental University Hospital, Ireland
- King’s College London, UK
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Hand Function and Appearance following Reconstruction for Congenital Hand Differences. Plast Reconstr Surg 2016; 138:73e-81e. [DOI: 10.1097/prs.0000000000002286] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Stock NM, Feragen KB. Psychological adjustment to cleft lip and/or palate: A narrative review of the literature. Psychol Health 2016; 31:777-813. [DOI: 10.1080/08870446.2016.1143944] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Perceptions of Young Adults Having Undergone Combined Orthodontic and Orthognathic Surgical Treatment: A Grounded Theory Approach. J Oral Maxillofac Surg 2015; 73:2391-8. [DOI: 10.1016/j.joms.2015.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 05/06/2015] [Accepted: 05/08/2015] [Indexed: 10/23/2022]
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Kulinna-Cosentini C, Czerny C, Baumann A, Weber M, Sinko K. TrueFisp versus HASTE sequences in 3T cine MRI: Evaluation of image quality during phonation in patients with velopharyngeal insufficiency. Eur Radiol 2015; 26:2892-8. [DOI: 10.1007/s00330-015-4115-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/29/2015] [Accepted: 11/12/2015] [Indexed: 11/30/2022]
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Stock NM, Feragen KB, Rumsey N. “It Doesn't All Just Stop at 18”: Psychological Adjustment and Support Needs of Adults Born with Cleft Lip and/or Palate. Cleft Palate Craniofac J 2015; 52:543-54. [DOI: 10.1597/14-178] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Cleft in the lip and/or the palate (CL/P) is considered to be a lifelong condition, yet relatively little is known about the long-term outcomes for patients. Existing literature is largely outdated and conflicted, with an almost exclusive focus on medical aspects and deficits. Objective To explore the psychological adjustment and possible support needs of a large number of adults born with CL/P from their own perspective. Design Fifty-two individual telephone interviews eliciting qualitative data. Results Qualitative analysis identified five themes. Participants reported a range of challenges in relation to discharge from the service, additional surgery as an adult, social and romantic relationships, higher education, vocational achievement, and access to psychological support. The findings imply that most adults with a cleft adjust well to these challenges and report many positive outcomes. For a minority of patients, issues attributed to the cleft may continue to cause distress in adulthood. Conclusions Adults with CL/P may require psychological support, information about the heritability of cleft, signposting and referrals from nonspecialists, support regarding further treatment, and opportunities to take part in research and activities. New issues arising in adulthood, such as entering the workplace, forming long-term relationships, and starting a family, may warrant both further investigation and additional support. Further work is needed to identify the factors that contribute to psychological distress and resilience, as well as the timing of particular points of risk and opportunity for personal growth.
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Affiliation(s)
- Nicola Marie Stock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | | | - Nichola Rumsey
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
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Ward K, Gott M, Hoare K. Participants' views of telephone interviews within a grounded theory study. J Adv Nurs 2015; 71:2775-85. [PMID: 26256835 DOI: 10.1111/jan.12748] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2015] [Indexed: 11/30/2022]
Abstract
AIM To offer a unique contribution to the evolving debate around the use of the telephone during semistructured interview by drawing on interviewees' reflections on telephone interview during a grounded theory study. BACKGROUND The accepted norm for qualitative interviews is to conduct them face-to-face. It is typical to consider collecting qualitative data via telephone only when face-to-face interview is not possible. During a grounded theory study, exploring users' experiences with overnight mask ventilation for sleep apnoea, the authors selected the telephone to conduct interviews. This article reports participants' views on semistructured interview by telephone. DESIGN An inductive thematic analysis was conducted on data pertaining to the use of the telephone interview in a grounded theory study. METHODS The data were collected during 4 months of 2011 and 6 months in 2014. The article presents an inductive thematic analysis of sixteen participants' opinions about telephone interviewing and discusses these in relation to existing literature reporting the use of telephone interviews in grounded theory studies. FINDINGS Overall, participants reported a positive experience of telephone interviewing. From each participants reports we identified four themes from the data: being 'phone savvy; concentrating on voice instead of your face; easy rapport; and not being judged or feeling inhibited. CONCLUSION By drawing on these data, we argue that the telephone as a data collection tool in grounded theory research and other qualitative methodologies need not be relegated to second best status. Rather, researchers can consider telephone interview a valuable first choice option.
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Affiliation(s)
- Kim Ward
- The University of Auckland's School of Nursing, New Zealand
| | - Merryn Gott
- The University of Auckland's School of Nursing, New Zealand.,The University of Auckland, New Zealand
| | - Karen Hoare
- The University of Auckland's School of Nursing and the Department of General Practice and Primary Healthcare, New Zealand
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Aravena PC, Gonzalez T, Oyarzún T, Coronado C. Oral Health-Related Quality of Life in Children in Chile Treated for Cleft Lip and Palate: A Case-Control Approach. Cleft Palate Craniofac J 2015; 54:e15-e20. [PMID: 26153758 DOI: 10.1597/15-095] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare the oral health-related quality of life of patients treated for cleft lip and/or cleft palate (CL/P) versus unaffected children between 8 and 15 years of age using a Spanish-language version of the Child Oral Health Impact Profile (COHIP-Sp) administered to a Chilean population. DESIGN A cross-sectional study with a matched case-control design was used. METHODS Participants were 48 children (mean age 11.3 years) with a history of CL/P from three cities in Chile and one group of 96 children (mean age 11.2 years) unaffected by CL/P. The COHIP-Sp was applied to both groups. Quality of life was compared according to the overall score and the average score of items and domains on the COHIP-Sp scale between the two groups (Mann-Whitney U test; P < .05). RESULTS The COHIP-Sp score was 94.1 ± 19.3 in children with CL/P and 97.1 ± 15.6 for the control group (P = .31). A significantly lower score was observed in the group with CL/P in the domains "functional well-being" (P = .001) and "school environment" (P = .001); the only average in favor of the quality of life in children with CL/P was in "self-image" (P = .0002). CONCLUSION The oral health-related quality of life of children with a history of CL/P was similar to that of the control group. Nevertheless, a lower quality of life was observed concerning items associated with speech and being understood by other people. Further study into the risk factors associated with surgery and rehabilitative treatment is recommended.
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Cesario JM, Landin Malt A, Deacon LJ, Sandberg M, Vogt D, Tang Z, Zhao Y, Brown S, Rubenstein JL, Jeong J. Lhx6 and Lhx8 promote palate development through negative regulation of a cell cycle inhibitor gene, p57Kip2. Hum Mol Genet 2015; 24:5024-39. [PMID: 26071365 DOI: 10.1093/hmg/ddv223] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 06/08/2015] [Indexed: 12/23/2022] Open
Abstract
Cleft palate is a common birth defect in humans. Therefore, understanding the molecular genetics of palate development is important from both scientific and medical perspectives. Lhx6 and Lhx8 encode LIM homeodomain transcription factors, and inactivation of both genes in mice resulted in profound craniofacial defects including cleft secondary palate. The initial outgrowth of the palate was severely impaired in the mutant embryos, due to decreased cell proliferation. Through genome-wide transcriptional profiling, we discovered that p57(Kip2) (Cdkn1c), encoding a cell cycle inhibitor, was up-regulated in the prospective palate of Lhx6(-/-);Lhx8(-/-) mutants. p57(Kip2) has been linked to Beckwith-Wiedemann syndrome and IMAGe syndrome in humans, which are developmental disorders with increased incidents of palate defects among the patients. To determine the molecular mechanism underlying the regulation of p57(Kip2) by the Lhx genes, we combined chromatin immunoprecipitation, in silico search for transcription factor-binding motifs, and in vitro reporter assays with putative cis-regulatory elements. The results of these experiments indicated that LHX6 and LHX8 regulated p57(Kip2) via both direct and indirect mechanisms, with the latter mediated by Forkhead box (FOX) family transcription factors. Together, our findings uncovered a novel connection between the initiation of palate development and a cell cycle inhibitor via LHX. We propose a model in which Lhx6 and Lhx8 negatively regulate p57(Kip2) expression in the prospective palate area to allow adequate levels of cell proliferation and thereby promote normal palate development. This is the first report elucidating a molecular genetic pathway downstream of Lhx in palate development.
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Affiliation(s)
- Jeffry M Cesario
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, NY 10010, USA
| | - Andre Landin Malt
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, NY 10010, USA
| | - Lindsay J Deacon
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, NY 10010, USA
| | - Magnus Sandberg
- Department of Psychiatry, Nina Ireland Laboratory of Developmental Neurobiology, University of California, San Francisco, CA 94158, USA
| | - Daniel Vogt
- Department of Psychiatry, Nina Ireland Laboratory of Developmental Neurobiology, University of California, San Francisco, CA 94158, USA
| | - Zuojian Tang
- Center for Health Informatics and Bioinformatics, New York University School of Medicine, New York, NY 10016, USA and
| | - Yangu Zhao
- Program on Genomics of Differentiation, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
| | - Stuart Brown
- Center for Health Informatics and Bioinformatics, New York University School of Medicine, New York, NY 10016, USA and
| | - John L Rubenstein
- Department of Psychiatry, Nina Ireland Laboratory of Developmental Neurobiology, University of California, San Francisco, CA 94158, USA
| | - Juhee Jeong
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, NY 10010, USA,
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Abstract
BACKGROUND Although functional outcomes following reconstruction for congenital hand differences are frequently described, much less is known regarding children's ability to cope with the psychosocial effects of these conditions. The authors qualitatively explored stress and coping mechanisms among children following reconstructive surgery for congenital hand differences. METHODS Forty patients and their parents participated in semistructured interviews examining children's stress related to hand functioning and appearance, emotional responses to stress, and coping strategies. Interviews were audio-taped, transcribed, and analyzed thematically. A consensus taxonomy for classifying content evolved from comparisons of coding by two reviewers. Themes expressed by participants were studied for patterns of connection and grouped into broader categories. RESULTS In this sample, 58 percent of children and 40 percent of parents reported stress related to congenital hand differences, attributed to functional deficits (61 percent), hand appearance (27 percent), social interactions (58 percent), and emotional reactions (46 percent). Among the 18 children who reported stress, 43 percent of parents were not aware of the presence of stress. Eight coping strategies emerged, including humor (12 percent), self-acceptance (21 percent), avoidance (27 percent), seeking external support (30 percent), concealment (30 percent), educating others (9 percent), support programs (21 percent), and religion (24 percent). CONCLUSIONS Although children with congenital hand differences often experience emotional stress related to functional limitations and aesthetic deformities, many apply positive coping mechanisms that enhance self-esteem. Clinicians caring for children with congenital hand differences should inform families about potential sources of stress to direct resources toward strengthening coping strategies and support systems.
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Habersaat S, Monnier M, Peter C, Bolomey L, Borghini A, Despars J, Pierrehumbert B, Müller-Nix C, Ansermet F, Hohlfeld J. Early Mother-Child Interaction and Later Quality of Attachment in Infants with an Orofacial Cleft Compared to Infants without Cleft. Cleft Palate Craniofac J 2013; 50:704-12. [DOI: 10.1597/12-094.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective The main objective of this study was to assess mother-child patterns of interaction in relation to later quality of attachment in a group of children with an orofacial cleft compared with children without cleft. Design Families were contacted when the child was 2 months old for a direct assessment of mother-child interaction and then at 12 months for a direct assessment of the child's attachment. Data concerning socioeconomical information and posttraumatic stress symptoms in mothers were collected at the first appointment. Participants Forty families of children with a cleft and 45 families of children without cleft were included in the study. Families were recruited at birth in the University Hospital of Lausanne. Results Results showed that children with a cleft were more difficult and less cooperative during interaction at 2 months of age with their mother compared with children without a cleft. No significant differences were found in mothers or in dyadic interactive styles. Concerning the child's attachment at 12 months old, no differences were found in attachment security. However, secure children with a cleft were significantly more avoidant with their mother during the reunion episodes than secure children without cleft. Conclusion Despite the facial disfigurement and the stress engendered by treatment during the first months of the infant's life, children with cleft and their mothers are doing as well as families without cleft with regard to the mothers' mental health, mother-child relationships, and later quality of attachment. A potential contribution for this absence of difference may be the pluridisciplinary support that families of children with cleft benefit from in Lausanne.
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Affiliation(s)
- Stephanie Habersaat
- Department of Child and Adolescent Psychiatry, University Hospital of Lausanne, Switzerland
| | - Maryline Monnier
- Department of Child and Adolescent Psychiatry, University Hospital of Lausanne, Switzerland
| | - Camille Peter
- Department of Child and Adolescent Psychiatry, University Hospital of Lausanne, Switzerland
| | - Luce Bolomey
- Department of Child and Adolescent Psychiatry, University Hospital of Lausanne, Switzerland
| | - Ayala Borghini
- Department of Child and Adolescent Psychiatry, University Hospital of Lausanne, Switzerland
| | - Josée Despars
- Department of Child and Adolescent Psychiatry, University Hospital of Lausanne, Switzerland
| | - Blaise Pierrehumbert
- Department of Child and Adolescent Psychiatry, University Hospital of Lausanne, Switzerland
| | - Carole Müller-Nix
- Department of Child and Adolescent Psychiatry, University Hospital of Lausanne, Switzerland
| | - François Ansermet
- Department of Child and Adolescent Psychiatry, Hospital of Geneva, Switzerland
| | - Judith Hohlfeld
- Department of Child Surgery, Department of Pediatric Surgery, University Hospital of Lausanne, Switzerland
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Dzioba A, Skarakis-Doyle E, Doyle PC, Campbell W, Dykstra AD. A comprehensive description of functioning and disability in children with velopharyngeal insufficiency. JOURNAL OF COMMUNICATION DISORDERS 2013; 46:388-400. [PMID: 23809882 DOI: 10.1016/j.jcomdis.2013.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 05/22/2013] [Accepted: 05/31/2013] [Indexed: 06/02/2023]
Abstract
UNLABELLED Children with velopharyngeal insufficiency (VPI) experience functional impairments in a variety of areas that extend beyond the primary physical impairment associated with this disorder. At present, the physical deficits associated with VPI have been studied extensively; however, a comprehensive description of social and communicative participation in this population is needed. Therefore, a biopsychosocial framework such as the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), may offer an enhanced understanding of the daily experiences of children with VPI. Specifically, the ICF-CY framework is intended to model complex nonlinear systems, and as such, to describe functioning as the interaction of multiple components from which a limitation in communicative participation may emerge. This paper describes how the ICF-CY framework can be utilized to comprehensively describe functioning and disability in children with VPI by describing the interaction of components of this framework. LEARNING OUTCOMES As a result of this activity, the reader will be able to: (1) discuss the utility of the ICF-CY in describing the multi-dimensional nature of velopharyngeal insufficiency (VPI); (2) describe interrelationships between functioning and disability in children with VPI; and (3) identify how limitations in communicative participation may emerge from the interaction of components of the ICF-CY in children with VPI.
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Affiliation(s)
- Agnieszka Dzioba
- University of Western Ontario, Doctoral Program in Health and Rehabilitation Sciences, Elborn College, London, Ontario, Canada N6G 1H1.
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Sharif MO, Callery P, Tierney S. The Perspectives of Children and Young People Living with Cleft Lip and Palate: A Review of Qualitative Literature. Cleft Palate Craniofac J 2013; 50:297-304. [DOI: 10.1597/12-054] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To explore the experiences of children and young people with cleft lip and/or palate (CL/P) in relation to being treated for and living with this condition. Design A systematic review of qualitative research. Electronic databases and hand-searching were employed to identify relevant studies. The review centered on studies examining the views or experiences of young patients first-hand. Any study using a qualitative/mixed method design was eligible for inclusion. Results From 184 potential references, 38 papers were read in full, from which only two studies of young people met all the review's inclusion criteria. Common reasons for exclusion were not being a qualitative study, not focusing on CL/P, or data coming from parents only. A further two papers provided a retrospective account of childhood with CL/P from interviews with adults. Their suitability for the review's aims was limited, but they were discussed. Conclusions This review demonstrates that there is a paucity of evidence about the experiences of young people living with CL/P. No studies of children and only two studies of young people met all inclusion criteria. Identified papers implied that more attention is needed within families and services to help young people manage everyday difficulties such as bullying and self-consciousness due to facial difference.
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Affiliation(s)
- Mohammad Owaise Sharif
- National Institute for Health Academic, Orthodontics, School of Dentistry, the University of Manchester; Higher Cambridge Street, Manchester, U.K
| | - Peter Callery
- Children's Nursing, the School of Nursing, Midwifery and Social Work the University of Manchester, U.K.; Higher Cambridge Street, Manchester, U.K
| | - Stephanie Tierney
- The School of Nursing, Midwifery and Social Work, the University of Manchester; Higher Cambridge Street, Manchester
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Havstam C, Laakso K, Lohmander A, Ringsberg KC. Taking Charge of Communication: Adults' Descriptions of Growing up with a Cleft-Related Speech Impairment. Cleft Palate Craniofac J 2011; 48:717-26. [DOI: 10.1597/10-033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To obtain descriptions of the experience of growing up with a cleft-related speech impairment and how it was dealt with. Design Semistructured interviews were tape-recorded, transcribed verbatim, and analyzed using a qualitative approach inspired by grounded theory methodology. Setting Interviews took place at participants' homes or workplaces or at the university. Participants Thirteen young adults (25 to 34 years of age) born with cleft palate with or without cleft lip. Results The analysis resulted in the core category Taking charge of communication, which comprised three main categories: Forming an idea of one's speech, Learning about one's communication, and Taking responsibility for communication. The first main category was made up of three subcategories and the other two had two. The categories emerged as parallel processes in the understanding and active handling of communicative interaction. Conclusions The participants described the processes that had enabled them to take charge of their communication. Seeing things from the listener's perspective and being open about the cleft and the speech disorder emerged as important parts of taking active responsibility for communication, as well as accepting their present speech and communication. Communicative participation should be assessed more thoroughly to understand the individual needs of people born with a cleft who have a speech impairment into adolescence.
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Affiliation(s)
- Christina Havstam
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Katja Laakso
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Anette Lohmander
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, Sahlgrenska Academy at University of Gothenburg and CLINTEC, Division of Speech and Language Pathology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
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Abstract
Individuals born with a cleft lip and palate risk developing a deviant appearance and speech during childhood and sometimes also as adults. In this study, 13 young adults born with a cleft (lip and) palate, who had had deviant speech in adolescence, participated in semi-structured interviews. The core category Making sense of the cleft, comprising the two categories Shaping one’s attitude to the cleft and Dealing with being different with seven subcategories, describes the processes of developing self-image in relation to the cleft. The findings are believed to be relevant for individuals born with a cleft, their parents and caregivers.
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