Search

Background: Speech‐sound development in preschoolers with unilateral cleft lip and palate (UCLP) as a group is delayed/disordered, and obstruents comprise the most vulnerable sound class. Aims: To evaluate the development of obstruent correctness (PCC‐obs) and error types (cleft speech characteristics (CSCs) and developmental speech characteristics (DSCs)) from ages 3–5 and to investigate possible predictors (error types, velopharyngeal dysfunction (VPD) and gender) of PCC‐obs at age 5 in two groups of children with UCLP. Methods & Procedures: Subgroup analysis was conducted within a multicentre randomized controlled trial (RCT) of primary surgery (Scandcleft Project). A total of 125 Danish children with UCLP received lip and soft palate repair around 4 months of age and early hard palate closure at 12 months (EHPC group) or late hard palate closure at 36 months (LHPC group). Audio and video recordings of a naming test were available for 108 children at ages 3 and 5, and recordings were transcribed phonetically by blinded raters. Outcomes & Results: PCC‐obs scores increased significantly from ages 3–5 in both groups, but with small effect sizes in the EHPC group that had higher scores at age 3 than the LHPC group. DSCs decreased in both groups whereas CSCs only decreased in the LHPC group that had more CSCs at age 3 than the EHPC group. The frequency of CSCs at age 3 was a significant predictor of PCC‐obs scores at age 5 in both groups. DSCs significantly improved the logistic regression model in the EHPC group, whereas VPD and gender did not significantly improve the model in either group. Conclusions & Implications: Although PCC‐obs developed significantly from ages 3 to 5, children with UCLP as a group did not catch up to typically developing Danish children at age 5. Furthermore, the LHPC group at age 5 did not reach the 3‐year level of the EHPC group, which means that delaying hard palate closure until age 3 is detrimental to obstruent development. Both CSCs and DSCs at age 3 were important predictors of PCC‐obs at age 5 and should be considered when determining need for intervention. [ABSTRACT FROM AUTHOR]

Patient-reported outcome data have moved from the realm of research to center stage in efforts to provide patient-centered care. In a Danish context, health authorities are seeking to promote and standardize the use of patient-reported outcome data. This involves normative articulations of what counts as meaningful data work in a healthcare system characterized by intensified data-sourcing. Based on ethnographic material, I suggest that an assemblage of actors, both human and technological, has accomplished the articulation of meaningful data work, with patient-reported outcome as being dependent on the active application of data in clinical trajectories--in contrast to supplying data "passively" for secondary use for research or governance. This normative articulation of "Active patient-reported outcome" legitimizes the Danish patient-reported outcome assemblage by showing alignment of the concerns of patients, clinicians and health authorities. At the same time, "Active patient-reported outcome" foreshadows challenges in making data work meaningful in local practice. [ABSTRACT FROM AUTHOR]

Abstract: Background: Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. Aims: To assess the influence of different timing of hard palate closure in a two‐stage procedure on articulation skills in 3‐year‐olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery, hearing and speech therapy. Methods & Procedures: A randomized controlled trial (RCT). Early hard palate closure (EHPC) at 12 months versus late hard palate closure (LHPC) at 36 months in a two‐stage procedure was tested in a cohort of 126 Danish‐speaking children born with non‐syndromic UCLP. All participants had the lip and soft palate closed around 4 months of age. Audio and video recordings of a naming test were available from 113 children (32 girls and 81 boys) and were transcribed phonetically. Recordings were obtained prior to hard palate closure in the LHPC group. The main outcome measures were percentage consonants correct adjusted (PCC‐A) and consonant errors from blinded assessments. Results from 36 Danish‐speaking children without CP obtained previously by Willadsen in 2012 were used for comparison. Outcomes & Results: Children with EHPC produced significantly more target consonants correctly (83%) than children with LHPC (48%; p < .001). In addition, children with LHPC produced significantly more active cleft speech characteristics than children with EHPC (p < .001). Boys achieved significantly lower PCC‐A scores than girls (p = .04) and produced significantly more consonant errors than girls (p = .02). No significant differences were found between groups regarding burden of treatment. The control group performed significantly better than the EHPC and LHPC groups on all compared variables. [ABSTRACT FROM AUTHOR]

This article is concerned with the ways in which bodies and subjects are enacted and negotiated in the encounter between client and practitioner within specialized kinesiology – a specific complementary and alternative medical practice. In the article we trace the ideas of connections and disconnections, which are conceptualized and practised within kinesiology. We attempt to come to grips with these specific notions of relatedness through the introduction of the concept ‘energetic kinship’ and to relate them to more general discussions about the nature of subjects, bodies and social identity in late modern society. We argue that through the particular approach to the body as a prime locus of knowledge on which kinesiological treatment practices are based, kinesiology offers clients an alternative understanding of being-in-the-world. The understanding of the body as the locus of knowledge might, on the one hand, potentially alleviate the individual from the weight of a late modern focus on self-responsible, rational and autonomous individuality, while, on the other hand, it simultaneously supports this understanding. Hence, we argue that kinesiology operates with a subject which is both inherently related and individual at the same time, and that these particular understandings may be appealing in a world in which health and illness are increasingly seen as a question of individual responsibility. The article was written on the basis of interviews and participant observation among kinesiological teachers and practitioners in Denmark. [ABSTRACT FROM PUBLISHER]

This article argues that although there is no necessary link between constructivism and particular sets of norms, constructivism opens up a space for normativity and can be articulated through particular normative or political programmes. In the article it is shown how Laclau's deconstructive constructivism can be articulated within the framework of an ethos of democratisation. The article takes its empirical point of departure in recent Danish debates on dangerous dogs. [ABSTRACT FROM AUTHOR]