Biomedical subjects

P J Allison

Publications and source records attributed to P J Allison.

17 recordsLinked to original sources

PubMed2005

Clinical evaluation of mastication: validation of video versus electromyography.

BACKGROUNDS AND AIMS: The ability to evaluate masticatory function in people with neurological disabilities is important as this function is often compromised in these groups. However, current standard techniques are often impossible in such groups due to cognitive difficulties. This study is a validation of several variables read from standardised video recordings of mastication as indicators of masticatory function. METHODS: Fifteen healthy, fully dentate male subjects were recorded using EMG and by video simultaneously. An evaluation was undertaken of the video parameters (i) to compare their validity against the electromyographic parameters, (ii) to test intra-rater and inter-rater reliability and (iii) to test the ability to discriminate between four model foods differing in hardness. RESULTS: Masticatory time and the number of masticatory cycles counted on video were found to be valid and reliable indicators. In addition, the number of active chewing cycles performed with an open mouth and identification of the chewing side, were found to have reasonable validity and reliability. The former may allow discrimination between food types. CONCLUSION: As an alternative to the complex evaluation of masticatory function, observation of certain parameters from video recording could be an alternative for use in uncooperative patients.

Adult↗

PubMed2005

Chewing indicators between adults with Down syndrome and controls.

Down syndrome induces a neuromotor deficiency that affects the orofacial musculature, and thus could be implicated in the feeding difficulties affecting people with this disease. This study aimed to investigate the differences in chewing indicators between a group of 11 adults with Down syndrome and a group of 12 healthy subjects without Down syndrome. Chewing ability was evaluated by means of video recordings taken during a standardized meal that included 10 natural foods. The variables collected were masticatory time, number of masticatory cycles, chewing frequency, number of open masticatory cycles, and number of food refusals. There were several differences in both directions for masticatory time and number of masticatory cycles between the two groups. In addition, with the exception of purée, the group with Down syndrome had significantly lower mean chewing frequency than the reference group, and was unable to eat all the foods presented.

Adolescent↗

PubMed2004

Results of a feasibility study for a psycho-educational intervention in head and neck cancer.

BACKGROUND: With survival rates for people with head and neck (H&N) cancers static during the past 30 years and the enormous burden of psychosocial impacts they suffer well documented, the testing of psychosocial interventions in this group is a priority. OBJECTIVE: To test the feasibility of providing a psycho-educational intervention for people with H&N cancer. METHODOLOGY: A prospective non-randomised design was used. Subjects were patients with H&N cancer. They were offered the Nucare coping strategies program in one of three formats: small group and one-to-one formats with therapists; and a home format, with material for home use, without a therapist. Outcomes measures (quality of life (QOL) and anxiety and depression) were collected at baseline and following the intervention. Analyses were performed using non-parametric statistics. RESULTS: Of 128 people invited to participate, 66 agreed, 59 completed the intervention and 50 had outcomes data. Following the intervention, there were significant improvements in physical and social functioning and global QOL, and reduced fatigue, sleep disturbance and depressive symptoms. CONCLUSIONS: These data suggest that the intervention is desired by the target group, feasible to deliver after cancer therapy and may have some beneficial effects, although an appropriately designed study is required to confirm this.

Feasibility Studies↗

PubMed2004

Video evaluation for mastication validation in persons with Down's syndrome.

This article reports the second stage of a validation process. It investigates the discriminatory ability of three video indicators of mastication for a group of people with Down's syndrome, representing a target group with neurological disabilities. The variables were generated through video recordings of 11 adults with Down's syndrome and 12 healthy subjects eating four natural foods varying in hardness. The collected variables were masticatory time, number of masticatory cycles, and number of open masticatory cycles. The analytical approach attempts to test four hypotheses exploring the variations of the video indicators according to food hardness for both groups. It was demonstrated that masticatory time and the number of masticatory cycles have very strong, positive correlations and the number of open masticatory cycles has a fair, positive correlation with the food hardness rankings for both groups. Video evaluation of the test variables using real foods in people with Down's syndrome was found to be a valid means of evaluating aspects of their masticatory function.

Adult↗

PubMed2004

Teaching head and neck cancer patients coping strategies: results of a feasibility study.

To test the feasibility of providing a psycho-educational intervention for people with head and neck (H&N) cancer. A prospective non-randomized design was used. Subjects were patients with H&N cancer. They were offered the Nucare coping strategies program in one of three formats: small group and one-to-one formats with therapists; and a home format, with material for home use, without a therapist. Outcomes measures (quality of life (QOL) and anxiety and depression) were collected at baseline and following the intervention. Analyses were performed using non-parametric statistics. Of 128 people invited to participate, 66 agreed, 59 completed the intervention and 50 had outcomes data. Following the intervention, there were significant improvements in physical and social functioning and global QOL, and reduced fatigue, sleep disturbance and depressive symptoms. These data suggest that the intervention may have some beneficial effects, although an appropriately designed study is required to confirm this.

Adaptation, Psychological↗

PubMed2002

Alcohol consumption is associated with improved health-related quality of life in head and neck cancer patients.

The study aim was to investigate the relationship between alcohol consumption and health-related quality of life (HRQL) in post-therapeutic head and neck cancer patients. A cross-sectional study design was used with a sample of 191 subjects. Data were collected through interview and chart review. Alcohol consumption was evaluated through the dichotomous response to the question "During the past month have you drunk alcohol on one or more occasions?" HRQL was evaluated through the EORTC QLQ-C30 and H&N35 instruments. Data were also collected concerning sociodemographic and clinical variables. Multivariate regression was used to evaluate the hypothesized association. Of 28 domains comprising the EORTC QLQ-C30 and H&N35 instruments, eight were significantly associated with alcohol consumption, while 19 of the 20 remaining domains showed a tendency towards an association. Alcohol drinking was associated with significantly better physical and role functioning, and better global HRQL, plus less fatigue, pain, problems swallowing, dry mouth and feelings of illness. This suggests that, while the study findings are limited by its design and the sample bias, despite alcohol's role as an aetiological factor, it may be reasonable to drink a little as one recovers from head and neck cancer.

Adult↗

PubMed2001

Factors associated with smoking and alcohol consumption following treatment for head and neck cancer.

The study aim was to investigate the correlates of smoking and alcohol drinking in post-therapeutic head and neck (H&N) cancer patients. A cross-sectional design was used with a sample of 191 patients. Data were collected by interview and chart review. Multiple logistic regression analysis was used to evaluate the correlates of dependent variables. Higher education, living with one's partner, later stage, laryngeal site and having surgery or combined therapy were associated with decreased odds for smoking. There was a significant trend for decreasing odds for smoking with increasing stage. Male gender, stage I disease and longer time since treatment were associated with increased odds for drinking alcohol. There was a significant trend for increased odds for drinking with increased time since treatment. These findings suggest that smoking and alcohol drinking have different patterns of associated variables in post-therapeutic H&N cancer patients, which has important implications for intervention design.

Aged↗

PubMed2001

Health-related quality of life comparisons in French and English-speaking populations.

OBJECTIVE: A comparison of health-related quality of life (HRQL) outcomes across three culturally different groups of head and neck (H&N) cancer patients. BASIC RESEARCH DESIGN: A cross-sectional study design with convenience samples. PARTICIPANTS: Study subjects were English- and French-speaking H&N cancer patients recruited in Quebec and France. INTERVENTION: Subjects completed EORTC QLQ-C30 and H&N35 HRQL instruments 3-6 months following the completion of cancer therapy. The former (the core instrument) is a HRQL instrument designed to be used as an outcome measure in patients with any form of cancer, while the latter instrument (the H&N module) is an outcome measure specific to people with H&N cancer. Both instruments are designed to generate domain scores rather than an overall evaluation. The core instrument has 15 domains and the H&N module 18. RESULTS: In the second study, of 33 HRQL domains tested, only 'head and neck pain' and 'constipation' were associated significantly with cultural background, with French-speaking Canadians reporting higher levels of both. CONCLUSION: This study suggests that cultural background is not related to the large majority of HRQL domains assessed by the EORTC QLQ-C30 and H&N35 instruments, thereby enabling international comparisons of (oral) HRQL.

Aged↗

PubMed2000

Prevalence of oral health problems in a group of individuals with Down syndrome in France.

This cross-sectional study describes oral health problems in a sample of children with Down syndrome (DS) compared with their siblings. Data were collected using the Oral Assessment - Down Syndrome questionnaire, a validated French language evaluation to be completed by the child's carer. Parents attending a national meeting anonymously answered a questionnaire for their child with DS and for the sibling closest in age and returned their replies by post. Data concerning 204 individuals with DS (103 males, 101 females; mean age 9.6 years) and 161 of their siblings (80 males, 81 females; mean age 11.8 years) were returned. The association between DS status, age, and oral health was analysed. There was a greater frequency of oral health problems in those with DS with regard to function, clinical signs, disability, and development. The prevalence of chewing problems did not improve with age, the prevalence of bleeding gums and mouth breathing increased with age, and that of tongue protrusion reduced with age. Most parents rated the general and oral health of their children with DS highly, although worse than for their siblings.

Adolescent↗

PubMed2000

A prospective investigation of dispositional optimism as a predictor of health-related quality of life in head and neck cancer patients.

The aim of this study was to investigate the role of dispositional optimism (DO) as a predictor of health-related quality of life (HRQL) in a sample of upper aerodigestive tract cancer (UADT) patients. A prospective observational study design was used with a cohort of patients from one centre. DO was evaluated using a French version of the Life Orientation Test (the FLOT) translated and validated for this study. HRQL was evaluated using the EORTC QLQ-C30 prior to and 3 months following treatment. The association between FLOT ratings and HRQL was evaluated using linear multiple regression analysis and a two-way ANOVA with repeated measures. Baseline data were gathered on 101 subjects and follow-up data on 88 of these. The sample was dichotomized around the median FLOT score creating 'optimist' and 'pessimist' groups. Before treatment, optimists reported better role, cognitive and emotional function, less pain and fatigue and a better global rating of HRQL than did pessimists. Following treatment, optimists reported better role and cognitive functioning, less pain and better global HRQL than did pessimists. Pessimists reported a greater deterioration in the role domain following treatment than did optimists. At no point did pessimists rate HRQL better than optimists. The results suggest that optimism is associated with better HRQL in French UADT cancer patients.

Analysis of Variance↗

PubMed2000

The oral assessment in Down syndrome questionnaire (OADS): development of an instrument to evaluate oral health problems in individuals with Down syndrome.

OBJECTIVE: To develop a French language instrument whose primary aim is the description of oral health status in Down syndrome (DS) individuals. METHOD: Due to the reduced intellectual capacity in DS individuals, the instrument was designed to be completed by their parents. Items were generated through a literature review plus interviews with relevant professionals and DS parents. Following pilot testing, the 31-item questionnaire was divided into seven domains (access, function, development, signs, pain, disability and a global evaluation of oral health status), and subjected to a psychometric evaluation of internal reliability, test-retest reliability and discriminant validity. Internal reliability was assessed through evaluation of Cronbach's alpha or the Kuder-Richardson-20 value where appropriate. Test-retest reliability was assessed through the evaluation of the intra-class correlation coefficient (ICC) for each domain. Discriminant validity was assessed through evaluations of hypothesised differences in domain scores between different groups of DS individuals by age and between DS and non-DS individuals. The theoretical domain categorisation was empirically evaluated through the generation of inter-item correlation coefficients. RESULTS: Internal reliability coefficients ranged from 0.43 for the disability domain to 0.83 for the function domain, while the domain ICCs ranged from 0.56 to 0.77 for the signs and function domains respectively. For discriminant validity, the domains largely performed as hypothesised. Finally, inter-item correlation coefficients largely supported the proposed domain structure of the questionnaire. CONCLUSION: This investigation of the psychometric properties of a proxy. French language, assessment of oral health problems in the DS population has demonstrated an instrument with good preliminary indicators of reliability and validity.

Child↗

PubMed1999

The relationship between dental status and health-related quality of life in upper aerodigestive tract cancer patients.

Although the oral sequelae of treatments for upper aerodigestive tract (UADT) cancers have been well described, very little is known about the relationship between dental status and health-related quality of life (HRQL) in patients with UADT cancer. The aim of this study was to investigate the hypothesis that dental status is a predictor of HRQL in a sample of post-therapeutic UADT cancer patients. A cross-sectional study design was used with a sample of 188 subjects. HRQL was evaluated through the global domain of the EORTC QLQ-C30 instrument and data were collected on sociodemographic, disease, treatment and dental status variables. Linear multiple regression analysis was used to determine those variables with a significant independent association with the HRQL. Two multivariate models were developed each containing age, gender, employment status, cancer site and disease stage, plus either the dental status category "partially dentate with no prosthesis" (P/NP) (F-value for model = 7.31; P < 0.0001; r2 = 0.20) which predicted a significantly worse HRQL, or the dental status category "edentulous with prostheses" (E/WP) (F-value for model = 7.56; P < 0.0001; r2 = 0.20) which predicted a significantly better HRQL. Furthermore, the P/NP group reported significantly more "problems with their teeth" (ANOVA, P = 0.0004), significantly more "trouble eating" (ANOVA, P = 0.024) and significantly more "trouble enjoying their meals" (ANOVA, P = 0.01). Although the cross-sectional nature of the data collection and the somewhat crude nature of the dental status variable limit inferences, the results of this study suggest that dental status has an important effect on HRQL in post-therapeutic UADT cancer patients.

Adult↗

PubMed1998

Correlates of health-related quality of life in upper aerodigestive tract cancer patients.

Reflecting a limited understanding of the definition and determinants of health-related quality of life (HRQoL), the majority of research in this field has concentrated upon the effect of disease- and treatment-related variables. That work specifically investigating HRQoL among upper aerodigestive tract (UADT) cancer patients is no exception to this observation. Treating subject-related and non-subject-related variables separately, the aim of this study was to investigate predictors of global HRQoL rating in a sample of UADT cancer patients, concentrating upon the relative importance of sociodemographic and clinical variables. A cross-sectional study design was used with a sample of 188 UADT cancer patients. Global HRQoL was assessed using the EORTC QLQ-C30 instrument, global domain (global QoL). Other study variables were collected by subject interview and chart review. Two multivariate regression models were independently developed, containing, respectively, subject-rated and non-subject rated variables. In the model containing subject-rated predictors of global QoL, emotional, breathing, physical, financial, pain and appetite problems were significant predictors (F = 14.6, p < 0.0001 and r2 = 0.54). Among non-subject-rated sociodemographic and clinical variables tested, unemployment, older age, female gender, being dentate and a more advanced disease stage predicted worse global QoL rating, while oral as opposed to pharyngeal or laryngeal cancer predicted a better global QoL rating (F = 5.1, p < 0.0001 and r2 = 0.21). In the latter model, a greater proportion of the variance was explained by sociodemographic variables than by clinical variables.

Adult↗

PubMed1997

Quality of life: a dynamic construct.

The principle of Einstein's theory of special relativity is that an observer of an apparently moving body cannot be sure if the body really has moved, if he/she has moved or if both events have occurred. Although Einstein was discussing physical events, a similar hypothesis may apply to quality of life. When using quality of life instruments, one presumes that the point of reference (the observer in Einstein's terms) does not move, i.e. that an individual's attitude towards a particular construct will remain stable. Otherwise, changes in response to particular variables cannot be interpreted. However, attitudes are not constant: they vary with time and experience and are modified by such psychological phenomena as adaptation, coping, expectancy, optimism, self-control and self-concept. For example, eating problems may be extremely important at one point in a person's life. However, when oral discomfort has been diagnosed as cancer and treated with surgery or radiation, the same individual may "objectively" demonstrate more problems when eating, but report them as less because they have now become relatively unimportant. Furthermore, paradoxical reports that some groups of ill individuals rate their quality of life higher than do "healthy" persons raise similar questions concerning between-group point of reference differences. Investigators in the fields of organisational management, education and psychology have developed techniques such as "then ratings", saliency indicators and individualised questionnaires in attempts to quantify within-subject variability and between-group differences pertaining to point of reference. We suggest that similar methods may help us to measure change in the impact of the different items of quality of life instruments. In this paper, we will describe the theories of change associated with quality of life measurement. In addition, we will present evidence suggesting that the point of reference does change, the reasons for this and possible solutions to the problem.

Activities of Daily Living↗

PubMed1995

Cloning and sequencing of a gene encoding pyruvate kinase from Schizosaccharomyces pombe; implications for quaternary structure and regulation of the enzyme.

A cDNA encoding pyruvate kinase from Schizosaccharomyces pombe has been isolated from a lambda ZAPII library. This cDNA was sequenced and found to contain an open reading frame of 1524 nucleotides, giving a predicted protein subunit M, of 55470. The sequence shows a high degree of identity with other pyruvate kinase sequences, with residues implicated in the binding of substrate and metal ion co-factors conserved. However, there are significant differences in the putative subunit interface and effector binding regions which may account for the unusual quaternary structure and regulatory properties of the S. pombe enzyme.

Amino Acid Sequence↗

PubMed1994

A study of the dietary fluoride supplementation prescribing pattern of south Glamorgan dentists.

Following the inclusion of dietary fluoride supplements in the Dental Practitioners Formulary on 1st January 1993, the aims of this study were to observe the fluoride supplementation prescribing pattern of South Glamorgan general dental practitioners and relate it to the latest caries prevalence data. The analysis was carried out on the prescribers and recipients of the prescriptions using post codes to locate all members of both groups into one of 26 dental planning areas (DPA) within the district. As the age of a minority of recipients could not be substantiated, an assumption that they were all 14 years or under was used to calculate a prescription to population ratio for each DPA. These ratios were correlated against the latest available caries prevalence data for each DPA to ascertain any relationship between the level of fluoride supplement prescription and the caries prevalence within South Glamorgan. Data were collected via the Prescription Pricing Division of Welsh Health Common Services Authority for the six month period, 1st January to 30th June 1993. Of 623 prescriptions dispensed within South Glamorgan, 581 were issued by dentists working in the District for patients living in the District. Of the 163 dentists registered within South Glamorgan FHSA, (boundary coterminous with the DHA) 49 made one or more prescription. Of these, 10 dentists wrote 20 prescriptions or more, totalling 401, during the study period, i.e. 6 per cent of the dentists made 69 per cent of the prescriptions. The correlation of the number of prescriptions issued per DPA (according to the dentists' location) with whole time equivalents in that DPA was 0.58 (P < 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

Dental care access among individuals with Down syndrome in France.

The aim of this study was to compare levels of dental care utilization, receipt of dental services, and oral hygiene habits between a sample of individuals with Down syndrome (DS) and their siblings. Data were collected by means of a recently validated, French-language, questionnaire measured of oral health and its related problems for individuals with DS. A cross-sectional survey was undertaken of parents of children with DS attending a national meeting for families and carers of individuals with DS in France. Older individuals with DS were significantly more likely to visit a dentist regularly than their older non-DS siblings, but the group with DS was significantly less likely to have received any dental treatment. The group with DS was significantly more likely to have difficulty finding both medical and dental services. Parents were nearly twice as likely to report problems finding dental services for their child with DS as they were medical services. In a multiple logistic regression analysis within the DS group, it was found that older age, regular speech therapy and ophthalmology consultations, and reports of no difficulty finding a dentist were independently associated with increased odds for regular dental consultations. Analysis of the findings suggests that the parents of children with DS in France frequently encounter problems of access to oral health care and that individuals with DS are less likely to receive dental services than are their non-DS siblings.

Adolescent↗