PubMed Health⌕ Search

Biomedical subjects

W G Webb

Publications and source records attributed to W G Webb.

At least 19 recordsLinked to original sources

Inter- and intrajudge reliability for videofluoroscopic swallowing evaluation measures.

Interjudge reliability for videofluoroscopic (VFS) swallowing evaluations has been investigated, and results have, for the most part, indicated that reliability is poor. While previous studies are well-designed investigations of interjudge reliability, few reports of intrajudge reliability are available for VFS measures derived from frame-by-frame analysis that clinicians typically employ. The purpose of this study was to examine the inter- and intrajudge reliability of VFS examination measures commonly used to assess swallowing functions. No training to criteria occurred. VFS examinations were conducted on 20 patients who had suffered a stroke within six weeks and had no structural abnormalities or tracheostomies. Three clinical judges served as subjects and rated the VFS examinations from videotape using frame-by-frame analysis. A clinician's repeated review of measures employed in the 20 examinations indicated high intrajudge reliability for a number of measures, suggesting that an experienced clinician may employ consistent standards for rating certain VFS measures across patients and time. These standards appear to vary among clinicians and yield unacceptable interjudge reliability. The need to train clinicians to criteria to improve interjudge reliability is discussed.

Adult↗

A review of orthodontic appliance problems in general dental practice.

Patients will often visit their general dental practitioner when experiencing problems with orthodontic appliances, even if they were referred to a specialist for treatment. Reassurance may be all that is necessary, but simple intervention may allow the treatment to continue with a minimum of interruption. This article is an overview of the common orthodontic appliance problems that may be encountered and provides practical advice on how to deal with them.

Equipment Failure↗

An investigation into the standard of orthodontic treatment carried out by GDPs after completion of a clinical assistant training.

A sample of 172 orthodontic patients treated by 10 general dental practitioners in their practices was assessed in terms of treatment need and standard of treatment provided. The practitioners had been clinical assistants, for a minimum of 2 years, at a District General Hospital before starting any of the cases. Prior to treatment 70% of the cases had a 'clear need' for treatment on dental health grounds and 73% of the cases had a 'moderate' or 'great need' for treatment on aesthetic grounds. Using the Peer Assessment Rating nomogram to assess the treatment standard, 83% of patients could be classed as 'improved' or 'greatly improved' with treatment but 17% were 'worse or no different'. The standard of treatment produced by fixed appliances was found to be superior to that produced by removable appliances alone. When removable appliances were used the best results were obtained when consultant advice was given. The results for the clinical assistant sample are compared with the results for the GDS sample published in 1993. Ways of further improving the treatment standards produced by the general dental practitioners are considered.

Chi-Square Distribution↗

Orthodontics in the general dental service of England and Wales: a critical assessment of standards.

Out of a sample of 1210 orthodontic patients treated within the General Dental Services in England and Wales, a high proportion showed no improvement. Upper and lower fixed appliances had the greatest influence on the outcome of treatment in terms of aesthetics, dental health need and standards. When treatment was analysed according to the appliance used, there were no statistically significant differences in the standard of treatment undertaken by specialist orthodontists and general dental practitioners. Methods for improving British orthodontic standards are considered.

Analysis of Variance↗

Anomia in cerebral diseases.

Naming performance was studied in demented patients, age-matched controls, left-hemisphere stroke patients with aphasia and right-hemisphere stroke patients. The experimental naming test compared four levels of perceptual difficulty and two language variables: word frequency and word length. Naming accuracy and error types were compared among subject groups. Perceptual difficulty influenced naming in the demented and right-hemisphere stroke patients, but not in aphasics and controls. Visual errors, likewise, characterized the former two groups. Semantically-related errors and circumlocutions characterized the naming of aphasic and demented patients, while phonemic errors were common only in aphasics. The results suggested differing patterns of anomia in different patient groups.

Aged↗

Language disturbance. An initial symptom of cortical degenerations and dementia.

Six patients manifested progressive language disturbance, resembling aphasia secondary to a focal dominant hemisphere lesion, as either an isolated initial symptom or a prominent early feature of a more generalized dementing illness. None had a history of transient ischemic attacks or stroke, and in all cases an extensive clinical and laboratory investigation failed to show either a focal brain lesion or a definable etiology of dementia. This article discusses the relationship of isolated or early aphasia to known dementing syndromes. Patients who consult physicians for language disturbance should be evaluated and followed up both for evidence of progressive language deterioration and for the development of a generalized dementia.

Aged↗

The naming disorder of dementia.

Naming impairment is a common feature of the language disorder of dementia, yet agreement has not been reached on its mechanisms. In this study, the confrontation naming performance of twelve demented subjects was compared to that of age-matched controls. Naming deficits were studied in relation to overall language and cognitive dysfunction and analysed to assess the importance of both perceptual and linguistic factors. Naming dysfunction occurred even in mild dementia, in patients whose overall language function remained normal, and worsened in proportion to the degree both of language deficit and overall cognitive dysfunction. Perceptual difficulty and word frequency, but not word length, were important determinants of naming performance in demented patients.

Aged↗

Reading problems in chronic aphasia.

Thirty-five aphasic subjects who were 1 year or longer post onset of brain injury were given a battery of reading tests which was composed of recognition and oral reading tests for letters, words, sentences, and paragraphs, and comprehension tests for sentences and paragraphs. Results indicated a residual reading disorder or alexia in all subjects, with comprehension tests producing the highest error rate, oral reading tests second, and then recognition tests. Reading ability was found to be related to overall language skill, level of education, and oral reading ability. Results are discussed in light of current theories of reading and future research needs.

Aphasia↗

Word and letter reading and the mechanism of the third alexia.

Four patients, two with global aphasia and two with Broca's aphasia, demonstrated the seemingly paradoxical ability to read words but not their component letters. Picture naming was only moderately impaired, and repetition of word and letter names was intact, excluding both a generalized dysnomia and an articulatory disturbance as the cause of the literal alexia. Matching tests revealed processing deficits in three of the patients, more severe for letters than for words. Oral reading of word lists showed that short, high-frequency, and picturable words were read best, whereas nonsense trigrams, which require phonetic processing, were the most difficult. The residual reading of patients with severe Broca's or global aphasia and the "third alexia" appears to involve purely visual, nonphonetic mechanisms for word recognition, using posterior left hemisphere or even minor hemisphere centers. Letter reading, by contrast, along with phonetic reading of syllables, appears to be a more specialized, anterior left hemisphere process.

Aphasia↗

Alexia and agraphia in Wernicke's aphasia.

Three patients with otherwise typical Wernicke's aphasia showed consistently greater impairment of reading than auditory comprehension. While this syndrome resembles alexia with agraphia, the paraphasia of speech, repetition, and naming underline the aphasic nature of the disorder. Together with previous reports of isolated word deafness in Wernicke's aphasia, these cases suggest a relative independence of auditory and visual language processing.

Aged↗

Some thoughts on undergraduate orthodontic training viewed by a regional consultant.

The emphasis in the undergraduate orthodontic curriculum should be on understanding the principles of removable appliance therapy. The student must be able to design and adjust these appliances and to realise their limitations. The effect of extractions with or without appliance therapy should be stressed. Some theoretical background is needed on the development of normal occlusion and its variations, and on diagnosis and treatment planning but the emphasis should be on the practical aspects of treatment. This means that the practitioner will then be in a position to treat the more simple cases to a consultant prescription. Obviously this knowledge can be expanded on short post-graduate courses for general practitioners and ideally with clinical attachment in a Regional orthodontic department for the most interested.

Adult↗

Word deafness in Wernicke's aphasia.

Three patients with otherwise typical Wernicke's aphasia showed consistent superiority of visual over auditory comprehension. The precedents for and anatomical basis of a selective auditory deficit in Wernicke's aphasia are discussed, including the relationship to pure word deafness. One implication of spared visual language function may be the use of gesture in language therapy for such patients.

Aphasia↗

The effects of auditory and visual "distractors" on the frequency of stuttering.

The purpose of this study was to evaluate the effects of auditory and visual "distractors' on the frequency of stuttering. Ten stutters spoke extemporaneously during conditions of auditory masking, when lights were turned on and off in a room, and during normal conditions. No significant differences in stuttering frequency were found between conditions. The results of this study suggest that further research is needed to clarify the relationship between stuttering frequency, vocal intensity, and supposed distractors during conversational speech.

Adult↗

The efficacy of cueing techniques in Broca's aphasia.

Twenty Broca's aphasia patients were stimulated with four cues in a picture-naming task. Among the severe aphasics in the group, presentation of a word to be imitated was the most effective cue and presentation of the initial syllable of the word ranked second. Sentence completion and printed word cues were equally effective and ranked third. Mild aphasic patients responded equally well to all four classes of cues. Reliability measures indicated that the order of potency of cues for the severe group was stable over time. Oral apraxia did not appear to contribute significantly to the severity of Broca's aphasia in any of these subjects. Possible explanations are presented for the effectiveness of cues studied.

Aphasia↗