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Biomedical subjects

William Shaw

Publications and source records attributed to William Shaw.

6 recordsLinked to original sources
PubMed2005

Workplace-based return-to-work interventions: optimizing the role of stakeholders in implementation and research.

INTRODUCTION: The challenges of engaging and involving stakeholders in return-to-work (RTW) intervention and research have not been well documented. METHODS: This article contrasts the diverse paradigms of workers, employers, insurers, labor representatives, and healthcare providers when implementing and studying workplace-based RTW interventions. RESULTS: Analysis of RTW stakeholder interests suggests that friction is inevitable; however, it is possible to encourage stakeholders to tolerate paradigm dissonance while engaging in collaborative problem solving to meet common goals. We review how specific aspects of RTW interventions can be instrumental in resolving conflicts arising from differing paradigms: calibration of stakeholders' involvement, the role of supervisors and of insurance case managers, and procedural aspects of RTW interventions. The role of the researcher in engaging stakeholders, and ethical aspects associated with that process are discussed. CONCLUSIONS: Recommendations for future research include developing methods for engaging stakeholders, determining the optimal level and timing of stakeholder involvement, expanding RTW research to more diverse work settings, and developing RTW interventions reflecting all stakeholders' interests.

Community Participation↗
PubMed2005

Facial attractiveness: a longitudinal study.

BACKGROUND: The aim of the study was to investigate various factors that might affect facial attractiveness from ages 11 to 31 years. METHODS: Sixty subjects were selected from a sample participating in the longitudinal Cardiff Survey. Three-quarter-view facial photographs were taken of the subjects smiling and not smiling. Photos were taken in 1981, when the subjects were aged 11 years, and in 2001, when they were aged 31. Twelve judges used a 9-point Likert scale to evaluate overall facial attractiveness and the attractiveness of various facial features. The judges were also asked to estimate the adults' ages. Univariate and multivariate statistical tests and the generalizability theory were used. RESULTS AND CONCLUSIONS: Overall facial attractiveness does not depend on any single feature; smiling and youthful facial appearance make women look more attractive; facial attractiveness tends to decrease over time from ages 11 to 31; people tend to retain their relative levels of attractiveness throughout their life spans; orthodontic treatment improves dental appearance, but it does not necessarily make a person more attractive in the long term. Nevertheless, the positive effect of orthodontic treatment could still be observed, especially in men with lower levels of facial attractiveness in childhood.

Adult↗
PubMed2005

Pharyngeal flap and sphincterplasty for velopharyngeal insufficiency have equal outcome at 1 year postoperatively: results of a randomized trial.

OBJECTIVE: The aim of this trial was to compare the relative effectiveness (efficacy and morbidity) of two surgical procedures for correcting velopharyngeal insufficiency (VPI). DESIGN: This was an international multicenter randomized trial to study the outcome of two surgical procedures (flap and sphincter pharyngoplasty) for speech, incidence of sleep apnea, and surgical complications. METHOD: Ninety-seven patients 3 to 25 years old with repaired cleft palate and previously identified VPI were enrolled from five centers in the United States, Norway, and the U.K. Data were collected at presurgery, 3 months postsurgery, and 12 months postsurgery for subsequent analysis blind to the procedure. Main outcome measures included perceptual speech parameters, sleep apnea, nasalance measures, endoscopic features, and surgical complications. RESULTS: Groups for both surgical procedures achieved a high level of clinical improvement. At 3 months postsurgery, elimination of hypernasal resonance was achieved in twice as many patients after the flap procedure. This reached significance. However, at 12 months postsurgery, no statistically significant difference in outcomes remained between the two procedures for resonance, nasalance, endoscopic outcomes, or surgical complications. Flap and sphincter pharyngoplasty rarely resulted in clinically significant sleep apnea, and no difference was detected between the two procedures in the long-term incidence of sleep apnea. CONCLUSIONS: Despite strongly held views in the literature concerning the relative effectiveness and safety of flap and sphincter pharyngoplasty, no significant differences were detected 1 year postoperatively.

Adolescent↗
PubMed2004

Disability prevention and communication among workers, physicians, employers, and insurers--current models and opportunities for improvement.

PURPOSE: To review prevailing models of disability management and prevention with respect to communication, and to suggest alternative approaches. METHOD: Review of selected articles. RESULTS: Effective disability management and return to work strategies have been the focus of an increasing number of intervention programmes and associated research studies, spanning a variety of worker populations and provider and business perspectives. Although primary and secondary disability prevention approaches have addressed theoretical basis, methods and costs, few identify communication as a key factor influencing disability outcomes. Four prevailing models of disability management and prevention (medical model, physical rehabilitation model, job-match model, and managed care model) are identified. The medical model emphasizes the physician's role to define functional limitations and job restrictions. In the physical rehabilitation model, rehabilitation professionals communicate the importance of exercise and muscle reconditioning for resuming normal work activities. The job-match model relies on the ability of employers to accurately communicate physical job requirements. The managed care model focuses on dissemination of acceptable standards for medical treatment and duration of work absence, and interventions by case managers when these standards are exceeded. Despite contrary evidence for many health impairments, these models share a common assumption that medical disability outcomes are highly predictable and unaffected by either individual or contextual factors. As a result, communication is often authoritative and unidirectional, with workers and employers in a passive role. CONCLUSION: Improvements in communication may be responsible for successes across a variety of new interventions. Communication-based interventions may further improve disability outcomes, reduce adversarial relationships, and prove cost-effective; however, controlled trials are needed.

Communication↗
PubMed2003

Prediction of outcomes of secondary alveolar bone grafting in children born with unilateral cleft lip and palate.

The aim of this cross-sectional clinical outcome study using retrospective data capture of treatment histories was to examine the characteristics of children born with unilateral cleft lip and palate (UCLP) in the United Kingdom (UK) who were not grafted at the appropriate age or who had an unsuccessful secondary alveolar bone graft. The subjects were born with complete non-syndromic UCLP between 1.4.82 and 31.3.84 and were aged between 12.0 years and 14.7 years at the time of data collection under the care of 48 cleft teams. The success of secondary alveolar bone grafting was assessed using a modification of the Bergland index. There were no independent predictors for unmet bone grafting need. The outcome of secondary alveolar bone grafting was assessed for 164 subjects; 90 (55%) had a successful first graft. Non-Caucasian (P = 0.037) and increasing age at grafting (P = 0.007) were risk factors for poor outcome. After adjustment for other risk factors, increased age at grafting was independently associated with having a seriously deficient or failed graft (OR = 1.03; 95% CI 1.01-1.06 P = 0.036). All the non-Caucasians in this sample had an unsatisfactory graft. Increasing age in months at grafting and ethnicity are predictors for poor outcome of secondary alveolar bone grafting in children born with UCLP in the UK.

Adolescent↗