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Biomedical subjects

G Andrews

Publications and source records attributed to G Andrews.

At least 181 records · Page 10Linked to original sources
PubMed1981

Regression to the mean in pretreatment measures of stuttering.

Pre-post treatment evaluation designs are common in stuttering research. Their propriety depends on the assumption that spontaneous remission is not likely. There are six studies in the literature in which stutterers have been measured on two occasions some months apart. In all studies there was a trend to less stuttering on the second assessment, but in no study was the difference between scores significant. One hundred and thirty-two stutterers awaiting treatment were assessed when they were first seen and then at the beginning of treatment 1--23 months later. There was a small but significant improvement between the two assessments. The size of the improvement was comparable to those reported in the six published studies. This spontaneous improvement occurs mainly in the three months following the first assessment, and there is little change thereafter. It is concluded that pre-post studies of subjects who waited more than three months for treatment are valid and that the observed improvement can be due solely to the effects of treatment. Studies that assess improvement from the time subjects are first seen should allow for spontaneous remission to determine the improvement due to treatment.

Adult↗
PubMed1981

Procedures for verification of electrode placement in EMG studies of orofacial and mandibular muscles.

Many muscles used in speech are small and intimately interconnected. There is a need for anatomical and physiological data which would allow identification of the particular muscle fibers being recorded in electromyographic (EMG) investigations. EMG recordings were taken from eighteen orofacial and mandibular muscles while gestures believed to be specific to each muscle were performed. The anatomic criteria for the placement of the electrodes, the quality of the EMG spikes and interference patterns obtained, and the degree of differentiation of the temporal sequence of activity from that in neighboring muscles were used to decide on the degree of certainty that a particular muscle was being recorded. The appropriateness of each gesture as a stimulus to any muscle was determined on the basis of the level of activation occurring with the gesture relative to other muscles and its degree of variability between subjects.

Electrodes↗
PubMed1980

General practitioner as psychotherapist.

The importance of general practitioners attending to the emotional problems of their patients is demonstrated. Evidence has been presented concerning the feasibility and cost effectiveness of general practitioners developing the skills required to manage such disorders. A model for training general practitioners in counselling and interviewing skills, and in the more complex psychological therapies, is presented. It is argued that such an integrated approach would produce results superior to the present fragmented approach.

Adult↗
PubMed1980

Meta-analysis of the effects of stuttering treatment.

Despite the many reports of stuttering treatment, there is little consensus either on the long term effectiveness of treatment or on which treatments are the most effective. The literature was searched for treatment outcome studies that reported sufficient data to allow a meta-analysis to be conducted. Forty-two studies covering the treatment of a total of 756 stutterers were located. In these studies the typical client was a 25-year-old severe stutterer who received 80 hours of symptom reduction treatment. Most studies used reliable measures of both stuttering and attitude to assess improvement some six months after treatment had ended. Treatment effects were calculated from 116 pre- and posttreatment pairs of measures. Average effect size was 1.3, which indicates that after treatment the groups of stutterers experienced a 1.3 standard deviation improvement in their pretreatment scores. Clearly, stuttering treatments can be beneficial, and the benefits appear comparable to other treatments in the health sciences. Prolonged speech and gentle onset techniques evidenced better gains in the short term and long term than either attitude or airflow techniques. These four seem preferable to any of the other reported treatments and were certainly better than no treatment.

Adult↗
PubMed1980

Dysarthria of adult cerebral palsy: I. Intelligibility and articulatory impairment.

The speech intelligibility and articulatory impairment of 32 spastic and 18 athetoid males, aged 17-55, were examined. Selection was based on a definite diagnosis of cerebral palsy, and adequate intelligence, hearing, and ability to perform the required tasks. Two estimates of speech intelligibility were obtained from naive listeners: single words correctly recognized and prose intelligibility rating. Diadochokinetic (DDK) syllable rates and percent correct articulation of selected phonemes were employed as indices of articulatory impairment. The 50 subjects were, on average, judged to be 50% intelligible on both intelligibility estimates. Group mean DDK rate was 2.9 syllables per second and 78% of phonemes were transcribed as correctly articulated. :The mean scores of the spastic subjects were superior to the athetoids on all speech measures, significantly so for single-word intelligibility and DDK rate even when group inequalities for physical disability and I.Q. were adjusted. In this sample, spastics were less physically disabled and had lower I.Q.'s than athetoids. Specific phonemic features characteristic of the dysarthria in cerebral-palsied subjects were: (1) anterior lingual place inaccuracy; (2) reduced precision of fricative and affricate manners; and (3) inability to achieve the extreme positions in the vowel articulatory space. A comparison of these results with those reported for children with cerebral palsy suggests that the consonantal place and manner problems are fairly stable features of cerebral palsy dysarthria.

Adolescent↗
PubMed1980

Dysarthria of adult cerebral palsy: II. Phonemic analysis of articulation errors.

The articulation errors of 32 spastic and 18 athetoid males, aged 17-55 years, were analyzed using a confusion matrix paradigm. The subjects had a diagnosis of congenital cerebral palsy, and adequate intelligence, hearing, and ability to perform the speech task. Phonetic transcriptions were made of single-word utterances which contained 49 selected phonemes: 22 word-initial consonants, 18 word-final consonants and nine vowels. Errors of substitution, omission and distortion were categorized on confusion matrices such that patterns could be observed. It was found that within-manner errors (place or voicing errors or both) exceeded between-manner errors by a substantial amount, more so on final consonants. The predominant within-manner errors occurred on fricative phonemes for both initial and final positions. Affricate within-manner errors, all of devoicing, were also frequent in final position. The predominant between-manner initial position errors involved liquid-to-glide and affricate-to-stop changes, and for final position, affricate-to-fricative. Phoneme omission occurred three times more frequently on final than on initial consonants. The error data of individual subjects were found to correspond with the identified overall group patterns. Those with markedly reduced speech intelligibility demonstrated the same patterns of error as the overall group. The implications for treatment are discussed.

Adolescent↗
PubMed1979

Tonic stretch reflexes in lip, tongue and jaw muscles.

Despite considerable speculation it remains unclear as to whether stretch reflexes perform a functional role in speech articulator muscles. Recent research, however, has shown that long loop stretch reflex mechanisms are brought into play during voluntary contraction of limb muscles and a functional role in oscillatory damping has been suggested. It was decided, therefore, to use a method and a technique of analysis similar to that used in limb muscles to search for tonic stretch reflex (TSR) responses in lip, tongue and jaw muscles during sustained voluntary contraction. The term 'action TSR' is used to differentiate stretch reflex responses measured from voluntary activity from those measured at rest. Simultaneous electromyogram (EMG) recordings were taken from the lip, tongue and jaw musculature in normal, stutterer and cerebral spastic subjects. Subjects were instructed to hold the appropriate articulator in a fixed position while the experiment applied an irregular, continuously changing, stretching force. The stretch and EMG signals were analyzed using a cross correlation and spectral analysis technique. This provided a sensitive means of detecting any EMG fluctuations which covaried with applied stretch and might therefore be classified as reflex. No suggestion of such action TSR responses could be found in lip or tongue muscles of any of the subjects tested, including the cerebral spastic subjects with dysarthric speech. It is therefore concluded that action TSR mechanisms are not operative in control of lip and tongue muscles in man. Furthermore, dysarthric speech in cerebral spasticity cannot be attributed to exaggerated tone of lip and tongue muscles resulting from hypersensitivity of TSR mechanisms. In contrast, clear action TSR responses were demonstrable in jaw closing muscles while in jaw opening muscles, small amplitude responses were detected but were not substantial in comparison with background activity. Since the action TSR is present in jaw and limb muscles, but absent in lip and tongue muscles, the suggestion of a functional role of this reflex in damping mechanical oscillations associated with inertial loads is further supported.

Adult↗
PubMed1979

Asbestos disease in maintenance workers of the chemical industry.

In several large groups of workers employed in chemical plants, chest x-ray abnormalities (small irregular opacities and/or pleural changes) of the type known to be induced by asbestos were found in a proportion of those examined. A cross-sectional study of maintenance workers in a large chemical plant was undertaken to evaluate the prevalence of asbestosis; 185 workers were examined. Radiologic evidence of parenchymal interstitial fibrosis was found in 24% of those examined; in 10% of workers, parenchymal fibrosis was the only abnormality. Pleural fibrosis and/or calcification was found in the absence of parenchymal fibrosis in 14% of cases; in another 14% of workers, both parenchymal and pleural abnormalities were detected. The prevalence was significantly higher in those employed 20 or more years. Pleural abnormalities were more prevalent than were parenchymal changes. The increased risk of lung cancer and mesothelioma remains to be studied.

Adult↗
PubMed1978

Life event stress, social support, coping style, and risk of psychological impairment.

The effects of life event stress, coping style, and social support on psychological impairment were examined in a survey of a representative Australian suburban sample (N = 863). Psychological impairment was defined as a score of 4 or more on the 20-item General Health Questionnaire. Life event stress, coping style, and one of the social support variates, crisis support, were related to impairment, significantly decreasing or increasing the risk of being identified as impaired from the total sample frequency of 24 per cent. There was no evidence that coping style or social support became associated by moderating the relationship between life event stress and impairment, but rather because of their independent relationship with psychological impairment.

Adaptation, Psychological↗