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Biomedical subjects

W C Shaw

Publications and source records attributed to W C Shaw.

At least 37 records · Page 2Linked to original sources
PubMed1996

The surgical care of cleft lip and palate patients in England and Wales.

The results of a postal survey in 1992 of surgeons in England and Wales undertaking primary repairs for babies born with cleft lip and palate are presented. 64 plastic surgeons undertaking primary cleft repairs were identified. The majority of cleft surgeons were low volume operators undertaking 10 or less lip repairs annually. Low volume operators were less likely to attend joint disciplinary clinics than high volume operators and those that did attended clinics with fewer specialities represented. None of the low volume operators collected standardised records for their patients. The recommendations of the Royal College of Surgeons of England for centralisation of cleft care in England and Wales on a regional basis and a minimum case-load per surgeon of 30 new cases per year are discussed.

Child, Preschool↗
PubMed1996

Digital imaging of cephalometric radiography, Part 1: Advantages and limitations of digital imaging.

Digital imaging has several potential advantages over traditional cephalometry. These include storage, transmission, and enhancement of images, reduced exposure to radiation for patients, and the possibility of automated cephalometric analysis. This paper outlines some of these advantages, discusses the limitations of digital imaging and suggests possible future developments.

Cephalometry↗
PubMed1996

Digital imaging of cephalometric radiographs, Part 2: Image quality.

The aim of this study was to compare the diagnostic quality of conventional cephalometric radiographs with that of digital image counterparts. The random error associated with angular and linear measurements recorded on the digital images was greater than on the conventional radiographs. In addition, there was a systematic error producing statistically significant differences in the majority of angular and linear measurements between the digital images and the conventional radiographs. The errors that occurred with some measurements were of sufficient magnitude to be of clinical significance, particularly in a cephalometric situation where a high degree of accuracy is required. It is therefore suggested that, for digital imaging of cephalometric radiographs, a pixel matrix larger than 512 x 512 with more than 64 gray levels is required to maintain the diagnostic quality of the original radiograph.

Cephalometry↗
PubMed1996

Consultant orthodontic services for cleft patients in England and Wales.

A postal questionnaire survey of consultant orthodontists in England and Wales was undertaken as part of a national audit of the care of children born with cleft lip/and or cleft palate. A 100% response rate was achieved. The majority of respondents stated that they provide orthodontic treatment for cleft patients but only 78% of these attend multi-disciplinary cleft clinics. Consultant orthodontists provide treatment not only in the form of appliances for patients born with clefts but are also involved in the counselling of parents and coordination of regional data bases. Only 24% of hospital orthodontists are involved in the provision of presurgical appliances for cleft babies on a regular basis. The lack of rationalisation of orthodontic services and a low uptake of standardised record keeping protocols for cleft patients by consultant orthodontists gives cause for concern.

Child↗
PubMed1996

Use of standardized video recordings to assess cleft surgery outcome.

A standardized method of video recording the nasolabial area of children with complete unilateral clefts of the lip and nose is described. Assessment of the outcome of cleft surgery using a scoring system to evaluate the video recordings was carried out by a panel of plastic surgeons familiar with the problems of secondary deformity in cleft patients. Nine features of the appearance and function of the lip and 10 features of the nose appearance were assessed in 30 children, aged 11 to 14 years, from two cleft treatment centers. The reliability of the panel ranged from poor to excellent for different features of the lip and nose. With further development this technique may be useful in quality assurance, intercenter comparisons, or outcome studies of surgical techniques.

Adolescent↗
PubMed1996

Minimum standards for the management of cleft lip and palate: efforts to close the audit loop. Royal College of Surgeons of England.

Intercentre audit in the late 1980s revealed poorer outcomes for facial growth for British patients with cleft lip and palate than equivalent patients in northern Europe. A subsequent survey of the surgical practices in England and Wales, under the auspices of the Surgical Audit and Epidemiology Unit, revealed the widespread involvement of low-volume operators in cleft care, a tendency for low-volume operators to have an incomplete network of associated professionals, and non-standardised record keeping protocols. Recommendations for minimum standards of care for children born with cleft lip and palate were produced by a multidisciplinary steering group. A further investigation is planned to determine their validity and to provide a baseline for future audit cycles.

Cleft Lip↗
PubMed1995

The relationship between the index of orthodontic treatment need and consensus opinion of a panel of 74 dentists.

This study looked at the aesthetic and dental health components of the index of orthodontic treatment need in relation to peer assessment of dental health and aesthetic need (panel of 74 dentists). The dental health component had a Spearmans correlation coefficient of +0.64 and the aesthetic component +0.86 when compared with the mean subjective opinion of 74 dentists. It has been proposed to have three categories for both the dental health and aesthetic components in accordance with consensus opinion. The panel of 74 examiners were more likely to regard aesthetics as a greater need for treatment than dental health.

Attitude of Health Personnel↗
PubMed1995

The use of occlusal indices: a European perspective.

Although occlusal indices are used in connection with public health orthodontic programs in some states, their adoption in everyday practice in the United States is extremely limited. On the other hand, indices are used extensively in Northern Europe, especially in determining access to public health orthodontics or the level of third party copayment. This article describes the development and validation of two new indices, IOTN (an index of treatment need) and PAR (an index of treatment outcome). Their application in a series of studies has led us to conclude that occlusal indices have a role in resource allocation and planning, promoting treatment standards, identifying prospective patients, and informed consent.

Europe↗
PubMed1995

The influence of incisal malocclusion on the social attractiveness of young adults in Finland.

The aim of this study was to investigate the importance of dentofacial appearance on the perceived social attractiveness of young adults in Finland. The dental arrangements studied were incisal crowding, median diastema, protruding incisors, and ideal incisal occlusion. Facial photographs of six young adults were obtained and modified, so that for each face, four different dental arrangements could be portrayed. The photographs were shown to 1007 Finnish students to estimate social and personal characteristics of the person in the photograph. Dental arrangement had a significant influence on the perceived beauty and success of the persons. Test faces with incisal crowding and median diastema were ranked as significantly less intelligent, beautiful and sexually attractive, and judged to belong to lower social class than the same faces with ideal occlusion. Protruded incisors did not affect the ratings compared to ideal occlusion. On the average, female test faces were judged more favourably than the male ones. The results indicate that among Finnish students conspicuous incisal crowding or spacing represent a social disadvantage compared to normal or protruded incisors.

Adolescent↗
PubMed1995

Psychosocial adjustment in Norwegian adults who had undergone standardised treatment of complete cleft lip and palate. II. Self-reported problems and concerns with appearance.

Aspects of social and psychological adjustment were investigated in a sample of 233 Norwegian adults 20-35 years old with repaired complete cleft lip and palate (CLP); in 126 the cleft was on the left, in 45 on the right, and in 62 it was bilateral. All subjects received a standardised regimen of care from the Oslo cleft palate team. The study, based on response to a questionnaire, partly copied a national survey of social and economic life in the Norwegian population. Adults with complete clefts were compared with a large control sample of the same age. The purpose of this paper is to describe the occurrence of common psychological problems among subjects with CLP. Anxiety, depression, and palpitations were reported about twice as often by subjects with CLP compared with controls, and these psychological problems were strongly associated with concerns about appearance, dentition, speech, and desire for further treatment. These findings suggest that there is an impaired level of psychological wellbeing among subgroups of subjects with clefts.

Adaptation, Psychological↗
PubMed1995

Psychosocial adjustment in Norwegian adults who had undergone standardised treatment of complete cleft lip and palate. I. Education, employment and marriage.

Aspects of social and psychological adjustment were investigated in a sample of 233 Norwegian adults 20-35 years old with repaired complete cleft of the lip and palate (CLP); in 126 the cleft was on the left, in 45 on the right, and in 62 it was bilateral. All subjects received a standardised regimen of care from the Oslo cleft palate team. The investigation, based on response to a questionnaire, partly replicated a national survey of social and economic life in the population, so that adults with complete clefts could be compared with a large control sample of the same age. This report covers education, employment, and marriage. The results confirm previous findings that there are few differences in educational attainment and employment between adults with CLP and other people. Fewer with CLP marry, and when they marry they do so later in life, particularly if the CLP is bilateral. Income seemed to be lower among married men and single women with CLP than among the control population.

Adaptation, Psychological↗
PubMed1994

Residual orthodontic treatment need in a sample of 15- and 16-year-olds.

This study investigated the residual unmet orthodontic need, both normative and perceived, in young adults who had passed the age at which orthodontic treatment would have normally commenced. A total of 506 15- and 16-year-olds attending eight secondary schools were screened by a single trained examiner using the 'Index of Orthodontic Treatment Need' (IOTN). There were 154 (30.4%) subjects classified as being in need of orthodontic treatment using IOTN and 82 of these (16% of the sample) were found to be in need of orthodontic treatment but had no recollection of orthodontic treatment ever being discussed with them. Children with malocclusion, who had received no orthodontic advice, came from across the range of socio-economic groups, were more likely to be male, and were less likely to be happy with their appearance than their unaffected peers.

Adolescent↗
PubMed1994

Glove use by orthodontists in England and Wales: changes since 1989 and comparisons with general dental practitioners.

Glove wearing during patient treatment has been considered to be an integral part of dental surgery cross-infection control routines. The degree of compliance with this recommendation was tested by distribution of a questionnaire to 1950 dentists known to be practising under the National Health Service (NHS) regulations in England and Wales. Of the dentists who replied, 40 were specialist orthodontists. Results indicated that 60 per cent of these orthodontic respondents used gloves routinely for all patients and procedures, while 25 per cent wore gloves for either selected patients or selected procedures. Fifteen per cent never wore gloves. Comparison with results from a similar survey carried out in 1989 indicated increasing compliance by the orthodontic respondents to glove-wearing recommendations. However, the levels of glove use by orthodontists was found to be lower than that of their general dental practitioner colleagues.

England↗