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A Reading

Publications and source records attributed to A Reading.

8 recordsLinked to original sources

A study of the vaginal contraceptive sponge used with and without the fertility awareness method.

The actual effectiveness rates of natural and barrier methods of family planning are lower than the theoretical ones. If couples accurately defined the limits of the fertile phase and used barriers at that time, then actual effectiveness might increase. A randomized, controlled clinical trial was initiated to determine the effectiveness of the contraceptive sponge used only during the fertile time and to compare this with sponge use at every intercourse. Recruitment problems and discontinuation forced the early termination of this study, but qualitative information about compliance and acceptability was collected. Common sponge problems were reported as were misuses of the sponge, but problems and misuse were not related. Determination of the fertile phase was reportedly easy, but complaints of and discontinuation for inconvenience occurred. For unplanned pregnancies, contraceptive behaviors around the time of conception are presented.

Adolescent

Evaluating suicidal risk.

Suicide is seldom, if ever, a comfortable subject to deal with. Medical school curricula, for various reasons, are too often unable to include the subject in a useful way, and consequently physicians feel unprepared when confronted with a severely depressed or desperate patient in practice. In addition, suicide is an unsettling reality because it relects and reminds us of our own frailty and humanity. Nearly everyone has had an experience of depression or some fleeting thought of suicide at some time in his life. Growing up can often be almost unbearably painful at certain times during adolescence. Middle age inevitably brings with it losses, possibly of loved ones, and with this uncertainties about whether it is really all worth the effort. And as age advances, health and vigor and aspirations slowly depart. Exactly when, at times of crisis such as these, suicidal thoughts take over and lead to action is difficult to define, but the physician must always be prepared for this possibility. Factors have been described which may be useful in alerting the physician to the possibility of suicide. Physical illness may give rise to feelings of hopelessness to which the physician must stay attuned; the patient may also use physical illness as a pretext for seeking help for deeper things that trouble him. As Havens points out, neither reassurance, nor criticism, nor abbreviating the interview will help the situation of a desperate patient. Clarification of the patient's feelings and thoughts are mandatory. Psychiatric consultation can be an important adjunct in achieving this goal and may at times be life saving.

Adolescent