A comparison of multiple factors in the surgical management of cervical incompetence was carried out in 114 procedures. Factors examined included training level of the operator, gestational age, cervical effacement and dilation at the time of operation, diagnostic evaluation, Shirodkar or McDonald procedure, year of the procedure, and tocolytic therapy. The endpoint for successful outcome was defined as 37 weeks or newborn weighing over 2500 gm rather than neonatal survival, thus differing from previous studies. All patients were delivered vaginally unless there was an obstetric indication for cesarean delivery. The most important determinants of a term birth in patients with incompetent cervix were operator experience and the use of a Shirodkar procedure.

Adult↗

PubMedDate not supplied

A behavioural programme for the modification of encopresis.

This paper describes a behaviour modification programme for the treatment of encopresis. The programme, which is carried out by the parents over a relatively short period of time in the home setting, aims to make the child aware of internal cues prior to elimination and to rearrange the contingencies for appropriate use of the toilet. To date, seven of eleven children, both continuous and discontinuous encopretics, have been treated successfully and have remained clean for up to 7 months regardless of other problems in the child and his family. From a relatively detailed analysis of those treated it can be concluded that a behavioural approach is effective with chronic encopretic children, many of whom had been previously treated unsuccessfully by both physical and psychotherapeutic procedures. The failures suggest, firstly that careful assessment of each child and the motivation of the parents is required, so that the standard programme can be modified to suit each individual case. Secondly a maintenance programme must follow the intensive treatment procedure to ensure that parents continue to handle the child consistently.

Behavior Therapy↗

PubMedDate not supplied

The themes and consequences of consultations between a psychiatrist and a tutorial class teacher working with children from a deprived inner-city area.

This article describes the way in which consultation sessions between a tutorial class teacher and a psychiatrist were set up, and the themes that arose during the first term. We discuss the effect of the consultation on the relationship of the teacher with other professionals in her network. A hypothesis is put forward about the way in which the consultation caused changes which reduced the stress the teacher experienced.

Acting Out↗

PubMedDate not supplied

Rehabilitation facilities of Greater New York.

Explore the source record for details and available documents.

Humans↗