Two methods of relaxing laryngeal musculature were investigated in adults with hyperfunctional dysphonia. Assessments were conducted pre‐treatment, post‐treatment and at three month follow‐up. Measures included the level of superficial laryngeal tension using an electromyogram, control of vocal fold vibration using Fx traces from an electrolaryngograph and an auditory evaluation using a phonation profile. Two personality questionnaires were administered and the subjects' self‐rating of voice was recorded. The duration of treatment was noted. Subjects were matched into groups receiving either laryngeal EMG biofeedback or progressive relaxation, both within a graded voice training programme. A significant improvement in all measures occurred for both programmes, which was maintained at follow‐up. No significant difference between the two approaches emerged. Implications for the assessment and treatment of hyperfunctional dysphonia are discussed.

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Factors associated with longer-term outcomes of multilevel orthopaedic surgery in ambulatory children with cerebral palsy using a multivariate approach were evaluated using a retrospective pretest-posttest design. The population included 20 ambulatory children with spastic diplegia who had undergone multilevel orthopaedic surgery with a minimum of 4-year interval between a preoperative and a postoperative gait assessment. Multiple regression analysis was used to identify factors associated with postoperative velocity and mean knee flexion in stance. Independent variables included in the regression models were velocity, mean knee flexion in stance, age at preoperative evaluation, Gross Motor Function Classification System level, use of ankle-foot orthoses, leg length, age-adjusted body mass index, number of surgical procedures, and range of motion of hip and knee. Children who demonstrated faster postoperative gait velocity 4 years or more after surgery were younger at the time of initial evaluation, had undergone fewer surgical procedures, had faster preoperative gait velocity, used ankle-foot orthoses postoperatively, and had increased hip extension range of motion postoperatively (R = 0.55). Children who demonstrated greater knee flexion in stance 4 years or more after surgery had undergone more surgical procedures, greater postoperative popliteal angle, and less knee extension range of motion (R = 0.73). This study demonstrates the usefulness of a multivariate approach toward understanding and predicting outcomes. The results of this study will provide clinicians and researchers more information about those factors associated with maintained improvements in the longer term and may be useful for treatment planning.

ithoErigist to the Middlese,z. Hospital. INTRODUCTION.TIIM investigation is tlic work of three differerit groups of workers, cach group independently snbniitting its report on the completion of the whole series. It was only when the investigation was finished that the clinical, bioclicniical, and bacteriological results were compared. I n this paper are considered the remote results of gastreetomy only. Precise operative tec*hnique, immediate mortality, and post-operative treatment have not been dealt with ; nor have the theories of the causation of ulceration, and the relative merits of the various other types of SUI gic:al operations perfornied for the relief or benign ulceration of the stoniach and duodenum, been disciissed. The paper is divided into four scctioiis~~histoIical, clinical findings, laboratory findings, and, lastly, the commentarj. which expresses the considered opinion of the three groups of workers.

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