Clacton Hospital

In spite of having been formulated nearly two decades back, there is as yet no consensus on the validity of the clinically popular self-medication hypothesis (SMH) of substance use disorders in patients with dual diagnosis. SMH broadly proposes that patients use substances in a non-random fashion so that the psychopharmacologic characteristics of particular substances are used to alleviate a variety of psychiatric symptoms and emotional distress. In order to test the SMH empirically, it was broken down to five sub-hypotheses, which were tested in a group of dual-diagnosis schizophrenia (DDS) patients vis-à-vis a group of only-schizophrenia (S) patients (n = 22 each). The DDS group scored lower than the S group regarding general and some specific psychopathology. The DDS patients ascribed reasons for substance use more often for hedonistic pursuit but also for reduction in symptoms and distress. There was a trend for alcohol to be used more for self-medication purposes compared to opioids and cannabis. The perceived effects of these three substances were significantly different on several symptom/distress dimensions. Finally, there was some degree of "match" between symptom-oriented reasons for use of substances and the effect that was perceived. All of this evidence provides a consistent but modest support for the SMH for "some patients, some substances, and some symptoms." The implications are discussed.

Mid-shaft sections of 100% silicone (Bardex) and hydrogel-coated latex (Biocath) catheters were subjected to controlled in vitro encrustation conditions for periods of up to 18 weeks. There was no significant difference in the quantities of encrusting deposits formed on these two materials during the course of the experiment.

R. S. Sayers; The End of French Predominance in Europe. The Financial Crisis of 1924 and the Adoption of the Dawes Plan, The Economic Journal, Volume 87, Issue

An automated technique has been developed for assessing the extent to which existing or potential materials for the construction of indwelling catheters become encrusted during exposure to infected urine. In this technique the enzyme urease is added to artificial urine containing albumin in a reaction vessel which contains the samples to be tested. Controlled replacement of reactants leads to appreciable formation of encrusting deposits which adhere firmly to the surface of the test samples. Deposits have the same chemical composition as those which encrust catheters in vivo.

The authors present the case of a 68-year-old lady with a 35-year history of bipolar affective disorder (BPAD) type I, who developed frontotemporal dementia (FTD). Description of the psychopathology is illustrated with examples of patient's writings in order to demonstrate cognitive abilities at different stages. The diagnosis is supported by MRI and SPECT scans. The authors discuss the difficulties in differentiating the clinical presentation of chronic BPAD and FTD and examine the evidence for two important questions: Is there a relationship between BPAD and FTD and is there a relationship between lithium and risk of dementia? This is, to the best of our knowledge, the first reported SPECT scan finding in a case of frontotemporal dementia following chronic bipolar affective disorder.

OBJECTIVES: To highlight and discuss thyrotoxicosis after lithium withdrawal as a potential complication of lithium therapy for bipolar disorder. CASE REPORTS: Both patients presented developed thyrotoxicosis, the first patient after stopping the lithium completely, and the second patient after a reduction in the lithium dose. CONCLUSIONS: Clinicians should be alert to the possibility of thyrotoxicosis emerging when lithium is being completely or partially withdrawn. Such withdrawal could unmask a latent hyperthyroidism.

R. S. Sayers; The Collected Writings of John Maynard Keynes. Vol. XXII: Activities 1939-1945, Internal War Finance. Vol. XXIII: Activities 1940-1943, External W

This paper describes a dynamic group for elderly chronically mentally ill patients within a day hospital setting. It highlights some of the difficulties of working psychodynamically with older people, but also suggests that psychological mindedness can be learnt as part of the process. Dependency issues can be confronted, facilitating increased autonomy and self-esteem.

The age of the volcanic rocks in the Woo Dale borehole, Derbyshire SIR -The highly altered character of the volcanic rocks which were encountered in the lower part of the Woo Dale borehole (Cope, 1973), situated about 5 km E of Buxton in North Derbyshire, has until recently defied attempts to obtain a meaningful radiometric age for these rocks.These altered rocks were encountered at a depth of 275.60 m beneath a 2 m thick mantle of blue, green and grey pyritous breccia containing angular fragments of limestone, lava and pyroclastics.The lower limit of this breccia is somewhat difficult to define because there is a downward gradation through a thickness of 4-5 m into relatively fresh purple and purplish-brown tuffs, which were encountered at a depth of 279 m.This upper 7 m of the volcanic sequence, because of its altered nature as well as its obvious close relationship to the underlying volcanic rocks, is interpreted as a deep weathered zone of the volcanic pile brought about at some time subsequent to eruption but prior to the onset of limestone sedimentation.The stratigraphical relationships of the volcanic rocks, based upon borehole cores only 0.04 m in diameter, leave their precise age uncertain.Their minimum age must be approximately that of the immediately overlying limestones.The lowest 30 m of these limestones were tentatively assigned to the top of the Tournaisian (Cope, 1973) or possibly to the higher part of the Courceyan Stage in the revised nomenclature for the Dinantian (George et al. 1976).Professor R. Conil has examined thin-sections of the cores from this part of the borehole, and is of the opinion that, on the evidence of the foraminifera, these beds are to be assigned to the lowest Vise'an and that the Tournaisian is not represented (pers.comm.).Nevertheless, the presence of Dainella including D. fleronensis (Conil & Lys) would not be inconsistent with these lowest beds of limestone representing the uppermost Courceyan.This would therefore be the approximate minimum age for the upper part of the volcanic rocks.Their maximum age is very much an open question on stratigraphical grounds.There is clearly a marked break between the volcanic rocks and the succeeding limestones which is marked by a polygenetic breccia and a deeply weathered zone at the top of the volcanic pile.Evidently, the late-Courceyan sea transgressed an old land-surface composed of volcanic rocks undergoing tropical weathering.Such a state of affairs is quite unknown in the Dinantian lava flows and bedded pyroclastic rocks which are exposed in North Derbyshire.Moreover, the Woo Dale volcanic rocks are petrologically distinct from any Lower Carboniferous lavas and pyroclastic rocks known in Great Britain.There is evidence too in the borehole cores that the Dinantian limestones rest with marked unconformity upon the volcanic rocks, for whilst the former are virtually horizontal the latter show dips of the order of 40°.The most that can be said on stratigraphical grounds is that such evidence is undeniably in favour of a pre-Carboniferous age for the volcanic rocks.Of the thickness of 33 m of volcanic rocks proved by the borehole, the upper part to a depth of 302 m consists of a variety of tuffs which are largely sericitized and silicified; from a depth of 302 m to the bottom of the hole at 312 m are fine-grained porcellanous-looking lavas in which there is a distinct flow-banding indicating a dip of about 40°.These lavas are sub-alkaline in character and approach sodic-dacites or sodic-rhyolites.A detailed account of their petrology and geochemistry is in course of preparation.

Some of these deficits relate to service provision but for most the remedy lies with the health professionals. The challenge for educators is to stimulate and moti- vate colleagues to practise patient centred medicine in this difficult and demanding field.

This paper presents an updated geological reconstruction of the Quaternary evolution of the River Thames at its downstream extremities, close to the North Sea coast, based on new data from multi-disciplinary and citizen-science sources. In this area, the interaction of the Thames with the MIS 12 (Anglian) glaciation is an important part of the Quaternary archive. The Anglian ice sheet, which reached parts of north and east London, was responsible for diverting the Thames southwards into its present course, although the footprint of the maximum ice sheet(s) does not reach the North Sea coast south of Hollesley, Suffolk. Further south, the coastal zone hosts pre-Anglian and early Anglian river-terrace deposits of the pre-diversion Thames system, superimposed upon which are products of later post-Anglian rivers, of both Middle and Late Pleistocene age. On the peninsula between the Stour and Blackwater–Colne estuaries, the lowest and most recent terrace of the pre-diversion Thames includes evidence directly pertaining to the glacial disruption event, for which geochronological data are reported here for the first time. The first post-diversion terrace of the Thames also reaches this peninsula, the river having essentially re-joined its original valley before crossing the alignment of the modern coastline. This terrace passes beneath Clacton-on-Sea, where it includes the type locality of the Clactonian Palaeolithic Industry. The area of interest to this paper, in NE Essex and southern Suffolk, includes a number of interglacial and Palaeolithic sites, the data from which assist in constraining the chronostratigraphy of the sequence. In some cases, there has been uncertainty as to whether these sites represent pre-Anglian environments and hominin occupations, part of the palaeo-Thames sequence, or whether they are the product of later post-Anglian streams, formed after the Thames had migrated southwards. This paper compiles evidence from a wide range of recent sources, including developer-funded archaeological appraisal and citizen-science activities, to explore and update the evidence from sites at Ipswich, Upper Dovercourt and Thorpe-le-Soken, as well as a number of localities associated with the Clacton Channel Deposits (host to the type-Clactonian), amongst others. The resulting new data are placed within the wider context of the Quaternary fluvial archives in southern Britain, with a discussion of how disparate sources of information, including the work of citizen scientists, have contributed.

(1976). Phenomenology and the future of religious education. Learning for Living: Vol. 16, No. 1, pp. 4-8.

Internet usage is high amongst the general population but access problems persist for adults with intellectual disability. A descriptive study was conducted to explore linguistic accessibility of websites designed for this user group. The purposive sample comprised fifteen U.K. based websites associated with the self advocacy organisation People First, plus a matched, mainstream website for comparison. Linguistic measures at lexical and sentence levels were applied to text samples from each website. Readability scores ranged from 4.4 to 23.6 with only three websites achieving below the recommended standard for universal accessibility. Word variability scores ranged from 54 to 80 with many websites employing diverse vocabularies. Most of the websites achieved word frequency mean values within the 5 to 800,000 range. Only one website achieved scores indicative of positive accessibility value on all three measures. Mainstream website scores were unremarkable compared to the People First websites. Linguistic accessibility of websites designed for people with intellectual disability appears to be highly variable. A review of text authoring principles is called for as well as consideration of a mediating role for significant others providing support.

The potential importance of botanical controls on the properties and behaviour of blanket peat involved in peat landslides was identified almost twenty years ago. During 2010–2012, investigations of the blanket peat at three bogflows in north-west Ireland were done with the aim of establishing some form of relationship between botanical or palaeoecological characteristics and standard physical and geotechnical properties, assuming the latter to be meaningful but recognising that this may not be the case. In situ measurements and investigations at all three sites were followed by extensive laboratory characterisation of small core, block and monolith samples. The botanical composition of the peat could not be fully determined due to the high degree of decomposition. However, analysis of macrofossils allowed distinct depth-related patterns of several key botanical indicators to be determined. In particular, the monocotyledon fragments, dominated by Eriophorum vaginatum, showed distinct and potentially useful distributions throughout the peat profiles. Overall results showed that the basal peat at one site was discernibly different from the other two sites, having fewer monocotyledons, fewer fibres, higher dry bulk density and higher saturated hydraulic conductivity. This approach therefore offers a potential basis for developing a means of assessing peat mass characteristics from small auger samples.

Summary The influence of teachers on the religious beliefs and moral values of pupils in two multi‐racial comprehensive schools was studied. Nearly all the teachers had come from homes where the traditional religious beliefs and moral values had been affirmed. Only one half of them, in each school, still supported a religious view of life and just over half still accepted the Christian ethic as their basis for morality. The majority, however, saw character development in one form or another as their primary aim in teaching and counted religious and moral education as part of their task. Most of the teachers wished religious education to continue in the schools but approximately half of the sample thought that it should be more broadly based than at present. The head teachers held rather conservative views. In conclusion, evidence is cited suggesting that the teachers’ influence was not substantial and the view put forward that change to a more open approach in this area of school life is needed.

REHABILITATION AND THE HEMIPLEGIC PATIENT Get access J. B. MILLARD J. B. MILLARD Passmore Edwards Rehabilitation centreClacton-on-Sea, Essex Search for other works by this author on: Oxford Academic PubMed Google Scholar Rheumatology, Volume 8, Issue 7, August 1966, Pages 244–249, https://doi.org/10.1093/rheumatology/8.7.244 Published: 01 August 1966

Conformable and conventional indwelling urinary catheters, made of latex coated with Teflon and of the same nominal size, were encrusted in vitro. The extent of encrustation was quantified by dissolving the deposits, determining the concentrations of calcium and magnesium in the resulting solutions (by atomic adsorption spectroscopy), and calculating the surface densities of calcium and magnesium. Surface densities of both elements were significantly less on the conformable than on the conventional catheters. This result can be explained by the pulsed flow of urine through the conformable catheter tending to dislodge deposits adhering to its inner surface. A similar action is expected to occur in vivo.

There has been increasing concern in England regarding the neglect of alcohol treatment in favour of treatment for illicit drug users (especially offenders). The project sought to obtain the views of addiction professionals in specialist NHS services in England regarding recent changes to service provision. Postal survey questionnaires were sent to the duty worker at 120 Community Drug and Alcohol Teams in the England. Responses were received from 180 participants representing at least one clinician at 87 of the teams. Respondents had 1660 years of experience in substance misuse treatment. Only 11% felt that alcohol treatment services had improved over the last few years and 53% agreed that ‘Government targets for treatment of illicit drug users has had a disastrous effect on the provision of alcohol treatment services’. The enhanced treatment for offenders was widely regarded as unfair to other service users. Half of respondents considered that the recent Government Alcohol Strategy was either ‘pathetic’ or ‘a recipe for ineffectiveness.’ Despite the limited number of self‐selecting participants, the opinions are clearly cause for concern.

This article demonstrates that the arguments for education vouchers have not achieved political acceptance and that, in any case, there is a better way to liberate education.

Summary The revised Neale Analysis of Reading Ability, the British Ability Scales (BAS) single‐word reading test, the Hertfordshire sentence reading test and the NFER‐Nelson Group Reading Test 6‐12 (GRT 6‐12), were given to infant and junior children in a primary school. The results were analysed as infant and junior data, then re‐analysed according to reading ability. For the latter analysis two ability groups were formed, those scoring a reading age under 9 on the Neale and those scoring over 9. In practical terms it was considered important to discuss the results in terms of low and high reading ages as well as in terms of infant and junior data. Significantly higher scores were obtained on the BAS, Hertfordshire and GRT 6‐12 tests than on the Neale for the infant children in analysis 1 and for the lower ability group in analysis 2. However, children in the higher ability group in analysis 2 obtained equivalent scores on the BAS and the Neale. In addition to the quantitative analysis, a qualitative analysis of the items in the tests was carried out. It is argued that the discrepancies observed in the test scores are sufficiently large to warrant re‐standardisation of particular tests.