South East Hampshire Research Articles

Enigmatic rocks and sarsen stones of the West Sussex Coastal Plain, southern Britain

The coastal plain of West Sussex and south-east Hampshire preserves a succession of Pleistocene raised beaches, periglacial deposits, and estuarine channels. These incorporate numerous ‘erratics’ or ‘exotic’ rocks, here described as enigmatic rocks, and sarsen stones. The enigmatic rocks include large boulders of non-local igneous, metamorphic, and sedimentary rocks, which have attracted interest since the early 19th century. Many suggestions have been made regarding their origins, transport, and date of emplacement. More recently, it has been realised that these rocks may have important implications for understanding the Quaternary history of southern Britain and the palaeogeography of the English Channel region during the Pleistocene. This paper presents a literature review, supported by details of historic and extant boulders, distribution, and dimensions. In agreement with previous authors, it is concluded that the enigmatic rocks were likely transported within ice floes or icebergs, but further studies are required to identify possible sources. Suggestions have included northern Britain, Scotland, Scandinavia, Greenland and Laurentia. There are doubts concerning an adequate build-up of periglacial sea-ice to accept the historic consensus for a source in Brittany, the Cotentin Peninsula, and the Channel Islands. The date of emplacement is suggested to be MIS 13, but multiple phases of emplacement cannot be excluded. In contrast, the sarsen stones are considered to be relic of pre-MIS 7 periglacial erosion of weathered Lambeth Group in a regolith of Clay-with-flints formerly capping the local Chalk outcrop. Many questions remain unanswered, particularly regarding the enigmatic rocks, so aspects for future study are identified.

Margaret E M O’Flynn (Foley)

Margaret O’Flynn (nee Boulton, known professionally as Foley) devoted most of her career to the development and improvement of contraception, the sexual health of women, and management of the menopause,...

Facillitating diabetes care - a community approach.

Instigated through the vision of a local GP, the South East Hampshire Community Diabetes Team (CDT) is provided by Southern Health NHS Foundation Trust. Through taking an integrated, multidisciplinary, community based specialist approach, the team works in partnership with colleagues across primary and secondary care. The team support care of both newly diagnosed people with diabetes (PWD), and those requiring ongoing follow up, unless they fall into the ‘super six’ categories. The key focus of the team is to optimise the knowledge and self management of diabetes through clinician and patient education programmes.

A cluster of infectious syphilis among young heterosexuals in south-east Hampshire

A small cluster of infectious syphilis among young heterosexuals aged under 25 years in south-east Hampshire has highlighted the limitations of effective partner notification, the challenges of providing effective awareness raising and the need for increased accessibility to genitourinary (GU) medicine services. Evaluation of awareness raising to both the target age group and health care professionals indicated that the strategies employed did not increase testing and had limited impact on young people in terms of seeking further information.

THE LEGAL DUTIES OF CARERS

At one time, carers could legitimately claim to be ‘ignored and invisible’.1 Now it seems that carers' rights are a hot political issue and the carer is likely to feature prominently in the forthcoming general election. Although carers' rights might have begun to enter the political and legal consciousness, the duties of carers have not. R (Jenkins) v HM Coroner for Portsmouth and South East Hampshire and Cameron and Finn concerned an appeal against the findings of a coroner. The coroner had returned a narrative verdict on the death of Russell Jenkins which set out the facts as follows: In late December 2006 Russell Anthony Neal Jenkins stepped on a plug of an electrical appliance in his home, injuring his left foot. He developed an infection in the wound of his foot which did not resolve itself and developed ultimately into gangrene. His condition deteriorated, particularly so in the last few days and hours of his life and, on 16 April 2007, he lapsed into an unconscious state and died during the night of 16/17 April 2007 at his home. At no stage following the injury to his foot did Russell Jenkins or anyone else on his behalf seek to obtain conventional medical advice or treatment for his condition. In consequence, Russell Jenkins' condition was inappropriately and ineffectively treated by himself and by others and this led to his death.2

Review: Church and Chapel in Portsmouth and South-East Hampshire, 1660-1850

Review: Church and Chapel in Portsmouth and South-East Hampshire, 1660-1850

Opportunistic screening for genital chlamydial infection. I: Acceptability of urine testing in primary and secondary healthcare settings

Objectives: To determine the acceptability of opportunistic screening for Chlamydia trachomatis in young people in a range of healthcare settings. Design: An opportunistic screening programme (1 September 1999 to 31...

UK department of health guidance on prescribing for impotence following the introduction of sildenafil: potential to contain costs in the average health authority district.

To evaluate the effectiveness at containing service costs of the UK's Department of Health (DoH) guidance on prescribing for impotence implemented after the introduction of sildenafil and taking effect from 1 July 1999. A pragmatic economic analysis of the impact of the DoH guidance on specialist-care activity and costs and primary-care prescribing costs from the perspective of the UK National Health Service. Primary-care prescribing costs and specialist-care activity and cost data were collected for 12-month periods before and after the introduction of the guidance. Portsmouth and South East Hampshire Health Authority. Specialist-care activity and associated costs fell by 70% in the first year following the introduction of the DoH guidance while primary-care prescribing costs doubled. The overall cost for providing impotence services in Portsmouth and South East Hampshire in 1999-2000 was pound 232,619, and is similar to the cost incurred in 1998-1999 of pound 225,108 (uplifted to 1999-2000 values). The DoH guidance on prescribing for impotence has effectively reduced specialist-care activity and costs in Portsmouth and South East Hampshire. It offers the potential to allow the overall costs of impotence services in the district to be contained even with the use of higher cost drugs, such as sildenafil.

Do general practitioners' risk-taking propensities and learning styles influence their continuing medical education preferences?

US studies have shown that a clinician's risk-taking propensity significantly predicts clinical behaviour. Other US studies examining relationships between family practice doctors' preferences for CME and their Kolb learning style have described conflicting findings. The aim of the present study was to investigate GPs' learning styles, risk-taking propensities and CME preferences, and to explore links between them. A descriptive confidential cross-sectional postal questionnaire survey of the 304 general practitioner principals within Portsmouth and South East Hampshire Health Authority was conducted. Two hundred and seventy-four GPs returned questionnaires, a response rate of 90.1%. The Kolb learning style types were assimilators 43.8% (predominant learning abilities watching and thinking), divergers 21.1% (feeling and watching), convergers 18.3% (doing and thinking), and accommodators 16.8% (doing and feeling). The Pearson risk-taking propensities were 65.8% risk neutral, 19.4% risk seeking and 14.8% risk averse. Risk-seeking GPs were significantly more likely to be accommodators or convergers than divergers or assimilators (p = 0.006). Majorities of 54.9% stated that the present PGEA system works well, 85% welcomed feedback from their peers, and 76.8% stated that learning should be an activity for all the practice team. Further majorities would welcome help to decide their learning needs (63.8%) and are looking to judge CME effectiveness by changes in GP performance or patient care (54.8%). Further significant correlations and cross-tabulations were found between learning style and risk-taking and CME attitudes, experiences and preferences. It is concluded that risk seekers and accommodators (doing and feeling) prefer feedback, interaction and practical hands-on learning, and assimilators (watching and thinking) and the risk averse tend towards lectures, theoretical learning formats and less interactive activities. Sharing feelings in groups may be difficult for the risk averse and assimilators. The success of a combined educational strategy will depend on an inclusive philosophy, both recognizing and engaging the wide range of differences in learning style and risk taking for all the individuals who make up learning teams.

Rectal bleeding in general and hospital practice; ‘the tip of the iceberg’

To determine the incidence of rectal bleeding and its predictive value for cancer in the general population, patient consultation rates to GPs, referral rates to hospital and the nature of rectal bleeding from benign causes. The study was based on a postal questionnaire in the setting of three General Practices in Portsmouth and South-east Hampshire (two in Portsmouth, one in Petersfield). There were 6000 subjects, over the age of 16 years, randomly selected from the three General Practices. The main outcome measures were incidence of rectal bleeding with respect to age and sex, the number who sought medical advice from their GPs and the numbers referred on to hospital. The frequency of dark red bleeding, of an associated change in bowel habit and the presence or absence of anal symptoms were also determined. The prevalence of colorectal cancer was determined in subjects reporting rectal bleeding in the 5-year period after the postal survey. Six thousand questionnaires were sent and 4006 (67%) were returned. Of the respondents 18% (709/4006) reported rectal bleeding in the previous year. Four percent (175/4006) had had bleeding for the first time and 38% (1522/4006) had bled at some time in the past. Of the 709 individuals, 512 (72%) had not consulted their GPs. Of the 197 (28%) who did, 50 (1:4, 7%) were referred to hospital. Eighteen percent (125/709) described the blood as dark red, and 88% (621/709) had anal symptoms. In 56% (394/709) the rectal bleeding was associated with a change in bowel habit mostly to hard stools (n=208), fewer to loose stools (n=98). Rectal cancer was diagnosed in only one patient 4 years after the first episode of rectal bleeding, giving a predictive value of rectal bleeding for colorectal cancer in the community of 1:709. Many people in the community have painless rectal bleeding, an associated change in bowel habit and dark red bleeding, factors previously thought to indicate a high risk of colorectal cancer. Rectal bleeding has however a low (1:709) predictive value for cancer. As the result of a considerable selection process, only a small number are investigated in hospital. These patients therefore represent a small proportion of all patients with this symptom. The value of the factors used to decide which patients need investigation should be re-assessed.

A collaborative audit of the management of hypertension in general practice.

We carried out an audit of the management of essential hypertension in general practice, against standards based on current guidelines. We examined the records of 882 hypertensive subjects (on medication)...

The teaching of cardiopulmonary resuscitation in schools in Hampshire

In order to maximise the number of potential providers of cardiopulmonary resuscitation (CPR) in the community, it has been suggested that a programme of basic life support (BLS) training should be included within the school curriculum. Using a questionnaire sent to 275 schools in south east Hampshire (representing 71 716 pupils), we discovered that BLS was taught at only 26% of schools which replied. The age at which teaching commenced ranged from 7–16 years (mode=10 years). We estimated that almost 5000 children might currently be trained annually in these schools. Consequently, each year approximately 40% of children in south east Hampshire schools might be exposed to BLS training. On average, schools offering BLS tuition were larger, had more teaching staff and employed a higher proportion of staff who were themselves BLS providers. The majority of BLS teaching was undertaken by school staff (50.9% of schools) and members of the Red Cross, The St. John Ambulance Brigade or statutory ambulance service (30.9%). One school utilised members of the local fire brigade. Only one school offering BLS training to its pupils did not have a staff member trained in CPR.

Serum screening for Down's syndrome: how much do health professionals know?

To assess knowledge about serum screening for Down's syndrome in health professionals involved in antenatal care. Postal questionnaire survey of knowledge of performance and interpretation of serum screening. Portsmouth and South East Hampshire health district. All health professionals likely to be involved in antenatal care. Questionnaires were sent to all general practitioners (n = 288), hospital midwives (n = 129), community midwives (n = 71), and obstetricians (n = 29) working in the district. Total number of correct responses given to eight factual questions and percentage of correct responses to each individual question. Responses were received from 434 health professionals (84%). Fifty-nine percent of health professionals correctly answered only a half or less of the factual questions on serum screening. Questions relating to the sensitivity, specificity, and positive predictive value were particularly poorly answered. Obstetricians scored most highly. General practitioners scored significantly less than the other groups. Women need accurate information to give informed consent to serum screening. Most health professionals likely to be involved in antenatal care in this district do not fully understand the test and are thus unlikely to provide such information. Changes in the provision of maternity services following Changing Childbirth may increase the input of midwives and general practitioners. Training of professionals about serum screening should be reviewed.

Study of urinary tract infection in children in one health district.

To determine the number of children who had urine specimens sent for culture, who had infections or sterile pyuria, and who were investigated further. To relate the laboratory findings to the results of imaging. One year survey of urine specimens submitted to a laboratory; review of previous and subsequent laboratory reports; review of the findings of imaging of the urinary tract. Portsmouth and South East Hampshire health district. An estimated population of 89,086 children aged 12 years or under. Urine bacterial count and results of imaging. 12,551 urine specimens were submitted from 7450 children, 3138 boys and 4312 girls. 2238 children had infection or sterile pyuria at least once during the study (13.9/1000 boys, 37/1000 girls). 996 (45%) of the children with infection or sterile pyuria underwent some form of imaging. 128 children who had infection or sterile pyuria were already known to have urinary tract abnormalities and 114 children had newly identified abnormalities (1.0/1000 boys, 1.5/1000 girls). 50 (44%) of the children with newly detected abnormalities had no pyuria and 48 (42%) had bacterial counts below 10(8)/l. Eight children who had sterile pyuria on presentation were found to have abnormalities on imaging. Urinary tract infection is much commoner in children than is widely believed. Low bacterial counts, the absence of pyuria, or a finding of sterile pyuria should not be disregarded.

Nurse education initiatives — making Project 2000 a reality Managing the dynamic organisation

The following edited papers were presented at a National Conference in March 1990 under the Chairmanship of Mr Colin Ralph, Registrar and Chief Executive of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting. Portsmouth District, Royal Naval and Royal Isle of Wight School of Nursing and Midwifery, The Associate School of Health Studies Portsmouth Polytechnic organised this day conference to describe how one integrated school of nursing is tackling the radical changes in nurse education and the new initiatives that are taking place. These papers have been collated for a special edition of Network. Papers: Managing the dynamic organisation — Jean Hooper MSc, BA, RG, RGN, RNT; From Project 2000 to diploma of higher education — curriculum and course development — Susan Frost MPhil, BA, RGN, HV, RNT Principal; curriculum development and research — Project 2000: the higher education context — Mark Mitchell BA, MSc, Head of School of Social and Historical Studies, Postsmouth Polytechnic; A District General Manager's perspective — Christopher West MSc, AHSM, District General Manager, Portsmouth & South East Hampshire Health Authority.

The development of community based adult mental health services — a research contribution

The desire to provide care and services for people with mental health problems in a community context, rather than in large institutions, is a long-established feature of Government policy. In the more local context of the Portsmouth and South East Hampshire District Health Authority, a strategy of decentralising both the organisation and the delivery of services for adults with mental health problems began to be implemented early in 1986. Five multi-disciplinary area community mental health teams would work with and alongside other service-providers in their localities to provide a range of support, including residential, day and other community and domiciliary services.

Malignant otitis externa — a serious complication of diabetes mellitus

AbstractThis paper reviews five cases of malignant otitis externa treated in Portsmouth between 1979 and 1986. These five patients constitute all the cases seen in the Portsmouth, South East Hampshire, Chichester and South West Sussex area during the period, indicating the condition to be rare. All cases showed a number of features in common: all were elderly (over 55 years); diabetic; the majority (4:1) being male. In all cases Pseudomonus aeruginosa was cultured from pus exuding from the external auditory canal. Each of the five cases was resident in the Chichester and South West Sussex part of the catchment area. Every case presented with otorrhoea and otalgia and all were treated with a combination of topical and intravenous antibiotics plus intensified diabetic control. Two cases followed ear syringing.Neurological complications seen in this series of patients included facial palsy (three cases), fifth nerve palsy, dysphagia, vocal cord palsy, ataxia and Argyll‐Robertson pupil.

Unexpected sudden infant deaths in Gosport—some comparisons between Service and civilian families

SummaryIn both the Service and civilian populations the incidence of unexpected sudden infant death (USID) occurring in Gosport during the 5-year period from 1 January 1977 to 31 December 1981 was considerably higher than in other areas in South-east Hampshire. The results of a retrospective study of 47 of the 49 deaths over this period suggest that potentially avoidable social and child care factors may have contributed to this relatively high incidence. An analysis of risk factors suggests that a scoring system similar to the ‘Sheffield’ system with additional information on weight gain collected by health visitors would be useful in identifying babies at high risk of USID in Gosport in the future. There appear to be no significant differences either in incidence or predicted risk of USID between the civilian and Service population overall (the latter comprising almost entirely families from the Royal Navy).