A terrestrial (lacustrine and fluvial) palaeoclimate record from Hoxne (Suffolk, UK) shows two temperate phases separated by a cold episode, correlated with MIS 11 subdivisions corresponding to isotopic events 11.3 (Hoxnian interglacial period), 11.24 (Stratum C cold interval), and 11.23 (warm interval with evidence of human presence). A robust, reproducible multiproxy consensus approach validates and combines quantitative palaeotemperature reconstructions from three invertebrate groups (beetles, chironomids, and ostracods) and plant indicator taxa with qualitative implications of molluscs and small vertebrates. Compared with the present, interglacial mean monthly air temperatures were similar or up to 4.0°C higher in summer, but similar or as much as 3.0°C lower in winter; the Stratum C cold interval, following prolonged nondeposition or erosion of the lake bed, experienced summers 2.5°C cooler and winters between 5°C and 10°C cooler than at present. Possible reworking of fossils into Stratum C from underlying interglacial assemblages is taken into account. Oxygen and carbon isotopes from ostracod shells indicate evaporatively enriched lake water during Stratum C deposition. Comparative evaluation shows that proxy-based palaeoclimate reconstruction methods are best tested against each other and, if validated, can be used to generate more refined and robust results through multiproxy consensus.

COVID-19 has presented society with a public health threat greater than any in living memory, leaving us to question almost every aspect of our society. An ever increasing concern is how we protect the global population from mental illness and whether public mental health policies can achieve this. In this article I reflect on the history of mental health service development, and furthermore on how COVID-19 might impact on the delivery of public mental health strategies into the future.

Mental health and the failings of the mental health services are in the spotlight as never before. Nowhere is this more apparent than in the often dire situation with regard to child and adolescent mental health. At the same time, there is a renewed interest in the scope for prevention of mental illness and distress, and in population approaches to mental well-being. It may come as a surprise to some that others have given such serious consideration to strategic approaches to public mental health as long ago as the 1950s. It appears that such consideration was squeezed out by the dominant concerns of serious and enduring mental illness and a prevailing biological view of psychiatry. The time is right to engage with this agenda in recognition of the importance of public mental health, not only for the individual and for families, but also for society as a whole and for the economy. The publication of a review of the subject by the Faculty of Public Health and the Mental Health Foundation is to be commended. Let us make sure it leads to action.

How is the association of the descent/ascent motif with the Johannine Son of Man to be explained if the gnosticism theory no longer holds? ἀναβέβηκεν (3.13) is usually taken to refer to Jesus' final ascension. But Odeberg saw that it refers to a tradition of heavenly ascent in Jesus' lifetime. Bühner argued rather for a double reference—to the ascent of a visionary seer involving a metamorphosis into a heavenly being and a final ascent at death. Yet he ignores the likelihood, sustained by Jarl Fossum and Morton Smith, that the transfiguration tradition was based on an authentic memory. In chs. 9 and 5 the evangelist recognizes that Jesus had been invested with the authority of the heavenly Son of Man. He sees the crucifixion as an exaltation (3.14), and follows a statement of Jesus' ascent, descent and exaltation by a full summary of God's loving gift to the world.

Ageing women may choose to drink soya milk to reduce menopausal symptoms. As fermentation enriches soya milk with isoflavone aglycones, its beneficial qualities may improve. To reduce osteoporotic risk, however, soya milk must be Ca enriched, and it is not known how fermentation affects Ca bioavailability. A randomised crossover pilot study was undertaken to compare the Ca absorption of fortified soya milk with that of fermented and fortified soya milk in twelve Australian osteopenic post-menopausal women. The fortified soya milk was inoculated with Lactobacillus acidophilus American Type Culture Collection (ATCC) 4962 and fermented for 24 h at 37°C. Ca absorption from soya milk samples was measured using a single isotope radiocalcium method. Participants had a mean age of 54·8 (sd 12·3) years, with mean BMI of 26·5 (sd 5·5) kg/m2 and subnormal to normal serum 25-hydroxyvitamin D (mean 62·5 (sd 19·1) nmol/l). Participants consumed 185 kBq of 45Ca in 44 mg of Ca carrier. The mean fractional Ca absorption (α) from soya milk and fermented soya milk was 0·64 (sd 0·23) and 0·71 (sd 0·29), respectively, a difference not of statistical significance (P = 0·122). Although fermentation of soya milk may provide other health benefits, fermentation had little effect on acute Ca absorption.

Background: Late life depression is often accompanied by slowed information processing during neuropsychological testing, and this has been related to underlying cerebrovascular disease. We investigated whether changes in electrophysiological markers of information processing might share the same pathological correlates.

Methods: Differences in power spectra frequency, contingent negative variation (CNV), post-imperative negative variation (PINV), and auditory P300a amplitude and latency in 19 patients with DSM-IV major depression aged ≥ 60 years were compared with 25 recordings in age-matched healthy controls. Associations with total brain volume and degree of white matter hyperintensities (WMH) were examined in those who had undergone additional magnetic resonance imaging (MRI).

Results: Compared with healthy controls, patients had more slow-wave delta (group difference: p = 0.024) and theta activity (p = 0.015) as well as alpha activity (p = 0.005) but no decrease in beta band frequency (p = 0.077). None of these changes related differently to brain volume or WMH in patients or controls. Patients further showed prolonged P300a latencies (p = 0.027), which were associated with decreased total brain volume in patients but not controls (interaction by group: p = 0.004). While there were no overall differences in PINV between both groups, patients showed a decrease in PINV magnitude with increasing WMH, a relation that was not seen in controls (interaction by group: p = 0.024).

Conclusion: Patients with late life depression show changes in several electrophysiological markers of cerebral arousal and information processing, some of which relate to brain atrophy and WMH on MRI.

An epidemic of suicide by burning in England and Wales occurred during the one-year period October 1978 to October 1979, following a widely publicized political suicide. For the 82 cases, death certificates were obtained and coroners' inquest reports sought. The victims were predominantly young single men or older married women; both groups had strong psychiatric histories; and there were no suicides which had political overtones, apart from the index case. Compared with suicides by this method in the past, a higher proportion of victims were born in the UK. It is proposed that a code of practice for the reporting of suicides by the media is required.

Out of 197 Wessex women undergoing a legal abortion at the British Pregnancy Advisory Service (BPAS) clinic at Brighton, 31 (15·7%) had already been refused a termination of pregnancy by at least one National Health Service doctor in Wessex. Almost all of these pregnancies were terminated for reasons covered by the social clause of the 1967 Abortion Act.

The principal reasons given for refusal of termination were that the women had insufficient grounds for termination under the Abortion Act, or that they were too late. Some were given misleading information. Refusal of an operation may have led to one woman having a second trimester rather a first trimester procedure when she went to BPAS. Some of these patients reported medical consultations which they had found to be upsetting or hurtful. It is suggested that the interests both of women seeking abortion and of doctors opposed to abortion would be best served if the Health Authorities were to provide alternative referral pathways to special abortion facilities.

Discussion and decision-making amongst Wessex women who obtained an induced abortion at two centres are studied. The most important discussants were family doctors, boy-friends, girl-friends, husbands, mothers and pregnancy counsellors. In the majority of key discussions which occurred the patient had been able to discuss the pregnancy fully, had a sympathetic reception and met a discussant who was favourable to her having a termination. However, younger patients were less likely to have such an experience and were later in arriving at their abortion decision and were more prone to uncertainty. It is argued that alternative counselling and referral systems need to be developed for younger patients with unplanned pregnancies who may request abortion.

A study of the factors involved in delay amongst a group of Wessex women obtaining induced abortions is reported and the importance of age is stressed. Only 47% of women aged 17–18 years obtained their operation before 12 weeks gestation compared with more than 70% of women of other age groups. The implications of this for the health of these women is discussed and the case stated for the development of adequate sex education, birth control and early abortion services orientated towards late teenagers.

Four special groups of women resident and obtaining abortions in one health district are described: women under 16 years and over 35 years, those undergoing a second or third abortion, and those obtaining operations later than 20 weeks gestation. These women rarely obtain adequate contraceptive advice and services, particularly when oral contraception has not proved to be suitable for them. It appears that some general practitioners do not offer a comprehensive family planning service and that this can result in women resorting to unreliable methods of birth control despite their demonstrated willingness to use contraception.

Among the very young, though most have received teaching about contraception, few appear to use any method; the confusion over the age of consent may be contributing to the failure of adults to make adequate provision for this group. The women over 35 years seemed to have little contact with family planning advice. There was a disturbing failure to meet the demand for sterilization until an unwanted pregnancy had occurred.

Patients undergoing a second or third abortion were frequently found to have contraceptive problems; there was no evidence that they were irresponsible as a group. A description of two patients obtaining operations after 20 weeks gestation illustrates the complexities of the late abortion issue. It is suggested that restrictive legislation cannot hope to contain the determination which may accompany the decision to seek abortion.

Three hundred and eight Wessex women obtaining induced abortions in the National Health Service, or in a charitable clinic, were interviewed at the time of their operation. Information was obtained as to their sources of sexual knowledge, their use and experience of contraception and their intentions with regard to sterilization in the future.

Whilst there has apparently been an increase in the amount of sex education provided in schools over the last decade, its effectiveness must be in some doubt. There is still a failure to provide contraceptive services which reach younger patients, and it is suggested that family doctors may sometimes miss opportunities to offer their patients full advice as to the methods available.

The Lower Palaeolithic site at Elveden, Suffolk, was the subject of new excavations from 1995–1999. Excavations around the edge and in the centre of the former clay-pit revealed sediments infilling a lake basin that had formed in Lowestoft till, overlying Chalk, the till being attributed to the Anglian glaciation (MIS 12). The lake sediments contain pollen that can be assigned to pollen zones HoI and HoIIa of the early Hoxnian (MIS 11). Overlying grey clays contain ostracods, molluscs, vertebrates, and carbonate concretions. Together they are indicative of a fluvial environment in a temperate climate. AAR ratios (amino acid racemisation) on the molluscs also suggest correlation with MIS 11. Further indications of a fluvial context are indicated by thin spreads of lag gravel along opposite sides of the clay-pit, marking the edges of a channel. The gravel forms the raw material for the human industries which consist of handaxes, flake tools, flakes, and cores. Further artefacts are found in the overlying black clay, which is interpreted as a palaeosol that formed with the silting-up of the channel. The basin was further infilled with colluvial ‘brickearths’, which also contain artefacts that are probably derived from the underlying gravel. Further evidence of soil formation was identified in the ‘brickearth’. Coversands with periglacial involutions overlie the ‘brickearth’ at the top of the sequence. These probably formed in the last cold stage, the Devensian (MIS 5d-2).