Shear strength characteristics of certain colliery discards with respect to coal rank

This work forms part of the research programme into the properties of colliery discards undertaken in Durham since the Aberfan disaster of 1966. The discussion relating to residual strength in the paper 'Colliery Spoil Tips - after Aberfan' was summed up by the authors, McKechnie Thomson and Rodin, with the words "The information currently available on residual strength poses a number of questions and further studies are needed to clarify such factors as the effect of normal pressure and magnitude ofstrain". The current work attempts to clarify some of these problems. Large strain (1.5 to 2.5 metres total displacement) 12-inch shear-box tests have been undertaken on selected samples from different National Coal Board coalfield areas. Supplementary programmes of tests in a 60mm shear-box were used to confirm the results of the large-scale tests. Similarly, additional tests have been conducted at normal stresses which are generally higher than those customarily adopted for normal soils testing. The results show that at low normal stresses (80 kN/m (^2), shear strength reduction in most discards is limited (15 - 25 per cent) for a displacement of one metre. The exception is extreme low rank material from the West Midlands coalfield, for which a strength reduction of over 40 per cent was obtained. Tests revealed a marked increase in the rate of shear strength reduction for most discards at a normal stress value between 200 - 300 kN/m (^2). Above 500 kN/m (^2) increase in the rate of breakdown is limited. Correlation of shear strength characteristics with the rank code number of the associated coal show generally negative results, the exception being extreme 'low rank' discard from collieries in the West Midlands. Statistical treatment of the results has revealed significant correlations between the shear strength properties and the grading parameters. In practical terms, vehicular activity is unlikely to cause shear planes to develop in the majority of new or existing tips during emplacement or regarding operations

Towards standard setting for patient-reported outcomes in the NHS homeopathic hospitals

We report findings from a pilot data collection study within a programme of quality assurance, improvement and development across all five homeopathic hospitals in the UK National Health Service (NHS).<p></p> <b>Aims</b> (1) To pilot the collection of clinical data in the homeopathic hospital outpatient setting, recording patient-reported outcome since first appointment; (2) to sample the range of medical complaints that secondary-care doctors treat using homeopathy, and thus identify the nature and complexity of complaints most frequently treated nationally; (3) to present a cross section of outcome scores by appointment number, including that for the most frequently treated medical complaints; (4) to explore approaches to standard setting for homeopathic practice outcome in patients treated at the homeopathic hospitals.<p></p> <b>Methods</b> A total of 51 medical practitioners took part in data collection over a 4-week period. Consecutive patient appointments were recorded under the headings: (1) date of first appointment in the current series; (2) appointment number; (3) age of patient; (4) sex of patient; (5) main medical complaint being treated; (6) whether other main medical complaint(s); (7) patient-reported change in health, using Outcome Related to Impact on Daily Living (ORIDL) and its derivative, the ORIDL Profile Score (ORIDL-PS; range, –4 to +4, where a score ≤−2 or ≥+2 indicates an effect on the quality of a patient's daily life); (8) receipt of other complementary medicine for their main medical complaint.<p></p> <b>Results</b> The distribution of patient age was bimodal: main peak, 49 years; secondary peak, 6 years. Male:female ratio was 1:3.5. Data were recorded on a total of 1797 individual patients: 195 first appointments, 1602 follow-ups (FUs). Size of clinical service and proportion of patients who attended more than six visits varied between hospitals. A total of 235 different medical complaints were reported. The 30 most commonly treated complaints were (in decreasing order of frequency): eczema; chronic fatigue syndrome (CFS); menopausal disorder; osteoarthritis; depression; breast cancer; rheumatoid arthritis; asthma; anxiety; irritable bowel syndrome; multiple sclerosis; psoriasis; allergy (unspecified); fibromyalgia; migraine; premenstrual syndrome; chronic rhinitis; headache; vitiligo; seasonal allergic rhinitis; chronic intractable pain; insomnia; ulcerative colitis; acne; psoriatic arthropathy; urticaria; ovarian cancer; attention-deficit hyperactivity disorder (ADHD); epilepsy; sinusitis. The proportion of patients with important co-morbidity was higher in those seen after visit 6 (56.9%) compared with those seen up to and including that point (40.7%; P < 0.001). The proportion of FU patients reporting ORIDL-PS ≥ +2 (improvement affecting daily living) increased overall with appointment number: 34.5% of patients at visit 2 and 59.3% of patients at visit 6, for example. Amongst the four most frequently treated complaints, the proportion of patients that reported ORIDL-PS ≥ +2 at visit numbers greater than 6 varied between 59.3% (CFS) and 73.3% (menopausal disorder).<p></p> <b>Conclusions</b> We have successfully piloted a process of national clinical data collection using patient-reported outcome in homeopathic hospital outpatients, identifying a wide range and complexity of medical complaints treated in that setting. After a series of homeopathy appointments, a high proportion of patients, often representing “effectiveness gaps” for conventional medical treatment, reported improvement in health affecting their daily living. These pilot findings are informing our developing programme of standard setting for homeopathic care in the hospital outpatient context

Personal Papers (MS 80-0002)

Letter from Terence P. Hanna to H. Kempner regarding a receipt for sails for a boat and requesting he forward the Genoa

Personal Papers (MS 80-0002)

Letter from Terence P. Hanna to Harris Kempner acknowledging their inability to produce yacht duck and being unable to complete Kempner's order

Personal Papers (MS 80-0002)

Letter from Terence P. Hanna to Harris L. Kempner confirming that they cannot supply any sail cloth and offering the address of other sail makers

Personal Papers (MS 80-0002)

Letter from Terence P. Hanna to Harris L. Kempner declining to make a sail out of cotton canvas, but offering to make a sail out of nylon and discussing the benefits of doing so, as well as offering to fix his spinnaker

Personal Papers (MS 80-0002)

Letter from Terence P. Hanna to Harris L. Kempner acknowledging the receipt of Kempner's check, but refusing to take Kempner's order for a new sail

Personal Papers (MS 80-0002)

Letter from Terence P. Hanna to Harris L. Kempner discussing sizes for a sail and cutting down a jib