Bexhill Hospital

Power system interconnections using high-voltage direct-current (HVDC) technologies between different areas can be an effective solution to enhance system efficiency and reliability. Particularly, the multi-terminal dc grids that could balance and ensure resource adequacy increase asset utilization and reduce costs. In this paper, the technical feasibility of building dc grids using the line-commutated converter-based (LCC) and voltage source converter-based (VSC) HVDC technologies is discussed. Apart from presenting the technical challenges of building LCC dc grids and LCC/VSC hybrid dc grids, the reliability modeling and analysis of theseDCgrids are also presented. First, the detailed reliability model of the modular multi-level converters (MMCs) with series-connected high-voltage and low-voltage bridges is developed. The active mode of redundancy design is considered for the reliability model. To this end, a comprehensive whole system reliability model of the studied systems is developed. The reliability model of each subsystem is modeled in detail. Various reliability indices are calculated using this whole system reliability model. The impacts of the redundancy design of the MMCs on these indices are presented. The studies of this paper provide useful guidance for dc grid design and reliability analysis.

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The authors studied 10 men charged with patricide, including 2 men charged with both patricide and matricide and compared them with 10 schizophrenic patients who did not commit any crime. Eight patients who committed patricide were diagnosed as suffering from schizophrenic illness and 2 patients received a diagnosis of personality-disorder. Seven schizophrenics who committed patricide and both personality-disordered patients had a cruel and unusual relationship with their father. All were single at the time of patricide. The EMBU inventory revealed fathers to be more punitive than mothers and fathers favoured siblings more than the patients. Mothers were more overprotective and tolerant than fathers. Patricide patients' fathers were more punitive and shaming than control patients' fathers, and control patients' fathers were more stimulating and depriving than patricide patients' fathers. Patricide patients' mothers were more overinvolved and tolerant than control patients' mothers. A sense of relief was felt following the patricide rather than remorse. In contrast, the majority of patients in the control group described their father and mother as kind and affectionate. The EMBU inventory did not reveal any significant difference between father and mother.

This retrospective study was performed to assess whether type III intestinal metaplasia is an obligatory precancerous lesion of intestinal-type gastric carcinoma and to determine its possible use as a marker of enhanced cancer risk. From 48 consecutive patients with gastric cancer who underwent a gastrectomy over a 3-year period (mean age 72.0 years; 29 M/19 F), at least two sections from antrum, corpus and tumour-surrounding mucosa were obtained for the examination of presence and subtypes of intestinal metaplasia (IM). It was found that 77.1% of the carcinomas were of the intestinal type and 22.9% of the diffuse type. The intestinal-type was more often found in males (P = 0.01); the mean age at diagnosis in this type was higher than in the diffuse cancer group (P = 0.004). There was a high prevalence of total IM in both the intestinal (75.7%) and diffuse group (88.9%). Type I IM was predominant in antrum and corpus of patients from both groups. Type III IM was only found among patients with intestinal-type carcinoma. However, its prevalence was rather low (26.3%). Therefore the absence of this lesion in patients with other risk factors cannot be used as an argument for lowering the degree of surveillance and its presence seems to be sufficient indication for long-term follow-up.

OBJECTIVE: To determine the appropriateness of referrals from general practice to hospital outpatient departments. DESIGN: Prospective audit of referrals from a group practice over one year. SETTING: Six handed practice in a southern coastal town. SUBJECTS: All patients referred during the study period for whom a copy of the referral letter was available. MAIN OUTCOME MEASURES: The investigations carried out by the consultant that led to the diagnosis; the diagnosis reached; and the management. RESULTS: Of roughly 3000 patients referred during the year, 277 with various skin and soft tissue disorders could probably have been managed solely by the general practitioner. Referrals for cryotherapy (96 in this series) and diabetes (19) could probably also have been avoided by specialist training of the general practitioner. In addition, in cases of haematuria and prostatic hypertrophy (34 and 22 referrals) substantial time could have been saved for both the patient and the consultant had the general practitioner supplied the results of relevant investigations. Probably the most important outcome was the model that the study offered for other general practitioners to improve the appropriateness of referrals. CONCLUSION: This approach to determining the appropriateness of referrals benefits the general practitioners, the consultant, and the patient.

Merkel first discovered the cells named after him in the snout skin of voles in 1875. These cells are thought to originate from the neural crest and act as mechanoreceptors. When they have undergone malignant change, the neurosecretory granules in the cytoplasm may release various polypeptides, suggesting that the tumor is an APUDoma. In a computer search of the literature 121 cases were identified. It was revealed that the most common lesion is an erythematous nodule arising in the face or lower limb and occurring predominantly in women in their late 60s. The regional nodes became involved in half the patients, and the three-year survival was approximately 60%. Two unusual cases, in women 72 and 73 years old respectively, with metastasizing lesions that responded to a combination of surgery and radiotherapy are reported, and the literature is discussed.

These are exciting times for training as new technologies allow us to understand how the brain functions and learns. The concept of lifelong learning is reinforced by brain research and becomes an important reality for maintaining a lifetime of health and happiness. Research confirms our belief that we all have the brain capacity to learn throughout our lives. This has important implications for the mental and physical health of the ageing population. It also has important implications for training to use strategies that will allow all learners to be successful. Now is the time and the opportunity to examine our training model. to ensure that it embraces brain‐based learning, multiple intelligence and emotional intelligence, bringing to the training environment a special attitude that provides a true understanding, empathy and respect for all learners.

SUMMARY On 30 May 2012, Surrey and Sussex Health Protection Unit was called by five nurseries reporting children and staff with sudden onset vomiting approximately an hour after finishing their lunch that day. Over the following 24 h 50 further nurseries supplied by the same company reported cases of vomiting (182 children, 18 staff affected). Epidemiological investigations were undertaken in order to identify the cause of the outbreak and prevent further cases. Investigations demonstrated a nursery-level attack rate of 55 out of 87 nurseries (63·2%, 95% confidence interval 52·2–73·3). Microbiological tests confirmed the presence of Bacillus cereus in food and environmental samples from the catering company and one nursery. This was considered microbiologically and epidemiologically consistent with toxin from this bacterium causing the outbreak. Laboratory investigations showed that the conditions used by the caterer for soaking of pearl haricot beans (known as navy bean in the USA) used in one of the foods supplied to the nurseries prior to cooking, was likely to have provided sufficient growth and toxin production of B. cereus to cause illness. This large outbreak demonstrates the need for careful temperature control in food preparation.

Abstract The contracting out to private providers of services previously delivered within the state has been framed critically as ‘hollowing out’ and read for its erosion of social democracy, social justice and welfare, as well as its inefficiencies in practice. It is commonly dismissed as neoliberalism. In this paper, we highlight the gains made through this new contractualism by Te Oranga, the Family, Health and Education division of Te Runanga o Te Rarawa located in the Far North of New Zealand. Our aim is not to narrate the exceptional, but to point to the inherent resistances to totalising projects residing in agency and place. Placed at the service of a deep sense of community being and community good rather than self‐interest, delivery contracts have enabled Te Oranga to pursue an alternative form of local development and craft a set of progressive spaces. Although highly contingent upon powerful Maori political projects, we argue that the case suggests that gains may be sought in other settings, albeit partial, temporary, and politically contingent. We thus offer a more nuanced account of neoliberalism by highlighting its agency, fractures, politics, and contradictions, and by demonstrating that actualised neoliberalisms are co‐constituted with other political projects.

Purpose The purpose of this paper is to provide an autoethnographic account of the stories of a mental health professional and a mental health survivor. Design/methodology/approach Using the autoethnographic approach, the authors provide summaries of their respective psychiatric careers in three parts. Findings The authors studied at the same University, Reading. Voyce failed his Politics finals and embarked on a trajectory as a mental patient. Carson graduated in Psychology and trained as a clinical psychologist. The recovery movement brought them together, and they have now established an educational and personal bond. Research limitations/implications These are of course only two accounts, yet both authors have played a role in developing the recovery model in Britain. The accounts and story show the benefits of adopting a partnership approach between professional and service user. Practical implications Both accounts are recovery journeys in their own way. Both highlight the value of education for recovery. Social implications There is no doubt that clinical psychologists are both highly valued and well paid for their expertise. However, the expertise gained through Andrew’s life experience is equally invaluable for today’s mental health professionals to learn from, but perhaps not as well remunerated. Originality/value Both accounts stretch back over 45 years and have covered the move from institutional to community care. This paper presents two contrasting perspectives on these changes and the lives of the two people involved.

Abstract A case study is presented of a 10‐year follow‐up of a 46‐year‐old alcohol dependent client who chose a goal of controlled drinking on discharge from an ATU. Despite the severity of his problem, the data collected throughout the 10 year period from a variety of sources indicate that he has been successful in maintaining his goal. Variables are suggested which might have been influential in this particular individual's outcome.

BACKGROUND: Some selective cyclooxygenase-2 (COX-2) inhibitors have been shown to provide analgesic efficacy in patients with acute pain. AIM: To compare the efficacy and safety of the COX-2 inhibitor lumiracoxib 400 mg once daily (qd) and naproxen 500 mg twice daily (bid) in patients with acute musculoskeletal pain caused by uncomplicated soft tissue injury. METHODS: This was a randomised, double-blind, parallel-group, non-inferiority study set in 39 primary care centres in the UK. Patients were randomised to lumiracoxib 400 mg qd or naproxen 500 mg bid and took the study medication for as long as they felt that it was needed, up to day 7. The primary efficacy analysis was the sum of the pain intensity difference (0-100 mm visual analogue scale) determined morning and evening over the first 5 days of treatment (SPID-5). RESULTS: The intention-to-treat population comprised 406 patients [lumiracoxib 400 mg qd (n = 207); naproxen 500 mg bid (n = 199)]. Both treatments were effective in reducing pain intensity over 5 days. The mean SPID-5 scores were 117.0 mm.day for lumiracoxib and 118.2 mm.day for naproxen [the treatment difference based on adjusted means from the ANCOVA was -2.78 mm.day, 95% confidence interval (CI) -17.4, 11.9]. The lower margin of the 95% CI was above the predetermined non-inferiority margin (-50 mm.day) for SPID-5, indicating non-inferiority of lumiracoxib compared with naproxen. Both treatments were well tolerated. CONCLUSION: Lumiracoxib 400 mg qd is as effective as naproxen 500 mg bid for the management of moderate-to-severe acute musculoskeletal pain.

Purpose This paper aims to provide a profile of Andrew Voyce. Design/methodology/approach Andrew gives a short biography and is then interviewed by Jerome. Areas covered in the interview include the central role of Mrs Thatcher in closing down the old asylums, homelessness, education, benefits and digital art. Findings Andrew's recovery from long term mental health problems has seen him return to higher education. He failed to get his undergraduate degree, but decades later and with the encouragement of workers in the community, he completed both undergraduate and postgraduate studies. He talks of the negative impact of asylum care, especially the terrible side effect of akathisia, which resulted from the depot neuroleptic medication. Originality/value This paper shows a remarkable journey of recovery, from a life of being a “revolving door” patient, to homelessness, to re‐establishing an ordinary life in the community. The inmate's perspective is one that has largely been absent from narratives of asylum care.

Hepatitis B vaccines do not generate protective immune responses in older adults as effectively as they do in children and young adults. Improved formulations of existing vaccines may have the potential to improve this. This study investigated the persistence of serum antibodies against hepatitis B surface antigens (anti-HBs) 3.1-3.5 years following primary vaccination with 3 doses of HBvaxPRO® or Engerix B™ in healthy adults aged ≥ 50 years who were further challenged with 1 dose of recombinant hepatitis B antigen. This was an open-label extension study. Individuals (N = 204) with a mean (standard deviation) age at enrollment of 63.7 (7.0) years receiving HBvaxPRO® or Engerix B™ in a randomized, double-blind primary study were challenged with 1 dose of HBvaxPRO® (10 μg). Anti-HBs were measured pre- and 30 days post-challenge. 45.5% (34.8, 56.4 [95% CI]) of individuals who received HBvaxPRO® in the per protocol set (PPS) had anti-HBs titers ≥ 10 mIU/mL pre-challenge and 85.2% (76.1, 91.9) 1-month post-challenge. In those who received Engerix B™ in the primary vaccination series, the results were 58.8% (48.6, 68.5) and 88.3% (80.5, 93.8), respectively. The challenge dose of HBvaxPRO® was generally well tolerated. Subjects aged ≥ 50 years receiving a challenge dose of HBvaxPRO® demonstrated immune memory against hepatitis B 3 years after a 3-dose primary. The safety profile of this challenge dose of HBvaxPRO® was consistent with the well-established safety profile of the vaccine HBvaxPRO®.

There has been a recent surge of interest in recovery, co-production in care and political inclusion for persons with mental health difficulties (Voorberg, Bekkers & Tummers, 2015). This has revealed a need for principles based on robust theoretical and empirical enquiry to guide practices that enhance political participation in institutional settings. This need is likely to be felt in any jurisdiction that has ratified the UNCRPD and therefore the concern is internationally relevant. The Universal Declaration of Human Rights (UDHR) 1948 constructs widespread political inclusion in elections as a primary method of driving the establishment, implementation and enforcement of human rights. Political rights are therefore of great importance for people with mental health challenges who are at greater risk of their freedoms and rights being violated through state interference in their personal affairs. The UDHR Article 21 states: Everyone has the right to take part in the government of his/her country, directly or through freely chosen representatives. The will of the people shall be the basis of the authority of government; this will shall be expressed in periodic and genuine elections which shall be by universal and equal suffrage and shall be held by secret ballot or by equivalent free voting procedures. The European Convention for the Protection of Human Rights, Protocol 1, Art 3 (1952), also established a right to free and fair elections. For people with mental health challenges and disabilities, these rights are too often abstract and partial (European Union Agency for Fundamental Rights, 2014). The United Nations Convention of the Rights for Persons with Disabilities (UNCRPD) aims to substantiate and extend these rights under Article 29—the right to equal opportunities to participate in public and political life. Article 29 is merely one of several UNCRPD participation rights (e.g. Article 3, 4(3), 8 12, 19, 21, 22, 24 and 33) that aim to ensure people with disabilities can directly influence decisions that affect their lives. The World Health Organisation (WHO), in guidelines relating to Community-Based Rehabilitation, recommends that Article 29 is implemented internationally as a mandate to support and encourage engagement with a broad range of political activities (WHO, 2010). In an analysis of implementation of Article 29 across the EU, the European Union Agency for Fundamental Rights found that in many Member States, a lack of legal capacity automatically excludes many people with mental disabilities from the franchise (European Union Agency for Fundamental Rights, 2014). Such restrictions being directly based on a disability or a proxy such as capacity, contravene the principles of the UNCRPD as interpreted by the CRPD Committee. In many jurisdictions, procedures for persons with disabilities to request support or assistance to vote are inaccessible. For people living in institutions, disenfranchisement can be caused by the lack of reasonable accommodation and support. When the right to political inclusion on an equal basis with others is violated, there are frequently no obvious routes to redress. Substantiation of political rights, through the implementation of reasonable accommodation and positive support, is vital to provide equal opportunities for political participation. Further, political inclusion symbolically recognizes people with mental health difficulties as equal citizens and is a practical application of the principles of humanistic, person-centred recovery. Recent empirical research in which the development and implementation of policies were observed and discussed in interviews concludes that these principles are too often relegated as a secondary concern for mental health practitioners preoccupied with risk aversion (Clubbs Coldron, 2020). In this paper, I seek to identify a number of ethical dilemmas that arise in psychiatric practice centring around the need to reconcile patient autonomy with paternalism and beneficence. It is argued that in the context of advancing political rights for residents of psychiatric rehabilitation facilities, these principles can often be incompatible. The focus of this paper is the implementation of policies aiming to improve and expand political opportunities for people with mental health challenges. Prior to discussing the ethical and practical dilemmas inherent in this practice, a working definition of politics is provided. Contemporary definitions of politics, according to Van der Eijk (2018) can be categorized into two groups. There are “Domain” definitions that rely on identifying an institutionalized political sphere—for example governments, politicians or political parties—associated with large scale and explicit governance and public administration. At any given moment, there is a certain domain or sphere of which you can say that is governmental and whatever happens there is political. Definitions based in this tradition are referred to in this paper as domain politics or big-P Politics. Van der Eijk points to a second type—“Aspect” definitions—which rely on identifying aspects of behaviour in processes that attempt to resolve conflict relevant to a community as a whole. This category of definitions I refer to as aspect, or small-p, politics. A definition of politics restricted to big-P politics can result in barriers to the development of political identities and capabilities (Community rehabilitation: CBR Guidelines WHO 2010). For example, in mental health rehabilitation policies of political inclusion may only be implemented to support the right to vote during elections. Participation in the everyday politics of mental health care and treatment may as a result be deemed inappropriate for service users (Clubbs Coldron, 2020). This can be avoided if a broader definition is adopted that includes small-p politics. The WHO CRB guidelines indicate that, in implementing Article 29, what aspect definitions result in more inclusive practices encompassing “interrelationships between people—between men and women, parents and children, people with and without disabilities—and the operation of power at every level of human interaction” (WHO, 2010). For people with mental health challenges who are detained in institutions, this brings into focus the day-to-day processes of conflict and cooperation on matters relevant to the community within the mental health institution of which both staff and residents are a part. The WHO CBR guidelines are not without some pitfalls from the point of view of people experiencing mental health difficulties. For example, they recommend encouraging activities ranging from “developing thinking about disability or other social issues at the individual or family level, joining disabled people's organizations or other groups and organizations, and campaigning at the local, regional or national level, to the process of formal politics, such as voting, joining a political party, or standing for elections.” Despite the reference to “other social issues,” the WHO focuses on the politics of disability which potentially narrows the field of appropriate political engagement to disability issues, that is, the health services, mental health law and policy, and welfare systems. Engagement with such topics, in practice, appears to depend on embracing the role and identity of the “disabled person.” Further, the CBR guidelines are based on the premise that people with disabilities have reduced capabilities and opportunities to engage in public and political life. In addition, they assume that political participation is something to be achieved at the later stages of recovery. Therefore, political inclusion is positioned as something that is only attainable following achievement of good health, educational attainment, employment and the establishment of a settled social and family life. Therefore, political inclusion is potentially subordinated to the principles of functional rehabilitation and treatment. It is also constructed as dependent on psychiatric staff “giving” people with mental health difficulties the opportunity to participate. Although participation may be dependent on the provision of support and reasonable accommodation for those with significant mental impairments, the assumption that this is broadly the case for mental health service users may be unfounded. Political autonomy is not a binary status (i.e. you have it or you don’t) but is a matter of degree and increases and decreases according to cognitive function as well as the support offered, and the opportunities presented, in a given context. Policies aiming to enhance and increase opportunities for political participation are currently being implemented in residential psychiatric rehabilitation in England. 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Pediatric chronic myeloid leukemia (pCML) is a rare malignancy accounting for only 2%-3% of all childhood leukemias. Due to this rarity, familiarity with pCML is limited among most pediatric practitioners, including even pediatric hemato-oncologists. In low- and middle-income countries (LMICs), limited financial resources and limited data specific to pCML represent obstacles that healthcare providers must face in diagnosing and treating this rare condition in children. The International CML Foundation (iCMLf) is improving outcomes for people with CML in these countries where resources, diagnostics, and access to medicines may be limited (https://www.cml-foundation.org/lmic-programs.html). Virtual meetings with the purpose of teaching participating pediatricians from LMICs of defined geographical regions were organised by the iCMLf in 2023. At a virtual meeting of the South Asia region, the case of a 14-year-old Indian boy was presented diagnosed with CML in a chronic phase complicated by priapism and loss of vision in his left eye due to hyperleukocytosis. Key aspects of this case are discussed in-depth from the perspective of (i) a pediatric hemato-oncologist practicing in a high-income country, (ii) a pediatric hemato-oncologist practicing in a LMIC, (iii) an adult CML hematologist, and (iv) from the iCMLf in improving the care of children with CML worldwide. Thus by discussing a multifaceted complicated case of pCML in written form as well as pointing to the pediatric module of the iCMLf Knowledge Centre will hopefully contribute to minimize existing knowledge gaps in a rare pediatric malignancy.

The fragility of digital data as a means of storing our images, texts and finances, is well-known to anyone who has ever experienced a failed hard drive, with vital work still to be backed up. Curators worldwide are charged with finding means of safely preserving all the born digital and digitised material in their collections. Yet the likelihood that technologies and generally accepted methods for data preservation utilised at the start of their time in post, are likely to be vastly different in every way, later in their career. We are already aware of many of the technical issues faced in longer-term digital preservation, redundant software and file formats, data storage hardware failure, bit rot literally breaking down data over time, to name but a few. However, these may be the least of the issues facing our particular digital works in any archive, supposing there is no funding for further vital migration, or the archive has newer material that is considered more important, or simply that our, yet unborn, great-great-grandchildren have very different aesthetic tastes and do not like or value our particular collection. This paper proposes an alternative approach to very long-term digital preservation where our most important and significant works of art can be safely preserved for centuries into the future, by utilising a proven technology many thousands of years old.

Purpose The purpose of this study is to compare lived recovery journeys in mental health with recovery models. Design/methodology/approach Unstructured interviews with prompts were conducted with two individuals. Findings Some recovery models correspond in part with the live experience of subjects. These narratives have personal emphasis that is incongruent with the highlighted models. In particular, the subjects have a place for therapeutic interventions, i.e. talking therapies and medication. Research limitations/implications The live experience of the two people with mental health issues crosses boundaries of recovery models. Relevant models include those used in peer support; however, they too do not fit exactly with the detailed journeys. Practical implications A varied approach without preconceptions is appropriate to understand the components of these two recovery journeys. Social implications The medical model approach to mental health is not discounted rather it is integral to these two recovery journeys. Originality/value This is qualitative research using stated models of mental health recovery. In addition to the principles of hope, meaning, connectedness, identity and empowerment, the two subjects include the essential part for medication and talking therapies in their recovery.

Gordon Howes with PhD student Mo Tian-Pei in Gordon's office, old Spirit Building, British Museum of Natural History, in the 1980s. Gordon Howes was born in Kingsbury, north London, England, on 2 August 1938 and he died on 6 March 2013. He had been ill for several months, though had remained characteristically cheerful throughout this time. His health declined rapidly in early March, triggering fatal internal organ failure. Gordon, Gordi to his large array of close friends and work colleagues, was an internationally respected ichthyologist who was largely self-taught through his enormous enthusiasm for the subject, his earnestness in listening and learning from colleagues, and his amazing capacity for observation. The example he set for how to be an excellent researcher, and how to thrive on curiosity, was deeply influential for all of us. Gordon's interests in systematic ichthyology were broad. He had once said that he was hesitant to focus his energy solely on one particular group of fishes and become a world expert on them; he would rather understand the breadth and diversity of fishes, because he felt that learning about many different groups provided the perspective needed to understand the subtleties of any one group. To paraphrase from Gordon himself [in his description of Humphry Greenwood (Howes, 1995)], Gordon had a holistic eye for morphology which enabled him to see ‘the place of the particular within the general.’ So, he was a bit of a ‘Jack of all trades,’ but remained impressively masterly of many of them at the same time. His work covered the anatomy, phylogenetics and biogeography of Cypriniformes, Siluriformes, Characiformes, Gonorynchiformes, Gadiformes, Ophidiformes, Osmeriformes and Mugiliformes. He was also quick to appreciate the importance of fossil taxa, one of his early publications was on fossil fishes (Greenwood & Howes, 1975), and he had an enormous respect for his palaeoichthyologist colleagues at the Natural History Museum in London, such as Colin Patterson and Peter Forey. Gordon's father worked for Harland & Wolff, where he was responsible for the docking and unloading of ships, including the time of World War 2 and the Blitz, and he spent time working for the aircraft manufacturer, De Havilland. His mother worked as a nanny until she had her own children and was then a full-time housewife. Gordon did not talk much about his family life, but he indicated his respect for his father's capacity to manage a large work staff professionally and effectively; he once wryly commented that the rising, self-styled ‘middle managers’ of the scientific civil service in the late 1980s and early 1990s, who exasperated him towards the end of his scientific career, could have learned some skills from people such as his father who really knew how to manage people. Gordon is survived by his sister, Hazel; they were close throughout his life and he spoke of her affectionately. Gordon left school at the age of 15 to work in commerce, at the well-known photographic company Wallace Heaton Ltd in New Bond Street, London. He was a focused worker throughout his life, and did not like interruptions. For example, while working at Wallace Heaton Ltd, he was trying to complete some complicated shipping forms and was being interrupted by the phone ringing. Finally, he picked up the phone and shouted ‘I don't care who you are, just bugger off,’ before slamming down the phone. Unfortunately, at the other end of the phone was Jack Wallace Heaton, the owner of the business. It was only the intervention of the departmental manager and a begrudging letter of apology that saved Gordon's job. This was also perhaps the start of a tempestuous relationship that Gordon had with phones (see below). While working at New Bond Street, Gordon studied in the evening, acquiring his ‘O’ and ‘A’ level exams. He did a short period of voluntary work at the Natural History Museum in London after which, in 1968, he was offered a position in the museum as a Scientific Assistant in the Fish Section, and was assigned as a personal assistant to Humphry Greenwood. His initial responsibilities were often clerical, for example, taking letters for Humphry (Gordon's skills included short-hand, but he had adapted his own method for this) and doing scientific illustration. Gordon's scientific illustrations are typically accurate, clear and uncluttered; these were critical issues for Gordon in all aspects of his work. He was a great believer in transmitting knowledge to people in a way that expressed the important information without unnecessary complexity. He deeply valued clarity, honesty and clear-thinking. Gordon wanted people to appreciate the subtleties of fish anatomy as much as he did. This desire was also transferred to the paintings of fishes that he worked on through much of his career at the Natural History Museum and after his retirement. As with so many of his skills, his artistry was largely self-taught. He preferred realism in his art. He could paint an excellent, traditional lateral profile of a fish showing colour beautifully. He also liked to paint fishes from unusual angles, to help the viewer understand the living form of the fish better, for example, halfbeaks facing head on, tunas in fast turns away from the viewer, all giving an intriguing perspective that one did not usually encounter. Gordon worked in the Fish Section of the Natural History Museum for 25 years, rising through the ranks on the way. He conducted fieldwork during this time, in Africa and in South America, but his real energy was in the collection room and laboratory, where his scientific mind and great skills as an artist found fulfilment and he contributed an important body of work to science. He wrote over 40 scientific papers during his career at the Natural History Museum, an impressive record given the large number of other tasks he had to perform as part of his job, as well as the extra work he happily chose to take on to help students and researchers visiting the museum. Gordon was extremely serious about the care of the fish collection, working side-by-side with his colleagues in cataloguing, documenting and curating the collection, answering public enquiries and assisting with loans. He sometimes became exasperated when distractions prevented him from focusing on projects. True to his sense of honesty throughout life, Gordon would not hide that exasperation from his colleagues. There is a legendary story of him smashing a Natural History Museum phone into pieces when he finally could no longer deal with the constant phone interruptions (haven't we all wanted to do that at some point in time?). Gordon, however, consistently went out of his way to be helpful to anyone who needed his assistance. His professional attitude was well summarized by Roberts & Stewart (1976) in their Acknowledgements where they state ‘Gordon Howes responded with his characteristic promptness and thoroughness to our requests for information about types and other specimens housed in the British Museum.’ This description barely scratches the surface of how open Gordon was to helping others and taking an interest in them. For example, Gordon worked closely with the aquarist community in the greater London area. One of us (R.V.) was struck, on more than one occasion, by the incongruity of some visiting aquarist holding a plastic bag with a live fish next to a jar containing a holotype in discoloured alcohol while Gordon attempted to determine whether they were conspecific. These fishes were often Lake Victoria cichlids and the visitors were more than likely people who had been expecting to meet with Humphry Greenwood but instead received Gordon's patient and unstinting help. Gordon also gave excellent presentations to aquarist groups (especially catfish enthusiasts) around London. He would travel to these often accompanied by colleagues from the museum and loaded down with fish skulls and whole specimens which he used to great effect to engage the interest of his audience. For his research, Gordon had a long-lasting interest in cyprinids. He published on cypriniforms more than on any other group. His review of the systematics and biogeography of cyprinids (Howes, 1991a) provided an excellent and easily understandable introduction into these complex subjects. Most of Gordon's papers focused on internal anatomy (particularly the identification of skeletal, muscular and nerve characters) and he used this information to interpret the phylogenetic relationships of the taxa and hence their historical biogeography (Howes, 1980, 1984). Gordon examined alizarin/alcian-cleared and stained specimens preserved in glycerine, to study the skeletal anatomy, but also said that he enjoyed handling and examining the dry skulls of specimens because they gave him an understanding of the nuances of the bones' sutures and articulations. He was quick to appreciate the importance of muscles as an underutilized source of characters to define phylogenetic relationships; for him, the morphology of bones, muscles and indeed nerves were all obviously linked, so one had to look at them all together. While most of Gordon's papers were focused on levels above alpha taxonomy, he was quick to spot an interesting species-level question and investigate this where it was appropriate (e.g. his discussion of the only known specimen of Barilius longirostris; Howes, 1991b). As noted above, Gordon was also quick to turn his skills to many other groups besides cyprinids. He wrote several papers on catfishes, including his well-cited discussion of the phylogenetic relationships of electric catfishes (Howes, 1985). In the final part of his career at the Natural History Museum, when researchers were forced to work on groups that were economically important, he started work on gadiforms. He immediately challenged existing ideas on their phylogenetic relationships and biogeography (Howes, 1991c, 1993). One of us (I.H.) was lucky enough to work with Gordon on mugilids (Harrison & Howes, 1991), benefitting enormously from Gordon's expertise, and learning the importance of studying ontogenetic series, muscles and bones, all pivotal parts of good anatomical description. Gordon encouraged these analyses in all PhD students and postdoctoral researchers he knew, with excellent results for their dissertations and subsequent publications. Gordon took the role of mentoring students very seriously. Though many of the PhD students who passed through the Natural History Museum in the 1970s and 1980s were officially supervised by Humphry Greenwood, it was Gordon who sat with them, answered their questions, looked at the specimens with them and helped them develop into professional researchers. Gordon would push students to think carefully about their observations, and to read deeply from the scientific literature, and to ask questions. He taught them to be unafraid of admitting what they did not know, so they could focus on what they needed to learn and research. He did this because that is exactly how he worked. There is an impressive list of systematic ichthyologists who had the good fortune to study at the museum and many of whom owe much of their knowledge, and in some cases their distinguished careers, to Gordon. Notable among them are (with the groups they worked on in their early career association with Gordon): Gordon McGregor Reid (Labeo and African fishes), Melanie Stiassny (cichlids), Lynne Parenti (Cyprinodontiformes), Rich Vari (Characiformes), Rob Travers (Mastacembelidae), Chris Sanford (Salmoniformes) and Tian Pei Mo (Bagridae). Gordon went to great lengths to help visiting scientists at the Natural History Museum. This would include the basic necessity of ensuring that they had somewhere comfortable to stay in London, and making them feel at home in London by taking them out to dinner or for a drink, or inviting them to a meal at his own home. In the museum, he would help them find fishes in the collections; no easy task among the several floors of collection rooms in the old Spirit Building, or in the large, old, Dry Storeroom Number 2 in the main museum building. He was also a capable guide to the various libraries of the museum; he appreciated the enormous importance of the material these libraries housed, and was quick to share his knowledge and to locate reprints among his own, large collection. Gordon also valued the time spent with visitors as this was an opportunity to talk with them about their work, learn new information from them, and share his opinions. Among the range of visitors Gordon worked with, he was influential in training His Imperial Highness Prince Akishino of Japan in fish taxonomy, focusing on catfishes, between 1988 and 1990, and Gordon was subsequently interviewed on Japanese television on the day of the Prince's wedding. It really didn't matter, however, if you were a college intern, a visiting PhD student, an internationally respected expert or an amateur enthusiast, everyone was the same in Gordon's eyes. The most exciting period for Gordon at the Natural History Museum must have been through the mid to late 1970s and into the 1980s. His own research was expanding rapidly, and cladistic methodology was being embraced, at least by some, in ichthyology; Humphry Greenwood and Gordon were among those ichthyologists. Gordon's obituary for Humphry (Howes, 1995) gives a small window into the excitement of those times. Towards the end of 1970s, the Fish Section of the Natural History Museum hit a research peak, attended by some of us (e.g. Melanie Stiassny, Lynne Parenti and Rich Vari) and other exceptionally talented PhD students, postdocs and visitors (e.g. Gordon McGregor Reid, Rob Travers and Paul Skelton). Gordon thrived in this atmosphere of excellence, enthusiasm and shared interest in cladistics. He was impressed by the progressive approaches of many systematic ichthyologists from the U.S.A. in the 1970s and 1980s; these researchers were ready to question the traditional concepts of taxonomy and classification, and break new ground. Equally, he respected the very important research of his colleagues, which the alpha work of examining large of diversity and He worked closely with colleagues in and the such as and who were doing some of the work on the diversity of African fish that were of particular interest to Gordon. His close with them well his from the Natural History Museum. as a museum but after his Gordon was not a of the of that are by a particular morphology in a In he this as on that are more on that and do not have however, he also that we a where we all understand that we are about the same as of what is in the we have to a for the of One of us (I.H.) the with Gordon and from the Natural History Museum, and Gordon took in a where is a discussion about what the be one of the characters be if you don't it a Gordon was that they took their Gordon was his his was to share information so that others could look at it or it to He would be the to point out where he have a and where others had on his work. There were a aspects of the world of systematic however, for which Gordon had personal He was not a great of systematics as a by but only because he that is so much to learn from anatomy, and he felt that systematics was making it to state a for traditional anatomical He from systematic ichthyology before phylogenetics really took His were in the of a the just as well as Gordon's perspective on phylogenetics is well in a that his Colin Patterson in a different but appropriate in or is at and as carefully and in as much as you for you and on what is the and from you it in a Gordon was in and rather than He had an of the towards that and because he felt these and research away from answering new questions. Most of he the and that was around in the late 1980s and early in the that it more to do the work that he felt was important at the museum. with museum he to take early in so he could to focus his time on that him and gave him he left the Natural History Museum, he to England, where one could him because he remained so He spent more time his before and after fishes and as a but he also and from he of the from the for which he had a great were also subjects. His gave him more opportunity for paintings for His had been before his in in and he went on to in London and and in after from the Natural History Museum, he had a of at the of His paintings are in within the and in the the and South Gordon did not the museum community on his retirement. He remained in with his ichthyologist friends and colleagues, and a close of many of his colleagues from the Natural History Museum whom he had in of the fish He had worked closely with one of us while were at the Natural History Museum, of her on fish and illustrations and in their Gordon helped her He many of their colleagues in of not before he Gordon as a of he valued personal and would rather a and or the phone. the noted with phone he would be just as ready to he was doing and engage in a and with Gordon also a close on scientific to to and information to his colleagues. the of the of and in New of us and a small dinner to and Gordon's to ichthyology and the of so many The next day at the a was passed in of Gordon, to our understanding of the anatomy and of groups of fishes was and his service to researchers who passed through the fish was and that was also in his and to of students from around the personal This would have Gordon. He was a of the as a focus for students in the of and the of discussion on the science. In the for this was Gordon the as noted As well as his ichthyology in his Gordon his from the Natural History Museum to the main of the British Museum at where he spent as a guide and with in and African and the He himself into these on the so that he could them (Howes, of us had the opportunity to to him about these and the he and they were of the same enthusiasm for the that he had for Gordon contributed his time and to help his colleagues in the British to new In he was the British for and the of Museum who have an important and long-lasting of time, and enthusiasm to help the Museum the of of visitors Gordon would have been deeply and to have received this in Gordon's and for knowledge was and he to share He was to and he it his much more in life was so very important to He as an artist and had a for with friends he would ask to to take a He would these that he to his Gordon himself in of as well as of a of and which was on a or somewhere in his home or He once said that he could not understand anyone without a of He was in his to a see but liked and had an knowledge of many He had a for that and people in and He had a for because it so well the and of the British which he so This is he chose to his living close to the and through it with his friends he Gordon was a great he but so very the of many people who he or with whom he from all parts of the He was at the and of times. one occasion, one of us was with Gordon in the in the U.S.A. and became in a This was in the before and Chris and Gordon were on the of a the was was no of any and they were out of Chris out of the looked over the of the trying to out how to out of the Gordon to found some on the but Gordon had a sense of which he was ready to at himself as much as anyone One of us a artist and one of Gordon's Gordon for years, shared the story at Gordon's one and an of which so him that he wrote the most in the He it have been to that Gordon's life was and he was deeply with what he of it and the people he shared it One of us was with him in his in Gordon was in that time and in his as he into of where he he you the and so much about what important to Gordon through his as he his were in the museum and he was in to the very As one of us said when he the for Gordon at the British Museum (see Gordon was an artist and a but that he was and The world is a place because of him as so many of his friends and colleagues around the and think of him but time we do the are great of and

There is ample evidence of misunderstandings and confusion over conventions relating to even such a simple circuit as a generator feeding a load. The reasons for this are traced and a simple solution offered which harmonizes opposing arguments and renders controversy unnecessary.