Enhanced Sexual Health Services (ESHS) have the potential to widen access to sexual health services for populations in England. This study aimed to identify what provision was commissioned in ESHS for men who have sex with men (MSM). We undertook a web-based survey of Primary Care Trust (PCT) commissioners in the southeast of England, exploring what sexual health services were commissioned for MSM and comparing them with published standards. Fourteen of 17 PCTs (82%) responded. All PCTs identified at least one genitourinary (GU) medicine clinic and 13 identified at least one ESHS commissioned for their population. However no single ESHS provided the full range of essential services for MSM. Testing for Chlamydia (84.6% PCTs) and for HIV (69.2% PCTs) were most commonly provided in ESHS, while only 46% and 62% of PCTs had an ESHS commissioned to provide gonorrhoea testing and hepatitis B/syphilis serology testing respectively. Under two-thirds reported training of staff in the sexual health needs of MSM. ESHS are not commissioned to provide the full range of essential sexual health services for MSM. This needs to be addressed by improving staff training in these services and strengthening care pathways between ESHS and GU medicine clinics.

Correction to: British Journal of Cancer (2010) 103, 209-216. doi:10.1038/sj.bjc.6605747 Owing to an error during final correction of this paper, Figure 3 was incorrectly reproduced. The correct Figure 3 is now shown, below. The publishers apologise for this mistake.

Sexual health services in primary care, known in the UK as local enhanced services in sexual health (LESSH), aim to increase access to sexually transmitted infection (STI) screening and treatment. Little is known about the characteristics, quality or public health impact of these services. We identified national standards for service provision, and evaluated LESSH against them using a structure, process and outcome approach. Clinical structure and process standards were generally well met, with the exception of partner notification provision. However, public health and outcome measures were largely unascertainable and often undefined in the standards. If the primary care STI services are to deliver public health benefit, improved outcome measures and data collection are required.

Results of a community HIV testing pilot (fasTest) targeting men who have sex with men (MSM) in Brighton are reported and service users are compared with those testing in genitourinary medicine (GUM) clinics. FasTest offers rapid HIV testing in a weekly evening drop-in session staffed by GUM professionals in a community organisation. It was prospectively evaluated from November 2004 to March 2006 using a self-completed paper questionnaire assessing demographics, previous use of GUM, HIV testing history and sexual behaviour. Follow-up through GUM/HIV services was monitored. A simplified questionnaire was completed by MSM accessing the GUM clinic over the same time period. Men were included in the analysis if they identified as gay or bisexual or had recent sex with a man, tested for HIV and received a result. In both the fastest and GUM groups, men reported high rates of unprotected anal sex in the last 3 months. fasTest clients were significantly younger and less likely to test positive for HIV. This difference was independent of age and HIV testing history. There was no difference in rates of recent infection between the two. We conclude that community HIV testing is feasible and reaches the target group of high risk MSM.

Introduction: Antiretroviral therapy for HIV infection has transformed it from a terminal illness to a chronic manageable condition. This review summarizes the history of the treatment and explains the current practice in the field, including uses in prevention strategies.Sources of data: National and international guidelines, important publications in peer reviewed literature and recent important conference abstracts.Areas of agreement: There is a broad agreement on the choice of drug regimens and on the need to treat patients with symptomatic HIV infection and with CD4 cell counts less than 350 cells/mm(3). The need to adapt therapy to individual circumstances is also well accepted, e.g. hepatitis co-infection and pregnancy.Areas of controversy: Treatment of acute HIV infection and the optimum time to commence therapy in asymptomatic chronic infection remain controversial. Use of antiretrovirals for prevention, e.g. pre-exposure and post-exposure prophylaxis, is still developing.Growing points: This article summarizes the current use of anti-HIV medication and the evidence behind it for the non-specialist.Areas timely for developing research: New strategies for using current drugs, the best use of newly available drugs and new uses of antiretroviral drugs, such as in prevention of HIV transmission, are key areas for research. Further research addressing the question of when to start antiretrovirals and assessing their long-term effects is also needed.

Summary: The Sexually Transmitted Infection Foundation course (STIF) is a recommended training course for UK general practitioners (GPs) and others delivering sexual health services in the community. We assessed the impact of attending the course on testing for HIV and chlamydia. Thirty-one GPs attending Brighton STIF courses were identified and the laboratory database was searched to identify all chlamydia and HIV tests they requested in the three months prior to attending, the first three months after attending and the subsequent three months. Three hundred and eight chlamydia tests were performed precourse, 390 postcourse and 342 in the following three months. This represented a significant increase from baseline to postcourse (P = 0.007), which was lost by three to six months (P = 0.25). The proportion of positives did not change. A total of 98, 111 and 131 HIV tests were performed in the three time periods of which; none were positive. Barriers other than training may need to be overcome to increase HIV testing in primary care.

Male F344 rats were exposed for 8 weeks to extracts of green tea (2% w/v) or black tea (1% w/v), or to 0.1% dietary indole-3-carbinol (I3C). In weeks 3 and 4 of the study, rats were given 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) every other day by oral gavage (50 mg/kg body wt) in order to induce aberrant crypt foci (ACF) in the colon. Compared with controls given IQ alone, all three inhibitors reduced the number of total aberrant crypts per colon, and green tea and I3C inhibited significantly the mean number of ACF (P < 0.05). Rats pre-treated with green tea, black tea, or I3C and given a single p.o. injection of 50 mg IQ/kg body wt 24-48 h before sacrifice had reduced levels of IQ-DNA adducts in the liver, and excreted lower amounts of IQ and other promutagens in the urine and feces. Inhibitors also reduced the excretion of IQ-sulfamate in the urine, but increased the relative amounts of IQ-5-O-sulfate and IQ-5-O-glucuronide. Western blotting together with assays for 7-ethoxyresorufin O-deethylase and methoxyresorufin O-demethylase established that I3C preferentially induced cytochrome P4501A1 over 1A2, consistent with the altered profile of urinary metabolites. However, both teas caused slight induction of cytochrome P4501A2 versus 1A1, which would be predicted to enhance the activation of IQ. Thus, green tea and black tea are likely to protect against IQ-DNA adducts and ACF by mechanisms other than induction of cytochromes P450, such as inhibition of enzymes which activate IQ or the scavenging of reactive intermediates.

ABSTRACT This paper describes some of the more recent work in the United Kingdom on the utilization of quantitative weather radar data in hydrological modelling. The historical background to weather radar developments is briefly discussed and several projects presently underway in the area of real-time flood forecasting and flood producing storm analysis are outlined.

ABSTRACT THE effects of tire size, inflation pressure, and percent travel reduction on bulk density were determined on ourdoor bins filled with soil from the lower Ap horizon of the Cecil, Hiwassee, and Lakeland soil series. The single-wheel tire tester of the National Tillage Machinery Laboratory at Auburn, Alabama, were used in the tests. The three skidder tires used in the study were a 10 ply 18.4-34, a 12 ply 24.5-32, and a 12 ply 30.5L-32. Travel reduction (percent slip) had a greater influence on soil compaction than tire size or inflation pressure. The higher travel reduction level (30%) was associated with a decrease in soil compaction. Dynamic loads beyond about 20 kN did not cause additional increases in soil compaction.

ABSTRACT THE performance of three different sizes of log-skidder tires was compared at two travel reduction and two inflation pressure levels. Results indicated that when log-skidder tires are operated on dry soil conditions there is little effect on performance due to tire size. Inflation pressure should be set at the minimum recommended level for a particular tire load.

ABSTRACT A13.6 X 38 tractor tire was operated at the recom-mended load of 16.3 kN and also at half load to simulate dualing. The tire was run four times in the same rut in three different soils. Each soil was freshly tilled and loose before the first pass. Results showed both net traction and tractive efficien-cy significantly lower on the first pass than on subse-quent passes. Sinkage and bulk density changes were noted after each of the four passes. Approximately 75 percent of the total change in bulk density and 90 per-cent of the sinkage occurred on the first pass of the tire.

ABSTRACT A tandem tractor tire system was simulated to deter-mine the dynamic load ratio (ratio of dynamic load on the first pass to that of the second pass) as well as the velocity ratio (ratio of angular velocity for the first pass to that of the second pass) for optimum performance. The potential for automatically controlling these ratios based on soil condition was explored. Results indicated that, under good traction conditions, a value of 1 for each of these ratios is adequate.

ABSTRACT TWO different size tires carrying unequal total loads that resulted in approximately equal soil surface pressures were run over soil pressure transducers buried at 18-, 30-, and 50-cm depths. The larger tire consistent-ly produced higher soil pressures at these depths. Froehlich's equation approximately described the soil pressure distribution in both a sandy soil and a clay soil with uniform density profiles. However, when a com-pacted layer was inserted in the density profile, this equation was no longer suitable. The data indicated no simple relationship between soil pressures and bulk densities.

ABSTRACT THE feasibility of using analog tool data with scale model data to predict draft forces on a prototype tillage tool was investigated using three analog-prototype systems. The three analog-prototype systems were a cone penetrometer-chisel, a cone penetrometer-disk, and a chisel-disk. These systems were operated at low speed in six soil conditions, and data were analyzed for three scaled-depth levels. The cone penetrometer-disk system proved to be the best analog-prototype system.

ABSTRACT ARADIAL ply tire and a bias ply tire were compared in both soft and firm soil conditions. The coefficient of net traction and the tractive efficiency were consistently higher for the radial ply tire in five of seven soil conditions. There was essentially no difference in the performance of the two tires in the other two soil condi-tions. The advantage for the radial ply tire was greatest in the firm soils.

Interferometric measurements of the linear thermal expansion coefficients are reported for thec anda crystallographic axis directions of calcium tungstate in the temperature range 30–270°K. The results are believed to be accurate to within 2% at 270°K, falling to 25% at 30°K. The reduced mean Grüneisen parameter (χ s γ mean ) = βV/Ct, calculated from the volume expansion coefficient β and earlier heat-capacity measurements, falls with diminishing temperature. Detailed identification of contributions to the thermodynamic properties arising from translational, rotational, and internal modes of vibration is prevented by spectral overlap. The quasiharmonic approximation has been applied to calculate provisional reduced moments of a representative vibrational frequency spectrum, which are in qualitative accord with earlier findings based upon observations of infrared reflection and first-order Raman spectra.

Interferometric measurements of the linear thermal-expansion coefficients α∥ and α⊥ in the ``c'' and ``a'' axial directions of well-oriented pyrolytic graphite between approximately 20° and 270°K are reported. Grüneisen parameters γ∥ and γ⊥, defined for strain coordinates parallel and perpendicular to the ``c'' axis, respectively, have been calculated from the present thermal expansion coefficients and related data. Between 30° and 270°K γ∥ is positive, indicating the preponderance of longitudinal modes of vibration, while γ⊥ is negative, indicating the predominance of transverse modes. The quasiharmonic approximation has been applied to calculate the characteristic temperatures θ(n) corresponding to the maximum frequencies ωD(n) of the Debye distributions having the same nth moments 〈ωn〉 as the specimens, which vary between approximately 420° and 2270°K as n increases from −3 to +6. The dimensional dependence of the moments, defined by γ(n) =Σγjωjn /Σωjn corresponding to γ∥(n) and γ⊥(n), and their variations with n, are consistent with the existence of low-frequency modes of vibration between planes of atoms perpendicular to the ``c'' axis, and high-frequency modes within the planes, a result supported by calculations of the rms displacements of the atoms.

Interferometric measurements of the thermal expansion of palladium, silver and five alloys of these metals are reported in the temperature range 30 to 270 °K. The experimental uncertainties rise from approximately 1% at 270 °K to 15% at 30 °K. The variation of thermal expansion with concentration is non-linear and the form of the variation is not substantially affected by temperature in the range covered. A degree of correlation has been found with related thermodynamic properties of the alloys, and the need has been established for a rigorous theory of the thermal expansion of binary alloys on an atomic scale.

Interferometric measurements of the linear thermal expansion coefficients x of CsCl and CsBr between 20 and 273°k are reported. The results are believed to be accurate to within 2% down to 30°K, falling to 3% at 25°k. The Debye characteristic temperatures θ of CsCl and CsI are shown to rise with increasing temperature at intermediate temperatures, in contrast to the results for alkali halides possessing a rocksalt structure. Attributing this to the influence of anharmonic effects, the anharmonic contribution to the heat capacity of Csl is shown to be proportional to temperature above T∼2θ D. Any temperature variation of the Grüneisen parameters γ=β/CVXT, calculated from the volume expansion coefficients β and earlier heat capacity and elasticity measurements, and in the case of CsBr from the pressure derivatives of the elastic constants, is smaller than the uncertainty of the values derived, i.e. approximately 5% at 270°k, rising to approximately 20% at 25°K. In the cases of CsCl and CsI the quasi-harmonic approximation has been applied to calculate the maximum frequencies VD{n) of the Debye distributions having the same nth moments as the actual crystals for −3≤n≤6. As in the case of alkali halides with a rocksalt structure. vD(n) has been found to fall with increasing mass of the halide ion and the variations of vD(n) with n display characteristic minima.