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To evaluate the effectiveness of human papillomavirus (HPV) testing in primary cervical screening. This was a cross-sectional study from the recruitment phase of a prospective randomised trial. Women were screened for HPV in addition to routine cervical cytology testing. Greater Manchester, attendees at routine NHS Cervical Screening Programme. In all, 24 510 women aged 20 -64 screened with liquid-based cytology (LBC) and HPV testing at entry. HPV testing in primary cervical screening. Type-specific HPV prevalence rates are presented in relation to age as well as cytological and histological findings at entry. In all, 24 510 women had adequate cytology and HPV results. Cytology results at entry were: 87% normal, 11% borderline or mild, 1.1% moderate and 0.6% severe dyskaryosis or worse. Prevalence of HPV decreased sharply with age, from 40% at age 20 -24 to 12% at 35 -39 and 7% or less above age 50. It increased with cytological grade, from 10% of normal cytology and 31% of borderline to 70% mild, 86% moderate, and 96% of severe dyskaryosis or worse. HPV 16 or HPV 18 accounted for 64% of infections in women with severe or worse cytology, and one or both were found in 61% of women with severe dyskaryosis but in only 2.2% of those with normal cytology. The majority of young women in Greater Manchester have been infected with a high-risk HPV by the age of 30. HPV testing is practicable as a primary routine screening test, but in women aged under 30 years, this would lead to a substantial increase in retesting and referral rates. HPV 16 and HPV 18 are more predictive of underlying disease, but other HPV types account for 30% of high-grade disease. Cervical cancer is the second most common cancer among women worldwide, and ranks first in many developing countries (Parkin, 2004). Human papillomaviruses (HPV), most frequently HPV 16, are the primary cause of cervical carcinogenesis (IARC, 1995). Over 100 HPV types have now been described, including about 20 'high-risk' types that are associated with cervical cancer (Clifford et al, 2005). The overall prevalence of HPV in cervical cancers in a large international study was over 99%, implying the highest attributable fraction ever identified for a specific cause of a major human cancer (Walboomers et al, 1999). In many developed countries, particularly the UK, systematic cervical screening based on cytology has been responsible for a significant fall in the incidence and death rate from cervical cancer (Peto et al, 2004). The NHS Cervical Screening Programme in England now offers screening 3 yearly between ages 25 and 49 and 5 yearly between 50 and 64 years, and liquid-based cytology (LBC) is currently being implemented. Nonrandomised studies have shown that HPV DNA testing is more sensitive than cytology for detecting CIN, and the International Agency for Research on Cancer (IARC) recently concluded that testing for HPV as a primary screening modality could reduce cancer incidence and mortality (IARC, 2004).In order to evaluate the effectiveness of HPV testing in prima...

Summary1. The high spatial and temporal variability of forest understorey light environments requires lengthy and/or extensive sampling in order to characterize it by direct measurement. As this is often impractical, a number of surrogate measures have been developed that estimate light availability from assessments of forest canopy structure. 2. The subjective crown illumination index developed by Clark & Clark (1992) was compared with Garrison's (1949) moosehorn and two new methods: (i) the crown illumination ellipses method, which compares the size of canopy gaps with a series of standard area ellipses printed on a transparent screen; and (ii) the canopy-scope that, like the moosehorn, uses an array of 25 dots printed on a transparent screen to assess canopy openness, but is more robust and portable, measuring the largest canopy gap visible from the point of measurement rather than canopy openness overhead. 3. The new measures were more highly correlated with canopy openness in the range 0±30%, measured from hemispherical photographs, than the crown illumination index, and showed lower levels of between-observer variability. 4. The canopy-scope has the potential to be widely used for the simple and rapid assessment of forest understorey light environments. It has the advantage of giving ratio scale measurements that can be used in parametric statistics. The crown illumination ellipses can be used to score the illumination of crowns that are above head height.

The purpose of the study was to assess the psychosocial impact of human papillomavirus (HPV) testing as an adjunct to cytology in routine primary cervical screening. A controlled study of the psychosocial impact of HPV testing within a randomized trial of HPV testing to assess its efficacy in cervical screening was carried out. The trial provides a randomized setting of revealed HPV results versus concealed results permitting valid comparisons for assessing true psychosocial impact. The setting comprised a large number of general practices in primary care. Women aged 20-64 years who underwent routine cervical screening participated in the study. The intervention was a revealed high-risk HPV test result in addition to cervical cytology. The main outcome was measured using General Health Questionnaire (GHQ-28), Spielberger State-Trait Anxiety Inventory, and Sexual Rating Scale (SRS). Among women with either mildly abnormal or normal cytology, receiving an HPV(+ve) result did not impact significantly on GHQ caseness and mean scores or on Spielberger State and Trait scores when compared with women in whom the HPV(+ve) test result was concealed. Among women with normal cytology, receiving an HPV(+ve) result was associated with a reduction in the Sexual Rating Scale compared with similar women whose HPV(+ve) result was concealed. HPV testing does not add significant psychologic distress when combined with cytology in routine primary cervical screening.

Artificial reefs are increasingly used worldwide as a method for managing recreational diving since they have the potential to satisfy both conservation goals and economic interests. In order to help maximize their utility, further information is needed to drive the design of stimulating resources for scuba divers. We used a questionnaire survey to explore divers’ perceptions of artificial reefs in Barbados. In addition, we examined reef resource substitution behaviour among scuba divers. Divers expressed a clear preference for large shipwrecks or sunken vessels that provided a themed diving experience. Motives for diving on artificial reefs were varied, but were dominated by the chance of viewing concentrated marine life, increased photographic opportunities, and the guarantee of a ‘good dive’. Satisfaction with artificial reef diving was high amongst novices and declined with increasing experience. Experienced divers had an overwhelming preference for natural reefs. As a management strategy, our results emphasize the capacity of well designed artificial reefs to contribute towards the management of coral reef diving sites and highlight a number of important areas for future research. Suggested work should validate the present findings in different marine tourism settings and ascertain support of artificial reefs in relationship to level of diver specialization.

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Habitat improvements through agri‐environment schemes are the most important tool for reversing biodiversity declines in European farmland. However, little is known about their impact on mammals, including the brown hare, a priority species for conservation in the UK. We studied radio‐collared hares for 13 months in a mixed agricultural area using ‘homing in’ to provide high spatial‐resolution fixes. Hares selected agri‐environment field margins during both active and inactive periods and used the areas in the middle of large fields less frequently than those closer to the field boundaries. Blocks of woods and lines of trees were selected as resting sites while sheep‐grazed fields were generally avoided throughout the year. We suggest that agri‐environment schemes targeted at creating and increasing non‐farmed habitat features associated with field boundaries and reducing sward depletion through less intensive or mixed grazing regimes could prove beneficial for populations of this priority species in farmland.

A technique using fresh feeding signs as an index of density was validated and used to survey the effects of sheep grazing on vole population densities in four upland habitats in the northern Peak District National Park, UK. In grazed areas Molinia caerulea grasslands supported most voles, Nardus stricta grasslands supported fewer and Eriophorum vaginatum and Calluna vulgaris-dominated areas supported least.There were highly significant negative relationships between vole sign density and sheep numbers in these habitats. Where sheep were excluded, these same habitats had between three and nine times higher sign densities, corresponding to between 1.5 and