ABSTRACT The economic crisis and present government’s strategy on spending cuts have put pressure... more ABSTRACT The economic crisis and present government’s strategy on spending cuts have put pressure on public bodies to do ‘more with less’. With their pursuit of a balance between social and economic objectives, social enterprises have the potential to minimise costs for public sector service delivery and fulfil a number of other policy priorities. The coalition government suggests identifying the best social enterprises and then rolling out their innovative services across the country. However, nowhere is the social, environmental and health value created by social enterprises captured systematically and there is not a level playing field that enables comparison across different types of social enterprises. In this article, the State of Social Enterprise Survey 2009—one of the the largest surveys on social enterprises ever conducted in the UK—is used to discuss the extent of the uptake of impact measurement tools. Results from the survey show a poor use of these tools in the social enterprise sector overall, although health and social care social enterprises fare slightly better. Some policy implications are considered, particularly around the need to create a more appropriate, easy to use impact assessment tool and make sure that organisations are appropriately funded and encouraged to make use of it.
The features and clinical course of chronic balanitis in 5 patients are presented. In each case, ... more The features and clinical course of chronic balanitis in 5 patients are presented. In each case, histological examination of a cutaneous biopsy sample showed pronounced features of human papillomavirus (HPV) infection. In addition, HPV DNA was demonstrated in each biopsy specimen by a polymerase chain reaction and was found to be type 6 by Southern blot hybridization in 4 of the cases. Although the association of histological features of HPV infection with balanitis does not prove that HPV is causal, the failure to find other causes, the prolonged and distressing symptoms, and the ineffectiveness of topical steroids in improving symptoms, all suggest the importance of HPV infection. While effective treatment needs to be sought and developed, the response of one patient to oral isotretinoin suggests that this agent may be appropriate for a larger trial.
Little is known of the in vivo role of the immune system in controlling human papillomavirus infe... more Little is known of the in vivo role of the immune system in controlling human papillomavirus infection in the genital tract. The authors have studied 125 closely monitored patients with genital warts. Of these 125 patients, wart regression was seen in 28 patients. This study provides evidence that clearance of human papillomavirus from the genital tract is characterized by an active cell-mediated immune response. Regressing warts (n = 14) contained significantly more T lymphocytes (P < .05, Wilcoxon rank sum test) and macrophages (P < .01) than did nonregressing controls (n = 14). CD4-positive lymphocytes predominated in regression, both within the wart stroma and the surface epithelium, where there was a significant change in the ratio of CD4+ to CD8+ cells (P < .01). Lymphocytes in regression also showed greater expression of activation markers, and the majority were of the "antigen-experienced" phenotype. There was no difference in Langerhans cell numbers, alth...
One hundred and fifty women who attended a genitourinary medicine clinic and who required a specu... more One hundred and fifty women who attended a genitourinary medicine clinic and who required a speculum examination were investigated to determine the association between Chlamydia trachomatis and urethral symptoms and signs. Those who had taken antibiotics with anti-chlamydial activity within 3 months or those who were menstruating, pregnant or using an intrauterine contraceptive device were excluded. C. trachomatis infection of the urethra, or infection of the urethra and cervix together, combined with each separately, were strongly associated with > = 5 polymorphonuclear (PMN) leucocytes per high-power field (x 1000) in a Gram-stained urethral smear (P < 0.00005 and P < 0.0005, respectively). This appeared not to arise from leucocyte contamination from the lower genital tract. However, C. trachomatis infection of the urethra was not associated with symptoms of dysuria or frequency. In conclusion, it seems likely that C. trachomatis infection of the urethra in women probably...
7 Genitourinary Medicine Services A Renton, S Hawkes, M Hickman, E Claydon, H Ward, D Taylor-Robi... more 7 Genitourinary Medicine Services A Renton, S Hawkes, M Hickman, E Claydon, H Ward, D Taylor-Robinson 1 Summary This chapter addresses the need for ... Table 4: Initial contacts by KC60 diagnosis per 100000 population aged 16-64 in Z 2 yy 1990/91 3? HH* fii amy y" t ...
ABSTRACT The economic crisis and present government’s strategy on spending cuts have put pressure... more ABSTRACT The economic crisis and present government’s strategy on spending cuts have put pressure on public bodies to do ‘more with less’. With their pursuit of a balance between social and economic objectives, social enterprises have the potential to minimise costs for public sector service delivery and fulfil a number of other policy priorities. The coalition government suggests identifying the best social enterprises and then rolling out their innovative services across the country. However, nowhere is the social, environmental and health value created by social enterprises captured systematically and there is not a level playing field that enables comparison across different types of social enterprises. In this article, the State of Social Enterprise Survey 2009—one of the the largest surveys on social enterprises ever conducted in the UK—is used to discuss the extent of the uptake of impact measurement tools. Results from the survey show a poor use of these tools in the social enterprise sector overall, although health and social care social enterprises fare slightly better. Some policy implications are considered, particularly around the need to create a more appropriate, easy to use impact assessment tool and make sure that organisations are appropriately funded and encouraged to make use of it.
The features and clinical course of chronic balanitis in 5 patients are presented. In each case, ... more The features and clinical course of chronic balanitis in 5 patients are presented. In each case, histological examination of a cutaneous biopsy sample showed pronounced features of human papillomavirus (HPV) infection. In addition, HPV DNA was demonstrated in each biopsy specimen by a polymerase chain reaction and was found to be type 6 by Southern blot hybridization in 4 of the cases. Although the association of histological features of HPV infection with balanitis does not prove that HPV is causal, the failure to find other causes, the prolonged and distressing symptoms, and the ineffectiveness of topical steroids in improving symptoms, all suggest the importance of HPV infection. While effective treatment needs to be sought and developed, the response of one patient to oral isotretinoin suggests that this agent may be appropriate for a larger trial.
Little is known of the in vivo role of the immune system in controlling human papillomavirus infe... more Little is known of the in vivo role of the immune system in controlling human papillomavirus infection in the genital tract. The authors have studied 125 closely monitored patients with genital warts. Of these 125 patients, wart regression was seen in 28 patients. This study provides evidence that clearance of human papillomavirus from the genital tract is characterized by an active cell-mediated immune response. Regressing warts (n = 14) contained significantly more T lymphocytes (P < .05, Wilcoxon rank sum test) and macrophages (P < .01) than did nonregressing controls (n = 14). CD4-positive lymphocytes predominated in regression, both within the wart stroma and the surface epithelium, where there was a significant change in the ratio of CD4+ to CD8+ cells (P < .01). Lymphocytes in regression also showed greater expression of activation markers, and the majority were of the "antigen-experienced" phenotype. There was no difference in Langerhans cell numbers, alth...
One hundred and fifty women who attended a genitourinary medicine clinic and who required a specu... more One hundred and fifty women who attended a genitourinary medicine clinic and who required a speculum examination were investigated to determine the association between Chlamydia trachomatis and urethral symptoms and signs. Those who had taken antibiotics with anti-chlamydial activity within 3 months or those who were menstruating, pregnant or using an intrauterine contraceptive device were excluded. C. trachomatis infection of the urethra, or infection of the urethra and cervix together, combined with each separately, were strongly associated with > = 5 polymorphonuclear (PMN) leucocytes per high-power field (x 1000) in a Gram-stained urethral smear (P < 0.00005 and P < 0.0005, respectively). This appeared not to arise from leucocyte contamination from the lower genital tract. However, C. trachomatis infection of the urethra was not associated with symptoms of dysuria or frequency. In conclusion, it seems likely that C. trachomatis infection of the urethra in women probably...
7 Genitourinary Medicine Services A Renton, S Hawkes, M Hickman, E Claydon, H Ward, D Taylor-Robi... more 7 Genitourinary Medicine Services A Renton, S Hawkes, M Hickman, E Claydon, H Ward, D Taylor-Robinson 1 Summary This chapter addresses the need for ... Table 4: Initial contacts by KC60 diagnosis per 100000 population aged 16-64 in Z 2 yy 1990/91 3? HH* fii amy y" t ...
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