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The purpose of this paper is to examine patterns of drug use among a cohort of drug treatment-seeking drug-using gay men and other men who have sex with men (MSM), and whether these activities differ between, or predict, HIV status.

Cross-sectional study was conducted in a specialist club drug clinic in London covering 407 consecutive attendees who identified as MSM. Substance use, including injecting drug use (IDU), associated sexual activity and self-reported HIV status were measured by clinical interview and National Drug Treatment Monitoring System data tool.

Over a 45-month period, 407 MSM attended the clinic. In total, 62.1 per cent were HIV positive, 48.9 per cent had injected drugs, 14.9 per cent reported needle sharing and 73.3 per cent used drugs to facilitate sex. The most commonly reported problem drugs were GHB/GBL (54.3 per cent) methamphetamine (47.7 per cent) and mephedrone (37.8 per cent). HIV status was associated with methamphetamine, mephedrone, IDU, sharing equipment, using drugs to facilitate sex, older age and older age of drug initiation, as well as Hepatitis C virology (HCV) status. Use of methamphetamine, HCV infection, older age and IDU predicted HIV positive status in a logistic regression model.

The findings describe a constellation of risk factors including high levels of IDU, sharing of equipment and high-risk sexual activity in a population with high rates of HIV positive serology. They also provide further evidence for a link between HIV infection and use of methamphetamine.

The authors suggest a need for greater awareness of HIV-related risk activities and promotion of HIV prevention strategies for MSM by both sexual health and drug treatment services.

This paper is amongst the very first studies of its nature.

Clearly defined information is essential for rational decision‐making, planning and control, at all management levels. The current climate in the UK National Health Service dictates that clinicians should be more actively involved in management. However, no relevant and accurate information is routinely available on either the workload or work patterns of individual hospital departments. If clinicians were supplied with this they would then be in a better position to manage their own services. This paper provides a synopsis of the philosophy behind the design of management information systems and presents the results of a pilot study, which was undertaken in a hospital neurology department. The general guidance which emerges is that analysts must always concentrate on ivhat information is needed and the uses to which it will be put. A systems approach to design helps to: (i) define the information required; (ii) establish processes for data capture and analysis; and (iii) establish standards with which actual service performance can be compared (feedback control feature). The pilot study provided information on all stages of development. The systems approach employed could be applied within any clinical department, but doctors must be actively involved. Information derived from running the prototype provided insight into many aspects of work activity, organisation and use of resources within a neurology specialty. A comparison between actual service performance and standards of service as perceived by the consultant neurologists involved, was also undertaken.

Walt Crawford is a Senior Analyst for the Research Libraries Group (http://www.rlg.org) where he designs and develops library‐related applications, with an emphasis on the user interface design. His most recent book is Future Libraries: Dreams, Madness & Reality, which he co‐authored with Michael Gorman (ALA Editions, 1995). He is also on the board of Online, amongst other titles, where he recently published a paper about the enormous economic and ecological disadvantages to the all‐digital library.

In this article, I would like to examine both the areas of commitment and lethargy in approaches to training in the UK. I believe it is a fallacy that no one cares about training in this country. This image has arisen through a low level of motivation. I know politicians debate about “the great strength of the British is innovation and world‐shattering new ideas”, arguments which are greeted with a great deal of scepticism.

Following a brief history of cataloguing and the MARC format this paper describes current challenges in developing suitable international formats and cataloguing rules for dealing with electronic resources. Extensive references to the past and current literature provide an overview of the problems faced.

There has been a dramatic increase in interest in the learning organization. However there is confusion, among writers on the subject, about what a learning organization is and about how organizational learning occurs. Critiques some of the best known contributions to the field and argues that they are reductionist and do not indicate how organizational learning relates to business performance and strategic realignment.

Numismatics, the systematic study and collecting of coins and related items such as tokens, medals, and paper money, has been a recognized scholarly discipline since the Middle Ages. Archaeologists, historians, economists, artists, and engravers have found numismatics a valuable adjunct to their respective fields of study. Coins are the official product of an issuing authority, and as such they can provide an important primary historical source of documentation concerning monetary values, patterns of economic exchange, trade routes, colonization, migration, military campaigns, linguistic and epigraphic data, mythology, religion, art, historical portraits, and views of buildings, monuments, and statues that have long since been destroyed. For the researcher in American history, numismatics can provide insights into historical economic trends.