The removal of patients who live outside the practice boundary:a study of outside-area removals in Northern Ireland in 2001-2002

It has been suggested that there are significant overlaps between removals due to deregistration and removals arising because patients live outside the practice area. If this is true, it would mean that the current estimates of deregistration would need to be revised upwards. All outside-area removals for the calendar years 2001 and 2002 were reviewed and characterised by age, sex and Jarman score of the enumeration district of the patients' residence and distance from the practice. The average outside-area removal rate was just over one removal per practice per year. Removal rates were highest between the ages of 18 and 44 years; there were no significant differences between the sexes. Rates of removal increased exponentially with distance, although even at marked distances from the practice there were about 10 patients remaining on the list for each one removed. Residents in deprived areas were more likely to be removed, although because areas most distal to the practice tend to be affluent, overall there was a predominance of affluent patients among those who are removed. In Northern Ireland rates of outside-area removal are only slightly higher than those of deregistration. It is evident that GPs are exercising some discretion as to which of the outside-area patients they retain on their list. This has the potential to cause some misunderstanding and resentment among patients, as has been reported previously.

Depletion of four nitrofuran antibiotics and their tissue-bound metabolites in porcine tissues and determination using LC-MS/MS and HPLC-UV

Depletion of the nitrofuran antibiotics furazolidone, furaltadone, nitrofurantoin and nitrofurazone and their tissue-bound metabolites AOZ, AMOZ, AHD and SEM from pig muscle, liver and kidney tissues is described. Groups of pigs were given feed medicated with one of the nitrofuran drugs at a therapeutic concentration (400 mg kg(-1)) for ten days. Animals were slaughtered at intervals and tissue samples collected for analysis for six weeks following withdrawal of medicated feed. These samples were analysed both for parent nitrofurans (using LC-MS/MS and HPLC-UV), and for tissue-bound metabolites (using LC-MS/MS). The parent drugs were detectable only sporadically and only in pigs subjected to no withdrawal period whatsoever. This confirms the instability of the four major nitrofuran antibiotics in edible tissues. In contrast, the metabolites accumulated to high concentrations in tissues (ppm levels) and had depletion half lives of between 5.5 and 15.5 days. The metabolites of all four drugs were still readily detectable in tissues six weeks after cessation of treatment. This emphasizes the benefits of monitoring for the stable metabolites of the nitrofurans.

Profiling excretory/secretory proteins of Trichinella spiralis muscle larvae by two-dimensional gel electrophoresis and mass spectrometry

Infection of mammalian skeletal muscle with the intracellular parasite Trichinella spiralis results in profound alterations in the host cell and a realignment of host cell gene expression. The role of parasite excretory/secretory (E/S) products in mediating these effects is unknown, largely due to the difficulty in identifying and assigning function to individual proteins. In this study, we have used two-dimensional electrophoresis to analyse the profile of muscle larva excreted/secreted proteins and have coupled this to protein identification using MALDI-TOF mass spectrometry. Interpretation of the peptide mass fingerprint data has relied primarily on the interrogation of a custom-made Trichinella EST database and the NemaGene cluster database for T. spiralis. Our results suggest that this proteomic approach is a useful tool to study protein expression in Trichinella spp. and will contribute to the identification of excreted/secreted proteins.

Non-covalent imprinting of phosphorous esters

The creation of molecularly imprinted polymers (MIPs) for the recognition of phosphate and phosphonate esters is reported. The single, weak hydrogen-bond acceptor site in these molecules has been targeted using a 1,3-diarylurea functional monomer. Polymers were prepared using either stoichiometric ratios of functional monomer to template or a large excess of the template during imprinting. The recognition properties of the polymers were assessed in the chromatographic mode for their ability to retain the templates and analogous analytes. The results are discussed with regards to the choice and amount of template, polymerisation conditions and the composition of the chromatographic mobile phase.

Welfare regimes and household income packaging in the European Union

This paper uses harmonized data for the member states of the European Union to analyse household income packaging from a 'welfare regimes' perspective. Using data from the third wave of the ECHP, it looks at how the role of welfare transfers in the income package varies across countries and welfare regimes, and assesses whether this is consistent with the predictions of welfare regime theory, having first elaborated some specific hypotheses in that regard. It finds that when one focuses on averages across countries categorized into regimes, many of these hypotheses about the role of transfers are in broad terms borne out by the evidence. However, when one focuses on individual countries rather than regime averages the picture is a good deal more complex and consistency with the range of hypotheses more limited. It is essential that this variation across countries is taken into account in interpreting and using welfare regime theory and typologies.

Delamination threshold load for dynamic impact on plates

A criterion is derived for delamination onset in transversely isotropic laminated plates under small mass, high velocity impact. The resulting delamination threshold load is about 21% higher than the corresponding quasi-static threshold load. A closed form approximation for the peak impact load is then used to predict the delamination threshold velocity. The theory is validated for a range of test cases by comparison with 3D finite element simulation using LS-DYNA and a newly developed interface element to model delamination onset and growth. The predicted delamination threshold loads and velocities are in very good agreement with the finite element simulations. Good agreement is also shown in a comparison with published experimental results. In contrast to quasi-static impacts, delamination growth occurs under a rapidly decreasing load. Inclusion of finite thickness effects and a proper description of the contact stiffness are found to be vital for accurate prediction of the delamination threshold velocity

Economic boom and social mobility:The Irish experience

In this paper we examine the consequences for social mobility of the recent unprecedented period of economic growth experienced in Ireland and the implications of such developments for current theories of social fluidity. Contrary to suggestions that the "Celtic Tiger" experience has been associated with deepening problem marginalization, we found evidence for a substantial upgrading of the class structure, increased levels of social mobility and increased social fluidity in relation to long-range hierarchical mobility. Such increased openness could not be explained by changes in the mediating role of education. The pattern of change suggests that both the upgrading of the class structure and the recent unprecedented tightness of the labour market have led employers to increasingly apply criteria other than education in a manner that has facilitated increased social fluidity. The Irish case provides further support for the argument for reconsidering the balance that mobility research has struck between social fluidity and absolute mobility and encouraging increased attention to the evolution of firms and jobs. It also suggests that, in circumstances where policies in advanced industrial societies have shown an increasing tendency to diverge, increased social fluidity may come about as a consequence of very different economic and social policies. © 2006 Elsevier Ltd. All rights reserved.

Magnetic properties of TlCu2-xFexSe2 crystals

The magnetic properties of two compositions of random solutions in the TlCu2-xFexSe2 system with x = 0.2 and 0.45 have been investigated by superconducting quantum interference device magnetometry. The crystal structure is of a layer type and ordering due to the iron atoms occurs at low temperatures, with T-c = 85 K for x = 0.2 and T-c = 130 K for x = 0.45. The samples were highly textured crystals and the magnetic moments of both compositions were found to align along the c axis of the structure. The saturation moments were found to be 1.5 mu(B)/Fe x = 0.2 and 0.66 mu(B)/Fe for x = 0.45. (c) 2005 American Institute of Physics.

Cycloidal magnetic order in the compound IrMnSi

A new compound, IrMnSi, has been synthesized, and its crystal structure and magnetic properties have been investigated by means of neutron powder diffraction, magnetization measurements, and first-principles theory. The crystal structure is found to be of the TiNiSi type (ordered Co2P, space group Pnma). The Mn-projected electronic states are situated at the Fermi level, giving rise to metallic binding, whereas a certain degree of covalent character is observed for the chemical bond between the It and Si atoms. A cycloidal, i.e., noncollinear, magnetic structure was observed below 460 K, with the propagation vector q=[0,0,0.4530(5)] at 10 K. The magnetism is dominated by large moments on the Mn sites, 3.8 mu(B)/atom from neutron diffraction. First-principles theory reproduces the propagation vector of the experimental magnetic structure as well as the angles between the Mn moments. The calculations further result in a magnetic moment of 3.21 mu(B) for the Mn atoms, whereas the Ir and Si moments are negligible, in agreement with observations. A calculation that more directly incorporates electron-electron interactions improves the agreement between the theoretical and experimental magnetic moments. A band mechanism is suggested to explain the observed magnetic order.

Hydrogen adsorption on functionalized nanoporous activated carbons

There is considerable interest in hydrogen adsorption on carbon nanotubes and porous carbons as a method of storage for transport and related energy applications. This investigation has involved a systematic investigation of the role of functional groups and porous structure characteristics in determining the hydrogen adsorption characteristics of porous carbons. Suites of carbons were prepared with a wide range of nitrogen and oxygen contents and types of functional groups to investigate their effect on hydrogen adsorption. The porous structures of the carbons were characterized by nitrogen (77 K) and carbon dioxide (273 K) adsorption methods. Hydrogen adsorption isotherms were studied at 77 K and pressure up to 100 kPa. All the isotherms were Type I in the IUPAC classification scheme. Hydrogen isobars indicated that the adsorption of hydrogen is very temperature dependent with little or no hydrogen adsorption above 195 K. The isosteric enthalpies of adsorption at zero surface coverage were obtained using a virial equation, while the values at various surface coverages were obtained from the van't Hoff isochore. The values were in the range 3.9-5.2 kJ mol(-1) for the carbons studied. The thermodynamics of the adsorption process are discussed in relation to temperature limitations for hydrogen storage applications. The maximum amounts of hydrogen adsorbed correlated with the micropore volume obtained from extrapolation of the Dubinin-Radushkevich equation for carbon dioxide adsorption. Functional groups have a small detrimental effect on hydrogen adsorption, and this is related to decreased adsorbate-adsorbent and increased adsorbate-adsorbate interactions.

Incidence and natural history of proliferative sickle cell retinopathy:Observations from a cohort study

Objective: To describe the incidence, prevalence, and natural history of proliferative sickle cell retinopathy (PSR). Design: Prospective longitudinal study over 20 years. Participants: Newborn screening of 100000 consecutive deliveries from 1973 to 1981 identified 315 children with homozygous sickle cell (SS) disease and 201 with SS-hemoglobin C (SC) disease. By the age of 5 years, 307 SS patients and 166 SC patients were alive and living in Jamaica and were recruited for this ophthalmic study. Methods: Description of retinal vascular changes on annual angiography and angioscopy. Main Outcome Measures: Incidence and prevalence of PSR and its behavior on follow-up. Progression of PSR was investigated using the number of eyes affected (none, one, both) and the interval until PSR onset. Results: At last review in January 2000, PSR had developed in 59 patients (14 SS, 45 SC), unilaterally in 36 patients and bilaterally in 23. Incidence increased with age in both genotypes, with crude annual incidence rates of 0.5 cases (95% confidence interval [CI], 0.3-0.8) per 100 SS subjects and 2.5 cases (95% CI, 1.9-3.3) per 100 SC subjects. Prevalence was greater in SC disease, and by the ages of 24 to 26 years, PSR had occurred in 43% subjects with SC disease and in 14% subjects with SS disease. Patients with unilateral PSR had a 16% (11% SS, 17% SC) probability of regressing to no PSR and a 14% (16% SS, 13% SC) probability of progressing to bilateral PSR. Those with bilateral PSR had an 8% (8% SS, 8% SC) probability of regressing to unilateral PSR and a 1% (0 SS, 2% SC) probability of regressing to a PSR-free state. Irretrievable visual loss occurred in only 1 of 82 PSR-affected eyes, and 1 required detachment surgery and recovered normal visual acuity. Conclusions: Longitudinal observations over 20 years in a cohort of patients followed from birth confirms a greater incidence and severity of PSR in SC disease, and shows that spontaneous regression occurred in 32% of PSR-affected eyes. Permanent visual loss was uncommon in subjects observed up to the age of 26 years. © 2005 by the American Academy of Ophthalmology.

Ultrasound biomicroscopy in deep sclerectomy

Purpose: To evaluate by ultrasound biomicroscopy (UBM) the anatomical characteristics and the intraocular pressure (IOP) lowering mechanisms of deep sclerectomy after long-term follow-up. Methods: In all, 22 eyes of 21 consecutive patients who had deep sclerectomy were examined by UBM. Several UBM variables were prospectively evaluated, including the presence and maximum length and height of the intrascleral space, the minimum thickness of residual trabeculo-Descemet membrane (TDM), the presence and type of subconjunctival filtering bleb, and the presence of other possible drainage sites, for example suprachoroidal. Surgical success was considered to be achieved when the IOP was

Effect of intensive glycemic control on levels of markers of inflammation in type 1 diabetes mellitus in the diabetes control and complications trial

Type 1 diabetes mellitus is associated with an increased risk of cardiovascular disease (CVD) that is not fully explained by conventional risk factors. The Diabetes Control and Complications Trial (DCCT) showed that intensive diabetes therapy reduced levels of LDL cholesterol and triglycerides but increased the risk of major weight gain, which might adversely affect CVD risk. The present study examined the effect of intensive therapy on levels of several markers of inflammation that have been linked to risk of CVD.