Perceived and reported access to the general practitioner: an international comparison of universal access and mixed private/public systems.

Timely and convenient access to primary healthcare is essential for the health of the population as delays can incur additional health and financial costs. Access to health care is under increasing scrutiny as part of the drive to contain escalating costs, while attempting to maintain equity in service provision. The objective was to compare primary care services in Republic of Ireland and Northern Ireland, and to report on perceived and reported access to GP services in universal access and mixed private/public systems. A questionnaire study was performed in Northern Ireland (NI) and the Republic of Ireland (ROI). Patients of 20 practices in the ROI and NI were contacted (n = 22,796). Main outcome measures were overall satisfaction and the access to GP services. Individual responses and scale scores were derived using the General Practice Assessment Questionnaire (G-PAQ). The response rate was 52% (n = 11,870). Overall satisfaction with GP practices was higher in ROI than in NI (84.2% and 80.9% respectively). Access scores were higher in ROI than in NI (69.2% and 57.0% respectively) Less than 1 in 10 patients in ROI waited two or more working days to see a doctor of choice (8.1%) compared to almost half (45.0%) in NI. In NI overall satisfaction decreased as practice size increased; 82.8%, 80.4%, and 75.8%. In both systems, in large practices, accessibility is reduced when compared to smaller practices. The faster access to GP services in ROI may be due to the deterrent effect of the consultation charge freeing up services although, as it is the poorest and sickest who are deterred by the charge this improved accessibility may come at a significant cost in terms of equity. The underlying concern for policy makers centres around provision of equitable services.

The atmospheric parameters and chemical composition of early B-type giants in h and chi Persei

Atmospheric parameters and surface chemical compositions are presented for eight stars, classified as B1 or B2 but with a range of luminosity classes, in the northern double cluster h and chi Persei. Echelle spectroscopy (covering the wavelength region 3900 to 4700 Ä) and grating spectroscopy (of the Balmer, H? and Hß lines) were analysed using non-LTE synthetic spectra based on LTE line-blanketed atmosphere structures. High microturbulences are found in our sample, and this quantity must be included in the computation of the non-LTE level populations; its effect is generally to decrease the derived metal abundances by typically 0.1 dex but by up to 0.4 dex. Our absolute abundances are in reasonable agreement with those previously found for main sequence B-type stars, while we find some evidence for small abundance variations (particularly for nitrogen) within our sample. One star (BD+56 678) appears to be a spectrum variable and at two epochs shows a highly enriched nitrogen spectrum. Our atmospheric parameters imply that two stars have previously been mis-identified as main sequence objects and a distance modulus, at the higher end of the values previously deduced. The observational HR diagram is consistent with stellar evolutionary models that explicitly include the effects of rotation.

Universal power quality manager with a new control scheme

A new universal power quality manager is proposed. The proposal treats a number of power quality problems simultaneously. The universal manager comprises a combined series and shunt three-phase PWM controlled converters sharing a common DC link. A control scheme based on fuzzy logic is introduced and the general features of the design and operation processes are outlined. The performance of two configurations of the proposed power quality manager are compared in terms of a recently formulated unified power quality index. The validity and integrity of the proposed system is proved through computer simulated experiments

Universal elements for non-linear operators and their applications

We prove that under certain topological conditions on the set of universal elements of a continuous map T acting on a topological space X, that the direct sum T and M_g is universal, where M_g is multiplication by a generating element of a compact topological group. We use this result to characterize R_+-supercyclic operators and to show that whenever T is a supercyclic operator and z_1,...,z_n are pairwise different non-zero complex numbers, then the operator z_1T\oplus ... \oplus z_n T is cyclic. The latter answers affirmatively a question of Bayart and Matheron.

Universal Abelian topological groups

A topological group G is said to be universal in a class K of topological groups if G is an element of K and if for every group H is an element of K there is a subgroup K of G that is isomorphic to H as a topological group. A group is constructed that is universal in the class of separable metrizable topological Abelian groups.

Invasion by the amphipod Gammarus pulex alters community composition of native freshwater macroinvertebrates

Assessing the effects of invading species on native community structure is often confounded by environmental factors and weakened by lack of replicated, long-term pre- and post-invasion monitoring. Here, we uncouple the community effects of a freshwater amphipod invader from environmental differences. In Irish rivers, the introduced Gammarus pulex replaces the native Gammarus duebeni celticus. However, the River Lissan in Northern Ireland is dissected by a weir that has slowed the upstream invasion by G. pulex. This allowed us in 2000 to sample three contiguous 150-m reaches that were (1) G. pulex dominated; (2) mixed Gammarus spp.; and (3) G. duebeni celticus only. In 2003, we resampled these reaches and one additional of mixed Gammarus species and one with only G. duebeni celticus further upstream. In temperature, conductivity, and pH, there were statistically significant but no biologically relevant differences among the five reaches of 2003, and between the three reaches surveyed in both years. Although there was evidence of recovery in macroinvertebrate diversity and richness in invaded reaches between years, continued upstream invasion was associated with sustained reductions in these community metrics as compared to un-invaded sites. Community ordination indicated (1) different associations of community composition attributed to the distribution, abundance, and biomass of the invader; and (2) increasing similarity of invaded communities over time. The impact mechanisms of G. pulex on macroinvertebrate community composition may include predation and competition. The consequences of the observed community changes for ecosystem functioning require further investigation.

Differences in composition of macroinvertebrate communities with invasive and native Gammarus spp. (Crustacea : Amphipoda)

1. Assessing the effects on communities of invasive species is often confounded by environmental factors. In Irish rivers, the introduced amphipod Gammarus pulex replaces the native G. duebeni celticus in lowland stretches. The two amphipods are associated with different macroinvertebrate communities, which may in part be the result of natural longitudinal physicochemical change. However, this hinders assessment of any direct community impacts of the invasive as compared with the native species. Here, we report on a fortuitous circumstance that allowed us to uncouple the community effects of Gammarus species from environmental differences.

Universal primers for the amplification of chloroplast microsatellites in grasses (Poaceae)

Attempts to design truly universal primers to amplify chloroplast microsatellites have met with limited success due to nonconservation of repeat loci across widely divergent taxa. We have used the complete chloroplast genome sequences of rice, maize and wheat to design five pairs of primers that amplify homologous mononucleotide repeats across the Poaceae (grasses). Sequencing confirmed conservation of repeat motifs across subfamilies and a preliminary study in Anthoxanthum odoratum revealed polymorphism at two loci with a haplotype diversity value of 0.495. These primers provide a valuable tool to study cytoplasmic diversity in this extensively studied and economically important range of taxa.

Universal plastid primers for chlorophyta and rhodophyta

To date, the majority of molecular genetic studies in algae have utilized a fairly limited range of markers such as the plastid rbcL gene and spacer, the mitochondrial cox2-3 spacer or the nuclear ribosomal DNA and spacers. The lack of available markers has been particularly problematic in studies of within-species variation. Whilst microsatellites are now being developed in many algal species, there remains a need for universal markers that can be applied to a wide range of species. The increasing availability of complete plastid genome sequences for several algae has allowed us to develop two sets of universal primers, similar to those available in higher plants, for the amplification of coding and non-coding regions of the plastid genome in red and green algae. These markers are expected to be useful in a broad range of algal population genetic and phylogenetic studies.