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.

General practitioner deprivation payments in Northern Ireland:is the current system equitable?

The allocation of General practitioners deprivation payments has been a contentious issue since it was first proposed. This paper examines the method of allocation of such payments in Northern Ireland. A more equitable system would be based on enumeration districts, have a lower Jarman score and a closer relationship between Jarman score and remuneration. Unlike other parts of the UK these changes are now possible in Northern Ireland and should be implemented.

More equitable systems for allocating general practice deprivation payments:financial consequences

The allocation of general practitioner (GP) deprivation payments has been a controversial topic since they were first proposed. It has recently been suggested that the current system could be made more equitable if the payments were allocated at enumeration districts and if there was a more graded relationship between Jarman score and funding. However, the implications of these changes on the distribution of deprivation payments have not been worked out.

Age-related reference intervals for lymphocyte subsets in whole blood of healthy individuals

Enumeration of various lymphocyte subsets is used widely in the diagnosis and monitoring of various disease states. With the development of flow cytometric technology and whole blood analysis, methodologies have become more sensitive. It is therefore important to establish reference intervals in normal, healthy individuals using these techniques to give a better indication of the border between health and disease. Since some lymphocyte subpopulations are known to change with age, we have enumerated common subsets in healthy individuals from all decades of adult life, including nonagenarian subjects. We report reference intervals for these subsets in each age group, which will be of use in diagnosis and disease monitoring, particularly in elderly subjects, the most rapidly expanding group within the population today.

Combined effect of high pressure processing and antimicrobial packaging to control the growth of Listeria monocytogenes on ready-to-eat chicken breast

In the European Union, food is considered safe with regard to Listeria monocytogenes if its numbers do not exceed 100 cfu/g throughout the shelf-life of the food. Therefore, it is important to determine if a food supports growth of L. monocytogenes. Challenge tests are laboratory-based studies that measure the growth of L. monocytogenes on artificially contaminated food stored under foreseeable conditions of transportation, distribution and storage. The aim of this study was to elaborate and optimize a user-friendly protocol to perform challenge tests on food and to apply it to determine whether growth of L. monocytogenes is supported during the production and distribution of a potentially risky food i.e. mushrooms. A three-strain mixture of L. monocytogenes was inoculated onto three independent batches of whole mushrooms, sliced mushrooms, mushroom casing and mushroom substrate at a concentration of about 100 -1000 cfu/g. The batches were incubated at potential abuse temperatures, as a worst case scenario, and at intervals during storage L. monocytogenes numbers, % moisture and pH were determined. The results showed that the sliced and whole mushrooms supported growth of L. monocytogenes while mushroom casing allowed survival but did not support growth. Mushroom substrate showed a rich background microflora able of growing in Listeria selective media which hindered enumeration of L. monocytogenes. Combase predictions were not always accurate, indicating that challenge tests are a necessary part of growth determination of L. monocytogenes.

People and places: Understanding geographical accuracy in administrative data from the census and healthcare systems

Administrative systems such as health care registration are of increasing importance in providing information for statistical, research, and policy purposes. There is thus a pressing need to understand better the detailed relationship between population characteristics as recorded in such systems and conventional censuses. This paper explores these issues using the unique Northern Ireland Longitudinal Study (NILS). It takes the 2001 Census enumeration as a benchmark and analyses the social, demographic and spatial patterns of mismatch with the health register at individual level. Descriptive comparison is followed by multivariate and multilevel analyses which show that approximately 25% of individuals are reported to be in different addresses and that age, rurality, education, and housing type are all important factors. This level of mismatch appears to be maintained over time, as earlier migrants who update their address details are replaced by others who have not yet done so. In some cases, apparent mismatches seem likely to reflect complex multi-address living arrangements rather than data error.

Examination timetabling automation using hybrid meta-heuristics

Trabalho de projeto realizado para obtenção do grau de Mestre em Engenharia Informática e de Computadores

Tarification logit dans un réseau

Le problème de tarification qui nous intéresse ici consiste à maximiser le revenu généré par les usagers d'un réseau de transport. Pour se rendre à leurs destinations, les usagers font un choix de route et utilisent des arcs sur lesquels nous imposons des tarifs. Chaque route est caractérisée (aux yeux de l'usager) par sa "désutilité", une mesure de longueur généralisée tenant compte à la fois des tarifs et des autres coûts associés à son utilisation. Ce problème a surtout été abordé sous une modélisation déterministe de la demande selon laquelle seules des routes de désutilité minimale se voient attribuer une mesure positive de flot. Le modèle déterministe se prête bien à une résolution globale, mais pèche par manque de réalisme. Nous considérons ici une extension probabiliste de ce modèle, selon laquelle les usagers d'un réseau sont alloués aux routes d'après un modèle de choix discret logit. Bien que le problème de tarification qui en résulte est non linéaire et non convexe, il conserve néanmoins une forte composante combinatoire que nous exploitons à des fins algorithmiques. Notre contribution se répartit en trois articles. Dans le premier, nous abordons le problème d'un point de vue théorique pour le cas avec une paire origine-destination. Nous développons une analyse de premier ordre qui exploite les propriétés analytiques de l'affectation logit et démontrons la validité de règles de simplification de la topologie du réseau qui permettent de réduire la dimension du problème sans en modifier la solution. Nous établissons ensuite l'unimodalité du problème pour une vaste gamme de topologies et nous généralisons certains de nos résultats au problème de la tarification d'une ligne de produits. Dans le deuxième article, nous abordons le problème d'un point de vue numérique pour le cas avec plusieurs paires origine-destination. Nous développons des algorithmes qui exploitent l'information locale et la parenté des formulations probabilistes et déterministes. Un des résultats de notre analyse est l'obtention de bornes sur l'erreur commise par les modèles combinatoires dans l'approximation du revenu logit. Nos essais numériques montrent qu'une approximation combinatoire rudimentaire permet souvent d'identifier des solutions quasi-optimales. Dans le troisième article, nous considérons l'extension du problème à une demande hétérogène. L'affectation de la demande y est donnée par un modèle de choix discret logit mixte où la sensibilité au prix d'un usager est aléatoire. Sous cette modélisation, l'expression du revenu n'est pas analytique et ne peut être évaluée de façon exacte. Cependant, nous démontrons que l'utilisation d'approximations non linéaires et combinatoires permet d'identifier des solutions quasi-optimales. Finalement, nous en profitons pour illustrer la richesse du modèle, par le biais d'une interprétation économique, et examinons plus particulièrement la contribution au revenu des différents groupes d'usagers.

La texture et la granulométrie de la moulée influencent les concentrations d’acide propionique et butyrique de même que la prévalence d’Escherichia coli dans le tractus gastro-intestinal du porc d’engraissement

Certaines stratégies alimentaires sont actuellement considérées pour remplacer l’usage des antimicrobiens dans les fermes porcines. Les objectifs de cette étude étaient d'évaluer l'effet de la granulométrie et de la texture des aliments sur les concentrations d'acides gras volatils intestinaux, la composition des populations pathogènes et commensales d’E. coli et sur les performances de croissance des porcs. Des porcs d'engraissement (n= 840) ont reçu l'une des six diètes suivantes: moulée texturée 500, 750 et 1250 µm et moulée cubée 500, 750 et 1250 µm. Le gain de poids a été mesuré à chaque changement de formulation de moulée. À l'abattoir, les contenus du caecum et du côlon de 165 porcs ont été échantillonnés pour le dénombrement des E. coli par PCR quantitatif (qPCR) et pour la quantification des AGV. Le gène yccT a été utilisé pour dénombrer les E. coli totaux. Une diminution du taux de conversion alimentaire a été associée avec la moulée cubée et/ou la moulée de 500 µm. Les concentrations d’acide propionique et butyrique, et ce tant au niveau du caecum que du côlon, étaient plus élevées chez les porcs recevant de la moulée texturée que chez ceux recevant de la moulée cubée. Du point de vue de la granulométrie, les concentrations caecales et du côlon d’acide butyrique étaient plus élevées chez les porcs alimentés avec de la moulée de 1250 µm que chez ceux recevant de la moulée de 500 µm. D'autre part, les niveaux intestinaux d’E. coli totaux étaient plus élevés pour les porcs nourris avec de la moulée cubée que pour ceux ayant reçu de la moulée texturée. Les résultats ont montré que la moulée texturée est associée à des performances de croissance plus faibles mais à des changements intestinaux favorables.

Biochemical and molecular investigations on Salmonella serovars from seafood

The present investigation was envisaged to determine the prevalence and identify the different Salmonella serovar in seafood from Cochin area. Though, the distribution of Salmonella serovars in different seafood samples of Cochin has been well documented, the present attempt was made to identify the different Salmonella serovars and determine its prevalence in various seafoods. First pan of this investigation involved the isolation and identification of Salmonella strains with the help of different conventional culture methods. The identified isolates were used for the further investigation i.e. serotyping, this provides the information about the prevalent serovars in seafood. The prevalent Salmonella strains have been further characterized based on the utilization of different sugars and amino acids, to identify the different biovar of a serovar.A major research gap was observed in molecular characterization of Salmonella in seafood. Though, previous investigations reported the large number of Salmonella serovars from food sources in India, yet, very few work has been reported regarding genetic characterization of Salmonella serovars associated with food. Second part of this thesis deals with different molecular fingerprint profiles of the Salmonella serovars from seafood. Various molecular typing methods such as plasmid profiling, characterization of virulence genes, PFGE, PCR- ribotyping, and ERIC—PCR have been used for the genetic characterization of Salmonella serovars.The conventional culture methods are mainly used for the identification of Salmonella in seafood and most of the investigations from India and abroad showed the usage of culture method for detection of Salmonella in seafood. Hence, development of indigenous, rapid molecular method is most desirable for screening of Salmonella in large number of seafood samples at a shorter time period. Final part of this study attempted to develop alternative, rapid molecular detection method for the detection of Salmonella in seafood. Rapid eight—hour PCR assay has been developed for detection of Salmonella in seafood. The performance of three different methods viz., culture, ELISA and PCR assays were evaluated for detection of Salmonella in seafood and the results were statistically analyzed. Presence of Salmonella cells in food and enviromnental has been reported low in number, hence, more sensitive method for enumeration of Salmonella in food sample need to be developed. A quantitative realtime PCR has been developed for detection of Salmonella in seafood. This method would be useful for quantitative detection of Salmonella in seafood.

Studies on the effect of the organophosphorus pesticide Eka(Rlu) x EC 25 on the bacterial flora of Villorita cyprinoides var. cochinensis (Han1ey)

The thesis is Studies on the Effect or the Obganophosphorus Pesticide Ekalux(R) EC 25 on the Bacterial Flora or Villorita Cyprinoides Var.Cochinensis (Hanley). For the present investigation, the black clam Villorita gyprinoides var. cochinensis (Hanley), a most common clam genus present in this estuarine system has been selected as test organaism and Ekalux (R) EC 25 as toxicant. The aspects dealt with are 1. Total heterotrophic bacterial population, 2. Generic composition, 3. Hydrolytic enzyme producing bacteria, 4. Antibiotic resistance, 5. Heavy metal resistance, 6. The effect of pesticide concentration on the growth of the bacteria and 7. Effect of temperature, pH and sodium chloride on the growth and phosphate release of selected isolates.The samples for the experiment were collected from the Vembanad Lake, near Kumbalam Island during the period of September 1985 to May '86. The THB of the estuarine water and clams contained 6.5 x I04/ml and 2.975 x l06/g respectively, immediately after collection. Untreated water and clam samples showed enormous increase in THB from 0 hr population. The treated samples (water and clams) contained higher THB than 0 hr. In general, THB was observed to increase tremendously in the samples treated with pesticide when compared to their native flora. With reference to various concentrations of pesticides, THB recorded an increase with increase of concentration in water and clam samples.

Immobilization of nitrifying bacterial consortia on wood particles for bioaugmenting nitrification in shrimp culture systems

Shrimp grow out systems under zero water exchange mode demand constant remediation of total ammonia nitrogen (TAN) andNO2 −–Nto protect the crop. To address this issue, aninexpensive and user-friendly technology using immobilized nitrifying bacterial consortia (NBC) as bioaugmentors has been developed and proposed for adoption in shrimp culture systems. Indigenous NBC stored at 4 °C were activated at room temperature (28 °C) and cultured in a 2 L bench top fermentor. The consortia, after enumeration by epifluorescence microscopy,were immobilized on delignifiedwood particles of a soft wood tree Ailantus altissima (300–1500 μm) having a surface area of 1.87m2 g−1. Selection of wood particle as substratumwas based on adsorption of NBC on to the particles, biofilm formation, and their subsequent nitrification potential. The immobilization could be achievedwithin 72 h with an initial cell density of 1×105 cells mL−1. On experimenting with the lowest dosage of 0.2 g (wet weight) immobilized NBC in 20 L seawater, a TAN removal rate of 2.4 mg L−1 within three days was observed. An NBC immobilization device could be developed for on site generation of the bioaugmentor preparation as per requirement. The product of immobilization never exhibited lag phase when transferred to fresh medium. The extent of nitrification in a simulated systemwas two times the rate observed in the control systems suggesting the efficacy in real life situations. The products of nitrification in all experiments were undetectable due to denitrifying potency, whichmade the NBC an ideal option for biological nitrogen removal. The immobilized NBC thus generated has been named TANOX (Total Ammonia Nitrogen Oxidizer)

Algal Blooms and Associated Bacteria along the Southwest Coast of India

It is essential to understand how the distribution and composition of microalgae as well as dynamics of HABs in economically important shelf seas relate to the particular physico-chemical and biological properties of the water column in which they live. In view of the importance of southwest coast of India, which is considered as one of the most biologically productive areas in the world, regular monitoring of distribution and abundance of microalgae is important. The present work is concentrated on the estuarine and coastal open sea stations along the southwest coast of India. In order to get further insights into the abiotic factors governing bloom dynamics, the physicochemical parameters that regulated three particular bloom events during this period were studied. Bearing in mind the role of bacterial fauna associated with algal blooms as a biological factor in regulating its dynamics, isolation of bacteria associated with the algal blooms, their identification, enumeration, and ability to produce extracellular enzymes have been duly incorporated into this study

A Theory of Quantitative Inference Applied to a Mechanical Design Compiler

This thesis presents the ideas underlying a computer program that takes as input a schematic of a mechanical or hydraulic power transmission system, plus specifications and a utility function, and returns catalog numbers from predefined catalogs for the optimal selection of components implementing the design. Unlike programs for designing single components or systems, the program provides the designer with a high level "language" in which to compose new designs. It then performs some of the detailed design process. The process of "compilation" is based on a formalization of quantitative inferences about hierarchically organized sets of artifacts and operating conditions. This allows the design compilation without the exhaustive enumeration of alternatives.

Optimizing Product Line Designs: Efficient Methods and Comparisons

We compare a broad range of optimal product line design methods. The comparisons take advantage of recent advances that make it possible to identify the optimal solution to problems that are too large for complete enumeration. Several of the methods perform surprisingly well, including Simulated Annealing, Product-Swapping and Genetic Algorithms. The Product-Swapping heuristic is remarkable for its simplicity. The performance of this heuristic suggests that the optimal product line design problem may be far easier to solve in practice than indicated by complexity theory.