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PubMed1998

International retirement migration in Europe.

"This paper presents a review and prospectus of international retirement migration (IRM), dealing mainly with European evidence but also referring to some analogous trends in North America. The paper is in three main parts. It first makes the case for regarding IRM as a significant aspect of population geography and of migration studies; in certain areas of Mediterranean Europe, IRM also has effects on regional economic geography. The second section of the paper discusses some of the early findings from a comparative study of British elderly residents in Tuscany, Malta, the Costa del Sol and the Algarve.... The final part of the article offers further reflections on why IRM is important--for the individual migrants themselves, for the host communities, and for public policy."

Adult↗
PubMed1985

Migration in an economic-demographic model for the Canadian provinces.

"This paper is a description of the structure of a multiregion economic-demographic model for the Canadian provinces. An important part of the demographic model is the estimation of net migration equations based on a human capital approach and incorporating the adding-up constraint that arises since the sum of the net migration flows across all provinces must be 0 in each period. These endogenous migration flows allow for variables from the economic model (wage rates and unemployment rates) to influence the source population, the labour force and, therefore, the unemployment rate and other variables in the economic model." The model is used in simulation experiments in order to illustrate the interaction between economic and demographic factors and how this interaction affects the impact of policies.

Americas↗
PubMed1989

The demographic evolution of rural France (1968-1982).

"After more than a century of decline, noticeable increases in the rural population of France became apparent in the 1982 census. The spatial patterns of these changes are interpreted by comparing a set of demographic variables in the 1968-1975 and 1975-1982 intercensal periods. Migration to rural areas near many of the major cities (rurbanization) and to the southern part of France is the main demographic explanation. Using factor analysis and a hierarchical classification system the underlying demographic associations are established and the nation is differentiated into seven types. A method for estimating the probabilities of any one type occurring is also demonstrated. The timing of the demographic changes and the fundamental societal forces which have influenced them suggest that government policy has played a minor part in the evolution."

Demography↗
PubMed2005

Austrian experiences with redo antireflux surgery.

BACKGROUND: From 1996, the entire number of fundoplications performed in Austria increased dramatically, favoring the laparoscopic technique. Despite good results, some patients experience failure of antireflux surgery and therefore require redo surgery if medical therapy fails to control symptoms. The aim of the study was to describe the refundoplication policy in Austria with evaluation of the postoperative results. METHODS: A questionnaire was sent to all Austrian surgical departments at the beginning of 2003 with questions about redo fundoplications (number, techniques, intraoperative complications, history, migration of patients, preoperative workup, mortality, and postoperative long-term complaints). It also included questions about primary fundoplications (number, technique, postoperative symptoms). RESULTS: Out of 4,504 primary fundoplications performed in Austria since 1990, 3,952 have been carried out laparoscopically. In a median of 31 months after the primary operation, 225 refundoplications have been performed, laparoscopically in the majority of patients. The Nissen and the partial posterior fundoplication were the preferred techniques. The conversion rate in these was 10.8%, mainly because of adhesions and lacerations of the spleen, the stomach, and the esophagus. The mortality rate after primary fundoplications was 0.04%, whereas the rate after refundoplications was 0.4%, all resulting from an open approach. CONCLUSION: Laparoscopic refundoplications are widely accepted as a treatment option after failed primary antireflux surgery in Austria. However, the conversion rate is 6 times higher and the mortality rate is 10 times higher than for primary antireflux surgery. Therefore, redo fundoplications should be performed only in departments with large experience.

Austria↗
PubMed2000

Cancer and men from minority ethnic groups: an exploration of the literature.

The authors reviewed literature which has been published in the last 20 years. Cancer is the second leading cause of death in developed countries and is expected to become a significant cause of death in developing countries. Whilst there are a large number of studies on cancer and men, there is a paucity of data on men from minority ethnic groups. In the USA, African Americans are more likely to develop cancer than any other ethnic group. Although cancer rates amongst minority ethnic groups in the UK are thought to be low, 11% of Indian and African men and 19% of Caribbean men died from cancer during 1979-1983. There is also further evidence in the USA that African American, Filipinos and Native Americans have the lowest cancer survival rates. Service utilization, especially tertiary care, is also thought to be low amongst minority ethnic groups from the USA and the UK. Reasons for these variations include artefactual, cultural, materialist and social selectivist explanations as well as the effects of migration, racism and genetic disposition. This area is under-researched, in particular cultural beliefs about cancer. Further research into this area should apply culturally competent methods to ensure valid data to inform cancer policy, education and practice.

Attitude to Health↗
PubMed2000

Structural barriers and facilitators in HIV prevention: a review of international research.

OBJECTIVES: This article provides an overview of a growing body of international research focusing on the structural and environmental factors that shape the spread of the HIV/AIDS epidemic, and create barriers and facilitators in relation to HIV-prevention programs. OVERVIEW OF STRUCTURAL-FACTORS LITERATURE: Most of the research on structural and environmental factors can be grouped into a small number of analytically distinct but interconnected categories: economic (under)development and poverty; mobility, including migration, seasonal work, and social disruption due to war and political instability; and gender inequalities. An additional focus in research on structural and environmental factors has been on the effects of particular governmental and intergovernmental policies in increasing or diminishing HIV vulnerability and transmission. INTERVENTIONS: A smaller subset of the research on structural factors describes and/or evaluates specific interventions in detail. Approaches that have received significant attention include targeted interventions developed for heterosexual women, female commercial sex workers, male truck drivers, and men who have sex with men. CONCLUSIONS: The structural and environmental factors literature offers important insights and reveals a number of productive intervention strategies that might be explored in both resource-rich and -poor settings. However, new methodologies are required to document and evaluate the effects of the structural interventions, which by their very nature involve large-scale elements that cannot be easily controlled by experimental or quasi-experimental research designs. Innovative, interdisciplinary approaches are needed that can move beyond the limited successes of traditional behavioral interventions and explicitly attempt to achieve broader social and structural change.

Developing Countries↗
PubMed2002

Concepts and approaches for marine ecosystem research with reference to the tropics.

The present article gives an overview on the leading concepts and modelling approaches for marine ecosystems' research including (1) The trophodynamic theory of pelagic ecosystems, (2) Compartment/network models, (3) Mesocosm experiments and (4) Individual based modelling approaches and virtual ecosystems (VE). The main research questions addressed, as well as the potential and limits of each approach, are summarized and discussed and it is shown how the concept of ecosystem has changed over time. Aquatic biomass spectra (derived from the theory of pelagic ecosystems) can give insight into the trophic structure of different systems, and can show how organism sizes are distributed within the system and how different size groups participate in the system's metabolism and production. Compartment/network models allow for a more detailed description of the trophic structure of ecosystems and of the energy/biomass fluxes through the explicit modelling of P/B- and food consumption rates and biomasses for each system compartment. Moreover, system indices for a characterization and comparison with other systems can be obtained such as average trophic efficiency, energy throughput, and degree of connectivity, degree of maturity, and others. Recent dynamic extensions of trophic network models allow for exploring past and future impacts of fishing and environmental disturbances as well as to explore policies such as marine protected areas. Mesocosm experiments address a multitude of questions related to aquatic processes (i.e. primary production, grazing, predation, energy transfer between trophic levels etc.) and the behaviour of organisms (i.e. growth, migration, response to contaminants etc.) under semi-natural conditions. As processes within mesocosms often differ in rate and magnitude from those occurring in nature, mesocosms should be viewed as large in vitro experiments designed to test selected components of the ecosystem and not as an attempt to enclose a multitude of interacting processes. Models that use individual organisms as units can provide insight into the causes of natural variability within populations (growth, phenotype, behaviour) and into the role of intraspecific variation for interspecific processes, succession, and feedback mechanisms. In biological oceanography, interdisciplinary research is increasingly using "Virtual Ecosystem" to simulate non-linear interactions between the dynamics of fluctuating ocean circulation, the physics of air-sea interaction, turbulence and optics, biogeochemistry, and the physiology and behaviour of plankton, which can be compared with real observations. The different approaches available for the analysis of aquatic ecosystems should be seen as complementary ways for the description and understanding of ecosystems. The modern view of marine ecosystems, as has emerged from ecosystem analysis over the last decades, is that of a composite of loosely coupled subsystems of desynchrone dynamics which through their combined action maintain the fundamental structure and function of the whole.

Animals↗
PubMed2004

Struggling with imaginaries of trauma and trust: the refugee experience in Switzerland.

This article discusses some effects of migration politics on asylum seekers and refugees and on the Swiss health services. It is based on multisited ethnographic research that tracked interpretative concepts of the refugee experience. Following a grounded theory approach, it identifies imaginaries of trauma and trust as key categories in the field of transnational migration and health. The psychiatric concept of trauma and a more popularized discourse of traumatic memory are strongly emphasized in all of the investigated field sites: the providers of primary health care and psychosocial services and representatives of social welfare agencies and law-making bodies use this "diagnosis" extensively. This leads refugees to develop tactics of a) identifying with the trauma discourse in order to become "good refugees" and achieve legal status in Switzerland; b) struggling with the ascribed pathologies and suffering from retraumatizing effects of these predominant trauma policies; and c) trying to refuse or subvert them by emphasizing the existence of structural violence in the receiving countries. An analysis of the interactions of health providers and refugees shows that it takes place in an environment of social and economic insecurity and in a shared imaginary of (mis)trust, putting at stake the moral economy of recent migration politics and the refugee experience.

Diagnostic and Statistical Manual of Mental Disord↗
PubMedDate not supplied

Globalization, migration and health.

The term 'globalization' describes the integration of economic systems through improved communication, but it also represents increased insecurity for those with few resources--particularly refugees. This article examines why people migrate, their numbers, constraints on their movement and their particular health care needs. Immigrants have much to contribute to their recipient countries, but at some loss to their homelands. Both economically and morally, more liberal immigration policies would be beneficial. Policies towards asylum seekers should not be more restrictive in the aftermath of 11 September 2001 and detention should be the exception rather than the rule. Globalization should be managed so as to improve people's lives throughout the world.

Altruism↗
PubMed2005

The origins and spread of antimalarial drug resistance: lessons for policy makers.

Understanding the frequency with which new resistance alleles arise and their subsequent patterns of spread is critical to our attempts to manage drug resistance in parasite populations. We review recent molecular evolutionary studies utilizing marker loci situated close to resistance loci on the Plasmodium falciparum genome that have given surprising insights into the origins and spread of drug resistance loci. We discuss possible reasons for the patterns observed, and highlight the implications of these results for resistance management. In particular, we show that many resistance mutations have rather few independent origins. De novo mutation appears to be less important than migration for introducing resistance alleles into parasite populations. Attempts to manage drug resistance will be of limited effectiveness unless this is taken into account.

ATP-Binding Cassette Transporters↗
PubMed1989

Urbanization and economic development in Burma.

"Since British colonial rule in Burma [Myanmar], urban centres have emerged and grown. This has continued with independence in 1948. Urbanization has proceeded apace, first primarily because of rural-urban migration and then mainly because of natural growth in cities and towns, leading to a host of urban problems exacerbated by an ailing economy which has not permitted adequate levels of investment in, and development of, urban infrastructure. This article examines these issues in urbanization and economic development and concludes that long-term solutions to these problems can only be arrived at if population growth and urbanization are given sufficient attention in economic policies which must, necessarily, seek to restructure the economy. The urban future of Burma, otherwise, remains bleak."

Asia↗
PubMed1979

[Respiratory signs linked to passive inhalation of tobacco smoke in infants (author's transl)].

Thirty observations done on infants formed the base of a review of the literature on the epidemiology, the clinical signs and the physiopathological mechanisms of passive smoking (PS). The main signal was a chronic cough but in infants under 12 months, PS also provoked, as well, an "asthmatoid bronchitis", progressing relentlessly since the coming out of maternity ward, in relation with the maternal tobacco addiction. In these patients, examinations failed to disclose the different causes of recurring respiratory infections. Among the granulocytic tests, only the spontaneous migration of neutrophil polykaryocytes in the absence of chemotactic stimulus was significantly lowered, by comparison with the controls. The authors did a review on epidemiological surveys done to this day; they revealed a direct relationship between the parent's addiction to tobacco and the frequency of recurring respiratory disorders. It was particularly evident when the mother smoked and the child was under 12 months. At this age it was independant from the infection eventually transmitted by the parent's cough. The constituants of tobacco smoke probably have a depressive action over the regional or perhaps the general means of immunitary defense as it is suggested by the decrease of leukocyte migration noted in parents with PS. It is therefore necessary in our country to define the true risks of PS in infants thanks to well organized epidemiological surveys and to obtain the means of an efficient preventive policy.

Adult↗
PubMed1989

Health needs of older adults displaced to Sudan by war and famine: questioning current targeting practices in health relief.

The high rates of death, disability and illness and the scarcity of resources associated with relief operations for victims of oppression, war and famine have led to some support systems of triage for health and nutritional care in relief. Two vulnerable groups have often been given priority for targeting in health relief--young children and their mothers. This paper reports the findings of a study of the health needs of another vulnerable group, older adults, among those who had been recently displaced to Sudan in 1984-1985 by the war and famine in Tigray region of Ethiopia. The study attempted to determine the extent to which morbidity events and migration affected the life-style of older adults and the socio-economic support mechanisms which were available to them. The findings indicate that older adults (those over 45 years of age) were a very small proportion of the population and that over half of those aged 60 years and over (defined as 'elderly' in this paper) had been left behind in Tigray. This may well indicate that disability, illness or both, forced many older adults, particularly those most in need, to remain in Tigray. Among older adults living in Sudan, high levels of minor disability, social isolation and total economic dependency indicated vulnerability, but older adults had not been specifically considered in health policies and plans. Their primary needs were basic--for cloth, food, shelter, transport, seeds, oxen and farming tools. We conclude that priority in relief should be to support individuals, families and entire communities by adequately providing for basic needs. Furthermore, international relief agencies should give equal consideration to those who remain in their homes and those who migrate for assistance. This approach would take into consideration quality of life, not just the number of lives saved among those who reach the camps and shelters, and would assume responsibility for 'Health for All', not just for selected 'vulnerable groups'.

Aged↗
PubMed2002

Small area comparisons of health: applications for policy makers and challenges for researchers.

It is a challenge to researchers to present their results in a way that serves the needs of health policy makers. Small area maps of life expectancy provide an insightful presentation. In this study, we pursued small area comparisons on a scale that is smaller than is currently available on a province-wide basis. We visualized Nova Scotia's provincial variation in health and identified the Cape Breton Regional Municipality and Halifax's disadvantaged "North End" neighbourhood as areas with major health concerns. The observed health differences are only partially explained by socioeconomic factors such as income and unemployment. The study also demonstrated the feasibility of small area comparisons at the level of census consolidated subdivisions and neighbourhoods. There are various methodological challenges for researchers, however: allocation procedures such as the postal code-conversion-file may introduce substantial error; the application of appropriate spatial smoothing procedures is crucial to the interpretation of regional variation in health; and the migration of frail individuals to nursing homes affects the geographic variation in health.

Aged↗

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