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Rural-destined migration in Third World settings: a neglected phenomenon?

This paper 1st reviews earlier research on rural-destined migration in Third World settings, in order to derive generalizations for a topic most often treated in idiosyncratic fashion. Descriptive analysis of all Costa Rican migration flows for 1968-73 then establishes that a surprisingly high proportion are rural directed. Finally, statistical analyses identify differences, in terms of explanatory variables, between urban-and rural-destined migrations, and for rural-destined migrations only, between those originating in urban and rural areas.

Americas↗

The destination for single-pass membrane proteins is influenced markedly by the length of the hydrophobic domain.

The tonoplast was proposed as a default destination of membrane-bound proteins without specific targeting signals. To investigate the nature of this targeting, we created type I fusion proteins with green fluorescent protein followed by the transmembrane domain of the human lysosomal protein LAMP1. We varied the length of the transmembrane domain from 23 to either 20 or 17 amino acids by deletion within the hydrophobic domain. The resulting chimeras, called TM23, TM20, and TM17, were expressed either transiently or stably in tobacco. TM23 clearly accumulated in the plasmalemma, as confirmed by immunoelectron microscopy. In contrast, TM17 clearly was retained in the endoplasmic reticulum, and TM20 accumulated in small mobile structures. The nature of the TM20-labeled compartments was investigated by coexpression with a marker localized mainly in the Golgi apparatus, AtERD2, fused to a yellow fluorescent protein. The strict colocalization of both fluorescent proteins indicated that TM20 accumulated in the Golgi apparatus. To further test the default destination of type I membrane proteins, green fluorescent protein was fused to the 19-amino acid transmembrane domain of the plant vacuolar sorting receptor BP-80. The resulting chimera also accumulated in the Golgi instead of in post-Golgi compartments, where native BP-80 localized. Additionally, when the transmembrane domain of BP-80 was lengthened to 22 amino acids, the reporter escaped the Golgi and accumulated in the plasma membrane. Thus, the tonoplast apparently is not a favored default destination for type I membrane proteins in plants. Moreover, the target membrane where the chimera concentrates is not unique and depends at least in part on the length of the membrane-spanning domain.

Amino Acid Sequence↗

Destinations of some fast-transported proteins in sensory neurons of bullfrog sciatic nerve.

Many characteristics of proteins that are fast axonally transported have been described, but the destinations of most within the neuron remain unknown. We have studied the destinations of some fast-transported proteins in sensory neurons of the bullfrog sciatic nerve, specifically to determine which may be deposited in axons and which may be destined for more distal, possibly terminal, areas. Dorsal root ganglia were pulse-labeled with [35S]methionine in vitro, following which they were separated from the sciatic nerve. After additional periods of transport, radioactive proteins from two areas of the nerve were separated by two-dimensional polyacrylamide gel electrophoresis and used to develop x-ray film. The first area contained the wavefront of transported radioactivity (wavefront region), whereas the second area was taken from nerve through which the wavefront had already passed (plateau region). The amount of radioactivity in certain fast-transported protein species from each area was determined by computer analysis of digitized video images of fluorographs. Certain proteins were preferentially left behind the wavefront and, therefore, may supply axon and possibly other nerve components, whereas other proteins were found almost exclusively in the wavefront and, hence, may supply more distal, possibly terminal, areas.

Animals↗

Should pediatric emergency care be decentralized?: an out-of-hospital destination model for critically ill children.

OBJECTIVES: A time-to-initial-stabilization model for out-of-hospital destinations of critically ill children (CICs) was developed. Application of this model to assess the impact of changes in different parameters of an emergency medical services for children (EMSC) system is described. METHODS: A computer model created a 2,500-square-mile community containing ten community hospitals (CHs) and one pediatric critical care center (PCC). Community hospitals capable of providing initial immediate stabilization of CICs were defined as emergency departments accepting pediatrics (EDAPs). Critically ill children were randomly selected in proportion to population densities across the modeled community. Time to initial stabilization (TIS) was defined as the time to arrival at either an EDAP or a PCC or time to arrival at a non-EDAP CH + travel time for a team from the PCC to the non-EDAP CH + preparation/dispatch (P/D) time. The following parameters of the model were varied and their effect on TIS was evaluated: location of CHs, location of PCC, primary destinations for CICs, percent of CHs meeting EDAP standards, out-of-hospital compliance with designated hospitals for CICs, P/D time, and ambulance speed. RESULTS: The computer model selected 1,000 CICs in accordance with the population densities of the community. The scenario with the shortest TIS was one in which every CH achieved EDAP designation (9.8 +/- 0.5 minutes). The scenario with the longest TIS involved a model in which every CIC was transported directly to the PCC (28.6 +/- 0.33 minutes). The number of EDAPs in a community and out-of-hospital compliance with use of EDAPs produced comparable effects on the TIS. Travel speeds had a direct effect on TIS but also exaggerated inefficiencies between scenarios. The P/D time had little effect on the TIS. CONCLUSIONS: An out-of-hospital destination model has been developed with the ability to modify multiple EMSC system variables. Application of this model demonstrates the shortest times to stabilization of critically ill children occur in systems that maximize the number of hospitals that meet EDAP standards and decentralize pediatric emergency care.

Adolescent↗

Two women with multiple disabilities sharing an acoustic orientation system and traveling together to indoor destinations.

This study assessed whether two women with total blindness and profound intellectual disability could share an acoustic orientation system and travel together simultaneously to common indoor destinations to perform occupational and vocational activities. The orientation system provided acoustic cues which indicated the direction to the destinations. Analysis of data indicated that the women were successful in sharing the system and could reach the destinations independently.

Acoustic Stimulation↗

The relationship between convenience of destinations and walking levels in older women.

PURPOSE: To examine the relationship between physical activity and (1) convenience of destinations, measured by whether destinations (such as a park, trail, businesses, and services) are within walking distance of the home, and (2) participants' perception of the quality of their neighborhood surroundings for walking, captured with a global neighborhood "walkability" rating. DESIGN: Cross-sectional analysis of data obtained in 1999. SETTING: Community in southwest Pennsylvania. SUBJECTS: Older Caucasian women (n = 149, mean age = 74.2 years). Response rate = 79%. MEASURES: Walking levels, leisure-time physical activity, and features of the neighborhood environment were measured with interviewer-administered questionnaires. Physical activity was also measured objectively with a pedometer. RESULTS: Living within walking distance (defined as within a 20-minute walk of home) of a park; biking or walking trail; or department, discount, or hardware store was related to higher pedometer readings (p < .01). In addition, there was a positive trend between the sum of destinations within walking distance of home and activity levels measured by pedometer and questionnaire (p < .01). There was also a positive trend between participants' neighborhood "walkability" rating and activity levels measured by pedometer and questionnaire (p < .01). CONCLUSION: These findings suggest that the ability to make utilitarian walking trips from home and the perception of having favorable neighborhood surroundings for walking are associated with increased physical activity levels in older women.

Aged↗

Triage, transportation, and destination decisions by out-of-hospital emergency care providers.

INTRODUCTION: The effectiveness of a tiered emergency medical services system often hinges upon the ability of initial care providers with little or no formal training to identify emergent patient needs and determine the best means to meet those needs. OBJECTIVES: To determine if out-of-hospital emergency care providers consistently make appropriate triage, transportation, and destination decisions; and to determine if experience and training have an effect on these decisions. METHODS: A survey consisting of 14 patient-care scenarios was administered to certified and non-certified out-of-hospital emergency-care providers (n = 311) from 20 randomly selected EMS agencies. These agencies were part of EMS systems that utilize one, two, and three tiered responses by ambulance and fire-based commercial, municipal, and volunteer agencies. Participants were asked to select the most appropriate mode of transport and destination facility using the assumption that they had responded to each scenario in a basic life support ambulance. Answers included transporting the patient to various receiving facilities or requesting a more advanced-level unit to respond to the scene. Transport times to receiving facilities and estimated times of arrival for advanced-level units were provided with each choice. Eight emergency physicians unanimously had agreed upon the most appropriate answer for each scenario. A two-tailed t-test was used to compare the scores of the certified and non-certified groups; and Spearman's Correlation Coefficients were used to test the effects of experience and training. RESULTS: Non-certified providers (n = 108) had a mean score of 32.6% or 4.6 (SD = 1.84) correct answers; certified providers (n = 203) had a mean score of 41.1% or 5.76 (SD = 2.12) correct answers (p < 0.000001). Spearman's Correlation Coefficients were: 1) individual provider level--(0.3978); 2) agency provider level--(0.2741); 3) hours worked per week--(0.2505); 4) years in EMS--(-0.0821); 5) commercial or volunteer provider--(0.2398); 6) agency call volume--(0.2012); 7) agency location--(0.0685), and 8) transporting versus non-transporting agency--(0.2523). CONCLUSIONS: A need exists for further education of out-of-hospital emergency care providers with respect to triage, transportation, and destination decisions. Provider experience and level of certification do not appear to affect these critical patient-care decisions.

Caregivers↗

Effects of migration on the educational levels of the black resident population at the origin and destination, 1955--1960 and 1965--1970.

Using the 1960 and 1970 census data, this paper analyzes the net effects of the interregional migration of black males on the educational levels of the resident black male population at the regions of origin and destination. Significant variations are observed in the educational selectivity of out-migrants from each region, by region of destination. Comparing the educational levels of the return migrants to the South with those of the resident population in the nonsouthern regions provides no evidence that the return migrants are "failed" migrants. The net effect of interregional migration on the educational levels of the black male resident population at the regions of origin and destination is insignificant in most age groups, for both the 1955--1960 and 1965--1970 periods. In particular, in-migration from the South to nonsouthern regions has little effect on the educational levels of the resident population in most age groups. In fact, for nonsouthern regions, out-migration is more detrimental to the educational level of the resident black male population than is in-migration from the South. Furthermore, the net effect of interregional migration has declined from the 1955--1960 period to the 1965--1970 period.

Adult↗

The choice of migration destination: Dominican and Cuban immigrants to the mainland United States and Puerto Rico.

"Puerto Rico provides an alternative destination for immigrants from the Spanish-speaking Caribbean because the culture is similar to that in the source country. In this study, we use the 1980 [U.S.] Census of Population to examine the importance of relative earnings and culture in the choice of destination. The main finding is the similar pattern of choice of location for immigrants from the Dominican Republic and Cuba. The more educated and more professional immigrants are found in either Puerto Rico or outside the enclave on the [U.S.] mainland. Within this group, those with less time remaining in the labor market and lower English ability are found in Puerto Rico. We find that not all differences in location decision are attributable to differences in reward structure by location."

Age Factors↗

Golf course development in a major tourist destination: implications for planning and management.

The planning and design of golf course developments is influenced by many factors. This paper focuses on the environmental ramifications of insufficient or lack of compliance with standard environmental and economic planning practices. Specifically, it looks at a tourist destination location that was under the influence of extensive land development and investment speculation. The Gold Coast in Australia was the focal point for large overseas investment due to changes in government legislation regarding foreign investment. Due to the economic climate in the second half of the 1980s many golf course resort developments were built, approved, or planned. Many of these circumvented normal business and environment planning processes. The result has been a dangerous concentration of golf facilities in environmentally sensitive areas and an oversupply of golf facilities. Both of these matters are discussed in terms of the general planning process and the potential economic and environmental impacts to the Gold Coast and similar destinations in other parts of the world.

Commerce↗

Biochemical evidence of impaired trophoblastic invasion of decidual stroma in women destined to have preeclampsia.

OBJECTIVE: Reduced trophoblastic migration into the decidua during the first half of pregnancy is a fundamental abnormality in preeclampsia. CA 125 and insulin-like growth factor binding protein-1 are major endometrial proteins whose primary sources are decidual epithelial and stromal cells, respectively. We hypothesized that reduced trophoblastic invasion in pregnancies destined for preeclampsia would affect the maternal vascular deportation of these decidual proteins. STUDY DESIGN: CA 125 and insulin-like growth factor binding protein-1 concentrations were analyzed by radioimmunoassays of plasma from preeclamptic and matched control patients in a longitudinal, nested case-control study. RESULTS: CA 125 concentrations did not differ with respect to pregnancy outcome or trimester. Midtrimester plasma insulin-like growth factor binding protein-1 concentrations were significantly lower in women who later had preeclampsia compared with normal pregnant controls. CONCLUSION: These findings provide biochemical evidence that abnormalities of trophoblastic invasion affect the maternal vascular deportation of a decidual stromal protein. Lower circulating concentrations of insulin-like growth factor binding protein-1 in women destined to have preeclampsia were observed 12 to 26 weeks before the onset of clinical signs of this syndrome.

Adult↗

Discharge destination and motor function outcome in severe stroke as measured by the functional independence measure/function-related group classification system.

OBJECTIVES: Function-related groups based on the Functional Independence Measure have been proposed as a model for a prospective payment system for medical rehabilitation. This study describes discharge destination and motor function outcomes in a sample of patients with stroke from the FIM-FRG STR1 classification. STUDY DESIGN: A retrospective review of 293 cases of stroke from the years 1993 to 1995. The demographic and outcome characteristics of this sample were described. RESULTS/CONCLUSIONS: Forty-five percent of the patients were discharged to home after a mean length of stay of 23.8 days in acute medical rehabilitation. Patients who were discharged home had higher admission and discharge motor FIM scores than those discharged to a subacute facility or long-term care facility, although the correlation between motor FIM score and discharge destination was low to moderate. Median discharge motor FIM scores indicate considerable residual disability in this classification after rehabilitation. Research problems that address methods to improve the usefulness of the FIM-FRG system in a prospective payment system are discussed.

Activities of Daily Living↗

Devices as destination therapy.

The use of circulatory support as destination therapy has been a goal for the treatment of endstage heart failure for several decades. Current investigations are evaluating several circulatory pumps with that particular objective. With continued modification of design, the current and future pumps will become more reliable and provide improved quality of life to patients in need of mechanical circulatory assistance. The new pumps on the horizon specifically address reliability, size, and cost, and are based on the centrifugal system. These devices use the Maglev (Magnetic Levitation) concept that allows for frictionless pumping, low thrombogenicity, minimal noise, and increased durability. Further research with this goal in mind and support from the federal government will be the key to the future use of circulatory assistance as destination therapy for heart failure patients. In addition, the cost-effectiveness of these devices will need to be maintained as the technology improves, as in any new technology that confronts a more intuitive option like the native heart.

Clinical Trials as Topic↗

Destination compatibility, affordances, and coding rules: a reply to Proctor, Van Zandt, Lu, and Weeks.

Proctor, Van Zandt, Lu, and Weeks (1993) argued that the invocation of affordances to explain stimulus-response (S-R) compatibilities in reaction time is not needed because left-right direction compatibility, from the coding rules approach, explains the apparent "destination compatibility" effect of Michaels (1988). In this reply, an experiment demonstrates that destination compatibility can be shown even when contradicted by relative left-right motion. The second half of the article addresses theoretical issues separating and joining these two approaches. It is argued that the domain of the affordance approach in S-R compatibility is the guidance of action by information, whereas the domain of coding rules is S-R incompatibility and noncompatibility, situations in which required responses are not afforded and rules must be invoked. The manipulation of rules can mimic some of the consequences of more fundamental perception-action couplings, but principles of the latter sort are needed.

Adult↗

The subcellular destinations of APC proteins.

Adenomatous polyposis coli (APC) is an important tumour suppressor in the human colon, and is conserved in various organisms. Its best understood function is the destabilization of beta-catenin, a key effector of the Wnt signalling pathway. APC proteins are highly motile, and shuttle between several subcellular destinations. These destinations have prompted the discovery of new functions for the APC proteins, and this multitasking of APC might explain why its loss often leads to cancer.

Adenomatous Polyposis Coli↗

Catecholaminergic projections onto spinal neurons destined to the pelvis including the penis in rat.

In rats, the spinal cord contains proerectile autonomic motoneurons destined to the penile tissue and its vasculature, and somatic motoneurons destined to the perineal striated muscles. It receives dense catecholaminergic projections issued from the medulla and pons. In adult male rats, we evidenced the catecholaminergic innervation of spinal neurons controlling lower urogenital tissues and regulating penile erection. We combined retrograde tracing techniques and immunohistochemistry against synthetic enzymes of noradrenaline and adrenaline. Both sympathetic and parasympathetic preganglionic neurons, labeled from the major pelvic ganglion or from the corpus cavernosum, were apposed by catecholaminergic immunoreactive fibers. Motoneurons, retrogradely labeled from the striated muscles, were also apposed by catecholaminergic immunoreactive fibers. Synapses between these motoneurons and fibers were suggested by confocal microscopy and confirmed by electron microscopy in some cases. The results reinforce the hypothesis of a catecholaminergic control of autonomic and somatic motoneurons regulating penile erection at the spinal level.

Animals↗

Altered plasma concentrations of leptin, transforming growth factor-beta(1) and plasminogen activator inhibitor type 2 at 18 weeks of gestation in women destined to develop pre-eclampsia. Circulating markers of disturbed placentation?

BACKGROUND: In many pre-eclamptic women the placentation process seems to be disturbed. Our objective was to investigate if disturbed placentation in pre-eclamptic women may be recognized in early second trimester as altered plasma levels of factors involved in the formation of the uteroplacental unit. METHODS: In a prospective study of 2190 pregnant women we compared plasma leptin, transforming growth factor-beta(1) (TGF-beta(1)) and plasminogen activator inhibitor type 2 (PAI-2) concentrations at 18 weeks' gestation in 71 women with subsequent pre-eclampsia and 71 controls matched for age, parity and first trimester body mass index. RESULTS: Leptin and TGF-beta(1) concentrations were lower and PAI-2 concentration higher in women destined to develop pre-eclampsia relative to controls (leptin: median (25-75 percentiles): 19.0 (14.5-29.0) vs 25.0 (16.0-35.0) ng/ml (p =0.03), TGF-beta(1): 3.2 (2.0-6.1) vs 5.3 (3.8-7.1) ng/ml (P=0.01) and PAI-2: 78.8 (65.1-118.1) vs 67.6 (61.6-79.6) ng/ml (P=0.002)). OR (95 per cent CI) for pre-eclampsia for women in the upper quartile compared to women in the lower quartile were: leptin: 0.2 (0.03-0.7), TGF-beta(1): 0.2 (0.08-0.7) and PAI-2: 3.1 (1.2-8.2). CONCLUSIONS: Altered plasma concentrations levels of factors involved in the process of placentation in women destined to develop pre-eclampsia, indicate that disturbed formation of the uteroplacental unit is reflected in the maternal circulation before 20 weeks' gestation.

Adult↗