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PubMed2002

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↗
PubMed2001

Impairment of growth in fetuses destined to deliver preterm.

OBJECTIVE: The objective of this study was to test the hypothesis that fetuses destined to deliver preterm do not reach their individual growth potential. STUDY DESIGN: In a case control design, data on 44 preterm deliveries at < or =34 weeks were compared with data on a control group of next consecutive term deliveries. Criteria for inclusion were dating by ultrasonography at <20 weeks and no medical or obstetric complications. For each fetus, GROW v.2 software was used to generate an individual optimal growth curve and to calculate the percentile of achieved growth potential for birth weight based on 6 independent factors (maternal weight, height, parity, ethnicity, fetal sex, and gestational age) identified as determining fetal weight from multivariate logistic regression analysis of 40,000 uncomplicated term pregnancies. Birth weight percentiles based on standard norms were also calculated for each fetus. RESULTS: The number of fetuses with birth weight below the 5th, 10th, and 25th percentile of their growth potential was significantly higher in the preterm group (10, 13, and 18) compared with that in the control group (2, 2, and 6; P <.008, P <.001, and P <.008, respectively). There were no significant differences in variables defining growth potential between the case and control groups. The number of fetuses below the 5th and 10th percentile based on standard birth weight norms was not significantly different between preterm and term pregnancies (3 vs 1 and 5 vs 2; P =.37 and P =.27). Among preterm deliveries, those preceded by preterm premature rupture of the membranes had significantly fewer fetuses >75th percentile of their growth potential (2 vs 8; P =.025). Fetuses with lower gestational ages at preterm delivery achieved lower median percentiles of their growth potential. CONCLUSION: A significant proportion of fetuses destined to deliver preterm do not reach their individual growth potential compared with those delivered at term. This finding challenges our concept of preterm delivery and management strategy aimed at tocolysis.

Birth Weight↗
PubMed2004

Prognostic social factors in the subacute phase after a stroke for the discharge destination from the hospital stroke-unit. A systematic review of the literature.

PURPOSE: The objective of our study was to identify prognostic social factors in the subacute phase after stroke for the discharge destination from the hospital stroke-unit. METHODS: A systematic literature search was performed, designed in accordance with the Cochrane Collaboration criteria. Internal, statistical and external validity of the studies were assessed using a checklist with 11 methodological criteria. RESULTS: Characteristics of the social situation that proved to be important for prediction of the discharge destination are marital status and social support. Quantity and methodological quality of the research studies were insufficient, and the number of possible social prognostic factors investigated was limited by the absence of a conceptual framework of social subdomains in the studies, including an unambiguous definition of the prognostic social factors within these subdomains. CONCLUSIONS: A great need exists for research into the prognostic qualities of the following social factors: the ability to provide support, presence, and readiness of the homefront; the availability of professional care, personal financial means, membership of societies and clubs, frequency of contacts with close relatives and friends; the quality of the patient's residence with regard to the adaptation to the needs and abilities of the patient. A commitment about the aforementioned conceptual framework is mandatory.

Activities of Daily Living↗
PubMed1987

Distance versus destination: stream selectivity of elderly interstate migrants.

Migration streams of persons age 60 years and older that share a common origin state, but with widely separated county-group destinations, were examined to determine the relative effect of distance upon migration selectivity. Socioeconomic and demographic characteristics common to selectivity studies were used for the comparisons. The findings showed that distance made little difference. Controlling for destination, we matched and compared the characteristics of older migrants from states of different distances. We looked at those coming to Arizona from California, Illinois, and Ohio, to the New York City suburbs from Pennsylvania and Florida, and to Chicago from Michigan and California. Repeatedly the story was the same. Distance was not an important factor; significant differences between these streams were rare. This analysis used the 1-in-100 1970 census public use microdata sample and used tests for identifying significant differences between streams.

Aged↗
PubMed1989

Importance of a quality assurance scheme for factor VIII assays in quality monitoring of human plasma destined for fractionation into factor VIII concentrate.

A national quality assurance scheme has been established to monitor the validity of factor VIII assays performed by the various laboratories of the Scottish National Blood Transfusion Service engaged in collection and processing of donor plasma destined for fractionation. The results over the first 3-year period show that comparable assay values can be obtained by participating centres using a common standard, despite differences in equipment, methods or substrate chosen for the one-stage assay. The results also showed that chromogenic factor VIII assays correlated well with the one-stage method. Random factor VIII assays performed on plasma, harvested and frozen within 18 h from collection, were analysed to validate recently proposed Scottish specifications which stipulate that 70% of plasma donations destined for fractionation should contain at least 0.7 IU/ml. Plasma harvested and frozen between 8 and 18 h from collection did not meet the specified level in any of the regional centres. This nationally specified level was also not met by plasma harvested and frozen within 8 h from collection in spite of being achieved individually by three regional centres. Assays performed on large plasma pools at the Fractionation Centre suggested loss of some factor VIII during storage, transportation and thawing of plasma prior to bulk processing.

Blood Banks↗
PubMed2005

Predictors of mortality, length of stay and discharge destination in blunt trauma.

BACKGROUND: The present study explored a range of variables to identify predictors of mortality and morbidity and to develop prediction models based on these variables. METHODS: Tools for predicting mortality, hospital length of stay and a patient's destination post-hospital discharge were developed using logistic regression in one dataset (design) and evaluated for prediction performance in a separate dataset (validation). The performance of the mortality model was compared to the trauma and injury severity score (TRISS) and a severity characterization of trauma (ASCOT). RESULTS: The profile of variables contributing to the final prediction models developed from the design dataset varied across the different outcomes of interest although age, injury severity score, development of complications and triage category were common predictors of all three outcomes. The performance of the new mortality prediction model was superior to both TRISS and ASCOT in the validation dataset. Overall, the new models did not meet the prespecified performance criteria. CONCLUSIONS: The present study identified key predictors of mortality and morbidity (length of hospital stay and discharge destination). The newly developed mortality model out-performed published trauma scoring methods. However, further development and trial of the new prediction models is required before implementation as definitive audit and benchmarking tools could be recommended.

Adult↗
PubMed1976

Methyl galactosidase activity: an alternative evolutionary destination for the ebgA0 gene.

Previous studies (Campbell et al., 1973; Hall and Hartl, 1974; Hall and Hartl, 1975) have shown that the ebgA0 gene, whose product does not hydrolyze lactose may evolve so that its product does hydrolyze lactose; i.e., lactase activity is one evolutionary destination of the ebgA0 gene. Beginning with a strain that synthesizes ebgA0 gene product constitutively and grows extremely slowly (doubling time, 30 to 50 h) on methyl-beta-D-galactopyranoside (MG), a derivative was selected capable of growth on MG at a moderate rate (doubling time, 5.9 h). Genetic evidence is presented showing that the gene that permits growth on MG is an allele of ebgA. A comparison among strains bearing several alleles of ebgA shows that the new allele, termed ebgAmg, synthesizes a product specific for MG and thus represents a true alternative evolutionary destination for the ebgA0 gene.

Alleles↗
PubMed2005

Length of stay, discharge destination, and functional improvement: utility of the Australian National Subacute and Nonacute Patient Casemix Classification.

BACKGROUND AND PURPOSE: Although implemented in 1998, no research has examined how well the Australian National Subacute and Nonacute Patient (AN-SNAP) Casemix Classification predicts length of stay (LOS), discharge destination, and functional improvement in public hospital stroke rehabilitation units in Australia. METHODS: 406 consecutive admissions to 3 stroke rehabilitation units in Queensland, Australia were studied. Sociodemographic, clinical, and functional data were collected. General linear modeling and logistic regression were used to assess the ability of AN-SNAP to predict outcomes. RESULTS: AN-SNAP significantly predicted each outcome. There were clear relationships between the outcomes of longer LOS, poorer functional improvement and discharge into care, and the AN-SNAP classes that reflected poorer functional ability and older age. Other predictors included living situation, acute LOS, comorbidity, and stroke type. CONCLUSIONS: AN-SNAP is a consistent predictor of LOS, functional change and discharge destination, and has utility in assisting clinicians to set rehabilitation goals and plan discharge.

Aged↗
PubMed2000

Predicting discharge destination for patients with severe motor stroke: important functional tasks.

Many patients with severe stroke are capable of returning to the community after receiving rehabilitation services. The purpose of this study was to describe outcomes of patients with stroke in FIM-FRG STR1, a classification based on the Functional Independence Measure, and identify important functional tasks associated with discharge to home. FIM-FRG STR1 is one of nine subpopulations of stroke that have been identified based on motor/cognitive FIM subscale score and age. We reviewed the program evaluation data of 259 cases of stroke from 1993 to 1996. We performed a descriptive analysis of the data and a logistic regression analysis to determine which tasks measured by the FIM were associated with discharge destination, a key indicator of rehabilitation success. We found that three admission FIM variables (bladder management, toilet transfers, memory) and three discharge FIM variables (upper body dressing, bed/chair transfers, comprehension) were associated with discharge destination with up to 75% accuracy. The implications of these findings are discussed.

Aged↗
PubMed2004

An axon scaffold induced by retinal axons directs glia to destinations in the Drosophila optic lobe.

In the developing Drosophila visual system, glia migrate into stereotyped positions within the photoreceptor axon target fields and provide positional information for photoreceptor axon guidance. Glial migration conversely depends on photoreceptor axons, as glia precursors stall in their progenitor zones when retinal innervation is eliminated. Our results support the view that this requirement for retinal innervation reflects a role of photoreceptor axons in the establishment of an axonal scaffold that guides glial cell migration. Optic lobe cortical axons extend from dorsal and ventral positions towards incoming photoreceptor axons and establish at least four separate pathways that direct glia to proper destinations in the optic lobe neuropiles. Photoreceptor axons induce the outgrowth of these scaffold axons. Most glia do not migrate when the scaffold axons are missing. Moreover, glia follow the aberrant pathways of scaffold axons that project aberrantly, as occurs in the mutant dachsous. The local absence of glia is accompanied by extensive apoptosis of optic lobe cortical neurons. These observations reveal a mechanism for coordinating photoreceptor axon arrival in the brain with the distribution of glia to multiple target destinations, where they are required for axon guidance and neuronal survival.

Animals↗
PubMed1996

Computations on metric maps in mammals: getting oriented and choosing a multi-destination route.

The capacity to construct a cognitive map is hypothesized to rest on two foundations: (1) dead reckoning (path integration); (2) the perception of the direction and distance of terrain features relative to the animal. A map may be constructed by combining these two sources of positional information, with the result that the positions of all terrain features are represented in the coordinate framework used for dead reckoning. When animals need to become reoriented in a mapped space, results from rats and human toddlers indicate that they focus exclusively on the shape of the perceived environment, ignoring non-geometric features such as surface colors. As a result, in a rectangular space, they are misoriented half the time even when the two ends of the space differ strikingly in their appearance. In searching for a hidden object after becoming reoriented, both kinds of subjects search on the basis of the object's mapped position in the space rather than on the basis of its relationship to a goal sign (e.g. a distinctive container or nearby marker), even though they have demonstrably noted the relationship between the goal and the goal sign. When choosing a multidestination foraging route, vervet monkeys look at least three destinations ahead, even though they are only capable of keeping a maximum of six destinations in mind at once.

Animals↗
PubMed2005

Gender and family composition related to discharge destination and length of hospital stay after acute stroke.

Informal care by family members still plays an important role in home care after acute stroke. This study determined the clinical and demographic factors, such as family structure, that predict discharge to home and length of hospital stay (LOS) after acute stroke hospitalization. We reviewed the sex, age, family structure before stroke, type of stroke, size of the lesion, activities of daily living (ADL) function at discharge, discharge destination, and LOS of stroke patients (114 cerebral infarctions and 44 intracerebral hemorrhages) admitted to a neurosurgical hospital. Patients with cerebral infarction were older than those with intracerebral hemorrhage (median 75 vs 66 years). Ninety-eight were discharged to home (62%). In the logistic regression analysis, low ADL function, medium or large infarction, and intracerebral hemorrhage (vs lacunar infarction) were significantly associated with discharge to a destination other than home. Of the patients discharged home, low ADL function was strongly associated with LOS in the multiple regression analysis. In addition, living with a spouse only had the opposite effect on LOS in men and women (p=0.050 and 0.071, respectively). LOS tended to be shorter for men with a wife, but longer for women with a husband. The structure and gender roles in a stroke patient's household may need further attention for the efficient use of hospital resources.

Acute Disease↗
PubMed2006

Motion by nearby players biases perception but not action in judgments of baseball destination.

In this research, the influence of irrelevant reference frames on estimates of ball destination was examined. In 3 experiments, confederate base runners and fielders served as distractor stimuli while balls were rolled from home plate to random locations along a barrier hidden under an elevated tarp between first and second base. Stationary participants estimated the position that the ball would exit from under the tarp if there were no barrier, whereas running participants ran along the back edge of the barrier and touched the top of the tarp above where they believed the ball would exit. Estimates of ball destination were significantly biased in the direction opposite to the confederates' motion for stationary participants, but were accurate for running participants. These findings are consistent with other perception-action dissociations, and show that relative motion effects can occur in a naturalistic setting.

Adolescent↗
PubMed2000

Evaluation of health information provided on the Internet by airlines with destinations in tropical and sub-tropical countries.

The travel industry is being called upon increasingly to provide health information for its clients. Websites of all 73 international airlines with tropical or sub-tropical destinations accessible via the International Air Transport Association homepage were evaluated for the quality of their health advice. Seven of the 73 homepages contained health information, six of which addressed health problems that might be encountered when travelling to tropical countries. Fifty-five of the 73 airlines had functional email addresses and were asked for pre-travel health advice on malaria prophylaxis using a fictitious scenario. Among the 25 airlines that replied, only half referred to malaria and a third gave wrong information about malaria endemicity in the destination area. The only two airlines that recommended a specific drug regimen correctly reflected the medical situation described in our fictitious email. In general, international airlines are not set up to provide health information.

Aviation↗
PubMed1981

Measuring interstate migration flows: an origin-destination network based on Internal Revenue Service records.

"This paper examines gross interstate migration flows for five periods for the years between 1969 and 1978. The analysis is based upon a newly available data source--Federal income tax returns. Approximately 90% of the US population is covered by this data series. The matching of Internal Revenue Service (IRS) returns between filing dates enables the determination both of the origin and of the destination of migrants, with few of the risks of geographic miscoding present. "These data illustrate that despite divergent economic fluctuations over the past nine years, the patterns of interstate migration have remained virtually unchanged. With few exceptions, the number of migrants either leaving or entering a particular state comprise identical proportions over time.... In addition, these data offer considerable evidence that current residence has a significant impact on the selection of a destination." Comparisons are made with data from the Current Work History Sample and the 1970 census.

Americas↗
PubMed1988

Components of change in migration and destination-propensity rates for metropolitan and nonmetropolitan areas: 1935-1980.

This article focuses on components of change in out-migration and destination-propensity rates of metropolitan and nonmetropolitan areas. The results indicate that changes in subgroup-specific rates were the driving force behind the changing patterns between and within these two areas. Composition effects played a secondary role, mainly counteracting the negative impact of changing rates. Although the rate of change in out-migration from metropolitan areas has been reduced and out-migration from nonmetropolitan areas declined during the most recent period, the propensity to select metropolitan areas increased over the period studied. Finally, rate-specific changes vary by age and education, indicating a change in migration's impact on population composition at origin and destination.

Adult↗
PubMed1996

[Diagnosis and discharge destination of patients admitted for mental dysfunctioning in a geriatric department].

OBJECTIVE: To determine the prevalence of psychiatric and somatic disorders and to evaluate functional status and discharge destinations of patients with impairment of mental functioning admitted to a geriatric unit of a general hospital. SETTING: Rijnstate Hospital Arnhem, the Netherlands. DESIGN: Descriptive prospective study. PATIENTS AND METHODS: In 1993, 43 patients with recent impairment in mental functioning were followed. Physical illness, course of physical and psychiatric problems and discharge destination were recorded. Psychiatric diagnoses were classified according to the DSM-III-R. The 'Barthel index' for activities of daily living (ADL), 'Mini-mental state examination', 'Hamilton depression scale' and 'delirium rating scale' were used in evaluation of functional status and mental functioning. RESULTS: All the patients had psychiatric problems (delirium 28, dementia 23, depression 6, several problems 21). Thirty-eight patients (88%) had recent physical illness, in 21 (49%) functional status was impaired (p < 0.001). In many patients improvement in mental functioning (70%), functional status (26%) and somatic condition (79%) was achieved. Improvement of the somatic condition (79%) was often (87%) accompanied by improvement of the psychiatric condition (other patients (21%): 50%, p < 0.05). Nursing home placement was needed in 53% (admitted geriatric patients in general: 13%, p < 0.001). CONCLUSION: Most patients suffered from delirium (65%). In 23 patients (53%) dementia was diagnosed, mostly for the first time. Improvement of the somatic condition was significantly related to improvement of the psychiatric condition. Patients admitted with recent impairment of mental functioning are at greater risk to be placed in a nursing home than admitted geriatric patients in general.

Activities of Daily Living↗
PubMed1992

Effects of personal factors on the destination choice patterns of Canadian immigrants: an evaluation within a multivariate framework.

"The purpose of this paper is to study the effects of personal factors on the established destination choice patterns of Canadian immigrants in 1981 within a multivariate context, using the micro data in the Public Use Sample (PUS) of the 1981 Canadian population census. Six personal attributes encompassing ethnic origin, level of education, occupation, class of work, income and period of immigration are...used." (SUMMARY IN CHI)

Americas↗