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Exploratory studies aimed at a synthesis of vinigrol. 2. Attempts to exploit ring-closing metathesis for construction of the central cyclooctane belt.

A program directed to the possible adaptation of ring closing metathesis to a total synthesis of vinigrol is described. With a convenient route to intermediates of general type 3 available from a prior investigation, several candidate substrates were prepared. These included the epoxy dienes 10 and 22, the diacetoxy triene 42, and the heavily functionalized cyclohexane 48. The central issue of this approach was to convey a maximum degree of conformational flexibility to these functionalized intermediates, such that the olefinic termini of the side chains could enter into intramolecular carbon-carbon bond formation. In no example was ring closure observed to operate. Instead, the strategically placed pi-bonds were seen to migrate internally to the chain in select examples. Although the pivotal transformations failed, the deployment of a number of useful stereo-controlled reactions has ultimately resulted in the preparation of heavily substituted cis-decalins.

Cyclization↗

[Immigrants with female circumcision in Switzerland: background information and recommendations for medical practice].

Due to increasing international migration Switzerland hosts women who have undergone female genital mutilation. Complications of female genital mutilation call for a comprehensive medically, socially and culturally adapted care. Health care providers in Switzerland are not adequately prepared to meet the specific needs of the women concerned, particularly because they are rarely exposed and have no national guidelines to rely on. This article based on qualitative research provides recommendations with the aim to improve the care for concerned African immigrant women in the Swiss health care system.

Adolescent↗

Space-time clustering of childhood leukaemia in Greece: evidence supporting a viral aetiology.

The method introduced by Knox for evaluation of space-time clustering has been applied to 872 cases of childhood (0-14 year old) leukaemia diagnosed in Greece over the 10 year period 1980-89. Greek towns are characterised by substantial population mixing due to internal migration, whereas there is relative isolation in mountainous rural areas. Predetermined space (5 km) and time (1 year) limits were used on the basis of previous reports in order to define the clustering cell. There is highly significant evidence for clustering of childhood leukaemia in Greece as a whole, the observed number of pairs that are close in both spaces and time exceeding the expected number by 5.2% (P = 0.004). The excess is particularly evident for leukaemia cases in 0 to 4-year-old children, among whom the observed number of pairs that are close in both space and time exceeded the expected number by 9.4% (P = 0.004). There is no evidence of space-time clustering for leukaemia cases older than 5 years. The overall pattern is descriptively similar in urban and semiurban areas and is especially marked for acute lymphoblastic leukaemia at the childhood peak ages (2-4 years) with an excess of 19% (P = 0.0006). In the rural population there is evidence for clustering of cases belonging to older and broader age groups, a phenomenon compatible with a delay in the development of herd immunity against putative infectious aetiological agents. The findings of the present study provide support for the hypothesis that a substantial proportion of cases of childhood leukaemia may arise as a rare sequel to exposure to an agent or agents, most probably viral in nature.

Adolescent↗

Founder mutations among the Dutch.

Many genetic disorders demonstrate mutations that can be traced to a founder, sometimes a person who can be identified. These founder mutations have generated considerable interest, because they facilitate studies of prevalence and penetrance and can be used to quantify the degree of homogeneity within a population. This paper reports on founder mutations among the Dutch and relates their occurrence to the history and demography of the Netherlands. International migration, regional and religious endogamy, and rapid population growth played key roles in shaping the Dutch population. In the first millenniums BC and AD, the Netherlands were invaded by Celts, Romans, Huns, and Germans. In more recent times, large numbers of Huguenots and Germans migrated into the Netherlands. Population growth within the Netherlands was slow until the 19th century, when a period of rapid population growth started. Today, the Dutch population numbers 16 million inhabitants. Several different classes of founder mutations have been identified among the Dutch. Some mutations occur among people who represent genetic isolates within this country. These include mutations for benign familial cholestasis, diabetes mellitus, type I, infantile neuronal ceroid lipofuscinosis, L-DOPA responsive dystonia, and triphalangeal thumb. Although not related to a specific isolate, other founder mutations were identified only within the Netherlands, including those predisposing for hereditary breast-ovarian cancer, familial hypercholesterolemia, frontotemporal dementia, hereditary paragangliomas, juvenile neuronal ceroid lipofuscinosis, malignant melanoma, protein C deficiency, and San Filippo disease. Many of these show a regional distribution, suggesting dissemination from a founder. Some mutations that occur among the Dutch are shared with other European populations and others have been transmitted by Dutch émigrés to their descendents in North America and South Africa. The occurrence of short chromosomal regions that have remained identical by descent has resulted in relatively limited genetic heterogeneity for many genetic conditions among the Dutch. These observations demonstrate the opportunity for gene discovery for other diseases and traits in the Netherlands.

Alleles↗

[Tinea capitis and corporis caused by Trichophyton soudanense in an immigrant family from Africa].

HISTORY AND FINDINGS: Several weeks before coming to Germany the two daughters (aged 3 and 6 years) of a family from Togo had developed desquamating skin changes over the hairy scalp. These had then spread to the trunk and limbs. The 8-weeks-old son also had discrete lesions on the hairy scalp and neck. In all of them these lesions had then spread and begun to itch markedly. When first seen as out-patients the father was free of symptoms, but the other members of the family had multiple, sharply circumscribed, partly confluent, dry and desquamating lesions, about 2-4 cm in diameter, with areas of alopecia and hair breaking off at skin level. In addition there were dry, desquamating, sharply circumscribed, partly hyperpigmented, partly infiltrated plaques, 1-3 cm in diameter, disseminated over the entire body surface, but especially the neck and limbs. INVESTIGATIONS: Typical micromorphological characteristics for T. soudanese were demonstrated in the outer zones of a primary culture and the organism was also demonstrated in culture on Sabouraud-glucose-agar. Typical colonies on Löwenstein-Jensen medium allowed differentiation from Microsporum ferrugineum. TREATMENT AND COURSE: The patients were treated systemically with griseofulvin and locally with ciclopiroxolamine. Marked clinical improvement occurred within 2 months and cultures became negative. But as fungal elements were still demonstrated in native preparations from two of the patients, treatment was continued. CONCLUSION: Efficacious treatment of tinea needs reliable diagnosis of the pathogen. Human infection with T. soudanese usually results from contact with other humans. If this infection occurs in persons not from Africa there is usually the history of indirect or direct contact with Africans. Increased international migration and tourism is likely to result in more cases of this kind: this pathogen should be considered in the differential diagnosis of tinea of scalp and body.

Adult↗

Gene defects in congenital factor XIII deficiency.

The knowledge of the molecular basis of factor XIII deficiency has improved significantly in recent years. Almost 20 different mutations have been described in the gene coding for the factor A-subunit and 3 mutations in the gene coding for the B-subunit. Half of the mutations in the factor XIIIa A-subunit gene are nonsense mutations that result in premature termination of translation. Three of them are frameshift mutations that are caused by minor deletions. Two of them are splicing mutations and 3 are stop mutations that are caused by single nucleotide substitutions. Ten of the mutations are missense mutations caused by nucleotide transitions leading to amino acid substitutions. In the factor XIII B-subunit gene, the 3 mutations are an amino acid substitution, a splicing mutation, and a trinucleotide insertion. These mutations explain the disease in the two families reported to have XIII B-subunit deficiency. In factor XIII A-subunit deficiency, the genetic defects have been characterized so far only in a minority of cases. In most of the reports of factor XIII A-subunit mutations, each family carries its own mutation/mutations. However, in some populations such as Finns and Arabs some enrichment of specific mutations has occurred. Some international migration of a few mutations has also been noted. The structural and functional effects of the mutations have been analyzed by studying the expression of the factor XIII subunits on mRNA and protein levels in vivo or in vitro, and by utilizing the three-dimensional model of crystallized factor XIII A-subunit in modeling of the missense mutations.

Arabs↗

The dynamics of spatial labor mobility in the Netherlands.

"This paper discusses several factors that may explain [the] dynamic properties of internal labor migration. [The authors] focus especially on the influence of labor market and housing conditions on the mobility of people. A two-stage, generation-allocation model is proposed to investigate the role of different factors in the explanation of aggregate interregional migration flows. This model is applied to recent data on interprovincial labor migration in the Netherlands. The results indicate that housing supply seems to be an important determinant of temporal developments of spatial mobility, and that also the conditions on national and regional labor markets are associated with specific properties of recent migration patterns."

Demography↗

Estimating the stability of census-based racial/ethnic classifications: the case of Brazil.

This study presents a method of estimating the degree to which people change their racial/ethnic identity from one census enumeration to another. The technique is applied to the classification of skin colour in Brazil (white, black, brown, yellow). For the period 1950-80, the findings show a deficit of 38 per cent in the black category and a gain of 34 per cent in the brown category, suggesting that a large proportion of individuals who declared themselves black in 1950 reclassified themselves as brown in 1980. Estimates for 1980-90, adjusted for the effects of international migration, reveal a similar pattern, although the magnitude of colour reclassification may have declined somewhat during the 1980s. Procedures to determine the stability of racial/ethnic identity produce data useful to recent policy initiatives that rely on demographic censuses to measure changes in the status of minority groups in less developed countries.

Brazil↗

Substance use and HIV risks among male heterosexual and 'money boy' migrants in Shanghai, China.

There is a growing awareness that internal migration in China might shift the HIV epidemic by broadening the social and sexual mixing of its population. However, little is known about how drug use/abuse might contribute to the spread of HIV. This qualitative study aims to elucidate factors for preventing substance abuse and HIV among two types of male migrants living in the Shanghai metropolitan area; the general migrant population and so-called 'money boys' (those who engaged in same-sex activities for money). Compared to most male migrants, the 'money boys' had a slightly better economic situation; rarely visited their hometowns; used alcohol less but drugs more; had more knowledge about HIV and sexually transmitted diseases; higher HIV/ STD testing rates and fewer HIV risk behaviors. The general male migrants had more misconceptions about HIV (e.g. the need to pay for HIV testing) than the 'money boys'. However, it was noted that 'money boys' who were new to the enterprise and men who have sex with men but did not engage in commercial sex often lacked HIV knowledge and protective skills. Given the needs of various sub-types of 'migrants', differential approaches to HIV prevention are needed.

Adolescent↗

Changing sexual attitudes and behaviour in China: implications for the spread of HIV and other sexually transmitted diseases.

In Imperial China sexual behaviour was regarded as an indispensable activity to reach harmony with the universe, through the unity of the interaction of two opposing forces: yin and yang. Sexual intercourse was accepted when linked to procreation within a family context, while an individual's sexuality was not considered important. Homosexuality was tolerated although not advocated, while masturbation was denounced. Since the One Child Family and Open Door policies in the 1970s and the economic reforms of the 1980s, attitudes towards sexuality in China have changed. Premarital sex has become widely accepted among young people and people in China are now more tolerant toward extramarital sex. Nowadays young people consider that love should dominate marriage and the quality of an individual's sex life is currently more valued than it used to be. Attitudes towards masturbation have become more tolerant and though homosexuality has been hidden by society for a long time, in recent years it has begun to be considered as a legitimate lifestyle choice. Attitudes towards sex and sexual behaviour have become recognized as an individuals' responsibility as long as no offence occurs against society or the interests of other individuals, resulting in the recognition of diversity of sexual behaviour. As part of the changing attitudes to sex and sexual behaviour, heterosexual transmission is becoming the most important route of HIV transmission in China. This is complicated by the internal migration of an estimated 120 million labourers moving from the countryside to the cities as the result of economic reforms, most of whom are sexually active young men. Unless addressed directly, these factors may add to the estimated 300,000 HIV-infected Chinese, further fuelling an already rapidly spreading epidemic. The ramifications of the Chinese HIV epidemic will not only be felt within China, but also within the surrounding Asian countries thereby fuelling the HIV pandemic.

Attitude to Health↗

Urban-rural comparisons of depressive disorders in French Canada.

A field survey in French Canada confirmed the familiar finding that rural residents have lower rates of depression than metropolitan residents and showed that this difference remains even after allowing for sex, age, marital status, education, employment, and internal migration. However, no support was obtained for the hypothesis that the metropolitan sample was feeling less communally supported than the rural sample, and the rates in a small county center proved to be lower than in the rural area, not higher as would be predicted on the assumption that its life is urban. Finally, the rural-metropolitan differences proved to be concentrated in two minorities, the unemployed men and the unpartnered women, rather than spread widely. It is suggested for these reasons that the traditional urban-rural dichotomy may now be inappropriate for sociopsychiatric research.

Adolescent↗

Migration as a consumption activity.

"While a generalized utility maximization approach to migration decisionmaking is not innovative, the principal extensions of this paper involve the search for an instrument capable of measuring changes in utility levels consistent with all preferences (i.e., with all forms of utility functions), requiring only data on observed behaviour. Our approach is to construct a Location-Specific Utility Index (LSUI), whose component variables serve as proxies for the arguments in [U.S.] households' utility functions.... The testable hypothesis is formulated as follows: Assuming constant household preferences and expansion of the household's feasible set over time, the household's utility level is greater following the migration decision.... The results are compared with the households' migration decisions. The empirical evidence shows that migration may reasonably be modelled as a consumption activity by households to maximize utility." (SUMMARY IN FRE AND SPA)

Americas↗

Nurses, nannies and caring work: importation, visibility and marketability.

This paper examines nurses' international migration within the broader context of female migration, particularly against more studied groups of women who have migrated for employment in care-giving roles. We analyze the similarities and differences between skilled professional female migrants (nurses) and domestic workers (nannies and in-home caretakers) and how societal expectations, meanings, and values of care and 'women's work', together with myriad social, cultural, economic and political processes, construct the female migrant care-giver experience. We argue that, as the recruitment of foreign workers gains visibility, strategies are introduced to better prepare female migrant care-givers for the marketplace. Language, specifically command of English and accent modification, is highlighted as one means to assimilate migrant care-givers to host communities.

Acculturation↗

Hydatid disease: the alveolar variety in Australia. A case report with comment on the toxicity of mebendazole.

The alveolar form of hydatid disease, caused by the larval stage of the cestode Echinococcus multilocularis, is virtually confined geographically to the northern hemisphere. It produces clinically malignant multivesicular infiltrating lesions most often in the liver, and is quite different from the usual cystic variety caused by E. granulosus. We present a case report of a patient with alveolar hydatid disease, whose treatment with mebendazole was brief due to side effects of alopecia and granulocytopenia; and review the features of this disease which, with increasing international migration, may be encountered more frequently in Australia.

Agranulocytosis↗