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Existing literature demonstrates that social networks play a key role in international migrants' selection of destinations. But how do such networks begin? The Republic of Georgia is an example of a country from which migrants travel to many different destination countries, most of which had no Georgian population before the collapse of the Soviet Union. This paper uses a combination of nationally representative survey data and semi-structured interviews to identify the patterns and logic of men's and women's destination choices. I find that a wide variety of micro- and macro-level factors influence the desirability of destinations and that perceived gender differences in the labour market demands of the destination countries and variation in the accessibility of different countries explain much of the variation in destination selection among migrants. Social networks play a vital role in shaping perceptions of destination countries, which can be highly localised and changeable in the early stages of migration. [ABSTRACT FROM AUTHOR]

In this paper, we explore how individual women cope with the tensions between economic forces encouraging temporary labour migration and cultural norms tying 'proper' women to their homes and families. Combining in-depth interviews with returned migrant women in the Georgian capital of Tbilisi with secondary migration data for the region, we illustrate the recent increases in Georgian women's participation in international labour migration. Deteriorating economic conditions in Georgia leave women with few local opportunities to financially support their families, while institutional changes have altered the accessibility and attractiveness of international destinations, leading to increasing motivations and opportunities for women's migration. Focusing on the contradictions between growing female migration and persistent adherence to cultural norms stigmatizing migration in Georgia, we explore the cognitive strategies migrant women employ in an attempt to balance internalized perceptions of acceptable gendered behaviour with their migration choices. Two key pathways of adaptation emerge: framing migration as a necessity rather than a choice and stressing the unique and individually exceptional nature of their own migration experience. We posit that these strategies may serve to limit the norm-challenging nature of women's migration in Georgia. Although migration is often described as an empowering experience for women, if women migrants work to present their migration in a way that fits within the bounds of traditional gender norms, these norms may be strengthened rather than challenged. [ABSTRACT FROM AUTHOR]

Objective: This study was undertaken to determine the prevalence, characteristics, risk factors, and temporal profile of concurrent ischemic lesions in patients with acute primary intracerebral hemorrhage (ICH). Methods: Patients were recruited within a prospective, longitudinal, magnetic resonance imaging (MRI)-based study of primary ICH. Clinical, demographic, and MRI data were collected on all subjects at baseline and 1 month. Results: Of the 138 patients enrolled, mean age was 59 years, 54% were male, 73% were black, and 84% had a history of hypertension. At baseline, ischemic lesions on diffusion-weighted imaging (DWI) were found in 35% of patients. At 1 month, lesions were present in 27%, and of these lesions, 83% were new and not present at baseline. ICH volume ( p = 0.025), intraventricular hemorrhage ( p = 0.019), presence of microbleeds ( p = 0.024), and large, early reductions in mean arterial pressure ( p = 0.003) were independent predictors of baseline DWI lesions. A multivariate logistical model predicting the presence of 1-month DWI lesions included history of any prior stroke ( p = 0.012), presence of 1 or more microbleeds ( p = 0.04), black race ( p = 0.641), and presence of a DWI lesion at baseline ( p = 0.007). Interpretation: This study demonstrates that >⅓ of patients with primary ICH have active cerebral ischemia at baseline remote from the index hematoma, and ¼ of patients experience ongoing, acute ischemic events at 1 month. Multivariate analyses implicate blood pressure reductions in the setting of an active vasculopathy as a potential underlying mechanism. Further studies are needed to determine the impact of these lesions on outcome and optimal management strategies to arrest vascular damage. Ann Neurol 2012;71:199-205 [ABSTRACT FROM AUTHOR]

Acquired myasthenia gravis is a relatively uncommon disorder, with prevalence rates that have increased to about 20 per 100,000 in the US population. This autoimmune disease is characterized by muscle weakness that fluctuates, worsening with exertion, and improving with rest. In about two-thirds of the patients, the involvement of extrinsic ocular muscle presents as the initial symptom, usually progressing to involve other bulbar muscles and limb musculature, resulting in generalized myasthenia gravis. Although the cause of the disorder is unknown, the role of circulating antibodies directed against the nicotinic acetylcholine receptor in its pathogenesis is well established. As this disorder is highly treatable, prompt recognition is crucial. During the past decade, significant progress has been made in our understanding of the disease, leading to new treatment modalities and a significant reduction in morbidity and mortality. [ABSTRACT FROM AUTHOR]

Rationale PROTECT DC examines whether stroke navigators can improve cardiovascular risk factors in urban underserved individuals newly hospitalized for stroke or ischemic attack. Within one-year of hospital discharge, up to one-third of patients no longer adhere to secondary prevention behaviors. Adherence rates are lower in minority-underserved groups, contributing to health disparities. In-hospital programs increase use of stroke prevention therapies but may not be as successful in underserved individuals. In these groups, low literacy, limited healthcare access, and sparse community resources may reduce adherence. Lay community health workers (navigators) improve adherence in other illnesses through education and assisting in overcoming barriers to achieving desired health behaviors and obtaining needed healthcare services. Aims and design PROTECT DC is a Phase II, single-blind, randomized, controlled trial comparing in-hospital education plus stroke navigators to usual care. Atherogenic ischemic stroke and transient ischemic attack survivors are recruited from Washington, DC hospitals. Navigators meet with participants during the index hospitalization, perform home visits, and meet by phone. They focus on stroke education, medication compliance, and overcoming practical barriers to adherence. The interventions are driven by the theories of reasoned action and planned behavior. Study outcomes The primary dependent measure is a summary score of four objective measures of stroke risk factor control: systolic blood pressure, low-density lipoprotein, hemoglobin Hb A1C, and antiplatelet agent pill counts. Secondary outcomes include stroke knowledge, exercise, dietary modification, and smoking cessation. Conclusion PROTECT DC will determine whether a Phase III trial of stroke navigation for urban underserved individuals to improve adherence to secondary stroke prevention behaviors is warranted. [ABSTRACT FROM AUTHOR]

The Russian Federation has experienced simultaneous declines in health and rises in international migration. Guided by the "healthy migrant effect" found elsewhere, we examine two questions. First, do the foreign-born in the Russian Federation exhibit better overall health than the native-born? Second, to the extent positive health selectivity exists, is it transferred to the second generation? Using the first wave of the Russian Generations and Gender Survey, our findings support the idea of positive health selection among international migrants from non-Slavic regions. The effect of migrant status, regardless of origin, diminishes when age, sex, and native language are taken into account. [ABSTRACT FROM AUTHOR]

Discusses state governance patterns for community colleges in the U.S. State governance practices, definition and patterns; Models for community college governance structures; Factors influencing statewide governance; State and federal policies; Emerging issues.