Internal migration and health in South Africa: determinants of healthcare utilisation in a young adult cohort.

BACKGROUND: In South Africa, human geographic mobility is high as people engage in both permanent and temporary relocation, predominantly from rural to urban areas. Such mobility can compromise healthcare access and utilisation. The objective of this paper is to explore healthcare utilisation and its determinants in a cohort of internal migrants and permanent residents (non-migrants) originating from the Agincourt sub-district in South Africa's rural northeast. METHODS: A 5-year cohort study of 3800 individuals aged 18 to 40 commenced in 2017. Baseline data have been collected from 1764 Agincourt residents and 1334 temporary, mostly urban-based, migrants, and are analysed using bivariate analyses, logistic and multinomial regression models, and propensity score matching analysis. RESULTS: Health service utilisation differs sharply by migrant status and sex. Among those with a chronic condition, migrants had 0.33 times the odds of non-migrants to have consulted a health service in the preceding year, and males had 0.32 times the odds of females of having used health services. Of those who utilised services, migration status was further associated with the type of healthcare utilised, with 97% of non-migrant rural residents having accessed government facilities, while large proportions of migrants (31%) utilised private health services or consulted traditional healers (25%) in migrant destinations. The multinomial logistic regression analysis indicated that, in the presence of controls, migrants had 8.12 the relative risk of non-migrants for utilising private healthcare (versus the government-services-only reference category), and 2.40 the relative risk of non-migrants for using a combination of public and private sector facilities. These findings of differential utilisation hold under statistical adjustment for relevant controls and for underlying propensity to migrate. CONCLUSIONS: Migrants and non-migrants in the study population in South Africa were found to utilise health services differently, both in overall use and in the type of healthcare consulted. The study helps improve upon the limited stock of knowledge on how migrants interface with healthcare systems in low and middle-income country settings. Findings can assist in guiding policies and programmes to be directed more effectively to the populations most in need, and to drive locally adapted approaches to universal health coverage.

Holomorphic Hartree-Fock Theory: The Nature of Two-Electron Problems.

We explore the existence and behavior of holomorphic restricted Hartree-Fock (h-RHF) solutions for two-electron problems. Through algebraic geometry, the exact number of solutions with n basis functions is rigorously identified as 1/2(3n - 1), proving that states must exist for all molecular geometries. A detailed study on the h-RHF states of HZ (STO-3G) then demonstrates both the conservation of holomorphic solutions as geometry or atomic charges are varied and the emergence of complex h-RHF solutions at coalescence points. Using catastrophe theory, the nature of these coalescence points is described, highlighting the influence of molecular symmetry. The h-RHF states of HHeH2+ and HHeH (STO-3G) are then compared, illustrating the isomorphism between systems with two electrons and two electron holes. Finally, we explore the h-RHF states of ethene (STO-3G) by considering the π electrons as a two-electron problem and employ NOCI to identify a crossing of the lowest energy singlet and triplet states at the perpendicular geometry.

Does It Take a Village? Migration among Rural South African Youth.

In a rural African context, the saying, "it takes a village to raise a child," suggests that community characteristics are substantially important in children's lives as they transition to adulthood. Are these contextual factors also related to youth migration? Demographers are uncertain about how community characteristics improve our understanding of an individual's propensity to migrate, beyond individual and household factors. In many low and middle-income country settings, youth become migrants for the first time in their lives to provide access to resources that their families need. We employ discrete-time event history models from the 20032011 Agincourt Health and socio-Demographic Surveillance System in rural South Africa to test whether markers of development in a village are associated with the likelihood of youth and young adults migrating, distinguishing between becoming temporary and permanent migrants during this critical life cycle phase. We find that village characteristics indeed differentially predict migration, but not nearly as substantially as might be expected.

Moving beyond the household: Innovations in data collection on kinship.

Across settings, it has been shown that the co-residential household is an insufficient measure of family structure and support. However, it continues to be the primary means of population data collection. To address this problem, we developed a new instrument, the Kinship Support Tree (KST), to collect kinship structure and support data on co-residential and non-residential kin and tested it on a sample of 462 single mothers and their children in a slum community in Nairobi, Kenya. This instrument is unique in four important ways: (1) it is not limited to the co-residential household; (2) it distinguishes potential from functional kin; (3) it incorporates multiple geospatial measures; and (4) it collects data on kin relationships specifically for children. In this paper, we describe the KST instrument, assess the data collected in comparison to data from household rosters, and consider the challenges and feasibility of administration of the KST.

Figuring large optics at the sub-nanometer level: compensation for coating and gravity distortions.

Large, precision optics can now be manufactured with surface figures specified at the sub-nanometer level. However, coatings and gravity deform large optics, and there are limits to what can be corrected by clever compensation. Instead, deformations caused by stress from optical mounts and deposited coatings must be incorporated into the optical design. We demonstrate compensation of coating stress on a 370mm substrate to λ/200 by a process of coating and annealing. We also model the same process and identify the leading effects that must be anticipated in fabrication of optics for future gravitational wave detectors and other applications of large, precisely figured optics, and identify the limitations inherent in using coatings to compensate for these deformations.

Micro-battery development for juvenile salmon acoustic telemetry system applications.

The Endangered Species Act requires actions that improve the passage and survival rates for migrating salmonoids and other fish species that sustain injury and mortality when passing through hydroelectric dams. To develop a low-cost revolutionary acoustic transmitter that may be injected instead of surgically implanted into the fish, one major challenge that needs to be addressed is the micro-battery power source. This work focuses on the design and fabrication of micro-batteries for injectable fish tags. High pulse current and required service life have both been achieved as well as doubling the gravimetric energy density of the battery. The newly designed micro-batteries have intrinsically low impedance, leading to significantly improved electrochemical performances at low temperatures as compared with commercial SR416 batteries. Successful field trial by using the micro-battery powered transmitters injected into fish has been demonstrated, providing an exemplary model of transferring fundamental research into practical devices with controlled qualities.

Ultraviolet laser-induced damage on fused silica substrate and its sol-gel coating.

A comparative study of the laser-induced damage thresholds (LIDTs) of fused silica substrates and their sol-gel silica coatings was carried out with 355 nm laser irradiation. Chemical etching and superpolishing were employed in different ways to improve the substrate. The laser damage tests showed that the coated substrate was no more susceptible to laser damage than the bare substrate, showing that the substrate quality was the dominant factor limiting the LIDT for UV irradiation. In addition, it was found that high value of substrate microroughness was more harmful to the LIDT of the coated than the bare substrate, and that a proper combination of etching and superpolishing can optimize the LIDT.

Optimization of coating uniformity in an ion beam sputtering system using a modified planetary rotation method.

A modified planetary rotation system has been developed to obtain high uniformity optical coatings on large substrates in an ion beam sputter coater. The system allows the normally fixed sun gear to rotate, thus allowing an extra degree of freedom and permitting more complex motions to be used. By moving the substrate platen between two fixed positions around the sun axis, averaging of the distributions at these two positions takes place and improved uniformity can be achieved. A peak-to-valley radial uniformity of ∼0.15% (∼0.07% rms) on a single layer film on a 400 mm diameter substrate has been achieved without the aid of masking.

A deterministic optical figure correction technique that preserves precision-polished surface quality.

A deterministic surface correction technique has been used to improve the surface figure of two fused silica optical flats over a diameter of 60 mm with no measurable degradation in their surface quality at spatial frequencies of

Deterministic control of thin film thickness in physical vapor deposition systems using a multi-aperture mask.

A technique for controlling the thickness profile of a thin film in physical vapor deposition systems is reported. The technique uses a novel mask design with apertures of varying dimension to selectively deposit the required film thickness at predetermined locations across the aperture of the substrate. The technique has been used to correct the thickness uniformity of a 55 mm diameter, 280 microm thick, lithium niobate wafer to less than 0.5 nm rms, and also to improve the uniformity of deposited films in an Ion Beam Sputtering system to better than 0.5% over a 50 mm aperture.

Mechanical characteristics of optical coatings prepared by various techniques: a comparative study.

Good performance of optical coatings depends on the appropriate combination of optical and mechanical properties. Therefore, successful applications require good understanding of the relationship between optical microstructural and mechanical characteristics and film stability. In addition, there is a lack of standard mechanical tests that allow one to compare film properties measured in different laboratories. We give an overview of the methodology of mechanical measurements suitable for optical coatings; this includes depth-sensing indentation, scratch resistance, friction, abrasion and wear testing, and stress and adhesion evaluation. We used the techniques mentioned above in the same laboratory to systematically compare the mechanical behavior of frequently used high- and low-index materials, namely, TiO2, Ta2O5, and SiO2, prepared by different complementary techniques. They include ion-beam-assisted deposition by electron-beam evaporation, magnetron sputtering, dual-ion-beam sputtering, plasma-enhanced chemical-vapor deposition, and filtered cathodic arc deposition. The mechanical properties are correlated with the film microstructure that is inherently related to energetic conditions during film growth.