Advice on malaria and yellow fever prevention provided at travel agencies in Cuzco, Peru.

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Villanueva-Meyer, Pablo G; Garcia-Jasso, Carlos A; Springer, Chelsea A; Lane, Jenna K; Su, Bonny S; Hidalgo, Idania S; Goodrich, Mary R; Deichsel, Emily L; White, A C; Cabada, Miguel M

2015-01-01

Travelers receive medical advice from a variety of sources, including travel agencies. The aim of this study is to describe the quality of pre-travel advice provided by travel agencies in Cuzco to travelers interested in visiting malaria and yellow fever endemic areas. Trained medical students posed as tourists and visited travel agencies in Cuzco requesting travel advice for a trip to the southern Amazon of Peru, recording advice regarding risk and prevention of malaria and yellow fever. A total of 163 registered travel agencies were included in the study. The mean proposed tour duration was 6.8 days (±1.4 days) with a median time to departure of 3 days and a median tour cost of 805 US dollars (USD) [interquartile range (IQR) 580-1,095]. Overall, 45% employees failed to mention the risk for any illness. Eighteen percent of the employees acknowledged risk of malaria and 53% risk of yellow fever. However, 36% denied malaria risk and 2% denied risk of yellow fever in the region. The price of tours from travel agencies that did not mention any health risk was significantly lower [1,009.6 ± 500.5 vs 783.9 ± 402 USD, t (152) = 3, p yellow fever (100%) were able to provide at least one recommendation for prevention. However, advice was not always accurate or spontaneously volunteered. Only 7% of the employees provided both correct scheduling and location information for administration of the yellow fever vaccine. The majority of registered travel agencies in Cuzco did not provide sufficient and accurate information regarding risk and prevention of malaria and yellow fever to travelers inquiring about trips to the southern Amazon of Peru. © 2014 International Society of Travel Medicine.

Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia.

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Heywood, Anita E; Zhang, Meng; MacIntyre, C Raina; Seale, Holly

2012-02-17

Forward planning and preventative measures before travelling can significantly reduce the risk of many vaccine preventable travel-related infectious diseases. Higher education students may be at an increased risk of importing infectious disease as many undertake multiple visits to regions with higher infectious disease endemicity. Little is known about the health behaviours of domestic or international university students, particularly students from low resource countries who travel to high-resource countries for education. This study aimed to assess travel-associated health risks and preventative behaviours in a sample of both domestic and international university students in Australia. In 2010, a 28 item self-administered online survey was distributed to students enrolled at the University of New South Wales, Sydney, Australia. Multiple methods of distributing links to the online survey were utilised. The survey examined the international travel history, travel intentions, infection control behaviours and self-reported vaccination history. A total of 1663 respondents completed the online survey, 22.1% were international students and 83.9% were enrolled at an undergraduate level. Half had travelled internationally in the previous 12 months, with 69% of those travelling only once during that time with no difference in travel from Australia between domestic and international students (p = 0.8). Uptake of pre-travel health advice was low overall with 68% of respondents reporting they had not sought any advice from a health professional prior to their last international trip. Domestic students were more likely to report uptake of a range of preventative travel health measures compared to international students, including diarrhoeal medication, insect repellent, food avoidance and condoms (P students reported low risk perception of travel threats and a low corresponding concern for these threats. Our study highlights the need to educate students about the risk

Travel risk assessment, advice and vaccinations in immunocompromised travellers (HIV, solid organ transplant and haematopoeitic stem cell transplant recipients): A review.

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Aung, A K; Trubiano, J A; Spelman, D W

2015-01-01

International travellers with immunocompromising conditions such as human immunodeficiency virus (HIV) infection, solid organ transplantation (SOT) and haematopoietic stem cell transplantation (HSCT) are at a significant risk of travel-related illnesses from both communicable and non-communicable diseases, depending on the intensity of underlying immune dysfunction, travel destinations and activities. In addition, the choice of travel vaccinations, timing and protective antibody responses are also highly dependent on the underlying conditions and thus pose significant challenges to the health-care providers who are involved in pre-travel risk assessment. This review article provides a framework of understanding and approach to aforementioned groups of immunocompromised travellers regarding pre-travel risk assessment and management; in particular travel vaccinations, infectious and non-infectious disease risks and provision of condition-specific advice; to reduce travel-related mortality and morbidity. Copyright © 2014 Elsevier Ltd. All rights reserved.

Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia

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Heywood Anita E

2012-02-01

Full Text Available Abstract Background Forward planning and preventative measures before travelling can significantly reduce the risk of many vaccine preventable travel-related infectious diseases. Higher education students may be at an increased risk of importing infectious disease as many undertake multiple visits to regions with higher infectious disease endemicity. Little is known about the health behaviours of domestic or international university students, particularly students from low resource countries who travel to high-resource countries for education. This study aimed to assess travel-associated health risks and preventative behaviours in a sample of both domestic and international university students in Australia. Methods In 2010, a 28 item self-administered online survey was distributed to students enrolled at the University of New South Wales, Sydney, Australia. Multiple methods of distributing links to the online survey were utilised. The survey examined the international travel history, travel intentions, infection control behaviours and self-reported vaccination history. Results A total of 1663 respondents completed the online survey, 22.1% were international students and 83.9% were enrolled at an undergraduate level. Half had travelled internationally in the previous 12 months, with 69% of those travelling only once during that time with no difference in travel from Australia between domestic and international students (p = 0.8. Uptake of pre-travel health advice was low overall with 68% of respondents reporting they had not sought any advice from a health professional prior to their last international trip. Domestic students were more likely to report uptake of a range of preventative travel health measures compared to international students, including diarrhoeal medication, insect repellent, food avoidance and condoms (P Conclusions Our study highlights the need to educate students about the risk associated with travel and improve preventative

International travel in the immunocompromised patient: a cross-sectional survey of travel advice in 254 consecutive patients.

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Bialy, C; Horne, K; Dendle, C; Kanellis, J; Littlejohn, G; Ratnam, I; Woolley, I

2015-06-01

Our primary aim was to determine the rate of overseas travel in immunocompromised individuals attending appropriate clinics at an Australian tertiary care hospital. We also aimed to characterise health-seeking behaviour prior to travel and investigated sources of pre-travel advice, compared travel patterns and activities between three specific immunosuppressed groups, and examined pre-immunosuppression patient serology. We implemented a cross-sectional survey of patients between February and August 2012. This survey was implemented among three outpatient populations at Monash Medical Centre, an Australian tertiary care hospital. We recruited 254 immunosuppressed adults from three patient populations: human immunodeficiency virus-positive individuals, renal transplant patients and rheumatology patients requiring immunosuppressive therapy. No clinical intervention was performed. In the 10 years preceding the survey, 153 (60.2%) participants reported international travel. Of these, 105 (68.6%) were immunosuppressed at the time of travel. These patients were 47.6% male and 60% Australian born. Forty per cent were visiting friends and relatives as part of their travel. Fifty-four per cent of those immunocompromised at the time of travel were going to high-risk destinations. Pathology files indicated that serological screening was frequently not performed prior to immunosuppression in the renal transplant and rheumatology groups. Immunocompromised patients often travel to high-risk destinations with limited or inadequate pre-travel preparations. Doctors caring for the immunocompromised should be aware of travel risks, suitable vaccination protocols and when to refer to specialist travel clinics. © 2015 Royal Australasian College of Physicians.

The travel advice as an inhibiting factor of tourist movement

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Mylonopoulos Dimitrios

2016-01-01

Full Text Available Tourism is significantly affected by unpredictable and uncertain factors such as the occurrence of a terrorist attack, an epidemic outbreak or a natural disaster, etc. The impact of these phenomena on the tourist movement of the country or the place where the event occurred is aggravated by the way it is presented by the media both locally and internationally. The adverse climate gets worse by the issuance of travel advice that usually accompanies such phenomena and has the effect of limiting or even halting tourist flows. In order to identify and study the different types of travel advice that have been issued during international tourism crisis incidents, an internet search was carried out using keywords. Moreover, a study on the travel advice issued by major tourists' origin states, as the USA, Australia, Canada, Germany, the United Kingdom, etc. was carried out. Incidents (terrorist attacks, epidemics, natural disasters which had a great impact on tourism were then selected. In addition, the issuance of travel advice, their different issuing authorities, the classification level and the impact on the tourism of the country or the place in question were examined. An analysis of the reaction and the instructions of major international organizations (World Health Organization, World Tourism Organization concerning the management of such crises, directly or indirectly affecting tourism, were also analyzed. The study of the relevant websites, the international literature and the recorded incidents shows that the issuing of travel advice has negative effects on many sectors of tourism activity and is a bottleneck for tourism development. In fact, in many cases, travel advice is used by countries to exert pressure on other countries in order to achieve a desired result. Due to the enormous economic and social effects when issuing travel advice, the states proper management is necessary in order to minimize the negative consequences and avoid

Do British travel agents provide adequate health advice for travellers?

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Lawlor, D A; Burke, J; Bouskill, E; Conn, G; Edwards, P; Gillespie, D

2000-01-01

Travel-related illness is a burden for primary care, with more than two million travellers consulting a general practitioner each year. The annual cost of travel-related illness in the United Kingdom is 11 million Pounds. Travel agents are in a unique position to influence this burden as the most common and most serious problems are preventable with simple advice and/or immunisation. This study, using covert researchers, suggests this potential is not being fully utilised. PMID:10954940

The pattern of clinical advice sought by general practitioners from a medical consultant in clinical biochemistry.

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Bhatnagar, D

1997-01-01

Clinical biochemistry departments can be a valuable source of clinical advice for further investigations and the need for referral to specialist clinics. This paper outlines the pattern of clinical advice sought by general practitioners in a district hospital setting, and addresses some of the issues regarding seeking such advice and the implications for continuing medical education and training. PMID:9196966

The reliability of pre-travel history to decide on appropriate counseling and vaccinations: a prospective study.

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Rossi, Isabelle A; Genton, Blaise

2012-01-01

Although medical and travel plans gathered from pre-travel interviews are used to decide the provision of specific pre-travel health advice and vaccinations, there has been no evaluation of the relevance of this strategy. In a prospective study, we assessed the agreement between pre-travel plans and post-travel history and the effect on advice regarding the administration of vaccines and recommendations for malaria prevention. We included prospectively all consenting adults who had not planned an organized tour. Pre- and post-travel information included questions on destination, itineraries, departure and return dates, access to bottled water, plan of bicycle ride, stays in a rural zone, and close contact with animals. The outcomes measured included: agreement between pre- and post-travel itineraries and activities; and the effect of these differences on pre-travel health recommendations, had the traveler gone to the actual versus intended destinations for actual versus intended duration and activities. Three hundred and sixty-five travelers were included in the survey, where 188 (52%) were males (median age 38 years). In 81(23%) travelers, there was no difference between pre- and post-travel history. Disagreement between pre- and post-travel history were the highest for stays in rural zones or with local people (66% of travelers), close contact with animals (33%), and bicycle riding (21%). According to post-travel history, 125 (35%) travelers would have needed rabies vaccine and 9 (3%) typhoid fever vaccine. Potential overprovision of vaccine was found in travelers. A change in the malaria prescription would have been recommended in 18 (5%) travelers. Pre-travel history does not adequately reflect what travelers do. However, difference between recommendations for the actual versus intended travel plans was only clinically significant for the need for rabies vaccine. Particular attention during pre-travel health counseling should focus on the risk of rabies, the

Travel-associated infection presenting in Europe (2008-12): an analysis of EuroTravNet longitudinal, surveillance data, and evaluation of the effect of the pre-travel consultation

NARCIS (Netherlands)

Schlagenhauf, Patricia; Weld, Leisa; Goorhuis, Abraham; Gautret, Philippe; Weber, Rainer; von Sonnenburg, Frank; Lopez-Vélez, Rogelio; Jensenius, Mogens; Cramer, Jakob P.; Field, Vanessa K.; Odolini, Silvia; Gkrania-Klotsas, Effrossyni; Chappuis, Francois; Malvy, Denis; van Genderen, Perry J. J.; Mockenhaupt, Frank; Jauréguiberry, Stéphane; Smith, Catherine; Beeching, Nicholas J.; Ursing, Johan; Parola, Philippe; Grobusch, Martin P.

2015-01-01

Travel is important in the acquisition and dissemination of infection. We aimed to assess European surveillance data for travel-related illness to profile imported infections, track trends, identify risk groups, and assess the usefulness of pre-travel advice. We analysed travel-associated morbidity

Destination image and crime in Mexico: An analysis of foreign government travel advice

Directory of Open Access Journals (Sweden)

J. Carlos Monterrubio

2013-01-01

Full Text Available Destination image has been recognised as an influential component of travel decision processes. Although organic sources of information play an important role in shaping destination image, researchers have often ignored the types of sources and the information they deliver. In particular, official websites where government travel advice is given, especially in relation to crime, have been widely excluded from scholarly research. This paper analyses the relationship between crime-related travel advice given by foreign governments and Mexico’s destination image. Qualitative content analysis of official websites from the US, Canada, the UK and Spain reveals that the travel advice given relates largely to the violence and insecurity that Mexico is currently experiencing. “No advisory in effect”, “Exercise caution” and “Defer non-essential travel” are messages commonly found in the governments’ travel advice about Mexico.

Pre-travel consultation: evaluation of primary care physician practice in the Franche-Comté region.

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Piotte, Emeline; Bellanger, Anne-Pauline; Piton, Gaël; Millon, Laurence; Marguet, Philippe

2013-01-01

Primary care physicians (PCP) are first in line to provide adequate pre-travel medical advice. Little data are available on the content of pre-travel PCP consultations in France. We undertook an observational survey to assess the level of specific knowledge among PCPs on health advice, vaccinations, and malaria prophylaxis. Standardized questionnaires were sent to a random sample of 400 PCPs practicing in the Franche-Comté regions (eastern France) who were asked to complete and return it on a voluntary and anonymous basis. The questionnaire requested sociodemographic details, practice-related characteristics, and proposed three clinical situations with multiple choice questions (MCQ). To identify factors associated with a higher level of specific knowledge in travel medicine, results were studied by uni- and multivariate analyses. An overall score was calculated based on the MCQ answers and a motivation score was calculated based on parameters such as frequency and developments in pre-travel consulting at the practice, PCPs' personal experience as travelers, and the formal agreement of PCPs to administer yellow fever vaccination. The response rate was 37.5%, with 150 questionnaires returned completed and suitable for analysis. After multivariate logistic regression, the three variables associated with a higher score were: proximity of a vaccination center (p = 0.001), motivation score (p = 0.004), and absence of request for expert advice on malaria prophylaxis (p = 0.007). PCPs play an important role in travel medicine. This study showed that their high level of knowledge in travel medicine was mostly linked to their motivation to practice in this specialized discipline. © 2013 International Society of Travel Medicine.

Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel.

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Hagmann, Stefan H F; Han, Pauline V; Stauffer, William M; Miller, Andy O; Connor, Bradley A; Hale, DeVon C; Coyle, Christina M; Cahill, John D; Marano, Cinzia; Esposito, Douglas H; Kozarsky, Phyllis E

2014-12-01

US residents make 60 million international trips annually. Family practice providers need to be aware of travel-associated diseases affecting this growing mobile population. To describe demographics, travel characteristics and clinical diagnoses of US residents who present ill after international travel. Descriptive analysis of travel-associated morbidity and mortality among US travellers seeking care at 1 of the 22 US practices and clinics participating in the GeoSentinel Global Surveillance Network from January 2000 to December 2012. Of the 9624 ill US travellers included in the analysis, 3656 (38%) were tourist travellers, 2379 (25%) missionary/volunteer/research/aid workers (MVRA), 1580 (16%) travellers visiting friends and relatives (VFRs), 1394 (15%) business travellers and 593 (6%) student travellers. Median (interquartile range) travel duration was 20 days (10-60 days). Pre-travel advice was sought by 45%. Hospitalization was required by 7%. Compared with other groups of travellers, ill MVRA travellers returned from longer trips (median duration 61 days), while VFR travellers disproportionately required higher rates of inpatient care (24%) and less frequently had received pre-travel medical advice (20%). Illnesses of the gastrointestinal tract were the most common (58%), followed by systemic febrile illnesses (18%) and dermatologic disorders (17%). Three deaths were reported. Diagnoses varied according to the purpose of travel and region of exposure. Returning ill US international travellers present with a broad spectrum of travel-associated diseases. Destination and reason for travel may help primary health care providers to generate an accurate differential diagnosis for the most common disorders and for those that may be life-threatening. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pre-Travel Medical Preparation of Business and Occupational Travelers: An Analysis of the Global TravEpiNet Consortium, 2009 to 2012.

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Khan, Nomana M; Jentes, Emily S; Brown, Clive; Han, Pauline; Rao, Sowmya R; Kozarsky, Phyllis; Hagmann, Stefan H F; LaRocque, Regina C; Ryan, Edward T

2016-01-01

The aim of the study was to understand more about pre-travel preparations and itineraries of business and occupational travelers. De-identified data from 18 Global TravEpiNet clinics from January 2009 to December 2012 were analyzed. Of 23,534 travelers, 61% were non-occupational and 39% occupational. Business travelers were more likely to be men, had short times to departure and shorter trip durations, and commonly refused influenza, meningococcal, and hepatitis B vaccines. Most business travelers indicated that employers suggested the pre-travel health consultation, whereas non-occupational travelers sought consultations because of travel health concerns. Sub-groups of occupational travelers have characteristic profiles, with business travelers being particularly distinct. Employers play a role in encouraging business travelers to seek pre-travel consultations. Such consultations, even if scheduled immediately before travel, can identify vaccination gaps and increase coverage.

Pre-Travel Health Preparation of Pediatric International Travelers: Analysis From the Global TravEpiNet Consortium.

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Hagmann, Stefan; LaRocque, Regina C; Rao, Sowmya R; Jentes, Emily S; Sotir, Mark J; Brunette, Gary; Ryan, Edward T

2013-12-01

Children frequently travel internationally. Health-related data on such children are limited. We sought to investigate the demographics, health characteristics, and preventive interventions of outbound US international pediatric travelers. We analyzed data from 32 099 travelers presenting for pre-travel healthcare at the Global TravEpiNet (GTEN), a national consortium of 19 travel clinics, from January 1, 2009 to June 6, 2012. A total of 3332 (10%) of all GTEN travelers were children (traveled mostly for leisure (36%) or to visit friends or relatives (VFR) (36%). Most popular destination regions were Africa (41%), Southeast Asia (16%), Central America (16%), and the Caribbean (16%). Compared with children traveling for leisure, VFR children were more likely to present travel consultation (44% vs 28%), intended to travel for 28 days or longer (70% vs 22%), and to travel to Africa (62% vs 32%). Nearly half of the pediatric travelers (46%) received at least 1 routine vaccine, and most (83%) received at least 1 travel-related vaccine. Parents or guardians of one third of the children (30%) refused at least 1 recommended travel-related vaccine. Most pediatric travelers visiting a malaria-endemic country (72%) received a prescription for malaria chemoprophylaxis. Ten percent of travelers seeking pre-travel healthcare at GTEN sites are children. VFR-travel, pre-travel consultation close to time of departure, and refusal of recommended vaccines may place children at risk for travel-associated illness. Strategies to engage pediatric travelers in timely, pre-travel care and improve acceptance of pre-travel healthcare interventions are needed. © The Author 2013. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

HIV and travel.

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Schuhwerk, M A; Richens, J; Zuckerman, Jane N

2006-01-01

There is a high demand for travel among HIV-positive individual. This demand arises partly from those who have benefited from advances in antiretroviral therapy as well as those with disease progression. The key to a successful and uneventful holiday lies in careful pre-trip planning, yet many patients fail to obtain advice before travelling. Travel advice for HIV patients is becoming increasingly specialized. In addition to advice on common travel-related infectious diseases, HIV-positive travellers are strongly advised to carry information with them and they need specific advice regarding country entry restrictions, HIV inclusive travel insurance, safety of travel vaccinations and highly active antiretroviral therapy-related issues. A wide range of relevant issues for the HIV-positive traveller are discussed in this review and useful websites can be found at the end.

The impact of injection anxiety on education of travelers about common travel risks.

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Noble, Lorraine M; Farquharson, Lorna; O'Dwyer, Niamh A; Behrens, Ron H

2014-01-01

Despite many travelers receiving at least one vaccination during the pre-travel consultation, little is known about travelers' fear of injections and the impact this may have on educating travelers about health risks associated with their trip. This study aimed to investigate: (1) the prevalence of injection anxiety in travelers attending a pre-travel consultation, (2) whether anxiety due to anticipating a vaccination adversely affects recall of information and advice, and (3) whether clinicians can recognize travelers' anxiety, and how they respond to anxious travelers. Consecutive adult travelers (N = 105) attending one of two inner-city travel clinics completed self-report measures of state anxiety, injection anxiety, and symptoms of needle phobia immediately before and after their pre-travel consultation. Clinicians were also asked to rate travelers' anxiety and report any anxiety management strategies. Standardized information was presented during the consultation and recall of information and advice was assessed immediately post-consultation. Delayed recall (24 hours) was assessed for a subsample (20%) of participants. More than one third of travelers reported feeling nervous or afraid when having an injection (39%). Travelers' state anxiety was related to their psychological and physiological reactions to needles, and reduced significantly post-consultation. Recall of information and advice varied, with failure of recall ranging from 2 to 70% across 15 items, and delayed recall being significantly lower. No relationship was found between recall and anxiety. Clinician-rated anxiety moderately correlated with travelers' self-reported anxiety. A significant proportion of travelers experienced injection anxiety when attending the pre-travel consultation, with some travelers reporting symptoms consistent with criteria for Blood Injection Injury phobia. There were important gaps in recall of information and advice about common travel risks. Although no

Travellers' profile, travel patterns and vaccine practices--a 10-year prospective study in a Swiss Travel Clinic.

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Boubaker, Rim; Meige, Pierrette; Mialet, Catherine; Buffat, Chantal Ngarambe; Uwanyiligira, Mediatrice; Widmer, Francine; Rochat, Jacynthe; Fossati, Annie Hérard; Souvannaraj-Blanchant, Manisinh; Payot, Sylvie; Rochat, Laurence; de Vallière, Serge; Genton, Blaise; D'Acremont, Valérie

2016-01-01

The travel clinic in Lausanne serves a catchment area of 700 000 of inhabitants and provides pre- and post-travel consultations. This study describes the profile of attendees before departure, their travel patterns and the travel clinic practices in terms of vaccination over time. We included all pre-travel first consultation data recorded between November 2002 and December 2012 by a custom-made program DIAMM/G. We analysed client profiles, travel characteristics and vaccinations prescribed over time. Sixty-five thousand and forty-six client-trips were recorded. Fifty-one percent clients were female. Mean age was 32 years. In total, 0.1% were aged travellers had pre-existing medical conditions. Forty-six percent were travelling to Africa, 35% to Asia, 20% to Latin America and 1% (each) to Oceania and Europe; 19% visited more than one country. India was the most common destination (9.6% of travellers) followed by Thailand (8.6%) and Kenya (6.4%). Seventy-three percent of travellers were planning to travel for ≤ 4 weeks. The main reasons for travel were tourism (75%) and visiting friends and relatives (18%). Sixteen percent were backpackers. Pre-travel advice were sought a median of 29 days before departure. Ninety-nine percent received vaccine(s). The most frequently administered vaccines were hepatitis A (53%), tetanus-diphtheria (46%), yellow fever (39%), poliomyelitis (38%) and typhoid fever (30%). The profile of travel clinic attendees was younger than the general Swiss population. A significant proportion of travellers received vaccinations that are recommended in the routine national programme. These findings highlight the important role of travel clinics to (i) take care of an age group that has little contact with general practitioners and (ii) update vaccination status. The most commonly prescribed travel-related vaccines were for hepatitis A and yellow fever. The question remains to know whether clients do attend travel clinics because of compulsory

Trends and characteristics among HIV-infected and diabetic travelers seeking pre-travel advice.

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Elfrink, Floor; van den Hoek, Anneke; Sonder, Gerard J B

2014-01-01

The number of individuals with a chronic disease increases. Better treatment options have improved chronic patients' quality of life, likely increasing their motivation for travel. This may have resulted in a change in the number of HIV-infected travelers and/or travelers with Diabetes Mellitus (DM) visiting our travel clinic. We retrospectively analyzed the database of the travel clinic of the Public Health Service Amsterdam, between January 2001 and December 2011 and examined the records for patients with these conditions. Of the 25,000 travelers who consult our clinic annually, the proportion of travelers with HIV or DM has increased significantly. A total of 564 HIV-infected travelers visited our clinic. The mean age was 41 years, 86% were male, 43% visited a yellow fever endemic country and 46.5% had a CD4 count Travelers with low CD4 counts traveled significantly more often to visit friends or relatives. A total of 3704 diabetics visited our clinic. The mean age was 55 years, 52% were male, 27% visited a yellow fever endemic country and 36% were insulin-dependent. Insulin-dependent diabetics traveled more often for work than non-insulin-dependent diabetics. Adequately trained and qualified travel health professionals and up-to-date guidelines for travelers with chronic diseases are of increasing importance. Copyright © 2013 Elsevier Ltd. All rights reserved.

Travel-associated infection presenting in Europe (2008-12): an analysis of EuroTravNet longitudinal, surveillance data, and evaluation of the effect of the pre-travel consultation.

Science.gov (United States)

Schlagenhauf, Patricia; Weld, Leisa; Goorhuis, Abraham; Gautret, Philippe; Weber, Rainer; von Sonnenburg, Frank; Lopez-Vélez, Rogelio; Jensenius, Mogens; Cramer, Jakob P; Field, Vanessa K; Odolini, Silvia; Gkrania-Klotsas, Effrossyni; Chappuis, Francois; Malvy, Denis; van Genderen, Perry J J; Mockenhaupt, Frank; Jauréguiberry, Stéphane; Smith, Catherine; Beeching, Nicholas J; Ursing, Johan; Rapp, Christophe; Parola, Philippe; Grobusch, Martin P

2015-01-01

Travel is important in the acquisition and dissemination of infection. We aimed to assess European surveillance data for travel-related illness to profile imported infections, track trends, identify risk groups, and assess the usefulness of pre-travel advice. We analysed travel-associated morbidity in ill travellers presenting at EuroTravNet sites during the 5-year period of 2008-12. We calculated proportionate morbidity per 1000 ill travellers and made comparisons over time and between subgroups. We did 5-year trend analyses (2008-12) by testing differences in proportions between subgroups using Pearson's χ(2) test. We assessed the effect of the pre-travel consultation on infection acquisition and outcome by use of proportionate morbidity ratios. The top diagnoses in 32 136 patients, ranked by proportionate morbidity, were malaria and acute diarrhoea, both with high proportionate morbidity (>60). Dengue, giardiasis, and insect bites had high proportionate morbidity (>30) as well. 5-year analyses showed increases in vector borne infections with significant peaks in 2010; examples were increased Plasmodium falciparum malaria (χ(2)=37·57, ptravel consultation was associated with significantly lower proportionate morbidity ratios for P falciparum malaria and also for acute hepatitis and HIV/AIDS. The pattern of travel-related infections presenting in Europe is complex. Trend analyses can inform on emerging infection threats. Pre-travel consultation is associated with reduced malaria proportionate morbidity ratios and less severe illness. These findings support the importance and effectiveness of pre-travel advice on malaria prevention, but cast doubt on the effectiveness of current strategies to prevent travel-related diarrhoea. European Centre for Disease Prevention and Control, University Hospital Institute Méditerranée Infection, US Centers for Disease Control and Prevention, and the International Society of Travel Medicine. Copyright © 2015 Elsevier Ltd

Pre-travel health seeking practices of Umrah pilgrims departing from Assiut International Airport, Egypt.

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Aziz, Mirette M; Abd El-Megeed, Hosnia S; Abd Ellatif, Mennat Allah M

2018-04-22

to assess the health seeking practices and their determinants among Umrah pilgrims departing from Assiut international Airport. We interviewed 300 pilgrims departing from Assiut International Airport while they were in the departure lounge, using a semi-structured questionnaire. Only 60%, 46.3% and 46.3% of Umrah pilgrims believed in importance of pre-travel vaccination, seeking health information, and health examination, respectively. The most frequently practiced pre-travel health related behaviour was getting vaccinated (56.3%), as compared to much lower frequencies of seeking health information (24%) or having a clinical health examination (26.7%). Private clinics, internet and the tourism companies were the main sources of health information of the pilgrims. Positive attitude of pilgrims about health seeking practices, the perception of health risk of travelling to Hajj/Umrah and having a chronic disease were the predictors of pre-travel health practices. Raising awareness among Hajj/Umrah pilgrims about the importance of seeking professional pre-travel health advice and communicating the risk of exposure to travel-related diseases to pilgrims could be important strategies to improve the uptake of preventive measures. Training of general practitioners in the public health sector about the travel health information would promote the travel health services. Copyright © 2018. Published by Elsevier Ltd.

Dietary Advice for Airline Travel.

Science.gov (United States)

Leggat; Nowak

1997-03-01

In addition to their regular meal service, most of the major domestic and international airlines offer special meals. It should be noted that regular meal services on international flights often give a choice of meals, even in economy class, and often include a salad and or fruit dish, which could be consumed by most people. More airlines also seem to be moving towards having at least one more culturally appropriate meal on the menu, particularly for relevant flight sectors. However, these meals may be inappropriate for some passengers, and there is a need for this special meals service. Meals services on airlines have improved greatly in recent years, particularly with the employment of consultant dietitians to the catering staff of airlines and advances in chef training. Special meal services are designed to cater to the most common variations of meals required by most passengers for medical, religious, or other reasons. The special requirements for these meals are described elsewhere.1 It is important to realize that the meals are designed and the ingredients interpreted by that airline, and may not necessarily reflect what the traveler might eat at home. So it is important to advise travelers not to have high expectations of this special meal service. This paper aims to provide some basic practical advice for selection of special diets for airline travelers.

Trends and characteristics among HIV-infected and diabetic travelers seeking pre-travel advice

NARCIS (Netherlands)

Elfrink, Floor; van den Hoek, Anneke; Sonder, Gerard J. B.

2014-01-01

The number of individuals with a chronic disease increases. Better treatment options have improved chronic patients' quality of life, likely increasing their motivation for travel. This may have resulted in a change in the number of HIV-infected travelers and/or travelers with Diabetes Mellitus (DM)

Provision of travel medicine advice through community pharmacies: assessment of knowledge, attitudes and practices of pharmacists in Malaysia.

Science.gov (United States)

Taha, Nur Akmar; See, Yee Lian

2016-10-01

The risk for travel-related illnesses has increased with significant growth in international travel, but very few travellers seek travel advice. Community pharmacists can play a vital role in the provision of travel medicine advice due to their accessibility. This study aimed to assess travel medicine knowledge, attitudes and practices (KAP) among community pharmacists in Kuala Lumpur, Malaysia. A self-administered KAP questionnaire was distributed to a convenience sample of pharmacists in Kuala Lumpur identified from the list of licensed community pharmacists in Malaysia year 2014. Questionnaires were returned by 111 pharmacists of 143 distributed (response rate, 78%). Most of the respondents (82%) were not trained in travel medicine. Overall, mean knowledge score was 4.4 ( ± 1.7), indicating a moderate level of knowledge on a variety of travel-related health issues. Community pharmacists who graduated from foreign universities possessed significantly higher knowledge scores than did those who graduated locally (P pharmacy curricula, continuous pharmacy education or certified training may improve the quality of travel advice given and allow pharmacists to be recognised as a credible source of information on travel medicine. © 2016 Royal Pharmaceutical Society.

Pretravel health advice among international travelers visiting Cuzco, Peru.

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Cabada, Miguel M; Maldonado, Fernando; Quispe, Wanda; Serrano, Edson; Mozo, Karen; Gonzales, Elsa; Seas, Carlos; Verdonck, Kristien; Echevarria, Juan I; Gotuzzo, Eduardo

2005-01-01

Cuzco, a Peruvian city of historical interest located 3,326 m above sea level, is a frequent destination for tourists. We conducted a descriptive study to assess the extent and sources of pretravel health advice received by international travelers before their arrival to Cuzco. Data were collected as part of a health survey among travelers. Between August and November 2002, travelers between 15 and 65 years old were invited to fill out a questionnaire in the departing area of Cuzco's international airport. A total of 5,988 travelers participated. The mean age was 35.4 years (SD 11.4 yr); 50.6% were female and 50.8% were single. Tourism was the reason for traveling in 90.2% of the participants, and 89.3% of them were traveling with companions. Pretravel health information was received by 93.6%. The median number of information sources was two, with books (41.5%), travel medicine clinics (38.8%), the Internet (23.3%), and general practitioners (22.7%) as the main sources. Most frequently received recommendations were about safe food and water consumption (85%), use of insect repellents (66.0%), sunburn protection (64.4%), and condom use (22%). Only 16.5% took medication to prevent altitude sickness, and 14.2% took medication to prevent traveler's diarrhea. Variables independently associated with receiving pretravel health information from a health care professional were female gender, country of residence other than the United States, length of stay in Cuzco > 7 days, length of stay in other Peruvian cities > 7 days, tourism as the main reason for visiting Cuzco, traveling with companions, and consulting of more than one source of information. Most travelers arriving to Cuzco had received pretravel health information, and the majority obtained it from more than one source. Recommendations addressed for specific health risks, such as altitude sickness prophylaxis, were received by few travelers.

Travelers' health problems and behavior: prospective study with post-travel follow-up.

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Vilkman, Katri; Pakkanen, Sari H; Lääveri, Tinja; Siikamäki, Heli; Kantele, Anu

2016-07-13

The annual number of international tourist arrivals has recently exceeded one billion, yet surprisingly few studies have characterized travelers' behavior, illness, and risk factors in a prospective setting. Particularly scarce are surveys of data spanning travel, return, and follow-up of the same cohort. This study examines behavior and illness among travelers while abroad, after return home, and at follow-up. Patterns of behavior connected to type of travel and illness are characterized so as to identify risk factors and provide background data for pre-travel advice. Volunteers to this prospective cohort study were recruited at visits to a travel clinic prior to departure. Data on the subjects' health and behavior were collected by questionnaires before and after journeys and over a three-week follow-up. In addition, the subjects were asked to fill in health diaries while traveling. The final study population consisted of 460 subjects, 79 % of whom reported illness during travel or on arrival: 69 % had travelers' diarrhea (TD), 17 % skin problems, 17 % fever, 12 % vomiting, 8 % respiratory tract infection, 4 % urinary tract infection, 2 % ear infection, 4 % gastrointestinal complaints other than TD or vomiting, and 4 % other symptoms. Of all subjects, 10 % consulted a doctor and 0.7 % were hospitalized; 18 % took antimicrobials, with TD as the most common indication (64 %). Ongoing symptoms were reported by 25 % of all travelers upon return home. During the three-week follow-up (return rate 51 %), 32 % of respondents developed new-onset symptoms, 20 % visited a doctor and 1.7 % were hospitalized. Factors predisposing to health problems were identified by multivariable analysis: certain regions (Southern Asia, South-Eastern Asia, and Eastern Africa), female gender, young age, and long travel duration. Despite proper preventive measures like vaccinations, malaria prophylaxis, and travel advice, the majority of our subjects fell ill during or

Travel Medicine Encounters of Australian General Practice Trainees-A Cross-Sectional Study.

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Morgan, Simon; Henderson, Kim M; Tapley, Amanda; Scott, John; van Driel, Mieke L; Spike, Neil A; McArthur, Lawrie A; Davey, Andrew R; Catzikiris, Nigel F; Magin, Parker J

2015-01-01

Travel medicine is a common and challenging area of clinical practice and practitioners need up-to-date knowledge and experience in a range of areas. Australian general practitioners (GPs) play a significant role in the delivery of travel medicine advice. We aimed to describe the rate and nature of travel medicine consultations, including both the clinical and educational aspects of the consultations. A cross-sectional analysis from an ongoing cohort study of GP trainees' clinical consultations was performed. Trainees contemporaneously recorded demographic, clinical, and educational details of consecutive patient consultations. Proportions of all problems/diagnoses managed in these consultations that were coded "travel-related" and "travel advice" were both calculated with 95% confidence intervals (CIs). Associations of a problem/diagnosis being "travel-related" or "travel advice" were tested using simple logistic regression within the generalized estimating equations (GEE) framework. A total of 856 trainees contributed data on 169,307 problems from 108,759 consultations (2010-2014). Travel-related and travel advice problems were managed at a rate of 1.1 and 0.5 problems per 100 encounters, respectively. Significant positive associations of travel-related problems were younger trainee and patient age; new patient to the trainee and practice; privately billing, larger, urban, and higher socioeconomic status practices; and involvement of the practice nurse. Trainees sought in-consultation information and generated learning goals in 34.7 and 20.8% of travel advice problems, respectively, significantly more than in non-travel advice problems. Significant positive associations of travel advice problems were seeking in-consultation information, generation of learning goals, longer consultation duration, and more problems managed. Our findings reinforce the importance of focused training in travel medicine for GP trainees and adequate exposure to patients in the practice

Randomised controlled trial of site specific advice on school travel patterns.

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Rowland, D; DiGuiseppi, C; Gross, M; Afolabi, E; Roberts, I

2003-01-01

To evaluate the effect of site specific advice from a school travel coordinator on school travel patterns. Cluster randomised controlled trial of children attending 21 primary schools in the London boroughs of Camden and Islington. A post-intervention survey measured the proportion of children walking, cycling, or using public transport for travel to school, and the proportion of parents/carers very or quite worried about traffic and abduction. The proportion of schools that developed and implemented travel plans was assessed. One year post-intervention, nine of 11 intervention schools and none of 10 control schools had travel plans. Proportions of children walking, cycling, or using public transport on the school journey were similar in intervention and control schools. The proportion of parents who were very or quite worried about traffic danger was similar in the intervention (85%) and control groups (87%). However, after adjusting for baseline and other potential confounding factors we could not exclude the possibility of a modest reduction in parental concern about traffic danger as a result of the intervention. Having a school travel coordinator increased the production of school travel plans but there was no evidence that this changed travel patterns or reduced parental fears. Given the uncertainty about effectiveness, the policy of providing school travel coordinators should only be implemented within the context of a randomised controlled trial.

Pre-travel care for immunocompromised and chronically ill travellers: A retrospective study.

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van Aalst, Mariëlle; Verhoeven, Roos; Omar, Freshta; Stijnis, Cornelis; van Vugt, Michèle; de Bree, Godelieve J; Goorhuis, Abraham; Grobusch, Martin P

2017-09-01

Immunocompromised and chronically ill travellers (ICCITs) are susceptible to travel related diseases. In ICCITs, pre-travel care regarding vaccinations and prophylactics is complex. We evaluated the protection level by preventive measures in ICCITs by analysing rates of vaccination protection, antibody titres, and the prescription of standby antibiotics. We analysed, and reported according to STROBE guidelines, pre-travel care data for ICCITs visiting the medical pre-travel clinic at the Academic Medical Centre, The Netherlands from 2011 to 2016. We analysed 2104 visits of 1826 ICCITs. Mean age was 46.6 years and mean travel duration 34.5 days. ICCITs on immunosuppressive treatment (29.7%), HIV (17.2%) or diabetes mellitus (10.2%) comprised the largest groups. Most frequently visited countries were Suriname, Indonesia, and Ghana. Most vaccination rates were >90%. Of travellers in high need of hepatitis A and B protection, 56.6 and 75.7%, underwent titre assessments, respectively. Of ICCITs with a respective indication, 50.6% received a prescription for standby antibiotics. Vaccination rates in our study population were overall comparable to those of healthy travellers studied previously in our centre. However, regarding antibody titre assessments and prescription of standby antibiotics, this study demonstrates that uniform pre-travel guidelines for ICCITs are highly needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Characteristics and pre-travel preparation of travelers at a Canadian pediatric tertiary care travel clinic: A retrospective analysis.

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Ma, Xiao Wei; Pell, Lisa G; Akseer, Nadia; Khan, Sarah; Lam, Ray E; Louch, Debra; Science, Michelle; Morris, Shaun K

2016-01-01

International travelers are susceptible to a wide spectrum of travel related morbidities. Despite rising number of international travelers in Canada, the demographics, risk profiles, and preventative strategies of high-risk traveler groups, including pediatric travelers visiting friends and relatives (VFRs) are not well described. A descriptive analysis was conducted on pre-travel consultations completed between January 2013 and August 2014 at a large pediatric tertiary care center in Toronto, Canada. Data on demographics, travel characteristics, and pre-travel interventions were extracted from 370 pre-travel consultations. Results were compared between all VFR and non-VFR travelers, as well as between children traveling to visit friends and relatives, for vacation, and for education and/or volunteer purposes. Forty-eight percent of consultations were for children travel to visit friends and/or relatives than for other purposes (29% vs 9%, p travel for >28 days than children traveling for vacation (43% vs 1%, p traveling for education/volunteer purposes (43% vs 21%, p = 0.03). Around half of cVFRs traveled to destinations in Asia (51%). The majority stayed with locals, friends and/or relatives (85%), and nearly all traveled to urban destinations (98%). The most prescribed interventions for children were azithromycin (84%), Dukoral (66%), and the hepatitis A vaccine (60%). Atovaquone/proguanil was the most commonly prescribed antimalarial for children. Children that travel to visit friends and relatives represent a unique travel group and may require specific considerations during pre-travel preparations. Our findings can help develop targeted pre-travel strategies for children VFRs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impact of advice given to travelers concerning the main infectious risks associated with traveling in the tropics.

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Lestelle, C; Aymeric, S; Maakaroun-Vermesse, Z; Pouliquen, A; Bernard, L; Chandenier, J; Grammatico-Guillon, L

2015-06-01

The prevention of sanitary risks related to traveling in the tropics implies delivering a large amount of information to travelers. The objective of our study was to assess the knowledge acquired by travelers during a pre-travel consultation. A before and after study was conducted among 202 travelers having consulted at the Tours international vaccine center. We used self-administrated questionnaires (score out of 100 marks) concerning diet, hygiene, anti-vectorial prevention (AVP), and sexual-transmitted infections (STI). The scores obtained before and after consultation were compared globally and for each topic. The travelers' global knowledge had improved after consultation (66.1 vs. 75.5%; P traveling compared to humanitarian mission prepared ahead of departure time). The recommendations for diet were less well acquired in travelers > 50 years of age than in those travel consultation improves the travelers' knowledge for the main prevention measures but does not allow them to acquire all required knowledge. Taking into account the travelers' initial knowledge and their ability to learn could improve the impact of the pre-travel consultation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Health risks and travel preparation among foreign visitors and expatriates during the 2008 Beijing Olympic and Paralympic Games.

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Jentes, Emily S; Davis, Xiaohong M; Macdonald, Susan; Snyman, P Johann; Nelson, Hugh; Quarry, Doug; Lai, Irene; van Vliet, Erik W N; Balaban, Victor; Marano, Cinzia; Mues, Katherine; Kozarsky, Phyllis; Marano, Nina

2010-03-01

During the 2008 Olympic and Paralympic Games, we conducted surveillance of illnesses among travelers at six Beijing clinics. Surveys asked about demographic, pre-travel, and vaccination information, and physician-provided diagnoses. Of 807 respondents, 38% and 57% were classified as foreign visitors (FV) and expatriates, respectively. Less than one-half of FV sought pre-travel advice; sources included health-care providers and friends/family. FV vaccination rate was also low; however, most vaccines given were recommended by the Centers for Disease Control and Prevention. The most common FV diagnoses were respiratory, injury/musculoskeletal, and gastrointestinal illnesses; for expatriates, injury/musculoskeletal, respiratory, and dermatologic were the most common illnesses. Respiratory illnesses in expatriates were significantly less in 2008 than during 2004-2007 (chi(2) = 10.2; P = 0.0014), suggesting that control programs may have reduced pollutants/respiratory irritants during the 2008 Games. We found no previous studies of health outcomes among expatriates living in cities with mass travel events. These findings highlight the need to continuously disseminate information to health-care providers advising travelers.

International travel patterns and travel risks for stem cell transplant recipients.

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Mikati, Tarek; Griffin, Kenneth; Lane, Dakotah; Matasar, Matthew; Shah, Monika K

2015-01-01

Stem cell transplantation (SCT) is being increasingly utilized for multiple medical illnesses. However, there is limited knowledge about international travel patterns and travel-related illnesses of stem cell transplant recipients (SCTRs). An observational cross-sectional study was conducted among 979 SCTRs at Memorial Sloan Kettering Cancer Center using a previously standardized and validated questionnaire. International travel post SCT, pre-travel health advice, exposure risks, and travel-related illnesses were queried. A total of 516 SCTRs completed the survey (55% response rate); of these, 40% were allogeneic SCTRs. A total of 229 (44.3%) respondents reported international travel outside the United States and Canada post SCT. The international travel incidence was 32% [95% confidence interval CI 28-36] within 2 years after SCT. Using multivariable Cox regression analysis, variables significantly associated with international travel within first 2 years after SCT were history of international travel prior to SCT [hazard ratio (HR) = 5.3, 95% CI 2.3-12.0], autologous SCT (HR = 2.6, 95% CI 1.6-2.8), foreign birth (HR = 2.3, 95% CI 1.5-3.3), and high income (HR = 2.0, 95% CI 1.8-3.7). During their first trip, 64 travelers (28%) had traveled to destinations that may have required vaccination or malaria chemoprophylaxis. Only 56% reported seeking pre-travel health advice. Of those who traveled, 16 travelers (7%) became ill enough to require medical attention during their first trip after SCT. Ill travelers were more likely to have visited high-risk areas (60 vs 26%, p = 0.005), to have had a longer mean trip duration (24 vs 12 days, p = 0.0002), and to have visited friends and relatives (69 vs 21%, p travel was common among SCTRs within 2 years after SCT and was mainly to low-risk destinations. Although the overall incidence of travel-related illnesses was low, certain subgroups of travelers were at a significantly higher risk. Pre-travel

Business travelers' risk perception of infectious diseases: where are the knowledge gaps, and how serious are they?

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Wynberg, Elke; Toner, Sharyn; Wendt, Judy K; Visser, Leo G; Breederveld, Daan; Berg, Johannes

2013-01-01

Many studies have explored the risk perception of frequent business travelers (FBT) toward malaria. However, less is known about their knowledge of other infectious diseases. This study aimed to identify knowledge gaps by determining the risk perception of FBT toward 11 infectious diseases. Our retrospective web-based survey assessed the accuracy of risk perception among a defined cohort of FBT for 11 infectious diseases. We used logistic regression and the chi-square test to determine the association of risk perception with source of travel advice, demographic variables, and features of trip preparation. Surveys were returned by 63% of the 608 self-registered FBT in Rijswijk, and only the 328 completed questionnaires that adhered to our inclusion criteria were used for analysis. The majority (71%) sought pre-travel health advice and used a company health source (83%). Participants seeking company travel health advice instead of external had significantly more accurate risk knowledge (p = 0.03), but more frequently overestimated typhoid risk (odds ratio = 2.03; 95% confidence interval = 1.23-3.34). While underestimation of disease risk was on average 23% more common than overestimation, HIV risk was overestimated by 75% of FBT. More accurate knowledge among FBT seeking company health advice demonstrates that access to in-company travel clinics can improve risk perception. However, there is an obvious need for risk knowledge improvement, given the overall underestimation of risk. The substantial overestimation of HIV risk is probably due to both public and in-company awareness efforts. Conversely, typhoid risk overestimation was statistically associated with seeking company health advice, and therefore specifically reflects the high focus on typhoid fever within Shell's travel clinic. This study serves as a reminder that a knowledge gap toward infectious diseases besides malaria still exists. Our article will explore the future requirements for more

Travellers and influenza: risks and prevention.

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Goeijenbier, M; van Genderen, P; Ward, B J; Wilder-Smith, A; Steffen, R; Osterhaus, A D M E

2017-01-01

Influenza viruses are among the major causes of serious human respiratory tract infection worldwide. In line with the high disease burden attributable to influenza, these viruses play an important, but often neglected, role in travel medicine. Guidelines and recommendations regarding prevention and management of influenza in travellers are scarce. Of special interest for travel medicine are risk populations and also circumstances that facilitate influenza virus transmission and spread, like travel by airplane or cruise ship and mass gatherings. We conducted a PUBMED/MEDLINE search for a combination of the MeSH terms Influenza virus, travel, mass gathering, large scale events and cruise ship. In addition we gathered guidelines and recommendations from selected countries and regarding influenza prevention and management in travellers. By reviewing these search results in the light of published knowledge in the fields of influenza prevention and management, we present best practice advice for the prevention and management of influenza in travel medicine. Seasonal influenza is among the most prevalent infectious diseases in travellers. Known host-associated risk factors include extremes of age and being immune-compromised, while the most relevant environmental factors are associated with holiday cruises and mass gatherings. Pre-travel advice should address influenza and its prevention for travellers, whenever appropriate on the basis of the epidemiological situation concerned. Preventative measures should be strongly recommended for travellers at high-risk for developing complications. In addition, seasonal influenza vaccination should be considered for any traveller wishing to reduce the risk of incapacitation, particularly cruise ship crew and passengers, as well as those participating in mass gatherings. Besides advice concerning preventive measures and vaccination, advice on the use of antivirals may be considered for some travellers. © International Society of

Travel risk behaviors as a determinants of receiving pre-travel health consultation and prevention.

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Shady, Ibrahim; Gaafer, Mohammed; Bassiony, Lamiaa

2015-01-01

An estimated 30-60 % of travelers experience an illness while traveling. The incidence of travel-related illness can be reduced by preventive measures such as those provided by the Traveler Health Clinic (THC) in Kuwait. The present study is an analytical comparative study between groups of travelers visiting the THC during the study period (May 2009 - December 2010) and an age- and gender-matched control group of non-visitors (800 people). Both groups completed a modified pre-departure questionnaire. Bivariate analysis revealed that Kuwaitis (68.2 %), those traveling for work (25.3 %) or leisure (59.5 %), those living in camps (20.4 %) or hotels (64.0 %), and those with knowledge of the THC from the media (28.1 %) or other sources (57.3 %), were more likely to be associated with a high frequency of visits to the THC ( p  travelers heading to Africa (47 %) and South America (10 %) visited the THC more than did others ( P  travel, duration of stay, and choice of travel destination are independent predictors of receiving pre-travel consultation from the THC. Nationality, purpose of travel, length of stay, and travel destination are predictors for receiving a pre-travel consultation from the THC.

Pre-travel care for immunocompromised and chronically ill travellers: A retrospective study

NARCIS (Netherlands)

van Aalst, Mariëlle; Verhoeven, Roos; Omar, Freshta; Stijnis, Cornelis; van Vugt, Michèle; de Bree, Godelieve J.; Goorhuis, Abraham; Grobusch, Martin P.

2017-01-01

Background: Immunocompromised and chronically ill travellers (ICCITs) are susceptible to travel related diseases. In ICCITs, pre-travel care regarding vaccinations and prophylactics is complex. We evaluated the protection level by preventive measures in ICCITs by analysing rates of vaccination

Effectiveness of pre-travel consultation in the prevention of travel-related diseases: a retrospective cohort study.

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Tafuri, Silvio; Guerra, Rocco; Gallone, Maria Serena; Cappelli, Maria Giovanna; Lanotte, Serafina; Quarto, Michele; Germinario, Cinzia

2014-01-01

This study aims to evaluate the effectiveness of pre-travel counselling carried out in Travel Clinics. This is a retrospective cohort. Three hundred international travellers were enrolled; 150 people were from users of Bari Travel Clinic, 150 were users of a travel agency. Enrolled subjects were interviewed using a questionnaire. The average age of the enrolled subjects was 37.5 ± 13.9, without statistically significant differences between the two groups. 86% of cases and 19.3% of the controls reported the use of anti-malaria prophylaxis (p Travel Clinic users, 6% reported diarrhoea and these figures were 27% in the control group (p study demonstrated the effectiveness of pre-travel counselling; in the future, new studies must investigate the cost-effectiveness of pre-travel prevention measures.

Thromboembolic disease and air travel in pregnancy: a survey of advice given by obstetricians.

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Voss, M; Cole, R; Moriarty, T; Pathak, Mamta; Iskaros, J; Rodeck, C

2004-11-01

The objective of this study was to document the awareness of risk and the nature of advice given by obstetricians to pregnant women who intend to travel by air and to compare the results with the advice given in an opinion paper of the Royal College of Obstetricians and Gynaecologists. The results were based on a self-completed questionnaire. All registered members of the Royal College of Obstetricians and Gynaecologists comprising 1349 individuals, obtained from a list provided by the RCOG, were invited to participate. An anonymous postal questionnaire was completed by the individuals before publication of the opinion paper of the RCOG. A total of 862 (62%) questionnaires returned, and 690 (51%) were available for analysis; 67% of obstetricians regard flying as being safe throughout pregnancy, 33% only in the 2nd and 3rd trimester. Nearly all obstetricians advised on simple prophylactic measures such as mobilisation, fluid intake and leg exercise. Fifty-three per cent would advise the use of prophylactic aspirin (75 mg), 49% the use of compression stockings; 4% recommended heparinisation; 44% believed this advice to be applicable only for the 2nd and 3rd trimester, while the RCOG emphasises that the risk of developing venous thromboembolism begins in the 1st trimester. Obstetricians as well as other health professionals need to be made aware that advice on air travel in pregnancy needs to start in the 1st trimester. Further research is needed to explore the relevance of the duration of flight when considering the application of thromboprophylactic measures as well as the value and choice of pharmacological treatment such as aspirin and heparin.

Advice to Travelers

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Barrett-Connor, Elizabeth

1975-01-01

Travelers, particularly those whose tastes or occupations lead to deviation from the usual tourist routes, are at a small but significant risk of acquiring certain diseases they would be unlikely to encounter had they remained in the continental United States. Many of these infections can be rendered unlikely even for the most adventuresome traveler through the appropriate use of immunization and chemoprophylaxis. Other infections are currently unpreventable and the physician's responsibility lies in their premorbid detection. PMID:1154779

Risk factors and pre-travel healthcare of international travellers attending a Dutch travel clinic: a cross-sectional analysis.

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Wieten, Rosanne W; van der Schalie, Maurice; Visser, Benjamin J; Grobusch, Martin P; van Vugt, Michèle

2014-01-01

The number of international travellers is currently estimated to exceed one billion annually. To address travel related health risks and facilitate risk reduction strategies, detailed knowledge of travellers' characteristics is important. In this cross-sectional study, data of a 20% sample of travellers visiting the Academic Medical Center (AMC) travel clinic Amsterdam from July 2011 to July 2012 was collected. Itineraries and protection versus exposure rates of preventable infectious diseases were mapped and reported according to STROBE guidelines. 1749 travellers were included. South-Eastern Asia, South-America and West-Africa were most frequently visited. 26.2% of the population had pre-existing medical conditions (often cardiovascular). Young and VFR travellers had a longer median travel time (28 and 30 days) compared to the overall population (21 days). Young adult travellers were relatively often vaccinated against hepatitis B (43.9% vs. 20.5%, p travellers. Pre-travel guidelines were well adhered to. Young adult travellers had high-risk itineraries but were adequately protected. Improvement of hepatitis B and rabies protection would be desirable, specifically for VFRs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Expatriates ill after travel: results from the Geosentinel Surveillance Network.

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Lim, Poh-Lian; Han, Pauline; Chen, Lin H; MacDonald, Susan; Pandey, Prativa; Hale, DeVon; Schlagenhauf, Patricia; Loutan, Louis; Wilder-Smith, Annelies; Davis, Xiaohong M; Freedman, David O

2012-12-31

Expatriates are a distinct population at unique risk for health problems related to their travel exposure. We analyzed GeoSentinel data comparing ill returned expatriates with other travelers for demographics, travel characteristics, and proportionate morbidity (PM) for travel-related illness. Our study included 2,883 expatriates and 11,910 non-expatriates who visited GeoSentinel clinics ill after travel. Expatriates were more likely to be male, do volunteer work, be long-stay travelers (>6 months), and have sought pre-travel advice. Compared to non-expatriates, expatriates returning from Africa had higher proportionate morbidity (PM) for malaria, filariasis, schistosomiasis, and hepatitis E; expatriates from the Asia-Pacific region had higher PM for strongyloidiasis, depression, and anxiety; expatriates returning from Latin America had higher PM for mononucleosis and ingestion-related infections (giardiasis, brucellosis). Expatriates returning from all three regions had higher PM for latent TB, amebiasis, and gastrointestinal infections (other than acute diarrhea) compared to non-expatriates. When the data were stratified by travel reason, business expatriates had higher PM for febrile systemic illness (malaria and dengue) and vaccine-preventable infections (hepatitis A), and volunteer expatriates had higher PM for parasitic infections. Expatriates overall had higher adjusted odds ratios for latent TB and lower odds ratios for acute diarrhea and dermatologic illness. Ill returned expatriates differ from other travelers in travel characteristics and proportionate morbidity for specific diseases, based on the region of exposure and travel reason. They are more likely to present with more serious illness.

Risk of potentially rabid animal exposure among foreign travelers in Southeast Asia.

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Watcharapong Piyaphanee

Full Text Available BACKGROUND: Each year millions of travelers visit Southeast Asia where rabies is still prevalent. This study aimed to assess the risk of rabies exposure, i.e., by being bitten or licked by an animal, among travelers in Southeast Asia. The secondary objective was to assess their attitudes and practices related to rabies. METHODOLOGY/PRINCIPAL FINDINGS: Foreign travelers departing to the destination outside Southeast Asia were invited to fill out the study questionnaire in the departure hall of Bangkok International Airport. They were asked about their demographic profile, travel characteristics, pre-travel health preparations, their possible exposure and their practices related to rabies during this trip. From June 2010 to February 2011, 7,681 completed questionnaires were collected. Sixty-two percent of the travelers were male, and the median age was 32 years. 34.0% of the participants were from Western/Central Europe, while 32.1% were from East Asia. Up to 59.3% had sought health information before this trip. Travel clinics were the source of information for 23.6% of travelers. Overall, only 11.6% of the participants had completed their rabies pre-exposure prophylaxis, and 15.3% had received only 1-2 shots, while 73.1% had not been vaccinated at all. In this study, the risk of being bitten was 1.11 per 100 travelers per month and the risk of being licked was 3.12 per 100 travelers per month. Among those who were bitten, only 37.1% went to the hospital to get post exposure treatment. Travelers with East Asian nationalities and longer duration of stay were significantly related to higher risk of animal exposure. Reason for travel was not related to the risk of animal exposure. CONCLUSIONS: Travelers were at risk of being exposed to potentially rabid animals while traveling in Southeast Asia. Many were inadequately informed and unprepared for this life-threatening risk. Rabies prevention advice should be included in every pre-travel visit.

Travel itinerary uncertainty and the pre-travel consultation--a pilot study.

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Flaherty, Gerard; Md Nor, Muhammad Najmi

2016-01-01

Risk assessment relies on the accuracy of the information provided by the traveller. A questionnaire was administered to 83 consecutive travellers attending a travel medicine clinic. The majority of travellers was uncertain about destinations within countries, transportation or type of accommodation. Most travellers were uncertain if they would be visiting malaria regions. The degree of uncertainty about itinerary potentially impacts on the ability of the travel medicine specialist to perform an adequate risk assessment, select appropriate vaccinations and prescribe malaria prophylaxis. This study reveals high levels of traveller uncertainty about their itinerary which may potentially reduce the effectiveness of their pre-travel consultation. © The Author 2016. Published by Oxford University Press on behalf of International society of travel medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Travelers' knowledge, attitudes and practices on the prevention of infectious diseases: results from a study at Johannesburg International Airport.

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Toovey, Stephen; Jamieson, Andrew; Holloway, Michele

2004-01-01

Although Johannesburg International Airport (JIA) acts as a hub for travel into Africa, little was known of the knowledge, attitudes, and practices (KAP) with respect to infectious disease prevention of departing travelers. The study was conducted among departing passengers at JIA from August to October 2003. Travelers aged at least 18 years, resident in non-malarious developed countries and departing from JIA for risk destinations, were given either a malaria (Q-mal, n=219) or vaccine-preventable disease (Q-vac, n=200) questionnaire. European Travel Health Advisory Board traveler KAP questionnaires were used. African destinations accounted for 99% of the total. Traveler mean age was 42 years, with 30% aged 50 years or above. Leisure (42%) and business (37%) were the commonest travel reasons; 8% of subjects were visiting friends or relatives. Forty-six per cent of travelers prepared for their trip at least 1 month in advance; 86% had sought pre-travel health advice, with travel clinics and the Internet being rated highest by travelers for quality of advice. World Health Organization immunization guidelines were followed poorly: only 37% and 27%, respectively, of travelers had demonstrable proof of protection against hepatitis A and B, with 40% of all Q-vac travelers unable to produce a vaccination certificate. Of travelers to yellow fever- endemic countries, 76% were able to produce a valid vaccination certificate; 22% of travelers to countries not endemic for yellow fever had nevertheless been specifically immunized against yellow fever for their journeys. Forty-nine per cent of Q-mal travelers carried either no or inappropriate antimalarials. Considerable deficiencies in KAP were documented with regard to travel vaccinations and malaria protection in travelers departing JIA. Improved vaccine uptake and antimalarial prescribing are required for travelers to Africa.

Quality of travel health advice in higher-education establishments in the United Kingdom and its relationship to the demographic background of the provider.

Science.gov (United States)

Porter, J F Hugh; Knill-Jones, Robin P

2004-01-01

The number of international trips undertaken by residents of the United Kingdom has risen dramatically over the past 50 years. Likewise, the numbers studying in higher education have also shown a huge increase. This study aimed to assess the appropriateness of advice given to traveling students by higher education-based health services and to relate this to the demography and experience of the professionals involved. A postal questionnaire describing three hypothetical groups of students traveling to different parts of the world was sent to 335 doctors and nurses. These clinicians belonged to the British Association of Health Services in Higher Education. They worked in 105 practices that serve higher-educational establishments in the United Kingdom. Main outcome measures included whether appropriate immunizations were advised and given correctly through the National Health Service (NHS) or privately, and whether appropriate advice was given regarding malaria, human immunodeficiency virus (HIV), and miscellaneous risks. The sources of information used to advise travelers were also asked, and the effect of demographic characteristics of the respondents on the quality of advice was investigated. Two hundred fifteen (64%) questionnaires were returned. The mean score for whether the correct immunizations were advised was 77%, and for whether these were given correctly through the NHS or privately was 79.6%. For malaria, HIV, and miscellaneous risks, the scores were lower at 65%, 38%, and 32%, respectively. The score for correct immunizations was significantly affected by sex, with females respondents scoring higher (p = .036). Previous training in travel medicine improved scores for immunizations (p = .034) and for the correct choice being given through the NHS or privately (p = .006). Age, hours worked, role, and size of practice had no influence on scores. Charts in the general practice free newspapers were the most popular source of information. Practices serving

Expatriates ill after travel: Results from the Geosentinel Surveillance Network

Directory of Open Access Journals (Sweden)

Lim Poh-Lian

2012-12-01

Full Text Available Abstract Background Expatriates are a distinct population at unique risk for health problems related to their travel exposure. Methods We analyzed GeoSentinel data comparing ill returned expatriates with other travelers for demographics, travel characteristics, and proportionate morbidity (PM for travel-related illness. Results Our study included 2,883 expatriates and 11,910 non-expatriates who visited GeoSentinel clinics ill after travel. Expatriates were more likely to be male, do volunteer work, be long-stay travelers (>6 months, and have sought pre-travel advice. Compared to non-expatriates, expatriates returning from Africa had higher proportionate morbidity (PM for malaria, filariasis, schistosomiasis, and hepatitis E; expatriates from the Asia-Pacific region had higher PM for strongyloidiasis, depression, and anxiety; expatriates returning from Latin America had higher PM for mononucleosis and ingestion-related infections (giardiasis, brucellosis. Expatriates returning from all three regions had higher PM for latent TB, amebiasis, and gastrointestinal infections (other than acute diarrhea compared to non-expatriates. When the data were stratified by travel reason, business expatriates had higher PM for febrile systemic illness (malaria and dengue and vaccine-preventable infections (hepatitis A, and volunteer expatriates had higher PM for parasitic infections. Expatriates overall had higher adjusted odds ratios for latent TB and lower odds ratios for acute diarrhea and dermatologic illness. Conclusions Ill returned expatriates differ from other travelers in travel characteristics and proportionate morbidity for specific diseases, based on the region of exposure and travel reason. They are more likely to present with more serious illness.

A cross-sectional study of pre-travel health-seeking practices among travelers departing Sydney and Bangkok airports

OpenAIRE

Heywood Anita E; Watkins Rochelle E; Iamsirithaworn Sopon; Nilvarangkul Kessarawan; MacIntyre C

2012-01-01

Abstract Background Pre-travel health assessments aim to promote risk reduction through preventive measures and safe behavior, including ensuring travelers are up-to-date with their immunizations. However, studies assessing pre-travel health-seeking practices from a variety of medical and non-medical sources and vaccine uptake prior to travel to both developing and developed countries within the Asia-Pacific region are scarce. Methods Cross-sectional surveys were conducted between July and De...

PRT Impact Study Pre-PRT Phase : Volume 1. Travel Analysis.

Science.gov (United States)

1976-03-01

Part of a three-volume work, this report describes the analysis performed on travel data collected for the Pre-PRT Impact Study. The data analyzed consist of travel behavior, travel patterns, model utilization and travel costs of various modes of tra...

[Accidents in travellers - the hidden epidemic].

Science.gov (United States)

Walz, Alexander; Hatz, Christoph

2013-06-01

The risk of malaria and other communicable diseases is well addressed in pre-travel advice. Accidents are usually less discussed. Thus, we aimed at assessing accident figures for the Swiss population, based on data of the register from 2004 to 2008 of the largest Swiss accident insurance organization (SUVA). More than 139'000 accidents over 5 years showed that 65 % of the accidents overseas are injuries, and 24 % are caused by poisoning or harm by cold, heat or air pressure. Most accidents happened during leisure activities or sports. More than one third of the non-lethal and more than 50 % of the fatal accidents happened in Asia. More than three-quarters of non-lethal accidents take place in people between 25 and 54 years. One out of 74 insured persons has an accident abroad per year. Despite of many analysis short-comings of the data set with regard to overseas travel, the figures document the underestimated burden of disease caused by accidents abroad and should affect the given pre-health advice.

Did public health travel advice reach EURO 2012 football fans? A social network survey.

Science.gov (United States)

Janiec, J; Zielicka-Hardy, A; Polkowska, A; Rogalska, J; Sadkowska-Todys, M

2012-08-02

We posted a survey on the Union of European Football Associations (UEFA)’s EURO 2012 Facebook profile to evaluate whether public health travel advice, specifically on the importance of measles vaccination,reached fans attending EURO 2012. Responses suggested that these messages were missed by 77% of fans. Social networks could serve as innovative platforms to conduct surveys, enabling rapid access to target populations at low cost and could be of use during upcoming mass gatherings such as the Olympics.

41 CFR 301-75.102 - What pre-employment interview travel expenses are not payable?

Science.gov (United States)

2010-07-01

... interview travel expenses are not payable? 301-75.102 Section 301-75.102 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 75-PRE-EMPLOYMENT INTERVIEW TRAVEL Travel Expenses § 301-75.102 What pre-employment interview travel...

Telemedicine for health issues while abroad: interest and willingness to pay among travellers prior to departure.

Science.gov (United States)

Rochat, Laurence; Genton, Blaise

2018-01-01

Telemedicine is emerging as a useful tool to provide expert medical advice to individuals facing health issues while travelling in remote areas. Before embarking on the development of a telemedicine system, we conducted a survey to assess the needs and expectations of travellers for such a service, and evaluate opinions about the importance of various travel criteria that may determine the contract of such insurance. (i) To assess whether a telemedicine service is considered useful by travellers, (ii) to investigate which telecommunication medium is preferred, (iii) to determine which subgroup of travellers would be most interested in this service and (iv) to estimate the amount of money travellers would be willing to pay for a telemedicine service. Travellers coming to our clinic for pre-travel advice were given a questionnaire to be filled in before consultation. The questionnaire focused on demographics, travel details, health status, interest and willingness to pay for a telemedicine service. Among 307 returned questionnaires, 59% of travellers were interested in a telemedicine service. Email was the preferred communication medium for 63%, mobile phone for 46% and video calls for 31% individuals (multiple answers). Travellers aged ≥60 years and those with an immunocompromising condition tended to be more interested in telemedicine (respectively OR = 1.65; 95% CI: 0.75-3.62 and OR = 3.56; 95% CI: 0.41-30.95). The 99% of travellers were willing to pay for such a service. Median price was 50 USD (IQR: 30-50 USD). There was no correlation between travel duration and amount to be paid. Among individuals consulting for pre-travel advice at a specialized clinic, there is considerable interest in telemedicine, particularly among older and immunocompromised travellers. Based on these data, a pilot system using email communication to help travellers confronted with health issues while abroad was developed and implemented in our travel clinic.

41 CFR 301-75.101 - What pre-employment interview travel expenses may we pay?

Science.gov (United States)

2010-07-01

... interview travel expenses may we pay? 301-75.101 Section 301-75.101 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 75-PRE-EMPLOYMENT INTERVIEW TRAVEL Travel Expenses § 301-75.101 What pre-employment interview travel expenses may we...

Factors influencing adherence to referral advice following pre-referral treatment with artesunate suppositories in children in rural Tanzania.

Science.gov (United States)

Simba, Daudi O; Warsame, Marian; Kimbute, Omari; Kakoko, Deodatus; Petzold, Max; Tomson, Goran; Premji, Zul; Gomes, Melba

2009-07-01

WHO recommends artemisinin suppository formulations as pre-referral treatment for children who are unable to take oral medication and cannot rapidly reach a facility for parenteral treatment. We investigated factors influencing caretakers' adherence to referral advice following pre-referral treatment of their children with rectal artesunate suppositories. The study was nested within an intervention study that involved pre-referral treatment of all children who came to a community dispenser for treatment because they were unable to take oral medications because of repeated vomiting, lethargy, convulsions or altered consciousness. All patients who did not comply with referral advice were stratified by actions taken post-referral: taking their children to a drug shop, a traditional healer, or not seeking further treatment, and added to a random selection of patients who complied with referral advice. Caretakers of the children were interviewed about their socio-economic status (SES), knowledge about malaria, referral advice given and actions they took following pre-referral treatment. Interview data for 587 caretakers were matched with symptoms of the children, the time of treatment, arrival at a health facility or other actions taken post-pre-referral treatment. The majority (93.5%) of caretakers reported being given referral advice by the community drug dispenser. The odds of adherence with this advice were three times greater for children with altered consciousness and/or convulsions than for children with other symptoms [odds ratio (OR) 3.47, 95% confidence interval (CI) 2.32-5.17, P < 0.001]. When questioned, caretakers who remembered when (OR 2.19, 95% CI 1.48-3.23, P < 0.001) and why (OR 1.77, 95% CI 1.07-2.95, P = 0.026) they were advised to proceed to health facility - were more likely to follow referral advice. Cost did not influence adherence except within a catchment area of facilities that charged for services. In these areas, costs deterred adherence by

Does the use of alcohol-based hand gel sanitizer reduce travellers' diarrhea and gastrointestinal upset?: A preliminary survey.

Science.gov (United States)

Henriey, Delphine; Delmont, Jean; Gautret, Philippe

2014-01-01

Use of alcohol-based hand sanitizer is recommended by the CDC to reduce the risk for travellers' diarrhoea, but its effectiveness has not been assessed. We investigated the potential protective effect of hand sanitizer use on the occurrence of diarrhoea and/or vomiting in 200 international travellers, who were returning home, at an international airport. We also conducted a knowledge, aptitude and practice survey about hand gel use among international travellers consulting for pre-travel advice at a specialized clinic. 200 returning travellers were included of which 32.5% declared having used alcohol-based hand sanitizer during travel. Travellers who used hand sanitizer reported diarrhoea and vomiting significantly less frequently than those who did not (17% vs. 30%, OR = 0.47; 95% CI [0.21-0.97], p = 0.04). A total of 257 travellers consulting for pre-travel advice were included. A majority of travellers knew that hand sanitizer may be used for hand hygiene and had already used hand sanitizer; 72% planned to bring hand sanitizer during their next travel. Use of hand sanitizer is highly acceptable by travellers and is associated with a reduction in the incidence of travellers' diarrhoea and/or vomiting. Copyright © 2014 Elsevier Ltd. All rights reserved.

Prevalence of travel related illness amongst a group of Chinese undergraduate students in Hong Kong.

Science.gov (United States)

Abdullah AS, A M; Hedley, A J; Fielding, R

2000-01-01

Regional and global travel by Asian residents is increasing. Young people seeking new experiences through travel may be particularly at risk of a wide spectrum of health problems. This study assesses travel-associated health risks and examines the prevalence and likely impact of pretravel health advice among Chinese undergraduate students in Hong Kong. Year 1 and year 3 undergraduate students of the University of Hong Kong were surveyed during September to December 1996, using a structured self-administered questionnaire. A total of 1,067 subjects were required to give a power of 95% (p =.50+/-3%). Of 1,197 students (514 male and 680 female) surveyed, 52% had traveled outside Hong Kong at least once within the previous 12 months. Of these travelers (n = 578), 41% had developed one or more health problems, 7% had to consult a doctor and 2% needed hospitalization during travel, and 8% developed health problems within 2 weeks of returning for which they had to consult a doctor. Most (75%) took no pretravel health advice and 48% took no travel health precautions. About half (41%) of those who received advice received this from nonexpert sources. Those more likely to develop health problems were aged over 20 years (Odds Ratio, 1.49, 95% confidence interval, 1.06-2.10), in financial difficulties (1.60, 1.02-2.51), ever-smokers (1.69, 1.03-2.77), reporting poorer current health status (1.64, 1.04-2.57). Also, those who sought health advice from nonprofessional sources (2.13, 1.03-4.01) and took precautions (1.88, 1.33-2.63) were more likely to develop health problems. This study demonstrated that young Chinese adults, with the benefits of higher education, are potentially at risk of a variety of avoidable travel-related health problems. Taking pretravel health advice from nonprofessional sources was common among respondents, but taking precautions did not reduce health problems. The comprehensibility and effectiveness of the advice and appropriateness of precautions taken

The quantified self during travel: mapping health in a prospective cohort of travellers.

Science.gov (United States)

Farnham, Andrea; Furrer, Reinhard; Blanke, Ulf; Stone, Emily; Hatz, Christoph; Puhan, Milo A

2017-09-01

Travel medicine research has remained relatively unchanged in the face of rapid expansion of international travel and is unlikely to meet health challenges beyond infectious diseases. Our aim was to identify the range of health outcomes during travel using real-time monitoring and daily reporting of health behaviours and outcomes and identify traveller subgroups who may benefit from more targeted advice before and during travel. We recruited a prospective cohort of travellers ≥ 18 years and planning travel to Thailand for travel clinics in Zurich and Basel (Switzerland). Participants answered demographic, clinical and risk behaviour questionnaires pre-travel and a daily health questionnaire each day during travel using a smartphone application. Environmental and location data were collected passively by GPS. Classification trees were used to identify predictors of health behaviour and outcomes during travel. Non-infectious disease events were relatively common, with 22.7% (17 out of 75 travellers) experiencing an accident, 40.0% ( n  = 30) a wound or cut and 14.7% ( n  = 11) a bite or lick from an animal. Mental health associated events were widely reported, with 80.0% ( n  = 60) reporting lethargy, 34.7% ( n  = 26) anxiety and 34.7% ( n  = 26) feeling tense or irritable. Classification trees identified age, trip length, previous travel experience and having experienced a sports injury in the past year as the most important discriminatory variables for health threats. Our study offers a revolutionary look at an almost real-time timeline of health events and behaviours during travel using mHealth technology. Non-infectious disease related health issues were common in this cohort, despite being largely unaddressed in traditional travel medicine research and suggest a substantial potential for improving evidence-based travel medicine advice. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights

[Travel medicine for HIV-infected patients].

Science.gov (United States)

Rossi, M; Furrer, H

2001-06-01

Many HIV-infected persons travel from temperate zones to (sub)tropical destinations. HIV-specific immigration issues, medical resources abroad and problems regarding travelling with multiple medications have to be anticipated. When prescribing immunizations and specific chemoprophylaxis, the stage of immunodeficiency as well as drug interactions with antiretrovirals and medicaments against opportunistic infections have to be taken into account. Live vaccines may be contraindicated. Immunocompromised HIV-infected travellers have a higher risk for serious courses of diseases by enteropathogens. Therefore a good information about food hygiene is important and a prescription of an antibiotic to take in case of severe diarrhea may be indicated. A new antiretroviral combination therapy should not be started immediately before travelling to the tropics. The possibility to continue an established HIV treatment during travel has to be evaluated cautiously. With good pre-travel advice the risk of severe health problems is low for most HIV-infected travellers.

Health risks, travel preparation, and illness among public health professionals during international travel.

Science.gov (United States)

Balaban, Victor; Warnock, Eli; Ramana Dhara, V; Jean-Louis, Lee Ann; Sotir, Mark J; Kozarsky, Phyllis

2014-01-01

Few data currently exist on health risks faced by public health professionals (PHP) during international travel. We conducted pre- and post-travel health surveys to assess knowledge, attitudes, and practices (KAP), and illnesses among PHP international travelers. Anonymous surveys were completed by PHP from a large American public health agency who sought a pre-travel medical consult from September 1, 2009, to September 30, 2010. Surveys were completed by 122 participants; travelers went to 163 countries. Of the 122 respondents, 97 (80%) reported at least one planned health risk activity (visiting rural areas, handling animals, contact with blood or body fluids, visiting malarious areas), and 50 (41%) reported exposure to unanticipated health risks. Of the 62 travelers who visited malarious areas, 14 (23%) reported inconsistent or no use of malaria prophylaxis. Illness during travel was reported by 33 (27%) respondents. Most of the PHP travelers in our study reported at least one planned health risk activity, and almost half reported exposure to unanticipated health risks, and one-quarter of travelers to malarious areas reported inconsistent or no use of malaria chemoprophylaxis. Our findings highlight that communication and education outreach for PHP to prevent travel-associated illnesses can be improved. Published by Elsevier Ltd.

A survey of the health experiences of international business travelers. Part One--Physiological aspects.

Science.gov (United States)

Rogers, H Lynn; Reilly, Sandra M

2002-10-01

Occupational health professionals need to know more about the health, worklife, and family life of international business travelers (IBTs). This descriptive correlational study, in two parts, examines the physiological and psychosocial experiences associated with business travel for a sample of 140 employees from western Canada's oil and gas industry. Results for Part One show that 76% of IBTs report travel related health problems, 74% have jet lag, 45% have travelers' diarrhea and gastrointestinal complaints, 12% to 16% have climate adaptation problems, and 2% report accidents and minor injuries. High risk behaviors include not carrying a first aid travel kit (54%); drinking more alcohol than ordinarily (21%); and neglecting food, water, and antimalarial precautions (6% to 14%). Other risk factors include age, length of stay, destination, pre-travel medical examinations, pre-travel advice, and eating and accommodation facilities. Findings show that IBTs are at risk for travel related physiological health problems. Implications for practitioners call for increased occupational health expertise in pre-travel preparation, follow up post-travel and regular health surveillance for employees who travel on international business.

Pre-travel health advice for human immunodeficiency virus-infected travelers, from Rio de Janeiro Aconselhamento pré-viagem para os viajantes infectados pelo vírus da imunodeficiência humana no Rio de Janeiro

Directory of Open Access Journals (Sweden)

Ricardo Pereira Igreja

2009-06-01

Full Text Available Counseling for human immunodeficiency virus infected travelers is becoming increasingly specialized. Previous studies have reported the experience of HIV-infected travelers from temperate-climate countries but little is known about HIV-infected travelers from tropical countries. A retrospective study was conducted on HIV-infected travelers presenting at a travel health clinic in Rio de Janeiro. Eleven journeys by ten people were recorded. Brazil (Amazon region and Northeast was the destination for six journeys. Other destinations were Peru, Angola, Europe and Asia. Nine attendees were undergoing antiretroviral therapy. Few HIV-infected people from Rio de Janeiro consulted a travel medicine specialist before traveling. Since they travel to destinations in Brazil and abroad where there are endemic diseases not encountered in Rio de Janeiro, careful pre-travel planning needs to be undertaken. Strategies for increasing the frequency of pre-travel consultations need to be developed, such as closer collaboration between HIV clinics and travel health clinics.O aconselhamento para os viajantes infectados pelo vírus da imunodeficiência humana está se especializando cada vez mais. Estudos prévios relatam a experiência dos viajantes infectados pelo vírus da imunodeficiência humana dos países de clima temperado, mas pouco se sabe sobre os viajantes infectados pelo vírus da imunodeficiência humana dos países tropicais. Foi realizado um estudo retrospectivo dos viajantes infectados pelo vírus da imunodeficiência humana que consultaram um serviço de medicina de viagem no Rio de Janeiro. Dez viajantes realizaram onze viagens. O Brasil (Amazônia e Nordeste foi o destino de seis viagens. Outros destinos foram Peru, Angola, Europa e Ásia. Nove pacientes estavam sob terapia anti-retroviral. No Rio de Janeiro, poucas pessoas infectadas pelo vírus da imunodeficiência humana consultaram um especialista em medicina de viagem antes de viajar. Como elas

41 CFR 301-75.2 - May we pay pre-employment interview travel expenses?

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false May we pay pre-employment interview travel expenses? 301-75.2 Section 301-75.2 Public Contracts and Property Management...-EMPLOYMENT INTERVIEW TRAVEL General Rules § 301-75.2 May we pay pre-employment interview travel expenses? Yes...

HIV, Other Blood-Borne Viruses and Sexually Transmitted Infections amongst Expatriates and Travellers to Low- and Middle-Income Countries: A Systematic Review

Science.gov (United States)

Crawford, Gemma; Lobo, Roanna; Brown, Graham; Macri, Chloe; Smith, Hannah; Maycock, Bruce

2016-01-01

In some high-income countries, a proportion of human immunodeficiency virus (HIV), other blood-borne virus (BBV) or sexually transmitted infection (STI) diagnoses have been reported as acquired overseas in low- and middle-income countries. A review was conducted to explore HIV, other BBV or STI related knowledge, risk behavior and acquisition amongst expatriates and travelers, particularly males, travelling from high to low- and middle-income countries. Seven academic databases were searched for 26 peer reviewed articles that met inclusion criteria. Significant variability in the studies was noted, in age, travel duration and frequency and outcomes/risk factors measured and reported on. Risk factors described included longer duration of stay; being single; travel for romance or sex; alcohol and other drug use; lack of travel advice; being male; higher number of sexual partners; and inconsistent condom use. Vaccination, pre-travel health advice, and having fewer sexual partners were described as protective. Studies are needed focusing on the social context in which risk-taking occurs. Better collaboration is essential to deliver comprehensive health promotion interventions alongside more consistent pre- and post- travel testing and advice. Policy measures are crucial, including consistent evaluation indicators to assess impacts of HIV, other BBVs or STIs in the context of mobility. Risks and responses for these epidemics are shared globally. PMID:27999275

Use of pre-travel vaccine-preventable disease serology as a screening tool to identify patients in need of pre-travel vaccination: a retrospective audit.

Science.gov (United States)

Turner, David P; McGuinness, Sarah L; Cohen, Jonathan; Waring, Lynette J; Leder, Karin

2017-05-01

Vaccination is a safe and effective public health intervention that not only protects individual travellers from vaccine-preventable diseases (VPDs), but prevents them from becoming a source of disease in their destination and on their return. Obtaining an accurate vaccination history from travellers during a pre-travel review can be difficult; serology may be used to identify patients who are non-immune to specific diseases in order to guide vaccination requirements. Clinically relevant data about the usefulness of serology in this setting are lacking. We performed a retrospective audit of pre-travel VPD serology requested by practitioners of a busy community-based travel clinic. All serological results for measles, mumps, rubella, varicella zoster virus, hepatitis A and B requested over a 5-year period were extracted and analysed. Results were stratified by gender and year of birth and compared using Stata. Four thousand four hundred and fifty-one serological assays from 1445 individual were assessed. Overall, 47% of patients tested had at least one negative serological result. High rates of seropositivity for measles, mumps and rubella were seen in those born prior to 1966 but >10% of travellers born after 1966 lacked serological evidence of protection against these diseases. Hepatitis A and B serological results revealed broadly lower rates of immunity in our community likely reflecting the absence of these vaccines from historical vaccine protocols. Serology can be a useful tool in the identification of non-immune travellers to enable targeted vaccination prior to travel. We recommend that travel health clinicians assess patients' vaccination and infection histories, and strongly consider serology or vaccination where there is doubt about immunity. This will help protect the traveller and prevent importation of disease into destination or home communities. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights

41 CFR 301-75.100 - Must we pay all of the interviewee's pre-employment interview travel expenses?

Science.gov (United States)

2010-07-01

... interviewee's pre-employment interview travel expenses? 301-75.100 Section 301-75.100 Public Contracts and... RESPONSIBILITIES 75-PRE-EMPLOYMENT INTERVIEW TRAVEL Travel Expenses § 301-75.100 Must we pay all of the interviewee's pre-employment interview travel expenses? If you decide to pay the interviewee per diem or common...

Common ailments observed among students and their parents during travel.

Science.gov (United States)

Sweni, Shah; Muthusundari, Arunachalam; Meenakshisundaram, Ramachandran; Thirumalaikolundusubramanian, Ponniah

2009-09-01

Vast majority of Indians travel for religious, cultural and socio-economic purposes either alone or with families. The present study attempts to elicit the travel related health issues experienced by college students (youth) and their parents (elderly) during travel, to identify the variations between youth and elderly, and to suggest remedial measures. A total of 400 college students (age range 17-25; mean age 21) and 330 of their parents (age range 39-64; mean age 49) were included in the study. After a brief introduction to the study, a pretested structured anonymous questionnaire was distributed and completed. The data was analyzed statistically. Ailments were significantly (pstudents (youth) and were attributed to co-existing or exacerbation of pre-existing illnesses, stress of travel and waning immunity. None carried medical insurance or took pre-travel advice. Less than 21% of students and more than 70% of parents carried medicines for common ailments during travel. Also, parents carried personal protective materials significantly more than their wards. A joint effort by health care professionals, travel agents, government and media towards community education may decrease the travel related ailments/illnesses.

41 CFR 301-75.4 - What other responsibilities do we have for pre-employment interview travel?

Science.gov (United States)

2010-07-01

... responsibilities do we have for pre-employment interview travel? 301-75.4 Section 301-75.4 Public Contracts and... RESPONSIBILITIES 75-PRE-EMPLOYMENT INTERVIEW TRAVEL General Rules § 301-75.4 What other responsibilities do we have for pre-employment interview travel? You must: (a) Provide your interviewees with a list of FEMA...

Uncertainty and sensitivity results for pre-waste-emplacement groundwater travel time

International Nuclear Information System (INIS)

Kaplan, P.G.

1992-01-01

In this paper uncertainty and sensitivity analyses for pre-waste-emplacement groundwater travel time conducted. Although preliminary, a numbed of interesting results were obtained. Uncertainty in the ground water travel time statistics, as measured by the coefficient of variation, increases and then decrease as the modeled system transitions from matrix-dominated to fracture-dominated flow. The uncertainty analysis also suggests that the median, as opposed to the mean, may be a better indicator of performance with respect to the regulatory criterion. The sensitivity analysis shows a strong correlation between an effective fracture property, fracture porosity, and failure to meet the regulatory pre-waste-emplacement groundwater travel time criterion of 1,000 years

The quality of travel clinics in the Netherlands

NARCIS (Netherlands)

Moerland, Wendy; Koeman, Susan C.; van den Hoek, Anneke; Warris-Versteegen, Anita A.; Inspector, Health; Overbosch, David; Sonder, Gerard J. B.

2006-01-01

In 1996, the Dutch National Coordination Center for Travelers' Health Advice (LCR) was established to improve uniformity in health advice to travelers and in the quality of national vaccination centers. In this study, we evaluate the influence of LCR guidelines on the quality of travel clinics in

Pre-travel preparation practices among business travellers to tropical and subtropical destinations: results from the Athens International Airport Survey.

Science.gov (United States)

Pavli, Androula; Silvestros, Chrysovalantis; Patrinos, Stavros; Lymperi, Ioanna; Maltezou, Helena C

2014-01-01

The number of business travellers from Greece to tropical and subtropical areas has recently increased. The study aimed to assess travel health preparation practices of business travellers departing to Africa, the Middle East and Asia. A questionnaire-based survey was conducted at Athens International Airport, from 1st of November 2011 to 30th of April 2013. A total of 684 business travellers participated in the study; the majority were men (86.1%), of Greek nationality (95.3%), with tertiary education (90.8%) and employed (98%). Their mean age was 40 years; 62% and 26% of them were 35-49 and 19-34 years of age respectively. 84.8% were travelling alone. Most frequent destinations were the Middle East (46.8%) and sub-Saharan Africa (16%). For 23.5% of the travellers it was their first trip to a tropical or subtropical country. Only 58.8% pursued pre-travel health consultation; vaccination and malaria chemoprophylaxis were administered to 24.7% and 25.7% of the travellers, respectively. Hepatitis A and typhoid vaccination rates were lower than expected (70% and 35%, respectively). Nearly half of the travellers who visited malaria endemic areas did not receive any chemoprophylaxis. Having elementary education level, travelling to the Middle East or North Africa, travelling for less than 1 month duration, and staying in a house or a hotel were associated with a higher probability of not pursuing health consultation. Significant gaps were found in pre-travel health practices of business travellers departing to Africa, the Middle East and Asia. Strategies should be developed in order to improve awareness of business travellers. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Vaccinations and malaria prophylaxis for international travelers].

Science.gov (United States)

Alberer, Martin; Löscher, Thomas

2015-05-01

The prevention of infectious diseases by vaccination and by counselling about malaria prophylaxis is a central aspect of travel medicine. Besides mandatory vaccinations required for entry to certain countries various vaccinations may be indicated depending on destination and type of travel as well as on individual risks of the traveler. In addition, pre-travel counselling should always include a check-up of standard vaccinations. Protection against mosquito bites is the basis of malaria prophylaxis. The addition of chemoprophylaxis is warranted in high risk areas. When regular chemoprophylaxis is not applied it is recommended to carry an appropriate antimalarial drug which can be used for emergency stand-by treatment in case of unexplained fever and when medical attention is not available within 24 hours. Travelers should realize that self-treatment is a first-aid measure and that they should still seek medical advice as soon as possible. © Georg Thieme Verlag KG Stuttgart · New York.

Travel advice for the immunocompromised traveler: prophylaxis, vaccination, and other preventive measures

Directory of Open Access Journals (Sweden)

Patel RR

2015-02-01

Full Text Available Rupa R Patel,1 Stephen Y Liang,1 Pooja Koolwal,2 Frederick Matthew Kuhlmann1 1Division of Infectious Diseases, 2Division of Medical Education, Washington University School of Medicine, St Louis, MO, USA Abstract: Immunocompromised patients are traveling at increasing rates. Physicians caring for these complex patients must be knowledgeable in pretravel consultation and recognize when referral to an infectious disease specialist is warranted. This article outlines disease prevention associated with international travel for adults with human immunodeficiency virus, asplenia, solid organ and hematopoietic transplantation, and other immunosuppressed states. While rates of infection may not differ significantly between healthy and immunocompromised travelers, the latter are at greater risk for severe disease. A thorough assessment of these risks can ensure safe and healthy travel. The travel practitioners’ goal should be to provide comprehensive risk information and recommend appropriate vaccinations or prevention measures tailored to each patient’s condition. In some instances, live vaccines and prophylactic medications may be contraindicated. Keywords: immunocompromised, vaccines, travel, malaria, diarrhea

Family compliance with counseling for children traveling to the tropics.

Science.gov (United States)

Caillet-Gossot, Stéphanie; Laporte, Rémi; Noël, Guilhem; Gautret, Philippe; Soula, Georges; Delmont, Jean; Faucher, Benoit; Parola, Philippe; Osei, Lindsay; Minodier, Philippe

2013-01-01

The number of people, both adults and children, traveling abroad, is on the rise. Some seek counseling at travel medicine centers before departure. A prospective study was conducted among children travel medicine center in Marseille, France, from February 2010 to February 2011. Parents were contacted by telephone 4 weeks after their return, and asked about compliance with pre-travel advice. One hundred sixty-seven children were evaluated after their trip. Compliance with immunizations, malaria chemoprophylaxis, and food-borne disease prevention was 71, 66, and 31%, respectively. Compliance with malaria chemoprophylaxis varied significantly with destination, and was higher for African destinations. Significant features associated with poor compliance with chemoprophylaxis were a trip to Asia or the Indian Ocean, age travel counseling in children traveling overseas was achieved only for drinking bottled water, using repellents, a routine vaccine update, and yellow fever immunization. © 2013 International Society of Travel Medicine.

Reduction of travellers' diarrhoea by WC/rBS oral cholera vaccine in young, high-risk travellers.

Science.gov (United States)

Torrell, Josep Ma Ramon; Aumatell, Cristina Masuet; Ramos, Sergi Morchon; Mestre, Laura Gavaldà; Salas, Carme Micheo

2009-06-19

A bidirectional cohort study investigates whether pre-travel vaccination with whole cell/recombinant B subunit inactivated, killed oral cholera vaccine reduces the incidence of diarrhoea in young adult travellers to high-risk areas. Risk of travellers' diarrhoea was assessed according to destination and reason for travel in high-risk travellers of a travel clinic in Barcelona, Spain. Those at high-risk between January and December 2005 were advised on water/food safety and hygiene. High-risk travellers between January and December 2006 were additionally vaccinated with WC/rBS oral cholera vaccine. Data regarding diarrhoea were gathered by structured telephone interview or e-mailed questionnaire following the travellers' return. The incidence of diarrhoea in the group vaccinated with WC/rBS oral cholera vaccine (n=321) was 17.4%, compared with 39.7% in the non-vaccinated group (n=337) (adjusted risk ratio 0.40). The first episode was significantly shorter in the vaccinated group (mean 2.3 days) than in the non-vaccinated group (mean 3.8 days) (pyoung, high-risk travellers. Vaccination with the WC/rBS oral cholera vaccine as well as food safety and hygiene advice could offer effective means of reducing the risk of diarrhoea while abroad.

41 CFR 301-75.200 - How will we pay for pre-employment interviewee travel expenses?

Science.gov (United States)

2010-07-01

...-employment interviewee travel expenses? 301-75.200 Section 301-75.200 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 75-PRE-EMPLOYMENT INTERVIEW TRAVEL Obtaining Travel Services and Claiming Reimbursement § 301-75.200 How...

41 CFR 301-75.1 - What is the purpose of the allowance for pre-employment interview travel expenses?

Science.gov (United States)

2010-07-01

... the allowance for pre-employment interview travel expenses? 301-75.1 Section 301-75.1 Public Contracts... RESPONSIBILITIES 75-PRE-EMPLOYMENT INTERVIEW TRAVEL General Rules § 301-75.1 What is the purpose of the allowance for pre-employment interview travel expenses? To help you recruit highly qualified individuals. ...

Business travel-associated illness: a GeoSentinel analysis.

Science.gov (United States)

Chen, Lin H; Leder, Karin; Barbre, Kira A; Schlagenhauf, Patricia; Libman, Michael; Keystone, Jay; Mendelson, Marc; Gautret, Philippe; Schwartz, Eli; Shaw, Marc; MacDonald, Sue; McCarthy, Anne; Connor, Bradley A; Esposito, Douglas H; Hamer, Davidson; Wilson, Mary E

2018-01-01

Analysis of a large cohort of business travelers will help clinicians focus on frequent and serious illnesses. We aimed to describe travel-related health problems in business travelers. GeoSentinel Surveillance Network consists of 64 travel and tropical medicine clinics in 29 countries; descriptive analysis was performed on ill business travelers, defined as persons traveling for work, evaluated after international travel 1 January 1997 through 31 December 2014. Among 12 203 business travelers seen 1997-2014 (14 045 eligible diagnoses), the majority (97%) were adults aged 20-64 years; most (74%) reported from Western Europe or North America; two-thirds were male. Most (86%) were outpatients. Fewer than half (45%) reported a pre-travel healthcare encounter. Frequent regions of exposure were sub-Saharan Africa (37%), Southeast Asia (15%) and South Central Asia (14%). The most frequent diagnoses were malaria (9%), acute unspecified diarrhea (8%), viral syndrome (6%), acute bacterial diarrhea (5%) and chronic diarrhea (4%). Species was reported for 973 (90%) of 1079 patients with malaria, predominantly Plasmodium falciparum acquired in sub-Saharan Africa. Of 584 (54%) with malaria chemoprophylaxis information, 92% took none or incomplete courses. Thirteen deaths were reported, over half of which were due to malaria; others succumbed to pneumonia, typhoid fever, rabies, melioidosis and pyogenic abscess. Diarrheal illness was a major cause of morbidity. Malaria contributed substantial morbidity and mortality, particularly among business travelers to sub-Saharan Africa. Underuse or non-use of chemoprophylaxis contributed to malaria cases. Deaths in business travelers could be reduced by improving adherence to malaria chemoprophylaxis and targeted vaccination for vaccine-preventable diseases. Pre-travel advice is indicated for business travelers and is currently under-utilized and needs improvement.

From Livingstone to ecotourism. What's new in travel medicine?

Science.gov (United States)

Houston, S

2000-01-01

To review recent developments in the field of travel medicine and to outline the knowledge and resources family physicians need for providing health advice to travelers headed for tropical or developing countries. Personal files; references from review articles and from a recent textbook of travel medicine; current guidelines on pretravel advice; and a review of the 1996 to 1999 MEDLINE database using "travel medicine" as a term and subject heading, "trave(l)lers' diarrhea" as a text word and subject heading, "immunization + travel," and "malaria + chemo prevention" were used as information sources. Priority was given to randomized controlled trials and recommendations of expert or national bodies. Some elements of travel medicine, such as malaria chemoprophylaxis, have become more complex. Some valuable new preventive measures, such as hepatitis A vaccine, treated bed nets, and antimalarial drugs, have become available. Some health risks, such as cholera, have been overemphasized in the past, whereas others, such as tuberculosis and sexually transmitted diseases, have been underemphasized. Information sources relevant for providing travel health advice have improved and expanded. Canadian evidence-based guidelines addressing most important travel health issues are now available. Travel medicine is a rapidly evolving field. Physicians intending to provide health advice to travelers to high-risk parts of the world should be well prepared and have access to good, up-to-date information.

Knowledge, attitudes, and practices regarding travel health among Muscat International Airport travelers in Oman: Identifying the gaps and addressing the challenges.

Science.gov (United States)

Al-Abri, Seif S; Abdel-Hady, Doaa M; Al-Abaidani, Idris S

2016-06-01

Although the majority of travel-associated communicable diseases can be prevented, the public health burden of these diseases remains significant. Relatively little is known about how travelers know and perceive the health risks associated with travel and how they utilize preventive measures before and while traveling abroad. This study was conducted to determine the level of the knowledge, attitudes, and practices (KAP) of Muscat International Airport travelers about travel health in order to assess the knowledge gap and the need for travel health services in Oman. A cross-sectional study was conducted over a period of 1week using a self-administered questionnaire. The overall level of knowledge about vaccine-preventable diseases, food safety, and preventive measures against insect bites of the participants was inadequate. The practice concerning preventive travel health measures, such as the use of specific immunizations and antimalarial prophylaxis, was very limited, and influenced by some personal and travel-related factors. The inadequate level of travelers' knowledge and poor utilization of travel medicine services highlights the need for the provisions of specialized travel medicine services at the national level and to develop educational materials promoting the importance of pre-travel health advice. Copyright © 2016 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Road traffic and other unintentional injuries among travelers to developing countries

Science.gov (United States)

Stewart, Barclay; Yankson, Isaac Kofi; Afukaar, Francis; Medina, Martha Hijar; Cuong, Pham Viet; Mock, Charles

2015-01-01

Synopsis Injuries result in nearly 6 million deaths and incur 52 million disability-adjusted life years annually, comprising 15% of the global disease burden. More than 90% of this burden occurs in low- and middle-income countries (LMICs). Given this burden, it’s not unexpected that injuries are the leading cause of death among travelers to LMICs, namely from road traffic crashes and drowning. Opportunely, the majority of injuries are preventable. Therefore, pre-travel advice regarding foreseeable dangers and how to avoid them may significantly mitigate injury risk, such as: wearing seatbelts, helmets and personal flotation devices when appropriate; responsibly consuming alcohol; and closely supervising children. Upon return, travelers to LMICs are in a unique position; having shared injury risks while abroad, travelers can advocate for injury control initiatives that might make the world safer for travelers and local populations alike. PMID:26900117

Imported malaria in Finland 1995 to 2008: an overview of surveillance, travel trends, and antimalarial drug sales.

Science.gov (United States)

Guedes, Sandra; Siikamäki, Heli; Kantele, Anu; Lyytikäinen, Outi

2010-01-01

To improve pre-travel advice, we analyzed nationwide population-based surveillance data on malaria cases reported to the National Infectious Disease Register of Finland (population 5.3 million) during 1995 to 2008 and related it to data on traveling and antimalarial drug sales. Surveillance data comprised information on malaria cases reported to the National Infectious Disease Register during 1995 to 2008. Traveling data were obtained from Statistics Finland (SF) and the Association of Finnish Travel Agents (AFTA). SF data included information on overnight leisure trips to malaria-endemic countries during 2000 to 2008. AFTA data included annual number of organized trips during 1999 to 2007. Quarterly numbers of antimalarial drug sales were obtained from the Finnish Medicines Agency. Descriptive and time series analyses were performed. A total of 484 malaria cases (average annual incidence 0.7/100,000 population) were reported; 283 patients were Finnish- and 201 foreign-born. In all, 15% of all cases were children; 72% foreign- and 28% Finnish-born. Malaria infections were mostly acquired in Africa (76%). Among foreign-born cases, 89% of the infections were acquired in the region of birth. The most common species were Plasmodium falciparum (61%) and Plasmodium vivax (22%). Although traveling to malaria-endemic areas increased, no increase occurred in malaria cases, and a decreasing trend was present in antimalarial drug sales. Traveling to malaria-endemic countries and drug sales followed the same seasonal pattern, with peaks in the first and last quarter of the year. More efforts should be focused on disseminating pre-travel advice to immigrants planning to visit friends and relatives and travelers on self-organized trips. © 2010 International Society of Travel Medicine.

41 CFR 301-75.3 - What governing policies and procedures must we establish related to pre-employment interview travel?

Science.gov (United States)

2010-07-01

... and procedures must we establish related to pre-employment interview travel? 301-75.3 Section 301-75.3... ALLOWANCES AGENCY RESPONSIBILITIES 75-PRE-EMPLOYMENT INTERVIEW TRAVEL General Rules § 301-75.3 What governing policies and procedures must we establish related to pre-employment interview travel? You must establish...

Malaria chemoprophylaxis of 3,446 French travelers departing from Paris to eight tropical countries.

Science.gov (United States)

Semaille, C; Santin, A; Prazuck, T; Bargain, P; Lafaix, C; Fisch, A

1999-03-01

Each year more and more French travelers are visiting areas where malaria is endemic. The aim of this study was to assess prophylactic regimens used by French travelers and to determine whether they meet current published recommendations. This 12 month transversal study (May 1, 1995 to April 31, 1996) was conducted in embarkment lounges of Roissy Charles de Gaulle Airport to eight "tropical" destinations. 3,446 French travelers were enrolled. Twenty two and three-fifths percent of travelers had not sought any advice. The percentages of travelers staying less than 3 months (n = 2899) at risk of malaria (i.e., using none or inadequate chemoprophylaxis) were, according to the destination: Brazil (20%), Gabon (83%), Ivory Coast (26%), Kenya (43%), Madagascar (39%), Thailand (22%), Venezuela (41%) and Vietnam (8%). The suitability of the prophylaxis according to the information source for travelers staying less than 3 months varied as follows: specialist physician (OR = 1), travel agent (OR = 1.01, CI = 0.9 - 1. 1), occupational physician (OR = 1.13, CI = 0.6 - 2.1), GP (OR = 1. 58, CI = 1.1 - 2.3), none (OR = 1.95, CI = 1.3 - 2.9), friends (OR = 3, CI = 1.8 - 5) and pharmacist (OR = 3.94, CI = 2.1 - 7.5). Suitability of prophylaxis also varied according to the type of trip: organized tour (OR = 1), business trip (OR = 1.04, CI = 0.8 - 1.4), adventure tourism (OR = 2.1, CI = 1.6 - 2.9) and visit to family or friends (OR = 2.3, CI = 1.7 - 3.1). This study shows that the quality of advice on antimalarial chemoprophylaxis varies markedly according to the source, and that nearly one in three French travelers (29.3 %, 850/2899) to tropical areas is at risk of malaria.

Travel Emission Profile of Iskandar Malaysia Neighbourhoods from Pre-1980s to 2000s

Science.gov (United States)

Majid, M. R.; Nordin, A. N.; Johar, F.; Tifwa, H. Y.

2014-02-01

Vehicle Miles Travelled (VMT), an indicator of travel levels on the roadway system mainly by private vehicles, has been widely used in urban planning to help indicate CO2 emission due to changes in built environment. Bordering Singapore to the south, neighbourhood development has been constantly happening in Johor Bahru since 1980's. These neighbourhood developments are believed to have undergone a continuous layout design evolution affecting its land use distribution, road network design, and density. Thus, this paper investigates the quiet influence of neighbourhood design, as it evolves over the decades on VMT and eventually travel carbon emission. Twenty two residential neighbourhoods representing several decades from pre-1980s to the 2010s were selected and travel diaries of their randomly selected households were recorded. Findings from this study reveal that travel carbon emission for pre-1980s residential areas is only 8.7 kilograms/household/day with a daily travel range of 40 km/day. However, the amount increases up to 21.8 kilograms/household/day for 2010s houses with daily travel range of 100 km/day. Car usage among residents in Iskandar Malaysia is undoubtly increasing as car ownership proportion increases from 0.8 in pre-1980s to 2.37 in 2010s. Number and distance of vehicles trip can be reduced by organizing activities in compact communities rather than in auto dependent suburbs. In addition, a carbon emission reduction of up to 10 percent may result from a change in land use approach alone while additional reductions will result from employing other strategies such as transit investment, fuel pricing, and parking charges.

Travel Emission Profile of Iskandar Malaysia Neighbourhoods from Pre-1980s to 2000s

International Nuclear Information System (INIS)

Majid, M R; Nordin, A N; Johar, F; Tifwa, H Y

2014-01-01

Vehicle Miles Travelled (VMT), an indicator of travel levels on the roadway system mainly by private vehicles, has been widely used in urban planning to help indicate CO 2 emission due to changes in built environment. Bordering Singapore to the south, neighbourhood development has been constantly happening in Johor Bahru since 1980's. These neighbourhood developments are believed to have undergone a continuous layout design evolution affecting its land use distribution, road network design, and density. Thus, this paper investigates the quiet influence of neighbourhood design, as it evolves over the decades on VMT and eventually travel carbon emission. Twenty two residential neighbourhoods representing several decades from pre-1980s to the 2010s were selected and travel diaries of their randomly selected households were recorded. Findings from this study reveal that travel carbon emission for pre-1980s residential areas is only 8.7 kilograms/household/day with a daily travel range of 40 km/day. However, the amount increases up to 21.8 kilograms/household/day for 2010s houses with daily travel range of 100 km/day. Car usage among residents in Iskandar Malaysia is undoubtly increasing as car ownership proportion increases from 0.8 in pre-1980s to 2.37 in 2010s. Number and distance of vehicles trip can be reduced by organizing activities in compact communities rather than in auto dependent suburbs. In addition, a carbon emission reduction of up to 10 percent may result from a change in land use approach alone while additional reductions will result from employing other strategies such as transit investment, fuel pricing, and parking charges

Individual traveller health priorities and the pre-travel health consultation.

Science.gov (United States)

Flaherty, Gerard T; Chen, Bingling; Avalos, Gloria

2017-09-01

The purpose of this study was to examine the principal travel health priorities of travellers. The most frequently selected travel health concerns were accessing medical care abroad, dying abroad, insect bites, malaria, personal safety and travel security threats. The travel health risks of least concern were culture shock, fear of flying, jet lag and sexually transmitted infections. This study is the first to develop a hierarchy of self-declared travel health risk priorities among travellers. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Antimalarial measures - type, sources of advice and compliance ...

African Journals Online (AJOL)

1994-06-01

Jun 1, 1994 ... pharmacies as well as actual behaviour in this regard and sources of advice accessed ... pharmacies and 53 'care providers' (members of travel parties). Doctors ... TPS Drug Information Services, Johannesburg. L Baker, DIP.

Characteristics of HIV infected individuals traveling abroad. Results from the +REDIVI Collaborative Network.

Science.gov (United States)

Pérez-Molina, Jose A; Martinez-Perez, Angela; Serre, Nuria; Treviño, Begoña; Ruiz-Giardín, José Manuel; Torrús, Diego; Goikoetxea, Josune; Echevarría, Esteban Martín; Malmierca, Eduardo; Rojo, Gerardo; Calabuig, Eva; Gutierrez, Belén; Norman, Francesca; Lopez-Velez, Rogelio

2016-02-01

The improvement in the prognosis of HIV infection, coupled with the increase in international travel and migration, has led to a rising number of HIV infected travelers. The objective of this study was to describe the epidemiological and clinical features of returning travelers, according to their HIV status. An observational prospective study was conducted including travelers and immigrants who traveled to visit friends and relatives (VFRs) registered in the +REDIVI collaborative network (January-2009; October-2014). +REDIVI is a national network that registers information regarding infections imported by travelers and immigrants at 21 different centers using a standardized protocol. A total of 3464 travellers were identified: 72 were HIV+ (2.1%) and 3.392 HIV- (98%). HIV+ vs. HIV- travelers were often older (40.5y vs. 34.2y P=.001), VFRs (79.1% vs. 44.4%; Ptravel advice (27% vs. 37%; P=.078). The main destinations for both groups were sub-Saharan Africa and Latin America. The most frequent reasons for consultation after travel were fever, request for a health examination, gastrointestinal complaints, and abnormal laboratory tests (mainly eosinophilia and anemia), which differed between groups. The most frequent diagnoses in HIV+ travelers were malaria (38.8%), newly diagnosed HIV infection (25%), and intestinal parasites (19.4%), while for HIV- travelers the main diagnoses were "healthy" (17.9%), malaria (14%), and intestinal parasites (17.3%). The typical profile of an HIV+ traveler in +REDIVI was that of a VFR traveler who did not seek pre-travel advice and made high-risk trips. This may increase the chance of acquiring travel-related infections which may pose a special risk for HIV-infected travelers. The post-travel visit was a good opportunity for HIV infection screening. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

A descriptive study of advising practices during travel health consultations in France.

Science.gov (United States)

Marchand, C; Merrina, F; Gagnayre, R; Bouchaud, O

2017-09-01

Recommendations for improving traveler adherence address both the content of the advice given and the structure of the consultation. The objective of this article is to describe how travel health consultations are structured in France. A questionnaire based on both theoretical foundations and recommendations in the literature was sent to health professionals who practice in travel clinics, all of them members of France's Société de Médecine des Voyages. The response rate was 78.5% (176/224). One hundred thirty nine respondents (78.9%) reported that treatment (vaccinations, in particular) and advising were done at separate times in the consultation. The majority of respondents questioned the traveler on his wishes, difficulties, expectations, experiences, and previous knowledge. A third explored the traveler's perceptions regarding the seriousness of diseases, the effectiveness of prevention measures and the latter's adverse effects with a difference when health professionals were practicing >5 years and/or had received specific training ( P  traveler whether he understood the advice given. One hundred thirty seven respondents (77.8%) gave travelers a booklet with additional advice, and 66.5% gave them a website where they could find health advice on their destination. Travelers were almost never offered group consultations or the opportunity to work on real-life situations. When there were language barriers, the respondents were more likely to seek help from a French-speaking member of the traveler's entourage (48.9%) than from an interpreter (22.7%). While the majority of practitioners follow most of the recommendations regarding the structure of travel health consultations, some of the factors that enhance traveler learning are underutilized, reducing the likelihood that travelers will apply the advice given. The study illustrates the need to develop more educational intervention methods and to evaluate their impact on travelers. © International Society

Travel Advice for Higher Functioning Individuals on the Autism Spectrum

Science.gov (United States)

VanBergeijk, Ernst

2009-01-01

While travel training on local mass transit makes intuitive sense, the thought of larger scale travel training does not occur to most people. Possible benefits that could be gained from long distance or more involved traveling with individuals on the autism spectrum are vast. In this article, the author presents 11 essential skills that are a…

Louisville region demonstration of travel management coordination center : system pre-deployment preparation.

Science.gov (United States)

2013-03-01

The purpose of the Greater Louisville Region Demonstration of Travel Management Coordination Center (TMCC): System Pre-Deploy-ment Preparation grant was to further phased implementation of the regions TMCC design by focusing on two major component...

Are we there yet? Travel vaccinations for Australian children.

Science.gov (United States)

Slonim, Marnie; Starr, Mike; Blashki, Grant

2014-06-01

Australians travel overseas frequently and general practitioners (GPs) are often asked to provide detailed advice on travel vaccinations for children. Planning a safe and effective vaccination schedule is dependent on the context: where and when the family is travelling, the individual child's medical needs and past vaccination history, and if they are visiting family and friends. In this paper we provide an overview of the issues to consider when vaccinating Australian children for overseas travel. We also list the suite of common travel vaccinations and discuss some clinical scenarios that are likely to present in Australian general practice. Australians love to travel overseas and, increasingly, GPs are asked by patients to provide detailed advice on travel vaccinations for their children. Decisions regarding vaccinations for travelling children can be complex and the advice often differs from that provided for adults. Children differ from adults in their vulnerability to illnesses and side effects of medications. These differences, as well as their status regarding routine childhood vaccinations, all need to be taken into account. As with adults, it is important to consider the location and duration of travel and time until departure. The age of the child is also important and there may be a case for accelerating the routine childhood vaccinations in some children. The aim of this paper is to provide a clear and simple outline of the vaccination recommendations for children travelling overseas from Australia.

Advice for families traveling to developing countries with young children.

Science.gov (United States)

Doan, Sylvia; Steele, Russell W

2013-09-01

Young children are most likely to travel to developing countries with their parents to visit relatives. Preparation for such travel must include careful counseling and optimal use of preventive vaccines and chemoprophylaxis. For infants and very young children, data defining safety and efficacy of these agents are often limited. However, accumulated experience suggests that young travelers may be managed similarly to older children and adults.

Personal security a guide for international travelers

CERN Document Server

Spencer, Tanya

2013-01-01

Personal Security: A Guide for International Travelers provides the perfect mix of lessons-learned, tools, and recommendations from experts so that readers can personalize their own approach to managing travel risks. If followed, the information provided will allow readers to get out and experience the local culture while still traveling safely.-Bernie Sullivan, Director Global Security, Hanesbrands Inc....a must-have for any traveler. Having worked in South and Southeast Asia, I know the advice provided in the book holds the key to keeping safe, avoiding dangerous situations, and managing threats when they occur. The book's methodological framework, combined with the author's extensive experience and hands-on knowledge, provide very practical and useful advice.-Kathrine Alexandrowiz, Independent consultant at Kathalyst, former coordinator for the "Regional Risk Management Project for NGOs in Asia Pacific" (ECHO)... a go-to guide for all travelers irrespective of mission or purpose. An excellent piece of work...

Travel-related health problems in Japanese travelers.

Science.gov (United States)

Mizuno, Yasutaka; Kudo, Koichiro

2009-09-01

Although the number of Japanese individuals traveling abroad has increased steadily, reaching approximately 17.3 million in 2007, the incidence of various travel-related health problems in Japan remains unknown. The travel-related health problems of Japanese travelers returning to Japan from abroad are analyzed by assessing the records. Data were collected retrospectively on returning travelers who visited the authors' travel clinic during the period from January 2005 through to December 2006 with any health problem acquired overseas. A total of 345 patients were included in this study (200 male, 145 female; average age, 34+/-12.3 years). Reasons for travel included leisure (45.8%); business (39.1%); visiting friends and relatives or accompanying other travelers (8.7%); volunteering (3.8%); and long stays in order to study or live (2.6%). The most visited destination was Asia (n=260), followed by Africa (n=105). The most commonly reported health problems were gastro-intestinal infections (39.1%), followed by respiratory tract infections (16.2%), animal bites (8.1%), and skin problems (5.8%). Together, malaria and dengue accounted for 10% of diagnoses in 125 febrile patients (36.2%). Although the profile of travel-related health problems in Japanese travelers is similar to that of Western travelers, the characteristics of travel were quite different. Therefore Japanese travel advice should be tailored to suit the Japanese traveler.

The elderly, the young and the pregnant traveler -- A retrospective data analysis from a large Swiss Travel Center with a special focus on malaria prophylaxis and yellow fever vaccination.

Science.gov (United States)

Jaeger, Veronika K; Tschudi, Nadine; Rüegg, Rolanda; Hatz, Christoph; Bühler, Silja

2015-01-01

Vulnerable individuals such as elderly, children/adolescents and pregnant/breastfeeding women increasingly travel overseas. We describe the travel and vaccination patterns of these groups at the largest Travel Clinic in Switzerland especially focusing on travel to yellow fever and malaria-endemic countries, and yellow fever vaccination (YFV) and malaria medications. An analysis of pre-travel visits between 2010 and 2012 at the Travel Clinic of the University of Zurich, was performed assessing differences between the elderly, young and middle-aged travelers as well as between pregnant/breastfeeding and other female travelers. Overall, the vulnerable groups did not differ from other travelers regarding their travel patterns. YFV was the most often administered vaccine to elderly travelers; half of them received it for the first time. More than 30% of children/adolescents received YFV, but no child below six months was vaccinated. 80% of young travelers and a similar percentage of pregnant women went to malaria-endemic regions. Twenty-five pregnant/breastfeeding women traveled to YF endemic areas. Travel patterns of vulnerable travelers are comparable to those of other travelers. In view of the limited data on malaria medications and precautions against YFV during pregnancy and at the extreme ages of life, giving travel advice to these groups is challenging. Copyright © 2015 Elsevier Ltd. All rights reserved.

Traveling with children: beyond car seat safety.

Science.gov (United States)

Polli, Janaina Borges; Polli, Ismael

2015-01-01

To spread knowledge and instigate the health professional to give advice on childcare during travels and on child transport safety. Literature review through the LILACS and MEDLINE(®) databases, using the terms: travel, safety, protective equipment, child, preventive medicine, retrieving articles published in the last 21 years. The authors analyzed 93 articles, of which 66 met the inclusion criteria after summaries were read. For drafting this article, the following sub-themes were proposed: getting ready to travel with children; knowing some of the transfer risks (air, land and water transportation) and exploring the destination with children (sun exposure, accommodations, altitude, food, traveler's diarrhea, insect bites) and return from the trip with children. Over the years, there has been an increase in the number of children who travel around the world. However, this population is still subject to health problems while traveling and may be even more susceptible than the adult age group. These problems arise from a variety of factors, including exposure to infectious organisms, the use of certain types of transportation, and participation in some activities, such as hiking at high altitudes, among others. However, when traveling with children, these risk factors can be overlooked; a trip that is considered safe for an adult might not be a good choice for this age group. The pediatric consultation should be a good opportunity to optimize preventive guidelines at the pre-trip planning. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Electronic Commerce, the Internet and Travel Cybermediaries

Directory of Open Access Journals (Sweden)

Paul O'Brien

1998-11-01

Full Text Available The purchase of a very expensive, complex holiday requires a great deal of information and reliable expert advice. The risks involved in such a purchase are substantial. Industry opinion leaders believe that consumers will continue to take advice from a human sales consultant before purchasing, with the exception of major corporate bookings and simple point to point bookings. This paper investigates the likely disintermediation effects of electronic commerce on Retail Travel Agents. It provides the basis for the development of a strategic framework for intermediaries that can be used to enhance business performance. The findings of exploratory interviews with travel industry opinion leaders are presented, together with recommended strategic responses for Retail Travel Agents.

Safe travels? HIV transmission among Britons travelling abroad.

Science.gov (United States)

Rice, B; Gilbart, V L; Lawrence, J; Smith, R; Kall, M; Delpech, V

2012-05-01

The aim of the study was to identify and describe the characteristics of persons born in the UK who acquire HIV infection abroad. Analyses using case reports and follow-up data from the national HIV database held at the Health Protection Agency were performed. Fifteen per cent (2066 of 13 891) of UK-born adults diagnosed in England, Wales and Northern Ireland between 2002 and 2010 acquired HIV infection abroad. Thailand (534), the USA (117) and South Africa (108) were the countries most commonly reported. As compared with UK-born adults acquiring HIV infection in the UK, those acquiring HIV infection abroad were significantly (P sex with a commercial sex worker (5.6% vs. 1%, respectively). Among men infected in Thailand, 11% reported sex with a commercial sex worker. A substantial number of UK-born adults are acquiring HIV infection in countries with generalized HIV epidemics, and in common holiday destinations. Of particular concern is the high proportion of men infected reporting sex with a commercial sex worker. We recommend HIV prevention and testing efforts be extended to include travellers abroad, and that sexual health advice be provided routinely in travel health consultations and in occupational health travel advice packs, particularly to those travelling to high HIV prevalence areas and destinations for sex tourism. Safer sex messages should include an awareness of the potential detrimental health and social impacts of the sex industry. © 2012 British HIV Association.

Travel medicine advice to UK based international motor sport teams.

Science.gov (United States)

Walters, A

2000-01-01

International motor sport teams travel extensively. Over the years, the design and build of racing cars has improved so that morbidity and mortality in motor sport has been lessened. Those team members supporting the competitors need to be physically and mentally fit to perform complicated tasks, despite having traveled. This group of travelers has not been studied to any extent previously. An anonymous questionnaire asking some basic travel medicine related questions was distributed to the support team members of a Rally team, and Formula One Grand Prix team. Both teams were based in the UK, and competed in all the rounds of their respective world championships. Ten Rally team members and 18 Formula One team members responded to the questionnaire. The results showed moderate coverage of commonly used vaccinations; appropriate use of antimalarials and insect repellents, but by no means by all team members; little or no problems with traveler's diarrhea; some tendencies to problems related to jet lag, but no real attempt to prevent the problem; and finally some attempt at skin protection against solar damage. Support teams are reasonably well prepared for the combination of, the rigors of frequent travel, and a demanding job. There is a deficit in vaccine coverage, especially of both hepatitis A and B, some education is needed in preventing skin problems later in life due to sun exposure, and further study of jet lag and its implications might be appropriate.

Preliminary uncertainty analysis of pre-waste-emplacement groundwater travel times for a proposed repository in basalt

International Nuclear Information System (INIS)

Clifton, P.M.; Arnett, R.C.

1984-01-01

Preliminary uncertainty analyses of pre-waste-emplacement groundwater travel times are presented for a potential high-level nuclear waste repository in the deep basalts beneath the Hanford Site, Washington State. The uncertainty analyses are carried out by means of a Monte Carlo technique, which requires the uncertain inputs to be described as either random variables or spatial stochastic processes. Pre-waste-emplacement groundwater travel times are modeled in a continuous, flat-lying basalt flow top that is assumed to overlie the repository horizon. Two-dimensional, steady state groundwater flow is assumed, and transmissivity, effective thickness, and regional hydraulic gradient are considered as uncertain inputs. Groundwater travel time distributions corresponding to three groundwater models are presented and compared. Limitations of these preliminary simulation results are discussed in detail

[Viral hepatitis in travellers].

Science.gov (United States)

Abreu, Cândida

2007-01-01

Considering the geographical asymmetric distribution of viral hepatitis A, B and E, having a much higher prevalence in the less developed world, travellers from developed countries are exposed to a considerable and often underestimated risk of hepatitis infection. In fact a significant percentage of viral hepatitis occurring in developed countries is travel related. This results from globalization and increased mobility from tourism, international work, humanitarian and religious missions or other travel related activities. Several studies published in Europe and North America shown that more than 50% of reported cases of hepatitis A are travel related. On the other hand frequent outbreaks of hepatitis A and E in specific geographic areas raise the risk of infection in these restricted zones and that should be clearly identified. Selected aspects related with the distribution of hepatitis A, B and E are reviewed, particularly the situation in Portugal according to the published studies, as well as relevant clinical manifestations and differential diagnosis of viral hepatitis. Basic prevention rules considering enteric transmitted hepatitis (hepatitis A and hepatitis E) and parenteral transmitted (hepatitis B) are reviewed as well as hepatitis A and B immunoprophylaxis. Common clinical situations and daily practice "pre travel" advice issues are discussed according to WHO/CDC recommendations and the Portuguese National Vaccination Program. Implications from near future availability of a hepatitis E vaccine, a currently in phase 2 trial, are highlighted. Potential indications for travellers to endemic countries like India, Nepal and some regions of China, where up to 30% of sporadic cases of acute viral hepatitis are caused by hepatitis E virus, are considered. Continued epidemiological surveillance for viral hepatitis is essential to recognize and control possible outbreaks, but also to identify new viral hepatitis agents that may emerge as important global health

Are they really refusing to travel? A qualitative study of prehospital records

Directory of Open Access Journals (Sweden)

Christopher Sarah

2006-09-01

Full Text Available Abstract Background Refusal by the patient to travel after calling an emergency ambulance may lead to a preventable waste of scarce resources if it can be shown that an alternative more appropriate response could be employed. A greater understanding is required of the reasons behind 'refusal to travel' (RTT in order to find appropriate solutions to address this issue. We sought to investigate the reasons why patients refuse to travel following emergency call-out in a rural county. Methods Written records made by ambulance crews for patients (n = 397 who were not transported to hospital following an emergency call-out during October 2004 were retrospectively analysed. Results Twelve main themes emerged for RTT which included non injury or minor injury, falls and recovery after treatment on scene; other themes included alternative supervision, follow-up and treatment arrangements or patients arranging their own transport. Importantly, only 8% of the sample was recorded by ambulance crews as truly refusing to travel against advice. Conclusion A system that facilitates standardised recording of RTT information including social reasons for non-transportation needs to be designed. 'Refused to travel' disclaimers need to reflect instances when crew and patient are satisfied that not going to hospital is the right outcome. These recommendations should be considered within the context of the plans for widening the role of ambulance services.

Towards improved uptake of malaria chemoprophylaxis among West African travellers: identification of behavioural determinants.

Science.gov (United States)

Wieten, Rosanne W; Harting, Janneke; Biemond, Pieter M; Grobusch, Martin P; van Vugt, Michèle

2013-10-10

Malaria is a potentially lethal illness for which preventive measures are not optimally used among all travellers. Travellers visiting friends and relatives in their country of origin (VFRs) are known to use chemoprophylaxis less consistently compared to tourist travellers. In this study, factors explaining the low use of chemoprophylaxis were pursued to contribute to improving uptake of preventive measures among VFRs. Following in-depth interviews with Ghanaians living in Amsterdam, a questionnaire was developed to assess which behavioural determinants were related to taking preventive measures. The questionnaire was administered at gates of departing flights from Schiphol International Airport, Amsterdam (the Netherlands) to Kotoka International Airport, Accra (Ghana). In total, 154 questionnaires were eligible for analysis. Chemoprophylaxis had been started by 83 (53.9%) and bought by 93 (60.4%) travellers. Pre-travel advice had been obtained by 104 (67.5%) travellers. Those who attended the pre-travel clinic and those who incorrectly thought they had been vaccinated against malaria were more likely to use preventive measures. Young-, business- and long-term travellers, those who had experienced malaria, and those who thought curing malaria was easier than taking preventive tablets were less likely to use preventive measures. Almost half of the VFRs travelling to West Africa had not started chemoprophylaxis; therefore, there is room for improvement. Risk reduction strategies could aim at improving attendance to travel clinics and focus on young-, business and long term travellers and VFRs who have experienced malaria during consultation. Risk reduction strategies should focus on improving self-efficacy and conceptions of response efficacy, including social environment to aim at creating the positive social context needed.

Towards improved uptake of malaria chemoprophylaxis among West African travellers: identification of behavioural determinants

Science.gov (United States)

2013-01-01

Background Malaria is a potentially lethal illness for which preventive measures are not optimally used among all travellers. Travellers visiting friends and relatives in their country of origin (VFRs) are known to use chemoprophylaxis less consistently compared to tourist travellers. In this study, factors explaining the low use of chemoprophylaxis were pursued to contribute to improving uptake of preventive measures among VFRs. Methods Following in-depth interviews with Ghanaians living in Amsterdam, a questionnaire was developed to assess which behavioural determinants were related to taking preventive measures. The questionnaire was administered at gates of departing flights from Schiphol International Airport, Amsterdam (the Netherlands) to Kotoka International Airport, Accra (Ghana). Results In total, 154 questionnaires were eligible for analysis. Chemoprophylaxis had been started by 83 (53.9%) and bought by 93 (60.4%) travellers. Pre-travel advice had been obtained by 104 (67.5%) travellers. Those who attended the pre-travel clinic and those who incorrectly thought they had been vaccinated against malaria were more likely to use preventive measures. Young-, business- and long-term travellers, those who had experienced malaria, and those who thought curing malaria was easier than taking preventive tablets were less likely to use preventive measures. Conclusion Almost half of the VFRs travelling to West Africa had not started chemoprophylaxis; therefore, there is room for improvement. Risk reduction strategies could aim at improving attendance to travel clinics and focus on young-, business and long term travellers and VFRs who have experienced malaria during consultation. Risk reduction strategies should focus on improving self-efficacy and conceptions of response efficacy, including social environment to aim at creating the positive social context needed. PMID:24107150

Travelling to china for the beijing 2008 olympic and paralympic games.

Science.gov (United States)

Shaw, Marc T M; Leggat, Peter A; Borwein, Sarah

2007-11-01

The 29th modern Olympic Summer Games, conducted once every 4 years since 1896, will be held in Beijing, China, from 8 to 24 August 2008. There will be approximately 28 major and 302 minor events in 37 venues in the prominent cities of Beijing, Hong Kong and Shanghai, and also in Qingdao (a coastal town in Shandong Province), Qinhuangdao (northeast of Beijing), Shanghai, Shenyang (an industrial city in Liaoning Province) and in Tianjin (on the coast near Beijing). Following the Olympic Games, the Paralympic Games will be conducted from 6 to 17 September 2008 in Beijing and 20 Paralympic Sports will be represented. This paper focuses on health and safety issues for travellers to China in general, although it makes specific references to advice for visiting Olympic and Paralympic athletes and team staff, who will be travelling to the games. It must be remembered that travel health advice can change, and that travellers should be advised to seek up-to-date travel health advice for China closer to their departure.

Knowledge, attitudes, and practices toward malaria risk and prevention among frequent business travelers of a major oil and gas company.

Science.gov (United States)

Berg, Johannes; Breederveld, Daan; Roukens, Anna H; Hennink, Yvonne; Schouten, Marjolijn; Wendt, Judy K; Visser, Leo G

2011-01-01

Despite significant morbidity and mortality among business travelers due to malaria, very little has been published on knowledge, attitudes, and practices (KAP) toward malaria risk. The aim of this study was to assess KAP among frequent international business travelers (FBT) and to identify recommendations for improving malaria prevention that could be applied to the wider FBT community in occupational health. A retrospective web-based survey was conducted in 2005 among self-registered FBT of an oil and gas company based in the Netherlands. The survey was completed by 328 of the 608 self-registered FBT (54%). Fifty-four percent of respondents had visited a high-risk area for malaria. Most respondents (96%) were experienced travelers; the majority (71%) sought health advice before their trip and made use of a company health resource. Fever was recognized as a malaria symptom by all FBT; travel to high-risk malaria areas was correctly identified by 96%, and 99% of these travelers adhered to use of adequate personal protective measures. The proportion of travelers carrying appropriate anti-malaria drug regimen was positively associated with receiving company advice among FBT traveling to high-risk destinations (RR = 2.10, 95% CI: 1.21-3.67), but not for those traveling to low- or no-risk destinations. Only 8% (14) of those going to a high-risk area were not carrying malaria prophylaxis. One in five of FBT traveling to no-risk areas were unnecessarily carrying malaria prophylaxis. The majority of KAP results were excellent. We postulate that a company culture with a strong focus on health, safety, security, and environment can positively contribute to high KAP scores. Notwithstanding the excellent findings, this study also provides a cautionary tale for company health functions against overprescribing of malaria prophylaxis. It demonstrates the need for constant review and audit of adherence to quality criteria. © 2011 International Society of Travel Medicine.

Should travellers to rabies-endemic countries be pre-exposure vaccinated? An assessment of post-exposure prophylaxis and pre-exposure prophylaxis given to Danes travelling to rabies-endemic countries 2000-12.

Science.gov (United States)

Christiansen, Annette H; Rodriguez, Anna B; Nielsen, Jens; Cowan, Susan A

2016-04-01

Since 2000, a steady increase of vaccines used for both rabies Post-exposure prophylaxis (PEP) and rabies Pre-exposure prophylaxis (PrEP) given to Danish travellers was observed. This study aims to evaluate whether the increase of PEP and PrEP was due to increased travelling, increased awareness of the need for PrEP, or more animal bites per travel, leading to more PEP being administered, in order to assess the need for changing the recommendations. We also described in which countries Danish travelers most frequently reported possible exposure to rabies, and evaluated the timeliness of rabies PEP, including rabies immunoglobulin (RIG). We included all Danes reported to the National Database for Rabies Treatment as having started rabies PEP either abroad or after returning to Denmark, between 2000 and 2012. Data on the yearly number of Danish travelers from 2004 to 2012 to Thailand were collected to calculate the incidence of animal bites at this destination. We also included data on rabies vaccines sold for PrEP or for booster vaccination in Denmark. PEP after possible exposure to rabies abroad increased yearly by 8.8 %. Likewise vaccines sold for PrEP increased by 8.2% annually. The number of Danish travelers to Thailand increased by 7.3% per year, resulting in a stable incidence of animal bites per 100,000 travelers. Seventy-five % started PEP in the country of exposure, while only 10 % received RIG. The yearly increase in PEP and PrEP are parallel to the yearly increase in number of travelers, and can thus be explained by the increased rate of traveling, and not by a rise in awareness of rabies risk or more bites per traveler.Even short term travelers should be given the option of including PrEP in their travel immunisation program, as PEP and especially RIG is not always available in rabies-endemic countries. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

Traveling to Australia for the Sydney 2000 Olympic and Paralympic Games.

Science.gov (United States)

Shaw, M; Leggat, P A

2000-01-01

The modern Olympic Games, conducted only once every 4 years since 1900, will be held in Sydney, Australia, from September 15 to October 1, 2000. There will be approximately 35 competition venues, 5 villages, 100 training venues, a media center, and sponsor hospitality areas.1 There will be about 300 events for 28 sports, involving 10,300 athletes from 200 countries, 5,100 team officials, 50,000 volunteers, 15,000 media, a world wide audience of around 3.5 billion viewers and listeners, and up to several hundred-thousand spectators at any one time.1 The Paralympic Games will also be held in Sydney, after the Olympic Games, from October 18 to 29, 2000, with more than 4,000 athletes competing.1 This paper focuses on health and safety issues for travelers to Australia in general, although it makes specific references to advice for visiting Olympic and Paralympic athletes and team staff, who will be traveling to the games. It must be remembered that travel health advice can change, and that travelers should be advised to seek up-to-date travel health advice for Australia closer to their departure.

Pediatric travel consultation in an integrated clinic.

Science.gov (United States)

Christenson , J C; Fischer , P R; Hale , D C; Derrick , D

2001-01-01

In May 1997, a pediatric travel service was created within a larger integrated University-County Health Department international travel clinic. The purpose of the service was to further enhance the travel advice and care provided to children and their parents or guardians. The current study was designed to describe the care of children in this setting and to compare the care of children seen in the Pediatric Travel Service with that of children seen by other providers. All pediatric patients (defined as individuals Mexico, South America, and Southeast Asia. When compared to travelers seen in the Regular Clinic, individuals in the Pediatric Travel Service group were more likely to travel for humanitarian work, and for parental work relocation. Persons in the Regular Clinic were more likely to travel to Mexico and Central America. They were also more likely to travel on vacation and for missionary work or study. Hepatitis B and tetanus-diphtheria booster vaccinations were given more frequently to travelers seen in the Regular Clinic. Also, ciprofloxacin and antimotility agents were more commonly prescribed in this group. No differences were noted in the duration of travel or in the time interval between clinic visit and departure. While general travel advice was considered to be similar in both clinic groups, some differences were observed in the frequency of administration of certain vaccines and prescriptions of medications. These differences were likely due to a difference in age in the two study groups. The high volume and success of the clinic suggest that integrated pediatric and adult travel services in a coordinated setting can be effective.

Impact of Binding Study Advice on Study Behavior and Pre-University Education Qualification Factors in a Problem-Based Psychology Bachelor Program

Science.gov (United States)

de Koning, Björn B.; Loyens, Sofie M. M.; Rikers, Remy M. J. P.; Smeets, Guus; van der Molen, Henk T.

2014-01-01

In the Netherlands, university programs increasingly use the binding study advice (BSA) to select students after the first year. Students with insufficient progress after the first year and who therefore do not conform to pre-defined BSA norms have to quit their program. This study investigated whether the introduction of the BSA is associated…

Spectrum of illness among returned Australian travellers from Bali, Indonesia: a 5-year retrospective observational study.

Science.gov (United States)

Sohail, Asma; McGuinness, Sarah L; Lightowler, Rachel; Leder, Karin; Jomon, Bismi; Bain, Christopher A; Peleg, Anton Y

2018-06-05

Bali, Indonesia presents significant infectious and non-infectious health risks for Australian travellers. Understanding this spectrum of illnesses has the potential to assist clinicians in evaluating unwell returning travellers and guide provision of pre-travel advice. To describe the spectrum of illnesses seen in returned travellers from Bali. Using a novel text mining approach, we performed a retrospective, observational study of all adult emergency department (ED) presentations to a metropolitan health service in Melbourne, from 2011-2015. Outcome measures included demographic, clinical and laboratory features of travel-related illnesses. A total of 464 patients met inclusion criteria. Gastroenteritis (119/464, 26%), systemic febrile illness (88/464, 19%) and respiratory tract infection (51/464, 11%) were the most common diagnoses. Dengue was the most common laboratory-confirmed diagnosis (25/464, 5%). No cases of malaria were identified. Common non-infectious presentations included traumatic injury (47/464, 10%) and animal bites requiring rabies post-exposure prophylaxis (29/464, 6%). 110 patients (24%) were admitted to hospital; those presenting with systemic febrile illness were more likely to be admitted compared to those presenting with other illnesses (OR 3.42, CI 2.02-5.75, pBali by Australian travellers. While infections are important causes of illness, trauma and animal bites account for a significant number of hospital presentations. Our findings contribute to knowledge on the health risks for travellers to Bali, and will assist clinicians in relevant pre- and post-travel evaluations. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Schistosomiasis in Scottish travellers: public health importance of laboratory testing and the need for enhanced surveillance.

Science.gov (United States)

Alexander, Claire L; Cottom, Laura; Smith, Kitty; Perrow, Kali; Coyne, Michael; Jones, Brian L

2018-03-01

Imported schistosomiasis is of significant public health importance and is likely to be underestimated since infection is often asymptomatic. We describe data from travellers residing in Scotland which includes a subset of group travellers from one of the largest Health Boards in Scotland. Clotted bloods were obtained during the period 2001-15 from a total of 8163 Scottish travellers. This included seven groups comprising of 182 travellers. Sera were examined for the presence of Schistosome species antibody at the Scottish Parasite Diagnostic and Reference Laboratory (SPDRL). Of all, 25% (n = 1623) tested positive with 40% (n = 651) of those patients aged between 20 and 24 years. Although 62% (n = 1006) of those who tested positive reported travel to Africa, important information on the specific region visited was lacking in almost one-third of samples received. Overall, 62 (34%) of group travellers tested positive and 95% (n = 59) reporting travel to Africa. Globalization, affordable air travel and improved awareness, are likely to contribute towards the increasing number of imported schistosomiasis cases. Therefore, enhanced surveillance capturing detailed travel history and fresh water exposures will improve risk stratification, pre-travel advice and optimize testing and treatment regimes for this increasingly important parasitic disease.

The 12-month effects of structured lifestyle advice and pelvic floor muscle training for pelvic organ prolapse

DEFF Research Database (Denmark)

Due, Ulla; Brostrøm, Søren; Lose, Gunnar

2016-01-01

INTRODUCTION: We evaluated the 12-month effects of adding pelvic floor muscle training to a lifestyle advice program in women with symptomatic pelvic organ prolapse stage II-III and the number of women who had sought further treatment. MATERIAL AND METHODS: This study was a 12-month follow up...... of a randomized controlled trial comparing a structured lifestyle advice program alone (lifestyle group) or in combination with pelvic floor muscle training (training and lifestyle group). Both programs consisted of six separate group sessions within 12 weeks. RESULTS: Data were available from 83 (76%) of the 109...... surgery. More severe anterior prolapse and more bladder symptoms at the 3-month follow up were significantly associated with having sought further treatment in both groups. CONCLUSIONS: At 12-month follow up, the effects of adding pelvic floor muscle training to a structured lifestyle advice program were...

Parents’ professional sources of advice regarding child discipline and their use of corporal punishment

Science.gov (United States)

Taylor, Catherine A.; Moeller, William; Hamvas, Lauren; Rice, Janet C.

2014-01-01

Parents (n=500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents that sought advice from religious leaders (vs. pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported they were more likely to follow the advice of pediatricians than any other professional; however, Black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents. PMID:23185082

Parents' professional sources of advice regarding child discipline and their use of corporal punishment.

Science.gov (United States)

Taylor, Catherine A; Moeller, William; Hamvas, Lauren; Rice, Janet C

2013-02-01

Parents (n = 500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of the parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents who sought advice from religious leaders (vs pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported that they were more likely to follow the advice of pediatricians than any other professional; however, black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents.

Health challenges of young travelers visiting friends and relatives compared with those traveling for other purposes.

Science.gov (United States)

Han, Pauline; Yanni, Emad; Jentes, Emily S; Hamer, Davidson H; Chen, Lin H; Wilson, Mary E; Macleod, William B; Ooi, Winnie W; Kogelman, Laura; Karchmer, Adolf W; Barnett, Elizabeth D

2012-09-01

The study objective was to assess differences in demographics and travel health challenges between youths ≤18 years old traveling internationally to visit friends and relatives (VFRs) compared with those traveling for other purposes (non-VFR). The Boston Area Travel Medicine Network consists of 5 clinics collecting anonymous data from international pretravel consultations. Data on all travelers ≤18 years of age seen between January 2008 and July 2010 were used. VFRs were compared with non-VFRs on demographics, primary language, trip characteristics, travel vaccinations administered, malaria prophylaxis and antidiarrheal medications prescribed. Thirty-five percent (610/1731) listed VFR as their purpose of travel. Almost half of VFRs were travel to countries that were yellow fever holoendemic, had malaria risk and were high-risk for typhoid (44% versus 20%, 39% versus 12%, 25% versus 15%, P travel-related morbidity, healthcare providers should be prepared to give travel advice to parents of VFR infants and children, particularly those US-born VFRs with foreign-born parents, regarding antimalarial and antidiarrheal medications and preventing yellow fever, malaria and typhoid.

Health hazards of international travel.

Science.gov (United States)

Cossar, J H; Reid, D

1989-01-01

The growth of travel and the increasing numbers of those affected by travel-related illnesses, some of a serious nature, will cause this subject to demand the attention of the medical profession, the travel trade, travellers themselves and the health authorities of countries receiving tourists. Provision of appropriate advice for the traveller is a shared responsibility, best channelled mainly through travel agencies; it can moreover be shown to be cost-beneficial. Continued monitoring of illness in travellers and provision of information systems geared to this problem and its prevention are fully justified. They should be based on traditional channels of communication and currently-available modern technology, and be readily accessible to medical and related workers. Increased collaboration between medical workers, health educators and those involved in the travel trade would be a positive and useful contribution towards the reduction of illness and discomfort among travellers and the associated expense incurred by the various national health services concerned. There are clearly economic benefits from the development of international tourism, but these have to be balanced in countries accepting tourists by attention to the prevention of illnesses associated with travel.

Travel health prevention.

Science.gov (United States)

Korzeniewski, Krzysztof

All around the world there has been a rapid growth in the number of international travels. According to the World Tourism Organisation the number of international tourist arrivals reached 1,235 billion in 2016 and continues to grow at a high rate. This has been much due to the development of air transport (including low-cost airlines), increasingly common economic migration, a growing number of travellers visiting friends and relatives, and an increase in medical tourism. With tropical destinations becoming increasingly popular among travellers, doctors have seen a rising number of patients who seek medical advice on health risks prevalent in hot countries and health prevention measures to be taken in tropical destinations, especially where sanitation is poor. The risk for developing a medical condition while staying abroad depends on a variety of factors, including the traveller's general health condition, health prevention measures taken before or during travel (vaccinations, antimalarial chemoprophylaxis, health precautions during air, road and sea travel, proper acclimatisation, prevention of heat injuries, protection against local flora and fauna, personal hygiene, water, food and feeding hygiene), as well as the prevalence of health risk factors in a given location. Health prevention is a precondition for safe travel and maintaining good physical health; in the era of a rapid growth in international tourism it has become of key importance for all travellers.

Patient characteristics associated with receipt of lifestyle behavior advice.

Science.gov (United States)

Corsino, Leonor; Svetkey, Laura P; Ayotte, Brian J; Bosworth, Hayden B

2009-01-01

Lifestyle behaviors such as reducing weight if overweight or obese, reducing salt intake, exercising, reducing alcohol intake, quitting smoking, and eating a healthy diet are related to the prevention and control of chronic diseases. However the amount of lifestyle advice provided by clinicians has been declining over the last decade. In 2002, a telephone survey was conducted to assess the quality of preventive care offered by health care providers. The study was a cross-sectional observational study of a randomly selected sample of 516 diverse individuals in Durham County, North Carolina. Information regarding age, sex, race, education, health conditions, and self-reported receipt of lifestyle advice was examined in the study. The odds of receiving advice to engage in preventive lifestyle behaviors were significantly higher for those with a pre-existing diagnosis of diabetes or hypertension and for participants reporting poor health status. For example, the odds of receiving advice to control or lose weight was 8.32 (95% CI, 2.65, 26.75) among individuals reporting a diagnosis of diabetes. Similarly, the odds of reporting "receiving advice to reduce salt intake" was 6.97 (95% CI, 3.74, 13.00) among subjects reporting a diagnosis of hypertension. The results are from a cross-sectional study of a sample of individuals in only one county. Additionally, the results are based on patient self-reported information, which could be subject to recall and social desirability bias. Patients with identified health problems were more likely than others to report being advised to adopt healthy lifestyle recommendations. Future research should examine methods to encourage health care providers to offer lifestyle advice to those without pre-existing illness.

[Immunization for children travelling to the tropics: neglected vaccines].

Science.gov (United States)

Imbert, P; Guérin, N; Sorge, F

2008-06-01

Each year hundreds of thousands of children leave France to travel to developing countries where they are exposed to infectious agents that can be prevented by vaccination. During the child's pre-travel check-up, practitioners should check that all mandatory immunizations are up-to-date and provide advice on relevant vaccines in function of the epidemiological situation at the chosen destination. However various factors hinder full compliance with this approach and some vaccines are underused. Underused vaccines are referred to as neglected vaccines. In the French vaccination schedule three vaccinations can be considered as neglected. The first is the hepatitis B vaccine that has a low coverage level in France due to strong reluctance to its use despite the fact that the virus is widespread in tropical areas. The second is pneumococcal vaccine that should be administered to all infants less than 2 years of age, especially for travel to areas where pneumonia and meningitis are frequent. The third is BCG vaccine that is now at greater risk of being neglected in child travellers because its use has been downgraded from a general requirement to a recommendation only for children at risk. A serious limitation on the use of travel vaccinations is cost that can lead families to neglect some infectious risk such as hepatitis A that is a major risk for child travellers as well as for their relatives during or after the trip and typhoid fever that is essentially an imported disease. Rabies vaccine is also underused due to its cost and to poor understanding of the risk by many practitioners and families. The purpose of this article is to underline the need to improve information and access to vaccines that are all too often neglected in child travellers.

Risk factors and pre-travel healthcare of international travellers attending a Dutch travel clinic: a cross-sectional analysis

NARCIS (Netherlands)

Wieten, Rosanne W.; van der Schalie, Maurice; Visser, Benjamin J.; Grobusch, Martin P.; van Vugt, Michèle

2014-01-01

The number of international travellers is currently estimated to exceed one billion annually. To address travel related health risks and facilitate risk reduction strategies, detailed knowledge of travellers' characteristics is important. In this cross-sectional study, data of a 20% sample of

Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature

Directory of Open Access Journals (Sweden)

Hulshof Carel

2005-08-01

Full Text Available Abstract Background Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based practice and EBM we compared professional advice on occupational health topics with best evidence from the literature. Methods We asked 14 occupational physicians to consult their usual information sources on 12 pre-conceived occupational health problems. The problems were presented in the form of case vignettes which contained sufficient clinical information to be used by the occupational physicians for the consultation of their experts. We had searched the literature for the best available evidence on the 12 problems, which made it possible to answer the clinical questions with a clear yes or no. Results The cases could be used by the occupational physicians as arising from their own practice. All together the occupational physicians consulted 75 different experts. Almost half of the consulted experts were near colleagues, 10% were industrial hygienists, 8% medical specialists and the rest had a varied background. Fifty three percent (95% confidence interval 42% to 65% of all professional advice was not in line with the research literature. In 18 cases (24% professional advice explicitly referred to up-to-date research literature as their used source. These cases were substantially less incorrect (17% than advice that had not mentioned the literature as a source (65% (difference 48%, 95% Confidence Interval from 27% to 69%. Conclusion Advice that occupational physicians routinely get in their daily practice differs substantially from best evidence from the literature. Occupational physicians who ask professional advice should always ask about the evidence of this advice.

Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature

Science.gov (United States)

Schaafsma, Frederieke; Verbeek, Jos; Hulshof, Carel; van Dijk, Frank

2005-01-01

Background Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM) promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based practice and EBM we compared professional advice on occupational health topics with best evidence from the literature. Methods We asked 14 occupational physicians to consult their usual information sources on 12 pre-conceived occupational health problems. The problems were presented in the form of case vignettes which contained sufficient clinical information to be used by the occupational physicians for the consultation of their experts. We had searched the literature for the best available evidence on the 12 problems, which made it possible to answer the clinical questions with a clear yes or no. Results The cases could be used by the occupational physicians as arising from their own practice. All together the occupational physicians consulted 75 different experts. Almost half of the consulted experts were near colleagues, 10% were industrial hygienists, 8% medical specialists and the rest had a varied background. Fifty three percent (95% confidence interval 42% to 65%) of all professional advice was not in line with the research literature. In 18 cases (24%) professional advice explicitly referred to up-to-date research literature as their used source. These cases were substantially less incorrect (17%) than advice that had not mentioned the literature as a source (65%) (difference 48%, 95% Confidence Interval from 27% to 69%). Conclusion Advice that occupational physicians routinely get in their daily practice differs substantially from best evidence from the literature. Occupational physicians who ask professional advice should always ask about the evidence of this advice. PMID:16131405

17 CFR 202.2 - Pre-filing assistance and interpretative advice.

Science.gov (United States)

2010-04-01

... filings with the Commission may receive advice of a general nature as to the preparation thereof..., except in connection with matters under the Public Utility Holding Company Act of 1935 and certain matters under the Investment Company Act of 1940, at one of its regional offices. [25 FR 6736, July 15...

Infectious Risks of Traveling Abroad.

Science.gov (United States)

Chen, Lin H; Blair, Barbra M

2015-08-01

A popular leisure activity, international travel can be associated with some infections. The most common travel-related illnesses appear to be gastrointestinal, dermatologic, respiratory, and systemic febrile syndromes. The pretravel medical consultation includes immunizations, malaria chemoprophylaxis, self-treatment for traveler's diarrhea, and advice on the prevention of a myriad of other infectious causes including dengue, chikungunya, rickettsiosis, leptospirosis, schistosomiasis, and strongyloidiasis. Travel to locations experiencing outbreaks such as Ebola virus disease, Middle East respiratory syndrome, avian influenza, and chikungunya call for specific alerts on preventive strategies. After travel, evaluation of an ill traveler must explore details of exposure, including destinations visited; activities; ingestion of contaminated food or drinks; contact with vectors, animals, fresh water, or blood and body fluids; and other potential exposures. Knowledge of the geographic distribution of infectious diseases is important in generating the differential diagnoses and testing accordingly. Empiric treatment is sometimes necessary when suspicion of a certain diagnosis is strong and confirmatory tests are delayed or lacking, particularly for infections that are rapidly progressive (for example, malaria) or for which timing of testing is prolonged (such as leptospirosis).

Outcomes of imported malaria during pregnancy within Venezuelan states: implications for travel advice.

Science.gov (United States)

Rodríguez-Morales, Alfonso J; Arria, Melissa; Sánchez, Elia; Vargas, Miguel; Piccolo, Carmelina; Colina, Rosa; Franco-Paredes, Carlos

2007-01-01

Prevention of malaria in pregnant women is an utmost priority because the disease can cause serious maternal and neonatal complications. Maternal complications include marked anemia, increased risk of severe disease, and mortality, while the fetus or neonate is at risk of prematurity, anemia, and low birthweight. Pregnant women living in malaria endemic areas may be semiimmune to a particular Plasmodium spp. but when traveling to other regions, sometimes within their same country, where malaria epidemiology is different, may develop severe malaria complications. Here, we describe our experience in northeastern Venezuela associated with unfavorable outcomes of imported malaria cases among pregnant women who traveled to other Venezuelan regions with different malaria epidemiology. Travel medicine practitioners should be aware and educate their pregnant patients regarding the risk of malaria even when living in malaria endemic areas and traveling to other endemic areas such as occurs in Venezuela.

The role of travel in measles outbreaks in Australia - An enhanced surveillance study.

Science.gov (United States)

MacIntyre, C R; Karki, S; Sheikh, M; Zwar, N; Heywood, A E

2016-08-17

Many developed countries, like Australia, maintain a high population level immunity against measles, however, there remains a risk of acquisition of measles in non-immune travellers and subsequent importation into Australia leading to localised outbreaks. In this study, we estimate the incidence of measles and describe characteristics including immunisation and pre-travel health seeking behaviour of notified cases of measles in New South Wales and Victoria, Australia between February 2013 and January 2014. Cases were followed up by telephone interview using a questionnaire to collect information of demographic and travel characteristics. In NSW, the incidence was highest in age group 0-9years (20/million population) whereas in Victoria the highest incidence was observed in 10-19 (23/million population) years group. Out of 44 cases interviewed, 25 (56.8%) had history of travel outside of Australia during or immediately prior to the onset of measles. Holiday (60%) was the main reason for travel with 44% (11/25) reporting visiting friends and relatives (VFR) during the trip. The major reason described for not seeking prior medical advice before travel were "no perceived risk of diseases" (41%) and "previous overseas travel without any problem" (41%). Of the 25 measles cases with recent overseas travel during the incubation period, one reported a measles vaccine prior to their recent trip. Four cases were children of parents who refused vaccination. Twenty out of 25 (80.0%) had attended mass gathering events. Young adults and VFR travellers should be a high priority for preventive strategies in order to maintain measles elimination status. Copyright © 2016. Published by Elsevier Ltd.

Patients with mental problems - the most defenseless travellers.

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Felkai, Peter; Kurimay, Tamas

2017-09-01

Severe mental illness occurring abroad is a difficult situation for patients, their families, and for the local medical community. Patients with mental problem are doublely stigmatized due to their mental illness and because they are foreigners in an unfamiliar country. The appropriate treatment is often delayed, while patients are often dealt with in a manner that violates their human rights. Moreover, repatriation - which is vital in this case - is often delayed due to the lack of international protocols for the transportation and treatment of mentally ill travelers. Authors analyzed several factors related to acute mental health problems during travel: the etiology of symptoms, the appropriate treatment possibilities abroad, and medical evacuation and repatriation of the psychotic patient. The article presents a brief review of travel-related mental disorders, the epidemiology of mental health issues faced by travelers, and the significance of pre-travel advice for these patients. The first problem is to recognize (and redress) the particular challenges faced by a psychotic patient in a strange country. The second challenge is to prepare the patients, often in a poor psychiatric state, for medical evacuation by commercial aircraft. Another important question is the best way to take the patient through customs and security control. All of these, as yet unresolved, issues can make the mental patient virtually defenseless. Although timely repatriation of a mentally ill patient is vital and urgent, most travel insurance policies exclude treatment and repatriation costs incurred due to acute mental illness. The high cost of treatment and repatriation must be paid by the patient or their family, which could lead to severe financial strain or insolvency. Changing the approaches taken by the local mental health care community, police, airport security, and insurance companies remain a challenge for psychiatrists. © International Society of Travel Medicine, 2017

Travel, infection and immunity

NARCIS (Netherlands)

Soonawala, Darius

2016-01-01

Preface: The content of this thesis is based on research that was conducted at the travel and vaccination clinic at Leiden University Medical Centre (LUMC). This clinic provides pre-travel care to the general population, and to special groups of travellers, such as patients who use

Travel agents and the prevention of health problems among travelers in Québec.

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Provost, Sylvie; Gaulin, Colette; Piquet-Gauthier, Blandine; Emmanuelli, Julien; Venne, Sylvie; Dion, Réjean; Grenier, Jean-Luc; Dessau, Jean-Claude; Dubuc, Martine

2002-01-01

Among the factors influencing travelers to seek preventive health advice before departure, the travel agent's recommendation plays an important role. The objective of our study was to document the practices and needs of travel agents in Québec (Canada) in relation to the prevention of health problems among travelers. In June 2000, a cross-sectional descriptive survey was carried out among travel agents from all travel agencies in Québec. One agent per agency was asked to answer our questions. Data were collected using a 32-item telephone questionnaire. Altogether, 708 travel agents from the 948 agencies contacted answered our questionnaire (participation rate: 75%). Most respondents (81%) believed that the travel agent has a role to play in the prevention of health problems among travelers, especially to recommend that travelers consult a travel clinic before departure. Although over 80% of the agents interviewed mentioned recommending a visit to a travel clinic before an organized tour to Thailand or a backpacking trip in Mexico, less than half said they make the same recommendation for a stay in a seaside resort in Mexico. The majority of respondents were acquainted with the services offered in travel health clinics, and these clinics were the source of travel health information most often mentioned by travel agents. However, nearly 60% of the agents questioned had never personally consulted a travel clinic. When asked about the best way to receive information about travelers' health, more than 40% of respondents favoured receiving information newsletters from public health departments regularly whereas 28% preferred the Internet. Despite the limits of this study, our results should help the public health network better target its interventions aimed to inform travel agents on prevention of health problems among travelers.

Travel characteristics and risk-taking attitudes in youths traveling to nonindustrialized countries.

Science.gov (United States)

Han, Pauline; Balaban, Victor; Marano, Cinzia

2010-01-01

importance of pretravel advice, target parents of children who are traveling, and be communicated through family doctors. © 2010 International Society of Travel Medicine.

Acceptability of delivery of dietary advice in the dentistry setting to address obesity in pre-school children: a case study of the Common Risk Factor Approach.

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Henderson, Emily J

2015-07-01

The Common Risk Factor Approach proposes that public health efforts can be improved by multiple agencies working together on a shared risk factor. The present study aimed to assess the acceptability to parents, dental practice staff and commissioners of the delivery of dietary advice in the dentistry setting in order to address obesity. Semi-structured focus groups with dental practice staff and one-to-one interviews with parents of pre-school children and public health commissioners involved in an oral health promotion initiative delivering dietary advice in dental surgeries. Data were analysed using the Framework Approach. General dental practice surgeries and pre-schools in areas of high deprivation in north-east England. Parents (n 4), dental practice staff (n 23) and one commissioner. All participants found acceptable the concept of delivering public health messages in non-conventional settings. Dental practice staff were concerned about the potential for conflicting messages and deprioritisation of oral health advice, and they identified practical barriers to delivery, such as lack of training. Parents were very apprehensive about the potential of such approaches to stigmatise overweight children, including bullying. Uncertainty over the causes of obesity led to confusion about its solutions and the roles of public health and health care. Major concerns about the implementation of the Common Risk Factor Approach were raised by parents and dental practice staff. Specific dietary guidance for both oral health and healthy weight, as well as further research into issues of suitability, feasibility and stigmatisation, are needed.

[The profile of Israeli travelers to developing countries: perspectives of a travel clinic].

Science.gov (United States)

Stienlauf, Shmuel; Meltzer, Eyal; Leshem, Eyal; Rendi-Wagner, Pamela; Schwartz, Eli

2010-09-01

The number of Israeli travelers is increasing, including the number of travelers to developing countries. This study aimed to characterize the profile of Israeli travelers to developing countries. Data regarding demographics, travel destinations, trip duration and the purpose of travel were collected on travelers attending the pre-travel clinic at the Sheba Medical Center during a period of 9 years. Between the dates 1/1/1999 and 31/12/2007, 42,771 travelers presented for consultation at the Sheba Medical Center pre-travel clinic. The average age was 30.8 +/- 13.4 years and 54% of the travelers were males. The female proportion increased from 42% in 1999 to 49% in 2006. There was a steady increase in the number of travelers attending our clinic, except in 2003 (coinciding with the SARS epidemic). Post-army backpackers (20-25 year-old age group) were only 43% of the travelers. Children (60 years) comprised 4.4% and 4.6% of the travelers, respectively. The favorite destinations were Asia (55%), followed by Latin America (27%) and Africa (13%). The distribution of travel destinations varied significantly during the study period. Of note is the sharp decline in travel to Africa following the terrorist attack in Mombassa, Kenya (November 2002). The median trip duration changed during the study period, from 30 to 45 days, between 1999-2004 and 2005-2007 respectively. The majority (87%) of voyagers traveled for pleasure, 6% went for business, and 7% were representatives of governmental organizations. This study found an increasing diversity in the traveler population (more women, more children and older travelers) and more diversity in travel destinations. Disease outbreaks and terrorist attacks had transient negative impacts on the number of travelers.

41 CFR 301-75.204 - May we use Government contractor-issued travelers checks to pay for the interviewee's travel...

Science.gov (United States)

2010-07-01

... contractor-issued travelers checks to pay for the interviewee's travel expenses? 301-75.204 Section 301-75.204 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 75-PRE-EMPLOYMENT INTERVIEW TRAVEL Obtaining Travel Services...

Travel-related schistosomiasis, strongyloidiasis, filariasis, and toxocariasis: the risk of infection and the diagnostic relevance of blood eosinophilia

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Sonder Gerard J

2011-04-01

Full Text Available Abstract Background This study prospectively assessed the occurrence of clinical and subclinical schistosomiasis, strongyloidiasis, filariasis, and toxocariasis, and the screening value of eosinophilia in adult short-term travelers to helminth-endemic countries. Methods Visitors of a pre-travel health advice centre donated blood samples for serology and blood cell count before and after travel. Samples were tested for eosinophilia, and for antibodies against schistosomiasis, strongyloidiasis, filariasis, and toxocariasis. Previous infection was defined as seropositivity in pre- and post-travel samples. Recent infection was defined as a seroconversion. Symptoms of parasitic disease were recorded in a structured diary. Results Previous infection was found in 112 of 1207 subjects: schistosomiasis in 2.7%, strongyloidiasis in 2.4%, filariasis in 3.4%, and toxocariasis in 1.8%. Recent schistosomiasis was found in 0.51% of susceptible subjects at risk, strongyloidiasis in 0.25%, filariasis in 0.09%, and toxocariasis in 0.08%. The incidence rate per 1000 person-months was 6.4, 3.2, 1.1, and 1.1, respectively. Recent infections were largely contracted in Asia. The positive predictive value of eosinophilia for diagnosis was 15% for previous infection and 0% for recent infection. None of the symptoms studied had any positive predictive value. Conclusion The chance of infection with schistosomiasis, strongyloidiasis, filariasis, and toxocariasis during one short-term journey to an endemic area is low. However, previous stay leads to a cumulative risk of infection. Testing for eosinophilia appeared to be of no value in routine screening of asymptomatic travelers for the four helminthic infections. Findings need to be replicated in larger prospective studies.

Relationships between female tourists and male locals in Cuzco/Peru: implications for travel health education.

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Bauer, Irmgard

2009-11-01

Health concerns regarding casual sexual encounters during travel have been recognized for some time. The perception that female travellers' motivations are more romantic rather than sexual when entering a relationship with local men may exclude them from receiving appropriate travel health advice. This may pose even greater health risks, not only to themselves but also to their local partners. This paper presents 11 Western female tourists' perceptions of their relationships with local men in Cuzco/Peru, based on in-depth interviews, observations, and informal discussions. Relationships with local men were often triggered by their physical appearance. Other themes identified were: methods and location of first contact, benefits for the local men, safe sex/condom use, and travel health advice received. The findings support calls for more emphasis on sexual health in travel health education. Three aspects should be included: 1) an awareness that unfamiliar environment can cause 'out of character' behaviour, 2) an emphasis on not only to use but to not stop using condoms, and 3) the need to acquire negotiation skills.

Travel vaccines: Information for health care workers | Schellack ...

African Journals Online (AJOL)

This review briefly examines some of the important vaccine preventable diseases related to travel. We then outline diseases known to Africa and other similar parts of the world, and potential approaches for preventing these conditions. The paper provides practical advice for health care workers when consulting with the ...

Travel, infection and immunity

OpenAIRE

Soonawala, Darius

2016-01-01

Preface: The content of this thesis is based on research that was conducted at the travel and vaccination clinic at Leiden University Medical Centre (LUMC). This clinic provides pre-travel care to the general population, and to special groups of travellers, such as patients who use immunosuppressants or who have chronic diseases. The clinic is closely connected to the department of Infectious Diseases at LUMC. The setting of a travel clinic within an academic medical hospital, provides unique...

A cluster randomised controlled trial of advice, exercise or multifactorial assessment to prevent falls and fractures in community-dwelling older adults: protocol for the prevention of falls injury trial (PreFIT).

Science.gov (United States)

Bruce, Julie; Lall, Ranjit; Withers, Emma J; Finnegan, Susanne; Underwood, Martin; Hulme, Claire; Sheridan, Ray; Skelton, Dawn A; Martin, Finbarr; Lamb, Sarah E

2016-01-18

Falls are the leading cause of accident-related mortality in older adults. Injurious falls are associated with functional decline, disability, healthcare utilisation and significant National Health Service (NHS)-related costs. The evidence base for multifactorial or exercise interventions reducing fractures in the general population is weak. This protocol describes a large-scale UK trial investigating the clinical and cost-effectiveness of alternative falls prevention interventions targeted at community dwelling older adults. A three-arm, pragmatic, cluster randomised controlled trial, conducted within primary care in England, UK. Sixty-three general practices will be randomised to deliver one of three falls prevention interventions: (1) advice only; (2) advice with exercise; or (3) advice with multifactorial falls prevention (MFFP). We aim to recruit over 9000 community-dwelling adults aged 70 and above. Practices randomised to deliver advice will mail out advice booklets. Practices randomised to deliver 'active' interventions, either exercise or MFFP, send all trial participants the advice booklet and a screening survey to identify participants with a history of falling or balance problems. Onward referral to 'active' intervention will be based on falls risk determined from balance screen. The primary outcome is peripheral fracture; secondary outcomes include number with at least one fracture, falls, mortality, quality of life and health service resource use at 18 months, captured using self-report and routine healthcare activity data. The study protocol has approval from the National Research Ethics Service (REC reference 10/H0401/36; Protocol V.3.1, 21/May/2013). User groups and patient representatives were consulted to inform trial design. Results will be reported at conferences and in peer-reviewed publications. A patient-friendly summary of trial findings will be published on the prevention of falls injury trial (PreFIT) website. This protocol adheres to the

Attitude and practice of medical students studying in Hungary and India toward health during overseas and domestic travel.

Science.gov (United States)

Sweni, Shah; Muthusundari, Arunachalam; Meenakshisundaram, Ramachandran; Uma, Alagappan; Thirumalaikolundusubramanian, Ponniah

2010-01-01

[150/0], sun screen [160/14], and items against sexually transmitted diseases [159/0]; health documents such as medical insurance card [161/3], previous health records [40/0], immuno-prophylaxis [127/0], family physician's phone number [43/9] and pre-travel advice [57/2]. Students studying in Hungary were better informed about travel-related issues than native students from Indian medical colleges. The probable reasons for such variations were cultural differences, variation in their pre-medical curricula and teaching, frequent travel, a previous university degree, military training, maturity, and staying away from parents. The overall attitude and practice of medical students toward travel health issues were sub-optimal, since the subjects taught did not focus much on travel and health-related issues. Hence, there is an urgent need to initiate standardized teaching in the field of travel medicine for the students of health sciences for the benefit of the community. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Who Will Use Pre-Trip Traveler Information and How Will They Respond? Insights from Zhongshan Metropolitan Area, China

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Yi Zhang

2015-05-01

Full Text Available The Intelligent Transportation System (ITS is able to make the transportation system safer, smoother, and more sustainable. The research and practice of pre-trip traveler information (PTI, an indispensable component of ITS, is very limited in China. With data collected from Zhongshan Metropolitan Area, China, this empirical study revealed the socio-demographics of potential PTI users and feasible travel responses in daily trips under PTI. Young-and-middle-aged, influential, and motorized males were the most potential PTI users, while unemployed young females the least. Among the motorized potential users who habitually traveled by car, the high-income sub-group was least likely to shift travel modes under PTI. The younger white-collar or blue-collar had a lower propensity to shift to bicycle, but the younger blue-collar workers were more likely to shift to walking. The low income preferred to shift to bus rather than elevated light rail due to the difference of travel cost. The findings will facilitate our understanding of the market segments and effects of PTI, improve the system design and implementation strategy, and help address urban traffic and environmental issues throughout China.

Risk of rabies exposure among travellers

NARCIS (Netherlands)

Wieten, R. W.; Tawil, S.; van Vugt, M.; Goorhuis, A.; Grobusch, M. P.

2015-01-01

In recent years, requests for rabies immunoglobulin have increased at Amsterdam's Academic Medical Center's travel clinic. Travellers who received rabies pre-exposure prophylaxis (PrEP) before travel departure have immunological memory that can quickly be activated by timely booster vaccinations

Tuberculosis screening of travelers to higher-incidence countries: A cost-effectiveness analysis

Directory of Open Access Journals (Sweden)

Menzies Dick

2008-06-01

Full Text Available Abstract Background Travelers to countries with high tuberculosis incidence can acquire infection during travel. We sought to compare four screening interventions for travelers from low-incidence countries, who visit countries with varying tuberculosis incidence. Methods Decision analysis model: We considered hypothetical cohorts of 1,000 travelers, 21 years old, visiting Mexico, the Dominican Republic, or Haiti for three months. Travelers departed from and returned to the United States or Canada; they were born in the United States, Canada, or the destination countries. The time horizon was 20 years, with 3% annual discounting of future costs and outcomes. The analysis was conducted from the health care system perspective. Screening involved tuberculin skin testing (post-travel in three strategies, with baseline pre-travel tests in two, or chest radiography post-travel (one strategy. Returning travelers with tuberculin conversion (one strategy or other evidence of latent tuberculosis (three strategies were offered treatment. The main outcome was cost (in 2005 US dollars per tuberculosis case prevented. Results For all travelers, a single post-trip tuberculin test was most cost-effective. The associated cost estimate per case prevented ranged from $21,406 for Haitian-born travelers to Haiti, to $161,196 for US-born travelers to Mexico. In all sensitivity analyses, the single post-trip tuberculin test remained most cost-effective. For US-born travelers to Haiti, this strategy was associated with cost savings for trips over 22 months. Screening was more cost-effective with increasing trip duration and infection risk, and less so with poorer treatment adherence. Conclusion A single post-trip tuberculin skin test was the most cost-effective strategy considered, for travelers from the United States or Canada. The analysis did not evaluate the use of interferon-gamma release assays, which would be most relevant for travelers who received BCG

Health risks for students on overseas placements.

Science.gov (United States)

Driver, Carolyn

Health profession students are encouraged to take an elective during training and many do this overseas in tropical, low-income countries. Higher education institutions should offer advice and support on organising these placements but this varies and students may present for pre-travel health advice at their general practice or travel clinic. This article discusses how they should be advised.

European pet travel: misleading information from veterinarians and government agencies.

Science.gov (United States)

Davidson, R K; Robertson, L J

2012-12-01

Inter-country travel of companion animals provides an opportunity for introduction of zoonotic pathogens, such as rabies virus and Echinococcus spp. Regulations are in place to control this threat, but Schengen Agreements mean that border controls between some European countries are minimal, and animals may enter countries without any checks that they have been appropriately treated. Veterinarians provide an important source of information for people intending to travel with their pets. We conducted a telephone survey to investigate provision of correct advice to someone intending to travel with their dog to Norway. Mainland Norway is considered free of both rabies and E. multilocularis and is a signatory to the Schengen Agreement. Ten randomly selected veterinary clinics were surveyed in Austria, Belgium (Wallonia), Finland, France, Germany, Norway, Sweden, Switzerland and United Kingdom. The information provided was scored as correct, incorrect or incomplete. The information provided by secondary information sources (website or government agency), which the clinic had referred the caller to, was also assessed (correct, incorrect, incomplete). Whilst the majority of clinics provided appropriate information regarding rabies, many clinics did not provide correct information regarding treatment for E. multilocularis. Less than one in 10 clinics provided the correct information regarding both pathogens directly at the time of calling. The correct information was obtained, once taking into account secondary sources, just 62% of the time. Countrywise, most clinics in Finland provided correct advice, either directly or indirectly via referring the caller to another source, whilst the majority in Belgium, Germany and France did not. The apparent paucity of readily accessible, correct advice for owners intending to travel with their dogs is concerning. The compulsory treatment regulations are only as good as the checks that ensure compliance, and this is also lacking in

Self-reported infections during international travel and notifiable infections among returning international travellers, Sweden, 2009-2013.

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Viktor Dahl

Full Text Available We studied food and water-borne diseases (FWDs, sexually transmitted diseases (STDs, vector-borne diseases (VBDs and diseases vaccinated against in the Swedish childhood vaccination programme among Swedish international travellers, in order to identify countries associated with a high number of infections. We used the national database for notifiable infections to estimate the number of FWDs (campylobacteriosis, salmonellosis, giardiasis, shigellosis, EHEC, Entamoeba histolytica, yersinosis, hepatitis A, paratyphoid fever, typhoid fever, hepatitis E, listeriosis, cholera, STIs (chlamydia, gonorrhoea and acute hepatitis B, VBDs (dengue fever, malaria, West Nile fever, Japanese encephalitis and yellow fever and diseases vaccinated against in the Swedish childhood vaccination programme (pertussis, measles, mumps, rubella, diphtheria acquired abroad 2009-2013. We obtained number and duration of trips to each country from a database that monthly collects travel data from a randomly selected proportion of the Swedish population. We calculated number of infections per country 2009-2013 and incidence/million travel days for the five countries with the highest number of infections. Thailand had the highest number of FWDs (7,697, incidence 191/million travel days, STIs (1,388, incidence 34/million travel days and VBDs (358, incidence 9/million travel days. France had the highest number of cases of diseases vaccinated against in the Swedish childhood vaccination programme (8, 0.4/million travel days. Swedish travellers contracted most infections in Thailand. Special focus should be placed on giving advice to travellers to this destination.

Travel-related acquisition of diarrhoeagenic bacteria, enteral viruses and parasites in a prospective cohort of 98 Dutch travellers.

Science.gov (United States)

van Hattem, Jarne M; Arcilla, Maris S; Grobusch, Martin P; Bart, Aldert; Bootsma, Martin C; van Genderen, Perry J; van Gool, Tom; Goorhuis, Abraham; van Hellemond, Jaap J; Molenkamp, Richard; Molhoek, Nicky; Oude Lashof, Astrid M; Stobberingh, Ellen E; de Wever, Bob; Verbrugh, Henri A; Melles, Damian C; Penders, John; Schultsz, Constance; de Jong, Menno D

2017-09-01

Limited prospective data are available on the acquisition of viral, bacterial and parasitic diarrhoeagenic agents by healthy individuals during travel. To determine the frequency of travel associated acquisition of 19 pathogens in 98 intercontinental travellers, qPCR was used to detect 8 viral pathogens, 6 bacterial enteric pathogens and 5 parasite species in faecal samples collected immediately before and after travel. We found high pre-travel carriage rates of Blastocystis spp. and Dientamoeba fragilis of 32% and 19% respectively. Pre-travel prevalences of all other tested pathogens were below 3%. Blastocystis spp. (10%), Plesiomonas shigelloides (7%), D. fragilis (6%) and Shigella spp. (5%) were the most frequently acquired pathogens and acquisition of enteral viruses and hepatitis E virus in this relatively small group of travellers was rare or non-existent. Our findings suggest that the role of viruses as the cause of persisting traveller's diarrhoea is limited and bacterial pathogens are more likely as a cause of traveller's diarrhoea. The substantial proportion of travellers carrying Blastocystis spp. and D. fragilis before travel warrants cautious interpretation of positive samples in returning travellers with gastrointestinal complaints. Copyright © 2017 Elsevier Ltd. All rights reserved.

Post-Travel Consultations in a Regional Hub City Hospital, Japan.

Science.gov (United States)

Yaita, Kenichiro; Sakai, Yoshiro; Iwahashi, Jun; Masunaga, Kenji; Hamada, Nobuyuki; Watanabe, Hiroshi

2016-01-01

To clarify the characteristics of post-travel consultation services in Japan, particularly in the provinces, we analyzed our post-travel patients in the travel clinic of Kurume University Hospital located in Kurume City (a regional hub City in southwestern Japan). Sixty post-travel patients visited our clinic between April 2008 and October 2014 and participated in this study: 55 were Japanese and five were foreign. We summarized and compared the characteristics of the patients after dividing the Japanese participants into long-term travelers (>14 days) and short-term travelers (≤14 days). The foreign travelers were described in a separate analysis. Of the 55 Japanese travelers, the mean age (± standard deviation) was 37.3 ± 16.3 years, and 36 patients (65%) were men. Southeast Asia was the major destination (30/55, 55%), and business was stated as the major reason for travel (16/55, 29%). Post-exposure rabies prophylaxis (16/55, 29%) was the most common purpose for the consultations. There were 34 participants (62%) who were classified as short-term travelers. Fewer of the short-term travelers stated receiving pre-travel consultations compared with long-term travelers (11% vs. 79%, p=0.0002). The five foreign travelers included one dengue fever patient and two malaria patients. Most post-travel Japanese patients visited our clinic were short-term travelers who had not received any pre-travel consultation. One of the most common complaints, post-exposure rabies prophylaxis, could have been avoided to some extent by appropriate pre-travel consultations. The results of this study suggest that pre-travel consultations should therefore be encouraged for both long- and short-term travelers.

Diseases and injuries associated with travel among students, employees and teachers of the Central University of Venezuela during the national summer vacations.

Science.gov (United States)

Risquez, Alejandro; Marrero, Aiskel; Naranjo, Niurka; Palacios, Yanine; Rossomando, Maria T; Rodriguez-Morales, Alfonso J

2010-01-01

The objective of this study was to describe the incidence of disease and injuries associated with travel, etiology, risk factors and medical management in a cross-sectional evaluation of university students, employees and teachers of the Central University of Venezuela, Caracas, Venezuela, who returned from domestic travel. A questionnaire completed by 500 individuals was used to evaluate the incidence of disease and injuries associated with travel, the etiology, risk factors and medical management in university students, employees and teachers of Caracas, Venezuela. From the total who accepted and responded to the interview (460, 92%), 50.8% were females. Almost half of them had some vaccination before travel for: measles 78%, rubella 73.6%, hepatitis B 57%, Yellow fever 53.7%. After travel, 53.9% of the individuals reported disease or injury related with travel, including insect bites (22%), which was reported most commonly. Occurrence of disease and injuries was higher for those who traveled to the jungle (OR=5.23, 95% CI 0.62-43.80), followed by those who travel to two areas (OR=1.82, 95% CI 1.06-3.13). Drinking alcohol during travel was identified in 73.8%, was significantly higher in men (ptravel. The results indicated the importance of education and training in travel medicine, a relatively new medical discipline in Venezuela. Venezuela has a significant number of people visiting areas at risk for the acquisition of tropical and non-tropical conditions. Occasionally, travelers were without adequate preventive measures and pre-travel advice which is considered of utmost importance. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

What proportion of international travellers acquire a travel-related illness? A review of the literature.

Science.gov (United States)

Angelo, Kristina M; Kozarsky, Phyllis E; Ryan, Edward T; Chen, Lin H; Sotir, Mark J

2017-09-01

As international travel increases, travellers may be at increased risk of acquiring infectious diseases not endemic in their home countries. Many journal articles and reference books related to travel medicine cite that between 22-64% of international travellers become ill during or after travel; however, this information is minimal, outdated and limited by poor generalizability. We aim to provide a current and more accurate estimate of the proportion of international travellers who acquire a travel-related illness. We identified studies via PubMed or travel medicine experts, published between January 1, 1976-December 31, 2016 that included the number of international travellers acquiring a travel-related illness. We excluded studies that focused on a single disease or did not determine a rate based on the total number of travellers. We abstracted information on traveller demographics, trip specifics, study enrollment and follow-up and number of ill travellers and their illnesses. Of 743 studies, nine met the inclusion criteria. The data sources were from North America (four studies) and Europe (five studies). Most travellers were tourists, the most frequent destination regions were Asia and Africa, and the median trip duration ranged from 8-21 days. Six studies enrolled participants at the travellers' pre-travel consultation. All studies collected data through either extraction from the medical record, weekly diaries, or pre- and post-travel questionnaires. Data collection timeframes varied by study. Between 6-87% of travellers became ill across all studies. Four studies provided the best estimate: between 43-79% of travellers who frequently visited developing nations (e.g. India, Tanzania, and Kenya) became ill; travellers most frequently reported diarrhoea. This is the most comprehensive assessment available on the proportion of international travellers that develop a travel-related illness. Additional cohort studies would provide needed data to more precisely

Destination specific risks of acquisition of notifiable food- and waterborne infections or sexually transmitted infections among Finnish international travellers, 1995-2015.

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Zöldi, Viktor; Sane, Jussi; Kantele, Anu; Rimhanen-Finne, Ruska; Salmenlinna, Saara; Lyytikäinen, Outi

2017-10-10

Overnight international travels made by Finns more than doubled during 1995-2015. To estimate risks and observe trends of travel-related notifiable sexually transmitted and food- and water-borne infections (STIs and FWIs) among travellers, we analysed national reports of gonorrhoea, syphilis, hepatitis A, shigellosis, campylobacteriosis and salmonellosis cases and related them to travel statistics. Cases notified as travel-related to the Finnish infectious diseases register were used as numerators and overnight stays of Statistics Finland surveys as denominator. We calculated overall risks (per 100,000 travellers) and assessed trends (using regression model) in various geographic regions. Of all travel-related cases during 1995-2015, 2304 were STIs and 70,929 FWIs. During 2012-2015, Asia-Oceania showed highest risk estimates for gonorrhoea (11.0; 95%CI, 9.5-13), syphilis (1.4; 0.93-2.1), salmonellosis (157; 151-164), and campylobacteriosis (135; 129-141), and Africa for hepatitis A (4.5; 2.5-7.9), and shigellosis (35; 28-43). When evaluating at country level, the highest risks of infections was found in Thailand, except for hepatitis A ranking Hungary the first. During 2000-2011, significantly decreasing trends occurred for most FWIs particularly in the European regions and for STIs in Russia-Baltics. Our findings can be used in targeting pre-travel advice, which should also cover those visiting Thailand or European hepatitis A risk areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of cardiology consultations sought from the anaesthesia clinic

International Nuclear Information System (INIS)

Minai, F.N.; Kamal, R.S.

2004-01-01

Objective: To evaluate the criteria for cardiology referrals and to assess the perioperative relevance of the cardiology advice given in patients evaluated for non-cardiac surgery. Materials and Methods: A review of case files of 70 patients, scheduled for non-cardiac surgery, who were referred for cardiology consultations from the Anaesthesia Clinic at AKUH during the study period. The clinical criteria for seeking cardiology advice, the cardiology advice given, its influence on patient management, as well as number of adverse cardiac events in the perioperative period were documented. Results: A history of hypertension, ischemic heart disease, and ECG abnormalities were the major criteria for seeking opinion on cardiac status. Cardiology advice frequently resulted in the ordering of extensive cardiac investigations. Among the patients identified for further tests by the cardiologists, 75% had no evidence of ischemic heart disease or myocardial dysfunction; none of them were monitored invasively intraoperatively or had adverse cardiac events in the perioperative period requiring intensive care or prolonged hospital stay. Conclusion: No definite criteria or pattern for referrals was identified. Most of the referrals did not fall within the AHA guidelines. Cardiology advice given had very little influence on the perioperative management. (author)

Pharmacy travel health services: current perspectives and future prospects

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Houle SKD

2018-03-01

Full Text Available Sherilyn KD HouleSchool of Pharmacy, University of Waterloo, Waterloo, ON, CanadaAbstract: Rates of international travel are increasing annually, with particular growth observed in travel to Southeast Asia and to emerging economies. While all patients traveling across geographic regions are recommended to receive a pre-travel consultation to consider their individual risks, many do not, or receive care and recommendations that are not consistent with current evidence-based guidelines. As experts in drug therapy, and given the largely preventive nature of most travel health recommendations, pharmacists are well suited to help address this need. Pharmacists generally possess a high degree of knowledge and confidence with more commonly observed travel health topics in community practice such as travelers’ diarrhea; however, training in more specialized travel health topics such as travel vaccinations and traveling at altitude has generally been lacking from pharmacy curricula. Pharmacists with an interest in providing pre-travel consultations are encouraged to pursue additional training in this specialty and to consider Certificate in Travel Health designation from the International Society of Travel Medicine. Future roles for pharmacists to include the prescribing of medications and vaccines for travel and the in-pharmacy administration of travel vaccinations may improve patient access to pre-travel consultations and recommended preventive measures, improving the health of travelers and potentially reducing the burden of communicable disease worldwide. Pharmacists providing travel care to patients are also reminded to consider noninfectious risks of illness and injury abroad and to counsel patients on strategies to minimize these risks in addition to providing drug and vaccine recommendations.Keywords: pharmacist, community pharmacy, travel, vaccination

Vaccination knowledge, attitude and practice among Chinese travelers who visit travel clinics in Preparation for international travel.

Science.gov (United States)

Zhang, Min; Zhang, Jianming; Hao, Yutong; Fan, ZhengXing; Li, Lei; Li, Yiguang; Ju, Wendong; Zhang, Hong; Liu, Wei; Zhang, Mengzhang; Wu, Di; He, Hongtao

2016-06-01

Although international travel has become increasingly more common in main land China, few data are available on vaccination knowledge, attitude and practice (KAP) among Chinese travelers. In each of 14 International Travel Healthcare Centers (ITHCs) situated in mainland China 200 volunteers were recruited for a cross-sectional investigation by questionnaire on KAP related to travel vaccinations. For the evaluation the study subjects were grouped by demographic data, past travel experience, travel destination, duration of stay abroad, purpose of travel. Among the 2,800 Chinese travelers who participated in the study, 67.1% were aware of national and travel vaccination recommendations. The knowledge about vaccine preventable diseases was low. The most common sources (73.4%) of information were requirements by destination countries obtained in connection with the visa application, Chinese companies employing workers/laborers for assignments overseas, and foreign schools. The overall acceptance rate of recommended vaccines was 68.7%, but yellow fever was accepted by 99.8% of the participants when recommended. Among 81.1% respondents who recalled to have received vaccinations in the past, only 25.9% of them brought the old vaccination records with them to their ITHC consultations. The results indicate that increased awareness of the importance of pre-travel vaccination is needed among the travellers in order to improve their KAP. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

Real-time travel time prediction framework for departure time and route advice

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Calvert, S.C.; Snelder, M.; Bakri, T.; Heijligers, B.; Knoop, V.L.

2015-01-01

Heavily used urban networks remain a challenge for travel time prediction because traffic flow is rarely homogeneous and is also subject to a wide variety of disturbances. Various models, some of which use traffic flow theory and some of which are data driven, have been developed to predict traffic

Travel related diseases and optimizing preventive strategies

NARCIS (Netherlands)

Wieten, R.W.

2016-01-01

With the figure of 1 billion annual travellers continuously increasing, travel is becoming more and more common. The binding element of this thesis is the aim to contribute to the improvement of pre-travel healthcare. The diseases studied either carry a high mortality (rabies, malaria, yellow fever)

Health care workers and researchers traveling to developing-world clinical settings: disease transmission risk and mitigation.

Science.gov (United States)

Kortepeter, Mark G; Seaworth, Barbara J; Tasker, Sybil A; Burgess, Timothy H; Coldren, Rodney L; Aronson, Naomi E

2010-12-01

With the recent emphasis on funding and training opportunities for global health and humanitarian aid and the increased interest in the field, many health care workers and medical researchers are traveling from resource-replete to resource-limited settings. This type of travel brings unique disease risks not routinely considered for the business or vacationing traveler. This review provides practical advice for this special population of travelers, targeted to specific health care-related risks (needlestick, hemorrhagic fever viruses, severe viral respiratory disease, and tuberculosis), with suggestions for risk mitigation.

MANAGEMENT OF DIABETES DURING AIR TRAVEL: A SYSTEMATIC LITERATURE REVIEW OF CURRENT RECOMMENDATIONS AND THEIR SUPPORTING EVIDENCE.

Science.gov (United States)

Pavela, James; Suresh, Rahul; Blue, Rebecca S; Mathers, Charles H; Belalcazar, L Maria

2018-02-01

Individuals with diabetes are increasingly seeking pretravel advice, but updated professional recommendations remain scant. We performed a systematic review on diabetes management during air travel to summarize current recommendations, assess supporting evidence, and identify areas of future research. A systematic review of the English literature on diabetes management during air travel was undertaken utilizing PubMed and MEDLINE. Publications regarding general travel advice; adjustment of insulin and noninsulin therapies; and the use of insulin pumps, glucometers and subcutaneous glucose sensors at altitude were included. Gathered information was used to create an updated summary of glucose-lowering medication adjustment during air travel. Sixty-one publications were identified, most providing expert opinion and few offering primary data (47 expert opinion, 2 observational studies, 2 case reports, 10 device studies). General travel advice was uniform, with increasing attention to preflight security. Indications for oral antihyperglycemic therapy adjustments varied. There were few recommendations on contemporary agents and on nonhypoglycemic adverse events. There was little consensus on insulin adjustment protocols, many antedating current insulin formulations. Most publications advocated adjusting insulin pump time settings after arrival; however, there was disagreement on timing and rate adjustments. Glucometers and subcutaneous glucose sensors were reported to be less accurate at altitude, but not to an extent that would preclude their clinical use. Recommendations for diabetes management during air travel vary significantly and are mostly based on expert opinion. Data from systematic investigation on glucose-lowering medication adjustment protocols may support the development of a future consensus statement. CSII = continuous subcutaneous insulin infusion (device) DPP-4 = dipeptidyl peptidase 4 EGA = error grid analysis GDH = glucose dehydrogenase GOX = glucose

STRATEGI PEMASARAN PAKET WISATA PADA PT. PANDAWA LIMA TOUR AND TRAVEL INDONESIA DI DENPASAR

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I Gede Adhi Suputra Arimbawa PG.

2017-01-01

Full Text Available This research is about the marketing strategies implemented by PT. Pandawa Lima Tour and Travel tour packages. Company offers tour packages in Bali and beyond Bali tour packages with variety of facilities. As a common general company, PT. Pandawa Lima Tour and Travel has the objective to make profit and trying to satisfy consumers. This research aims to determine the marketing strategy package in PT. Pandawa Lima Tour and Travel tour package in Denpasar. The data collection method in research carried out by the method of observation, in-depth interviews, library research, and technique documentation. The data analysis technique used is descriptive qualitative combined with the SWOT approach. Discussion of the results of the marketing strategy adopted by the PT. Pandawa Lima Tour and Travel is SO strategy by increasing sales promotion to target markets, enhance cooperation with hotels and travel agents and maintain the diversity and innovation of product and service quality. ST strategies to further enhance cooperation with other travel agencies, and improve service quality. WO strategies to enhance the promotion through the mass media, and printing brochures, expanding market segments and improve the quality of human resources in education and training. While WT strategy by increasing promotional activities and improve human resources. Based on the results of the discussion, can give advice - advice on marketing strategies in PT. Pandawa Lima Tour and Travel tour packages that maintain good relations with the company's existing transport and suggest PT. Pandawa Lima Tour and Travel to their own transport, improving education and training for employees and appropriate compensation, as well as updating the architecture buildings and office equipment.

Homeless Blogs as Travelogues. Travel as a Struggle for Recognition and Emplacement

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Halina Gąsiorowska

2017-07-01

Full Text Available Applying Clifford’s broad concept of travel, I discuss American homeless blogs as autobiographical travel writing serving the struggle for recognition of the street people. The analysed travelogues are hitchhiker Ruth Rader’s Ruthie in the Sky blog and self-made woman Brianna Karp’s Girl’s Guide to Homelessness – a memoir published on the basis of the blog bearing the same title. In the travelogues I analyse the characteristic features of a personal travel writing: travel of the self, advice for future travelers, geographic information and portrayal of society in which the travel is undertaken. I claim that homeless bloggers recounting their stories of otherness and displacement in the US contribute to (reconstructing American cultural identity their personal Self, just like many other American travelers before. Additionally, homeless blogging about homelessness is shown as the process of emplacement (Casey – the bloggers’ attempt of making themselves at home in the world.

Post-Travel Screening of Asymptomatic Long-Term Travelers to the Tropics for Intestinal Parasites Using Molecular Diagnostics

NARCIS (Netherlands)

Soonawala, D.; Lieshout, L.; Boer, den M.A.M.; Claas, E.C.J.; Verweij, J.J.; Godkewitsch, A.; Ratering, M.; Visser, L.G.

2014-01-01

The incidence of asymptomatic travel-related parasitic infection is uncertain. Previous studies did not distinguish new incident infections, from past infections. Regardless of symptoms, we performed multiplex real-time polymerase chain reaction on pre- and post-travel stool samples of Dutch

[Characteristics associated with pre travel medical consultation in tourists visiting Cuzco, Peru].

Science.gov (United States)

Mejia, Christian R; Cvetkovic-Vega, Aleksandar; Cruz, Briggite; Cárdenas, Matlin M; Quiñones-Laveriano, Dante M; Rodríguez-Morales, Alfonso J

2016-02-01

International tourism is increasing. Preventive Medicine remains important, especially the Pre-Travel Consultation (PTC). To determinate, the characteristics of tourists associated with PTC in tourists at Cuzco, Peru. A cross-sectional, analytical study, a secondary analysis of data from a database generated by survey of foreign tourists who visited Cuzco, in the waiting room of the airport was performed. The main variable was to have had a PTC at the tourist's country of residence, the area of residence was categorized according to health/risk of acquiring infectious diseases as traveler's diarrhea during their stay. These and other variables were analyzed and statistical association with generalized linear models were done. Of the 1827 tourists, 875 (48%) were men, with a median age of 33 years (range 18-88 years); 42% had a PTC. In the multivariate analysis, it was found that a PTC lower frequency was associated with male gender (aPR: 0.84; 95% CI: 0.75-0.94), and a higher frequency was associated with have born (aPR: 1.77; 95% CI: 1.39-2.27) and reside in an area of low risk of acquiring infectious diseases (aPR: 1.95; 95% CI: 1.26-3.00), adjusted for the history of a disease. Sex, region of birth and residence of tourists (as risk of acquiring infectious diseases) are associated with having a PTC. These findings may serve the health and government attending tourists who come to our country.

Pre-waste-emplacement ground-water travel time sensitivity and uncertainty analyses for Yucca Mountain, Nevada

International Nuclear Information System (INIS)

Kaplan, P.G.

1993-01-01

Yucca Mountain, Nevada is a potential site for a high-level radioactive-waste repository. Uncertainty and sensitivity analyses were performed to estimate critical factors in the performance of the site with respect to a criterion in terms of pre-waste-emplacement ground-water travel time. The degree of failure in the analytical model to meet the criterion is sensitive to the estimate of fracture porosity in the upper welded unit of the problem domain. Fracture porosity is derived from a number of more fundamental measurements including fracture frequency, fracture orientation, and the moisture-retention characteristic inferred for the fracture domain

Telemedical advice to long-distance passenger ferries

DEFF Research Database (Denmark)

Jensen, Olaf C; Bo Bøggild, Niels; Kristensen, Søren

2005-01-01

BACKGROUND: Radio medical (RM) advice for seafarers and traveling passengers is important and can be crucial for the optimal medical treatment on board ships. The aim of this study was to analyze the data from consultations with passenger ferries to identify areas for possible improvements. METHODS......: Data from the journals for 1 year from Radio Medical Denmark consultations with the medical officers on passenger ferries were analyzed retrospectively. RESULTS: Two hundred fourteen RM records, 73% pertaining to passengers and 27% for crew members, were analyzed. Passenger patients were generally...... complaints, and more than half of these involved severe or considerable pain. Only acetaminophen (paracetamol) and opioids were in the ferry medicine chest. At least 77 patients would have benefited from use of nonsteroidal anti-inflammatory drugs. CONCLUSIONS: The paramedical assistance and the medicine...

Guides to Sustainable Connections? Exploring Human-Nature Relationships among Wilderness Travel Leaders

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Grimwood, Bryan S. R.; Haberer, Alexa; Legault, Maria

2015-01-01

This paper explores and critically interprets the role wilderness travel may play in fostering environmental sustainability. The paper draws upon two qualitative studies that sought to understand human-nature relationships as experienced by different groups of wilderness travel leaders in Canada. According to leaders involved in the studies,…

Anxiety and health problems related to air travel.

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McIntosh, I B; Swanson, V; Power, K G; Raeside, F; Dempster, C

1998-12-01

A significant proportion of air travelers experience situational anxiety and physical health problems. Take-off and landing are assumed to be stressful, but anxiety related to other aspects of the air travel process, anxiety coping strategies, and in-flight health problems have not previously been investigated. We aimed to investigate frequency of perceived anxiety at procedural stages of air travel, individual strategies used to reduce such anxiety, and frequency of health problems on short-haul and long-haul flights. A questionnaire measuring the occurrence and frequency of the above was administered to two samples of intending travelers during a 3 month period to: (a) 138 travel agency clients, and (b) 100 individuals attending a hospital travel clinic. Of the 238 respondents, two thirds were women. Take-off and landing were a perceived source of anxiety for about 40% of respondents, flight delays for over 50%, and customs and baggage reclaim for a third of individuals. Most frequent anxiety-reduction methods included alcohol and cigarette use, and distraction or relaxation techniques. Physical health problems related to air travel were common, and there was a strong relationship between such problems and frequency of anxiety. Travel agency clients reported more anxiety but not more physical health symptoms overall than travel clinic clients. Women reported greater air-travel anxiety, and more somatic symptoms than men. Significant numbers of air travelers report perceived anxiety related to aspects of travel, and this is associated with health problems during flights. Airlines and travel companies could institute specific measures, including improved information and communication, to reassure clients and thereby diminish anxiety during stages of air-travel. Medical practitioners and travel agencies should also be aware of the potential stresses of air travel and the need for additional information and advice.

Dengue infections in non-immune travellers to Thailand.

Science.gov (United States)

Massad, E; Rocklov, J; Wilder-Smith, A

2013-02-01

Dengue is the most frequent arboviral disease and is expanding geographically. Dengue is also increasingly being reported in travellers, in particular in travellers to Thailand. However, data to quantify the risk of travellers acquiring dengue when travelling to Thailand are lacking. Using mathematical modelling, we set out to estimate the risk of non-immune persons acquiring dengue when travelling to Thailand. The model is deterministic with stochastic parameters and assumes a Poisson distribution for the mosquitoes' biting rate and a Gamma distribution for the probability of acquiring dengue from an infected mosquito. From the force of infection we calculated the risk of dengue acquisition for travellers to Thailand arriving in a typical year (averaged over a 17-year period) in the high season of transmission. A traveller arriving in the high season of transmission and remaining for 7 days has a risk of acquiring dengue of 0·2% (95% CI 0·16-0·23), whereas the risk for travel of 15 and 30 days' duration is 0·46% (95% CI 0·41-0·50) and 0·81% (95% CI 0·76-0·87), respectively. Our data highlight that the risk of non-immune travellers acquiring dengue in Thailand is substantial. The incidence of 0·81% after a 1-month stay is similar to that reported in prospective seroconversion studies in Israeli travellers to Thailand, highlighting that our models are consistent with actual data. Risk estimates based on mathematical modelling offer more detailed information depending on various travel scenarios, and will help the travel medicine provider give better evidence-based advice for travellers to dengue-endemic countries.

Student travel health and the role of universities and health clinics in New Zealand to prevent imported infections: a cross-sectional study.

Science.gov (United States)

Neave, Penny E; Nair, Balakrishnan; Heywood, Anita E

2017-05-01

Tertiary students are at risk of acquiring infectious diseases during overseas travel as they visit low-income countries, have low perceptions of risk and are unlikely to access travel health advice. Some will visit friends and relatives abroad, a group identified as disproportionately affected by imported infections. There is no national student travel health policy in NZ. This study aimed to explore travel health training of university-based health providers; academics' practices and perceptions of travel health; reasons for travel and countries visited by NZ university students, their travel health uptake and factors affecting decision making about this. A cross-sectional study consisting of surveys sent in 2014 to university clinics, senior academics and students. Surveys were completed by 251 respondents. Three of nine clinicians had only undertaken a short course in travel health. Competing resources and time constraints in health clinics were amongst the barriers to providing optimal services. Of the senior academics, only 14% were able to confirm their university collaborated with health clinics. Sixty seven percent of students were unaware that clinics provided travel health services and 19% had or intended to seek professional travel health advice. A national policy is warranted involving all stakeholders, utilizing innovative technologies to increase uptake of student travel health services. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Contact lens wearers' experiences while trekking in the Khumbu region/Nepal: a cross-sectional survey.

Science.gov (United States)

Bauer, Irmgard L

2015-01-01

Safe contact lens wear depends on a hygiene regime and lens-appropriate wear patterns which may be compromised during travel in remote and wilderness areas. The purpose of this study was to describe the experience of contact lens wearers while trekking at high-altitude in Nepal. For this descriptive study, trekkers with contact lenses were recruited in Lukla and invited to complete an online-questionnaire on trip preparation, contact lens use, care and experiences, and possible changes for future travel. Quantitative data were analysed using SurveyMonkey; content analysis applied to qualitative responses. The majority of the 158 participants (124; 78.48%) reported no problems with their lenses (daily disposables, soft lenses, extended-wear lenses, hard/rigid lenses) during their stay although dry air, dust, wind, cold temperatures, and difficult hygiene maintenance were challenging. Freezing lenses and freezing solutions were additional challenges. Thirty-four (21.52%) experienced a variety of problems. Improvements were requested from manufacturers. Lodges should provide better access to clean water, mirrors and lighting. Almost 60% of participants had not sought any pre-travel health advice. Remote and wilderness areas provide a challenge for appropriate contact lens wear and care. The decision between the potential risk of infection due to touching lenses (daily disposables, soft/hard lenses) and the potential risk of corneal erosion (extended-wear lenses) needs to be made in pre-travel consultations. Travel health professionals and travel agencies should remind CL-wearing trekkers to carefully assess their wear and care routine to accommodate potentially challenging conditions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Are French general practitioners consulted before travel to developing countries? A cross-sectional study conducted in a French airport.

Science.gov (United States)

Rovira, C; Buffel du Vaure, C; Partouche, H

2015-08-01

General practitioners (GPs) could play a central role in preventing travel-related health issues. The aim of this study was to assess, in travellers departing to developing countries from a French airport, the proportion of individuals having sought GP counseling before departure and to identify determinants for having consulted a GP. Cross-sectional study conducted between November 2012 and July 2013, in all adults living in France. Sociodemographic, health characteristics, type of travel and resources consulted before departure were collected. A descriptive analysis was performed. Determinants for having consulted a GP before departure were investigated using a logistic regression analysis. Of the 360 travellers included, 230 (64%) sought health counseling before departure. GPs were the main source of information for 134 (58%) travellers having sought health information and the only one for 49 (21%). Almost half of the travellers (48%) departing to sub-Saharan countries did not seek health counseling from a medical doctor (GP, non-GP specialist, specialist consulted in an international vaccination center or occupational physician). Individuals significantly more likely to travel without having consulted a GP were young and male, held foreign nationality, had travelled more than five times before, rarely consulted their GP and were travelling to a non-malarious area. GPs were the main but not the only source of information and counseling before traveling to a developing country. This study helps identify the characteristics of individuals likely to travel without having consulted a GP before departure. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Evaluation of a telephone advice nurse in a nursing faculty managed pediatric community clinic.

Science.gov (United States)

Beaulieu, Richard; Humphreys, Janice

2008-01-01

Nurse-managed health centers face increasing obstacles to financial viability. Efficient use of clinic resources and timely and appropriate patient care are necessary for sustainability. A registered nurse with adequate education and support can provide high-quality triage and advice in community-based practice sites. The purpose of this program evaluation was to examine the effect of a telephone advice nurse service on parent/caregiver satisfaction and access to care. A quasi-experimental separate pre-post sample design study investigated parent/caregiver satisfaction with a telephone advice nurse in an urban pediatric nurse-managed health center. The clinic medical information system was used to retrieve client visit data prior to the service and in the first year of the program. Statistically significant differences were found on two items from the satisfaction with the advice nurse survey: the reason for calling (P decision making (P nurse may increase both parent/caregiver and provider satisfaction and access to care.

Implicit normativity in scientific advice

DEFF Research Database (Denmark)

Folker, Anna Paldam; Andersen, Hanne; Sandøe, Peter

2008-01-01

This paper focuses on implicit normative considerations underlying scientific advice-those normative questions, decisions, or issues that scientific advisers and the general public are not fully aware of but that nevertheless have implications for the character of the advice given. Using...... nutritional science as an example, we identify three such implicit normative issues. The first concerns the aim of scientific advice: whether it is about avoiding harm or promoting good. The second concerns the intended beneficiaries of the advice: whether advice should be framed to benefit the society...... as a whole or with special concern for the most vulnerable members of the population. The third consideration involves scientific advisers' attempts to balance the strengths of the scientific evidence with the expected consequences of scientific advice. We hope to promote more explicit discussion...

Instructional Advice, Time Advice and Learning Questions in Computer Simulations

Science.gov (United States)

Rey, Gunter Daniel

2010-01-01

Undergraduate students (N = 97) used an introductory text and a computer simulation to learn fundamental concepts about statistical analyses (e.g., analysis of variance, regression analysis and General Linear Model). Each learner was randomly assigned to one cell of a 2 (with or without instructional advice) x 2 (with or without time advice) x 2…

Candiru--a little fish with bad habits: need travel health professionals worry? A review.

Science.gov (United States)

Bauer, Irmgard L

2013-01-01

Over the last 150 years, a little South American fish with alleged unsavory habits has become the stuff legends are made of. With growing visitor numbers to the Amazon basin, the question of whether the animal poses a threat to the many travelers to the region arises. Scientific literature was identified by searching MEDLINE, ScienceDirect, ProQuest, and Google Scholar. The reference lists of all obtained sources served to refine the search, including the original historical writings where obtainable. Nonscientific material was discovered through extensive web searches. First, the current popular understanding of the fish and its interaction with humans are presented followed by an overview of the historical literature on which this understanding is based. Next, the fish and its supposed attraction to humans are introduced. Finally, this review queries the evidence current medical advice utilizes for the prevention of attacks and the treatment of unfortunate hosts. Until evidence of the fish's threat to humans is forthcoming, there appears to be no need for considering the candiru in health advice for travelers to the Amazon. © 2013 International Society of Travel Medicine.

Health risks encountered by Dutch medical students during an elective in the tropics and the quality and comprehensiveness of pre-and post-travel care

Directory of Open Access Journals (Sweden)

Vandenbroucke Jan P

2010-12-01

Full Text Available Abstract Background Clinical and research electives abroad offer medical students many unique experiences. However, participating in an unfamiliar health-care setting combined with limited medical experience may place students at risk of illness. To improve pre-and post-travel care, we assessed the health risks and the quality and comprehensiveness of pre-and post-travel care in a cohort of Dutch medical students returning form an elective abroad. Methods All medical students who had performed an elective in the tropics between July 2006 and December 2008 were sent an informative email asking them to complete a web-based questionnaire. Results 180 of 242 (74% students completed the questionnaire. Regarding the risk of bloodborne viral infection: 67% of all students and 32% of junior students engaged in procedures that constitute a risk of exposure to bloodborne viral infection, often in countries with high HIV prevalence rates. None of nine students who experienced possible or certain mucosal or percutaneous exposure to potentially infectious body fluids reported the exposure at the time it occurred and none used PEP. Regarding other health risks: 8 of 40 (20% students stopped using mefloquine due to adverse effects. This left a sizeable proportion unprotected in countries that are hyperendemic for malaria. Post-travel screening for schistosomiasis, tuberculosis (tuberculin skin test and carriage of methicillin-resistant Staphylococcus aureus (MRSA encompassed approximately half of all students who should have been screened. Conclusions Based on the results of this study we have adopted an integral set of measures to reduce the health risks associated with an elective abroad. The pre and post-travel consult has been centralized and standardized as well as the distribution of PEP. In addition we have developed a mandatory module on Global Health for all medical students planning an elective abroad.

Health risks encountered by Dutch medical students during an elective in the tropics and the quality and comprehensiveness of pre-and post-travel care.

Science.gov (United States)

Sharafeldin, Elhadi; Soonawala, Darius; Vandenbroucke, Jan P; Hack, Evelien; Visser, Leo G

2010-12-02

Clinical and research electives abroad offer medical students many unique experiences. However, participating in an unfamiliar health-care setting combined with limited medical experience may place students at risk of illness. To improve pre-and post-travel care, we assessed the health risks and the quality and comprehensiveness of pre-and post-travel care in a cohort of Dutch medical students returning form an elective abroad. All medical students who had performed an elective in the tropics between July 2006 and December 2008 were sent an informative email asking them to complete a web-based questionnaire. 180 of 242 (74%) students completed the questionnaire. Regarding the risk of bloodborne viral infection: 67% of all students and 32% of junior students engaged in procedures that constitute a risk of exposure to bloodborne viral infection, often in countries with high HIV prevalence rates. None of nine students who experienced possible or certain mucosal or percutaneous exposure to potentially infectious body fluids reported the exposure at the time it occurred and none used PEP. Regarding other health risks: 8 of 40 (20%) students stopped using mefloquine due to adverse effects. This left a sizeable proportion unprotected in countries that are hyperendemic for malaria. Post-travel screening for schistosomiasis, tuberculosis (tuberculin skin test) and carriage of methicillin-resistant Staphylococcus aureus (MRSA) encompassed approximately half of all students who should have been screened. Based on the results of this study we have adopted an integral set of measures to reduce the health risks associated with an elective abroad. The pre and post-travel consult has been centralized and standardized as well as the distribution of PEP. In addition we have developed a mandatory module on Global Health for all medical students planning an elective abroad.

Sickle cell children traveling abroad: primary risk is infection.

Science.gov (United States)

Runel-Belliard, Camille; Lesprit, Emmanuelle; Quinet, Béatrice; Grimprel, Emmanuel

2009-01-01

Pediatricians taking care of sickle cell children in France are concerned about giving travel advice. Very few articles are published and no study has been done about it. A lot of pediatricians are using their own experience to decide if sickle cell children can travel abroad. Studying the consequences of such travel for sickle cell children is important to discuss common recommendations. We conducted a prospective study from June 2006 to December 2007 on desires to travel expressed during our consultations with sickle cell children. We studied notable events that occurred during travel and at least 2 months after return. Of 52 desires to travel, 10 were cancelled. All of the 42 trips were to Africa. Median duration of travel was 1.29 months (0.5-3). Median age at travel was 7.6 years (0.2-17.7). Events during travel were two hospitalizations (4.8%), a transfusion (2.4%), and four paramedical or medical examinations (9.6%). After return, four events occurred: two SS children had Plasmodium falciparum malaria (4.8%) and two had digestive bacteremia (4.8%) in SC and Sbeta+ children. No event occurred during plane travel. None of our patients died. The primary risk for sickle cell children traveling to Africa is infection: malaria first and digestive septicemia second. These risks are increased by long travel and poor sanitary conditions. Each travel should be prepared a long time before departure, and each pediatrician should insist on malaria prophylaxis and sanitary conditions, especially for young children. Trips should be shorter than 1 month when possible. A longer prospective study will be done to confirm these results.

Medical and psychological problems faced by young Australian gap year travellers.

Science.gov (United States)

Furuya-Kanamori, Luis; Mills, Deborah; Sheridan, Sarah; Lau, Colleen

2017-09-01

Gap year travellers can potentially be exposed to many infectious diseases and other travel-related health problems including injuries and psychological problems. Currently, there is little information on health and wellbeing of this particular group of travellers. Participants were recruited from an organization that specialized in organising international gap year placements. Gap year travellers were asked to complete a pre-departure survey on demographics, placement destination and duration, previous travel experience, hobbies, risk taking behaviour, anticipated problems during the placement, and pre-travel preparations. After the placement, participants were asked to complete a post-trip survey on their experiences, problems, health issues, and medical treatment required. The 88 and 34 gap year travellers aged 17-23 years completed pre- and post-placement surveys respectively. The duration of placements ranged from 3 to 12 months. Psychological stressors were frequently reported [ n = 26 (76.5%) felt home sick; n = 18 (52.9%) experienced culture shock; n = 17 (50.0%) had difficulty communicating with the locals]. The majority of participants (91.2%) tried to work out a solution for the stressor on their own. Twenty-eight (82.4%) participants reported medical problems during their placement; the most common problems were sunburn ( n = 19; 55.9%), respiratory infections ( n = 15; 44.1%), weight change ( n = 14; 41.2%), and diarrhoea/food poisoning ( n = 13; 38.2%). Three participants (3.4%) were admitted to hospital; for a muscle injury, head injury and skin infection after getting a tribal tattoo. Psychological stressors were common, but most did not seek help. Some medical problems encountered during their placement may have been preventable with improved pre-departure preparation. Gap year, pre-departure, preparation. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e

The Effect of Corporate Influence in the Short Haul Business Travel Market

Science.gov (United States)

Mason, Keith J.

1999-01-01

The importance of corporate involvement in the decision making process for business related air travel is being increasingly recognised in the literature. Business travellers consume air services (i.e. they take airline flights), however; they may not be the principal decision-maker in the purchase. Also it is the organization that employs the traveller that incurs die cost for air travel. Consequently this research addresses the relationship between the traveller and the employing organisation in the purchase of air travel. In this paper traveller opinions on their corporate travel policy are evaluated using a Likert summated rating scale. The benefits sought, by the traveller, from the air service are also investigated and these benefits are used to segment the short haul business air travel market in the EU. Changes in the market for short haul business travel since the full liberalisation of the aviation market in-the EU are evaluated by comparing the data to an earlier study of similar travellers in 1992.

Reducing travel delay by in-car advice on speed, headway and lane use based on downstream traffic flow conditions - a simulation study

NARCIS (Netherlands)

Schakel, W.J.; Klunder, G.; van Arem, B.; Harmsen, E.; Hagenzieker, M.P.

2012-01-01

A new advisory ADAS system is implemented in micro simulation to asses the effects on traffic flow as well as on safety. The system uses loop detector data from which situations may be recognized where advices are given to drivers in-car. Advice is given on speed, headway and lane use. Effectively

Post-travel screening of asymptomatic long-term travelers to the tropics for intestinal parasites using molecular diagnostics.

Science.gov (United States)

Soonawala, Darius; van Lieshout, Lisette; den Boer, Marion A M; Claas, Eric C J; Verweij, Jaco J; Godkewitsch, André; Ratering, Marchel; Visser, Leo G

2014-05-01

The incidence of asymptomatic travel-related parasitic infection is uncertain. Previous studies did not distinguish new incident infections, from past infections. Regardless of symptoms, we performed multiplex real-time polymerase chain reaction on pre- and post-travel stool samples of Dutch long-term travelers to the (sub)tropics. Serological screening for Schistosoma spp. was only performed in travelers to sub-Saharan Africa. In total, 679 travelers were included in the study. The follow-up rate was 82% (556 of 679). Participants' median travel duration was 12 weeks. There was one incident infection with Strongyloides stercoralis; there were none with Entamoeba histolytica, 4 with Cryptosporidium spp. (1%), and 22 with Giardia lamblia (4%). Nine of 146 travelers (6%) seroconverted for Schistosoma spp. Routine screening of stool samples for parasitic infection is not indicated for asymptomatic people, who travel to the (sub)tropics for up to 3 months. Screening for Schistosoma spp. should be offered to travelers with fresh-water contact in endemic regions.

Impact of traveling to visit friends and relatives on chronic disease management.

Science.gov (United States)

Gurgle, Holly E; Roesel, David J; Erickson, Tiffany N; Devine, Emily Beth

2013-01-01

Travelers visiting friends and relatives (VFR) are known to be at high risk of acquiring infectious diseases during travel. However, little is known about the impact of VFR travel on chronic diseases. This was a nonrandomized, retrospective observational study. Patients were adult VFR travelers who received care from an internal medical clinic serving immigrants and refugees. The primary objective was to determine the impact of VFR travel on markers of chronic disease management including: blood pressure, glycosylated hemoglobin, body mass index, serum creatinine, and anticoagulation. Of the 110 VFR travelers in our study, N = 48 traveled to Africa and N = 62 traveled to Asia for a mean duration of 59 (range 21-303) days. Of the 433 counseling points discussed at pre-travel visits, 71% were infectious disease prevention, 16% chronic disease related, and 13% travel safety. A total of 63 patients (57%) reported one or more health problems while traveling. Of these, 35 patients (32%) experienced a problem related to a chronic condition. In comparison, 24 (22%) patients experienced an acute infection. Sixty percent of patients were nonadherent to medications during travel. An average increase in diastolic blood pressure of 3.6 mmHg among patients with hypertension was the only statistically significant change in a chronic disease marker when values before and after travel were compared. Subgroup analysis revealed that travel to Africa and nonadherence to medications were also associated with worsening blood pressure control, and patients traveling to Africa experienced a decrease in body mass index. This study identified a high proportion of problems related to chronic conditions experienced during VFR travel, while pre-travel appointments tended to focus on infectious disease prevention. A greater emphasis on medication adherence and chronic disease management during VFR travel is also needed during pre-travel preparations. © 2013 International Society of

Standardized training in nurse model travel clinics.

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Sofarelli, Theresa A; Ricks, Jane H; Anand, Rahul; Hale, Devon C

2011-01-01

International travel plays a significant role in the emergence and redistribution of major human diseases. The importance of travel medicine clinics for preventing morbidity and mortality has been increasingly appreciated, although few studies have thus far examined the management and staff training strategies that result in successful travel-clinic operations. Here, we describe an example of travel-clinic operation and management coordinated through the University of Utah School of Medicine, Division of Infectious Diseases. This program, which involves eight separate clinics distributed statewide, functions both to provide patient consult and care services, as well as medical provider training and continuing medical education (CME). Initial training, the use of standardized forms and protocols, routine chart reviews and monthly continuing education meetings are the distinguishing attributes of this program. An Infectious Disease team consisting of one medical doctor (MD) and a physician assistant (PA) act as consultants to travel nurses who comprise the majority of clinic staff. Eight clinics distributed throughout the state of Utah serve approximately 6,000 travelers a year. Pre-travel medical services are provided by 11 nurses, including 10 registered nurses (RNs) and 1 licensed practical nurse (LPN). This trained nursing staff receives continuing travel medical education and participate in the training of new providers. All nurses have completed a full training program and 7 of the 11 (64%) of clinic nursing staff serve more than 10 patients a week. Quality assurance measures show that approximately 0.5% of charts reviewed contain a vaccine or prescription error which require patient notification for correction. Using an initial training program, standardized patient intake forms, vaccine and prescription protocols, preprinted prescriptions, and regular CME, highly trained nurses at travel clinics are able to provide standardized pre-travel care to

A global travelers' electronic health record template standard for personal health records.

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Li, Yu-Chuan; Detmer, Don E; Shabbir, Syed-Abdul; Nguyen, Phung Anh; Jian, Wen-Shan; Mihalas, George I; Shortliffe, Edward H; Tang, Paul; Haux, Reinhold; Kimura, Michio

2012-01-01

Tourism as well as international business travel creates health risks for individuals and populations both in host societies and home countries. One strategy to reduce health-related risks to travelers is to provide travelers and relevant caregivers timely, ongoing access to their own health information. Many websites offer health advice for travelers. For example, the WHO and US Department of State offer up-to-date health information about countries relevant to travel. However, little has been done to assure travelers that their medical information is available at the right place and time when the need might arise. Applications of Information and Communication Technology (ICT) utilizing mobile phones for health management are promising tools both for the delivery of healthcare services and the promotion of personal health. This paper describes the project developed by international informaticians under the umbrella of the International Medical Informatics Association. A template capable of becoming an international standard is proposed. This application is available free to anyone who is interested. Furthermore, its source code is made open.

Reintermediation Strategies For Disintermediated Travel Agencies: A Strategic Marketing Perspective

OpenAIRE

Kim Viljoen; Mornay Roberts-Lombard; Chris Jooste

2015-01-01

The evolution and advancement of the Internet has disintermediated many 20th century businesses, in particular traditional travel agencies. Reintermediation strategies for travel agents that result in additional value being delivered to customers need to be sought with the ultimate objective of retaining customers. The research on which this article is based was concerned with the apparent gap in existing research on this topic. Focus group discussions were held and an online survey was condu...

Nutrition Advice and Recipes

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... Sign-Up Home Patient Information Nutrition Advice & Recipes Nutrition Advice & Recipes This is a very important section ... information on all aspects of daily life, including nutrition, medical treatments, pain management, and practical tips. For ...

"Activity Types" and "Discourse Types": Mediating "Advice" in Interactions between Foreign Language Assistants and Their Supervisors in Schools in France and England

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Culpeper, Jonathan; Crawshaw, Robert; Harrison, Julia

2008-01-01

This paper aims to enhance our understanding of interactions between French/English Foreign Language Assistants (FLAs) and their school mentors (MEs), and, more specifically, of how "advice" is sought, given and received. More generally, it will articulate a pragmatic approach (employing the notion of "activity type") that can…

International Travelers' Sociodemographic, Health, and Travel Characteristics: An Italian Study.

Science.gov (United States)

Troiano, Gianmarco; Mercone, Astrid; Bagnoli, Alessandra; Nante, Nicola

Approximately the 8% of travelers requires medical care, with the diagnosis of a vaccine-preventable disease. The aim of our study was to analyze the socio-demographic, health and travel characteristics of the Italian international travelers. We conducted a cross sectional study from January 2015 to June 2016, at the Travel Medicine Clinic of Siena, asking the doctor to interview patients who attended the Clinic, recording socio-demographic and travel information, malaria prophylaxis, vaccinations. The data were organized in a database and processed by software Stata®. We collected 419 questionnaires. Patients chose 71 countries for their travels; the favorite destinations were: India (6.31%), Thailand (6.31%), and Brazil (5.10%). The mean length of stay was 36.17 days. Italians, students, and freelancers tended to stay abroad for a longer time (mean: 36.4 days, 59.87 days and 64.16 days respectively). 33.17% of our sample used drugs for malaria chemoprophylaxis: 71.9% of them used Atovaquone/Proguanil (Malarone®), 26.6% used Mefloquine (Lariam®), 1.5% other drugs. The vaccinations that travelers mostly got in our study were to prevent hepatitis A (n = 264), the typhoid fever (n = 187), the Tetanus + Diphtheria + Pertussis (n = 165), the Yellow fever (n = 118) and the cholera (n = 78). Twenty-eight (6.68%) refused some recommended vaccinations. The vaccines mostly refused were for Typhoid fever (n = 20), hepatitis a (n = 9), and cholera (n = 9). Our results demonstrated that Italian international travelers are at-risk because of their poor vaccinations adherence. This implies that pre-travel counseling is fundamental to increase the knowledge of the risks and the compliance of future travelers. Copyright © 2016 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

The effect of flight-related behaviour on the risk of venous thrombosis after air travel.

Science.gov (United States)

Schreijer, Anja J M; Cannegieter, Suzanne C; Doggen, Carine J M; Rosendaal, Frits R

2009-02-01

In a case-control study including 11,033 participants (The Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis study) on risk factors of venous thrombosis, we studied the effect of flight-related behaviour on the risk of venous thrombosis after air travel. Patients and control subjects received a questionnaire on risk factors for venous thrombosis, including recent travel history and details of their last flight. From this population, 80 patients and 108 control subjects were selected who had recently (1.1-4.4], particularly in those who were obese (OR 6.1; 95% CI: 0.5-76.2). Anxiety (OR 2.5; 95% CI: 0.9-7.0) and sleeping (OR 1.5; 95% CI: 0.7-3.1) may increase the risk slightly. The risk was not affected by alcohol consumption (OR 1.1; 95% CI: 0.5-2.4). Flying business class may lower the risk (OR 0.7; 95% CI: 0.2-1.8). We did not find a protective effect for several measures currently part of standard advice from airlines and clinicians, i.e. drinking non-alcoholic beverages, exercising or wearing stockings. The effect of behavioural factors during flying on the risk of venous thrombosis after air travel is limited. Current advice on prevention of travel-related thrombosis may have to be reconsidered.

Transfer of Knowledge on Agroforestry Management Practices: the Structure of Farmer Advice Networks

Directory of Open Access Journals (Sweden)

Marney E. Isaac

2007-12-01

Full Text Available Access to knowledge on farm management practices is essential for the maintenance of productive agroforestry systems. Farmers who lack the means to acquire farming knowledge from formal sources often rely on information within their informal social networks. However, little research has explored the explicit structure of farmer communication patterns. We examined advice network structures by using farmer attributes, i.e., kin relationships, community involvement, and imitation, to characterize structural positions and investigated the consequences of such structure on farming practices in cocoa agroforestry systems in Ghana, West Africa. Furthermore, we used a multicommunity approach; we constructed networks for four communities to increase replication and enhance the generality of our conclusions. A high density of advice ties occurred among a small group of farmers, indicating a core-periphery structure. Settler farmers composed 73% of core position members, suggesting that social proximity did not control the formation of informal advice structures. Because core farmers were highly participative in community activities, the promotion of community involvement may facilitate the movement of knowledge and social exchange to strengthen informal networks. Farmers in both core and peripheral structural positions indicated that they observed fellow farmers and subsequently adopted their practices. Of highly sought farmers, 84% used external information, predominately from government institutions, thus functioning as bridging links between formal and informal networks. Both external and farmer-derived sources of knowledge of agroforestry practices were transferred through informal advice networks, providing available information throughout the farming community, as well as a foundation for community-based adaptive management.

Regulating household financial advice

Directory of Open Access Journals (Sweden)

Benjamin F. Cummings

2012-08-01

Full Text Available This paper reviews economic theory related to investment advice. This theory explains 1 why financial advisors need to be carefully regulated for the benefit of both the investment advice industry and for consumers, 2 why principles-based regulation (e.g., a fiduciary standard is more efficient than rules-based regulation, 3 why dual regulation of financial professionals providing investment or insurance advice is inefficient and inequitable policy, and 4 why the application of a universal and uniform fiduciary standard will be difficult to implement.

Vaccination for the expatriate and long-term traveler.

Science.gov (United States)

Shepherd, Suzanne M; Shoff, William H

2014-06-01

Duration of travel is an important factor in addressing travel health safety due to cumulative risk of exposure to illness and injury. The diverse group of expatriate and long-term business and leisure travelers present a different spectrum of issues for the travel medicine practitioner to address during consultation than does the short-term traveler, due to changes in travel patterns and activities, lifestyle alterations, and increased interaction with local populations. Immunization provides one safe and reliable method of preventing infectious illness in this group. We review travel patterns and available data on illnesses that they may be exposed to, including the increased risk of certain vaccine-preventable illnesses. We review the pre-travel management of these travelers, particularly the increased risk of certain vaccine-preventable illnesses as it applies to routine vaccines, recommended travel vaccines and required travel vaccines.

[Travel advice and vaccinations in patients with chronic inflammatory diseases: the earlier, the better

NARCIS (Netherlands)

Mast, Q. de; Keuter, M.; Thiel, P.P. van; Ven, A.J. van der

2014-01-01

The number of patients with chronic inflammatory diseases who have been travelling to the tropics or subtropics has been rising. Use of immunomodulating drugs increases the risk for infectious diseases and may reduce seroprotection rates following vaccination. In addition, live vaccines, such as the

On the Travel Emissions of Sustainability Science Research

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Timothy Waring

2014-05-01

Full Text Available This paper presents data on carbon emissions generated by travel undertaken for a major sustainability science research effort. Previous research has estimated CO2 emissions generated by individual scientists, by entire academic institutions, or by international climate conferences. Here, we sought to investigate the size, distribution and factors affecting the carbon emissions of travel for sustainability research in particular. Reported airline and automobile travel of participants in Maine’s Sustainability Solutions Initiative were used to calculate the carbon dioxide emissions attributable to research-related travel over a three-year period. Carbon emissions varied substantially by researcher and by purpose of travel. Travel for the purpose of dissemination created the largest carbon footprint. This result suggests that alternative networking and dissemination models are needed to replace the high carbon costs of annual society meetings. This research adds to literature that questions whether the cultural demands of contemporary academic careers are compatible with climate stabilization. We argue that precise record keeping and routine analysis of travel data are necessary to track and reduce the climate impacts of sustainability research. We summarize the barriers to behavioral change at individual and organizational levels and conclude with suggestions for reducing climate impacts of travel undertaken for sustainability research.

Health hazards and medical treatment of volunteers aged 18-30 years working in international social projects of non-governmental organizations (NGO).

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Küpper, T; Rieke, B; Neppach, K; Morrison, A; Martin, J

2014-01-01

The specific health risk profile and diversity of treatments sought by young volunteers participating in international social projects should differ from those of their older colleagues. In the absence of any data to identify whether this was correct, a retrospective analysis was performed using a standardized questionnaire. Questions included what diseases occurred, and details of the frequency and types of treatment sought during their stay - (e.g. self-treatment, medical/dental intervention, or local healer). The 153 participants were aged 18-30 years and worked in a non-governmental organization for >6 months. The participants were: 53% female, mean age 20 years, and mean duration of stay was 11.2 months. Their NGO placement abroad was in Latin America 65.4%, 14.4% in Africa, and 9.8% in Asia. 83% of the young volunteers had received some advice regarding travel medicine before their departure. However, they suffered from more injuries compared to private travellers, and febrile infections were more common when compared to older studies. 21.2% suffered from dental problems and 50% of them sought medical treatment. This study highlights a previously unreported higher risk profile of specific health problems occurring in young NGO volunteers, including some potentially life-threatening diagnoses that differed from their older colleagues and normal travellers. It is recommended that young volunteers should receive age specific, comprehensive pre-departure training in health and safety, first aid, and management of common health problems. A medical check-up upon returning home should be mandatory. The provision of a basic first aid kit to each volunteer before departure is also recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

The practice of travel medicine in Europe.

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Schlagenhauf, P; Santos-O'Connor, F; Parola, P

2010-03-01

Europe, because of its geographical location, strategic position on trade routes, and colonial past, has a long history of caring for travellers' health. Within Europe, there is great diversity in the practice of travel medicine. Some countries have travel medicine societies and provisions for a periodic distribution of recommendations, but many countries have no national pre-travel guidelines and follow international recommendations such as those provided by the WHO. Providers of travel medicine include tropical medicine specialists, general practice nurses and physicians, specialist 'travel clinics', occupational physicians, and pharmacists. One of the core functions of the European Centre for Disease Prevention and Control-funded network of travel and tropical medicine professionals, EuroTravNet, is to document the status quo of travel medicine in Europe. A three-pronged approach is used, with a real-time online questionnaire, a structured interview with experts in each country, and web searching.

Calculation of groundwater travel time

International Nuclear Information System (INIS)

Arnett, R.C.; Sagar, B.; Baca, R.G.

1984-12-01

Pre-waste-emplacement groundwater travel time is one indicator of the isolation capability of the geologic system surrounding a repository. Two distinct modeling approaches exist for prediction of groundwater flow paths and travel times from the repository location to the designated accessible environment boundary. These two approaches are: (1) the deterministic approach which calculates a single value prediction of groundwater travel time based on average values for input parameters and (2) the stochastic approach which yields a distribution of possible groundwater travel times as a function of the nature and magnitude of uncertainties in the model inputs. The purposes of this report are to (1) document the theoretical (i.e., mathematical) basis used to calculate groundwater pathlines and travel times in a basalt system, (2) outline limitations and ranges of applicability of the deterministic modeling approach, and (3) explain the motivation for the use of the stochastic modeling approach currently being used to predict groundwater pathlines and travel times for the Hanford Site. Example calculations of groundwater travel times are presented to highlight and compare the differences between the deterministic and stochastic modeling approaches. 28 refs

Who Do Hospital Physicians and Nurses Go to for Advice About Medications? A Social Network Analysis and Examination of Prescribing Error Rates.

Science.gov (United States)

Creswick, Nerida; Westbrook, Johanna Irene

2015-09-01

To measure the weekly medication advice-seeking networks of hospital staff, to compare patterns across professional groups, and to examine these in the context of prescribing error rates. A social network analysis was conducted. All 101 staff in 2 wards in a large, academic teaching hospital in Sydney, Australia, were surveyed (response rate, 90%) using a detailed social network questionnaire. The extent of weekly medication advice seeking was measured by density of connections, proportion of reciprocal relationships by reciprocity, number of colleagues to whom each person provided advice by in-degree, and perceptions of amount and impact of advice seeking between physicians and nurses. Data on prescribing error rates from the 2 wards were compared. Weekly medication advice-seeking networks were sparse (density: 7% ward A and 12% ward B). Information sharing across professional groups was modest, and rates of reciprocation of advice were low (9% ward A, 14% ward B). Pharmacists provided advice to most people, and junior physicians also played central roles. Senior physicians provided medication advice to few people. Many staff perceived that physicians rarely sought advice from nurses when prescribing, but almost all believed that an increase in communication between physicians and nurses about medications would improve patient safety. The medication networks in ward B had higher measures for density, reciprocation, and fewer senior physicians who were isolates. Ward B had a significantly lower rate of both procedural and clinical prescribing errors than ward A (0.63 clinical prescribing errors per admission [95%CI, 0.47-0.79] versus 1.81/ admission [95%CI, 1.49-2.13]). Medication advice-seeking networks among staff on hospital wards are limited. Hubs of advice provision include pharmacists, junior physicians, and senior nurses. Senior physicians are poorly integrated into medication advice networks. Strategies to improve the advice-giving networks between senior

A preliminary study on travel health issues of medical students undertaking electives.

Science.gov (United States)

Goldsmid, John M; Bettiol, Silvana S; Sharples, Nadine

2003-01-01

With the inclusion of elective programs, often overseas, in many medical courses, it was decided that a preliminary retrospective analysis of health problems associated with these programs in medical students from the University of Tasmania would be desirable. A questionnaire covering general travel health issues was distributed to all medical students in the University of Tasmania, on return from their elective. They were asked to complete the questionnaire and return it on an anonymous and voluntary basis. In addition, student elective submissions were consulted for information relating to their chosen destination. Results of the study indicate that general practitioners were the most common source of pretravel advice for Tasmanian medical students. Overall, 64% of students experienced some sort of health problem of which travelers' diarrhea was the most common. Most problems were mild and self-limiting, but a number of serious infections were recorded, including acute leptospirosis, paratyphoid, and Staphylococcus aureus cellulitis. Of particular concern were the reports of assault and sexual harassment recorded by several students. Elective programs are an important part of many medical courses. With the widespread destinations chosen by students, it is important that they be given adequate pretravel health advice. Most of the health problems encountered by students from the University of Tasmania were mild, but exposure to serious infections was recorded. It is thus imperative that students take out travel health insurance and that they are counseled on how to avoid dangerous situations while abroad.

41 CFR 301-75.203 - May we provide the interviewee with a travel advance?

Science.gov (United States)

2010-07-01

... interviewee with a travel advance? 301-75.203 Section 301-75.203 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 75-PRE-EMPLOYMENT INTERVIEW TRAVEL Obtaining Travel Services and Claiming Reimbursement § 301-75.203 May we provide...

Wandering tales: evolutionary origins of mental time travel and language

Science.gov (United States)

Corballis, Michael C.

2013-01-01

A central component of mind wandering is mental time travel, the calling to mind of remembered past events and of imagined future ones. Mental time travel may also be critical to the evolution of language, which enables us to communicate about the non-present, sharing memories, plans, and ideas. Mental time travel is indexed in humans by hippocampal activity, and studies also suggest that the hippocampus in rats is active when the animals replay or pre play activity in a spatial environment, such as a maze. Mental time travel may have ancient origins, contrary to the view that it is unique to humans. Since mental time travel is also thought to underlie language, these findings suggest that language evolved gradually from pre-existing cognitive capacities, contrary to the view of Chomsky and others that language and symbolic thought emerged abruptly, in a single step, within the past 100,000 years. PMID:23908641

Wandering Tales: Evolutionary origins of mental time travel and language

Directory of Open Access Journals (Sweden)

Michael Charles Corballis

2013-07-01

Full Text Available A central component of mind wandering is mental time travel, the calling to mind of remembered past events and of imagined future ones. Mental time travel may also be critical to the evolution of language, which enables us to communicate about the nonpresent, sharing memories, plans, and ideas. Mental time travel is indexed in humans by hippocampal activity, and studies also suggest that the hippocampus in rats is active when the animals replay or pre play activity in a spatial environment, such as a maze. Mental time travel may have ancient origins, contrary to the view that it is unique to humans. Since mental time travel is also thought to underlie language, these findings suggest that language evolved gradually from pre-existing cognitive capacities, contrary to the view of Chomsky and others that language and symbolic thought emerged abruptly, in a single step, within the past 100,000 years.

Travel habits and complications in patients treated with vitamin K antagonists: a cross sectional analysis.

Science.gov (United States)

Ringwald, Juergen; Lehmann, Marina; Niemeyer, Nicole; Seifert, Isabell; Daubmann, Anne; Wegscheider, Karl; Salzwedel, Annett; Luxembourg, Beate; Eckstein, Reinhold; Voeller, Heinz

2014-01-01

Travel-related conditions have impact on the quality of oral anticoagulation therapy (OAT) with vitamin K-antagonists. No predictors for travel activity and for travel-associated haemorrhage or thromboembolic complications of patients on OAT are known. A standardised questionnaire was sent to 2500 patients on long-term OAT in Austria, Switzerland and Germany. 997 questionnaires were received (responder rate 39.9%). Ordinal or logistic regression models with travel activity before and after onset of OAT or travel-associated haemorrhages and thromboembolic complications as outcome measures were applied. 43.4% changed travel habits since onset of OAT with 24.9% and 18.5% reporting decreased or increased travel activity, respectively. Long-distance worldwide before OAT or having suffered from thromboembolic complications was associated with reduced travel activity. Increased travel activity was associated with more intensive travel experience, increased duration of OAT, higher education, or performing patient self-management (PSM). Travel-associated haemorrhages or thromboembolic complications were reported by 6.5% and 0.9% of the patients, respectively. Former thromboembolic complications, former bleedings and PSM were significant predictors of travel-associated complications. OAT also increases travel intensity. Specific medical advice prior travelling to prevent complications should be given especially to patients with former bleedings or thromboembolic complications and to those performing PSM. Copyright © 2014 Elsevier Ltd. All rights reserved.

Prevention of influenza among travellers attending at a UK travel clinic: beliefs and perceptions. A cross-sectional study.

Science.gov (United States)

Masuet-Aumatell, Cristina; Toovey, Stephen; Zuckerman, Jane N

2013-07-01

Travellers' compliance with measures to prevent influenza through the use of antivirals and influenza vaccine remains very poor despite influenza being one of the commonest travel and vaccine-preventable diseases. A study was undertaken to assess travellers' beliefs, perceptions and intentions to take antivirals for the treatment and prevention of influenza during the H1N1 pandemic. A cross-sectional survey (n = 96) of travellers who attended the Royal Free Travel Health Centre, London, UK was undertaken in September 2009. A self-administered questionnaire was completed by a traveller in advance of their pre-travel health consultation. Logistic regression identified variables independently associated with compliance. Influenza vaccination uptake for the 5 years preceding the study was found to be 20·8%. This was statistically significantly higher for older travellers and those with underlying health conditions (P study identifies some beliefs and perceptions travellers consider with regard to the therapeutic and preventive influenza use of antivirals during the H1N1 pandemic; it underscores the importance of travellers receiving hemisphere appropriate influenza vaccination. The external validity of these study findings requires further corroboration involving other travel clinics and different cohorts of travellers during seasonal activity or outbreaks of influenza. These findings could guide the development of future strategies for the prevention of influenza in travellers. © 2012 John Wiley & Sons Ltd.

Extended-spectrum β-lactamase-producing Enterobacteriaceae colonisation in long-term overseas business travellers.

Science.gov (United States)

Mizuno, Yasutaka; Miura, Yuri; Yamaguchi, Tetsuo; Matsumoto, Tetsuya

International travel is considered a risk for colonisation with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE). To our knowledge, no studies to date have focused on ESBL-PE colonisation among long-term business travellers. Therefore this study aimed to clarify the characteristics associated with ESBL-PE colonisation in Japanese long-term business travellers. Japanese business travellers planning to stay abroad for ≥6 months were enrolled. Of the 192 travellers, 135 provided only post-travel stool samples and 57 provided both pre- and post-travel stool samples. Additionally, microbiological analyses of ESBL-PE strains, including susceptibility tests and polymerase chain reaction amplification of CTX-M genes and their sequencing were performed. A post-travel survey showed that of the 55 travellers (40.7%) who tested positive for ESBL-PE after travel, the highest proportion was travellers returning from East and Central Asia. CTX-M gene analyses showed that CTX-M-15 was the most frequently observed (55.0%). A pre- and post-travel survey showed that of the 22 travellers (44.9%) acquired ESBL-PE during their travel, with acquisition most frequently observed in travellers returning from South Asia. Risk-based evaluations of ESBL-PE colonisation should be performed not only for regular tourists but also for long-term business travellers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Actions and advice in coli

DEFF Research Database (Denmark)

Knoche, Hendrik; Jamadagni, HS; Rao, PR Sheshagiri

2015-01-01

To improve their agricultural output, farmers require timely and contextualized information and advice. Relevant information and advice provided by trusted peers represents a promising approach. We present the considerations for the design of coli, an agricultural information network on touch scr...

Original Article Social Aspects of Malaria among Students in Two ...

African Journals Online (AJOL)

2011-08-02

Aug 2, 2011 ... (2001) similarly found a relationship between level. *Corresponding author: Tel: +234 ..... Response of Students to Malaria and Therapy in a. University in ... Implementation of Pre-travel Advice. Good for. Malaria; Bad for ...

Good health abroad a traveller's handbook

CERN Document Server

Jopling, W H

2013-01-01

Good Health Abroad: A Traveller's Handbook guides travelers of possible risks to health, comfort and peace of mind encountered abroad. It discusses the steps to be taken before departure, during the journey, and upon arrival of the tourist. It addresses the measures to protect the health of the individual. Some of the topics covered in the book are the medical and dental check-up; active immunization; vaccination against smallpox, yellow fever, and cholera; optional vaccinations in regions of the world; optional vaccinations which are restricted to special categories of travelers; anti-glare precautions; and pre-travel exercises. The definition of acclimatization is covered. The medical, visa, and currency requirements are discussed. The text describes the clothing for warm, temperate, and cold climates. A study of the travel sickness, postural oedema, package cruises, and survival at sea are presented. A chapter is devoted to the food, water, heat effects abroad. Another section focuses on the accidental hyp...

Knowledge, attitudes and practices of business travelers regarding malaria risk and prevention.

Science.gov (United States)

Weber, Roger; Schlagenhauf, Patricia; Amsler, Lorenz; Steffen, Robert

2003-01-01

This study aimed to determine the knowledge, attitudes and practices of Swiss business travelers with regard to malaria. Questionnaires printed in three languages were distributed by employers, travel agencies and tropical medicine specialists to business travelers with destinations in malaria endemic countries. In total, 401 questionnaires were evaluated. Thirty-three percent visited high-risk areas, 27% visited low-risk areas, and 40% visited only malaria-free areas within endemic countries. Among the investigated business travelers, 6% had experienced malaria infection, and 29% had previously had blood smears tested for malaria at least once. Almost all business travelers, 95%, knew that mosquitoes are the main vectors of malaria. The infection risk between dusk and dawn was known to 71%, and the incubation time to 36%. Apart from fever (99%) and headache (63%), other malaria symptoms were known to only 13% to 36% of the travelers. If signs of illness such as fever and headache occurred, 63% would react adequately and seek medical advice within 24 h. Only 16% of the travelers to African high-risk areas followed the recommended behavior concerning anti-mosquito and antimalarial strategies; 31% of those on trips to low-risk areas used an adequate protective strategy. Of the business travelers using chemoprophylaxis during travel, just 50% continued intake post travel, as requested, after leaving the endemic area. Business travelers are well informed regarding the mode of transmission and the risk of malaria at specific destinations but tend to comply poorly with anti-mosquito and chemoprophylactic strategies. The knowledge, attitudes and practices of business travelers with regard to malaria prevention need to be improved.

Self-diagnosis of malaria by travellers: a cohort study on the use of malaria rapid diagnostic tests provided by a Swiss travel clinic.

Science.gov (United States)

Berthod, Delphine; Rochat, Jacynthe; Voumard, Rachel; Rochat, Laurence; Genton, Blaise; D'Acremont, Valérie

2017-10-28

The WHO recommends that all suspect malaria cases be tested before receiving treatment. Rapid diagnostic tests (RDT) for malaria can be performed reliably by community health workers with no formal medical background and thus, RDTs could also be provided to travellers for self-diagnosis during visits to endemic regions. RDTs were proposed during pre-travel consultations to pre-defined categories of travellers. A training run on their own blood was performed and, if carried out correctly, the traveller was given a written procedure on how to perform the test and act on its result. The travellers were then proposed to buy a malaria RDT kit and were interviewed upon their return. From February 2012 to February 2017, 744 travellers were proposed RDTs and 692 performed the training run (one could not complete it due to a hand tremor). Among the 691 subjects included, 69% travelled to moderate- or low-risk areas of malaria, 18% to high-risk areas and 13% to mixed-risk areas. The two most frequent categories of travellers to whom RDTs were proposed were long-term travellers (69%) and those travelling to remote areas (57%). 543 travellers (79%) were interviewed upon return. During their trip, 17% (91/543) had a medical problem with fever and 12% (65/543) without fever. Among 91 febrile patients, 57% (52/91) performed an RDT, 22% (20/91) consulted immediately without using the test, and 21% (19/91) did neither. Four RDTs (4/52; 8%) were positive: 2 in low-risk and 2 in high-risk areas (0.7% attack rate of self-documented malaria). Two travellers could not perform the test correctly and attended a facility or took standby emergency treatment. Four travellers with negative results repeated the test after 24 h; all were still negative. Carrying RDTs made travellers feel more secure, especially when travelling with children. 1/6 travellers experienced fever and 4/5 of those reacted appropriately: more than half used RDTs and a quarter consulted immediately. Four travellers

Financial Literacy, Confidence and Financial Advice Seeking

NARCIS (Netherlands)

Kramer, Marc M.

2016-01-01

We find that people with higher confidence in their own financial literacy are less likely to seek financial advice, but no relation between objective measures of literacy and advice seeking. The negative association between confidence and advice seeking is more pronounced among wealthy households.

Skin disorders among travellers returning from tropical and non-tropical countries consulting a travel medicine clinic.

Science.gov (United States)

Herbinger, K-H; Siess, C; Nothdurft, H D; von Sonnenburg, F; Löscher, T

2011-11-01

To evaluate the causes and risks for imported skin disorders among travellers. Data of 34,162 travellers returning from tropical and non-tropical countries and presenting at the outpatient travel medicine clinic of the University of Munich, Germany, between 1999 and 2009 were analyzed for this study. Of these, 12.2% were diagnosed with skin disorders. Main destinations visited were Asia (40%), Africa (27%) and Latin America (21%). Tourism in the form of adventure travel/backpacking (47%) and package holidays (23%) was the most common purpose of travel. The leading causes of skin disorders were arthropodal (23%), bacterial (22%), helminthic (11%), protozoan (6%), viral (6%), allergic (5%) and fungal (4%). The 10 most frequently diagnosed specific skin diseases associated with specific destinations were insect bites (17%, Southern Europe), cutaneous larva migrans (8%, Asia and Latin America), cutaneous leishmaniasis (2.4%, Mediterranean Region/Middle East), dengue fever (1.5%, Asia), rickettsioses (1.3%, Southern Africa), myiasis (0.8%, Central America), filarioses (0.7%, Africa), tick bites (0.6%, Central/Eastern Europe), schistosomiasis (0.6%, Africa) and tungiasis (0.6%, Africa). Travellers in sub-Saharan Africa had the highest relative risk of acquiring skin disorders. As more than 20% of all skin disorders among returned travellers were caused by arthropods and about 50% by infectious pathogens, pre-travel consultations should include specific prophylaxis and consider the most important risk factor for the travel destination. © 2011 Blackwell Publishing Ltd.

32 CFR 776.10 - Informal ethics advice.

Science.gov (United States)

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Informal ethics advice. 776.10 Section 776.10... § 776.10 Informal ethics advice. (a) Advisors. Covered attorneys may seek informal ethics advice either... of Director, JA Division, HQMC; and (5) Head, Standards of Conduct/Government Ethics Branch...

Morbidity and outcomes of foreign travelers in Zakynthos island, Greece: a retrospective study.

Directory of Open Access Journals (Sweden)

Eleni Plessa

Full Text Available BACKGROUND: Although there is satisfactory recording of diseases affecting travelers visiting developing countries, little is known regarding morbidity of travelers when visiting developed countries. We sought to evaluate the morbidity of foreign travelers in Zakynthos, a popular Greek island attracting large number of foreign tourists every summer. METHODS: Data from foreign travelers that accommodated in Zakynthos and sought medical services from the private offices of Zante Medical Care from May 1 to October 30 2012 were retrospectively analyzed. RESULTS: Two thousand six hundred and eighty-eight patients were included in the study. The mean age (± SD of the patients whom the age was recorded was 29.6 (± 18.3 and 51.5% of them were from 18 to 40 years old. Disorders of the respiratory tract (32.7%, dermatologic conditions (21.1%, musculoskeletal injuries (16.4%, and gastrointestinal disorders (16.3% were the four most prevalent clinical categories among patients. Ear disorder was the most common syndromic description (14.5% among which 81.2% were ear infections; otitis externa and otitis media were diagnosed in 8.5% and 3.3% patients in total. The most common specific diagnosis was gastroenteritis (14.3%. Insect bite and sunburn were the most common diagnosis (6.5% and 3.8%, respectively among patients with a dermatologic condition. Ear infection was the most common diagnosis in pediatric patients. CONCLUSION: Disorders mainly of the upper respiratory tract were the predominant causes of illness among foreign travelers in Zakynthos. Traveler's diarrhea was the most common specific diagnosis but the prevalence within the total population was not very high.

Advice dilemmas: Managing advice against the competing public ...

African Journals Online (AJOL)

Key to resolving this issue is an acknowledgement that, whether as counsellor or health adviser, persuasion and influence are central features of the VCT interaction. Clear practice guidelines and tools are required to assist counsellors to distinguish between advice, suggestion or mere confirmation of an intended client ...

Pre-Exposure Rabies Vaccination among US International Travelers: Findings from the Global TravEpiNet Consortium

Science.gov (United States)

Dolan, Samantha B.; Sotir, Mark J.; Han, Pauline; Blanton, Jesse D.; Rao, Sowmya R.; LaRocque, Regina C.; Ryan, Edward T.

2014-01-01

Abstract Background: People who travel to areas with high rabies endemicity and have animal contact are at increased risk for rabies exposure. We examined characteristics of international travelers queried regarding rabies vaccination during pretravel consultations at Global TravEpiNet (GTEN) practices during 2009–2010. Material and Methods: We performed bivariate and multivariable analyses of data collected from 18 GTEN clinics. Travel destinations were classified by strength level of rabies vaccination recommendation. Results: Of 13,235 travelers, 226 (2%) reported previous rabies vaccination, and 406 (3%) received rabies vaccine at the consultation. Common travel purposes for these 406 travelers were leisure (26%), research/education (17%), and nonmedical service work (14%). Excluding the 226 who were previously vaccinated, 8070 (62%) of 13,009 travelers intended to visit one or more countries with a strong recommendation for rabies vaccination; 1675 (21%) of these 8070 intended to travel for 1 month or more. Among these 1675 travelers, 145 (9%) were vaccinated, 498 (30%) declined vaccination, 832 (50%) had itineraries that clinicians determined did not indicate vaccination, and 200 (12%) remained unvaccinated for other reasons. In both bivariate and multivariate analyses, travelers with trip durations >6 months versus 1–3 months (adjusted odds ratio [OR]=4.9 [95% confidence interval [CI] 2.1, 11.4]) and those traveling for “research/education” or to “provide medical care” (adjusted OR=5.1 [95% CI 1.9, 13.7] and 9.5 [95% CI 2.2, 40.8], respectively), compared with leisure travelers, were more likely to receive rabies vaccination. Conclusions: Few travelers at GTEN clinics received rabies vaccine, although many planned trips 1 month long or more to a strong-recommendation country. Clinicians often determined that vaccine was not indicated, and travelers often declined vaccine when it was offered. The decision to vaccinate should take into account the

Pre-exposure rabies vaccination among US international travelers: findings from the global TravEpiNet consortium.

Science.gov (United States)

Dolan, Samantha B; Jentes, Emily S; Sotir, Mark J; Han, Pauline; Blanton, Jesse D; Rao, Sowmya R; LaRocque, Regina C; Ryan, Edward T; Abraham, George M; Alvarez, Salvador; Ansdell, Vernon; Yates, Johnnie A; Atkins, Elisha H; Cahill, John; Birich, Holly K; Vitek, Dagmar; Connor, Bradley A; Dismukes, Roberta; Kozarsky, Phyllis; Dosunmu, Rone; Goad, Jeffrey A; Hagmann, Stefan; Hale, DeVon; Hynes, Noreen A; Jacquerioz, Frederique; McLellan, Susan; Knouse, Mark; Lee, Jennifer; LaRocque, Regina C; Ryan, Edward T; Oladele, Alawode; Demeke, Hanna; Pasinski, Roger; Wheeler, Amy E; Rao, Sowmya R; Rosen, Jessica; Schwartz, Brian S; Stauffer, William; Walker, Patricia; Vinetz, Joseph

2014-02-01

People who travel to areas with high rabies endemicity and have animal contact are at increased risk for rabies exposure. We examined characteristics of international travelers queried regarding rabies vaccination during pretravel consultations at Global TravEpiNet (GTEN) practices during 2009-2010. We performed bivariate and multivariable analyses of data collected from 18 GTEN clinics. Travel destinations were classified by strength level of rabies vaccination recommendation. Of 13,235 travelers, 226 (2%) reported previous rabies vaccination, and 406 (3%) received rabies vaccine at the consultation. Common travel purposes for these 406 travelers were leisure (26%), research/education (17%), and nonmedical service work (14%). Excluding the 226 who were previously vaccinated, 8070 (62%) of 13,009 travelers intended to visit one or more countries with a strong recommendation for rabies vaccination; 1675 (21%) of these 8070 intended to travel for 1 month or more. Among these 1675 travelers, 145 (9%) were vaccinated, 498 (30%) declined vaccination, 832 (50%) had itineraries that clinicians determined did not indicate vaccination, and 200 (12%) remained unvaccinated for other reasons. In both bivariate and multivariate analyses, travelers with trip durations >6 months versus 1-3 months (adjusted odds ratio [OR]=4.9 [95% confidence interval [CI] 2.1, 11.4]) and those traveling for "research/education" or to "provide medical care" (adjusted OR=5.1 [95% CI 1.9, 13.7] and 9.5 [95% CI 2.2, 40.8], respectively), compared with leisure travelers, were more likely to receive rabies vaccination. Few travelers at GTEN clinics received rabies vaccine, although many planned trips 1 month long or more to a strong-recommendation country. Clinicians often determined that vaccine was not indicated, and travelers often declined vaccine when it was offered. The decision to vaccinate should take into account the strength of the vaccine recommendation at the destination country, duration

Development and feasibility of falls prevention advice.

Science.gov (United States)

van Harten-Krouwel, Diny; Schuurmans, Marieke; Emmelot-Vonk, Mariëlle; Pel-Littel, Ruth

2011-10-01

This study examined the feasibility of nursing falls prevention advice and factors influencing feasibility. The frequency and seriousness of falls in hospitalised patients are underestimated, and such falls should be preventable because of the presence of professionals. A best practice-based falls prevention advice was developed to decrease the incidence of secondary falls and the incidence of primary falls in the long term and to increase the knowledge of nurses about falls prevention and the seriousness of falls. A descriptive, explorative study. Feasibility of the advice for 30 patients was assessed 82 times (theoretically, three times per patient) by observation and by interviewing nurses, patients and their families. The falls prevention advice was used in 48% of the assessments. There was a difference in use between interventions. Interventions that required more knowledge, communication and extra activities were implemented the least. The absence of materials and knowledge about falls prevention were important determinants of the non-implementation of certain interventions. Before falls prevention advice is implemented, it is important to educate nurses about falls, communication skills and implementation of the advice. The falls prevention advice might help nurses to prevent falls and increase their knowledge about falls prevention. © 2011 Blackwell Publishing Ltd.

Poor compliance with child safety restraint use while travelling.

LENUS (Irish Health Repository)

Fallon, R

2011-02-01

Road traffic accidents are a leading cause of death of children. It is the law that all children should be appropriately secured when traveling in vehicles. The aim of this study was to evaluate parental conformity with these regulations and to test if advice given at a Paediatric outpatient clinic could improve compliance. Two groups were assigned, an intervention group (parents given an information leaflet and a clear explanation about appropriate restraints for their children) and a non-intervention group (received no information). They were contacted again after 2 months and asked regarding compliance. A total of 394 children from 186 families were initially given the questionnaire. Nearly one third of children (29.2%) were not using any restraint while travelling rising to 35.3% on follow up. This study concluded that once off parental education made negligible difference to an already inconsistent and haphazard approach to compliance with safety regulations.

A self-help book is better than sleep hygiene advice for insomnia: a randomized controlled comparative study.

Science.gov (United States)

Bjorvatn, Bjørn; Fiske, Eldbjørg; Pallesen, Ståle

2011-12-01

The objective was to compare the effects of two types of written material for insomnia in a randomized trial with follow-up after three months. Insomniacs were recruited through newspaper advertisements to a web-based survey with validated questionnaires about sleep, anxiety, depression, and use of sleep medications. A self-help book focusing on cognitive behavioral therapy for insomnia was compared to standard sleep hygiene advice; 77 and 78 participants were randomized to self-help book or sleep hygiene advice, respectively. The response rate was 81.9%. The self-help book gave significantly better scores on the sleep questionnaires compared to sleep hygiene advice. The proportion using sleep medications was reduced in the self-help book group, whereas it was increased in the sleep hygiene group. Compared to pre-treatment, the self-help book improved scores on the sleep (effect sizes 0.61-0.62) and depression (effect size 0.18) scales, whereas the sleep hygiene advice improved scores on some sleep scales (effect sizes 0.24-0.28), but worsened another (effect size -0.36). In addition, sleep hygiene advice increased the number of days per week where they took sleep medications (effect size -0.50). To conclude, in this randomized controlled trial, the self-help book improved sleep and reduced the proportion using sleep medications compared to sleep hygiene advice. The self-help book is an efficient low-threshold intervention, which is cheap and easily available for patients suffering from insomnia. Sleep hygiene advice also improved sleep at follow-up, but increased sleep medication use. Thus, caution is warranted when sleep hygiene advice are given as a single treatment. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

ARISTOTLE (All Risk Integrated System TOward The hoListic Early-warning): a multi-hazard expert advice system for the EU disaster response

Science.gov (United States)

Michelini, A.; Wotawa, G.; Arnold-Arias, D.

2017-12-01

ARISTOTLE (http://aristotle.ingv.it/) is a Pilot Project funded by the DG ECHO (EU Humanitarian Aid and Civil Protection) that provides expert scientific advice on natural disasters around the world that may cause a country to seek international help to the EU's Emergency Response Coordination Centre (ERCC) and, consequently, to the Union Civil Protection Mechanism Participating States. The EU is committed to providing disaster response in a timely and efficient manner and to ensure European assistance meets the real needs in the population affected, whether in Europe or beyond. When a disaster strikes, every minute counts for saving lives and rapid, coordinated and pre-planned response is essential. The ARISTOTLE consortium includes 15 partner institutions (11 from EU Countries; 2 from non-EU countries and 2 European organizations) operating in the Meteorological and Geophysical domains. The project coordination is shared among INGV and ZAMG for the geophysical and meteorological communities, respectively. ARISTOTLE harnesses operational expertise from across Europe to form a multi-hazard perspective on natural disasters related to volcanoes, earthquake (and resulting tsunami), severe weather and flooding. Each Hazard Group brings together experts from the particular hazard domain to deliver a `collective analysis' which is then fed into the partnership multi-hazard discussions. Primary target of the pilot project has been the prototyping and the implementation of a scalable system (in terms of number of partners and hazards) capable of providing to ERCC the sought advice. To this end, the activities of the project have been focusing on the establishment of a "Multi-Hazard Operational Board" that is assigned the 24*7 operational duty regulated by a "Standard Operating Protocol" and the implementation of a dedicated IT platform to assembly the resulting reports. The project has reached the point where the routine and emergency advice services are being provided and

Pre-OSART mission highlights. 1988-1990

International Nuclear Information System (INIS)

1994-09-01

The IAEA Pre-Operational Safety Review Teams (Pre-OSART) programme is part of the Operational Safety Review teams (OSART) programme and provides advice and assistance to Member States for enhancing the operational safety of nuclear power plants. OSART and Pre-OSART reviews are available to all countries with nuclear power plants in operation or approaching operation. Most of these countries have participated in the programme, by hosting one or more OSART or Pre-OSART missions or by making experts available to participate in missions. This document, which summarizes the finding of Pre-OSART reviews, covers the period from January 1988 to December 1990, and it is intended that further such documents will be prepared to cover subsequent Pre-OSART reviews

Pragmatic dietary advice for diabetes during Navratris

Directory of Open Access Journals (Sweden)

Lovely Gupta

2017-01-01

Full Text Available Navratri is one of the most common religious fasts observed among Hindus. A large number of people with diabetes follow Navratris fast irrespective of its health implications, often without proper education and medical advice. The quest for the scientific research on dietary advices for Hindu fasts including Navratris shows paucity of literature comparative to the dietary advices advocated during Ramadan. The eating and physical activity patterns during different fasts vary a lot depending up on social and cultural factors. Even eating pattern is not uniform among all persons following Navratris and is modified as per their region, local culture, and religious beliefs. Dietary advice during Navratris depends upon pattern of fasting, religious beliefs, and local sociocultural factors. In this review, efforts are made to provide pragmatic dietary advice for people with diabetes, modifications in the menus and cooking practices, and timings of the meals for successful blood glucose management during Navratris. This review will also help plan diet and physical activity advice for persons observing other fasts as well.

Common Health Risks, Required Precautions of Travelers and their Customs Towards the Use of Travel Medicine Services.

Science.gov (United States)

Roupa, Zoe; Zikos, Dimitrios; Vasilopoulos, Aristides; Diomidous, Marianna

2012-01-01

There is an increasing number of people who travel around the world. Every traveler is exposed to nearly all infectious risks which may occur during his travel time. Some of the main risk factors can be water quality, temperature and high humidity and the exposure to multi-resistant microorganisms. To tackle the upcoming problem there is an imperative need to develop a new branch of medicine with the name of travel medicine. A consultation prior to departure for an upcoming trip is required, focusing to a personalized healthcare plan, based on international scientific protocols and epidemiological studies.Travelers must acquire essential information about the prevailing hygiene conditions and climatic differentiations that occur in the region. Additionally there are several health risks upon the arrival at destination. A scheduled visit to a health professional is necessary, especially in the case of travelers suffering from chronic diseases or those taking medication, while vaccination is considered essential for specific destination countries. Healthcare professionals should be able to inform travelers and evaluate their needs. According to research studies on notion and attitudes travelers' specific risks, only few of them are well-informed during a trip. While most studies indicate that travelers have some kind of pre travel medical consultation, not all of them proceed to the required vaccinations and medications. Travelling for business or leisure around the world may be unhealthy. The importance of proper preparation prior to the travel requires to be adequately informed by specialized healthcare professionals, and to receive appropriate vaccinations and medications, when required. The results of the review of notions and attitudes of travelers during the trip indicate not only the need for further development of the branch of travel medicine but especially the need for the expansion and the availability of health services.

Travel health risk perceptions and prevention behaviors of US study abroad students.

Science.gov (United States)

Hartjes, Laurie B; Baumann, Linda C; Henriques, Jeffrey B

2009-01-01

The number of American study abroad students increased more than 150% in the past decade, along with growth in destinations with increased health risks. This study investigated travel health risk perceptions and prevention behaviors to guide interventions that address the emerging health needs of US study abroad students. A cross-sectional design was used to collect data from 318 American study abroad students using a Web-based survey. The primary source of travel health information was youth-oriented travel guidebooks (85%). The grand mean risk perception score for 18 travel health threats was 1.7 on a 1 to 4 scale, with top-rated threats being contaminated food/water, psychological distress, personal assault, and excessive sun exposure. Predeparture advice was received from primary care providers (52%) and travel health specialists (18%). Additional prevention measures were vaccines (42%) and medication (24%). Of 114 students listing their travel vaccinations, 11% described receiving a malaria vaccine and 4% a hepatitis C vaccine, although no such vaccines exist. Most respondents were confident/very confident in their ability to engage in prevention behaviors (94%). Health problems were primarily infectious disease (70%), psychological distress (10%), and injuries (8%). When asked if prior travel destinations involved areas where malaria transmission occurs, 20% responded, "Don't know." Identified gaps in travel health knowledge and prevention behaviors may produce hazardous consequences when combined with low-perceived risk, reliance on travel guidebooks for health information, and high ratings for prevention self-efficacy. Future research is needed to test the effectiveness of educational interventions designed for student travelers who would benefit from guided practice with destination-specific risk appraisal and prevention planning. Web-based educational resources are a good fit for this population because they are easily updated, available in all phases of

Professional advice

DEFF Research Database (Denmark)

Ottaviani, Marco; Sørensen, Peter Norman

2006-01-01

on the basis of the advice given and the realized state of the world. In equilibrium of this reputational cheap-talk game, no more than two messages are effectively reported. The model is extended to consider sequential communication by experts with conditionally independent signals. In the long run, learning...

Health, sustainability and student travel.

Science.gov (United States)

Green, Gill; Morris, Jenny; Wade, Margaret

2012-01-01

A survey of 246 pre-registration nursing students in a University in the South West of England was carried out to explore the impact of course related travel on the student experience. Results from the survey indicated that students' main mode of transport to practice placements was by car which reflects the rural nature of the South West and the relative paucity of public transport. Long distances that many students travel to their study centre and to placements, and the concurrent financial strain that this creates, impacted negatively on the student experience. Students recognised the need to travel to a place of study and clinical placements and suggestions of minimising the negative impact of travel were offered. These included the increased use of electronic delivery of lectures, attendance at local university premises, the provision of shared transport to placements and placements closer to the student's home. Few students, however, considered the environmental impact of travel. Higher Education Institutions need to address issues of sustainability through promoting student wellbeing and taking steps to reduce greenhouse gas emissions. It is therefore important that student awareness of sustainability related issues is increased as well as focusing on reducing the environmental impact through organisational change. Copyright © 2011 Elsevier Ltd. All rights reserved.

Multicenter EuroTravNet/GeoSentinel Study of Travel-related Infectious Diseases in Europe

Science.gov (United States)

Gautret, Philippe; Schlagenhauf, Patricia; Gaudart, Jean; Castelli, Francesco; Brouqui, Philippe; von Sonnenburg, Frank; Loutan, Louis

2009-01-01

We analyzed prospective data on 17,228 European patients who sought treatment at GeoSentinel sites from 1997 to 2007. Gastrointestinal illness (particularly in tourists), fever (those visiting friends and relatives [VFRs]), and skin disorders (in tourists) were the most common reasons for seeking medical care. Diagnoses varied by country of origin, region visited, or categories of travelers. VFRs who returned from sub-Saharan Africa and Indian Ocean islands were more likely to experience falciparum malaria than any other group. Multiple correspondence analysis identified Italian, French, and Swiss VFRs and expatriate travelers to sub-Saharan Africa and Indian Ocean Islands as most likely to exhibit febrile illnesses. German tourists to Southeast and south-central Asia were most likely to seek treatment for acute diarrhea. Non-European travelers (12,663 patients from other industrialized countries) were less likely to acquire certain travel-associated infectious diseases. These results should be considered in the practice of travel medicine and development of health recommendations for European travelers. PMID:19891866

Prescribed Travel Schedules for Fatigue Management

Science.gov (United States)

Whitmire, Alexandra; Johnston, Smith; Lockley, Steven

2011-01-01

The NASA Fatigue Management Team is developing recommendations for managing fatigue during travel and for shift work operations, as Clinical Practice Guidelines for the Management of Circadian Desynchrony in ISS Operations. The Guidelines provide the International Space Station (ISS ) flight surgeons and other operational clinicians with evidence-based recommendations for mitigating fatigue and other factors related to sleep loss and circadian desynchronization. As much international travel is involved both before and after flight, the guidelines provide recommendations for: pre-flight training, in-flight operations, and post-flight rehabilitation. The objective of is to standardize the process by which care is provided to crewmembers, ground controllers, and other support personnel such as trainers, when overseas travel or schedule shifting is required. Proper scheduling of countermeasures - light, darkness, melatonin, diet, exercise, and medications - is the cornerstone for facilitating circadian adaptation, improving sleep, enhancing alertness, and optimizing performance. The Guidelines provide, among other things, prescribed travel schedules that outline the specific implementation of these mitigation strategies. Each travel schedule offers evidence based protocols for properly using the NASA identified countermeasures for fatigue. This presentation will describe the travel implementation schedules and how these can be used to alleviate the effects of jet lag and/or schedule shifts.

Why Do Long-Distance Travelers Have Improved Pancreatectomy Outcomes?

Science.gov (United States)

Jindal, Manila; Zheng, Chaoyi; Quadri, Humair S; Ihemelandu, Chukwuemeka U; Hong, Young K; Smith, Andrew K; Dudeja, Vikas; Shara, Nawar M; Johnson, Lynt B; Al-Refaie, Waddah B

2017-08-01

Centralization of complex surgical care has led patients to travel longer distances. Emerging evidence suggested a negative association between increased travel distance and mortality after pancreatectomy. However, the reason for this association remains largely unknown. We sought to unravel the relationships among travel distance, receiving pancreatectomy at high-volume hospitals, delayed surgery, and operative outcomes. We identified 44,476 patients who underwent pancreatectomy for neoplasms between 2004 and 2013 at the reporting facility from the National Cancer Database. Multivariable analyses were performed to examine the independent relationships between increments in travel distance mortality (30-day and long-term survival) after adjusting for patient demographics, comorbidity, cancer stage, and time trend. We then examined how additional adjustment of procedure volume affected this relationship overall and among rural patients. Median travel distance to undergo pancreatectomy increased from 16.5 to 18.7 miles (p for trend pancreatectomy, it was also related to higher odds of receiving pancreatectomy at a high-volume hospital and lower postoperative mortality. In multivariable analysis, difference in mortality among patients with varying travel distance was attenuated by adjustment for procedure volume. However, longest travel distance was still associated with a 77% lower 30-day mortality rate than shortest travel among rural patients, even when accounting for procedure volume. Our large national study found that the beneficial effect of longer travel distance on mortality after pancreatectomy is mainly attributable to increase in procedure volume. However, it can have additional benefits on rural patients that are not explained by volume. Distance can represent a surrogate for rural populations. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

"It's because it's cancer, not because you're a Traveller"-exploring lay understanding of cancer in English Romany Gypsy and Irish Traveller communities.

Science.gov (United States)

Berlin, Jenni; Smith, David; Newton, Paul

2018-06-01

The lay understanding of cancer among English Romany Gypsies and Irish Travellers, has not been studied in depth before. Lay understandings of cancer, and illness in general, varies between different ethnic groups suggesting that procedures that work for one community may not work for another. Therefore, the measures that are in place in the UK to educate and treat people with cancer may not work for the - often hard to reach - Gypsy and Traveller communities. This study explores Gypsies and Travellers lay perceptions of cancer. In collaboration with community interviewers, 18 Gypsies and Travellers were recruited to take part in this study. Data comes from four semi-structured focus groups that were transcribed and thematically analysed using data-driven coding. A lack of trust of the wider society has contributed to some Gypsies and Travellers' health related practices as has the persistence of old customs that negatively influence their health. As a reticence towards seeking outside help often exists, information about cancer is sought from family members. When engaged with cancer services however, Gypsies and Travellers generally feel them to be non-discriminative. Health professionals need to develop a better understanding of Gypsy and Travellers' health beliefs and practices in order to successfully interact with them. Information about cancer has to be delivered in an understandable form and to places where it reaches these communities. Because of historical societal discrimination, including by some health services, engaging with Gypsies and Travellers may require considerably more time and effort. Copyright © 2018 Elsevier Ltd. All rights reserved.

Construction of health monitoring system for traveler based on the mobile Internet

Directory of Open Access Journals (Sweden)

Wei Haoqian

2017-04-01

Full Text Available With the development of communication technology and computer technology,intelligent terminals represented by smartphone and mobile Internet have become indispensable tools in people's life and work.As the intelligent terminal platform is widely used and the wearable medical equipment is gradually mature,this paper based on the Internet designs and develops a health monitoring system for travelers who suffered from chronic diseases or worried about their physical conditions,to provide a whole process of health monitoring and assistant service.The system,combing smartphone and wearable medical devices,uploads the health and physical signs data to the health monitoring platform through the mobile Internet.Then the professionals statistically analyze the data and provide appropriate advice and guidance,so as to achieve the remote medical treatment for travelers.

The best advice I ever got.

Science.gov (United States)

Wademan, Daisy

2005-01-01

A young manager faces an impasse in his career. He goes to see his mentor at the company, who closes the office door, offers the young man a chair, recounts a few war stories, and serves up a few specific pointers about the problem at hand. Then, just as the young manager is getting up to leave, the elder executive adds one small kernel of avuncular wisdom--which the junior manager carries with him through the rest of his career. Such is the nature of business advice. Or is it? The six essays in this article suggest otherwise. Few of the leaders who tell their stories here got their best advice in stereotypical form, as an aphorism or a platitude. For Ogilvy & Mather chief Shelly Lazarus, profound insight came from a remark aimed at relieving the tension of the moment. For Novartis CEO Daniel Vasella, it was an apt comment, made on a snowy day, back when he was a medical resident. For publishing magnate Earl Graves and Starwood Hotels' Barry Sternlicht, advice they received about trust from early bosses took on ever deeper and more practical meaning as their careers progressed. For Goldman Sachs chairman Henry Paulson, Jr., it was as much his father's example as it was a specific piece of advice his father handed down to him. And fashion designer Liz Lange rejects the very notion that there's inherent wisdom in accepting other people's advice. As these stories demonstrate, people find wisdom when they least expect to, and they never really know what piece of advice will transcend the moment, profoundly affecting how they later make decisions, evaluate people, and examine--and reexamine--their own actions.

41 CFR 301-75.201 - May we allow the interviewee to use individual Government contractor-issued charge cards for pre...

Science.gov (United States)

2010-07-01

... interviewee to use individual Government contractor-issued charge cards for pre-employment interview travel? 301-75.201 Section 301-75.201 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 75-PRE-EMPLOYMENT INTERVIEW TRAVEL...

5 CFR 2635.107 - Ethics advice.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Ethics advice. 2635.107 Section 2635.107 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.107 Ethics advice. (a) As required by §§ 2638.201...

The Financial Coaching Advice Model: An Exploration into how it Satisfies Expectations of Quality Advice

Directory of Open Access Journals (Sweden)

Julie Knutsen

2012-11-01

Full Text Available For 20 years, the financial planning sector in Australia has been transitioning from a sales-orientated force to aprofession of qualified and skilled practitioners. Today, the potential for professional financial planning adviceto benefit Australians financially, economically and psychologically is recognised by government. Financially,these benefits include increased savings, less interest expense through faster debt reduction, higher investmentreturns and appropriate levels of insurance. Economically, a more financially literate society has the potentialfor less reliance on an already burdened social security system. Psychologically, the benefits include the peaceof mind that comes from an individual being confident in financial matters. However, despite this level ofrecognition and development, national surveys have reported that only a small percentage of the populationactually seek professional financial advice. The factors attributing to these low percentages included the gapsin financial literacy limiting an individual’s engagement in financial matters and consumer’s current mistrust ofthe financial advice business models that remain dominated by commission-driven product sales. Thesedeficiencies have led some financial planning firms to break from financial product sales as the primary advicemodel and focus on financial coaching. Exploratory interviews with the practitioners and clients of a selectedfinancial planning firm have generated insightful discussion into how a financial coaching advice model isachieving the financial, economic and psychological benefits recognised by government as the potentialoutcomes of professional financial advice. The aim of this paper is to present the findings from that discussionand demonstrate the opportunities embedded within a financial coaching advice model. It is argued that thisdiscussion offers a foundation for future research direction in an area currently under researched in

Stepwise Advice Negotiation in Writing Center Peer Tutoring

Science.gov (United States)

Park, Innhwa

2014-01-01

While the delivery and reception of advice is a practice integral to a wide range of settings, little attention has been given to the detailed practices of advice resistance and how it leads to advice negotiation. Based on 7 hours of videotaped tutoring interactions among 6 tutors and 11 tutees, this conversation analytic study examines the…

Verification of Bayesian Clustering in Travel Behaviour Research – First Step to Macroanalysis of Travel Behaviour

Science.gov (United States)

Satra, P.; Carsky, J.

2018-04-01

Our research is looking at the travel behaviour from a macroscopic view, taking one municipality as a basic unit. The travel behaviour of one municipality as a whole is becoming one piece of a data in the research of travel behaviour of a larger area, perhaps a country. A data pre-processing is used to cluster the municipalities in groups, which show similarities in their travel behaviour. Such groups can be then researched for reasons of their prevailing pattern of travel behaviour without any distortion caused by municipalities with a different pattern. This paper deals with actual settings of the clustering process, which is based on Bayesian statistics, particularly the mixture model. An optimization of the settings parameters based on correlation of pointer model parameters and relative number of data in clusters is helpful, however not fully reliable method. Thus, method for graphic representation of clusters needs to be developed in order to check their quality. A training of the setting parameters in 2D has proven to be a beneficial method, because it allows visual control of the produced clusters. The clustering better be applied on separate groups of municipalities, where competition of only identical transport modes can be found.

Perspectives on Long-Distance Air Travel with Type 1 Diabetes.

Science.gov (United States)

Pinsker, Jordan E; Schoenberg, Benjamen E; Garey, Colleen; Runion, Asher; Larez, Arianna; Kerr, David

2017-12-01

We sought to determine the real-life experiences of individuals traveling long distance (across five or more time-zones) with type 1 diabetes (T1D). Five hundred three members of the T1D Exchange online community ( www.myglu.org ) completed a 45-question survey about their travel experiences flying long distance. The cohort was stratified by duration of T1D and whether or not participants used continuous subcutaneous insulin infusion (CSII) therapy and/or a continuous glucose monitor (CGM). In the last 5 years, 71% of participants had flown long distance. When asked about their perceived "fear of flying," CSII users (with and without a CGM) reported their primary anxiety was "losing supplies," while non-CSII users described concerns over "unstable blood glucose (highs and lows)" (P traveling overseas and 9% had avoided international travel altogether because of problems related to diabetes management. Furthermore, 22% of participants had run out of insulin at some point during a trip and 37% reported inadequate attention in current sources of information to the unpredictability of self-management needs while traveling. Especially problematic for individuals traveling with T1D are a lack of resources adequately addressing (1) protocols for emergencies while abroad, (2) how to navigate airport security, and (3) managing basal insulin rates when crossing time zones. A strong need exists for easily accessible, free resources for traveling with T1D that is tailored to both device use and duration of the disease.

Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States

Directory of Open Access Journals (Sweden)

Vaccaro Joan A

2012-03-01

Full Text Available Abstract Background Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH] who participated in the National Health and Nutrition Examination Survey (NHANES 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical

Streaming data from a smartphone application: A new approach to mapping health during travel.

Science.gov (United States)

Farnham, Andrea; Röösli, Martin; Blanke, Ulf; Stone, Emily; Hatz, Christoph; Puhan, Milo A

New research methods offer opportunities to investigate the influence of environment on health during travel. Our study uses data from a smartphone application to describe spatial and environmental patterns in health among travellers. A prospective cohort of travellers to Thailand used a smartphone application during their trips to 1) answer a daily questionnaire about health behaviours and events, and 2) collect streaming data on environment, itinerary, and weather. Incidence of health events was described by region and trip type. The relationship between environmental factors and health events was modelled using a logistic mixed model. The 75/101 (74.3%) travellers that completed the study answered 940 questionnaires, 796 (84.7%) of which were geolocated to Southeast Asia. Accidents occurred to 20.0% of participants and were mainly in the Thai islands, while self-rated "severe" mental health events (21.3%) were centred in Bangkok. The odds of a health event were higher in Chiang Mai (2.34, 95% CI: 1.08, 5.08) and on rainy days (1.86, 95% CI: 1.03, 3.36). Distinct patterns in spatial and environmental risk factors emerged in travellers to Thailand. Location based tracking could identify "hotspots" for health problems and update travel advice to target specific risk groups and regions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Surveillance of Water Quality in the Songhuajiang River System in Heilongjiang Province - Pre-feasibility study - 1995. Travel report from Heilongjiang Province, China, Oct./Nov

OpenAIRE

Wathne, B.

1996-01-01

A request for co-operation on a system for water quality surveillance of Songhuajiang River System in Heilongjiang Province, China, was received by NIVA from the Environmental Protection Agency (EPA) of the Heilongjiang Province. Funds were made available from NORAD, to initiate a co-operative work with the EPA. T. Skancke, NORGIT Centre, and B. M. Wathne, NIVA, travelled to Harbin, capital of Heilongjiang Province, to make a pre-feasibility study and project plans for further co-operation. T...

Travel patterns of cancer surgery patients in a regionalized system.

Science.gov (United States)

Smith, Andrew K; Shara, Nawar M; Zeymo, Alexander; Harris, Katherine; Estes, Randy; Johnson, Lynt B; Al-Refaie, Waddah B

2015-11-01

Regionalization of complex surgeries has increased patient travel distances possibly leaving a substantial burden on those at risk for poorer surgical outcomes. To date, little is known about travel patterns of cancer surgery patients in regionalized settings. To inform this issue, we sought to assess travel patterns of those undergoing a major cancer surgery within a regionalized system. We identified 4733 patients who underwent lung, esophageal, gastric, liver, pancreatic, and colorectal resections from 2002-2014 within a multihospital system in the Mid-Atlantic region of the United States. Patient age, race and/or ethnicity, and insurance status were extracted from electronic health records. We used Geographical Information System capabilities in R software to estimate travel distance and map patient addresses based on cancer surgery type and these characteristics. We used visual inspection, analysis of variance, and interaction analyses to assess the distribution of travel distances between patient populations. A total of 48.2% of patients were non-white, 49.9% were aged >65 y, and 54.9% had private insurance. Increased travel distance was associated with decreasing age and those undergoing pancreatic and esophageal resections. Also, black patients tend to travel shorter distances than other racial and/or ethnic groups. These maps offer a preliminary understanding into variations of geospatial travel patterns among patients receiving major cancer surgery in a Mid-Atlantic regionalized setting. Future research should focus on the impact of regionalization on timely delivery of surgical care and other quality metrics. Copyright © 2015 Elsevier Inc. All rights reserved.

Different types of dietary advice for women with gestational diabetes mellitus.

Science.gov (United States)

Han, Shanshan; Middleton, Philippa; Shepherd, Emily; Van Ryswyk, Emer; Crowther, Caroline A

2017-02-25

Dietary advice is the main strategy for managing gestational diabetes mellitus (GDM). It remains unclear what type of advice is best. To assess the effects of different types of dietary advice for women with GDM for improving health outcomes for women and babies. We searched Cochrane Pregnancy and Childbirth's Trials Register (8 March 2016), PSANZ's Trials Registry (22 March 2016) and reference lists of retrieved studies. Randomised controlled trials comparing the effects of different types of dietary advice for women with GDM. Two authors independently assessed study eligibility, risk of bias, and extracted data. Evidence quality for two comparisons was assessed using GRADE, for primary outcomes for the mother: hypertensive disorders of pregnancy; caesarean section; type 2 diabetes mellitus; and child: large-for-gestational age; perinatal mortality; neonatal mortality or morbidity composite; neurosensory disability; secondary outcomes for the mother: induction of labour; perineal trauma; postnatal depression; postnatal weight retention or return to pre-pregnancy weight; and child: hypoglycaemia; childhood/adulthood adiposity; childhood/adulthood type 2 diabetes mellitus. In this update, we included 19 trials randomising 1398 women with GDM, at an overall unclear to moderate risk of bias (10 comparisons). For outcomes assessed using GRADE, downgrading was based on study limitations, imprecision and inconsistency. Where no findings are reported below for primary outcomes or pre-specified GRADE outcomes, no data were provided by included trials. Primary outcomes Low-moderate glycaemic index (GI) versus moderate-high GI diet (four trials): no clear differences observed for: large-for-gestational age (risk ratio (RR) 0.71, 95% confidence interval (CI) 0.22 to 2.34; two trials, 89 infants; low-quality evidence); severe hypertension or pre-eclampsia (RR 1.02, 95% CI 0.07 to 15.86; one trial, 95 women; very low-quality evidence); eclampsia (RR 0.34, 95% CI 0.01 to 8

Malaria after international travel: a GeoSentinel analysis, 2003-2016.

Science.gov (United States)

Angelo, Kristina M; Libman, Michael; Caumes, Eric; Hamer, Davidson H; Kain, Kevin C; Leder, Karin; Grobusch, Martin P; Hagmann, Stefan H; Kozarsky, Phyllis; Lalloo, David G; Lim, Poh-Lian; Patimeteeporn, Calvin; Gautret, Philippe; Odolini, Silvia; Chappuis, François; Esposito, Douglas H

2017-07-20

More than 30,000 malaria cases are reported annually among international travellers. Despite improvements in malaria control, malaria continues to threaten travellers due to inaccurate perception of risk and sub-optimal pre-travel preparation. Records with a confirmed malaria diagnosis after travel from January 2003 to July 2016 were obtained from GeoSentinel, a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. Records were excluded if exposure country was missing or unascertainable or if there was a concomitant acute diagnosis unrelated to malaria. Records were analyzed to describe the demographic and clinical characteristics of international travellers with malaria. There were 5689 travellers included; 325 were children travel visit. More than half (62%) were hospitalized; children were hospitalized more frequently than adults (73 and 62%, respectively). Ninety-two per cent had a single Plasmodium species diagnosis, most frequently Plasmodium falciparum (4011; 76%). Travellers with P. falciparum were most frequently VFRs (60%). More than 40% of travellers with a trip duration ≤7 days had Plasmodium vivax. There were 444 (8%) travellers with severe malaria; 31 children had severe malaria. Twelve travellers died. Malaria remains a serious threat to international travellers. Efforts must focus on preventive strategies aimed on children and VFRs, and chemoprophylaxis access and preventive measure adherence should be emphasized.

Previous exposure in a high-risk area for travellers' diarrhoea within the past year is associated with a significant protective effect for travellers' diarrhoea: a prospective observational cohort study in travellers to South Asia.

Science.gov (United States)

Kuenzli, Esther; Juergensen, David; Kling, Kerstin; Jaeger, Veronika K; DeCrom, Susan; Steffen, Robert; Widmer, Andreas F; Battegay, Manuel; Hatz, Christoph; Neumayr, Andreas

2017-09-01

Travellers' diarrhoea is the most common health problem in travellers. Depending on the region visited, up to 40% of travellers develop diarrhoea during a 2-week trip. The aim of this study was to assess risk factors for TD among travellers to the Indian subcontinent. An observational prospective multicentre cohort study investigated travellers to the Indian subcontinent. Participants completed questionnaires assessing the incidence of travellers' diarrhoea and identifying potential risk factors. Covariates were assessed univariately, followed by a multivariate regression. Two-hundred and twenty-six travellers were enrolled into the study, 178 filled in both pre- and post-travel questionnaires. Overall, the attack rate of travellers' diarrhoea was 38.2%. Travel destination is a key risk factor for the occurrence of TD. Travelling to India or Nepal vs Bhutan is associated with an increased risk for TD (OR 6.68 and 6.62, respectively). A length of stay of more than 3 weeks compared to less than 2 weeks is also associated with a significantly increased risk (OR 5.45). Having stayed in a high-risk area for travellers' diarrhoea within the past year before the current trip is associated with a significantly decreased risk (OR 0.19). No association was found between consumption of high risk food (i.e. tap water, ice cream, raw meat and hamburgers) and travellers' diarrhoea. Travellers' diarrhoea is a frequent problem in travellers to the Indian subcontinent. Previous exposure in a high-risk area for travellers' diarrhoea within the past year appears to have a significant protective effect. Furthermore, an association between the occurrence of travellers' diarrhoea and travel destination and length of stay, respectively, was observed. Consumption of risk food did not confer a TD risk in our study. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Management of Type 2 diabetes in Ramadan: Low-ratio premix insulin working group practical advice

Science.gov (United States)

Hassanein, Mohamed; Belhadj, Mohamed; Abdallah, Khalifa; Bhattacharya, Arpan D.; Singh, Awadhesh K.; Tayeb, Khaled; Al-Arouj, Monira; Elghweiry, Awad; Iraqi, Hinde; Nazeer, Mohamed; Jamoussi, Henda; Mnif, Mouna; Al-Madani, Abdulrazzaq; Al-Ali, Hossam; Ligthelm, Robert

2014-01-01

The challenge of insulin use during Ramadan could be minimized, if people with diabetes are metabolically stable and are provided with structured education for at least 2–3 months pre-Ramadan. Although, American diabetes association (ADA) recommendations 2010 and South Asian Consensus Guideline 2012 deal with management of diabetes in Ramadan and changes in insulin dosage, no specific guidance on widely prescribed low-ratio premix insulin is currently available. Hence, the working group for insulin therapy in Ramadan, after collective analysis, evaluation, and opinion from clinical practice, have formulated a practical advice to empower physicians with pre-Ramadan preparation, dose adjustment, and treatment algorithm for self-titration of low-ratio premix insulin. PMID:25364673

Management of Type 2 diabetes in Ramadan: Low-ratio premix insulin working group practical advice

Directory of Open Access Journals (Sweden)

Mohamed Hassanein

2014-01-01

Full Text Available The challenge of insulin use during Ramadan could be minimized, if people with diabetes are metabolically stable and are provided with structured education for at least 2-3 months pre-Ramadan. Although, American diabetes association (ADA recommendations 2010 and South Asian Consensus Guideline 2012 deal with management of diabetes in Ramadan and changes in insulin dosage, no specific guidance on widely prescribed low-ratio premix insulin is currently available. Hence, the working group for insulin therapy in Ramadan, after collective analysis, evaluation, and opinion from clinical practice, have formulated a practical advice to empower physicians with pre-Ramadan preparation, dose adjustment, and treatment algorithm for self-titration of low-ratio premix insulin.

A study of students’ travellers values and needs in order to establish futures patterns and insights

OpenAIRE

Elena Cavagnaro; Simona Staffieri

2015-01-01

Purpose – If the only viable future for tourism is sustainable tourism then ways should be sought to increase the demand for sustainable offers. The purpose of this paper is to explore whether sustainability values influence the travel needs of students. The aim is to discover cues in the present behaviour of young tourists that can enhance sustainable travel choices and therefore secure the future of the tourism industry. Moreover, the study provides a solid basis for predicting the future t...

Using Logarithmic Fuzzy Preference Programming To Prioritization Social Media Utilization Based On Tourists’ Perspective

Directory of Open Access Journals (Sweden)

Balouchi Mina

2015-06-01

Full Text Available The advent of Web 2.0 or social media technologies gives travelers a chance to access quickly and conveniently to a mass of travel-related information. This study investigates the importance of social media in travel process in three different phases (pre-visit, on site, post-visit from the perspective of Iranian travelers. It is worthwhile to know the level of influence of social media on respondents’ travel behavior. Logarithmic fuzzy preference programming methodology is used in this article to determine the importance of social media usage in each phase of travel process and its subcategories. Fuzzy analytic hierarchy process methodology, based on Chang’s Fuzzy Extent Analysis is also used for the data analysis, then the results of these two methods are presented for comparison and better understanding. The results of this study suggest that the most usage of social media is on pre-visit phase while post-visit has the least usage. This study shows that Iranian travelers use social media mainly to share experiences (post-visit phase, get help in different circumstances and gain travel advice.

MOBIC: Designing a Travel Aid for Blind and Elderly People

Science.gov (United States)

Petrie, Helen; Johnson, Valerie; Strothotte, Thomas; Raab, Andreas; Fritz, Steffi; Michel, Rainer

This paper presents the research for the development of a new travel aid to increase the independent mobility of blind and elderly travellers. This aid will build on the technologies of geographical information systems (GIS) and the Global Positioning System (GPS). The MOBIC Travel Aid (MOTA) consists of two interrelated components: the MOBIC Pre-journey System (MOPS) to assist users in planning journeys and the MOBIC Outdoor System (MOODS) to execute these plans by providing users with orientation and navigation assistance during journeys. The MOBIC travel aid is complementary to primary mobility aids such as the long cane or guide dog. Results of a study of user requirements are presented and their implications for the initial design of the system are discussed.

The 'selfie' phenomenon: reducing the risk of harm while using smartphones during international travel.

Science.gov (United States)

Flaherty, Gerard T; Choi, Joonkoo

2016-02-01

Photography is an integral component of the international travel experience. Self-photography is becoming a mainstream behaviour in society and it has implications for the practice of travel medicine. Travellers who take selfies, including with the use of selfie sticks, may be subject to traumatic injuries associated with this activity. This review article is the first in the medical literature to address this emerging phenomenon. Articles indexed on PubMed and Scopus databases through 2015 were retrieved, using the search terms 'travel', combined with 'selfie', 'self-photography', 'smartphone', 'mobile phone' and 'social media'. The reference lists of articles were manually searched for additional publications, and published media reports of travel-related self-photography were examined. The lack of situational awareness and temporary distraction inherent in selfie-taking exposes the traveller to potential hazards. A diverse group of selfie injuries has been reported, including injury and death secondary to selfie-related falls, attacks from wild animals, electrocution, lightning strikes, trauma at sporting events, road traffic and pedestrian accidents. Public health measures adopted by the Russian Federation in response to over 100 reported selfie injuries in 2015 alone are presented. The review also discusses the potential for direct trauma from the use of selfie sticks. Travel-related scenarios where selfies should be avoided include photographs taken from a height, on a bridge, in the vicinity of vehicular traffic, during thunderstorms, at sporting events, and where wild animals are in the background. Recommendations exist which discourage use of mobile phones in drivers and pedestrians. The travel medicine practitioner should routinely counsel travellers about responsible self-photography during international travel and should include this advice in printed material given to the patient. The travel and mobile phone industries should reinforce these health

Safety advice sheets

CERN Multimedia

HSE Unit

2013-01-01

You never know when you might be faced with questions such as: when/how should I dispose of a gas canister? Where can I find an inspection report? How should I handle/store/dispose of a chemical substance…?   The SI section of the DGS/SEE Group is primarily responsible for safety inspections, evaluating the safety conditions of equipment items, premises and facilities. On top of this core task, it also regularly issues “Safety Advice Sheets” on various topics, designed to be of assistance to users but also to recall and reinforce safety rules and procedures. These clear and concise sheets, complete with illustrations, are easy to display in the appropriate areas. The following safety advice sheets have been issued so far: Other sheets will be published shortly. Suggestions are welcome and should be sent to the SI section of the DGS/SEE Group. Please send enquiries to general-safety-visits.service@cern.ch.

Content and Style of Advice in Iran and Canada

Science.gov (United States)

Tavakoli, Mahin

2013-01-01

The content and nature of nonprofessional advice in Iran, a hierarchical and collectivist culture, was compared to the same type of advice in Canada, an egalitarian and individualist culture. A researcher developed a questionnaire that consisted of 10 letters, each describing a writer's problem and asking for advice. The responses of participants…

Explaining customer experience of digital financial advice

NARCIS (Netherlands)

van Raaij, W.F.

2017-01-01

The goal of this paper is to analyze the customer experience of digital-driven financial advice systems. It is the objective of this study to develop a cross-cultural model for validating customer experiences of digital financial advice. In doing so, both objective and subjective system aspects have

The epidemiology of travel-related Salmonella Enteritidis in Ontario, Canada, 2010–2011

Directory of Open Access Journals (Sweden)

Tighe Mary-Kathryn

2012-05-01

Full Text Available Abstract Background Increases in the number of salmonellosis cases due to Salmonella Enteritidis (SE in 2010 and 2011 prompted a public health investigation in Ontario, Canada. In this report, we describe the current epidemiology of travel-related (TR SE, compare demographics, symptoms and phage types (PTs of TR and domestically-acquired (DA cases, and estimate the odds of acquiring SE by region of the world visited. Methods All incident cases of culture confirmed SE in Ontario obtained from isolates and specimens submitted to public health laboratories were included in this study. Demographic and illness characteristics of TR and DA cases were compared. A national travel survey was used to provide estimates for the number of travellers to various destinations to approximate rates of SE in travellers. Multivariate logistic regression was used to estimate the odds of acquiring SE when travelling to various world regions. Results Overall, 51.9% of SE cases were TR during the study period. This ranged from 35.7% TR cases in the summer travel period to 65.1% TR cases in the winter travel period. Compared to DA cases, TR cases were older and were less likely to seek hospital care. For Ontario travellers, the adjusted odds of acquiring SE was the highest for the Caribbean (OR 37.29, 95% CI 17.87-77.82 when compared to Europe. Certain PTs were more commonly associated with travel (e.g., 1, 4, 5b, 7a, Atypical than with domestic infection. Of the TR cases, 88.9% were associated with travel to the Caribbean and Mexico region, of whom 90.1% reported staying on a resort. Within this region, there were distinct associations between PTs and countries. Conclusions There is a large burden of TR illness from SE in Ontario. Accurate classification of cases by travel history is important to better understand the source of infections. The findings emphasize the need to make travellers, especially to the Caribbean, and health professionals who provide advice to

Public views of different sources of health advice: pharmacists, social media and mobile health applications.

Science.gov (United States)

Crilly, Philip; Jair, Sophia; Mahmood, Zahra; Moin Khan, Armineh; Munir, Aneesah; Osei-Bediako, Irene; Samir, Mustafa; Kayyali, Reem

2018-05-06

Investigating public perceptions of community pharmacists (CP) in public health and their use of social media (SM) and mobile health applications (MH apps) in that regard. Two surveys were created. One sought public perceptions of SM and the other of MH apps for health advice. Both included a section on perceptions of the role of CPs in public health. A convenience sampling strategy, based on proximity, was used.The study population was the public (n = 8 500 000) living in Greater London. The general public were recruited face-to-face in public spaces. A minimum sample (95% confidence interval/5% margin of error) of 385 was needed. Ethical approval was obtained from the university ethics committee. Responses were analysed in SPSS. About 820/1800 (45.6%) completed one/both surveys. Respondents seek health advice primarily from GPs, followed by digital mediums and then CPs. Under 35s use digital mediums more frequently (P = 0.039). Those who had used SM (41.7%) or MH apps (61.8%) for health information did not confirm its accuracy with a healthcare professional (HCP). Of those that did (MH apps = 39.2%; SM = 58.3%), the HCP disagreed with the information on MH apps and SM on 19.6% and 36.7% of occasions, respectively. Nevertheless, 64.5% stated that if a SM page was maintained by an HCP they would use it. The public are using digital mediums for health advice instead of speaking to an HCP. If CPs want to have an impact on public health they must start imbedding digital mediums into their services. © 2018 Royal Pharmaceutical Society.

ADVICE--Educational System for Teaching Database Courses

Science.gov (United States)

Cvetanovic, M.; Radivojevic, Z.; Blagojevic, V.; Bojovic, M.

2011-01-01

This paper presents a Web-based educational system, ADVICE, that helps students to bridge the gap between database management system (DBMS) theory and practice. The usage of ADVICE is presented through a set of laboratory exercises developed to teach students conceptual and logical modeling, SQL, formal query languages, and normalization. While…

19 CFR 111.39 - Advice to client.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Advice to client. 111.39 Section 111.39 Customs... CUSTOMS BROKERS Duties and Responsibilities of Customs Brokers § 111.39 Advice to client. (a) Withheld or false information. A broker must not withhold information relative to any customs business from a client...

Travel Health Advisory Group: a joint travel industry and travel health Special Interest Group promoting healthy travel in Australia.

Science.gov (United States)

Leggat, Peter A; Zwar, Nicholas; Hudson, Bernie

2012-09-01

The Travel Health Advisory Group (THAG), established in 1997, is a joint initiative between the travel industry and travel health professionals in Australia that aims to promote healthy travel. THAG seeks to promote cooperation in improving the health of travellers between the travel industry and travel medicine professionals and to raise public awareness of the importance of travel health. From 2011, THAG has been a Special Interest Group of The Australasian College of Tropical Medicine and its membership has been active in several areas, including web-based travel health information, travel health promotion, media releases, research and education in Australia. Information is given on the objectives, membership and an overview of the various activities of the group. Copyright © 2012 Elsevier Ltd. All rights reserved.

Particle tracking for unsaturated-zone groundwater travel time analysis at Yucca Mountain

International Nuclear Information System (INIS)

Arnold, B.W.; Skinner, L.H.; Zieman, N.B.

1995-01-01

A particle tracking code developed to link numerical modeling of groundwater flow in the unsaturated zone to the analysis of groundwater travel times was used to produce preliminary estimates of the distribution of groundwater-travel time from a potential repository at Yucca Mountain, Nevada to the water table. Compliance with 10CFR960 requires the demonstration that pre-waste-emplacement groundwater travel time from the disturbed zone to the accessible environment is expected to exceed 1,000 years along any path of likely and significant radionuclide travel. The use of multiple particles and multiple realizations of the geology and parameter distributions in the unsaturated zone allows a probabilistic analysis of groundwater travel times that may be applied for evaluating compliance

Numerical modeling for saturated-zone groundwater travel time analysis at Yucca Mountain

International Nuclear Information System (INIS)

Arnold, B.W.; Barr, G.E.

1996-01-01

A three-dimensional, site-scale numerical model of groundwater flow in the saturated zone at Yucca Mountain was constructed and linked to particle tracking simulations to produce an estimate of the distribution of groundwater travel times from the potential repository to the boundary of the accessible environment. This effort and associated modeling of groundwater travel times in the unsaturated zone were undertaken to aid in the evaluation of compliance of the site with 10CFR960. These regulations stipulate that pre-waste-emplacement groundwater travel time to the accessible environment shall exceed 1,000 years along any path of likely and significant radionuclide travel

Advice Complexity of the Online Search Problem

DEFF Research Database (Denmark)

Clemente, Jhoirene; Hromkovič, Juraj; Komm, Dennis

2016-01-01

the minimum amount of information needed in order to achieve a certain competitive ratio. We design an algorithm that reads $b$ bits of advice and achieves a competitive ratio of (M/m)^{1/(2^b+1)} where M and m are the maximum and minimum price in the input. We also give a matching lower bound. Furthermore......The online search problem is a fundamental problem in finance. The numerous direct applications include searching for optimal prices for commodity trading and trading foreign currencies. In this paper, we analyze the advice complexity of this problem. In particular, we are interested in identifying......, we compare the power of advice and randomization for this problem....

GYNOTEL: telephone advice to gynaecological surgical patients after discharge.

Science.gov (United States)

Caljouw, Monique A A; Hogendorf-Burgers, Marja E H J

2010-12-01

To investigate in surgical gynaecological patients the types of health problems arising or persisting up to six weeks after discharge and the effectiveness of telephone advice. The decreasing length of hospital stay has increased the need for specific instructions about the postdischarge period. Telephone advice could be a valuable tool to address this problem. To our knowledge, postdischarge health problems and the value of telephone advice have not been investigated among gynaecological patients. Randomised controlled trial. Gynaecological patients expected to stay in the ward longer than 24 hour were invited to participate. A pilot study showed that wound healing, pain, mobility, urination, defecation and vaginal bleeding were the most common health problems postdischarge. Based on that information, guidelines were formulated that were used by trained nurses to give telephone advice to the intervention group (n=235), in addition to the usual care. The control group of gynaecological patients (n=233) received usual care only. Of all 468 participants, about 50% were operated for general gynaecology. At discharge, wound pain (56%), mobility problems (54%) and constipation (27%) were the most frequently mentioned problems in both groups. Participants who completely followed the advice with regard to wound healing (p=0.02), pain (p=0.01), vaginal bleeding (p=0.03) and mobility (p=0.04) experienced greater improvement than participants who did not follow, or only partly followed, the advice. The telephone advice appears to make a significant contribution to help gynaecological surgical patients to solve or reduce their postdischarge health problems. The positive effect of such advice can be interpreted as an improvement in the quality of life of the postoperative gynaecological patient. © 2010 Blackwell Publishing Ltd.

Package and Assisted Travel Arrangement

Directory of Open Access Journals (Sweden)

Ivan Tot

2015-01-01

Full Text Available In the ordinary legislative procedure before the European Parliament and the Council, there is a proposal of the European Commission for the adoption of a new directive that would bring the regulation of the contract on organized tours into line with current market development of organized trips. The proposal is intended to regulate the various combinations of travel services that are today offered to passengers, particularly online, which are identical or comparable to the travel services provided in a classic pre-arranged package. The subject of the paper are the provisions of the proposal of the directive which govern the field of application of the proposed directive, in particular the proposed changes regarding the concept of "package" contained in the European Commission proposal and amendments of the European Parliament, as well as the analysis of the proposed new concept of "assisted travel arrangements." The paper also critically refers to the method of targeted maximum harmonization as a proposed new intensity of the harmonization. The conclusion is that, despite the welcome updating of an outdated text of the directive on package travel which is line with the current market needs, the proposed text of the new directive is burdened with technical and complex definitions that could lead to significant difficulties in their transposition into the provisions of national law of the Member States.

Achieving Appropriate Gestational Weight Gain: The Role of Healthcare Provider Advice.

Science.gov (United States)

Deputy, Nicholas P; Sharma, Andrea J; Kim, Shin Y; Olson, Christine K

2018-01-10

The Institute of Medicine (IOM) revised gestational weight gain recommendations in 2009. We examined associations between healthcare provider advice about gestational weight gain and inadequate or excessive weight gain, stratified by prepregnancy body mass index category. We analyzed cross-sectional data from women delivering full-term (37-42 weeks of gestation), singleton infants from four states that participated in the 2010-2011 Pregnancy Risk Assessment Monitoring System (unweighted n = 7125). Women reported the weight gain range (start and end values) advised by their healthcare provider; advice was categorized as follows: starting below recommendations, starting and ending within recommendations (IOM consistent), ending above recommendations, not remembered, or not received. We examined associations between healthcare provider advice and inadequate or excessive, compared with appropriate, gestational weight gain using adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs). Overall, 26.3% of women reported receiving IOM-consistent healthcare provider advice; 26.0% received no advice. Compared with IOM-consistent advice, advice below recommendations was associated with higher likelihood of inadequate weight gain among underweight (aPR 2.22, CI 1.29-3.82) and normal weight women (aPR 1.57, CI 1.23-2.02); advice above recommendations was associated with higher likelihood of excessive weight gain among all but underweight women (aPR range 1.36, CI 1.08-1.72 to aPR 1.42, CI 1.19-1.71). Not remembering or not receiving advice was associated with both inadequate and excessive weight gain. Few women reported receiving IOM-consistent advice; not receiving IOM-consistent advice put women at-risk for weight gain outside recommendations. Strategies that raise awareness of IOM recommendations and address barriers to providing advice are needed.

No Effect of Writing Advice on Reading Comprehension

DEFF Research Database (Denmark)

Balling, Laura Winther

2018-01-01

This article considers text comprehension through the integrated perspectives of language processing research and practical writing advice as expressed in writing guides and language policies. Such guides for instance include advice to use active constructions instead of passives and sentences...

An overview of travel-associated central nervous system infectious diseases: risk assessment, general considerations and future directions.

Science.gov (United States)

Izadi, Morteza; Is'haqi, Arman; Is'haqi, Mohammad Ali; Jonaidi Jafari, Nematollah; Rahamaty, Fatemeh; Banki, Abdolali

2014-08-01

Nervous system infections are among the most important diseases in travellers. Healthy travellers might be exposed to infectious agents of central nervous system, which may require in-patient care. Progressive course is not uncommon in this family of disorders and requires swift diagnosis. An overview of the available evidence in the field is, therefore, urgent to pave the way to increase the awareness of travel-medicine practitioners and highlights dark areas for future research. In November 2013, data were collected from PubMed, Scopus, and Web of Knowledge (1980 to 2013) including books, reviews, and peer-reviewed literature. Works pertained to pre-travel care, interventions, vaccinations related neurological infections were retrieved. Here we provide information on pre-travel care, vaccination, chronic nervous system disorders, and post-travel complications. Recommendations with regard to knowledge gaps, and state-of-the-art research are made. Given an increasing number of international travellers, novel dynamic ways are available for physicians to monitor spread of central nervous system infections. Newer research has made great progresses in developing newer medications, detecting the spread of infections and the public awareness. Despite an ongoing scientific discussion in the field of travel medicine, further research is required for vaccine development, state-of-the-art laboratory tests, and genetic engineering of vectors.

Illness in travelers returned from Brazil: the GeoSentinel experience and implications for the 2014 FIFA World Cup and the 2016 Summer Olympics.

Science.gov (United States)

Wilson, Mary E; Chen, Lin H; Han, Pauline V; Keystone, Jay S; Cramer, Jakob P; Segurado, Aluisio; Hale, DeVon; Jensenius, Mogens; Schwartz, Eli; von Sonnenburg, Frank; Leder, Karin

2014-05-01

Brazil will host the 2014 FIFA World Cup and the 2016 Olympic and Paralympic Games, events that are expected to attract hundreds of thousands of international travelers. Travelers to Brazil will encounter locally endemic infections as well as mass event-specific risks. We describe 1586 ill returned travelers who had visited Brazil and were seen at a GeoSentinel Clinic from July 1997 through May 2013. The most common travel-related illnesses were dermatologic conditions (40%), diarrheal syndromes (25%), and febrile systemic illness (19%). The most common specific dermatologic diagnoses were cutaneous larva migrans, myiasis, and tungiasis. Dengue and malaria, predominantly Plasmodium vivax, were the most frequently identified specific causes of fever and the most common reasons for hospitalization after travel. Dengue fever diagnoses displayed marked seasonality, although cases were seen throughout the year. Among the 28 ill returned travelers with human immunodeficiency virus (HIV) infection, 11 had newly diagnosed asymptomatic infection and 9 had acute symptomatic HIV. Our analysis primarily identified infectious diseases among travelers to Brazil. Knowledge of illness in travelers returning from Brazil can assist clinicians to advise prospective travelers and guide pretravel preparation, including itinerary-tailored advice, vaccines, and chemoprophylaxis; it can also help to focus posttravel evaluation of ill returned travelers. Travelers planning to attend mass events will encounter other risks that are not captured in our surveillance network.

No Effect of Writing Advice on Reading Comprehension

Science.gov (United States)

Balling, Laura Winther

2018-01-01

This article considers text comprehension through the integrated perspectives of language processing research and practical writing advice as expressed in writing guides and language policies. Such guides for instance include advice to use active constructions instead of passives and sentences instead of nominalizations. These recommended and…

Advice-giving in the English lingua franca classroom

African Journals Online (AJOL)

important pragmatic differences between the ways in which advice is given by native speakers and ... gender differences and that teacher modeling may have an effect on which available form of advice-giving a ... nation wishes to participate in global enterprises such as international finance, multi-national corporations, and ...

Factors Influencing Sexual Behaviour Between Tourists and Tourism Employees: A Systematic Review.

Science.gov (United States)

Simkhada, Padam P; Sharma, Aditi; van Teijlingen, Edwin R; Beanland, Rachel L

2016-03-01

Increased travel abroad has a significant impact on the incidence and prevalence of Sexually Transmitted Infections (STIs). Previous reviews have focused on the knowledge, attitudes and behaviour of tourists and acquisition of STIs. Less is known about the impact on tourism operators in countries visited by tourists. The aim of this review is to ascertain factors influencing sexual behaviour between workers in the tourism industry and tourists; exploring the prevalence of sexual behaviour between the two populations, their perceptions of sexual risk while engaging in sexual activities and the knowledge of tourism operators regarding STIs. A systematic review was conducted. Database searches were performed in Medline/Ovid, EMBASE, Cochrane library and CINAHL for studies published between 2000 and March 2016. Grey literature searches were completed in the NHS database and Google Scholar between 2000 and December 2013. Papers were independently selected by two researchers. Data were extracted and critically appraised using a pre-designed extraction form and adapted CASP checklist. The search identified 1,602 studies and 16 were included after review of the full text. Studies were conducted in nine countries. Findings suggest that STI knowledge, attitude and practice were fairly good among tourists and tourism workers, but there is a need for pre-travel advice for travellers, especially those travelling to low and middle-income countries. Greater importance was given to tourists than to tourism operators and locals interacting with tourists. Studies suggest that as a group both tourist and tourist workers were likely to engage in sexual activities. Overall, both condom use and STI screening were low, among tourists as well as tourism operators. Furthermore, studies reported links between drug and alcohol use and sexual behaviour and risk taking. Although less research appeared to have been conducted among tourism workers than tourists, it does demonstrate the need for

Stop measles in Switzerland - The importance of travel medicine.

Science.gov (United States)

Bühler, Silja; Lang, Phung; Bally, Bettina; Hatz, Christoph; Jaeger, Veronika K

2017-06-27

In line with the worldwide strive to combat measles, the Swiss Federal Office of Public Heath (FOPH) launched a National Strategy for measles elimination 2011-2015. In this study, we highlight the importance of travel medicine consultations to complement measles vaccination programmes based on data from the Travel Clinic of the University of Zurich. We analysed measles vaccination data from the Zurich Travel Clinic between July 2010 and February 2016 and focused on three groups: (i) all clients who received the measles vaccination, (ii) all clients aged>two years who received the measles vaccination ("catch-up vaccination"), and (iii) all clients aged>two years and born after 1963 ("FOPH recommended catch-up vaccination"). 107,669 consultations were performed from 2010 to 2016. In 12,470 (11.6%) of these, a measles vaccination was administered; 90.9% measles vaccinations were given during a pre-travel consultation, and 99.4% were administered to individuals aged>two years ("catch-up vaccinations"). An "FOPH recommended catch-up vaccination" was received by 13.6% of all Zurich Travel Clinic clients aged >2years and born after 1963. In this study, we highlight the importance of travel medicine consultations to enhance the measles vaccination coverage in the adult Swiss population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Travel journalism 2.0. Tourists’ motivations, expectations, and practices online.

Directory of Open Access Journals (Sweden)

Bryan Pirolli

2015-11-01

Full Text Available With travel culture increasingly moving online, from bookings to sharing photos on social networks, information concerning tourist destinations is also shifting to the web and digital sources. Whereas travel guides, magazines, and newspaper travel sections were once the gatekeepers of the tourism industry, online forums, review sites, and blogs driven by audiences are quickly becoming equally important sources of information for tourists. Audiences are increasingly producing, selecting, and distributing travel advice and critiques that are viewed as trustworthy, but without the transparency demanded of journalists. But when it comes to nding information, where do today’s tourists actually look and what do they trust? A sample of travelers interviewed in Paris helped explore how they search for information and what value they attribute to various categories, speci cally blogs, in ful lling their travel needs. Results reveal that travelers show a preference for audience-driven content like blogs and TripAdvisor when looking for “insider” or “authentic” information. They deem such sites more personal and akin to word of mouth advice sought by travelers. These same information sources, however, do not always adhere to journalistic standards of transparency or veri cation, putting into question their trustworthiness. While non-professional travel content gains more readers, professional media is not left behind. Travelers identi ed journalistic sources as valuable when it comes to more standard or perennial information that bloggers may not, or cannot, provide. Travelers also revealed they systematically search multiple sources – forums, articles, review sites, and blogs – before planning a trip. According to our interviews, this plurality of sources illustrates a lack of total con dence in any one particular source. What’s more, bloggers and other non-professionals are integrating into professional publications, and such convergence

A phenomenologic investigation of pediatric residents' experiences being parented and giving parenting advice.

Science.gov (United States)

Bax, A C; Shawler, P M; Blackmon, D L; DeGrace, E W; Wolraich, M L

2016-09-01

Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The primary purpose of this study was to examine pediatric residents' self-reported experiences giving parenting advice and explore the relationship between parenting advice given and types of parenting residents received as children. Thirteen OUHSC pediatric residents were individually interviewed to examine experiences being parented and giving parenting advice. Phenomenological methods were used to explicate themes and secondary analyses explored relationships of findings based upon Baumrind's parenting styles (authoritative, authoritarian, permissive). While childhood experiences were not specifically correlated to the parenting advice style of pediatric residents interviewed, virtually all reported relying upon childhood experiences to generate their advice. Those describing authoritative parents reported giving more authoritative advice while others reported more variable advice. Core interview themes related to residents' parenting advice included anxiety about not being a parent, varying advice based on families' needs, and emphasis of positive interactions and consistency. Themes related to how residents were parented included discipline being a learning process for their parents and recalling that their parents always had expectations, yet always loved them. Pediatric residents interviewed reported giving family centered parenting advice with elements of positive interactions and consistency, but interviews highlighted many areas of apprehension residents have around giving parenting advice. Our study suggests that pediatric residents may benefit from more general educational opportunities to develop the content of their parenting advice, including reflecting on any impact from their own upbringing.

STRATEGI PEMASARAN PAKET WISATA PILGRIM PT. DONGAN SAHUTA TOUR AND TRAVEL DI BALI

Directory of Open Access Journals (Sweden)

Paradita Putri Amelia

2017-04-01

Full Text Available This study aimed to determine the marketing activities of pilgrim package tour that have been performed by PT. Dongan Sahuta Tour and Travel, develop strategies and also marketing programs that can be implemented by the company. Data collection by observation, interviews, questionnaires and literature study. The sampling technique used purposive sampling. Data were analyzed using qualitative descriptive analysis, analysis of the Likert scale and SWOT analysis approach. The results obtained there are four teen indicators of strengths, weaknesses of tree indicators, four indicators of opportunities and four indicators threats. Marketing strategies that can be implemented by the firm such as 1create and develop a quality product, 2provide rebates to customers who have used the services of PT. Dongan Sahuta Tour and Travel several times.The advice given are more active in the promotion by giving rebates, conduct marketing activities as E-commers, expand cooperation with business trips or individuals.

Scientific Advice, Traditional Practices and the Politics of Health-Care : The Australian Debate over Public Funding of Non-Therapeutic Circumcision, 1985

Directory of Open Access Journals (Sweden)

Robert Darby

2011-12-01

Full Text Available In 1985 the Australian Government sought to delete circumcision of infants from the benefits payable under its newly established universal health scheme, Medicare. Although the decision had been recommended by the government's health advisers and was welcomed by medical authorities, it was soon reversed after protests from Jewish community leaders. I present a detailed narrative of this affair and explain why a decision based on sound medical knowledge advice was rescinded after quite mild objections. The answer is found to lie partly in contingent factors, such as the details of the policy change, the personalities of the government figures involved, and problems with implementation and communication; and partly in the sensibilities of the ethnic/religious communities most directly affected. I dispel the misconception that the original decision aroused widespread opposition and show, on the contrary, that it was based on good advice, represented sound public policy, and was widely supported. I conclude that the episode may have useful lessons for other governments seeking to implement or resist policy changes that affect the sensitivities of cultural minorities.

From single-species advice to mixed-species management: taking the next step

DEFF Research Database (Denmark)

Vinther, Morten; Reeves, S.A.; Patterson, K.R.

2004-01-01

Fishery management advice has traditionally been given on a stock-by-stock basis. Recent problems in implementing this advice, particularly for the demersal fisheries of the North Sea, have highlighted the limitations of the approach. In the long term, it would be desirable to give advice...... that accounts for mixed-fishery effects, but in the short term there is a need for approaches to resolve the conflicting management advice for different species within the same fishery, and to generate catch or effort advice that accounts for the mixed-species nature of the fishery. This paper documents...... a recent approach used to address these problems. The approach takes the single-species advice for each species in the fishery as a starting point, then attempts to resolve it into consistent catch or effort advice using fleet-disaggregated catch forecasts in combination with explicitly stated management...

Innovation and Patchwork Partnerships: Advice Services in Austere Times

Directory of Open Access Journals (Sweden)

Alice Forbess

2017-12-01

Full Text Available In the UK’s austerity regime, government spending has been slashed, while audit regimes tie up officers of charitable organisations in bureaucracy rather than leaving them free to attend to the substance of their jobs. These funding-cuts-masquerading-as-market-based-restructuring have drastically affected the provision of advice to welfare dependents. But advisers, and the organisations they work for, piece together new patchworks of funds, devise new forms of face-to-face advice, and rework the boundaries of the law. Local authority funds are invested to yield returns from centrally-funded sources. People are helped to honour their tax commitments while challenging debts incurred from the incorrect award and reclaim of benefits, and to pay their council tax and rent. For advisers, austerity is more a matter of seeking new resource flows, inventing novel interventions, and creating new spaces where justice may be sought and found, than of passively accepting funding cuts. En el Reino Unido, las políticas de recortes de fondos maquilladas como restructuraciones basadas en el mercado han afectado drásticamente la provisión a los dependientes de la asistencia social. Pero los asesores y las organizaciones para las que trabajan forman nuevos tejidos de fondos financieros, ingenian nuevas formas de ayudar en persona y reconfiguran los límites de la ley. Los fondos financieros de los gobiernos locales se invierten para obtener réditos de fuentes de financiación centralizada. Se ayuda a la gente a cumplir con sus obligaciones fiscales y, al mismo tiempo, a recortar las deudas generadas por una incorrecta concesión y reclamación de prestaciones, y a pagar sus tasas municipales y sus alquileres. Para los asesores, la austeridad es una cuestión de buscar nuevos flujos de recursos, idear nuevas formas de intervención y crear nuevos espacios en los que la justicia pueda ser buscada y hallada. DOWNLOAD THIS PAPER FROM SSRN: http

A 1 year retrospective audit of quality indicators of clinical pharmacological advice for personalized linezolid dosing: one stone for two birds?

Science.gov (United States)

Pea, Federico; Cojutti, Piergiorgio; Dose, Lucia; Baraldo, Massimo

2016-02-01

This study explored the clinical and economic impact of clinical pharmacological advice (CPA) (based on therapeutic drug monitoring [TDM] results, and on patients' characteristics and co-medications) on personalized linezolid therapy in a tertiary care hospital. A 1 year retrospective analysis of quality indicators of CPA (clinicians' adherence rate to CPA, pre-post rate of linezolid trough concentrations within the desired range and cost balance analysis) was conducted. Five hundred and forty-four CPAs were provided to clinicians during 2014 for personalizing linezolid therapy in 168 patients. Clinicians' adherence to CPAs was very high (94.7%). The pre-post rate of linezolid Cmin distribution showed a favourable impact of CPA on patient care (pre-post ratio of Cmin within the desired range + 23.4%, pre, 51.2% vs. post, 74.6%). Overall, linezolid dosage was mainly reduced (56.9% of cases), whereas dose augmentation was needed only in a minority of cases (7.7%). Cost balance analysis showed that overall 1258 standard doses of linezolid (unitary dose 600 mg) were spared for treating 168 patients with a personalized dosage for a median duration of 11 days (range 3-128 days) with a cost saving of 60038.05 €. Active computerized advice elaborated by the clinical pharmacologist on the basis of TDM results and of patient's pathophysiological data and co-medications may be cost-effective for personalizing linezolid treatment. © 2015 The British Pharmacological Society.

Travel medicine

Science.gov (United States)

Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

2014-01-01

Abstract Objective To define the practice of travel medicine, provide the basics of a comprehensive pretravel consultation for international travelers, and assist in identifying patients who might require referral to travel medicine professionals. Sources of information Guidelines and recommendations on travel medicine and travel-related illnesses by national and international travel health authorities were reviewed. MEDLINE and EMBASE searches for related literature were also performed. Main message Travel medicine is a highly dynamic specialty that focuses on pretravel preventive care. A comprehensive risk assessment for each individual traveler is essential in order to accurately evaluate traveler-, itinerary-, and destination-specific risks, and to advise on the most appropriate risk management interventions to promote health and prevent adverse health outcomes during travel. Vaccinations might also be required and should be personalized according to the individual traveler’s immunization history, travel itinerary, and the amount of time available before departure. Conclusion A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required. Those who advise travelers are encouraged to be aware of the extent of this responsibility and to refer all high-risk travelers to travel medicine professionals whenever possible. PMID:25500599

International business travel: impact on families and travellers.

Science.gov (United States)

Espino, C M; Sundstrom, S M; Frick, H L; Jacobs, M; Peters, M

2002-05-01

Spouses and staff of the World Bank Group (WBG) were questioned about the impact of international business travel on families and travellers. Dependent variables were self reported stress, concern about the health of the traveller, and negative impact on the family. We hypothesised that several travel factors (independent variables) would be associated with these impacts. These travel factors had to do with the frequency, duration, and predictability of travel and its interference with family activities. Survey forms were developed and distributed to all spouses of travelling staff as well as a small sample of operational staff. Kendall's tau b correlation coefficients of response frequencies were computed with the data from scaled items. Written responses to open ended questions were categorised. Response rates for spouses and staff were 24% and 36%, respectively. Half the spouse sample (n=533) and almost 75% of the staff sample (n=102) reported high or very high stress due to business travel. Self reported spouse stress was associated with six out of eight travel factors. Female spouses, those with children, and younger spouses reported greater stress. Self reported staff stress was significantly associated with four out of nine travel factors. Further insight into how business travel affects families and staff (including children's behavioural changes) and how families cope was gained through responses to written questions. The findings support the notion that lengthy and frequent travel and frequent changes in travel dates which affect family plans, all characteristic of WBG missions, negatively affects many spouses and children (particularly young children) and that the strain on families contributes significantly to the stress staff feel about their travel. Policies or management practices that take into consideration family activities and give staff greater leeway in controlling and refusing travel may help relieve stress.

Advice about infant feeding for allergy prevention: A confusing picture for Australian consumers?

Science.gov (United States)

Netting, Merryn J; Allen, Katrina J

2017-09-01

Early feeding plays an important role in programming the immune system, particularly the risk of food allergy. There are many infant feeding guides published for consumers available in Australia, with most based on the National Health and Medical Research Council (NHMRC) 2012 Infant Feeding Guidelines for Health Workers and the Australasian Society of Clinical Immunology and Allergy (ASCIA) Infant Feeding Advice for allergy prevention. We sought to compare allergy-specific content of infant feeding educational material written for parents with these two documents. Australian websites of children's hospitals, early child health organisations and consumer groups providing information about diet during pregnancy, breastfeeding and early infancy were compared with NHMRC and ASCIA guidelines. Twenty-five sets of infant feeding information were identified. Food allergy was discussed in 18 resources. Recommended length of exclusive breastfeeding and timing of commencing solid foods was consistently around 6 months, with some variation in wording. Advice regarding to include and not delay introduction of common allergens into babies' diets was generally consistent with NHMRC and ASCIA recommendations, however the audit identified some resources that still recommended delayed introduction of common allergens. As consumers have access to a plethora of health information it is imperative that information about infant feeding from health-care authorities is simple, evidence-based and consistent to avoid confusion. Use of consensus wording related to infant feeding guidelines to prevent allergies will provide clear messages related to the timing of introduction to solid foods and inclusion of allergens in the early diet. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Explaining customer experience of digital financial advice

OpenAIRE

van Raaij, W.F.

2017-01-01

The goal of this paper is to analyze the customer experience of digital-driven financial advice systems. It is the objective of this study to develop a cross-cultural model for validating customer experiences of digital financial advice. In doing so, both objective and subjective system aspects have been considered. It is found that experiential subjective system aspects are the most important. Surveys have been conducted in The United Kingdom and The Netherlands. In exploratory factor analys...

[Business travel and staying abroad].

Science.gov (United States)

Holdener, F; Stahel, E

1989-11-01

The growing internationalization of business and the economy is leading more and more working people to spend short or even long stays abroad. With fast journeys across several time zones, travellers are mainly confronted with problems of time difference adjustment, commonly known as "jet lag". For longer stays, especially when the family comes along too, a number of additional difficulties may arise which are not normally faced by tourists. People's physical ability to tolerate a long stay in the tropics is rarely questioned nowadays, except in cases of serious physical illness. However, the effects of such stays on an individual's psychological condition are receiving increasing attention. Inoculations and advice are largely determined by the epidemiology of infectious diseases and the medical infrastructure of the country of destination. Death caused by illness can almost always be avoided through the appropriate prophylaxis and/or therapy. Unfortunately, the same does not apply to accidents. The local medical infrastructure in the larger cities of the developing countries and the range of flights available for sick and injured people are continually improving with a few exceptions.

Reentrainment of the circadian pacemaker during jet lag: East-west asymmetry and the effects of north-south travel.

Science.gov (United States)

Diekman, Casey O; Bose, Amitabha

2018-01-21

The normal alignment of circadian rhythms with the 24-h light-dark cycle is disrupted after rapid travel between home and destination time zones, leading to sleep problems, indigestion, and other symptoms collectively known as jet lag. Using mathematical and computational analysis, we study the process of reentrainment to the light-dark cycle of the destination time zone in a model of the human circadian pacemaker. We calculate the reentrainment time for travel between any two points on the globe at any time of the day and year. We construct one-dimensional entrainment maps to explain several properties of jet lag, such as why most people experience worse jet lag after traveling east than west. We show that this east-west asymmetry depends on the endogenous period of the traveler's circadian clock as well as daylength. Thus the critical factor is not simply whether the endogenous period is greater than or less than 24 h as is commonly assumed. We show that the unstable fixed point of an entrainment map determines whether a traveler reentrains through phase advances or phase delays, providing an understanding of the threshold that separates orthodromic and antidromic modes of reentrainment. Contrary to the conventional wisdom that jet lag only occurs after east-west travel across multiple time zones, we predict that the change in daylength encountered during north-south travel can cause jet lag even when no time zones are crossed. Our techniques could be used to provide advice to travelers on how to minimize jet lag on trips involving multiple destinations and a combination of transmeridian and translatitudinal travel. Copyright © 2017 Elsevier Ltd. All rights reserved.

Transferring 2001 National Household Travel Survey

Energy Technology Data Exchange (ETDEWEB)

Hu, Patricia S [ORNL; Reuscher, Tim [ORNL; Schmoyer, Richard L [ORNL; Chin, Shih-Miao [ORNL

2007-05-01

England, Middle Atlantic, and Pacific), MSA size, and the availability of rail. Extrapolating NHTS data within small geographic areas could risk developing and subsequently using unreliable estimates. For example, if a planning agency in City X of State Y estimates travel rates and other travel characteristics based on survey data collected from NHTS sample households that were located in City X of State Y, then the agency could risk developing and using unreliable estimates for their planning process. Typically, this limitation significantly increases as the size of an area decreases. That said, the NHTS contains a wealth of information that could allow statistical inferences about small geographic areas, with a pre-determined level of statistical certainty. The question then becomes whether a method can be developed that integrates the NHTS data and other data to estimate key travel characteristics for small geographic areas such as Census tract and transportation analysis zone, and whether this method can outperform other, competing methods.

Analysis and design of advice

CERN Document Server

Jureta, Ivan

2011-01-01

This innovative book offers a rigorous approach to the analysis and design of advice in real-world decision situations, in which the advisor must manage with variously imprecise, unclear, incomplete or conflicting qualitative information.

Financial Advice: Who Pays

Science.gov (United States)

Finke, Michael S.; Huston, Sandra J.; Winchester, Danielle D.

2011-01-01

Using a cost-benefit framework for financial planning services and proprietary data collected in the summer of 2008, the client characteristics that are associated with the likelihood of paying for professional financial advice, as well as the type of financial services purchased, are identified. Results indicate that respondents who pay for…

The design, purpose, and effects of voting advice applications

NARCIS (Netherlands)

Rosema, Martin; Anderson, Joel; Walgrave, Stefaan

2014-01-01

In recent electoral politics, one of the most striking internet-related developments is the increasingly widespread use of Voting Advice Applications (VAAs). In this introduction to the symposium devoted to analysing the design, purpose, and effects of voting advice applications, we briefly discuss

Ethnicity predicts viral rebound after travel to the tropics in HIV-infected travelers to the tropics in the Swiss HIV Cohort Study.

Science.gov (United States)

Gebreselassie, H M; Kraus, D; Fux, C A; Haubitz, S; Scherrer, A; Hatz, C; Veit, O; Stoeckle, M; Fehr, J; de Lucia, S; Cavassini, M; Bernasconi, E; Schmid, P; Furrer, H; Staehelin, C

2017-09-01

rather than travel per se. Pre-travel adherence counselling should focus on patients of SSA origin. © 2017 British HIV Association.

5 CFR 1304.4607 - Advice to former Government employees.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Advice to former Government employees. 1304.4607 Section 1304.4607 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES POST EMPLOYMENT CONFLICT OF INTEREST § 1304.4607 Advice to former Government employees. The Office...

Deconstructing the risk for malaria in United States donors deferred for travel to Mexico.

Science.gov (United States)

Spencer, Bryan; Kleinman, Steven; Custer, Brian; Cable, Ritchard; Wilkinson, Susan L; Steele, Whitney; High, Patrick M; Wright, David

2011-11-01

More than 66,000 blood donors are deferred annually in the United States due to travel to malaria-endemic areas of Mexico. Mexico accounts for the largest share of malaria travel deferrals, yet it has extremely low risk for malaria transmission throughout most of its national territory, suggesting a suboptimal balance between blood safety and availability. This study sought to determine whether donor deferral requirements might be relaxed for parts of Mexico without compromising blood safety. Travel destination was recorded from a representative sample of presenting blood donors deferred for malaria travel from six blood centers during 2006. We imputed to these donors reporting Mexican travel a risk for acquiring malaria equivalent to Mexican residents in the destination location, adjusted for length of stay. We extrapolated these results to the overall US blood donor population. Risk for malaria in Mexico varies significantly across endemic areas and is greatest in areas infrequently visited by study donors. More than 70% of blood donor deferrals were triggered by travel to the state of Quintana Roo on the Yucatán Peninsula, an area of very low malaria transmission. Eliminating the travel deferral requirement for all areas except the state of Oaxaca might result in the recovery of almost 65,000 blood donors annually at risk of approximately one contaminated unit collected every 20 years. Deferral requirements should be relaxed for presenting donors who traveled to areas within Mexico that confer exceptionally small risks for malaria, such as Quintana Roo. © 2011 American Association of Blood Banks.

Rural emergency medical technician pre-hospital electrocardiogram transmission.

Science.gov (United States)

Powell, A M; Halon, J M; Nelson, J

2014-01-01

Emergent care of the acute heart attack patient continues to be at the forefront of quality and cost reduction strategies throughout the healthcare industry. Although the average cardiac door-to-balloon (D2B) times have decreased substantially over the past few years, there are still vast disparities found in D2B times in populations that reside in rural areas. Such disparities are mostly related to prolonged travel time and subsequent delays in cardiac catherization lab team activation. Urban ambulance companies that are routinely staffed with paramedic level providers have been successful in the implementation of pre-hospital 12-lead electrocardiogram (ECG) protocols as a strategy to reduce D2B times. The authors sought to evaluate the evidence related to the risk and benefits associated with the replication of an ECG transmission protocol in a small rural emergency medical service. The latter is staffed with emergency medical technician-basics (EMT-B), emergency medical technician-advanced (EMT-A), and emergency medical technician-intermediate (EMT-I) level. The evidence reviewed was limited to studies with relevant data regarding the challenges and complexities of the ECG transmission process, the difficulties associated with ECG transmission in rural settings, and ECG transmission outcomes by provider level. The evidence supports additional research to further evaluate the feasibility of ECG transmission at the non-paramedic level. Multiple variables must be investigated including equipment cost, utilization, and rural transmission capabilities. Clearly, pre-hospital ECG transmission and early activation of the cardiac catheterization laboratory are critical components to successfully decreasing D2B times.

The implementation of ergonomics advice and the stage of change approach.

Science.gov (United States)

Rothmore, Paul; Aylward, Paul; Karnon, Jonathan

2015-11-01

This paper investigates the implementation of injury prevention advice tailored according to the Stage of Change (SOC) approach. The managers of 25 workgroups, drawn from medium to large companies across a wide range of occupational sectors were allocated to receive either standard ergonomics advice or ergonomics advice tailored according to the workgroup SOC. Twelve months after the advice was provided, semi-structured interviews were conducted with each manager. In a multivariate model, managers who had received tailored advice were found to have implemented significantly more of the recommended changes (IRR = 1.68, 95% CI 1.07-2.63) and more "additional" changes (IRR = 1.90, 95% CI 1.12-3.20). Qualitative analysis identified that the key barriers and facilitators to the implementation of changes were largely related to worker resistance to change and the attitudes of senior managers towards health and safety. The findings from this study suggest that the implementation of ergonomics recommendations may be improved by the tailoring of advice according to SOC principles. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

On Advice Complexity of the k-server Problem under Sparse Metrics

DEFF Research Database (Denmark)

Gupta, S.; Kamali, S.; López-Ortiz, A.

2013-01-01

O (n(log μ +log logN)) bits of advice. Among other results, this gives a 3-competitive algorithm for planar graphs, provided with O (n log log N) bits of advice. On the other side, we show that an advice of size Ω (n) is required to obtain a 1-competitive algorithm for sequences of size n even......We consider the k-Server problem under the advice model of computation when the underlying metric space is sparse. On one side, we introduce Θ (1)-competitive algorithms for a wide range of sparse graphs, which require advice of (almost) linear size. Namely, we show that for graphs of size N...... and treewidth α, there is an online algorithm which receives O (n(log α +log log N))1 bits of advice and optimally serves a sequence of length n. With a different argument, we show that if a graph admits a system of μ collective tree (q, r)- spanners, then there is a (q + r)-competitive algorithm which receives...

Predictors of travel-related hepatitis A and B among native adult Danes: a nationwide case-control study.

Science.gov (United States)

Nielsen, Ulla Schierup; Thomsen, Reimar Wernich; Cowan, Susan; Larsen, Carsten Schade; Petersen, Eskild

2012-04-01

To assess journey length and other predictors of travel-related acute hepatitis A (HAV) and B (HBV) virus infection among native Danes and determine the sensitivity and specificity of current pre-travel vaccination guidelines. A nationwide case-control study was perfomed involving 60 Danes with HAV and 14 with HBV who acquired hepatitis in non-western countries from 2000 to 2010. Non-immune travellers from a nationwide survey (1188 HAV and 1709 HBV) served as controls. The odds ratios (ORs) for HAV and HBV increased with increasing journey length (p<0.0001). However, 90% of HAV and 62% of HBV cases travelled for less than 4 weeks, and the daily infection rate did not increase with journey length; rather, for HAV it decreased. Increasing age (p<0.0001) and journeys to Africa (OR 6.1 (3.2-11)) raised the risk of acute HAV. Travelling alone or with friends as compared to travelling with a partner/family (OR: 15 (3.2-134)) strongly predicted HBV risk. Danish vaccination guidelines had HAV/HBV sensitivities of 86%/31%, and specificities of 27%/95%, respectively. Incidence rates were 12.8 (HAV) and 10.2 (HBV) per 100,000 non-immune travel months, and acute disease severity affected HAV and HBV cases equally. These results may support revision of current pre-travel vaccination guidelines. Copyright © 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Pre-surgery evaluations by telephone decrease travel and cost for families of children with cerebral palsy.

Science.gov (United States)

Robinson, John D; Prochaska, John D; Yngve, David A

2017-01-01

Children with cerebral palsy need highly specialized care. This can be very burdensome for families, particularly in large rural states, due to the need for long-distance travel to appointments. In this study, children undergoing the selective percutaneous myofascial lengthening surgery utilized a telephone-based telemedicine evaluation to assess for surgical eligibility. The goal was to avoid a separate preoperative clinic visit weeks before the surgery. If possible, eligibility was determined by telephone, and then, the patient could be scheduled for a clinic visit and possible surgery the next day, saving the family a trip. The purposes of the study were to calculate estimated reductions in miles traveled, in travel expenses, and in carbon emissions and to determine whether the telephone assessment was accurate and effective in determining eligibility for surgery. From 2010 to 2012, 279 patients were retrospectively reviewed, and of those, 161 mailed four-page questionnaire and anteroposterior pelvis X-ray followed by a telephone conference. Geographic information system methods were used to geocode patients by location. Savings in mileage and travel costs were calculated. From 2014 to 2015, 195 patients were additionally studied to determine accuracy and effectiveness. The telephone prescreening method saved 106,070 miles in transportation over 3 years, a 38% reduction with US$55,326 in savings. Each family saved an average of 658 (standard deviation = 340) miles of travel and US$343.64 (standard deviation = US$178) in travel expenses. For each increase of 10 miles in distance from the health center, the odds of a patient utilizing telephone screening increased by 10% (odds ratio: 1.101, 95% confidence interval: 1.073-1.129, p < 0.001). After the telephone prescreening, 86% were determined to be likely candidates for the procedure. For 14%, a clinic visit only was scheduled, and they were not scheduled for surgery. Families seeking specialized

29 CFR 1400.735-3 - Advice and counseling service.

Science.gov (United States)

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Advice and counseling service. 1400.735-3 Section 1400.735-3 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE STANDARDS OF CONDUCT, RESPONSIBILITIES, AND DISCIPLINE General § 1400.735-3 Advice and counseling service...

NADIM-Travel: A Multiagent Platform for Travel Services Aggregation

OpenAIRE

Ben Ameur, Houssein; Bédard, François; Vaucher, Stéphane; Kropf, Peter; Chaib-draaa, Brahim; Gérin-Lajoie, Robert

2010-01-01

With the Internet as a growing channel for travel services distribution, sophisticated travel services aggregators are increasingly in demand. A travel services aggregation platform should be able to manage the heterogeneous characteristics of the many existing travel services. It should also be as scalable, robust, and flexible as possible. Using multiagent technology, we designed and implemented a multiagent platform for travel services aggregation called NADIM-Travel. In this platform, a p...

Propagation characteristics of bedrock waves traveling from pre-Tertiary basement to engineering bedrock

Science.gov (United States)

Kinoshita, S.

2007-11-01

This study uses borehole array recordings to measure the propagation characteristics of bedrock waves traveling from pre-Tertiary basement (seismic bedrock) to engineering bedrock with an S-wave velocity of approximately 0.5-0.8 km/s. To avoid the destructive interference of surface-reflected down-going waves and incidence waves in seismic and engineering bedrock, borehole data recorded at sufficient depth levels are used in this study. This is the most important aspect of the fundamental basis of this study. The propagation characteristics, i.e., the transfer function, of bedrock motions for S-waves are well represented by a Butterworth-type low-pass filter model with a high corner frequency in excess of 15 Hz and a low decay rate of -3 power of frequency. The use of such a filter model is based on the concise representation of the transfer function from an engineering viewpoint. Simple one-dimensional ray theory with a plane wave approximation explains the characteristics of the model filter at low frequencies of less than approximately 5 Hz; however, one-dimensional ray theory with a plane wave approximation at high frequencies in excess of 5 Hz requires the unusual frequency characteristics of Q_S-1(f), which increases with increasing frequency, to explain the frequency characteristics of the model filter. These facts imply that the filter gain can be determined using the impedance ratio of seismic bedrock to engineering bedrock and the attenuation characteristics of the intervening media at low frequencies less than 5 Hz. However, the cutoff frequency and decay rate of the filter must be determined from observational data.

The severe acute respiratory syndrome: impact on travel and tourism.

Science.gov (United States)

Wilder-Smith, Annelies

2006-03-01

SARS and travel are intricately interlinked. Travelers belonged to those primarily affected in the early stages of the outbreak, travelers became vectors of the disease, and finally, travel and tourism themselves became the victims. The outbreak of SARS created international anxiety because of its novelty, its ease of transmission in certain settings, and the speed of its spread through jet travel, combined with extensive media coverage. The psychological impacts of SARS, coupled with travel restrictions imposed by various national and international authorities, have diminished international travel in 2003, far beyond the limitations to truly SARS hit areas. Governments and press, especially in non SARS affected areas, have been slow to strike the right balance between timely and frequent risk communication and placing risk in the proper context. Screening at airport entry points is costly, has a low yield and is not sufficient in itself. The low yield in detecting SARS is most likely due to a combination of factors, such as travel advisories which resulted in reduced travel to and from SARS affected areas, implementation of effective pre-departure screening at airports in SARS-hit countries, and a rapid decline in new cases at the time when screening was finally introduced. Rather than investing in airport screening measures to detect rare infectious diseases, investments should be used to strengthen screening and infection control capacities at points of entry into the healthcare system. If SARS reoccurs, the subsequent outbreak will be smaller and more easily contained if the lessons learnt from the recent epidemic are applied. Lessons learnt during the outbreak in relation to international travel will be discussed.

Advice taking from humans and machines: an fMRI and effective connectivity study

Directory of Open Access Journals (Sweden)

Kimberly Goodyear

2016-11-01

Full Text Available With new technological advances, advice can come from different sources such as machines or humans, but how individuals respond to such advice and the neural correlates involved need to be better understood. We combined functional MRI and multivariate Granger causality analysis with an X-ray luggage-screening task to investigate the neural basis and corresponding effective connectivity involved with advice utilization from agents framed as experts. Participants were asked to accept or reject good or bad advice from a human or machine agent with low reliability (high false alarm rate. We showed that unreliable advice decreased performance overall and participants interacting with the human agent had a greater depreciation of advice utilization during bad advice compared to the machine agent. These differences in advice utilization can be perceivably due to reevaluation of expectations arising from association of dispositional credibility for each agent. We demonstrated that differences in advice utilization engaged brain regions that may be associated with evaluation of personal characteristics and traits (precuneus, posterior cingulate cortex, temporoparietal junction and interoception (posterior insula. We found that the right posterior insula and left precuneus were the drivers of the advice utilization network that were reciprocally connected to each other and also projected to all other regions. Our behavioral and neuroimaging results have significant implications for society because of progressions in technology and increased interactions with machines.

Travel health attitudes among Turkish business travellers to African countries.

Science.gov (United States)

Selcuk, Engin Burak; Kayabas, Uner; Binbasioglu, Hulisi; Otlu, Baris; Bayindir, Yasar; Bozdogan, Bulent; Karatas, Mehmet

The number of international travellers is increasing worldwide. Although health risks related to international travel are important and generally well-understood, the perception of these risks was unclear among Turkish travellers. We aimed to evaluate the attitudes and health risk awareness of Turkish travellers travelling to African countries. A survey was performed of Turkish travellers bound for Africa from Istanbul International Ataturk Airport in July 2013. A total of 124 travellers were enrolled in the study. Among them, 62.9% had information about their destination but only 11.3% had looked for information on health problems related to travel and their destination. Of all travellers, 53.2% had at least one vaccination before travelling. The most commonly administered vaccine was for typhoid. Among the travellers, 69.3% and 80.6% had "no idea" about yellow fever vaccination and malaria prophylaxis, respectively. A positive correlation was found between a higher level of travellers' education and receiving the recommended vaccination for the destination. Our study revealed significant gaps in the vaccination and chemoprophylaxis uptake of Turkish travellers departing to Africa. An awareness and training program should be developed for travellers, as well as public health workers, to address health risks related to travel. Copyright © 2016 Elsevier Ltd. All rights reserved.

Danish long distance travel A study of Danish travel behaviour and the role of infrequent travel activities

DEFF Research Database (Denmark)

Knudsen, Mette Aagaard

2014-01-01

, this is problematic. The average travel distance has steadily increased during the latest decades together with the increasing motorisation of daily travel and international aviation. Previously most focus has been on domestic daily travel activities, but globalisation has, together with changes in price structures......), the TU overnight survey, and the Danish Tourism Statistics from the Business and Holiday Survey (HBS). This has enabled focus on infrequent travel activities segmented relative to travel purpose, distance threshold, or travelling with overnight stays. At an overall level the thesis has three main.......g. socio-economic variables. The analysis of Danish travel activities described in the three different travel surveys has outlined detailed information on Danish travel behaviour at an aggregated level during the past two decades. It has above all revealed the significant role of leisure travel. Private...

Protecting Against Influenza (Flu): Advice for Caregivers of Young Children

Science.gov (United States)

... Avian Swine Variant Pandemic Other Protecting Against Influenza (Flu): Advice for Caregivers of Young Children Language: English ( ... from the flu. Advice on How to Prevent Flu for Caregivers of Young Children 1. Take Time ...

Knowledge, attitudes, and practices of business travelers regarding influenza and the use of antiviral medication.

Science.gov (United States)

Helfenberger, Salome; Tschopp, Alois; Robyn, Luc; Hatz, Christoph; Schlagenhauf, Patricia

2010-01-01

This study aimed to determine the knowledge, attitudes, and practices of Swiss business travelers with regard to influenza and the use of antiviral medication. Questionnaires, available in three languages, were distributed manually and online through companies, organizations, and travel medicine specialists in Switzerland to business travelers who were traveling during the period January 2005 to April 2009. In total, 661 questionnaires were fully completed and evaluated. A total of 58.9% (n = 388) of the respondents stated that they had contracted influenza in the past; some 48.6% (n = 321) of the travelers had been vaccinated against seasonal influenza at least once in their lifetime; 87.1% (n = 576) of the travelers knew that influenza can be transmitted by droplets; and 62.3% (n = 412) were aware of transmission by direct contact. Almost all respondents (96.8%; n = 633) recognized fever as a main symptom of influenza, 80.0% (n = 523) knew about muscular aches and pain, 79.5% (n = 520) about shivering, and 72.9% (n = 477) about joint pain. Some 38.0% (n = 250) of the respondents stated that the annual vaccination is their preferred prevention method for influenza, 35.6% (n = 234) would neither do an annual vaccination nor carry antiviral medication, 16.0% (n = 105) would carry antiviral medication, 8.5% (n = 56) would prefer to do both the annual vaccination and to carry antivirals, and 2.0% (n = 13) would use antivirals as influenza prophylaxis. Regarding prevention, the majority (78.9%; n = 498) of the travelers did not seek advice on influenza before going on their last business trip, 58.0% (n = 381) did not take any preventive measures against influenza, 27.2% (n = 179) had their annual vaccination, and 15.7% (n = 103) observed hand hygiene. Of the travelers, 9.7% (n = 64) carried antiviral medication on their last business trip and 7.0% (n = 46) actually used this medication. Business travelers have a good knowledge about the transmission and the symptoms of

Dengue virus infection among long-term travelers from the Netherlands: A prospective study, 2008-2011.

Directory of Open Access Journals (Sweden)

Femke W Overbosch

Full Text Available Dengue is increasing rapidly in endemic regions. Data on incidence among travelers to these areas are limited. Five prospective studies have been performed thus far, mainly among short-term travelers.To obtain the attack and incidence rate (AR, IR of dengue virus (DENV infection among long-term travelers and identify associated risk factors.A prospective study was performed among long-term travelers (12-52 weeks attending the Public Health Service in Amsterdam. Clients planning to travel to (subtropical countries were invited to participate. Participants kept a travel diary, recording itinerary, symptoms, and physician visits. Pre- and post-travel blood samples were serologically tested for the presence of Anti-DENV IgG antibodies. Seroconversion was considered suggestive of a primary DENV infection. Anti-DENV IgG present in both corresponding samples in combination with a post-/pre-travel ratio of ≥4:1 was suggestive of a secondary infection. Risk factors for a DENV infection were studied using poisson regression.In total, 600 participants were included; median age was 25 years (IQR: 23-29, 35.5% were male, and median travel duration was 20 weeks (IQR: 15-25. In 39 of 600 participants (AR: 6.5%; 95% CI 4.5-8.5% anti-DENV IgG test results were suggestive of a recent infection, yielding an IR of 13.9 per 1,000 person-months traveling (95%CI: 9.9-19.1. No secondary infections were found. IR for Asia, Africa, and America were comparable and 13.5, 15.8, and 13.6 per 1,000 person-months respectively. Of participants with a recent DENV infection, 51% did not report dengue-like illness (DLI or fever, but 10% were hospitalized. In multivariable analysis, travelers who seroconverted were significantly more likely to be vaccinated with ≥2 flavivirus vaccines for the current trip or to have reported DLI in >1 consecutive weeks.Long-term travelers are at substantial risk of DENV infection. Half of those with a DENV infection reported no symptoms, but 10

Racial disparities in reported prenatal care advice from health care providers.

Science.gov (United States)

Kogan, M D; Kotelchuck, M; Alexander, G R; Johnson, W E

1994-01-01

OBJECTIVES. The relationship between certain maternal behaviors and adverse pregnancy outcomes has been well documented. One method to alter these behaviors is through the advice of women's health care providers. Advice from providers may be particularly important in minority populations, who have higher rates of infant mortality and prematurity. This study examines racial disparities according to women's self-report of advice received from health care providers during pregnancy in four areas: tobacco use, alcohol consumption, drug use, and breast-feeding. METHODS. Health care providers' advice to 8310 White non-Hispanic and Black women was obtained from the National Maternal and Infant Health Survey. RESULTS. After controlling for sociodemographic, utilization, and medical factors, Black women were more likely to report not receiving advice from their prenatal care providers about smoking cessation and alcohol use. The difference between Blacks and Whites also approached significance for breast-feeding. No overall difference was noted in advice regarding cessation of drug use, although there was a significant interaction between race and marital status. CONCLUSIONS. These data suggest that Black women may be at greater risk for not receiving information that could reduce their chances of having an adverse pregnancy outcome. PMID:8279618

Marine Scorpaenidae Envenomation in Travelers: Epidemiology, Management, and Prevention.

Science.gov (United States)

Diaz, James H

2015-01-01

The Scorpaenidae are a large family of venomous marine fish that include scorpionfish, lionfish, and stonefish. Although most stonefish are confined to the Indo-Pacific, scorpionfish are distributed in the tropics worldwide, and two species of Indo-Pacific lionfish were inadvertently introduced into the Eastern Atlantic in the 1990s. Since then, lionfish have invaded shallow reef systems in the Eastern Atlantic, Gulf of Mexico, and Caribbean Sea. All of these regions are popular travel destinations for beachcombing, fishing, swimming, and scuba diving-recreational activities that increase risks of Scorpaenidae envenomation. To meet the objectives of describing species-specific presenting clinical manifestations, diagnostic and treatment strategies, and outcomes of Scorpaenidae envenomation in travelers, Internet search engines were queried with the key words. Well-conducted, retrospective epidemiological investigations of Scorpaenidae envenomation case series concluded: (1) most cases occurred in young adult male vacationers visiting endemic regions; (2) victims sought medical attention for pain control within 2 hours of injury and presented with intense pain, edema, and erythema in affected extremities; (3) systemic manifestations and surgical interventions were relatively uncommon following initial management with hot water soaks and parenteral analgesics; (4) all cases required tetanus prophylaxis; deeply penetrating, lacerated, and necrotic wounds required antibiotic prophylaxis; and (5) equine Fab stonefish antivenom does have antigen-neutralizing cross-reactivities with both Indo-Pacific and Atlantic Scorpaenidae species and is indicated in severe scorpionfish and stonefish envenomation worldwide. Travel medicine practitioners should counsel their patients about Scorpaenidae envenomation risks in endemic regions and maintain a high index of suspicion regarding Scorpaenidae envenomation in all travelers returning from tropical beach and ocean holidays and

PrEP-dossier : Pre-Expositie Profylaxe voor hiv-negatieven in Nederland

NARCIS (Netherlands)

Urbanus AT; Blom C; Zantkuijl P; David S; P&B; I&V

2017-01-01

In October 2016, the Minister for Health, Welfare and Sport requested advice from the Health Council of the Netherlands on the use of medication to prevent HIV infection (pre-exposure prophylaxis, or PrEP) in people with an increased risk of HIV. The National Institute for Public Health and the

Illness and risk behaviour in health care students studying abroad.

Science.gov (United States)

Angelin, Martin; Evengård, Birgitta; Palmgren, Helena

2015-07-01

The numbers of university students studying abroad increase every year. These students are not tourists as their studies require different types of travel that expose them to different risks. Moreover, health care students (HCSs) may be exposed to even greater risks according to their travel destinations and itineraries. Clearly, research-based pre-travel advice is needed. This study reports on a prospective survey conducted from April 2010 to January 2014 of health care and non-health care students from Swedish universities in Umeå, Stockholm and Gothenburg studying abroad. Of the 393 students included in the study, 85% responded. Over half (55%) were HCSs. Pre-travel health information was received by 79% and information on personal safety by 49% of HCSs. The rate of illness during travel was 52%. Health care students more often travelled to developing regions and were at increased risk for travellers' diarrhoea. One in 10 experienced theft and 3% were involved in traffic accidents. One in five met a new sexual partner during travel and 65% of these practised safe sex. Half of all participants increased their alcohol consumption while abroad; high alcohol consumption was associated with increased risk for being a victim of theft, as well as for meeting a new sexual partner during travel. University authorities are responsible for the safety and well-being of students studying abroad. This study supplies organisers and students with epidemiological data that will help improve pre-travel preparation and increase student awareness of the potential risks associated with studying abroad. © 2015 John Wiley & Sons Ltd.

Effects of long-haul transmeridian travel on player preparedness: Case study of a national team at the 2014 FIFA World Cup.

Science.gov (United States)

Fowler, Peter M; McCall, Alan; Jones, Mark; Duffield, Rob

2017-04-01

Describe the effects of eastward long-haul transmeridian air travel on subjective jet-lag, sleep and wellness in professional football (soccer) players prior to the 2014 FIFA World Cup in Brazil. Single cohort involving twenty-two male professional football players representing a national football team. Data was collected from players prior to and following international travel from Sydney, Australia to Vitoria, Brazil. In total there were three flights, 19-h and 14,695km of travel east across 11 time-zones. Training load and wellness measures were obtained in the week prior to and following travel, whilst sleep and jet-lag measures were collected on the day prior to travel (Pre), the day of arrival and for five days following travel (Post 1-5). Compared to Pre, perceived jet-lag was significantly increased on Post 1 to 4, with significantly greater levels on Post 1 compared to Post 5 (pplayer wellness. Consequently, player preparedness for subsequent training and competition may be impeded, though physical performance data is lacking. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Patient awareness of need for hepatitis a vaccination (prophylaxis) before international travel.

Science.gov (United States)

Liu, Stephen J; Sharapov, Umid; Klevens, Monina

2015-01-01

Although hepatitis A virus (HAV) infection is preventable through vaccination, cases associated with international travel continue to occur. The purpose of this study was to examine the frequency of international travel and countries visited among persons infected with HAV and assess reasons why travelers had not received hepatitis A vaccine before traveling. Using data from sentinel surveillance for HAV infection in seven US counties during 1996 to 2006, we examined the role of international travel in hepatitis A incidence and the reasons for patients not being vaccinated. Of 2,002 hepatitis A patients for whom travel history was available, 300 (15%) reported traveling outside of the United States. Compared to non-travelers, travelers were more likely to be female [odds ratio (OR) = 1.74 (95% confidence interval [95% CI], 1.35, 2.24)], aged 0 to 17 years [OR = 3.30 (1.83, 5.94)], Hispanic [OR = 3.69 (2.81, 4.86)], Asian [OR = 2.00 (1.06, 3.77)], and were less likely to be black non-Hispanic [OR = 0.30 (0.11, 0.82)]. The majority, 189 (61.6%), had traveled to Mexico. The most common reason for not getting pre-travel vaccination was "Didn't know I could [or should] get shots" [100/154 (65%)]. Low awareness of HAV vaccination was the predominant reason for not being protected before travel. Different modes of traveler education could improve prevention of hepatitis A. To highlight the risk of infection before traveling to endemic countries including Mexico, travel and consulate websites could list reminders of vaccine recommendations. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Connected Traveler

Energy Technology Data Exchange (ETDEWEB)

2016-06-01

The Connected Traveler framework seeks to boost the energy efficiency of personal travel and the overall transportation system by maximizing the accuracy of predicted traveler behavior in response to real-time feedback and incentives. It is anticipated that this approach will establish a feedback loop that 'learns' traveler preferences and customizes incentives to meet or exceed energy efficiency targets by empowering individual travelers with information needed to make energy-efficient choices and reducing the complexity required to validate transportation system energy savings. This handout provides an overview of NREL's Connected Traveler project, including graphics, milestones, and contact information.

Behavior Modification of Studying Through Study Skills Advice and Self-Control Procedures

Science.gov (United States)

Richards, C. Steven

1975-01-01

Investigates the efficacy of two behavioral self-control procedures as additions to the typical treatment for college students' study behavior--study skills advice. Predicted self-monitoring would be an effective treatment addition to study skills advice and study skills advice would be superior to the control groups. Results supported…

Organisational travel plans for improving health.

Science.gov (United States)

Hosking, Jamie; Macmillan, Alexandra; Connor, Jennie; Bullen, Chris; Ameratunga, Shanthi

2010-03-17

quality and extracted data. Seventeen studies were included. Ten were conducted in a school setting, two in universities, and five in workplaces. One study directly measured health outcomes, and all included studies measured travel outcomes. Two cluster randomised controlled trials in the school setting showed either no change in travel mode or mixed results. A randomised controlled trial in the workplace setting, conducted in a pre-selected group who were already contemplating or preparing for active travel, found improved health-related quality of life on some sub scales, and increased walking. Two controlled before-after studies found that school travel interventions increased walking. Other studies were judged to be at high risk of bias. No included studies were conducted in low- or middle-income countries, and no studies measured the social distribution of effects or adverse effects, such as injury. There is insufficient evidence to determine whether organisational travel plans are effective for improving health or changing travel mode. Organisational travel plans should be considered as complex health promotion interventions, with considerable potential to influence community health outcomes depending on the environmental context in which they are introduced. Given the current lack of evidence, organisational travel plans should be implemented in the context of robustly-designed research studies, such as well-designed cluster randomised trials.

Dietary Advice on Prescription: A novel approach to dietary counseling

Directory of Open Access Journals (Sweden)

Gunnar Johansson

2011-05-01

Full Text Available This article describes a novel approach to giving dietary advice, which is called “Dietary Advice on Prescription” (DAP; Matordning på Recept [MoR] in Swedish. It is the same principle as prescription on medicine and “Physical Activity on Prescription” (PAP; Fysisk aktivitet på Recept [FaR] in Swedish. The main idea is that a written prescription will strengthen the oral advice and emphasize certain aspects of the dietary recommendation. The DAP is on the brink of being tested in a planned study.

Car Travel-Related Thrombosis: Fact or Fiction?

Science.gov (United States)

Lippi, Giuseppe; Favaloro, Emmanuel J

2018-06-01

The condition sometimes referred to as "economy class syndrome," and also known as "traveler's thrombosis," is a distinctive pathological condition characterized by occurrence of venous thromboembolism (VTE) in a patient who has recently experienced a long journey (i.e., ≥ 4 h). Typically, the identified travel is by airplane, but travel with other vehicles, such as trains, trucks, buses, or cars, could potentially qualify as contributing to VTE events. Although the enhanced risk of VTE after long haul flights is now widely acknowledged, albeit potentially overhyped, the risk of venous thrombosis after prolonged travel by other modes of transport, in particular, by cars, is less well appreciated. Current evidence, collected from some epidemiological studies, suggests that if any risk of VTE can be attributed to prolonged and uninterrupted car travels, and we give moderate credibility to such an association, the risk may be similar to that already proven for long haul flights. The risk is especially high in individuals undergoing uninterrupted car journeys lasting 4 hours or longer, in vehicles with a narrow seat-pitch, and in particularly would affect those with pre-existing acquired or inherited prothrombotic conditions. The putative biological mechanisms basically entail venous stasis and edema, which are often compounded by a certain degree of hypercoagulability. When these factors are combined with preexistent prothrombotic conditions, the risk may be substantially magnified. In this perspective, then, 'car thrombosis' may be regarded as a trigger rather than a risk factor for venous thrombosis. Although the current evidence is certainly not solid enough to endorse the use of general chemical prophylaxis for lowering the risk of car-related VTE, a set of possible precautionary measures, with no or very little side effects, may be suggested before planning prolonged car travels, especially for at risk individuals. Thieme Medical Publishers 333 Seventh Avenue

Investigating Classroom Teaching Competencies of Pre Service Elementary Mathematics Teachers

Science.gov (United States)

Gokalp, Murat

2016-01-01

The study has sought answers to two major questions: What is the current situation in Elementary Mathematics Education programs at Faculty of Education in terms of classroom teaching competencies? To what extent do pre service teachers acquire these competencies? The research was conducted on 202 senior pre service teachers studying at the…

Frequent flyer business travelers: major exposure hazards.

Science.gov (United States)

Tompkins, Olga S; Randolph, Susan A; Ostendorf, Judith S

2005-02-01

Bagshaw (2004) notes "the modern commercial aircraft cabin is maintained with adequate environmental control for the comfort of most healthy individuals" (p. 417). Occupational health nurses frequently deal with a population that may include unhealthy individuals or those with pre-existing conditions. It is critical for occupational health nurses to stay current with major hazards faced by frequent flyer business travelers to assist in identifying and preventing adverse health effects associated with these exposures.

The volitional travel speed varies with reproductive state in mature female brown trout Salmo trutta

DEFF Research Database (Denmark)

Svendsen, Jon Christian; Aarestrup, Kim; Dolby, Jes

2009-01-01

This study tested the effect of reproduction on the volitional travel speed of mature female brown trout Salmo trutta L. The downstream travel speed in the pre-spawning state was 0·25 m s−1 (95% CI : 0·19, 0·34) while it increased significantly to 0·65 m s−1 (95% CI: 0·49, 0·87) in the post...

Let Me Give You a Piece of Advice: Empirical Papers about Advice Taking in Marketing

NARCIS (Netherlands)

S.C. Tzioti (Stefanie)

2010-01-01

textabstractUsing advice in decision making is widespread for all sorts of important personal and professional decisions. Yet, traditional research on individual decision making has failed to systematically study the impact that social interactions about a decision problem can have on the decision

Nutrigenomics-based personalised nutritional advice: in search of a business model?

Science.gov (United States)

Ronteltap, Amber; van Trijp, Hans; Berezowska, Aleksandra; Goossens, Jo

2013-03-01

Nutritional advice has mainly focused on population-level recommendations. Recent developments in nutrition, communication, and marketing sciences have enabled potential deviations from this dominant business model in the direction of personalisation of nutrition advice. Such personalisation efforts can take on many forms, but these have in common that they can only be effective if they are supported by a viable business model. The present paper takes an inventory of approaches to personalised nutrition currently available in the market place as its starting point to arrive at an identification of their underlying business models. This analysis is presented as a unifying framework against which the potential of nutrigenomics-based personalised advice can be assessed. It has uncovered nine archetypical approaches to personalised nutrition advice in terms of their dominant underlying business models. Differentiating features among such business models are the type of information that is used as a basis for personalisation, the definition of the target group, the communication channels that are being adopted, and the partnerships that are built as a part of the business model. Future research should explore the consumer responses to the diversity of "archetypical" business models for personalised nutrition advice as a source of market information on which the delivery of nutrigenomics-based personalised nutrition advice may further build.

Virtual Travel Agencies - Tourist Value through Travel Information Systems

OpenAIRE

Anckar, Bill

1999-01-01

Anckar, B. (1999), ?Virtual Travel Agencies - Tourist Value through Travel Information Systems?. IAMSR Research Report 5/99. Institute for Advanced Management Systems Research, ?bo Akademi University. As electronic commerce enables the tourist service providers to sell their products directly to the consumer, travel agencies are faced with the imminent threat of being by-passed in the travel industry chain in the information age. This paper suggests that virtual travel agencies can compete su...

Advising in austerity reflections on challenging times for advice agencies

CERN Document Server

Kirwan, Samuel

2016-01-01

Advising in austerity provides a lively and thought-provoking account of the conditions, consequences and challenges of advice work in the UK. It examines how advisors negotiate the private troubles of those who come to Citizens Advice Bureaux (CAB) and construct ways forward.

Travel expenses

OpenAIRE

Pištěková, Petra

2014-01-01

The thesis "Travel expenses" is dedicated to the travel expenses according to Czech legislation. The aim is to describe the travel reimbursement and to analyze the providing of compensation travel expenses on example of the elementary art school Zruč nad Sázavou. The purpose of this analysis is primarily to find an optimal solution to the problem of determining the place of regular workplace for the travel expenses. The theoretical part focuses on the identification and definition of all prin...

Traveller Information System for Heterogeneous Traffic Condition: A Case Study in Thiruvananthapuram City, India

Science.gov (United States)

Satyakumar, M.; Anil, R.; Sreeja, G. S.

2017-12-01

Traffic in Kerala has been growing at a rate of 10-11% every year, resulting severe congestion especially in urban areas. Because of the limitation of spaces it is not always possible to construct new roads. Road users rely on travel time information for journey planning and route choice decisions, while road system managers are increasingly viewing travel time as an important network performance indicator. More recently Advanced Traveler Information Systems (ATIS) are being developed to provide real-time information to roadway users. For ATIS various methodologies have been developed for dynamic travel time prediction. For this work the Kalman Filter Algorithm was selected for dynamic travel time prediction of different modes. The travel time data collected using handheld GPS device were used for prediction. Congestion Index were calculated and Range of CI values were determined according to the percentage speed drop. After prediction using Kalman Filter, the predicted values along with the GPS data was integrated to GIS and using Network Analysis of ArcGIS the offline route navigation guide was prepared. Using this database a program for route navigation based on travel time was developed. This system will help the travelers with pre-trip information.

Travelers' Health: Rubella

Science.gov (United States)

... Stamaril clinics Disease Directory Resources Resources for Travelers Adventure Travel Animal Safety Blood Clots Bug Bites Evite ... Minute Travel Long-Term Travel Mass Gatherings Medical Tourism Mental Health Motion Sickness Natural Disasters Pregnant Travelers ...

Emotions in advice taking: the roles of agency and valence

NARCIS (Netherlands)

de Hooge, I.E.; Verlegh, P.W.J.; Tzioti, S.C.

2014-01-01

Recently, advice taking has received attention in decision-making research, and some studies suggest that emotions may play a role in this process. Yet a clear account of how emotions influence advice taking is lacking. The current research introduces a parsimonious explanation by suggesting that

Emotions in Advice Taking: The Roles of Agency and Valence

NARCIS (Netherlands)

Hooge, de I.E.; Verlegh, P.W.J.; Tzioti, S.C.

2014-01-01

Recently, advice taking has received attention in decision-making research, and some studies suggest that emotions may play a role in this process. Yet a clear account of how emotions influence advice taking is lacking. The current research introduces a parsimonious explanation by suggesting that

The present day relevance of Paul's advice to the family in the ...

African Journals Online (AJOL)

Many people and organizations have made several efforts to improve and enhance the survival of the family. An example is the advice of Saint Paul, the Apostle to the Christian family in Ephesians 5:22-25 and 6:1-9. This paper examines this advice and its relevance to the society today. Key Words: Paul, Apostle; Advice; ...

77 FR 5252 - Federal Travel Regulation; GSA E-Gov Travel Service (ETS) Transition to E-Gov Travel Service 2...

Science.gov (United States)

2012-02-02

... Travel Regulation; GSA E-Gov Travel Service (ETS) Transition to E-Gov Travel Service 2 (ETS2) AGENCY..., ETS Program Manager Center for Travel Management (QMCD), Office of Travel and Transportation Services (QMC), at [email protected] or (703) 605-2151. SUPPLEMENTARY INFORMATION: The Federal Travel...

Factors Influencing Sexual Behaviour Between Tourists and Tourism Employees: A Systematic Review

Science.gov (United States)

Sharma, Aditi; van Teijlingen, Edwin R; Beanland, Rachel L

2016-01-01

Background: Increased travel abroad has a significant impact on the incidence and prevalence of Sexually Transmitted Infections (STIs). Previous reviews have focused on the knowledge, attitudes and behaviour of tourists and acquisition of STIs. Less is known about the impact on tourism operators in countries visited by tourists. The aim of this review is to ascertain factors influencing sexual behaviour between workers in the tourism industry and tourists; exploring the prevalence of sexual behaviour between the two populations, their perceptions of sexual risk while engaging in sexual activities and the knowledge of tourism operators regarding STIs. Methods: A systematic review was conducted. Database searches were performed in Medline/Ovid, EMBASE, Cochrane library and CINAHL for studies published between 2000 and March 2016. Grey literature searches were completed in the NHS database and Google Scholar between 2000 and December 2013. Papers were independently selected by two researchers. Data were extracted and critically appraised using a pre-designed extraction form and adapted CASP checklist. Results: The search identified 1,602 studies and 16 were included after review of the full text. Studies were conducted in nine countries. Findings suggest that STI knowledge, attitude and practice were fairly good among tourists and tourism workers, but there is a need for pre-travel advice for travellers, especially those travelling to low and middle-income countries. Greater importance was given to tourists than to tourism operators and locals interacting with tourists. Studies suggest that as a group both tourist and tourist workers were likely to engage in sexual activities. Overall, both condom use and STI screening were low, among tourists as well as tourism operators. Furthermore, studies reported links between drug and alcohol use and sexual behaviour and risk taking. Conclusion: Although less research appeared to have been conducted among tourism workers than

Targeting the robo-advice customer: the development of a psychographic segmentation model for financial advice robots

NARCIS (Netherlands)

van Thiel, D.; van Raaij, W.F.

2017-01-01

The purpose of this study is to develop the world’s first psychographic market segmentation model that supports personalization, customer education, customer activation, and customer engagement strategies with financial advice robots. As traditional segmentation models in consumer finance primarily

Valuation of Travel Time and TravelIer Information

NARCIS (Netherlands)

Rietveld, Piet

2003-01-01

The value of travel time plays an important role in cost benefit analysis of infrastructureprojects. However, the issue of uncertainty on travel times and the implications this has forestimations of travel time values has received much less attention in the literature. In thispaper we compare

Advice Complexity of the Online Induced Subgraph Problem

DEFF Research Database (Denmark)

Komm, Dennis; Královič, Rastislav; Královič, Richard

2016-01-01

of the input can influence the solution quality. We evaluate the information in a quantitative way by considering the best possible advice of given size that describes the unknown input. Using a result from Boyar et al. we give a tight trade-off relationship stating that, for inputs of length n, roughly n...... subgraph problem, preemption does not significantly help by giving a lower bound of Omega(n/(c^2\\log c)) on the bits of advice that are needed to obtain competitive ratio c, where c is any increasing function bounded from above by \\sqrt{n/\\log n}. We also give a linear lower bound for c close to 1....... these problems by investigating a generalized problem: for an arbitrary but fixed hereditary property, find some maximal induced subgraph having the property. We investigate this problem from the point of view of advice complexity, i.e. we ask how some additional information about the yet unrevealed parts...

Diagnostic medical exposures: advice on exposure to ionising radiation during pregnancy

International Nuclear Information System (INIS)

Anon.

1993-01-01

The NRPB offers advice on exposure to ionizing radiation during pregnancy, based on data published since 1985. In providing this advice the Board has considered risks to the developing embryo and fetus of death, malformation, mental impairment, cancer (solid tumours and leukaemias) and genetic damage from irradiation after the first missed menstrual period. The possible risks from irradiation of the early (up to 3-4 weeks) conceptus and from gonodal irradiation of patients is also covered in the present advice. (Author)

Determinants of physical activity frequency and provider advice during pregnancy.

Science.gov (United States)

Santo, Eilann C; Forbes, Peter W; Oken, Emily; Belfort, Mandy B

2017-09-05

Our aims were to (1) describe the frequency of physical activity and prenatal healthcare provider advice about physical activity during pregnancy and (2) examine determinants and correlates of 3rd trimester physical activity and receipt of physical activity advice. We analyzed data from the 2008 Pregnancy Risk Assessment Monitoring System. We studied 2669 women from North Carolina and Colorado with data on physical activity frequency in the 3 months prior to pregnancy and during the 3rd trimester and 1584 women from Oklahoma with data on provider advice regarding physical activity during pregnancy. Respondents reported physical activity, defined as 30 min or more of exercise/physical activity (excluding vocationally related activity), in in these categories: pregnancy was strongly associated with low likelihood of ACOG guideline adherence in the 3rd trimester (aOR 0.10, 95% CU 0.04, 0.30 vs. 1-4 days/week). Underweight women were more likely to adhere to ACOG guidelines than normal weight women (aOR 2.27, 95% CI 1.36, 3.79). Overweight women were more likely to receive physical activity advice (aOR 2.9, 95% CI 1.3, 6.3 vs. normal weight), but obese women were not (aOR 0.65, 95% CI 0.4, 1.2). Few women meet ACOG guideline criteria for physical activity during pregnancy. Improving physical activity and weight status prior to pregnancy may improve activity levels during pregnancy. Nearly one third did not receive advice about physical activity during prenatal care. Obese women were no more likely to receive advice than their normal weight counterparts, indicating the need for targeted physical activity counseling in this population.

Family planning advice and postpartum contraceptive use among low-income women in Mexico.

Science.gov (United States)

Barber, Sarah L

2007-03-01

In Mexico, family planning advice has been incorporated into the clinical guidelines for prenatal care. However, the relationship between women's receipt of family planning advice during prenatal care and subsequent contraceptive use has not been evaluated. Data were collected in 2003 and 2004 in 17 Mexican states from 2,238 urban low-income women postpartum. Participating women reported on prenatal services received and contraceptive use. Logistic and multinomial logistic regression models evaluated whether receiving family planning advice during prenatal care predicted current contraceptive use, after quality of care in the community, service utilization, delivery characteristics, household socioeconomic characteristics, and maternal and infant characteristics were controlled for. Overall, 47% of women used a modern contraceptive method. Women who received family planning advice during prenatal care were more likely to use a contraceptive than were those who did not receive such advice (odds ratio, 2.2). Women who received family planning advice had a higher probability of using condoms (relative risk ratio, 2.3) and IUDs (5.2), and of undergoing sterilization (1.4), than of using no method. Integrating family planning advice into prenatal care may be an important strategy for reaching women when their demand for contraception is high.

Traveling Companions Add Complexity and Hinder Performance in the Spatial Behavior of Rats

DEFF Research Database (Denmark)

Dorfman, Alex; Nielbo, Kristoffer Laigaard; Eilam, David

2016-01-01

-mate. It was found that the presence of another rat substantially altered the rats' spatial behavior. Lone rats collected the food items faster while traveling a shorter distance, reflecting a higher efficiency of task completion. When accompanied by a partner, however, the rats traveled together, visiting the same......We sought to uncover the impact of the social environment on the spatial behavior of rats. Food-deprived rats were trained in a spatial task of collecting food items from 16 equispaced objects. Following training, they were tested, first alone and then with a similarly-trained cage...... of rats’ natural behavior. Revisiting an object following food depletion implies that searching for food was not the main driving force in the rats' spatial behavior. Specifically, despite food deprivation, rats were more attentive to one another than to the food. This could be adaptive, since foraging...

À La Recherche De L’Espace Perdu: Architecture, Urban Fabric, and French Travelers to Antioch (1784–1914

Directory of Open Access Journals (Sweden)

Ümit Fırat Açıkgöz

2016-11-01

Full Text Available Ottoman Antioch, a marginalized outpost by the late 18th century, attracted French travelers thanks to its illustrious Roman, Early Christian, and crusader histories. To make sense of the city, these travelers relied either on previous travelogues or on their own observations of the built environment. This article sheds light on the inter-textual relationship among travelogues, and on how both the built environment of Ottoman Antioch and representations of the pre-Islamic city and its monuments shaped the travelers’ narratives. The dramatic contrast between the insignificance of Ottoman Antioch and the grandeur of the pre-Islamic city prompted the travelers to reflect on the glories of Greco-Roman antiquity and the ‘decadence of the Oriental civilizations’. I focus on four French travelers who visited Antioch between 1780 and 1914, and argue that they turned the state of the city’s architecture and urban fabric into a critical tool to imagine their historical connections to the region, reproduce the Orientalist stereotypes in circulation in Europe at the time, and, thereby setting the tone for the colonization of the region.

Danish long distance travel A study of Danish travel behaviour and the role of infrequent travel activities

OpenAIRE

Knudsen, Mette Aagaard; Rich, Jeppe; Nielsen, Otto Anker

2014-01-01

Historically there has been a lack of knowledge with respect to long distance travel. Due to the considerable contribution of long distance travel to total travelled kilometres and the related energy consumption from the transport sector and derived impacts on greenhouse emissions, this is problematic. The average travel distance has steadily increased during the latest decades together with the increasing motorisation of daily travel and international aviation. Previously most focus has been...

Travel personae of American pleasure travelers

DEFF Research Database (Denmark)

Park, S.; Tussyadiah, Iis; Mazanec, J.A.

2010-01-01

Travel style has been shown to be a useful concept for understanding travelers. In this study it is argued that the portfolio of trips (specifically, the portfolio of various trip styles) one takes can be used to describe his/her overall travel persona. Network analysis was used to examine...... personae which, in turn, are related to their choices of places visited and their response to advertising materials. It was concluded that the framework provided by these findings along with new tools on the Internet offer the potential to develop highly personalized communications with existing...

21 CFR 312.41 - Comment and advice on an IND.

Science.gov (United States)

2010-04-01

.... Examples of such advice may include advice on the adequacy of technical data to support an investigational plan, on the design of a clinical trial, and on whether proposed investigations are likely to produce the data and information that is needed to meet requirements for a marketing application. (c) Unless...

Educating international students about tuberculosis and infections associated with travel to visit friends and relatives (VFR-travel).

Science.gov (United States)

Gibney, Katherine B; Brass, Amanda; Hume, Sam C; Leder, Karin

2014-01-01

International students in Victoria, Australia, originate from over 140 different countries. They are over-represented in disease notifications for tuberculosis and travel-associated infections, including enteric fever, hepatitis A, and malaria. We describe a public health initiative aimed to increase awareness of these illnesses among international students and their support staff. We identified key agencies including student support advisors, medical practitioners, health insurers, and government and professional organisations. We developed health education materials targeting international students regarding tuberculosis and travel-related infections to be disseminated via a number of different media, including electronic and printed materials. We sought informal feedback from personnel in all interested agencies regarding the materials developed, their willingness to deliver these materials to international students, and their preferred media for disseminating these materials. Education institutions with dedicated international student support staff and on-campus health clinics were more easily engaged to provide feedback and disseminate the health education materials than institutions without such dedicated personnel. Response to contacting off-campus medical practices was poor. Delivery of educational materials via electronic and social media was preferred over face-to-face education. It is feasible to provide health education messages targeting international students for dissemination via appropriately-staffed educational institutions. This initiative could be expanded in terms of age-group, geographic range, and health issues to be targeted. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sociality Mental Modes Modulate the Processing of Advice-Giving: An Event-Related Potentials Study

Directory of Open Access Journals (Sweden)

Jin Li

2018-02-01

Full Text Available People have different motivations to get along with others in different sociality mental modes (i.e., communal mode and market mode, which might affect social decision-making. The present study examined how these two types of sociality mental modes affect the processing of advice-giving using the event-related potentials (ERPs. After primed with the communal mode and market mode, participants were instructed to decide whether or not give an advice (profitable or damnous to a stranger without any feedback. The behavioral results showed that participants preferred to give the profitable advice to the stranger more slowly compared with the damnous advice, but this difference was only observed in the market mode condition. The ERP results indicated that participants demonstrated more negative N1 amplitude for the damnous advice compared with the profitable advice, and larger P300 was elicited in the market mode relative to both the communal mode and the control group. More importantly, participants in the market mode demonstrated larger P300 for the profitable advice than the damnous advice, whereas this difference was not observed at the communal mode and the control group. These findings are consistent with the dual-process system during decision-making and suggest that market mode may lead to deliberate calculation for costs and benefits when giving the profitable advice to others.

Nutrigenomics-based personalised nutritional advice: in search of a business model?

NARCIS (Netherlands)

Ronteltap, A.; Trijp, van J.C.M.; Berezowska, A.; Goossens, Jo

2013-01-01

Nutritional advice has mainly focused on population-level recommendations. Recent developments in nutrition, communication, and marketing sciences have enabled potential deviations from this dominant business model in the direction of personalisation of nutrition advice. Such personalisation efforts

Increasing referral of at-risk travelers to travel health clinics: evaluation of a health promotion intervention targeted to travel agents.

Science.gov (United States)

MacDougall, L A; Gyorkos, T W; Leffondré, K; Abrahamowicz, M; Tessier, D; Ward, B J; MacLean, J D

2001-01-01

Increases in travel-related illness require new partnerships to ensure travelers are prepared for health risks abroad. The travel agent is one such partner and efforts to encourage travel agents to refer at-risk travelers to travel health clinics may help in reducing travel-attributable morbidity. A health promotion intervention encouraging travel agents to refer at-risk travelers to travel health clinics was evaluated. Information on the knowledge, attitudes, and behaviors of travel agents before and after the intervention was compared using two self-administered questionnaires. The Wilcoxon signed rank test was used to compare the mean difference in overall scores to evaluate the overall impact of the intervention and also subscores for each of the behavioral construct groupings (attitudes, barriers, intent, and subjective norms). Multiple regression techniques were used to evaluate which travel agent characteristics were independently associated with a stronger effect of the intervention. A small improvement in travel agents overall attitudes and beliefs (p =.03) was found, in particular their intention to refer (p =.01). Sixty-five percent of travel agents self-reported an increase in referral behavior; owners or managers of the agency were significantly more likely to do so than other travel agents (OR = 7.25; 95% CI: 1.64 32.06). Older travel agents, those that worked longer hours and those with some past referral experience, had significantly higher post-intervention scores. Travel agents can be willing partners in referral, and agencies should be encouraged to develop specific referral policies. Future research may be directed toward investigating the role of health education in certification curricula, the effectiveness of different types of health promotion interventions, including Internet-facilitated interventions, and the direct impact that such interventions would have on travelers attending travel health clinics.

A quantitative analysis of the quality and content of the health advice in popular Australian magazines.

Science.gov (United States)

Wilson, Amanda; Smith, David; Peel, Roseanne; Robertson, Jane; Kypri, Kypros

2017-06-01

To examine how health advice is provided in popular magazines and the quality of that advice. A prospective quantitative analysis of the quality of health advice provided in Australian magazines between July and December 2011 was conducted. A rating instrument was adapted from the Media Doctor Australia rating tool used to assess quality of health news reporting. Criteria included: recommends seeing a doctor; advice based on reliable evidence; advice clear and easily applied; benefits presented meaningfully; potential harms mentioned; evidence of disease mongering; availability and cost of treatments; obvious advertising; vested interest, and anecdotal evidence. 163 health advice articles were rated showing a wide variation in the quality of advice presented between magazines. Magazines with 'health' in the title, rated most poorly with only 36% (26/73) of these articles presenting clear and meaningful advice and 52% (38/73) giving advice based on reliable evidence. Australian magazines, especially those with health in the title, generally presented poor quality, unreliable health advice. Teen magazine Dolly provided the highest quality advice. Consumers need to be aware of this when making health choices. © 2016 Public Health Association of Australia.

Regulations and classification advice: transport safety

International Nuclear Information System (INIS)

Davies, M.; Owen, K.

1990-01-01

The packaging of radioactive material for transport must conform with the regulations of the International Atomic Energy Agency (IAEA). These regulations are extensive and complex and require specialist interpretation. Packaging must be designed to contain the material, to limit radiation to safe levels, and to maintain the material in a safe state under both normal and accident conditions. British Nuclear Fuels Ltd. (BNFL) developed the TRANAID expert system to provide automated expert advice on the subject. It is used at BNFL and by other users internationally. The system was produced to meet an internal BNFL emphasis on accurate consistent and reliable interpretation of the complex IAEA regulations; and to provide a commercial product which would meet an external need. TRANAID provides reliable and consistent advice on safe transport procedures which reduce the workload on scarce skilled personnel, and allows them to concentrate on their primary task of packaging design. TRANAID also avoids overclassifying radioactive shipments, which would lead to the use of more expensive packaging than strictly is required. The IAEA regulations are applied internationally, and so there is a large potential worldwide market. The indications from the initial response are that future sales and use are expected to more than cover the investment. Other non-quantifiable benefits include the provision of consistent advice within a uniform approach, the safe-guarding of knowledge of the IAEA regulations, training and improvement in the expertise of users, improved management control, and enhancement of the professional image of BNFL. (author)

Human travel and traveling bedbugs.

Science.gov (United States)

Delaunay, Pascal

2012-12-01

A dramatic increase of reported bedbug (Cimex lectularius and Cimex hemipterus) infestations has been observed worldwide over the past decade. Bedbug infestations have also been detected across a wide range of travel accommodations, regardless of their comfort and hygiene levels. Travelers are increasingly exposed to the risks of bedbug bites, infestation of personal belongings, and subsequent contamination of newly visited accommodations and their homes. We searched Medline publications via the PubMed database. National bedbug recommendations, textbooks, newspapers, and Centers for Disease Control websites were also searched manually. To detect infested sites, avoid or limit bedbug bites, and reduce the risk of contaminating one's belongings and home, bedbug biology and ecology must be understood. A detailed search of their most classic hiding niches is a key to finding adult bedbugs, nymphs, eggs, and feces or traces of blood from crushed bedbugs. Locally, bedbugs move by active displacement to feed (bite) during the night. Bed, mattress, sofa, and/or curtains are the most frequently infested places. If you find bedbugs, change your room or, even better, the hotel. Otherwise, travelers should follow recommendations for avoiding bedbugs and their bites during the night and apply certain simple rules to avoid infesting other sites or their home. Travelers exposed to bedbugs can minimize the risks of bites and infestation of their belongings, and must also do their civic duty to avoid contributing to the subsequent contamination of other hotels and, finally, home. © 2012 International Society of Travel Medicine.

Prospective study of pathogens in asymptomatic travellers and those with diarrhoea: aetiological agents revisited.

Science.gov (United States)

Lääveri, T; Antikainen, J; Pakkanen, S H; Kirveskari, J; Kantele, A

2016-06-01

Travellers' diarrhoea (TD) remains the most frequent health problem encountered by visitors to the (sub)tropics. Traditional stool culture identifies the pathogen in only 15% of cases. Exploiting PCR-based methods, we investigated TD pathogens with a focus on asymptomatic travellers and severity of symptoms. Pre- and post-travel stools of 382 travellers with no history of antibiotic use during travel were analysed with a multiplex quantitative PCR for Salmonella, Yersinia, Campylobacter, Shigella, Vibrio cholerae and five diarrhoeagenic Escherichia coli: enteroaggregative (EAEC), enteropathogenic (EPEC), enterotoxigenic (ETEC), enterohaemorrhagic (EHEC) and enteroinvasive (EIEC). The participants were categorized by presence/absence of TD during travel and on return, and by severity of symptoms. A pathogen was indentified in 61% of the asymptomatic travellers, 83% of those with resolved TD, and 83% of those with ongoing TD; 25%, 43% and 53% had multiple pathogens, respectively. EPEC, EAEC, ETEC and Campylobacter associated especially with ongoing TD symptoms. EAEC and EPEC proved more common than ETEC. To conclude, modern methodology challenges our perception of stool pathogens: all pathogens were common both in asymptomatic and symptomatic travellers. TD has a multibacterial nature, but diarrhoeal symptoms mostly associate with EAEC, EPEC, ETEC and Campylobacter. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Iterative Bayesian Estimation of Travel Times on Urban Arterials: Fusing Loop Detector and Probe Vehicle Data.

Science.gov (United States)

Liu, Kai; Cui, Meng-Ying; Cao, Peng; Wang, Jiang-Bo

2016-01-01

On urban arterials, travel time estimation is challenging especially from various data sources. Typically, fusing loop detector data and probe vehicle data to estimate travel time is a troublesome issue while considering the data issue of uncertain, imprecise and even conflicting. In this paper, we propose an improved data fusing methodology for link travel time estimation. Link travel times are simultaneously pre-estimated using loop detector data and probe vehicle data, based on which Bayesian fusion is then applied to fuse the estimated travel times. Next, Iterative Bayesian estimation is proposed to improve Bayesian fusion by incorporating two strategies: 1) substitution strategy which replaces the lower accurate travel time estimation from one sensor with the current fused travel time; and 2) specially-designed conditions for convergence which restrict the estimated travel time in a reasonable range. The estimation results show that, the proposed method outperforms probe vehicle data based method, loop detector based method and single Bayesian fusion, and the mean absolute percentage error is reduced to 4.8%. Additionally, iterative Bayesian estimation performs better for lighter traffic flows when the variability of travel time is practically higher than other periods.

General physical health advice for people with serious mental illness.

Science.gov (United States)

Tosh, Graeme; Clifton, Andrew V; Xia, Jun; White, Margueritte M

2014-03-28

There is currently much focus on provision of general physical health advice to people with serious mental illness and there has been increasing pressure for services to take responsibility for providing this. To review the effects of general physical healthcare advice for people with serious mental illness. We searched the Cochrane Schizophrenia Group's Trials Register (last update search October 2012) which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO and registries of Clinical Trials. There is no language, date, document type, or publication status limitations for inclusion of records in the register. All randomised clinical trials focusing on general physical health advice for people with serious mental illness.. We extracted data independently. For binary outcomes, we calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data, we estimated the mean difference (MD) between groups and its 95% CI. We employed a fixed-effect model for analyses. We assessed risk of bias for included studies and created 'Summary of findings' tables using GRADE. Seven studies are now included in this review. For the comparison of physical healthcare advice versus standard care we identified six studies (total n = 964) of limited quality. For measures of quality of life one trial found no difference (n = 54, 1 RCT, MD Lehman scale 0.20, CI -0.47 to 0.87, very low quality of evidence) but another two did for the Quality of Life Medical Outcomes Scale - mental component (n = 487, 2 RCTs, MD 3.70, CI 1.76 to 5.64). There was no difference between groups for the outcome of death (n = 487, 2 RCTs, RR 0.98, CI 0.27 to 3.56, low quality of evidence). For service use two studies presented favourable results for health advice, uptake of ill-health prevention services was significantly greater in the advice group (n = 363, 1 RCT, MD 36.90, CI 33.07 to 40.73) and service use: one or more primary

Essential travel medicine

CERN Document Server

Zuckerman, Jane N; Leggat, Peter

2015-01-01

This 1st edition of Essential Travel Medicine provides an excellent concise introduction to the specialty of Travel Medicine. This core text will enable health care practitioners particularly those new to the clinical practice of Travel Medicine, to gain a fundamental understanding of the diverse and complex issues which can potentially affect the health of the many millions of people who undertake international travel. Jane N Zuckerman is joined by Gary W Brunette from CDC and Peter A Leggat from Australia as Editors. Leading international specialists in their fields have contributed authoritative chapters reflecting current knowledge to facilitate best clinical practice in the different aspects of travel medicine. The aim of Essential Travel Medicine is to provide a comprehensive guide to Travel Medicine as well as a fundamental knowledge base to support international undergraduate and postgraduate specialty training programmes in the discipline of Travel Medicine. The 1st edition of Essential Travel ...

For the sake of whom: conversation analysis of advice giving in offender counseling.