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.
Expatriates ill after travel: results from the Geosentinel Surveillance Network.
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.
Expatriates ill after travel: Results from the Geosentinel Surveillance Network
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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.
Malaria after international travel: a GeoSentinel analysis, 2003-2016.
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.
Hamer, Davidson H.; Barbre, Kira A.; Chen, Lin H.; Grobusch, Martin P.; Schlagenhauf, Patricia; Goorhuis, Abraham; van Genderen, Perry J. J.; Molina, Israel; Asgeirsson, Hilmir; Kozarsky, Phyllis E.; Caumes, Eric; Hagmann, Stefan H.; Mockenhaupt, Frank P.; Eperon, Gilles; Barnett, Elizabeth D.; Bottieau, Emmanuel; Boggild, Andrea K.; Gautret, Philippe; Hynes, Noreen A.; Kuhn, Susan; Lash, R. Ryan; Leder, Karin; Libman, Michael; Malvy, Denis J. M.; Perret, Cecilia; Rothe, Camilla; Schwartz, Eli; Wilder-Smith, Annelies; Cetron, Martin S.; Esposito, Douglas H.
2017-01-01
Zika virus has spread rapidly in the Americas and has been imported into many nonendemic countries by travelers. To describe clinical manifestations and epidemiology of Zika virus disease in travelers exposed in the Americas. Descriptive, using GeoSentinel records. 63 travel and tropical medicine
Business travel-associated illness: a GeoSentinel analysis.
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.
Jensenius, Mogens; Han, Pauline V.; Schlagenhauf, Patricia; Schwartz, Eli; Parola, Philippe; Castelli, Francesco; von Sonnenburg, Frank; Loutan, Louis; Leder, Karin; Freedman, David O.; Simon, Fabrice; Delmont, Jean; Carosi, Giampiero; Chappuis, François; Caumes, Eric; Pérignon, Alice; Burchard, Gerd-Dieter; Torresi, Joseph; Brown, Graham; Kain, Kevin; Boggild, Andrea; Keystone, Jay S.; Pandey, Prativa; Pradhan, Rashila; Murphy, Holly; Coyle, Christina M.; Wittner, Murray; de Vries, Peter; Grobusch, Martin C.; Gadroen, Kartini; Rapp, Christophe; Aoun, Olivier; Kanagawa, Shuzo; Kato, Yasuyuki; Mizunno, Yasutaka; Gkrania-Klotsas, Effrossyni; McCarthy, Anne; Weber, Rainer; Steffen, Robert; Hagmann, Stefan; Henry, Michael; Miller, Andy O.; Hale, Devon C.; Anand, Rahul; Gelman, Stephanie S.; Kozarsky, Phyllis E.; Fairley, Jessica; Franco-Paredes, Carlos; Barnett, Elizabeth D.; Libman, Michael D.
2013-01-01
We performed a descriptive analysis of acute and potentially life-threatening tropical diseases among 82,825 ill western travelers reported to GeoSentinel from June of 1996 to August of 2011. We identified 3,655 patients (4.4%) with a total of 3,666 diagnoses representing 13 diseases, including
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.
Surveillance for travel-related disease--GeoSentinel Surveillance System, United States, 1997-2011.
Harvey, Kira; Esposito, Douglas H; Han, Pauline; Kozarsky, Phyllis; Freedman, David O; Plier, D Adam; Sotir, Mark J
2013-07-19
probable travel-related diagnoses. Of these, 23,006 (16%) patients were evaluated in the United States, 10,032 (44%) of whom were evaluated after returning from travel outside of the United States (i.e., after-travel patients). Of the 10,032 after-travel patients, 4,977 (50%) were female, 4,856 (48%) were male, and 199 (2%) did not report sex; the median age was 34 years. Most were evaluated in outpatient settings (84%), were born in the United States (76%), and reported current U.S. residence (99%). The most common reasons for travel were tourism (38%), missionary/volunteer/research/aid work (24%), visiting friends and relatives (17%), and business (15%). The most common regions of exposure were Sub-Saharan Africa (23%), Central America (15%), and South America (12%). Fewer than half (44%) reported having had a pretravel visit with a health-care provider. Of the 13,059 diagnoses among the 10,032 after-travel patients, the most common diagnoses were acute unspecified diarrhea (8%), acute bacterial diarrhea (5%), postinfectious irritable bowel syndrome (5%), giardiasis (3%), and chronic unknown diarrhea (3%). The most common diagnostic groupings were acute diarrhea (22%), nondiarrheal gastrointestinal (15%), febrile/systemic illness (14%), and dermatologic (12%). Among 1,802 patients with febrile/systemic illness diagnoses, the most common diagnosis was Plasmodium falciparum malaria (19%). The rapid communication component of the GeoSentinel network has allowed prompt responses to important health events affecting travelers; during 2010 and 2011, the notification capability of the GeoSentinel network was used in the identification and public health response to East African trypanosomiasis in Eastern Zambia and North Central Zimbabwe, P. vivax malaria in Greece, and muscular sarcocystosis on Tioman Island, Malaysia. The GeoSentinel Global Surveillance System is the largest repository of provider-based data on travel-related illness. Among ill travelers evaluated in U.S. GeoSentinel
Boggild, Andrea K; Esposito, Douglas H; Kozarsky, Phyllis E; Ansdell, Vernon; Beeching, Nicholas J; Campion, Daniel; Castelli, Francesco; Caumes, Eric; Chappuis, Francois; Cramer, Jakob P; Gkrania-Klotsas, Effrossyni; Grobusch, Martin P; Hagmann, Stefan H F; Hynes, Noreen A; Lim, Poh Lian; López-Vélez, Rogelio; Malvy, Denis J M; Mendelson, Marc; Parola, Philippe; Sotir, Mark J; Wu, Henry M; Hamer, Davidson H
2015-06-02
The largest-ever outbreak of Ebola virus disease (EVD), ongoing in West Africa since late 2013, has led to export of cases to Europe and North America. Clinicians encountering ill travelers arriving from countries with widespread Ebola virus transmission must be aware of alternate diagnoses associated with fever and other nonspecific symptoms. To define the spectrum of illness observed in persons returning from areas of West Africa where EVD transmission has been widespread. Descriptive, using GeoSentinel records. 57 travel or tropical medicine clinics in 25 countries. 805 ill returned travelers and new immigrants from Sierra Leone, Liberia, or Guinea seen between September 2009 and August 2014. Frequencies of demographic and travel-related characteristics and illnesses reported. The most common specific diagnosis among 770 nonimmigrant travelers was malaria (n = 310 [40.3%]), with Plasmodium falciparum or severe malaria in 267 (86%) and non-P. falciparum malaria in 43 (14%). Acute diarrhea was the second most common diagnosis among nonimmigrant travelers (n = 95 [12.3%]). Such common diagnoses as upper respiratory tract infection, urinary tract infection, and influenza-like illness occurred in only 26, 9, and 7 returning travelers, respectively. Few instances of typhoid fever (n = 8), acute HIV infection (n = 5), and dengue (n = 2) were encountered. Surveillance data collected by specialist clinics may not be representative of all ill returned travelers. Although EVD may currently drive clinical evaluation of ill travelers arriving from Sierra Leone, Liberia, and Guinea, clinicians must be aware of other more common, potentially fatal diseases. Malaria remains a common diagnosis among travelers seen at GeoSentinel sites. Prompt exclusion of malaria and other life-threatening conditions is critical to limiting morbidity and mortality. Centers for Disease Control and Prevention.
Muscular Sarcocystosis in travelers returning from Tioman Island, Malaysia — 2011
In October 2011, the GeoSentinel global surveillance system for travel-related morbidity detected an unusual cluster of illnesses among travelers returning from Tioman Island, Malaysia. Complete information was received for 17 of 32 (53%) patients reported to GeoSentinel; 9 probable and 1 confirmed ...
Gautret, Philippe; Mockenhaupt, Frank; Grobusch, Martin P.; Rothe, Camilla; von Sonnenburg, Frank; van Genderen, Perry J.; Chappuis, Francois; Asgeirsson, Hilmir; Caumes, Eric; Bottieau, Emmanuel; Malvy, Denis; Lopez-Vélez, Rogelio; Jensenius, Mogens; Larsen, Carsten Schade; Castelli, Francesco; Rapp, Christophe; Field, Vanessa; Molina, Israel; Gkrania-Klotsas, Effrossyni; Florescu, Simin; Lalloo, David; Schlagenhauf, Patricia
2016-01-01
We evaluated EuroTravNet (a GeoSentinel subnetwork) data from June 2013 to May 2016 on 508 ill travellers returning from Brazil, to inform a risk analysis for Europeans visiting the 2016 Olympic and Paralympic Games in Brazil. Few dengue fever cases (n = 3) and no cases of chikungunya were
Multicenter EuroTravNet/GeoSentinel Study of Travel-related Infectious Diseases in Europe
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
Gautret, P; Lim, P L; Shaw, M; Leder, K
2011-03-01
Since 2008, when the outbreak of rabies in Bali began, 45 patients have attended GeoSentinel or EuroTravNet sites for rabies post-exposure prophylaxis (PEP), representing 12.6% of all travellers seen for PEP in all network clinics during the same time period. This suggests that Bali is emerging as a commonly visited destination among travellers presenting for rabies PEP. The data demonstrate that the majority of animal-related injuries in travellers returning from Bali are associated with exposure to monkeys, and not dog bites/scratches. The clinical implications of this are discussed. © 2010 The Authors. Clinical Microbiology and Infection © 2010 European Society of Clinical Microbiology and Infectious Diseases.
The Use of Travel Guidebooks by Tourist Visiting Yogyakarta
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Gabriela Intani Putri
2014-12-01
Full Text Available This research aims to know to what extend tourist use travel guidebooks for their visit to Yogyakarta, as one of tourism destination in Indonesia. This research was conducted by taking tourist who has been to or during their visit to Yogyakarta. Qualitative interviews with three travel experts precede this research in order to gather the purpose of using travel guidebooks by tourist visiting Yogyakarta. The results are 31 purposes of using travel guidebooks. After conducting factor analysis and reliability tests, seven factors comprising 26 statements were extracted which are: functional needs, forward-looking needs, learning needs, autonomy needs, tension reduction needs, security needs, and objectification needs.
Gautret, Philippe; Mockenhaupt, Frank; Grobusch, Martin P; Rothe, Camilla; von Sonnenburg, Frank; van Genderen, Perry J; Chappuis, Francois; Asgeirsson, Hilmir; Caumes, Eric; Bottieau, Emmanuel; Malvy, Denis; Lopez-Vélez, Rogelio; Jensenius, Mogens; Larsen, Carsten Schade; Castelli, Francesco; Rapp, Christophe; Field, Vanessa; Molina, Israel; Gkrania-Klotsas, Effrossyni; Florescu, Simin; Lalloo, David; Schlagenhauf, Patricia
2016-07-07
We evaluated EuroTravNet (a GeoSentinel subnetwork) data from June 2013 to May 2016 on 508 ill travellers returning from Brazil, to inform a risk analysis for Europeans visiting the 2016 Olympic and Paralympic Games in Brazil. Few dengue fever cases (n = 3) and no cases of chikungunya were documented during the 2013-15 Brazilian winter months, August and September, the period when the Games will be held. The main diagnoses were dermatological (37%), gastrointestinal (30%), febrile systemic illness (29%) and respiratory (11%). This article is copyright of The Authors, 2016.
Mejia, Christian R; Centeno, Emperatriz; Cruz, Briggitte; Cvetkovic-Vega, Aleksandar; Delgado, Edison; Rodriguez-Morales, Alfonso J
2016-01-01
Peru is an increasingly popular tourist destination that poses a risk to travelers due to endemic vector-borne diseases (VBDs). The objective of our study was to determine which factors are associated with receiving pre-travel advice (PTA) for VBDs among travelers visiting Cuzco, Peru. A cross-sectional secondary analysis based on data from a survey among travelers departing Cuzco at Alejandro Velazco Astete International Airport during the period January-March 2012 was conducted. From the 1819 travelers included in the original study, 1717 were included in secondary data analysis. Of these participants, 42.2% received PTA and 2.9% were informed about vector-borne diseases, including yellow fever (1.8%), malaria (1.6%) and dengue fever (0.1%). Receiving information on VBDs was associated with visiting areas endemic to yellow fever and dengue fever in Peru. The only disease travelers received specific recommendations for before visiting an endemic area for was yellow fever. Only 1 in 30 tourists received information on VBD prevention; few of those who traveled to an endemic area were warned about specific risks for infectious diseases prior to their trip. These important findings show that most tourists who travel to Peru do not receive PTA for the prevention of infectious and VBD, which can affect not only the travelers but their countries of origin as well. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.
Rowe, Kate; Chaves, Nadia; Leder, Karin
2017-09-01
Travellers visiting friends and relatives (VFRs) often have complex pre-travel needs. We identified the characteristics, destinations, vaccinations and pre-travel advice provided to VFRs and compared these with non-VFR travellers. The significant differences we found suggest that future research should focus on improving the uptake of recommended interventions in VFR travellers. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
Scully, Jason Y; Vernez Moudon, Anne; Hurvitz, Philip M; Aggarwal, Anju; Drewnowski, Adam
2017-01-01
To assess differences between GPS and self-reported measures of location, we examined visits to fast food restaurants and supermarkets using a spatiotemporal framework. Data came from 446 participants who responded to a survey, filled out travel diaries of places visited, and wore a GPS receiver for seven consecutive days. Provided by Public Health Seattle King County, addresses from food permit data were matched to King County tax assessor parcels in a GIS. A three-step process was used to verify travel-diary reported visits using GPS records: (1) GPS records were temporally matched if their timestamps were within the time window created by the arrival and departure times reported in the travel diary; (2) the temporally matched GPS records were then spatially matched if they were located in a food establishment parcel of the same type reported in the diary; (3) the travel diary visit was then GPS-sensed if the name of food establishment in the parcel matched the one reported in the travel diary. To account for errors in reporting arrival and departure times, GPS records were temporally matched to three time windows: the exact time, +/- 10 minutes, and +/- 30 minutes. One third of the participants reported 273 visits to fast food restaurants; 88% reported 1,102 visits to supermarkets. Of these, 77.3 percent of the fast food and 78.6 percent supermarket visits were GPS-sensed using the +/-10-minute time window. At this time window, the mean travel-diary reported fast food visit duration was 14.5 minutes (SD 20.2), 1.7 minutes longer than the GPS-sensed visit. For supermarkets, the reported visit duration was 23.7 minutes (SD 18.9), 3.4 minutes longer than the GPS-sensed visit. Travel diaries provide reasonably accurate information on the locations and brand names of fast food restaurants and supermarkets participants report visiting.
Impact of traveling to visit friends and relatives on chronic disease management.
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
Jentes, Emily S; Han, Pauline; Gershman, Mark D; Rao, Sowmya R; LaRocque, Regina C; Staples, J Erin; Ryan, Edward T
2013-05-01
Yellow fever (YF) vaccine-associated serious adverse events and changing YF epidemiology have challenged healthcare providers to vaccinate only travelers whose risk of YF during travel is greater than their risk of adverse events. We describe the travel characteristics and YF vaccine use among US travelers visiting Global TravEpiNet clinics from January of 2009 to March of 2011. Of 16,660 travelers, 5,588 (34%) had itineraries to areas with risk of YF virus transmission. Of those travelers visiting one country with YF risk (N = 4,517), 71% were vaccinated at the visit, and 20% were presumed to be immune from prior vaccination. However, travelers visiting friends and relatives (odds ratio [OR] = 2.57, 95% confidence interval [95% CI] = 1.27-5.22) or going to Nigeria (OR = 3.01, 95% CI = 1.37-6.62) were significantly more likely to decline vaccination. To optimize YF vaccine use, clinicians should discuss an individual's risk-benefit assessment of vaccination and close knowledge gaps regarding vaccine use among at-risk populations.
Directory of Open Access Journals (Sweden)
Jason Y Scully
Full Text Available To assess differences between GPS and self-reported measures of location, we examined visits to fast food restaurants and supermarkets using a spatiotemporal framework. Data came from 446 participants who responded to a survey, filled out travel diaries of places visited, and wore a GPS receiver for seven consecutive days. Provided by Public Health Seattle King County, addresses from food permit data were matched to King County tax assessor parcels in a GIS. A three-step process was used to verify travel-diary reported visits using GPS records: (1 GPS records were temporally matched if their timestamps were within the time window created by the arrival and departure times reported in the travel diary; (2 the temporally matched GPS records were then spatially matched if they were located in a food establishment parcel of the same type reported in the diary; (3 the travel diary visit was then GPS-sensed if the name of food establishment in the parcel matched the one reported in the travel diary. To account for errors in reporting arrival and departure times, GPS records were temporally matched to three time windows: the exact time, +/- 10 minutes, and +/- 30 minutes. One third of the participants reported 273 visits to fast food restaurants; 88% reported 1,102 visits to supermarkets. Of these, 77.3 percent of the fast food and 78.6 percent supermarket visits were GPS-sensed using the +/-10-minute time window. At this time window, the mean travel-diary reported fast food visit duration was 14.5 minutes (SD 20.2, 1.7 minutes longer than the GPS-sensed visit. For supermarkets, the reported visit duration was 23.7 minutes (SD 18.9, 3.4 minutes longer than the GPS-sensed visit. Travel diaries provide reasonably accurate information on the locations and brand names of fast food restaurants and supermarkets participants report visiting.
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.
Jentes, Emily S.; Han, Pauline; Gershman, Mark D.; Rao, Sowmya R.; LaRocque, Regina C.; Staples, J. Erin; Ryan, Edward T.
2013-01-01
Yellow fever (YF) vaccine-associated serious adverse events and changing YF epidemiology have challenged healthcare providers to vaccinate only travelers whose risk of YF during travel is greater than their risk of adverse events. We describe the travel characteristics and YF vaccine use among US travelers visiting Global TravEpiNet clinics from January of 2009 to March of 2011. Of 16,660 travelers, 5,588 (34%) had itineraries to areas with risk of YF virus transmission. Of those travelers visiting one country with YF risk (N = 4,517), 71% were vaccinated at the visit, and 20% were presumed to be immune from prior vaccination. However, travelers visiting friends and relatives (odds ratio [OR] = 2.57, 95% confidence interval [95% CI] = 1.27–5.22) or going to Nigeria (OR = 3.01, 95% CI = 1.37–6.62) were significantly more likely to decline vaccination. To optimize YF vaccine use, clinicians should discuss an individual's risk–benefit assessment of vaccination and close knowledge gaps regarding vaccine use among at-risk populations. PMID:23458961
The visiting internet Fiancé/ée (VIF): an emerging group of international travelers.
Sofarelli, Theresa A; Birich, Holly K; Hale, DeVon C
2014-01-01
Here we describe an emerging category of travelers called the Visiting Internet Fiancé/ée (VIF), characterized by their travel to pursue a romantic relationship with an individual they have only encountered online. The VIF is not well identified in travel medicine literature despite having a higher risk for several travel-related issues including sexually transmitted infections, monetary fraud, and international scams. We also propose specific counseling interventions designed to minimize the adverse outcomes faced by the VIF traveler. © 2014 International Society of Travel Medicine.
Profile of illness in Syrian refugees: A GeoSentinel analysis, 2013 to 2015.
Mockenhaupt, Frank P; Barbre, Kira A; Jensenius, Mogens; Larsen, Carsten S; Barnett, Elizabeth D; Stauffer, William; Rothe, Camilla; Asgeirsson, Hilmir; Hamer, Davidson H; Esposito, Douglas H; Gautret, Philippe; Schlagenhauf, Patricia
2016-01-01
Screening of 488 Syrian unaccompanied minor refugees (Syrian refugees examined at GeoSentinel clinics worldwide, cutaneous leishmaniasis affected one in three patients; other noteworthy infections were active tuberculosis (11%) and chronic hepatitis B or C (9%). These data can contribute to evidence-based guidelines for infectious disease screening of Syrian refugees.
Pretravel health advice among international travelers visiting Cuzco, Peru.
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.
Meningococcal vaccination for international travellers from Greece visiting developing countries.
Pavli, Androula; Katerelos, Panagiotis; Smeti, Paraskevi; Maltezou, Helena C
2016-01-01
Meningococcal meningitis is a serious disease. Travel-associated infection for the general traveller is low; however regular epidemics in indigenous population, particularly in sub-Saharan Africa are responsible for significant morbidity and mortality. Our aim was to assess meningococcal vaccination for international travellers from Greece. A prospective questionnaire-based study was conducted during 2009-2013. A total of 5283 travellers were studied (median age: 39.2 years); Meningococcal tetravalent vaccine (A,C,W135,Y) was delivered to 1150 (21.8%) of them. Of those who travelled to the Middle East and sub-Saharan Africa, 73.1% and 21.2% received meningococcal vaccine, respectively. Of those travellers who travelled to sub-Saharan Africa from November to June and from July to October, 22.1% and 20.6% were vaccinated with meningococcal vaccine, respectively. Of all travellers who travelled for travelled for recreation, and 13.8% of those who travelled for work. Of travellers who stayed in urban, in rural, and in urban and rural areas, 32%, 11.6% and 12.7% were vaccinated, respectively. Meningococcal vaccine was delivered to 29.2%, 21.1%, 19.4% and 5.1% of those who stayed in hotels, at local people's home, in camps, and on ships, respectively. The association of meningococcal vaccine administration with the destination, duration and purpose of travel, area of stay and type of accommodation was statistically significant. There is a need to improve meningococcal vaccine recommendations for travellers from Greece, particularly for high risk populations, such as VFRs, business travellers and those visiting sub-Saharan Africa especially during the dry season. Copyright © 2016 Elsevier Ltd. All rights reserved.
Boggild, Andrea K; Costiniuk, Cecilia; Kain, Kevin C; Pandey, Prativa
2007-01-01
Adventure travel necessarily places travelers at risk of environmental hazards. We assessed the burden of "environmental" hazards among a cohort of travelers and expatriates presenting to a large travel clinic in Nepal. Data on travelers and expatriates seen at the Canadian International Water and Energy Consultants (CIWEC) clinic in Kathmandu were prospectively collected and entered into the GeoSentinel Surveillance Network database. Data on individuals receiving predefined diagnoses related to environmental hazards were extracted and analyzed. Of 10,499 travelers and 4,854 expatriates in the database, 2,160 were diagnosed with 2,533 environment-related illnesses. Injuries were common among both travelers and expatriates [N= 788 (6.1%) and 328 (4.9%), respectively], while altitude illness was seen almost exclusively in travelers [N= 611 (4.7%) vs N= 8 (0.1%)]. Factors independently associated with environmental diagnoses include male gender (p tourism (p educational impact in others.
Tick-borne encephalitis: What travelers should know when visiting an endemic country.
Chrdle, Aleš; Chmelík, Václav; Růžek, Daniel
2016-10-02
Tick-borne encephalitis (TBE) is an acute febrile illness with neurological manifestations that is prevalent in forested areas of moderate climate in Europe and Asia. TBE virus is transmitted by ticks and rarely by unpasteurized milk and dairy products. The disease burden is attributed mainly to resulting long-term disability, especially in individuals over 50 y of age. Currently, there is no causative treatment, but a very effective vaccination is available with a good safety profile. The vaccination requires 3 basic doses to be fully effective and regular boosters afterwards. An accelerated vaccination schedule enables a patient to reach reasonably protective titres within 3 to 4 weeks from the first injection. The risk of travel-related TBE is estimated to be less than the risk of acquiring typhoid fever while visiting highly endemic regions in South Asia, but more than the risk of acquiring Japanese encephalitis, meningococcal invasive disease, or rabies. The pre-travel risk assessment of acquiring TBE should consider known risk factors which include 1) the country and regions to be visited; 2) April to November season; 3) altitude less than 1500 m above the sea level; 4) duration of stay; 5) the extent of tick-exposure associated activities including leisure and professional outdoor activities within the endemic area; and 6) age and comorbidities of the traveler. A major challenge, however, is the very low awareness of the risk of contracting TBE in those who travel to industrialized European countries.
DEFF Research Database (Denmark)
Kawsar, Mahidi Hasan; Al Pavel, Muha Abdullah; Uddin, Mohammad Belal
2015-01-01
Estimation of recreational benefits is an important tool for both biodiversity conservation and ecotourism development in national parks and sanctuaries. The design of this work is to estimate the recreational value and to establish functional relationship between travel cost and visitation...... of Lawachara National Park (LNP) in Bangladesh. This study employed zonal approach of the travel cost method. The work is grounded on a sample of 422 visitors of the LNP. Results showed that the total value of environmental assets of the LNP is 55,694,173 Taka/Year. Moreover, our suggestion based on visitors...
Travel-related health problems in Japanese travelers.
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.
Trends and characteristics among HIV-infected and diabetic travelers seeking pre-travel advice.
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.
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.
Patrick T. Tierney; Deborah J. Chavez; James D. Absher
2008-01-01
Leisure travel and visitation to natural areas and constraints to undertaking these activities are important concerns for recreation resource managers and tourism businesses. Surveys were administered to Los Angeles, Barcelona, Glasgow, and Morelia, Mexico, residents to ascertain leisure travel and undeveloped natural area visitation levels and constraints. A...
Scully, Jason Y.; Vernez Moudon, Anne; Hurvitz, Philip M.; Aggarwal, Anju; Drewnowski, Adam
2017-01-01
To assess differences between GPS and self-reported measures of location, we examined visits to fast food restaurants and supermarkets using a spatiotemporal framework. Data came from 446 participants who responded to a survey, filled out travel diaries of places visited, and wore a GPS receiver for seven consecutive days. Provided by Public Health Seattle King County, addresses from food permit data were matched to King County tax assessor parcels in a GIS. A three-step process was used to v...
Matteelli, Alberto; Schlagenhauf, Patricia; Carvalho, Anna C. C.; Weld, Leisa; Davis, Xiaohong M.; Wilder-Smith, Annelies; Barnett, Elizabeth D.; Parola, Philippe; Pandey, Prativa; Han, Pauline; Castelli, Francesco; Murphy, Holly; Weber, Rainer; Steffen, Robert; von Sonnenburg, Frank; Jenks, Nancy Piper; Kerr, Christine A.; Borwein, Sarah; Leder, Karin; Torresi, Joseph; Brown, Graham V.; Keystone, Jay S.; Kain, Kevin C.; Jensenius, Mogens; Wang, Andy; Eason, Jane; MacDonald, Susan; McCarthy, Anne E.; Anderson, Nicole L.; Batchelor, Trish; Meisch, Dominique; López-Vélez, Rogelio; Pérez-Molina, Jose A.; Field, Vanessa; Schwartz, Eli; Gkrania-Klotsas, Effrossyni; Loutan, Louis; Chappuis, François; Caumes, Eric; Pérignon, Alice; Lim, Poh Lian; Burchard, Gerd-Dieter; Libman, Michael D.; Ward, Brian J.; Maclean, J. Dick; Stauffer, William M.; Walker, Patricia F.; Hale, Devon C.; Anand, Rahul; de Vries, Peter J.
2013-01-01
Travel is thought to be a risk factor for the acquisition of sexually transmitted infections (STIs), but no multicentre analyses have been done. We aimed to describe the range of diseases and the demographic and geographical factors associated with the acquisition of travel-related STIs through
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.
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.
Travel risk behaviors as a determinants of receiving pre-travel health consultation and prevention.
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.
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.
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.
Montgomery, Martha E; Fatch, Robin S; Evans, Jennifer L; Yu, Michelle; Davidson, Peter J; Page, Kimberly; Hahn, Judith A
2013-06-01
Young injection drug users (IDUs), a highly mobile population, engage in high levels of injecting risk behavior, yet little is understood about how such risk behavior may vary by the characteristics of the cities to which they travel, including the existence of a syringe exchange program (SEP), as well as travel partner characteristics. In 2004-2005, we conducted a 6-month prospective study to investigate the risk behavior of 89 young IDUs as they traveled, with detailed information gathered about 350 city visits. In multivariable analyses, travel to larger urban cities with a population of 500,000-1,000,000 was significantly associated with injecting drugs (adjusted odds ratio (AOR) = 3.71; 95 % confidence interval (CI), 1.56-8.82), ancillary equipment sharing (AES; AOR = 7.05; 95 % CI, 2.25-22.06) and receptive needle sharing (RNS; AOR = 5.73; 95 % CI, 1.11-27.95), as compared with visits to smaller cities with populations below 50,000. Region of the country, and the existence of a SEP within the city visited, were not independently associated with injecting drugs, AES, or RNS during city visits. Traveling with more than one injecting partner was associated with injecting drugs during city visits (AOR = 2.77; 95 % CI, 1.46-5.27), when compared with traveling alone. Additionally, both non-daily and daily/almost daily alcohol use during city visits were associated with AES (AOR = 3.37; 95 % CI, 1.42-7.68; AOR = 3.03; 95 % CI, 1.32-6.97, respectively) as compared with no alcohol consumption. Traveling young IDUs are more likely to inject when traveling with other IDUs and to engage in higher risk injection behavior when they are in large cities. Risk behavior occurring in city visits, including equipment sharing and alcohol consumption, suggests further need for focused interventions to reduce risk for viral infection among this population.
Leder, Karin; Grobusch, Martin P.; Gautret, Philippe; Chen, Lin H.; Kuhn, Susan; Lim, Poh Lian; Yates, Johnnie; McCarthy, Anne E.; Rothe, Camilla; Kato, Yasuyuki; Bottieau, Emmanuel; Huber, Kristina; Schwartz, Eli; Stauffer, William; Malvy, Denis; Shaw, Marc T. M.; Rapp, Christophe; Blumberg, Lucille; Jensenius, Mogens; van Genderen, Perry J. J.; Hamer, Davidson H.
2017-01-01
Zika virus (ZIKV) was first isolated in Africa; decades later, caused large outbreaks in the Pacific, and is considered endemic in Asia. We aim to describe ZIKV disease epidemiology outside the Americas, the importance of travelers as sentinels of disease transmission, and discrepancies in travel
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...
Keles, Havva; Sonder, Gerard J. B.; van den Hoek, Anneke
2011-01-01
Methods. We extracted all data from the PHS database pertaining to Muslims who visited the clinic before travel to Mecca. From 2001 to 2009, the characteristics are described and trends are analyzed retrospectively. Acceptance of dTP vaccine was used as a proxy for acceptance of recommended
[Characteristics associated with pre travel medical consultation in tourists visiting Cuzco, Peru].
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.
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
Travelers' health problems and behavior: prospective study with post-travel follow-up.
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
A profile of travelers--an analysis from a large swiss travel clinic.
Bühler, Silja; Rüegg, Rolanda; Steffen, Robert; Hatz, Christoph; Jaeger, Veronika K
2014-01-01
Globally, the Swiss have one of the highest proportions of the population traveling to tropical and subtropical countries. Large travel clinics serve an increasing number of customers with specific pre-travel needs including uncommon destinations and preexisting medical conditions. This study aims to identify health characteristics and travel patterns of travelers seeking advice in the largest Swiss travel clinic so that tailored advice can be delivered. A descriptive analysis was performed on pre-travel visits between July 2010 and August 2012 at the Travel Clinic of the Institute of Social and Preventive Medicine, University of Zurich, Switzerland. A total of 22,584 travelers sought pre-travel advice. Tourism was the main reason for travel (17,875, 81.5%), followed by visiting friends and relatives (VFRs; 1,715, 7.8%), traveling for business (1,223, 5.6%), and "other reasons" (ie, volunteer work, pilgrimage, study abroad, and emigration; 1,112, 5.1%). The main travel destination was Thailand. In the VFR group, the highest proportions of traveling children (258, 15.1%) and of pregnant or breastfeeding women (23, 3.9%) were observed. Mental disorders were more prominent in VFRs (93, 5.4%) and in travel for "other reasons" (63, 5.7%). The latter stayed for the longest periods abroad; 272 (24.9%) stayed longer than 6 months. VFR travelers received the highest percentage of yellow fever vaccinations (523, 30.5%); in contrast, rabies (269, 24.2%) and typhoid vaccinations (279, 25.1%) were given more often to the "other travel reasons" group. New insights into the characteristics of a selected and large population of Swiss international travelers results in improved understanding of the special needs of an increasingly diverse population and, thus, in targeted preventive advice and interventions. © 2014 International Society of Travel Medicine.
Barrett-Connor, E
1973-03-01
On the average, one-fourth of North Americans visiting developing countries experience a self-limited diarrheal illness that interferes with holiday or business activities. Recent work suggests that these episodes are caused by a small inoculum of enteropathogenic Escherichia coli which are common in the country visited and rare in the country of origin. Neither antimicrobial treatment nor anti-diarrheal agents have proven benefit once the illness has begun. Despite its frequent use, iodochlorhydroxyquin has not been shown in double blind studies to be effective as a preventive agent, and may be dangerous. The status of furazolidone for prevention of tourist diarrhea is questionable. Both neomycin sulfate and phythalylsulfathiazole have demonstrated efficacy as chemoprophylactics in Mexico. However, their use should be restricted to limited types of travel and travelers. General admonitions concerning avoidance of certain ingestibles are recommended; despite questionable value in preventing travelers' diarrhea such precautions may prevent more serious gastrointestinal illness.
Business Model Development for travel agency : Case company - Goh Travel Korea
Manuilova, Mariia
2016-01-01
Millions of tourists visit South Korea every year to experience the culture and a different life style. Moreover, due to economic development, the country has become popular as a study and work destination. As the tourism market is growing, there are many opportunities for travel agencies to find niches in the market. The purpose of this study is to develop a business model for Goh travel Korea – a travel agency for foreign low budget travelers around Korea, to make it more efficient and incr...
Travel itinerary uncertainty and the pre-travel consultation--a pilot study.
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.
Schwartz, Brian S; Rosen, Jessica; Han, Pauline V; Hynes, Noreen A; Hagmann, Stefan H; Rao, Sowmya R; Jentes, Emily S; Ryan, Edward T; LaRocque, Regina C
2015-11-01
An increasing number of immunocompromised individuals are pursuing international travel, and a better understanding of their international travel patterns and pretravel health care is needed. We evaluated the clinical features, itineraries, and pretravel health care of 486 immunocompromised international travelers seen at Global TravEpiNet sites from January 2009 to June 2012. We used bivariate analyses and logistic regressions using random intercept models to compare demographic and travel characteristics, vaccines administered, and medications prescribed for immunocompromised travelers versus 30,702 immunocompetent travelers. Immunocompromised travelers pursued itineraries that were largely similar to those of immunocompetent travelers, with nearly one-third of such travelers visiting countries with low human development indices. Biological agents, including tumor necrosis factor blockers, were commonly used immunosuppressive medications among immunocompromised travelers. A strong collaboration between travel-medicine specialists, primary care doctors, and specialist physicians is needed to prepare immunocompromised people for international travel. Incorporating routine questioning and planning regarding travel into the primary care visits of immunocompromised people may be useful. © The American Society of Tropical Medicine and Hygiene.
International travel patterns and travel risks for stem cell transplant recipients.
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
SEGMENTING THE U.S.A. NON-TRAVEL MARKET
Directory of Open Access Journals (Sweden)
Wayne W. Smith
2011-12-01
Full Text Available Tourism marketers focus on understanding the many different segments that comprise their visitors. Understanding these segments’ motivations for travel is important in order to motivate repeat visitation and to attract like-minded consumers to visit. But how about those who do not travel? This surprisingly large percentage of the population is a lost opportunity for the industry. The research that follows, based upon a very significant USA-based sample of non-travelers, suggests that non-travelers can be effectively segmented and targeted. Understanding these segments will better allow vacation marketers to craft their product and their message, hopefully bringing more travelers to the mix.
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.
Travel websites: Changing visits, evaluations and posts
Bronner, Fred; de Hoog, Robert
2016-01-01
Many studies concerning the role of web-based information in tourism measure one-time interactions. This paper presents results of a longitudinal study. Data collected in 2014 about website visits, evaluations and posts, are compared with data from 2007. The main finding is the advance of sites
Aubry, Camille; Gaudart, Jean; Gaillard, Catherine; Delmont, Jean; Parola, Philippe; Brouqui, Philippe; Gautret, Philippe
2012-09-01
With the aim to identify at-risk individuals among a cohort of international travellers, 3442 individuals who sought advice at Marseille travel health centre in 2009 were prospectively included. Demographics, travel characteristics, chronic medical conditions, vaccinations and antimalarial chemoprophylaxis were documented. Chronic medical conditions were reported by 11% of individuals, including hypertension (39%), asthma (20%), thyroid disease (15%) and depression (13%). 4% reported taking a daily medication, and psychotropic and cardiovascular medications were the most commonly used. Older travellers (≥60 years) accounted for 10% of the travellers and the prevalence of chronic medical conditions was 27% in this group. Individuals aged 15 years or less accounted for 13% of the travellers. Age, last minute travel (17%) and neurological and psychiatric diseases were the most frequent factors that influenced Yellow fever vaccination and malaria chemoprophylaxis, with more than one tenth of the travellers reporting at least one risk factor for which adjusted advice may be necessary. Migrants visiting their relatives in their origin country accounted for 14% of travellers and 73% of this group travelled with their family including young children. We demonstrate that a significant proportion of travellers are at-risk (43%) because of their travel conditions (VFR), their age, or their health status, and should be targeted for risk reduction strategies. Copyright © 2012 Elsevier Ltd. All rights reserved.
Sociodemographic Analysis of the Profile and the Motivations of Tourists Visiting Quito, Ecuador
Directory of Open Access Journals (Sweden)
Guzmán Muñoz Fernández
2018-04-01
Full Text Available This paper presents a fieldwork-based analysis on the sociodemographic characteristics, travel arrangements, motivations and travel experience evaluation of tourists visiting Quito, Ecuador. The results of this research show differences in the profile of tourists in terms of travel arrangements, their motivation and their evaluation of the destination, based on tourists’ geographical origin. The main practical implication of this research is to better understand the characteristics of tourists who visit Quito, with the purpose of designing cultural and touristic products that meet the needs of different groups of travelers.
HIV in elderly women after travelling abroad
DEFF Research Database (Denmark)
Jespersen, Sanne; Thorsteinsson, Kristina; David, Kim Peter
2016-01-01
We report two cases of HIV infection among female travellers of older age. A Danish woman in her eighties was diagnosed with acute HIV infection after travelling to West Africa. A sexual history was not recorded before her third hospital visit. A West African woman in her seventies who had been...... living in Denmark for 40 years was diagnosed with advanced HIV after having been to West Africa for family visits. We want to emphasize that women of older age also have sex that may put them at risk of HIV, that febrile returning travellers should be tested for HIV, and that presence of HIV indicator...
Good information cuts medical risk of travel
International Nuclear Information System (INIS)
Clyde, J.D.
1996-01-01
Today the oil industry is seeking exploration, production, and business opportunities around the globe. A result is that its employees are traveling more and visiting distant and remote locations. This travel significantly increases the level of their exposure to illness and accident. This paper discusses the information needs for oil company personnel which will be visiting foreign countries. It describes the medical preparation, immunizations, sanitary conditions, medical facilities, auto accidents, and other hazards which should be known about
Schubert, Erin C; Duininck, Megan; Shlafer, Rebecca J
2016-01-01
We describe an evaluation of a prison visiting program, Extended Visiting (EV), for incarcerated mothers and their children. Mothers ( N = 24) and caregivers ( N = 19) were interviewed regarding experiences with the program. Mothers identified benefits including maintaining a relationship with children, physical contact, motivation, privacy, peer support, and personal growth. Caregivers echoed mothers' appreciation for the opportunity to maintain mother-child relationships and physical contact. Mothers identified barriers including desire for overnight visits and more age-appropriate activities. Caregivers perceived travel time and costs and children's adverse reactions as barriers. When comparing EV to typical visiting, participants unanimously preferred EV.
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; Burchard, Gerd-Dieter; Anand, Rahul; Gelman, Stephanie S.; Kain, Kevin; Boggild, Andrea; Perret, Cecilia; Valdivieso, Francisca; Loutan, Louis; Chappuis, François; Schlagenhauf, Patricia; Weber, Rainer; Steffen, Robert; Caumes, Eric; Pérignon, Alice; Libman, Michael D.; Ward, Brian; Maclean, J. Dick; Grobusch, Martin C.; Goorhuis, Abram; de Vries, Peter; Gadroen, Kartini; Mockenhaupt, Frank; Harms, Gunder; Parola, Philippe; Simon, Fabrice; Delmont, Jean; Carosi, Giampiero; Castelli, Francesco; Connor, Bradley A.; Kozarsky, Phyllis E.; Wu, Henry; Fairley, Jessica; Franco-Paredes, Carlos; Using, Johan; Fröberg, Gabrielle; Askling, Helena Hervius; Bronner, Ulf; Haulman, N. Jean; Roesel, David
2014-01-01
Background. 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. Methods. We
The Quadratic Selective Travelling Salesman Problem
DEFF Research Database (Denmark)
Thomadsen, Tommy; Stidsen, Thomas K.
2003-01-01
A well-known extension of the Travelling Salesman Problem (TSP) is the Selective TSP (STSP): Each node has an associated profit and instead of visiting all nodes, the most profitable set of nodes, taking into account the tour cost, is visited. The Quadratic STSP (QSTSP) adds the additional...
Human travel and traveling bedbugs.
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.
"Golden Walk" Gets a Makeover from an Auditor of Campus Visits
Hoover, Eric
2009-01-01
A consultant on an endless road trip, Jeff Kallay travels the nation visiting colleges and universities that hire him to conduct a "campus visit audit." After each tour, he discusses his first impressions with admissions officials. Later he sends them a detailed report, with recommendations covering the logistical aspects of visits, such…
Effects of travel cost and participation in recreational activities on national forest visits
Seong-Hoon Cho; J.M. Bowker; Donald B.K. English; Roland K. Roberts; Taeyoung Kim
2014-01-01
In the face of higher travel costs due to rising gasoline prices and scarce budget resources,we explored differences in the impacts of travel costs on recreational demand for visitors participating in various recreational activities. Five individual travel cost models were estimated, one for each of 5 national forests (i.e., Allegheny, Coconino, Mount Baker-Snoqualmie...
[Pre-travel advice and patient education of Hungarian travellers].
Lengyel, Ingrid; Felkai, Péter
2018-03-01
, our survey clearly points out the importance of the propagation of doctor's advice before trips, even if the travellers visit exclusively non-endemic countries like the European Union. Orv Hetil. 2018; 159(9): 357-362.
Directory of Open Access Journals (Sweden)
Mutsuo Kobayashi
2014-09-01
Full Text Available A German traveler developed dengue fever in late August 2013, following a direct flight from Germany. Autochthonous dengue virus (DENV infection has not been reported in Japan. To evaluate the risk of autochthonous DENV transmission in Japan, the authors performed a retrospective search of the five areas visited by the German patient to determine the population density of dengue vector mosquito, Aedes albopictus. The annual mean temperature of each area was higher than 12 °C, which is considered suitable for the establishment of A. albopictus populations. Our retrospective search revealed the population density of A. albopictus to be high in the urban areas of Japan.
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.
Koski, Olivia; Rosin, Mark; Guerilla Science Team
2014-03-01
The Intergalactic Travel Bureau is an interactive theater outreach experience that engages the public in the incredible possibilities of space tourism. The Bureau is staffed by professional actors, who play the role of space travel agents, and professional astrophysicists, who play the role of resident scientists. Members of the public of all ages were invited to visit with bureau staff to plan the vacation of their dreams-to space. We describe the project's successful nine day run in New York in August 2013. Funded by the American Physical Society Public Outreach and Informing the Public Grants.
Travel Experience in hotels for the MICE Industry
Gurkina, Anastasija
2013-01-01
The following report is a research-oriented bachelor thesis that investigates the travel experience in the business oriented concentrated in MICE Industry. The objective of this thesis was to assess and measure the level of satisfaction of the MICE travellers in hotels, as well as to find out what are the services and aspects of the hotel that influences the most on the travel experience. The MICE travellers due to the purposes of their visit require specific services from the hotel t...
Knowledge, attitudes and practices of business travelers regarding malaria risk and prevention.
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.
Post-Travel Consultations in a Regional Hub City Hospital, Japan.
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.
Stennis visits Lake Cormorant school
2010-01-01
Alexis Harry, assistant director of Astro Camp at NASA's John C. Stennis Space Center, talks with students at Lake Cormorant (Miss.) Elementary School during a 'Living and Working in Space' presentation March 30. Stennis hosted the school presentation during a visit to the Oxford area. Harry, who also is a high school biology teacher in Slidell, La., spent time discussing space travel with students and answering questions they had about the experience, including queries about how astronauts eat, sleep and drink in space. The presentation was sponsored by the NASA Office of External Affairs and Education at Stennis. For more information about NASA education initiatives, visit: http://education.ssc.nasa.gov/.
2011-09-20
... on state and local economies, providing visitation estimates, key market intelligence, and identifying traveler and trip characteristics. The U.S. Department of Commerce assists travel industry...) has been developed that reflects input from over 70 respondents, including: Travel Industry (airlines...
Pharmacist home visits: A 1-year experience from a community pharmacy.
Monte, Scott V; Passafiume, Sarah N; Kufel, Wesley D; Comerford, Patrick; Trzewieczynski, Dean P; Andrus, Kenneth; Brody, Peter M
2016-01-01
To provide experience on the methods and costs for delivering a large-scale community pharmacist home visit service. Independent urban community pharmacy, Buffalo, NY. Mobile Pharmacy Solutions provides traditional community pharmacy walk-in service and a suite of clinically oriented services, including outbound adherence calls linked to home delivery, payment planning, medication refill synchronization, adherence packaging, and pharmacist home visits. Pharmacist daily staffing included three dispensing pharmacists, one residency-trained pharmacist, and two postgraduate year 1 community pharmacy residents. A large-scale community pharmacy home visit service delivered over a 1-year period. Pharmacist time and cost to administer the home visit service as well as home visit request sources and description of patient demographics. A total of 172 visits were conducted (137 initial, 35 follow-up). Patients who received a home visit averaged 9.8 ± 5.2 medications and 3.0 ± 1.6 chronic disease states. On average, a home visit required 2.0 ± 0.8 hours, which included travel time. The percentages of visits completed by pharmacists and residents were 60% and 40%, respectively. The amounts of time to complete a visit were similar. Average home visit cost including pharmacist time and travel was $119 ($147 for a pharmacist, $77 for a resident). In this community pharmacy-based home visit service, costs are an important factor, with each pharmacist visit requiring 2 hours to complete. This experience provides a blueprint and real-world perspective for community pharmacies endeavoring to implement a home visit service and sets a foundation for future prospective trials to evaluate the impact of the service on important indicators of health and cost. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
Japanese Visit CERN's Jardin d'Enfants
2000-01-01
On 1 November twenty four Japanese teachers from the Association of Private Kindergartens in Osaka visited CERNs Jardin dEnfants to exchange experience and learn more about the Swiss educational system. The delegation was lead by Mrs. Nobuko Shirae, President of the Association, and Mr. Takeshi Kakimoto from the Japan Travel Bureau.
Arctic Visiting Speakers Series (AVS)
Fox, S. E.; Griswold, J.
2011-12-01
The Arctic Visiting Speakers (AVS) Series funds researchers and other arctic experts to travel and share their knowledge in communities where they might not otherwise connect. Speakers cover a wide range of arctic research topics and can address a variety of audiences including K-12 students, graduate and undergraduate students, and the general public. Host applications are accepted on an on-going basis, depending on funding availability. Applications need to be submitted at least 1 month prior to the expected tour dates. Interested hosts can choose speakers from an online Speakers Bureau or invite a speaker of their choice. Preference is given to individuals and organizations to host speakers that reach a broad audience and the general public. AVS tours are encouraged to span several days, allowing ample time for interactions with faculty, students, local media, and community members. Applications for both domestic and international visits will be considered. Applications for international visits should involve participation of more than one host organization and must include either a US-based speaker or a US-based organization. This is a small but important program that educates the public about Arctic issues. There have been 27 tours since 2007 that have impacted communities across the globe including: Gatineau, Quebec Canada; St. Petersburg, Russia; Piscataway, New Jersey; Cordova, Alaska; Nuuk, Greenland; Elizabethtown, Pennsylvania; Oslo, Norway; Inari, Finland; Borgarnes, Iceland; San Francisco, California and Wolcott, Vermont to name a few. Tours have included lectures to K-12 schools, college and university students, tribal organizations, Boy Scout troops, science center and museum patrons, and the general public. There are approximately 300 attendees enjoying each AVS tour, roughly 4100 people have been reached since 2007. The expectations for each tour are extremely manageable. Hosts must submit a schedule of events and a tour summary to be posted online
Infectious Risks of Traveling Abroad.
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).
Travel agents and the prevention of health problems among travelers in Québec.
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.
Han, Pauline; Balaban, Victor; Marano, Cinzia
2010-01-01
International travel to developing countries is increasing with rising levels of disposable income; this trend is seen in both adults and children. Risk-taking attitude is fundamental to research on the prevention of risky health behaviors, which can be an indicator of the likelihood of experiencing illness or injury during travel. The aim of this study is to investigate whether risk-taking attitudes of youths are associated with travel characteristics and likelihood of experiencing illness or injury while traveling to nonindustrialized countries. Data were analyzed from the 2008 YouthStyles survey, an annual mail survey gathering demographics and health knowledge, attitudes, and practices of individuals from 9 through 18 years of age. Travelers were defined as respondents who reported traveling in the last 12 months to a destination other than the United States, Canada, Europe, Japan, Australia, or New Zealand. Risk-taking attitude was measured by using a four-item Brief Sensation-Seeking Scale. All p values ≤ 0.05 were considered significant. Of 1,704 respondents, 131 (7.7%) traveled in the last 12 months. Females and those with higher household income were more likely to travel (odds ratio = 1.6,1.1). Of those who traveled, 16.7% reported seeking pretravel medical care, with most visiting a family doctor for that care (84.0%). However, one-fifth of respondents reported illness and injury during travel; of these, 83.3% traveled with their parents. Males and older youths had higher mean sensation-seeking scores. Further, travelers had a higher mean sensation-seeking score than nontravelers. Those who did not seek pretravel medical care also had higher mean sensation-seeking scores (p = 0.1, not significant). Our results show an association between risk-taking attitudes and youth travel behavior. However, adult supervision during travel and parental directives prior to travel should be taken into consideration. Communication messages should emphasize the
About an Optimal Visiting Problem
Energy Technology Data Exchange (ETDEWEB)
Bagagiolo, Fabio, E-mail: bagagiol@science.unitn.it; Benetton, Michela [Unversita di Trento, Dipartimento di Matematica (Italy)
2012-02-15
In this paper we are concerned with the optimal control problem consisting in minimizing the time for reaching (visiting) a fixed number of target sets, in particular more than one target. Such a problem is of course reminiscent of the famous 'Traveling Salesman Problem' and brings all its computational difficulties. Our aim is to apply the dynamic programming technique in order to characterize the value function of the problem as the unique viscosity solution of a suitable Hamilton-Jacobi equation. We introduce some 'external' variables, one per target, which keep in memory whether the corresponding target is already visited or not, and we transform the visiting problem in a suitable Mayer problem. This fact allows us to overcome the lacking of the Dynamic Programming Principle for the originary problem. The external variables evolve with a hysteresis law and the Hamilton-Jacobi equation turns out to be discontinuous.
Khan, Mohammad J.; Chelliah, Shankar; Haron, Mahmod S.; Ahmed, Sahrish
2017-01-01
Travel motivations, perceived risks and travel constraints, along with the attributes and characteristics of medical tourism destinations, are important issues in medical tourism. Although the importance of these factors is already known, a comprehensive theoretical model of the decision-making process of medical tourists has yet to be established, analysing the intricate relationships between the different variables involved. This article examines a large body of literature on both medical and conventional tourism in order to propose a comprehensive theoretical framework of medical tourism decision-making. Many facets of this complex phenomenon require further empirical investigation. PMID:28417022
Advice for families traveling to developing countries with young children.
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.
Cobelens, F. G.; Leentvaar-Kuijpers, A.
1997-01-01
Self-reported compliance with a malaria chemoprophylaxis regimen of proguanil (PG) plus chloroquine (CQ) was assessed in a cohort of 547 Dutch travellers who visited a single travel clinic when travelling to various areas endemic for falciparum malaria. 503 (92%) had taken PG/CQ prophylaxis, but
Stephens, J Mark; Li, Xiaoyan; Reiner, Maureen; Tzivelekis, Spiros
2016-01-01
Prophylactic treatment with granulocyte-colony stimulating factors (G-CSFs) is indicated for chemotherapy patients with a significant risk of febrile neutropenia. This study estimates the annual economic burden on patients and caregivers of clinic visits for prophylactic G-CSF injections in the US. Annual clinic visits for prophylactic G-CSF injections (all cancers) were estimated from national cancer incidence, chemotherapy treatment and G-CSF utilization data, and G-CSF sales and pricing information. Patient travel times, plus time spent in the clinic, were estimated from patient survey responses collected during a large prospective cohort study (the Prospective Study of the Relationship between Chemotherapy Dose Intensity and Mortality in Early-Stage (I-III) Breast Cancer Patients). Economic models were created to estimate travel costs, patient co-pays and the economic value of time spent by patients and caregivers in G-CSF clinic visits. Estimated total clinic visits for prophylactic G-CSF injections in the US were 1.713 million for 2015. Mean (SD) travel time per visit was 62 (50) min; mean (SD) time in the clinic was 41 (68) min. Total annual time for travel to and from the clinic, plus time at the clinic, is estimated at 4.9 million hours, with patient and caregiver time valued at $91.8 million ($228 per patient). The estimated cumulative annual travel distance for G-CSF visits is 60.2 million miles, with a total transportation cost of $28.9 million ($72 per patient). Estimated patient co-pays were $61.1 million, ∼$36 per visit, $152 per patient. The total yearly economic impact on patients and caregivers is $182 million, ∼$450 per patient. Data to support model parameters were limited. Study estimates are sensitive to the assumptions used. The burden of clinic visits for G-CSF therapy is a significant addition to the total economic burden borne by cancer patients and their families.
Wieten, Rosanne W.; Harting, Janneke; Biemond, Pieter M.; Grobusch, Martin P.; van Vugt, Michèle
2013-01-01
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
German travelers' preferences for travel vaccines assessed by a discrete choice experiment.
Poulos, Christine; Curran, Desmond; Anastassopoulou, Anastassia; De Moerlooze, Laurence
2018-02-08
Many travelers to regions with endemic infectious diseases do not follow health authorities' recommendations regarding vaccination against vaccine-preventable infectious diseases, before traveling. The determinants of individual travelers' decisions to vaccinate before traveling are largely unknown. This study aimed to provide this information using a discrete choice experiment (DCE) administered to four types of German travelers: (1) business travelers; (2) travelers visiting friends and relatives (VFR); (3) leisure travelers; and (4) backpackers. A DCE survey was developed, pretested and administered online. It included a series of choice questions in which respondents chose between two hypothetical vaccines, each characterized by four disease attributes with varying levels describing the of risk, health impact, curability and transmissibility of the disease they would prevent (described with four disease attributes with varying levels of risk, health impact, curability and transmissibility), and varying levels of four vaccine attributes (duration of protection, number of doses required, time required for vaccination, and vaccine cost). A random-parameters logit model was used to estimate the importance weights each traveler type placed on the various attribute levels. These weights were used to calculate mean monetary equivalents (MMEs) of changes in each attribute (holding all others constant) and of hypothetical disease-vaccine combinations. All traveler types' choices indicated that they attached the greatest importance to the risk and health impact of disease and to the vaccine cost whereas the other disease and vaccine attributes were less important for their decisions about travel vaccines. An option of not choosing any of the vaccine-pairs presented was rarely selected indicating that travelers' generally prefer to be vaccinated rather than not. The MMEs of changes in vaccine attributes indicated a very high variability between the individual travelers
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
Baaten, Gijs G; Sonder, Gerard J B; Van Der Loeff, Maarten F Schim; Coutinho, Roel A; Van Den Hoek, Anneke
2010-01-01
To evaluate whether changes in attack rates of fecal-orally transmitted diseases among travelers are related to changes in pretravel vaccination practices or better hygienic standards at travel destination. National surveillance data on all laboratory-confirmed cases of travel-related hepatitis A, shigellosis, and typhoid fever diagnosed in the Netherlands from 1995 to 2006 were matched with the number of Dutch travelers to developing countries to calculate region-specific annual attack rates. Trends in attack rates of non-vaccine-preventable shigellosis were compared with those of vaccine-preventable hepatitis A and typhoid fever. Trends were also compared with three markers for hygienic standards of the local population at travel destinations, drawn from the United Nations Development Programme database: the human development index, the sanitation index, and the water source index. Attack rates among Dutch travelers to developing regions declined for hepatitis A, shigellosis, and typhoid fever. Region-specific trends in attack rates of shigellosis resembled trends of hepatitis A and typhoid fever. Declining attack rates of the three fecal-orally transmitted diseases correlated with improvements in socioeconomic, sanitary, and water supply conditions of the local population at travel destination. These findings suggest that improved hygienic standards at travel destination strongly contributed to the overall decline in attack rates of fecal-orally transmitted diseases among visiting travelers. © 2010 International Society of Travel Medicine.
Declining national park visitation: An economic analysis
Thomas H. Stevens; Thomas A. More; Marla. Markowski-Lindsay
2014-01-01
Visitation to the major nature-based national parks has been declining. This paper specifies an econometric model that estimates the relative impact of consumer incomes, travel costs, entry fees and other factors on per capita attendance from 1993 to 2010. Results suggest that entrance fees have had a statistically significant but small impact on per capita attendance...
UK school visit: Alfriston School for girls
Sophie Louise Hetherton
2014-01-01
Pupils with learning disabilities from Alfriston School in the UK visited the CMS detector last week. This visit was funded by the UK's Science and Technologies Facilities Council (STFC) as part of a grant awarded to support activities that will help to build the girls’ self-esteem and interest in physics. Alfriston School students at CMS. On Friday, 10 October, pupils from Alfriston School – a UK secondary school catering for girls with a wide range of special educational needs and disabilities – paid a special visit to CERN. Dave Waterman, a science teacher at the school, recently received a Public Engagement Small Award from the STFC, which enabled the group of girls and accompanying teachers to travel to Switzerland and visit CERN. The awards form part of a project to boost the girls’ confidence and interest in physics. The aim is to create enthusiastic role models with first-hand experience of science who can inspire their peers back hom...
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.
A Study of Tourist Perceptions of Overseas Travel Stress While Visiting Bangkok, Thailand
Adarsh Batra
2011-01-01
Traveling has long been considered one of the best ways to release the stress caused by work and life. But in fact, uncertainties and negative experiences can break down the benefits and may make travelers feel stressed. A considerable amount of literature in tourism focuses on topic areas like destination building, market operation, and consumer satisfaction, but ignores one important aspect which negates many of the positive benefits of tourism—stress. Thus, the main purpose of this study...
International Patients' Travel Decision Making Process- A Conceptual Framework.
Khan, Mohammad Jamal; Chelliah, Shankar; Haron, Mahmod Sabri
2016-02-01
Role of information source, perceived benefits and risks, and destination image has significantly been examined in travel and tourism literature; however, in medical tourism it is yet to be examined thoroughly. The concept discussed in this article is drawn form well established models in tourism literature. The purpose of this research was to identify the source of information, travel benefits and perceived risks related to movement of international patients and develop a conceptual model based on well-established theory. Thorough database search (Science Direct, utmj.org, nih.gov, nchu.edu.tw, palgrave-journals, medretreat, Biomedcentral) was performed to fulfill the objectives of the study. International patients always concern about benefits and risks related to travel. These benefits and risks form images of destination in the minds of international patients. Different sources of information make international patients acquaint about the associated benefits and risks, which later leads to development of intention to visit. This conceptual paper helps in establishing model for decision-making process of international patients in developing visit intention. Ample amount of literature is available detailing different factors involved in travel decision making of international patients; however literature explaining relationship between these factors is scarce.
Hepatitis B Vaccination Status among Japanese Travelers.
Yaita, Kenichiro; Yahara, Koji; Sakai, Yoshiro; Iwahashi, Jun; Masunaga, Kenji; Hamada, Nobuyuki; Watanabe, Hiroshi
2017-05-08
This study clarified the characteristics of travelers who received hepatitis B vaccinations. Subjects were 233 Japanese travelers who visited our clinic prior to travel. We summarized the characteristics of the clients and performed two comparative studies: first, we compared a hepatitis B-vaccinated group with an unvaccinated group; second, we compared a group that had completed the hepatitis B vaccine series with a group that did not complete the series. The hepatitis B vaccine was administered to 152 clients. Factors positively associated with the hepatitis B vaccination (after adjusting for age and sex) included the following: travel for business or travel as an accompanying family member; travel to Asia; travel for a duration of a month or more; and, inclusion of the vaccine in a company or organization's payment plan. Meanwhile, factors negatively associated with the vaccination were travel for leisure or education, and travel to North America or Africa. Among 89 record-confirmed cases, only 53 completed 3 doses. The completion rate was negatively associated with the scheduled duration of travel if it was from a month to less than a year (after adjusting for age and sex). The present study provides a basis for promoting vaccination compliance more vigorously among Japanese adults.
Recommended vaccines for international travelers to India.
Verma, Ramesh; Khanna, Pardeep; Chawla, Suraj
2015-01-01
India's tourism industry generated 6.6% of the nation's Gross Domestic Product (GDP) during 2012. International travel to India is predicted to grow at an average annual rate of ∼ 8% over the next decade. The number of foreign tourists has increased by 9% to 5.8 million. Approximately 8% of travelers to developing countries require medical care during or after travel; the main diagnoses are vaccine-preventable diseases. Travelers to India can be exposed to various infectious diseases; water-borne, water-related, and zoonotic diseases may be imported to India where the disease is not endemic. The World Health Organization (WHO) emphasizes that all international travelers should be up to date with routine vaccinations. The recommended vaccinations for travelers to India vary according to the traveler's age, immunization history, existing medical conditions, duration, legal requirements for entry into countries being visited, travelers preferences, and values. Travelers should consult with a doctor so that there is sufficient time for completion of optimal vaccination schedules. No matter where traveling, one should be aware of potential exposure to certain organisms that can cause severely illnesses, even death. There is no doubt that vaccines have reduced or virtually eliminated many diseases that killed or severely disabled children and adults just a few generations ago. Thus, travelers must take recommended vaccines per schedule before traveling to India.
Khan, Mohammad J; Chelliah, Shankar; Haron, Mahmod S; Ahmed, Sahrish
2017-02-01
Travel motivations, perceived risks and travel constraints, along with the attributes and characteristics of medical tourism destinations, are important issues in medical tourism. Although the importance of these factors is already known, a comprehensive theoretical model of the decision-making process of medical tourists has yet to be established, analysing the intricate relationships between the different variables involved. This article examines a large body of literature on both medical and conventional tourism in order to propose a comprehensive theoretical framework of medical tourism decision-making. Many facets of this complex phenomenon require further empirical investigation.
Boggild, Andrea K.; Esposito, Douglas H.; Kozarsky, Phyllis E.; Ansdell, Vernon; Beeching, Nicholas J.; Campion, Daniel; Castelli, Francesco; Caumes, Eric; Chappuis, Francois; Cramer, Jakob P.; Gkrania-Klotsas, Effrossyni; Grobusch, Martin P.; Hagmann, Stefan H. F.; Hynes, Noreen A.; Lim, Poh Lian; López-Vélez, Rogelio; Malvy, Denis J. M.; Mendelson, Marc; Parola, Philippe; Sotir, Mark J.; Wu, Henry M.; Hamer, Davidson H.; Field, Vanessa; Libman, Michael D.; Rothe, Camilla; Barnett, Elizabeth D.; Schwartz, Eli; Gautret, Philippe; von Sonnenburg, Frank; van Genderen, Perry; Jensenius, Mogens; Stauffer, William M.; Mockenhaupt, Frank; Kain, Kevin C.; Kanagawa, Shuzo; Coyle, Christina M.; Connor, Bradley A.; Ursing, Johan; Leder, Karin; Haulman, Jean; Schlagenhauf, Patricia; Vincelette, Jean; McCarthy, Anne; Pandey, Prativa; Chen, Lin H.; Cahill, John D.; Rapp, Christophe; Kendall, Brian; Lalloo, David; Yoshimura, Yukihiro
2015-01-01
Background: The largest-ever outbreak of Ebola virus disease (EVD), ongoing in West Africa since late 2013, has led to export of cases to Europe and North America. Clinicians encountering ill travelers arriving from countries with widespread Ebola virus transmission must be aware of alternate
van Hattem, Jarne M; Arcilla, Maris S; Bootsma, Martin Cj; van Genderen, Perry J; Goorhuis, Abraham; Grobusch, Martin P; Molhoek, Nicky; Oude Lashof, Astrid Ml; Schultsz, Constance; Stobberingh, Ellen E; Verbrugh, Henri A; de Jong, Menno D; Melles, Damian C; Penders, John
2016-07-01
The aim was to study acquisition and persistence of carbapenemase-producing Enterobacteriaceae (CPE) among travelers. Stools from 2001 travelers and 215 nontraveling household members, collected before and immediately post-travel as well as 1, 3, 6 and 12 months upon return, were screened for CPE. Five travelers, all visiting Asia outside the Indian subcontinent, acquired CPE. One traveler persistently carried the same OXA-244 CPE up to 6 months post-travel. Three months after travel, her co-traveling spouse also became positive for this OXA-244 CPE strain, suggesting clonal transmission within this household. Acquisition of CPE is not restricted to travelers to the Indian subcontinent and/or to travelers seeking healthcare during travel and can persist up to at least 6 months post-travel.
Cuba: U.S. Restrictions on Travel and Legislative Initiatives
National Research Council Canada - National Science Library
Sullivan, Mark P
2003-01-01
.... In March 2003, the Administration eased restrictions on those visiting close family members in Cuba, while at the same time it eliminated travel for people-to-people educational exchanges unrelated...
The Dynamics of Online Purchase Visits: Inertia or Switching?
Institute of Scientific and Technical Information of China (English)
Zelin Zhang; Xia Wang; Peter T.L.Popkowski Leszczyc; Xiao Zuo
2016-01-01
This paper studies the dynamics of online purchase patterns,focusing on the impact of the channel used on conversion probability,as well as the transition of channel use over time.A novel data set from a major Chinese online travel agency is used for analysis,consisting of four months of data with 24,337 store visits through three types of channels:direct visit,search advertising and referral.Results of a Bayesian multinomial logit model show that the search channel significantly affects consumers' conversion probability,and show a high degree of inertia in channel use.This finding contrasts sharply with suggestions of previous research that most future purchases will converge to the direct-visit channel.
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.
Allen, Joanna E; Patel, Dipti
2016-03-01
People who travel while immunocompromised are more at risk of serious travel-related infection. Their condition, medications or treatments can contraindicate, decrease the effectiveness of or increase the toxicity of vaccinations or malaria chemoprophylaxis. Therefore, immunocompromised travellers require careful assessment and specialized pre-travel advice. The aims of this study were to investigate enquiries by healthcare professionals (HCPs) to the UK National Travel Health Network and Centre (NaTHNaC) advice line regarding travellers with immunocompromise and to identify their most common concerns. Documentation for all calls taken by advisers at the London office during 2013 was reviewed. Of the 4910 enquiries to the London NaTHNaC advice line, 397 calls concerned immunocompromised travellers (8.1%). The majority of immunocompromised travellers were planning to visit Sub-Saharan Africa (53%) for the purpose of tourism (43%). Sixty-seven percent of enquiries concerned vaccine use, 11% were about malaria chemoprophylaxis, 20% were about both and 2% were for other reasons. Causes of immunocompromise included inflammatory or autoimmune conditions (43%), cancer (18%), splenic dysfunction (13%), immunosuppressive drugs (12%), human immunodeficiency virus (11%), primary immunodeficiency (1%), neutropenia (0.5%) and thymus abnormalities (0.5%). There were frequent enquires to the advice line by UK HCPs regarding immunocompromised travellers. The travellers in this study had a wide range of underlying medical conditions and varying levels of immunocompromise. These enquiries may reflect a lack of clarity in current national guidelines, difficulties in interpreting them or both. Establishing the reasons for these deficiencies as well as the reasons behind UK HCP concerns and lack of confidence requires further investigation. This research has highlighted potential knowledge gaps and will help inform future guidance and educational activities for UK HCPs advising
Directory of Open Access Journals (Sweden)
Mohammad J. Khan
2017-03-01
Full Text Available Travel motivations, perceived risks and travel constraints, along with the attributes and characteristics of medical tourism destinations, are important issues in medical tourism. Although the importance of these factors is already known, a comprehensive theoretical model of the decision-making process of medical tourists has yet to be established, analysing the intricate relationships between the different variables involved. This article examines a large body of literature on both medical and conventional tourism in order to propose a comprehensive theoretical framework of medical tourism decision-making. Many facets of this complex phenomenon require further empirical investigation.
PENYELESAIAN MULTI TRAVELING SALESMAN PROBLEM DENGAN ALGORITMA GENETIKA
Directory of Open Access Journals (Sweden)
NI KADEK MAYULIANA
2017-01-01
Full Text Available Genetic algorithm is a part of heuristic algorithm which can be applied to solve various computational problems. This work is directed to study the performance of the genetic algorithm (GA to solve Multi Traveling Salesmen Problem (multi-TSP. GA is simulated to determine the shortest route for 5 to 10 salesmen who travelled 10 to 30 cities. The performance of this algorithm is studied based on the minimum distance and the processing time required for 10 repetitions for each of cities-salesmen combination. The result showed that the minimum distance and the processing time of the GA increase consistently whenever the number of cities to visit increase. In addition, different number of sales who visited certain number of cities proved significantly affect the running time of GA, but did not prove significantly affect the minimum distance.
Travellers' diarrhoea: contemporary approaches to therapy and prevention.
DuPont, Herbert L
2006-01-01
Travellers' diarrhoea remains a major public health problem, contributing to significant morbidity and disability. Because bacterial enteropathogens cause a majority of this form of diarrhoea, antibacterial drugs are effective when used in chemoprophylaxis or for empirical treatment.A review of the MEDLINE listings for travellers' diarrhoea for the past 4 years was conducted; a library of >1,000 scientific articles on the topic was also considered in developing this review. Persons who travel from industrialised countries to developing countries of the tropical and semi-tropical world are the individuals who experience travellers' diarrhoea. While diarrhoea occurs with reduced frequency among persons travelling to low-risk areas from other low- or other high-risk areas, and there remain areas of intermediate risk, this review looks primarily at the illness occurring in persons from industrialised regions visiting high-risk regions of Latin America, Africa and Southern Asia. The material reviewed deals with the high frequency of acquiring diarrhoea during international travel to high-risk areas, seen in approximately 40%, and the expected bacterial causes of illness, of which diarrhoeagenic Escherichia coli is the most important. The host risk factors associated with increased susceptibility to diarrhoea include young age, lack of previous travel to high-risk regions in the past 6 months, indiscriminate food and beverage selection patterns, and host genetics. It appears feasible to decrease the rate of illness among the travelling public by careful food and beverage selection or through chemoprophylaxis with nonabsorbed rifaximin. Chemoprophylaxis with rifaximin should help to reduce the occurrence of travellers' diarrhoea and hopefully prevent post-diarrhoea complications, including irritable bowel syndrome. Early empirical therapy with antibacterial drugs, including rifaximin, a fluoroquinolone or azithromycin, will decrease the duration of illness and return
International Patients’ Travel Decision Making Process- A Conceptual Framework
KHAN, Mohammad Jamal; CHELLIAH, Shankar; HARON, Mahmod Sabri
2016-01-01
Background: Role of information source, perceived benefits and risks, and destination image has significantly been examined in travel and tourism literature; however, in medical tourism it is yet to be examined thoroughly. The concept discussed in this article is drawn form well established models in tourism literature. Methods: The purpose of this research was to identify the source of information, travel benefits and perceived risks related to movement of international patients and develop a conceptual model based on well-established theory. Thorough database search (Science Direct, utmj.org, nih.gov, nchu.edu.tw, palgrave-journals, medretreat, Biomedcentral) was performed to fulfill the objectives of the study. Results: International patients always concern about benefits and risks related to travel. These benefits and risks form images of destination in the minds of international patients. Different sources of information make international patients acquaint about the associated benefits and risks, which later leads to development of intention to visit. This conceptual paper helps in establishing model for decision-making process of international patients in developing visit intention. Conclusion: Ample amount of literature is available detailing different factors involved in travel decision making of international patients; however literature explaining relationship between these factors is scarce. PMID:27114978
The traveling salesman problem a computational study
Applegate, David L; Chvatal, Vasek; Cook, William J
2006-01-01
This book presents the latest findings on one of the most intensely investigated subjects in computational mathematics--the traveling salesman problem. It sounds simple enough: given a set of cities and the cost of travel between each pair of them, the problem challenges you to find the cheapest route by which to visit all the cities and return home to where you began. Though seemingly modest, this exercise has inspired studies by mathematicians, chemists, and physicists. Teachers use it in the classroom. It has practical applications in genetics, telecommunications, and neuroscience.
Brucellosis in a group of travelers to Spain.
Arnow, P M; Smaron, M; Ormiste, V
1984-01-27
An epidemiologic investigation, initiated when Brucella melitensis infection was detected in a high school student, identified five unrecognized cases in classmates. Before the investigation, four infected students had symptoms of brucellosis for one to ten weeks, made nine visits to physicians, and were confined to the school infirmary or hospitals for 27 days. The other two students were asymptomatic when Brucella agglutination testing demonstrated elevated titers, and treatment was quickly instituted when symptoms occurred. Travel to Spain was implicated because cases were clustered in six of 27 travelers compared with none of 23 control students. Food-history questionnaires showed more frequent consumption of cheese by infected than noninfected travelers. This cluster of cases demonstrates the risk of brucellosis in travelers to endemic areas and illustrates the value of an epidemiologic investigation of cases.
Cluster of Imported Vivax Malaria in Travelers Returning From Peru.
Weitzel, Thomas; Labarca, Jaime; Cortes, Claudia P; Rosas, Reinaldo; Balcells, M Elvira; Perret, Cecilia
2015-01-01
We report a cluster of imported vivax malaria in three of five Chilean travelers returning from Peru in March 2015. The cluster highlights the high risk of malaria in the Loreto region in northern Peru, which includes popular destinations for international nature and adventure tourism. According to local surveillance data, Plasmodium vivax is predominating, but Plasmodium falciparum is also present, and the incidence of both species has increased during recent years. Travelers visiting this region should be counseled about the prevention of malaria and the options for chemoprophylaxis. © 2015 International Society of Travel Medicine.
“GOING OFF THE BEATEN PATH: KNUT HAMSUN’S FORAYS INTO TRAVEL WRITING”
Directory of Open Access Journals (Sweden)
Tom Conner
2016-04-01
Full Text Available This paper examines Knut Hamsun’s travel writing, from his many newspaper articles about America published before The Cultural Life of Modern America (Fra det moderne Amerikas aandsliv, 1889 – his idiosyncratic and very personal reckoning with America – to his only real (i.e., formal travelogue or travel book, In Wonderland (I Æventyrland, 1903, documenting his visit to the Russian Caucasus. The article focuses on some common themes as well as striking differences among these works, so as to highlight Hamsun’s creative use of the travel genre. As the term “foray” in my title suggests, there is something illicit and transgressive about Hamsun’s travel writing. He does not readily conform to the norms of the genre; rather, he transforms the genre to suit his own purposes by infusing a large dose of his idiosyncratic genius in everything he writes about the faraway lands he visits.
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.
Tuberculosis screening of travelers to higher-incidence countries: A cost-effectiveness analysis
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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
Morbidity among Israeli paediatric travellers.
Rabinowicz, Shira; Schwartz, Eli
2017-09-01
International travel, particularly to developing countries, is becoming increasingly common among the Israeli population, including an increase in the number of travelling children. Since children are a distinct travellers' population, data about their post-travel morbidity are needed. A retrospective study which examined all children (0-19 years old) who presented to our centre after international travel from 1999 to 2015. About 314 children were seen. The mean age was 10 years (SD ± 5.8). Most of the patients (80.6%) were tourists, and the rest were expatriates. The main destinations visited were South-Asia (46.5%), Sub-Saharan Africa (33.4%), Latin-America (7%) and Europe (6.4%). Overall, the most common diagnoses were gastrointestinal (GI) (mainly chronic) disorders (30.6%), followed by febrile diseases (26.4%), among which 18.1% of patients were diagnosed with dengue fever and 12% with malaria. Dermatologic conditions accounted for 25.2%. Additional diagnoses were schistosomiasis (6.4%) and neuropsychiatric symptoms (2.2%). A substantial part, 10.8%, had eosinophilia, either symptomatic or asymptomatic. Travellers to Asia, compared to travellers to Africa, presented more commonly with GI illness (OR 2.02, 95% confidence interval 1.13-3.61), and dermatologic conditions (OR 1.94, 95% confidence interval 1.05-3.61). Morbidity was associated with a variety of transmission modes, such as food-borne illnesses (30.9%), bite and sting wounds (10.2%), mosquito-borne infections (8%), freshwater contact (6.7%) and tick-borne infections (2.2%). The main conditions seen in paediatric returning travellers were GI, febrile and dermatologic illnesses, some may be rare in their country of origin. Targeting care for the suspected pathogens based on updated knowledge of epidemiology and thorough travel history is essential. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com
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.
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
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.
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.
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
Pediatric travel consultation in an integrated clinic.
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.
Smart travel guide: from internet image database to intelligent system
Chareyron, Ga"l.; Da Rugna, Jérome; Cousin, Saskia
2011-02-01
To help the tourist to discover a city, a region or a park, many options are provided by public tourism travel centers, by free online guides or by dedicated book guides. Nonetheless, these guides provide only mainstream information which are not conform to a particular tourist behavior. On the other hand, we may find several online image databases allowing users to upload their images and to localize each image on a map. These websites are representative of tourism practices and constitute a proxy to analyze tourism flows. Then, this work intends to answer this question: knowing what I have visited and what other people have visited, where should I go now? This process needs to profile users, sites and photos. our paper presents the acquired data and relationship between photographers, sites and photos and introduces the model designed to correctly estimate the site interest of each tourism point. The third part shows an application of our schema: a smart travel guide on geolocated mobile devices. This android application is a travel guide truly matching the user wishes.
The Brazil of Marianne North: Memories of an English Traveler
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Ana Lúcia Almeida Gazzola
2008-09-01
Full Text Available Starting from reflections about woman and femininity in the Victorian era, the explosion of literary market in the 19th century, and the access of women to education, literature, and journalism, this text introduces the work of Marianne North, English painter who used to travel aiming to paint the flora of other countries, particularly the exotic tropical flora. Marianne became one of the most famous globetrotter travelers of her time, visiting several countries such as Canada, USA, Jamaica, Brazil, Tenerife, Japan, Borneo, Java, Ceylon, Singapore, India, Wales, Australia, New Zealand, Tasmania, South Africa, Seychelles Islands, and Chile. In total, she left registers of about 272 genres (almost 1000 species of plants, some of them little known by the experts. Hence, the text deals with the dual condition of Marianne North as a painter and author of reports about the visited countries. In Brazil, for instance, she lived between 1972 and 1873. Her professionalism and objectivity distinguish her from the other travelers of 19th century.
Tick-borne encephalitis: What travelers should know when visiting an endemic country
Czech Academy of Sciences Publication Activity Database
Chrdle, A.; Chmelík, V.; Růžek, Daniel
2016-01-01
Roč. 12, č. 10 (2016), s. 2694-2699 ISSN 2164-5515 R&D Projects: GA MZd(CZ) NV16-34238A Institutional support: RVO:60077344 Keywords : endemic country * flavivirus * tick-borne encephalitis * tick-borne encephalitis virus * travel medicine * vaccination Subject RIV: EE - Microbiology, Virology Impact factor: 2.157, year: 2016
Wieten, Rosanne W; Harting, Janneke; Biemond, Pieter M; Grobusch, Martin P; van Vugt, Mich?le
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 ...
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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
Branch-and-cut-and-price for the traveling salesman problem with time windows
DEFF Research Database (Denmark)
Røpke, Stefan; Madsen, Oli B.G.
In the traveling salesman problem with time windows (TSPTW) one is given a depot and a set of nodes to be visited by a salesman. The salesman starts his trip at the depot and must visit all nodes while respecting time windows at the nodes. The objective of the problem is to minimize the total...... distance traveled by the salesman. The TSPTW is formulated as a set-partitioning problem which is solved by using combined cut and column generation. The pricing sub problem in the column generation procedure is a shortest path problem with time window constraints and 2-cycle elimination. A standard column...
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.
Harker, Richard J. W.; Badger, James
2015-01-01
This study investigated the use of different pedagogical techniques to create an intellectually engaging experience for middle school students who visited a traveling exhibition from the United States Holocaust Memorial Museum at a non-museum host site: the University of North Georgia Dahlonega's Library and Technology Center. The findings of this…
Travel-related illness at a tertiary care hospital in Osaka, Japan
Hadano,Yoshiro; Shirano,Michinori; Goto,Tetsushi
2016-01-01
Yoshiro Hadano, Michinori Shirano, Tetsushi Goto Center for Infectious Diseases, Osaka City General Hospital, Osaka, Japan Abstract: We analyzed the travel-related health problems in persons returning to Japan from overseas. Data were extracted retrospectively for all patients visiting the infectious diseases department of Osaka City General Hospital, Osaka, Japan, between July 2012 and September 2013. There were 209 sick returning travelers during the period of the study. ...
Providing Cardiology Care in Rural Areas Through Visiting Consultant Clinics.
Gruca, Thomas S; Pyo, Tae-Hyung; Nelson, Gregory C
2016-06-30
Workforce experts predict a future shortage of cardiologists that is expected to impact rural areas more severely than urban areas. However, there is little research on how rural patients are currently served through clinical outreach. This study examines the impact of cardiology outreach in Iowa, a state with a large rural population, on participating cardiologists and on patient access. Outreach clinics are tracked annually in the Office of Statewide Clinical Education Programs Visiting Medical Consultant Database (University of Iowa Carver College of Medicine). Data from 2014 were analyzed. In 2014, an estimated 5460 visiting consultant clinic days were provided in 96 predominantly rural cities by 167 cardiologists from Iowa and adjoining states. Forty-five percent of Iowa cardiologists participated in rural outreach. Visiting cardiologists from Iowa and adjoining states drive an estimated 45 000 miles per month. Because of monthly outreach clinics, the average driving time to the nearest cardiologist falls from 42.2±20.0 to 14.7±11.0 minutes for rural Iowans. Cardiology outreach improves geographic access to office-based cardiology care for more than 1 million Iowans out of a total population of 3 million. Direct travel costs and opportunity costs associated with physician travel are estimated to be more than $2.1 million per year. Cardiologists in Iowa and adjoining states have expanded access to office-based cardiology care from 18 to 89 of the 99 counties in Iowa. In these 71 counties without a full-time cardiologist, visiting consultant clinics can accommodate more than 50% of office visits in the patients' home county. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
Kantele, Anu; Lääveri, Tinja; Mero, Sointu; Vilkman, Katri; Pakkanen, Sari H.; Ollgren, Jukka; Antikainen, Jenni; Kirveskari, Juha
2015-01-01
Background. More than 300 million travelers visit regions with poor hygiene annually. A significant percentage of them become colonized by resistant intestinal bacteria such as extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL-PE) and may transmit the strains to others and to medical care settings when they return home. Despite the threats to global healthcare caused by an upsurge in antimicrobial resistance, no effort has been centered on prevention of colonization while traveling. Methods. Stool samples were collected from 430 Finns before and after traveling outside Scandinavia. All specimens were analyzed for ESBL- and carbapenemase-producing Enterobacteriaceae (CPE). Questionnaires were used to survey volunteers about use of antimicrobials as well as other potential risk factors. The results were subjected to multivariable analysis. Results. Twenty-one percent (90/430) of the travelers became colonized by ESBL-PE and none by CPE. Geographic region, occurrence of travelers' diarrhea (TD), age, and use of antimicrobial (AB) for TD were identified as independent risk factors predisposing to contracting ESBL-PE. Eleven percent of those in subgroup TD−AB−, 21% in TD+AB−, and 37% in TD+AB+ acquired ESBL-PE. The risk proved to be highest in South Asia (46%); 23% became colonized in subgroup TD−AB−, 47% in TD+AB−, and 80% in TD+AB+. In Southeast Asia, the rates were 14%, 37%, and 69%, respectively. Conclusions. TD and antimicrobials for TD proved to be independent risk factors, with up to 80% of TD+AB+ travelers contracting ESBL-PE. In modern pre-travel counseling for those visiting high-risk regions, travelers should be advised against taking antibiotics for mild or moderate TD. PMID:25613287
Ostholm-Balkhed, Ase; Tärnberg, Maria; Nilsson, Maud; Nilsson, Lennart E; Hanberger, Håkan; Hällgren, Anita
2013-09-01
To study the acquisition of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) among the faecal flora during travel, with a focus on risk factors, antibiotic susceptibility and ESBL-encoding genes. An observational prospective multicentre cohort study of individuals attending vaccination clinics in south-east Sweden was performed, in which the submission of faecal samples and questionnaires before and after travelling outside Scandinavia was requested. Faecal samples were screened for ESBL-PE by culturing on ChromID ESBL and an in-house method. ESBL-PE was confirmed by phenotypic and genotypic methods. Susceptibility testing was performed with the Etest. Individuals who acquired ESBL-PE during travel (travel-associated carriers) were compared with non-carriers regarding risk factors, and unadjusted and adjusted ORs after manual stepwise elimination were calculated using logistic regression. Of 262 enrolled individuals, 2.4% were colonized before travel. Among 226 evaluable participants, ESBL-PE was detected in the post-travel samples from 68 (30%) travellers. The most important risk factor in the final model was the geographic area visited: Indian subcontinent (OR 24.8, P Asia (OR 8.63, P < 0.001) and Africa north of the equator (OR 4.94, P = 0.002). Age and gastrointestinal symptoms also affected the risk significantly. Multiresistance was seen in 77 (66%) of the ESBL-PE isolates, predominantly a combination of reduced susceptibility to third-generation cephalosporins, trimethoprim/sulfamethoxazole and aminoglycosides. The most common species and ESBL-encoding gene were Escherichia coli (90%) and CTX-M (73%), respectively. Acquisition of multiresistant ESBL-PE among the faecal flora during international travel is common. The geographical area visited has the highest impact on ESBL-PE acquisition.
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Jänisch Thomas
2010-10-01
Full Text Available Abstract Background The presence of ongoing local malaria transmission, identified though local surveillance and reported to regional WHO offices, by S-E Asian countries, forms the basis of national and international chemoprophylaxis recommendations in western countries. The study was designed to examine whether the strategy of using malaria transmission in a local population was an accurate estimate of the malaria threat faced by travellers and a correlate of malaria in returning travellers. Methods Malaria endemicity was described from distribution and intensity in the local populations of ten S-E Asian destination countries over the period 2003-2008 from regionally reported cases to WHO offices. Travel acquired malaria was collated from malaria surveillance reports from the USA and 12 European countries over the same period. The numbers of travellers visiting the destination countries was based on immigration and tourism statistics collected on entry of tourists to the destination countries. Results In the destination countries, mean malaria rates in endemic countries ranged between 0.01 in Korea to 4:1000 population per year in Lao PDR, with higher regional rates in a number of countries. Malaria cases imported into the 13 countries declined by 47% from 140 cases in 2003 to 66 in 2008. A total of 608 cases (27.3% Plasmodium falciparum (Pf were reported over the six years, the largest number acquired in Indonesia, Thailand and Korea. Four countries had an incidence > 1 case per 100,000 traveller visits; Burma (Myanmar, Indonesia, Cambodia and Laos (range 1 to 11.8-case per 100,000 visits. The remaining six countries rates were Conclusion The intensity of malaria transmission particularly sub-national activity did not correlate with the risk of travellers acquiring malaria in the large numbers of arriving visitors. It is proposed to use a threshold incidence of > 1 case per 100,000 visits to consider targeted malaria prophylaxis
Advice on malaria and yellow fever prevention provided at travel agencies in Cuzco, Peru.
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.
Liu, Jodi L; Han, Bing; Cohen, Deborah A
2015-08-06
Accurate conceptualizations of neighborhood environments are important in the design of policies and programs aiming to improve access to healthy food. Neighborhood environments are often defined by administrative units or buffers around points of interest. An individual may eat and shop for food within or outside these areas, which may not reflect accessibility of food establishments. This article examines the relevance of different definitions of food environments. We collected data on trips to food establishments using a 1-week food and travel diary and global positioning system devices. Spatial-temporal clustering methods were applied to identify homes and food establishments visited by study participants. We identified 513 visits to food establishments (sit-down restaurants, fast-food/convenience stores, malls or stores, groceries/supermarkets) by 135 participants in 5 US cities. The average distance between the food establishments and homes was 2.6 miles (standard deviation, 3.7 miles). Only 34% of the visited food establishments were within participants' neighborhood census tract. Buffers of 1 or 2 miles around the home covered 55% to 65% of visited food establishments. There was a significant difference in the mean distances to food establishments types (P = .008). On average, participants traveled the longest distances to restaurants and the shortest distances to groceries/supermarkets. Many definitions of the neighborhood food environment are misaligned with individual travel patterns, which may help explain the mixed findings in studies of neighborhood food environments. Neighborhood environments defined by actual travel activity may provide more insight on how the food environment influences dietary and food shopping choices.
Willingness to travel to avoid conflicts in Danish forests
DEFF Research Database (Denmark)
Bakhtiari, Fatemeh; Jacobsen, Jette Bredahl; Jensen, Frank Søndergaard
2014-01-01
were identified. Furthermore, a choice experiment was constructed to estimate the distance visitors are willing to travel to encounter few visitors as opposed to many visitors, and thereby potentially experience fewer conflicts. Comparing the marginal willingness to travel (WTT) of different user...... groups suggests that some groups have a WTT further than the average to reach a forest with ‘Few’ visitors. The average WTT to reach a forest area with ‘Few’ visitors. ‘Mountain bikers,’ ‘Peace and nature lovers’ and ‘Horse riders’ are willing to travel 4 km more than the average per visit to reach...... a less crowded forest. At the other end of the scale, we find that people who are doing physical exercise are willing to travel 2 km less than the average to reach a less crowded forest....
Back or to the future? Preferences of time travelers
Directory of Open Access Journals (Sweden)
Ralph Hertwig
2012-07-01
Full Text Available Popular culture reflects whatever piques our imagination. Think of the myriad movies and books that take viewers and readers on an imaginary journey to the past or the future (e.g., Gladiator, The Time Machine. Despite the ubiquity of time travel as a theme in cultural expression, the factors that underlie people's preferences concerning the direction of time travel have gone unexplored. What determines whether a person would prefer to visit the (certain past or explore the (uncertain future? We identified three factors that markedly affect people's preference for (hypothetical travel to the past or the future, respectively. Those who think of themselves as courageous, those with a more conservative worldview, and---perhaps counterintuitively---those who are advanced in age prefer to travel into the future. We discuss implications of these initial results.
Relations with the Host States Service
2001-01-01
You are reminded that holders of French residence permits (for example, the carte spéciale issued by the French Ministry of Foreign Affairs, a resident's card, a temporary residence card or a receipt issued during the renewal of such residence documents) do not need visas for tourist travel (including conferences) to countries applying the provisions of the Schengen Convention, provided that the duration of the travel is less than three months. The countries applying the provisions of the Schengen Convention are Austria, Belgium, France, Germany, Greece, Italy, Luxembourg, the Netherlands, Portugal and Spain; and since 25 March 2001 Denmark, Finland, Iceland, Norway and Sweden. For longer stays and for other than tourist visits, you are strongly advised to make enquiries at the relevant consulates.http://www.cern.ch/relations/
The Home Care Crew Scheduling Problem: Preference-based visit clustering and temporal dependencies
DEFF Research Database (Denmark)
Rasmussen, Matias Sevel; Justesen, Tor Fog; Dohn, Anders Høeg
2012-01-01
In the Home Care Crew Scheduling Problem a staff of home carers has to be assigned a number of visits to patients’ homes, such that the overall service level is maximised. The problem is a generalisation of the vehicle routing problem with time windows. Required travel time between visits and time...... preference constraints. The algorithm is tested both on real-life problem instances and on generated test instances inspired by realistic settings. The use of the specialised branching scheme on real-life problems is novel. The visit clustering decreases run times significantly, and only gives a loss...... windows of the visits must be respected. The challenge when assigning visits to home carers lies in the existence of soft preference constraints and in temporal dependencies between the start times of visits.We model the problem as a set partitioning problem with side constraints and develop an exact...
IAEA Director General to Visit Iran
International Nuclear Information System (INIS)
2012-01-01
Full text: The Director General of the IAEA, Yukiya Amano, will travel to Tehran this Sunday, 20 May 2012, to discuss issues of mutual interest with high Iranian officials. In the course of his one-day working visit, on Monday 21 May 2012 the Director General will meet the Secretary of Iran's Supreme National Security Council, His Excellency Saeed Jalili, and other senior representatives of the Iranian government. Herman Nackaerts, Deputy Director General for Safeguards, and Rafael Mariano Grossi, Assistant Director General for Policy, will accompany the Director General. (IAEA)
DEFF Research Database (Denmark)
Mak, Vicky; Thomadsen, Tommy
2004-01-01
A well-known extension of the Travelling Salesman Problem (TSP) is the Selective (or Prize-collecting) TSP: In addition to the edge-costs, each node has an associated reward (denoted the node-reward) and instead of visiting all nodes, only profitable nodes are visited. The Quadratic Selective TSP...
The causes of skin lesions in the returning travelers: with special reference to Egypt.
Morsy, Tosson A
2012-04-01
Often people yearn of a greater travel adventure like a year in Africa to get away from their routine situations and locations, for a quick vacation or as a means of finding one's self, to enjoy new experiences, to learn and experience new languages, new food, and new cultures. While most people associate Sub-Saharan Africa with safaris, there are endless other possibilities for adventure. Some African countries have actual entry requirements and won't let you in unless you have proof you've been vaccinated against a specific disease. Every African country is unique in the quality of its parks and reserves, roads and other infrastructure, visitor accommodations and receptivity to tourists. Creating an itinerary and arranging travel logistics can intimidate even the most enthusiastic tourist. Others travel more nowadays for the better economy and the advancements in transportation make it easier to do so. If family members do not reside in the same country or are probably working abroad, other family members would want to visit them and would do so as frequently as their resources would allow. Visiting families and friends in different states or countries are probably the most important reasons for taking time off to travel. No doubt, travelling to different climates, cultures and environments abroad can expose to tropical infectious diseases and health risks. This review dealt with skin lesions in the returning travelers.
Nikolai Katanov in China: Unpublished Travel Diaries
Directory of Open Access Journals (Sweden)
Yulia A. Martynova
2014-12-01
Full Text Available The article summarizes the results of Xinjiang expedition by N.F. Katanov, conducted in 1889–1892 by order of the Russian Academy of Sciences. The core materials and undifferentiated diaries remained unpublished and are deposited in the National Archives of the Republic of Tatarstan. N.F. Katanov’s data in the National Archives of the Republic of Tatarstan (Fund 969 includes 551 files, covering the period of 1878 – 1919. We are talking about three documents: - Fund 969, Inv. 1, d. 10: Journey to Siberia, Dzungaria and East Turkestan, committed in 1890 (241 pages; - F. 969, Inv. 1, d. 11: Trip to the Seven Rivers and Tarbagatai, 1891 (558 p. - F. 969, Inv. 1, d. 76: Travel to Central Asia, Western China (Turfan and Mongolia (487 p.. N.F. Katanov travelled across the territory of Qing China several times. In 1890 he visited eight Chinese centers – Hotan, Kashgar, Aksu, Kuchar, Karakash, Baya, Lo-gucheng and Turpan, the language and folklore of the Turkic peoples of Eastern Turkestan were of his primarily concern. Then he visited mainly Seven Rivers (Zhetysu, settled in Chuguchak, starting from May 13 to November 7, 1891, and in Chuguchak (where he settled from May 13 to November 7. Since November 8, 1891 to March 7, 1892, he visited Xinjiang, where he lived mainly in Hami. Then he went to Kulja, and returned to the Russian Empire in May 1892, staying within the China territory 18 months in total.
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
Making Travel to Cuba Work for Health and Sustainable Development.
Gorry, Conner
2017-01-01
In 2015, a record-breaking 3.5 million visitors-1 million from Canada alone-traveled to Cuba to explore its history, culture, natural splendor, and visit family. That same year, US President Barack Obama relaxed travel restrictions, giving general authorization for a dozen categories of legal travel by US citizens and residents. As a result, US visitors to the island ballooned by 80% between January 2015 and June 2016. And the numbers keep growing: the latest data show that foreign arrivals reached 4 million in 2016.[1] The surge in visitors highlights the potential negative impact of tourism on a developing country's infrastructure, environment, cultural patrimony and local economy-all considered important social determinants of health.
Visit Sunny Chernobyl: And Other Adventures in the World's Most Polluted Places
International Nuclear Information System (INIS)
Blackwell, Andrew
2013-01-01
This book is the French translation of 'Visit Sunny Chernobyl' published in 2012 by Random House editor. For most of us, traveling means visiting the most beautiful places on Earth. It's rare to book a plane ticket to visit the lifeless moonscape of Canada's oil sand strip mines, or to seek out the Chinese city of Linfen, legendary as the most polluted in the world. But in this book, the author embraces a different kind of travel, taking a jaunt through the most gruesomely polluted places on Earth. From the hidden bars and convenience stores of a radioactive wilderness to the sacred but reeking waters of India, the book fuses immersive first-person reporting with satire and analysis, making the case that it's time to start appreciating our planet as it is not as we wish it would be. Irreverent and reflective, the book is a love letter to our biosphere's most tainted, most degraded ecosystems, and a measured consideration of what they mean for us. Equal parts travelogue, expose, environmental memoir, and faux guidebook, the author careens through a rogue's gallery of environmental disaster areas in search of the worst the world has to offer and approaches a deeper understanding of what's really happening to our planet in the process
Importance of Wellness to the Tourists visiting Batangas Province
Directory of Open Access Journals (Sweden)
Romualdo L. Roque
2017-05-01
Full Text Available Wellness is having a healthy body, mind and spirit. Health and wellness go hand in hand. Most people link wellness to physical health condition only but the researcher found out the other dimension of wellness that matters to the tourists. This study assessed the other dimensions of wellness such as social, spiritual, intellectual, emotional and occupational wellness and reveals the most significant wellness dimension among the tourists visiting Wellness Spa in Batangas Province. The researcher aimed to present the profile of the wellness spa center along with the facilities and services they offer and how it helped wellness travelers achieve their purpose when visiting wellness spa. Descriptive design was used with 5 Wellness Spa Centers in Batangas as subject of the study with the used of adopted questionnaire; 216 enthusiastic wellness tourists were asked to sincerely answer the questions in order to collect relevant data. This study unveils that social wellness is important among tourists. They visit wellness spa to build social network, to openly communicate to others and openly express their thoughts and feelings. This wellness tourists aging from 26 – 35 years old earning an average of Php20, 000 prefer spa services and facilities to relax, use gym to shape up in order to maintain a healthy physical wellbeing. Knowing their purpose in life and discovering the true meaning of their existence is the aim of this wellness travel. People that acquire a higher educational degree, most of them are married put emphasis about what is important in life and discover the real purpose of their existence.
Are we there yet? Travel vaccinations for Australian children.
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.
Pre-travel advice: an overview.
Sanford, Christopher
2002-12-01
The message of the pre-travel provider is necessarily paradoxic. First the provider lists a score of causes of illness and premature demise, and then states, "But it sounds like a great trip and I think you'll have fun." Pre-travel providers need to walk a fine line: they must encourage patients to be cautious but not paranoid, optimistic but realistic. This discussion is complicated further by the fact that risk reduction is not the only consideration; if it were, practitioners would advise patients to remain in the developed world and foray from their homes only to visit health clubs and the fruit-and-vegetable section of grocery stores. A tacit assumption in travel medicine is that some degree of acceptance of heightened risk is tolerated for the benefit of improved quality of life offered by travel abroad. The amount of risk that is reasonable to accept for a given benefit in quality of life yielded by travel cannot be quantified, however. Providers must render judgments on what is "reasonable" and what is not, and this complex decision is based on equal parts medical knowledge and intuition. At one extreme, mountaineers in Nepal have been found to have a 2.4% mortality rate per expedition [83,84]. The travel provider might make the reasonable decision to counsel these travelers to avoid that activity. These travelers most likely will ignore that advice, at which point the provider must endeavor to reduce risk to the extent possible. Other situations in which the provider should advise a change in itinerary or activities include counseling parents who plan to take an infant to high altitude or a pregnant woman who plans to scuba dive. If travelers remain cloistered in their hotel rooms, eating all meals from room service and watching CNN, then it could be suggested that they are overly risk-adverse and might consider foraying out of the hotel, despite the potential associated increased risks to health. Conversely, if travelers find themselves on motorcycles
41 CFR 301-11.10 - Am I required to record departure/arrival dates and times on my travel claim?
2010-07-01
... departure/arrival dates and times on my travel claim? 301-11.10 Section 301-11.10 Public Contracts and... dates and times on my travel claim? You must record the date of departure from, and arrival at, the... visited. You do not have to record departure/arrival times, but you must annotate your travel claim when...
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.
Directory of Open Access Journals (Sweden)
Mohammed Zia
2018-03-01
Full Text Available The Equality-Generalized Travelling Salesman Problem (E-GTSP, which is an extension of the Travelling Salesman Problem (TSP, is stated as follows: given groups of points within a city, like banks, supermarkets, etc., find a minimum cost Hamiltonian cycle that visits each group exactly once. It can model many real-life combinatorial optimization scenarios more efficiently than TSP. This study presents five spatially driven search-algorithms for possible transformation of E-GTSP to TSP by considering the spatial spread of points in a given urban city. Presented algorithms are tested over 15 different cities, classified by their street-network’s fractal-dimension. Obtained results denote that the R-Search algorithm, which selects the points from each group based on their radial separation with respect to the start–end point, is the best search criterion for any E-GTSP to TSP conversion modelled for a city street network. An 8.8% length error has been reported for this algorithm.
2016-2017 Travel Expense Report for Sylvain Dufour, Vice ...
International Development Research Centre (IDRC) Digital Library (Canada)
Beata Bialic
Purpose: Visit to IDRC's Regional Office in Montevideo. Date(s):. 2016-04-01 to 2016-04-10. Destination(s):. Montevideo. Airfare: $5,886.83. Other. Transportation: $67.50. Accommodation: $952.70. Meals and. Incidentals: $1,163.44. Other: $121.80. Total: $8,192.27. Comments: 2016-2017 Travel Expense Report for ...
On the Core of Multiple Longest Traveling Salesman Games
Estevez Fernandez, M.A.; Borm, P.E.M.; Hamers, H.J.M.
2003-01-01
In this paper we introduce multiple longest traveling salesman (MLTS) games. An MLTS game arises from a network in which a salesman has to visit each node (player) precisely once, except its home location, in an order that maximizes the total reward.First it is shown that the value of a coalition of
Pregnancy course and outcome in women traveling to developing countries.
Sammour, Rami N; Bahous, Rabia; Grupper, Moti; Ohel, Gonen; Steinlauf, Shmuel; Schwartz, Eli; Potasman, Israel
2012-01-01
The issue of travel to developing countries during pregnancy has not been sufficiently studied. The aim of this study is to investigate the rate, course, and outcome of pregnancies in women who traveled to developing countries while pregnant, or became pregnant during such travel. Women visiting two major travel clinics in Israel for consultation within the years 2004 to 2009, who were pregnant or declared an intention of becoming pregnant during travel were contacted. This was followed by a telephone interview by an obstetrician with those women who were actually pregnant. Background characteristics, morbidity during travel, and pregnancy course and outcome were collected. Overall 52,430 travelers' records had been screened. Of these, we identified 49 women who were pregnant during their trip, but 3 declined participation. Of the remaining 46 women, 33 were pregnant at departure, and 13 conceived during travel. The incidence of pregnancy during travel was thus 0.93/1000 travelers. Thirty-three women traveled to East Asia, 8 to South and Central America, 5 to Africa. More than two thirds of women received pretravel vaccinations. Adherence to the World Health Organization recommendations regarding food and drink was high (87%) and travelers' diarrhea occurred in only 11% of women. Five of 22 women traveling to malarious areas had taken antimalarial prophylaxis. Six women required medical therapy during travel. Pregnancy outcome was not different from the normal population except for an unusually low rate of preterm delivery. In this cohort, travel to developing countries was not associated with adverse pregnancy outcome. Larger studies are needed to support these findings. © 2012 International Society of Travel Medicine.
Directory of Open Access Journals (Sweden)
Gusti Eka Yuliastuti
2017-03-01
Full Text Available The route of the travel tour packages offered by travel agents is not considered optimum, so the level of satisfaction the tourist is not maximal. Selection of the route of the travel packages included in the traveling salesman problem (TSP. The problem that occurs is uncertain tourists visiting destinations at the best destinations timing hereinafter be referred to as the fuzzy time window problem. Therefore, the authors apply the genetic algorithm to solve the problem. Based on test results obtained optimum solution with the fitness value of 1.3291, a population size of 100, the number of generations of 1000, a combination of CR=0,4 and MR=0.6.
Dullet, Navjit W; Geraghty, Estella M; Kaufman, Taylor; Kissee, Jamie L; King, Jesse; Dharmar, Madan; Smith, Anthony C; Marcin, James P
2017-04-01
The objective of this study was to estimate travel-related and environmental savings resulting from the use of telemedicine for outpatient specialty consultations with a university telemedicine program. The study was designed to retrospectively analyze the telemedicine consultation database at the University of California Davis Health System (UCDHS) between July 1996 and December 2013. Travel distances and travel times were calculated between the patient home, the telemedicine clinic, and the UCDHS in-person clinic. Travel cost savings and environmental impact were calculated by determining differences in mileage reimbursement rate and emissions between those incurred in attending telemedicine appointments and those that would have been incurred if a visit to the hub site had been necessary. There were 19,246 consultations identified among 11,281 unique patients. Telemedicine visits resulted in a total travel distance savings of 5,345,602 miles, a total travel time savings of 4,708,891 minutes or 8.96 years, and a total direct travel cost savings of $2,882,056. The mean per-consultation round-trip distance savings were 278 miles, average travel time savings were 245 minutes, and average cost savings were $156. Telemedicine consultations resulted in a total emissions savings of 1969 metric tons of CO 2 , 50 metric tons of CO, 3.7 metric tons of NO x , and 5.5 metric tons of volatile organic compounds. This study demonstrates the positive impact of a health system's outpatient telemedicine program on patient travel time, patient travel costs, and environmental pollutants. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Directory of Open Access Journals (Sweden)
Andersson Yvonne
2004-09-01
Full Text Available Abstract Background Among human Salmonella Enteritidis infections, phage type 4 has been the dominant phage type in most countries in Western Europe during the last years. This is reflected in Salmonella infections among Swedish travellers returning from abroad. However, there are differences in phage type distribution between the countries, and this has also changed over time. Methods We used data from the Swedish infectious disease register and the national reference laboratory to describe phage type distribution of Salmonella Enteritidis infections in Swedish travellers from 1997 to 2002, and have compared this with national studies conducted in the countries visited. Results Infections among Swedish travellers correlate well with national studies conducted in the countries visited. In 2001 a change in phage type distribution in S. Enteritidis infections among Swedish travellers returning from some countries in southern Europe was observed, and a previously rare phage type (PT 14b became one of the most commonly diagnosed that year, continuing into 2002 and 2003. Conclusions Surveillance of infections among returning travellers can be helpful in detecting emerging infections and outbreaks in tourist destinations. The information needs to be communicated rapidly to all affected countries in order to expedite the implementation of appropriate investigations and preventive measures.
Malaria: prevention in travellers.
Croft, Ashley M
2010-07-12
Malaria transmission occurs most frequently in environments with humidity greater than 60% and ambient temperature of 25 °C to 30 °C. Risks increase with longer visits and depend on activity. Infection can follow a single mosquito bite. Incubation is usually 10 to 14 days but can be up to 18 months depending on the strain of parasite. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug preventive interventions in non-pregnant adult travellers? What are the effects of drug prophylaxis in non-pregnant adult travellers? What are the effects of antimalaria vaccines in adult and child travellers? What are the effects of antimalaria interventions in child travellers, pregnant travellers, and in airline pilots? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 79 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: aerosol insecticides, amodiaquine, air conditioning and electric fans, atovaquone-proguanil, biological control measures, chloroquine (alone or with proguanil), diethyltoluamide (DEET), dietary supplementation, doxycycline, electronic mosquito repellents, full-length and light-coloured clothing, insecticide-treated clothing/nets, mefloquine, mosquito coils and vapourising mats, primaquine, pyrimethamine-dapsone, pyrimethamine-sulfadoxine, smoke, topical (skin-applied) insect repellents, and vaccines.
Characterizing International Travel Behavior from Geotagged Photos: A Case Study of Flickr.
Yuan, Yihong; Medel, Monica
2016-01-01
Recent advances in multimedia and mobile technologies have facilitated large volumes of travel photos to be created and shared online. Although previous studies have utilized geotagged photos to model travel patterns at individual locations, there is limited research on how these datasets can model international travel behavior and inter-country travel flows-a crucial indicator to quantify the interactions between countries in tourism economics. Realizing the necessity to investigate the potential of geotagged photos in tourism geography, this research investigates international travel patterns from two perspectives: 1) We apply a series of indicators (radius of gyration (ROG), number of countries visited, and entropy) to measure the descriptive characteristics of international travel in different countries; 2) By constructing a gravity model of trade, we investigate how distance decay influences the magnitude of international travel flow between geographic entities, and whether (or how much) the popularity of a given destination (defined as the percentage of tourist income in national gross domestic product (GDP)) affects travel choices in different countries. The results provide valuable input to various commercial applications such as individual travel planning and destination suggestions.
Characterizing International Travel Behavior from Geotagged Photos: A Case Study of Flickr.
Directory of Open Access Journals (Sweden)
Yihong Yuan
Full Text Available Recent advances in multimedia and mobile technologies have facilitated large volumes of travel photos to be created and shared online. Although previous studies have utilized geotagged photos to model travel patterns at individual locations, there is limited research on how these datasets can model international travel behavior and inter-country travel flows-a crucial indicator to quantify the interactions between countries in tourism economics. Realizing the necessity to investigate the potential of geotagged photos in tourism geography, this research investigates international travel patterns from two perspectives: 1 We apply a series of indicators (radius of gyration (ROG, number of countries visited, and entropy to measure the descriptive characteristics of international travel in different countries; 2 By constructing a gravity model of trade, we investigate how distance decay influences the magnitude of international travel flow between geographic entities, and whether (or how much the popularity of a given destination (defined as the percentage of tourist income in national gross domestic product (GDP affects travel choices in different countries. The results provide valuable input to various commercial applications such as individual travel planning and destination suggestions.
Current State of Travel Industry in the Republic of Abkhazia
Directory of Open Access Journals (Sweden)
Irma V. Tsulaya
2012-05-01
Full Text Available Analysis of travel industry activity of the last few years showed that the popularity of Abkhazia as a tourist destination tends to increase, which is indicated by the figures of Abkhazia visits by tourists. Besides, the number of tour routes increase and the service sector develops.
Directory of Open Access Journals (Sweden)
H. Amirnejad
2016-03-01
for the revealed and the expressed travel costs and total travel costs. Results Discussion: Collected data shows that the average age of visitors is 31 years. Most of them are young, 66% of visitors are male and the rest are female. Most of the respondents chose the spring season for visiting Sofeh Park. Results of negative binomial regression estimation showed that age, income, distance and the revealed and total travel cost have a significant effect on the total number of visits in both scenarios. Age and income coefficients are positive. Thus, these variables have a direct effect on the number of visit in both scenarios. But distance and travel cost coefficients are negative. Therefore, these variables have a reverse effect on the total number of visits in both scenarios. These results confirm the demand law. The law of demand states that the quantity demanded and the price of a commodity are inversely related. Travel cost as commodity price for tourism demand function in the first scenario is only revealed -travel- cost of trip to location and in the second scenario is the revealed cost in addition to the opportunity cost of trip to the recreational location. Consumer surplus as the average value of environmental amenities is calculated by1/ , where is the coefficient related to travel cost variable in the tourism demand functions. Also, the average value of environmental amenities for anyone visit in the first and the second scenarios are 797 and 1145 thousand Rials, respectively. The obvious difference between recreational values in the two scenarios is due to opportunity cost. The total recreational value of the Sofeh Highland Park equals to the product of number of annual visits and average recreational value. Finally the total value of annual visits to the park, in the above scenarios is more than 11952 and 17174 billion Rials, respectively. Conclusion: In this study, the value of environmental amenities of the Sofeh Highland Park were estimated. Notice that
Calleri, G.; Behrens, R.H.; Schmid, M.L.; Gobbi, F.; Grobusch, M.P.; Castelli, F.; Gascon, J.; Bisoffi, Z.; Jelinek, T.; Caramello, P.
2011-01-01
Background: Numbers of travellers visiting friends and relatives (VFRs) from Europe to malaria endemic countries are increasing and include long-term and second generation immigrants, who represent the major burden of malaria cases imported back into Europe. Most recommendations for malaria
Calleri, Guido; Behrens, Ron H.; Schmid, Matthias L.; Gobbi, Federico; Grobusch, Martin P.; Castelli, Francesco; Gascon, Joaquim; Bisoffi, Zeno; Jelinek, Tomas; Caramello, Pietro; Atouguia, J.; Berg, A.; Clerinx, J.; Cuadros, J.; da Cunha, S.; Develoux, M.; Fry, G.; Genton, B.; Gjorup, I.; Hatz, C.; Hellgren, U.; Kern, P.; Kapaun, A.; Lucchini, A.; Morch, K.; Munoz, J.; Myrvang, B.; Paul, M.; Puente, S.; Siikamaki, H.
2011-01-01
Numbers of travellers visiting friends and relatives (VFRs) from Europe to malaria endemic countries are increasing and include long-term and second generation immigrants, who represent the major burden of malaria cases imported back into Europe. Most recommendations for malaria chemoprophylaxis
Transportation cost of anticoagulation clinic visits in an urban setting.
Hwang, Jamie M; Clemente, Jennifer; Sharma, Krishna P; Taylor, Thomas N; Garwood, Candice L
2011-10-01
Patients being managed on warfarin make frequent or regular visits to anticoagulation monitoring appointments. International studies have evaluated transportation cost and associated time related to anticoagulation clinic visits. To our knowledge, no studies have evaluated the cost of transportation to such clinic visits in the United States. To describe the methods of transportation and estimate the average total cost of transportation to and from an anticoagulation clinic in an urban setting. We prospectively conducted a survey of patients treated at the Harper Anticoagulation Clinic located in Detroit, Michigan, during November 2010. The survey was given to patients while waiting at their regularly scheduled clinic appointments and included questions regarding mode of transportation, distance traveled in miles, parking payment, and time missed from work for clinic appointments. The mean distance traveled was translated into cost assuming 50 cents per mile based on 2010 estimates by the Internal Revenue Service. Sixty patients responded to the 11-item survey; response rates for individual items varied because participants were instructed to skip questions that did not pertain to them. Of the 47 participants responding to demographic questions, 70.2% were female, and 46.8% were older than 60 years. Transportation by private vehicle (80.0%), either driven by patients (41.7%) or someone else (38.3%), was the most common method reported. Use of private automobile translated into a cost of $11.19 per round trip. Other means of transportation identified include a ride from a medical transportation service (10.0%), bus (5.0%), walking (3.3%), and taxi (1.7%). The mean (SD) distance traveled to the clinic for all methods of transportation was 8.34 (7.7) miles. We estimated the average cost of round-trip transportation to be $10.78 weighted for all transportation modes. This is a direct nonmedical cost that is paid for by most patients out of pocket. However, 9 of 44 (20
Malaria chemoprophylaxis of 3,446 French travelers departing from Paris to eight tropical countries.
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.
Escutia, Gabriela; McDonald, Eric; Rodríguez-Lainz, Alfonso; Healy, Jessica
2018-06-01
Most Zika disease cases diagnosed in the continental US have been associated with travel to areas with risk of Zika transmission, mainly the Caribbean and Latin America. Limited information has been published about the demographic and travel characteristics of Zika case-patients in the United States, besides their age and gender. During 2016-2017 the County of San Diego Health and Human Services Agency, California, expanded the scope and completeness of demographic and travel information collected from Zika case-patients for public health surveillance purposes. The majority (53.8%) of travel-related Zika virus infection case-patients (n = 78) in the county were Hispanic, significantly higher (p ≤ 0.05) than the 33.0% of Hispanics in the county. Foreign-born residents, mainly from Mexico, were also overrepresented among cases compared to their share in the county population (33.3 vs. 23.0%; p ≤ 0.05). Seventeen (21.8%) patients reported a primary language other than English (14 Spanish). Most case-patients traveled for tourism (54%) or to visit friends and relatives (36%). This surveillance information helps identify higher-risk populations and implement culturally targeted interventions for Zika prevention and control.
Morbidity and outcomes of foreign travelers in Zakynthos island, Greece: a retrospective study.
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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.
Virtual visits and Hangouts – how cool is CERN…
Joannah Caborn Wengler
2012-01-01
New media are really making the world smaller. Using a simple lap-top and Vidyo® or Google Hangouts, you can visit experiments’ control rooms and ask physicists those questions you always wanted to ask, all from the comfort of your own home. Here’s how a few people connected with CERN recently. Students from the Al-Quds University in the Palestinian West Bank participating in the ATLAS virtual visit. It was an old-fashioned aeroplane which took Kate Shaw of the Udine ICTP (Italy) ATLAS group to give a particle physics master class to about 20 students from Al-Quds University in the Palestinian West Bank, but it was via the ether that they were able to take a virtual visit of the ATLAS control room on 2 April. Without having to deal with with the complications of international air travel, they were able to see the experts, monitors and screens via two remote controlled cameras mounted on the ceiling of the ATLAS control room. By the door there is another screen, w...
Disaster-related fatalities among US citizens traveling abroad.
Partridge, Robert; Bouslough, David; Proano, Lawrence
2013-01-01
To describe the locations and risk of death associated with natural disaster fatalities for US citizens traveling abroad. A retrospective database review of US citizen disaster deaths occurring worldwide. None. Information on fatalities due to disasters was abstracted from the US Department of State Web site reporting deaths of US citizens abroad by non-natural causes from October 2002 through June 2012. The main outcome measures were the frequency of disaster deaths and countries where disasters occurred. Descriptive statistics and rates were used to evaluate the study data. There were 7,963 total non-natural deaths of US citizens traveling abroad during the study period. Of these, 163 (2.0 percent) were disaster-related deaths, involving 19 disaster events in 15 countries. Only two disaster-related events resulted in more than two deaths of US travelers-the 2010 earthquake in Haiti causing 121 fatalities (74.2 percent of disaster deaths), and the 2004 tsunami in Thailand causing 22 fatalities (13.5 percent of disaster deaths). The approximate annual mean death rate for US citizen travelers as a result of disaster events is 0.27 deaths/1 million travelers, compared with 1.4 deaths/1 million residents due to disaster annually within the United States. The risk of disaster-related fatality is low for US citizens traveling abroad. Although disaster-related death among travelers is unpredictable, during a period of almost 10 years, there was only one reported death due to disaster in the five countries most frequently visited by US travelers. Further investigation may identify population-, seasonal-, country-, or location-specific risks from which prevention strategies can be developed.
Management of the returning traveler with diarrhea.
de Saussure, Philippe P H
2009-11-01
Traveler's diarrhea (TD) strikes 20-60% of travelers visiting developing countries. It occurs shortly after the return and can be distinguished into two categories: acute and persistent TD. Acute TD, mostly caused by bacterial and viral pathogens, is usually mild and self-limited, and deserves empirical symptomatic and/or antibiotic therapy in selected cases. Fluoroquinolones are progressively superseded in this indication by azithromycin, a well tolerated macrolide active against most bacteria responsible for TD, including the quinolone-resistant species of Campylobacter jejuni that are now pervasive, especially in Southeast Asia and India. Persistent TD in the returning traveler is much rarer than its acute counterpart and may be associated with three types of causes. Persistent infections, among which Giardia and possibly Entamoeba predominate, account for a significant proportion of cases. Postinfectious processes represent a second cause and comprise temporary lactose malabsorption and postinfectious irritable bowel syndrome, now considered a major cause of persistent TD. Finally, apparently unrelated chronic diseases causing diarrhea are occasionally unmasked by TD and represent a third type of persistent TD, among which the well established case of incident inflammatory bowel disease poses intriguing pathogenesis questions. This review discusses recent advances in the field and provides practical recommendations for the management of TD in adult, immunocompetent returning travelers.
Noser, Rahel; Byrne, Richard W
2010-01-01
How do humans and animals travel between multiple destinations on a given foraging trip? This question is of theoretical and practical interest, yet few empirical data exist to date. We examined how a group of wild chacma baboons travelled among multiple, simultaneously fruiting mountain fig trees (Ficus glumosa). In the course of a 16-month study, this highly preferred fruit was available during a 3-week period, from relatively few sites, which were also utilized by four larger baboon groups. We used directness of route and travel speed of 13 days of observation, and approach rates of 31 days of observation to differentiate between purposeful and opportunistic encounters with 50 fig trees. The study group visited a total of 30 fig trees overall, but only 8 trees per day on average. Each morning, they travelled along a highly repetitive route on all days of observation, thereby visiting 2-4 fig trees. They approached these trees rapidly along highly directed paths without intermittently exploiting other food sources that were available in large quantities. Then, they abruptly changed behaviour, switching to lower travel speed and less directed routes as they foraged on a variety of foods. They approached additional fig trees later in the day, but approach rates were similar to those at times of year when fruit of this fig species was unavailable; this suggested that encounters with trees after the behavioural switch were not planned. Comparing visits to purposefully and opportunistically encountered trees, we found no difference in the average time spent feeding or frequency of feeding supplants, suggesting that purposefully and opportunistically visited trees had similar values. We conclude that when foraging for mountain fig fruit the baboons' cognitive maps either contain information on relatively few trees or of only a single route along which several trees are situated, leading to very limited planning abilities.
On the road for education: Turning business travel into E/PO opportunities
Richardson, A.; Jasnow, M.; Srinivasan, M.; Rosmorduc, M.; Blanc, F.
2003-04-01
One seemingly universal characteristic of the research scientist and their associates is the necessity for travel. Members of the joint NASA/CNES TOPEX/Poseidon/Jason-1 (T/P/J) Education and Public Outreach Team are promoting a concept that benefits both the scientist on business travel, and the general public. "On the Road for Education" is a program whereby members of the Project take a few hours in their travel schedule to visit a school, informal education venue, or a community group located in the destination city. Formal and informal educators, and civic group officers always welcome visits by professional scientists to give lectures on their research activities, do some hands-on demonstrations in a science center, or just talk to a group of students about career opportunities in science and engineering. The T/P/J outreach team has an educator mailing list that includes members across the country. When contacted in advance of a science team member's travel schedule, outreach team members are happy to locate a school, museum or science center in or near the destination city and arrange an outreach opportunity for the scientist. We can also provide support with handouts for both public and educational uses. It is a goal of NASA to inspire the public and the next generation of explorers. "On the Road for Education" provides an easy mechanism for involvement by any scientist, and may help to make that next business trip even more enjoyable.
Travelling to china for the beijing 2008 olympic and paralympic games.
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.
Sick-visit immunizations and delayed well-baby visits.
Robison, Steve G
2013-07-01
Giving recommended immunizations during sick visits for minor and acute illness such as acute otitis media has long been an American Academy of Pediatrics/Advisory Committee on Immunization Practice recommendation. An addition to the American Academy of Pediatrics policy in 2010 advised considering whether giving immunizations at the sick visit would discourage making up missed well-baby visits. This study quantifies the potential tradeoff between sick-visit immunizations and well-baby visits. This study was a retrospective cohort analysis with a case-control component of sick visits for acute otitis media that supplanted normal well-baby visits at age 2, 4, or 6 months. Infants were stratified for sick-visit immunization, no sick-visit immunization but quick makeup well-baby visits, or no sick-visit immunizations or quick makeup visits. Immunization rates and well-baby visit rates were assessed through 24 months of age. For 1060 study cases, no significant difference was detected in immunization rates or well-baby visits through 24 months of age between those with or without sick-visit immunizations. Thirty-nine percent of infants without a sick-visit shot failed to return for a quick makeup well-baby visit; this delayed group was significantly less likely to be up-to-date for immunizations (relative risk: 0.66) and had fewer well-baby visits (mean: 3.8) from 2 through 24 months of age compared with those with sick-visit shots (mean: 4.7). The substantial risk that infants will not return for a timely makeup well-baby visit after a sick visit should be included in any consideration of whether to delay immunizations.
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
On a model of spatial spread of epidemics with long-distance travel
International Nuclear Information System (INIS)
Blyuss, Konstantin B.
2005-01-01
This Letter studies the dynamics of infectious diseases which are spread geographically through long-distance travel between two regions and subsequent local redistribution through a process of diffusion. A particular case of an equiproportionate travel is considered, and the model describes migration rather than short visits. We examine uniform and nonuniform steady states together with their linear stability. Numerical simulations are performed to illustrate the evolution of initial distribution of population towards its final stage, which is represented by uniform distribution of the total population among infected individuals
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
Estimating the demand for drop-off recycling sites: a random utility travel cost approach.
Sidique, Shaufique F; Lupi, Frank; Joshi, Satish V
2013-09-30
Drop-off recycling is one of the most widely adopted recycling programs in the United States. Despite its wide implementation, relatively little literature addresses the demand for drop-off recycling. This study examines the demand for drop-off recycling sites as a function of travel costs and various site characteristics using the random utility model (RUM). The findings of this study indicate that increased travel costs significantly reduce the frequency of visits to drop-off sites implying that the usage pattern of a site is influenced by its location relative to where people live. This study also demonstrates that site specific characteristics such as hours of operation, the number of recyclables accepted, acceptance of commingled recyclables, and acceptance of yard-waste affect the frequency of visits to drop-off sites. Copyright © 2013 Elsevier Ltd. All rights reserved.
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
The number of HIV-infected individuals from developed countries travelling to tropical and subtropical areas has increased as a result of the clinical and survival benefits of combination antiretroviral therapy. The aim of our study was to describe the traveler population in the SHCS and to determine the frequency of viral rebound in virologically suppressed individuals after a travel episode to the tropics compared to non-travelers. Swiss HIV Cohort Study participants with at least one follow-up visit between 1 January 1989 and 28 February 2015 were eligible for inclusion in the study. The primary outcome was the occurrence of viral rebound (viral load > 200 HIV-1 RNA copies/mL) after a travel episode compared with a nontravel episode in previously suppressed individuals (≤ 200 copies/mL). All virologically suppressed patients contributed multiple travel or nontravel episodes to the analysis. Logistic regression was performed including factors associated with viral rebound. We included 16 635 patients in the study, of whom 6084 (36.5%) had ever travelled to the tropics. Travel frequency increased over time, with travellers showing better HIV parameters than nontravellers [less advanced Centers for Disease Control and Prevention (CDC) stage and higher CD4 count nadir]. Viral rebound was seen in 477 (3.9%) of 12 265 travel episodes and in 5121 (4.5%) of 114 884 nontravel episodes [unadjusted odds ratio (OR) 0.87; 95% confidence interval (CI) 0.78-0.97]. Among these 477 post-travel viral rebounds, 115 had a resistance test performed and 51 (44%) of these showed new resistance mutations. Compared with European and North American patients, the odds for viral rebound were significantly lower in Southeast Asian (OR 0.67; 95% CI 0.51-0.88) and higher in sub-Saharan African (SSA) patients (OR 1.41; 95% CI 1.22-1.62). Travel further increased the odds of viral rebound in SSA patients (OR 2.00; 95% CI 1.53-2.61). Region of origin is the main risk factor for viral rebound
Suzana, Mariyam; Walls, Helen; Smith, Richard; Hanefeld, Johanna
2018-06-19
The resolution adopted in 2006 by the World Health Organization on international trade and health urges Member States to understand the implications of international trade and trade agreements for health and to address any challenges arising through policies and regulations. The government of Maldives is an importer of health services (with outgoing medical travelers), through offering a comprehensive universal health care package for its people that includes subsidized treatment abroad for services unavailable in the country. By the end of the first year of the scheme approximately US$11.6 m had been spent by the government of Maldives to treat patients abroad. In this study, affordability, continuity and quality of this care were assessed from the perspective of the medical traveler to provide recommendations for safer and more cost effective medical travel policy. Despite universal health care, a substantial proportion of Maldivian travelers have not accessed the government subsidy, and a third reported not having sufficient funds for the treatment episode abroad. Among the five most visited hospitals in this study, none were JCI accredited at the time of the study period and only three from India had undergone the National Accreditation Board for Hospitals (NABH) in India. Satisfaction with treatment received was high amongst travelers but concern for the continuity of care was very high, and more than a third of the patients had experienced complications arising from the treatment overseas. Source countries can use their bargaining power in the trade of health services to offer a more comprehensive package for medical travelers. Source countries with largely public funded health systems need to ensure that medical travel is truly affordable and universal, with measures for quality control such as the use of accredited foreign hospitals to make it safer and to impose measures that ensure the continuity of care for travelers.
Rothstein, Brooke E; Gonzalez, Jessica; Cunningham, Kiera; Saraiya, Ami; Dornelles, Adriana C; Nguyen, Bichchau M
2017-12-01
The direct and indirect costs of dermatology clinic visits are infrequently quantified. Indirect costs, such as the time spent traveling to and from appointments and the value of lost earnings from time away from work, are substantial costs that often are not included in economic analyses but may pose barriers to receiving care. Due to the national shortage of dermatologists, patients may have to wait longer for appointments or travel further to see dermatologists outside of their local community, resulting in high time and travel costs for patients. Patients' lost time and earnings comprise the opportunity cost of obtaining care. A monetary value for this opportunity cost can be calculated by multiplying a patient's hourly wage by the number of hours that the patient dedicated to attending the dermatology appointment. Using a single institution survey, this study quantified the direct and indirect patient costs, including opportunity costs and time burden, associated with dermatology clinic visits to better appreciate the impact of these factors on health care access and dermatologic provider preference.
Individual single-site travel cost model for Czech paradise geopark
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Jan Špaček
2013-01-01
Full Text Available Geotourism is a new phenomenon, which has emerged in the tourism literature during the past two decades, and whose meaning suffered from global census. Geotourism is still a new discipline and relatively little has been written about its demand side, demonstrated by a lack of studies in the literature This article studies the recreational value of geotourism areas, and focuses on the first geopark in the Czech Republic, namely the Czech Paradise Geopark. To assess the recreational value the travel cost method is applied, specifically the individual travel cost model. The necessary research data was gathered through intensive tourist surveys conducted in the study area. Data gathered in the respondents’ survey served to determine the consumer surplus as a measure of recreational value and to develop the single site travel cost model. The dependent variable in the conducted model is the number of visits in the area and among the independent variables, studied age, education, travel cost, family status, economic activity and income. The results were subsequently compared to findings in the available literature, research works and case studies.
Distance traveled and frequency of interstate opioid dispensing in opioid shoppers and nonshoppers.
Cepeda, M Soledad; Fife, Daniel; Yuan, Yingli; Mastrogiovanni, Greg
2013-10-01
Little is known about how far opioid shoppers travel or how often they cross state lines to fill their opioid prescriptions. This retrospective cohort study evaluated these measures for opioid shoppers and nonshoppers using a large U.S. prescription database. Patients with ≥3 opioid dispensings were followed for 18 months. A subject was considered a shopper when he or she filled overlapping opioid prescriptions written by >1 prescriber at ≥3 pharmacies. A heavy shopper had ≥5 shopping episodes. Outcomes assessed were distance traveled among pharmacies and number of states visited to fill opioid prescriptions. A total of 10,910,451 subjects were included; .7% developed any shopping behavior and their prescriptions accounted for 8.6% of all opioid dispensings. Shoppers and heavy shoppers were younger than the nonshoppers. Shoppers traveled a median of 83.8 miles, heavy shoppers 199.5 miles, and nonshoppers 0 miles. Almost 20% of shoppers or heavy shoppers, but only 4% of nonshoppers, visited >1 state. Shoppers traveled greater distances and more often crossed state borders to fill opioid prescriptions than nonshoppers, and their dispensings accounted for a disproportionate number of opioid dispensings. Sharing of data among prescription-monitoring programs will likely strengthen those programs and may decrease shopping behavior. This study shows that opioid shoppers travel greater distances and more often cross state borders to fill opioid prescriptions than nonshoppers, and their dispensings accounted for a disproportionate number of opioid dispensings. The findings support the need for data sharing among prescription-monitoring programs to deter opioid shopping behavior. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
Sistem Informasi Geografis Tour Dan Travel Berbasis Android Di Kabupaten Tegal
Directory of Open Access Journals (Sweden)
Farijz Milzan
2016-04-01
Full Text Available The development of a device move technology , facilitate human life in undergo kesehariannya .To progress , technology device move could determine the existence of users , find out which address want to intended , and give a route to the location .The use of devices movement for the district government tegal , and students tegal in particular made them in the visits to the agent travel and tourism tegal spread across the country .Needed a system that help you in seeking information on travel agent and tourist tegal especially for students and the tegal problems that hampered by the agent the location. The geographic information system created using the Java programming language with SDK (Software Development Kit Android and using MySQL and SQLite databases, the system is a client-server. The process of making and development of Geographic Information System using SDLC (Software Development Life Cycle using prototyping life cycle. By using the life cycle of prototyping, the design can be quickly created and tested by users. Users can participate in helping the development of a system to provide feedback on the prototype that has been tried before, so that the system be made better. The result of design this program is a system for the geographic information on device move that would facilitate users in find information and to travel agent and tourist attractions contained in district tegal .Information systems geographical location use technology LBS ( location based service , this technology allows users to find the location of travel agent and tourist destinations want to visited .This system will developed in a move that runs the android operating system.
Flores, Jose; DuPont, Herbert L.; Lee, Stephanie A.; Belkind-Gerson, Jaime; Paredes, Mercedes; Mohamed, Jamal A.; Armitige, Lisa Y.; Guo, Dong-Chuan; Okhuysen, Pablo C.
2008-01-01
Up to 60% of U.S. visitors to Mexico develop traveler's diarrhea (TD), mostly due to enterotoxigenic Escherichia coli (ETEC) strains that produce heat-labile (LT) and/or heat-stable (ST) enterotoxins. Distinct single-nucleotide polymorphisms (SNPs) within the interleukin-10 (IL-10) promoter have been associated with high, intermediate, or low production of IL-10. We conducted a prospective study to investigate the association of SNPs in the IL-10 promoter and the occurrence of TD in ETEC LT-exposed travelers. Sera from U.S. travelers to Mexico collected on arrival and departure were studied for ETEC LT seroconversion by using cholera toxin as the antigen. Pyrosequencing was performed to genotype IL-10 SNPs. Stools from subjects who developed diarrhea were also studied for other enteropathogens. One hundred twenty-one of 569 (21.3%) travelers seroconverted to ETEC LT, and among them 75 (62%) developed diarrhea. Symptomatic seroconversion was more commonly seen in subjects who carried a genotype producing high levels of IL-10; it was seen in 83% of subjects with the GG genotype versus 54% of subjects with the AA genotype at IL-10 gene position −1082 (P, 0.02), in 71% of those with the CC genotype versus 33% of those with the TT genotype at position −819 (P, 0.005), and in 71% of those with the CC genotype versus 38% of those with the AA genotype at position −592 (P, 0.02). Travelers with the GCC haplotype were more likely to have symptomatic seroconversion than those with the ATA haplotype (71% versus 38%; P, 0.002). Travelers genetically predisposed to produce high levels of IL-10 were more likely to experience symptomatic ETEC TD. PMID:18579697
Flores, Jose; DuPont, Herbert L; Lee, Stephanie A; Belkind-Gerson, Jaime; Paredes, Mercedes; Mohamed, Jamal A; Armitige, Lisa Y; Guo, Dong-Chuan; Okhuysen, Pablo C
2008-08-01
Up to 60% of U.S. visitors to Mexico develop traveler's diarrhea (TD), mostly due to enterotoxigenic Escherichia coli (ETEC) strains that produce heat-labile (LT) and/or heat-stable (ST) enterotoxins. Distinct single-nucleotide polymorphisms (SNPs) within the interleukin-10 (IL-10) promoter have been associated with high, intermediate, or low production of IL-10. We conducted a prospective study to investigate the association of SNPs in the IL-10 promoter and the occurrence of TD in ETEC LT-exposed travelers. Sera from U.S. travelers to Mexico collected on arrival and departure were studied for ETEC LT seroconversion by using cholera toxin as the antigen. Pyrosequencing was performed to genotype IL-10 SNPs. Stools from subjects who developed diarrhea were also studied for other enteropathogens. One hundred twenty-one of 569 (21.3%) travelers seroconverted to ETEC LT, and among them 75 (62%) developed diarrhea. Symptomatic seroconversion was more commonly seen in subjects who carried a genotype producing high levels of IL-10; it was seen in 83% of subjects with the GG genotype versus 54% of subjects with the AA genotype at IL-10 gene position -1082 (P, 0.02), in 71% of those with the CC genotype versus 33% of those with the TT genotype at position -819 (P, 0.005), and in 71% of those with the CC genotype versus 38% of those with the AA genotype at position -592 (P, 0.02). Travelers with the GCC haplotype were more likely to have symptomatic seroconversion than those with the ATA haplotype (71% versus 38%; P, 0.002). Travelers genetically predisposed to produce high levels of IL-10 were more likely to experience symptomatic ETEC TD.
Traveling to Australia for the Sydney 2000 Olympic and Paralympic Games.
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.
In Pursuit of the Traveling Salesman Mathematics at the Limits of Computation
Cook, William J
2011-01-01
What is the shortest possible route for a traveling salesman seeking to visit each city on a list exactly once and return to his city of origin? It sounds simple enough, yet the traveling salesman problem is one of the most intensely studied puzzles in applied mathematics--and it has defied solution to this day. In this book, William Cook takes readers on a mathematical excursion, picking up the salesman's trail in the 1800s when Irish mathematician W. R. Hamilton first defined the problem, and venturing to the furthest limits of today's state-of-the-art attempts to solve it. Cook examines
Patient awareness of need for hepatitis a vaccination (prophylaxis) before international travel.
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.
Visiting the Republic of Cuba: An Experience to Remember.
Brown, Geraldine
2015-01-01
A few years ago, I was privileged to visit the Republic of Cuba as a summer vacation. Officially, this Spanish island is the largest island in the Caribbean, with more than 12 million people. It is only second as being most populous after Hispaniola with its people, culture and customs. Havana is the capital and Cuba's largest city. The United States lies to the immediate north only about 95 miles away, and the Bahamas and Mexico to the west, the Cayman Islands and Jamaica are on the southern end, and Haiti and the Dominion Republic are in the southeastern area. The history of this island is truly amazing. I was able to vist a hospital, and ride public transportation (bus). The trip was made at the time when Cuba was not open to travelers coming direct from the United States. I traveled to Montreal, Canada to board Cabana Arlines to Havana, Cuba.
Determinants of Adherence with Malaria Chemoprophylactic Drugs Used in a Traveler's Health Clinic
Shady, Ibrahim
2015-01-01
Background. The WHO recommends mefloquine, atovaquone/proguanil, and doxycycline for malaria chemoprophylaxis. Adherence to a drug is determined by many factors. Objective. To detect the determinants of travelers' adherence to malaria chemoprophylaxis. Methods. A prospective comparative study was conducted from January 2012 to July 2013 that included travelers (928 travelers) to malaria endemic countries who visited the THC. They were classified into 3 groups: the 1st is the mefloquine group (396 travelers), the 2nd is the doxycycline group (370 travelers), and finally those who did not receive any drugs (162 travelers). The participants from the 1st and 2nd groups enrolled in the study. Results. Univariate and multivariate analyses were performed. The predictors for adherence in the mefloquine group were travel to an African destination [OR = 51 (6.8–2385)], higher than a secondary school education [OR = 21 (4.1–144.2)], organized travel [OR = 4 (2.1–6.5)], traveling for leisure [OR = 2.1 (1.1–0.4)], and nationality [OR = 2 (1.11–4.00)]. In the doxycycline group, the predictors included higher than a secondary education [OR = 20.1 (4.5–125.1)], organized travel [OR = 11.4 (5.5–20.9)], travel for leisure [OR = 7 (2.3–22.9)], travel to an African destination [OR = 6.1 (0.41–417)], and nationality [OR = 4.5 (2.3–9.5)]. Conclusion. Adherence with malaria chemoprophylaxis could be affected by many factors such as nationality, education, and organized travel. PMID:26379712
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.
McGrail, Matthew Richard; Humphreys, John Stirling; Ward, Bernadette
2015-05-29
Poor access to doctors at times of need remains a significant impediment to achieving good health for many rural residents. The two-step floating catchment area (2SFCA) method has emerged as a key tool for measuring healthcare access in rural areas. However, the choice of catchment size, a key component of the 2SFCA method, is problematic because little is known about the distance tolerance of rural residents for health-related travel. Our study sought new evidence to test the hypothesis that residents of sparsely settled rural areas are prepared to travel further than residents of closely settled rural areas when accessing primary health care at times of need. A questionnaire survey of residents in five small rural communities of Victoria and New South Wales in Australia was used. The two outcome measures were current travel time to visit their usual doctor and maximum time prepared to travel to visit a doctor, both for non-emergency care. Kaplan-Meier charts were used to compare the association between increased distance and decreased travel propensity for closely-settled and sparsely-settled areas, and ordinal multivariate regression models tested significance after controlling for health-related travel moderating factors and town clustering. A total of 1079 questionnaires were completed with 363 from residents in closely-settled locations and 716 from residents in sparsely-settled areas. Residents of sparsely-settled communities travel, on average, 10 min further than residents of closely-settled communities (26.3 vs 16.9 min, p time prepared to travel (54.1 vs 31.9 min, p time remained significant after controlling for demographic and other constraints to access, such as transport availability or difficulties getting doctor appointments, as well as after controlling for town clustering and current travel times. Improved geographical access remains a key issue underpinning health policies designed to improve the provision of rural primary health care
Increase in imported malaria in the Netherlands in asylum seekers and VFR travellers.
de Gier, Brechje; Suryapranata, Franciska S T; Croughs, Mieke; van Genderen, Perry J J; Keuter, Monique; Visser, Leo G; van Vugt, Michele; Sonder, Gerard J B
2017-02-02
Malaria is a notifiable disease in the Netherlands, a non-endemic country. Imported malaria infections occur regularly among travellers, migrants and visitors. Surveillance data were analysed from 2008 to 2015. Trends in amounts of notifications among risk groups were analysed using Poisson regression. For asylum seekers, yearly incidence was calculated per region of origin, using national asylum request statistics as denominator data. For tourists, denominator data were used from travel statistics to estimate incidence per travel region up to 2012. A modest increase in overall imported malaria notifications occurred in 2008-2015 (from 222 in 2008 to 344 in 2015). Notably, in 2014 and 2015 sharp increases were seen in malaria among travellers visiting friends and relatives (VFR), and in asylum seekers. Of all Plasmodium falciparum infections, most (1254/1337; 93.8%) were imported from Africa; 1037/1337 (77.6%) were imported from Central and West Africa. Malaria in VFR was mostly caused by P. falciparum infection after visiting Ghana (22%) or Nigeria (19%). Malaria in asylum seekers was mostly caused by Plasmodium vivax infection from the Horn of Africa. The large number of notifications in asylum seekers resulted from both an increase in number of asylum seekers and a striking increase of malaria incidence in this group. Incidence of malaria in asylum seekers from the Horn of Africa ranged between 0.02 and 0.3% in 2008-2013, but rose to 1.6% in 2014 and 1.3% in 2015. In 2008-2012, incidence in tourists visiting Central and West Africa dropped markedly. Imported malaria is on the rise again in the Netherlands, most notably since 2013. This is mostly due to immigration of asylum seekers from the Horn of Africa. The predominance of P. vivax infection among asylum seekers warrants vigilance in health workers when a migrant presents with fever, as relapses of this type of malaria can occur long after arrival in the Netherlands.
Yen, Irene H; Leung, Cindy W; Lan, Mars; Sarrafzadeh, Majid; Kayekjian, Karen C; Duru, O Kenrik
2015-04-01
Some studies indicate that older adults lead active lives and travel to many destinations including those not in their immediate residential neighborhoods. We used global positioning system (GPS) devices to track the travel patterns of 40 older adults (mean age: 69) in San Francisco and Los Angeles. Study participants wore the GPS devices for 7 days in fall 2010 and winter 2011. We collected survey responses concurrently about travel patterns. GPS data showed a mean of four trips/day, and a mean trip distance of 7.6 km. Survey data indicated that older adults commonly made trips for four activities (e.g., volunteering, work, visiting friends) at least once each week. Older adults regularly travel outside their residential neighborhoods. GPS can document the mode of travel, the path of travel, and the destinations. Surveys can document the purpose of the travel and the impressions or experiences in the specific locations. © The Author(s) 2013.
New Italian guidelines for malaria prophylaxis in travellers to endemic areas.
Calleri, G; Castelli, F; El Hamad, I; Gobbi, F; Matteelli, A; Napoletano, G; Romi, R; Rossanese, A; Italian Society of Tropical Medicine
2014-02-01
As a consequence of the rapid evolution of malaria prophylaxis recommendations throughout the world, the Italian Society of Tropical Medicine (SIMET-Società Italiana di Medicina Tropicale) has set up a working group in charge of preparing a new national guideline. Other scientific societies interested in the topic were also involved in the project. The group stated that awareness about malaria risk and characteristics, as well as protection from mosquito bites, are recommended for all travellers visiting malaria-endemic countries. The risk and benefit of malaria chemoprophylaxis must be carefully balanced before prescribing drugs: the disease-related risk must outweigh the possibility of drugs' side effects. As a general rule, malaria pills are the first choice for travellers to high-risk areas, such as sub-Saharan Africa, Eastern India, Myanmar, Eastern Indonesia, Papua New Guinea and, with some limitations, South-East Asia, and the Amazon part of Venezuela, Guyana and French Guyana. However, several other factors, such as itinerary, season, duration of trip, availability of insect bite protection, pre-existing conditions and compliance, must be taken into account. In low-risk areas, stand-by emergency treatment is the first option. In minimal-risk areas and in Plasmodium vivax areas, a prompt diagnosis only is advised (Central America, South America outside the Amazon basin, Middle East, China, Thailand, Nepal). Recommendations may be modified when particular groups of travellers are concerned, such as long-term residents, visiting friends and relatives, patients with pre-existing conditions, pregnant women and children.
Photographing travel of classical windturbines in Europe; Oshu Koen fusha satsuei ryoko
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Suzuki, H.
1997-03-01
Travel in Europe for taking photographs of classical windturbines is reported. The Netherlands which is a representative windturbine country, Spain which is a theme country of this travel, Greece which is a root country of the windmills, and the UK with the Windturbine Museum were visited. In the Netherlands, photographs of Kinder d`eiche Windturbine, Leiden de Valk Windturbine Museum, and a windturbine in the south end of Amstle Park were taken. Photographs of don Quijote Windturbine at Campo de Criptana in Spain, and Crete Windturbine and sail-type windturbine in the Rhodes Island, Greece were taken. In the UK, the Windturbine Museum was visited at Wimbledon. After coming back to Japan, films were exposed. The walls of windturbines were dark due to insufficient exposure against the light sky. In spite of consideration of the exposure, 70% of the photographs of windturbine walls were still dark. Only 10% of them can be available. This may be a limit of amateur photographer. Professional photographer may be complete. 12 figs.
Guardians' Perceptions of Cats' Welfare and Behavior Regarding Visiting Veterinary Clinics.
Mariti, Chiara; Bowen, Jonathan E; Campa, Sonia; Grebe, Gabriele; Sighieri, Claudio; Gazzano, Angelo
2016-01-01
To assess the welfare of cats at the veterinary clinic and how caregivers and veterinarians affect it, a survey of Italian cat guardians (n = 1,111) was conducted using a 28-item multichoice questionnaire. Most cats showed impaired welfare during all stages of a clinic visit: before entering, in the waiting room, moving to the examination room, on the examination table, and after returning home. A relationship was found between welfare states in each stage. Stress worsened with further experience and had negative effects on traveling and handling in other situations. Restraint, pain, and anxiety led to aggression toward vets and guardians. Guardians showed a positive attitude toward their cats' health and welfare, and the veterinarians' behavior toward the cats was a reason for changing the veterinarian. One in 10 veterinarians examined the cat immediately, without stroking, talking, or offering food. However, the use of food was effective only if cats were not already stressed. Educating guardians and veterinarians to minimize stress during every stage of a clinic visit is the best approach to improving welfare for cats visiting the clinic.
Mental time travel: a case for evolutionary continuity.
Corballis, Michael C
2013-01-01
In humans, hippocampal activity responds to the imagining of past or future events. In rats, hippocampal activity is tied to particular locations in a maze, occurs after the animal has been in the maze, and sometimes corresponds to locations the animal did not actually visit. This suggests that mental time travel has neurophysiological underpinnings that go far back in evolution, and may not be, as some (including myself) have claimed, unique to humans. Copyright © 2012 Elsevier Ltd. All rights reserved.
Shaping Southeast Asia: Tracing Tourism Imaginaries in Guidebooks and Travel Blogs
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Felix M. Bergmeister
2015-12-01
Full Text Available Tourism constitutes both an economic activity and a cultural force that involves a dynamic interplay between travelers and their ideas about the societies they visit. This paper traces the construction and negotiation of “tourism imaginaries” (Salazar, 2012 in popular guidebooks and independent travel-blogs, critically examining questions of representation and power relations in a Southeast Asian context. Employing critical discourse analysis, this paper investigates how particular Southeast Asian destinations are represented from a Western perspective. Whereas long-established commercial media such as guidebooks function mainly to communicate destination images to the reader, recent participatory media formats (e.g. travel-blogs are more experienced-based and enable tourists to form ideas about foreign places in idiosyncratic ways. The preliminary insights of this study show that hegemonic narratives from guidebooks are rather reproduced than critically challenged and subverted in the examples under review.
THE DUBINS TRAVELING SALESMAN PROBLEM WITH CONSTRAINED COLLECTING MANEUVERS
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Petr Váňa
2016-11-01
Full Text Available In this paper, we introduce a variant of the Dubins traveling salesman problem (DTSP that is called the Dubins traveling salesman problem with constrained collecting maneuvers (DTSP-CM. In contrast to the ordinary formulation of the DTSP, in the proposed DTSP-CM, the vehicle is requested to visit each target by specified collecting maneuver to accomplish the mission. The proposed problem formulation is motivated by scenarios with unmanned aerial vehicles where particular maneuvers are necessary for accomplishing the mission, such as object dropping or data collection with sensor sensitive to changes in vehicle heading. We consider existing methods for the DTSP and propose its modifications to use these methods to address a variant of the introduced DTSP-CM, where the collecting maneuvers are constrained to straight line segments.
Lee, Vernon J; Wilder-Smith, Annelies
2006-10-01
Singapore has a fast-growing travel industry, but few studies have been done on travel characteristics and travel health practices. This study describes the profile and healthseeking behaviour of travellers attending a travel health clinic in Singapore. A cross-sectional survey was conducted on travellers attending the Traveller's Health and Vaccination Centre (THVC) between September and November 2002 using a standardised questionnaire. Information obtained included individual demographic and medical information, travel patterns, vaccination status and travel health practices. Four hundred and ninetyfive (74%) eligible travellers seen at THVC responded to the questionnaire. Their mean age was 36 years; 77% were professionals, managers, executives, and businessmen, students, and white collar workers. Asia was the main travel destination, and most travelled for leisure and resided in hotels or hostels. The median duration of travel was 16 days. Although >90% had previously travelled overseas, only 20% had previously sought pre-travel advice. Malays were significantly underrepresented (P travel advice compared with Chinese, Indians and Malays. Factors associated with seeking pre-travel advice included travel outside of Asia, especially Africa and South America. Singaporean travellers travel more often to cities rather than rural areas, compared with non-Asian travellers. Asia is the preferred destination, and travel outside of Asia is perceived as more risky and is associated with seeking pre-travel advice and vaccinations. Travel patterns and behaviours need to be taken into account when developing evidence-based travel medicine in Asia.
Digestive tract colonization by multidrug-resistant Enterobacteriaceae in travellers: An update.
Ruppé, Etienne; Andremont, Antoine; Armand-Lefèvre, Laurence
Enterobacteriaceae have become increasingly resistant, especially due to the acquisition and spread of extended-spectrum beta-lactamases (ESBLs), which confer resistance to the majority of beta-lactams. Multi-resistant Enterobacteriaceae (MRE) were first isolated in hospitals, but now they are disseminating in the community setting, mostly in low and middle income countries. Consequently, the increasing number of international travels leads to the importation of MRE from high-prevalence to low-prevalence countries. The Pubmed database was used to conduct research from 1980 to 2016 by combining the following key words: travel, antibiotic resistance, ESBL, Enterobacteriaceae, genomic, metagenomic, urinary tract infection, infection. The research found that the MRE acquisition rates in healthy travellers from low-prevalence countries ranged from 21% to 51% depending on the study design and the visited geographic regions. After a trip to Asia and especially to South Asia, the acquisition rate could reach 85%. A trip to Africa or to the Middle East was associated with lower rates but still worrisome (13-44%). Digestive disorder, diarrhoea and antibiotics used during travel are major risks factors associated with the acquisition of MRE. Travel to endemic areas has also been identified as a risk factor for MRE infection, including urinary tract infections. Travellers are at high risk of MRE acquisition and consequently of MRE infection. This risk should not be ignored by general practitioners. To reduce the risk of acquisition and subsequent transmission to relatives, travellers should be given recommendations prior to their travel. Copyright © 2017. Published by Elsevier Ltd.
Travel and migration associated infectious diseases morbidity in Europe, 2008
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Lopez-Velez Rogelio
2010-11-01
diagnoses such as Chagas disease in immigrant travellers from South America and P. falciparum malaria in immigrants from sub-Saharan Africa. Travel within Europe was also associated with health risks with distinctive profiles for Eastern and Western Europe. Conclusions In 2008, a broad spectrum of travel associated diseases were diagnosed at EuroTravNet core sites. Diagnoses varied according to regions visited by ill travellers. The spectrum of travel associated morbidity also shows that there is a need to dispel the misconception that travel, close to home, in Europe, is without significant health risk.
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.
Reuland, E A; Sonder, G J B; Stolte, I; Al Naiemi, N; Koek, A; Linde, G B; van de Laar, T J W; Vandenbroucke-Grauls, C M J E; van Dam, A P
2016-08-01
Travel to (sub)tropical countries is a well-known risk factor for acquiring resistant bacterial strains, which is especially of significance for travellers from countries with low resistance rates. In this study we investigated the rate of and risk factors for travel-related acquisition of extended spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E), ciprofloxacin-resistant Enterobacteriaceae (CIPR-E) and carbapenem-resistant Enterobacteriaceae. Data before and after travel were collected from 445 participants. Swabs were cultured with an enrichment broth and sub-cultured on selective agar plates for ESBL detection, and on plates with a ciprofloxacin disc. ESBL production was confirmed with the double-disc synergy test. Species identification and susceptibility testing were performed with the Vitek-2 system. All isolates were subjected to ertapenem Etest. ESBL and carbapenemase genes were characterized by PCR and sequencing. Twenty-seven out of 445 travellers (6.1%) already had ESBL-producing strains and 45 of 445 (10.1%) travellers had strains resistant to ciprofloxacin before travel. Ninety-eight out of 418 (23.4%) travellers acquired ESBL-E and 130 of 400 (32.5%) travellers acquired a ciprofloxacin-resistant strain. Of the 98 ESBL-E, predominantly Escherichia coli and predominantly blaCTX-M-15, 56% (55/98) were resistant to gentamicin, ciprofloxacin and co-trimoxazole. Multivariate analysis showed that Asia was a high-risk area for ESBL-E as well as CIPR-E acquisition. Travellers with diarrhoea combined with antimicrobial use were significantly at higher risk for acquisition of resistant strains. Only one carbapenemase-producing isolate was acquired, isolated from a participant after visiting Egypt. In conclusion, travelling to Asia and diarrhoea combined with antimicrobial use are important risk factors for acquiring ESBL-E and CIPR-E. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All
Pre-travel advice seeking from GPs by travellers with chronic illness seen at a travel clinic.
Gagneux-Brunon, Amandine; Andrillat, Carole; Fouilloux, Pascale; Daoud, Fatiha; Defontaine, Christiane; Charles, Rodolphe; Lucht, Frédéric; Botelho-Nevers, Elisabeth
2016-03-01
Travellers are ageing and frequently report chronic illness. Pre-travel health advice is crucial, particularly in this subgroup, and general practitioners (GPs) are first in line for treatment adjustment before departure. Our aim is to evaluate pre-travel health advice seeking from GPs by travellers with chronic illness seen at a travel clinic. A cross-sectional observational survey using a questionnaire was conducted between August 2013 and July 2014 in travellers attending the travel medicine clinic of a tertiary university hospital in France. During the study, 2019 travellers were included. Mean age was 39.4 years (±18.8). Three hundred and ninety-one (19.4%) travellers reported a history of a chronic illness. Arterial hypertension and diabetes mellitus were the most frequently reported illnesses, affecting, respectively, 168 (8.3%) travellers and 102 (5.1%). Hajj pilgrims were more likely to report a history of chronic illness than other travellers. Only 810 (40.1%) travellers sought pre-travel advice from their GP. Six hundred and fifty-two (40.1%) healthy travellers and 158 (40.5%) travellers reporting chronic illness sought pre-travel advice from their GP (P = 0.96). Travellers with a history of chronic illness do not seek pre-travel health advice from their GP more frequently than healthy travellers. Travel health specialists are generally not the best practitioners to manage the care of underlying medical conditions presenting risks during travel. However, GPs offer continuity and disease management expertise to improve the specificity of pre-travel planning. Thus, ongoing collaboration between the traveller, GP and travel health specialist is likely to yield the best outcomes. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.
Pre-Travel Medical Preparation of Business and Occupational Travelers
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
Objectives: The aim of the study was to understand more about pre-travel preparations and itineraries of business and occupational travelers. Methods: De-identified data from 18 Global TravEpiNet clinics from January 2009 to December 2012 were analyzed. Results: 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. Conclusions: 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. PMID:26479857
Incidence of dengue virus infection among Japanese travellers, 2006 to 2010
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Yuki Tada
2012-06-01
Full Text Available Introduction: Dengue continues to be a global public health concern. In Japan, although dengue cases are currently seen only among travellers returning from endemic areas, the number of reported cases is rising according to the national case-based surveillance system. We evaluated the characteristics of dengue cases imported into Japan and the relationship between the incidence of infection and season of travel to popular destinations.Methods: Dengue cases reported to the national surveillance system were retrospectively examined. The number of reported cases per number of Japanese travellers to a dengue-endemic country was calculated to estimate the country-specific incidence of imported dengue virus infection. The incidence of dengue infection among Japanese travellers was compared between dengue high season and low season in each country using relative risk (RR and associated 95% confidence intervals (CI.Results: Among 540 Japanese residents who were reported as dengue cases from 2006 to 2010, the majority had travelled to Indonesia, India, the Philippines and Thailand. The RR of dengue infection among Japanese travellers during dengue high season versus low season was 4.92 (95% CI: 3.01–8.04 for the Philippines, 2.76 (95% CI: 1.67–4.54 for Thailand and 0.37 (95% CI: 0.15–0.92 for Indonesia.Discussion: Overall, higher incidence of imported cases appeared to be related to historic dengue high seasons. Travellers planning to visit dengue-endemic countries should be aware of historic dengue seasonality and the current dengue situation.
The CERN Visits Service proposes: Lab Visits for CERN People
2001-01-01
The CMS assembly hall at point 5 - one of the new Visits Service itineraries. Discover the new visits itineraries of your laboratory with the Visits Service! The recently completed visitors platform in the CMS detector assembly hall at point 5, first of a series of new visit tours, will be the destination for special summer visits organised by the Visits Service for CERN people. Each week the Visits Service will reserve a slot to take CERN people to visit the CMS assembly hall and get first hand experience of the magnitude of the LHC endeavour. Tours will be shorter than the public visit programme, and will include a short introduction in the bus along with a guided tour of the CMS visitor platform. Visits will start at 3.30 pm from the visits meeting point in the reception of building 33, and the bus will be back at reception at 5 pm. Up to 24 people can take part in each visit. The calendar for the coming weeks is: Friday 27 July in French Thursday 2 August in English Wednesday 8 August in French Booking...
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
A HYBRID HEURISTIC ALGORITHM FOR THE CLUSTERED TRAVELING SALESMAN PROBLEM
Directory of Open Access Journals (Sweden)
Mário Mestria
2016-04-01
Full Text Available ABSTRACT This paper proposes a hybrid heuristic algorithm, based on the metaheuristics Greedy Randomized Adaptive Search Procedure, Iterated Local Search and Variable Neighborhood Descent, to solve the Clustered Traveling Salesman Problem (CTSP. Hybrid Heuristic algorithm uses several variable neighborhood structures combining the intensification (using local search operators and diversification (constructive heuristic and perturbation routine. In the CTSP, the vertices are partitioned into clusters and all vertices of each cluster have to be visited contiguously. The CTSP is -hard since it includes the well-known Traveling Salesman Problem (TSP as a special case. Our hybrid heuristic is compared with three heuristics from the literature and an exact method. Computational experiments are reported for different classes of instances. Experimental results show that the proposed hybrid heuristic obtains competitive results within reasonable computational time.
Mosquito-borne illnesses in travelers: a review of risk and prevention.
Mirzaian, Edith; Durham, Melissa J; Hess, Karl; Goad, Jeffery A
2010-10-01
In 2008, residents of the United States made 12 million visits to developing countries in Asia, South America, Central America, Oceania, the Middle East, and Africa. Due to the presence of Anopheles, Aedes, and Culex mosquitoes, travel to these destinations poses a risk for diseases such as malaria, yellow fever, and Japanese encephalitis that cause significant morbidity and mortality. To gain a better understanding of the major emerging and established travel-related infectious diseases transmitted principally by mosquitoes and the measures for their prevention in U.S. residents who travel to these developing countries, we performed a literature search of the PubMed and MEDLINE databases (January 1950-February 2010). Information from the Centers for Disease Control and Prevention and the World Health Organization and relevant references from the publications identified were also reviewed. Vaccines for the prevention of Japanese encephalitis and yellow fever are commercially available to U.S. travelers and should be administered when indicated. However, the prevention of malaria, dengue fever, chikungunya, and West Nile virus relies on personal insect protection measures and chemoprophylaxis for malaria. As the rate of international travel continues to rise, individuals traveling overseas should be made aware of the risk of various infectious diseases and the importance of prevention. Physicians, pharmacists, nurses, and other practitioners can play a vital role in disease education and prevention, including the administration of vaccines and provision of chemoprophylactic drugs.
The CERN Visits Service proposes: Lab Visits for CERN People
2001-01-01
The CMS assembly hall at point 5 - one of the new Visits Service itineraries. Discover the new visits itineraries of your laboratory with the Visits Service! The recently completed visitors platform in the CMS detector assembly hall at point 5, first of a series of new visit itineraries, will be the destination for special summer visits organised by the Visits Service for CERN people. Each week the Visits Service will reserve a slot to take CERN people to visit the CMS assembly hall and get first hand experience of the magnitude of the LHC endeavour. Tours will be shorter than the public visit programme, and will include a short introduction in the bus along with a guided tour of the CMS visitor platform. Visits will start at 3.30 pm from the reception of building 33, and the bus will be back at reception at 5 pm. Up to 22 people can take part in each visit. The calendar for the coming weeks is: Wednesday 15 August in English Wednesday 22 August in French Wednesday 29 August in English Bookings should be m...
The CERN Visits Service proposes: Lab Visits for CERN People
2001-01-01
The CMS assembly hall at point 5 - one of the new Visits Service itineraries. Discover the new visits itineraries of your laboratory with the Visits Service! The recently completed visitors platform in the CMS detector assembly hall at point 5, first of a series of new visit itineraries, will be the destination for special summer visits organised by the Visits Service for CERN people. Each week the Visits Service will reserve a slot to take CERN people to visit the CMS assembly hall and get first hand experience of the magnitude of the LHC endeavour. Tours will be shorter than the public visit programme, and will include a short introduction in the bus along with a guided tour of the CMS visitor platform. Visits will start at 3.30 pm from the reception of building 33, and the bus will be back at reception at 5 pm. Up to 22 people can take part in each visit. The calendar for the coming weeks is: Wednesday 8 August in French Wednesday 15 August in English Wednesday 22 August in French Bookings should be mad...
The CERN Visits Service proposes: Lab Visits for CERN People
2001-01-01
The CMS assembly hall at point 5 - one of the new Visits Service itineraries. Discover the new visits itineraries of your laboratory with the Visits Service! The recently completed visitors platform in the CMS detector assembly hall at point 5, first of a series of new visit itineraries, will be the destination for special summer visits organised by the Visits Service for CERN people. Each week the Visits Service will reserve a slot to take CERN people to visit the CMS assembly hall and get first hand experience of the magnitude of the LHC endeavour. Tours will be shorter than the public visit programme, and will include a short introduction in the bus along with a guided tour of the CMS visitor platform. Visits will start at 3.30 pm from the reception of building 33, and the bus will be back at reception at 5 pm. Up to 22 people can take part in each visit. The calendar for the coming weeks is: Thursday 2 August in English Wednesday 8 August in French Wednesday 15 August in English Bookings should be made...
International business travel: impact on families and travellers.
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.
Paudel, Prakash; Raina, C; Zwar, Nicholas; Seale, Holly; Worth, Heather; Sheikh, Mohamud; Heywood, Anita E
2017-09-01
Travellers are at risk of acquiring infectious diseases during travel, with risks differing by destination, travel and traveller characteristics. A pre-travel health consultation may minimize this risk. However, uptake of pre-travel health advice remains low. We investigated pre-travel health preparations and disease-specific risk behaviours among notified cases of selected travel-associated infectious diseases imported into Australia. Prospective enhanced surveillance of notified cases of typhoid, paratyphoid, measles, hepatitis A, hepatitis E, malaria and chikungunya was conducted in two Australian states between February 2013 and January 2014. Details of pre-travel health preparation and disease-specific risk behaviours were collected. Among 180 cases associated with international travel, 28% were travellers and 22% were frequent travellers, having travelled ≥5 times in the past 5 years. 25% had sought pre-travel advice from a healthcare provider, and 16% reported a pre-travel vaccine. Seeking pre-travel health advice did not differ by immigrant status ( P = 0.22) or by reason for travel ( P = 0.13) but was more commonly sought by first time travellers ( P = 0.03). Travellers visiting friends and relatives were more likely to report at-risk activities of brushing teeth with tap water ( P food ( P = 0.03) during travel compared to other travellers. Pre-travel health advice seeking practices and vaccine uptake was suboptimal among cases of notified disease. The results of this study highlight the need for a better understanding of barriers to pre-travel health seeking, particularly among high risk travellers, to reduce the importation of infectious diseases into Australia. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com
2012-01-01
Experiment areas, offices, workshops: it is possible to have co-workers or friends visit these places. You already know about the official visits service, the VIP office, and professional visits. But do you know about the safety instruction GSI-OHS1, “Visits on the CERN site”? This is a mandatory General Safety Instruction that was created to assist you in ensuring safety for all your visits, whatever their nature—especially those that are non-official. Questions? The HSE Unit will be happy to answer them. Write to safety-general@cern.ch. The HSE Unit
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.
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
An overview: tularemia and travel medicine.
Ulu-Kilic, Aysegul; Doganay, Mehmet
2014-01-01
Tularemia is a bacterial zoonotic infection. The disease is endemic in most parts of the world, has been reported through the northern hemisphere between 30 and 71° N latitude. Francisella tularensis causes infection in a wide range of vertebrates (rodents, lagomorphs) and invertebrates (ticks, mosquitoes and other arthropods). Humans can acquire this infection through several routes including; a bite from an infected tick, deerfly or mosquito, contact with an infected animal or its dead body. It can also be spread to human by drinking contaminated water or breathing contaminated dirt or aerosol. Clinical manifestation of this disease varies depending on the biotype, inoculum and port of entry. Infection is potentially life threatening, but can effectively be treated with antibiotics. Travelers visiting rural and agricultural areas in endemic countries may be at greater risk. Appropriate clothing and use of insect repellants is essential to prevent tick borne illness. Travelers also should be aware of food and waterborne disease; avoid consuming potentially contaminated water and uncooked meat. Physicians should be aware of any clinical presentation of tularemia in the patients returning from endemic areas. Copyright © 2014 Elsevier Ltd. All rights reserved.
The role of international travel in the worldwide spread of multiresistant Enterobacteriaceae.
van der Bij, Akke K; Pitout, Johann D D
2012-09-01
From international tourists to war-displaced refugees, more people are on the move than ever before. This provides the opportunity for a variety of antimicrobial-resistant bacteria to be carried from one geographic location to another. The Enterobacteriaceae are among the most important causes of serious hospital-acquired and community-onset bacterial infections in humans, and resistance to antimicrobial agents in these bacteria has become an increasingly relevant problem. International travel and tourism are important modes for the acquisition and spread of antimicrobial-resistant Enterobacteriaceae, especially CTX-M-producing Escherichia coli. Infections with KPC-, VIM-, OXA-48- and NDM-producing Enterobacteriaceae in developed countries have been associated with visiting and being hospitalized in endemic areas such as the USA, Greece and Israel for KPCs, Greece for VIMs, Turkey for OXA-48, and the Indian subcontinent for NDMs. To combat the spread of antimicrobial-resistant Enterobacteriaceae, the French Healthcare Safety Advisory Committee recently issued national recommendations for screening and contact isolation precautions for patients transferred from, or hospitalized outside, France. For effective public and patient health interventions, it is important to understand the role of international travel in the spread of antimicrobial-resistant Enterobacteriaceae. We urgently need well-designed studies to evaluate the transmission potential and risks for colonization and infections due to multiresistant Enterobacteriaceae in travellers who have recently visited or have been hospitalized in endemic areas. The emergence of CTX-M-, KPC- and NDM-producing bacteria is a good example of the role that globalization plays in the rapid dissemination of new antibiotic resistance mechanisms.
NADIM-Travel: A Multiagent Platform for Travel Services Aggregation
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...
Experiences Accessing Abortion Care in Alabama among Women Traveling for Services.
White, Kari; deMartelly, Victoria; Grossman, Daniel; Turan, Janet M
2016-01-01
In Alabama, more than one-half of reproductive-aged women live in counties without an abortion provider. State regulations require in-person counseling (or confirmed receipt of materials sent by certified mail) followed by a 48-hour waiting period. We explored the impact of this service and policy environment on experiences accessing abortion care for women traveling long distances to clinics. We conducted in-depth interviews with 25 women who traveled more than 30 miles to an Alabama clinic providing abortion care between July and September 2014. Women were interviewed by telephone at least 1 day after their consultation, procedure, or follow-up visit. We used content analysis methods to code and analyze interview transcripts. Almost all women found a clinic by searching online or talking to others in their social networks who had abortions. These strategies did not always direct women to the closest clinic, and some described searches that yielded inaccurate information. The majority of women did not believe an in-person consultation visit was necessary and found it to be burdensome because of the extra travel required and long waits at the clinic. Two-thirds of the women were unable to schedule their abortion 48 hours later owing to work schedules or because appointments were offered only once a week, and four women were delayed until their second trimester even though they sought services earlier in pregnancy. It is often difficult for women in communities without an abortion provider to find and access timely abortion care. Efforts are needed to make abortion more accessible and prevent further restrictions on services. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
The role of travel in measles outbreaks in Australia - An enhanced surveillance study.
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.
Travel health attitudes among Turkish business travellers to African countries.
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.
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...
Engaging Youth Through Volunteer Service Travel: In Service of the Common Good
Directory of Open Access Journals (Sweden)
Andrew Bailey
2009-12-01
Full Text Available Volunteer Tourism is becoming a popular topic in the travel literature. These experiences combine the adventure of travel with opportunities to serve the communities visited. This burgeoning field of tourism may provide an attractive outlet for generating positive developmental assets and for encouraging future civic engagement. This paper highlights a study which explored the relationship of wisdom and social capital and also discussed the influence of a voluntourism experience on wisdom and social capital domains. The sample consisted of 68 high school youth from the various high schools in Illinois. Results indicate that wisdom and social capital are positively and significantly related. In addition, wisdom and social capital indicators increased significantly over the course of the experience.
Mulcahey, Mary K; Waterman, Brian R
2016-10-01
In its brief 10-year existence, the Arthroscopy Association of North America Advanced Arthroscopy Traveling Fellowship has quickly established itself as the paramount educational experience for aspiring young surgeons in sports medicine and arthroscopy. The Traveling Fellowship is structured as a 10-day experience with visits to 3 host sites and culminates at the AANA Annual Meeting. With 4 selected fellows and an honorary "Godfather," the Traveling Fellowship affords a unique and invaluable opportunity to forge enduring friendships and rare mentorships with established leaders in the field of Arthroscopy. Potential applicants can anticipate not only developing their surgical acumen and aspects of clinical practice, but also assimilating key leadership skills, pearls on work-life balance, and a broader commitment to life-long education. The Dr. Don Johnson AANA Traveling Fellowship Alumni Group, named in honor of the two-time godfather and AANA Past President, represent an emerging class of leaders within AANA who are poised to contribute immensely to its mission of continuing medical education and collaboration. Copyright © 2016 Arthroscopy Association of North America. All rights reserved.
Boubaker, Rim; Hérard Fossati, Annie; Meige, Pierrette; Mialet, Catherine; Ngarambe Buffat, Chantal; Rochat, Jacynthe; Souvannaraj-Blanchant, Manisinh; Uwanyiligira, Mediatrice; Widmer, Francine; Payot, Sylvie; Rochat, Laurence; de Vallière, Serge; D'Acremont, Valérie; Genton, Blaise
2017-09-01
There are several possible malaria prevention strategies for travellers. In Switzerland, chemoprophylaxis (CP) is recommended for persons visiting areas highly endemic for malaria and stand-by emergency treatment (SBET) for areas with moderate to low risk. To describe the type of malaria prevention prescribed to travel clinic attendees with a specific focus on changes over time following adaptation of recommendations. All pre-travel first consultation data recorded between November 2002 and December 2012 were included. Country-specific malaria preventive recommendations provided and medicines prescribed over time were analysed. In total, 64 858 client-trips were recorded. 91% of travellers planned to visit a malaria endemic country. Among those clients, 42% were prescribed an antimalarial medicine as CP only, 36% as SBET only, and 3% both. Between 2002 and 2012, there was a 16% drop of CP prescription ( P travellers receiving CP, the proportion of those prescribed mefloquine dropped from 82% in 2002 to 46% in 2012 while those prescribed atovaquone-proguanil (AP) increased from 7% to 39%. For those prescribed SBET, the proportion dropped from 46% to 30% for AP and increased from 2% to 61% for artemether-lumefantrine. CP prescription for travellers to India fell from 62% to 5% and SBET prescription increased from 40% to 88% after the change of recommendation from CP to SBET in 2005 for this country. Comparatively, CP prescription for travellers to Senegal, for which no change of recommendation occurred, remained relatively stable between 88% in 2002 and 89% in 2012. This study shows the considerable decline of antimalarial prescription for chemoprophylaxis that occurred over the 10-year period in favour of SBET. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com
Hirata, Kazuki; Ogawa, Taku; Fujikura, Hiroyuki; Ogawa, Yoshihiko; Hirai, Nobuyasu; Nakagawa-Onishi, Tomoko; Uno, Kenji; Takeyama, Masahiro; Kasahara, Kei; Nakamura-Uchiyama, Fukumi; Konishi, Mitsuru; Mikasa, Keiichi
2018-03-01
Few studies have analyzed the characteristics of patients who develop physical disorders after overseas travel. We retrospectively reviewed the medical records of 183 patients who visited Nara Medical University Hospital from 2008 to 2016 because of physical problems after traveling abroad. The main travel destinations were Southeast Asia (n = 100), Africa (n = 27), and South Asia (n = 23). The main reasons for the travel were leisure (n = 96), business (n = 51), and volunteer work (n = 19). The most common final diagnosis was gastrointestinal disease (n = 72), followed by febrile disease (n = 59) and respiratory disease (n = 19). There were eight malaria cases, including one patient who was infected after travel. Additionally, 61 of 71 cases of travelers' diarrhea and 15 of 21 cases of dengue fever occurred after travel. 26 cases of vaccine preventable diseases, such as hepatitis A, typhoid fever, and influenza, were observed. Consequently, healthcare providers should notify Japanese overseas travelers that there is a non-negligible health risk inherent to short-term travel, while stressing on the importance of pre-travel medical consultation. Copyright © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Individual traveller health priorities and the pre-travel health consultation.
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.
Plasmodium knowlesi in travellers, update 2014.
Müller, Mattia; Schlagenhauf, Patricia
2014-05-01
=3), back pain (n=3), abdominal problems (n=1), anorexia (n=2), fatigue (n=2), malaise (n=1), arthralgia (n=1), sore throat (n=1) vomiting (n=2), and jaundice (n=1). All patients were treated successfully with currently available antimalaria treatments. The identification of the pathogen by microscopy can be problematic due to the morphological similarity of P. knowlesi to Plasmodium malariae. P. knowlesi appears to be a threat not only to the local population in Malaysia, but also to the estimated 25 million annual tourists and occupational travellers to Malaysia, especially those who visit rural, forested areas of the country. The P. knowlesi risk is not limited to Malaysia, and travellers from Southeast Asia presenting with possible malaria should be considered for a diagnostic work-up that includes P. knowlesi. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
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.
Rickettsiae and rickettsial diseases in Croatia: Implications for travel medicine.
Dzelalija, Boris; Punda-Polic, Volga; Medic, Alan; Dobec, Marinko
To review the current state of knowledge concerning rickettsiae and rickettsioses in Croatia and to discuss their implications for travellers. The PubMed database was searched from 1991 to 2015 by combining the words "rickettsia," "rickettsiosis", "travellers" and "Croatia". Since 1969, Croatia appears to be free of epidemic typhus (ET) caused by Rickettsia prowazekii and the last case of Brill-Zinsser disease was recorded in 2008. Mediterranean spotted fever (MSF) caused by Rickettsia conorii is the most frequent human rickettsial infection in Croatia, followed by murine typhus caused by Rickettsia typhi. Human cases of MSF and murine typhus have been predominantly observed along the eastern Adriatic coast from Zadar to Dubrovnik and between Zadar and Split, respectively. Rickettsia akari, etiologic agent of rickettsialpox, was isolated from blood of a patient diagnosed with MSF in Zadar, but no cases of rickettsialpox were reported. Several species of pathogenic (Rickettsia slovaca, Rickettsia aeschlimannii, Ricketsia helvetica, and Ricketsia raoultii) and species of undetermined pathogenicity (Ricketsia hoogstraalii sp. nov.) rickettsiae were identified in ticks collected in different ecological regions of Croatia. A search of the literature revealed no evidence of rickettsial infection in travellers visiting Croatia. Three imported cases of Rickettsia africae were observed in travellers returning from South Africa. Rickettsiae and rickettsial diseases continue to be present in Croatia. As they can be acquired while travelling, physicians should consider rickettsial infection in the differential diagnosis of patients returning from Croatia and presenting with febrile illness. Copyright © 2016 Elsevier Ltd. All rights reserved.
Hess, Karl M; Dai, Chih-Wei; Garner, Brian; Law, Anandi V
To describe the acceptance and refusal rates of travel-related vaccine and medication recommendations in a pharmacist-run travel health clinic, to evaluate the change in patient understanding of travel-related issues, to determine patient satisfaction with this clinic, and to determine factors influencing both patient acceptance and satisfaction. Southern California (Claremont) between July 2007 and October 2008. Hendricks Pharmacy is an independently owned community pharmacy that is part of the Good Neighbor Pharmacy Provider Network. The pharmacy offers a range of services including home delivery, compounding, and blood glucose, blood pressure, and cholesterol screenings. Comprehensive pharmacist-run travel health clinic. Patient acceptance and refusal rates of pharmacist-made recommendations, changes in patient understanding of travel-related issues resulting from pharmacist counseling, and patient satisfaction with this travel health clinic. In a sample of 283 patients, overall patient acceptance of pharmacist-made recommendations was 84.7%. The primary reason for patient refusal of a recommendation was self-perceived low risk for infection. A subsample of patients (n = 82) completing a patient satisfaction survey found that 96% were satisfied with their overall visit. Patient satisfaction with the clinic and pharmacist services was correlated with overall patient acceptance. The high rate of patient acceptance and satisfaction with this clinic supports adoption of pharmacists as nontraditional providers of travel health services.
Directory of Open Access Journals (Sweden)
Saroha Manulang
2016-03-01
Full Text Available Airport are the first and the last contact point for tourists when they arrive at their holiday destination. Therefore, the airport facilities are a source of first impression that effect the quality expectations of the tourists on holiday activities. Bali as a world class tourism destination to develop and renovate the Ngurah Rai International Airport in order to improve quality of service in order to give higher satisfaction for tourists visiting Bali. Based on this study aims to determine (1 the effect of quality of service to tourists' satisfaction and the image of Bali tourism; (2 the effect of the image of tourism and the quality of service to the loyalty of tourists visiting Bali; (3 the effect of the satisfaction of tourists to the tourism image and loyalty of tourists visiting Bali; (4 the effect of indirect tourism image of the traveler loyalty through satisfaction of tourists; (5 service quality indirectly traveler loyalty through tourism image; and (6 to determine the rating opinion on the quality of service Bali's Ngurah Rai International Airport. Population of this research was all foreign tourists visiting Bali through Ngurah Rai Airport at the time of the research. The research samples included 348 respondents were chosen with nonprobability sampling. accidental sampling technique. Data collected through questionnaires, interviews and observations. The collected data were analyzed with SERVQUAL, Importance Performance Analysis (IPA, and Structural Equation Modelling (SEM for hypothesis testing. The results showed (1 the quality of service Bali's Ngurah Rai International Airport is a positive effect on tourist satisfaction and the image of Bali tourism; (2 the image of tourism and service quality Bali's Ngurah Rai International Airport is a positive effect on loyalty rating; (3 The traveler satisfaction positive effect on tourism image and loyalty of tourists visiting Bali; (4 Tourism image positive effect on loyalty through
A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment
Directory of Open Access Journals (Sweden)
Wong AWY
2014-05-01
Full Text Available Amy WY Wong, Chengfei Zhang, Chun-hung Chu Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China Abstract: Conventional endodontic treatment used to require multiple visits, but some clinicians have suggested that single-visit treatment is superior. Single-visit endodontic treatment and multiple-visit endodontic treatment both have their advantages and disadvantages. This paper is a literature review of the research on nonsurgical single-visit versus multiple-visit endodontic treatment. The PubMed database was searched using the keywords (endodontic treatment OR endodontic therapy OR root canal treatment OR root canal therapy AND (single-visit OR one-visit OR 1-visit. Review papers, case reports, data studies, and irrelevant reports were excluded, and 47 papers on clinical trials were reviewed. The studies generally had small sample sizes, and the endodontic procedures varied among the studies. Meta-analysis on the selected studies was performed, and the results showed that the postoperative complications of the single-visit and multiple-visit endodontic treatment were similar. Furthermore, neither single-visit endodontic treatment nor multiple-visit treatment had superior results over the other in terms of healing or success rate. Results of limited studies on disinfection of the root canals using low-energy laser photodynamic therapy is inconclusive, and further studies are necessary to show whether laser should be used in endodontic treatment. This review also found that that neither single-visit endodontic treatment nor multiple-visit treatment could guarantee the absence of postoperative pain. Since the study design of many studies displayed significant limitation and the materials and equipment used in endodontic treatment have dramatically changed in recent years, prospective randomized clinical trials are needed to further verify the postoperative pain and success rates of
Deconstructing the risk for malaria in United States donors deferred for travel to Mexico.
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.
Virtual Travel Agencies - Tourist Value through Travel Information Systems
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...
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...
... 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 ...
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
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...
Valerio, Lluís; Roure, Sílvia; Sabrià, Miquel; de Balanzó, Xavier; Moreno, Nemesio; Martinez-Cuevas, Octavio; Peguero, Carme
2011-01-01
Imported diseases recorded in the European Union (EU) increasingly involve traveling immigrants returning from visits to their relatives and friends (VFR). Children of these immigrant families can represent a population of extreme vulnerability. A randomized cross-sectional study of 698 traveling children under the age of 15 was performed. VFR traveling children and non-VFR (or tourist) children groups were compared. A total of 698 individuals were analyzed: 354 males (50.7%) and 344 females (49.3%), with a median age (interquartile range) of 4 (2-9) years. Of these, 578 (82.8%) had been born in the EU with 542 (77.7%) being considered as VFR, whereas 156 (22.3%) were considered tourists. VFR children were younger (4.7 vs 8.2 yr; p travel time interval was shorter (21.8 vs 32.2 d; p traveling children showed a greater risk of exposure to infectious diseases compared with tourists. Immigrant families may represent a target group to prioritize international preventive activities. © 2011 International Society of Travel Medicine.
CERN Bulletin
2013-01-01
CERN Internal Communication is organising a visit to ISOLDE – an opportunity for you to see the CERN set-up that can produce over 1000 different isotopes! If you wish to participate, you can sign up for a visit by sending us an e-mail. Note that the visits will take place between 18 and 22 February, and will be open only to CERN access-card holders. The visit will include an introduction by experts and a tour of the ISOLDE set-up. NB: For security reason, pregnant women and kids under the age of 16 can not take the tour.
Valuation of Travel Time and TravelIer Information
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
Marine Scorpaenidae Envenomation in Travelers: Epidemiology, Management, and Prevention.
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
Bi-criteria travelling salesman subtour problem with time threshold
Kumar Thenepalle, Jayanth; Singamsetty, Purusotham
2018-03-01
This paper deals with the bi-criteria travelling salesman subtour problem with time threshold (BTSSP-T), which comes from the family of the travelling salesman problem (TSP) and is NP-hard in the strong sense. The problem arises in several application domains, mainly in routing and scheduling contexts. Here, the model focuses on two criteria: total travel distance and gains attained. The BTSSP-T aims to determine a subtour that starts and ends at the same city and visits a subset of cities at a minimum travel distance with maximum gains, such that the time spent on the tour does not exceed the predefined time threshold. A zero-one integer-programming problem is adopted to formulate this model with all practical constraints, and it includes a finite set of feasible solutions (one for each tour). Two algorithms, namely, the Lexi-Search Algorithm (LSA) and the Tabu Search (TS) algorithm have been developed to solve the BTSSP-T problem. The proposed LSA implicitly enumerates the feasible patterns and provides an efficient solution with backtracking, whereas the TS, which is metaheuristic, will give the better approximate solution. A numerical example is demonstrated in order to understand the search mechanism of the LSA. Numerical experiments are carried out in the MATLAB environment, on the different benchmark instances available in the TSPLIB domain as well as on randomly generated test instances. The experimental results show that the proposed LSA works better than the TS algorithm in terms of solution quality and, computationally, both LSA and TS are competitive.
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...
Gaines, Joanna; Sotir, Mark J; Cunningham, Timothy J; Harvey, Kira A; Lee, C Virginia; Stoney, Rhett J; Gershman, Mark D; Brunette, Gary W; Kozarsky, Phyllis E
2014-08-01
Travelers from around the globe will attend the 2014 Fédération Internationale de Football Association (FIFA) World Cup and the 2016 Olympic and Paralympic Games in Brazil. Travelers to these mass gathering events may be exposed to a range of health risks, including a variety of infectious diseases. Most travelers who become ill will present to their primary care physicians, and thus it is important that clinicians are aware of the risks their patients encountered. To highlight health and safety concerns for people traveling to these events in Brazil so that health care practitioners can better prepare travelers before they travel and more effectively diagnose and treat travelers after they return. We reviewed both peer-reviewed and gray literature to identify health outcomes associated with travel to Brazil and mass gatherings. Thirteen specific infectious diseases are described in terms of signs, symptoms, and treatment. Relevant safety and security concerns are also discussed. Travelers to Brazil for mass gathering events face unique health risks associated with their travel. Travelers should consult a health care practitioner 4 to 6 weeks before travel to Brazil and seek up-to-date information regarding their specific itineraries. For the most up-to-date information, health care practitioners can visit the Centers for Disease Control and Prevention (CDC) Travelers' Health website (http://wwwnc.cdc.gov/travel) or review CDC's Yellow Book online (http://wwwnc.cdc.gov/travel/page/yellowbook-home-2014).
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.
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.
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
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
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.
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 ...
Artifice and Excess: Travel Narratives and the Representation of Women in Portugal and Brazil
Directory of Open Access Journals (Sweden)
Margareth de Almeida Gonçalves
2005-01-01
Full Text Available This article analyses the images of Brazilian and Portuguese women in the reports of English travelers who visited Portugal and Brazil in the final years of the 18th century and early decades of the 19th century. We seek to investigate the way in which a moral register based on bourgeois values influenced these travelers’ views and interfered in their descriptions of the Luso- Brazilian universe. The connection they made between the ‘civilized’ European world and the regions which were peripheral to the processes of bourgeois capitalism generally involved a double movement of confrontation and negotiation between culturally distinct values and worldviews. Thus, their travel narratives reveal a space of constant negotiation of feelings and perceptions about themselves and the natives.
Bhuiyan, Mejbah U; Luby, Stephen P; Alamgir, Nadia I; Homaira, Nusrat; Mamun, Abdullah A; Khan, Jahangir A M; Abedin, Jaynal; Sturm-Ramirez, Katharine; Gurley, Emily S; Zaman, Rashid U; Alamgir, A S M; Rahman, Mahmudur; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo
2014-07-01
Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh. From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010. We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93-8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96-121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76-147) in direct costs and US$59 million (95% CI: 37-91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4-2.6) in direct costs and US$0.4 million (95% CI: 0.1-0.8) in indirect costs in 2010. In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits. © 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons
Bhuiyan, Mejbah U; Luby, Stephen P; Alamgir, Nadia I; Homaira, Nusrat; Mamun, Abdullah A; Khan, Jahangir A M; Abedin, Jaynal; Sturm-Ramirez, Katharine; Gurley, Emily S; Zaman, Rashid U; Alamgir, ASM; Rahman, Mahmudur; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo
2014-01-01
Objective Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh. Design From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010. Results We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93–8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96–121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76–147) in direct costs and US$59 million (95% CI: 37–91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4–2.6) in direct costs and US$0.4 million (95% CI: 0.1–0.8) in indirect costs in 2010. Conclusions In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits. PMID:24750586
DEFF Research Database (Denmark)
Nielsen, Ulla S; Jensen-Fangel, Søren; Pedersen, Gitte
2014-01-01
BACKGROUND: We aimed to describe travel patterns, extent of professional pre-travel advice and health problems encountered during travel among HIV-infected individuals. METHODS: During a six-month period a questionnaire was handed out to 2821 adult HIV-infected individuals attending any...... of the eight Danish medical HIV care centers. RESULTS: A total of 763 individuals responded. During the previous two years 49% had travelled outside Europe; 18% had travelled less and 30% were more cautious when choosing travel destination than before the HIV diagnosis. Pre-travel advice was sought by only 38......%, and travel insurance was taken out by 86%. However, 29%/74% did not inform the advisor/the insurance company about their HIV status. Nearly all patients on highly active antiretroviral therapy (HAART) were adherent, but 58% worried about carrying HIV-medicine and 19% tried to hide it. Only 19% experienced...
The New England travel market: changes in generational travel patterns
Rodney B. Warnick
1995-01-01
The purpose of this study was to examine and explore the New England domestic travel market trends, from 1979 through 1991 within the context of generations. The existing travel markets, who travel to New England, are changing by age cohorts and specifically within different generations. The New England changes in generational travel patterns do not reflect national...
Huettig, Fabian; Behrend, Florian
2016-01-01
It is unknown what disadvantages are faced by patients deciding for a prosthodontic treatment by inexperienced students. Commonly, the related extra effort and time are compensated by cost reduction of treatment fees. Thereby, the dental schools subsidize treatments to teach clinical prosthodontics. The aim of this study was to clarify the benefits to patients as well as the efforts of the dental school. Data collected from three courses in a dental school in Germany were patient gender, age, occupation, zip code, number of visits, scope of treatment including costs, financial discount, and remaining copayment. Travel costs were calculated based on zip code. Balance of travel costs and treatment discount was defined as financial benefit. The results showed that 185 patients (95 male) aged 32 to 82 years (median=58) were treated with fixed restorations (FR, n=110), telescopic dentures (TD, n=87), complete dentures (CD, n=17), or other (RD, n=3). The mean number of visits was 11 for FR, 12 for TD, and 9 for CD. Single distance to the clinic ranged from 0.6 to 65 miles (median=12). Total costs of prosthodontics were reduced by 19% on average. The mean financial benefit was 429 USD (median=298, min=-482, max=4025). The financial benefits were found to differ widely, including additional expenditures of patients. Participation, travel burden, and copayment did not depend on age, gender, or occupation. The financial benefit was relativized because students needed at least twice the sessions of a dentist. As a result, the financial efforts of dental schools are significant and compromise a cost-covering education.
On the relationship between travel time and travel distance of commuters
Rietveld, P.; Zwart, A.P.; Wee, van G.P.; Hoorn, van der T.
1999-01-01
This paper gives a detailed empirical analysis of the relationships between different indicators of costs of commuting trips by car: difference as the crow flies, shortest travel time according to route planner, corresponding travel distance, and reported travel time. Reported travel times are
The impact of injection anxiety on education of travelers about common travel risks.
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
[The profile of Israeli travelers to developing countries: perspectives of a travel clinic].
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.
Contact Frequency, Travel Time, and Travel Costs for Patients with Rheumatoid Arthritis
Sørensen, Jan; Linde, Louise; Hetland, Merete Lund
2014-01-01
Objectives. To investigate travel time, and travel cost related to contacts with health care providers for patients with rheumatoid arthritis (RA) during a three-month period. Methods. Patient-reported travel time and travel cost were obtained from 2847 patients with RA. Eleven outpatient clinics across Denmark recruited patients to the study. Data collected included frequency, travel time and travel costs for contacts at rheumatology outpatient clinics, other outpatient clinics, general prac...
Truth, Power, and Knowledge. Female Travel Writings
Directory of Open Access Journals (Sweden)
Nara Araújo
2008-09-01
Full Text Available This article begins with a reflection about the influences of the travel reports – real or imaginary ones – on the modern discourse, diversity, and alterities. It also considers the reports as a power instrument, since, according to Foucault, the force of power resides in the production of positive effects in both knowledge and desire levels. Thus, the chroniclers responsible for the first descriptions of the New World are visited. Their books were very useful to the new travelers by revealing the mystery of the foreign lands, as well as their customs, alimentary habits, dressing ways, and familiar relationships, among others. The narratives written by women are then introduced considering the specificity of their approach. After all, when appearing to the public, they need to establish a relationship between space, knowledge and authority, and, in order to validate their discourse, they make use of history and references to the consulted sources. Marquesa Calderón de la Barca (Life in Mexico during a residence of two years in that country, de 1843; Condessa de Merlín (La Havane, de 1844; and Nísia Floresta (Itinerário de uma viagem à Alemanha, de 1857 are some of the writers analyzed here.
Loiasis in a Japanese Traveler Returning from Central Africa
Kobayashi, Tetsuro; Hayakawa, Kayoko; Mawatari, Momoko; Itoh, Makoto; Akao, Nobuaki; Yotsu, Rie R.; Sugihara, Jun; Takeshita, Nozomi; Kutsuna, Satoshi; Fujiya, Yoshihiro; Kanagawa, Shuzo; Ohmagari, Norio; Kato, Yasuyuki
2015-01-01
We encountered a probable case of loiasis in a returned traveler from Central Africa. A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin. She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem. Although no microfilariae were found in her blood, there was an elevated level of IgG antibodies against the crude antigens of Brugia pahangi, which have cross-reactivity with Loa loa. She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred. PMID:26161033
Frew, E; Wolstenholme, J L; Atkin, W; Whynes, D K
1999-01-01
To identify the characteristics of mode of travel to screening clinics; to estimate the time and travel costs incurred in attending; to investigate whether such costs are likely to bias screening compliance. Twelve centres in the trial of flexible sigmoidoscopy screening for colorectal cancer, drawn from across Great Britain. Analysis of 3525 questionnaires completed by screening subjects while attending clinics. Information supplied included sociodemographic characteristics, modes of travel, expenses, activities foregone owing to attendance, and details of companions. More than 80% of subjects arrived at the clinics by car, and about two thirds were accompanied. On average, the clinic visit involved a 14.4 mile (22.8 km) round trip, requiring 130 minutes. Mean travel costs amounted to 6.10 Pounds per subject. The mean gross direct non-medical and indirect cost per subject amounted to 16.90 Pounds, and the mean overall gross cost per attendance was 22.40 Pounds. Compared with the Great Britain population as a whole, non-manual classes were more strongly represented, and the self employed less strongly represented, among the attendees. In relation to direct medical costs, the time and travel costs of clinic based screening can be substantial, may influence the overall cost effectiveness of a screening programme, and may deter potential subjects from attending.
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...
Fellow travellers: Working memory and mental time travel in rodents.
Dere, Ekrem; Dere, Dorothea; de Souza Silva, Maria Angelica; Huston, Joseph P; Zlomuzica, Armin
2017-03-19
The impairment of mental time travel is a severe cognitive symptom in patients with brain lesions and a number of neuropsychiatric disorders. Whether animals are also able to mentally travel in time both forward and backward is still a matter of debate. In this regard, we have proposed a continuum of mental time travel abilities across different animal species, with humans being the species with the ability to perform most sophisticated forms of mental time travel. In this review and perspective article, we delineate a novel approach to understand the evolution, characteristics and function of human and animal mental time travel. Furthermore, we propose a novel approach to measure mental time travel in rodents in a comprehensive manner using a test battery composed of well-validated and easy applicable tests. Copyright © 2017. Published by Elsevier B.V.
The Concept of Travel Medicine and the Actual Situation of Travel-Related Illnesses.
Tunalı, Varol; Turgay, Nevin
2017-06-01
Travel medicine defines all diseases and medical situations that are related to travel. Travel medicine comprises infectious diseases, traumas, altitude sickness, sun burns, embolisms, jet lag, and many more travel-related situations. With the increasing possibility and ease of travel, the number of people who have travelled internationally has exceeded 1.13 billion in 2014, and the revenues of international travel have exceeded 1.25 trillion dollars. With every passing day, international travels are shifting toward the developing countries and to more exotic regions of the world, and travelers tend to be more adventurous and daring, thereby increasing risky behaviors during travels. Traveling plays an important role in transmitting infections such as Zika virus infection, Ebola, avian flu, severe acute respiratory syndrome, Chikungunya, and dengue fever and is the principal reason for the epidemics of these types of infections on a global scale. With this background, we suggest that travel medicine is an important but "neglected" medical discipline as the discipline of Parasitology itself like most parasitic diseases.
Culinary Travel as New Approach for Cultural Tourism
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Tomás López-Guzmán
2016-01-01
Full Text Available Gastronomy is emerging as one of the key elements for the development and promotion of tourist destinations, also having a positive influence both on increasing overnight stays as in the enhancement of primary sector of a certain geographic area. The methodology used to carry out this research study was based on the realization of a fieldwork with the objective of getting to know the tourist profile visiting the city of Cáceres, Spain and its feedback and motivations regarding gastronomy. The results of this research show the important relationship between culture and gastronomy and point out how cultural destinations can enhance visitor satisfaction through the promotion of its cuisine. The findings of this research point to the importance of gastronomy in the satisfaction of tourists visiting the city of Cáceres. Thus an enhancement of the same would, consequently, determine higher tourist satisfaction. This paper can contribute to the analysis of gastronomic tourism in Europe, contributing as a key element, in addition to the high level of response from tourists, the fact that surveys have been conducted at the restaurants themselves when the traveler was having lunch or dinner.
Contact frequency, travel time, and travel costs for patients with rheumatoid arthritis
DEFF Research Database (Denmark)
Sørensen, Jan; Linde, Louise; Hetland, Merete Lund
2014-01-01
Objectives. To investigate travel time, and travel cost related to contacts with health care providers for patients with rheumatoid arthritis (RA) during a three-month period. Methods. Patient-reported travel time and travel cost were obtained from 2847 patients with RA. Eleven outpatient clinics...... across Denmark recruited patients to the study. Data collected included frequency, travel time and travel costs for contacts at rheumatology outpatient clinics, other outpatient clinics, general practitioners, privately practicing medical specialists, inpatient hospitals and accident and emergency...... and 13 € on travelling per contact, corresponding to a total of 4.6 hours and 56 € during the 3-month period. There was great variation in patient travel time and costs, but no statistically significant associations were found with clinical and sociodemographic characteristics. Conclusion. The results...
Contact frequency, travel time, and travel costs for patients with rheumatoid arthritis.
Sørensen, Jan; Linde, Louise; Hetland, Merete Lund
2014-01-01
Objectives. To investigate travel time, and travel cost related to contacts with health care providers for patients with rheumatoid arthritis (RA) during a three-month period. Methods. Patient-reported travel time and travel cost were obtained from 2847 patients with RA. Eleven outpatient clinics across Denmark recruited patients to the study. Data collected included frequency, travel time and travel costs for contacts at rheumatology outpatient clinics, other outpatient clinics, general practitioners, privately practicing medical specialists, inpatient hospitals and accident and emergency departments. Results. Over a 3-month period, patients with RA had on average 4.4 (sd 5.7) contacts with health care providers, of which 2.8 (sd 4.0) contacts were with rheumatology outpatient clinics. Private car and public travel were the most frequent modes of travel. The average patient spent 63 minutes and 13 € on travelling per contact, corresponding to a total of 4.6 hours and 56 € during the 3-month period. There was great variation in patient travel time and costs, but no statistically significant associations were found with clinical and sociodemographic characteristics. Conclusion. The results show that patients with RA spend private time and costs on travelling when they seek treatment. These findings are particularly important when analyzing social costs associated with RA.
VISIT - Virtual visits to nuclear power plants
International Nuclear Information System (INIS)
Mollaret, Jean-Christophe
2001-01-01
For more than twenty years, EDFs Communication Division has conducted a policy of opening its generation sites to the general public. Around 300,000 people visit a nuclear power plant every year. However, for the security of persons and the safety of facilities, those parts of the plant situated in controlled areas are not accessible to visitors. For the sake of transparency, EDF has taken an interest in the technologies offered by virtual reality to show the general public what a nuclear power plant is really like, so as to initiate dialogue on nuclear energy, particularly with young people. Visit has been developed with virtual reality technologies. It serves to show the invisible (voyage to the core of fission), the inaccessible and to immerse the visitors in environments which are usually closed to the general public (discovery of the controlled area of a nuclear power plant). Visit is used in Public Information Centres which receive visitors to EDF power plants and during international exhibitions and conferences. Visit allows a virtual tour of the following controlled areas: locker room hot area/cold area, a necessary passage before entering the controlled areas; reactor building; fuel building; waste auxiliary building (liquid, solid and gaseous effluents). It also includes a tour of the rooms or equipment usually accessible to the general public: control room, turbine hall, transformer, air cooling tower
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
Validation of a multimodal travel simulator with travel information provision
Chorus, C.G.; Molin, E.J.E.; Arentze, T.A.; Hoogendoorn, S.P.; Timmermans, H.J.P.; Wee, van G.P.
2007-01-01
This paper presents a computer based travel simulator for collecting data concerning the use of next-generation ATIS and their effects on traveler decision making in a multimodal travel environment. The tool distinguishes itself by presenting a completely abstract multimodal transport network, where
Do British travel agents provide adequate health advice for travellers?
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
International Travelers' Sociodemographic, Health, and Travel Characteristics: An Italian Study.
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.
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.
Ericsson, Charles D
2003-02-01
Risk of travellers' diarrhoea is about 7% in developed countries and 20-50% in the developing world. Options for prevention include education and chemoprophylaxis. Vaccination is a promising but incomplete option. Achieving behaviour modification of food and water choices among tourists is difficult. Bismuth subsalicylate (BSS)-containing compounds are about 62% effective in the prevention of travellers' diarrhoea. Antibiotics are about 84% effective in preventing travellers' diarrhoea. Routine prophylaxis of travellers' diarrhoea, especially with antibiotics, should be discouraged. Oral rehydration is generally important in the treatment of diarrhoea, but travellers' diarrhoea is only infrequently dehydrating in adults. The addition of oral rehydration solutions confers no additional benefit to loperamide in the treatment of travellers' diarrhoea in adults. Presently, the most active of the antibiotics routinely available for treatment are members of the fluoroquinolone group. Antibiotics that are not absorbed such as aztreonam and a rifampicin-like agent, rifaximin, are both effective. The latter might become a therapy of choice once it is routinely available, due to predictably less adverse reactions with a non-absorbed antibiotic. Preliminary results with azithromycin look very promising. Less severe disease can be treated with a variety of non-antibiotic agents (e.g. BSS-containing compounds, loperamide and a calmodulin inhibitor, zaldaride). The combination of an antibiotic and loperamide is superior to treatment with either agent alone in a several studies and is arguably the treatment of choice for distressing travellers' diarrhoea.
Directory of Open Access Journals (Sweden)
Bivek DATTA
2018-05-01
Full Text Available The purpose of this paper is to understand the decision making pattern of the Business Travellers in Delhi National Capital Region in India while booking their trips through Online Travel Portals. The study revolves around purchase decision pattern of Business Travellers by investigating their travel decision making style in selecting online travel portals for their trip booking. The authors have adopted the quantitative methodology to achieve the objective of the study. The study is confined purely to the Business Travellers who book their travel through online travel portals. The data was collected through a structured questionnaire. 300 Business Travellers were interviewed at the departure lounge of Indira Gandhi International Airport, New Delhi, India out of which 150 questionnaires were incomplete in many respects and could not be used and only 150 questionnaires were usable resulting in the response rate of 50%. The Analytical Hierarchy process method was adopted to analyze the relative weights assigned by Business Travellers. The present study identifies through literature review the nine fundamental values of internet purchase i.e. product quality, cost, time to receive the product, convenience, time spent, confidentiality, shopping enjoyment, security and environmental impact. The research findings indicate that business travellers value confidentiality, security and product quality the most while choosing the Online Travel Portal to book their trip. The study is primarily centered on the consumer typology approach to study the decision making patterns of business travellers whereas there are other variables such as lifestyle, personality, attitude which can also be investigated. The study is only restricted to Business Travellers decision making pattern pertaining to their travel booking whereas a study can also be undertaken on leisure travellers decision making pattern. The study is restricted to only Delhi National Capital Region
The Tourist Itinerary Travel Loop: historical and contemporary travel characteristics
Lundgren, Jan O.
2012-01-01
In today’s tourist travel, the travel loop represents a very popular itinerary design, although the circumstances under which it is applied, as well as its geographic scale, often differ from the grandiose loop designs of centuries past. During the past couple of decades, a popular kind of new travel has emerged, the cruise-ship travel phenomenon, which often is arranged as quite an extensive itinerary loop. . However, the cruises can also be transoceanic, even global, with the tourist flying...
Contact Frequency, Travel Time, and Travel Costs for Patients with Rheumatoid Arthritis
Directory of Open Access Journals (Sweden)
Jan Sørensen
2014-01-01
Full Text Available Objectives. To investigate travel time, and travel cost related to contacts with health care providers for patients with rheumatoid arthritis (RA during a three-month period. Methods. Patient-reported travel time and travel cost were obtained from 2847 patients with RA. Eleven outpatient clinics across Denmark recruited patients to the study. Data collected included frequency, travel time and travel costs for contacts at rheumatology outpatient clinics, other outpatient clinics, general practitioners, privately practicing medical specialists, inpatient hospitals and accident and emergency departments. Results. Over a 3-month period, patients with RA had on average 4.4 (sd 5.7 contacts with health care providers, of which 2.8 (sd 4.0 contacts were with rheumatology outpatient clinics. Private car and public travel were the most frequent modes of travel. The average patient spent 63 minutes and 13 € on travelling per contact, corresponding to a total of 4.6 hours and 56 € during the 3-month period. There was great variation in patient travel time and costs, but no statistically significant associations were found with clinical and sociodemographic characteristics. Conclusion. The results show that patients with RA spend private time and costs on travelling when they seek treatment. These findings are particularly important when analyzing social costs associated with RA.
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.
On the relationship between travel time and travel distance in the Netherlands
Rietveld, P.; Zwart, B.; van Wee, B.; van der Hoorn, A.I.J.M.
1999-01-01
This paper gives a detailed empirical analysis of the relationships between different indicators of costs of commuting trips by car: difference as the crow flies, shortest travel time according to route planner, corresponding travel distance, and reported travel time. Reported travel times are
78 FR 73702 - Federal Travel Regulation (FTR); Telework Travel Expenses Test Programs
2013-12-09
...; Docket Number 2013-0012, Sequence 1] RIN 3090-AJ23 Federal Travel Regulation (FTR); Telework Travel...). ACTION: Final rule. SUMMARY: GSA is amending the Federal Travel Regulation (FTR) to incorporate the Telework Enhancement Act of 2010, which establishes and authorizes telework travel expenses test programs...
International travel and vaccinations.
Rizvon, M K; Qazi, S; Ward, L A
1999-01-01
With the increase in global travel, no disease is beyond the reach of any population. Traveling patients should be advised to follow food and water precautions and encouraged to receive the recommended immunizations. Travel medicine plays a vital role not only in limiting the morbidity of travel-related illnesses but also in limiting the spread of diseases. This article addresses the common issues related to travel, reviews the care of the immunocompromised traveler, and updates the available...
2006-01-01
The European Commissioner for Science and Research, Janez PotoÄnik, (on the right) visited the CMS assembly hall accompanied by Jim Virdee, Deputy Spokesman of CMS (on the left), and Robert Aymar, Director-General of CERN. The European Commissioner for Science and Research, Janez PotoÄnik, visited CERN on Tuesday 31 January. He was welcomed by the Director-General, Robert Aymar, who described the missions and current activities of CERN to him, in particular the realisation of the LHC with its three components: accelerator, detectors, storage and processing of data. The European Commissioner then visited the CMS assembly hall, then the hall for testing the LHC magnets and the ATLAS cavern. During this first visit since his appointment at the end of 2004, Janez PotoÄnik appeared very interested by the operation of CERN, an example of successful scientific co-operation on a European scale. The many projects (30 on average) that CERN and the European Commission carry out jointly for the benefit of res...
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
Danish travel activities: do we travel more and longer – and to what extent?
DEFF Research Database (Denmark)
Knudsen, Mette Aagaard
Two separate Danish National travel surveys are analysed to outline the amount and extent of national and international travelling during the latest 15-20 years; the national travel survey (TU) describes mainly national daily travel activities, whereas the holiday and business travel survey...... describes national and international travel activities including overnight stay(s). When sampling only respondents with trips above 100 kilometres, they only accounts for around 2% of all daily travel activities, however, this share appears to increase and suggest in general that we do travel longer....... But due to this limited share of trips, the overall impacts of longer distance travelling vanish when considering all daily travel activities. Especially as about 95% of all daily travel destinations range less than 50 kilometres away and in total induce an average trip length of 20 kilometres. If focus...
Directory of Open Access Journals (Sweden)
Diez-Diaz Rosa
2009-05-01
Full Text Available Abstract Background Nowadays there is a debate about the indication of the oral whole-cell/recombinant B-subunit cholera vaccine (WC/rBS in traveller's diarrhoea. However, a cost-benefit analysis based on real data has not been published. Methods A cost-effectiveness and cost-benefit study of the oral cholera vaccine (WC/rBS, Dukoral® for the prevention of traveller's diarrhoea (TD was performed in subjects travelling to cholera risk areas. The effectiveness of WC/rBS vaccine in the prevention of TD was analyzed in 362 travellers attending two International Vaccination Centres in Spain between May and September 2005. Results The overall vaccine efficacy against TD was 42,6%. Direct healthcare-related costs as well as indirect costs (lost vacation days subsequent to the disease were considered. Preventive vaccination against TD resulted in a mean saving of 79.26 € per traveller. Conclusion According to the cost-benefit analysis performed, the recommendation for WC/rBS vaccination in subjects travelling to zones at risk of TD is beneficial for the traveller, regardless of trip duration and visited continent.
Inter-temporal variation in the travel time and travel cost parameters of transport models
Börjesson, Maria
2012-01-01
The parameters for travel time and travel cost are central in travel demand forecasting models. Since valuation of infrastructure investments requires prediction of travel demand for future evaluation years, inter-temporal variation of the travel time and travel cost parameters is a key issue in forecasting. Using two identical stated choice experiments conducted among Swedish drivers with an interval of 13 years, 1994 and 2007, this paper estimates the inter-temporal variation in travel time...
STRATEGI PEMASARAN PAKET WISATA MELALUI MEDIA ONLINE DI TRULY ASIA TOUR AND TRAVEL
Directory of Open Access Journals (Sweden)
Ade Prawita Sari
2016-07-01
Full Text Available The purpose of this research is to find out the marketing strategy of tour package at Truly Asia tour and travel through online system. SWOT analysis is the method for this research and implemented into SWOT matrix table to find out the right strategy for the tour package at Truly Asia tour and travel through online system. Now days Marketing strategy through online system very popular and the conclusion of this research is Truly Asia as a company need to improve their variant of tour package in order to make tourist more interest to visit the company website. Besides that, increase the cheap price must be accompanied by quality of products to suit with the target, providing accurate information on the website is rather tourist confidence crisis, as well as using the internet connection system that has good quality, in order to minimize system error.
Flare-up rate in pulpally necrotic molars in one-visit versus two-visit endodontic treatment.
Eleazer, P D; Eleazer, K R
1998-09-01
This retrospective study compared one-visit versus two-visit endodontic treatment. The same technique and materials were used before and after making the sole change to one-visit endodontic treatment in 1991. Treatment records of 402 consecutive patients with pulpally necrotic first and second molars were compared. In 201 patients, treatment was provided by debridement and instrumentation, followed by obturation at a second visit; whereas the second group received single visit therapy. Flare-ups were defined as either patient reports of pain not controlled with over-the-counter medication or as increasing swelling. Sixteen flare-ups (8%) occurred in the two-visit group versus six flare-ups (3%) for the one-visit group. This showed an advantage for one-visit treatment at a 95% confidence level. In a second comparison, one-visit patients who had previously received two-visit treatment for a different pulpally necrotic molar served as their own control. No significant differences were present in this subgroup of 17 patients.
The quantified self during travel: mapping health in a prospective cohort of travellers.
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
Towards More Responsible Business Travel : Green Travel Guide for Business Travellers
Aila, Anu
2010-01-01
The purpose of this research type thesis is to find ways how to develop sustainability in business travel. The target is increase the level of understanding and knowledge to respect natural environment and local cultures and find the right channels and ways to raise the knowledge. The study has been done to raise the awareness how business travel can be more sustainable. This thesis analyzes sustainable tourism based on the economic, environmental, and socio-cultural considerations. Green...
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.
25 CFR 700.533 - Restrictions affecting travel and travel expense reimbursement.
2010-04-01
... having or seeking business with the Commission. (d) Commission employees traveling on official business, as well as employees traveling on personal business, may not accept the use of private airplanes... official business, provided administrative procedures have been followed in making the travel arrangements. ...
Bethell, Kerry
2018-01-01
This article chronicles the experiences of four New Zealand kindergarten teachers who, between 1932 and 1937, were individually awarded Carnegie Corporation of New York Travel Fellowships to undertake an academic year of advanced study at the progressive Teachers College at Columbia University in New York and to visit educational provisions in…
Suzana, Mariyam; Mills, Anne; Tangcharoensathien, Viroj; Chongsuvivatwong, Virasakdi
2015-09-26
Access to tertiary care is a problem common to many small states, especially island ones. Although medical treatment overseas (MTO) may result in cost savings to high income countries, it can be a relatively high cost for low and middle income source countries. The purpose of this study was to estimate the costs of overseas medical treatment incurred by the households of medical travelers from Maldives and assess the burden of medical treatment overseas on the government and on households. A survey was conducted of inbound Maldivian medical travelers who traveled during the period June - December 2013. Participants were stratified by the source of funds used for treatment abroad. Three hundred and forty four government-subsidized and 471 privately funded Maldivians were interviewed. Self-reported data on the utilization and expenses incurred during the last visit abroad, including both expenses covered by the government and borne by the household, were collected using a researcher administered structured questionnaire. The median per capita total cost of a medical travel episode amounted to $1,470. Forty eight percent of the cost was spent on travel. Twenty six percent was spent on direct medical costs, which were markedly higher among patients subsidized by the government than self-funded patients (p = economic burden to the Maldives in terms of lost consumer spending in the local economy and catastrophic health spending by households. Geographical inequality in access to public funds for MTO and the disproportionate travel cost borne by travelers from rural areas need to be addressed in the existing Universal Health Care programme to minimize the burden of MTO. Increased investment to create more capacity in the domestic health infrastructure either through government, private or by foreign direct investment can help divert the outflow on MTO.
Yurtkuran, Alkın
2014-01-01
The traveling salesman problem with time windows (TSPTW) is a variant of the traveling salesman problem in which each customer should be visited within a given time window. In this paper, we propose an electromagnetism-like algorithm (EMA) that uses a new constraint handling technique to minimize the travel cost in TSPTW problems. The EMA utilizes the attraction-repulsion mechanism between charged particles in a multidimensional space for global optimization. This paper investigates the problem-specific constraint handling capability of the EMA framework using a new variable bounding strategy, in which real-coded particle's boundary constraints associated with the corresponding time windows of customers, is introduced and combined with the penalty approach to eliminate infeasibilities regarding time window violations. The performance of the proposed algorithm and the effectiveness of the constraint handling technique have been studied extensively, comparing it to that of state-of-the-art metaheuristics using several sets of benchmark problems reported in the literature. The results of the numerical experiments show that the EMA generates feasible and near-optimal results within shorter computational times compared to the test algorithms. PMID:24723834
Mapping Femininity as Self-reflection Strategy in Lady Mary Wortley Montagu’s Travel Letters
Directory of Open Access Journals (Sweden)
Amelia Precup
2017-07-01
Full Text Available The present paper participates in the discussion about the differences between masculine and feminine modes of travel in terms of interests, perception, and representation, by exploring the Letters of the Right Honourable Lady M--y W--y M--e Written during Her Travels in Europe, Asia and Africa, by Lady Mary Wortley Montagu. As a traveller, Lady Mary engaged in the contemplation of cultural landscapes: she attempted to understand the social logic of the communities she met and to assess the cultural distance between the English society and the local customs of the countries she visited. Within this large social and cultural framework, the focus of her keen spirit of observation is represented, in many of her letters, by gender dynamics and the status of women, thus allowing a feminine configuration of the map of continental Europe and the Ottoman Empire and a comparative understanding of femininity and expected feminine behaviour. Therefore, the contention of this paper is that, in Lady Mary’s letters, the female-traveller’s gaze ends in meditation and self-contemplation, and functions as a means of comparing and reassessing female identity.
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Alkın Yurtkuran
2014-01-01
Full Text Available The traveling salesman problem with time windows (TSPTW is a variant of the traveling salesman problem in which each customer should be visited within a given time window. In this paper, we propose an electromagnetism-like algorithm (EMA that uses a new constraint handling technique to minimize the travel cost in TSPTW problems. The EMA utilizes the attraction-repulsion mechanism between charged particles in a multidimensional space for global optimization. This paper investigates the problem-specific constraint handling capability of the EMA framework using a new variable bounding strategy, in which real-coded particle’s boundary constraints associated with the corresponding time windows of customers, is introduced and combined with the penalty approach to eliminate infeasibilities regarding time window violations. The performance of the proposed algorithm and the effectiveness of the constraint handling technique have been studied extensively, comparing it to that of state-of-the-art metaheuristics using several sets of benchmark problems reported in the literature. The results of the numerical experiments show that the EMA generates feasible and near-optimal results within shorter computational times compared to the test algorithms.
Buddhism in Sarnath: An Account of Two Chinese Travellers
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Dr Anuradha Singh
2014-11-01
Full Text Available This paper aims to draw the religious life in Sarnath (and Varanasi as accounted by the Chinese travellers—Fa-Hien and Hiuen-tsang. The accounts not only talk about the stupas, pillars, statues built by King Ashoka; vihars and monks (bhikshus living in those vihars but also contain the first preachings of Lord Buddha, establishment of Sangha and the story of Mrigajataka that remain significant. With the increased popularity of Buddha dharma in China, the Chinese were attracted towards travelling to India. They came to India mainly with the intentions to visit the places related to the fond memories of Lord Buddha, to study the Buddha religion and philosophy and carry the copies of the Buddhist compositions. Fa-Hien and Hiuen-tsang occupy significant places among these Chinese travellers. These accounts can be associated with ancient history as well as with historical geography, religion and philosophy. While Fa-hien in his journey details had described about the Buddha Empire, Hiuen-tsang highlighted the civilisation of India and its cultural landscape, albeit it has been often accepted by the historians that these accounts of their journeys should be considered as significant only when they are backed by historical evidences. They opine that these travellers were mainly influenced by the Buddha dharma and therefore, their accounts are liable to containing exaggerated journey details. It is true that the journey details contain few imaginary instances; nevertheless, these accounts have been validated by the remnants, stupas and vihars at the sites.
DEFF Research Database (Denmark)
Helles, Rasmus; Lai, Signe Sophus
2017-01-01
-12) travelling to multiple countries on several continents. The article shows that there are systematic differences in terms of formal characteristics, themes, and characters’ communicative style between the series that travel and the series that do not. Especially, the analysis finds that the presence of strong...... female lead characters is systematically linked to the positive travel patterns of the series, and that this cuts across different genres of series. The analysis also finds that series, which have explicitly low production values and simple narrative structure, systematically travels poorer....
Effect of Rainfall on Travel Time and Accuracy of Travel Time prediction with rainfall
CHUNG, E; EL-FAOUZI, NE; KUWAHARA, M
2007-01-01
Travel time is an important parameter to report to travelers. From the user's perspective, accurate predictions and an estimate of their precision are more beneficial than the current travel time since conditions may change significantly before a traveler completes the journey. Past researches have developed travel time prediction models without considering accidents and rain. Normally accident and Rain may cause to increase travel time. Therefore, it may be interesting to consider Rain and a...
Topic Map for Authentic Travel
Wandsvik, Atle; Zare, Mehdi
2007-01-01
E-business is a new trend in Internet use. Authentic travel is an approach to travel and travel business which helps the traveler experience what is authentic in the travel destination. But how can the traveler find those small authentic spots and organize them together to compose a vacation? E-business techniques, combined withTopic Maps, can help.
DEFF Research Database (Denmark)
Christensen, Linda
2014-01-01
This paper presents an overview of the Dane’s long distance travel. It is a part of the Drivers and Limits project about long distance travel. Long distance travel is in the project defined as infrequent travel with overnight stay. Danes 15-85 years-old travel in average 5.5 long distance travel...... per year og which a third is for international destinations, a third is for domestic second homes and a third are other domestic trips. However, 87% of the kilometres are for international destinations and only 4% are for domestic second homes. Travel activity is very uneven distributed with only half...... of the population having had a journey during the last three month. At the other hand 60% have travelled internationally during the last year and only 2% have never travelled abroad. The paper presents among other things how the travel activity is distributed on travel purpose and mode and how the mode choice...
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Thomas V Pollet
Full Text Available The theory of inclusive fitness has transformed our understanding of cooperation and altruism. However, the proximate psychological underpinnings of altruism are less well understood, and it has been argued that emotional closeness mediates the relationship between genetic relatedness and altruism. In this study, we use a real-life costly behaviour (travel time to dissociate the effects of genetic relatedness from emotional closeness. Participants travelled further to see more closely related kin, as compared to more distantly related kin. For distantly related kin, the level of emotional closeness mediated this relationship--when emotional closeness was controlled for, there was no effect of genetic relatedness on travel time. However, participants were willing to travel further to visit parents, children and siblings as compared to more distantly related kin, even when emotional closeness was controlled for. This suggests that the mediating effect of emotional closeness on altruism varies with levels of genetic relatedness.
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Mário Mestria
2013-08-01
Full Text Available The Clustered Traveling Salesman Problem (CTSP is a generalization of the Traveling Salesman Problem (TSP in which the set of vertices is partitioned into disjoint clusters and objective is to find a minimum cost Hamiltonian cycle such that the vertices of each cluster are visited contiguously. The CTSP is NP-hard and, in this context, we are proposed heuristic methods for the CTSP using GRASP, Path Relinking and Variable Neighborhood Descent (VND. The heuristic methods were tested using Euclidean instances with up to 2000 vertices and clusters varying between 4 to 150 vertices. The computational tests were performed to compare the performance of the heuristic methods with an exact algorithm using the Parallel CPLEX software. The computational results showed that the hybrid heuristic method using VND outperforms other heuristic methods.
Visiting Astronomers Travel Guide | CTIO
Norwegian Persian Polish Portuguese Punjabi Romanian Russian Serbian Sesotho Sinhala Slovak Slovenian Somali Marathi Mongolian Myanmar (Burmese) Nepali Norwegian Persian Polish Portuguese Punjabi Romanian Russian
Travel time and attrition from VHA care among women veterans: how far is too far?
Friedman, Sarah A; Frayne, Susan M; Berg, Eric; Hamilton, Alison B; Washington, Donna L; Saechao, Fay; Maisel, Natalya C; Lin, Julia Y; Hoggatt, Katherine J; Phibbs, Ciaran S
2015-04-01
Travel time, an access barrier, may contribute to attrition of women veterans from Veterans Health Administration (VHA) care. We examined whether travel time influences attrition: (a) among women veterans overall, (b) among new versus established patients, and (c) among rural versus urban patients. This retrospective cohort study used logistic regression to estimate the association between drive time and attrition, overall and for new/established and rural/urban patients. In total, 266,301 women veteran VHA outpatients in the Fiscal year 2009. An "attriter" did not return for VHA care during the second through third years after her first 2009 visit (T0). Drive time (log minutes) was between the patient's residence and her regular source of VHA care. "New" patients had no VHA visits within 3 years before T0. Models included age, service-connected disability, health status, and utilization as covariates. Overall, longer drive times were associated with higher odds of attrition: drive time adjusted odds ratio=1.11 (99% confidence interval, 1.09-1.14). The relationship between drive time and attrition was stronger among new patients but was not modified by rurality. Attrition among women veterans is sensitive to longer drive time. Linking new patients to VHA services designed to reduce distance barriers (telemedicine, community-based clinics, mobile clinics) may reduce attrition among women new to VHA.
The Image of Russia in French Travel Literature of the XIXth century
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Jeanne M. Aroutiounova
2017-03-01
Full Text Available The article presents the analysis of the literature of travel of French authors of the XIXth century. Authers put the aim to create the general investigation dedicated to this therm, bringing in the quality of the source base as a quite famous works of the French travelers and writers, and little-known to a wide circle of readers. XIX century is a time of expanding cultural, humanitarian, diplomatic contacts between Russia and France, which resulted in an increase in the number of foreigners who traveled to Russia, and, consequently, of the works explaining all the features of the trip, impressions, fears, etc. During this period, the Europeans started to visit not only Moscow and Saint Petersburg, but also Siberia, the Far East, the geography of travelling considerably expanded, and new works of foreigners about Russia appeared. Still, as in the previous epoch, the French authors writed about traditions and mores, the state and social structure, religious peculiarities, the culture of Russia. In general, the travel literature on Russia is significantly enriched, indicating the increasing interest of the Russian state.It is not only about informative motives, but also need to learn the realities of the Russian state, the mood in society, the level of military capabilities etc.Notes of a travelling foreigners were thus provided very valuable information about the state of affairs in Russia, it was important for European readers and, of course, diplomats, military and the rulers of other states. Of course, the French authors reproduced pictures seen in Russia through the prism of their own experience, political affiliation, certain stereotypes and myths about the Russian state and people, developed in a previous era. However, despite a certain subjectivity in the estimates and judgments, the works of French authors are a very valuable source in the framework of imagological research, studying the image of «their» and «alien» in the view of
Flare-up rate in molars with periapical radiolucency in one-visit vs two-visit endodontic treatment.
Akbar, Iftikhar; Iqbal, Azhar; Al-Omiri, Mahmoud K
2013-05-01
The objective of this study was to compare postobturation flare-ups following single and two-visit endodontic treatment of molar teeth with periapical radiolucency. A total of 100 patients with asymptomatic molar teeth with periapical radiolucency were selected. They were randomly allocated into two groups. Fifty patients received complete endodontic treatment in one-visit. Fifty patients received treatment by debridement and instrumentation at the first visit followed by obturation at the second visit. 10% of patients had flare-ups in the single visit group and 8% of patients had flare-ups in the two-visit group. Number of visits did not affect the success of endodontic treatment (p>0.05). Age, gender and tooth type had no effects on the occurrence of flare-ups regardless the number of visits (p>0.05). One-visit endodontic treatment was as successful as two-visit endodontic treatment as evaluated by rate of flareups in asymptomatic molar teeth with periapical radiolucency.
DEFF Research Database (Denmark)
Nielson, Hanne Riis; Skyum, S.
1981-01-01
It is shown that any well-defined attribute grammar is k-visit for some k. Furthermore, it is shown that given a well-defined grammar G and an integer k, it is decidable whether G is k-visit. Finally it is shown that the k-visit grammars specify a proper hierarchy with respect to translations...
Search the Division of Finance site DOF State of Alaska Finance Home Content Area Accounting Charge Cards Top Department of Administration logo Alaska Department of Administration Division of Finance Search You are here Administration / Finance / Travel Travel The Department of Administration administers the
Pre-travel care for immunocompromised and chronically ill travellers: A retrospective study
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
Mendes, Isabel; Proença, Isabel
2011-11-01
In this article, we apply count-data travel-cost methods to a truncated sample of visitors to estimate the Peneda-Gerês National Park (PGNP) average consumer surplus (CS) for each day of visit. The measurement of recreation demand is highly specific because it is calculated by number of days of stay per visit. We therefore propose the application of altered truncated count-data models or truncated count-data models on grouped data to estimate a single, on-site individual recreation demand function, with the price (cost) of each recreation day per trip equal to out-of-pocket and time travel plus out-of-pocket and on-site time costs. We further check the sensitivity of coefficient estimations to alternative models and analyse the welfare measure precision by using the delta and simulation methods by Creel and Loomis. With simulated limits, CS is estimated to be €194 (range €116 to €448). This information is of use in the quest to improve government policy and PNPG management and conservation as well as promote nature-based tourism. To our knowledge, this is the first attempt to measure the average recreation net benefits of each day of stay generated by a national park by using truncated altered and truncated grouped count-data travel-cost models based on observing the individual number of days of stay.
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.
The New England travel market: generational travel patterns, 1979 to 1996
Rod Warnick
2002-01-01
Generations of travelers who select New England as a primary destination are examined over time from the years of 1979 through 1996 and the analysis serves to update an earlier review of generational travel patterns of the region (Warnick, 1994). Changes in travel patterns are noted by overall adjusted annual change rates by demographic and geographic regions of...
Travel Daily China Travel Innovation Summit to Be Held in Beijing
Institute of Scientific and Technical Information of China (English)
2009-01-01
Guangzhou,China,April 7th- TravelDaily (www.traveldaily.cn), China’s leading online publisher and event organizer with emphasis on trends in the distribution,marketing and technology of the travel and tourism industries,today announced it will partner with PhoCusWright to host the 2009 China Travel Innovation Summit in Beijing from May 12 to 13,2009.
Directory of Open Access Journals (Sweden)
van Dulmen Sandra
2008-10-01
Full Text Available Abstract Background The general practitioner (GP can play an important role in promoting a healthy lifestyle, which is especially relevant in people with an elevated risk of cardiovascular diseases due to hypertension. Therefore, the aim of this study was to determine the frequency and content of lifestyle counseling about weight loss, nutrition, physical activity, and smoking by GPs in hypertension-related visits. A distinction was made between the assessment of lifestyle (gathering information or measuring weight or waist circumference and giving lifestyle advice (giving a specific advice to change the patient's behavior or referring the patient to other sources of information or other health professionals. Methods For this study, we observed 212 video recordings of hypertension-related visits collected within the Second Dutch National Survey of General Practice in 2000/2001. Results The mean duration of visits was 9.8 minutes (range 2.5 to 30 minutes. In 40% of the visits lifestyle was discussed (n = 84, but in 81% of these visits this discussion lasted shorter than a quarter of the visit. An assessment of lifestyle was made in 77 visits (36%, most commonly regarding body weight and nutrition. In most cases the patient initiated the discussion about nutrition and physical activity, whereas the assessment of weight and smoking status was mostly initiated by the GP. In 35 visits (17% the GP gave lifestyle advice, but in only one fifth of these visits the patient's motivation or perceived barriers for changing behavior were assessed. Supporting factors were not discussed at all. Conclusion In 40% of the hypertension-related visits lifestyle topics were discussed. However, both the frequency and quality of lifestyle advice can be improved.
Sundling, Catherine
2015-11-18
Accessibility of travel may be better understood if psychological factors underlying change in travel behavior are known. This paper examines older (65+) travelers' motives for changing their travel behavior. These changes are grounded in critical incidents earlier encountered in public-transport travel. A scientific framework is developed based on cognitive and behavioral theory. In 29 individual interviews, travelers' critical reactions (i.e., cognitive, emotional, and/or behavioral) to 77 critical incidents were examined. By applying critical incident technique (CIT), five reaction themes were identified that had generated travel-behavior change: firm restrictions, unpredictability, unfair treatment, complicated trips, and earlier adverse experiences. To improve older travelers' access to public transport, key findings were: (a) service must be designed so as to strengthen the feeling of being in control throughout the journey; (b) extended personal service would increase predictability in the travel chain and decrease travel complexity; consequently, (c) when designing new services and making effective accessibility interventions, policy makers should consider and utilize underlying psychological factors that could direct traveler behavior.
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Bisoffi Zeno
2011-05-01
Full Text Available Abstract Background Numbers of travellers visiting friends and relatives (VFRs from Europe to malaria endemic countries are increasing and include long-term and second generation immigrants, who represent the major burden of malaria cases imported back into Europe. Most recommendations for malaria chemoprophylaxis lack a solid evidence base, and often fail to address the cultural, social and economic needs of VFRs. Methods European travel medicine experts, who are members of TropNetEurop, completed a sequential series of questionnaires according to the Delphi method. This technique aims at evaluating and developing a consensus through repeated iterations of questionnaires. The questionnaires in this study included questions about professional experience with VFRs, controversial issues in malaria prophylaxis, and 16 scenarios exploring indications for prescribing and choice of chemoprophylaxis. Results The experience of participants was rather diverse as was their selection of chemoprophylaxis regimen. A significant consensus was observed in only seven of 16 scenarios. The analysis revealed a wide variation in prescribing choices with preferences grouped by region of practice and increased prescribing seen in Northern Europe compared to Central Europe. Conclusions Improving the evidence base on efficacy, adherence to chemoprophylaxis and risk of malaria and encouraging discussion among experts, using techniques such as the Delphi method, may reduce the variability in prescription in European travel clinics.
Bivek DATTA; Manohar SAJNANI; Joby THOMAS
2018-01-01
The purpose of this paper is to understand the decision making pattern of the Business Travellers in Delhi National Capital Region in India while booking their trips through Online Travel Portals. The study revolves around purchase decision pattern of Business Travellers by investigating their travel decision making style in selecting online travel portals for their trip booking. The authors have adopted the quantitative methodology to achieve the objective of the study. The study is confi...
Sundling, Catherine
2015-01-01
Accessibility of travel may be better understood if psychological factors underlying change in travel behavior are known. This paper examines older (65+) travelers? motives for changing their travel behavior. These changes are grounded in critical incidents earlier encountered in public-transport travel. A scientific framework is developed based on cognitive and behavioral theory. In 29 individual interviews, travelers? critical reactions (i.e., cognitive, emotional, and/or behavioral) to 77 ...
You, too, can be an international medical traveler: Reading medical travel guidebooks
Ormond, M.E.; Sothern, M.
2012-01-01
Drawing on literature on self-help and travel guide writing, this paper interrogates five international medical travel guidebooks aimed at encouraging American and British audiences to travel abroad to purchase medical care. These guidebooks articulate a three-step self-help “program” to produce a
Valuing travel time variability: Characteristics of the travel time distribution on an urban road
DEFF Research Database (Denmark)
Fosgerau, Mogens; Fukuda, Daisuke
2012-01-01
This paper provides a detailed empirical investigation of the distribution of travel times on an urban road for valuation of travel time variability. Our investigation is premised on the use of a theoretical model with a number of desirable properties. The definition of the value of travel time...... variability depends on certain properties of the distribution of random travel times that require empirical verification. Applying a range of nonparametric statistical techniques to data giving minute-by-minute travel times for a congested urban road over a period of five months, we show that the standardized...... travel time is roughly independent of the time of day as required by the theory. Except for the extreme right tail, a stable distribution seems to fit the data well. The travel time distributions on consecutive links seem to share a common stability parameter such that the travel time distribution...
Hummel, R. E.
1989-09-01
Today, more than one year has passed since our travels to China, and, as the media has informed us, much has happened in the intervening months. Having visited Tiananmen Square and having met so many Beijing students, we feel the greatest sympathy for the Chinese people. Yet, despite these events, we hope that our Chinese colleagues in the scientific and academic community continue to cultivate their contacts with the West and that the lines of communication do not close permanently. We all stand to gain.
The strategies that peanut and nut-allergic consumers employ to remain safe when travelling abroad.
Barnett, Julie; Botting, Neil; Gowland, M Hazel; Lucas, Jane S
2012-07-09
An understanding of the management strategies used by food allergic individuals is needed as a prerequisite to improving avoidance and enhancing quality of life. Travel abroad is a high risk time for severe and fatal food allergic reactions, but there is paucity of research concerning foreign travel. This study is the first to investigate the experiences of, and strategies used by peanut and tree nut allergic individuals when travelling abroad. Thirty-two adults with a clinical history of reaction to peanuts or tree nuts consistent with IgE-mediated allergy participated in a qualitative interview study. Travel abroad was considered difficult with inherent risks for allergic individuals. Many participants recounted difficulties with airlines or restaurants. Inconsistency in managing allergen avoidance by airlines was a particular risk and a cause of frustration to participants. Individuals used a variety of strategies to remain safe including visiting familiar environments, limiting their activities, carrying allergy information cards in the host language, preparing their own food and staying close to medical facilities. Participants used a variety of allergen avoidance strategies, which were mostly extensions or modifications of the strategies that they use when eating at home or eating-out in the UK. The extended strategies reflected their recognition of enhanced risk during travel abroad. Their risk assessments and actions were generally well informed and appropriate. A need for airline policy regarding allergy to be declared and adhered to is needed, as is more research to quantify the true risks of airborne allergens in the cabin. Recommendations arising from our study are presented.
de Vries, Anne
Travel intermediaries, commonly known as travel agencies, are important and well-known actors in the travel sector and online travel agencies such as Expedia, Booking.com and AirBnB are booming. Although intermediaries obviously bring clear benefits for contracting parties, they also complicate the
Representation of Central Asia and Traveling Self in Vambery’s Travels in Central Asia
Directory of Open Access Journals (Sweden)
Ahmad Gholi
2016-03-01
Full Text Available In the course of the nineteenth century Arminius Vambery, an anglophile travel writer, in the guise of a mendicant dervish with a group of Tartar pilgrims departs to secluded and sealed Central Asia. After six months travel in the Khanates of Central Asia, he undertakes a journey to England where he offers his observations to the Royal Geographical Society and publishes his travelogue, Travel in Central Asia. Despite its literary merits and connection with British imperialism, the travelogue has not been scrutinized separately by the scholars of travel writing. To fill the gap, this article by drawing on the theories of post-structuralism: Orientalism and Postcolonialism, endeavors to unveil the political agenda behind the travel writer’s representation of his travelees, destination, and his own traveling self. Additionally, it argues that the travel writer in dialogue with other Western travel writers to deterritorialize his traversed region or justify the prospective presence of Britain in Central Asia, represents his journey destination as the locus of barbarity, a region under the grip of despotic rulers, as well as an area with frozen time, while to exhibit his Eurocentrism, he portrays his traveling subject as the a suffering hero and a benign traveler.
Travelers' Health: HIV Infection
... Last-Minute Travel Long-Term Travel Mass Gatherings Medical Tourism Mental Health Motion Sickness Natural Disasters Pregnant Travelers ... for purposes of medical treatment (see Chapter 2, Medical Tourism ), the blood and blood products used in the ...
Intercity Travel Demand Analysis Model
Ming Lu; Hai Zhu; Xia Luo; Lei Lei
2014-01-01
It is well known that intercity travel is an important component of travel demand which belongs to short distance corridor travel. The conventional four-step method is no longer suitable for short distance corridor travel demand analysis for the time spent on urban traffic has a great impact on traveler's main mode choice. To solve this problem, the author studied the existing intercity travel demand analysis model, then improved it based on the study, and finally established a combined model...
An Italian Architect’s First Visit to Ankara: Giulio Mongeri – 1897
Directory of Open Access Journals (Sweden)
Sedat Bornovalı
2016-12-01
Full Text Available Giulio Mongeri is an Italian architect credited as behind some of the most important structures all across Turkey, but foremost in Istanbul and Ankara. He served the Ottoman state in the first quarter of the 20th century, and provided a noteworthy contribution to Ankara in the Early Republican era. Mongeri carried out his first visit to Ankara in 1897. His observations of the era are extremely interesting. Mongeri’s notes on this visit were published over a few weeks in the 25th volume of Illustrazione Italiana journal, which rarely sees daylight nowadays and is barely spoken of in the Ankara research literature. As a contribution to Turkish publications about Ankara, this study aims to evaluate this visit and compare it from various perspectives to other publications and the Ankara of today.First of all, new digital imaging was carried out in place of the low-resolution digitalized copies published by the Italian Ministry of Culture and Tourism, then a field examination of Mongeri’s route was carried out, and following study comparing this to historical sources, it was made ready for detailed investigations to be carried out by later researchers. On certain issues, Mongeri was not well informed, but on many others his deep interest in history emerges thanks to the education he had received in Milan. These travel notes may catch the eye as showing from an earlier age the basics of the historicist approach he would take in his professional life as a historian..
Unhealthy travelers present challenges to sustainable primate ecotourism.
Muehlenbein, Michael P; Martinez, Leigh Ann; Lemke, Andrea A; Ambu, Laurentius; Nathan, Senthilvel; Alsisto, Sylvia; Sakong, Rosman
2010-05-01
Ecotourism can function as a powerful tool for species conservation. However, a significant proportion of travelers at wildlife sanctuaries may be ill and potentially infectious, creating unnecessary risk of pathogen transmission to wildlife. A questionnaire was distributed to adult visitors at the Sepilok Orangutan Rehabilitation Centre, Sabah, Malaysia. The questionnaire recorded age, occupation, region of origin, history of recent travel, recent contact with livestock, domestic and wild animals, and diagnoses/symptoms of various infections. 15% of the 633 tourists self-reported at least one of the following current symptoms: cough, sore throat, congestion, fever, diarrhea and vomiting. Participants who reported recent animal contact were significantly more likely to report current respiratory symptoms compared to other participants. Likewise, participants with a medical-related occupation were more likely to report current respiratory symptoms while at Sepilok compared to other participants. Despite being ill and potentially infectious, these tourists were visiting a wildlife sanctuary to view endangered species. Many of these visitors had animal contact immediately prior to arriving, and many had at least some basic knowledge about infection transmission. While participants in nature-based tourism are generally concerned about environmental protection, present analyses suggest that a significant proportion of ecotourists are uninformed of the risks they may pose to non-human animal health. Copyright 2010 Elsevier Ltd. All rights reserved.
Travel opinion leaders and seekers
DEFF Research Database (Denmark)
Yoo, Kyung-Hyan; Gretzel, Ulrike; Zach, Florian
2011-01-01
While opinion leadership has been recognized as important in tourism, there has been very little empirical research investigating the phenomenon. Given new developments in social media technologies, it is especially important to understand whether travel opinion leadership and seeking are drivers...... of specific social media perceptions and behaviours. Based on an online survey of US online travellers, this paper seeks to identify travel opinion leaders and seekers and their characteristics. Further, the research conducted investigated linkages between travel opinion leadership/seeking and travel social...... media use. The findings suggest that travel opinion leadership and seeking are distinct but connected. Both opinion leaders and seekers are technology savvy, young, educated, involved in travel planning and engaged in social media use for travel. What distinguishes opinion leaders is their greater...
Travel experience ecosystem model : building travel agencies’ business resilience in Portugal
Salvado, Josefina
2011-01-01
The Portuguese tourism distribution recognizes in the digital economy drivers - based on e-business, collaborative networks and information exchange - an incentive to productivity and rendibility, leading to sustainable competitive advantages. Travel agencies live currently in a Darwinian business-oriented environment, where only resilient entrepreneurs are able to survive. This framing allows the genesis of a new theoretical archetype of travel agencies, the “TEEM - Travel Exp...
Energy Technology Data Exchange (ETDEWEB)
Young, Stanley
2017-04-24
The Connected Traveler project is a multi-disciplinary undertaking that seeks to validate potential for transformative transportation system energy savings by incentivizing energy efficient travel behavior.
Hietala, V.M.; Vawter, G.A.
1993-12-14
The traveling-wave photodetector of the present invention combines an absorptive optical waveguide and an electrical transmission line, in which optical absorption in the waveguide results in a photocurrent at the electrodes of the electrical transmission line. The optical waveguide and electrical transmission line of the electrically distributed traveling-wave photodetector are designed to achieve matched velocities between the light in the optical waveguide and electrical signal generated on the transmission line. This velocity synchronization provides the traveling-wave photodetector with a large electrical bandwidth and a high quantum efficiency, because of the effective extended volume for optical absorption. The traveling-wave photodetector also provides large power dissipation, because of its large physical size. 4 figures.
Heywood, Anita E; Watkins, Rochelle E; Iamsirithaworn, Sopon; Nilvarangkul, Kessarawan; MacIntyre, C Raina
2012-05-02
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. Cross-sectional surveys were conducted between July and December 2007 to assess pre-travel health seeking practices, including advice from health professionals, health information from other sources and vaccine uptake, in a sample of travelers departing Sydney and Bangkok airports. A two-stage cluster sampling technique was used to ensure representativeness of travelers and travel destinations. Pre-travel health seeking practices were assessed using a self-administered questionnaire distributed at the check-in queues of departing flights. Logistic regression models were used to identify significant factors associated with seeking pre-travel health advice from a health professional, reported separately for Australian residents, residents of other Western countries and residents of countries in Asia. A total of 843 surveys were included in the final sample (Sydney 729, response rate 56%; Bangkok 114, response rate 60%). Overall, pre-travel health information from any source was sought by 415 (49%) respondents with 298 (35%) seeking pre-travel advice from a health professional, the majority through general practice. Receipt of a pre-travel vaccine was reported by 100 (12%) respondents. Significant factors associated with seeking pre-travel health advice from a health professional differed by region of residence. Asian travelers were less likely to report seeking pre-travel health advice and uptake of pre-travel vaccines than Australian or other Western travelers. Migrant Australians were less likely to report seeking pre-travel health advice than Australian
2012-01-01
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 December 2007 to assess pre-travel health seeking practices, including advice from health professionals, health information from other sources and vaccine uptake, in a sample of travelers departing Sydney and Bangkok airports. A two-stage cluster sampling technique was used to ensure representativeness of travelers and travel destinations. Pre-travel health seeking practices were assessed using a self-administered questionnaire distributed at the check-in queues of departing flights. Logistic regression models were used to identify significant factors associated with seeking pre-travel health advice from a health professional, reported separately for Australian residents, residents of other Western countries and residents of countries in Asia. Results A total of 843 surveys were included in the final sample (Sydney 729, response rate 56%; Bangkok 114, response rate 60%). Overall, pre-travel health information from any source was sought by 415 (49%) respondents with 298 (35%) seeking pre-travel advice from a health professional, the majority through general practice. Receipt of a pre-travel vaccine was reported by 100 (12%) respondents. Significant factors associated with seeking pre-travel health advice from a health professional differed by region of residence. Asian travelers were less likely to report seeking pre-travel health advice and uptake of pre-travel vaccines than Australian or other Western travelers. Migrant Australians were less likely to report seeking pre-travel health
International Nuclear Information System (INIS)
Gregg, D.W.; Kidder, R.E.; Biehl, A.T.
1975-01-01
The invention broadly involves a method and means for generating a traveling wave laser pulse and is basically analogous to a single pass light amplifier system. However, the invention provides a traveling wave laser pulse of almost unlimited energy content, wherein a gain medium is pumped in a traveling wave mode, the traveling wave moving at essentially the velocity of light to generate an amplifying region or zone which moves through the medium at the velocity of light in the presence of directed stimulating radiation, thereby generating a traveling coherent, directed radiation pulse moving with the amplification zone through the gain medium. (U.S.)
ETT Division; Division ETT; Service des visites
2000-01-01
The Visit Service noticed that for many years countries such as Great Britain, Germany, Spain, Portugal, the Netherlands and the Scandinavian countries visit CERN less than other member countries and that is due to the high price of the trip for the students. To improve the situation the Visit Service plans to create a network of 'Family-Accommodation' ('Famille-Accueil') in Geneva and in France nearbywith the aim to facilitate the trip to foreign students especially from the more distant member countries and to encourage them to visit our unique laboratory. We expect this exchange to be an interesting experience for both the students and the welcoming family ('famille d'accueil'). If you are interested in participating in this family network, please fill in the questionnaire below. The questionnaire is to be returned to the Visit Service, Mrs Christine Fromm, e-mail Christine.Fromm@cern.ch.Name: First name: CERN address: E-mail: Portable phone number: Home address...
2003-01-01
On 6 October, Professor Michal Kleiber, Polish Minister of Science and Chairman of the State Committee for Scientific Research, visited CERN and met both the current and designated Director General, Luciano Maiani and Robert Aymar. Professor Kleiber visited the CMS and ATLAS detector assembly halls, the underground cavern for ATLAS, and the LHC superconducting magnet string test hall. Michal Kleiber (left), Polish minister of science and Jan Krolikowski, scientist at Warsaw University and working for CMS, who shows the prototypes of the Muon Trigger board of CMS.
Mind your travel ! Motivation, time use, and intent : Three factors of travel to be investigated
PAPON , Francis; Meissonnier , Joël
2013-01-01
The objective is to investigate the drivers of travel demand beyond the need to travel to destination; travellers may engage a trip for the sake of it, at least to some extent: travel includes a share of 'primary utility'. The paper focuses on two types of data and analysis: the primary utility of travel questions passed in the last French national travel survey, and eight dimensions of a trip proposed from a sociological analysis. The paper mixes these approaches and correlate survey answ...
A travel clinic in your office: grow your practice and protect international travelers.
Kirsch, Michael
2009-01-01
Medical practices today face economic challenges from declining reimbursements and rising overhead costs. Physicians need to develop new income sources to invigorate their practices and remain viable. Travel medicine-advising and immunizing international travelers-is a rapidly growing specialty in the United States that generates substantial cash reimbursements and professional satisfaction. Travel Clinics of America, a physician-operated company, specializes in helping physicians to incorporate travel medicine into their existing practices.
Health hazards of international travel.
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.
Farnham, Andrea; Blanke, Ulf; Stone, Emily; Puhan, Milo A; Hatz, Christoph
2016-06-01
mHealth methodology such as smartphone applications offers new opportunities to capture the full range of health risks during travel in real time. Our study aims to widen the scope of travel health research in tropical and subtropical destinations by using a smartphone application to collect detailed information on health behaviours, clinical symptoms, accidents and environmental factors during travel. We enrolled travel clinic clients in Zurich and Basel ≥18 years of age travelling to Thailand for travel. Participants were equipped with a smartphone and an application that (1) actively administers a daily self-report questionnaire on the health risks, behaviours and symptoms the traveller encountered, and (2) passively collects information on the traveller's location and environmental conditions by transformation of raw GPS data. A prospective cohort of 101 travellers planning travel to Thailand between January and June 2015 was recruited. Of the 101 enrolled travellers, 75 (74.3%) answered at least one questionnaire during travel, 10 (9.9%) had technical difficulties and 16 (15.8%) dropped out. Those who completed questionnaires were a median of 27.0 years old (range 18-57). Travellers filled out a median of 12.0 questionnaires during their trip (range 1-30), corresponding to a median completion rate of 85.0% days of travel. The typical example of a healthy female traveller shows that many and diverse health issues arise during a trip that clusters on certain days. The rich data on behaviour and local environment may be used to explain the occurrence and clustering of health issues. Use of a smartphone app to collect health information is technically feasible and acceptable amongst a traveller population, minimizes recall bias and greatly increases the quality and quantity of data collected during travel. mHealth technology shows great potential for innovation in travel medicine. © International Society of Travel Medicine, 2016. All rights reserved
Knowledge Representation in Travelling Texts
DEFF Research Database (Denmark)
Mousten, Birthe; Locmele, Gunta
2014-01-01
Today, information travels fast. Texts travel, too. In a corporate context, the question is how to manage which knowledge elements should travel to a new language area or market and in which form? The decision to let knowledge elements travel or not travel highly depends on the limitation...... and the purpose of the text in a new context as well as on predefined parameters for text travel. For texts used in marketing and in technology, the question is whether culture-bound knowledge representation should be domesticated or kept as foreign elements, or should be mirrored or moulded—or should not travel...... at all! When should semantic and pragmatic elements in a text be replaced and by which other elements? The empirical basis of our work is marketing and technical texts in English, which travel into the Latvian and Danish markets, respectively....
2011-07-20
...; Sequence 5] Federal Travel Regulation (FTR): Temporary Duty (TDY) Travel Allowances: Notice of Public... public meeting. SUMMARY: The General Services Administration (GSA) is revising the Federal Travel Regulation (FTR) in an effort to streamline travel policies, increase travel efficiency and effectiveness...
Scheffer, Alice C; van Hensbroek, Pieter Boele; van Dijk, Nynke; Luitse, Jan S K; Goslings, Johannes C; Luigies, René H; de Rooij, Sophia E
2013-07-26
Little is known about the prevalence of modifiable risk factors of falling in elderly persons with a fall-history who do not visit the Accident and Emergency (A&E) Department after one or more falls. The objective of this study was to determine the prevalence of modifiable risk factors in a population that visited the A&E Department after a fall (A&E group) and in a community-dwelling population of elderly individuals with a fall history who did not visit the A&E Department after a fall (non-A&E group). Two cohorts were included in this study. The first cohort included 547 individuals 65 years and older who were visited at home by a mobile fall prevention team. The participants in this cohort had fall histories but did not visit the A&E Department after a previous fall. These participants were age- and gender-matched to persons who visited the A&E Department for care after a fall. All participants were asked to complete the CAREFALL Triage Instrument. The mean number of modifiable risk factors in patients who did not visit the A&E Department was 2.9, compared to 3.8 in the group that visited the A&E Department (pfalling, impaired vision, mood and high risk of osteoporosis were all independently associated with visiting the A&E Department. All modifiable risk factors for falling were found to be shared between community-dwelling elderly individuals with a fall history who visited the A&E Department and those who did not visit the Department, although the prevalence of these factors was somewhat lower in the A&E group. Preventive strategies aimed both at patients presenting to the A&E Department after a fall and those not presenting after a fall could perhaps reduce the number of recurrent falls, the occurrence of injury and the frequency of visits to the A&E Department.
Travel, infection and immunity
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...
Song, Hanqun; Sparks, Beverley; Wang, Ying
2017-01-01
The young Chinese travel market is becoming increasingly significant in domestic and international tourism. However, there is limited research on the market. This study examines the decision-making processes of young Chinese travellers, with a particular interest in disagreement prevention and resolution. On the basis of interviews with 25 young Chinese travellers, this study found that while a small number of travellers did not perceive any disagreement, or did not voice their disagreement, ...
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
Hagmann, Stefan H F; Rao, Sowmya R; LaRocque, Regina C; Erskine, Stefanie; Jentes, Emily S; Walker, Allison T; Barnett, Elizabeth D; Chen, Lin H; Hamer, Davidson H; Ryan, Edward T
2017-12-01
To study characteristics and preventive interventions of adult pregnant and breastfeeding travelers seeking pretravel health care in the United States. This cross-sectional study analyzed data (2009-2014) of pregnant and breastfeeding travelers seen at U.S. travel clinics participating in Global TravEpiNet. Nonpregnant, nonbreastfeeding adult female travelers of childbearing age were used for comparison. We evaluated the prescription of malaria chemoprophylaxis and antibiotics for this population as well as the administration of three travel-related vaccines: hepatitis A, typhoid, and yellow fever. We also evaluated use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis and influenza vaccines, because these are widely recommended in pregnancy. Of 21,138 female travelers of childbearing age in Global TravEpiNet, 170 (0.8%) were pregnant and 139 (0.7%) were breastfeeding. Many traveled to destinations endemic for mosquito-borne illnesses, including malaria (pregnant: 95%; breastfeeding: 94%), dengue (pregnant: 87%; breastfeeding: 81%), or yellow fever (pregnant: 35%; breastfeeding: 50%). Compared with nonpregnant, nonbreastfeeding adult female travelers, eligible pregnant travelers were less likely to be vaccinated against hepatitis A (28% compared with 51%, Ptravelers did not receive influenza vaccination. Yellow fever vaccine was occasionally provided to pregnant and breastfeeding travelers traveling to countries entirely endemic for yellow fever (6 [20%] of 30 pregnant travelers and 18 [46%] of 39 breastfeeding travelers). Half of pregnant travelers and two thirds of breastfeeding travelers preparing to travel to malaria-holoendemic countries received a prescription for malaria prophylaxis. Most pregnant and breastfeeding travelers seen for pretravel health consultations traveled to destinations with high risk for vector-borne or other travel-related diseases. Destination-specific preventive interventions were frequently underused.
The value of travel time variance
DEFF Research Database (Denmark)
Fosgerau, Mogens; Engelson, Leonid
2011-01-01
This paper considers the value of travel time variability under scheduling preferences that are defined in terms of linearly time varying utility rates associated with being at the origin and at the destination. The main result is a simple expression for the value of travel time variability...... that does not depend on the shape of the travel time distribution. The related measure of travel time variability is the variance of travel time. These conclusions apply equally to travellers who can freely choose departure time and to travellers who use a scheduled service with fixed headway. Depending...... on parameters, travellers may be risk averse or risk seeking and the value of travel time may increase or decrease in the mean travel time....
2011-08-02
...; Sequence 5] Federal Travel Regulation (FTR): Temporary Duty (TDY) Travel Allowances: Notice of Public... and the general public in an effort to streamline travel policies, incorporated travel efficiency and.... Flynn, Deputy Director, Office of Travel, Transportation & Asset Management. [FR Doc. 2011-19482 Filed 8...
Ettema, D.F.; Timmermans, H.J.P.
2006-01-01
A negative effect of congestion that tends to be overlooked is travel time uncertainty. Travel time uncertainty causes scheduling costs due to early or late arrival. The negative effects of travel time uncertainty can be reduced by providing travellers with travel time information, which improves
International Nuclear Information System (INIS)
Gregg, D.W.; Kidder, R.E.; Biehl, A.T.
1975-01-01
A method is described for generating a traveling wave laser pulse of almost unlimited energy content wherein a gain medium is pumped into a traveling wave mode, the traveling wave moving at essentially the velocity of light to generate an amplifying region or zone which moves through the medium at the velocity of light in the presence of directed stimulating radiation, thereby generating a traveling coherent, directed radiation pulse moving with the amplification zone through the gain medium. (U.S.)
Directory of Open Access Journals (Sweden)
Ardhila Ayu Prasetyowati
2014-04-01
Full Text Available This study aims to analyze the tourists’ perception about the importance and satisfaction on the product of fisheries tourism, and to assess the visiting time of tourist based on climate conditions. The research was conducted in May to June 2013 in Ngebel Lake, Ponorogo. We used descriptive quantitative approach, with 45 respondents. Data collected from interview, questionnaire and observation. Analytical methods were used to determine the perception of tourists on the satisfaction and interest in fisheries tourism products, i.e. Importance Performance Analysis (IPA. We also used Tourism Climate Index (TCI to determine the visiting time of tourist. The results show the value of satisfaction and tourist interest is low, therefore the improvement of several aspects become important. It is encompasses: a the existence of parking area; b the condition of Ngebel Lake; c planning and management system, the condition of the local community; and d activities of fish course restaurant and fish farming system of floating net cages. TCI value indicates ideal conditions for tourists traveled in Ngebel Lake is in November (convenience index value of 106, in December (97 and in April (94. This appropriate time to visit Ngebel Lake is expected to create a good impression for the tourists and enjoy the various fisheries activities in Ngebel Lake. Keywords: Importance Performance Analysis, Ngebel Lake, Tourist Climate Index
ON SAMPLING BASED METHODS FOR THE DUBINS TRAVELING SALESMAN PROBLEM WITH NEIGHBORHOODS
Directory of Open Access Journals (Sweden)
Petr Váňa
2015-12-01
Full Text Available In this paper, we address the problem of path planning to visit a set of regions by Dubins vehicle, which is also known as the Dubins Traveling Salesman Problem Neighborhoods (DTSPN. We propose a modification of the existing sampling-based approach to determine increasing number of samples per goal region and thus improve the solution quality if a more computational time is available. The proposed modification of the sampling-based algorithm has been compared with performance of existing approaches for the DTSPN and results of the quality of the found solutions and the required computational time are presented in the paper.
Travel, infection and immunity
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
Zheng, F.
2011-01-01
Urban travel times are intrinsically uncertain due to a lot of stochastic characteristics of traffic, especially at signalized intersections. A single travel time does not have much meaning and is not informative to drivers or traffic managers. The range of travel times is large such that certain
Travelers' Health: Trypanosomiasis, American (Chagas Disease)
... 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 ...
Human Resources Division
2002-01-01
Administrative procedures for : Travel to the home station and home leave (hl) Additional travel to the home station (at) Travel to the home station and home leave for family reasons (hlf) As part of the process of simplifying administrative procedures, HR and AS Divisions have devised a new, virtually automatic procedure for payment of travel expenses to the home station. The changes are aimed at rationalising administrative procedures and not at reducing benefits. The conditions of eligibility are unchanged. The new procedure, which will be operational with effect from 1st June 2002, will greatly simplify the administrative processing of claims for travel expenses and the recording of home leaves. Currently, requests for payment are introduced manually into the Advances and Claims system (AVCL) by divisional secretariats. All travel to the home station starting prior to 1st June 2002 will be processed according to the existing system whereas that starting on 1st June and after will be processed accordi...
Bohte, W.
2010-01-01
Most Western national governments aim to influence individual travel patterns – at least to some degree – through spatial planning in residential areas. Nevertheless, the extent to which the characteristics of the built environment influence travel behaviour remains the subject of some debate among
High speed rail and coastal tourism: Identifying passenger profiles and travel behaviour.
Gutiérrez, Aaron; Ortuño, Armando
2017-01-01
In this paper, we characterise tourists most likely to visit a coastal destination by high-speed rail (HSR). Our data came from a survey conducted among HSR passengers during 2014's high season (July and August) at Spain's Camp de Tarragona and Alicante Stations, each of which is near a mass tourism destination on the Mediterranean coast: the Costa Daurada and the Costa Blanca, respectively. We used responses to the survey, which presented binary discrete-choice situations, to construct a database necessary for a logistic regression model that allowed us to examine how passenger profile, trip characteristics, and stay conditions influenced the use of HSR services on visits to each coastal destination. Results highlighted significant differences in the profiles of tourists who arrived at each destination by HSR and, in turn, that no specific tourist profile is associated with HSR, even for two stations that serve sunny beach destinations. Among its implications, to analyse travellers that HSR can attract, it is vital to consider the specific characteristics of each destination and its current market.
First tooth, first visit, zero cavities: a practical approach to the infant oral health visit
LENUS (Irish Health Repository)
Fitzgerald, Kirsten
2017-04-01
The IDA adopted a formal policy on children’s oral health in 2011. There is increasing evidence to support early dental visits for children. The background to the infant oral health visit is discussed and a systematic approach to the practicalities of the visit is offered. General dental practitioners are encouraged to offer the first oral health visit before the first birthday, and this paper aims to give them practical advice concerning this visit. The feature is accompanied by a companion paper that reviews the literature pertaining to the topic, and serves to complement the recent clinical feature published in the Journal of the Irish Dental Association.
Writing Travel in the Anthropocene
DEFF Research Database (Denmark)
Graulund, Rune
2016-01-01
the Anthropocene - which is to say an age in which nowhere, not the furthest reachest of the stratosphere nor the lowest point in the marine abyss, are untouched by the activities and detritus of humankind. The essay will give a short overview of the manner in which the notion of 'travel' has been contested......Travel writing critics have proclaimed the end of travel since at least the beginning of the 20th Century. Yet the global age of the 21st century presents us with a range a problems that challenge the notion of travel in manners that neither travellers, travel writers, nor travel writing critics...... could have imagined just a century ago. Globalisation and increased mobility, whether it is that of the privileged few who can travel on holiday on jet airplanes, or that of the immigrant labourer seeking employment by crossing borders on foot, have meant millions (if not indeed billions) are constantly...
A population-based algorithm for the multi travelling salesman problem
Directory of Open Access Journals (Sweden)
Rubén Iván Bolaños
2016-04-01
Full Text Available This paper presents the implementation of an efficient modified genetic algorithm for solving the multi-traveling salesman problem (mTSP. The main characteristics of the method are the construction of an initial population of high quality and the implementation of several local search operators which are important in the efficient and effective exploration of promising regions of the solution space. Due to the combinatorial complexity of mTSP, the proposed methodology is especially applicable for real-world problems. The proposed algorithm was tested on a set of six benchmark instances, which have from 76 and 1002 cities to be visited. In all cases, the best known solution was improved. The results are also compared with other existing solutions procedure in the literature.
Information impact on quality of travel choices: analysis of data from a multimodal travel simulator
Chorus, C.G.; Arentze, T.A.; Timmermans, H.J.P.; Silva, da A.N.R.; Souza, de L.C.L.
2007-01-01
This paper investigates the impact of travel information on the quality of travel choices. It distinguishes itself from earlier studies on this topic by empirically investigating the impact of a variety of travel information types on the quality of observed multimodal travel choices. Choice quality
Drug use, travel and HIV risk.
Lee, D; Bell, D C; Hinojosa, M
2002-08-01
A study was conducted to examine the travel experiences of a community sample of 160 drug users and 44 non-users recruited as part of a study of HIV risk. Of the sample, 47% (96/204) reported intercity travel in the previous ten years. Results showed that men were more likely to travel than women, Anglos more than minorities, and young persons more than old. When travellers testing HIV-seropositive (n = 13) were compared with seronegative travellers, HIV-positive travellers reported more sex while travelling than HIV-negative persons, but virtually all of the difference reported involved sex with condoms. There were no significant differences in sex risk behaviours while travelling between drug users and non-drug users, or in sex risk behaviors between drug injectors and non-injectors. Travellers had fewer injection partners while travelling than they had while at home. There was also a significant difference in number of sex partners with whom a condom was not used, with fewer sex partners while travelling.
Travel time to maternity care and its effect on utilization in rural Ghana: a multilevel analysis.
Masters, Samuel H; Burstein, Roy; Amofah, George; Abaogye, Patrick; Kumar, Santosh; Hanlon, Michael
2013-09-01
Rates of neonatal and maternal mortality are high in Ghana. In-facility delivery and other maternal services could reduce this burden, yet utilization rates of key maternal services are relatively low, especially in rural areas. We tested a theoretical implication that travel time negatively affects the use of in-facility delivery and other maternal services. Empirically, we used geospatial techniques to estimate travel times between populations and health facilities. To account for uncertainty in Ghana Demographic and Health Survey cluster locations, we adopted a novel approach of treating the location selection as an imputation problem. We estimated a multilevel random-intercept logistic regression model. For rural households, we found that travel time had a significant effect on the likelihood of in-facility delivery and antenatal care visits, holding constant education, wealth, maternal age, facility capacity, female autonomy, and the season of birth. In contrast, a facility's capacity to provide sophisticated maternity care had no detectable effect on utilization. As the Ghanaian health network expands, our results suggest that increasing the availability of basic obstetric services and improving transport infrastructure may be important interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.
Directory of Open Access Journals (Sweden)
Katherinne Giselle Mora Pacheco
2015-07-01
Full Text Available Different works of Agrarian History reproduce a similar description of Bogota Plateau (Colombia throughout the nineteenth century: agricultural use since colonial times; vast fields of wheat and barley; abrupt replacement of crops by cattle; agricultural crisis linked to the agro-export booms and the demand for tropical products that could not be obtained above 2000 meters. This paper discusses how this approach has perpetuated descriptions of travelers who visited the region during the nineteenth century and wrote up their notebooks based on their origins, objectives, political and economic interests, or from affirmations of their guides and informants. This article rebuilds a profile of travelers that are most often quoted by historians, their views about the Plateau landscape and its farming and ranching, and their influence on today reconstructions of the agrarian history of Bogota Plateau along nineteenth century. This text invites to contrast the travel accounts among themselves and with another sources, and also to incorporate the results of the research about the Colonial period and the biophysical conditions of the regions under study in the analysis.
Kim, Byoungjip; Kang, Seungwoo; Ha, Jin-Young; Song, Junehwa
2015-01-01
In this paper, we introduce a novel smartphone framework called VisitSense that automatically detects and predicts a smartphone user’s place visits from ambient radio to enable behavioral targeting for mobile ads in large shopping malls. VisitSense enables mobile app developers to adopt visit-pattern-aware mobile advertising for shopping mall visitors in their apps. It also benefits mobile users by allowing them to receive highly relevant mobile ads that are aware of their place visit patterns in shopping malls. To achieve the goal, VisitSense employs accurate visit detection and prediction methods. For accurate visit detection, we develop a change-based detection method to take into consideration the stability change of ambient radio and the mobility change of users. It performs well in large shopping malls where ambient radio is quite noisy and causes existing algorithms to easily fail. In addition, we proposed a causality-based visit prediction model to capture the causality in the sequential visit patterns for effective prediction. We have developed a VisitSense prototype system, and a visit-pattern-aware mobile advertising application that is based on it. Furthermore, we deploy the system in the COEX Mall, one of the largest shopping malls in Korea, and conduct diverse experiments to show the effectiveness of VisitSense. PMID:26193275
Kim, Byoungjip; Kang, Seungwoo; Ha, Jin-Young; Song, Junehwa
2015-07-16
In this paper, we introduce a novel smartphone framework called VisitSense that automatically detects and predicts a smartphone user's place visits from ambient radio to enable behavioral targeting for mobile ads in large shopping malls. VisitSense enables mobile app developers to adopt visit-pattern-aware mobile advertising for shopping mall visitors in their apps. It also benefits mobile users by allowing them to receive highly relevant mobile ads that are aware of their place visit patterns in shopping malls. To achieve the goal, VisitSense employs accurate visit detection and prediction methods. For accurate visit detection, we develop a change-based detection method to take into consideration the stability change of ambient radio and the mobility change of users. It performs well in large shopping malls where ambient radio is quite noisy and causes existing algorithms to easily fail. In addition, we proposed a causality-based visit prediction model to capture the causality in the sequential visit patterns for effective prediction. We have developed a VisitSense prototype system, and a visit-pattern-aware mobile advertising application that is based on it. Furthermore, we deploy the system in the COEX Mall, one of the largest shopping malls in Korea, and conduct diverse experiments to show the effectiveness of VisitSense.
Carlson Wagonlit Travel
2005-01-01
Dear customers, On 3 January we informed you that the airlines had decided to cease paying commission to travel agencies in Switzerland. This measure has since been progressively introduced, with rare exceptions. Consequently, in agreement with CERN, we are obliged to apply new transaction fees for private travel, with immediate effect. Carlson Wagonlit Travel (CWT) offers: A personalized, professional and competent consultancy service To seek the most economical and best solution adapted to your needs Neutrality in comparing prices and benefits Additional information concerning e.g. visa regulations, insurance, vaccinations, etc. Support in the event of problems We draw your attention to the fact that, in spite of the increase, these prices remain very competitive on today's market. Thank you for your trust and understanding. Yours truly, Carlson Wagonlit Travel CERN agency
Hepatitis B vaccination in travelers
Sonder, Gerard J. B.
2008-01-01
An increasing number of travelers travel to hepatitis B-endemic countries. In travel medicine, vaccinations should be advised according to risks. The actual incidence of hepatitis B infection in short-term tourists is very low and probably not higher than it is for people who do not travel. There is
Trends and characteristics among HIV-infected and diabetic travelers seeking pre-travel advice
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)
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.
Baer, Atar; Libassi, Lisa; Lloyd, Jennifer K; Benoliel, Eileen; Brucker, Rachel; Jones, Megan Q; Kwan-Gett, Tao Sheng; McKeirnan, Shelly; Pecha, Monica; Rietberg, Krista; Serafin, Lauri; Walkinshaw, Lina P; Duchin, Jeffrey S
2014-01-01
We sought to describe travel-related illness among our residents and gain insight into targeting pre-travel health advice to prevent travel-related illness. A supplemental travel questionnaire was developed and administered for cases with a legally notifiable communicable disease reported in 2011-2012, who spent at least part of their exposure period outside the United States. Among 451 cases meeting the eligibility criteria, 259 were interviewed. Forty four percent reported receiving pre-travel advice. Two-thirds adhered fully with risk behavior recommendations; 94% followed immunization recommendations partially or fully; and 84% adhered fully with malaria prophylaxis recommendations. The primary reasons for not obtaining pre-travel advice were being unaware of the need (47.5%), or believing they already knew what to do (34.5%). Adults (OR = 2.8, 95% CI = 1.4-5.5), males (OR = 1.8, 95% CI = 1.1-3.0), those born outside the United States (OR = 2.0, 95% CI = 1.1-3.7), and those with planning time under two weeks (OR = 4.8, 95% CI = 1.5-15.9) or travel duration less than 7 days (OR = 7.9, 95% CI = 3.0-20.9) were more likely to travel without seeking pre-travel advice. The majority of cases reported not receiving pre-travel advice. Understanding the predictors of failure to receive pre-travel advice may help target public health prevention efforts. Copyright © 2014 Elsevier Ltd. All rights reserved.
Travel Time Reliability in Indiana
Martchouk, Maria; Mannering, Fred L.; Singh, Lakhwinder
2010-01-01
Travel time and travel time reliability are important performance measures for assessing traffic condition and extent of congestion on a roadway. This study first uses a floating car technique to assess travel time and travel time reliability on a number of Indiana highways. Then the study goes on to describe the use of Bluetooth technology to collect real travel time data on a freeway and applies it to obtain two weeks of data on Interstate 69 in Indianapolis. An autoregressive model, estima...
2004-01-01
On 11 December, President Stjepan Mesic of the Republic of Croatia visited CERN. He was welcomed by Director General, Robert Aymar, and the President of CERN Council, Maurice Bourquin. Afterwards he met, among others, the Directors of CERN and Croatian scientists working here. He finished his tour by visiting the underground cavern for the ATLAS experiment. The arrival at CERN of the President of the Republic of Croatia, Stjepan Mesic. In the first row, from left to right: Maurice Bourquin, President of CERN Council, Stjepan Mesic, President of the Republic of Croatia and Robert Aymar, Director General of CERN.
The strategies that peanut and nut-allergic consumers employ to remain safe when travelling abroad
Directory of Open Access Journals (Sweden)
Barnett Julie
2012-07-01
Full Text Available Abstract Background An understanding of the management strategies used by food allergic individuals is needed as a prerequisite to improving avoidance and enhancing quality of life. Travel abroad is a high risk time for severe and fatal food allergic reactions, but there is paucity of research concerning foreign travel. This study is the first to investigate the experiences of, and strategies used by peanut and tree nut allergic individuals when travelling abroad. Methods Thirty-two adults with a clinical history of reaction to peanuts or tree nuts consistent with IgE-mediated allergy participated in a qualitative interview study. Results Travel abroad was considered difficult with inherent risks for allergic individuals. Many participants recounted difficulties with airlines or restaurants. Inconsistency in managing allergen avoidance by airlines was a particular risk and a cause of frustration to participants. Individuals used a variety of strategies to remain safe including visiting familiar environments, limiting their activities, carrying allergy information cards in the host language, preparing their own food and staying close to medical facilities. Conclusions Participants used a variety of allergen avoidance strategies, which were mostly extensions or modifications of the strategies that they use when eating at home or eating-out in the UK. The extended strategies reflected their recognition of enhanced risk during travel abroad. Their risk assessments and actions were generally well informed and appropriate. A need for airline policy regarding allergy to be declared and adhered to is needed, as is more research to quantify the true risks of airborne allergens in the cabin. Recommendations arising from our study are presented.
Guerrero-Lillo, Lisette; Medrano-Díaz, Jorge; Pérez, Carmen; Chacón, Rodrigo; Silva-Urra, Juan; Rodriguez-Morales, Alfonso J
2009-01-01
Because information about travel medicine in Chile is lacking, a knowledge, attitudes, and practices evaluation in international travelers and medical students was done. The travelers and medical students did not know the travel medicine and sanitary conditions of their destinations, although they perceived travel-associated health risks, but <10% had any vaccination and 5% got sick during international trips.
Directory of Open Access Journals (Sweden)
Byoungjip Kim
2015-07-01
Full Text Available In this paper, we introduce a novel smartphone framework called VisitSense that automatically detects and predicts a smartphone user’s place visits from ambient radio to enable behavioral targeting for mobile ads in large shopping malls. VisitSense enables mobile app developers to adopt visit-pattern-aware mobile advertising for shopping mall visitors in their apps. It also benefits mobile users by allowing them to receive highly relevant mobile ads that are aware of their place visit patterns in shopping malls. To achieve the goal, VisitSense employs accurate visit detection and prediction methods. For accurate visit detection, we develop a change-based detection method to take into consideration the stability change of ambient radio and the mobility change of users. It performs well in large shopping malls where ambient radio is quite noisy and causes existing algorithms to easily fail. In addition, we proposed a causality-based visit prediction model to capture the causality in the sequential visit patterns for effective prediction. We have developed a VisitSense prototype system, and a visit-pattern-aware mobile advertising application that is based on it. Furthermore, we deploy the system in the COEX Mall, one of the largest shopping malls in Korea, and conduct diverse experiments to show the effectiveness of VisitSense.
... Videos for Educators Search English Español Traveling and Asthma KidsHealth / For Kids / Traveling and Asthma Print en ... pack it, too. How Can I Avoid My Asthma Triggers? Staying at a hotel Ask for a ...
2010-10-01
... INSURANCE BENEFITS Home Health Services Under Hospital Insurance § 409.48 Visits. (a) Number of allowable... home health visits. All Medicare home health services are covered under hospital insurance unless there... 42 Public Health 2 2010-10-01 2010-10-01 false Visits. 409.48 Section 409.48 Public Health CENTERS...
Understanding the reasons why tourists visit the Kruger National Park during a recession
Directory of Open Access Journals (Sweden)
Marco Scholtz
2013-02-01
Full Text Available The 2008 and 2009 recession increased pressure on travellers to cut costs on luxury items, such as going on holiday, and this has led to a global tourism decline of 8%. This, however, was not the case in the Kruger National Park (KNP in South Africa where a sustained 1.6% accommodation unit occupancy growth was experienced. In order to sustain this growth, it is of the utmost importance to determine why people still visited the Park during this period. Thus the aim of the study was to determine why people still visited the KNP amidst the 2008 and 2009 economic recession. A total of 355 completed questionnaires were obtained at the Park during 15 December 2009 – 20 December 2009 (high season after which various analyses (including factor analysis were conducted. Six motives were identified and ‘escape’, ‘wildlife experience’ and ‘family benefits’ were rated most important. Push factors were more dominant to the extent that visitors regard taking a holiday to the Park as a necessity. It furthermore seems that visitors adapt their spending behaviour at the Park to still be able to afford the visit. This was the first time that research was conducted at a national park during a recession period and this information is important for South African National Parks, seeing as it provides a better understanding of visitors’ behaviour as well as feeling towards the Park (especially during recession, and leads to improved niche marketing and a competitive advantage. This research also provides a better understanding of visitors’ behaviour during economic downturns.
The Medicare Annual Wellness Visit.
Colburn, Jessica L; Nothelle, Stephanie
2018-02-01
The Medicare Annual Wellness Visit is an annual preventive health benefit, which was created in 2011 as part of the Patient Protection and Affordable Care Act. The visit provides an opportunity for clinicians to review preventive health recommendations and screen for geriatric syndromes. In this article, the authors review the requirements of the Annual Wellness Visit, discuss ways to use the Annual Wellness Visit to improve the care of geriatric patients, and provide suggestions for how to incorporate this benefit into a busy clinic. Copyright © 2017 Elsevier Inc. All rights reserved.
DEFF Research Database (Denmark)
Simonsen, Karen-Margrethe
2013-01-01
Review of "Travelling Concepts, Metaphors, and Narratives: Literary and Cultural Studies in an Age of Interdisciplinary Research" ed. by Sibylle Baumgarten, Beatrice Michaelis and Ansagar Nünning, Trier; Wissenschaftlicher Verlag Trier, 2012......Review of "Travelling Concepts, Metaphors, and Narratives: Literary and Cultural Studies in an Age of Interdisciplinary Research" ed. by Sibylle Baumgarten, Beatrice Michaelis and Ansagar Nünning, Trier; Wissenschaftlicher Verlag Trier, 2012...
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.
28 CFR 540.41 - Visiting facilities.
2010-07-01
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Visiting facilities. 540.41 Section 540... WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.41 Visiting facilities. The Warden shall have... have a portion of the visiting room equipped and set up to provide facilities for the children of...
41 CFR 301-71.105 - Must we issue a written or electronic travel authorization in advance of travel?
2010-07-01
... or electronic travel authorization in advance of travel? 301-71.105 Section 301-71.105 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 71-AGENCY TRAVEL ACCOUNTABILITY REQUIREMENTS Travel Authorization § 301-71.105...
Yerby, Dennis
2012-01-01
The purpose of this quantitative study was to examine the role that available Online Travel Agency (OTA) destination information may have on a traveler's perceptions and intent in transaction decisions with that respective OTA. Specifically, this research examined a pleasure traveler's transaction perceptions and intentions with an OTA…
British Columbia Dept. of Education, Victoria.
Written for college entry-level travel agent training courses, this course outline can also be used for inservice training programs offered by travel agencies. The outline provides information on the work of a travel agent and gives clear statements on what learners must be able to do by the end of their training. Material is divided into eight…
Travel time variability and rational inattention
DEFF Research Database (Denmark)
Fosgerau, Mogens; Jiang, Gege
2017-01-01
This paper sets up a rational inattention model for the choice of departure time for a traveler facing random travel time. The traveler chooses how much information to acquire about the travel time out-come before choosing departure time. This reduces the cost of travel time variability compared...
Monitoring Travel Time Reliability on Freeways
Tu, Huizhao
2008-01-01
Travel time and travel time reliability are important attributes of a trip. The current measures of reliability have in common that in general they all relate to the variability of travel times. However, travel time reliability does not only rely on variability but also on the stability of travel
Directory of Open Access Journals (Sweden)
Catherine Sundling
2015-11-01
Full Text Available Accessibility of travel may be better understood if psychological factors underlying change in travel behavior are known. This paper examines older (65+ travelers’ motives for changing their travel behavior. These changes are grounded in critical incidents earlier encountered in public-transport travel. A scientific framework is developed based on cognitive and behavioral theory. In 29 individual interviews, travelers’ critical reactions (i.e., cognitive, emotional, and/or behavioral to 77 critical incidents were examined. By applying critical incident technique (CIT, five reaction themes were identified that had generated travel-behavior change: firm restrictions, unpredictability, unfair treatment, complicated trips, and earlier adverse experiences. To improve older travelers’ access to public transport, key findings were: (a service must be designed so as to strengthen the feeling of being in control throughout the journey; (b extended personal service would increase predictability in the travel chain and decrease travel complexity; consequently, (c when designing new services and making effective accessibility interventions, policy makers should consider and utilize underlying psychological factors that could direct traveler behavior.
Sundling, Catherine
2015-01-01
Accessibility of travel may be better understood if psychological factors underlying change in travel behavior are known. This paper examines older (65+) travelers’ motives for changing their travel behavior. These changes are grounded in critical incidents earlier encountered in public-transport travel. A scientific framework is developed based on cognitive and behavioral theory. In 29 individual interviews, travelers’ critical reactions (i.e., cognitive, emotional, and/or behavioral) to 77 critical incidents were examined. By applying critical incident technique (CIT), five reaction themes were identified that had generated travel-behavior change: firm restrictions, unpredictability, unfair treatment, complicated trips, and earlier adverse experiences. To improve older travelers’ access to public transport, key findings were: (a) service must be designed so as to strengthen the feeling of being in control throughout the journey; (b) extended personal service would increase predictability in the travel chain and decrease travel complexity; consequently, (c) when designing new services and making effective accessibility interventions, policy makers should consider and utilize underlying psychological factors that could direct traveler behavior. PMID:26593935
Time-use and well-being impacts of travel-to-work and travel-for-work
Wheatley, D; Bickerton, C
2016-01-01
This article contributes to understanding of the complex patterns of travel-to-work and travel-for-work which \\ud increasingly characterize highly skilled employment, using 2015 data from a UK Midlands study comprising an online survey and follow-up interviews. Travel-to-work essentially lengthens the working day, and is difficult to use productively, especially when commuting by car. Travel-for-work, by contrast, results in intense schedules \\ud especially when requiring overnight stays. Own...
49 CFR 229.55 - Piston travel.
2010-10-01
... 49 Transportation 4 2010-10-01 2010-10-01 false Piston travel. 229.55 Section 229.55... Piston travel. (a) Brake cylinder piston travel shall be sufficient to provide brake shoe clearance when... piston travel may not exceed 11/2 inches less than the total possible piston travel. The total possible...
Visiting Vehicle Ground Trajectory Tool
Hamm, Dustin
2013-01-01
The International Space Station (ISS) Visiting Vehicle Group needed a targeting tool for vehicles that rendezvous with the ISS. The Visiting Vehicle Ground Trajectory targeting tool provides the ability to perform both realtime and planning operations for the Visiting Vehicle Group. This tool provides a highly reconfigurable base, which allows the Visiting Vehicle Group to perform their work. The application is composed of a telemetry processing function, a relative motion function, a targeting function, a vector view, and 2D/3D world map type graphics. The software tool provides the ability to plan a rendezvous trajectory for vehicles that visit the ISS. It models these relative trajectories using planned and realtime data from the vehicle. The tool monitors ongoing rendezvous trajectory relative motion, and ensures visiting vehicles stay within agreed corridors. The software provides the ability to update or re-plan a rendezvous to support contingency operations. Adding new parameters and incorporating them into the system was previously not available on-the-fly. If an unanticipated capability wasn't discovered until the vehicle was flying, there was no way to update things.
Travel and biologic therapy: travel-related infection risk, vaccine response and recommendations.
Hall, Victoria; Johnson, Douglas; Torresi, Joseph
2018-01-01
Biologic therapy has revolutionized the management of refractory chronic autoimmune and auto-inflammatory disease, as well as several malignancies, providing rapid symptomatic relief and/or disease remission. Patients receiving biologic therapies have an improved quality of life, facilitating travel to exotic destinations and potentially placing them at risk of a range of infections. For each biologic agent, we review associated travel-related infection risk and expected travel vaccine response and effectiveness. A PUBMED search [vaccination OR vaccine] AND/OR ['specific vaccine'] AND/OR [immunology OR immune response OR response] AND [biologic OR biological OR biologic agent] was performed. A review of the literature was performed in order to develop recommendations on vaccination for patients in receipt of biologic therapy travelling to high-risk travel destinations. There is a paucity of literature in this area, however, it is apparent that travel-related infection risk is increased in patients on biologic therapy and when illness occurs they are at a higher risk of complication and hospitalization. Patients in receipt of biologic agents are deemed as having a high level of immunosuppression-live vaccines, including the yellow fever vaccine, are contraindicated. Inactivated vaccines are considered safe; however, vaccine response can be attenuated by the patient's biologic therapy, thereby resulting in reduced vaccine effectiveness and protection. Best practice requires a collaborative approach between the patient's primary healthcare physician, relevant specialist and travel medicine expert, who should all be familiar with the immunosuppressive and immunomodulatory effects resulting from the biologic therapies. Timing of vaccines should be carefully planned, and if possible, vaccination provided well before established immunosuppression.
2008-01-01
Last December CERN received visits from two Ministers. Bulgaria’s Deputy Prime Minister and Minister of Science and Education, Daniel Vylchev, visited the CMS experiment in the company of the CMS Spokesman, T. Virdee, and several Bulgarian physicists. From left to right: J. Stamenov, M. Mateev, S. Stavrev, T. Virdee, V. Genchev, the Minister Daniel Vylchev, A. Hristova Vutsova, L. Litov and G. Soultanov. CERN Director-General, Robert Aymar, and Montenegro’s Minister of Education and Science, Slobodan Backović. On 18 December, Robert Aymar welcomed Bulgaria’s Deputy Prime Minister and Minister of Science and Education, Daniel Vylchev. A particular highlight of his visit was a tour of the CMS site, during which he met the many Bulgarian physicists working on the experiment. He also attended a presentation of the LHC Computing Grid and visited the Computer Centre. Bulgaria has been a CERN ...
Travel time data collection handbook
1998-03-01
This Travel Time Data Collection Handbook provides guidance to transportation : professionals and practitioners for the collection, reduction, and presentation : of travel time data. The handbook should be a useful reference for designing : travel ti...
The value of travel time variance
Fosgerau, Mogens; Engelson, Leonid
2010-01-01
This paper considers the value of travel time variability under scheduling preferences that are de�fined in terms of linearly time-varying utility rates associated with being at the origin and at the destination. The main result is a simple expression for the value of travel time variability that does not depend on the shape of the travel time distribution. The related measure of travel time variability is the variance of travel time. These conclusions apply equally to travellers who can free...
Approaches to groundwater travel time
International Nuclear Information System (INIS)
Kaplan, P.; Klavetter, E.; Peters, R.
1989-01-01
One of the objectives of performance assessment for the Yucca Mountain Project is to estimate the groundwater travel time at Yucca Mountain, Nevada, to determine whether the site complies with the criteria specified in the Code of Federal Regulations, Title 10 CFR 60.113 (a). The numerical standard for performance in these criteria is based on the groundwater travel time along the fastest path of likely radionuclide transport from the disturbed zone to the accessible environment. The concept of groundwater travel time as proposed in the regulations, does not have a unique mathematical statement. The purpose of this paper is to discuss the ambiguities associated with the regulatory specification of groundwater travel time, two different interpretations of groundwater travel time, and the effect of the two interpretations on estimates of the groundwater travel time
Adolescent school travel: Is online mapping a practical alternative to GPS-assessed travel routes?
DEFF Research Database (Denmark)
Stewart, Tom; Schipperijn, Jasper; Snizek, Bernhard
2017-01-01
AbstractBackground Geographically accurate travel routes are necessary to estimate exposure to the environment and its potential influence on travel behaviour. Although assessing travel behaviours with Global Positioning System (GPS) receivers is increasingly common, these protocols place......-reporting error seems more pronounced for longer routes, and when multiple travel modes are used. Researchers should consider the advantages (e.g., ease of collection) and disadvantages (e.g., lack of temporal information) when deciding if the data obtainable are sufficient to answer their research questions....
Schwendicke, Falk; Göstemeyer, Gerd
2017-02-01
Single-visit root canal treatment has some advantages over conventional multivisit treatment, but might increase the risk of complications. We systematically evaluated the risk of complications after single-visit or multiple-visit root canal treatment using meta-analysis and trial-sequential analysis. Controlled trials comparing single-visit versus multiple-visit root canal treatment of permanent teeth were included. Trials needed to assess the risk of long-term complications (pain, infection, new/persisting/increasing periapical lesions ≥1 year after treatment), short-term pain or flare-up (acute exacerbation of initiation or continuation of root canal treatment). Electronic databases (PubMed, EMBASE, Cochrane Central) were screened, random-effects meta-analyses performed and trial-sequential analysis used to control for risk of random errors. Evidence was graded according to GRADE. 29 trials (4341 patients) were included, all but 6 showing high risk of bias. Based on 10 trials (1257 teeth), risk of complications was not significantly different in single-visit versus multiple-visit treatment (risk ratio (RR) 1.00 (95% CI 0.75 to 1.35); weak evidence). Based on 20 studies (3008 teeth), risk of pain did not significantly differ between treatments (RR 0.99 (95% CI 0.76 to 1.30); moderate evidence). Risk of flare-up was recorded by 8 studies (1110 teeth) and was significantly higher after single-visit versus multiple-visit treatment (RR 2.13 (95% CI 1.16 to 3.89); very weak evidence). Trial-sequential analysis revealed that firm evidence for benefit, harm or futility was not reached for any of the outcomes. There is insufficient evidence to rule out whether important differences between both strategies exist. Dentists can provide root canal treatment in 1 or multiple visits. Given the possibly increased risk of flare-ups, multiple-visit treatment might be preferred for certain teeth (eg, those with periapical lesions). Published by the BMJ Publishing Group Limited
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.
150 Bulgarian students visit CERN
Alizée Dauvergne
2010-01-01
Between 27 March and 8 April 2010, 150 Bulgarian students from the Astronomical Observatory in Varna visited CERN as part of the “From Galileo to CERN” programme. Bulgarian students participating in the "From Galileo to CERN" educational programme. “It’s interesting to combine astronomy and particle physics”, explains Svejina Dimitrova, organiser of the programme and Director of Varna Astronomical Observatory. The three groups, each one comprising 50 students, first visited Pisa, Padua and other places in Italy related to Galileo’s life. “Thanks to the visit, students understood telescopes and why Galileo is such an important scientist”, says Svejina. After Italy, they came to CERN for three days and visited several sites: Linac, the Computer Centre CCC, etc. Another group of Bulgarian students in their visit to CERN. “They became aware that particle physics is not only the...
AGUILERA, Anne
2013-01-01
Business travel has been relatively neglected in strategies to promote sustainable travel. A two-stage approach is taken beginning by showing how sustainability of business travel is relevant not only environmentally, but also from an economic and social perspective. On the one hand, this form of travel helps to generate jobs in numerous business sectors, not only in transportation. On the other hand, the social dimension cannot be ignored either, since business travel is often a source of fa...
Travellers and influenza: risks and prevention.
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
Parvaneh, Zahra; Arentze, Theo; Timmermans, Harry
2014-01-01
The rapid and inevitable growth of availability of travel information for travellers has increased expectations among policy makers about the benefits of travel information. It is increasingly expected that providing advanced travel information can trigger particular travel behaviors that would
Rosaria Marraffino
2014-01-01
Emeritus Professor Sir Thomas W.B. Kibble, from Imperial College London visited LHC for the first time last week and delivered a colloquium on the genesis of electroweak unification and the Brout-Englert-Higgs mechanism. From left to right: Jim Virdee, Tiziano Camporesi, Tom Kibble and Austin Ball on the visit to CMS. On his way back from Trieste, where he received the Abdus Salam International Centre for Theoretical Physics' Dirac Medal, Tom Kibble stopped by CERN for his first visit to the LHC. Kibble had a standing invitation from Jim Virdee, former CMS spokesperson, who is also a researcher from Imperial College London. Peter Jenni (left) and Tom Kibble tour the ATLAS detector. (Image: Erwan Bertrand) Kibble made the trip to CERN a family outing and brought along 14 relatives, including his children and grandchildren. He visited the ATLAS detector with Peter Jenni, its former spokesperson, on Friday 10 October. In the afternoon, Kibble delivered a colloquium in the...
Ashkenaz, P J
1984-10-01
I would like to conclude with some personal observations and comments on the use of single-visit endodontics in private practice based on my 12 years of experience utilizing this procedure. I cannot stress in strong enough terms that one-visit endodontics should not be undertaken by the novice. As an evolutionary philosophy of treatment, its use grows out of a full understanding of fundamental endodontic principles by the experienced practitioner. It is only after considering all of the indications and contraindications in each case on an individual basis, that a decision should be made as to whether or not it can be completed in a single visit. However, it is also important for the practitioner to have a clinical sense of what can be accomplished once the rubber dam has been placed and work commenced on the tooth. I submit to you that this very important clinical sense can be gained only after many years of clinical experience. Therefore, the endodontic competence of the practicing dentist becomes the overriding factor in determining the outcome of any one particular case. This is not to say that only a specialized few can and should perform this procedure. However, it does mean that a high degree of clinical skill is necessary to perform it in a successful manner. The performance of better endodontics in multiple visits will ensure success in single visits. Therefore, it is incumbent upon the individual practitioner to objectively evaluate his or her endodontic skills. The clinician should critically evaluate every aspect of his or her endodontic practice by determining the incidences of biomechanical errors such as ledging, perforations, overinstrumentation, broken instruments, interappointment flare-ups, and failures. For only after evaluating these areas will the clinician have an indication as to his or her level of endodontic skill and whether or not future study and practice need be done in one or more specific aspects of endodontic practice. Once a high
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.
Approaches to groundwater travel time
International Nuclear Information System (INIS)
Kaplan, P.; Klavetter, E.; Peters, R.
1989-01-01
One of the objectives of performance assessment for the Yucca Mountain Project is to estimate the groundwater travel time at Yucca Mountain, Nevada, to determine whether the site complies with the criteria specified in the Code of Federal Regulations. The numerical standard for performance in these criteria is based on the groundwater travel time along the fastest path of likely radionuclide transport from the disturbed zone to the accessible environment. The concept of groundwater travel time, as proposed in the regulations, does not have a unique mathematical statement. The purpose of this paper is to discuss (1) the ambiguities associated with the regulatory specification of groundwater travel time, (2) two different interpretations of groundwater travel time, and (3) the effect of the two interpretations on estimates of the groundwater travel time. 3 refs., 2 figs., 2 tabs
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...
2007-01-01
Dutch Minister of Education, Culture and Science R. Plasterk (third from left) in the ATLAS cavern with NIKHEF Director F. Linde, CERN Chief Scientific Officer J. Engelen, Ambassador J. van Eenennaam, ATLAS Collaboration Spokesperson P. Jenni, Mission Representative G. Vrielink and ATLAS Magnet Project Leader H. ten Kate.Minister of Education, Culture and Science from the Kingdom of the Netherlands, Ronald Plasterk, visited CERN on 25th October. With Jos Engelen, CERN Scientific Director, as his guide he visited Point 1 of the LHC tunnel and ATLAS, where Nikhef (the national institute for subatomic physics, a Dutch government and university collaboration) constructed all 96 of the largest muon drift chambers in the barrel as well as parts of the magnet system, the inner detector, the DAQ and triggering. Overall the Netherlands contribute 4.5% to the annual CERN budget and the minister’s visit celebrated the contributions of the 79 ...
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.
The Development of Independent Travel in China in the Future and Travel Agents’ Coping Strategies
Pan, Yulu
2010-01-01
Abstract The purpose of this research is to understand the general trend of independent travel in China from tourists’ perspectives and what strategies travel agents should adopt to cope with the increased independent travel. This project is based on both primary research and secondary research. Quantitative and qualitative data are collected and analyzed for deeply exploration about independent travel in order to understand tourists’ attitudes, expectations and perspectives. By this w...
Safe travels? HIV transmission among Britons travelling abroad.
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.
Rolling, Thierry; Mühlenpfordt, Melina; Addo, Marylyn M; Cramer, Jakob P; Vinnemeier, Christof D
Specific travel-related recommendations exist for the prevention or self-treatment of infectious diseases contracted by travellers to the tropics. In the current study, we assessed the medical preparedness per these recommendations, focusing on whether travellers carried antidiarrheal and antimalarial medication with them stratified by type of pre-travel advice. We surveyed travellers departing from Hamburg International Airport to South or Southeast Asia, using a questionnaire on demographic, medical and travel characteristics. 975 travellers were analysed - the majority (817, 83%) being tourists. A large proportion packed any antidiarrheal medication (612, 63%) - most frequently loperamide (440, 72%). Only 176 of 928 (19%) travellers to destinations with low-to medium risk for malaria packed a recommended antimalarial medication. The majority (162, 17%) of them carried antimalarials as stand-by emergency treatment (SBET). 468 (48%) travellers had a pre-travel medical consultation. This lead to higher odds of carrying SBET- with the highest odds associated with a consultation at a travel medicine specialist (OR 7.83 compared to no consultation). Attending a travel medicine specialist was associated with better adherence to current recommendations concerning the carriage of stand-by emergency treatment of malaria. However, the proportion of travellers seeking pre-travel health advice was overall low in our population. Promoting pre-travel consultations may, therefore, lead to higher adherence to the current recommendations in travel medicine. Copyright © 2017 Elsevier Ltd. All rights reserved.
Season and weather effects on travel-related mood and travel satisfaction
Ettema, Dick; Friman, Margareta; Olsson, Lars E.; Gärling, Tommy
2017-01-01
This study examines the effects of season and weather on mood (valence and activation) and travel satisfaction (measured by the Satisfaction with Travel Scale). Analyses are presented of 562 time-sampled morning commutes to work made by 363 randomly sampled people in three different Swedish cities
Network structure and travel time perception.
Parthasarathi, Pavithra; Levinson, David; Hochmair, Hartwig
2013-01-01
The purpose of this research is to test the systematic variation in the perception of travel time among travelers and relate the variation to the underlying street network structure. Travel survey data from the Twin Cities metropolitan area (which includes the cities of Minneapolis and St. Paul) is used for the analysis. Travelers are classified into two groups based on the ratio of perceived and estimated commute travel time. The measures of network structure are estimated using the street network along the identified commute route. T-test comparisons are conducted to identify statistically significant differences in estimated network measures between the two traveler groups. The combined effect of these estimated network measures on travel time is then analyzed using regression models. The results from the t-test and regression analyses confirm the influence of the underlying network structure on the perception of travel time.
UN Secretary General visits CERN
2008-01-01
UN Secretary General praises CERN in recent visit. Ban Ki-moon, Robert Aymar, CERN Director-General, and Sergei Ordzhonikidze, Director-General of the United Nations Office in Geneva at the CMS site.On Sunday 31 August, Ban Ki-moon, the UN Secretary General, made an important visit to CERN. Arriving in the late afternoon, he was warmly greeted at Point 5 by Robert Aymar, the Director-General, and the Sous-préfet of Gex, Olivier Laurens-Bernard. Accompanied by a UN delegation, Ban Ki-moon was also introduced to Jos Engelen, the Chief Scientific Officer, and Jim Virdee, the CMS spokesperson. He then took the opportunity to visit CMS and the machine tunnel. At the end of his short trip, Ban Ki-moon signed the Guest Book in the tradition of important dignitaries visiting CERN. Expressing his admiration for CERN’s spirit of collaboration, Ban Ki-moon said, "I am very honored to visit CERN, an invaluable scientific institution a...
Travels in Architectural History
Directory of Open Access Journals (Sweden)
Davide Deriu
2016-11-01
Full Text Available Travel is a powerful force in shaping the perception of the modern world and plays an ever-growing role within architectural and urban cultures. Inextricably linked to political and ideological issues, travel redefines places and landscapes through new transport infrastructures and buildings. Architecture, in turn, is reconstructed through visual and textual narratives produced by scores of modern travellers — including writers and artists along with architects themselves. In the age of the camera, travel is bound up with new kinds of imaginaries; private records and recollections often mingle with official, stereotyped views, as the value of architectural heritage increasingly rests on the mechanical reproduction of its images. Whilst students often learn about architectural history through image collections, the place of the journey in the formation of the architect itself shifts. No longer a lone and passionate antiquarian or an itinerant designer, the modern architect eagerly hops on buses, trains, and planes in pursuit of personal as well as professional interests. Increasingly built on a presumption of mobility, architectural culture integrates travel into cultural debates and design experiments. By addressing such issues from a variety of perspectives, this collection, a special 'Architectural Histories' issue on travel, prompts us to rethink the mobile conditions in which architecture has historically been produced and received.
Visiting Filmmakers: Why Bother?
MacDonald, Scott
1995-01-01
Argues that visits by independent filmmakers to campus are exciting and intellectually invigorating for students and teachers, and these visits add to the cultural energy of the college. Notes that a commitment to independent cinema challenges the assumptions and the economics of conventional cinema. Discusses how much independent filmmakers are…
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.
Directory of Open Access Journals (Sweden)
Sri Hartiningsih
2012-11-01
their destinations are indigenousmeans of transportation and that the tourist objects visited are art metamorphosis, travel hyperreality,sacred places and natural and human recreational places. The factors motive ting thewomen to travel are inter personal, cultural, status and prestige. The things making theminterested in travelling are: the Castle of Chillon in Switzerland and the regions’s history, theevening party in Italy as a tradition to welcome new people, the architectures of Caesars’Palaces, the Coliseum and Chandrapore club as a tradition to welcome new people, the bridge party to know the language spoken and dress worn – traditional costumes of India, Koyasan asBuddhist religion and Paris as the centre of dress model. Cultural barriers refer to differentetiquettes, ideologies and moral values resulting in different ways of travelling and theirsolutions.Knowing the culture of the destination that is going to be visited is really needed, at least inorder not to know nothing at all about such a destination; furthermore, it reduces culturalbarriers. That is why cross cultural understanding is really necessarily given not only to thedoers of tourism but also to all institutions in order to reduce misunderstanding and increaseappreciation towards each other.
De Vos, Jonas; Mokhtarian, Patricia L; Schwanen, Tim; Van Acker, Veronique; Witlox, Frank
2016-01-01
Over the past decades research on travel mode choice has evolved from work that is informed by utility theory, examining the effects of objective determinants, to studies incorporating more subjective variables such as habits and attitudes. Recently, the way people perceive their travel has been analyzed with transportation-oriented scales of subjective wellbeing, and particularly the satisfaction with travel scale. However, studies analyzing the link between travel mode choice (i.e., decisio...
Visiting CERN… like “common people”
Antonella del Rosso
2012-01-01
Paul Young, the British pop star who made his name in the 80s, came to visit CERN on 17 December. His son brought him here because of his passion for science in general and physics in particular. Father and son found the visit exciting and CERN’s activities really thrilling. We could even expect a surprise for Paul's next visit… The visiting group in the CMS Control Room (Photo credit: P. Geeraert, ESO). Paul Young, famous for his interpretation of “Love of the Common People”, came to CERN because his teenage son is going to be studying A-level physics at school next year and wanted to visit the Laboratory. “I was fascinated by the visit. CERN is a place I didn’t know much about, but my son knows a lot more about science than I do. The explanations we got were great. We enjoyed the visit very much,” he said enthusiastically. Paul Young and his son visited the CMS underground cavern with Michael Hoch. &...
Reduction of travellers' diarrhoea by WC/rBS oral cholera vaccine in young, high-risk travellers.
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.
Travel/Travelers and Parasitic Diseases
... of the world and specific country. Many infectious diseases transmitted in food and water can also be acquired directly through the fecal-oral route. Parasitic Illnesses That Can Be Acquired During Travel* From Contaminated Food and Water More ... filariasis African sleeping sickness Onchoceriasis *This list ...
An approach using quantum PBIL to solve the traveling salesman problem
International Nuclear Information System (INIS)
Silva, Marcio Henrique; Schirru, Roberto
2011-01-01
Quantum inspired evolutionary algorithms are optimization tools based in artificial intelligence developed to simulate the quantum processing in classical computers viewing that there are not quantum computers available nowadays. In this work is introduced one of these tools, which adds quantum concepts such as the linear superposition of states and the qubit representation to standard PBIL named Quantum PBIL. Here we use Quantum PBIL to solve a well-known NPHard benchmark, the Traveling salesman problem. The objective is to find the shorter path made by a traveler linking all the available cities visiting each one only once and returning to the starter one at the final of his journey. As the main purpose of this work is employ the algorithm to solve the nuclear reload optimization in the future, and according to the similarities that both problems share, TSP is a good challenge for Quantum PBIL. The results have shown that the algorithm is able to obtain good performance when applied on this problem. It is also fast and has a great capacity to find good solutions when compared to other versions of PBIL found in literature despite of its stagnation of bits tendency can easily lead it to local minimums. (author)
An approach using quantum PBIL to solve the traveling salesman problem
Energy Technology Data Exchange (ETDEWEB)
Silva, Marcio Henrique; Schirru, Roberto, E-mail: marciohenrique@lmp.ufrj.br, E-mail: schirru@lmp.ufrj.br [Coordenacao dos Programas de Pos-Graduacao em Engenharia (PEN/COPPE), Rio de Janeiro, RJ (Brazil)
2011-07-01
Quantum inspired evolutionary algorithms are optimization tools based in artificial intelligence developed to simulate the quantum processing in classical computers viewing that there are not quantum computers available nowadays. In this work is introduced one of these tools, which adds quantum concepts such as the linear superposition of states and the qubit representation to standard PBIL named Quantum PBIL. Here we use Quantum PBIL to solve a well-known NPHard benchmark, the Traveling salesman problem. The objective is to find the shorter path made by a traveler linking all the available cities visiting each one only once and returning to the starter one at the final of his journey. As the main purpose of this work is employ the algorithm to solve the nuclear reload optimization in the future, and according to the similarities that both problems share, TSP is a good challenge for Quantum PBIL. The results have shown that the algorithm is able to obtain good performance when applied on this problem. It is also fast and has a great capacity to find good solutions when compared to other versions of PBIL found in literature despite of its stagnation of bits tendency can easily lead it to local minimums. (author)
Berliner Philarmoniker ATLAS visit
ATLAS Collaboration
2017-01-01
The Berliner Philarmoniker in on tour through Europe. They stopped on June 27th in Geneva, for a concert at the Victoria Hall. An ATLAS visit was organised the morning after, lead by the ATLAS spokesperson Karl Jakobs (welcome and overview talk) and two ATLAS guides (AVC visit and 3D movie).
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
Future Trends in Business Travel Decision Making
Mason, Keith J.
2002-01-01
This research surveys twenty large companies and their travellers to identify and evaluate the effects of pressures on the business travel market in the future. The influence of the following areas on the decision making process are addressed: (1) Corporate travel policies and increasing professionalism in corporate purchasing; (2) The development of global strategic airline alliances; (3) The emergence of low cost airlines on short haul markets; and (4) The development of internet based booking tools and travel agency IT. The survey shows differences in views between travel managers, and travellers with regard to corporate travel policies. While travel managers see policy rules, travellers interpret these as guidelines, indicating travel managers will need to take further actions to exercise true control of travel budgets. The data shows that companies are more likely to prescribe a class of airline ticket, than the choice of airline itself. Corporate hierarchical bias in travel policies is still common both for short and particularly long haul flying. Other findings show that while travel managers believe that their companies are likely to sign global deals with strategic airline groups within a five year period in a bid to consolidating spending, they also believe that nearly a third of short haul flying will be taken with low cost carriers, indicating further penetration in this business travel market by these carriers. The paper also provides other predictions about the business travel market, based on the survey findings.
Travelers' Health: Water Disinfection for Travelers
... Safety Road Safety - 8 Steps MERS Health Advisory poster MERS Pictogram CDC Guide for Healthy Travel Website ... compressed carbon, or large-pore hollow-fiber filter elements are sufficient to remove bacteria and protozoan cysts ...
2010-05-05
...-0010, sequence 1] RIN 3090-AJ02 Federal Travel Regulation (FTR); Transportation in Conjunction With Official Travel and Relocation AGENCY: Office of Governmentwide Policy, General Services Administration (GSA). ACTION: Final rule. SUMMARY: This final rule amends the Federal Travel Regulation (FTR), by...
Taniguchi, Ayako
2007-01-01
This study tested an integrated process model of travel behavior modification. We used a model that combined the theory of planned behavior (TPB), norm activation theory (NAT), a theory of implementation intention, and theories of habit. To test the integrated model, we used panel data (n = 208) obtained before and after travel feedback programs (TFPs); the TFP is a communication program aimed at voluntary travel behavior modification, from automobile use to non-auto means of travel such as p...
Gadomski, Anne M; Fothergill, Kate E; Larson, Susan; Wissow, Lawrence S; Winegrad, Heather; Nagykaldi, Zsolt J; Olson, Ardis L; Roter, Debra L
2015-03-01
To evaluate how a comprehensive, computerized, self-administered adolescent screener, the DartScreen, affects within-visit patient-doctor interactions such as data gathering, advice giving, counseling, and discussion of mental health issues. Patient-doctor interaction was compared between visits without screening and those with the DartScreen completed before the visit. Teens, aged 15-19 years scheduled for an annual visit, were recruited at one urban and one rural pediatric primary care clinic. The doctor acted as his/her own control, first using his/her usual routine for five to six adolescent annual visits. Then, the DartScreen was introduced for five visits where at the beginning of the visit, the doctor received a summary report of the screening results. All visits were audio recorded and analyzed using the Roter interaction analysis system. Doctor and teen dialogue and topics discussed were compared between the two groups. Seven midcareer doctors and 72 adolescents participated; 37 visits without DartScreen and 35 with DartScreen were audio recorded. The Roter interaction analysis system defined medically related data gathering (mean, 36.8 vs. 32.7 statements; p = .03) and counseling (mean, 36.8 vs. 32.7 statements; p = .01) decreased with DartScreen; however, doctor responsiveness and engagement improved with DartScreen (mean, 4.8 vs. 5.1 statements; p = .00). Teens completing the DartScreen offered more psychosocial information (mean, 18.5 vs. 10.6 statements; p = .01), and mental health was discussed more after the DartScreen (mean, 93.7 vs. 43.5 statements; p = .03). Discussion of somatic and substance abuse topics did not change. Doctors reported that screening improved visit organization and efficiency. Use of the screener increased discussion of mental health but not at the expense of other adolescent health topics. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
US Agency for International Development — E2 Solutions is a web based end-to-end travel management tool that includes paperless travel authorization and voucher document submissions, document approval...
The space-traveling neutralino is back at CERN
Antonella Del Rosso
2012-01-01
During his visit on 24 and 25 May, former CERN Fellow and ESA astronaut Christer Fuglesang gave a soft-toy neutralino back to CERN’s Director for Research Sergio Bertolucci. In 2009, CERN’s Director-General Rolf Heuer had given Christer the neutralino to be part of his official flight kit, just before the astronaut began his second mission on space shuttle flight STS-128. ESA astronaut Christer Fuglesang (right) returns the neutralino to CERN Director for Research Sergio Bertolucci (left). “The neutralino is a symbol of the link between particle physics and the science of the Universe,” said Rolf Heuer in his Word from the DG published in the Bulletin on that occasion. “Neutralinos are theoretical particles that the LHC will be looking for, and if they exist, they’re strong candidates for the Universe’s dark matter.” Today, the space-traveling neutralino from the Particle Zoo is back at CERN. At the...
Valuation of travel time savings for intercity travel: The Madrid-Barcelona corridor
DEFF Research Database (Denmark)
Roman, Concepcion; Carlos Martin, Juan; Espino, Raquel
2014-01-01
We derive values of travel time savings (VOT) for the Madrid-Barcelona corridor, linking the two largest cities in Spain, based on the estimation of discrete choice models among the main public transport services in the corridor: air transport, high speed rail (HSR) and bus. The new HSR alternative...... (which started to operate in February 2008) competes directly with one of the densest airline domestic markets in the world, and its introduction produced substantial improvements in level of service, achieving reductions in travel time of more than 50% over the conventional train. A specifically...... to provide useful information to quantify users' benefits during the lifespan of a given project. We found, as expected, that HSR and air transport users exhibit substantially higher values for saving travel time than bus travellers. Also as expected, savings of waiting time are more valued than savings...
28 CFR 540.62 - Institutional visits.
2010-07-01
....62 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Contact With News Media § 540.62 Institutional visits. (a) A media representative shall make advance appointments for visits. (b) When media representatives visit the institutions...
Intercity Travel Demand Analysis Model
Directory of Open Access Journals (Sweden)
Ming Lu
2014-01-01
Full Text Available It is well known that intercity travel is an important component of travel demand which belongs to short distance corridor travel. The conventional four-step method is no longer suitable for short distance corridor travel demand analysis for the time spent on urban traffic has a great impact on traveler's main mode choice. To solve this problem, the author studied the existing intercity travel demand analysis model, then improved it based on the study, and finally established a combined model of main mode choice and access mode choice. At last, an integrated multilevel nested logit model structure system was built. The model system includes trip generation, destination choice, and mode-route choice based on multinomial logit model, and it achieved linkage and feedback of each part through logsum variable. This model was applied in Shenzhen intercity railway passenger demand forecast in 2010 as a case study. As a result, the forecast results were consistent with the actuality. The model's correctness and feasibility were verified.
Moisã Claudia Olimpia; Moisã Claudia Olimpia
2011-01-01
Taking into account the suite of motivation that youth has when practicing tourism, it can be said that the youth travel takes highly diverse forms. These forms are educational tourism, volunteer programs and “work and travel”, cultural exchanges or sports tourism and adventure travel. In this article, we identified and analyzed in detail the main forms of youth travel both internationally and in Romania. We also illustrated for each form of tourism the specific tourism products targeting you...
DEFF Research Database (Denmark)
Bill, Jan; Roesdahl, Else
2007-01-01
On the interrelationship between travel, transport and society; on land transport, sea and river transport, and on winter transport; on the related technologies and their developments......On the interrelationship between travel, transport and society; on land transport, sea and river transport, and on winter transport; on the related technologies and their developments...
41 CFR 301-70.904 - Must travelers whom we carry on Government aircraft be authorized to travel?
2010-07-01
... flight in which they are also traveling (i.e., being transported from point to point) are considered... carry on Government aircraft be authorized to travel? 301-70.904 Section 301-70.904 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY...
8 CFR 1244.15 - Travel abroad.
2010-01-01
... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Travel abroad. 1244.15 Section 1244.15... REGULATIONS TEMPORARY PROTECTED STATUS FOR NATIONALS OF DESIGNATED STATES § 1244.15 Travel abroad. (a) After... Status shall not constitute permission to travel abroad. Permission to travel may be granted by the...
49 CFR 230.76 - Piston travel.
2010-10-01
... 49 Transportation 4 2010-10-01 2010-10-01 false Piston travel. 230.76 Section 230.76... Tenders Brake and Signal Equipment § 230.76 Piston travel. (a) Minimum piston travel. The minimum piston travel shall be sufficient to provide proper brake shoe clearance when the brakes are released. (b...
Staff Association
2017-01-01
“Hello, I am your delegate” – have you heard this line? Maybe you have already had the pleasure of receiving a visit from a Staff Association delegate – then you know what this is all about. As for those of you, who have not yet heard these words, it’s time to get curious. The Staff Association has decided to embark upon an adventure called “VICO”, Visiting Colleagues. From past experience, we have understood the value of personal, direct contact with the people we represent. We believe that the best way to achieve this is to knock on your office door and pay you a short visit. We do not want to make you fill in yet another online questionnaire and would much rather collect your feedback in a short conversation face to face. Of course, we have prepared ourselves thoroughly for these visit rounds, because we do not want to waste your time. We welcome criticism because it can make us aware of our shortcomings, tell us about how y...
2010-01-01
... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Travel abroad. 244.15 Section 244.15 Aliens... NATIONALS OF DESIGNATED STATES § 244.15 Travel abroad. (a) After the grant of Temporary Protected Status... to travel abroad. Permission to travel may be granted by the director pursuant to the Service's...
Schistosomiasis in european travelers and migrants
DEFF Research Database (Denmark)
Lingscheid, Tilman; Kurth, Florian; Clerinx, Jan
2017-01-01
Schistosomiasis remains one of the most prevalent parasitic diseases worldwide and the infection is frequently found in travelers and migrants. The European Network for Tropical Medicine and Travel Health conducted a sentinel surveillance study on imported schistosomiasis between 1997 and 2010...... or antigen testing. Schistosomiasis remains a frequent infection in travelers and migrants to Europe. Travelers should be made aware of the risk of schistosomiasis infection when traveling to sub-Saharan Africa. Posttravel consultations particularly for returning expatriates are useful given the high...
Accurate estimation of indoor travel times
DEFF Research Database (Denmark)
Prentow, Thor Siiger; Blunck, Henrik; Stisen, Allan
2014-01-01
The ability to accurately estimate indoor travel times is crucial for enabling improvements within application areas such as indoor navigation, logistics for mobile workers, and facility management. In this paper, we study the challenges inherent in indoor travel time estimation, and we propose...... the InTraTime method for accurately estimating indoor travel times via mining of historical and real-time indoor position traces. The method learns during operation both travel routes, travel times and their respective likelihood---both for routes traveled as well as for sub-routes thereof. InTraTime...... allows to specify temporal and other query parameters, such as time-of-day, day-of-week or the identity of the traveling individual. As input the method is designed to take generic position traces and is thus interoperable with a variety of indoor positioning systems. The method's advantages include...
Zhang, Y; Zhang, X; Liu, L; Zanchetti, A
2015-06-01
Many antihypertensive outcome trials have shown that visit-to-visit blood pressure variability is correlated closely with clinical outcomes in hypertensive patients. The objective of the study was to investigate the relationship between visit-to-visit blood pressure variability (BPV) and the major cardiovascular outcomes in the Chinese hypertensive patients. Felodipine Event Reduction (FEVER) study was a double-blind, randomized trial on 9711 Chinese hypertensive patients, in whom cardiovascular outcomes were significantly reduced by more intense therapy achieving a mean of 138 mmHg SBP compared with less-intense therapy achieving a mean of 142 mmHg. Visit-to-visit BPV during the follow-up period [defined as standard deviation (SD), coefficient of variation (CV), and average real variability(ARV)] was derived from casual cuff BP measures after six months follow-up until the end of the study. Hazard ratios (HRs), for the incidence of CVD associated with SD, CV, and ARV of SBP and DBP were calculated using Cox proportional hazard models. Overall predictive power [area under receiver operating characteristic (AUC ROC) curve] of the level of blood pressure, blood pressure variability and other baseline characteristics was calculated. In FEVER study, visit-to-visit variability in SBP were significant predictors of subsequent stroke [eg, hazard ratios [HR] for ARV, SD and CV was 1.071 (95% CI: 1.025-1.118), 1.373 (95% CI: 1.159-1.626) and 0.572 (95% CI: 0.451-0,726)]. Visit-to-visit variability in DBP were also showed similar trend [eg, HR for ARV, SD and CV was 1.066 (95% CI: 0.992-1.145), 1.931 (95% CI: 1.435-2.598) and 0.558 (95% CI: 0.438-0,710)]. However, using the analysis of AUC ROC analysis, the risk importance sequence of the stroke events in this cohort was level of SBP, age, level of DBP ARV, SD, sex, CV and treatment. Visit-to-visit blood pressure variability has some effects on the cardiovascular outcomes in the Chinese hypertensive patents in the cohort in
CARLSON WAGONLIT TRAVEL
2004-01-01
CARLSON WAGONLIT TRAVEL informs you that our agency will be closed from 17 December 2004 at 16:30 until 3 January 2005 at 8:30. For all URGENT MATTERS you can contact our CARLSON WAGONLIT TRAVEL branch at WHO (Mr Pierre Plumettaz), phone: 022 788 10 65 We wish you already a Merry Christmas and a Happy New Year!
... on traveling and dining out at restaurants with food allergies. Travel Tips for the U.S. and Other Countries Get information about medications and food labeling practices in select countries. Spam Control Text: ...
Jackson, Cath; Dyson, Lisa; Bedford, Helen; Cheater, Francine M; Condon, Louise; Crocker, Annie; Emslie, Carol; Ireland, Lana; Kemsley, Philippa; Kerr, Susan; Lewis, Helen J; Mytton, Julie; Overend, Karen; Redsell, Sarah; Richardson, Zoe; Shepherd, Christine; Smith, Lesley
2016-09-01
Gypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services, including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. (1) Investigate the barriers to and facilitators of acceptability and uptake of immunisations among six Traveller communities across four UK cities; and (2) identify possible interventions to increase uptake of immunisations in these Traveller communities that could be tested in a subsequent feasibility study. Three-phase qualitative study underpinned by the social ecological model. Phase 1: interviews with 174 Travellers from six communities: Romanian Roma (Bristol); English Gypsy/Irish Traveller (Bristol); English Gypsy (York); Romanian/Slovakian Roma (Glasgow); Scottish Showpeople (Glasgow); and Irish Traveller (London). Focus on childhood and adult vaccines. Phase 2: interviews with 39 service providers. Data were analysed using the framework approach. Interventions were identified using a modified intervention mapping approach. Phase 3: 51 Travellers and 25 service providers attended workshops and produced a prioritised list of potentially acceptable and feasible interventions. There were many common accounts of barriers and facilitators across communities, particularly across the English-speaking communities. Scottish Showpeople were the most similar to the general population. Roma communities experienced additional barriers of language and being in a new country. Men, women and service providers described similar barriers and facilitators. There was widespread acceptance of childhood and adult immunisation, with current parents perceived as more positive than their elders. A minority of English-speaking Travellers worried about multiple/combined childhood vaccines, adult flu and whooping cough. Cultural concerns about vaccines offered during pregnancy and about human papillomavirus were most evident in
Ernst, Kacey C; Erhart, Laura M
2014-01-01
Background: Hepatitis A (HAV) incidence has decreased in the United States, yet regional disparities persist. The role of international travel has become increasingly important in HAV transmission. We compared the relative burden of HAV in border and non-border regions in Arizona and examined the role of travel in sustaining HAV transmission. Methods: HAV vaccination coverage was calculated by age and region, using Arizona State Immunization Information System data. Incidence, demographics, and risk factors of cases reported through Arizona’s infectious disease surveillance system between 2006 and 2011 were analyzed. Results: Hepatitis A incidence was higher in the border region of Arizona. Compared with the rest of Arizona, one-dose coverage in children <15 years was lower in the border region until 2008. Second dose coverage was lower in the border region, particularly among Spanish speakers. International travel among cases was generally high; however, in the border region cases were more likely to visit Mexico or South/Central America (94% vs. 80%, P value = 0.01) and be Hispanic (68% vs. 42%, P value = 0.0003). Conclusions: Rates of HAV continue to be higher in the Arizona border region; the risk appears particularly high among Hispanics with recent travel in the Americas. Border surveillance should be emphasized, along with vaccination of all travelers, to continue to decrease and control HAV. PMID:24603091
Travelers' Health: Leishmaniasis, Visceral
... such as the United States reflects travel and immigration patterns. VL is uncommon in US travelers and ... whqlibdoc.who.int/trs/WHO_TRS_949_eng.pdf . Chapter 3 - Leishmaniasis, Cutaneous Chapter 3 - Leptospirosis File ...
Wildfire effects on hiking and biking demand in New Mexico: a travel cost study.
Hesseln, Hayley; Loomis, John B; González-Cabán, Armando; Alexander, Susan
2003-12-01
We use a travel cost model to test the effects of wild and prescribed fire on visitation by hikers and mountain bikers in New Mexico. Our results indicate that net benefits for mountain bikers is $150 per trip and that they take an average of 6.2 trips per year. Hikers take 2.8 trips per year with individual net benefits per trip of $130. Both hikers' and mountain bikers' demand functions react adversely to prescribed burning. Net benefits for both groups fall as areas recover from prescribed burns. Because both visitation and annual recreation benefits decrease to these two types of visitors, this gives rise to multiple use costs associated with prescribed burning. With respect to wildfire, hikers and mountain bikers both exhibit decreased visitation as areas recover from wildfires, however, only hikers indicate an increase in per trip net benefits. Bikers' demand effectively drops to zero. These results differ from previous findings in the literature and have implications for efficient implementation of the National Fire Plan and whether prescribed burning is a cost effective tool for multiple use management of National Forests. Specifically, that fire and recreation managers cannot expect recreation users to react similarly to fire across recreation activities, or different geographic regions. What is cost effective in one region may not be so in another.
Additive measures of travel time variability
DEFF Research Database (Denmark)
Engelson, Leonid; Fosgerau, Mogens
2011-01-01
This paper derives a measure of travel time variability for travellers equipped with scheduling preferences defined in terms of time-varying utility rates, and who choose departure time optimally. The corresponding value of travel time variability is a constant that depends only on preference...... parameters. The measure is unique in being additive with respect to independent parts of a trip. It has the variance of travel time as a special case. Extension is provided to the case of travellers who use a scheduled service with fixed headway....
DEFF Research Database (Denmark)
Mabit, Stefan Lindhard; Rich, Jeppe; Burge, Peter
2013-01-01
of travel time savings (VTTS). The final model, which was formulated as a nested logit model and included Box–Cox transformed travel time and cost attributes, revealed several interesting findings. Firstly, we found damping effects in both cost and time – most strongly in cost. Secondly, we found...... significant interactions among travel cost and time, and journey characteristics, such as distance and duration. This had direct impact on the VTTS, which was shown to decrease with distance and duration. Thirdly, we found that air travel implies a higher average VTTS, which is to be expected but rarely......The geographical scope of travel varies from short distances in urban areas to long distances across cities and countries. While urban travel has been widely analysed in the literature, travel over longer distances and particularly across countries, has received much less attention. While this may...
Traveling Safely with Medicines
... Medications Safely My Medicine List How to Administer Traveling Safely with Medicines Planes, trains, cars – even boats ... your trip, ask your pharmacist about how to travel safely with your medicines. Make sure that you ...
Estimating Household Travel Energy Consumption in Conjunction with a Travel Demand Forecasting Model
Energy Technology Data Exchange (ETDEWEB)
Garikapati, Venu M. [Systems Analysis and Integration Section, National Renewable Energy Laboratory, 15013 Denver West Parkway, Golden, CO 80401; You, Daehyun [Maricopa Association of Governments, 302 North First Avenue, Suite 300, Phoenix, AZ 85003; Zhang, Wenwen [School of City and Regional Planning, Center for Geographic Information Systems, Georgia Institute of Technology, 760 Spring Street, Suite 230, Atlanta, GA 30308; Pendyala, Ram M. [School of Sustainable Engineering and the Built Environment, Arizona State University, 660 South College Avenue, Tempe, AZ 85281; Guhathakurta, Subhrajit [School of City and Regional Planning, Center for Geographic Information Systems, Georgia Institute of Technology, 760 Spring Street, Suite 230, Atlanta, GA 30308; Brown, Marilyn A. [School of Public Policy, 685 Cherry Street, Georgia Institute of Technology, Atlanta, GA 30332; Dilkina, Bistra [School of Computational Science and Engineering, 266 Ferst Drive, Georgia Institute of Technology, Atlanta, GA 30332
2017-01-01
This paper presents a methodology for the calculation of the consumption of household travel energy at the level of the traffic analysis zone (TAZ) in conjunction with information that is readily available from a standard four-step travel demand model system. This methodology embeds two algorithms. The first provides a means of allocating non-home-based trips to residential zones that are the source of such trips, whereas the second provides a mechanism for incorporating the effects of household vehicle fleet composition on fuel consumption. The methodology is applied to the greater Atlanta, Georgia, metropolitan region in the United States and is found to offer a robust mechanism for calculating the footprint of household travel energy at the level of the individual TAZ; this mechanism makes possible the study of variations in the energy footprint across space. The travel energy footprint is strongly correlated with the density of the built environment, although socioeconomic differences across TAZs also likely contribute to differences in travel energy footprints. The TAZ-level calculator of the footprint of household travel energy can be used to analyze alternative futures and relate differences in the energy footprint to differences in a number of contributing factors and thus enables the design of urban form, formulation of policy interventions, and implementation of awareness campaigns that may produce more-sustainable patterns of energy consumption.
[Travel medicine for HIV-infected patients].
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.
Experienced travel time prediction for congested freeways
Yildirimoglu, Mehmet; Geroliminis, Nikolaos
2013-01-01
Travel time is an important performance measure for transportation systems, and dissemination of travel time information can help travelers make reliable travel decisions such as route choice or departure time. Since the traffic data collected in real time reflects the past or current conditions on the roadway, a predictive travel time methodology should be used to obtain the information to be disseminated. However, an important part of the literature either uses instantaneous travel time ass...
Directory of Open Access Journals (Sweden)
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.
Post-harmonised European National Travel Surveys
DEFF Research Database (Denmark)
Christensen, Linda; Sobrino Vázquez, Natalia
Look-up tables are collected and analysed for 12 European National Travel Surveys (NTS) in a harmonized way covering the age group 13-84 year. Travel behaviour measured as kilometres, time use and trips per traveller is compared. Trips per traveller are very similar over the countries whereas...... of walking trips rather similar with a higher level of cycling in the Netherlands, more public transport in Switzerland, and more air traffic in Sweden. Normally kilometres per respondent / inhabitant is used for national planning purpose and this is very affected by the share of mobile travellers...
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.
5 CFR 550.1404 - Creditable travel time.
2010-01-01
... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Creditable travel time. 550.1404 Section... ADMINISTRATION (GENERAL) Compensatory Time Off for Travel § 550.1404 Creditable travel time. (a) General. Subject... off for time in a travel status if— (1) The employee is required to travel away from the official duty...
2006-01-01
CARLSON WAGONLIT TRAVEL informs you that our agency will be closed from 22 December 2006 at 16:30 until 8 January 2007 at 8:30. For all URGENT MATTERS you can contact our CARLSON WAGONLIT TRAVEL branch at W.H.O. (Mr Pierre Plumettaz), phone: 022 791 55 95. We wish you already a Merry Christmas and a Happy New Year!
Directory of Open Access Journals (Sweden)
Joao CARDOSO NETO
2012-01-01
Full Text Available Chile is a country with great attractions for tourists in South America and the whole world. Among the many tourist Chilean attractions the city of Vina del Mar is one of the highlights, recognized nationally and internationally as one of the most beautiful places for summer. In Vina del Mar tourists have many options for leisure, besides pretty beaches, e.g. playa renaca, the city has beautiful squares and castles, e.g. Castillo Wulff built more than 100 (one hundred years ago. It is noteworthy that already exist over there five (5 tourist itineraries, so this work was developed in order to determine the best routes to these existing itineraries, and create a unique route that includes all the tourist points in Vina del Mar, because in this way, the tourists visiting this city can minimize the time spent in traveling, as well as optimize their moments of leisure, taking the opportunity to know all the city attractions. To determine shorter ways to do it and then propose some suggestions for improvement of the quality of the tourist service offered, it had used the exact method, by solving the mathematical model of the TSP (Traveling Salesman Problem, and the heuristic method, using the most economic insertion algorithm.
2003-10-01
Americans make more than 405 million long-distance business trips per year, : accounting for 16% of all long-distance travel, according to a : preliminary analysis of the National Household Travel Survey (NHTS). : Conducted from 2001 to 2002, the NHT...
International Nuclear Information System (INIS)
Tang Xiaoyan; Shukla, Padma Kant
2008-01-01
Exact solutions, including the periodic travelling and non-travelling wave solutions, are presented for the nonlinear Klein-Gordon equation with imaginary mass. Some arbitrary functions are permitted in the periodic non-travelling wave solutions, which contribute to various high dimensional nonlinear structures
Three European ministers visit CERN
2007-01-01
There have been three ministerial visits to CERN this month. Gediminas Kirkilas, Prime Minister of Lithuania, and Robert Aymar, CERN’s Director-General.On 2 July, the Prime Minister of Lithuania, Gediminas Kirkilas, was welcomed by CERN’s Director-General, Robert Aymar, before being taken on a visit of the ATLAS cavern at Point 2 and the LHC tunnel. Michal Sewerynski, Poland’s Minister for Science and Higher Education, and Robert Aymar, CERN’s Director-General.Ten days later, Poland’s Minister for Science and Higher Education, Michal Sewerynski, visited the CMS cavern and assembly hall and the LHC tunnel. He was also given a tour of the LHC Computer Centre and the CERN Control Centre. His visit was rounded off with a presentation of Polish companies involved in CERN’s activities, followed by a meeting with Polish personnel working at CERN. J�...
Directory of Open Access Journals (Sweden)
Nobuo Sasaki
2018-01-01
Full Text Available We evaluated data from 10,088 participants without cardiovascular disease (CVD who underwent 75 g oral glucose tolerance tests and had more than four visits during the first 5 years following the test to investigate the association between impaired glucose metabolism and visit-to-visit blood pressure (BP variability. Participants were classified into groups of normal glucose tolerance (NGT, impaired fasting glucose (IFG, impaired glucose tolerance (IGT, and diabetes. Visit-to-visit BP variability was estimated for each individual using standard deviation (SD and coefficients of variation (CV, defined as SD/mean. SDs and CVs of systolic BP (SBP values were divided into quartiles. The samples falling in the highest quartile were considered as having high SD/CV. The adjusted odds ratio (OR for high SD of SBP in the IFG (OR, 1.39; P<0.003, IGT (OR, 1.26; P<0.001, and diabetes (OR, 1.54; P<0.001 groups was significantly higher than that for high SD of SBP in the NGT group. Similarly, the OR for high CV of SBP in the IGT and diabetes groups was significantly higher than that for high CV of SBP in the NGT group. In participants without CVD, impaired glucose metabolism may modulate visit-to-visit BP variability.
Ettema, D.F.; Friman, M.; Gärling, Tommy; Olsson, Lars
2016-01-01
This chapter discusses how travel by different travel modes is related to primarily subjective well-being but also to health or physical well-being. Studies carried out in different geographic contexts consistently show that satisfaction with active travel modes is higher than travel by car and
2010-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Travel. 60.5 Section 60.5... TEMPORARY LODGING § 60.5 Travel. As a condition for receiving temporary lodging under this part, a veteran must be required to travel either 50 or more miles, or at least two hours from his or her home to the...
Wang, B.; Shao, C.; Ji, X.
2017-01-01
The Integrated Multimodal Travel Information (IMTI) plays an important role in the evolution process of holiday travel behaviour, which is seldom investigated. To fill this gap, this study analyses holiday travel behaviour dynamics with IMTI usage, based on the life-oriented approach. IMTI usage is
DEFF Research Database (Denmark)
La Paix, Lissy; Bierlaire, Michel; Cherchi, Elisabetta
2013-01-01
The relationship between urban environment and travel behaviour is not a new problem. Neighbourhood characteristics may affect mobility of dwellers in different ways, such as frequency of trips, mode used, structure of the tours, and so on. At the same time, qualitative issues related...... to the individual attitude towards specific behaviour have recently become important in transport modelling contributing to a better understanding of travel demand. Following this research line, in this paper we study the effect of neighbourhood characteristics in the choice of the type of tours performed, but we...... assume that neighbourhood characteristics can also affect the individual propensity to travel and hence the choice of the tours throughout the propensity to travel. Since the propensity to travel is not observed, we employ hybrid choice models to estimate jointly the discrete choice of tours...
Vaccination for the expatriate and long-term traveler.
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.
2016-08-01
Knowingly or not, people generally place economic value on their time. Wage workers are paid a rate per hour, and service providers may charge per hour of their time. In the transportation realm, travelers place a value on their travel time and have ...
2003-11-01
The Thanksgiving and Christmas/New Years holiday periods are among the busiest long-distance travel periods of the year. During the 6-day Thanksgiving travel period, the number of long-distance trips (to and from a destination 50 miles or more awa...
2002-01-01
The visit itinerary includes five area of halls 191 and 180:. End-Cap Toroid Integration Area . Barrel Toroid Integration Area . Cryogenic Test Facility for Toroid Magnets and Helium Pumps . Liquid Argon Cryostats Assembly Area . Central Solenoid Magnet Test Station