Previous Travel Research Articles

What Do Travelers Know about Traveler's Diarrhea? Impact of a Pre-Travel Consultation in the Lisbon Area, Portugal.

Traveler's diarrhea (TD) is one of the most common travel-related health problems, largely interfering with planned activities and potentially contributing to antimicrobial resistance. This study aimed to characterize the knowledge about TD among pre-travel consultation users of one Portuguese travel clinic and determine the impact of the consultation on knowledge levels. Using a quasi-experimental, separate-sample pretest-posttest design, participants were randomly assigned to two groups: control/pre-consultation group (CG) or experimental/post-consultation group (EG). An anonymous self-administered questionnaire was used. A total of 470 participants were analyzed (227 CG; 243 EG). The EG/post-consultation group showed significant improvement in knowledge, with correct answers increasing from 63% to 75% (p < 0.001). However, knowledge gaps persisted: over 50% were unaware of TD's self-limited nature, 30% did not recognize loperamide as a symptom reliever, and 36% believed all travelers should take antibiotics to prevent TD. The educational level and previous travel outside Europe influenced baseline knowledge; previous travel medicine consultations and information on TD improved knowledge in both groups and made it easier to acquire knowledge on the subject. Thus, a pre-travel consultation effectively increased travelers' TD knowledge. However, post-consultation knowledge levels remained suboptimal, indicating the need for targeted interventions to increase travelers' literacy and optimize pre-travel consultations.

Unlocking Loyalty: The Power of Local Culture in Bali Tourism

This article examines the influence of local culture on tourist loyalty, focusing on a case study in Bali, Indonesia. Through a quantitative approach, this study uses structural equation modelling (SEM) with smart partial least squares (PLS) to analyse data from a survey involving 276 tourists. This study identifies and measures the direct impact of two independent variables, namely local ‘cultural richness’, and ‘cultural interaction’, on destination loyalty, with ‘tourist satisfaction’ as the mediating variable and ‘previous travel experience’ as the moderating variable. The results show that local cultural richness and cultural interaction have a significant influence on tourist satisfaction, which in turn affects destination loyalty. Nonetheless, previous travel experience has proven not to moderate the relationship between tourist satisfaction towards destination loyalty (? = -0.021). These findings provide valuable insights for destination managers and policymakers in developing marketing strategies that focus on local culture to increase tourist loyalty.

Current trends and perspectives of scoliosis research society travel fellows

Abstract Purpose This study aims to measure the impact of the Scoliosis Research Society’s travel fellowship on a spinal surgeon’s career. Methods A non-incentivized survey was sent to 78 previous SRS junior travel fellows from 1993 to 2021. The questionnaire assessed fellowship influence on academic and administrative positions, professional society memberships, and commercial relationships. The trend of these quantitative measures was created according to a compounded annual growth rate (CAGR) calculation of the reported values. The Scopus database was queried for all fellows’ publication counts and h-index before the fellowship, as well as 3 years, 5 years, and currently after the fellowship. A control cohort of matched surgeons who did not participate in travel fellowships was used to compare research productivity measures relative to travel fellows. Results This study had a 73% response rate. Over the periods of 3–5 years after the fellowship, and up to the present, the mean publication count increased by 31.0%, 31.6%, and 46.4%, respectively. Over the same interval, the mean h-index increased by 19.5%, 17.3%, and 11.3%, respectively. From the year of their respective fellowship to present day, the fellows observed a mean CAGR of + 3.2% in academic positions, + 6.7% in administrative positions, + 2.3% in society memberships, and + 4.7% in commercial relations. Previous fellows concurred the fellowship changed their clinical practice (42.1% Strongly Agree, 36.8% Agree), expanded their network (71.9% Strong Agree, 24.6% Agree), expanded their research (33.3% Strongly Agree, 54.4% Agree), and improved their surgical technique (33.3% Strongly Agree, 49.1% Agree). Conclusion Robust feedback from previous fellows suggests a traveling fellowship has a meaningful impact on a surgeon’s research productivity and career achievements.

Understanding how and why travel mode changes: analysis of longitudinal qualitative interviews

BackgroundEncouraging alternatives to the car such as walking, cycling or public transport is a key cross-sector policy priority to promote population and planetary health. Individual travel choices are shaped by individual and environmental contexts, and changes in these contexts – triggered by key events – can translate to changes in travel mode. Understanding how and why these changes happen can help uncover more generalisable findings to inform future intervention research. This study aimed to identify the mechanisms and contexts facilitating changes in travel mode.MethodsProspective longitudinal qualitative cohort study utilising semi-structured interviews at baseline (in 2021), three- and six-month follow up. Participants were residents in a new town in Cambridgeshire, UK, where design principles to promote walking, cycling and public transport were used at the planning stage. At each interview, we followed a topic guide asking participants about previous and current travel patterns and future intentions. All interviews were audio recorded and transcribed. Data analysis used the framework approach based on realist evaluation principles identifying the context and mechanisms described by participants as leading to travel behaviour change.ResultsWe conducted 42 interviews with 16 participants and identified six mechanisms for changes in travel mode. These entailed increasing or reducing access, reliability and financial cost, improving convenience, increasing confidence and raising awareness. Participants described that these led to changes in travel mode in contexts where their existing travel mode had been disrupted, particularly in terms of reducing access or reliability or increasing cost, and where there were suitable alternative travel modes for their journey. Experiences of the new travel mode played a role in future travel intentions.ImplicationsApplying realist evaluation principles to identify common mechanisms for changes in travel mode has the potential to inform future intervention strategies. Future interventions using mechanisms that reduce access to, reduce reliability of, or increase the financial cost of car use may facilitate modal shift to walking, cycling and public transport when implemented in contexts where alternative travel modes are available and acceptable.

Analysis of Emotional Tendency of Tourism Consumers Based on LSTM and Fuzzy Control Algorithm

Learning the emotional tendency of travelers improves their interests and provide optimal traveling recommendations. This, however, requires large volumes of data such as travel plans, visit sites, personal interests, value for money, etc. for a detailed analysis. For ease of such analysis, in this article, an organized combinational control method (OC2M) is proposed. This method relies on conventional long short-term memory (LSTM) and fuzzy control (FC) to support such analysis. The first is responsible for filtering non-repeated data from the previous travel/ tour history reducing the data discreteness. This is organized non-recurrently to prevent outdated/ trivial data from influencing the consumer’s emotional learning. The FC process filters the adaptable data with the future tour/ travel plan for providing optimal recommendations that are liable to the consumer’s emotional tendency. This is identified based on the user's interest, preferences, and emotional connectivity with the place or plan from previous histories. Therefore, the proposed method improves the recommendation and validation tendencies of the consumer’s travel plan accordingly.

Clinical Course, Antifungal Susceptibility, and Genomic Sequencing of Trichophyton indotineae

Trichophyton indotineae is an emerging dermatophyte causing outbreaks of extensive tinea infections often unresponsive to terbinafine. This species has been detected worldwide and in multiple US states, yet detailed US data on infections with T indotineae are sparse and could improve treatment practices and medical understanding of transmission. To correlate clinical features of T indotineae infections with in vitro antifungal susceptibility testing results, squalene epoxidase gene sequence variations, and isolate relatedness using whole-genome sequencing. This retrospective cohort study of patients with T indotineae infections in New York City spanned May 2022 to May 2023. Patients with confirmed T indotineae infections were recruited from 6 New York City medical centers. Improvement or resolution at the last follow-up assessment. Among 11 patients with T indotineae (6 male and 5 female patients; median [range] age, 39 [10-65] years), 2 were pregnant; 1 had lymphoma; and the remainder were immunocompetent. Nine patients reported previous travel to Bangladesh. All had widespread lesions with variable scale and inflammation, topical antifungal monotherapy failure, and diagnostic delays (range, 3-42 months). Terbinafine treatment failed in 7 patients at standard doses (250 mg daily) for prolonged duration; these patients also had isolates with amino acid substitutions at positions 393 (L393S) or 397 (F397L) in squalene epoxidase that correlated with elevated terbinafine minimum inhibitory concentrations of 0.5 μg/mL or higher. Patients who were treated with fluconazole and griseofulvin improved in 2 of 4 and 2 of 5 instances, respectively, without correlation between outcomes and antifungal minimum inhibitory concentrations. Furthermore, 5 of 7 patients treated with itraconazole cleared or had improvement at the last follow-up, and 2 of 7 were lost to follow-up or stopped treatment. Based on whole-genome sequencing analysis, US isolates formed a cluster distinct from Indian isolates. The results of this case series suggest that disease severity, diagnostic delays, and lack of response to typically used doses and durations of antifungals for tinea were common in this primarily immunocompetent patient cohort with T indotineae, consistent with published data. Itraconazole was generally effective, and the acquisition of infection was likely in Bangladesh.

Exploring the influence of driver’s presence on passengers’ willingness level to take autonomous taxis – Evidence from Seattle metropolitan area

This study aims to identify the potential determinants of people's willingness to adopt autonomous vehicle (AV) taxis, with or without a backup driver, using Binary Logistic Regression in combination with the enhanced Random Forest attribute selection method. The results indicate that young men with frequent use of ride-sharing services, walk frequently, and have household incomes of approximately $150,000 − $200,000 are more likely to be interested in using AV taxis regardless of the presence of a backup driver. The study finds that previous travel habits (use of different modes) can greatly influence individuals' interest levels in using AV taxis. The study points AV taxi service providers should address female passengers' concerns to pursue a larger market. This study innovatively uses individuals’ preferences for their residential locations, such as proximity to workplace, walkability, and affordability. Through the inclusion of these variables in the analysis, this study offers a more comprehensive insight into the potential users of AV taxis, thus enabling policymakers and planners to pursue a transportation system that is sustainable, equitable, and responsive to the diverse needs and preferences of different populations. The study has limitations in that it lacks users' perceived benefits and their specific needs pertaining to AVs. Finally, the study emphasizes the importance of examining the causes of inequality and promoting equitable access to AV technology, particularly for vulnerable groups.

How Important are Best Practices and a Horse’s Characteristics to Protect Welfare During Equine Air Transport?

Abstract Equine air transport is a complex event. This study presents the cases of two horses transported from the USA to New Zealand and discusses the importance of knowing the horse’s temperament and previous travel history (i.e., transport-related health and behavioural problems) and appropriate management. The two horses were reported to have temperament traits of nervousness/excitability and stubbornness, limited travel training and experience, and previous transport-related problems. After being quarantined for 23 days, the horses were transported by road to the departure airport, where they were unloaded from the road vehicle, health-checked, and loaded without problems into three-horse capacity jet stalls, by a flight groom with 50 years of experience in horse handling. During the flight, the horses were regularly checked, watered, and fed; both ate and drank. However, on arrival, when the horses were monitored, both showed fever (rectal temperature &gt; 38.6°C). While the flight groom’s experience may have facilitated the handling of the horses during the air transport phases, reducing the risk of injuries, the horses could have had difficulty coping with air transport stress, developing fever after the flight due to their poor temperament and previous travel history. Knowing the individual details of the horses, training or re-training them for loading and travelling, and monitoring them carefully before, during, and after the air journey are recommended to minimise the welfare issues associated with air transport. Information © The Authors 2024

Navigating travel constraints for individuals with mental health conditions

ABSTRACT While previous accessible travel studies focused primarily on physical disabilities, this research examined the perceptions and challenges related to travel experiences among individuals with mental health conditions. Grounded on the leisure constraint model, this study captured the distinct travel constraints and experiences shared by individuals with mental health conditions. Utilising the Reddit API, we collected data from several subreddits that cater to various mental health conditions, including autism, attention-deficit hyperactivity disorder, post-traumatic stress disorder, bipolar disorder, anxiety disorders, eating disorders, and depression. Through the application of topic modelling and topic network analysis, 30 themes and 7 communities emerged, spotlighting the pre- and during-travel constraints of individuals with mental health conditions. The resulting travel constraints were identified, leading to their categorisation as intrapersonal, interpersonal, and structural constraints. This categorisation lays the foundation for developing strategies that can enhance the travel experiences and engagements of individuals with mental health conditions.

A new model for residential location choice using residential trajectory data

Traditional residential location choice (RLC) models are based on the characteristics of location and demographics, revealing important patterns of RLC, but no RLC models have yet incorporated individual preferences. This study fills this gap by integrating the pattern of home-based travel into the RLC model. Firstly, by analysing residential trajectory data collected from Beijing and Shenzhen, we find that both residents’ commuting time, that is, time spent commuting to work, and home-based non-commuting (HBNC) time, that is, time spent on the consumption of amenities when departing from homes, follow an extreme value distribution (EVT). This indicates that, based on time budget and financial constraints, residents strive to minimise commuting time and maximise HBNC time. Subsequently, by integrating these findings into individual-level RLC analysis, we obtain an RLC model that aligns with the gravity model. Throughout the model training process, we demonstrate that the RLC model exhibits strong robustness by incorporating control variables, changing the spatial scale of the observation unit, testing for endogeneity, and considering historical RLC. Moreover, the model performs well in applications including assessing dynamic changes in RLC behaviours and making predictions based on previous travel behaviours. The RLC model in this study advances our understanding of human habitat selection behaviour and can be utilised by policymakers to develop and implement effective urban planning and epidemic management policies.

Parasitic and Fungal Triggers of Cytokine Storm Syndrome.

Infections caused by parasites and fungi can trigger the cytokine storm syndrome (CSS). These infections causing CSS can occur together with acquired immunodeficiencies, lymphomas, the use of immunosuppressive medications, transplant recipients, cancer, autoinflammatory, and autoimmune diseases or less frequently in healthy individuals. Histoplasma, Leishmania, Plasmodium, and Toxoplasma are the most frequent organisms associated with a CSS. It is very important to determine a previous travel history when evaluating a patient with a CSS triggered by these organisms as this may be the clue to the causal agent. Even though CSS is treated with specific therapies, an effort to find the causal organism should be carried out since the treatment of the infectious organism may stop the CSS. Diagnosing a CSS in the presence of parasitic or fungal sepsis should also lead to the study of an altered cytotoxic or hemophagocytic response in the susceptible host.

Multimodal experience as a predictor and catalyst of travel behavior

Three surveys and an intervention experiment among university students investigated the relationship between past experience with multimodal transportation and current travel behavior. The case study university primarily draws students from rural, car-oriented communities but also attracts students from international and domestic urban cities where walking, biking, and public transit are common. Nearly 800 students responded to the first survey. They confirmed the hypothesis that rural students lack experience with multimodal travel and are less likely than their urban classmates to use multimodal opportunities in their new environment. Next, a subset of students was surveyed before and after participating in a multimodal exposure tour (the treatment group). Their responses were compared to students who completed the same surveys but did not participate in the tour. The results indicate that the treatment group increased their use of bus, bike, and walking. The exposure experiment should be interpreted with caution due to a small sample size, nevertheless, the results showed statistical and practical significance and were supported by the initial survey that involved a large, reliable sample. This case study is a microcosm of people moving to new mobility environments and the potential to transform travel habits. The survey design and tour event provide a model for investigating previous travel experience and promoting change in mode choice. The approach of this study can help planners, policymakers, business leaders, and university administrators better understand and shape the travel behavior of their constituents.

Examined The Relationship Between Travel Anxiety and Destination Choice: Implications for Tourism Marketing: A Qualitative Study

This qualitative study examined the relationship between travel anxiety and destination choice, specifically focusing on its implications for tourism marketing. Through in-depth interviews with individuals who have experienced travel anxiety, the study explored their past experiences and decision-making processes when selecting destinations. Participants were selected through purposive sampling, ensuring diverse travel anxiety levels and demographic backgrounds. Data analysis followed a thematic approach, using past tense verbs to capture participants' retrospective perspectives on their travel anxiety experiences. The findings revealed that travel anxiety significantly influenced destination choices, with various factors contributing to decision-making processes. Past tense verbs were employed to describe participants' experiences, emotions, and coping mechanisms during their previous travel experiences. These verbs highlighted the nuanced nature of travel anxiety and provided valuable insights into the specific triggers and manifestations of anxiety in different travel contexts. The implications for tourism marketing were identified through the lens of the findings. Strategies were proposed to address and alleviate travel anxiety, targeting specific stages of the decision-making process. Tourism marketers can tailor their marketing efforts to better accommodate and support individuals with travel anxiety, ultimately enhancing their overall travel experiences by comprehending the complex relationship between destination selection and travel anxiety. This study adds to the growing body of research on travel anxiety by shedding light on people's individual experiences and providing tourism marketers with practical implications. The long-term effects of marketing interventions on reducing travel anxiety and increasing destination satisfaction should be the subject of additional research.

Exploring hepatitis E virus seroprevalence and associated risk factors among the human population in Tandil, Buenos Aires, Argentina.

Hepatitis E virus (HEV) infection is a common cause of acute clinical hepatitis worldwide and is emerging as a disease in Argentina. It is primarily transmitted through contaminated water and food, following the fecal-oral route. Furthermore, is a zoonotic disease with swine as the primary reservoir. Prevalence of HEV infection in humans in several regions of Argentina remains unknown. (i) Determine the seroprevalence of HEV among the human population in Tandil, Buenos Aires, Argentina; (ii) Evaluate its association with demographic, socioeconomic and other risk exposures variables, and (iii) Describe and analyze spatial patterns related to HEV infection. From August 2020 to July 2021, serum samples were collected from 969 individuals aged 1-80 years. Seroprevalence and 95% Confidence Interval was determined. To assess the factors associated with the presence of anti-HEV antibodies, associations between the variables and seropositivity were evaluated through bivariate and multivariate analysis. Spatial scanning for clusters of positivity was carried out. Factors associated with these clusters were also assessed. Anti-HEV antibodies were detected in 4.64% (IC 95% 3.27-6.02) of samples. Dark urine was associated with seropositivity (p = 0.02). Seropositivity was linked with the presence of natural water courses near their households (p = 0.02); the age (p = 0.04); and previous travel to Europe (p = 0.04). A spatial cluster of low rates of HEV seropositivity was detected, with greater distance of the households to water courses associated to the cluster, and male sex inversely associated to it. This study is the first study to investigate the prevalence of HEV in the population from Tandil, Buenos Aires, Argentina. Considering HEV infection in the differential diagnosis in individuals presenting acute hepatitis is highlighted. The incorporation of HEV testing into blood screening policies should be mandatory. Factors related to the infection and spatial patterns of high and low risk were determined, and should be considered when implementing specific preventive measures.

Resourcing idle privately owned autonomous electric vehicles: System design and simulation for ride-sharing in residential areas of the aging in Japan

Shared mobility services, autonomous vehicles (AVs), and electric vehicles (EVs) are potential solutions to issues triggered by suburbanization, greenhouse gas emissions, and population aging. In this study, a shared autonomous electric vehicle (SAEV) system is proposed to create a convenient and environmentally friendly shared mobility service system based on AVs for commuters and aging users in the suburbs by exploiting the idle time of park-and-ride private vehicles in Japan. The SAEV system provides mobility services to two user groups, “inbound commuters” and “elderly and disabled residents,” in two study areas. The proposed system performance was investigated using an agent-based simulation. The results show that non-EV scenarios have a better level of service owing to the improvement in average waiting time by about 20% when compared to EV scenarios which require charging. However, the SAEVs can still provide acceptable levels of mobility services. The waiting time can be maintained within 5 min when the fleet size is set at 40 trips per vehicle or less, and ride-sharing can reduce the waiting time significantly when the demand is high such as 80 trips per vehicle. Further, an average emission reduction of over 40% is anticipated when compared with the users’ previous travel modes. The system managers are advised to keep the demand trips per vehicle under 40 trips/vehicle for a low waiting time (approximate 5 min or less).

A malaria death due to an imported Plasmodium falciparum infection in Sri Lanka during the prevention of re-establishment phase of malaria

BackgroundSri Lanka has maintained a rigorous programme to prevent the re-establishment of malaria ever since the disease was eliminated in October 2012. It includes efforts to sustain case surveillance to ensure early diagnosis and management of malaria. Yet, in April of 2023 the death occurred of an individual with imported malaria.Case presentationThe deceased was a 37-year-old Sri Lankan male who returned to Sri Lanka on the 10th of April after a business trip to several countries including Tanzania. He was febrile on arrival and consulted three Allopathic Medical Practitioners in succession in his home town in the Western Province of Sri Lanka, over a period of 5 days starting from the very day that he arrived in the country. Malaria was not tested for at any of these consultations and his clinical condition deteriorated. On the evening of 14th of April he was admitted to the medical intensive care unit of a major private hospital in the capital city of Colombo with multiple organ failure. There, on a request by the treating physician blood was tested for malaria and reported early the next morning as Plasmodium falciparum malaria with a high parasitaemia (> 10%). The patient died shortly after on the 15th of April before any anti-malarial medication was administered. The deceased had been a frequent business traveller to Africa, but with no past history of malaria. He had not taken chemoprophylaxis for malaria on this or previous travels to Africa.DiscussionThe patient’s P. falciparum infection progressed rapidly over 5 days of arriving in Sri Lanka leading to severe malaria without being diagnosed, despite him seeking healthcare from three different Medical Practitioners. Finally, a diagnosis of malaria was made on admission to an intensive care unit; the patient died before anti-malarial medicines were administered.ConclusionsThis first death due to severe P. falciparum malaria reported in Sri Lanka after elimination of the disease was due to the delay in diagnosing malaria.

Unexpected Loa loa Finding in an Asymptomatic Patient From The Gambia: A Case Report.

A 17-year-old asymptomatic male from The Gambia presented for a routine health examination after migration to Spain. Laboratory diagnosis confirmed the presence of Loa loa microfilariae. This unusual finding emphasizes the importance of screening in newly arrived migrants and the need of an extended anamnesis including migratory route and previous travels.

Profiles of travelers to intermediate-high health risk areas following the reopening of borders in the COVID-19 crisis: A clustering approach

BackgroundThe reactivation of international travel in 2021 has created a new scenario in which the profile of the traveler to medium-high health risk areas may well have changed. However, few studies have analyzed this new profile since the reopening of borders in that year. MethodsWe designed an ad hoc questionnaire that was administered face-to-face by our medical team during appointments with 330 travelers in the second half of 2021. Information was collected on the following topics: sociodemographic and socioeconomic status; type of travel and previous travel experience; health status and risk perception (of COVID-19 and tropical infectious diseases). Using all features simultaneously, an unsupervised machine learning approach (k-means) is implemented to characterize groups of travelers. Pairwise chi-squared tests were performed to identify key features that showed statistically significant differences between clusters. ResultsThe travelers were clustered into seven groups. We associated the clusters with different intensities of perceived risk of acquiring COVID-19 and tropical infectious diseases on the trip. The perceived risk of both diseases was low in the group "middle or lower middle class young inexperienced male tourist" but high in the group "middle or lower middle-class young with children inexperienced business traveler". ConclusionsBroadening our knowledge of the profiles of travelers to intermediate-high health risk areas would help to tailor the health advice provided by practitioners to their characteristics and type of travel. In a changing health context, the k-means approach supposes a flexible statistical method that calculates travelers’ profiles and can be easily adapted to process new information.

Community carriage of ESBL-producing Escherichia coli and Klebsiella pneumoniae: a cross-sectional study of risk factors and comparative genomics of carriage and clinical isolates.

The global prevalence of infections caused by extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) is increasing, and for Escherichia coli, observations indicate that this is partly driven by community-onset cases. The ESBL-E population structure in the community is scarcely described, and data on risk factors for carriage are conflicting. Here, we report the prevalence and population structure of fecal ESBL-producing E. coli and Klebsiella pneumoniae (ESBL-Ec/Kp) in a general adult population, examine risk factors, and compare carriage isolates with contemporary clinical isolates. Fecal samples obtained from 4,999 participants (54% women) ≥40 years in the seventh survey of the population-based Tromsø Study, Norway (2015, 2016), were screened for ESBL-Ec/Kp. In addition, we included 118 ESBL-Ec clinical isolates from the Norwegian surveillance program in 2014. All isolates were whole-genome sequenced. Risk factors associated with carriage were analyzed using multivariable logistic regression. ESBL-Ec gastrointestinal carriage prevalence was 3.3% [95% confidence interval (CI) 2.8%-3.9%, no sex difference] and 0.08% (0.02%-0.20%) for ESBL-Kp. For ESBL-Ec, travel to Asia was the only independent risk factor (adjusted odds ratio 3.46, 95% CI 2.18-5.49). E. coli ST131 was most prevalent in both collections. However, the ST131 proportion was significantly lower in carriage (24%) versus clinical isolates (58%, P < 0.001). Carriage isolates were genetically more diverse with a higher proportion of phylogroup A (26%) than clinical isolates (5%, P < 0.001), indicating that ESBL gene acquisition occurs in a variety of E. coli lineages colonizing the gut. STs commonly related to extraintestinal infections were more frequent in clinical isolates also carrying a higher prevalence of antimicrobial resistance, which could indicate clone-associated pathogenicity.IMPORTANCEESBL-Ec and ESBL-Kp are major pathogens in the global burden of antimicrobial resistance. However, there is a gap in knowledge concerning the bacterial population structure of human ESBL-Ec/Kp carriage isolates in the community. We have examined ESBL-Ec/Kp isolates from a population-based study and compared these to contemporary clinical isolates. The large genetic diversity of carriage isolates indicates frequent ESBL gene acquisition, while those causing invasive infections are more clone dependent and associated with a higher prevalence of antibiotic resistance. The knowledge of factors associated with ESBL carriage helps to identify patients at risk to combat the spread of resistant bacteria within the healthcare system. Particularly, previous travel to Asia stands out as a major risk factor for carriage and should be considered in selecting empirical antibiotic treatment in critically ill patients.

Student Perceptions on the Benefits and Barriers to Study Abroad

This study examines perceptions of the benefits and barriers to study abroad amongst undergraduate students studying at the Soltis Center for Research and Education in Costa Rica, in 2018 and 2019. A total of 49 students representing five different study abroad programs from three institutions participated in the study. Cost, personal obligations, and timing of the program were identified by all respondents as the most important barriers to student participation in a study abroad program. Results of a Q-sort suggests that perceived benefits varied by academic year of the student and their experience with study abroad, and other high impact learning experiences. Upper-year students, as well as those with previous travel experience, viewed study abroad as an opportunity to develop career-relevant skills, while lower-year students and those with less travel experience perceived broadening horizons and personal growth as the most important benefits. The transition in perceived benefits can be used to effectively structure study abroad within the undergraduate curriculum to maximize benefits for student learning.