Travel Risk Research Articles

Figure it out on your own: a mixed-method study on pelvic health survivorship care after gynecologic cancer treatments.

Pelvic health issues after treatment for gynecological cancer are common. Due to challenges in accessing physiotherapy services, exploring virtual pelvic healthcare is essential. This study aims to understand needs, preferences, barriers, and facilitators for a virtual pelvic healthcare program for gynecological cancer survivors. A multi-center, sequential mixed-methods study was conducted. An anonymous online survey (N=50) gathered quantitative data on pelvic health knowledge, opportunities, and motivation. Focus groups (N=14) explored patient experiences and consensus on pelvic health interventions and virtual delivery. Quantitative data used descriptive statistics, and focus group analyses employed inductive thematic analysis. Findings were mapped to the capability, opportunity, and motivation (COM-B) behavior change model. Participants reported lacking knowledge about pelvic health interventions and capability related to the use of vaginal dilators and continence care. Barriers to opportunity included lack of healthcare provider-initiated pelvic health discussions, limited time in clinic with healthcare providers, finding reliable information, and cost of physical therapy pelvic health services. Virtual delivery was seen favorably and may help to address motivational barriers related to embarrassment and frustration with care. Awareness of pelvic healthcare is lacking among people treated for gynecological cancer. Virtual delivery of pelvic health interventions is perceived as a solution to enhance access while minimizing travel, cost, embarrassment, and exposure risks. A better understanding of the pelvic health needs of individuals following gynecological cancer treatments enables the development of tailored virtual pelvic health rehabilitation interventions which may improve access to pelvic health survivorship care.

Machine learning approach to identify malaria risk in travelers using real-world evidence

BackgroundPre-travel consultation and chemoprophylaxis measures for malaria are a key component in the prevention of imported malaria in travelers. In this study we report a predictive tool for assessing personalized malaria risk in travelers based on the analysis of electronic medical records from travel consultations. The tool aims to guide physicians in the recommendation of appropriate prophylaxis prior to their trip. We also provide best-practice recommendations for pre-processing noisy and highly sparse real world evidence data. MethodsWe leveraged a large EMR dataset, containing demographic information about travelers and their destination. The data has been previously preprocessed using various strategies to handle missing and unbalanced data. We compared multiple machine learning approaches to assess the risk of malaria acquisition in travelers during their travels. Additionally, a feature importance analysis was performed using SHAP (SHapley Additive Explanations) values to identify patterns associated with malaria risk. ResultsOur study revealed that our XGB models achieved high predictive capacity (AUC >0.80). The most significant features predicting malaria infection during travel included travel destinations with low malaria risk, vaccination history, number of countries visited, age, and trip duration. Remarkably, we were able to obtain a reduced model with only five features. When comparing this model with a population of travelers recommended for malaria chemoprophylaxis, we observed that it was deemed necessary in only 40% of these travelers. This suggests that 60% received chemoprophylaxis despite having a low personalized risk of malaria. ConclusionWe have developed an algorithmic tool that utilizes a concise survey to generate a personalized travel risk assessment, effectively minimizing the prescription of unnecessary malaria chemoprophylaxis. Through the identification of patterns linked to predictions, our model significantly enhances the efficacy of pre-travel consultations.

Case report: Imported asymptomatic schistosomiasis among Belgian school travelers to Rwanda

Schistosomiasis is common in many tropical regions and poses a risk for the local population and travelers. In travelers, most of schistosomiasis are described as acute. We report the epidemiological, clinical, and laboratory characteristics associated with an outbreak of asymptomatic schistosomiasis among nonimmune Belgian school travelers in Rwanda. Schistosomiasis was diagnosed by serology in 12 out of the 15 (80%) travelers who swam in the lake nearly 2 years after a single exposure to freshwater at Kivu Lake, Rwanda. None showed signs of acute or chronic schistosomiasis. Eosinophilia was present in only 1 of them. Schistosoma mansoni eggs were not found in any infected patient. This report of an outbreak of asymptomatic schistosomiasis imported from Lake Kivu highlights the risk for travelers of acquiring the infection with only a short and single exposure, and provides strong arguments for routine serological screening for schistosomiasis in all individuals who have had any freshwater contact in endemic areas, irrespective of symptoms or laboratory findings.

Tele-Urology in the Era of COVID-19: an Experience of the Reconstructive Urology Department in Iran.

The outbreak of coronavirus has put additional pressure on the health care systems of many countries; but telemedicine can be an important way to deal with it, especially for people whose health has been affected by the virus. The present study aims to investigate the Implementation of a Tele-urology Program for Reconstructive Urologic Referrals: Initial Results and Patient Satisfaction. All patients with a history of a urethral reconstructive surgery during last year was entered to our study and two nurses collected data of demographic and past medical history of patients by existed. Telephone visits:Fellowship of reconstructive urology was connected to patients during a phone call and filled the USS-PROM and COVID-19 questionnaires. Face to face visits: All patients were asked to answer the questionnaire about recent exposure and infection by corona virus, recent travel and other risk factors of COVID-19. Mean of USSPROM scale was calculated as 1.65 (+2.91) with a range of 0-15. Based on categorization for USSPROM scale, 74 patients (94.8%) had mild symptoms while 4 patients (5.1%) had moderate symptoms and needed further medical attention. Four patients with moderate USSPROM score were required to cystoscopic evaluation, which one patient with moderate USSPROM score had severe stricture and candidate for redo urethroplasty. Two other patients need for urethral stricture dilatation. Cost was calculated based on taxi-service fee. Accordingly, the average (+SD) cost for in-person visits to the physician was estimated as 4.80 + 4.32 million Rials. In terms of distance, the average distance for receiving medical services according to the patient`s residence area was 373.2 +348.79 kilometres.In terms of the patient`s opinion regarding virtual examination, inappropriateness of virtual visits for physical examination, and patient`s inability to explain the problem correctly, patient`s condition at the time of the virtual visit were the main challenges reported by the respondent. Considering that the present COVID-19 emergency will likely last for months, telehealth could be the safest way to deliver urological care for a large percentage of the patients, such as those who are more at risk of unfavorable outcomes of COVID-19.

Does Travel Spread Infection?—Effects of Social Stirring Simulated on SEIRS Circuit Grid

Previous models of the spread of viral infection could not explain the potential risk of non-infectious travelers and exceptional events, such as the reduction in infected cases with an increase in travelers. In this study, we provide an explanation for improving the model by considering two factors. First, we consider the travel of susceptible (S), exposed (E), and recovered (R) individuals who may become infected and infect others in the destination region in the near future, as well as infectious (I). Second, people living in a region and those moving from other regions are treated as separate but interacting groups to consider the potential influence of movement before infection. We show the results of the simulation of infection spread in a country where individuals travel across regions and the government chooses regions to vaccinate with priority. As a result, vaccinating people in regions with larger populations better suppresses the spread of infection, which turns out to be a part of a general law that the same quantity of vaccines can work efficiently by maximizing the conditional entropy Hc of the distribution of vaccines to regions. This strategy outperformed vaccination in regions with a larger effective regeneration number. These results, understandable through the new concept of social stirring, correspond to the fact that travel activities across regional borders may even suppress the spread of vaccination if processed at a sufficiently high pace. This effect can be further reinforced if vaccines are equally distributed to local regions.

Impact of air pollution: tourists’ decision making behaviour during rural tourism

In recent years, the increasingly severe air pollution has not only posed a threat to residents’ health but also had a significant influence on tourists’ travel decision making behaviours. This study utilised empirical dynamic model–long short-term memory model to predict air pollutant concentrations in Xidi Village, China, and investigated their impact on tourists’ travel decisions. According to the results, there is a negative correlation between air quality and air quality index (AQI). The lowest AQIs were recorded in May and August 2022, with visitor numbers reaching 12 305 and 11 705, respectively. During the period from May to October, except for ozone (O3), which reached a maximum concentration of 157 μg/m3, all other pollutant concentrations remained at low levels. According to the predictions of the model, Xidi Village often experiences high concentrations of air pollutants during the spring and winter seasons, leading to hazy weather. This information provides accurate air quality data for tourists, helping them avoid periods of severe pollution at their travel destinations and reducing travel risks.

The reticent tourist in a COVID-adapted world

This paper examines the reasons why many people are reticent about travelling in a COVID-adapted world. It reports on a study of residents of Southeast Queensland, Australia conducted in mid-2022, up to six months after borders reopened after a prolonged COVID-19 shutdown. About one quarter of respondents were less interested in travel in a COVID-adapted world than they were before the pandemic struck. They were a diverse group whose reasons for their reticence could be categorised into four broad risk groups of: ongoing anxiety; fear of catching the disease; satisfaction risk, and; travel risk as reflected by an overall loss of interest in travel. Each group displayed different COVID-adapted travel patterns that reflect the operationalisation of different risk categories. A follow-up survey conducted in August 2023 confirmed that up to one in four people still have less desire to travel as a result of COVID-19.

Measuring Travel Insurance Literacy: Effect on Trust in Providers and Intention to Purchase

Recent research suggests that some deficiencies in the insurance industry might be associated with tourists’ lack of knowledge. However, the literature does not present a tool that captures objective knowledge of travel insurance literacy. This research presents a comprehensive, multi-step scale development process resulting in a 15-item scale, which measures objective knowledge about travel insurance terms, regulations, and processes. The results show that travel insurance literacy is associated with trust in sellers. Although no relationship was found between travel insurance literacy and perceived travel risks, these two constructs influence purchase intention. The results also show that there is no relationship between subjective knowledge (self-assessment literacy) and objective knowledge (ratings on the scale). Hence, the research presents a new measurement tool that differs from self-assessment scales prevailing in the tourism literature, opening new opportunities for literacy constructs in the field. Finally, the findings present key managerial implications for the insurance industry.

Understanding the relationship between fear of pandemics and hotel visit intention: A multiple mediation model

In the context of the COVID-19 pandemic, it is evident that pandemics entail significant and far-reaching economic and psychosocial consequences globally. This study seeks to examine the psychological impact of the fear of pandemics on the tourism sector by investigating the relationship between the Fear of COVID-19 and hotel visit intentions. Employing a multiple mediation model, we aim to enhance our understanding and specifically focus on the mediating roles of tourism based risks (destination risk, health risk, and travel risk) and purchase-based risk perception in a pandemic situation. The study draws on quantitative data obtained from travelers through a structured questionnaire. The findings reveal that, although fear of COVID-19 heightens tourism based risks and purchase-based risk perceptions, it concurrently diminishes hotel visit intentions. The authors propose a model to guide hotel managers and provide a concise summary of practical and strategic recommendations. It is noteworthy that the impact of the fear of COVID-19 on hotel service purchase intention, mediated by risk perception and various travel risk types, remains underexplored in the existing literature. Hence, the authors present a model that is particularly relevant for hotel managers, compressing practical and strategic insights.

Equilíbrio, quedas e risco de quedas na DPOC: revisão sistemática dos instrumentos de avaliação, propriedades de medida e utilidade clínica

Abstract Objectives to identify balance assessment instruments, issues and risks of issues used in COPD, evaluate their measurement properties, quality of evidence and clinical utility. Method A review was produced following the PRISMA and COSMIN guidelines, registered in PROSPERO: CRD42021235118. Searches were carried out from November 2021 to September 2022 in the PubMed, LILACS, CINAHL, Embase, Web of Science and PEDro databases. Cross-sectional and cohort observational studies were included, without restrictions on language or year of publication, as long as they described clinical instruments for assessing balance, falls and risk of falls reporting at least one of the measurement properties: validity, reliability and responsiveness. Two reviewers will independently apply the eligibility criteria, travel risk by COSMIN, quality of evidence by the GRADE approach and assessment of clinical utility by the Tyson and Connell Scale. Results 9,102 studies were selected and 21 included in the review, nine studies demonstrated adequate and sufficient measurement properties and 12 instruments were identified, of which six were evaluated for the quality of evidence. Conclusion Systematic reviews of measurement properties require specialized reviewers and skills in qualitative analysis. With a recommendation GRADE of “A”, the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test were the most recommended instruments for COPD. By requiring the evaluation of the clinical utility of the result, the TUG demonstrates superiority to the BBS, proving to be a great tool for judging individuals who need a thorough assessment of balance, falls and risk of falls.

COVID-19 passenger screening to reduce travel risk and translocation of disease.

Aviation passenger screening has been used worldwide to mitigate the translocation risk of SARS-CoV-2. We present a model that evaluates factors in screening strategies used in air travel and assess their relative sensitivity and importance in identifying infectious passengers. We use adapted Monte Carlo simulations to produce hypothetical disease timelines for the Omicron variant of SARS-CoV-2 for travelling passengers. Screening strategy factors assessed include having one or two RT-PCR and/or antigen tests prior to departure and/or post-arrival, and quarantine length and compliance upon arrival. One or more post-arrival tests and high quarantine compliance were the most important factors in reducing pathogen translocation. Screening that combines quarantine and post-arrival testing can shorten the length of quarantine for travelers, and variability and mean testing sensitivity in post-arrival RT-PCR and antigen tests decrease and increase with the greater time between the first and second post-arrival test, respectively. This study provides insight into the role various screening strategy factors have in preventing the translocation of infectious diseases and a flexible framework adaptable to other existing or emerging diseases. Such findings may help in public health policy and decision-making in present and future evidence-based practices for passenger screening and pandemic preparedness.

Unravelling perceived travel risk: a regression study with implications for tourism planners

Unravelling perceived travel risk: a regression study with implications for tourism planners

Identifying sites where wild boars can consume anthropogenic food waste with implications for African swine fever.

Wild boar population dynamics promote the increase in numbers and distribution of the species in Eurasia, leading to a rise in the interaction with human activities, as well as generating problems with the management of certain infectious diseases, most notably African swine fever (ASF). ASF virus possesses high stability in several contaminated pork and pork products that can be a source of indirect transmission to susceptible hosts habituated to anthropogenic food waste. This transmission route is a concerning threat for the dispersion of the disease, primarily into unaffected areas given the worldwide widespread distribution of the disease and the increase of wild boar contact with humans. Thus, in this study, a straightforward tool to assess the relative risk of wild boar natural populations potentially consuming food waste is presented using synthetic data. Three risk groups were defined related to urban areas, travel, and leisure. The surrounding quality of habitat of wild boar was used to obtain the relative risk of wild boar potentially consuming anthropogenic food waste. To assign the relative risk to the corresponding risk unit, we also included the population for the urban areas group, and traffic volume for the travel risk group. The leisure group had higher scaled risk scores, followed by the urban areas group. Higher risk was found in the edges of the study area where more natural landscapes are found. The implications of this risk are discussed focusing on the context of ASF transmission. The outputs can help prioritize decision-making in terms of the improvement of preventive measures against the habituation of wild boar to anthropogenic food waste and ASFV introduction in a given study area.

Virtual tourism experiences: adoption factors, participation and readiness to pay

ABSTRACTUbiquitous digitalization combined with recent crises has increased the drive to develop new virtual tourism (VT) offerings. However, the factors influencing end-users’ adoption, participation and, most crucially, their readiness to pay have yet to be sufficiently investigated. In the paper, we test behavioral intentions regarding VT experiences and their actual use. We integrate the extended unified theory of acceptance and use of technology (UTAUT2) with perceptions of travel risk, past behavior and measurement of actual behavior – the decision to participate and pay for a VT experience. Data were collected from 660 participants, half of whom were offered the virtual tourism experience for free and the other half for a payment. The results show a strong overall intention to use virtual tourism and that the UTAUT2 extended precedents predict it well. Still, once the user is asked to pay for the virtual experience, actual participation rates drop significantly, and strong behavioral intentions are not good predictors of actual behavior. While free virtual tourism experiences might see wide use, ones that are paid for must be carefully crafted.

General surgery applicant perspectives: Two years of virtual interview experiences and supplemental application impressions

BackgroundWe sought to evaluate the unique benefits and challenges the virtual recruitment and interviewing platform had on general surgery residency applicants. MethodsApplicants who interviewed for a categorical position at our institution during the 2021 and 2022 Match season were contacted to participate in the anonymous online survey focused on applicant behavior related to the virtual interview format. Data were analyzed using chi-square and paired t-tests. ResultsA response rate of 56.7 ​% (n ​= ​135) was achieved. Applicants accepted a median of 17 (IQR 13–20) interviews in 2021 and 15 (IQR 11–19) interviews in 2022. More than half (54 ​%) of applicants indicated they applied to more programs, and 53 ​% accepted more interviews, because of the virtual format. The greatest advantages of the virtual interviews as cited by applicants were saving money (96.3 ​%), saving time (49.6 ​%), and avoiding travel risks (43.7 ​%). The top limitations of virtual interviews were less exposure to current residents and faculty (61.5 ​%), to the city or location of the program (58.5 ​%), and difficultly comparing programs (57.8 ​%). The 2022 Match cycle included use of the supplemental application; however, 85 ​% of applicants did not feel that the supplemental improved their overall application. Some applicants (20 ​%) who “signaled” programs did not receive an interview offer from any of the programs they signaled. ConclusionThe transition to virtual interviews saved applicants time and money but limited their exposure. Future efforts to maintain virtual interviews will need to be balanced against the intangible benefit of human interaction and observing a program's culture.

A study on unmanned combat vehicle path planning for collision avoidance with enemy forces in dynamic situations

Abstract This study focuses on the path planning problem for unmanned combat vehicles (UCVs), where the goal is to find a viable path from the starting point to the destination while avoiding collisions with moving obstacles, such as enemy forces. The objective is to minimize the overall cost, which encompasses factors like travel distance, geographical difficulty, and the risk posed by enemy forces. To address this challenge, we have proposed a heuristic algorithm based on D* Lite. This modified algorithm considers not only travel distance but also other military-relevant costs, such as travel difficulty and risk. It generates a path that navigates around both fixed unknown obstacles and dynamically moving obstacles (enemy forces) that change positions over time. To assess the effectiveness of our proposed algorithm, we conducted comprehensive experiments, comparing and analyzing its performance in terms of average pathfinding success rate, average number of turns, and average execution time. Notably, we examined how the algorithm performs under two UCV path search strategies and two obstacle movement strategies. Our findings shed light on the potential of our approach in real-world UCV path planning scenarios.

Japanese Encephalitis Vaccine Acceptance and Strategies for Travelers: Insights from a Scoping Review and Practitioners in Endemic Countries.

Japanese encephalitis (JE) remains the cause of vaccine-preventable encephalitis in individuals living in endemic areas and international travelers. Although rare, the disease's high fatality rate emphasizes the need for effective immunization. This review aims to provide updated data on the JE burden between 2017 and 2023, vaccine acceptance, and vaccine strategies for travelers. We prospectively identified studies, using MEDLINE and PubMed, published through 2023. JE incidence has decreased in local populations and remains low among travelers from non-endemic countries. The local JE risk cannot be utilized to determine traveler risk. Adult travelers naïve to JEV infection or immunization may be at potentially higher risk. The JE vaccine acceptance rates among international travelers visiting JE endemic areas range from 0.2% to 28.5%. The cost of the vaccine and low risk perception could be barriers to JE vaccination. For travelers, an accelerated two-dose regimen of inactivated Vero cell JE vaccine (JE-VC) or a single dosage of live attenuated JE vaccine (JE-LV) may be an option. In conclusion, the JE burden among residents and travelers is lower, but the risk is not negligible. Practitioners should prioritize sharing knowledge, increasing awareness, and promoting vaccinations and preventive measures to reduce tourists' risk of JE along their journey.

System ochrony zdrowia w Polsce a turystyka

Health care system in Poland and tourism The aim of the study was to analyze the Polish health care system from the perspective of its use by outbound and inbound tourists. Health care facilities are part of the supporting facilities in tourism. This type of infrastructure primarily serves local residents, but also determines the proper organization of tourism at the destination. With regard to tourism, this infrastructure is used by people before their travels, mainly for preventive purposes, tourists staying in a particular destination, as well as those returning from trips (e.g., requiring further treatment). In connection with health prophylaxis preceding the trip, attention was paid to the activities of the Polish Society of Maritime, Tropical and Travel Medicine together with the National Network of Travel Medicine Centres. In addition to the data obtained from this association, information from the Central Statistical Office and the System and Implementation Analyzes Database, as well as data obtained from the National Health Fund, were used in the research procedure. However, despite the presence of increasingly available data, there is still much work to be done in developing knowledge about travel risks and preventive measures related to travel to another country.

Constructing influencing factors of sport event image and their consequential effect on tourists

ABSTRACT Watching sport events at tourist destinations is an appealing attraction for tourists because it generates excitement and direct understanding of the event, as well as the destination. Thus, a good event image can motivate people to re-attend sport events, make priority choices among similar games and even attach their personal feelings to the events. However, few researchers have explored the factors affecting sport event images and its consequential effects, particularly in the post-pandemic era. In the current study, 417 valid questionnaires were collected by convenience sampling during the 68th Macao Grand Prix, and analysed by structural modelling, via SPSS23 and AMOS26. The results showed that travel motivation, tourist-resident interaction and event quality are all important factors that positively influence the event image, with event quality having the most significant effect. Subsequently, event images positively affect event attachment and loyalty. Considering that the continued coronavirus disease 2019 pandemic travel risk still exist, it was incorporated as a moderator, which revealed that it negatively moderated the relations between event images, attachment and loyalty. This study supplements theoretical defects in sport event tourism by enriching the causes and effects of event images, and provides practical suggestions for sport event policymakers, planners and tourism managers.

TO TRAVEL OR NOT: TRAVEL INTENTION DURING POST-PANDEMIC TIMES

The COVID-19 pandemic has influenced the tourism industry in various ways, including tourists’ travel intentions. Unlike previous studies that have focused on the dark side of the pandemic, this study adds the dimension of perceptions of information on COVID-19, social groups, and perceived travel risk to explore their influence on travel intention. A total of 250 valid questionnaires were collected from a sample of Malaysian private university students. The results showed that students’ traveling intention for local or international destination in the forthcoming year following the COVID-19 pandemic outbreak is significantly high. In addition, the travel intention of Malaysian students was formed from the direct roles of COVID-19 information, social groups, and perceived travel risks. Perhaps, these students start travel plans when they feel the pandemic was under control by the government especially the statistics of affected people revealed by the Ministry of Health shows a decreasing trend. In addition, they might have the intention to travel since their family and friends have the same intention. However, students may choose destinations with less risk, and destinations that they perceive as risky may become undesirable. This study contributes to the understanding of the influence of the COVID-19 pandemic on tourism and of university students’ travel intentions. It also offers implications for the tourism industry to formulate relevant recovery strategies after the pandemic.