Travel Advice Research Articles

The Travel Advisory as an Obstacle to Travel and Tourism. Case Study-The Greek Economic Crisis

The Travel Advisory as an Obstacle to Travel and Tourism. Case Study-The Greek Economic Crisis

Visit your pharmacist for travel advice

Visit your pharmacist for travel advice

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

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

General Practitioners' Perception of Risk for Travelers Visiting Friends and Relatives.

General practitioners (GPs) are an important source of pre-travel health advice for travelers; however, only a few studies have investigated primary healthcare provider-related barriers to the provision of pre-travel health advice, particularly to travelers visiting friends and relatives (VFR). We aimed to investigate Australian GPs' knowledge, attitudes, and practices with regard to VFR travelers. A postal survey was sent to randomly sampled GPs in Sydney, Australia, in 2012. The questionnaire investigated GPs' perception of risk and barriers to the provision of advice to VFR travelers. Of 563 GPs, 431 (76.6%) spoke a language other than English (LOTE) with 361 (64.1%) consulting in a LOTE. Overall, 222 (39.4%) GPs considered VFR travelers to be at higher risk than holiday travelers, with GPs consulting in English only [adjusted odds ratio (aOR) 1.65, 95% confidence interval (CI) 1.11-2.44, p = 0.01] and GPs considering long-term migrants as VFR travelers (aOR 1.86 95% CI 1.07-3.23, p = 0.03) remaining significant on multivariate analysis. Multilingual GPs are a valuable resource to reducing language and cultural barriers to healthcare. Targeted education of this subgroup of GPs may assist in promoting pre-travel health assessments for VFR travelers. Awareness of the need for opportunistic targeting of migrants for pre-travel consultation through routine identification of future travel is needed.

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

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.

Empirical Analysis of Corporate Social Responsibility Influencing Not for Profit Organisation: A Case Study of Manipur, India

In the fast changing business scenario, business ethics and value based education form the foundation of a civilized society. This will find a focus in Training Programme under topics Corporate Social Responsibility in the light of The Companies Act 2013. They need to recognize the need to create organizations where ethical decisions are not undermined but are encouraged and promoted. They turned vibrant and actively functional as local governance modules. To realize the Government of Indias mission and Modis mantra of development Make in India, corporate sectors should spend Corporate Social Responsibility (CSR) money which is 2% of net profit currently on Swachh Bharat Abhiyaan. State Government should facilitate field visits by Embassy officials of those countries who issued travel advisories to their nationals against visiting states in the northeast region of India. In response to the demands of this new social system, NGOs begin to wonder what a responsible organization is like, as an exercise of assumption of its responsibilities. For the third sector, the starting point of social responsibility is the coherence between the values and the social proposal being done from their action fields: cooperation for development, social, human aid or environment.

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

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

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

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.

Travel medicine resources for Canadian practitioners.

To provide travel medicine practitioners with a comprehensive (though not exhaustive) list of resources. Resources that appear to be most frequently used by health professionals currently practising this specialty have been included. Select members of TravelMed, an international e-mail discussion forum for travel medicine practitioners were informally canvassed and presented with a question regarding which travel medicine resources they find to be most useful. Their responses informed the development of this Statement. In addition, the opinions of experts in travel medicine were solicited to identify resources. The scope was international; however, particular attention was given to Canadian sources of information. Travel medicine resources are listed and organized into the following categories: Courses, conferences and local travel medicine groups; Books; Canadian recommendations; Handbooks; periodicals and reports; Journals; Internet medicine forums; Online subscription services; Outbreak reports and travel advisories; Sources of malaria recommendations; More useful websites; Travel medicine clinics in Canada and abroad; and Certification. There are many Canadian and international resources available to inform Canadian travel medicine practitioners.

Following the mixed methods trail: some travel advice.

If you pay any attention to the primary care literature (as you are reading the BJGP , I assume you do), you may have noticed a new bandwagon snaking its way through our research teams and outputs in recent years. Yes, ‘mixed methods’ approaches are on the move and heading to an academic paper near you. Interviews, focus groups, surveys, observation, a sprinkling of statistics, a touch of thematic analysis: it’s all in there, strengthening inference and adding depth. Or is it? In truth, much of what is described as ‘mixed methods’ has rather fallen off the integrative path, and should more accurately be described as ‘multi-method’. So, here’s my brief road map for how to really follow the mixed methods trail. Let’s set off with a look at definitions. There are many, but a pretty common sense (and commonly-used) one is John Cresswell’s: ‘Mixed methods research is a methodology for conducting research that involves collecting, analyzing, and integrating (or mixing) quantitative and qualitative research (and data) in a single study or a longitudinal program of inquiry.’ 1 That looks clear: first, we need both quantitative and qualitative approaches, and, second, these need to be integrated or mixed in some way. However, although we’re pretty good at meeting the first requirement, we’re on a steep learning curve with the second. I’ll return to this later. Moving on, why might we want to do this? Greene, Caracelli, and Graham 2 formulated an influential scheme summarising different purposes for mixed methods research, including: These are not necessarily mutually exclusive: …

Travel health and pretravel preparation in the patient with inflammatory bowel disease

Background and aimsForeign travel for people with inflammatory bowel disease (IBD) carries an increased risk of travel-related morbidity. There is limited research looking specifically at travel-associated health risks and travel...

Tu1079 ‘IBDpassport’: Evaluating the Quality of an Internet-Based Travel Resource for Inflammatory Bowel Disease

Introduction Travellers’ with Inflammatory bowel disease (IBD) are at greater risk of travel-related morbidity with European guidelines recommending expert consultation prior to travel. 1 Previous research into travel and IBD found travel consultations and patient travel preparation and knowledge to be deficient. 2,3 As a result we developed a dedicated, evidence-based non-profit IBD travel advice website (www.ibdpassport.com) to enhance informed, safe travel. Here we present formal evaluation of this website. Method A link to the website, along with a structured web-based survey was sent to a sample of 15 UK IBD patients, clinical nurse specialists and Gastroenterologists respectively. The survey contained demographic questions and asked respondents to rate the content, functionality and credibility of the website using a series of parameters including a 5-point Global Quality Score and Integrity Score. 4 Readability statistics were graded on a 100 word sample of text from each page on the website using the Flesch Reading Ease and Flesch-Kincaid Grade level scores. Results A total of 33 individuals responded (73% response rate; 11, 33% Patient; 10, 30% Nurse; 12, 36% Gastroenterologist. The mean Global Quality score was 4.5 out of a possible 5 (Range 3–5). The Flesch-Kincaid Grade level score was US school grade 10.9 (range 7.2–17.1) and median Flesch Reading Ease score 50.5 out of a possible 100 (Range 22.4–65.1). The integrity score was 4.0 out of 6. The majority of respondents strongly agreed the website was an accurate source of travel information for IBD (60%), used appropriate citations (67%), and was easy to navigate (70%). 26/33 (79%) felt the website improved their knowledge of travel-related issues in IBD. All respondents would recommend the site to peers. Conclusion IBD Passport is the first internet-based travel resource created for both patients and professionals to provide IBD-specific travel information. Our findings demonstrate that patients and healthcare professionals consider IBD Passport to be an excellent quality, evidence-based resource. The readability statistics are favourable when compared to results from other studies examining website quality. Disclosure of interest None Declared. References Rahier JF, et al . J Crohns Colitis 2014;8:443–468 Soonawala D, et al . Inflamm Bowel Dis. 2012;18(11):2079–85 Greveson, et alet al. A recent flare of disease does not prohibit travel: early results of a single centre study in inflammatory bowel disease and travel digestive diseases week, 2014, abstract ID:Su1095 Bernard A, Langille M, Hughes S, et al . A systematic review of patient inflammatory bowel disease information resources on the world Wide Web. Am J Gastroenterol. 2007;102:2070–2077

The Pet Travel Scheme (PETS) and parasite protection for the travelling pet

Changes to the Pet Travel Scheme (PETS) has led to renewed interest in the scheme and concern surrounding pet travel. In addition to the new rules, the distribution of parasites not covered by the scheme are also changing and it is vital for veterinary professionals to keep up to date, not only with new legal requirements, but also the parasite prevention requirements of pets travelling abroad. Veterinary nurses play a vital role in giving pet travel advice, both in day-to-day interaction with clients and as part of organised travel clinics. This article discusses a practical approach both to the compulsory requirements of the scheme but also other parasite prevention that should be considered.

Are pharmacists ready for a greater role in travel health? An evaluation of the knowledge and confidence in providing travel health advice of pharmacists practicing in a community pharmacy chain in Alberta, Canada.

Patients often consult community pharmacists for medication needs related to travel, but little is known of pharmacists' knowledge and readiness to provide this care. The aim of this study was to evaluate pharmacists' knowledge in travel health, and to assess their confidence in providing travel-related advice to patients. A web-based survey was developed and distributed to 84 pharmacists practicing in a mid-size pharmacy chain in Alberta, Canada. The survey included knowledge and confidence assessment components. To assess knowledge, pharmacists were provided two cases, along with multiple-choice questions examining pre-travel risk assessment, and advice on travel at altitude, vaccines, malaria, travelers' diarrhea, and other potential travel health risks. Confidence was assessed by asking respondents to report their level of confidence in answering each knowledge assessment question and providing travel advice overall, using a 5-point Likert scale. Respondents were also asked to indicate preferred means for receiving additional training in travel health. A total of 53 pharmacists responded to the survey, with a response rate of 63%. Most (61%) indicated that they had some level of training in travel health and 69% counseled on travel health more than once a month. Only one respondent correctly answered all six questions in the knowledge assessment section. The mean knowledge score (proportion of correct answers, unaided) for the group was 27%. However, the majority (66%) felt confident that they would know where to seek the information required to answer the questions. Overall confidence in this group of pharmacists was determined to be low, with only 21% of respondents reporting that they felt highly confident in providing travel health advice. Travel health is becoming an increasingly common topic of discussion between patients and pharmacists. This study suggests that pharmacists' baseline knowledge of travel health may be incomplete, affecting their confidence in providing this advice. Undergraduate and continuing education training programs must expand travel health curricula to meet this growing need.

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

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.

Considerations on the current universal vaccination policy against hepatitis A in Greece after recent outbreaks.

Greece is the only European Union member state that in 2008 included hepatitis A (HAV) vaccine in the routine national childhood immunization program (NCIP). Given that the resources allocated to public health have dramatically decreased since 2008 and that Greece is a low endemicity country for the disease, the benefit from universal vaccination has been questioned. The aim of this paper is to summarize the available epidemiological data of the disease for 1982-2013, and discuss the effects of universal vaccination on disease morbidity. Descriptive analysis, ARIMA modeling and time series intervention analysis were conducted using surveillance data of acute HAV. A decreasing trend of HAV notification rate over the years was identified (p<0.001). However, universal vaccination (~ 80% vaccine coverage of children) had no significant effect on the annual number of reported cases (p = 0.261) and has resulted to a progressive increase of the average age of infection in the general population. The mean age of cases before the inclusion of the vaccine to NCIP (24.1 years, SD = 1.5) was significantly lower than the mean age of cases after 2008 (31.7 years, SD = 2.1) (p<0.001). In the last decade, one third of all reported cases were Roma (a population accounting for 1.5% of the country’s total population) and in 2013 three outbreaks with 16, 9 and 25 Roma cases respectively, were recorded, indicating the decreased effectiveness of the current immunization strategy in this group. Data suggest that universal vaccination may need to be re-considered. Probably a more cost effective approach would be to implement a program that will include: a) vaccination of high risk groups, b) universal vaccination of Roma children and improving conditions at Roma camps, c) education of the population and travel advice, and d) enhancement of the control measures to increase safety of shellfish and other foods.

A model of behavioral intentions to follow online travel advice based on social and emotional loneliness scales in the context of online travel communities: The moderating role of emotional expressivity

This study proposes a comprehensive hybrid model of the use of online travel communities for social and emotional loneliness (OTS-SEL), identification with the peer group (IPG), peer communication (PCO), user satisfaction (USAT), and behavioral intentions to follow travel advice (INFTA). The study determines whether OTS-SEL is composed of three subdimensions of social loneliness, friend loneliness, and romantic loneliness based on a second-order stricture; tests a structural equation model to examine the relationships between OTS-SEL, IPG, PCO, USAT, and INFTA; and provides a multi-group analysis to investigate the moderating effect of emotional expressivity (EME) on the relationship between USAT and INFTA. The results provide support for all hypotheses except for the one about the relationship between IPG and USAT; have important implications; and offer interesting avenues for future research.

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

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 < 0.01] compared with the price from agencies that did mention health risks. Almost all who acknowledged malaria (97%) and/or 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.

Empirical Analysis of Corporate Social Responsibility Influencing Not for Profit Organisation: A Case Study of Manipur, India

In the fast changing business scenario, business ethics and value based education form the foundation of a civilized society. This will find a focus in Training Programme under topics Corporate Social Responsibility in the light of The Companies Act 2013. They need to recognize the need to create organizations where ethical decisions are not undermined but are encouraged and promoted. They turned vibrant and actively functional as local governance modules. To realize the Government of Indias mission and Modis mantra of development Make in India, corporate sectors should spend Corporate Social Responsibility (CSR) money which is 2% of net profit currently on Swachh Bharat Abhiyaan. State Government should facilitate field visits by Embassy officials of those countries who issued travel advisories to their nationals against visiting states in the northeast region of India. In response to the demands of this new social system, NGOs begin to wonder what a responsible organization is like, as an exercise of assumption of its responsibilities. For the third sector, the starting point of social responsibility is the coherence between the values and the social proposal being done from their action fields: cooperation for development, social, human aid or environment.

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

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