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4.
Nat Commun ; 10(1): 2332, 2019 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-31133635

RESUMO

Malaria burden on Bioko Island has decreased significantly over the past 15 years. The impact of interventions on malaria prevalence, however, has recently stalled. Here, we use data from island-wide, annual malaria indicator surveys to investigate human movement patterns and their relationship to Plasmodium falciparum prevalence. Using geostatistical and mathematical modelling, we find that off-island travel is more prevalent in and around the capital, Malabo. The odds of malaria infection among off-island travelers are significantly higher than the rest of the population. We estimate that malaria importation rates are high enough to explain malaria prevalence in much of Malabo and its surroundings, and that local transmission is highest along the West Coast of the island. Despite uncertainty, these estimates of residual transmission and importation serve as a basis for evaluating progress towards elimination and for efficiently allocating resources as Bioko makes the transition from control to elimination.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Malária Falciparum/epidemiologia , Doença Relacionada a Viagens , Viagem/estatística & dados numéricos , Doenças Transmissíveis Importadas/parasitologia , Doenças Transmissíveis Importadas/prevenção & controle , Guiné Equatorial/epidemiologia , Humanos , Ilhas/epidemiologia , Malária Falciparum/parasitologia , Malária Falciparum/prevenção & controle , Plasmodium falciparum/isolamento & purificação , Prevalência , Fatores de Risco , Viagem/tendências
5.
Public Health ; 168: 168-171, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30739732

RESUMO

OBJECTIVES: Unemployment in Greece has been increasing as a result of the financial crisis. The aim of this study was to assess the changing trends of business travelers and their pretravel preparation. STUDY DESIGN: Prospective, questionnaire-based study. METHODS: The study was conducted between 2008 and 2016 at all Regional Public Health Departments. All travelers seeking pretravel advice during the study period were invited to participate. RESULTS: A total of 12,379 travelers completed the questionnaire, 58% of whom were business travelers. Between 2008 and 2016, the proportion of business travelers increased from 33% to 80.7% and those travelling for recreational purposes decreased from 47.9% to 15.5%. Business travelers sought pretravel advice at a mean of 18.5 days before departure; 89.1% were men with a mean age of 34.4 years. The Middle East was the most common destination (47.8%) followed by Sub-Saharan Africa (28.3%). Most business travelers stayed in urban areas (77.6%) and for ≥ 1 month (68.6%). Yellow fever vaccine was administered to 75% of business travelers. A total of 76.2%, 26.9%, 15.5%, and 13.9% of those visiting Sub-Saharan Africa received yellow fever, typhoid fever, hepatitis A, and meningococcal vaccines, respectively. Malaria prophylaxis vaccine was administered to 26.8% of business travelers; including 46.5% of those traveling to Sub-Saharan Africa and 53.5% to those traveling to the Indian subcontinent. CONCLUSIONS: There is an increasing trend for business travel from Greece, especially to developing countries. Improving the knowledge of travel health consultants about the risks of business travel and the pretravel preparation of business travelers is crucial.


Assuntos
Comércio , Recessão Econômica , Medicina de Viagem/estatística & dados numéricos , Viagem/tendências , Adulto , Feminino , Grécia , Humanos , Masculino , Estudos Prospectivos , Inquéritos e Questionários
6.
Int J Health Geogr ; 18(1): 4, 2019 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-30728007

RESUMO

BACKGROUND: Active travel for utilitarian purposes contributes to total physical activity and may help counter the obesity epidemic. However, the evidence linking active travel and individual-level body weight is equivocal. Statistical modeling that accounts for spatial autocorrelation and unmeasured spatial predictors has not yet used to explore whether the health benefits of active travel are shared equally across socioeconomic groups. METHODS: Bayesian hierarchical models with spatial random effects were developed using travel survey data from Saskatoon, Canada (N = 4625). Differences in log-transformed body mass index (BMI) were estimated for levels of active travel use (vehicular travel only, mixed vehicular/active travel, and active travel only), household income, and neighbourhood deprivation after controlling for sociodemographic and physical activity variables. The modifying effect of household income on the association between active travel and BMI was also evaluated. RESULTS: Significant and meaningful decreases in BMI were observed for mixed (ß = - 0.02, CrI - 0.036 to - 0.004) and active only (ß = - 0.043, CrI - 0.06 to - 0.025) compared to vehicular only travelers. BMI was significantly associated with levels of household income and neighbourhood deprivation. Accounting for the interaction between travel mode and household income, decreases in BMI were observed for active only compared to vehicular only travellers in the highest income category (ß = - 0.061, CrI - 0.115 to - 0.007). CONCLUSION: Strategies to increase active travel use can support healthy weight loss and maintenance, but the opportunity to benefit from active travel use may be limited by low income. Considerations should be given to how interventions to increase active transportation might exacerbate social inequalities in BMI. Spatial statistical models are needed to account for unmeasured but spatially structured neighbourhood factors.


Assuntos
Índice de Massa Corporal , Exercício/fisiologia , Características da Família , Renda , Viagem/economia , População Urbana , Adulto , Idoso , Teorema de Bayes , Estudos Transversais , Feminino , Humanos , Renda/tendências , Masculino , Pessoa de Meia-Idade , Características de Residência , Saskatchewan/epidemiologia , Fatores Socioeconômicos , Viagem/tendências , População Urbana/tendências , Adulto Jovem
7.
Acad Med ; 94(4): 496-500, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30379660

RESUMO

Away rotations are common among senior medical students preparing to apply for residency. For competitive specialties, multiple away rotations may be viewed as a de facto requirement for a strong application. Although away rotations are often valuable learning experiences, a variety of noneducational factors motivate students to enroll, including the need for letters of recommendation, students' uncertainty regarding their strength as applicants, perceived competitiveness of residency applications, and conflicting guidance from advisors.Students who enroll in away rotations often benefit from a novel educational environment, opportunities for career exploration, and the chance to assess "fit" with a program. Yet away rotations also come at a significant cost. Students must deal with the time and expenses of rotating at multiple institutions. The application process for away rotations is expensive, disjointed, and inefficient. Students must work hard to make an impression on host institution faculty, and risk hurting their residency applications with a negative letter of recommendation.To reduce the burden of away rotations, future research should assess the impact of multiple away rotations on success in the Match. Allowing students limited access to letters of recommendation content would allow students and advisors to make informed decisions regarding additional rotations. Students would benefit from greater standardization of the application process for away rotations, with uniform dates, timely acceptances and rejections, and a cap for the number of applications per student. Students can maximize their returns by targeting away rotations that provide the most diverse educational experiences and valuable letters of recommendation.


Assuntos
Educação Médica/métodos , Investimentos em Saúde/normas , Faculdades de Medicina/economia , Estudantes de Medicina/psicologia , Viagem/tendências , Educação Médica/economia , Educação Médica/normas , Humanos , Investimentos em Saúde/economia , Investimentos em Saúde/tendências , Faculdades de Medicina/organização & administração , Viagem/economia
8.
Int J Health Geogr ; 17(1): 40, 2018 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-30509275

RESUMO

BACKGROUND: Device-collected data from GPS and accelerometers for identifying active travel behaviors have dramatically changed research methods in transportation planning and public health. Automated algorithms have helped researchers to process large datasets with likely fewer errors than found in other collection methods (e.g., self-report travel diary). In this study, we compared travel modes identified by a commonly used automated algorithm (PALMS) that integrates GPS and accelerometer data with those obtained from travel diary estimates. METHODS: Sixty participants, who made 2100 trips during seven consecutive days of data collection, were selected from among the baseline sample of a project examining the travel behavior impact of a new light rail system in the greater Seattle, WA (USA) area. GPS point level analyses were first conducted to compare trip/place and travel mode detection results using contingency tables. Trip level analyses were then performed to investigate the effect of proportions of time overlap between travel logs and device-collected data on agreement rates. Global performance (with all subjects' data combined) and subject-level performance of the algorithm were compared at the trip level. RESULTS: At the GPS point level, the overall agreement rate of travel mode detection was 77.4% between PALMS and the travel diary. The agreement rate for vehicular trip detection (84.5%) was higher than for bicycling (53.5%) and walking (58.2%). At the trip level, the global performance and subject-level performance of the PALMS algorithm were 46.4% and 42.4%, respectively. Vehicular trip detection showed highest agreement rates in all analyses. Study participants' primary travel mode and car ownership were significantly related to the subject-level mode agreement rates. CONCLUSIONS: The PALMS algorithm showed moderate identification power at the GPS point level. However, trip level analyses found lower agreement rates between PALMS and travel diary data, especially for active transportation. Testing different PALMS parameter settings may serve to improve the detection of active travel and help expand PALMS's applicability in geographically different urbanized areas with a variety of travel modes.


Assuntos
Acelerometria/tendências , Algoritmos , Sistemas de Informação Geográfica/tendências , Autorrelato , Transportes , Viagem/tendências , Acelerometria/métodos , Ciclismo/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Veículos Automotores , Transportes/métodos , Caminhada/tendências , Washington/epidemiologia
10.
Environ Monit Assess ; 190(12): 729, 2018 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-30456566

RESUMO

The ecotourism industry is one of the largest industries and has an important role in the economic social and cultural development of societies, especially in developing countries. Policymaking and planning procedures in this industry require the application of the methods that can appropriately model mutual and complex interactions and contacts. System dynamics is an accurate modeling method to simulate complex systems in a structured way and to design more effective policies by using these complex systems. In this study, the interactions and dynamics of the main components of ecotourism (effective variables) in the Taleghan area are modeled using system dynamics. To formulate and model simulations in the period between 2005 and 2015 was considered, and then extending the period of investigation, the model simulation was performed till the year 2025. Among the most important results of this study is the effect of the environment on the demand for ecotourism. Environmental degradation and the degradation of the quality of the environment lead to a reduced demand for ecotourism. This study predicts the future of ecotourism by this dynamic and designs a group of policies for the sustainable and comprehensive development of ecotourism on the basis of the behavior of the model variables in order to prevent the degradation of environment and simultaneously ensure that ecotourism demand is not negatively affected. Finally, the best policy "depending construction to the state of the area environment" was selected among them.


Assuntos
Conservação dos Recursos Naturais/métodos , Meio Ambiente , Monitoramento Ambiental/métodos , Viagem/tendências , Conservação dos Recursos Naturais/economia , Países em Desenvolvimento , Monitoramento Ambiental/economia , Humanos , Irã (Geográfico) , Modelos Teóricos , Análise de Sistemas
11.
J Headache Pain ; 19(1): 108, 2018 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-30428826

RESUMO

BACKGROUND: This multicentric survey investigates the prevalence and characteristics of Airplane Headache in children affected by primary headaches. METHODS: Patients with symptoms of Airplane Headache were recruited from nine Italian Pediatric Headache Centres. Each patient was handed a structured questionnaire which met the ICHD-III criteria. RESULTS: Among 320 children suffering from primary headaches who had flights during their lifetime, 15 (4.7%) had Airplane Headache, with mean age of 12.4 years. Most of the patients were females (80%). The headache was predominantly bilateral (80%) and localized to the frontal area (60%); it was mainly pulsating, and lasted less than 30 min in all cases. Accompanying symptoms were tearing, photophobia, phonophobia in most of the cases (73.3%). More than 30% of patients used medications to treat the attacks, with good results. CONCLUSION: Our study shows that Airplane Headache is not a rare disorder in children affected by primary headaches and highlights that its features in children are peculiar and differ from those described in adults. In children Airplane Headache prevails in females, is more often bilateral, has frequently accompanying symptoms and occurs at any time during the flight. Further studies are needed to confirm the actual frequency of Airplane Headache in the general pediatric population not selected from specialized Headache Centres, with and without other concomitant headache condition, and to better clarify the clinical characteristics, pathophysiology and potential therapies.


Assuntos
Aeronaves , Transtornos da Cefaleia/diagnóstico , Transtornos da Cefaleia/epidemiologia , Medição da Dor/métodos , Inquéritos e Questionários , Viagem , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Itália/epidemiologia , Masculino , Medição da Dor/tendências , Fotofobia/diagnóstico , Fotofobia/epidemiologia , Viagem/tendências
12.
PLoS One ; 13(11): e0206820, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30388183

RESUMO

This paper uses text data mining to identify long-term developments in tourism academic research from the perspectives of thematic focus, geography, and gender of tourism authorship. Abstracts of papers published in the period of 1970-2017 in high-ranking tourist journals were extracted from the Scopus database and served as data source for the analysis. Fourteen subject areas were identified using the Latent Dirichlet Allocation (LDA) text mining approach. LDA integrated with GIS information allowed to obtain geography distribution and trends of scholarly output, while probabilistic methods of gender identification based on social network data mining were used to track gender dynamics with sufficient confidence. The findings indicate that, while all 14 topics have been prominent from the inception of tourism studies to the present day, the geography of scholarship has notably expanded and the share of female authorship has increased through time and currently almost equals that of male authorship.


Assuntos
Mineração de Dados , Pesquisa , Viagem/tendências , Autoria , Bases de Dados Factuais , Feminino , Previsões , Geografia , Humanos , Masculino , Motivação , Rede Social
13.
J Travel Med ; 25(1)2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30137586

RESUMO

HIGHLIGHT: The body of knowledge needed to effectively practice travel medicine has expanded since the 1990s, as migrants begin to comprise an increasing proportion of the world's population. We describe the unique needs of migrants and provide resources available to migration health practitioners. As the number of the world's migrants grows, collaboration across disciplines is key to achieving high-quality migration health practices.


Assuntos
Dinâmica Populacional/tendências , Migrantes/estatística & dados numéricos , Medicina de Viagem/tendências , Viagem/tendências , Países Desenvolvidos/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Saúde Global , Humanos
15.
Theor Biol Med Model ; 15(1): 9, 2018 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-29961429

RESUMO

BACKGROUND: Unlike the epidemic of yellow fever from 2016 to 17 in Brazil mostly restricted to the States of Minas Gerais and Espirito Santo, the epidemic from 2017 to 18 mainly involved São Paulo and Rio de Janeiro and resulted in multiple international disseminations. To understand mechanisms behind this observation, the present study analyzed the distribution of imported cases from Brazil, 2018. METHODS: A statistical model was employed to capture the risk of importing yellow fever by returning international travelers from Brazil. We estimated the relative risk of importation among travelers by the extent of wealth measured by GDP per capita and the relative risk obtained by random assignment of travelers' destination within Brazil by the relative population size. RESULTS: Upper-half wealthier countries had 2.1 to 3.4 times greater risk of importation than remainders. Even among countries with lower half of GDP per capita, the risk of importation was 2.5 to 2.8 times greater than assuming that the risk of travelers' infection within Brazil is determined by the regional population size. CONCLUSIONS: Travelers from wealthier countries were at elevated risk of yellow fever, allowing us to speculate that travelers' local destination and behavior at high risk of infection are likely to act as a key determinant of the heterogeneous risk of importation. It is advised to inform travelers over the ongoing geographic foci of transmission, and if it appears unavoidable to visit tourist destination that has the history of producing imported cases, travelers must be strongly advised to receive vaccination in advance.


Assuntos
Modelos Teóricos , Viagem , Febre Amarela/epidemiologia , Febre Amarela/transmissão , Brasil/epidemiologia , Humanos , Medição de Risco , Viagem/tendências , Vacinação/tendências , Febre Amarela/prevenção & controle
16.
Support Care Cancer ; 26(9): 2973-2982, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29796709

RESUMO

PURPOSE: Traveling for cancer care is difficult as patients might be suffering from the side effects of treatment, need to cover additional costs, and face disruption of daily life. The aim of this review was to synthesize the evidence on travel needs and experiences during cancer treatment from the point of view of patients and their families. METHODS: This is a systematic review of the literature. The PRISMA statement was used to guide the reporting of the methods and findings. We searched for peer-reviewed articles in MEDLINE, CINAHL PLUS, and Web of Science and selected articles based on the following criteria: focused on patients and their families; presented findings from empirical studies; and examined travel and transport experiences for cancer screening, treatment, and related care. The MMAT was used to assess the quality of the studies. RESULTS: A total of 16 articles were included in the review. Most of the studies used a qualitative design, were carried out in high-income countries and were conducted more than 10 years ago. Several problems were reported regarding travel and relocation: social and physical demands of transport, travel, and relocation; life disruption and loss of daily routines; financial impact; and anxieties and support needs when returning home. CONCLUSIONS: Patients and carers consistently reported lack of support when traveling, relocating, and returning home. Future research needs to explore patient experiences under current treatment protocols and healthcare delivery models, in a wider range of geographical contexts, and different stages of the patient pathway.


Assuntos
Cuidadores/psicologia , Neoplasias/terapia , Viagem/tendências , Humanos , Neoplasias/patologia , Pesquisa Qualitativa
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