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Yang CJ, Lu CW, Chiang CH, Chang HH, Yao CA, Huang KC. Traveler's knowledge, attitude, and practice about travel health insurance: A community-based questionnaire study. PLoS One 2023; 18:e0281199. [PMID: 36757921 PMCID: PMC9910690 DOI: 10.1371/journal.pone.0281199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 11/30/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Travel, especially international travel, has become one of the most popular leisure activities in the world. The risk of accidents and travel-related illnesses, including infectious and non-communicable diseases, should not be neglected. To provide a more comprehensive pre-travel consultation to international travelers, this study aimed to investigate the knowledge, attitude, and practice of travelers about travel health insurance. METHODS This was a cross-sectional study. Anonymous structured questionnaires were distributed to 1000 visitors to the Taiwan International Travel Fair in May 2019. RESULTS The top three important travel health insurances were accidental death and disablement insurance (92%), accidental medical reimbursement (90.4%), and 24-hour emergency assistance (89%). In addition to education level, travel-associated illness, and special activities during travel, a significant association was observed between the willingness to buy various travel health insurances and the willingness of pre-travel consultation. CONCLUSIONS Most travelers would buy travel health insurance; however, disproportional respondents understood the content of travel health insurance. Most travelers considered travel clinics to be the most reliable information source regarding travel health insurance. Therefore, travel medicine specialists are encouraged to offer more information about travel health insurance during pre-travel consultation.
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Affiliation(s)
- Chia-Jung Yang
- Department of Family Medicine, Kinmen Hospital, Ministry of Health and Welfare, Kinmen, Taiwan
- Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan
| | - Chia-Wen Lu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chien-Hsieh Chiang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Community and Family Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Hao-Hsiang Chang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chien-An Yao
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
- * E-mail:
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Managing the Unpredictable: Recommendations to Improve Trainee Safety During Global Health Away Electives. Ann Glob Health 2022; 88:86. [PMID: 36311896 PMCID: PMC9562969 DOI: 10.5334/aogh.3874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/23/2022] [Indexed: 11/20/2022] Open
Abstract
Background: For institutions offering global health programs, the safety of trainees during clinical rotations at international sites is paramount. Current guidelines for global health electives recommend pre-departure training and safety-net resources, yet their advice on managing unanticipated problems is limited. Objective: This report illustrates critical safety considerations requiring additional guidance for programs and students and highlights approaches that may improve trainee safety while abroad. Methods: We present a series of five cases adapted from the experiences of students traveling to and from the Yale School of Medicine between the years of 2011–2021. These cases include instances of personal injury, mental health challenges following trauma, sexual harassment, political instability, and natural disaster. For each case, we recommend ways in which programs and their participants may approach the challenges and we highlight issues requiring additional analysis. Findings: We categorized the types of trainee safety issues into three groups: personal health emergencies, individual-level stressors, and large-scale crises. Conclusion: Ultimately, we recommend that rather than solely emphasizing a universal policy, programs and trainees should also be educated on the tools and resources available for addressing unexpected emergencies.
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Silva PCD, Camacho LAB, Carmo CND. [Impact of calendar effect on morbidity and mortality from external causes in tourist towns in the State of São Paulo, Brazil, from 2004 to 2014]. CAD SAUDE PUBLICA 2021; 37:e00174019. [PMID: 33566989 DOI: 10.1590/0102-311x00174019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 06/19/2020] [Indexed: 11/21/2022] Open
Abstract
This study aims to analyze the association between temporal variations in injuries and deaths from external causes and periods of greater flow of visitors in tourist municipalities (counties) on the coastline of the state of São Paulo, Brazil, from 2004 to 2014. This is an ecological study of daily and monthly time series based on data from the Brazilian Mortality Information System (SIM) and Brazilian Hospital Information System of the Brazilian Unified National Health System (SIH/SUS) from January 1, 2004, to December 31, 2014, using as the analytical units the four municipalities on the northern coast of the State of São Paulo. Negative binomial regression models were adjusted for the outcome that represented the number of hospital admissions and/or deaths from external causes, with calendar variables as predictors (days of the week, holidays, month, and year of occurrence). The Brazilian holidays New Year's Day, Carnival, Tiradentes, and Proclamation of the Republic stood out with mean numbers greater than or equal to 5 outcomes per day. Among the days of the week, Monday and Sunday had the highest mean numbers. Considering all the predictors, there was a higher tendency to the occurrence of outcomes on Monday (OR = 1.11; 95%CI: 1.05-1.18), New Year's Day (OR = 1.44; 95%CI: 1.19-1.74), and Proclamation of the Republic Day (OR = 1.49; 95%CI: 1.13-1.94) and in the months of January (OR = 1.11; 95%CI: 1.02-1.20) and February (OR = 1.13; 95%CI: 1.04-1.23). Morbidity and mortality from external causes in these tourist towns were higher in the period with the greatest flow of tourists, emphasizing the need to organize care for these injuries, alongside measures for prevention and health promotion targeted to this group of causes.
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Affiliation(s)
- Paula Correia da Silva
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Wirawan IMA, Putri WCWS, Kurniasari NMD, Mulyawan KH, Hendrayana MA, Suharlim C. Geo-mapping of hazards, risks, and travel health services in Bali: Results from the first stage of the integrated travel health surveillance and information system at destination (TravHeSID) project. Travel Med Infect Dis 2020; 37:101698. [DOI: 10.1016/j.tmaid.2020.101698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 01/25/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
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Lee YH, Lu CW, Wu PZ, Huang HL, Wu YC, Huang KC. Attitudes and awareness of medical assistance while traveling abroad. Global Health 2018; 14:67. [PMID: 29996856 PMCID: PMC6042459 DOI: 10.1186/s12992-018-0382-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 06/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With globalization, more and more people travel to countries where they are at risk of injuries and travel-related diseases. To protect travelers' health, it is crucial to understand whether travelers accurately perceive medical assistance resources before and during their trips. This study investigated the need, awareness, and previous usage of overseas emergency medical assistance services (EMAS) among people traveling abroad. METHODS Anonymous questionnaires were distributed to patients (n = 500) at a travel clinic in Taipei, Taiwan. RESULTS The results showed that EMAS were important, especially in the following categories: 24-h telephone medical consultation (91.8%), emergent medical repatriation (87.6%), and assistance with arranging hospital admission (87.4%). Patients were less aware of the following services: arrangement of appointments with doctors (70.7%) and monitoring of medical conditions during hospitalization (73.0%). Less than 5% of respondents had a previous experience with EMAS. CONCLUSIONS EMAS are considered important to people who are traveling abroad. However, approximately 20-30% of travelers lack an awareness of EMAS, and the percentage of travelers who have previously received medical assistance through these services is extremely low. The discrepancy between the need and usage of EMAS emphasizes the necessity to adapt EMAS materials in pre-travel consultations to meet the needs of international travelers.
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Affiliation(s)
- Yi-Hsuan Lee
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan.,Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan.,Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan
| | - Chia-Wen Lu
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan
| | - Pei-Zu Wu
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan.,Department of Family Medicine, Taipei City Hospital Heping Fuyou Branch, No.33, Sec. 2, Zhonghua Rd., Wanhua District, Taipei, Taiwan
| | - Hsien-Liang Huang
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan
| | - Yi-Chun Wu
- Centers for Disease Control, No.6, Linsen S. Rd., Zhongzheng District, Taipei, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan. .,Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan. .,Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan.
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Rodrigues KMDP, Moreira BM. Preventing diseases in round-the-world travelers: a contemporary challenge for travel medicine advice. Rev Soc Bras Med Trop 2018; 51:125-132. [PMID: 29768543 DOI: 10.1590/0037-8682-0418-2017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 03/27/2018] [Indexed: 11/22/2022] Open
Abstract
Providing advice for travelers embarking on long-term trips poses a challenge in travel medicine. A long duration of risk exposure is associated with underuse of protective measures and poor adherence to chemoprophylaxis, increasing the chances of acquiring infections. Recently, in our clinic, we observed an increase in the number of travelers undertaking round-the-world trips. These individuals are typically aged around 32 years and quit their jobs to embark on one-to-two-year journeys. Their destinations include countries in two or more continents, invariably Southeast Asia and Indonesia, and mostly involve land travel and visiting rural areas. Such trips involve flexible plans, increasing the challenge, especially with regard to malaria prophylaxis. Advising round-the-world travelers is time-consuming because of the amount of information that must be provided to the traveler. Advisors must develop strategies to commit the traveler to his/her own health, and verify their learnings on disease-prevention measures. Contacting the advisor after the appointment or during the trip can be helpful to clarify unclear instructions or diagnosis made and prescriptions given abroad. Infectious diseases are among the most frequent problems affecting travelers, many of which are preventable by vaccines, medicines, and precautionary measures. The dissemination of counterfeit medicines, particularly antibiotics and antimalarial medicines, emphasizes the need for travelers to carry medicines that they may possibly need on their trip. Additional advice on altitude, scuba diving, and other possible risks may also be given. Considering the difficulties in advising this group, we present a review of the main recommendations on advising these travelers.
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Affiliation(s)
- Karis Maria de Pinho Rodrigues
- Departamento de Medicina Preventiva, Centro de Informação em Saúde para Viajantes (Cives), Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Beatriz Meurer Moreira
- Instituto de Microbiologia Paulo de Goés, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Sainato RJ, Ottolini MG, Hickey PW, Rajnik M. Preparing Families With Children for International Travel. Curr Probl Pediatr Adolesc Health Care 2015; 45:215-30. [PMID: 26253890 DOI: 10.1016/j.cppeds.2015.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Rebecca J Sainato
- Department of Pediatrics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
| | - Martin G Ottolini
- Office of Curriculum, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814.
| | - Patrick W Hickey
- Department of Pediatrics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
| | - Michael Rajnik
- Department of Pediatrics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814
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Wieten RW, van der Schalie M, Visser BJ, Grobusch MP, van Vugt M. Risk factors and pre-travel healthcare of international travellers attending a Dutch travel clinic: a cross-sectional analysis. Travel Med Infect Dis 2014; 12:511-24. [PMID: 25087666 DOI: 10.1016/j.tmaid.2014.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 05/13/2014] [Accepted: 05/14/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND The number of international travellers is currently estimated to exceed one billion annually. To address travel related health risks and facilitate risk reduction strategies, detailed knowledge of travellers' characteristics is important. METHOD In this cross-sectional study, data of a 20% sample of travellers visiting the Academic Medical Center (AMC) travel clinic Amsterdam from July 2011 to July 2012 was collected. Itineraries and protection versus exposure rates of preventable infectious diseases were mapped and reported according to STROBE guidelines. RESULTS 1749 travellers were included. South-Eastern Asia, South-America and West-Africa were most frequently visited. 26.2% of the population had pre-existing medical conditions (often cardiovascular). Young and VFR travellers had a longer median travel time (28 and 30 days) compared to the overall population (21 days). Young adult travellers were relatively often vaccinated against hepatitis B (43.9% vs. 20.5%, p < .001) and rabies (16.6% vs. 4.3%, p < .001). VFRs were less often vaccinated against hepatitis B (11.6% vs. 30.6%, p < .001) and rabies (1.3% vs. 9.0%, p .012) compared to non-VFR travellers. CONCLUSIONS Pre-travel guidelines were well adhered to. Young adult travellers had high-risk itineraries but were adequately protected. Improvement of hepatitis B and rabies protection would be desirable, specifically for VFRs.
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Affiliation(s)
- Rosanne W Wieten
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1)
| | - Maurice van der Schalie
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1)
| | - Benjamin J Visser
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1)
| | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1).
| | - Michèle van Vugt
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1)
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Kalaria PN, Satasia SP, Raval DK. Synthesis, characterization and biological screening of novel 5-imidazopyrazole incorporated fused pyran motifs under microwave irradiation. NEW J CHEM 2014. [DOI: 10.1039/c3nj01327h] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
BACKGROUND Human activity in wilderness areas has increased globally in recent decades, leading to increased risk of injury and illness. Wilderness medicine has developed in response to both need and interest. METHODS The field of wilderness medicine encompasses many areas of interest. Some focus on special circumstances (such as avalanches) while others have a broader scope (such as trauma care). Several core areas of key interest within wilderness medicine are discussed in this study. RESULTS Wilderness medicine is characterized by remote and improvised care of patients with routine or exotic illnesses or trauma, limited resources and manpower, and delayed evacuation to definitive care. Wilderness medicine is developing rapidly and draws from the breadth of medical and surgical subspecialties as well as the technical fields of mountaineering, climbing, and diving. Research, epidemiology, and evidence-based guidelines are evolving. A hallmark of this field is injury prevention and risk mitigation. The range of topics encompasses high-altitude cerebral edema, decompression sickness, snake envenomation, lightning injury, extremity trauma, and gastroenteritis. Several professional societies, academic fellowships, and training organizations offer education and resources for laypeople and health care professionals. CONCLUSIONS THE FUTURE OF WILDERNESS MEDICINE IS UNFOLDING ON MULTIPLE FRONTS: education, research, training, technology, communications, and environment. Although wilderness medicine research is technically difficult to perform, it is essential to deepening our understanding of the contribution of specific techniques in achieving improvements in clinical outcomes.
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Affiliation(s)
- Douglas G. Sward
- Department of Emergency Medicine, University of Maryland School of Medicine, Hyperbaric Medicine, Shock Trauma Center, Baltimore, Maryland, USA
| | - Brad L. Bennett
- Military & Emergency Medicine Department, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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