Sample records for air travel accessibility

  1. 76 FR 71914 - Nondiscrimination on the Basis of Disability in Air Travel: Accessibility of Web Sites and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... Disability in Air Travel: Accessibility of Web Sites and Automated Kiosks at U.S. Airports AGENCY: Office of... January 9, 2012. This extension is a result of requests from a number of parties for additional time to... constructive comments for the Department's consideration. The Interactive Travel Services Association requested...

  2. 78 FR 67918 - Nondiscrimination on the Basis of Disability in Air Travel; Accessibility of Aircraft and Stowage...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ...] RIN 2105-AD87 Nondiscrimination on the Basis of Disability in Air Travel; Accessibility of Aircraft... nondiscriminatory service to passengers with disabilities. A requirement that U.S. carriers provide in-cabin space... Department's intention was that new aircraft would have a designated space (e.g., a closet or similar...

  3. 76 FR 32107 - Nondiscrimination on the Basis of Disability in Air Travel; Accessibility of Aircraft and Stowage...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-03

    ...] RIN 2105-AD87 Nondiscrimination on the Basis of Disability in Air Travel; Accessibility of Aircraft... Administration or applicable foreign government). When the requirement for in-cabin space for a folding passenger... designated space (e.g., a closet or similar compartment) in which a passenger's wheelchair could be stowed...

  4. [Air travel during pregnancy].

    PubMed

    Rabinerson, David; Ninio, Avraham; Glezerman, Marek

    2008-04-01

    Nowadays, millions of people travel by air every day and it is common to find pregnant women among the passengers. Travelling during pregnancy raises the question of the woman's safety during the flight. This is due to the risk of exposure to cosmic radiation, the drop in air pressure, and the possibility of thromboembolism due to seating conditions and flight duration. Other risks include obstetric emergencies, such as hemorrhage, premature contractions and actual labor. Further issues associated with air travel during pregnancy have to do with the safety of pregnant aircrew, if emergency evacuation becomes necessary and the airline's view regarding the admittance of pregnant women on flights. We discuss these issues extensively in our review. We conclude that for a healthy woman whose pregnancy involves no risk factors, air travel is safe up to the 36th gestational week.

  5. The Traveler's Guide to E-mail Access.

    ERIC Educational Resources Information Center

    Clyde, Anne

    1999-01-01

    Presents options that travelers can use to keep in e-mail contact. Discusses equipment/access issues related to traveling with a laptop; Internet cafes; free e-mail services; accessing home mail via a Web page; and new options e-mail access for travelers. Includes Internet resources on Internet access providers. (AEF)

  6. Air travel in women with lymphangioleiomyomatosis

    PubMed Central

    Pollock‐BarZiv, Stacey; Cohen, Marsha M; Downey, Gregory P; Johnson, Simon R; Sullivan, Eugene; McCormack, Francis X

    2007-01-01

    Background and objective The safety of air travel in patients with pneumothorax‐prone pulmonary diseases, such as lymphangioleiomyomatosis (LAM), has not been studied to any great extent. A questionnaire‐based evaluation of air travel in patients with LAM was conducted to determine experiences aboard commercial aircraft. Methods A survey was sent to women listed in the US LAM Foundation registry (n = 389) and the UK LAM Action registry (n = 59) to assess air travel, including problems occurring during flight. Women reporting a pneumothorax in flight were followed up to ascertain further details about the incident. Results 327 (73%) women completed the survey. 308 women answered the travel section, of whom 276 (90%) had “ever” travelled by aeroplane for a total of 454 flights. 95 (35%) women had been advised by their doctor to avoid air travel. Adverse events reported included shortness of breath (14%), pneumothorax (2%, 8/10 confirmed by chest radiograph), nausea or dizziness (8%), chest pain (12%), unusual fatigue (11%), oxygen desaturation (8%), headache (9%), blue hands (2%), haemoptysis (0.4%) and anxiety (22%). 5 of 10 patients with pneumothorax had symptoms that began before the flight: 2 occurred during cruising altitude, 2 soon after landing and 1 not known. The main symptoms were severe chest pain and shortness of breath. Discussion and conclusion Adverse effects occurred during air travel in patients with LAM, particularly dyspnoea and chest pain. Hypoxaemia and pneumothorax were reported. The decision to travel should be individualised; patients with unexplained shortness of breath or chest pain before scheduled flights should not board. Patients with borderline oxygen saturations on the ground should be evaluated for supplemental oxygen therapy during flight. Although many women had been advised not to travel by air, most travelled without the occurrence of serious adverse effects. PMID:17040934

  7. Anxiety and health problems related to air travel.

    PubMed

    McIntosh, I B; Swanson, V; Power, K G; Raeside, F; Dempster, C

    1998-12-01

    A significant proportion of air travelers experience situational anxiety and physical health problems. Take-off and landing are assumed to be stressful, but anxiety related to other aspects of the air travel process, anxiety coping strategies, and in-flight health problems have not previously been investigated. We aimed to investigate frequency of perceived anxiety at procedural stages of air travel, individual strategies used to reduce such anxiety, and frequency of health problems on short-haul and long-haul flights. A questionnaire measuring the occurrence and frequency of the above was administered to two samples of intending travelers during a 3 month period to: (a) 138 travel agency clients, and (b) 100 individuals attending a hospital travel clinic. Of the 238 respondents, two thirds were women. Take-off and landing were a perceived source of anxiety for about 40% of respondents, flight delays for over 50%, and customs and baggage reclaim for a third of individuals. Most frequent anxiety-reduction methods included alcohol and cigarette use, and distraction or relaxation techniques. Physical health problems related to air travel were common, and there was a strong relationship between such problems and frequency of anxiety. Travel agency clients reported more anxiety but not more physical health symptoms overall than travel clinic clients. Women reported greater air-travel anxiety, and more somatic symptoms than men. Significant numbers of air travelers report perceived anxiety related to aspects of travel, and this is associated with health problems during flights. Airlines and travel companies could institute specific measures, including improved information and communication, to reassure clients and thereby diminish anxiety during stages of air-travel. Medical practitioners and travel agencies should also be aware of the potential stresses of air travel and the need for additional information and advice.

  8. Air travellers' awareness of the preventability of otic barotrauma.

    PubMed

    Mitchell-Innes, A; Young, E; Vasiljevic, A; Rashid, M

    2014-06-01

    Otic barotrauma is common among air travellers and can cause severe otalgia, perforation of the tympanic membrane and hearing loss. Many prevention measures exist, with varying evidence to support their use. There are no data to establish if air travellers are aware of them or indeed use them. We aimed to establish air travellers' knowledge of such prevention measures. We surveyed air travellers at two UK airports by means of a questionnaire. Answers to the questionnaire were collected over a two-week period. Overall, 179 air travellers with a mean age of 28 years (range: 15-72 years) completed the questionnaire. There were 66 female and 113 male air travellers. The majority (84 per cent) complained of symptoms while flying and 30 per cent were not aware of any prevention measures. Barotrauma-related symptoms were reported in 25 per cent of air travellers who were unaware of any prevention measures. Nearly all air travellers (86 per cent) indicated that more information regarding prevention measures would be useful. Air travellers are often not aware of prevention measures to avoid otic barotrauma, and the majority suffer as a result. Increasing public awareness of simple prevention measures would have a significant impact on air travellers.

  9. Development and Evaluation of the Air Travel Stress Scale

    ERIC Educational Resources Information Center

    Bricker, Jonathan B.

    2005-01-01

    Despite anecdotal evidence suggesting that air travel is personally demanding, little research has examined air travel stress. To address these issues, the author developed and evaluated the 1st known measure of air travel stress-the Air Travel Stress Scale-in 3 studies. Exploratory and confirmatory factor analysis indicated 3 components: (a)…

  10. Overview of the Air Carrier Access Act

    DTIC Science & Technology

    2007-06-19

    on-board wheelchair” for passengers’ use.43 Attendants, Equipment, and Service Animals . Generally, air carriers may not require that an individual...disabilities to travel with service animals .46 In addition, carriers must “permit a service animal to accompany a qualified individual with a...5 Aircraft Accessibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Attendants, Equipment, and Service

  11. Air travel and children’s health issues

    PubMed Central

    2007-01-01

    With more children travelling by air, health care professionals should become more familiar with some of the unique health issues associated with air travel. A thorough literature search involving a number of databases (1966 to 2006) revealed very few evidence-based papers on air travel and children. Many of the existing recommendations are based on descriptive evidence and expert opinion. The present statement will help physicians to inform families about the health-related issues concerning air travel and children, including otitis media, cardiopulmonary disorders, allergies, diabetes, infection and injury prevention. An accompanying document (Information for Parents and Caregivers) is also available in this issue of Paediatrics & Child Health (pages 51-52) to help answer common questions from parents. PMID:19030341

  12. Air Travel Health Tips

    MedlinePlus

    ... health Before your flight One key to air travel is to prepare ahead of time. If you are carrying on a bag, make ... need to change if your eating and sleeping times will change at your destination. If you have diabetes or epilepsy, you should travel with your ID card. For instance, the American ...

  13. Respiratory infections during air travel.

    PubMed

    Leder, K; Newman, D

    2005-01-01

    An increasing number of individuals undertake air travel annually. Issues regarding cabin air quality and the potential risks of transmission of respiratory infections during flight have been investigated and debated previously, but, with the advent of severe acute respiratory syndrome and influenza outbreaks, these issues have recently taken on heightened importance. Anecdotally, many people complain of respiratory symptoms following air travel. However, studies of ventilation systems and patient outcomes indicate the spread of pathogens during flight occurs rarely. In the present review, aspects of the aircraft cabin environment that affect the likelihood of transmission of respiratory pathogens on airplanes are outlined briefly and evidence for the occurrence of outbreaks of respiratory illness among airline passengers are reviewed.

  14. The Economic Importance of Air Travel in High-Amenity Rural Areas

    ERIC Educational Resources Information Center

    Rasker, Ray; Gude, Patricia H.; Gude, Justin A.; van den Noort, Jeff

    2009-01-01

    The western United States offers a case study on the importance of access to large population centers and their markets, via road and air travel, for economic development. The vast distances between towns and cities in the American West can be a detriment to business, yet they also serve to attract technology and knowledge-based workers seeking to…

  15. Hemorrhage from an enlarged emphysematous bulla during commercial air travel.

    PubMed

    Chen, Chien-Wen; Perng, Wann-Cherng; Li, Min-Hui; Yan, Horng-Chin; Wu, Chin-Pyng

    2006-12-01

    Pulmonary bullae are a common late complication in patients with emphysema. Non-communicating emphysematous bullae may expand during air travel when the ambient pressure is reduced, resulting in various forms of barotrauma including pneumothorax and air embolism. We report a 62-yr-old man with emphysema who developed hemoptysis during international commercial air travel. CT scan of the chest obtained after the travel showed air-fluid level in an enlarged bulla. He underwent resection of the bulla and had a full recovery. This is a unique presentation of stretch injury of a bulla as a form of pulmonary barotrauma occurring during commercial air travel. With the most recent ruling by the Federal Aviation Administration to allow patients with advanced chronic obstructive lung disease to travel by air with their own supplemental oxygen devices, physicians need to be aware of this type of pulmonary barotrauma and properly advise such patients who are planning to travel by air.

  16. Experiences of air travel in patients with chronic heart failure

    PubMed Central

    Ingle, Lee; Hobkirk, James; Damy, Thibaud; Nabb, Samantha; Clark, Andrew L.; Cleland, John G.F.

    2012-01-01

    Aim To conduct a survey in a representative cohort of ambulatory patients with stable, well managed chronic heart failure (CHF) to discover their experiences of air travel. Methods An expert panel including a cardiologist, an exercise scientist, and a psychologist developed a series of survey questions designed to elicit CHF patients' experiences of air travel (Appendix 1). The survey questions, information sheets and consent forms were posted out in a self-addressed envelope to 1293 CHF patients. Results 464 patients (response rate 39%) completed the survey questionnaires. 54% of patients had travelled by air since their heart failure diagnosis. 20% of all patients reported difficulties acquiring travel insurance. 65% of patients who travelled by air experienced no health-related problems. 35% of patients who travelled by air experienced health problems, mainly at the final destination, going through security and on the aircraft. 27% of all patients would not travel by air in the future. 38% of patients would consider flying again if there were more leg room on the aeroplane, if their personal health improved (18%), if they could find cheaper travel insurance (19%), if there were less waiting at the airport (11%), or if there were less walking/fewer stairs to negotiate at the airport (7%). Conclusion For most patients in this sample of stable, well managed CHF, air travel was safe. PMID:21256607

  17. Global malaria connectivity through air travel.

    PubMed

    Huang, Zhuojie; Tatem, Andrew J

    2013-08-02

    Air travel has expanded at an unprecedented rate and continues to do so. Its effects have been seen on malaria in rates of imported cases, local outbreaks in non-endemic areas and the global spread of drug resistance. With elimination and global eradication back on the agenda, changing levels and compositions of imported malaria in malaria-free countries, and the threat of artemisinin resistance spreading from Southeast Asia, there is a need to better understand how the modern flow of air passengers connects each Plasmodium falciparum- and Plasmodium vivax-endemic region to the rest of the world. Recently constructed global P. falciparum and P.vivax malaria risk maps, along with data on flight schedules and modelled passenger flows across the air network, were combined to describe and quantify global malaria connectivity through air travel. Network analysis approaches were then utilized to describe and quantify the patterns that exist in passenger flows weighted by malaria prevalence. Finally, the connectivity within and to the Southeast Asia region where the threat of imported artemisinin resistance arising is highest, was examined to highlight risk routes for its spread. The analyses demonstrate the substantial connectivity that now exists between and from malaria-endemic regions through air travel. While the air network provides connections to previously isolated malarious regions, it is clear that great variations exist, with significant regional communities of airports connected by higher rates of flow standing out. The structures of these communities are often not geographically coherent, with historical, economic and cultural ties evident, and variations between P. falciparum and P. vivax clear. Moreover, results highlight how well connected the malaria-endemic areas of Africa are now to Southeast Asia, illustrating the many possible routes that artemisinin-resistant strains could take. The continuing growth in air travel is playing an important role in the

  18. Global malaria connectivity through air travel

    PubMed Central

    2013-01-01

    Background Air travel has expanded at an unprecedented rate and continues to do so. Its effects have been seen on malaria in rates of imported cases, local outbreaks in non-endemic areas and the global spread of drug resistance. With elimination and global eradication back on the agenda, changing levels and compositions of imported malaria in malaria-free countries, and the threat of artemisinin resistance spreading from Southeast Asia, there is a need to better understand how the modern flow of air passengers connects each Plasmodium falciparum- and Plasmodium vivax-endemic region to the rest of the world. Methods Recently constructed global P. falciparum and P.vivax malaria risk maps, along with data on flight schedules and modelled passenger flows across the air network, were combined to describe and quantify global malaria connectivity through air travel. Network analysis approaches were then utilized to describe and quantify the patterns that exist in passenger flows weighted by malaria prevalence. Finally, the connectivity within and to the Southeast Asia region where the threat of imported artemisinin resistance arising is highest, was examined to highlight risk routes for its spread. Results The analyses demonstrate the substantial connectivity that now exists between and from malaria-endemic regions through air travel. While the air network provides connections to previously isolated malarious regions, it is clear that great variations exist, with significant regional communities of airports connected by higher rates of flow standing out. The structures of these communities are often not geographically coherent, with historical, economic and cultural ties evident, and variations between P. falciparum and P. vivax clear. Moreover, results highlight how well connected the malaria-endemic areas of Africa are now to Southeast Asia, illustrating the many possible routes that artemisinin-resistant strains could take. Discussion The continuing growth in air

  19. Exacerbation of pneumomediastinum after air travel in a patient with dermatomyositis.

    PubMed

    Ye, Qiuyue; Zhang, Lu; Tian, Xinlun; Shi, Juhong

    2011-07-01

    Although the presence of pneumothorax is generally considered an absolute contraindication to air travel, reports on pneumomediastinum after air travel are extremely rare. Moreover, to the best of our knowledge, exacerbation of existing pneumomediastinum after commercial air travel has never been reported. We report on a case of a patient (the first case that we are aware of) who suffered exacerbation of pneumomediastinum after commercial air travel. This patient, with confirmed pneumomediastinum before air travel, flew to our city for medical care without being warned about exacerbation by the local hospital or airlines. Obvious exacerbation of pneumomediastinum and subcutaneous emphysema was noticed after the travel. Subsequently, a diagnosis of amyopathic dermatomyositis with interstitial lung disease and pneumomediastinum was made. The patient died despite treatment with corticosteroid, cyclophosphamide and intravenous immunoglobulin. This report discusses this rare condition and offers suggestions regarding air travel for patients with presence of pneumomediastinum at the time of flight.

  20. Air travel and vector-borne disease movement.

    PubMed

    Tatem, A J; Huang, Z; Das, A; Qi, Q; Roth, J; Qiu, Y

    2012-12-01

    Recent decades have seen substantial expansions in the global air travel network and rapid increases in traffic volumes. The effects of this are well studied in terms of the spread of directly transmitted infections, but the role of air travel in the movement of vector-borne diseases is less well understood. Increasingly however, wider reaching surveillance for vector-borne diseases and our improving abilities to map the distributions of vectors and the diseases they carry, are providing opportunities to better our understanding of the impact of increasing air travel. Here we examine global trends in the continued expansion of air transport and its impact upon epidemiology. Novel malaria and chikungunya examples are presented, detailing how geospatial data in combination with information on air traffic can be used to predict the risks of vector-borne disease importation and establishment. Finally, we describe the development of an online tool, the Vector-Borne Disease Airline Importation Risk (VBD-Air) tool, which brings together spatial data on air traffic and vector-borne disease distributions to quantify the seasonally changing risks for importation to non-endemic regions. Such a framework provides the first steps towards an ultimate goal of adaptive management based on near real time flight data and vector-borne disease surveillance.

  1. Air Travel Safety in Postoperative Breast Cancer Patients: A Systematic Review.

    PubMed

    Co, Michael; Ng, Judy; Kwong, Ava

    2018-05-17

    Air travel has long been a dilemma in post-breast cancer surgery patients. Anecdotal reports have described adverse outcomes on surgical wound, implants, and lymphedema during air travel. This review aims to evaluate the best evidence from the literature concerning the air travel safety in breast cancer patients. A comprehensive review was performed of the Medline, Embase, CINAHL, and Cochrane databases using a predefined strategy. Retrieved studies were independently screened and rated for relevance. Data were extracted by 2 researchers. We reviewed the best evidence on air travel safety in postoperative breast cancer patients. Evidence was limited in the current literature to suggest adverse effects on postoperative mastectomy wounds and drains by high-altitude travel. Similarly, adverse effects on breast implants were limited to case reports and ex vivo experiments. A systematic review of 12 studies concluded that air travel is not associated with upper limb lymphedema after breast cancer surgery. Deep-vein thrombosis (DVT) is a known complication after air travel; in addition, malignancy itself is a known risk factor for DVT. Evidence of safety to continue tamoxifen during the period of air travel is lacking in the literature. Evidence to support the use of systemic DVT prophylaxis in general postoperative breast cancer patients is also limited. Best evidence from a large retrospective study suggested that mechanical antiembolism devices and early mobilization are the only measures required. Air travel is generally safe in patients after breast cancer surgery. Copyright © 2018. Published by Elsevier Inc.

  2. Venous thromboembolism associated with air travel: a report of 33 patients.

    PubMed

    Mercer, A; Brown, J D

    1998-02-01

    The medical literature suggests long distance travel, particularly air travel, may be a risk factor for venous thromboembolism, but the risk is poorly quantified. We reviewed 134 records of patients hospitalized with venous thromboembolism for comments regarding recent travel. Patients who had traveled within 31 d prior to venous thromboembolism were defined as recent travelers. Of 134 patients records, 66 (49%) had documented inquiries regarding travel and 33 (50%) were recent air travelers. Data regarding demographics, mode of travel, day of onset of symptoms in relation to travel, and other risk factors for venous thromboembolism were abstracted from the records of the recent travelers. There were 12 (36%) travelers who had no other predisposition for venous thromboembolism. All had traveled non-stop by aircraft for 4 or more hours; none was identified as a crew-member. The median day of onset of venous thromboembolism was on travel day 4 (range: day 1-31). There were 8 (24%) patients who had onset during air travel or on the day of arrival, and 27 (82%) had onset by travel day 15. Air travel for 4 or more hours within the preceding 31 d was the most common risk factor for venous thromboembolism in our study patients and was present in 50%. This incidence is much higher than previously described, perhaps due to limiting the study population to those in which the presence or absence of travel was documented. Prospective studies are needed to better define the risk factors for venous thromboembolism among long distance air passengers and crew-members, and to determine effective preventive measures.

  3. Effects of commercial air travel on patients with pulmonary hypertension air travel and pulmonary hypertension.

    PubMed

    Roubinian, Nareg; Elliott, C Gregory; Barnett, Christopher F; Blanc, Paul D; Chen, Joan; De Marco, Teresa; Chen, Hubert

    2012-10-01

    Limited data are available on the effects of air travel in patients with pulmonary hypertension (PH), despite their risk of physiologic compromise. We sought to quantify the incidence and severity of hypoxemia experienced by people with PH during commercial air travel. We recruited 34 participants for a prospective observational study during which cabin pressure, oxygen saturation (Sp O 2 ), heart rate, and symptoms were documented serially at multiple predefined time points throughout commercial flights. Oxygen desaturation was defined as SpO2, <85%. Median flight duration was 3.6 h (range, 1.0-7.3 h). Mean ± SD cabin pressure at cruising altitude was equivalent to the pressure 1,968 ± 371 m (6,456 ± 1,218 ft) above sea level (ASL)(maximum altitude 5 2,621 m [8,600 ft] ASL). Median change in Sp O 2 from sea level to cruising altitude was 2 4.9% (range, 2.0% to 2 15.8%). Nine subjects (26% [95% CI, 12%-38%]) experienced oxygen desaturation during flight (minimum Sp O 2 5 74%). Thirteen subjects (38%) reported symptoms during flight, of whom five also experienced desaturations. Oxygen desaturation was associated with cabin pressures equivalent to . 1,829 m (6,000 ft) ASL, ambulation, and flight duration(all P values , .05). Hypoxemia is common among people with PH traveling by air, occurring in one in four people studied. Hypoxemia was associated with lower cabin pressures, ambulation during flight, and longer flight duration. Patients with PH who will be traveling on flights of longer duration or who have a history of oxygen use, including nocturnal use only, should be evaluated for supplemental in-flight oxygen.

  4. Food-poisoning and commercial air travel.

    PubMed

    McMullan, R; Edwards, P J; Kelly, M J; Millar, B C; Rooney, P J; Moore, J E

    2007-09-01

    With the introduction of budget airlines and greater competitiveness amongst all airlines, air travel has now become an extremely popular form of travel, presenting its own unique set of risks from food poisoning. Foodborne illness associated with air travel is quite uncommon in the modern era. However, when it occurs, it may have serious implications for passengers and when crew are affected, has the potential to threaten safety. Quality, safe, in-flight catering relies on high standards of food preparation and storage; this applies at the airport kitchens (or at subcontractors' facilities), on the aircraft and in the transportation vehicles which carry the food from the ground source to the aircraft. This is especially challenging in certain countries. Several foodborne outbreaks have been recorded by the airline industry as a result of a number of different failures of these systems. These have provided an opportunity to learn from past mistakes and current practice has, therefore, reached such a standard so as to minimise risk of failures of this kind. This review examines: (i) the origin of food safety in modern commercial aviation; (ii) outbreaks which have occurred previously relating to aviation travel; (iii) the microbiological quality of food and water on board commercial aircraft; and (iv) how Hazard Analysis Critical Control Points may be employed to maintain food safety in aviation travel.

  5. MEDICAL ASPECTS OF COMMERCIAL JET AIR TRAVEL

    PubMed Central

    Leeds, M. Frederick

    1959-01-01

    Jet aircraft will further enhance the medically safe and comfortable transportation of persons with disease. Experience in military medicine, substantiated by civilian commercial air travel experience, has already proved that transportation of sick or disabled persons in propeller-driven planes is essentially benign. Certain restrictions are necessary regarding carriage of sick passengers on commercial aircraft whether jet-propelled or of propeller type. These restrictions are primarily related to the comfort of fellow passengers and to the nonmedical environment of commercial airliners rather than to any risk of air travel per se. PMID:13638839

  6. Traveller's thrombosis: a review of deep vein thrombosis associated with travel. The Air Transport Medicine Committee, Aerospace Medical Association.

    PubMed

    Bagshaw, M

    2001-09-01

    There is an increasing suspicion among the travelling public and the international media of an association between the occurrence of deep venous thrombosis (DVT) and air travel. It was noted by the UK House of Lords Select Committee on Science and Technology that up to 20% of the total population may have some degree of increased clotting tendency. It follows that some air travellers are at risk of developing DVT when, or soon after, travelling. There have been no epidemiological studies published which show a statistically significant increase in cases of DVT when travelling in the absence of pre-existing risk factors. The literature was reviewed. Current evidence indicates that any association between symptomatic DVT and travel by air is weak, and the incidence is less than the impression given by recent media publicity.

  7. Air travel with known pneumocephalus following outpatient sinus surgery.

    PubMed

    Willson, Thomas J; Grady, Conor; Braxton, Ernest; Weitzel, Erik

    2014-01-01

    Intracranial air is a common finding after many neurosurgical procedures and trauma to the head. In patients requiring transport via air to reach a destination there is risk of expansion of the intracranial air and development of neurological complications. Though relatively uncommon after functional endoscopic sinus surgery (FESS), pneumocephalus may be encountered. We describe one of our patients in whom intracranial air was introduced during FESS. Following the procedure she required commercial air transportation from our center to her home. A 45-min commercial flight to the destination was safely completed without the patient experiencing any neurological sequellae. This case highlights the controversy surrounding air travel with pneumocephalus and provides an example of safe commercial air travel after diagnosis of post-FESS pneumocephalus.

  8. The cost of simplifying air travel when modeling disease spread.

    PubMed

    Lessler, Justin; Kaufman, James H; Ford, Daniel A; Douglas, Judith V

    2009-01-01

    Air travel plays a key role in the spread of many pathogens. Modeling the long distance spread of infectious disease in these cases requires an air travel model. Highly detailed air transportation models can be over determined and computationally problematic. We compared the predictions of a simplified air transport model with those of a model of all routes and assessed the impact of differences on models of infectious disease. Using U.S. ticket data from 2007, we compared a simplified "pipe" model, in which individuals flow in and out of the air transport system based on the number of arrivals and departures from a given airport, to a fully saturated model where all routes are modeled individually. We also compared the pipe model to a "gravity" model where the probability of travel is scaled by physical distance; the gravity model did not differ significantly from the pipe model. The pipe model roughly approximated actual air travel, but tended to overestimate the number of trips between small airports and underestimate travel between major east and west coast airports. For most routes, the maximum number of false (or missed) introductions of disease is small (<1 per day) but for a few routes this rate is greatly underestimated by the pipe model. If our interest is in large scale regional and national effects of disease, the simplified pipe model may be adequate. If we are interested in specific effects of interventions on particular air routes or the time for the disease to reach a particular location, a more complex point-to-point model will be more accurate. For many problems a hybrid model that independently models some frequently traveled routes may be the best choice. Regardless of the model used, the effect of simplifications and sensitivity to errors in parameter estimation should be analyzed.

  9. [Research and production of air cleaner for traveller train carriage].

    PubMed

    Bi, Z

    1998-07-01

    After the traveller train carriage is closed, the air pollution would be serious in the carriage. In order to control the air pollution, the air cleaning technology must be studied and the air cleaner for the carriage must be designed. The authors discussed. 1. Working out a technology scheme and main technology parameter for the air cleaner, and the structure design of the air cleaner. 2. Texting the function and performance of the air cleaner. 3. Investigating the effectiveness of the cleaner in same train sections. Thereby it will be confirmed that the air cleaner can improve the air environment in the carriage, and give convincingly security to the health of attendants and travellers.

  10. Should I stay or should I go? COPD and air travel.

    PubMed

    Ergan, Begum; Akgun, Metin; Pacilli, Angela Maria Grazia; Nava, Stefano

    2018-06-30

    Chronic obstructive pulmonary disease (COPD) is a challenging respiratory problem throughout the world. Although survival is prolonged with new therapies and better management, the magnitude of the burden resulting from moderate-to-severe disease is increasing. One of the major aims of the disease management is to try to break the vicious cycle of patients being homebound and to promote an active lifestyle. A fundamental component of active daily life is, of course, travelling. Today, the world is getting smaller with the option of travelling by air. Air travel is usually the most preferred choice as it is easy, time saving, and relatively inexpensive. Although it is a safe choice for many passengers, the environment inside the aeroplane may sometimes have adverse effects on health. Hypobaric hypoxaemia due to cabin altitude may cause health risks in COPD patients who have limited cardiopulmonary reserve. Addressing the potential risks of air travel, promoting proactive strategies including pre-flight assessment, and education of COPD patients about the "fitness to fly" concept are essential. Thus, in this narrative review, we evaluated the current evidence for potential risks of air travel in COPD and tried to give a perspective for how to plan safe air travel for COPD patients. Copyright ©ERS 2018.

  11. Space and motion perception and discomfort in air travel.

    PubMed

    Ramos, Renato T; de Mattos, Danielle A; Rebouças, J Thales S; Ranvaud, Ronald D

    2012-12-01

    The perception of comfort during air trips is determined by several factors. External factors like cabin design and environmental parameters (temperature, humidity, air pressure, noise, and vibration) interact with individual characteristics (anxiety traits, fear of flying, and personality) from arrival at the airport to landing at the destination. In this study, we investigated the influence of space and motion discomfort (SMD), fear of heights, and anxiety on comfort perception during all phases of air travel. We evaluated 51 frequent air travelers through a modified version of the Flight Anxiety Situations Questionnaire (FAS), in which new items were added and where the subjects were asked to report their level of discomfort or anxiety (not fear) for each phase of air travel (Chronbach's alpha = 0.974). Correlations were investigated among these scales: State-Trait Anxiety Inventory (STAI), Cohen's Acrophobia Questionnaire, and the Situational Characteristics Questionnaire (SitQ, designed to estimate SMD levels). Scores of SitQ correlated with discomfort in situations involving space and movement perception (Pearson's rho = 0.311), while discomfort was associated with cognitive mechanisms related to scores in the anxiety scales (Pearson's rho = 0.375). Anxiety traits were important determinants of comfort perception before and after flight, while the influence of SMD was more significant during the time spent in the aircraft cabin. SMD seems to be an important modulator of comfort perception in air travel. Its influence on physical well being and probably on cognitive performance, with possible effects on flight safety, deserves further investigation.

  12. Safety of commercial air travel following myocardial infarction.

    PubMed

    Cox, G R; Peterson, J; Bouchel, L; Delmas, J J

    1996-10-01

    Travelers occasionally suffer myocardial infarction (MI) while abroad. Existing guidelines recommend a 4- to 24-week convalescent period following MI before air travel should be permitted. Air travel may be undertaken safely in the early post-MI period. The aeromedical transport records of two international medical assistance companies over a 3-yr period were reviewed. We identified 209 patients who suffered MI; 13 transported by private air ambulance were excluded. We reviewed the aeromedical transports of the remaining 196 adults carried on commercial aircraft between 3-53 d post-MI to investigate the safety of air travel in this group. Data were recorded regarding patient age; sex; location of MI; complications of MI; presence of medical escort; duration of flight(s); use of oxygen, medications, or cardiac monitoring during transport; and development of symptoms in flight. Within 7 d of their acute MI 3 patients (2%) were transported; 87 (44%) between days 8-14 post-MI; 65 (33%) between days 15-21; 27 (14%) between days 22-28; and 14 (7%) more than 28 d post-MI. Some 187 patients (95%) were transported without incident; 9 (5%) patients experienced symptoms requiring evaluation by the escorting physician. Of the 9, 6 problems occurred in patients being transported less than 14 d post-MI. Symptoms resolved spontaneously or immediately after physician intervention in all but one case. International aeromedical transport of patients may be safely accomplished 2-3 wk after an acute MI when an accompanying physician is present. Recommendations for delaying travel more than 4 wk after infarction are not supported by clinical experience and should be revised.

  13. Revamped Website Features Easier Access to Travel Survey Data, Offers New

    Science.gov Websites

    Datasets | News | NREL Revamped Website Features Easier Access to Travel Survey Data, Offers New Datasets Revamped Website Features Easier Access to Travel Survey Data, Offers New Datasets table. Each survey or study now has its own page, allowing users to bookmark it or provide a link to

  14. Fluid loss does not explain coagulation activation during air travel.

    PubMed

    Schreijer, Anja J M; Cannegieter, Suzanne C; Caramella, Marianna; Meijers, Joost C M; Krediet, Raymond T; Simons, Ries M; Rosendaal, Frits R

    2008-06-01

    The mechanism of air travel-related venous thrombosis is unclear. Although immobility plays a pivotal role, other factors such as fluid loss may contribute. We investigated whether fluid loss occurred more in individuals with coagulation activation after air travel than in subjects without. As a secondary aim, we investigated whether fluid loss per se occurred during air travel. In this crossover study, 71 healthy volunteers were exposed to eight hours of air travel, eight hours immobilization in a cinema, and a daily-life control situation. Markers of fluid loss (haematocrit, serum osmolality and albumin) and of coagulation activation were measured before and after each exposure. The study included 11 volunteers with and 55 volunteers without coagulation activation during the flight. The change in parameters of fluid loss was not different in volunteers with an activated clotting system from those without (difference between groups in haematocrit: -0.6%, 95% confidence interval [CI]: -1.9 to 0.6). On a group level, mean haematocrit values decreased during all three exposures. However, in some individuals it increased, which occurred in more participants during the flight (34%; 95% CI 22 to 46) than during the daily-life situation (19%; 95% CI 10 to 28). These findings do not support the hypothesis that fluid loss contributes to thrombus formation during air travel.

  15. Cosmic radiation exposure during air travel.

    DOT National Transportation Integrated Search

    1980-03-01

    In 1967 the FAA appointed an advisory committee on radiation biology aspects of SST flight. Some of the committee members were subsequently appointed to a working group to study radiation exposure during air travel in conventional jet aircraft. : Pre...

  16. An estimation of Canadian population exposure to cosmic rays from air travel.

    PubMed

    Chen, Jing; Newton, Dustin

    2013-03-01

    Based on air travel statistics in 1984, it was estimated that less than 4 % of the population dose from cosmic ray exposure would result from air travel. In the present study, cosmic ray doses were calculated for more than 3,000 flights departing from more than 200 Canadian airports using actual flight profiles. Based on currently available air travel statistics, the annual per capita effective dose from air transportation is estimated to be 32 μSv for Canadians, about 10 % of the average cosmic ray dose received at ground level (310 μSv per year).

  17. Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak.

    PubMed

    Bogoch, Isaac I; Creatore, Maria I; Cetron, Martin S; Brownstein, John S; Pesik, Nicki; Miniota, Jennifer; Tam, Theresa; Hu, Wei; Nicolucci, Adriano; Ahmed, Saad; Yoon, James W; Berry, Isha; Hay, Simon I; Anema, Aranka; Tatem, Andrew J; MacFadden, Derek; German, Matthew; Khan, Kamran

    2015-01-03

    The WHO declared the 2014 west African Ebola epidemic a public health emergency of international concern in view of its potential for further international spread. Decision makers worldwide are in need of empirical data to inform and implement emergency response measures. Our aim was to assess the potential for Ebola virus to spread across international borders via commercial air travel and assess the relative efficiency of exit versus entry screening of travellers at commercial airports. We analysed International Air Transport Association data for worldwide flight schedules between Sept 1, 2014, and Dec 31, 2014, and historic traveller flight itinerary data from 2013 to describe expected global population movements via commercial air travel out of Guinea, Liberia, and Sierra Leone. Coupled with Ebola virus surveillance data, we modelled the expected number of internationally exported Ebola virus infections, the potential effect of air travel restrictions, and the efficiency of airport-based traveller screening at international ports of entry and exit. We deemed individuals initiating travel from any domestic or international airport within these three countries to have possible exposure to Ebola virus. We deemed all other travellers to have no significant risk of exposure to Ebola virus. Based on epidemic conditions and international flight restrictions to and from Guinea, Liberia, and Sierra Leone as of Sept 1, 2014 (reductions in passenger seats by 51% for Liberia, 66% for Guinea, and 85% for Sierra Leone), our model projects 2.8 travellers infected with Ebola virus departing the above three countries via commercial flights, on average, every month. 91,547 (64%) of all air travellers departing Guinea, Liberia, and Sierra Leone had expected destinations in low-income and lower-middle-income countries. Screening international travellers departing three airports would enable health assessments of all travellers at highest risk of exposure to Ebola virus infection

  18. AsMA Medical Guidelines for Air Travel: Fitness to Fly and Medical Clearances.

    PubMed

    Thibeault, Claude; Evans, Anthony D; Dowdall, Nigel P

    2015-07-01

    Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. Not everyone is fit to travel by air and physicians should advise their patients accordingly. They should review the passenger's medical condition, giving special consideration to the dosage and timing of any medications, contagiousness, and the need for special assistance during travel. In general, an individual with an unstable medical condition should not fly; cabin altitude, duration of exposure, and altitude of the destination airport are all considerations when recommending a passenger for flight.

  19. Travellers accessing addiction services in Ireland (2007 to 2010): analysis of routine surveillance data.

    PubMed

    Carew, Anne Marie; Cafferty, Siobhán; Long, Jean; Bellerose, Delphine; Lyons, Suzi

    2013-01-01

    By accessing addiction treatment services recorded in routine national drug treatment data, the characteristics of Irish Travellers were analyzed to understand their needs and develop policies to tackle issues faced by this community. The number of Traveller cases accessing services increased by 163% between 2007 and 2010. Alcohol and opiates were the most common problem substances reported. Traveller women reported high rates of problem opiate use and risky injecting behaviors, contrary to the perception that problem substance use is a predominantly male issue. This presents a challenge to services to provide targeted, effective services to Travellers with problem substance use.

  20. [Medical Problems in Air Travel from a General Practitioner’s Perspective].

    PubMed

    Stutz, Andreas; Ensslin, Angela

    2016-07-06

    As travel by air increases, so does the number of passengers with chronic or acute medical issues. To evaluate fitness for air travel, it is necessary to consider the impact of the altered atmospheric surroundings in an airplane on the current illness to avoid a worsening of health conditions or even an emergency. As first medical contact person, the general practitioner will define supportive measures together with the patient and discuss these with the Medical Service of the airline for implementation. After a thorough evaluation, most patients will be classified fit to fly. Furthermore, a pre-travel consultation should address necessary vaccinations and information on infectious diseases.

  1. Air Charter - The Business Airline of the Future...But, Does the Business Traveler Know?

    NASA Technical Reports Server (NTRS)

    Kaps, Robert W.; Gardner, Robin C.; Hartung, Jeffrey W.

    2001-01-01

    Historically, FAR Part 121 commercial carriers have provided efficient, economical and safe air transportation for corporate and business users. Recently, however, corporate and business travelers find their travel plans disrupted by delays, bankruptcies, poor service, lost baggage, fare increases, labor strikes and other systemic difficulties that degrade their travel experience to unsatisfactory levels. This article examines these Part 121 service delivery problems and, utilizing a tripartite investigative methodology, examines an alternative air transport mode: FAR Part 135 on-demand charter travel products. This long extant segment of our national air transportation system is set prime to support increased demand for charter services. Corporate and business travelers are set prime to utilize viable, cost effective alternatives to commercial travel products. Two research questions emerge. First is whether corporate and business travelers are aware of Part 135 travel alternatives. Second is whether Part 135 charter service providers are aware of this latent demand and are effectively targeting this demand segment in their marketing efforts. The three-part surveys employed to investigate these questions examined demand side

  2. Air Transport and Travel Industry Training Board

    ERIC Educational Resources Information Center

    Industrial Training Journal, 1974

    1974-01-01

    Seeing its role as one of stimulating, guiding, and coordinating training activities rather than providing central training facilities, three programs have been developed by the Air Transport and Travel Industry Training Board: (1) an occupational program, (2) a company program, and (3) an industry program. (MW)

  3. Controlling Pandemic Flu: The Value of International Air Travel Restrictions

    PubMed Central

    Epstein, Joshua M.; Goedecke, D. Michael; Yu, Feng; Morris, Robert J.; Wagener, Diane K.; Bobashev, Georgiy V.

    2007-01-01

    Background Planning for a possible influenza pandemic is an extremely high priority, as social and economic effects of an unmitigated pandemic would be devastating. Mathematical models can be used to explore different scenarios and provide insight into potential costs, benefits, and effectiveness of prevention and control strategies under consideration. Methods and Findings A stochastic, equation-based epidemic model is used to study global transmission of pandemic flu, including the effects of travel restrictions and vaccination. Economic costs of intervention are also considered. The distribution of First Passage Times (FPT) to the United States and the numbers of infected persons in metropolitan areas worldwide are studied assuming various times and locations of the initial outbreak. International air travel restrictions alone provide a small delay in FPT to the U.S. When other containment measures are applied at the source in conjunction with travel restrictions, delays could be much longer. If in addition, control measures are instituted worldwide, there is a significant reduction in cases worldwide and specifically in the U.S. However, if travel restrictions are not combined with other measures, local epidemic severity may increase, because restriction-induced delays can push local outbreaks into high epidemic season. The per annum cost to the U.S. economy of international and major domestic air passenger travel restrictions is minimal: on the order of 0.8% of Gross National Product. Conclusions International air travel restrictions may provide a small but important delay in the spread of a pandemic, especially if other disease control measures are implemented during the afforded time. However, if other measures are not instituted, delays may worsen regional epidemics by pushing the outbreak into high epidemic season. This important interaction between policy and seasonality is only evident with a global-scale model. Since the benefit of travel restrictions

  4. Is air travel safe for those with lung disease?

    PubMed

    Coker, R K; Shiner, R J; Partridge, M R

    2007-12-01

    Airlines commonly report respiratory in-flight emergencies; flight outcomes have not been examined prospectively in large numbers of respiratory patients. The current authors conducted a prospective, observational study of flight outcomes in this group. UK respiratory specialists were invited to recruit patients planning air travel. Centres undertook their usual pre-flight assessment. Within 2 weeks of returning, patients completed a questionnaire documenting symptoms, in-flight oxygen use and unscheduled healthcare use. In total, 616 patients were recruited. Of these, 500 (81%) returned questionnaires. The most common diagnoses were airway (54%) and diffuse parenchymal lung disease (23%). In total, 12 patients died, seven before flying and five within 1 month. Pre-flight assessment included oximetry (96%), spirometry (95%), hypoxic challenge (45%) and walk test (10%). Of the patients, 11% did not fly. In those who flew, unscheduled respiratory healthcare use increased from 9% in the 4 weeks prior to travel to 19% in the 4 weeks after travel. However, when compared with self-reported data during the preceding year, medical consultations increased by just 2%. In patients flying after careful respiratory specialist assessment, commercial air travel appears generally safe.

  5. Overall accessibility to traveling by rail for the elderly with and without functional limitations: the whole-trip perspective.

    PubMed

    Sundling, Catherine; Berglund, Birgitta; Nilsson, Mats E; Emardson, Ragne; Pendrill, Leslie R

    2014-12-01

    Elderly persons' perceived accessibility to railway traveling depends on their functional limitations/diseases, their functional abilities and their travel behaviors in interaction with the barriers encountered during whole trips. A survey was conducted on a random sample of 1000 city residents (65-85 years old; 57% response rate). The travels were perceived least accessible by respondents with severely reduced functional ability and by those with more than one functional limitation/disease (e.g., restricted mobility and chronic pain). Those who traveled "often", perceived the accessibility to be better than those who traveled less frequently. For travelers with high functional ability, the main barriers to more frequent traveling were travel costs and low punctuality. For those with low functional ability, one's own health was reported to be the main barrier. Our results clarify the links among existing functional limitations/functional abilities, the barriers encountered, the travel behavior, and the overall accessibility to traveling. By operationalizing the whole-trip concept as a chain of events, we deliver practical knowledge on vulnerable groups for decision-making to improve the transport environment for all.

  6. Influenza A(H1N1)pdm09 during air travel

    PubMed Central

    Neatherlin, John; Cramer, Elaine H.; Dubray, Christine; Marienau, Karen J.; Russell, Michelle; Sun, Hong; Whaley, Melissa; Hancock, Kathy; Duong, Krista K.; Kirking, Hannah L.; Schembri, Christopher; Katz, Jacqueline M.; Cohen, Nicole J.; Fishbein, Daniel B.

    2015-01-01

    Summary The global spread of the influenza A(H1N1)pdm09 virus (pH1N1) associated with travelers from North America during the onset of the 2009 pandemic demonstrates the central role of international air travel in virus migration. To characterize risk factors for pH1N1 transmission during air travel, we investigated travelers and airline employees from four North American flights carrying ill travelers with confirmed pH1N1 infection. Of 392 passengers and crew identified, information was available for 290 (74%) passengers were interviewed. Overall attack rates for acute respiratory infection and influenza-like illness 1–7 days after travel were 5.2% and 2.4% respectively. Of 43 individuals that provided sera, 4 (9.3%) tested positive for pH1N1 antibodies, including 3 with serologic evidence of asymptomatic infection. Investigation of novel influenza aboard aircraft may be instructive. However, beyond the initial outbreak phase, it may compete with community-based mitigation activities, and interpretation of findings will be difficult in the context of established community transmission. PMID:23523241

  7. Clinical risk factors for venous thrombosis associated with air travel.

    PubMed

    Kesteven, P J; Robinson, B J

    2001-02-01

    Recent reports have linked air travel with venous thrombo-embolism (VTE). Risk factors and associated features of this link are poorly understood. We have accumulated clinical data from a relatively large cohort of patients with traveler's thrombosis. A total of 86 patients who developed venous thromboembolism within 28 d of flying were questioned concerning traveling habits, medical history (including risk factors for VTE) and characteristics of the index flight. Of the patients, 72% had at least one risk factor for VTE (excluding thrombophilia) prior to their flight. Of interest, 87% of VTE cases occurred following either a return trip or after an outward journey involving long trips made up of sequential flights. In only two cases could no identifiable risk factor or earlier journey be found. Duration of flights ranged from 2 to 30 h. Of responders, 38% presented with chest symptoms; 92% with VTE developed symptoms within 96 h of their flight. We conclude that the majority of VTE associated with air travel occur in those with identifiable risk factors prior to their flight, and that sequential flights may increase this risk.

  8. Best Practices For Improving The Air Travel Experience

    DOT National Transportation Integrated Search

    2000-10-01

    On August 21, 2000 Secretary Rodney Slater convened a meeting of aviation industry leaders from around the country to focus the industry's efforts on "putting people first" in dealing with air travel delays. Following the meeting, Secretary Slater fo...

  9. An Open-Access Modeled Passenger Flow Matrix for the Global Air Network in 2010

    PubMed Central

    Huang, Zhuojie; Wu, Xiao; Garcia, Andres J.; Fik, Timothy J.; Tatem, Andrew J.

    2013-01-01

    The expanding global air network provides rapid and wide-reaching connections accelerating both domestic and international travel. To understand human movement patterns on the network and their socioeconomic, environmental and epidemiological implications, information on passenger flow is required. However, comprehensive data on global passenger flow remain difficult and expensive to obtain, prompting researchers to rely on scheduled flight seat capacity data or simple models of flow. This study describes the construction of an open-access modeled passenger flow matrix for all airports with a host city-population of more than 100,000 and within two transfers of air travel from various publicly available air travel datasets. Data on network characteristics, city population, and local area GDP amongst others are utilized as covariates in a spatial interaction framework to predict the air transportation flows between airports. Training datasets based on information from various transportation organizations in the United States, Canada and the European Union were assembled. A log-linear model controlling the random effects on origin, destination and the airport hierarchy was then built to predict passenger flows on the network, and compared to the results produced using previously published models. Validation analyses showed that the model presented here produced improved predictive power and accuracy compared to previously published models, yielding the highest successful prediction rate at the global scale. Based on this model, passenger flows between 1,491 airports on 644,406 unique routes were estimated in the prediction dataset. The airport node characteristics and estimated passenger flows are freely available as part of the Vector-Borne Disease Airline Importation Risk (VBD-Air) project at: www.vbd-air.com/data. PMID:23691194

  10. An open-access modeled passenger flow matrix for the global air network in 2010.

    PubMed

    Huang, Zhuojie; Wu, Xiao; Garcia, Andres J; Fik, Timothy J; Tatem, Andrew J

    2013-01-01

    The expanding global air network provides rapid and wide-reaching connections accelerating both domestic and international travel. To understand human movement patterns on the network and their socioeconomic, environmental and epidemiological implications, information on passenger flow is required. However, comprehensive data on global passenger flow remain difficult and expensive to obtain, prompting researchers to rely on scheduled flight seat capacity data or simple models of flow. This study describes the construction of an open-access modeled passenger flow matrix for all airports with a host city-population of more than 100,000 and within two transfers of air travel from various publicly available air travel datasets. Data on network characteristics, city population, and local area GDP amongst others are utilized as covariates in a spatial interaction framework to predict the air transportation flows between airports. Training datasets based on information from various transportation organizations in the United States, Canada and the European Union were assembled. A log-linear model controlling the random effects on origin, destination and the airport hierarchy was then built to predict passenger flows on the network, and compared to the results produced using previously published models. Validation analyses showed that the model presented here produced improved predictive power and accuracy compared to previously published models, yielding the highest successful prediction rate at the global scale. Based on this model, passenger flows between 1,491 airports on 644,406 unique routes were estimated in the prediction dataset. The airport node characteristics and estimated passenger flows are freely available as part of the Vector-Borne Disease Airline Importation Risk (VBD-Air) project at: www.vbd-air.com/data.

  11. Overall Accessibility to Traveling by Rail for the Elderly with and without Functional Limitations: The Whole-Trip Perspective

    PubMed Central

    Sundling, Catherine; Berglund, Birgitta; Nilsson, Mats E.; Emardson, Ragne; Pendrill, Leslie R.

    2014-01-01

    Elderly persons’ perceived accessibility to railway traveling depends on their functional limitations/diseases, their functional abilities and their travel behaviors in interaction with the barriers encountered during whole trips. A survey was conducted on a random sample of 1000 city residents (65–85 years old; 57% response rate). The travels were perceived least accessible by respondents with severely reduced functional ability and by those with more than one functional limitation/disease (e.g., restricted mobility and chronic pain). Those who traveled “often”, perceived the accessibility to be better than those who traveled less frequently. For travelers with high functional ability, the main barriers to more frequent traveling were travel costs and low punctuality. For those with low functional ability, one’s own health was reported to be the main barrier. Our results clarify the links among existing functional limitations/functional abilities, the barriers encountered, the travel behavior, and the overall accessibility to traveling. By operationalizing the whole-trip concept as a chain of events, we deliver practical knowledge on vulnerable groups for decision-making to improve the transport environment for all. PMID:25514149

  12. The comfort and satisfaction of air travelers - Basis for a descriptive model

    NASA Technical Reports Server (NTRS)

    Jacobson, I. D.; Martinez, J.

    1974-01-01

    The results of a questionnaire and interview survey are used as a basis for proposing a descriptive model of the comfort and satisfaction of the commercial air traveler. Passenger attitudes toward the present commercial air travel system are examined. Comfort is interpreted as being represented by a four-dimensional composite of commonly encountered environmental variables. Satisfaction is represented as a composite of safety, cost-benefit, luxury, and in-flight activity dimensions.

  13. Travel behavior of low income older adults and implementation of an accessibility calculator

    PubMed Central

    Moniruzzaman, Md; Chudyk, Anna; Páez, Antonio; Winters, Meghan; Sims-Gould, Joanie; McKay, Heather

    2016-01-01

    Given the aging demographic landscape, the concept of walkable neighborhoods has emerged as a topic of interest, especially during the last decade. However, we know very little about whether walkable neighborhoods promote walking among older adults, particularly those with lower incomes. Therefore in this paper we: (i) examine the relation between trip distance and sociodemographic attributes and accessibility features of lower income older adults in Metro Vancouver; and, (ii) implement a web-based application to calculate the accessibility of lower income older adults in Metro Vancouver based on their travel behavior. We use multilevel linear regression to estimate the determinants of trip length. We find that in this population distance traveled is associated with gender, living arrangements, and dog ownership. Furthermore, significant geographical variations (measured using a trend surface) were also found. To better visualize the impact of travel behavior on accessibility by personal profile and location, we also implemented a web-based calculator that generates an Accessibility (A)-score using Google Maps API v3 that can be used to evaluate the accessibility of neighborhoods from the perspective of older adults. PMID:27104148

  14. Sleep, Travel, and Recovery Responses of National Footballers During and After Long-Haul International Air Travel.

    PubMed

    Fullagar, Hugh H; Duffield, Rob; Skorski, Sabrina; White, David; Bloomfield, Jonathan; Kölling, Sarah; Meyer, Tim

    2016-01-01

    The current study examined the sleep, travel, and recovery responses of elite footballers during and after long-haul international air travel, with a further description of these responses over the ensuing competitive tour (including 2 matches). In an observational design, 15 elite male football players undertook 18 h of predominantly westward international air travel from the United Kingdom to South America (-4-h time-zone shift) for a 10-d tour. Objective sleep parameters, external and internal training loads, subjective player match performance, technical match data, and perceptual jet-lag and recovery measures were collected. Significant differences were evident between outbound travel and recovery night 1 (night of arrival; P < .001) for sleep duration. Sleep efficiency was also significantly reduced during outbound travel compared with recovery nights 1 (P = .001) and 2 (P = .004). Furthermore, both match nights (5 and 10), showed significantly less sleep than nonmatch nights 2 to 4 and 7 to 9 (all P < .001). No significant differences were evident between baseline and any time point for all perceptual measures of jet-lag and recovery (P > .05), although large effects were evident for jet-lag on d 2 (2 d after arrival). Sleep duration is truncated during long-haul international travel with a 4-h time-zone delay and after night matches in elite footballers. However, this lost sleep appeared to have a limited effect on perceptual recovery, which may be explained by a westbound flight and a relatively small change in time zones, in addition to the significant increase in sleep duration on the night of arrival after the long-haul flight.

  15. The risk of developing decompression sickness during air travel following altitude chamber flight.

    PubMed

    Rush, W L; Wirjosemito, S A

    1990-11-01

    Approximately 35,000 students are trained annually in United States Air Force (USAF) altitude chambers. Students who depart the training site via aircraft on the same day as their altitude chamber exposure may place themselves at increased risk for decompression sickness (DCS). Air travel as a passenger in the immediate post-chamber flight period is unrestricted by current USAF regulations. A retrospective study was conducted to assess the potential risk involved in such post-chamber flight travel. During the years 1982-87, there were 292 cases of DCS involving altitude chamber students which were subsequently treated with hyperbaric oxygen therapy. Only seven cases were found wherein the student was asymptomatic prior to air travel and subsequently developed DCS. Because the percentage of students who postpone travel is unknown, a precise relative risk could not be determined. Although the number of cases where sequential chamber and aircraft hypobaric exposures has initiated DCS is small, the potential for such occurrences remains a health concern.

  16. Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach

    PubMed Central

    Aljunid, Syed Mohamed

    2018-01-01

    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent’s residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40–74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8–112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60–78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0–340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40–240.00). Higher travel impedance was noted

  17. Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach.

    PubMed

    Mahmud, Aidalina; Aljunid, Syed Mohamed

    2018-01-01

    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent's residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40-74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8-112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60-78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0-340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40-240.00). Higher travel impedance was noted among those who

  18. Interactive, open source, travel time scenario modelling: tools to facilitate participation in health service access analysis.

    PubMed

    Fisher, Rohan; Lassa, Jonatan

    2017-04-18

    Modelling travel time to services has become a common public health tool for planning service provision but the usefulness of these analyses is constrained by the availability of accurate input data and limitations inherent in the assumptions and parameterisation. This is particularly an issue in the developing world where access to basic data is limited and travel is often complex and multi-modal. Improving the accuracy and relevance in this context requires greater accessibility to, and flexibility in, travel time modelling tools to facilitate the incorporation of local knowledge and the rapid exploration of multiple travel scenarios. The aim of this work was to develop simple open source, adaptable, interactive travel time modelling tools to allow greater access to and participation in service access analysis. Described are three interconnected applications designed to reduce some of the barriers to the more wide-spread use of GIS analysis of service access and allow for complex spatial and temporal variations in service availability. These applications are an open source GIS tool-kit and two geo-simulation models. The development of these tools was guided by health service issues from a developing world context but they present a general approach to enabling greater access to and flexibility in health access modelling. The tools demonstrate a method that substantially simplifies the process for conducting travel time assessments and demonstrate a dynamic, interactive approach in an open source GIS format. In addition this paper provides examples from empirical experience where these tools have informed better policy and planning. Travel and health service access is complex and cannot be reduced to a few static modeled outputs. The approaches described in this paper use a unique set of tools to explore this complexity, promote discussion and build understanding with the goal of producing better planning outcomes. The accessible, flexible, interactive and

  19. Does long-distance air travel associated with the Sevens World Series increase players' risk of injury?

    PubMed

    Fuller, Colin W; Taylor, Aileen E; Raftery, Martin

    2015-04-01

    To assess whether players who cross ≥6 time zones and/or undertake ≥10 h air travel prior to competition experience a higher risk of injury during the Sevens World Series than players not required to undertake this level of travel. Five-year, prospective, cohort study. All players from nine core teams competing in the Sevens World Series from 2008/2009 to 2013/2014. A total of 436 match injuries and 3363 player-match-hours of exposure were recorded in the study, which corresponds to an overall incidence of 129.6 injuries/1000 player-match-hours, irrespective of the nature of pretournament travel. The incidence of injury for those players crossing ≥6 time zones and undertaking ≥10 h air travel prior to competition (99.3 injuries/1000 player-match-hours) was significantly lower than that of players undertaking ≥10 h air travel but crossing ≤2 time zones prior to competition (148.8 injuries/1000 player-match-hours; p=0.003) and of those undertaking ≤3 h air travel and crossing ≤2 time zones prior to competition (146.4 injuries/1000 player-match-hours; p=0.004). There was no significant difference in the incidence of injury for players crossing ≤2 time zones in the week prior to competition, irrespective of whether the length of air travel was ≤3 h or ≥10 h (p=0.904). Precompetition air travel had no significant effect (p=0.879) on the performance of teams in terms of their final Tournament ranking positions. There was no evidence to suggest that players were exposed to a greater risk of injury following extensive air travel and crossing multiple time zones prior to Tournaments in the Sevens World Series. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Coupling between air travel and climate

    NASA Astrophysics Data System (ADS)

    Karnauskas, Kristopher B.; Donnelly, Jeffrey P.; Barkley, Hannah C.; Martin, Jonathan E.

    2015-12-01

    The airline industry closely monitors the midlatitude jet stream for short-term planning of flight paths and arrival times. In addition to passenger safety and on-time metrics, this is due to the acute sensitivity of airline profits to fuel cost. US carriers spent US$47 billion on jet fuel in 2011, compared with a total industry operating revenue of US$192 billion. Beyond the timescale of synoptic weather, the El Niño/Southern Oscillation (ENSO), Arctic Oscillation (AO) and other modes of variability modulate the strength and position of the Aleutian low and Pacific high on interannual timescales, which influence the tendency of the exit region of the midlatitude Pacific jet stream to extend, retract and meander poleward and equatorward. The impact of global aviation on climate change has been studied for decades owing to the radiative forcing of emitted greenhouse gases, contrails and other effects. The impact of climate variability on air travel, however, has only recently come into focus, primarily in terms of turbulence. Shifting attention to flight durations, here we show that 88% of the interannual variance in domestic flight times between Hawaii and the continental US is explained by a linear combination of ENSO and the AO. Further, we extend our analysis to CMIP5 model projections to explore potential feedbacks between anthropogenic climate change and air travel.

  1. COPD and air travel: does hypoxia-altitude simulation testing predict in-flight respiratory symptoms?

    PubMed

    Edvardsen, Anne; Ryg, Morten; Akerø, Aina; Christensen, Carl Christian; Skjønsberg, Ole H

    2013-11-01

    The reduced pressure in an aircraft cabin may cause significant hypoxaemia and respiratory symptoms in patients with chronic obstructive pulmonary disease (COPD). The current study evaluated whether there is a relationship between hypoxaemia obtained during hypoxia-altitude simulation testing (HAST), simulating an altitude of 2438 m, and the reporting of respiratory symptoms during air travel. 82 patients with moderate to very severe COPD answered an air travel questionnaire. Arterial oxygen tensions during HAST (PaO2HAST) in subjects with and without in-flight respiratory symptoms were compared. The same questionnaire was answered within 1 year after the HAST. Mean ± sd PaO2HAST was 6.3 ± 0.6 kPa and 62 (76%) of the patients had PaO2HAST <6.6 kPa. 38 (46%) patients had experienced respiratory symptoms during air travel. There was no difference in PaO2HAST in those with and those without in-flight respiratory symptoms (6.3 ± 0.7 kPa versus 6.3 ± 0.6 kPa, respectively; p=0.926). 54 (66%) patients travelled by air after the HAST, and patients equipped with supplemental oxygen (n = 23, 43%) reported less respiratory symptoms when flying with than those without such treatment (four (17%) versus 11 (48%) patients; p=0.039). In conclusion, no difference in PaO2HAST was found between COPD patients with and without respiratory symptoms during air travel.

  2. The relationship of travel distance with cystectomy access and outcomes.

    PubMed

    Smith, Angela B; Meyer, Anne-Marie; Meng, Ke; Nielsen, Matthew E; Pruthi, Raj; Wallen, Eric; Woods, Michael; Tan, Hung-Jui

    2018-06-01

    Regionalization of care and travel distance may result in unintended consequences for complex surgery such as cystectomy. Our objective was to evaluate effect of differential distance on cystectomy receipt among patients with muscle-invasive bladder cancer (MIBC) and investigate the association between travel distance and cystectomy outcomes such as readmission. Using a linked data resource combining the NC Central Cancer Registry with claims data from Medicare, Medicaid, and private insurance plans, we included 736 patients with MIBC and 1,082 who underwent cystectomy. To evaluate access, differential distance was calculated as the difference between the nearest urologist and nearest cystectomy provider. To assess outcomes, logistic regression was used to evaluate rehospitalization and major complications, and Cox proportional hazards model for survival analysis. To evaluate access and outcomes, 736 patients with MIBC and 1,082 patients undergoing cystectomy were evaluated, respectively. Overall, 29% (211 of 736) with MIBC underwent cystectomy. Differential distance was not a predictor of cystectomy receipt (odds ratio = 1.0; 95% CI: 1.00, 1.01). Among patients undergoing cystectomy, travel distance from cystectomy provider was not a significant predictor of 30- or 31 to 90day readmissions (odds ratio = 1.0; 95% CI: 1.00, 1.00) although patients who lived further from their cystectomy provider were more likely to be readmitted to a nonindex hospital (P<0.001) when controlling for other factors. Although travel distance did not have a significant effect on overall survival, patients readmitted between 31 to 90days had worse overall survival (P<0.0001). The additional distance needed to reach a cystectomy provider did not predict receipt of surgery for MIBC. Furthermore, travel distance from cystectomy provider was not a significant predictor for subsequent readmission after cystectomy and did not affect overall survival. Copyright © 2018 Elsevier Inc. All rights

  3. Accessing doctors at times of need-measuring the distance tolerance of rural residents for health-related travel.

    PubMed

    McGrail, Matthew Richard; Humphreys, John Stirling; Ward, Bernadette

    2015-05-29

    Poor access to doctors at times of need remains a significant impediment to achieving good health for many rural residents. The two-step floating catchment area (2SFCA) method has emerged as a key tool for measuring healthcare access in rural areas. However, the choice of catchment size, a key component of the 2SFCA method, is problematic because little is known about the distance tolerance of rural residents for health-related travel. Our study sought new evidence to test the hypothesis that residents of sparsely settled rural areas are prepared to travel further than residents of closely settled rural areas when accessing primary health care at times of need. A questionnaire survey of residents in five small rural communities of Victoria and New South Wales in Australia was used. The two outcome measures were current travel time to visit their usual doctor and maximum time prepared to travel to visit a doctor, both for non-emergency care. Kaplan-Meier charts were used to compare the association between increased distance and decreased travel propensity for closely-settled and sparsely-settled areas, and ordinal multivariate regression models tested significance after controlling for health-related travel moderating factors and town clustering. A total of 1079 questionnaires were completed with 363 from residents in closely-settled locations and 716 from residents in sparsely-settled areas. Residents of sparsely-settled communities travel, on average, 10 min further than residents of closely-settled communities (26.3 vs 16.9 min, p < 0.001), though this difference was not significant after controlling for town clustering. Differences were more apparent in terms of maximum time prepared to travel (54.1 vs 31.9 min, p < 0.001). Differences of maximum time remained significant after controlling for demographic and other constraints to access, such as transport availability or difficulties getting doctor appointments, as well as after controlling for town

  4. An analysis of influenza prevention measures from air travellers' perspective.

    PubMed

    Chou, P-F

    2014-09-01

    The influenza A virus is easily transmitted through airborne saliva droplets disseminated by unprotected coughing or sneezing, particularly in a crowded, enclosed space. The purpose of this study was to analyse the knowledge, attitudes and practices of air travellers regarding influenza A preventive measures and to examine any significant differences in perceptions among different types of traveller groups. This study used a 5-point Likert scale questionnaire and surveyed 1684 passengers at Taoyuan International Airport in Taiwan. The frequencies, mean score and ranking of descriptive analyses were used to evaluate respondents' demographic profiles. t-Test, one-way analysis of variance and Scheffe post hoc analyses were used to evaluate the relationship among knowledge, attitudes and practices, and respondents' characteristics. There were significant differences in the knowledge, attitudes and practices measures among groups with different types of trip purposes and among occupation groups. Most passengers expressed common knowledge regarding influenza A; however, their attitudes and their degree of perception were not consistent with their prevention practices. This research is limited because it only examined surveyed air travellers in Taiwan. Air travellers could benefit greatly if the government and airlines were to implement a health policy that includes education on the importance of influenza prevention measures, such as frequent hand washing, to citizens. Nurses could be involved in this important health promotion activity. Schools should implement a health education policy to communicate the importance of prevention measures. Nurses can consider how they can be involved in emphasizing the importance of prevention and health promotion regarding this. Airlines should also include basic preventive measures as a component of flight attendant training. © 2014 International Council of Nurses.

  5. Lexical access and evoked traveling alpha waves

    PubMed Central

    Zauner, Andrea; Gruber, Walter; Himmelstoß, Nicole Alexandra; Lechinger, Julia; Klimesch, Wolfgang

    2014-01-01

    Retrieval from semantic memory is usually considered within a time window around 300–600 ms. Here we suggest that lexical access already occurs at around 100 ms. This interpretation is based on the finding that semantically rich and frequent words exhibit a significantly shorter topographical latency difference between the site with the shortest P1 latency (leading site) and that with the longest P1 latency (trailing site). This latency difference can be described in terms of an evoked traveling alpha wave as was already shown in earlier studies. PMID:24486978

  6. [Preparing patients with chronic pulmonary disease for air travel].

    PubMed

    Felkai, Péter; Böszörményi Nagy, György; Gyarmati, Ildikó

    2013-03-03

    Flying is the most important way of travelling in the continually growing international tourism. Number of passengers and those with preexisting diseases, mainly with cardiopulmonary problems, is increasing over years. One of the main tasks of the pre-travel advice is to assess tolerance to hypoxia of the traveler, and specify the necessity, as well as the type and volume of supplementary oxygen therapy. It is indispensable to know the cabin-environment and impact of that on the travelers' health. Travel medicine specialist has to be aware of the examinations which provide information for the appropriate decision on the fit-to-fly condition of the patient. The physician who prepares the patient with chronic obstructive pulmonary disease for repatriation by regular flight and the escorting doctor have to be fully aware of the possibilities, modalities, advantages and contraindications of the on-board oxygen supply and therapy. In this review, the authors give a summary of literature data, outline the tools of in-flight oxygen therapy as well as discuss possibilities for the preflight assessment of patients' condition including blood gas parameters required for safe air travel, as recommended in international medical literature. The preparation process for repatriation of patients with chronic obstructive pulmonary disease is also discussed.

  7. AsMA Medical Guidelines for Air Travel: Airline Special Services.

    PubMed

    Thibeault, Claude; Evans, Anthony D

    2015-07-01

    Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. Treating physicians should advise patients in need of special services to contact the airline well before travel to find out if the required services will be available. Ensuring the required services are available throughout a journey can be challenging, especially when different airlines and aircraft types are involved. For example, airlines carry a limited supply of oxygen for use in the event of an unexpected in-flight emergency; however, this supply is not intended for use by passengers needing supplemental oxygen. Arrangements must be made in advance with the airline. Therefore, early contact with the airline is helpful.

  8. 77 FR 39800 - Nondiscrimination on the Basis of Disability in Air Travel: Draft Technical Assistance Manual

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    ... specific learning disabilities. (Sec. 382.3). What is not considered a physical or mental impairment... Secretary 14 CFR Part 382 Nondiscrimination on the Basis of Disability in Air Travel: Draft Technical... [Docket No. DOT-OST-2012--0098] Nondiscrimination on the Basis of Disability in Air Travel: Draft...

  9. Accessible transportation technologies research initiative : advancing mobility solutions for travelers with disabilities.

    DOT National Transportation Integrated Search

    2016-01-01

    The Accessible Transportation Technologies Research Initiative (ATTRI) improves the mobility of travelers with disabilities through research, development, and implementation of transformative technologies, applications, or systems for people of all a...

  10. Lexical access and evoked traveling alpha waves.

    PubMed

    Zauner, Andrea; Gruber, Walter; Himmelstoß, Nicole Alexandra; Lechinger, Julia; Klimesch, Wolfgang

    2014-05-01

    Retrieval from semantic memory is usually considered within a time window around 300-600ms. Here we suggest that lexical access already occurs at around 100ms. This interpretation is based on the finding that semantically rich and frequent words exhibit a significantly shorter topographical latency difference between the site with the shortest P1 latency (leading site) and that with the longest P1 latency (trailing site). This latency difference can be described in terms of an evoked traveling alpha wave as was already shown in earlier studies. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Travelers' thrombosis.

    PubMed

    Johnston, Raymond V; Hudson, Martin F

    2014-02-01

    The suggestion that venous thromboembolism (VTE) is associated with air travel has for several decades been the subject of both "media hype" and extensive debate in the medical literature. As emotion and anecdote is often a feature in this debate, it is therefore necessary to separate evidence from anecdote. "Travelers' thrombosis" is a more appropriate term because the evidence suggests that any form of travel involving immobility lasting more than 4 h can predispose to thrombosis. There is no unique factor in the air travel cabin environment that has been shown to have any effect on the coagulation cascade. Prevention of thrombosis in any form of travel, including air travel, requires being aware of the issue and making an adequate risk assessment together with appropriate prophylactic measures.

  12. AsMA Medical Guidelines for Air Travel: In-Flight Medical Care.

    PubMed

    Thibeault, Claude; Evans, Anthony D; Pettyjohn, Frank S; Alves, Paulo M

    2015-06-01

    Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. All airlines are required to provide first aid training for cabin crew, and the crew are responsible for managing any in-flight medical events. There are also regulatory requirements for the carriage of first aid and medical kits. AsMA has developed recommendations for first aid kits, emergency medical kits, and universal precaution kits.

  13. Massive Ischemic Stroke Due to Pulmonary Barotrauma and Cerebral Artery Air Embolism During Commercial Air Travel

    PubMed Central

    Zarabi, Sara Farshchi; Parotto, Matteo; Katznelson, Rita; Downar, James

    2017-01-01

    Patient: Male, 65 Final Diagnosis: Air emboli Symptoms: Short of breath Medication: — Clinical Procedure: — Specialty: Anesthesiology Objective: Unusual setting of medical care Background: Air embolism into the systemic arterial circulation secondary to pulmonary barotrauma has rarely been reported. Herein, we report the clinical course of an extremely rare presentation of cerebral air embolism likely due to ruptured pulmonary bullae during commercial air travel. Case Report: A 65-year-old man suddenly became unconscious during an airplane descent. Upon landing, he was immediately transferred to the nearest emergency department where he was intubated for airway protection. His head CT angiogram showed multiple air pockets in the right parietal lobe suspicious for multiple air emboli. His chest CT scan showed multiple large bullae in the left upper and lower lobes as well as diffusely emphysematous lung tissue. After initial stabilization, he underwent emergent hyperbaric oxygen treatment (HBOT) in the multiplace chamber at 2.8 atmospheres. The patient tolerated HBOT well with no complications. However, his neurologic status deteriorated in the following 24 hours due to progression of his cerebral edema and mass effects. The patient’s clinical status was discussed with his family and the decision was made to withdraw life-sustaining measures. He died shortly after withdrawal of life support. Post-mortem examination confirmed the presence of very large bullae in the lungs bilaterally. Conclusions: Spontaneous cerebral air embolism is a possible complication of ruptured pulmonary bullae during air travel. HBOT is well-tolerated and may be used with caution even in the presence of emphysematous bullae. PMID:28607332

  14. Spontaneous pneumocephalus after commercial air travel complicated by meningitis.

    PubMed

    Javan, Ramin; Duszak, Richard; Eisenberg, Alan D; Eggers, Frank M

    2011-12-01

    Pneumocephalus usually results from trauma, infection, neoplasm, or iatrogenic causes. Barotrauma-induced spontaneous pneumocephalus is extremely rare, usually seen in divers or occassionally with air travel. We report a case of a 61-yr-old female presenting with confusion, fever, and respiratory failure one day after developing sudden nausea, vomiting, and headache during descent on a commercial airliner. Pneumocephalus and meningitis were present on admission. Sinus computed tomography (CT) showed pansinusitis and a tiny bone defect in the posterior wall of the right sphenoid sinus, through which a cisternogram later showed free communication with the prepontine cistern. An orbital CT 2 yr earlier after a fall showed the bone defect, with no other areas of abnormality or fracture. After repair of defects by otolaryngology and appropriate antibiotics, she did well and was eventually discharged. Changes in aircraft cabin pressure likely resulted in rupture of dura and arachnoid layers beneath the pre-existing bony defect, predisposed by existing sinus disease. The pathophysiology, implications, and potential sources of spontaneous pneumocephalus, as well as risks of postcraniotomy and post-trauma air-travel, are discussed.

  15. Medical oxygen and air travel.

    PubMed

    Lyznicki, J M; Williams, M A; Deitchman, S D; Howe, J P

    2000-08-01

    This report responds to a resolution that asked the American Medical Association (AMA) to take action to improve airport and airline accommodations for passengers requiring medical oxygen. Information for the report was derived from a search of the MEDLINE database and references listed in pertinent articles, as well as through communications with experts in aerospace and emergency medicine. Based on this information, the AMA Council on Scientific Affairs determined that commercial air travel exposes passengers to altitude-related hypoxia and gas expansion, which may cause some passengers to experience significant symptoms and medical complications during flight. Medical guidelines are available to help physicians evaluate and counsel potential passengers who are at increased risk of inflight hypoxemia. Supplemental oxygen may be needed for some passengers to maintain adequate tissue oxygenation and prevent hypoxemic complications. For safety and security reasons, federal regulations prohibit travelers from using their own portable oxygen system onboard commercial aircraft. Many U.S. airlines supply medical oxygen for use during flight but policies and procedures vary. Oxygen-dependent passengers must make additional arrangements for the use of supplemental oxygen in airports. Uniform standards are needed to specify procedures and equipment for the use of medical oxygen in airports and aboard commercial aircraft. Revision of federal regulations should be considered to accommodate oxygen-dependent passengers and permit them to have an uninterrupted source of oxygen from departure to destination.

  16. Estimating the malaria risk of African mosquito movement by air travel

    PubMed Central

    Tatem, Andrew J; Rogers, David J; Hay, Simon I

    2006-01-01

    Background The expansion of global travel has resulted in the importation of African Anopheles mosquitoes, giving rise to cases of local malaria transmission. Here, cases of 'airport malaria' are used to quantify, using a combination of global climate and air traffic volume, where and when are the greatest risks of a Plasmodium falciparum-carrying mosquito being importated by air. This prioritises areas at risk of further airport malaria and possible importation or reemergence of the disease. Methods Monthly data on climate at the World's major airports were combined with air traffic information and African malaria seasonality maps to identify, month-by-month, those existing and future air routes at greatest risk of African malaria-carrying mosquito importation and temporary establishment. Results The location and timing of recorded airport malaria cases proved predictable using a combination of climate and air traffic data. Extending the analysis beyond the current air network architecture enabled identification of the airports and months with greatest climatic similarity to P. falciparum endemic regions of Africa within their principal transmission seasons, and therefore at risk should new aviation routes become operational. Conclusion With the growth of long haul air travel from Africa, the identification of the seasonality and routes of mosquito importation is important in guiding effective aircraft disinsection and vector control. The recent and continued addition of air routes from Africa to more climatically similar regions than Europe will increase movement risks. The approach outlined here is capable of identifying when and where these risks are greatest. PMID:16842613

  17. World Air Travel Demand, 1950-1980

    NASA Technical Reports Server (NTRS)

    Sarames, G. N.

    1972-01-01

    Total world scheduled air passenger traffic carried by the airlines of the International Civil Aviation Organization (ICAO), excluding the U.S.S.R., increased from 17.4 billion passenger miles in 1950 to 237.4 billion in 1970. This represents an average annual growth rate of 14% during the past two decades. The U.S.S.R. became a member of ICAO in 1970, and Aeroflot - the only Russian airline - reported 49 billion passenger miles for 1970. This traffic, which encompasses both domestic and international travel as well as some nonscheduled flights, is not included in the ICAO world totals shown in this report.

  18. Experiences Accessing Abortion Care in Alabama among Women Traveling for Services.

    PubMed

    White, Kari; deMartelly, Victoria; Grossman, Daniel; Turan, Janet M

    2016-01-01

    In Alabama, more than one-half of reproductive-aged women live in counties without an abortion provider. State regulations require in-person counseling (or confirmed receipt of materials sent by certified mail) followed by a 48-hour waiting period. We explored the impact of this service and policy environment on experiences accessing abortion care for women traveling long distances to clinics. We conducted in-depth interviews with 25 women who traveled more than 30 miles to an Alabama clinic providing abortion care between July and September 2014. Women were interviewed by telephone at least 1 day after their consultation, procedure, or follow-up visit. We used content analysis methods to code and analyze interview transcripts. Almost all women found a clinic by searching online or talking to others in their social networks who had abortions. These strategies did not always direct women to the closest clinic, and some described searches that yielded inaccurate information. The majority of women did not believe an in-person consultation visit was necessary and found it to be burdensome because of the extra travel required and long waits at the clinic. Two-thirds of the women were unable to schedule their abortion 48 hours later owing to work schedules or because appointments were offered only once a week, and four women were delayed until their second trimester even though they sought services earlier in pregnancy. It is often difficult for women in communities without an abortion provider to find and access timely abortion care. Efforts are needed to make abortion more accessible and prevent further restrictions on services. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  19. Airport Ground Access Study

    DOT National Transportation Integrated Search

    1978-03-02

    In response to a request by Congress, the FAA and TSC have undertaken a study to determine the extent to which inadequate (off-airport) ground access to airports constrains airport capacity and air travel. Presently, TSC is preparing case studies of ...

  20. Hazards of air travel for the obese: Miss Pickwick and the Boeing 747.

    PubMed

    Toff, N J

    1993-10-01

    A morbidity obese woman took a touring holiday which included two long flights and a stay at altitude. At the end of the second week of her holiday she was admitted to hospital in respiratory and cardiac failure. When she was better she travelled home by a combination of air ambulance and scheduled flights with a medical escort. This extreme case illustrates some of the physiological and physical challenges of air travel to the obese passenger, which may precipitate respiratory and cardiac decompensation in susceptible individuals. When advising these patients, consultation with the airline medical department is recommended, and preflight testing by altitude simulation may be helpful. If medical transport is required, there may be particular problems in lifting and accommodating these patients on board normal air ambulance aircraft.

  1. Quality of malaria information provided on Internet travel operator websites.

    PubMed

    Bazaz, Rohit; Green, Edward; Green, Steve T

    2010-09-01

    Over the past 20 years, there has been a steady growth in the number of reported cases of malaria in the UK. With increasing Internet flight sales over recent years, online travel operator websites may be the only place many travellers could conceivably receive pre-travel malaria prevention advice. 29 Travel operator websites which allow for online flight purchases to malarious areas from the UK, identified using a Google(®) web search and the website of the International Air Transport Association, were assessed for the existence, accuracy and accessibility of malaria prevention advice available through internal and external website links. Eight (28%) websites provided malaria prevention information on their own pages. Five (17%) websites contained country specific malaria information relevant to the requested destination, including variation of malaria risk within that country and accurate destination specific chemoprophylaxis advice. No malaria information was available, either on internal or external links, on 8 (28%) websites. On average, it took 2.4 additional mouse clicks to access malaria information during the online flight booking process. Six of the 29 websites (21%) allowed for access to information with only 1 click. Malaria prevention information on online travel operator websites is most often absent or inadequate. Even on websites where such information is of good quality, it can be difficult to access. The travel industry should introduce and enforce guidelines for the malaria information provided by online travel operators. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.

    PubMed

    Heggestad, Torhild; Børsheim, Knut Yngve

    2002-01-01

    To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998. The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression. Accessibility was measured as the percentage of the population reached in different flying times, and we evaluated the service using a simulation of alternative locations for the helicopter bases. The helicopter service (HEMS) has short access times, with a mean reaction time of 8 minutes and a mean response time of 26 minutes for acute missions. Nearly all patients (98%) are reached within 1 hour. A simulation that tested alternative locations of the helicopter bases compared with current locations showed no increase in accessibility. The use of the service shows large regional differences. Multivariate analyses showed that the distances of the patients from the nearest helicopter base and the nearest hospital are significant determinants for the use of HEMS. Establishment of a national service has given the Norwegian population better access to highly qualified prehospital emergency services. Furthermore, the HEMS has a compensating effect in adjusting for differences in traveling distances to a hospital. Safety, cost-containment, and gatekeeper functions remain challenges.

  3. Nonurgent commercial air travel after acute coronary syndrome: a review of 288 patient events.

    PubMed

    Pearce, Emily; Haffner, Faith; Brady, Lauren B; Sochor, Mark; Duchateau, Francois X; O'Connor, Robert E; Verner, Laurent; Brady, William J

    2014-01-01

    We studied a population of individuals who experienced an acute coronary syndrome (ACS) event while traveling abroad and required nonurgent commercial air travel to the home region. This retrospective study gathered data from 288 patients enrolled in a travel-based medical assistance program. Interventions, complications, and travel home were assessed for trends. Descriptive and comparison statistical analyses were performed. Two hundred eighty-eight patients were identified and entered into the review. Of the patients in this study, 77.1% were male with an average age of 67.7 years. One hundred sixteen (40.3%) patients were diagnosed with unstable angina pectoris (USAP), whereas the remaining 172 (59.7%) patients experienced acute myocardial infarction (AMI). Regarding inpatient complications during the initial admission, 121 (42.0%) patients experienced 1 or more adverse event. The average number of days after an ACS event that a patient began to travel home was 10.5 days for the entire patient population (USAP patients = 8.8 days, AMI patients = 11.8 days). Two hundred twenty (76.4%) patients traveled with a medical escort, and 48 (16.7%) patients received supplemental oxygen during air travel. Four (1.4%) in-flight adverse events occurred in the following ACS diagnostic groups: 2 in the complicated AMI group, 1 in the uncomplicated USAP group, and 1 in the uncomplicated AMI group. No in-flight deaths occurred. Nine (3.1%) deaths were noted within 2 weeks after returning to the home region. The deaths after returning to the home region occurred in the following ACS diagnostic groups: 2 in the complicated USAP group, 1 in the uncomplicated USAP group, and 6 in the complicated AMI group. None of the patients who experienced in-flight events died after returning to their home region. Upon discharge, the vast majority of ACS patients who travel to their home region via commercial air do not experience adverse events in-flight; when such adverse events occur in

  4. A travel mode comparison of commuters' exposures to air pollutants in Barcelona

    NASA Astrophysics Data System (ADS)

    de Nazelle, Audrey; Fruin, Scott; Westerdahl, Dane; Martinez, David; Ripoll, Anna; Kubesch, Nadine; Nieuwenhuijsen, Mark

    2012-11-01

    Daily commutes may contribute disproportionately to overall daily inhalations of urban air contaminants. Understanding factors that explain variability of exposures during travel, and especially differences across transportation modes, is essential to accurately assess health impacts of traffic emissions and to develop effective mitigating measures. We evaluated exposures and inhaled doses of air pollution and assessed factors that contributed to their variability in different travel modes in Barcelona. Black carbon (BC), ultrafine particles (UFP), carbon monoxide (CO), fine particle mass (PM2.5) and carbon dioxide (CO2) were measured and compared across walk, bike, bus, and car modes for a total of 172 trips made on two different round trip routes. On average, the car mode experienced highest concentrations for all contaminants. In pairwise t-tests between concurrent mode runs, statistically significant differences were found for cars compared to walking and biking. Car-to-walk or car-to-bike concentration ratios ranged from 1.3 for CO2 to 25 for CO and were 2-3 for PM2.5, BC, and UFP. In multivariate analyses, travel mode explained the greatest variability in travel exposures, from 8% for PM2.5 to 70% for CO. Different modal patterns emerged when estimating daily inhaled dose, with active commuters' two to three times greater total inhalation volume during travel producing about equal UFP and BC daily inhaled doses to car commuters and 33-50% higher UFP and BC doses compared to bus commuters. These findings, however, are specific to the bike and pedestrian lanes in this study being immediately adjacent to the roadways measured. Dedicated bike or pedestrian routes away from traffic would lead to lower active travel doses.

  5. Air travel and the risk of thromboembolism.

    PubMed

    Gavish, Israel; Brenner, Benjamin

    2011-04-01

    Almost two billion people use commercial aircraft annually. Long-haul flights are taken by over 300 million people. A serious complication of long-distance travel (or prolonged time of flight) is thromboembolism. The real incidence of the problem is difficult to evaluate since there is no consensus about the diagnostic tests or limitation of time after landing connected to the VTE complication. A direct relation between VTE incidence and long-distance flights has been documented. The risk for DVT is 3-12% in a long-haul flight. The pathophysiologic changes that increase VTE risk at flight are stasis (sitting in crowded condition), hypoxia in the airplane cabin, and dehydration. Individual risk factors for air travel-related VTE include age over 40 years, gender (female), women who use oral contraceptives, varicose veins in lower limbs, obesity and genetic thrombophilia. Prevention measures include environmental protection such as keeping the pressure inside the airplane cabinet in hypobaric condition, avoiding dehydration and prolonged sitting. For individuals at increased risk, venous blood stasis can be reduced by wearing elastic stockings and prophylactic use of low-molecular-weight heparin.

  6. Perspectives on Long-Distance Air Travel with Type 1 Diabetes.

    PubMed

    Pinsker, Jordan E; Schoenberg, Benjamen E; Garey, Colleen; Runion, Asher; Larez, Arianna; Kerr, David

    2017-12-01

    We sought to determine the real-life experiences of individuals traveling long distance (across five or more time-zones) with type 1 diabetes (T1D). Five hundred three members of the T1D Exchange online community ( www.myglu.org ) completed a 45-question survey about their travel experiences flying long distance. The cohort was stratified by duration of T1D and whether or not participants used continuous subcutaneous insulin infusion (CSII) therapy and/or a continuous glucose monitor (CGM). In the last 5 years, 71% of participants had flown long distance. When asked about their perceived "fear of flying," CSII users (with and without a CGM) reported their primary anxiety was "losing supplies," while non-CSII users described concerns over "unstable blood glucose (highs and lows)" (P < 0.05). In addition, 74% of participants reported more hypoglycemia and/or hyperglycemia while traveling overseas and 9% had avoided international travel altogether because of problems related to diabetes management. Furthermore, 22% of participants had run out of insulin at some point during a trip and 37% reported inadequate attention in current sources of information to the unpredictability of self-management needs while traveling. Especially problematic for individuals traveling with T1D are a lack of resources adequately addressing (1) protocols for emergencies while abroad, (2) how to navigate airport security, and (3) managing basal insulin rates when crossing time zones. A strong need exists for easily accessible, free resources for traveling with T1D that is tailored to both device use and duration of the disease.

  7. Pulmonary embolism at autopsy in a normal population: implications for air travel fatalities.

    PubMed

    Pheby, D F H; Codling, B W

    2002-12-01

    Much attention has been focused on the apparent risk to long-haul air travelers of venous thromboembolism [deep vein thrombosis (DVT) and pulmonary embolism (PE)], following a number of well-publicized cases. However, there is little epidemiological data to elucidate the problem. PE tends to be under-diagnosed as a cause of death in the general population. This study sets out to establish the level of risk of fatal PE among long-haul passengers arriving in the UK, on the basis of a reappraisal of the role of PE in mortality in the general population. Autopsies carried out at Gloucester in 1996-2000 were reviewed to determine age-specific mortality rates for PE for West Gloucestershire. These rates were applied to long-haul air travelers arriving in the UK, for whom the number of passenger-years at risk were calculated, to estimate the expected numbers of deaths in this group. In 3764 autopsies, PE was the primary cause of death in 221 cases (5.9%), while in 304 (8.1%) it was present as an incidental finding. This suggests that PE was involved in approximately 13.9% of deaths, and is more common with age. Passenger years at risk per annum among long-haul passengers arriving in the UK were estimated (mid-range) at 21,830.482; it was anticipated that 6.55 deaths involving PEs, but not related to air travel, could be expected annually in this group. It appears that the risks of venous thromboembolism due to air travel are overstated. Some deaths are bound to occur inflight, but there is no evidence to suggest an increase, though clearly there are predisposing risk factors for DVT present on long journeys.

  8. People living with HIV travel farther to access healthcare: a population-based geographic analysis from rural Uganda.

    PubMed

    Akullian, Adam N; Mukose, Aggrey; Levine, Gillian A; Babigumira, Joseph B

    2016-01-01

    The availability of specialized HIV services is limited in rural areas of sub-Saharan Africa where the need is the greatest. Where HIV services are available, people living with HIV (PLHIV) must overcome large geographic, economic and social barriers to access healthcare. The objective of this study was to understand the unique barriers PLHIV face when accessing healthcare compared with those not living with HIV in a rural area of sub-Saharan Africa with limited availability of healthcare infrastructure. We conducted a population-based cross-sectional study of 447 heads of household on Bugala Island, Uganda. Multiple linear regression models were used to compare travel time, cost and distance to access healthcare, and log binomial models were used to test for associations between HIV status and access to nearby health services. PLHIV travelled an additional 1.9 km (95% CI (0.6, 3.2 km), p=0.004) to access healthcare compared with those not living with HIV, and they were 56% less likely to access healthcare at the nearest health facility to their residence, so long as that facility lacked antiretroviral therapy (ART) services (aRR=0.44, 95% CI (0.24 to 0.83), p=0.011). We found no evidence that PLHIV travelled further for care if the nearest facility supplies ART services (aRR=0.95, 95% CI (0.86 to 1.05), p=0.328). Among those who reported uptake of care at one of two facilities on the island that provides ART (81% of PLHIV and 68% of HIV-negative individuals), PLHIV tended to seek care at a higher tiered facility that provides ART, even when this facility was not their closest facility (30% of PLHIV travelled further than the closest ART facility compared with 16% of HIV-negative individuals), and travelled an additional 2.2 km (p=0.001) to access that facility, relative to HIV-negative individuals (aRR=1.91, 95% CI (1.00 to 3.65), p=0.05). Among PLHIV, residential distance was associated with access to facilities providing ART (RR=0.78, 95% CI (0.61 to 0.99), p=0

  9. Demand modelling of passenger air travel: An analysis and extension. Volume 1: Background and summary

    NASA Technical Reports Server (NTRS)

    Jacobson, I. D.

    1978-01-01

    The framework for a model of travel demand which will be useful in predicting the total market for air travel between two cities is discussed. Variables to be used in determining the need for air transportation where none currently exists and the effect of changes in system characteristics on attracting latent demand are identified. Existing models are examined in order to provide insight into their strong points and shortcomings. Much of the existing behavioral research in travel demand is incorporated to allow the inclusion of non-economic factors, such as convenience. The model developed is characterized as a market segmentation model. This is a consequence of the strengths of disaggregation and its natural evolution to a usable aggregate formulation. The need for this approach both pedagogically and mathematically is discussed.

  10. Commercial air travel and in-flight pulmonary hypertension.

    PubMed

    Smith, Thomas G; Chang, Rae W; Robbins, Peter A; Dorrington, Keith L

    2013-01-01

    It has recently been shown that commercial air travel triggers hypoxic pulmonary vasoconstriction and modestly increases pulmonary artery pressure in healthy passengers. There is large interindividual variation in hypoxic pulmonary vasoreactivity, and some passengers may be at risk of developing flight-induced pulmonary hypertension, with potentially dangerous consequences. This study sought to determine whether it is possible for a susceptible passenger to develop pulmonary hypertension in response to a routine commercial flight. Using in-flight echocardiography, a passenger was studied during a 6-h commercial flight from London to Dubai. The passenger was generally well and frequently traveled by air, but had been diagnosed with Chuvash polycythemia, a genetic condition that is associated with increased hypoxic pulmonary vasoreactivity. Hematocrit had been normalized with regular venesection. During the flight, arterial oxygen saturation fell to a minimum of 96% and systolic pulmonary artery pressure (sPAP) rapidly increased into the pulmonary hypertensive range. The in-flight increase in sPAP was 50%, reaching a peak of 45 mmHg. This study has established that an asymptomatic but susceptible passenger can rapidly develop in-flight pulmonary hypertension even during a medium-haul flight. Prospective passengers at risk from such responses, including those who have cardiopulmonary disease or increased hypoxic pulmonary vasoreactivity, could benefit from preflight evaluation with a hypoxia altitude simulation test combined with simultaneous echocardiography (HAST-echo). The use of in-flight supplementary oxygen should be considered for susceptible individuals, including all patients diagnosed with Chuvash polycythemia.

  11. Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak

    PubMed Central

    Bogoch, Isaac I; Creatore, Maria I; Cetron, Martin S; Brownstein, John S; Pesik, Nicki; Miniota, Jennifer; Tam, Theresa; Hu, Wei; Nicolucci, Adriano; Ahmed, Saad; Yoon, James W; Berry, Isha; Hay, Simon I; Anema, Aranka; Tatem, Andrew J; MacFadden, Derek; German, Matthew; Khan, Kamran

    2015-01-01

    Summary Background The WHO declared the 2014 west African Ebola epidemic a public health emergency of international concern in view of its potential for further international spread. Decision makers worldwide are in need of empirical data to inform and implement emergency response measures. Our aim was to assess the potential for Ebola virus to spread across international borders via commercial air travel and assess the relative efficiency of exit versus entry screening of travellers at commercial airports. Methods We analysed International Air Transport Association data for worldwide flight schedules between Sept 1, 2014, and Dec 31, 2014, and historic traveller flight itinerary data from 2013 to describe expected global population movements via commercial air travel out of Guinea, Liberia, and Sierra Leone. Coupled with Ebola virus surveillance data, we modelled the expected number of internationally exported Ebola virus infections, the potential effect of air travel restrictions, and the efficiency of airport-based traveller screening at international ports of entry and exit. We deemed individuals initiating travel from any domestic or international airport within these three countries to have possible exposure to Ebola virus. We deemed all other travellers to have no significant risk of exposure to Ebola virus. Findings Based on epidemic conditions and international flight restrictions to and from Guinea, Liberia, and Sierra Leone as of Sept 1, 2014 (reductions in passenger seats by 51% for Liberia, 66% for Guinea, and 85% for Sierra Leone), our model projects 2·8 travellers infected with Ebola virus departing the above three countries via commercial flights, on average, every month. 91 547 (64%) of all air travellers departing Guinea, Liberia, and Sierra Leone had expected destinations in low-income and lower-middle-income countries. Screening international travellers departing three airports would enable health assessments of all travellers at highest risk

  12. The absolute risk of venous thrombosis after air travel: a cohort study of 8,755 employees of international organisations.

    PubMed

    Kuipers, Saskia; Cannegieter, Suzanne C; Middeldorp, Saskia; Robyn, Luc; Büller, Harry R; Rosendaal, Frits R

    2007-09-01

    The risk of venous thrombosis is approximately 2- to 4-fold increased after air travel, but the absolute risk is unknown. The objective of this study was to assess the absolute risk of venous thrombosis after air travel. We conducted a cohort study among employees of large international companies and organisations, who were followed between 1 January 2000 and 31 December 2005. The occurrence of symptomatic venous thrombosis was linked to exposure to air travel, as assessed by travel records provided by the companies and organisations. A long-haul flight was defined as a flight of at least 4 h and participants were considered exposed for a postflight period of 8 wk. A total of 8,755 employees were followed during a total follow-up time of 38,910 person-years (PY). The total time employees were exposed to a long-haul flight was 6,872 PY. In the follow-up period, 53 thromboses occurred, 22 of which within 8 wk of a long-haul flight, yielding an incidence rate of 3.2/1,000 PY, as compared to 1.0/1,000 PY in individuals not exposed to air travel (incidence rate ratio 3.2, 95% confidence interval 1.8-5.6). This rate was equivalent to a risk of one event per 4,656 long-haul flights. The risk increased with exposure to more flights within a short time frame and with increasing duration of flights. The incidence was highest in the first 2 wk after travel and gradually decreased to baseline after 8 wk. The risk was particularly high in employees under age 30 y, women who used oral contraceptives, and individuals who were particularly short, tall, or overweight. The risk of symptomatic venous thrombosis after air travel is moderately increased on average, and rises with increasing exposure and in high-risk groups.

  13. Effects of simulated domestic and international air travel on sleep, performance, and recovery for team sports.

    PubMed

    Fowler, P; Duffield, R; Vaile, J

    2015-06-01

    The present study examined effects of simulated air travel on physical performance. In a randomized crossover design, 10 physically active males completed a simulated 5-h domestic flight (DOM), 24-h simulated international travel (INT), and a control trial (CON). The mild hypoxia, seating arrangements, and activity levels typically encountered during air travel were simulated in a normobaric, hypoxic altitude room. Physical performance was assessed in the afternoon of the day before (D - 1 PM) and in the morning (D + 1 AM) and afternoon (D + 1 PM) of the day following each trial. Mood states and physiological and perceptual responses to exercise were also examined at these time points, while sleep quantity and quality were monitored throughout each condition. Sleep quantity and quality were significantly reduced during INT compared with CON and DOM (P < 0.01). Yo-Yo Intermittent Recovery level 1 test performance was significantly reduced at D + 1 PM following INT compared with CON and DOM (P < 0.01), where performance remained unchanged (P > 0.05). Compared with baseline, physiological and perceptual responses to exercise, and mood states were exacerbated following the INT trial (P < 0.05). Attenuated intermittent-sprint performance following simulated international air travel may be due to sleep disruption during travel and the subsequent exacerbated physiological and perceptual markers of fatigue. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Demand modelling of passenger air travel: An analysis and extension, volume 2

    NASA Technical Reports Server (NTRS)

    Jacobson, I. D.

    1978-01-01

    Previous intercity travel demand models in terms of their ability to predict air travel in a useful way and the need for disaggregation in the approach to demand modelling are evaluated. The viability of incorporating non-conventional factors (i.e. non-econometric, such as time and cost) in travel demand forecasting models are determined. The investigation of existing models is carried out in order to provide insight into their strong points and shortcomings. The model is characterized as a market segmentation model. This is a consequence of the strengths of disaggregation and its natural evolution to a usable aggregate formulation. The need for this approach both pedagogically and mathematically is discussed. In addition this volume contains two appendices which should prove useful to the non-specialist in the area.

  15. MANAGEMENT OF DIABETES DURING AIR TRAVEL: A SYSTEMATIC LITERATURE REVIEW OF CURRENT RECOMMENDATIONS AND THEIR SUPPORTING EVIDENCE.

    PubMed

    Pavela, James; Suresh, Rahul; Blue, Rebecca S; Mathers, Charles H; Belalcazar, L Maria

    2018-02-01

    Individuals with diabetes are increasingly seeking pretravel advice, but updated professional recommendations remain scant. We performed a systematic review on diabetes management during air travel to summarize current recommendations, assess supporting evidence, and identify areas of future research. A systematic review of the English literature on diabetes management during air travel was undertaken utilizing PubMed and MEDLINE. Publications regarding general travel advice; adjustment of insulin and noninsulin therapies; and the use of insulin pumps, glucometers and subcutaneous glucose sensors at altitude were included. Gathered information was used to create an updated summary of glucose-lowering medication adjustment during air travel. Sixty-one publications were identified, most providing expert opinion and few offering primary data (47 expert opinion, 2 observational studies, 2 case reports, 10 device studies). General travel advice was uniform, with increasing attention to preflight security. Indications for oral antihyperglycemic therapy adjustments varied. There were few recommendations on contemporary agents and on nonhypoglycemic adverse events. There was little consensus on insulin adjustment protocols, many antedating current insulin formulations. Most publications advocated adjusting insulin pump time settings after arrival; however, there was disagreement on timing and rate adjustments. Glucometers and subcutaneous glucose sensors were reported to be less accurate at altitude, but not to an extent that would preclude their clinical use. Recommendations for diabetes management during air travel vary significantly and are mostly based on expert opinion. Data from systematic investigation on glucose-lowering medication adjustment protocols may support the development of a future consensus statement. CSII = continuous subcutaneous insulin infusion (device) DPP-4 = dipeptidyl peptidase 4 EGA = error grid analysis GDH = glucose dehydrogenase GOX = glucose

  16. Air travel by individuals with active tuberculosis: reporting patterns and epidemiologic characteristics, Canada 2006-2008.

    PubMed

    Scholten, Derek; Saunders, Andrea; Dawson, Kathryn; Wong, Thomas; Ellis, Edward

    2010-03-01

    Investigations related to tuberculosis (TB) cases on airline flights have received increased attention in recent years. In Canada, reports of air travel by individuals with active TB are sent to the Public Health Agency of Canada (PHAC) for public health risk assessment and contact follow-up. A descriptive analysis was conducted to examine reporting patterns over time. Reports of air travel by individuals with active TB received by PHAC between January 2006 and December 2008 were reviewed. Descriptive analyses were performed on variables related to reporting patterns, characteristics and actions taken. The number of reports increased each year with 18, 35 and 51 reports received in 2006, 2007 and 2008, respectively. Of the 104 total cases, most were male (63%) and born outside of Canada (87%). Ninety-eight cases (97%) met the criteria for infectiousness and a contact investigation was initiated for 136 flights. Reports of air travel by individuals with active TB have been increasing annually in Canada in recent years. Outcomes of the subsequent contact investigations, including passenger follow-up results and evidence of TB transmission, is necessary to further evaluate the effectiveness of the Canadian guidelines.

  17. AsMA Medical Guidelines for Air Travel: stresses of flight.

    PubMed

    Thibeault, Claude; Evans, Anthony D

    2015-05-01

    Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. Modern commercial aircraft are very safe and, in most cases, reasonably comfortable. However, all flights, short or long haul, impose stresses on passengers. Preflight stresses include airport commotion on the ground such as carrying baggage, walking long distances, getting to the gate on time, and being delayed. In-flight stresses include acceleration, vibration (including turbulence), noise, lowered barometric pressure, variations of temperature and humidity, and fatigue among others. Healthy passengers normally tolerate these stresses quite well; however, there is the potential for passengers to become ill during or after the flight due to these stresses, especially for those with pre-existing medical conditions and reduced physiological reserves.

  18. How accessible are coral reefs to people? A global assessment based on travel time.

    PubMed

    Maire, Eva; Cinner, Joshua; Velez, Laure; Huchery, Cindy; Mora, Camilo; Dagata, Stephanie; Vigliola, Laurent; Wantiez, Laurent; Kulbicki, Michel; Mouillot, David

    2016-04-01

    The depletion of natural resources has become a major issue in many parts of the world, with the most accessible resources being most at risk. In the terrestrial realm, resource depletion has classically been related to accessibility through road networks. In contrast, in the marine realm, the impact on living resources is often framed into the Malthusian theory of human density around ecosystems. Here, we develop a new framework to estimate the accessibility of global coral reefs using potential travel time from the nearest human settlement or market. We show that 58% of coral reefs are located < 30 min from the nearest human settlement. We use a case study from New Caledonia to demonstrate that travel time from the market is a strong predictor of fish biomass on coral reefs. We also highlight a relative deficit of protection on coral reef areas near people, with disproportional protection on reefs far from people. This suggests that conservation efforts are targeting low-conflict reefs or places that may already be receiving de facto protection due to their isolation. Our global assessment of accessibility in the marine realm is a critical step to better understand the interplay between humans and resources. © 2016 John Wiley & Sons Ltd/CNRS.

  19. 'Green' on the ground but not in the air: Pro-environmental attitudes are related to household behaviours but not discretionary air travel.

    PubMed

    Alcock, Ian; White, Mathew P; Taylor, Tim; Coldwell, Deborah F; Gribble, Matthew O; Evans, Karl L; Corner, Adam; Vardoulakis, Sotiris; Fleming, Lora E

    2017-01-01

    The rise in greenhouse gas emissions from air travel could be reduced by individuals voluntarily abstaining from, or reducing, flights for leisure and recreational purposes. In theory, we might expect that people with pro-environmental value orientations and concerns about the risks of climate change, and those who engage in more pro-environmental household behaviours, would also be more likely to abstain from such voluntary air travel, or at least to fly less far. Analysis of two large datasets from the United Kingdom, weighted to be representative of the whole population, tested these associations. Using zero-inflated Poisson regression models, we found that, after accounting for potential confounders, there was no association between individuals' environmental attitudes, concern over climate change, or their routine pro-environmental household behaviours, and either their propensity to take non-work related flights, or the distances flown by those who do so. These findings contrasted with those for pro-environmental household behaviours, where associations with environmental attitudes and concern were observed. Our results offer little encouragement for policies aiming to reduce discretionary air travel through pro-environmental advocacy, or through 'spill-over' from interventions to improve environmental impacts of household routines.

  20. 14 CFR 382.71 - What other aircraft accessibility requirements apply to carriers?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false What other aircraft accessibility requirements apply to carriers? 382.71 Section 382.71 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT... DISABILITY IN AIR TRAVEL Accessibility of Aircraft § 382.71 What other aircraft accessibility requirements...

  1. 14 CFR 382.71 - What other aircraft accessibility requirements apply to carriers?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false What other aircraft accessibility requirements apply to carriers? 382.71 Section 382.71 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT... DISABILITY IN AIR TRAVEL Accessibility of Aircraft § 382.71 What other aircraft accessibility requirements...

  2. 14 CFR 382.71 - What other aircraft accessibility requirements apply to carriers?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false What other aircraft accessibility requirements apply to carriers? 382.71 Section 382.71 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT... DISABILITY IN AIR TRAVEL Accessibility of Aircraft § 382.71 What other aircraft accessibility requirements...

  3. 14 CFR 382.71 - What other aircraft accessibility requirements apply to carriers?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false What other aircraft accessibility requirements apply to carriers? 382.71 Section 382.71 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT... DISABILITY IN AIR TRAVEL Accessibility of Aircraft § 382.71 What other aircraft accessibility requirements...

  4. 14 CFR 382.71 - What other aircraft accessibility requirements apply to carriers?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false What other aircraft accessibility requirements apply to carriers? 382.71 Section 382.71 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT... DISABILITY IN AIR TRAVEL Accessibility of Aircraft § 382.71 What other aircraft accessibility requirements...

  5. Multiscale model for pedestrian and infection dynamics during air travel

    NASA Astrophysics Data System (ADS)

    Namilae, Sirish; Derjany, Pierrot; Mubayi, Anuj; Scotch, Mathew; Srinivasan, Ashok

    2017-05-01

    In this paper we develop a multiscale model combining social-force-based pedestrian movement with a population level stochastic infection transmission dynamics framework. The model is then applied to study the infection transmission within airplanes and the transmission of the Ebola virus through casual contacts. Drastic limitations on air-travel during epidemics, such as during the 2014 Ebola outbreak in West Africa, carry considerable economic and human costs. We use the computational model to evaluate the effects of passenger movement within airplanes and air-travel policies on the geospatial spread of infectious diseases. We find that boarding policy by an airline is more critical for infection propagation compared to deplaning policy. Enplaning in two sections resulted in fewer infections than the currently followed strategy with multiple zones. In addition, we found that small commercial airplanes are better than larger ones at reducing the number of new infections in a flight. Aggregated results indicate that passenger movement strategies and airplane size predicted through these network models can have significant impact on an event like the 2014 Ebola epidemic. The methodology developed here is generic and can be readily modified to incorporate the impact from the outbreak of other directly transmitted infectious diseases.

  6. 41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

  7. 41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

  8. 41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

  9. 41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

  10. 41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

  11. CCP Crew Access Arm Arrival

    NASA Image and Video Library

    2016-08-11

    A heavy-lift transport truck, carrying the Crew Access Arm for Space Launch Complex 41, travels along the road toward Complex 41 at Cape Canaveral Air Force Station in Florida. The arm will be installed on the Complex 41 Crew Access Tower. It will be used as a bridge by astronauts to board Boeing's CST-100 Starliner spacecraft as it stands on the launch pad atop a United Launch Alliance Atlas V rocket.

  12. Acquisition of traveler information and its effects on travel choices : evidence from a Seattle-area travel diary survey

    DOT National Transportation Integrated Search

    2003-04-07

    Advanced Traveler Information Systems offer the promise of better informed travel decisions and more efficient use of transportation infrastructure. However, no firm consensus has emerged as to how travelers decide to access information, or how they ...

  13. The Absolute Risk of Venous Thrombosis after Air Travel: A Cohort Study of 8,755 Employees of International Organisations

    PubMed Central

    Kuipers, Saskia; Cannegieter, Suzanne C; Middeldorp, Saskia; Robyn, Luc; Büller, Harry R; Rosendaal, Frits R

    2007-01-01

    Background The risk of venous thrombosis is approximately 2- to 4-fold increased after air travel, but the absolute risk is unknown. The objective of this study was to assess the absolute risk of venous thrombosis after air travel. Methods and Findings We conducted a cohort study among employees of large international companies and organisations, who were followed between 1 January 2000 and 31 December 2005. The occurrence of symptomatic venous thrombosis was linked to exposure to air travel, as assessed by travel records provided by the companies and organisations. A long-haul flight was defined as a flight of at least 4 h and participants were considered exposed for a postflight period of 8 wk. A total of 8,755 employees were followed during a total follow-up time of 38,910 person-years (PY). The total time employees were exposed to a long-haul flight was 6,872 PY. In the follow-up period, 53 thromboses occurred, 22 of which within 8 wk of a long-haul flight, yielding an incidence rate of 3.2/1,000 PY, as compared to 1.0/1,000 PY in individuals not exposed to air travel (incidence rate ratio 3.2, 95% confidence interval 1.8–5.6). This rate was equivalent to a risk of one event per 4,656 long-haul flights. The risk increased with exposure to more flights within a short time frame and with increasing duration of flights. The incidence was highest in the first 2 wk after travel and gradually decreased to baseline after 8 wk. The risk was particularly high in employees under age 30 y, women who used oral contraceptives, and individuals who were particularly short, tall, or overweight. Conclusions The risk of symptomatic venous thrombosis after air travel is moderately increased on average, and rises with increasing exposure and in high-risk groups. PMID:17896862

  14. Population-Level Exposure to Particulate Air Pollution during Active Travel: Planning for Low-Exposure, Health-Promoting Cities

    PubMed Central

    Hankey, Steve; Lindsey, Greg; Marshall, Julian D.

    2016-01-01

    Background: Providing infrastructure and land uses to encourage active travel (i.e., bicycling and walking) are promising strategies for designing health-promoting cities. Population-level exposure to air pollution during active travel is understudied. Objectives: Our goals were a) to investigate population-level patterns in exposure during active travel, based on spatial estimates of bicycle traffic, pedestrian traffic, and particulate concentrations; and b) to assess how those exposure patterns are associated with the built environment. Methods: We employed facility–demand models (active travel) and land use regression models (particulate concentrations) to estimate block-level (n = 13,604) exposure during rush-hour (1600–1800 hours) in Minneapolis, Minnesota. We used the model-derived estimates to identify land use patterns and characteristics of the street network that are health promoting. We also assessed how exposure is correlated with indicators of health disparities (e.g., household income, proportion of nonwhite residents). Our work uses population-level rates of active travel (i.e., traffic flows) rather than the probability of walking or biking (i.e., “walkability” or “bikeability”) to assess exposure. Results: Active travel often occurs on high-traffic streets or near activity centers where particulate concentrations are highest (i.e., 20–42% of active travel occurs on blocks with high population-level exposure). Only 2–3% of blocks (3–8% of total active travel) are “sweet spots” (i.e., high active travel, low particulate concentrations); sweet spots are located a) near but slightly removed from the city-center or b) on off-street trails. We identified 1,721 blocks (~ 20% of local roads) where shifting active travel from high-traffic roads to adjacent low-traffic roads would reduce exposure by ~ 15%. Active travel is correlated with population density, land use mix, open space, and retail area; particulate concentrations were

  15. Travel Behavior Change in Older Travelers: Understanding Critical Reactions to Incidents Encountered in Public Transport.

    PubMed

    Sundling, Catherine

    2015-11-18

    Accessibility of travel may be better understood if psychological factors underlying change in travel behavior are known. This paper examines older (65+) travelers' motives for changing their travel behavior. These changes are grounded in critical incidents earlier encountered in public-transport travel. A scientific framework is developed based on cognitive and behavioral theory. In 29 individual interviews, travelers' critical reactions (i.e., cognitive, emotional, and/or behavioral) to 77 critical incidents were examined. By applying critical incident technique (CIT), five reaction themes were identified that had generated travel-behavior change: firm restrictions, unpredictability, unfair treatment, complicated trips, and earlier adverse experiences. To improve older travelers' access to public transport, key findings were: (a) service must be designed so as to strengthen the feeling of being in control throughout the journey; (b) extended personal service would increase predictability in the travel chain and decrease travel complexity; consequently, (c) when designing new services and making effective accessibility interventions, policy makers should consider and utilize underlying psychological factors that could direct traveler behavior.

  16. AsMA Medical Guidelines for Air Travel: Reported In-Flight Medical Events and Death.

    PubMed

    Thibeault, Claude; Evans, Anthony D

    2015-06-01

    Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. Although there are no publicly available databases providing information on the number of in-flight medical emergencies, the few studies published in the literature indicate that they are uncommon. Minor illnesses such as near-fainting, dizziness, and hyperventilation occur more frequently. However, serious illnesses, such as seizures and myocardial infarction, also occur. In-flight deaths are also rare.

  17. ‘Green’ on the ground but not in the air: Pro-environmental attitudes are related to household behaviours but not discretionary air travel

    PubMed Central

    White, Mathew P.; Taylor, Tim; Coldwell, Deborah F.; Gribble, Matthew O.; Evans, Karl L.; Corner, Adam; Vardoulakis, Sotiris; Fleming, Lora E.

    2017-01-01

    The rise in greenhouse gas emissions from air travel could be reduced by individuals voluntarily abstaining from, or reducing, flights for leisure and recreational purposes. In theory, we might expect that people with pro-environmental value orientations and concerns about the risks of climate change, and those who engage in more pro-environmental household behaviours, would also be more likely to abstain from such voluntary air travel, or at least to fly less far. Analysis of two large datasets from the United Kingdom, weighted to be representative of the whole population, tested these associations. Using zero-inflated Poisson regression models, we found that, after accounting for potential confounders, there was no association between individuals' environmental attitudes, concern over climate change, or their routine pro-environmental household behaviours, and either their propensity to take non-work related flights, or the distances flown by those who do so. These findings contrasted with those for pro-environmental household behaviours, where associations with environmental attitudes and concern were observed. Our results offer little encouragement for policies aiming to reduce discretionary air travel through pro-environmental advocacy, or through ‘spill-over’ from interventions to improve environmental impacts of household routines. PMID:28367001

  18. Influence of socio-demographic factors on distances travelled to access HIV services: enhanced surveillance of HIV patients in north west England

    PubMed Central

    Cook, Penny A; Downing, Jennifer; Wheater, C Philip; Bellis, Mark A; Tocque, Karen; Syed, Qutub; Phillips-Howard, Penelope A

    2009-01-01

    Background Patient choice and access to health care is compromised by many barriers including travel distance. Individuals with the human immunodeficiency virus (HIV) can seek free specialist care in Britain, without a referral, providing flexible access to care services. Willingness to travel beyond local services for preferred care has funding and service implications. Data from an enhanced HIV surveillance system were used to explore geodemographic and clinical factors associated with accessing treatment services. Methods We extracted data on the location, type and frequency of care services utilized by HIV positive persons (n = 3983) accessing treatment in north west England between January 1st 2005 and June 30th 2006. Individuals were allocated a deprivation score and grouped by urban/rural residence, and distance to care services was calculated. Analysis identified independent predictors of distance travelled (general linear modelling) and, for those bypassing their nearest clinic, the probability of accessing a specialist service (logistic regression, SPSS ver 14). Inter-relationships between variables and distance travelled were visualised using detrended correspondence analysis (PC-ORD ver 4.1). Results HIV infected persons travelled an average of 4.8 km (95% confidence intervals (CI) 4.6–4.9) per trip and had on average 6 visits (95% CI 5.9–6.2) annually for care. Longer trips were made by males (4.8 km vs 4.5 km), white people (6.2 km), the young (>15 years, 6.8 km) and elderly (60+ years, 6.3 km), those on multiple therapy (5.3 km vs 4.0 km), and the more affluent living in rural areas (16.1 km, P < 0.05). Half the individuals bypassed their nearest clinic to visit a more distant facility, and this was associated with being aged under 20 years, multiple therapy, being a male infected by sex between men, relative wealth, and living in rural areas (P < 0.05). Of those bypassing local facilities, poorer people were more likely to access a specialist

  19. COPD and air travel: oxygen equipment and preflight titration of supplemental oxygen.

    PubMed

    Akerø, Aina; Edvardsen, Anne; Christensen, Carl C; Owe, Jan O; Ryg, Morten; Skjønsberg, Ole H

    2011-07-01

    Patients with COPD may need supplemental oxygen during air travel to avoid development of severe hypoxemia. The current study evaluated whether the hypoxia-altitude simulation test (HAST), in which patients breathe 15.1% oxygen simulating aircraft conditions, can be used to establish the optimal dose of supplemental oxygen. Also, the various types of oxygen-delivery equipment allowed for air travel were compared. In a randomized crossover trial, 16 patients with COPD were exposed to alveolar hypoxia: in a hypobaric chamber (HC) at 2,438 m (8,000 ft) and with a HAST. During both tests, supplemental oxygen was given by nasal cannula (NC) with (1) continuous flow, (2) an oxygen-conserving device, and (3) a portable oxygen concentrator (POC). PaO(2) kPa (mm Hg) while in the HC and during the HAST with supplemental oxygen at 2 L/min (pulse setting 2) on devices 1 to 3 was (1) 8.6 ± 1.0 (65 ± 8) vs 12.5 ± 2.4 (94 ± 18) (P < .001), (2) 8.6 ± 1.6 (64 ± 12) vs 9.7 ± 1.5 (73 ± 11) (P < .001), and (3) 7.7 ± 0.9 (58 ± 7) vs 8.2 ± 1.1 (62 ± 8) (P= .003), respectively. The HAST may be used to identify patients needing supplemental oxygen during air travel. However, oxygen titration using an NC during a HAST causes accumulation of oxygen within the facemask and underestimates the oxygen dose required. When comparing the various types of oxygen-delivery equipment in an HC at 2,438 m (8,000 ft), compressed gaseous oxygen with continuous flow or with an oxygen-conserving device resulted in the same PaO(2), whereas a POC showed significantly lower PaO(2) values. ClinicalTrials.gov; No.: Identifier: NCT01019538; URL: clinicaltrials.gov.

  20. 14 CFR 382.29 - May a carrier require a passenger with a disability to travel with a safety assistant?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) Concern that a passenger with a disability may need personal care services (e.g., assistance in using... disability to travel with a safety assistant? 382.29 Section 382.29 Aeronautics and Space OFFICE OF THE... BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination and Access to Services and Information § 382.29 May...

  1. 14 CFR 382.29 - May a carrier require a passenger with a disability to travel with a safety assistant?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) Concern that a passenger with a disability may need personal care services (e.g., assistance in using... disability to travel with a safety assistant? 382.29 Section 382.29 Aeronautics and Space OFFICE OF THE... BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination and Access to Services and Information § 382.29 May...

  2. 14 CFR 382.29 - May a carrier require a passenger with a disability to travel with a safety assistant?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) Concern that a passenger with a disability may need personal care services (e.g., assistance in using... disability to travel with a safety assistant? 382.29 Section 382.29 Aeronautics and Space OFFICE OF THE... BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination and Access to Services and Information § 382.29 May...

  3. The challenges of disease risk ascertainment using accessible data sources for numbers of travelers.

    PubMed

    Behrens, Ronald H; Carroll, Bernadette

    2013-01-01

    Accessible travel has led to a rapid growth in international tourism, particularly to developing countries. With the increase, travel-associated morbidity and mortality has changed. Data on traveling populations are essential for policy makers to estimate infectious and noninfectious risks in travelers. Passenger flow statistics are compiled by the World Tourism Organization (WTO) and by official institutions of some countries. This study investigates sources of passenger flow statistics, methods of data collection, and compares datasets for consistency. Four national datasets of departing travelers were compared to the United Nations' World Tourism Organization (WTO) data on passenger arrivals to eight destination countries. The ratio between arrivals and departures was calculated (main destination ratio [MDR]) to estimate the proportion of direct to indirect traveler arrivals. With few exceptions, arrival data exceeded that of departure data for all destinations. India is a primary destination for Australian residents where arrival and departure figures were similar (MDR 1.1), while visits to Cambodia and Turkey, with 3.6- and 3.8-fold higher arrivals, respectively, are part of multidestination trips. For UK residents, arrivals exceeded departures for all destinations except India where the reverse was true (MDR 0.8). A close correlation between arrivals and departures was noted for visits to South Africa while arrivals to Singapore and Cambodia were 7- and 10-fold higher, respectively. Arrivals by Finnish residents to destination countries were 1.4- to 1.6-fold higher than departures and 2.2-fold higher for Canadians visiting China. Different methodologies used to capture arrival and departure statistics result in different estimations of traveler numbers. Data from a single source does not provide a comprehensive picture of most tourism itineraries. Inbound statistics give a more accurate reflection of the total visits made by travelers from a source country.

  4. Individual traveller health priorities and the pre-travel health consultation.

    PubMed

    Flaherty, Gerard T; Chen, Bingling; Avalos, Gloria

    2017-09-01

    The purpose of this study was to examine the principal travel health priorities of travellers. The most frequently selected travel health concerns were accessing medical care abroad, dying abroad, insect bites, malaria, personal safety and travel security threats. The travel health risks of least concern were culture shock, fear of flying, jet lag and sexually transmitted infections. This study is the first to develop a hierarchy of self-declared travel health risk priorities among travellers. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  5. 14 CFR 382.29 - May a carrier require a passenger with a disability to travel with a safety assistant?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false May a carrier require a passenger with a disability to travel with a safety assistant? 382.29 Section 382.29 Aeronautics and Space OFFICE OF THE... BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination and Access to Services and Information § 382.29 May...

  6. 14 CFR 382.29 - May a carrier require a passenger with a disability to travel with a safety assistant?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false May a carrier require a passenger with a disability to travel with a safety assistant? 382.29 Section 382.29 Aeronautics and Space OFFICE OF THE... BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination and Access to Services and Information § 382.29 May...

  7. Travel Behavior Change in Older Travelers: Understanding Critical Reactions to Incidents Encountered in Public Transport

    PubMed Central

    Sundling, Catherine

    2015-01-01

    Accessibility of travel may be better understood if psychological factors underlying change in travel behavior are known. This paper examines older (65+) travelers’ motives for changing their travel behavior. These changes are grounded in critical incidents earlier encountered in public-transport travel. A scientific framework is developed based on cognitive and behavioral theory. In 29 individual interviews, travelers’ critical reactions (i.e., cognitive, emotional, and/or behavioral) to 77 critical incidents were examined. By applying critical incident technique (CIT), five reaction themes were identified that had generated travel-behavior change: firm restrictions, unpredictability, unfair treatment, complicated trips, and earlier adverse experiences. To improve older travelers’ access to public transport, key findings were: (a) service must be designed so as to strengthen the feeling of being in control throughout the journey; (b) extended personal service would increase predictability in the travel chain and decrease travel complexity; consequently, (c) when designing new services and making effective accessibility interventions, policy makers should consider and utilize underlying psychological factors that could direct traveler behavior. PMID:26593935

  8. Population-Level Exposure to Particulate Air Pollution during Active Travel: Planning for Low-Exposure, Health-Promoting Cities.

    PubMed

    Hankey, Steve; Lindsey, Greg; Marshall, Julian D

    2017-04-01

    Providing infrastructure and land uses to encourage active travel (i.e., bicycling and walking) are promising strategies for designing health-promoting cities. Population-level exposure to air pollution during active travel is understudied. Our goals were a ) to investigate population-level patterns in exposure during active travel, based on spatial estimates of bicycle traffic, pedestrian traffic, and particulate concentrations; and b ) to assess how those exposure patterns are associated with the built environment. We employed facility-demand models (active travel) and land use regression models (particulate concentrations) to estimate block-level ( n = 13,604) exposure during rush-hour (1600-1800 hours) in Minneapolis, Minnesota. We used the model-derived estimates to identify land use patterns and characteristics of the street network that are health promoting. We also assessed how exposure is correlated with indicators of health disparities (e.g., household income, proportion of nonwhite residents). Our work uses population-level rates of active travel (i.e., traffic flows) rather than the probability of walking or biking (i.e., "walkability" or "bikeability") to assess exposure. Active travel often occurs on high-traffic streets or near activity centers where particulate concentrations are highest (i.e., 20-42% of active travel occurs on blocks with high population-level exposure). Only 2-3% of blocks (3-8% of total active travel) are "sweet spots" (i.e., high active travel, low particulate concentrations); sweet spots are located a ) near but slightly removed from the city-center or b ) on off-street trails. We identified 1,721 blocks (~ 20% of local roads) where shifting active travel from high-traffic roads to adjacent low-traffic roads would reduce exposure by ~ 15%. Active travel is correlated with population density, land use mix, open space, and retail area; particulate concentrations were mostly unchanged with land use. Public health officials and

  9. The effect of flight-related behaviour on the risk of venous thrombosis after air travel.

    PubMed

    Schreijer, Anja J M; Cannegieter, Suzanne C; Doggen, Carine J M; Rosendaal, Frits R

    2009-02-01

    In a case-control study including 11,033 participants (The Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis study) on risk factors of venous thrombosis, we studied the effect of flight-related behaviour on the risk of venous thrombosis after air travel. Patients and control subjects received a questionnaire on risk factors for venous thrombosis, including recent travel history and details of their last flight. From this population, 80 patients and 108 control subjects were selected who had recently (<8 weeks) travelled for more than 4 h by aeroplane. Window seating compared to aisle seating increased the risk twofold [odds ratio (OR) 2.2; 95% confidence interval (CI): 1.1-4.4], particularly in those who were obese (OR 6.1; 95% CI: 0.5-76.2). Anxiety (OR 2.5; 95% CI: 0.9-7.0) and sleeping (OR 1.5; 95% CI: 0.7-3.1) may increase the risk slightly. The risk was not affected by alcohol consumption (OR 1.1; 95% CI: 0.5-2.4). Flying business class may lower the risk (OR 0.7; 95% CI: 0.2-1.8). We did not find a protective effect for several measures currently part of standard advice from airlines and clinicians, i.e. drinking non-alcoholic beverages, exercising or wearing stockings. The effect of behavioural factors during flying on the risk of venous thrombosis after air travel is limited. Current advice on prevention of travel-related thrombosis may have to be reconsidered.

  10. Air Travel and TB: an airline perspective.

    PubMed

    Dowdall, Nigel P; Evans, Anthony D; Thibeault, Claude

    2010-03-01

    The commercial airline industry in the 21st century is a global business, able to transport large numbers of people to almost any part of the world within a few hours. There has long been concern in public health circles about the potential for transmission of communicable diseases, such as TB, on board aircraft. The recent threats from novel and emerging infectious diseases including SARS and pandemic flu has facilitated unprecedented levels of cooperation between international industry representatives, regulators and public health authorities in addressing the issues of air travel and communicable disease. This paper reviews the regulatory environment, ways in which the risks are mitigated through aspects of aircraft design, opportunities for prevention by identifying individuals who may be suffering from a communicable disease prior to flight and the approach used in managing suspected cases of communicable disease on board aircraft.

  11. The Interplay of Socioeconomic Status, Distance to Center, and Interdonor Service Area Travel on Kidney Transplant Access and Outcomes

    PubMed Central

    Axelrod, David A.; Dzebisashvili, Nino; Schnitzler, Mark A.; Salvalaggio, Paolo R.; Segev, Dorry L.; Gentry, Sommer E.; Tuttle-Newhall, Janet

    2010-01-01

    Background and objectives: Variation in kidney transplant access across the United States may motivate relocation of patients with ability to travel to better-supplied areas. Design, setting, participants, & measurements: We examined national transplant registry and U.S. Census data for kidney transplant candidates listed in 1999 to 2009 with a reported residential zip code (n = 203,267). Cox's regression was used to assess associations of socioeconomic status (SES), distance from residence to transplant center, and relocation to a different donation service area (DSA) with transplant access and outcomes. Results: Patients in the highest SES quartile had increased access to transplant compared with those with lowest SES, driven strongly by 76% higher likelihood of living donor transplantation (adjusted hazard ratio [aHR] 1.76, 95% confidence interval [CI] 1.70 to 1.83). Waitlist death was reduced in high compared with low SES candidates (aHR 0.86, 95% CI 0.84 to 0.89). High SES patients also experienced lower mortality after living and deceased donor transplant. Patients living farther from the transplant center had reduced access to deceased donor transplant and increased risk of post-transplant death. Inter-DSA travel was associated with a dramatic increase in deceased donor transplant access (HR 1.94, 95% CI 1.88 to 2.00) and was predicted by high SES, white race, and longer deceased-donor allograft waiting time in initial DSA. Conclusions: Ongoing disparities exist in kidney transplantation access and outcomes on the basis of geography and SES despite near-universal insurance coverage under Medicare. Inter-DSA travel improves access and is more common among high SES candidates. PMID:20798250

  12. International Air Travel to Ohio, USA, and the Impact on Malaria, Influenza, and Hepatitis A

    PubMed Central

    Brannen, Donald E.; Alhammad, Ali; Branum, Melissa; Schmitt, Amy

    2016-01-01

    The State of Ohio led the United States in measles in 2014, ostensibly related to international air travel (IAT), and ranked lower than 43 other states in infectious disease outbreak preparedness. We conducted a retrospective cohort study using surveillance data of the total Ohio population of 11 million from 2010 through 2014 with a nested case control of air travelers to determine the risk of malaria, seasonal influenza hospitalizations (IH), and hepatitis A (HA) disease related to international travel and to estimate the association with domestic enplanement. IAT appeared protective for HA and IH with a risk of 0.031 (.02–.04) but for malaria was 2.7 (2.07–3.62). Enplanement increased the risk for nonendemic M 3.5 (2.5–4.9) and for HA and IH 1.39 (1.34–1.44). IAT's ratio of relative risk (RRR) of malaria to HA and IH was 87.1 (55.8–136) greater than 219 times versus domestic enplanement which was protective for malaria at 0.397 (0.282–0.559). Malaria is correlated with IAT with cases increasing by 6.9 for every 10,000 passports issued. PMID:27123365

  13. Effects of northbound long-haul international air travel on sleep quantity and subjective jet lag and wellness in professional Australian soccer players.

    PubMed

    Fowler, Peter; Duffield, Rob; Howle, Kieran; Waterson, Adam; Vaile, Joanna

    2015-07-01

    The current study examined the effects of 10-h northbound air travel across 1 time zone on sleep quantity, together with subjective jet lag and wellness ratings, in 16 male professional Australian football (soccer) players. Player wellness was measured throughout the week before (home training week) and the week of (away travel week) travel from Australia to Japan for a preseason tour. Sleep quantity and subjective jet lag were measured 2 d before (Pre 1 and 2), the day of, and for 5 d after travel (Post 1-5). Sleep duration was significantly reduced during the night before travel (Pre 1; 4.9 [4.2-5.6] h) and night of competition (Post 2; 4.2 [3.7-4.7] h) compared with every other night (P<.01, d>0.90). Moreover, compared with the day before travel, subjective jet lag was significantly greater for the 5 d after travel (P<.05, d>0.90), and player wellness was significantly lower 1 d post-match (Post 3) than at all other time points (P<.05, d>0.90). Results from the current study suggest that sleep disruption, as a result of an early travel departure time (8 PM) and evening match (7:30 PM), and fatigue induced by competition had a greater effect on wellness ratings than long-haul air travel with a minimal time-zone change. Furthermore, subjective jet lag may have been misinterpreted as fatigue from sleep disruption and competition, especially by the less experienced players. Therefore, northbound air travel across 1 time zone from Australia to Asia appears to have negligible effects on player preparedness for subsequent training and competition.

  14. Middle-ear pain and trauma during air travel

    PubMed Central

    2015-01-01

    Introduction Changes in air pressure during flying can cause ear-drum pain and perforation, vertigo, and hearing loss. It has been estimated that 10% of adults and 22% of children might have changes to the ear drum after a flight, although perforation is rare. Symptoms usually resolve spontaneously. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions to prevent middle-ear pain during air travel? We searched: Medline, Embase, The Cochrane Library and other important databases up to July 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found three studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: nasal balloon inflation, nasal decongestants (topical), and oral pseudoephedrine. PMID:25599243

  15. Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial

    PubMed Central

    Tiralongo, Evelin; Wee, Shirley S.; Lea, Rodney A.

    2016-01-01

    Intercontinental air travel can be stressful, especially for respiratory health. Elderberries have been used traditionally, and in some observational and clinical studies, as supportive agents against the common cold and influenza. This randomized, double-blind placebo-controlled clinical trial of 312 economy class passengers travelling from Australia to an overseas destination aimed to investigate if a standardised membrane filtered elderberry (Sambucus nigra L.) extract has beneficial effects on physical, especially respiratory, and mental health. Cold episodes, cold duration and symptoms were noted in a daily diary and assessed using the Jackson score. Participants also completed three surveys containing questions regarding upper respiratory symptoms (WURSS-21) and quality of life (SF-12) at baseline, just before travel and at 4-days after travel. Most cold episodes occurred in the placebo group (17 vs. 12), however the difference was not significant (p = 0.4). Placebo group participants had a significantly longer duration of cold episode days (117 vs. 57, p = 0.02) and the average symptom score over these days was also significantly higher (583 vs. 247, p = 0.05). These data suggest a significant reduction of cold duration and severity in air travelers. More research is warranted to confirm this effect and to evaluate elderberry’s physical and mental health benefits. PMID:27023596

  16. The Effect of Corporate Influence in the Short Haul Business Travel Market

    NASA Technical Reports Server (NTRS)

    Mason, Keith J.

    1999-01-01

    The importance of corporate involvement in the decision making process for business related air travel is being increasingly recognized in the literature. Business travellers consume air services (i.e. they take airline flights), however; they may not be the principal decision-maker in the purchase, Also it is the organization that employs the traveller that incurs the cost for air travel, Consequently this research addresses the relationship between the traveller and the employing organization in the purchase of air travel. In this paper traveller opinions on their corporate travel policy are evaluated using a Likert summated rating scale. The benefits sought, by the traveller, from the air service are also investigated and these benefits are used to segment the short haul business air travel market in the EU. Changes in the market for short haul business travel since the full liberalisation of the aviation market in the EU are evaluated by comparing the data to an earlier study of similar travellers in 1992.

  17. The Effect of Corporate Influence in the Short Haul Business Travel Market

    NASA Technical Reports Server (NTRS)

    Mason, Keith J.

    1999-01-01

    The importance of corporate involvement in the decision making process for business related air travel is being increasingly recognised in the literature. Business travellers consume air services (i.e. they take airline flights), however; they may not be the principal decision-maker in the purchase. Also it is the organization that employs the traveller that incurs die cost for air travel. Consequently this research addresses the relationship between the traveller and the employing organisation in the purchase of air travel. In this paper traveller opinions on their corporate travel policy are evaluated using a Likert summated rating scale. The benefits sought, by the traveller, from the air service are also investigated and these benefits are used to segment the short haul business air travel market in the EU. Changes in the market for short haul business travel since the full liberalisation of the aviation market in-the EU are evaluated by comparing the data to an earlier study of similar travellers in 1992.

  18. Travel health prevention.

    PubMed

    Korzeniewski, Krzysztof

    All around the world there has been a rapid growth in the number of international travels. According to the World Tourism Organisation the number of international tourist arrivals reached 1,235 billion in 2016 and continues to grow at a high rate. This has been much due to the development of air transport (including low-cost airlines), increasingly common economic migration, a growing number of travellers visiting friends and relatives, and an increase in medical tourism. With tropical destinations becoming increasingly popular among travellers, doctors have seen a rising number of patients who seek medical advice on health risks prevalent in hot countries and health prevention measures to be taken in tropical destinations, especially where sanitation is poor. The risk for developing a medical condition while staying abroad depends on a variety of factors, including the traveller's general health condition, health prevention measures taken before or during travel (vaccinations, antimalarial chemoprophylaxis, health precautions during air, road and sea travel, proper acclimatisation, prevention of heat injuries, protection against local flora and fauna, personal hygiene, water, food and feeding hygiene), as well as the prevalence of health risk factors in a given location. Health prevention is a precondition for safe travel and maintaining good physical health; in the era of a rapid growth in international tourism it has become of key importance for all travellers.

  19. The impact of long-haul air travel on variables of the athlete's biological passport.

    PubMed

    Schumacher, Y O; Klodt, F; Nonis, D; Pottgiesser, T; Alsayrafi, M; Bourdon, P C; Voss, S C

    2012-12-01

    Dehydration, fluid shifts or changes in coagulation occurring during air travel can trigger distinct reactions in the haematological system. Athletes are concerned that these effects might impair sporting performance, increase the risk of thrombosis or cause abnormalities in blood values that might be mistaken for doping in the 'Athlete's biological passport' (ABP) a longitudinal monitoring of haematological variables in antidoping. The aim of the study was to investigate key variables of the ABP before and after a long-haul flight in athletes. Fifteen endurance athletes were submitted to ABP blood samples in the morning before and after arrival of an 8 h flight. Two additional samples were obtained in the morning and the evening 3 days after the travel. Twelve nontravelling subjects served as controls. Haemoglobin concentration was higher before than after travel in athletes (+0.5 g/dL, P = 0.038), a similar pattern was observed 3 days after the travel. No difference was observed in the control group. Reticulocyte% did not show any significant changes in neither of the groups. The observed changes are in line with normal diurnal variations. There is no indication that travel will affect haematological variables in way that might be mistaken for blood doping. © 2012 Blackwell Publishing Ltd.

  20. Managing patients with stable respiratory disease planning air travel: a primary care summary of the British Thoracic Society recommendations.

    PubMed

    Josephs, Lynn K; Coker, Robina K; Thomas, Mike

    2013-06-01

    Air travel poses medical challenges to passengers with respiratory disease, principally because of exposure to a hypobaric environment. In 2002 the British Thoracic Society published recommendations for adults and children with respiratory disease planning air travel, with a web update in 2004. New full recommendations and a summary were published in 2011, containing key recommendations for the assessment of high-risk patients and identification of those likely to require in-flight supplemental oxygen. This paper highlights the aspects of particular relevance to primary care practitioners with the following key points: (1) At cabin altitudes of 8000 feet (the usual upper limit of in-flight cabin pressure, equivalent to 0.75 atmospheres) the partial pressure of oxygen falls to the equivalent of breathing 15.1% oxygen at sea level. Arterial oxygen tension falls in all passengers; in patients with respiratory disease, altitude may worsen preexisting hypoxaemia. (2) Altitude exposure also influences the volume of any air in cavities, where pressure x volume remain constant (Boyle's law), so that a pneumothorax or closed lung bulla will expand and may cause respiratory distress. Similarly, barotrauma may affect the middle ear or sinuses if these cavities fail to equilibrate. (3) Patients with respiratory disease require clinical assessment and advice before air travel to: (a) optimise usual care; (b) consider contraindications to travel and possible need for in-flight oxygen; (c) consider the need for secondary care referral for further assessment; (d) discuss the risk of venous thromboembolism; and (e) discuss forward planning for the journey.

  1. Radiation Physics for Space and High Altitude Air Travel

    NASA Technical Reports Server (NTRS)

    Cucinotta, F. A.; Wilson, J. W.; Goldhagen, P.; Saganti, P.; Shavers, M. R.; McKay, Gordon A. (Technical Monitor)

    2000-01-01

    Galactic cosmic rays (GCR) are of extra-solar origin consisting of high-energy hydrogen, helium, and heavy ions. The GCR are modified by physical processes as they traverse through the solar system, spacecraft shielding, atmospheres, and tissues producing copious amounts of secondary radiation including fragmentation products, neutrons, mesons, and muons. We discuss physical models and measurements relevant for estimating biological risks in space and high-altitude air travel. Ambient and internal spacecraft computational models for the International Space Station and a Mars mission are discussed. Risk assessment is traditionally based on linear addition of components. We discuss alternative models that include stochastic treatments of columnar damage by heavy ion tracks and multi-cellular damage following nuclear fragmentation in tissue.

  2. Influence of travel speed on spray deposition uniformity from an air-assisted variable-rate sprayer

    USDA-ARS?s Scientific Manuscript database

    A newly developed LiDAR-guided air-assisted variable-rate sprayer for nursery and orchard applications was tested at various travel speeds to compare its spray deposition and coverage uniformity with constant-rate applications. Spray samplers, including nylon screens and water-sensitive papers (WSP)...

  3. Defense.gov Special Report: Travels With Fox

    Science.gov Websites

    2014 U.S. Army War College, Carlisle Barracks, Pa. U.S. Air War College, Maxwell Air Force Base, Ala Deputy Defense Secretary Christine H. Fox told airmen at the Air War College at Maxwell Air Force Base Base Travel Locations Travel Location: U.S. Naval War College, Newport, R.I. U.S. Army War College

  4. A one-year effective reproduction number of the 2014-2015 Ebola outbreaks in the widespread West African countries and quantitative evaluation of air travel restriction measure.

    PubMed

    Wiratsudakul, Anuwat; Triampo, Wannapong; Laosiritaworn, Yongjua; Modchang, Charin

    The 2014-2015 Ebola outbreak in West Africa is the largest and longest Ebola Virus Disease (EVD) outbreak in the history, and the virus has escaped across countries and continents via air travel in this outbreak. The interpolated data from WHO Ebola situation reports were used to estimate number of weekly infectious individuals and daily effective reproduction numbers (R t ) in Guinea, Liberia and Sierra Leone. A stochastic dynamic model was performed to estimate the risk of EVD importation into the top 20 final destination countries of air travelers departing from within the three epidemic countries, and the effectiveness of air travel restriction was subsequently evaluated. The daily R t was estimated at 0.72-1.32 in Guinea, 0.62-1.38 in Liberia and 0.81-1.38 in Sierra Leone. The peak of EVD importation probability was observed in early November 2014 and the restriction of air travel may mitigate the risk up to 67.7% (95% CI 66.6-68.7). Our results suggest that restriction of air travels is effective in reducing the risk of EVD importation but controlling of the virus at the original affected countries is vitally more important for preventing inter-terrestrial dissemination of EVD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. A comparison of greenhouse gas emissions and local area pollution of highspeed rail and air travel between Los Angeles and Las Vegas

    NASA Astrophysics Data System (ADS)

    Mullins, Damien

    Global warming is one of the most discussed global environmental issues in the world today. Global warming is driven by fossil fuel combustion emissions known as Green-house Gases (GHG). One of the major contributors to GHG emissions is the transport sector, emitting approximately 30% of total U.S. CO 2 emissions in 2010. Air travel contributed approximately 3.5% of total U.S. CO2 in 2008. High-speed Rail (HSR) is often touted as cleaner, more sustainable mode of transport than air travel. HSR is one of few modes of transport capable of competing with air travel for short to medium-haul distances. There has been considerable study of GHG emissions of each independently. Research has also been carried out into the economics and competition of these transport modes. However, there has been very limited study of the comparative emissions of each, apart from one study in Europe (Givoni, 2007). The current study was undertaken with the goal of quantifying potential emission savings due to mode substitution from air travel to HSR in the Los Angeles to Las Vegas corridor. This study only considered the emissions which occurred from the combustion of the relevant fuels, either in power plants or the engines of an aircraft. Emissions from fuel production/refining or transport of fuels were not considered. Another issue compared was Local Area Pollution (LAP), which is a measure of the severity of emissions effect on the environment. This was examined because all emissions from HSR occur close to the surface of the earth, and hence effect the local environment, while only a portion of aircraft emissions do. This study was carried out using internationally recognized emission inventory methodologies. For the air travel emission estimate methodologies and data published by the Intergovernmental Panel on Climate Change (IPCC) and the International Civil Aviation Organization (ICAO) were used. The HSR energy use was estimated from energy use data from currently running HSR

  6. Comparison of air pollution exposures in active vs. passive travel modes in European cities: A quantitative review.

    PubMed

    de Nazelle, Audrey; Bode, Olivier; Orjuela, Juan Pablo

    2017-02-01

    Transport microenvironments tend to have higher air pollutant concentrations than other settings most people encounter in their daily lives. The choice of travel modes may affect significantly individuals' exposures; however such considerations are typically not accounted for in exposure assessment used in environmental health studies. In particular, with increasing interest in the promotion of active travel, health impact studies that attempt to estimate potential adverse consequences of potential increased pollutant inhalation during walking or cycling have emerged. Such studies require a quantification of relative exposures in travel modes. The literature on air pollution exposures in travel microenvironments in Europe was reviewed. Studies which measured various travel modes including at least walking or cycling in a simultaneous or quasi-simultaneous design were selected. Data from these studies were harmonized to allow for a quantitative synthesis of the estimates. Ranges of ratios and 95% confidence interval (CI) of air pollution exposure between modes and between background and transportation modes were estimated. Ten studies measuring fine particulate matter (PM 2.5 ), black carbon (BC), ultrafine particles (UFP), and/or carbon monoxide (CO) in the walk, bicycle, car and/or bus modes were included in the analysis. Only three reported on CO and BC and results should be interpreted with caution. Pedestrians were shown to be the most consistently least exposed of all across studies, with the bus, bicycle and car modes on average 1.3 to 1.5 times higher for PM 2.5 ; 1.1 to 1.7 times higher for UFP; and 1.3 to 2.9 times higher for CO; however the 95% CI included 1 for the UFP walk to bus ratio. Only for BC were pedestrians more exposed than bus users on average (bus to walk ratio 0.8), but remained less exposed than those on bicycles or in cars. Car users tended to be the most exposed (from 2.9 times higher than pedestrians for BC down to similar exposures to

  7. Air pollution and general practitioner access and utilization: a population based study in Sarnia, 'Chemical Valley,' Ontario

    PubMed Central

    2011-01-01

    Background Health impacts of poor environmental quality have been identified in studies around the world and in Canada. While many of the studies have identified associations between air pollution and mortality or morbidity, few have focused on the role of health care as a potential moderator of impacts. This study assessed the determinants of health care access and utilization in the context of ambient air pollution in Sarnia, Ontario, Canada. Methods Residents of Sarnia participated in a Community Health Study administered by phone, while several ambient air pollutants including nitrogen dioxide (NO2), sulphur dioxide (SO2) and the volatile organic compounds benzene, toluene, ethylbenzene, mp- and o-xylene (BTEX) were monitored across the city. Land Use Regression models were used to estimate individual exposures to the measured pollutants and logistic regression models were utilized to assess the relative influence of environmental, socioeconomic and health related covariates on general practitioner access and utilization outcomes. Results The results show that general practitioner use increased with levels of exposure to nitrogen dioxide (NO2- Odds Ratio [OR]: 1.16, p < 0.05) and sulphur dioxide (SO2- OR: 1.61, p < 0.05). Low household income was a stronger predictor of having no family doctor in areas exposed to high concentrations of NO2 and SO2. Respondents without regular care living in high pollution areas were also more likely to report travelling or waiting for care in excess of 20 minutes (OR: 3.28, p < 0.05) than their low exposure counterparts (OR: 1.11, p > 0.05). Conclusions This study provides evidence for inequitable health care access and utilization in Sarnia, with particular relevance to its situation as a sentinel high exposure environment. Levels of exposure to pollution appears to influence utilization of health care services, but poor access to primary health care services additionally burden certain groups in Sarnia, Ontario, Canada. PMID

  8. 14 CFR 382.51 - What requirements must carriers meet concerning the accessibility of airport facilities?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false What requirements must carriers meet concerning the accessibility of airport facilities? 382.51 Section 382.51 Aeronautics and Space OFFICE OF THE... BASIS OF DISABILITY IN AIR TRAVEL Accessibility of Airport Facilities § 382.51 What requirements must...

  9. 14 CFR 382.51 - What requirements must carriers meet concerning the accessibility of airport facilities?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false What requirements must carriers meet concerning the accessibility of airport facilities? 382.51 Section 382.51 Aeronautics and Space OFFICE OF THE... BASIS OF DISABILITY IN AIR TRAVEL Accessibility of Airport Facilities § 382.51 What requirements must...

  10. Pulmonary artery pressure increases during commercial air travel in healthy passengers.

    PubMed

    Smith, Thomas G; Talbot, Nick P; Chang, Rae W; Wilkinson, Elizabeth; Nickol, Annabel H; Newman, David G; Robbins, Peter A; Dorrington, Keith L

    2012-07-01

    It is not known whether the mild hypoxia experienced by passengers during commercial air travel triggers hypoxic pulmonary vasoconstriction and increases pulmonary artery pressure in flight. Insidious pulmonary hypertensive responses could endanger susceptible passengers who have cardiopulmonary disease or increased hypoxic pulmonary vascular sensitivity. Understanding these effects may improve pre-flight assessment of fitness-to-fly and reduce in-flight morbidity and mortality. Eight healthy volunteers were studied during a scheduled commercial airline flight from London, UK, to Denver, CO. The aircraft was a Boeing 777 and the duration of the flight was 9 h. Systolic pulmonary artery pressure (sPAP) was assessed by portable Doppler echocardiography during the flight and over the following week in Denver, where the altitude (5280 ft/1610 m) simulates a commercial airliner environment. Cruising cabin altitude ranged between 5840 and 7170 ft (1780 to 2185 m), and mean arterial oxygen saturation was 95 +/- 0.6% during the flight. Mean sPAP increased significantly in flight by 6 +/- 1 mmHg to 33 +/- 1 mmHg, an increase of approximately 20%. After landing in Denver, sPAP was still 3 +/- 1 mmHg higher than baseline and remained elevated at 30 +/- 1 mmHg for a further 12 h. Pulmonary artery pressure increases during commercial air travel in healthy passengers, raising the possibility that hypoxic pulmonary hypertension could develop in susceptible individuals. A hypoxia altitude simulation test with simultaneous echocardiography ('HAST-echo') may be beneficial in assessing fitness to fly in vulnerable patients.

  11. 14 CFR 382.63 - What are the requirements for accessible lavatories?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false What are the requirements for accessible lavatories? 382.63 Section 382.63 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL...

  12. 14 CFR 382.63 - What are the requirements for accessible lavatories?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false What are the requirements for accessible lavatories? 382.63 Section 382.63 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL...

  13. 14 CFR 382.63 - What are the requirements for accessible lavatories?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false What are the requirements for accessible lavatories? 382.63 Section 382.63 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL...

  14. 14 CFR 382.63 - What are the requirements for accessible lavatories?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false What are the requirements for accessible lavatories? 382.63 Section 382.63 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL...

  15. 14 CFR 382.63 - What are the requirements for accessible lavatories?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false What are the requirements for accessible lavatories? 382.63 Section 382.63 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL...

  16. Long-range airplane study: The consumer looks at SST travel

    NASA Technical Reports Server (NTRS)

    Landes, K. H.; Matter, J. A.

    1980-01-01

    The attitudes of long-range air travelers toward several basic air travel decisions, were surveyed. Of interest were tradeoffs involving time versus comfort and time versus cost as they pertain to supersonic versus conventional wide-body aircraft on overseas routes. The market focused upon was the segment of air travelers most likely to make that type of tradeoff decision: those having flown overseas routes for business or personal reasons in the recent past. The information generated is intended to provide quantifiable insight into consumer demand for supersonic as compared to wide-body aircraft alternatives for long-range overseas air travel.

  17. Many intercity travelers face longer travel schedules

    DOT National Transportation Integrated Search

    2003-10-01

    Since 1995, scheduled travel times for direct : intercity air, bus, and rail service without an en : route transfer have measurably lengthened in : most major-market city-pairs. : Long-haul rail city-pairs affected by service : changes and short-...

  18. Modeling the impact of air, sea, and land travel restrictions supplemented by other interventions on the emergence of a new influenza pandemic virus

    PubMed Central

    2012-01-01

    Background During the early stages of a new influenza pandemic, travel restriction is an immediate and non-pharmaceutical means of retarding incidence growth. It extends the time frame of effective mitigation, especially when the characteristics of the emerging virus are unknown. In the present study, we used the 2009 influenza A pandemic as a case study to evaluate the impact of regulating air, sea, and land transport. Other government strategies, namely, antivirals and hospitalizations, were also evaluated. Methods Hong Kong arrivals from 44 countries via air, sea, and land transports were imported into a discrete stochastic Susceptible, Exposed, Infectious and Recovered (SEIR) host-flow model. The model allowed a number of latent and infectious cases to pass the border, which constitutes a source of local disease transmission. We also modeled antiviral and hospitalization prevention strategies to compare the effectiveness of these control measures. Baseline reproduction rate was estimated from routine surveillance data. Results Regarding air travel, the main route connected to the influenza source area should be targeted for travel restrictions; imposing a 99% air travel restriction delayed the epidemic peak by up to two weeks. Once the pandemic was established in China, the strong land connection between Hong Kong and China rendered Hong Kong vulnerable. Antivirals and hospitalization were found to be more effective on attack rate reductions than travel restrictions. Combined strategies (with 99% restriction on all transport modes) deferred the peak for long enough to establish a vaccination program. Conclusion The findings will assist policy-makers with decisions on handling similar future pandemics. We also suggest regulating the extent of restriction and the transport mode, once restriction has been deemed necessary for pandemic control. Although travel restrictions have yet to gain social acceptance, they allow time for mitigation response when a new and

  19. Deep venous thrombosis associated with corporate air travel.

    PubMed

    Dimberg, L A; Mundt, K A; Sulsky, S I; Liese, B H

    2001-01-01

    Deep venous thrombosis (DVT) is commonly seen among bedridden and postoperative patients. Its association with travel may also make DVT an occupational health risk to otherwise healthy business travelers. We estimated the incidence of and risk factors for DVT among 8,189 World Bank employees and a subset of 4,951 international business travelers. Occurrence of DVT between 1995 and 1998 was determined using 1) medical insurance claims; 2) Workers' Compensation claims; and 3) intra-office E-mail solicitation followed by interview. For each insurance claim case, 10 controls were randomly selected from among World Bank employees insured during the same month and year as the case's claim was filed, and case-control analyses were performed to identify potential predictors or risk factors for DVT. Thirty individuals filed claims for DVT of the legs (annual incidence rate: 0.9 per 1,000 employees); three of these claims were filed within 30 days after a travel mission. Two employees reported DVT as a Workers' Compensation injury, and five staff with verified DVT participated in interviews. After controlling for age and gender, no association with any travel-related covariate was seen. Results of analyses considering all thrombophlebitis and thromboembolism followed the same pattern. The average annual incidence of DVT occurring within 30 days of mission among traveling staff ranged from 0.10 per 1,000 to 0.25 per 1,000 travelers, depending on the case-finding method. No association between DVT and travel was observed after adjustment for gender and age. These results, however, are preliminary, and due to the rarity of DVT, based on small numbers.

  20. Air travel forecasting : 1965-1975

    DOT National Transportation Integrated Search

    1957-01-01

    The forecast presented herein illustrates methods developed by The Port of New York Authority for measuring the market for travel by application of national survey findings to the census : of population and national population projections furnished b...

  1. Air travel and pregnancy outcomes: a review of pregnancy regulations and outcomes for passengers, flight attendants, and aviators.

    PubMed

    Magann, Everett F; Chauhan, Suneet P; Dahlke, Joshua D; McKelvey, Samantha S; Watson, Erin M; Morrison, John C

    2010-06-01

    To review flight regulations and gestational complications associated with air travel in pregnant passengers, flight attendants, and aviators. A literature search was undertaken on the relationship of air travel and spontaneous pregnancy losses, intrauterine fetal demise (IUFD), birth weight<10th percentile, preterm delivery, and neonatal intensive care unit admissions. The literature search identified 128 abstracts, of which 9 evaluated air travel and pregnancy outcomes. The risk of a pregnancy loss (spontaneous abortion or IUFD) was greater in flight attendants than controls (odds ratio [OR]: 1.62, 95% confidence interval [CI]: 1.29, 2.04). The risk of preterm birth<37 weeks was greater in passengers than controls (OR: 1.44, 95% CI: 1.07, 1.93). However, the risk of preeclampsia (OR: 0.86, 95% CI: 0.58, 1.27), neonatal intensive care unit admissions (OR: 1.19, 95% CI: 0.78, 1.82), or birth weight<10th percentile (OR: 1.25, 95% CI: 0.62, 2.48) was not increased. Flight attendants did not have an increased risk of preterm birth compared to controls (OR: 1.37, 95% CI: 0.85, 2.22) or delivering infants with birth weight<10th percentile (OR: 1.57, 95% CI: 0.68, 3.74). The risks of spontaneous abortions and other adverse pregnancy outcomes have been poorly studied in a limited number of investigations. An analysis of the available information suggests a greater risk of spontaneous abortions or IUFD in flight attendants, and a greater risk of preterm birth<37 weeks in air passengers. However, the literature on which these findings are based is generally not of high methodologic quality.

  2. Paediatric international travellers from Greece: characteristics and pre-travel recommendations.

    PubMed

    Maltezou, Helena C; Pavli, Androula; Spilioti, Athina; Katerelos, Panos; Theodoridou, Maria

    2012-05-01

    The aim of this study was to describe the children who seek pre-travel advice in Greece. During 2008-2010, 4065 persons sought pre-travel services in the 57 Prefectures, including 128 (3.15%) children <15 years. Main travel destinations were sub-Saharan Africa (54 children; 42.2%), South America (18; 14.1%), the Middle East (16; 12.5%), the Indian subcontinent (12; 9.4%), and South East Asia (7; 5.5%). Seventy-six children (59.4%) stayed for <1 month, 34 (26.6%) for 1-6 months, and 10 (7.8%) for >6 months. Recreation was the main purpose of travel (81 children; 63.3%), followed by work (24; 18.8%), and to visit friends and relatives (VFRs) (14; 10.9%). Paediatric travellers VFRs stayed more frequently in local residences compared to non-VFR paediatric travellers (85.7% and 20.2%). Children stayed more frequently in local residences and travelled more frequently for recreational purposes or to VFRs (27.3%, 63.3%, and 10.9%, respectively), compared to older travellers (11.9%, 58.8%, and 4%, respectively). Malaria chemoprophylaxis was prescribed for 64.8% of children travelling to sub-Saharan Africa. This study demonstrated clearly that only a very small number of international paediatric travellers seek pre-travel services in Greece. Communication strategies to access paediatric travellers should be developed in order to improve travel medicine services for children in Greece. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Ontogenetic changes and developmental adjustments in lactate dehydrogenase isozymes of an obligate air-breathing fish Channa punctatus during deprivation of air access.

    PubMed

    Ahmad, Riaz; Hasnain, Absar-Ul

    2005-02-01

    In air-breathing snakehead Channa punctatus, Ldh-B is expressed at all ontogenetic and developmental stages, while Ldh-A is expressed temporally in pre-hatchlings 12-13 days ahead of bimodal respiration marked by air-breathing. Remarkable differences are observed in the LDH isozyme expression among various ontogenetic and developmental stages upon denying air access. When denied air access, water-breathing larvae show two distinct characteristics: (i) they survive longer than transitory air-breathers due to independence from air-breathing and (ii) there is more transient induction of Ldh-B than Ldh-A. Transition to bimodal breathing, which occurred post-hatching in 15-day old larvae, is coincidental with inducibility of Ldh-A and concomitant down-regulation of Ldh-B. Heart tissue from air-breathing adults denied air access shows a preferential expression of LDH-A subunit and slight down-regulation of LDH-B. Heterotetramers of A and B subunits participate in adjusting LDH levels among those stages which either precede air-breathing switchover, or are subsequent to this transition. The contribution of heterotetramers depends on the stage-specific levels of LDH homotetramers A(4) or B(4). Scaling of muscle mass during growth, tolerance to extended deprivation of air access and induction of Ldh-A are correlated. Response to restoring air contact indicated that advanced air-breathing stages of C. punctatus possess an inherent capacity to sense surface air. In kinetic properties, LDH isozymes of C. punctatus are teleost-like but species specificity is displayed in oxidative potential by cardiac muscle and in L-lactate reduction by skeletal muscle.

  4. Nurse-delivered universal point-of-care testing for HIV in an open-access returning traveller clinic.

    PubMed

    Herbert, R; Ashraf, A N; Yates, T A; Spriggs, K; Malinnag, M; Durward-Brown, E; Phillips, D; Mewse, E; Daniel, A; Armstrong, M; Kidd, I M; Waite, J; Wilks, P; Burns, F; Bailey, R; Brown, M

    2012-09-01

    Early diagnosis of HIV infection reduces morbidity and mortality associated with late presentation. Despite UK guidelines, the HIV testing rate has not increased. We have introduced universal HIV screening in an open-access returning traveller clinic. Data were prospectively recorded for all patients attending the open-access returning traveller clinic between August 2008 and December 2010. HIV testing was offered to all patients from May 2009; initially testing with laboratory samples (phase 1) and subsequently a point-of-care test (POCT) (phase 2). A total of 4965 patients attended the clinic; 1342 in phase 0, 792 in phase 1 and 2831 in phase 2. Testing rates for HIV increased significantly from 2% (38 of 1342) in phase 0 to 23.1% (183 of 792) in phase 1 and further increased to 44.5% (1261 of 2831) during phase 2 (P < 0.0001). Two new diagnoses of HIV-1 were identified in phase 1 (1.1% of tested); seven patients had a reactive POCT test in phase 2, of whom five (0.4% of those tested) were confirmed in a 4th generation assay. The patients with false reactive tests had a concurrent Plasmodium falciparum infection. Patients travelling to the Middle East and Europe were less likely to accept an HIV test with POCT. A nurse-delivered universal point-of-care HIV testing service has been successfully introduced and sustained in an acute medical clinic in a low-prevalence country. Caution is required in communicating reactive results in low-prevalence settings where there may be alternative diagnoses or a low population prevalence of HIV infection. © 2012 British HIV Association.

  5. Active Travel Behavior in a Border Region of Texas and New Mexico: Motivators, Deterrents, and Characteristics.

    PubMed

    Sener, Ipek N; Lee, Richard J

    2017-08-01

    Active travel has been linked with improved transportation and health outcomes, such as reduced traffic congestion and air pollution, improved mobility, accessibility, and equity, and increased physical and mental health. The purpose of this study was to better understand active travel characteristics, motivators, and deterrents in the El Paso, TX, region. A multimodal transportation survey brought together elements of transportation and health, with a focus on attitudinal characteristics. The analysis consisted of an initial descriptive analysis, spatial analysis, and multivariate binary and ordered-response models of walking and bicycling behavior. The motivators and deterrents of active travel differed for walkers, bicyclists, and noncyclists interested in bicycling. The link between active travel and life satisfaction was moderated by age, with a negative association for older travelers. This effect was stronger for bicycling than it was for walking. Based on the findings, several interventions to encourage walking and bicycling were suggested. These included infrastructure and built environment enhancements, workplace programs, and interventions targeting specific subpopulations.

  6. Pre-travel counselling in Greece for travellers visiting friends and relatives.

    PubMed

    Pavli, Androula; Katerelos, Panagiotis; Pierroutsakos, Ioannis N; Maltezou, Helen C

    2009-09-01

    Pre-travel services are underused by travellers visiting friends and relatives (VFRs). The objective of this study was to define the proportion and the profile of VFRs who seek pre-travel counselling in Greece. The study was conducted prospectively, from July, 2005 to December, 2007, in seven Health Departments of the Prefectures in Athens and Attica, where 35.6% of the Greek population resides; migrants account for 17% and 8% of the population in these areas, respectively. 2548 travellers seeking pre-travel advice were studied; 23 (0.9%) were identified as VFRs. Children younger than 15 years accounted for 30.4% of VFRs, compared to 2.3% among non-VFRs. VFRs were younger than non-VFRs (mean ages: 29.9 versus 40.4 years, respectively). A comparison of VFRs with non-VFRs revealed that VFRs travelled for longer periods of time, stayed at local people's home more frequently (87% versus 15.5%), and travelled on an organized trip less frequently (4.3% versus 54.6%). Considering the fact that 36,056 VFRs travelled from Greece to Africa and Asia during 2005-2007, and that only 1 out of 700 VFRs to these destinations pre-travel advice in Greece, communication strategies to access efficiently this group of travellers should be explored urgently.

  7. Travel During Pregnancy: Considerations for the Obstetric Provider.

    PubMed

    Antony, Kathleen M; Ehrenthal, Deborah; Evensen, Ann; Iruretagoyena, J Igor

    2017-02-01

    Travel among US citizens is becoming increasingly common, and travel during pregnancy is also speculated to be increasingly common. During pregnancy, the obstetric provider may be the first or only clinician approached with questions regarding travel. In this review, we discuss the reasons women travel during pregnancy, medical considerations for long-haul air travel, destination-specific medical complications, and precautions for pregnant women to take both before travel and while abroad. To improve the quality of pretravel counseling for patients before or during pregnancy, we have created 2 tools: a guide for assessing the pregnant patient's risk during travel and a pretravel checklist for the obstetric provider. A PubMed search for English-language publications about travel during pregnancy was performed using the search terms "travel" and "pregnancy" and was limited to those published since the year 2000. Studies on subtopics were not limited by year of publication. Eight review articles were identified. Three additional studies that analyzed data from travel clinics were found, and 2 studies reported on the frequency of international travel during pregnancy. Additional publications addressed air travel during pregnancy (10 reviews, 16 studies), high-altitude travel during pregnancy (5 reviews, 5 studies), and destination-specific illnesses in pregnant travelers. Travel during pregnancy including international travel is common. Pregnant travelers have unique travel-related and destination-specific risks. We review those risks and provide tools for obstetric providers to use in counseling pregnant travelers.

  8. 14 CFR 1260.36 - Travel and transportation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Travel and transportation. 1260.36 Section... AGREEMENTS General Provisions § 1260.36 Travel and transportation. Travel and Transportation October 2000 (a... international air transportation of personnel and property to the extent that service by those carriers is...

  9. Association Between Geographic Access to Cancer Care, Insurance, and Receipt of Chemotherapy: Geographic Distribution of Oncologists and Travel Distance.

    PubMed

    Lin, Chun Chieh; Bruinooge, Suanna S; Kirkwood, M Kelsey; Olsen, Christine; Jemal, Ahmedin; Bajorin, Dean; Giordano, Sharon H; Goldstein, Michael; Guadagnolo, B Ashleigh; Kosty, Michael; Hopkins, Shane; Yu, James B; Arnone, Anna; Hanley, Amy; Stevens, Stephanie; Hershman, Dawn L

    2015-10-01

    Geographic access to care may be associated with receipt of chemotherapy but has not been fully examined. This study sought to evaluate the association between density of oncologists and travel distance and receipt of adjuvant chemotherapy for colon cancer within 90 days of colectomy. Patients in the National Cancer Data Base with stage III colon cancer, diagnosed between 2007 and 2010, and age 18 to 80 years were selected. Generalized estimating equation clustering by hospital service area was conducted to examine the association between geographic access and receipt of oncology services, controlling for patient sociodemographic and clinical characteristics. Of 34,694 patients in the study cohort, 75.7% received adjuvant chemotherapy within 90 days of colectomy. Compared with travel distance less than 12.5 miles, patients who traveled 50 to 249 miles (odds ratio [OR], 0.87; P=.009) or ≥250 miles (OR, 0.36; P<.001) had decreased likelihood of receiving adjuvant chemotherapy. Density level of oncologists was not statistically associated with receipt of adjuvant chemotherapy (low v high density: OR, 0.98; P=.77). When stratifying analyses by insurance status, non-privately insured patients who resided in areas with low density of oncologists were less likely to receive adjuvant chemotherapy (OR, 0.85; P=.03). Increased travel burden was associated with a decreased likelihood of receiving adjuvant chemotherapy, regardless of insurance status. Patients with nonprivate insurance who resided in low-density oncologist areas were less likely to receive adjuvant chemotherapy. If these findings are validated prospectively, interventions to decrease geographic barriers may improve the timeliness and quality of colon cancer treatment. © 2015 by American Society of Clinical Oncology.

  10. Association Between Geographic Access to Cancer Care, Insurance, and Receipt of Chemotherapy: Geographic Distribution of Oncologists and Travel Distance

    PubMed Central

    Lin, Chun Chieh; Bruinooge, Suanna S.; Kirkwood, M. Kelsey; Olsen, Christine; Jemal, Ahmedin; Bajorin, Dean; Giordano, Sharon H.; Goldstein, Michael; Guadagnolo, B. Ashleigh; Kosty, Michael; Hopkins, Shane; Yu, James B.; Arnone, Anna; Hanley, Amy; Stevens, Stephanie; Hershman, Dawn L.

    2015-01-01

    Purpose Geographic access to care may be associated with receipt of chemotherapy but has not been fully examined. This study sought to evaluate the association between density of oncologists and travel distance and receipt of adjuvant chemotherapy for colon cancer within 90 days of colectomy. Patients and Methods Patients in the National Cancer Data Base with stage III colon cancer, diagnosed between 2007 and 2010, and age 18 to 80 years were selected. Generalized estimating equation clustering by hospital service area was conducted to examine the association between geographic access and receipt of oncology services, controlling for patient sociodemographic and clinical characteristics. Results Of 34,694 patients in the study cohort, 75.7% received adjuvant chemotherapy within 90 days of colectomy. Compared with travel distance less than 12.5 miles, patients who traveled 50 to 249 miles (odds ratio [OR], 0.87; P = .009) or ≥ 250 miles (OR, 0.36; P < .001) had decreased likelihood of receiving adjuvant chemotherapy. Density level of oncologists was not statistically associated with receipt of adjuvant chemotherapy (low v high density: OR, 0.98; P = .77). When stratifying analyses by insurance status, non–privately insured patients who resided in areas with low density of oncologists were less likely to receive adjuvant chemotherapy (OR, 0.85; P = .03). Conclusion Increased travel burden was associated with a decreased likelihood of receiving adjuvant chemotherapy, regardless of insurance status. Patients with nonprivate insurance who resided in low-density oncologist areas were less likely to receive adjuvant chemotherapy. If these findings are validated prospectively, interventions to decrease geographic barriers may improve the timeliness and quality of colon cancer treatment. PMID:26304878

  11. The Short Haul Air Travel Market: Evaluation of New Forms of Service

    NASA Technical Reports Server (NTRS)

    Couts, D. A.

    1972-01-01

    Aspects of the demand for air travel and an approach for incorporating them in evaluations of new services are discussed. The approach as described here is being used to evaluate the market for STOL aircraft in the 1980's but it could just as well be used to evaluate the market effects of schedule changes, equipment changes, and new routes, if certain basic data relating these changes to demand are available. A most important change in the market which is likely to take place in the next fifteen years, and which is already underway, is the increasing availability of alternative airports in major cities.

  12. Effect of hypobaric hypoxia, simulating conditions during long-haul air travel, on coagulation, fibrinolysis, platelet function, and endothelial activation.

    PubMed

    Toff, William D; Jones, Chris I; Ford, Isobel; Pearse, Robert J; Watson, Henry G; Watt, Stephen J; Ross, John A S; Gradwell, David P; Batchelor, Anthony J; Abrams, Keith R; Meijers, Joost C M; Goodall, Alison H; Greaves, Michael

    2006-05-17

    The link between long-haul air travel and venous thromboembolism is the subject of continuing debate. It remains unclear whether the reduced cabin pressure and oxygen tension in the airplane cabin create an increased risk compared with seated immobility at ground level. To determine whether hypobaric hypoxia, which may be encountered during air travel, activates hemostasis. A single-blind, crossover study, performed in a hypobaric chamber, to assess the effect of an 8-hour seated exposure to hypobaric hypoxia on hemostasis in 73 healthy volunteers, which was conducted in the United Kingdom from September 2003 to November 2005. Participants were screened for factor V Leiden G1691A and prothrombin G20210A mutation and were excluded if they tested positive. Blood was drawn before and after exposure to assess activation of hemostasis. Individuals were exposed alternately (> or =1 week apart) to hypobaric hypoxia, similar to the conditions of reduced cabin pressure during commercial air travel (equivalent to atmospheric pressure at an altitude of 2438 m), and normobaric normoxia (control condition; equivalent to atmospheric conditions at ground level, circa 70 m above sea level). Comparative changes in markers of coagulation activation, fibrinolysis, platelet activation, and endothelial cell activation. Changes were observed in some hemostatic markers during the normobaric exposure, attributed to prolonged sitting and circadian variation. However, there were no significant differences between the changes in the hypobaric and the normobaric exposures. For example, the median difference in change between the hypobaric and normobaric exposure was 0 ng/mL for thrombin-antithrombin complex (95% CI, -0.30 to 0.30 ng/mL); -0.02 [corrected] nmol/L for prothrombin fragment 1 + 2 (95% CI, -0.03 to 0.01 nmol/L); 1.38 ng/mL for D-dimer (95% CI, -3.63 to 9.72 ng/mL); and -2.00% for endogenous thrombin potential (95% CI, -4.00% to 1.00%). Our findings do not support the hypothesis

  13. A Heart for Travel: Travel Health Considerations for Patients with Heart Disease and Cardiac Devices.

    PubMed

    Flaherty, G; De Freitas, S

    2016-12-12

    Cardiovascular disease is the leading cause of death in adult international travellers. Patients living with heart disease should receive specific, individualised pre-travel health advice. The purpose of this article is to provide evidence-based advice to physicians who are consulted by travellers with cardiovascular disease. Fitness-to-travel evaluation will often be conducted by the general practitioner but other medical specialists may also be consulted for advice. Patients with chronic medical conditions should purchase travel health insurance. The general pre-travel health consultation addresses food and water safety, insect and animal bite avoidance, malaria chemoprophylaxis, and travel vaccinations. Patients with devices such as cardiac pacemakers should be familiar with how these may be affected by travel. Cardiac medications may cause adverse effects in cold or hot environments, and specific precautions must be followed by anticoagulated travellers. The physician should be aware of how to access medical care abroad, and of the potential for imported tropical diseases in returned travellers.

  14. President's Address: Travel Medicine and Principles of Safe Travel

    PubMed Central

    DuPont, Herbert L.

    2008-01-01

    Persons crossing international boundaries away from their medical support systems are put at risk for illness and injury. Travel medicine is a new medical discipline that quantifies these health risks and develops strategies for reducing them. Obtaining health and evacuation insurance for a future trip is important for persons with medical conditions, those planning trips to developing tropical or semi-tropical regions of the world or when an international stay anywhere will be as long as a month. Pre-travel medical evaluation, vaccines against endemic infectious diseases and medications to reduce the occurrence of diarrhea and malaria during trips to endemic areas, and medications for self-treatment of common illnesses such as diarrhea are fundamental to travel medicine. There are a number of miscellaneous areas to consider in travel medicine including preventing deep vein thrombosis and minimizing jet lag during long haul air travel and reducing the occurrence of accidents and water- and altitude-related illnesses. An important recently defined challenge to the field is the growing number of ill-prepared persons put at great risk for illness while visiting friends and relatives living in areas of reduced hygiene. All persons need to have an idea of how and where they may find medical care if they develop illness while abroad. This article summarizes essential elements in travel medicine and offers 10 recommendations for safe travel. PMID:18596858

  15. Air travel and venous thromboembolism: minimizing the risk.

    PubMed

    Bartholomew, John R; Schaffer, Jonathan L; McCormick, Georges F

    2011-02-01

    For those traveling on long flights, the risk of deep vein thrombosis or pulmonary embolism, generally referred to as venous thromboembolism (VTE), is real and dangerous if left unrecognized or untreated. The goal of this publication is to provide an overview of how best to prevent VTE during travel, and how to diagnose and treat it.

  16. 48 CFR 752.7002 - Travel and transportation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... referred to as the Standardized Regulations—as from time to time amended, for not more than the travel time...” clause of this contract, time spent away from post resulting from educational travel will be counted as... time amended, for not more than the travel time required by scheduled commercial air carrier using the...

  17. Information for Handicapped Travelers. Reference Circular No. 87-3.

    ERIC Educational Resources Information Center

    Nussbaum, Ruth, Comp.

    This circular provides information about travel agencies, travel information centers, and transportation services based on descriptive literature provided by companies and organizations that offer services to handicapped travelers; access guides to specific cities and tourist sites are not included. The first section lists books on travel for the…

  18. 14 CFR § 1260.36 - Travel and transportation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Travel and transportation. § 1260.36... COOPERATIVE AGREEMENTS General Provisions § 1260.36 Travel and transportation. Travel and Transportation... carriers for international air transportation of personnel and property to the extent that service by those...

  19. Current legal framework and practical aspects of oxygen therapy during air travel.

    PubMed

    Cascante-Rodrigo, Jose Antonio; Iridoy-Zulet, Amaia Atenea; Alfonso-Imízcoz, María

    2015-01-01

    It is unusual for pulmonologists to be familiar with the European and US regulations governing the administration of oxygen during air travel and each airline's policy in this respect. This lack of knowledge is in large part due to the scarcity of articles addressing this matter in specialized journals and the noticeably limited information provided by airlines on their websites. In this article we examine the regulations, the policies of some airlines and practical aspects that must be taken into account, so that the questions of a patient who may need to use oxygen during a flight may be answered satisfactorily. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  20. The challenge of global water access monitoring: evaluating straight-line distance versus self-reported travel time among rural households in Mozambique.

    PubMed

    Ho, Jeff C; Russel, Kory C; Davis, Jennifer

    2014-03-01

    Support is growing for the incorporation of fetching time and/or distance considerations in the definition of access to improved water supply used for global monitoring. Current efforts typically rely on self-reported distance and/or travel time data that have been shown to be unreliable. To date, however, there has been no head-to-head comparison of such indicators with other possible distance/time metrics. This study provides such a comparison. We examine the association between both straight-line distance and self-reported one-way travel time with measured route distances to water sources for 1,103 households in Nampula province, Mozambique. We find straight-line, or Euclidean, distance to be a good proxy for route distance (R(2) = 0.98), while self-reported travel time is a poor proxy (R(2) = 0.12). We also apply a variety of time- and distance-based indicators proposed in the literature to our sample data, finding that the share of households classified as having versus lacking access would differ by more than 70 percentage points depending on the particular indicator employed. This work highlights the importance of the ongoing debate regarding valid, reliable, and feasible strategies for monitoring progress in the provision of improved water supply services.

  1. 14 CFR 382.51 - What requirements must carriers meet concerning the accessibility of airport facilities?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false What requirements must carriers meet concerning the accessibility of airport facilities? 382.51 Section 382.51 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL...

  2. 14 CFR 382.51 - What requirements must carriers meet concerning the accessibility of airport facilities?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false What requirements must carriers meet concerning the accessibility of airport facilities? 382.51 Section 382.51 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL...

  3. 14 CFR 382.51 - What requirements must carriers meet concerning the accessibility of airport facilities?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false What requirements must carriers meet concerning the accessibility of airport facilities? 382.51 Section 382.51 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL...

  4. Traveling with Inflammatory Bowel Disease (IBD)

    MedlinePlus

    ... of restrooms related to their daily routines. Treat travel time with the same respect. When booking a reserved ... Check it out before you embark on air travel; you may need to make a verbal ... have them with you at all times. You will be able to purchase water and ...

  5. Federal travel restrictions to prevent disease transmission in the United States: An analysis of requested travel restrictions.

    PubMed

    Jungerman, M Robynne; Vonnahme, Laura A; Washburn, Faith; Alvarado-Ramy, Francisco

    Individuals with certain communicable diseases may pose risks to the health of the traveling public; there has been documented transmission on commercial aircraft of tuberculosis (TB), measles, and severe acute respiratory syndrome (SARS). Federal public health travel restrictions (PHTR) prevent commercial air or international travel of persons with communicable diseases that pose a public health threat. We described demographics and clinical characteristics of all cases considered for PHTR because of suspected or confirmed communicable disease from May 22, 2007, to December 31, 2015. We reviewed 682 requests for PHTR; 414 (61%) actions were completed to place 396 individuals on PHTR. The majority (>99%) had suspected (n = 27) or confirmed (n = 367) infectious pulmonary TB; 58 (16%) had multidrug-resistant-TB. There were 128 (85%) interceptions that prevented the initiation or continuation of travel. PHTR were removed for 310 (78%) individuals after attaining noninfectious status and 86 (22%) remained on PHTR at the end of the analysis period. PHTR effectively prevent exposure during commercial air travel to persons with potentially infectious diseases. In addition, they are effective tools available to public health agencies to prevent commercial travel of individuals with certain communicable diseases and possibly reconnect them with public health authorities. Published by Elsevier Ltd.

  6. Federal Travel Restrictions to Prevent Disease Transmission in the United States: an analysis of requested travel restrictions

    PubMed Central

    Jungerman, M. Robynne; Vonnahme, Laura A.; Washburn, Faith; Alvarado-Ramy, Francisco

    2017-01-01

    Background Individuals with certain communicable diseases may pose risks to the health of the traveling public; there has been documented transmission on commercial aircraft of tuberculosis (TB), measles, and severe acute respiratory syndrome (SARS). Federal public health travel restrictions (PHTR) prevent commercial air or international travel of persons with communicable diseases that pose a public health threat. Methods We described demographics and clinical characteristics of all cases considered for PHTR because of suspected or confirmed communicable disease from May 22, 2007, to December 31, 2015. Results We reviewed 682 requests for PHTR; 414 (61%) actions were completed to place 396 individuals on PHTR. The majority (>99%) had suspected (n=27) or confirmed (n=367) infectious pulmonary TB; 58 (16%) had multidrug-resistant-TB. There were 128 (85%) interceptions that prevented the initiation or continuation of travel. PHTR were removed for 310 (78%) individuals after attaining noninfectious status and 86 (22%) remained on PHTR at the end of the analysis period. Conclusions PHTR effectively prevent exposure during commercial air travel to persons with potentially infectious diseases. In addition, they are effective tools available to public health agencies to prevent commercial travel of individuals with certain communicable diseases and possibly reconnect them with public health authorities. PMID:28648932

  7. 20 CFR 404.999c - What travel expenses are reimbursable.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... necessary, to the coach fare for air travel between the specified travel points involved unless first-class... between the same two points. Total cost includes the cost for all the authorized travelers who travel in... allowable under this section for travel to the hearing site from any point within the geographic area of the...

  8. Airport surveys at travel destinations--underutilized opportunities in travel medicine research?

    PubMed

    Bauer, Irmgard L

    2015-01-01

    Research in destination airports, especially in resource-poor areas, allows unique immediate access to travelers at the conclusion of their trip. Response rates are high and the recall gap small. Trip-related health matters can be elicited relatively easily. An insight into travelers' decision-making processes on location would fill large gaps in our knowledge regarding travel health advice provision; yet, this approach is still much underutilized. Using PubMed, ScienceDirect, Google Scholar, and ProQuest, a review of the literature on airport surveys was conducted to determine where they were used, their response rates and purpose, and location-relevant methodological information. The lack of methodological guidelines in the reviewed literature resulted in recommendations for planning and conducting an airport survey at a destination airport. Millions of travelers in airports around the world represent an underutilized sample of potential study participants for topics that cannot be studied adequately in other settings. Benefiting from close cooperation between travel health professionals and airport authorities, researchers can expect not only large-scale convenience samples for surveys, but also opportunities to explore exciting and creative research topics to broaden our understanding of travel medicine and health. © 2014 International Society of Travel Medicine.

  9. Health impact modelling of different travel patterns on physical activity, air pollution and road injuries for São Paulo, Brazil.

    PubMed

    Sá, Thiago Hérick de; Tainio, Marko; Goodman, Anna; Edwards, Phil; Haines, Andy; Gouveia, Nelson; Monteiro, Carlos; Woodcock, James

    2017-11-01

    São Paulo city, Brazil, faces challenges caused by rapid urbanization. We illustrate how future travel patterns could lead to different health consequences in the city. We evaluated the health impacts of different travel pattern scenarios for the São Paulo adult population by comparing the travel patterns of São Paulo in 2012 with counterfactual scenarios in which the city adopted travel patterns of i) those living in the city's expanded centre; ii) London (2012); iii) a highly motorized São Paulo (SP California); and iv) a visionary São Paulo (SP 2040), with high levels of walking and cycling and low levels of car and motorcycle use. For each scenario we estimated changes in exposure to air pollution, road injury risk, and physical activity. Health outcomes were estimated using disability adjusted life years (DALYs) and premature deaths averted. Sensitivity analyses were performed to identify the main sources of uncertainty. We found considerable health gains in the SP 2040 scenario (total 63.6k DALYs avoided), with 4.7% of premature deaths from ischemic heart disease avoided from increases in physical activity alone. Conversely, we found substantial health losses in the scenario favouring private transport (SP California, total increase of 54.9k DALYs), with an increase in road traffic deaths and injuries among pedestrians and motorized vehicles. Parameters related to air pollution had the largest impact on uncertainty. Shifting travel patterns towards more sustainable transport can provide major health benefits in São Paulo. Reducing the uncertainties in the findings should be a priority for empirical and modelling research on the health impacts of such shifts. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Access to yellow fever travel vaccination centres in England, Wales, and Northern Ireland: A geographical study.

    PubMed

    Petersen, Jakob; Simons, Hilary; Patel, Dipti

    More than 700,000 trips were made by residents in England, Wales, and Northern Ireland (EWNI) in 2015 to tropical countries endemic for yellow fever, a potentially deadly, yet vaccine-preventable disease transmitted by mosquitoes. The aim of this study was to map the geographical accessibility of yellow fever vaccination centres (YFVC) in EWNI. The location of 3208 YFVC were geocoded and the average geodetic distance to nearest YFVC was calculated for each population unit. Data on trips abroad and centres were obtained regionally for EWNI and nationally for the World Top20 countries in terms of travel. The mean distance to nearest YFVC was 2.4 km and only 1% of the population had to travel more than 16.1 km to their nearest centre. The number of vaccines administered regionally in EWNI was found correlated with the number of trips to yellow fever countries. The number of centres per 100,000 trips was 6.1 in EWNI, which was below United States (12.1) and above the rest of Top20 countries. The service availability was in line with demand regionally. With the exception of remote, rural areas, yellow fever vaccination services were widely available with only short distances to cover for the travelling public. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  11. Health hazards of international travel.

    PubMed

    Cossar, J H; Reid, D

    1989-01-01

    The growth of travel and the increasing numbers of those affected by travel-related illnesses, some of a serious nature, will cause this subject to demand the attention of the medical profession, the travel trade, travellers themselves and the health authorities of countries receiving tourists. Provision of appropriate advice for the traveller is a shared responsibility, best channelled mainly through travel agencies; it can moreover be shown to be cost-beneficial. Continued monitoring of illness in travellers and provision of information systems geared to this problem and its prevention are fully justified. They should be based on traditional channels of communication and currently-available modern technology, and be readily accessible to medical and related workers. Increased collaboration between medical workers, health educators and those involved in the travel trade would be a positive and useful contribution towards the reduction of illness and discomfort among travellers and the associated expense incurred by the various national health services concerned. There are clearly economic benefits from the development of international tourism, but these have to be balanced in countries accepting tourists by attention to the prevention of illnesses associated with travel.

  12. Novel shielding materials for space and air travel.

    PubMed

    Vana, N; Hajek, M; Berger, T; Fugger, M; Hofmann, P

    2006-01-01

    The reduction of dose onboard spacecraft and aircraft by appropriate shielding measures plays an essential role in the future development of space exploration and air travel. The design of novel shielding strategies and materials may involve hydrogenous composites, as it is well known that liquid hydrogen is most effective in attenuating charged particle radiation. As precursor for a later flight experiment, the shielding properties of newly developed hydrogen-rich polymers and rare earth-doped high-density rubber were tested in various ground-based neutron and heavy ion fields and compared with aluminium and polyethylene as reference materials. Absorbed dose, average linear energy transfer and gamma-equivalent neutron absorbed dose were determined by means of LiF:Mg,Ti thermoluminescence dosemeters and CR-39 plastic nuclear track detectors. First results for samples of equal aerial density indicate that selected hydrogen-rich plastics and rare-earth-doped rubber may be more effective in attenuating cosmic rays by up to 10% compared with conventional aluminium shielding. The appropriate adaptation of shielding thicknesses may thus allow reducing the biologically relevant dose. Owing to the lower density of the plastic composites, mass savings shall result in a significant reduction of launch costs. The experiment was flown as part of the European Space Agency's Biopan-5 mission in May 2005.

  13. Traveller gypsies and primary care.

    PubMed Central

    Feder, G

    1989-01-01

    Traveller gypsies have resided in the British Isles for over 500 years, making them one of our oldest ethnic minorities. They experience widespread prejudice and discrimination from the settled population. In the sphere of health care the marginalization of traveller gypsies has resulted in poor access to services and relative neglect of their health needs. In this paper the health of traveller gypsies is reviewed from the perspective of primary care, and the role of general practitioners in improving health care for this community is discussed. PMID:2560026

  14. Cartographic Mapping and Travel Burden to Assess and Develop Strategies to Improve Minority Access to National Cancer Clinical Trials

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bruner, Deborah Watkins, E-mail: deborah.w.bruner@emory.edu; Pugh, Stephanie L.; Yeager, Katherine A.

    Purpose: To assess how accrual to clinical trials is related to US minority population density relative to clinical trial site location and distance traveled to Radiation Therapy Oncology Group (RTOG) clinical trial sites. Methods and Materials: Data included member site address and ZIP codes, patient accrual, and patient race or ethnicity and ZIP code. Geographic Information System maps were developed for overall, Latino, and African American accrual to trials by population density. The Kruskal-Wallis test was used to assess differences in distance traveled by site, type of trial, and race or ethnicity. Results: From 2006 to 2009, 6168 patients enrolledmore » on RTOG trials. The RTOG US site distribution is generally concordant with overall population density. Sites with highest accrual are located throughout the United States and parts of Canada and do not cluster, nor does highest minority accrual cluster in areas of highest US minority population density. Of the 4913 US patients with complete data, patients traveled a median of 11.6 miles to participate in clinical trials. Whites traveled statistically longer distances (12.9 miles; P<.0001) to participate, followed by Latinos (8.22 miles) and African Americans (5.85 miles). Patients were willing to drive longer distances to academic sites than community sites, and there was a trend toward significantly longer median travel for therapeutic versus cancer control or metastatic trials. Conclusions: Location matters, but only to a degree, for minority compared with nonminority participation in clinical trials. Geographic Information System tools help identify gaps in geographic access and travel burden for clinical trials participation. Strategies that emerged using these tools are discussed.« less

  15. 14 CFR 382.21 - May carriers limit access to transportation on the basis that a passenger has a communicable...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false May carriers limit access to transportation... 382.21 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination...

  16. 14 CFR 382.21 - May carriers limit access to transportation on the basis that a passenger has a communicable...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false May carriers limit access to transportation... 382.21 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination...

  17. Boise, Idaho: Improving Air Quality through Alternative Fuels & Reduced Vehicular Travel (City Energy: From Data to Decisions)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Strategic Priorities and Impact Analysis Team, Office of Strategic Programs

    This fact sheet "Boise, Idaho: Improving Air Quality through Alternative Fuels & Reduced Vehicular Travel" explains how the City of Boise used data from the U.S. Department of Energy's Cities Leading through Energy Analysis and Planning (Cities-LEAP) and the State and Local Energy Data (SLED) programs to inform its city energy planning. It is one of ten fact sheets in the "City Energy: From Data to Decisions" series.

  18. The travel-related carbon dioxide emissions of atmospheric researchers

    NASA Astrophysics Data System (ADS)

    Stohl, A.

    2008-11-01

    Most atmospheric scientists agree that greenhouse gas emissions have already caused significant changes to the global climate system and that these changes will accelerate in the near future. At the same time, atmospheric scientists who like other scientists rely on international collaboration and information exchange travel a lot and, thereby, cause substantial emissions of CO2. In this paper, the CO2 emissions of the employees working at an atmospheric research institute (the Norwegian Institute for Air Research, NILU) caused by all types of business travel (conference visits, workshops, field campaigns, instrument maintainance, etc.) were calculated for the years 2005 2007. It is estimated that more than 90% of the emissions were caused by air travel, 3% by ground travel and 5% by hotel usage. The travel-related annual emissions were between 1.9 and 2.4 t CO2 per employee or between 3.9 and 5.5 t CO2 per scientist. For comparison, the total annual per capita CO2 emissions are 4.5 t worldwide, 1.2 t for India, 3.8 t for China, 5.9 t for Sweden and 19.1 t for Norway. The travel-related CO2 emissions of a NILU scientist, occurring in 24 days of a year on average, exceed the global average annual per capita emission. Norway's per-capita CO2 emissions are among the highest in the world, mostly because of the emissions from the oil industry. If the emissions per NILU scientist derived in this paper are taken as representative for the average Norwegian researcher, travel by Norwegian scientists would nevertheless account for a substantial 0.2% of Norway's total CO2 emissions. Since most of the travel-related emissions are due to air travel, water vapor emissions, ozone production and contrail formation further increase the relative importance of NILU's travel in terms of radiative forcing.

  19. The travel-related carbon dioxide emissions of atmospheric researchers

    NASA Astrophysics Data System (ADS)

    Stohl, A.

    2008-04-01

    Most atmospheric scientists agree that greenhouse gas emissions have already caused significant changes to the global climate system and that these changes will accelerate in the near future. At the same time, atmospheric scientists who - like other scientists - rely on international collaboration and information exchange travel a lot and, thereby, cause substantial emissions of carbon dioxide (CO2). In this paper, the CO2 emissions of the employees working at an atmospheric research institute (the Norwegian Institute for Air Research, NILU) caused by all types of business travel (conference visits, workshops, field campaigns, instrument maintainance, etc.) were calculated for the years 2005-2007. It is estimated that more than 90% of the emissions were caused by air travel, 3% by ground travel and 5% by hotel usage. The travel-related annual emissions were between 1.9 and 2.4 t CO2 per employee or between 3.9 and 5.5 t CO2 per scientist. For comparison, the total annual per capita CO2 emissions are 4.5 t worldwide, 1.2 t for India, 3.8 t for China, 5.9 t for Sweden and 19.1 t for Norway. The travel-related CO2 emissions of a NILU scientist, occurring in 24 days of a year on average, exceed the global average annual per capita emission. Norway's per-capita CO2 emissions are among the highest in the world, mostly because of the emissions from the oil industry. If the emissions per NILU scientist derived in this paper are taken as representative for the average Norwegian researcher, travel by Norwegian scientists would nevertheless account for a substantial 0.2% of Norway's total CO2 emissions. Since most of the travel-related emissions are due to air travel, water vapor emissions, ozone production and contrail formation further increase the relative importance of NILU's travel in terms of radiative forcing.

  20. California motor vehicle stock, travel and fuel forecast.

    DOT National Transportation Integrated Search

    2009-06-01

    This is the twenty-fourth in a series of reports that forecasts Vehicle Miles of Travel (VMT) in California. This report is intended for transportation planning, travel forecasting, air quality modeling, and fuel tax revenue projection. : This report...

  1. Assessing Regional Emissions Reductions from Travel Efficiency: Applying the Travel Efficiency Assessment Method

    EPA Pesticide Factsheets

    This presentation from the 2016 TRB Summer Conference on Transportation Planning and Air Quality summarizes the application of the Travel Efficiency Assessment Method (TEAM) which analyzed selected transportation emission reduction strategies in three case

  2. Travel-related thrombosis.

    PubMed

    Cannegieter, Suzanne C

    2012-09-01

    Travel-related thrombosis is a serious public health concern considering the large and increasing number of travellers. Due to a lack of evidence, counselling air travellers on their venous thrombosis risk is not immediately straightforward, and advice will have to be based mostly on theoretical grounds. In this review a basis for these considerations is given. First of all it needs to be recognized that venous thrombosis is a multicausal disease, i.e. several risk factors have to be present before an event occurs. This is reflected in the literature where clearly increased risks have been described for certain groups, such as subjects with factor V Leiden, those who use oral contraceptives or are obese. Also, an increased risk for tall and short people has been reported. So, for subjects with a known risk factor who plan to travel, benefits and risks of thrombosis prophylaxis, (pharmacological or other), need to be weighed. This review provides some theoretical examples. For all other travellers, the advice to move and exercise as much as possible is likely to be sufficient. Copyright © 2012. Published by Elsevier Ltd.

  3. 41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

  4. 41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

  5. 41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

  6. 41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

  7. 41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

  8. Traveling with Portable Oxygen

    MedlinePlus

    ... preferred for patients in areas without access to electricity. Liquid oxygen is classi ed by the FAA ... ahead of time to make arrangements for any electrical power you will need. 4 TRAVELING WITH PORTABLE ...

  9. A global map of travel time to cities to assess inequalities in accessibility in 2015

    NASA Astrophysics Data System (ADS)

    Weiss, D. J.; Nelson, A.; Gibson, H. S.; Temperley, W.; Peedell, S.; Lieber, A.; Hancher, M.; Poyart, E.; Belchior, S.; Fullman, N.; Mappin, B.; Dalrymple, U.; Rozier, J.; Lucas, T. C. D.; Howes, R. E.; Tusting, L. S.; Kang, S. Y.; Cameron, E.; Bisanzio, D.; Battle, K. E.; Bhatt, S.; Gething, P. W.

    2018-01-01

    The economic and man-made resources that sustain human wellbeing are not distributed evenly across the world, but are instead heavily concentrated in cities. Poor access to opportunities and services offered by urban centres (a function of distance, transport infrastructure, and the spatial distribution of cities) is a major barrier to improved livelihoods and overall development. Advancing accessibility worldwide underpins the equity agenda of ‘leaving no one behind’ established by the Sustainable Development Goals of the United Nations. This has renewed international efforts to accurately measure accessibility and generate a metric that can inform the design and implementation of development policies. The only previous attempt to reliably map accessibility worldwide, which was published nearly a decade ago, predated the baseline for the Sustainable Development Goals and excluded the recent expansion in infrastructure networks, particularly in lower-resource settings. In parallel, new data sources provided by Open Street Map and Google now capture transportation networks with unprecedented detail and precision. Here we develop and validate a map that quantifies travel time to cities for 2015 at a spatial resolution of approximately one by one kilometre by integrating ten global-scale surfaces that characterize factors affecting human movement rates and 13,840 high-density urban centres within an established geospatial-modelling framework. Our results highlight disparities in accessibility relative to wealth as 50.9% of individuals living in low-income settings (concentrated in sub-Saharan Africa) reside within an hour of a city compared to 90.7% of individuals in high-income settings. By further triangulating this map against socioeconomic datasets, we demonstrate how access to urban centres stratifies the economic, educational, and health status of humanity.

  10. A global map of travel time to cities to assess inequalities in accessibility in 2015.

    PubMed

    Weiss, D J; Nelson, A; Gibson, H S; Temperley, W; Peedell, S; Lieber, A; Hancher, M; Poyart, E; Belchior, S; Fullman, N; Mappin, B; Dalrymple, U; Rozier, J; Lucas, T C D; Howes, R E; Tusting, L S; Kang, S Y; Cameron, E; Bisanzio, D; Battle, K E; Bhatt, S; Gething, P W

    2018-01-18

    The economic and man-made resources that sustain human wellbeing are not distributed evenly across the world, but are instead heavily concentrated in cities. Poor access to opportunities and services offered by urban centres (a function of distance, transport infrastructure, and the spatial distribution of cities) is a major barrier to improved livelihoods and overall development. Advancing accessibility worldwide underpins the equity agenda of 'leaving no one behind' established by the Sustainable Development Goals of the United Nations. This has renewed international efforts to accurately measure accessibility and generate a metric that can inform the design and implementation of development policies. The only previous attempt to reliably map accessibility worldwide, which was published nearly a decade ago, predated the baseline for the Sustainable Development Goals and excluded the recent expansion in infrastructure networks, particularly in lower-resource settings. In parallel, new data sources provided by Open Street Map and Google now capture transportation networks with unprecedented detail and precision. Here we develop and validate a map that quantifies travel time to cities for 2015 at a spatial resolution of approximately one by one kilometre by integrating ten global-scale surfaces that characterize factors affecting human movement rates and 13,840 high-density urban centres within an established geospatial-modelling framework. Our results highlight disparities in accessibility relative to wealth as 50.9% of individuals living in low-income settings (concentrated in sub-Saharan Africa) reside within an hour of a city compared to 90.7% of individuals in high-income settings. By further triangulating this map against socioeconomic datasets, we demonstrate how access to urban centres stratifies the economic, educational, and health status of humanity.

  11. Beyond "medical tourism": Canadian companies marketing medical travel.

    PubMed

    Turner, Leigh

    2012-06-15

    Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, "Liberation therapy" for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel. Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1) where in Canada these businesses are located; 2) the destination countries and health care facilities that they market; 3) the medical procedures they promote; 4) core marketing messages; and 5) whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures. Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism companies. Seven other businesses market regional, cross

  12. Air filtration systems and restrictive access conditions improve indoor air quality in clinical units: Penicillium as a general indicator of hospital indoor fungal levels.

    PubMed

    Araujo, Ricardo; Cabral, João Paulo; Rodrigues, Acácio Gonçalves

    2008-03-01

    High-efficiency particulate air (HEPA) filters do not completely prevent nosocomial fungal infections. The first aim of this study was to evaluate the impact of different filters and access conditions upon airborne fungi in hospital facilities. Additionally, this study identified fungal indicators of indoor air concentrations. Eighteen rooms and wards equipped with different air filter systems, and access conditions were sampled weekly, during 16 weeks. Tap water samples were simultaneously collected. The overall mean concentration of atmospheric fungi for all wards was 100 colony forming units/m(3). We found a direct proportionality between the levels of the different fungi in the studied atmospheres. Wards with HEPA filters at positive air flow yielded lower fungal levels. Also, the existence of an anteroom and the use of protective clothes were associated to the lowest fungal levels. Principal component analysis showed that penicillia afforded the best separation between wards' air fungal levels. Fungal strains were rarely recovered from tap water samples. In addition to air filtration systems, some access conditions to hospital units, like presence of anteroom and use of protective clothes, may prevent high fungal air load. Penicillia can be used as a general indicator of indoor air fungal levels at Hospital S. João.

  13. Patterns of measles transmission among airplane travelers.

    PubMed

    Edelson, Paul J

    2012-09-01

    With advanced air handling systems on modern aircraft and the high level of measles immunity in many countries, measles infection in air travelers may be considered a low-risk event. However, introduction of measles into countries where transmission has been controlled or eliminated can have substantial consequences both for the use of public health resources and for those still susceptible. In an effort to balance the relatively low likelihood of disease transmission among largely immune travelers and the risk to the public health of the occurrence of secondary cases resulting from importations, criteria in the United States for contact investigations for measles exposures consider contacts to be those passengers who are seated within 2 rows of the index case. However, recent work has shown that cabin air flow may not be as reliable a barrier to the spread of measles virus as previously believed. Along with these new studies, several reports have described measles developing after travel in passengers seated some distance from the index case. To understand better the potential for measles virus to spread on an airplane, reports of apparent secondary cases occurring in co-travelers of passengers with infectious cases of measles were reviewed. Medline™ was searched for articles in all languages from 1946 to week 1 of March 2012, using the search terms "measles [human] or rubeola" and ("aircraft" or "airplane" or "aeroplane" or "aviation" or "travel" or "traveler" or "traveller"); 45 citations were returned. Embase™ was searched from 1988 to week 11 2012, using the same search strategy; 95 citations were returned. Papers were included in this review if they reported secondary cases of measles occurring in persons traveling on an airplane on which a person or persons with measles also flew, and which included the seating location of both the index case(s) and the secondary case(s) on the plane. Nine reports, including 13 index cases and 23 apparent secondary cases

  14. Bon voyage: an update on safe travel in pregnancy.

    PubMed

    Jones, Claire Ann; Chan, Crystal

    2014-12-01

    Travel in pregnancy is common, particularly as international travel for work and leisure has become more commonplace. Few women are fully aware of the potential risks of travelling while pregnant, particularly the risk of delivering abroad. We describe here the medical risks and the many social, financial, and logistical considerations for travelling during pregnancy. Pertinent considerations include the risks of developing medical complications abroad, immunization considerations, access to obstetrical care in developing countries, travel medical insurance, and airline regulations.

  15. Travel Time to Hospital for Childbirth: Comparing Calculated Versus Reported Travel Times in France.

    PubMed

    Pilkington, Hugo; Prunet, Caroline; Blondel, Béatrice; Charreire, Hélène; Combier, Evelyne; Le Vaillant, Marc; Amat-Roze, Jeanne-Marie; Zeitlin, Jennifer

    2018-01-01

    Objectives Timely access to health care is critical in obstetrics. Yet obtaining reliable estimates of travel times to hospital for childbirth poses methodological challenges. We compared two measures of travel time, self-reported and calculated, to assess concordance and to identify determinants of long travel time to hospital for childbirth. Methods Data came from the 2010 French National Perinatal Survey, a national representative sample of births (N = 14 681). We compared both travel time measures by maternal, maternity unit and geographic characteristics in rural, peri-urban and urban areas. Logistic regression models were used to study factors associated with reported and calculated times ≥30 min. Cohen's kappa coefficients were also calculated to estimate the agreement between reported and calculated times according to women's characteristics. Results In urban areas, the proportion of women with travel times ≥30 min was higher when reported rather than calculated times were used (11.0 vs. 3.6%). Longer reported times were associated with non-French nationality [adjusted odds ratio (aOR) 1.3 (95% CI 1.0-1.7)] and inadequate prenatal care [aOR 1.5 (95% CI 1.2-2.0)], but not for calculated times. Concordance between the two measures was higher in peri-urban and rural areas (52.4 vs. 52.3% for rural areas). Delivery in a specialised level 2 or 3 maternity unit was a principal determinant of long reported and measured times in peri-urban and rural areas. Conclusions for Practice The level of agreement between reported and calculated times varies according to geographic context. Poor measurement of travel time in urban areas may mask problems in accessibility.

  16. Tuberculosis and the traveller: evaluating and reducing risk through travel consultation.

    PubMed

    Denholm, Justin T; Thevarajan, Irani

    2016-03-01

    Although the last 10 years have seen a slow decline in global tuberculosis (TB) incidence, it remains one of the most significant infectious diseases worldwide, with an estimated 9.6 million new cases and 1.5 million deaths in 2014. The consequences of contracting TB can be significant for the individual, with extended treatment requirements, risk of long-term health consequences and the possibility of transmitting infection to others among the complications of disease. This review article discusses the risk of TB infection as a result of international travel including evaluation of risk, risk reduction and a proposed testing strategy for travel-related TB infection. A review of the relevant literature combined with expert opinion was used to formulate this article. The global TB epidemic is varied and dynamic, including changing patterns of both drug sensitive and drug resistant disease. The annual incidence of TB in individual countries such as South Africa may be greater than 800/100,000, while multidrug resistance is found in up to 19% of new cases in the Russian Federation. Recent surveys of traveller risk are presented for short and long-term travellers to various countries and settings. Overall, risk to travelers is low, with rates of acquiring latent TB less than 1% per travel year for most settings. However, detailed travel evaluation is necessary to evaluate individual risk. Travellers with immunosuppressive conditions are at high risk for progression to active disease if infected, and should have special consideration in travel consultation. It is important for practitioners giving advice regarding tuberculosis risk and travel to access up-to-date information regarding local conditions. This article provides an approach to assessment and management of TB in travellers, including a guide to pre- and post-travel evaluation, testing and vaccination. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press

  17. Travelers' Health: Deep Vein Thrombosis and Pulmonary Embolism

    MedlinePlus

    ... risk factors for VTE. The risk decreases with time after air travel and returns to baseline by 8 weeks; most ... are at increased risk be evaluated with enough time prior to departure so ... travel health provider has prescribed. PREVENTIVE MEASURES FOR LONG- ...

  18. The Traveler with Sickle Cell Disease

    PubMed Central

    Willen, Shaina M.; Thornburg, Courtney D.; Lantos, Paul M.

    2014-01-01

    Background Sickle cell disease (SCD) is the most common genetic disease among persons with African ancestry. This article provides a background on SCD and reviews many important aspects of travel preparation in this population. Methods The medical literature was searched for studies about travel-associated preparedness and complications in individuals with SCD. Topics researched included malaria, bacterial infections, vaccinations, dehydration, altitude, air travel, and travel preparedness. Results There is very little published literature that specifically addresses the risks faced by travelers with SCD. Rates of medical complications during travel appear to be high. There is a body of literature that describes complications of SCD in indigenous populations, particularly within Africa. The generalizability of these data to a traveler are uncertain. Combining these sources of data and the broader medical literature we address major travel-related questions that may face a provider preparing an individual with SCD for safe travel. Conclusions Travelers with SCD face considerable medical risks when traveling to developing tropical countries; these include malaria, bacterial infections, hypovolemia, and sickle cell-associated vaso-occlusive crises. Frank counseling about risks, vigilant preventative measures, and contingency planning for illness while abroad are necessary parts of the pre-travel visit for individuals with SCD. PMID:24947546

  19. 48 CFR 752.7002 - Travel and transportation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... required by scheduled commercial air carrier using the most expeditious route. One stopover en route for a... time at post. (h) Delays en route. The Contractor may grant to travelers under this contract reasonable delays en route while in travel status when such delays are caused by events beyond the control of such...

  20. Profile of Travelers With Preexisting Medical Conditions Attending a Specialist Travel Medicine Clinic in Ireland.

    PubMed

    Han, Calvin Teo Jia; Flaherty, Gerard

    2015-01-01

    Patients with complex medical comorbidities travel for protracted periods to remote destinations, often with limited access to medical care. Few descriptions are available of their preexisting health burden. This study aimed to characterize preexisting medical conditions and medications of travelers seeking pre-travel health advice at a specialized travel medicine clinic. Records of travelers attending the Galway Tropical Medical Bureau clinic between 2008 and 2014 were examined and information relating to past medical history was entered into a database. Data were recorded only where the traveler had a documented medical history and/or was taking medications. Of the 4,817 records available, 56% had a documented medical history and 24% listed medications. The majority of travelers with preexisting conditions were female. The mean age of the cohort was 31.68 years. The mean period remaining before the planned trip was 40 days. Southeast Asia was the most popular single destination, and 17% of travelers with medical conditions were traveling alone. The most frequently reported conditions were allergies (20%), insect bite sensitivity (15%), asthma (11%), psychiatric conditions (4%), and hypertension (3%). Of the 30 diabetic travelers, 14 required insulin; 4.5% of travelers were taking immunosuppressant drugs, including corticosteroids. Half of the female travelers were taking the oral contraceptive pill while 11 travelers were pregnant at the time of their pre-travel consultation. This study provides an insight into the medical profile of travelers attending a travel health clinic. The diverse range of diseases reported highlights the importance of educating physicians and nurses about the specific travel health risks associated with particular conditions. Knowledge of the effects of travel on underlying medical conditions will inform the pre-travel health consultation. © 2015 International Society of Travel Medicine.

  1. Making a case for telehealth: measuring the carbon cost of health-related travel.

    PubMed

    Ellis, Isabelle; Cheek, Colleen; Jaffray, Linda; Skinner, Timothy

    2013-01-01

    Telehealth services are promoted to reduce the cost of travel for people living in rural areas. The previous Australian Government, through the national Digital Economy Strategy, invested heavily in telehealth service development, at the same time introducing a carbon pricing mechanism. In planning a range of new telehealth services to a rural community the authors sought to quantify the travel conducted by people from one rural area in Australia to access health care, and to calculate the associated carbon emissions. A population survey was conducted over a 1-week period of health-related travel events for the year 1 July 2011 to 30 June 2012 of all households on King Island, a community situated between the Australian mainland state of Victoria and the state of Tasmania. Validated emissions calculators were sourced from the Carbon Neutral website, including the vehicle and fuel use calculator and air travel carbon calculator, to calculate the total emissions associated with the fuel burned in tonnes of carbon dioxide equivalent (tCO2e). Thirty nine percent of the population (625 participants) reported a total of 511 healthcare-related travel events. Participants travelled a total of 346 573 km and generated 0.22 tCO2e per capita. Participants paid the cost of their own travel more than 70% of the time. Dependence on fossil fuels for transport in a carbon economy has a significant impact on total healthcare carbon emissions. Alternative models of care, such as telehealth, need be developed for an environmentally sustainable healthcare system for rural and remote areas.

  2. An Analysis of Federal Airport and Air Carrier Employee Access Control, Screening. and Training Regulations

    DTIC Science & Technology

    1998-03-01

    traveling public, air carriers, and persons employed by or conducting business at public airports. 14. SUBJECT TERMS Airport Security , Federal...26 4. Sterile Area 28 5. Exclusive Area 28 E. SECURITY ALERT LEVELS 29 F. AIRPORT SECURITY TOOLS 30 1. Electronic Detection System 31 a... Security Coordinator ASP Airport Security Program BIS Biometrie Identification System CCTV Closed Circuit Television CJIS Criminal Justice Information

  3. Commercial air travel after intraocular gas injection.

    PubMed

    Houston, Stephen; Graf, Jürgen; Sharkey, James

    2012-08-01

    Passengers with intraocular gas are at risk of profound visual loss when exposed to reduced absolute pressure within the cabin of a typical commercial airliner. Information provided on the websites of the world's 10 largest airlines offer a considerable range of opinion as to when it might be safe to fly after gas injection. Physicians responsible for clearing pseassengers as 'fit to fly' should be aware modern retinal surgical techniques increasingly employ long-acting gases as vitreous substitutes. The kinetics of long-acting intraocular gases must be considered when deciding how long after surgery it is safe to travel. It is standard practice to advise passengers not to fly in aircraft until the gas is fully resorbed. To achieve this, it may be necessary to delay travel for approximately 2 wk after intraocular injection of sulfur hexafluoride (SF6) and for 6 wk after injection of perfluoropropane (C3F8).

  4. Travel by public transit to mammography facilities in 6 US urban areas.

    PubMed

    Graham, S; Lewis, B; Flanagan, B; Watson, M; Peipins, L

    2015-12-01

    We examined lack of private vehicle access and 30 minutes or longer public transportation travel time to mammography facilities for women 40 years of age or older in the urban areas of Boston, Philadelphia, San Antonio, San Diego, Denver, and Seattle to identify transit marginalized populations - women for whom these travel characteristics may jointly present a barrier to clinic access. This ecological study used sex and race/ethnicity data from the 2010 US Census and household vehicle availability data from the American Community Survey 2008-2012, all at Census tract level. Using the public transportation option on Google Trip Planner we obtained the travel time from the centroid of each census tract to all local mammography facilities to determine the nearest mammography facility in each urban area. Median travel times by public transportation to the nearest facility for women with no household access to a private vehicle were obtained by ranking travel time by population group across all U.S. census tracts in each urban area and across the entire study area. The overall median travel times for each urban area for women without household access to a private vehicle ranged from a low of 15 minutes in Boston and Philadelphia to 27 minutes in San Diego. The numbers and percentages of transit marginalized women were then calculated for all urban areas by population group. While black women were less likely to have private vehicle access, and both Hispanic and black women were more likely to be transit marginalized, this outcome varied by urban area. White women constituted the largest number of transit marginalized. Our results indicate that mammography facilities are favorably located for the large majority of women, although there are still substantial numbers for whom travel may likely present a barrier to mammography facility access.

  5. Travel by public transit to mammography facilities in 6 US urban areas

    PubMed Central

    Graham, S; Lewis, B; Flanagan, B; Watson, M; Peipins, L

    2017-01-01

    We examined lack of private vehicle access and 30 minutes or longer public transportation travel time to mammography facilities for women 40 years of age or older in the urban areas of Boston, Philadelphia, San Antonio, San Diego, Denver, and Seattle to identify transit marginalized populations - women for whom these travel characteristics may jointly present a barrier to clinic access. This ecological study used sex and race/ethnicity data from the 2010 US Census and household vehicle availability data from the American Community Survey 2008–2012, all at Census tract level. Using the public transportation option on Google Trip Planner we obtained the travel time from the centroid of each census tract to all local mammography facilities to determine the nearest mammography facility in each urban area. Median travel times by public transportation to the nearest facility for women with no household access to a private vehicle were obtained by ranking travel time by population group across all U.S. census tracts in each urban area and across the entire study area. The overall median travel times for each urban area for women without household access to a private vehicle ranged from a low of 15 minutes in Boston and Philadelphia to 27 minutes in San Diego. The numbers and percentages of transit marginalized women were then calculated for all urban areas by population group. While black women were less likely to have private vehicle access, and both Hispanic and black women were more likely to be transit marginalized, this outcome varied by urban area. White women constituted the largest number of transit marginalized. Our results indicate that mammography facilities are favorably located for the large majority of women, although there are still substantial numbers for whom travel may likely present a barrier to mammography facility access. PMID:29285434

  6. Geographic Access to US Neurocritical Care Units Registered with the Neurocritical Care Society

    PubMed Central

    Shutter, Lori A.; Branas, Charles C.; Adeoye, Opeolu; Albright, Karen C.; Carr, Brendan G.

    2018-01-01

    Background Neurocritical care provides multidisciplinary, specialized care to critically ill neurological patients, yet an understanding of the proportion of the population able to rapidly access specialized Neurocritical Care Units (NCUs) in the United States is currently unknown. We sought to quantify geographic access to NCUs by state, division, region, and for the US as a whole. In addition, we examined how mode of transportation (ground or air ambulance), and prehospital transport times affected population access to NCUs. Methods Data were obtained from the Neurocritical Care Society (NCS), US Census Bureau and the Atlas and Database of Air Medical Services. Empirically derived prehospital time intervals and validated models estimating prehospital ground and air travel times were used to calculate total prehospital times. A discrete total prehospital time interval was calculated for each small unit of geographic analysis (block group) and block group populations were summed to determine the proportion of Americans able to reach a NCU within discrete time intervals (45, 60, 75, and 90 min). Results are presented for different geographies and for different modes of prehospital transport (ground or air ambulance). Results There are 73 NCUs in the US using ground transportation alone, 12.8, 20.5, 27.4, and 32.6% of the US population are within 45, 60, 75, and 90 min of an NCU, respectively. Use of air ambulances increases access to 36.8, 50.4, 60, and 67.3 within 45, 60, 75, and 90 min, respectively. The Northeast has the highest access rates in the US using ground ambulances and for 45, 60, and 75 min transport times with the addition of air ambulances. At 90 min, the West has the highest access rate. The Southern region has the lowest ground and air access to NCUs access rates for all transport times. Conclusions Using NCUs registered with the NCS, current geographic access to NCUs is limited in the US, and geographic disparities in access to care exist. While

  7. Using Open and Interoperable Ways to Publish and Access LANCE AIRS Near-Real Time Data

    NASA Astrophysics Data System (ADS)

    Zhao, P.; Lynnes, C.; Vollmer, B.; Savtchenko, A. K.; Yang, W.

    2011-12-01

    Atmospheric Infrared Sounder (AIRS) Near-Real Time (NRT) data from the Land Atmosphere Near real time Capability for EOS (LANCE) provide the information on the global and regional atmospheric state with very low latency. An open and interoperable platform is useful to facilitate access to and integration of LANCE AIRS NRT data. This paper discusses the use of open-source software components to build Web services for publishing and accessing AIRS NRT data in the context of Service Oriented Architecture (SOA). The AIRS NRT data have also been made available through an OPeNDAP server. OPeNDAP allows several open-source netCDF-based tools such as Integrated Data Viewer, Ferret and Panoply to directly display the Level 2 data over the network. To enable users to locate swath data files in the OPeNDAP server that lie within a certain geographical area, graphical "granule maps" are being added to show the outline of each file on a map of the Earth. The metadata of AIRS NRT data and services is then explored to implement information advertisement and discovery in catalogue systems. Datacasting, an RSS-based technology for accessing Earth Science data and information to facilitate the subscriptions to AIRS NRT data availability, filtering, downloading and viewing data, is also discussed. To provide an easy entry point to AIRS NRT data and services, a Web portal designed for customized data downloading and visualization is introduced.

  8. A comparison of personal exposure to air pollutants in different travel modes on national highways in India.

    PubMed

    Kolluru, Soma Sekhara Rao; Patra, Aditya Kumar; Sahu, Satya Prakash

    2018-04-01

    People often travel a long distance on highways to the nearest city for professional/business activities. However, relatively few publications on passenger exposure to pollutants on highways in India or elsewhere are available. The aim of this study was to examine the contribution of different travel modes to passengers' pollutant exposure for a long distance travel on a national highway in India. We measured PM 2.5 and CO exposure levels of the passengers over 200km on a national highway using two portable air monitors, EVM-7 and EPAM-5000. Personal concentration exposures and per min-, per hour-, per trip- and round trip mass exposures for three travel modes were calculated for 9 trips. Association between pollutants and weather variables were evaluated using levels Spearman correlation. ANOVA was carried out to evaluate the influence of travel mode, the timing of trips, temperature and RH on personal exposures. On an average, PM 2.5 personal concentration exposure levels were highest in the car (85.41±61.85μgm -3 ), followed by the bus (75.08±55.39μgm -3 ) and lowest in the car (ac) (54.43±34.09μgm -3 ). In contrast, CO personal exposure was highest in the car (ac) (1.81±1.3ppm). Travel mode explained the highest variability for CO (18.1%), CO 2 (9.9%), PM 2.5 (1.2%) exposures. In-city mass exposures were higher than trip averages; PM 2.5 :1.21-1.22, 1.13-1.19 and 1.03-1.28 times; CO: 1.20-1.57, 1.37-2.10 and 1.76-2.22 times for bus, car and car (ac) respectively. Traveling by car (ac) results in the lowest PM 2.5 exposures, although it exposes the passenger to high CO level. Avoiding national highways passing through cities can reduce up to 25% PM 2.5 and 50% CO mass exposures. This information can be useful for increasing environmental awareness among the passengers and for framing better pollution control strategies on highways. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Summary and recommendations for the NASA/MIT workshop on short haul air transport

    NASA Technical Reports Server (NTRS)

    Simpson, R. W.

    1971-01-01

    The material is summarized that was covered by the MIT/NASA Waterville Valley workshop which dealt with the institutional, socio-economic, operational and technological problems associated with introducing new forms of short haul domestic air transportation. It was found that future air systems hold great potential in satisfying society's needs for a low noise, low landspace, high access, high speed, large network system for public travel over distances between 5 and 500 miles. It is concluded that quiet air systems are necessary for obtaining community approval, and is recommended that extremely high priority be assigned to the development of quiet aircraft for future short haul air systems.

  10. Beyond "medical tourism": Canadian companies marketing medical travel

    PubMed Central

    2012-01-01

    Background Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, “Liberation therapy” for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel. Methods Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1) where in Canada these businesses are located; 2) the destination countries and health care facilities that they market; 3) the medical procedures they promote; 4) core marketing messages; and 5) whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures. Results Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism companies. Seven other

  11. Air travel and chronic obstructive pulmonary disease: a new algorithm for pre-flight evaluation.

    PubMed

    Edvardsen, Anne; Akerø, Aina; Christensen, Carl C; Ryg, Morten; Skjønsberg, Ole H

    2012-11-01

    The reduced pressure in the aircraft cabin may cause significant hypoxaemia and respiratory distress in patients with chronic obstructive pulmonary disease (COPD). Simple and reliable methods for predicting the need for supplemental oxygen during air travel have been requested. To construct a pre-flight evaluation algorithm for patients with COPD. In this prospective, cross-sectional study of 100 patients with COPD referred to hypoxia-altitude simulation test (HAST), sea level pulse oximetry at rest (SpO(2 SL)) and exercise desaturation (SpO(2 6MWT)) were used to evaluate whether the patient is fit to fly without further assessment, needs further evaluation with HAST or should receive in-flight supplemental oxygen without further evaluation. HAST was used as the reference method. An algorithm was constructed using a combination of SpO(2 SL) and SpO(2 6MWT). Categories for SpO(2 SL) were >95%, 92-95% and <92%, the cut-off value for SpO(2 6MWT) was calculated as 84%. Arterial oxygen pressure (PaO(2 HAST)) <6.6 kPa was the criterion for recommending supplemental oxygen. This algorithm had a sensitivity of 100% and a specificity of 80% when tested prospectively on an independent sample of patients with COPD (n=50). Patients with SpO(2 SL) >95% combined with SpO(2 6MWT) ≥84% may travel by air without further assessment. In-flight supplemental oxygen is recommended if SpO(2 SL)=92-95% combined with SpO(2 6MWT) <84% or if SpO(2 SL) <92%. Otherwise, HAST should be performed. The presented algorithm is simple and appears to be a reliable tool for pre-flight evaluation of patients with COPD.

  12. International Safety Regulation and Standards for Space Travel and Commerce

    NASA Astrophysics Data System (ADS)

    Pelton, J. N.; Jakhu, R.

    The evolution of air travel has led to the adoption of the 1944 Chicago Convention that created the International Civil Aviation Organization (ICAO), headquartered in Montreal, Canada, and the propagation of aviation safety standards. Today, ICAO standardizes and harmonizes commercial air safety worldwide. Space travel and space safety are still at an early stage of development, and the adoption of international space safety standards and regulation still remains largely at the national level. This paper explores the international treaties and conventions that govern space travel, applications and exploration today and analyzes current efforts to create space safety standards and regulations at the national, regional and global level. Recent efforts to create a commercial space travel industry and to license commercial space ports are foreseen as means to hasten a space safety regulatory process.

  13. Empirical Evidence for the Effect of Airline Travel on Inter-Regional Influenza Spread in the United States

    PubMed Central

    Brownstein, John S; Wolfe, Cecily J; Mandl, Kenneth D

    2006-01-01

    Background The influence of air travel on influenza spread has been the subject of numerous investigations using simulation, but very little empirical evidence has been provided. Understanding the role of airline travel in large-scale influenza spread is especially important given the mounting threat of an influenza pandemic. Several recent simulation studies have concluded that air travel restrictions may not have a significant impact on the course of a pandemic. Here, we assess, with empirical data, the role of airline volume on the yearly inter-regional spread of influenza in the United States. Methods and Findings We measured rate of inter-regional spread and timing of influenza in the United States for nine seasons, from 1996 to 2005 using weekly influenza and pneumonia mortality from the Centers for Disease Control and Prevention. Seasonality was characterized by band-pass filtering. We found that domestic airline travel volume in November (mostly surrounding the Thanksgiving holiday) predicts the rate of influenza spread (r 2 = 0.60; p = 0.014). We also found that international airline travel influences the timing of influenza mortality (r 2 = 0.59; p = 0.016). The flight ban in the US after the terrorist attack on September 11, 2001, and the subsequent depression of the air travel market, provided a natural experiment for the evaluation of flight restrictions; the decrease in air travel was associated with a delayed and prolonged influenza season. Conclusions We provide the first empirical evidence for the role of airline travel in long-range dissemination of influenza. Our results suggest an important influence of international air travel on the timing of influenza introduction, as well as an influence of domestic air travel on the rate of inter-regional influenza spread in the US. Pandemic preparedness strategies should account for a possible benefit of airline travel restrictions on influenza spread. PMID:16968115

  14. 76 FR 58243 - Proposed Information Collection; Comment Request; Survey of International Air Travelers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-20

    ...'s Office of Travel & Tourism Industries (OTTI), Phone: (202) 482-0140, and fax: (202) 482- 2887. E... Travel and Tourism Industries (OTTI) of the International Trade Administration provides source data... travel and tourism related acts to collect and publish comprehensive international travel and tourism...

  15. 23 CFR 511.309 - Provisions for traffic and travel conditions reporting.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... requirements for traffic and travel conditions made available by real-time information programs are: (1... or less from the time the hazardous conditions, blockage, or closure is observed. (4) Travel time information. The timeliness for the availability of travel time information along limited access roadway...

  16. Global Scenarios of Air Pollution until 2030: Combining Air Quality, Climate Change and Energy Access Policies

    NASA Astrophysics Data System (ADS)

    Rao, S.; Dentener, F. J.; Klimont, Z.; Riahi, K.

    2011-12-01

    Outdoor air pollution is increasingly recognized as a significant contributor to global health outcomes. This has led to the implementation of a number of air quality policies worldwide, with total air pollution control costs in 2005 estimated at US$195 billion. More than 80% of the world's population is still found to be exposed to PM2.5 concentrations exceeding WHO air quality guidelines and health impacts resulting from these exposures estimated at around 2-5% of the global disease burden. Key questions to answer are 1) How will pollutant emissions evolve in the future given developments in the energy system and how will energy and environmental policies influence such emission trends. 2) What implications will this have for resulting exposures and related health outcomes. In order to answer these questions, varying levels of stringency of air quality legislation are analyzed in combination with policies on universal access to clean cooking fuels and limiting global temperature change to 2°C in 2100. Bottom-up methodologies using energy emissions modeling are used to derive sector-based pollutant emission trajectories until 2030. Emissions are spatially downscaled and used in combination with a global transport chemistry model to derive ambient concentrations of PM2.5. Health impacts of these exposures are further estimated consistent with WHO data and methodology. The results indicate that currently planned air quality legislation combined with rising energy demand will be insufficient in controlling future emissions growth in developing countries. In order to achieve significant reductions in pollutant emissions of the order of more than 50% from 2005 levels and reduce exposures to levels consistent with WHO standards, it will be necessary to increase the stringency of such legislations and combine them with policies on energy access and climate change. Combined policies also result in reductions in air pollution control costs as compared to those associated

  17. Understanding taxi travel patterns

    NASA Astrophysics Data System (ADS)

    Cai, Hua; Zhan, Xiaowei; Zhu, Ji; Jia, Xiaoping; Chiu, Anthony S. F.; Xu, Ming

    2016-09-01

    Taxis play important roles in modern urban transportation systems, especially in mega cities. While providing necessary amenities, taxis also significantly contribute to traffic congestion, urban energy consumption, and air pollution. Understanding the travel patterns of taxis is thus important for addressing many urban sustainability challenges. Previous research has primarily focused on examining the statistical properties of passenger trips, which include only taxi trips occupied with passengers. However, unoccupied trips are also important for urban sustainability issues because they represent potential opportunities to improve the efficiency of the transportation system. Therefore, we need to understand the travel patterns of taxis as an integrated system, instead of focusing only on the occupied trips. In this study we examine GPS trajectory data of 11,880 taxis in Beijing, China for a period of three weeks. Our results show that taxi travel patterns share similar traits with travel patterns of individuals but also exhibit differences. Trip displacement distribution of taxi travels is statistically greater than the exponential distribution and smaller than the truncated power-law distribution. The distribution of short trips (less than 30 miles) can be best fitted with power-law while long trips follow exponential decay. We use radius of gyration to characterize individual taxi's travel distance and find that it does not follow a truncated power-law as observed in previous studies. Spatial and temporal regularities exist in taxi travels. However, with increasing spatial coverage, taxi trips can exhibit dual high probability density centers.

  18. Positioner with long travel in two dimensions

    DOEpatents

    Trumper, David L.; Williams, Mark E.

    1997-12-23

    A precision positioning system is provided which provides long travel in two of the linear dimensions, while using non-contact bearings for both a first subassembly which provides long travel in one of the linear dimension and a second subassembly which provides long travel in the second linear dimension. The first or upper subassembly is preferably a magnetic subassembly which, in addition to providing long travel, also compensates or positions in three rotary dimensions and in the third linear dimension. The second subassembly is preferably either an air bearing or magnetic subassembly and is normally used only to provide long travel. Angled surfaces may be provided for magnetic bearings and capacitive or other gap sensing probes may be mounted to the stage and ground flush with the bearing actuators to provide more precise gap measurements.

  19. Prevention of spread of communicable disease by air travel.

    PubMed

    Evans, Anthony D; Thibeault, Claude

    2009-07-01

    Mathematical modeling suggests that travel restrictions are likely to have only a limited effect on minimizing the spread of disease. Nevertheless, medical screening of travelers remains an option to be considered in a risk-reduction strategy. Screening of departing and/or arriving travelers are possibilities, although the World Health Organization (WHO) favors the former as it is normally easier to geographically contain a disease prior to its transmission outside the outbreak area. Apart from airport screening, several other related issues require consideration, including: transmission of disease on board aircraft; transmission of disease in airport terminal buildings; and contact tracing. A major challenge is to ensure adequate resources are devoted to pandemic preparedness planning in the aviation sector, which may not be fully considered in a national preparedness plan. This is because the prevention of accidents occupies most of the attention of regulatory aviation authorities, and public health authorities do not always see aviation as a priority area. Chief medical officers of regulatory authorities may be in a position to facilitate collaboration between the many stakeholders involved in preparedness planning for aviation.

  20. Air Quality uFIND: User-oriented Tool Set for Air Quality Data Discovery and Access

    NASA Astrophysics Data System (ADS)

    Hoijarvi, K.; Robinson, E. M.; Husar, R. B.; Falke, S. R.; Schultz, M. G.; Keating, T. J.

    2012-12-01

    Historically, there have been major impediments to seamless and effective data usage encountered by both data providers and users. Over the last five years, the international Air Quality (AQ) Community has worked through forums such as the Group on Earth Observations AQ Community of Practice, the ESIP AQ Working Group, and the Task Force on Hemispheric Transport of Air Pollution to converge on data format standards (e.g., netCDF), data access standards (e.g., Open Geospatial Consortium Web Coverage Services), metadata standards (e.g., ISO 19115), as well as other conventions (e.g., CF Naming Convention) in order to build an Air Quality Data Network. The centerpiece of the AQ Data Network is the web service-based tool set: user-oriented Filtering and Identification of Networked Data. The purpose of uFIND is to provide rich and powerful facilities for the user to: a) discover and choose a desired dataset by navigation through the multi-dimensional metadata space using faceted search, b) seamlessly access and browse datasets, and c) use uFINDs facilities as a web service for mashups with other AQ applications and portals. In a user-centric information system such as uFIND, the user experience is improved by metadata that includes the general fields for discovery as well as community-specific metadata to narrow the search beyond space, time and generic keyword searches. However, even with the community-specific additions, the ISO 19115 records were formed in compliance with the standard, so that other standards-based search interface could leverage this additional information. To identify the fields necessary for metadata discovery we started with the ISO 19115 Core Metadata fields and fields that were needed for a Catalog Service for the Web (CSW) Record. This fulfilled two goals - one to create valid ISO 19115 records and the other to be able to retrieve the records through a Catalog Service for the Web query. Beyond the required set of fields, the AQ Community added

  1. Racial disparities in travel time to radiotherapy facilities in the Atlanta metropolitan area

    PubMed Central

    Peipins, Lucy A.; Graham, Shannon; Young, Randall; Lewis, Brian; Flanagan, Barry

    2018-01-01

    Low-income women with breast cancer who rely on public transportation may have difficulty in completing recommended radiation therapy due to inadequate access to radiation facilities. Using a geographic information system (GIS) and network analysis we quantified spatial accessibility to radiation treatment facilities in the Atlanta, Georgia metropolitan area. We built a transportation network model that included all bus and rail routes and stops, system transfers and walk and wait times experienced by public transportation system travelers. We also built a private transportation network to model travel times by automobile. We calculated travel times to radiation therapy facilities via public and private transportation from a population-weighted center of each census tract located within the study area. We broadly grouped the tracts by low, medium and high household access to a private vehicle and by race. Facility service areas were created using the network model to map the extent of areal coverage at specified travel times (30, 45 and 60 min) for both public and private modes of transportation. The median public transportation travel time to the nearest radiotherapy facility was 56 min vs. approximately 8 min by private vehicle. We found that majority black census tracts had longer public transportation travel times than white tracts across all categories of vehicle access and that 39% of women in the study area had longer than 1 h of public transportation travel time to the nearest facility. In addition, service area analyses identified locations where the travel time barriers are the greatest. Spatial inaccessibility, especially for women who must use public transportation, is one of the barriers they face in receiving optimal treatment. PMID:23726213

  2. Racial disparities in travel time to radiotherapy facilities in the Atlanta metropolitan area.

    PubMed

    Peipins, Lucy A; Graham, Shannon; Young, Randall; Lewis, Brian; Flanagan, Barry

    2013-07-01

    Low-income women with breast cancer who rely on public transportation may have difficulty in completing recommended radiation therapy due to inadequate access to radiation facilities. Using a geographic information system (GIS) and network analysis we quantified spatial accessibility to radiation treatment facilities in the Atlanta, Georgia metropolitan area. We built a transportation network model that included all bus and rail routes and stops, system transfers and walk and wait times experienced by public transportation system travelers. We also built a private transportation network to model travel times by automobile. We calculated travel times to radiation therapy facilities via public and private transportation from a population-weighted center of each census tract located within the study area. We broadly grouped the tracts by low, medium and high household access to a private vehicle and by race. Facility service areas were created using the network model to map the extent of areal coverage at specified travel times (30, 45 and 60 min) for both public and private modes of transportation. The median public transportation travel time to the nearest radiotherapy facility was 56 min vs. approximately 8 min by private vehicle. We found that majority black census tracts had longer public transportation travel times than white tracts across all categories of vehicle access and that 39% of women in the study area had longer than 1 h of public transportation travel time to the nearest facility. In addition, service area analyses identified locations where the travel time barriers are the greatest. Spatial inaccessibility, especially for women who must use public transportation, is one of the barriers they face in receiving optimal treatment. Published by Elsevier Ltd.

  3. A unifying framework of the demand for transnational medical travel.

    PubMed

    Osterle, August; Johnson, Tricia; Delgado, Jose

    2013-01-01

    Transnational medical travel has gained attention recently as a strategy for patients to obtain care that is higher quality, costs less, or offers improved access relative to care provided within their home countries. This article examines institutional environments in the European Union and United States that influence transnational medical travel, describes the conceptual model of demand for medical travel, and illustrates individual dimensions in the conceptual model of medical travel using a series of case studies. The conceptual model of medical travel is predicated on Andersen's behavioral model of health services. Transnational medical travel is a heterogeneous phenomenon that is influenced by a number of patient-related factors and by the institutional environment in which the patient resides. While cost, access, and quality are commonly cited factors that influence a patient's decision regarding where to seek care, multiple factors may simultaneously influence the decision about the destination for care, including culture, social factors, and the institutional environment. The conceptual framework addresses the patient-related factors that influence where a patient seeks care. This framework can help researchers and regulatory bodies to evaluate the opportunities and the risks of transnational medical travel and help providers and governments to develop international patient programs.

  4. Air Force Officer Accession Planning: Addressing Key Gaps in Meeting Career Field Academic Degree Requirements for Nonrated Officers

    DTIC Science & Technology

    2016-06-09

    C O R P O R A T I O N Research Report Air Force Officer Accession Planning Addressing Key Gaps in Meeting Career Field Academic Degree Requirements...various Air Force missions in particular career fields. Key to this goal for nonrated officers is establishing and enforcing academic degree...35 Developing Accession Targets by Academic Degree Type

  5. Urban spatial structure and the potential for vehicle miles traveled reduction.

    DOT National Transportation Integrated Search

    2016-04-01

    This research informs metropolitan land use planning by studying a heretofore understudied variation of land use travel behavior : interactions: how access to jobs in employment sub-centers influences household vehicle miles traveled (VMT) in the...

  6. Sampling model of government travel vouchers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hu, P.S.; Wright, T.

    1987-02-01

    A pilot survey was designed and executed to better understand the structure of the universe of all government travel vouchers. Thirteen civilian and military sites were selected for the pilot survey. A total of 3916 travel vouchers with attached tickets were sampled. During the course of the pilot survey, it was felt that the compounding problems of the relative rarity of the expired, unused tickets and the enormously huge universe were too much of an obstacle to overcome in sampling the entire universe (including the US Air Force, US Army, US Navy, US Marines, other Department of Defense offices, andmore » civil) in the first year. The universe was then narrowed to the US Air Force, and US Army which have to two largest government travel expenditures. Based on the results of the pilot survey, ORNL recommends a stratified two-stage cluster sampling model. With probability of 0.90, a sample of size 78 (sites) will be needed to estimate the amounts per airline which will not be more than $50,000 from the true values. This sampling model allows one to estimate the total dollar amounts of expired, unused tickets for individual airlines.« less

  7. Problems associated with hemodialysis and travel.

    PubMed

    Corbett, Richard W; Prout, Virginia; Haynes, Deborah; Edwards, Claire; Frankel, Andrew H

    2014-01-01

    While there is a recognized risk of hepatitis C acquisition associated with dialysis away from the "home" center, there is little documented data on the effect that dialysis while traveling has on the dialysis patient's health. This study was designed to examine the incidence of travel within a hemodialysis population and to ascertain whether travel was associated with morbidity for patients on hemodialysis. Travel data were collected prospectively over a 6-month period, from April 2009, for all patients receiving maintenance hemodialysis across our dialysis centers. Biochemical, microbiological, and hematological parameters as well as hepatitis serology and antibiotic starts were recorded for 12 weeks prior to and following dialysis away from center. A total of 172 individuals traveled on 200 occasions. The blood stream infection rate for travelers with a central venous catheter was 0.25 versus 0.83/1,000 access days (p = 0.038) in the 12 weeks pre-travel versus post-travel. Parenteral and oral antibiotic starts were both significantly elevated post-travel and were mainly instituted for either chest or urinary sepsis. There was evidence of raised inflammatory markers and anemia on return to center but no evidence of hepatitis B or hepatitis C seroconversion. Travel and dialysis away from a patient's usual hemodialysis unit is a common occurrence but is associated with an increased risk of bacterial infection, anemia, and inflammatory response. This study provides evidence for the concern that hemodialysis away from center is associated with increased morbidity. © 2014 International Society of Travel Medicine.

  8. Can air pollution negate the health benefits of cycling and walking?

    PubMed

    Tainio, Marko; de Nazelle, Audrey J; Götschi, Thomas; Kahlmeier, Sonja; Rojas-Rueda, David; Nieuwenhuijsen, Mark J; de Sá, Thiago Hérick; Kelly, Paul; Woodcock, James

    2016-06-01

    Active travel (cycling, walking) is beneficial for the health due to increased physical activity (PA). However, active travel may increase the intake of air pollution, leading to negative health consequences. We examined the risk-benefit balance between active travel related PA and exposure to air pollution across a range of air pollution and PA scenarios. The health effects of active travel and air pollution were estimated through changes in all-cause mortality for different levels of active travel and air pollution. Air pollution exposure was estimated through changes in background concentrations of fine particulate matter (PM2.5), ranging from 5 to 200μg/m3. For active travel exposure, we estimated cycling and walking from 0 up to 16h per day, respectively. These refer to long-term average levels of active travel and PM2.5 exposure. For the global average urban background PM2.5 concentration (22μg/m3) benefits of PA by far outweigh risks from air pollution even under the most extreme levels of active travel. In areas with PM2.5 concentrations of 100μg/m3, harms would exceed benefits after 1h 30min of cycling per day or more than 10h of walking per day. If the counterfactual was driving, rather than staying at home, the benefits of PA would exceed harms from air pollution up to 3h 30min of cycling per day. The results were sensitive to dose-response function (DRF) assumptions for PM2.5 and PA. PA benefits of active travel outweighed the harm caused by air pollution in all but the most extreme air pollution concentrations. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Altitude-Related Illness: Advice to Travellers

    PubMed Central

    Crutcher, Rodney A.

    1990-01-01

    Altitude-related medical problems have received much attention in the recent medical literature. Family physicians must be knowledgeable about these problems so that they can give appropriate advice to travellers. The author, a practising family physician, discusses issues arising from both the modest cabin altitudes experienced in modern-day air travel and the greater altitudes experienced by skiers and trekkers, pilots and mountaineers, and lowland adventurers of all sorts. He reviews the process of acclimatization to altitude and the four principal forms of altitude illness. PMID:21233912

  10. The Ginghai-Tibet railway and Tibet tourism: travelers' perspectives

    Treesearch

    Ming Ming Su; Geoffrey Wall

    2009-01-01

    The Qinghai-Tibet railway opened in July 2006 and boosted Tibetan tourism markedly by increasing the accessibility and affordability of travel from China to Tibet. This study evaluates the railway's impacts on tourists' travel decisions and experiences in Tibet. The relative importance of the train journey in comparison with the destination experience in...

  11. Entry and exit screening of airline travellers during the A(H1N1) 2009 pandemic: a retrospective evaluation.

    PubMed

    Khan, Kamran; Eckhardt, Rose; Brownstein, John S; Naqvi, Raza; Hu, Wei; Kossowsky, David; Scales, David; Arino, Julien; MacDonald, Michael; Wang, Jun; Sears, Jennifer; Cetron, Martin S

    2013-05-01

    To evaluate the screening measures that would have been required to assess all travellers at risk of transporting A(H1N1)pdm09 out of Mexico by air at the start of the 2009 pandemic. Data from flight itineraries for travellers who flew from Mexico were used to estimate the number of international airports where health screening measures would have been needed, and the number of travellers who would have had to be screened, to assess all air travellers who could have transported the H1N1 influenza virus out of Mexico during the initial stages of the 2009 A(H1N1) pandemic. Exit screening at 36 airports in Mexico, or entry screening of travellers arriving on direct flights from Mexico at 82 airports in 26 other countries, would have resulted in the assessment of all air travellers at risk of transporting A(H1N1)pdm09 out of Mexico at the start of the pandemic. Entry screening of 116 travellers arriving from Mexico by direct or connecting flights would have been necessary for every one traveller at risk of transporting A(H1N1)pdm09. Screening at just eight airports would have resulted in the assessment of 90% of all air travellers at risk of transporting A(H1N1)pdm09 out of Mexico in the early stages of the pandemic. During the earliest stages of the A(H1N1) pandemic, most public health benefits potentially attainable through the screening of air travellers could have been achieved by screening travellers at only eight airports.

  12. Entry and exit screening of airline travellers during the A(H1N1) 2009 pandemic: a retrospective evaluation

    PubMed Central

    Eckhardt, Rose; Brownstein, John S; Naqvi, Raza; Hu, Wei; Kossowsky, David; Scales, David; Arino, Julien; MacDonald, Michael; Wang, Jun; Sears, Jennifer; Cetron, Martin S

    2013-01-01

    Abstract Objective To evaluate the screening measures that would have been required to assess all travellers at risk of transporting A(H1N1)pdm09 out of Mexico by air at the start of the 2009 pandemic. Methods Data from flight itineraries for travellers who flew from Mexico were used to estimate the number of international airports where health screening measures would have been needed, and the number of travellers who would have had to be screened, to assess all air travellers who could have transported the H1N1 influenza virus out of Mexico during the initial stages of the 2009 A(H1N1) pandemic. Findings Exit screening at 36 airports in Mexico, or entry screening of travellers arriving on direct flights from Mexico at 82 airports in 26 other countries, would have resulted in the assessment of all air travellers at risk of transporting A(H1N1)pdm09 out of Mexico at the start of the pandemic. Entry screening of 116 travellers arriving from Mexico by direct or connecting flights would have been necessary for every one traveller at risk of transporting A(H1N1)pdm09. Screening at just eight airports would have resulted in the assessment of 90% of all air travellers at risk of transporting A(H1N1)pdm09 out of Mexico in the early stages of the pandemic. Conclusion During the earliest stages of the A(H1N1) pandemic, most public health benefits potentially attainable through the screening of air travellers could have been achieved by screening travellers at only eight airports. PMID:23678200

  13. Defense.gov Special Report: Travels With Hagel

    Science.gov Websites

    Force base on the Florida panhandle, talking to pilots from the 33rd Fighter Wing, meeting with and in an F-35 fighter. Troop Event At Eglin Air Force Base More Video Hagel Troop Event Kings Bay Travel Locations Map of Hagel's Trip Naval Submarine Base Kings Bay, Georgia. Eglin Air Force Base, Florida. Fort

  14. A cross-sectional study of pre-travel health-seeking practices among travelers departing Sydney and Bangkok airports

    PubMed Central

    2012-01-01

    advice than Australian-born travelers. Conclusions This study highlights differences in health-seeking practices including the uptake of pre-travel health advice by region of residence and country of birth. There is a public health need to identify strategies targeting these travel groups. This includes the promotion of affordable and accessible travel clinics in low resource countries as traveler numbers increase and travel health promotion targeting migrant groups in high resource countries. General practitioners should play a central role. Determining the most appropriate strategies for increasing pre-travel health preparation, particularly for vaccine preventable diseases in travelers is the next stage in advancing travel medicine research. PMID:22550996

  15. A cross-sectional study of pre-travel health-seeking practices among travelers departing Sydney and Bangkok airports.

    PubMed

    Heywood, Anita E; Watkins, Rochelle E; Iamsirithaworn, Sopon; Nilvarangkul, Kessarawan; MacIntyre, C Raina

    2012-05-02

    -born travelers. This study highlights differences in health-seeking practices including the uptake of pre-travel health advice by region of residence and country of birth. There is a public health need to identify strategies targeting these travel groups. This includes the promotion of affordable and accessible travel clinics in low resource countries as traveler numbers increase and travel health promotion targeting migrant groups in high resource countries. General practitioners should play a central role. Determining the most appropriate strategies for increasing pre-travel health preparation, particularly for vaccine preventable diseases in travelers is the next stage in advancing travel medicine research.

  16. Environmental Assessment for Wing Infrastructure Development Outlook (WINDO) Projects at Holloman Air Force Base, New Mexico

    DTIC Science & Technology

    2005-11-01

    Air Force Base, Alamogordo, New Mexico Li ncol n Cou n ty Si err a Cou n ty Oter o Cou n ty Doñ a A n a Cou n ty Ruidoso Ruidoso Downs Tularosa...Tularosa, New Mexico; US 70 travels northeast through Ruidoso , New Mexico, and US 54 provides access to northern New Mexico. In Las Cruces, US 70

  17. Unsteady planar diffusion flames: Ignition, travel, burnout

    NASA Technical Reports Server (NTRS)

    Fendell, F.; Wu, F.

    1995-01-01

    In microgravity, a thin planar diffusion flame is created and thenceforth travels so that the flame is situated at all times at an interface at which the hydrogen and oxygen meet in stoichiometric proportion. If the initial amount of hydrogen is deficient relative to the initial amount of oxygen, then the planar flame will travel further and further into the half volume initially containing hydrogen, until the hydrogen is (virtually) fully depleted. Of course, when the amount of residual hydrogen becomes small, the diffusion flame is neither vigorous nor thin; in practice, the flame is extinguished before the hydrogen is fully depleted, owing to the finite rate of the actual chemical-kinetic mechanism. The rate of travel of the hydrogen-air diffusion flame is much slower than the rate of laminar flame propagation through a hydrogen-air mixture. This slow travel facilitates diagnostic detection of the flame position as a function of time, but the slow travel also means that the time to burnout (extinction) probably far exceeds the testing time (typically, a few seconds) available in earth-sited facilities for microgravity-environment experiments. We undertake an analysis to predict (1) the position and temperature of the diffusion flame as a function of time, (2) the time at which extinction of the diffusion flame occurs, and (3) the thickness of quench layers formed on side walls (i.e., on lateral boundaries, with normal vectors parallel to the diffusion-flame plane), and whether, prior to extinction, water vapor formed by burning will condense on these cold walls.

  18. 76 FR 2290 - TRICARE; Reimbursement for Travel for Specialty Care Under Exceptional Circumstances

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-13

    ... miles but more than 60 minutes in drive time to access needed specialty care. This travel reimbursement... specialty care requiring travel beyond a 60-minute drive time but within 100 miles of the military treatment...] TRICARE; Reimbursement for Travel for Specialty Care Under Exceptional Circumstances AGENCY: Office of the...

  19. Three essays on access pricing

    NASA Astrophysics Data System (ADS)

    Sydee, Ahmed Nasim

    access pricing with congestion and in which investments in infrastructure are lumpy. To fix ideas, the model is formulated in the context of airport infrastructure investments, which captures both the element of congestion and the lumpiness involved in infrastructure investments. The optimal investment program suggests how many units of capacity should be installed and at which times. Because time is continuous in the model, the discounted cost -- despite the lumpiness of capacity additions -- can be made to vary continuously by varying the time a capacity addition is made. The main results that emerge from the analysis can be described as follows: First, the global demand for air travel rises with time and experiences an upward jump whenever a capacity addition is made. Second, the access price is constant and stays at the basic level when the system is not congested. When the system is congested, a congestion surcharge is imposed on top of the basic level, and the congestion surcharge rises with the level of congestion until the next capacity addition is made at which time the access price takes a downward jump. Third, the individual demand for air travel is constant before congestion sets in and after the last capacity addition takes place. During a time interval in which congestion rises, the individual demand for travel is below the level that prevails when there is no congestion and declines as congestion worsens. The third essay contains a model of access pricing for natural gas transmission pipelines, both when pipeline operators are regulated and when they behave strategically. The high sunk costs involved in building a pipeline network constitute a serious barrier of entry, and competitive behaviour in the transmission pipeline sector cannot be expected. Most of the economic analyses of access pricing for natural gas transmission pipelines are carried out from the regulatory perspective, and the access price paid by shippers are cost-based. The model formalized

  20. Travel fosters tool use in wild chimpanzees

    PubMed Central

    Gruber, Thibaud; Zuberbühler, Klaus; Neumann, Christof

    2016-01-01

    Ecological variation influences the appearance and maintenance of tool use in animals, either due to necessity or opportunity, but little is known about the relative importance of these two factors. Here, we combined long-term behavioural data on feeding and travelling with six years of field experiments in a wild chimpanzee community. In the experiments, subjects engaged with natural logs, which contained energetically valuable honey that was only accessible through tool use. Engagement with the experiment was highest after periods of low fruit availability involving more travel between food patches, while instances of actual tool-using were significantly influenced by prior travel effort only. Additionally, combining data from the main chimpanzee study communities across Africa supported this result, insofar as groups with larger travel efforts had larger tool repertoires. Travel thus appears to foster tool use in wild chimpanzees and may also have been a driving force in early hominin technological evolution. DOI: http://dx.doi.org/10.7554/eLife.16371.001 PMID:27431611

  1. Travel fosters tool use in wild chimpanzees.

    PubMed

    Gruber, Thibaud; Zuberbühler, Klaus; Neumann, Christof

    2016-07-19

    Ecological variation influences the appearance and maintenance of tool use in animals, either due to necessity or opportunity, but little is known about the relative importance of these two factors. Here, we combined long-term behavioural data on feeding and travelling with six years of field experiments in a wild chimpanzee community. In the experiments, subjects engaged with natural logs, which contained energetically valuable honey that was only accessible through tool use. Engagement with the experiment was highest after periods of low fruit availability involving more travel between food patches, while instances of actual tool-using were significantly influenced by prior travel effort only. Additionally, combining data from the main chimpanzee study communities across Africa supported this result, insofar as groups with larger travel efforts had larger tool repertoires. Travel thus appears to foster tool use in wild chimpanzees and may also have been a driving force in early hominin technological evolution.

  2. 19. TRAVELING CRANE ATOP SUPERSTRUCTURE, FROM RUN LINE DECK. Looking ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    19. TRAVELING CRANE ATOP SUPERSTRUCTURE, FROM RUN LINE DECK. Looking up to north northeast. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-A, Test Area 1-120, north end of Jupiter Boulevard, Boron, Kern County, CA

  3. 75 FR 69080 - Federal Travel Regulation (FTR)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-10

    ... GENERAL SERVICES ADMINISTRATION Federal Travel Regulation (FTR) Fly America Act; United States and European Union ``Open Skies'' Air Transport Agreement (US-EU Open Skies Agreement) AGENCY: Office of Governmentwide Policy, General Services Administration (GSA). [[Page 69081

  4. Profiles of traveler information services, update 2007.

    DOT National Transportation Integrated Search

    2007-07-01

    Profiles of 511 Traveler Information Services Update 2007 was prepared by the Federal Transit Administrations (FTA) Office of Research, Demonstration and Innovation to increase public awareness, access, and knowledge of the transit content within ...

  5. Defense Travel Management Office (DTMO)

    Science.gov Websites

    ) Bullet Allowance Tables Bullet Allowance Calculators Bullet Restricted Fares Training Resources Training Resources Bullet Training Resource Lookup Bullet Listing of Available Training Resources Bullet New and Updated Training Resources Bullet Instructions for Accessing Training in Travel Explorer Bullet Enterprise

  6. Time-zone effects on the long distance air traveler.

    DOT National Transportation Integrated Search

    1969-09-01

    Findings are presented on the consequences of rapidly crossing numerous time zones, such as occurs in present-day jet aircraft travel. Conclusions reached by FAA researchers and scientists of other laboratories are included, together with recommendat...

  7. Forecasting the demand potential for STOL air transportation

    NASA Technical Reports Server (NTRS)

    Fan, S.; Horonjeff, R.; Kanafani, A.; Mogharabi, A.

    1973-01-01

    A process for predicting the potential demand for STOL aircraft was investigated to provide a conceptual framework, and an analytical methodology for estimating the STOL air transportation market. It was found that: (1) schedule frequency has the strongest effect on the traveler's choice among available routes, (2) work related business constitutes approximately 50% of total travel volume, and (3) air travel demand follows economic trends.

  8. The effect of centralization of health care services on travel time and its equality.

    PubMed

    Kobayashi, Daisuke; Otsubo, Tetsuya; Imanaka, Yuichi

    2015-03-01

    To analyze the regional variations in travel time between patient residences and medical facilities for the treatment of ischemic heart disease and breast cancer, and to simulate the effects of health care services centralization on travel time and equality of access. We used medical insurance claims data for inpatients and outpatients for the two target diseases that had been filed between September 2008 and May 2009 in Kyoto Prefecture, Japan. Using a geographical information system, patient travel times were calculated based on the driving distance between patient residences and hospitals via highways and toll roads. Locations of residences and hospital locations were identified using postal codes. We then conducted a simulation analysis of centralization of health care services to designated regional core hospitals. The simulated changes in potential spatial access to care were examined. Inequalities in access to care were examined using Gini coefficients, which ranged from 0.4109 to 0.4574. Simulations of health care services centralization showed reduced travel time for most patients and overall improvements in equality of access, except in breast cancer outpatients. Our findings may contribute to the decision-making process in policies aimed at improving the potential spatial access to health care services. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. 77 FR 63245 - Rules of Practice in Air Safety Proceedings; Rules Implementing the Equal Access to Justice Act...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-16

    ... of Practice in Air Safety Proceedings; Rules Implementing the Equal Access to Justice Act of 1980... procedure concerning applications for fees and expenses under the Equal Access to Justice Act of 1980 (EAJA... procedure, Airmen, Aviation safety. 49 CFR Part 826 Claims, Equal access to justice, Lawyers. For the...

  10. Using Open and Interoperable Ways to Publish and Access LANCE AIRS Near-Real Time Data

    NASA Technical Reports Server (NTRS)

    Zhao, Peisheng; Lynnes, Christopher; Vollmer, Bruce; Savtchenko, Andrey; Theobald, Michael; Yang, Wenli

    2011-01-01

    The Atmospheric Infrared Sounder (AIRS) Near-Real Time (NRT) data from the Land Atmosphere Near real-time Capability for EOS (LANCE) element at the Goddard Earth Sciences Data and Information Services Center (GES DISC) provides information on the global and regional atmospheric state, with very low temporal latency, to support climate research and improve weather forecasting. An open and interoperable platform is useful to facilitate access to, and integration of, LANCE AIRS NRT data. As Web services technology has matured in recent years, a new scalable Service-Oriented Architecture (SOA) is emerging as the basic platform for distributed computing and large networks of interoperable applications. Following the provide-register-discover-consume SOA paradigm, this presentation discusses how to use open-source geospatial software components to build Web services for publishing and accessing AIRS NRT data, explore the metadata relevant to registering and discovering data and services in the catalogue systems, and implement a Web portal to facilitate users' consumption of the data and services.

  11. A Case of Prolonged Delayed Postdural Puncture Headache in a Patient with Multiple Sclerosis Exacerbated by Air Travel

    PubMed Central

    Porhomayon, Jahan; Zadeii, Gino; Yarahamadi, Alireza; Nader, Nader D.

    2013-01-01

    The developments of new spinal needles and needle tip designs have reduced the incidence of postdural puncture headache (PDPH). Although it is clear that reducing the loss of CSF leak from dural puncture reduces the headache, there are areas regarding the pathogenesis, treatment, and prevention of PDPH that remain controversial. Air travel by itself may impose physiological alteration in central nervous system that may be detrimental to patients with PDPH. This case report highlights a case of a young female patient who suffered from a severe incapacitating PDPH headache during high-altitude flight with a commercial jet. PMID:23401803

  12. Attack rates of dengue fever in Swedish travellers.

    PubMed

    Rocklöv, Joacim; Lohr, Wolfgang; Hjertqvist, Marika; Wilder-Smith, Annelies

    2014-06-01

    Dengue is endemic in many countries visited by Swedish travellers. We aimed to determine the attack rate of dengue in Swedish travellers and analyse the trends over time and the geographical variation. We obtained the following data from the Swedish Institute for Communicable Disease Control for the y 1995-2010: number of Swedish residents with confirmed dengue, the country and year of infection. We also obtained registers on the Swedish annual air traveller arrivals to dengue endemic areas from the United Nations World Tourist Organization for the time period. We estimated attack rates with 95% confidence intervals (CI). In total, 925 Swedish travellers with confirmed dengue were reported. We found an increasing trend over time for most destinations. The majority of the dengue cases were acquired in Thailand (492 out of 925 travellers; 53%), with an attack rate of 13.6 (95% CI 12.7, 14.4) per 100,000 travellers. However, the 2 highest attack rates per 100,000 travellers were found for Sri Lanka (45.3, 95% CI 34.3, 56.4) and Bangladesh (42.6, 95% CI 23.8, 61.5). Information on attack rates in travellers is more helpful in guiding travel medicine practitioners than reports of absolute numbers, as the latter reflect travel preferences rather than the true risk. Although the majority of dengue infections in Swedish travellers were acquired in Thailand, the attack rates for dengue in travellers to Sri Lanka and Bangladesh were much higher. These data aid in refining information on the risk of dengue in travellers.

  13. Assessing and quantifying public transit access.

    DOT National Transportation Integrated Search

    2014-03-01

    Measuring access to transit services is important in evaluating existing services, predicting travel demands, allocating transportation investments and making decisions on land development. A composite index for assessing accessibility of public tran...

  14. Derivation of Nonlinear Wave Equation for Flexural Motions of AN Elastic Beam Travelling in AN Air-Filled Tube

    NASA Astrophysics Data System (ADS)

    Sugimoto, N.; Kugo, K.; Watanabe, Y.

    2002-07-01

    Asymptotic analysis is carried out to derive a nonlinear wave equation for flexural motions of an elastic beam of circular cross-section travelling along the centre-axis of an air-filled, circular tube placed coaxially. Both the beam and tube are assumed to be long enough for end-effects to be ignored and the aerodynamic loading on the lateral surface of the beam is considered. Assuming a compressible inviscid fluid, the velocity potential of the air is sought systematically in the form of power series in terms of the ratios of the tube radius to a wavelength and of a typical deflection to the radius. Evaluating the pressure force acting on the lateral surface of the beam, the aerodynamic loading including the effects of finite deflection as well as of air's compressibility and axial curvature of the beam are obtained. Although the nonlinearity arises from the kinematical condition on the beam surface, it may be attributed to the presence of the tube wall. With the aerodynamic loading thus obtained, a nonlinear wave equation is derived, whereas linear theory is assumed for the flexural motions of the beam. Some discussions are given on the results.

  15. Travelling for treatment; does distance and deprivation affect travel for intensity-modulated radiotherapy in the rural setting for head and neck cancer?

    PubMed

    Cosway, B; Douglas, L; Armstrong, N; Robson, A

    2017-06-01

    NHS England has commissioned intensity-modulated radiotherapy for head and neck cancers from Newcastle hospitals for patients in North Cumbria. This study assessed whether travel distances affected the decision to travel to Newcastle (to receive intensity-modulated radiotherapy) or Carlisle (to receive conformal radiotherapy). All patients for whom the multidisciplinary team recommended intensity-modulated radiotherapy between December 2013 and January 2016 were included. Index of multiple deprivation scores and travel distances were calculated. Patients were also asked why they chose their treating centre. Sixty-nine patients were included in this study. There were no significant differences in travel distance (p = 0.53) or index of multiple deprivation scores (p = 0.47) between patients opting for treatment in Carlisle or Newcastle. However, 29 of the 33 patients gave travel distance as their main reason for not travelling for treatment. Quantitatively, travel distance and deprivation does not impact on whether patients accept intensity-modulated radiotherapy. However, patients say distance is a major barrier for access. Future research should explore how to reduce this.

  16. 41 CFR 301-10.135 - When must I travel using U.S. flag air carrier service?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... be used, but only to or from the nearest interchange point on a usually traveled route to connect... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false When must I travel using... Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES ALLOWABLE TRAVEL EXPENSES...

  17. Patients without borders: understanding medical travel.

    PubMed

    Whittaker, Andrea; Manderson, Lenore; Cartwright, Elizabeth

    2010-10-01

    The rapidly growing medical travel industry has implications for the health systems of both sending and receiving countries. This article outlines the political economy of the industry and the potential opportunities and disadvantages it poses for access, equity, and the right to health. Although the trade carries economic benefits for countries receiving foreign medical patients, it comes at a cost to the provision of public health, through distortions in the health workforce and the development of two-tiered health systems. Inequalities and failures in the health systems of sending countries largely drive the need to travel for care.

  18. Importation of yellow fever into China: assessing travel patterns.

    PubMed

    Wilder-Smith, Annelies; Leong, W Y

    2017-07-01

    Rapid increase in trade and a growing air passenger market encourages high travel volume between the regions associated with increasing risks of such importations including China. Eleven Chinese workers infected during the 2016 yellow fever (YF) outbreak in Angola imported YF into China highlighting the potential for spread into Asia. Using outbound and inbound travel data, we assessed travel patterns from and to YF endemic countries in relation to China. Among YF endemic countries, Angola has the second highest number of travellers into China and also receives the second highest number of Chinese visitors. We estimated that China needs around half a million YF vaccine doses to cover their population travelling to YF endemic countries. The recent importation cases into China also unmasked the low YF vaccination coverage among Chinese travellers and workers to Angola, indicating the need to ensure better adherence to the International Health Regulations. © International Society of Travel Medicine, 2017.. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Pharmacy travel health services: current perspectives and future prospects

    PubMed Central

    Houle, Sherilyn KD

    2017-01-01

    Rates of international travel are increasing annually, with particular growth observed in travel to Southeast Asia and to emerging economies. While all patients traveling across geographic regions are recommended to receive a pre-travel consultation to consider their individual risks, many do not, or receive care and recommendations that are not consistent with current evidence-based guidelines. As experts in drug therapy, and given the largely preventive nature of most travel health recommendations, pharmacists are well suited to help address this need. Pharmacists generally possess a high degree of knowledge and confidence with more commonly observed travel health topics in community practice such as travelers’ diarrhea; however, training in more specialized travel health topics such as travel vaccinations and traveling at altitude has generally been lacking from pharmacy curricula. Pharmacists with an interest in providing pre-travel consultations are encouraged to pursue additional training in this specialty and to consider Certificate in Travel Health designation from the International Society of Travel Medicine. Future roles for pharmacists to include the prescribing of medications and vaccines for travel and the in-pharmacy administration of travel vaccinations may improve patient access to pre-travel consultations and recommended preventive measures, improving the health of travelers and potentially reducing the burden of communicable disease worldwide. Pharmacists providing travel care to patients are also reminded to consider noninfectious risks of illness and injury abroad and to counsel patients on strategies to minimize these risks in addition to providing drug and vaccine recommendations. PMID:29721445

  20. Distance traveled for Medicaid-covered abortion care in California.

    PubMed

    Johns, Nicole E; Foster, Diana Greene; Upadhyay, Ushma D

    2017-04-19

    Access to abortion care in the United States is limited by the availability of abortion providers and their geographic distribution. We aimed to assess how far women travel for Medicaid-funded abortion in California and identify disparities in access to abortion care. We obtained data on all abortions reimbursed by the fee-for-service California state Medicaid program (Medi-Cal) in 2011 and 2012 and examined distance traveled to obtain abortion care by several demographic and abortion-related factors. Mixed-effects multivariable logistic regression models were constructed to examine factors associated with traveling 50 miles or more. County-level t-tests and linear regressions were conducted to examine the effects of a Medi-Cal abortion provider in a county on overall and urban/rural differences in utilization. 11.9% (95% CI: 11.5-12.2%) of women traveled 50 miles or more. Women obtaining second trimester or later abortions (21.7%), women obtaining abortions at hospitals (19.9%), and rural women (51.0%) were most likely to travel 50 miles or more. Across the state, 28 counties, home to 10% of eligible women, did not have a facility routinely providing Medi-Cal-covered abortions. Efforts are needed to expand the number of abortion providers that accept Medi-Cal. This could be accomplished by increasing Medi-Cal reimbursement rates, increasing the types of providers who can provide abortions, and expanding the use of telemedicine. If national trends in declining unintended pregnancy and abortion rates continue, careful attention should be paid to ensure that reduced demand does not lead to greater disparities in geographic and financial access to abortion care by ensuring that providers accepting Medicaid payment are available and widely distributed.

  1. Malaria: prevention in travellers.

    PubMed

    Croft, Ashley M

    2007-11-29

    Malaria transmission occurs most frequently in environments with humidity over 60% and ambient temperature of 25-30 degrees C. Risks increase with longer visits and depend on activity. Infection can follow a single mosquito bite. Incubation is usually 10-14 days but can be up to 18 months depending on the strain of parasite. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug preventive interventions in adult travellers? What are the effects of drug prophylaxis in adult travellers? What are the effects of antimalaria vaccines in travellers? What are the effects of antimalaria interventions in child travellers, pregnant travellers, and in airline pilots? We searched: Medline, Embase, The Cochrane Library and other important databases up to February 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 69 systematic reviews, RCTs, or observational studies that met our inclusion criteria. In this systematic review we present information relating to the effectiveness and safety of the following interventions: acoustic buzzers, aerosol insecticides, amodiaquine, air conditioning and electric fans, atovaquone-proguanil, biological control measures, chloroquine (alone or with proguanil), diethyltoluamide (DEET), doxycycline, full-length and light-coloured clothing, insecticide-treated clothing/nets, mefloquine, mosquito coils and vaporising mats, primaquine, pyrimethamine-dapsone, pyrimethamine-sulfadoxine, smoke, topical (skin-applied) insect repellents, and vaccines.

  2. Vaccinations for international travellers travelling from Greece.

    PubMed

    Pavli, Androula; Spilioti, Athina; Lymperi, Ioanna; Katerelos, Panagiotis; Maltezou, Helena C

    2013-01-01

    The aim of this prospective, questionnaire-based study is to assess pre-travel vaccinations for international travellers who receive pre-travel advice in Greece. A total of 2494 travellers were studied from January 1, 2009 through December 31, 2010. Travellers sought pre-travel advice at a median of 16 days (range: 0-349 days) before departure. Sub-Saharan Africa was the most common destination (34.7%). Most travellers (60.8%) travelled for <1 month, for recreation purposes (58.9%), stayed in hotels (65.3%), and in urban areas (53.6%). Yellow fever, tetravalent meningococcal, typhoid fever, cholera, and rabies vaccines were administered to 1629 (65.3%), 666 (26.7%), 615 (24.7%), 28 (1.1%), and/or 12 (0.5%) travellers, respectively. Of those who received Yellow fever vaccine, 737 (45.2%) travelled to sub-Saharan Africa, 332 (20.4%) travelled to South America, 949 (58.3%) stayed for short term, and 762 (46.8%) stayed in urban areas. Of the 1629 travellers vaccinated against Yellow fever, 150 (9.2%) and 226 (13.8%) travelled to areas of sub-Saharan Africa and South America respectively, where the vaccine is not or generally not recommended. Of those travellers who received meningococcal vaccine, 327 (49.1%) travelled to the Middle East for the Hajj, 251 (29%) travelled to sub-Saharan Africa, 410 (61.6%) for short term, and 540 (64.4%) stayed in urban areas. Of those travellers who received typhoid vaccine, 241 (39.2%) travelled to sub-Saharan Africa, 78 (12.7%) to the Indian subcontinent, 234 (38%) for short term, and 419 (68.1%) stayed in urban areas. Regarding routine vaccines, tetanus-diphtheria, poliomyelitis, and measles-mumps-rubella vaccines were administered to 707 (28.3%), 639 (25.6%) and/or 149 (6%) travellers, respectively. Of those to whom poliomyelitis vaccine was recommended, 295 (46.2%) and 137 (21.4%) travelled to sub-Saharan Africa and the Middle East, respectively, and 362 (56.7%) travelled for short term. In conclusion, this study revealed that

  3. Profiles of 511 traveler information services update 2008.

    DOT National Transportation Integrated Search

    2008-07-01

    Profiles of 511 Traveler Information Services Update 2008 was prepared by the Federal Transit : Administrations (FTA) Office of Research, Demonstration and Innovation to increase public : awareness, access, and knowledge of the transit content wit...

  4. Profiles of 511 traveler information services update 2009.

    DOT National Transportation Integrated Search

    2009-04-01

    Profiles of 511 Traveler Information Services Update 2009 was prepared by the Federal Transit Administrations (FTA) Office of Research, Demonstration and Innovation to increase public awareness, access, and knowledge of the transit content within ...

  5. From Livingstone to ecotourism. What's new in travel medicine?

    PubMed

    Houston, S

    2000-01-01

    To review recent developments in the field of travel medicine and to outline the knowledge and resources family physicians need for providing health advice to travelers headed for tropical or developing countries. Personal files; references from review articles and from a recent textbook of travel medicine; current guidelines on pretravel advice; and a review of the 1996 to 1999 MEDLINE database using "travel medicine" as a term and subject heading, "trave(l)lers' diarrhea" as a text word and subject heading, "immunization + travel," and "malaria + chemo prevention" were used as information sources. Priority was given to randomized controlled trials and recommendations of expert or national bodies. Some elements of travel medicine, such as malaria chemoprophylaxis, have become more complex. Some valuable new preventive measures, such as hepatitis A vaccine, treated bed nets, and antimalarial drugs, have become available. Some health risks, such as cholera, have been overemphasized in the past, whereas others, such as tuberculosis and sexually transmitted diseases, have been underemphasized. Information sources relevant for providing travel health advice have improved and expanded. Canadian evidence-based guidelines addressing most important travel health issues are now available. Travel medicine is a rapidly evolving field. Physicians intending to provide health advice to travelers to high-risk parts of the world should be well prepared and have access to good, up-to-date information.

  6. Measuring geographic access to health care: raster and network-based methods

    PubMed Central

    2012-01-01

    Background Inequalities in geographic access to health care result from the configuration of facilities, population distribution, and the transportation infrastructure. In recent accessibility studies, the traditional distance measure (Euclidean) has been replaced with more plausible measures such as travel distance or time. Both network and raster-based methods are often utilized for estimating travel time in a Geographic Information System. Therefore, exploring the differences in the underlying data models and associated methods and their impact on geographic accessibility estimates is warranted. Methods We examine the assumptions present in population-based travel time models. Conceptual and practical differences between raster and network data models are reviewed, along with methodological implications for service area estimates. Our case study investigates Limited Access Areas defined by Michigan’s Certificate of Need (CON) Program. Geographic accessibility is calculated by identifying the number of people residing more than 30 minutes from an acute care hospital. Both network and raster-based methods are implemented and their results are compared. We also examine sensitivity to changes in travel speed settings and population assignment. Results In both methods, the areas identified as having limited accessibility were similar in their location, configuration, and shape. However, the number of people identified as having limited accessibility varied substantially between methods. Over all permutations, the raster-based method identified more area and people with limited accessibility. The raster-based method was more sensitive to travel speed settings, while the network-based method was more sensitive to the specific population assignment method employed in Michigan. Conclusions Differences between the underlying data models help to explain the variation in results between raster and network-based methods. Considering that the choice of data model/method may

  7. 2001 New York State NHTS: Travel Patterns of Special Populations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hu, Patricia S; Reuscher, Tim

    Policymakers rely on transportation statistics, including data on personal travel behavior, to formulate strategic transportation policies, and to improve the safety and efficiency of the U.S. transportation system. Data on personal travel trends are needed to examine the reliability, efficiency, capacity, and flexibility of the Nation's transportation system to meet current demands and accommodate future demands; to assess the feasibility and efficiency of alternative congestion-alleviating technologies (e.g., high-speed rail, magnetically levitated trains, intelligent vehicle and highway systems); to evaluate the merits of alternative transportation investment programs; and to assess the energy-use and air-quality impacts of various policies. To address thesemore » data needs, the U.S. Department of Transportation (USDOT) initiated an effort in 1969 to collect detailed data on personal travel. The 1969 survey was the first Nationwide Personal Transportation Survey (NPTS). The survey was conducted again in 1977, 1983, 1990, 1995, and 2001. Data on daily travel were collected in 1969, 1977, 1983, 1990 and 1995. Longer-distance travel was collected in 1977 and 1995. The 2001 National Household Travel Survey (NHTS) collected both daily and longer-distance trips in one survey. The 2001 survey was sponsored by three USDOT agencies: Federal Highway Administration (FHWA), Bureau of Transportation Statistics (BTS), and National Highway Traffic Safety Administration (NHTSA). The primary objective of the survey was to collect trip-based data on the nature and characteristics of personal travel so that the relationships between the characteristics of personal travel and the demographics of the traveler can be established. Commercial and institutional travel was not part of the survey. New York State participated in the 2001 NHTS by procuring additional 12,000 sample households. These additional sample households allowed New York State to address transportation planning

  8. When travel is a challenge: Travel medicine and the 'dis-abled' traveller.

    PubMed

    Bauer, Irmgard

    Travellers with recognised disabilities or the dis-ability to function as required during a trip have been overlooked in the travel medicine literature. This paper provides a starting point for further discussion and research into this neglected traveller population. In contrast, tourism research has explored travel with a disability for some time in order to understand the travellers' needs and to improve services accordingly. The contemporary bio-psycho-social understanding of disability serves as the framework for exploring motivations to travel as well as barriers, such as inter and intrapersonal, economic, structural and attitudinal obstacles. The demands of complex travel planning are acknowledged. Attention is also drawn to the particular issue of acquired disability. The theoretical discussion is complemented by travellers' own accounts using as examples mobility impairment on aeroplanes, sensory impairments, and obesity. These insights should inform high quality travel health care starting with an exploration of the health professionals' own views on such endeavours. Important are appropriate communication skills, an understanding of the travellers'/carers' views, wishes and judgment of abilities, as well as the appreciation of the reason for the trip, destination and planned activities. Challenging may be the need to accept that the traveller/carer will be more knowledgeable about the disability, needs, potential problems and solutions than the health professional. Finally, medical requirements for destination and activity need to be combined with the medical requirements for the dis-abling condition. Scarce literature and increasing numbers of travellers with disabilities should make this field a research priority in travel medicine. Unless there is an absolute medical contraindication, travel health professionals should encourage and support travellers for whom travel is a challenge. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Quality of travel health advice in a French travel medicine and vaccine center: a prospective observational study.

    PubMed

    Bouldouyre, Marie-Anne; De Verdière, Nathalie Colin; Pavie, Juliette; De Castro, Nathalie; Ponscarme, Diane; Hamane, Samia; Rachline, Anne; Ferret, Samuel; Molina, Jean-Michel

    2012-01-01

    The number of international trips undertaken by French citizens is rising and we wished to assess the appropriateness of advices given to travelers in a vaccine and travel medicine center in France. We conducted a 3-month prospective study in one center in Paris where prescriptions and advice to travelers are given by trained physicians in travel medicine who have access to a computerized decision support system (Edisan). A questionnaire was used to record trip characteristics, patients' demographics, and prescriptions. Main outcome measure was the adequacy of prescriptions for malaria prophylaxis, yellow fever, and hepatitis A vaccines to French guidelines. A total of 730 subjects were enrolled in this study, with a median age of 28 years. Travel destinations were sub-Saharan Africa (58%), Asia (21%), and South America (18%). Among the 608 patients (83%) traveling to malaria-endemic areas, malaria prophylaxis was in accordance with guidelines in 578/608 patients (95.1%, 95% CI: 93-96.5), and doxycycline was the regimen of choice (48%). Inappropriate malaria prophylaxis was given to eight patients, one of whom developed plasmodium falciparum malaria. All 413 patients (100%, 95% CI: 99-100) traveling to yellow fever-endemic areas who needed vaccination were correctly vaccinated. However, three patients received yellow fever vaccination without indication. Also, 442 of 454 patients (97.4%, 95% CI: 95.4-98.5) eligible to receive hepatitis A vaccination were immunized. Appropriate advice for malaria prophylaxis, yellow fever, and hepatitis A vaccinations was provided in a travel medicine and vaccine center where trained physicians used a computerized decision support system. Even in this setting, however, errors can occur and professional practices should be regularly assessed to improve health care. © 2012 International Society of Travel Medicine.

  10. Travel Health Advisory Group: a joint travel industry and travel health Special Interest Group promoting healthy travel in Australia.

    PubMed

    Leggat, Peter A; Zwar, Nicholas; Hudson, Bernie

    2012-09-01

    The Travel Health Advisory Group (THAG), established in 1997, is a joint initiative between the travel industry and travel health professionals in Australia that aims to promote healthy travel. THAG seeks to promote cooperation in improving the health of travellers between the travel industry and travel medicine professionals and to raise public awareness of the importance of travel health. From 2011, THAG has been a Special Interest Group of The Australasian College of Tropical Medicine and its membership has been active in several areas, including web-based travel health information, travel health promotion, media releases, research and education in Australia. Information is given on the objectives, membership and an overview of the various activities of the group. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. 78 FR 67881 - Nondiscrimination on the Basis of Disability in Air Travel: Accessibility of Web Sites and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... corresponding accessible pages on a mobile Web site by one year after the final rule's effective date; and (3... Mobile Web site conformant with any of the following standards: WCAG 1.0, WCAG 2.0 at Level A, existing Section 508 standards, or Mobile Web Best Practices (MWBP) 1.0 (if applicable). Two of the options they...

  12. Effects and costs of requiring child-restraint systems for young children traveling on commercial airplanes.

    PubMed

    Newman, Thomas B; Johnston, Brian D; Grossman, David C

    2003-10-01

    The US Federal Aviation Administration is planning a new regulation requiring children younger than 2 years to ride in approved child-restraint seats on airplanes. To estimate the annual number of child air crash deaths that might be prevented by the proposed regulation, the threshold proportion of families switching from air to car travel above which the risks of the policy would exceed its benefits, and the cost per death prevented. Risk and economic analyses. Child-restraint seat use could prevent about 0.4 child air crash deaths per year in the United States. Increased deaths as a result of car travel could exceed deaths prevented by restraint seat use if the proportion of families switching from air to car travel exceeded about 5% to 10%. The estimate for this proportion varied with assumptions about trip distance, driver characteristics, and the effectiveness of child-restraint seats but is unlikely to exceed 15%. Assuming no increase in car travel, for each dollar increase in the cost of implementing the regulation per round trip per family, the cost per death prevented would increase by about $6.4 million. Unless space for young children in restraint seats can be provided at low cost to families, with little or no diversion to automobile travel, a policy requiring restraint seat use could cause a net increase in deaths. Even excluding this possibility, the cost of the proposed policy per death prevented is high.

  13. Travel-related health problems in Japanese travelers.

    PubMed

    Mizuno, Yasutaka; Kudo, Koichiro

    2009-09-01

    Although the number of Japanese individuals traveling abroad has increased steadily, reaching approximately 17.3 million in 2007, the incidence of various travel-related health problems in Japan remains unknown. The travel-related health problems of Japanese travelers returning to Japan from abroad are analyzed by assessing the records. Data were collected retrospectively on returning travelers who visited the authors' travel clinic during the period from January 2005 through to December 2006 with any health problem acquired overseas. A total of 345 patients were included in this study (200 male, 145 female; average age, 34+/-12.3 years). Reasons for travel included leisure (45.8%); business (39.1%); visiting friends and relatives or accompanying other travelers (8.7%); volunteering (3.8%); and long stays in order to study or live (2.6%). The most visited destination was Asia (n=260), followed by Africa (n=105). The most commonly reported health problems were gastro-intestinal infections (39.1%), followed by respiratory tract infections (16.2%), animal bites (8.1%), and skin problems (5.8%). Together, malaria and dengue accounted for 10% of diagnoses in 125 febrile patients (36.2%). Although the profile of travel-related health problems in Japanese travelers is similar to that of Western travelers, the characteristics of travel were quite different. Therefore Japanese travel advice should be tailored to suit the Japanese traveler.

  14. 78 FR 10608 - David Grant United States Air Force Medical Center Specialty Care Travel Reimbursement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... appropriately trained provider within 4 weeks or sooner, if required, and within 1-hour travel time from the beneficiary's residence. The geographic area that represents 1-hour travel time surrounding an MTF is referred... Specialty Care Travel Reimbursement Demonstration Project AGENCY: Department of Defense. ACTION: Notice of...

  15. Designing a Methodology for Future Air Travel Scenarios

    NASA Technical Reports Server (NTRS)

    Wuebbles, Donald J.; Baughcum, Steven L.; Gerstle, John H.; Edmonds, Jae; Kinnison, Douglas E.; Krull, Nick; Metwally, Munir; Mortlock, Alan; Prather, Michael J.

    1992-01-01

    The growing demand on air travel throughout the world has prompted several proposals for the development of commercial aircraft capable of transporting a large number of passengers at supersonic speeds. Emissions from a projected fleet of such aircraft, referred to as high-speed civil transports (HSCT's), are being studied because of their possible effects on the chemistry and physics of the global atmosphere, in particular, on stratospheric ozone. At the same time, there is growing concern about the effects on ozone from the emissions of current (primarily subsonic) aircraft emissions. Evaluating the potential atmospheric impact of aircraft emissions from HSCT's requires a scientifically sound understanding of where the aircraft fly and under what conditions the aircraft effluents are injected into the atmosphere. A preliminary set of emissions scenarios are presented. These scenarios will be used to understand the sensitivity of environment effects to a range of fleet operations, flight conditions, and aircraft specifications. The baseline specifications for the scenarios are provided: the criteria to be used for developing the scenarios are defined, the required data base for initiating the development of the scenarios is established, and the state of the art for those scenarios that have already been developed is discussed. An important aspect of the assessment will be the evaluation of realistic projections of emissions as a function of both geographical distribution and altitude from an economically viable commercial HSCT fleet. With an assumed introduction date of around the year 2005, it is anticipated that there will be no HSCT aircraft in the global fleet at that time. However, projections show that, by 2015, the HSCT fleet could reach significant size. We assume these projections of HSCT and subsonic fleets for about 2015 can the be used as input to global atmospheric chemistry models to evaluate the impact of the HSCT fleets, relative to an all

  16. 75 FR 36300 - Enhancing Airline Passenger Protections

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-25

    ... on options to provide greater access to air travel for persons with peanut allergies. The June 8... that would provide greater access to air travel for persons with peanut allergies. The NPRM also sought... practices concerning the serving of peanuts. (75 FR 32318, 32332) We wish to clarify that, as alluded to in...

  17. Traveling Towards Disease: Transportation Barriers to Health Care Access

    PubMed Central

    Gerber, Ben S.; Sharp, Lisa K.

    2014-01-01

    Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes. PMID:23543372

  18. Traveling towards disease: transportation barriers to health care access.

    PubMed

    Syed, Samina T; Gerber, Ben S; Sharp, Lisa K

    2013-10-01

    Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes.

  19. 22 CFR 228.22 - Air transportation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Air transportation. 228.22 Section 228.22... for USAID Financing § 228.22 Air transportation. (a) The eligibility of air transportation is... U.S. flag air carriers for all international air travel and transportation, unless such service is...

  20. Traveling with children: beyond car seat safety.

    PubMed

    Polli, Janaina Borges; Polli, Ismael

    2015-01-01

    To spread knowledge and instigate the health professional to give advice on childcare during travels and on child transport safety. Literature review through the LILACS and MEDLINE(®) databases, using the terms: travel, safety, protective equipment, child, preventive medicine, retrieving articles published in the last 21 years. The authors analyzed 93 articles, of which 66 met the inclusion criteria after summaries were read. For drafting this article, the following sub-themes were proposed: getting ready to travel with children; knowing some of the transfer risks (air, land and water transportation) and exploring the destination with children (sun exposure, accommodations, altitude, food, traveler's diarrhea, insect bites) and return from the trip with children. Over the years, there has been an increase in the number of children who travel around the world. However, this population is still subject to health problems while traveling and may be even more susceptible than the adult age group. These problems arise from a variety of factors, including exposure to infectious organisms, the use of certain types of transportation, and participation in some activities, such as hiking at high altitudes, among others. However, when traveling with children, these risk factors can be overlooked; a trip that is considered safe for an adult might not be a good choice for this age group. The pediatric consultation should be a good opportunity to optimize preventive guidelines at the pre-trip planning. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  1. Integrated health impact assessment of travel behaviour: model exploration and application to a fuel price increase.

    PubMed

    Dhondt, Stijn; Kochan, Bruno; Beckx, Carolien; Lefebvre, Wouter; Pirdavani, Ali; Degraeuwe, Bart; Bellemans, Tom; Int Panis, Luc; Macharis, Cathy; Putman, Koen

    2013-01-01

    Transportation policy measures often aim to change travel behaviour towards more efficient transport. While these policy measures do not necessarily target health, these could have an indirect health effect. We evaluate the health impact of a policy resulting in an increase of car fuel prices by 20% on active travel, outdoor air pollution and risk of road traffic injury. An integrated modelling chain is proposed to evaluate the health impact of this policy measure. An activity-based transport model estimated movements of people, providing whereabouts and travelled kilometres. An emission- and dispersion model provided air quality levels (elemental carbon) and a road safety model provided the number of fatal and non-fatal traffic victims. We used kilometres travelled while walking or cycling to estimate the time in active travel. Differences in health effects between the current and fuel price scenario were expressed in Disability Adjusted Life Years (DALY). A 20% fuel price increase leads to an overall gain of 1650 (1010-2330) DALY. Prevented deaths lead to a total of 1450 (890-2040) Years Life Gained (YLG), with better air quality accounting for 530 (180-880) YLG, fewer road traffic injuries for 750 (590-910) YLG and active travel for 170 (120-250) YLG. Concerning morbidity, mostly road safety led to 200 (120-290) fewer Years Lived with Disability (YLD), while air quality improvement only had a minor effect on cardiovascular hospital admissions. Air quality improvement and increased active travel mainly had an impact at older age, while traffic safety mainly affected younger and middle-aged people. This modelling approach illustrates the feasibility of a comprehensive health impact assessment of changes in travel behaviour. Our results suggest that more is needed than a policy rising car fuel prices by 20% to achieve substantial health gains. While the activity-based model gives an answer on what the effect of a proposed policy is, the focus on health may make

  2. The stress of travel.

    PubMed

    Waterhouse, J; Reilly, T; Edwards, B

    2004-10-01

    International travel is an essential part of the life of elite athletes, both for competition and training. It is also becoming increasingly common among recreational sportspersons. Long-distance travel is associated with a group of transient negative effects, collectively referred to as 'travel fatigue', which result from anxiety about the journey, the change to an individual's daily routine, and dehydration due to time spent in the dry air of the aircraft cabin. Travel fatigue lasts for only a day or so, but for those who fly across several time zones, there are also the longer-lasting difficulties associated with 'jet lag'. The problems of jet lag can last for over a week if the flight crosses 10 time zones or more, and they can reduce performance and the motivation to train effectively. Knowledge of the properties of the body clock enables the cause of the difficulties to be understood (an unadjusted body clock), and forms the basis of using light in the new time zone to promote adjustment of the body clock. Sleep loss and its effects are important components of jet lag, and attempts to promote sleep by the use of melatonin and other hypnotics are also relevant. Sleep loss is also found in those who undertake challenges that involve long periods where the normal consolidated sleep of 8 h length is not possible. Advice on sleep regimens in such circumstances is given.

  3. Socioeconomic disparities in head and neck cancer patients' access to cancer treatment centers.

    PubMed

    Walker, Blake Byron; Schuurman, Nadine; Auluck, Ajit; Lear, Scott A; Rosin, Miriam

    2017-01-01

    Both socioeconomic status and travel time to cancer treatment have been associated with treatment choice and patient outcomes. An improved understanding of the relationship between these two dimensions of access may enable cancer control experts to better target patients with poor access, particularly in isolated suburban and rural communities. Using geographical information systems, head and neck cancer patients across British Columbia, Canada from 1981 to 2009, were mapped and their travel times to the nearest treatment center at their time of diagnosis were modelled. Patients' travel times were analysed by urban, suburban, and rural neighborhood types and an index of multiple socioeconomic deprivation was used to assess the role of socioeconomic status in patients' spatial access. Significant associations between socioeconomic deprivation and spatial access to treatment were identified, with the most deprived quintiles of patients experiencing nearly twice the travel time as the least deprived quintile. The sharpest disparities were observed among the most deprived patient populations in suburban and rural areas. However, the establishment of new treatment centers has decreased overall travel times by 28% in recent decades. Residence in a neighborhood with high socioeconomic deprivation is strongly associated with head and neck cancer patients' spatial access to cancer treatment centers. Patients residing in the most socioeconomically deprived neighborhoods consistently have longer travel times in urban, suburban, and rural communities in the study area.

  4. A Cost Analysis of Space Available Travel

    DTIC Science & Technology

    2014-06-14

    environmental and morale leave ( EML ) and accompanied family members 33.28% 1.35% 35.15% 7.69% 20.85% 1.68% Army Coast Guard Air Force Marines...consecutive days and unaccompanied family members (18 years or older) traveling on EML orders. - Category V: Unaccompanied Command-sponsored dependents and

  5. Air travel and adults with cyanotic congenital heart disease.

    PubMed

    Harinck, E; Hutter, P A; Hoorntje, T M; Simons, M; Benatar, A A; Fischer, J C; de Bruijn, D; Meijboom, E J

    1996-01-15

    Concern has been expressed that a reduction of partial oxygen pressure during flight in commercial aircraft may induce dangerous hypoxemia in patients with cyanotic congenital heart disease. To evaluate the validity of this concern, the transcutaneous SaO2 was measured in 12 adults with this type of heart disease and 27 control subjects during simulated commercial flights of 1.5 and 7 hours in a hypobaric chamber. Ten of those patients and 6 control subjects also were evaluated during two actual flights of approximately 2.5 hours in a DC-10 and an A-310, respectively. During the prolonged simulated and actual flights, the capillary blood pH, gases, and lactic acid were analyzed in the patients and during one of the actual flights also in the control subjects. During the simulated flights the SaO2 was at all times lower in the patients than in the control subjects. However, the maximal mean actual percentage decrease, as compared with sea level values, did not exceed 8.8% in either patients or control subjects. During the actual flights, this maximal decrease in the patients was 6%. In-flight reduction of the capillary PO2 was considerable in the control subjects but not in the patients. It is our hypothesis that the lack of a significant decrease of the PO2 in the patients might possibly be due to a high concentration of 2.3 diphosphoglycerate in the red cells. The flights had no influence on the capillary blood pH, PCO2, bicarbonate, or lactic acid levels in either patients or control subjects. Atmospheric pressure changes during commercial air travel do not appear to be detrimental to patients with cyanotic congenital heart disease.

  6. Migrant and Refugee Patient Perspectives on Travel and Tuberculosis along the Thailand-Myanmar Border: A Qualitative Study.

    PubMed

    Tschirhart, Naomi; Sein, Tabitha; Nosten, Francois; Foster, Angel M

    2016-01-01

    The Thailand-Myanmar border separates two very different health systems. The healthcare system in eastern Myanmar remains underdeveloped as a result of decades of instability. Comparatively, Tak province, Thailand has more healthcare resources. In this Thai border province government hospitals and non-governmental organizations provide tuberculosis (TB) treatment to migrants and refugees. Our overall study aimed to explore accessibility of TB treatment, TB surveillance and health system responsiveness specific to migrant and refugee populations in Tak province. In this paper, we focus on the perspectives of migrant and refugee TB patients with respect to travel and treatment in Tak province. In 2014 we conducted focus group discussions with 61 TB, Tuberculosis and Human Immunodeficiency Virus co-infection, and multidrug-resistant TB patients in Tak province. We analyzed the data for content and themes and documented individual travel trajectories. Migrants are travelling with active TB within the country and between Thailand and Myanmar. Migrants primarily travelled to obtain treatment but two participants reported travelling home to seek family care in Myanmar before returning to Thailand for treatment. Travel, while expensive and arduous, is an adaptive strategy that migrants use to access healthcare. Migrant's need for travel points to larger difficulties associated with healthcare access in the border region. Long distance travel with an infectious disease can be seen as an indicator that local healthcare is not available or affordable. These findings suggest that public health officials from both sides of the border should discuss the factors that contribute to travel with active TB and explore potential solutions to mitigate disease transmission in migrant populations.

  7. Urban Design, Urban Form, And Employee Travel Behavior

    DOT National Transportation Integrated Search

    1997-01-01

    Personal travel behavior choices made by employees appear to be influenced by a number of urban design and urban form characteristics of their work place. Several important attributes include the density of development and the accessibility of non-wo...

  8. Walkyourplace - Evaluating Neighbourhood Accessibility at Street Level

    NASA Astrophysics Data System (ADS)

    Steiniger, S.; Poorazizi, M. E.; Hunter, A. J. S.

    2013-05-01

    The popularity of a neighbourhood is often explained by its perceived "higher" quality of life. Good access to shops, restaurants, parks, etc., is seen as an indicator that reflects improved quality of life. We present a web-based tool for assessment of accessibility to such services. The system evaluates in real time an area that is accessible using pedestrian, transit, and cycling infrastructure. The accessible area is evaluated using "quality of life" indicators, such as the number of grocery stores, shopping and recreation facilities, and local crime within that area. This tool sets itself apart from pre-computed and neighbourhood-level walkability indices, because it makes use of detailed street-level data, rather than block-level generalizations. It uses real network travel time, and, when transit data are provided, permits the creation and evaluation of accessibility areas for a combination of travel modes such as walking with transit use.

  9. 41 CFR 301-70.804 - What amount must the Government be reimbursed for travel on a Government aircraft?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... no access to regularly scheduled commercial airline service. (c) For political travel on a Government... Government be reimbursed for travel on a Government aircraft? 301-70.804 Section 301-70.804 Public Contracts... Travel on Government Aircraft § 301-70.804 What amount must the Government be reimbursed for travel on a...

  10. 41 CFR 301-70.804 - What amount must the Government be reimbursed for travel on a Government aircraft?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... no access to regularly scheduled commercial airline service. (c) For political travel on a Government... Government be reimbursed for travel on a Government aircraft? 301-70.804 Section 301-70.804 Public Contracts... Travel on Government Aircraft § 301-70.804 What amount must the Government be reimbursed for travel on a...

  11. Rural applications of Advanced Traveler Information Systems : evaluation of satellite communications systems for mayday applications

    DOT National Transportation Integrated Search

    2001-02-01

    This study was conducted to: provide national measures of public satisfaction with the nation's highways, community transportation systems and options, and access to and travel on Federal lands (National Parks and National Forests); describe travel p...

  12. Travel characteristics and health practices among travellers at the travellers' health and vaccination clinic in Singapore.

    PubMed

    Lee, Vernon J; Wilder-Smith, Annelies

    2006-10-01

    Singapore has a fast-growing travel industry, but few studies have been done on travel characteristics and travel health practices. This study describes the profile and healthseeking behaviour of travellers attending a travel health clinic in Singapore. A cross-sectional survey was conducted on travellers attending the Traveller's Health and Vaccination Centre (THVC) between September and November 2002 using a standardised questionnaire. Information obtained included individual demographic and medical information, travel patterns, vaccination status and travel health practices. Four hundred and ninetyfive (74%) eligible travellers seen at THVC responded to the questionnaire. Their mean age was 36 years; 77% were professionals, managers, executives, and businessmen, students, and white collar workers. Asia was the main travel destination, and most travelled for leisure and resided in hotels or hostels. The median duration of travel was 16 days. Although >90% had previously travelled overseas, only 20% had previously sought pre-travel advice. Malays were significantly underrepresented (P < 0.01); and Caucasians and Eurasians were significantly more likely (P < 0.01) to have previously sought pre-travel advice compared with Chinese, Indians and Malays. Factors associated with seeking pre-travel advice included travel outside of Asia, especially Africa and South America. Singaporean travellers travel more often to cities rather than rural areas, compared with non-Asian travellers. Asia is the preferred destination, and travel outside of Asia is perceived as more risky and is associated with seeking pre-travel advice and vaccinations. Travel patterns and behaviours need to be taken into account when developing evidence-based travel medicine in Asia.

  13. Accessibility of low-income family flats in North Jakarta city

    NASA Astrophysics Data System (ADS)

    Feminin, T. A.; Wiranegara, H. W.; Supriatna, Y.

    2018-01-01

    The majority of relocated, low-income families in North Jakarta city who residing the flats, complained at decreasing their accessibility to the workplaces and to the social facilities. The aim of this research was to identify the changing of their accessibility before and after relocated, viewed from three dimensions: distance, travel time, and travel cost to the workplaces, educational facilities, and shopping areas. The research design was questionnaire survey containing the degree of accessibility before and after resided the flats. Five flats were chosen as cases. Their inhabitants were chosen as respondents which used simple random sampling. The result showed that their flats accessibility to the workplaces in all three dimensions was lower than when they resided in the slum area. Also, in distance and travel time accessibility to shopping areas was lower. Only accessibility to educational facilities measured in those three dimensions was higher after they moved. Supply for affordable public transport from their flats to reach their workplaces is needed to raise their accessibility. Also, they need subsidizeto rent of their flats so the burden to their income lesser.Using the ground space of their flats for retail activities was to make more accessible for their shopping activities.

  14. Consumer Expectations of Capacity Constrains and Their Effect on the Demand for Multi-Class Air Travel

    NASA Technical Reports Server (NTRS)

    Battersby, Bryn D.

    2003-01-01

    This paper argues that a consumer's decision on ticket class takes into account the expected likelihood of obtaining a seat in a particular class which, in turn, partially depends on an optimum "transaction cost". Taking into account the preferences of the consumer and the information that the consumer is endowed with, the consumer will select a ticket that includes its own optimal transaction cost. This motivates the inclusion of the capacity constraint as a proxy independent variable for these consumer expectations This then forms the basis of a model of air-travel demand with specific reference to Australia. A censored likelihood function allowing for correlation in the disturbance term across k classes is introduced. The correlation in the disturbances arises as a result of the interdependence of the capacity constraints in k different ticket classes on each flight.

  15. Malaria: prevention in travellers.

    PubMed

    Croft, Ashley M

    2010-07-12

    Malaria transmission occurs most frequently in environments with humidity greater than 60% and ambient temperature of 25 °C to 30 °C. Risks increase with longer visits and depend on activity. Infection can follow a single mosquito bite. Incubation is usually 10 to 14 days but can be up to 18 months depending on the strain of parasite. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug preventive interventions in non-pregnant adult travellers? What are the effects of drug prophylaxis in non-pregnant adult travellers? What are the effects of antimalaria vaccines in adult and child travellers? What are the effects of antimalaria interventions in child travellers, pregnant travellers, and in airline pilots? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 79 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: aerosol insecticides, amodiaquine, air conditioning and electric fans, atovaquone-proguanil, biological control measures, chloroquine (alone or with proguanil), diethyltoluamide (DEET), dietary supplementation, doxycycline, electronic mosquito repellents, full-length and light-coloured clothing, insecticide-treated clothing/nets, mefloquine, mosquito coils and vapourising mats, primaquine, pyrimethamine-dapsone, pyrimethamine-sulfadoxine, smoke, topical (skin-applied) insect repellents, and vaccines.

  16. Travel patterns during pregnancy: comparison between Global Positioning System (GPS) tracking and questionnaire data

    PubMed Central

    2013-01-01

    Background Maternal exposures to traffic-related air pollution have been associated with adverse pregnancy outcomes. Exposures to traffic-related air pollutants are strongly influenced by time spent near traffic. However, little is known about women’s travel activities during pregnancy and whether questionnaire-based data can provide reliable information on travel patterns during pregnancy. Objectives Examine women’s in-vehicle travel behavior during pregnancy and examine the difference in travel data collected by questionnaire and global positioning system (GPS) and their potential for exposure error. Methods We measured work-related travel patterns in 56 pregnant women using a questionnaire and one-week GPS tracking three times during pregnancy (<20 weeks, 20–30 weeks, and >30 weeks of gestation). We compared self-reported activities with GPS-derived trip distance and duration, and examined potentially influential factors that may contribute to differences. We also described in-vehicle travel behavior by pregnancy periods and influences of demographic and personal factors on daily travel times. Finally, we estimated personal exposure to particle-bound polycyclic aromatic hydrocarbon (PB-PAH) and examined the magnitude of exposure misclassification using self-reported vs. GPS travel data. Results Subjects overestimated both trip duration and trip distance compared to the GPS data. We observed moderately high correlations between self-reported and GPS-recorded travel distance (home to work trips: r = 0.88; work to home trips: r = 0.80). Better agreement was observed between the GPS and the self-reported travel time for home to work trips (r = 0.77) than work to home trips (r = 0.64). The subjects on average spent 69 and 93 minutes traveling in vehicles daily based on the GPS and self-reported data, respectively. Longer daily travel time was observed among participants in early pregnancy, and during certain pregnancy periods in women with

  17. Travel patterns during pregnancy: comparison between Global Positioning System (GPS) tracking and questionnaire data.

    PubMed

    Wu, Jun; Jiang, Chengsheng; Jaimes, Guillermo; Bartell, Scott; Dang, Andy; Baker, Dean; Delfino, Ralph J

    2013-10-09

    Maternal exposures to traffic-related air pollution have been associated with adverse pregnancy outcomes. Exposures to traffic-related air pollutants are strongly influenced by time spent near traffic. However, little is known about women's travel activities during pregnancy and whether questionnaire-based data can provide reliable information on travel patterns during pregnancy. Examine women's in-vehicle travel behavior during pregnancy and examine the difference in travel data collected by questionnaire and global positioning system (GPS) and their potential for exposure error. We measured work-related travel patterns in 56 pregnant women using a questionnaire and one-week GPS tracking three times during pregnancy (<20 weeks, 20-30 weeks, and >30 weeks of gestation). We compared self-reported activities with GPS-derived trip distance and duration, and examined potentially influential factors that may contribute to differences. We also described in-vehicle travel behavior by pregnancy periods and influences of demographic and personal factors on daily travel times. Finally, we estimated personal exposure to particle-bound polycyclic aromatic hydrocarbon (PB-PAH) and examined the magnitude of exposure misclassification using self-reported vs. GPS travel data. Subjects overestimated both trip duration and trip distance compared to the GPS data. We observed moderately high correlations between self-reported and GPS-recorded travel distance (home to work trips: r = 0.88; work to home trips: r = 0.80). Better agreement was observed between the GPS and the self-reported travel time for home to work trips (r = 0.77) than work to home trips (r = 0.64). The subjects on average spent 69 and 93 minutes traveling in vehicles daily based on the GPS and self-reported data, respectively. Longer daily travel time was observed among participants in early pregnancy, and during certain pregnancy periods in women with higher education attainment, higher income

  18. Travel Distance to Cancer Treatment Facilities in the Deep South.

    PubMed

    Wills, Mary J; Whitman, Marilyn V; English, Thomas M

    Despite ongoing efforts to improve rural healthcare, the health problems facing rural communities persist. The lack of healthcare providers and infrastructure in rural areas has been linked to a number of negative consequences. Among the elderly rural population, the lack of proximal access presents greater barriers because many elderly people are further limited in their ability to travel and pay for services. In the Deep South specifically, rural residents experience limited access to care and overall poor health outcomes. With cancer in particular, the Deep South has been dubbed the "cancer belt," faring far worse in prevalence and mortality rates than other areas of the country. The present study examines the average travel distance for rural elderly patients residing in the Deep South who are receiving treatment for prostate, breast, or colorectal cancer. We analyzed Medicare claims data of beneficiaries residing in the five Deep South states who had received a primary diagnosis of prostate, breast, or colorectal cancer, with a service date ranging from January 1, 2011, through December 31, 2014. The findings reveal that rural Medicare beneficiaries in the Deep South travel significantly greater distances than do their urban counterparts. In addition, travel distances to prostate cancer treatment facilities are significantly greater than those to breast or colorectal cancer treatment facilities. With cancer incidence predicted to increase, the need to reduce travel distances to treatment is vital in efforts to curb the mortality rate in the Deep South.

  19. Defense.gov Special Report: Travels with Hagel - March 2013

    Science.gov Websites

    Form. In this form, please indicate the nature of your accessibility issue/problem and your contact extremely informative, a senior defense official said in a statement issued to reporters traveling with

  20. Pre-travel advice seeking from GPs by travellers with chronic illness seen at a travel clinic.

    PubMed

    Gagneux-Brunon, Amandine; Andrillat, Carole; Fouilloux, Pascale; Daoud, Fatiha; Defontaine, Christiane; Charles, Rodolphe; Lucht, Frédéric; Botelho-Nevers, Elisabeth

    2016-03-01

    Travellers are ageing and frequently report chronic illness. Pre-travel health advice is crucial, particularly in this subgroup, and general practitioners (GPs) are first in line for treatment adjustment before departure. Our aim is to evaluate pre-travel health advice seeking from GPs by travellers with chronic illness seen at a travel clinic. A cross-sectional observational survey using a questionnaire was conducted between August 2013 and July 2014 in travellers attending the travel medicine clinic of a tertiary university hospital in France. During the study, 2019 travellers were included. Mean age was 39.4 years (±18.8). Three hundred and ninety-one (19.4%) travellers reported a history of a chronic illness. Arterial hypertension and diabetes mellitus were the most frequently reported illnesses, affecting, respectively, 168 (8.3%) travellers and 102 (5.1%). Hajj pilgrims were more likely to report a history of chronic illness than other travellers. Only 810 (40.1%) travellers sought pre-travel advice from their GP. Six hundred and fifty-two (40.1%) healthy travellers and 158 (40.5%) travellers reporting chronic illness sought pre-travel advice from their GP (P = 0.96). Travellers with a history of chronic illness do not seek pre-travel health advice from their GP more frequently than healthy travellers. Travel health specialists are generally not the best practitioners to manage the care of underlying medical conditions presenting risks during travel. However, GPs offer continuity and disease management expertise to improve the specificity of pre-travel planning. Thus, ongoing collaboration between the traveller, GP and travel health specialist is likely to yield the best outcomes. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

  1. Malaria after international travel: a GeoSentinel analysis, 2003-2016.

    PubMed

    Angelo, Kristina M; Libman, Michael; Caumes, Eric; Hamer, Davidson H; Kain, Kevin C; Leder, Karin; Grobusch, Martin P; Hagmann, Stefan H; Kozarsky, Phyllis; Lalloo, David G; Lim, Poh-Lian; Patimeteeporn, Calvin; Gautret, Philippe; Odolini, Silvia; Chappuis, François; Esposito, Douglas H

    2017-07-20

    More than 30,000 malaria cases are reported annually among international travellers. Despite improvements in malaria control, malaria continues to threaten travellers due to inaccurate perception of risk and sub-optimal pre-travel preparation. Records with a confirmed malaria diagnosis after travel from January 2003 to July 2016 were obtained from GeoSentinel, a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. Records were excluded if exposure country was missing or unascertainable or if there was a concomitant acute diagnosis unrelated to malaria. Records were analyzed to describe the demographic and clinical characteristics of international travellers with malaria. There were 5689 travellers included; 325 were children <18 years. More than half (53%) were visiting friends and relatives (VFRs). Most (83%) were exposed in sub-Saharan Africa. The median trip duration was 32 days (interquartile range 20-75); 53% did not have a pre-travel visit. More than half (62%) were hospitalized; children were hospitalized more frequently than adults (73 and 62%, respectively). Ninety-two per cent had a single Plasmodium species diagnosis, most frequently Plasmodium falciparum (4011; 76%). Travellers with P. falciparum were most frequently VFRs (60%). More than 40% of travellers with a trip duration ≤7 days had Plasmodium vivax. There were 444 (8%) travellers with severe malaria; 31 children had severe malaria. Twelve travellers died. Malaria remains a serious threat to international travellers. Efforts must focus on preventive strategies aimed on children and VFRs, and chemoprophylaxis access and preventive measure adherence should be emphasized.

  2. Travel burden to breast MRI and utilization: are risk and sociodemographics related

    PubMed Central

    Onega, Tracy; Lee, Christoph I.; Benkeser, David; Alford-Teaster, Jennifer; Haas, Jennifer S.; Tosteson, Anna N. A.; Hill, Deirdre; Shi, Xun; Henderson, Louise M.; Hubbard, Rebecca A.

    2016-01-01

    Background Mammograms, unlike magnetic resonance imaging (MRI), are relatively geographically accessible. Additional travel time is often required to access breast MRI. However, the amount of additional travel time and whether it varies based on sociodemographic or breast cancer risk factors is unknown. Methods We examine screening mammograms and MRIs between 2005 and 2012 in the Breast Cancer Surveillance Consortium (BCSC) by a) travel time to the closest and actual mammography facility used, and the difference between the two; b) woman's breast cancer risk factors and c) socio-demographic characteristics. We used logistic regression to examine the odds of traveling farther than the closest facility in relation to women's characteristics. Results Among 821,683 screening mammograms, 76.6% occurred at the closest facility compared to 51.9% of screening MRIs (N=3,687). The median differential travel time among women not using the closest facility for mammography was 14 minutes (IQR: 8-25) versus 20 minutes (IQR 11-40) for breast MRI. Differential travel time for both imaging modalities did not vary notably by breast cancer risk factors, but was significantly longer for non-urban residents. For non-Hispanic black, compared to non-Hispanic white women, the adjusted odds of traveling farther than the closest facility were 9% lower for mammography (OR 0.91; 95% CI:0.87-0.95), but more than two times higher for MRI (OR 2.64; 95% CI:1.36-5.13). Conclusions Breast cancer risk factors were not related to excess travel time for screening MRI, but sociodemographic factors were, suggesting the possibility that geographic distribution of advanced imaging may exacerbated disparities for some vulnerable populations. PMID:27026577

  3. Business Travel | Climate Neutral Research Campuses | NREL

    Science.gov Websites

    evaluated for research campus climate action plans, and it can be surprisingly large. At Cornell University , for example, business air travel generated 27,000 tons of carbon dioxide in 2008, accounting for 8.5 campus. The following outlines resources and opportunities for research campuses to manage business

  4. UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): protocol for an exploratory, qualitative study.

    PubMed

    Jackson, Cath; Bedford, Helen; Condon, Louise; Crocker, Annie; Emslie, Carol; Dyson, Lisa; Gallagher, Bridget; Kerr, Susan; Lewis, Helen J; Mytton, Julie; Redsell, Sarah A; Schicker, Frieda; Shepherd, Christine; Smith, Lesley; Vousden, Linda; Cheater, Francine M

    2015-06-08

    Gypsies, Travellers and Roma (referred to here as Travellers) experience significantly poorer health and have shorter life expectancy than the general population. They are also less likely to access health services including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. This study has two aims: (1) Investigate the barriers and facilitators to acceptability and uptake of immunisations among six Traveller communities in the UK; (2) Identify potential interventions to increase uptake in these Traveller communities. A three-phase qualitative study with six Traveller communities. PHASE 1: In each community, we will explore up to 45 Travellers' views about the influences on their immunisation behaviours and ideas for improving uptake in their community. PHASE 2: In each community, we will investigate 6-8 service providers' perspectives on barriers and facilitators to childhood and adult immunisations for Traveller communities with whom they work, and ideas to improve uptake. Interview data will be analysed using the Framework approach. PHASE 3: The findings will be discussed and interventions prioritised in six workshops, each with 10-12 phase 1 and 3-4 phase 2 participants. This research received approval from NRES Committee Yorkshire and The Humber-Leeds East (Ref. 13/YH/02). It will produce (1) findings on the barriers and facilitators to uptake of immunisations in six Traveller communities; (2) a prioritised list of potentially feasible and acceptable interventions for increasing uptake in these communities; and (3) methodological development in undertaking research with diverse Traveller communities. The study has the potential to inform new ways of delivering services to ensure high immunisation uptake. Findings will be disseminated to participants, relevant UK organisations with responsibility for the implementation of immunisation policy and Traveller health

  5. Tourism through Travel Club: A Database Project

    ERIC Educational Resources Information Center

    Pratt, Renée M. E.; Smatt, Cindi T.; Wynn, Donald E.

    2017-01-01

    This applied database exercise utilizes a scenario-based case study to teach the basics of Microsoft Access and database management in introduction to information systems and introduction to database course. The case includes background information on a start-up business (i.e., Carol's Travel Club), description of functional business requirements,…

  6. Migrant and Refugee Patient Perspectives on Travel and Tuberculosis along the Thailand-Myanmar Border: A Qualitative Study

    PubMed Central

    Sein, Tabitha; Nosten, Francois; Foster, Angel M.

    2016-01-01

    Background The Thailand-Myanmar border separates two very different health systems. The healthcare system in eastern Myanmar remains underdeveloped as a result of decades of instability. Comparatively, Tak province, Thailand has more healthcare resources. In this Thai border province government hospitals and non-governmental organizations provide tuberculosis (TB) treatment to migrants and refugees. Objectives Our overall study aimed to explore accessibility of TB treatment, TB surveillance and health system responsiveness specific to migrant and refugee populations in Tak province. In this paper, we focus on the perspectives of migrant and refugee TB patients with respect to travel and treatment in Tak province. Methods In 2014 we conducted focus group discussions with 61 TB, Tuberculosis and Human Immunodeficiency Virus co-infection, and multidrug-resistant TB patients in Tak province. We analyzed the data for content and themes and documented individual travel trajectories. Results and Discussion Migrants are travelling with active TB within the country and between Thailand and Myanmar. Migrants primarily travelled to obtain treatment but two participants reported travelling home to seek family care in Myanmar before returning to Thailand for treatment. Travel, while expensive and arduous, is an adaptive strategy that migrants use to access healthcare. Conclusions Migrant’s need for travel points to larger difficulties associated with healthcare access in the border region. Long distance travel with an infectious disease can be seen as an indicator that local healthcare is not available or affordable. These findings suggest that public health officials from both sides of the border should discuss the factors that contribute to travel with active TB and explore potential solutions to mitigate disease transmission in migrant populations. PMID:27509036

  7. Travel for HIV care in England: a choice or a necessity?

    PubMed

    Huntington, S; Chadborn, T; Rice, B D; Brown, A E; Delpech, V C

    2011-07-01

    The aims of the study were (1) to measure the distance required to travel, and the distance actually travelled, to HIV services by HIV-infected adults, and (2) to calculate the proportion of patients who travelled beyond local services and identify socio-demographic and clinical predictors of use of non-local services. The straight-line distance between a patient's residence and HIV services was determined for HIV-infected patients in England in 2007. 'Local services' were defined as the closest HIV service to a patient's residence and other services within an additional 5 km radius. Multivariable logistic regression was used to identify socio-demographic and clinical predictors of accessing non-local services. In 2007, nearly 57 000 adults with diagnosed HIV infection accessed HIV services in England; 42% lived in the most deprived areas. Overall, 81% of patients lived within 5 km of a service, and 8.7% used their closest HIV service. The median distance to the closest HIV service was 2.5 km [interquartile range (IQR) 1.5-4.2 km] and the median actual distance travelled was 4.8 km (IQR 2.5-9.7 km). A quarter of patients used a 'non-local' service. Patients living in the least deprived areas were twice as likely to use non-local services as those living in the most deprived areas [adjusted odds ratio (AOR) 2.16; 95% confidence interval (CI) 1.98-2.37]. Other predictors for accessing non-local services included living in an urban area (AOR 0.77; 95% CI 0.69-0.85) and being diagnosed more than 12 months (AOR 1.48; 95% CI 1.38-1.59). In England, 81% of HIV-infected patients live within 5 km of HIV services and a quarter of HIV-infected adults travel to non-local HIV services. Those living in deprived areas are less likely to travel to non-local services. © 2010 British HIV Association.

  8. Travel Schooling: Helping Children Learn through Travel.

    ERIC Educational Resources Information Center

    Byrnes, Deborah A.

    2001-01-01

    Provides information for teachers to help parents create rewarding and educational travel experiences for children. Examines the benefits of travel schooling, fundamental elements of a meaningful travel schooling experience, fostering cross cultural sensitivity through travel, and returning to the traditional classroom. (SD)

  9. The Flying Newsboy: A Small Daily Attempts Air Delivery.

    ERIC Educational Resources Information Center

    Watts, Elizabeth A.

    For 10 months in 1929-30, subscribers to "The McCook (Nebraska) Daily Gazette" (a daily newspaper serving 33 towns in southwestern Nebraska and northwestern Kansas) received their newspapers via air delivery with "The Newsboy," a Curtis Robin cabin monoplane. In an age when over-the-road travel was difficult and air travel was…

  10. Malaria Prevention Strategies: Adherence among Boston Area Travelers Visiting Malaria-Endemic Countries

    PubMed Central

    Stoney, Rhett J.; Chen, Lin H.; Jentes, Emily S.; Wilson, Mary E.; Han, Pauline V.; Benoit, Christine M.; MacLeod, William B.; Hamer, Davidson H.; Barnett, Elizabeth D.

    2016-01-01

    We conducted a prospective cohort study to assess adherence to malaria chemoprophylaxis, reasons for nonadherence, and use of other personal protective measures against malaria. We included adults traveling to malaria-endemic countries who were prescribed malaria chemoprophylaxis during a pre-travel consultation at three travel clinics in the Boston area and who completed three or more surveys: pre-travel, at least one weekly during travel, and post-travel (2–4 weeks after return). Of 370 participants, 335 (91%) took malaria chemoprophylaxis at least once and reported any missed doses; 265 (79%) reported completing all doses during travel. Adherence was not affected by weekly versus daily chemoprophylaxis, travel purpose, or duration of travel. Reasons for non adherence included forgetfulness, side effects, and not seeing mosquitoes. Main reasons for declining to take prescribed chemoprophylaxis were peer advice, low perceived risk, and not seeing mosquitoes. Of 368 travelers, 79% used insect repellent, 46% used a bed net, and 61% slept in air conditioning at least once. Because travelers may be persuaded to stop taking medication by peer pressure, not seeing mosquitoes, and adverse reactions to medications, clinicians should be prepared to address these barriers and to empower travelers with strategies to manage common side effects of antimalarial medications. PMID:26483125

  11. Pre-Travel Medical Preparation of Business and Occupational Travelers

    PubMed Central

    Khan, Nomana M.; Jentes, Emily S.; Brown, Clive; Han, Pauline; Rao, Sowmya R.; Kozarsky, Phyllis; Hagmann, Stefan H.F.; LaRocque, Regina C.; Ryan, Edward T.

    2016-01-01

    Objectives: The aim of the study was to understand more about pre-travel preparations and itineraries of business and occupational travelers. Methods: De-identified data from 18 Global TravEpiNet clinics from January 2009 to December 2012 were analyzed. Results: Of 23,534 travelers, 61% were non-occupational and 39% occupational. Business travelers were more likely to be men, had short times to departure and shorter trip durations, and commonly refused influenza, meningococcal, and hepatitis B vaccines. Most business travelers indicated that employers suggested the pre-travel health consultation, whereas non-occupational travelers sought consultations because of travel health concerns. Conclusions: Sub-groups of occupational travelers have characteristic profiles, with business travelers being particularly distinct. Employers play a role in encouraging business travelers to seek pre-travel consultations. Such consultations, even if scheduled immediately before travel, can identify vaccination gaps and increase coverage. PMID:26479857

  12. Defense.gov Special Report: Travels with Carter - March 2013

    Science.gov Websites

    Form. In this form, please indicate the nature of your accessibility issue/problem and your contact Common Security Challenges Deputy Defense Secretary Ash Carter is traveling to Asia to meet with U.S

  13. U.S. Pacific Command > Resources > Travel Requirements > ATFP FAQs

    Science.gov Websites

    receiving errors when I try to access the TT/IATP program; what is causing this and how do I gain access to the program? 7. How will I know when/if my APACS request has been approved? 8. Do I need Theater and Country Clearance approval if I'm traveling on leave? 9. If I work in the American Embassy (USDAO/JUSMAG

  14. UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study.

    PubMed

    Jackson, Cath; Dyson, Lisa; Bedford, Helen; Cheater, Francine M; Condon, Louise; Crocker, Annie; Emslie, Carol; Ireland, Lana; Kemsley, Philippa; Kerr, Susan; Lewis, Helen J; Mytton, Julie; Overend, Karen; Redsell, Sarah; Richardson, Zoe; Shepherd, Christine; Smith, Lesley

    2016-09-01

    Gypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services, including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. (1) Investigate the barriers to and facilitators of acceptability and uptake of immunisations among six Traveller communities across four UK cities; and (2) identify possible interventions to increase uptake of immunisations in these Traveller communities that could be tested in a subsequent feasibility study. Three-phase qualitative study underpinned by the social ecological model. Phase 1: interviews with 174 Travellers from six communities: Romanian Roma (Bristol); English Gypsy/Irish Traveller (Bristol); English Gypsy (York); Romanian/Slovakian Roma (Glasgow); Scottish Showpeople (Glasgow); and Irish Traveller (London). Focus on childhood and adult vaccines. Phase 2: interviews with 39 service providers. Data were analysed using the framework approach. Interventions were identified using a modified intervention mapping approach. Phase 3: 51 Travellers and 25 service providers attended workshops and produced a prioritised list of potentially acceptable and feasible interventions. There were many common accounts of barriers and facilitators across communities, particularly across the English-speaking communities. Scottish Showpeople were the most similar to the general population. Roma communities experienced additional barriers of language and being in a new country. Men, women and service providers described similar barriers and facilitators. There was widespread acceptance of childhood and adult immunisation, with current parents perceived as more positive than their elders. A minority of English-speaking Travellers worried about multiple/combined childhood vaccines, adult flu and whooping cough. Cultural concerns about vaccines offered during pregnancy and about human papillomavirus were most evident in

  15. [Travel and cultural activities in care homes for the elderly].

    PubMed

    Andriot, Hervé; Roumilhac, Vanessa

    2010-01-01

    Travel and cultural activities are still accessible for elderly people, in particular those living in care homes. With some precautions and adequate professional supervision, it is possible to carry out such activities, elderly people's limits being psychological rather than physical. Elderly people can thereby open up to the adventure of travelling whether it is an actual, physical trip or a virtual journey, through cultural activities. A report on the Residence Orpea des Noues care home's experience of such initiatives.

  16. Travel health knowledge, attitudes and practices among Australasian travelers.

    PubMed

    Wilder-Smith, Annelies; Khairullah, Nor S; Song, Jae-Hoon; Chen, Ching-Yu; Torresi, Joseph

    2004-01-01

    Although the Asia Pacific region is the focus of the fastest-growing tourist and travel industry, few data are available on the knowledge, attitudes and practices (KAP) of travelers from this region with regard to travel-related infectious diseases. We conducted a cross-sectional survey among travelers at the departure lounges of five airports in Australasia (Singapore, Kuala Lumpur, Taipeh, Melbourne, Seoul) whose travel destinations were Asia, Africa or South America. Two standardized questionnaires directed towards KAP in travel health, travel immunizations and malaria were administered. Of 2,101 respondents (82% Asian, 17% Western), 31% had sought pretravel health advice and only 4% sought travel health advice from the travel medicine specialist. The risk of vaccine-preventable infectious diseases and malaria at the destination country was perceived to be low. Overall, fewer than 5% of travelers had been vaccinated in preparation for their trip. The most frequent travel vaccinations were for hepatitis A and B. Only 40% of travelers to malaria-endemic areas carried malaria prophylaxis. Compared to Western travelers, those of Asian nationality were significantly less likely to obtain pretravel advice and malaria prophylaxis and to receive travel vaccinations. There is an urgent need for increased awareness about travel-related infectious diseases among Asian travelers, and greater uptake of pretravel health advice, vaccinations and malaria prophylactic measures.

  17. Travel medicine

    PubMed Central

    Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

    2014-01-01

    Abstract Objective To define the practice of travel medicine, provide the basics of a comprehensive pretravel consultation for international travelers, and assist in identifying patients who might require referral to travel medicine professionals. Sources of information Guidelines and recommendations on travel medicine and travel-related illnesses by national and international travel health authorities were reviewed. MEDLINE and EMBASE searches for related literature were also performed. Main message Travel medicine is a highly dynamic specialty that focuses on pretravel preventive care. A comprehensive risk assessment for each individual traveler is essential in order to accurately evaluate traveler-, itinerary-, and destination-specific risks, and to advise on the most appropriate risk management interventions to promote health and prevent adverse health outcomes during travel. Vaccinations might also be required and should be personalized according to the individual traveler’s immunization history, travel itinerary, and the amount of time available before departure. Conclusion A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required. Those who advise travelers are encouraged to be aware of the extent of this responsibility and to refer all high-risk travelers to travel medicine professionals whenever possible. PMID:25500599

  18. International business travel: impact on families and travellers

    PubMed Central

    Espino, C; Sundstrom, S; Frick, H; Jacobs, M; Peters, M

    2002-01-01

    Objectives: Spouses and staff of the World Bank Group (WBG) were questioned about the impact of international business travel on families and travellers. Dependent variables were self reported stress, concern about the health of the traveller, and negative impact on the family. We hypothesised that several travel factors (independent variables) would be associated with these impacts. These travel factors had to do with the frequency, duration, and predictability of travel and its interference with family activities. Methods: Survey forms were developed and distributed to all spouses of travelling staff as well as a small sample of operational staff. Kendall's tau b correlation coefficients of response frequencies were computed with the data from scaled items. Written responses to open ended questions were categorised. Results: Response rates for spouses and staff were 24% and 36%, respectively. Half the spouse sample (n=533) and almost 75% of the staff sample (n=102) reported high or very high stress due to business travel. Self reported spouse stress was associated with six out of eight travel factors. Female spouses, those with children, and younger spouses reported greater stress. Self reported staff stress was significantly associated with four out of nine travel factors. Further insight into how business travel affects families and staff (including children's behavioural changes) and how families cope was gained through responses to written questions. Conclusions: The findings support the notion that lengthy and frequent travel and frequent changes in travel dates which affect family plans, all characteristic of WBG missions, negatively affects many spouses and children (particularly young children) and that the strain on families contributes significantly to the stress staff feel about their travel. Policies or management practices that take into consideration family activities and give staff greater leeway in controlling and refusing travel may help relieve

  19. International business travel: impact on families and travellers.

    PubMed

    Espino, C M; Sundstrom, S M; Frick, H L; Jacobs, M; Peters, M

    2002-05-01

    Spouses and staff of the World Bank Group (WBG) were questioned about the impact of international business travel on families and travellers. Dependent variables were self reported stress, concern about the health of the traveller, and negative impact on the family. We hypothesised that several travel factors (independent variables) would be associated with these impacts. These travel factors had to do with the frequency, duration, and predictability of travel and its interference with family activities. Survey forms were developed and distributed to all spouses of travelling staff as well as a small sample of operational staff. Kendall's tau b correlation coefficients of response frequencies were computed with the data from scaled items. Written responses to open ended questions were categorised. Response rates for spouses and staff were 24% and 36%, respectively. Half the spouse sample (n=533) and almost 75% of the staff sample (n=102) reported high or very high stress due to business travel. Self reported spouse stress was associated with six out of eight travel factors. Female spouses, those with children, and younger spouses reported greater stress. Self reported staff stress was significantly associated with four out of nine travel factors. Further insight into how business travel affects families and staff (including children's behavioural changes) and how families cope was gained through responses to written questions. The findings support the notion that lengthy and frequent travel and frequent changes in travel dates which affect family plans, all characteristic of WBG missions, negatively affects many spouses and children (particularly young children) and that the strain on families contributes significantly to the stress staff feel about their travel. Policies or management practices that take into consideration family activities and give staff greater leeway in controlling and refusing travel may help relieve stress.

  20. Traveling Crossow Instability for HIFiRE-5 in a Quiet Hypersonic Wind Tunnel (Postprint)

    DTIC Science & Technology

    2013-06-01

    scale model of the 2:1 elliptic cone HIFiRE-5 flight vehicle was used to investigate the traveling crossflow instability at Mach 6 in Purdue...Force Research Laboratory, Air Vehicles Directorate 2130 8th St., WPAFB, OH 45433-7542, USA Abstract A scale model of the 2:1 elliptic cone HIFiRE-5...flight vehicle was used to investigate the traveling crossflow instability at Mach 6 in Purdue University’s Mach-6 quiet wind tunnel. Traveling crossflow

  1. Travel Burden to Breast MRI and Utilization: Are Risk and Sociodemographics Related?

    PubMed

    Onega, Tracy; Lee, Christoph I; Benkeser, David; Alford-Teaster, Jennifer; Haas, Jennifer S; Tosteson, Anna N A; Hill, Deirdre; Shi, Xun; Henderson, Louise M; Hubbard, Rebecca A

    2016-06-01

    Mammography, unlike MRI, is relatively geographically accessible. Additional travel time is often required to access breast MRI. However, the amount of additional travel time and whether it varies on the basis of sociodemographic or breast cancer risk factors is unknown. The investigators examined screening mammography and MRI between 2005 and 2012 in the Breast Cancer Surveillance Consortium by (1) travel time to the closest and actual mammography facility used and the difference between the two, (2) women's breast cancer risk factors, and (3) sociodemographic characteristics. Logistic regression was used to examine the odds of traveling farther than the closest facility in relation to women's characteristics. Among 821,683 screening mammographic examinations, 76.6% occurred at the closest facility, compared with 51.9% of screening MRI studies (n = 3,687). The median differential travel time among women not using the closest facility for mammography was 14 min (interquartile range, 8-25 min) versus 20 min (interquartile range, 11-40 min) for breast MRI. Differential travel time for both imaging modalities did not vary notably by breast cancer risk factors but was significantly longer for nonurban residents. For non-Hispanic black compared with non-Hispanic white women, the adjusted odds of traveling farther than the closest facility were 9% lower for mammography (odds ratio, 0.91; 95% confidence interval, 0.87-0.95) but more than two times higher for MRI (odds ratio, 2.64; 95% confidence interval, 1.36-5.13). Breast cancer risk factors were not related to excess travel time for screening MRI, but sociodemographic factors were, suggesting the possibility that geographic distribution of advanced imaging may exacerbated disparities for some vulnerable populations. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  2. UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): protocol for an exploratory, qualitative study

    PubMed Central

    Jackson, Cath; Crocker, Annie; Emslie, Carol; Dyson, Lisa; Gallagher, Bridget; Schicker, Frieda; Shepherd, Christine; Smith, Lesley; Vousden, Linda

    2015-01-01

    Introduction Gypsies, Travellers and Roma (referred to here as Travellers) experience significantly poorer health and have shorter life expectancy than the general population. They are also less likely to access health services including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. This study has two aims: (1) Investigate the barriers and facilitators to acceptability and uptake of immunisations among six Traveller communities in the UK; (2) Identify potential interventions to increase uptake in these Traveller communities. Methods and analysis A three-phase qualitative study with six Traveller communities. PHASE 1: In each community, we will explore up to 45 Travellers’ views about the influences on their immunisation behaviours and ideas for improving uptake in their community. PHASE 2: In each community, we will investigate 6–8 service providers’ perspectives on barriers and facilitators to childhood and adult immunisations for Traveller communities with whom they work, and ideas to improve uptake. Interview data will be analysed using the Framework approach. PHASE 3: The findings will be discussed and interventions prioritised in six workshops, each with 10–12 phase 1 and 3–4 phase 2 participants. Ethics and dissemination This research received approval from NRES Committee Yorkshire and The Humber-Leeds East (Ref. 13/YH/02). It will produce (1) findings on the barriers and facilitators to uptake of immunisations in six Traveller communities; (2) a prioritised list of potentially feasible and acceptable interventions for increasing uptake in these communities; and (3) methodological development in undertaking research with diverse Traveller communities. The study has the potential to inform new ways of delivering services to ensure high immunisation uptake. Findings will be disseminated to participants, relevant UK organisations with responsibility

  3. [Pre-travel advice and patient education of Hungarian travellers].

    PubMed

    Lengyel, Ingrid; Felkai, Péter

    2018-03-01

    According to international surveys, over half of the travellers face some kind of health issue when travelling. The overwhelming majority of travel-related illnesses can be prevented with pre-travel medical consultations, but the syllabus and content of the consultation have to match the travel habits and culture of the given society. This publication explores the specificities and travel habits of Hungarian travellers. One hundred participants of a travel exhibition completed a survey about their international travel. As the survey was not representative, the data could only be processed through simple statistical methods. However, since the exhibition was presumably attended by those wishing to travel, the conclusions drawn from the results are worth publishing, since no similar survey in Hungary has been published before. Based on the suitable classification of age groups in travel medicine, 11% of the participants were adolescents / young adults (aged 15-24), 81% adults (25-59) and 8% elderly (60-74). Twenty-eight percent of the participants travel multiple times a year, 40% yearly and 32% of them less frequently; 16% of the adults, 8% of the adolescents and 4% of the elderly age group travel multiple times a year. The travel destinations of Hungarian travellers have remained practically unchanged since a study was conducted 13 years ago: the vast majority (95%) travelled within Europe, 2% to the United States, and 11% of them elsewhere. Since Hungarians do not travel to endemic areas, only 5% consulted their general practitioners (GPs) prior to travelling, and 29% did when they had to be vaccinated. Forty-two percent of those wishing to travel never consult their GPs, even though 29% of them are aware of some chronic illness. Instead, 51% gather their health information from the internet and only 6% from their doctors. By the contradiction between the poor health status of the majority of Hungarian travellers and the negligence of seeking pre-travel advice

  4. Collaborative funding to facilitate airport ground access [research brief].

    DOT National Transportation Integrated Search

    2012-06-01

    Airports are major interchange nodes in the passenger and freight transportation system. Here, local and regional transportation systems interface with those for national and international air travel and air freight. However, funding projects to impr...

  5. Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents.

    PubMed

    Paez, Antonio; Mercado, Ruben G; Farber, Steven; Morency, Catherine; Roorda, Matthew

    2010-10-25

    Geographical access to health care facilities is known to influence health services usage. As societies age, accessibility to health care becomes an increasingly acute public health concern. It is known that seniors tend to have lower mobility levels, and it is possible that this may negatively affect their ability to reach facilities and services. Therefore, it becomes important to examine the mobility situation of seniors vis-a-vis the spatial distribution of health care facilities, to identify areas where accessibility is low and interventions may be required. Accessibility is implemented using a cumulative opportunities measure. Instead of assuming a fixed bandwidth (i.e. a distance threshold) for measuring accessibility, in this paper the bandwidth is defined using model-based estimates of average trip length. Average trip length is an all-purpose indicator of individual mobility and geographical reach. Adoption of a spatial modelling approach allows us to tailor these estimates of travel behaviour to specific locations and person profiles. Replacing a fixed bandwidth with these estimates permits us to calculate customized location- and person-based accessibility measures that allow inter-personal as well as geographical comparisons. The case study is Montreal Island. Geo-coded travel behaviour data, specifically average trip length, and relevant traveller's attributes are obtained from the Montreal Household Travel Survey. These data are complemented with information from the Census. Health care facilities, also geo-coded, are extracted from a comprehensive business point database. Health care facilities are selected based on Standard Industrial Classification codes 8011-21 (Medical Doctors and Dentists). Model-based estimates of average trip length show that travel behaviour varies widely across space. With the exception of seniors in the downtown area, older residents of Montreal Island tend to be significantly less mobile than people of other age cohorts

  6. An analysis of short haul air passenger demand, volume 2

    NASA Technical Reports Server (NTRS)

    Blumer, T. P.; Swan, W. M.

    1978-01-01

    Several demand models for short haul air travel are proposed and calibrated on pooled data. The models are designed to predict demand and analyze some of the motivating phenomena behind demand generation. In particular, an attempt is made to include the effects of competing modes and of alternate destinations. The results support three conclusions: (1) the auto mode is the air mode's major competitor; (2) trip time is an overriding factor in intermodal competition, with air fare at its present level appearing unimportant to the typical short haul air traveler; and (3) distance appears to underly several demand generating phenomena, and therefore, must be considered very carefully to any intercity demand model. It may be the cause of the wide range of fare elasticities reported by researchers over the past 15 years. A behavioral demand model is proposed and calibrated. It combines the travel generating effects of income and population, the effects of modal split, the sensitivity of travel to price and time, and the effect of alternative destinations satisfying the trip purpose.

  7. Spatial Access to Primary Care Providers in Appalachia

    PubMed Central

    Donohoe, Joseph; Marshall, Vince; Tan, Xi; Camacho, Fabian T.; Anderson, Roger T.; Balkrishnan, Rajesh

    2016-01-01

    Purpose: The goal of this research was to examine spatial access to primary care physicians in Appalachia using both traditional access measures and the 2-step floating catchment area (2SFCA) method. Spatial access to care was compared between urban and rural regions of Appalachia. Methods: The study region included Appalachia counties of Pennsylvania, Ohio, Kentucky, and North Carolina. Primary care physicians during 2008 and total census block group populations were geocoded into GIS software. Ratios of county physicians to population, driving time to nearest primary care physician, and various 2SFCA approaches were compared. Results: Urban areas of the study region had shorter travel times to their closest primary care physician. Provider to population ratios produced results that varied widely from one county to another because of strict geographic boundaries. The 2SFCA method produced varied results depending on the distance decay weight and variable catchment size techniques chose. 2SFCA scores showed greater access to care in urban areas of Pennsylvania, Ohio, and North Carolina. Conclusion: The different parameters of the 2SFCA method—distance decay weights and variable catchment sizes—have a large impact on the resulting spatial access to primary care scores. The findings of this study suggest that using a relative 2SFCA approach, the spatial access ratio method, when detailed patient travel data are unavailable. The 2SFCA method shows promise for measuring access to care in Appalachia, but more research on patient travel preferences is needed to inform implementation. PMID:26906524

  8. AccessMod 3.0: computing geographic coverage and accessibility to health care services using anisotropic movement of patients

    PubMed Central

    Ray, Nicolas; Ebener, Steeve

    2008-01-01

    Background Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial) coverage, which is an important measure for assessing the degree of accessibility of a health care network. Results This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.×, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation) that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on geographic coverage

  9. 41 CFR 301-10.137 - What exceptions to the Fly America Act requirements apply when I travel solely outside the United...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... or more; or (b) Extend your travel time by 6 hours or more; or (c) Require a connecting time of 4... Fly America Act requirements apply when I travel solely outside the United States, and a U.S. flag air... Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES...

  10. 41 CFR 301-10.137 - What exceptions to the Fly America Act requirements apply when I travel solely outside the United...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... or more; or (b) Extend your travel time by 6 hours or more; or (c) Require a connecting time of 4... Fly America Act requirements apply when I travel solely outside the United States, and a U.S. flag air... Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES...

  11. 41 CFR 301-10.137 - What exceptions to the Fly America Act requirements apply when I travel solely outside the United...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... or more; or (b) Extend your travel time by 6 hours or more; or (c) Require a connecting time of 4... Fly America Act requirements apply when I travel solely outside the United States, and a U.S. flag air... Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES...

  12. 41 CFR 301-10.137 - What exceptions to the Fly America Act requirements apply when I travel solely outside the United...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... or more; or (b) Extend your travel time by 6 hours or more; or (c) Require a connecting time of 4... Fly America Act requirements apply when I travel solely outside the United States, and a U.S. flag air... Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES...

  13. 41 CFR 301-10.137 - What exceptions to the Fly America Act requirements apply when I travel solely outside the United...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... or more; or (b) Extend your travel time by 6 hours or more; or (c) Require a connecting time of 4... Fly America Act requirements apply when I travel solely outside the United States, and a U.S. flag air... Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES...

  14. Sickness pattern among air travellers: review of 735 cases at the Oman airport.

    PubMed

    Singh, Bhupi

    2002-07-01

    The medical records of air travellers (passengers and crew) seeking emergency medical assistance at the Airport Emergency Clinic, Seeb International Airport, Muscat, Sultanate of Oman, during a 1-yr period were analyzed to determine the sickness pattern among them. The study revealed that 67% of the passengers seeking medical assistance were aged between 21 and 45 yr, and the majority (63.8%) was male. Upper respiratory tract infections (URTI), gastrointestinal (GI) conditions, injuries (sustained during journey), and otitic barotrauma/baro-otalgia accounted for more than half (51.9%) of the cases. The most common type of injury among passengers was cuts and bruises in the scalp area, but most injuries (34.7%) occurred on airport premises, not as the result of baggage falling in-flight. Lack of aerobridges is responsible for significant number of lower limb injuries to passengers. Such data highlight the need for an injury-free environment in the airports. Barotrauma was the most common cause of aircrew unfitness to continue the flight, and usually resulted in a forced layover for the concerned aircrew. The data may be useful for planning and developing medical facilities at commercial airports. Need for a safe, non-injurious environment at the airports is highlighted.

  15. Car travel time and accessibility by bus to general practitioner services: a study using patient registers and GIS.

    PubMed

    Lovett, Andrew; Haynes, Robin; Sünnenberg, Gisela; Gale, Susan

    2002-07-01

    Accessibility to general practitioner (GP) surgeries was investigated in a population study of East Anglia (Cambridgeshire, Norfolk and Suffolk) in the United Kingdom. Information from patient registers was combined with details of general practitioner surgery locations, road network characteristics, bus routes and community transport services, and a geographical information system (GIS) was used to calculate measures of accessibility to surgeries by public and private transport. Outcome measures included car travel times and indicators of the extent to which bus services could be used to visit GP surgeries. These variables were aggregated for wards or parishes and then compared with socio-economic characteristics of the populations living in those areas. The results indicated that only 10% of residents faced a car journey of more than 10 min to a GP. Some 13% of the population could not reach general medical services by daily bus. For 5% of the population, the car journey to the nearest surgery was longer than 10 min and there was no suitable bus service each weekday. In the remoter rural parishes, the lowest levels of personal mobility and the highest health needs indicators were found in the places with no daytime bus service each weekday and no community transport. The overall extent of accessibility problems and the existence of inverse care law effects in some rural localities have implications for the NHS, which aims to provide an equitable service to people wherever they live. The research also demonstrates the potential of patient registers and GIS as research and planning tools, though the practical difficulties of using these data sources and techniques should not be underestimated.

  16. Travel health attitudes among Turkish business travellers to African countries.

    PubMed

    Selcuk, Engin Burak; Kayabas, Uner; Binbasioglu, Hulisi; Otlu, Baris; Bayindir, Yasar; Bozdogan, Bulent; Karatas, Mehmet

    The number of international travellers is increasing worldwide. Although health risks related to international travel are important and generally well-understood, the perception of these risks was unclear among Turkish travellers. We aimed to evaluate the attitudes and health risk awareness of Turkish travellers travelling to African countries. A survey was performed of Turkish travellers bound for Africa from Istanbul International Ataturk Airport in July 2013. A total of 124 travellers were enrolled in the study. Among them, 62.9% had information about their destination but only 11.3% had looked for information on health problems related to travel and their destination. Of all travellers, 53.2% had at least one vaccination before travelling. The most commonly administered vaccine was for typhoid. Among the travellers, 69.3% and 80.6% had "no idea" about yellow fever vaccination and malaria prophylaxis, respectively. A positive correlation was found between a higher level of travellers' education and receiving the recommended vaccination for the destination. Our study revealed significant gaps in the vaccination and chemoprophylaxis uptake of Turkish travellers departing to Africa. An awareness and training program should be developed for travellers, as well as public health workers, to address health risks related to travel. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Dynamic assessment of exposure to air pollution using mobile phone data.

    PubMed

    Dewulf, Bart; Neutens, Tijs; Lefebvre, Wouter; Seynaeve, Gerdy; Vanpoucke, Charlotte; Beckx, Carolien; Van de Weghe, Nico

    2016-04-21

    Exposure to air pollution can have major health impacts, such as respiratory and cardiovascular diseases. Traditionally, only the air pollution concentration at the home location is taken into account in health impact assessments and epidemiological studies. Neglecting individual travel patterns can lead to a bias in air pollution exposure assessments. In this work, we present a novel approach to calculate the daily exposure to air pollution using mobile phone data of approximately 5 million mobile phone users living in Belgium. At present, this data is collected and stored by telecom operators mainly for management of the mobile network. Yet it represents a major source of information in the study of human mobility. We calculate the exposure to NO2 using two approaches: assuming people stay at home the entire day (traditional static approach), and incorporating individual travel patterns using their location inferred from their use of the mobile phone network (dynamic approach). The mean exposure to NO2 increases with 1.27 μg/m(3) (4.3%) during the week and with 0.12 μg/m(3) (0.4%) during the weekend when incorporating individual travel patterns. During the week, mostly people living in municipalities surrounding larger cities experience the highest increase in NO2 exposure when incorporating their travel patterns, probably because most of them work in these larger cities with higher NO2 concentrations. It is relevant for health impact assessments and epidemiological studies to incorporate individual travel patterns in estimating air pollution exposure. Mobile phone data is a promising data source to determine individual travel patterns, because of the advantages (e.g. low costs, large sample size, passive data collection) compared to travel surveys, GPS, and smartphone data (i.e. data captured by applications on smartphones).

  18. Sex difference in travel is concentrated in adolescence and tracks reproductive interests.

    PubMed

    Miner, Emily J; Gurven, Michael; Kaplan, Hillard; Gaulin, Steven J C

    2014-12-07

    Sexual selection theory suggests that the sex with a higher potential reproductive rate will compete more strongly for access to mates. Stronger intra-sexual competition for mates may explain why males travel more extensively than females in many terrestrial vertebrates. A male-bias in lifetime distance travelled is a purported human universal, although this claim is based primarily on anecdotes. Following sexual maturity, motivation to travel outside the natal territory may vary over the life course for both sexes. Here, we test whether travel behaviour among Tsimane forager-horticulturalists is associated with shifting reproductive priorities across the lifespan. Using structured interviews, we find that sex differences in travel peak during adolescence when men and women are most intensively searching for mates. Among married adults, we find that greater offspring dependency load is associated with reduced travel among women, but not men. Married men are more likely to travel alone than women, but only to the nearest market town and not to other Tsimane villages. We conclude that men's and women's travel behaviour reflects differential gains from mate search and parenting across the life course. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

  19. Sex difference in travel is concentrated in adolescence and tracks reproductive interests

    PubMed Central

    Miner, Emily J.; Gurven, Michael; Kaplan, Hillard; Gaulin, Steven J. C.

    2014-01-01

    Sexual selection theory suggests that the sex with a higher potential reproductive rate will compete more strongly for access to mates. Stronger intra-sexual competition for mates may explain why males travel more extensively than females in many terrestrial vertebrates. A male-bias in lifetime distance travelled is a purported human universal, although this claim is based primarily on anecdotes. Following sexual maturity, motivation to travel outside the natal territory may vary over the life course for both sexes. Here, we test whether travel behaviour among Tsimane forager–horticulturalists is associated with shifting reproductive priorities across the lifespan. Using structured interviews, we find that sex differences in travel peak during adolescence when men and women are most intensively searching for mates. Among married adults, we find that greater offspring dependency load is associated with reduced travel among women, but not men. Married men are more likely to travel alone than women, but only to the nearest market town and not to other Tsimane villages. We conclude that men's and women's travel behaviour reflects differential gains from mate search and parenting across the life course. PMID:25320169

  20. The air transportation/energy system

    NASA Technical Reports Server (NTRS)

    1973-01-01

    The changing pattern of transportation is discussed, and the energy intensiveness of various modes of transportation is also analyzed. Sociopsychological data affecting why people travel by air are presented, along with governmental regulation and air transportation economics. The aviation user tax structure is shown in tabular form.

  1. Potential travel cost saving in urban public-transport networks using smartphone guidance.

    PubMed

    Song, Cuiying; Guan, Wei; Ma, Jihui

    2018-01-01

    Public transport (PT) is a key element in most major cities around the world. With the development of smartphones, available journey planning information is becoming an integral part of the PT system. Each traveler has specific preferences when undertaking a trip, and these preferences can also be reflected on the smartphone. This paper considers transit assignment in urban public-transport networks in which the passengers receive smartphone-based information containing elements that might influence the travel decisions in relation to line loads, as well as passenger benefits, and the paper discusses the transition from the current widespread choosing approach to a personalized decision-making approach based on smartphone information. The approach associated with smartphone guidance that considers passengers' preference on travel time, waiting time and transfer is proposed in the process of obtaining his/her preferred route from the potential travel routes generated by the Deep First Search (DFS) method. Two other approaches, based on the scenarios reflecting reality, include passengers with access to no real time information, and passengers that only have access to the arrival time at the platform are used as comparisons. For illustration, the same network proposed by Spiess and Florian is utilized on the experiments in an agent-based model. Two experiments are conducted respectively according to whether each passenger's choosing method is consistent. As expected, the results in the first experiment showed that the travel for consistent passengers with smartphone guidance was clearly shorter and that it can reduce travel time exceeding 15% and weighted cost exceeding 20%, and the average saved time approximated 3.88 minutes per passenger. The second experiment presented that travel cost, as well as cost savings, gradually decreased by employing smartphone guidance, and the maximum cost savings accounted for 14.2% of the total weighted cost.

  2. Potential travel cost saving in urban public-transport networks using smartphone guidance

    PubMed Central

    2018-01-01

    Public transport (PT) is a key element in most major cities around the world. With the development of smartphones, available journey planning information is becoming an integral part of the PT system. Each traveler has specific preferences when undertaking a trip, and these preferences can also be reflected on the smartphone. This paper considers transit assignment in urban public-transport networks in which the passengers receive smartphone-based information containing elements that might influence the travel decisions in relation to line loads, as well as passenger benefits, and the paper discusses the transition from the current widespread choosing approach to a personalized decision-making approach based on smartphone information. The approach associated with smartphone guidance that considers passengers’ preference on travel time, waiting time and transfer is proposed in the process of obtaining his/her preferred route from the potential travel routes generated by the Deep First Search (DFS) method. Two other approaches, based on the scenarios reflecting reality, include passengers with access to no real time information, and passengers that only have access to the arrival time at the platform are used as comparisons. For illustration, the same network proposed by Spiess and Florian is utilized on the experiments in an agent-based model. Two experiments are conducted respectively according to whether each passenger’s choosing method is consistent. As expected, the results in the first experiment showed that the travel for consistent passengers with smartphone guidance was clearly shorter and that it can reduce travel time exceeding 15% and weighted cost exceeding 20%, and the average saved time approximated 3.88 minutes per passenger. The second experiment presented that travel cost, as well as cost savings, gradually decreased by employing smartphone guidance, and the maximum cost savings accounted for 14.2% of the total weighted cost. PMID:29746528

  3. Characteristics and pre-travel preparation of travelers at a Canadian pediatric tertiary care travel clinic: A retrospective analysis.

    PubMed

    Ma, Xiao Wei; Pell, Lisa G; Akseer, Nadia; Khan, Sarah; Lam, Ray E; Louch, Debra; Science, Michelle; Morris, Shaun K

    2016-01-01

    International travelers are susceptible to a wide spectrum of travel related morbidities. Despite rising number of international travelers in Canada, the demographics, risk profiles, and preventative strategies of high-risk traveler groups, including pediatric travelers visiting friends and relatives (VFRs) are not well described. A descriptive analysis was conducted on pre-travel consultations completed between January 2013 and August 2014 at a large pediatric tertiary care center in Toronto, Canada. Data on demographics, travel characteristics, and pre-travel interventions were extracted from 370 pre-travel consultations. Results were compared between all VFR and non-VFR travelers, as well as between children traveling to visit friends and relatives, for vacation, and for education and/or volunteer purposes. Forty-eight percent of consultations were for children <18 years of age (n = 177), of which 31% were for young children (<5 years of age). Young children were more likely to travel to visit friends and/or relatives than for other purposes (29% vs 9%, p < 0.0001). Children VFRs (cVFRs) were more likely to travel for >28 days than children traveling for vacation (43% vs 1%, p < 0.0001), and children traveling for education/volunteer purposes (43% vs 21%, p = 0.03). Around half of cVFRs traveled to destinations in Asia (51%). The majority stayed with locals, friends and/or relatives (85%), and nearly all traveled to urban destinations (98%). The most prescribed interventions for children were azithromycin (84%), Dukoral (66%), and the hepatitis A vaccine (60%). Atovaquone/proguanil was the most commonly prescribed antimalarial for children. Children that travel to visit friends and relatives represent a unique travel group and may require specific considerations during pre-travel preparations. Our findings can help develop targeted pre-travel strategies for children VFRs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Association between travel distance and metastatic disease at diagnosis among patients with colon cancer.

    PubMed

    Massarweh, Nader N; Chiang, Yi-Ju; Xing, Yan; Chang, George J; Haynes, Alex B; You, Y Nancy; Feig, Barry W; Cormier, Janice N

    2014-03-20

    Health care access and advanced cancer stage are associated with oncologic outcomes for numerous common cancers. However, the impact of patient travel distance to health care on stage at diagnosis has not been well characterized. This study used a historical cohort of patients with colon cancer in the National Cancer Data Base from 2003 through 2010. The primary outcome, stage at diagnosis, was evaluated using hierarchical regression modeling. A secondary outcome was time to receipt of initial therapy that was evaluated using Cox shared frailty modeling. Among 296,474 patients with colon cancer (mean age, 68 ± 13.6 years; 47.6% male; 78.5% white), 3.9% traveled ≥ 50 miles to the diagnosing facility. Fewer black patients, patients with higher income, and patients with lower education traveled longer distances (trend test P < .001 for all). Patients traveling ≥ 50 miles were more likely to present with metastatic disease compared with those traveling less than 12.5 miles (odds ratio [OR], 1.18; 95% CI, 1.12 to 1.24) or 12.5 to 49.9 miles (OR, 1.18; 95% CI, 1.12 to 1.24). In sensitivity analyses, the association was robust to alternate methods of modeling travel distance (quintile stratification or continuous). Travel distance ≥ 50 miles was also associated with a higher likelihood of earlier initiation of therapy compared with travel distance of less than 12.5 miles (hazard ratio [HR], 1.10; 95% CI, 1.08 to 1.13) or 12.5 to 49.9 miles (HR, 1.11; 95% CI, 1.08 to 1.13). Advanced colon cancer stage at diagnosis is associated with patient travel distance to health care, which may be a barrier to early cancer screening. Health care reform efforts designed to address only insurance coverage may not mitigate disparities based on difficulties accessing cancer care.

  5. Travel Medical Kit.

    PubMed

    Terry, Anne C; Haulman, N Jean

    2016-03-01

    "The traveler's medical kit is an essential tool for both the novice and expert traveler. It is designed to treat travel-related illness and injury and to ensure preexisting medical conditions are managed appropriately. Travelers are at increased risk for common gastrointestinal issues during travel. Respiratory illnesses make up approximately 8% of the ailments present in returned international travelers. Approximately 12% of travelers experience a travel-related skin condition. First aid treatment for minor injuries is essential to all travel medical kits. The complexity ranges from a small, simple case for the urban traveler to a larger, extensive case for wilderness travel." Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Visitor Access and Transportation Guide.

    DOT National Transportation Integrated Search

    2011-09-30

    This visitor access and transportation guide presents opportunities to manage or improve circulation and travel patterns in areas managed by Federal Land Management Agencies (FLMAs), such as the National Park Service (NPS), U.S. Forest Service (USFS)...

  7. Demographics, health and travel characteristics of international travellers at a pre-travel clinic in Marseille, France.

    PubMed

    Aubry, Camille; Gaudart, Jean; Gaillard, Catherine; Delmont, Jean; Parola, Philippe; Brouqui, Philippe; Gautret, Philippe

    2012-09-01

    With the aim to identify at-risk individuals among a cohort of international travellers, 3442 individuals who sought advice at Marseille travel health centre in 2009 were prospectively included. Demographics, travel characteristics, chronic medical conditions, vaccinations and antimalarial chemoprophylaxis were documented. Chronic medical conditions were reported by 11% of individuals, including hypertension (39%), asthma (20%), thyroid disease (15%) and depression (13%). 4% reported taking a daily medication, and psychotropic and cardiovascular medications were the most commonly used. Older travellers (≥60 years) accounted for 10% of the travellers and the prevalence of chronic medical conditions was 27% in this group. Individuals aged 15 years or less accounted for 13% of the travellers. Age, last minute travel (17%) and neurological and psychiatric diseases were the most frequent factors that influenced Yellow fever vaccination and malaria chemoprophylaxis, with more than one tenth of the travellers reporting at least one risk factor for which adjusted advice may be necessary. Migrants visiting their relatives in their origin country accounted for 14% of travellers and 73% of this group travelled with their family including young children. We demonstrate that a significant proportion of travellers are at-risk (43%) because of their travel conditions (VFR), their age, or their health status, and should be targeted for risk reduction strategies. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Travel determinants and multi-scale transferability of national activity patterns to local populations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Henson, Kriste M; Gou; ias, Konstadinos G

    The ability to transfer national travel patterns to a local population is of interest when attempting to model megaregions or areas that exceed metropolitan planning organization (MPO) boundaries. At the core of this research are questions about the connection between travel behavior and land use, urban form, and accessibility. As a part of this process, a group of land use variables have been identified to define activity and travel patterns for individuals and households. The 2001 National Household Travel Survey (NHTS) participants are divided into categories comprised of a set of latent cluster models representing persons, travel, and land use.more » These are compared to two sets of cluster models constructed for two local travel surveys. Comparison of means statistical tests are used to assess differences among sociodemographic groups residing in localities with similar land uses. The results show that the NHTS and the local surveys share mean population activity and travel characteristics. However, these similarities mask behavioral heterogeneity that are shown when distributions of activity and travel behavior are examined. Therefore, data from a national household travel survey cannot be used to model local population travel characteristics if the goal to model the actual distributions and not mean travel behavior characteristics.« less

  9. Study Design for a Method of Projecting Vehicle Miles of Travel

    DOT National Transportation Integrated Search

    1977-08-01

    Vehicle miles of travel (VMT) by passenger automobiles is an important determinant of gasoline consumption, ambient air quality, highway safety, and personal and corporate financial conditions in the United States. Changing patterns and trends in VMT...

  10. Student Guide for Documenting Experiential Learning: Travel Agency Operation.

    ERIC Educational Resources Information Center

    Coastline Community Coll., Fountain Valley, CA.

    Coastline Community College has developed a series of guides to assist adults who wish to obtain college credit or advanced standing in evaluating and verifying their non-college learning experiences. This guide lists the competency requirements of four courses within the Travel Agency Operation program: Domestic Air Transportation; International…

  11. Knowledge, attitudes, and practices of US practitioners who provide pre-travel advice.

    PubMed

    Kogelman, Laura; Barnett, Elizabeth D; Chen, Lin H; Quinn, Emily; Yanni, Emad; Wilson, Mary E; Benoit, Christine; Karchmer, Adolf W; Ooi, Winnie W; Jentes, Emily S; Hamer, Davidson H

    2014-01-01

    accessible travel medicine education programs for US providers from a wide range of disciplines is needed to improve the management of travelers. © 2014 International Society of Travel Medicine.

  12. Travel time and cancer care: an example of the inverse care law?

    PubMed

    Baird, G; Flynn, R; Baxter, G; Donnelly, M; Lawrence, J

    2008-01-01

    There is growing evidence that in rural areas cancer mortality is higher and referral occurs later, indicating different patterns of care. In Scotland services to rural areas have been organized through 'managed clinical networks'. In some cases, these organizational networks have been structured so that the referral hospital is not the one nearest to the patient's home. This study set out to discover if access to cancer specialist care in mainland Scotland altered with distance to tertiary care facilities. The aim was to explore the relationship between hospital admission rates, type of hospital and travel time. Retrospective analysis of all registered cancers in Scotland over the three-year period 2000-2002, examining incidence rates and accessibility of care over 3 years, measured by hospital discharge rates (equivalent to admission rates) and mean bed days for cancer patients. The type of hospital to which a cancer patient was admitted and the duration of admission varied with travel distance from a patient's home. All patients travelling more than one hour had lower admission rates to a specialist cancer centre. Those travelling more than 3 hours were not always admitted to the facility nearest their home address and were admitted for significantly fewer days than all other groups. Differences in tertiary cancer care obtained may explain some of the reasons behind late presentation and higher mortality rates. This study provides evidence that the recognized increased cancer mortality in rural patients is indeed compounded by an increased travel burden.

  13. Travellers' profile, travel patterns and vaccine practices--a 10-year prospective study in a Swiss Travel Clinic.

    PubMed

    Boubaker, Rim; Meige, Pierrette; Mialet, Catherine; Buffat, Chantal Ngarambe; Uwanyiligira, Mediatrice; Widmer, Francine; Rochat, Jacynthe; Fossati, Annie Hérard; Souvannaraj-Blanchant, Manisinh; Payot, Sylvie; Rochat, Laurence; de Vallière, Serge; Genton, Blaise; D'Acremont, Valérie

    2016-01-01

    The travel clinic in Lausanne serves a catchment area of 700 000 of inhabitants and provides pre- and post-travel consultations. This study describes the profile of attendees before departure, their travel patterns and the travel clinic practices in terms of vaccination over time. We included all pre-travel first consultation data recorded between November 2002 and December 2012 by a custom-made program DIAMM/G. We analysed client profiles, travel characteristics and vaccinations prescribed over time. Sixty-five thousand and forty-six client-trips were recorded. Fifty-one percent clients were female. Mean age was 32 years. In total, 0.1% were aged <1 year and 0.2% ≥80 years. Forty-six percent of travellers had pre-existing medical conditions. Forty-six percent were travelling to Africa, 35% to Asia, 20% to Latin America and 1% (each) to Oceania and Europe; 19% visited more than one country. India was the most common destination (9.6% of travellers) followed by Thailand (8.6%) and Kenya (6.4%). Seventy-three percent of travellers were planning to travel for ≤ 4 weeks. The main reasons for travel were tourism (75%) and visiting friends and relatives (18%). Sixteen percent were backpackers. Pre-travel advice were sought a median of 29 days before departure. Ninety-nine percent received vaccine(s). The most frequently administered vaccines were hepatitis A (53%), tetanus-diphtheria (46%), yellow fever (39%), poliomyelitis (38%) and typhoid fever (30%). The profile of travel clinic attendees was younger than the general Swiss population. A significant proportion of travellers received vaccinations that are recommended in the routine national programme. These findings highlight the important role of travel clinics to (i) take care of an age group that has little contact with general practitioners and (ii) update vaccination status. The most commonly prescribed travel-related vaccines were for hepatitis A and yellow fever. The question remains to know whether

  14. Impact of traffic composition on accessibility as indicator of transport sustainability

    NASA Astrophysics Data System (ADS)

    Nahdalina; Hadiwardoyo, S. P.; Nahry

    2017-05-01

    Sustainable transport is closely related to quality of life in the community at present and in the future. Some indicators of transport sustainability are accessibility measurement of origin/destination, the operating costs of transport (vehicle operating cost or VOC) and external transportation costs (emission cost). The indicators could be combined into accessibility measurement model. In other case, almost traffic congestion occurred on the condition of mixed traffic. This paper aimed to analyse the indicator of transport sustainability through simulation under condition of various traffic composition. Various composition of truck to total traffic flow are 0%, 10% and 20%. Speed and V/C are calculated from traffic flow to estimate the VOC and emission cost. 5 VOC components and 3 types of emission cost (CO2, CH4 and N2O) are counted to be a travel cost. Accessibility measurement was calculated using travel cost and gravity model approaches. Result of the research shows that the total traffic flow has indirect impact on accessibility measurement if using travel cost approach. Meanwhile, the composition of traffic flow has an affect on accessibility measurement if using gravity model approach.

  15. Impact of short- compared to long-haul international travel on the sleep and wellbeing of national wheelchair basketball athletes.

    PubMed

    Thornton, Heidi R; Miller, Joanna; Taylor, Lee; Sargent, Charli; Lastella, Michele; Fowler, Peter M

    2018-07-01

    Currently, very little is known about the impact of short- or long-haul air travel on the sleep and wellbeing of wheelchair basketball athletes. Eleven national wheelchair basketball athletes wore actigraphy monitors prior, during, and after air travel to the United Kingdom. Upon arrival, participants rated their subjective jet-lag, fatigue, and vigor. Individuals traveled to the United Kingdom from different locations in Australia, the United States, and Europe and were categorised according to travel length [LONG (up to 30.2 h) or SHORT (up to 6.5 h)]. Linear mixed models determined effects of travel length on sleep and subjective ratings of jet-lag, fatigue, and vigor. During competition, subjective fatigue and jet-lag were substantially higher (ES = 0.73; ±0.77) and (ES = 0.57; ±0.60), subjective vigor was lower (ES = 1.94; ±0.72), and get-up time was earlier (ES = 0.57; ±0.60) for LONG when compared to SHORT. Travelling greater distances by airplane had a larger effect on subjective ratings of jet-lag, fatigue and vigor, rather than sleep. Irrespective of travel group, sleep and subjective responses were compromised, reflecting the travel requirements, competition-mediated influences, and/or due to a change in environment.

  16. Connected Traveler

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    2016-06-01

    The Connected Traveler framework seeks to boost the energy efficiency of personal travel and the overall transportation system by maximizing the accuracy of predicted traveler behavior in response to real-time feedback and incentives. It is anticipated that this approach will establish a feedback loop that 'learns' traveler preferences and customizes incentives to meet or exceed energy efficiency targets by empowering individual travelers with information needed to make energy-efficient choices and reducing the complexity required to validate transportation system energy savings. This handout provides an overview of NREL's Connected Traveler project, including graphics, milestones, and contact information.

  17. A Free Program for Using and Teaching an Accessible Electronic Wayfinding Device

    ERIC Educational Resources Information Center

    Greenberg, Maya Delgado; Kuns, Jerry

    2012-01-01

    Accessible Global Positioning Systems (GPS) are changing the way many people with visual impairments (that is, those who are blind or have low vision) travel. GPS provides real-time orientation information so that a traveler with a visual impairment can make informed decisions about path of travel and destination. Orientation and mobility (O&M)…

  18. Profiles of 511 traveler information services : nationwide deployment areas : draft copy

    DOT National Transportation Integrated Search

    2006-04-01

    Profiles of 511 Traveler Information Services was prepared by the Federal Transit Administration's (FTA) Office of Research, Demonstration and Innovation to increase public awareness, access, and knowledge of the transit content within existing 511 t...

  19. Evaluation of the Lewis and Clark travel and tourism information kiosk

    DOT National Transportation Integrated Search

    2003-12-08

    Interactive touch screen kiosks can be a useful access point for people seeking tourism information. The Montana Department of Transportation (MDT) has successfully installed a network of traveler information kiosks under the Greater Yellowstone Regi...

  20. Multilevel Modeling and Policy Development: Guidelines and Applications to Medical Travel.

    PubMed

    Garcia-Garzon, Eduardo; Zhukovsky, Peter; Haller, Elisa; Plakolm, Sara; Fink, David; Petrova, Dafina; Mahalingam, Vaishali; Menezes, Igor G; Ruggeri, Kai

    2016-01-01

    Medical travel has expanded rapidly in recent years, resulting in new markets and increased access to medical care. Whereas several studies investigated the motives of individuals seeking healthcare abroad, the conventional analytical approach is limited by substantial caveats. Classical techniques as found in the literature cannot provide sufficient insight due to the nested nature of data generated. The application of adequate analytical techniques, specifically multilevel modeling, is scarce to non-existent in the context of medical travel. This study introduces the guidelines for application of multilevel techniques in public health research by presenting an application of multilevel modeling in analyzing the decision-making patterns of potential medical travelers. Benefits and potential limitations are discussed.

  1. Multilevel Modeling and Policy Development: Guidelines and Applications to Medical Travel

    PubMed Central

    Garcia-Garzon, Eduardo; Zhukovsky, Peter; Haller, Elisa; Plakolm, Sara; Fink, David; Petrova, Dafina; Mahalingam, Vaishali; Menezes, Igor G.; Ruggeri, Kai

    2016-01-01

    Medical travel has expanded rapidly in recent years, resulting in new markets and increased access to medical care. Whereas several studies investigated the motives of individuals seeking healthcare abroad, the conventional analytical approach is limited by substantial caveats. Classical techniques as found in the literature cannot provide sufficient insight due to the nested nature of data generated. The application of adequate analytical techniques, specifically multilevel modeling, is scarce to non-existent in the context of medical travel. This study introduces the guidelines for application of multilevel techniques in public health research by presenting an application of multilevel modeling in analyzing the decision-making patterns of potential medical travelers. Benefits and potential limitations are discussed. PMID:27252672

  2. Understanding Student Travel Behaviour in Semarang City

    NASA Astrophysics Data System (ADS)

    Manullang, O. R.; Tyas, W. P.; Anas, N.; Aji, F. N.

    2018-02-01

    The highest movement in Semarang City is dominated by motorcycles, which reached 79% of the number of vehicles. Highest percentage movement use motorcycle caused the highest percentage accident by motorcycle users, which reached 66% and 9% involving high school students. This happens because of the dependence of motorcycles usage in fulfilling the needs of movement in the city of Semarang. Understanding student travel behavior based on their activities is used to know travel needs and the cause of dependence on motorcycle usage. Analysis method in this study use network analysis to compare the potential accessibility and actual accessibility to known why motorcycle chosen by students as the main mode. In addition, phenomenology analysis is used to explain the intent and reasons the data produced by network analysis. The analysis result indicates that the high use of motorcycles by high school students in the Semarang city due to the absence of other effective and efficient modes in fulfilling the movement needs. Even, the student which can potentially use public transport preferred to use a motorcycle. This mode is more effective and efficient because of its flexibility and lower costs.

  3. Health research needs more comprehensive accessibility measures: integrating time and transport modes from open data.

    PubMed

    Tenkanen, Henrikki; Saarsalmi, Perttu; Järv, Olle; Salonen, Maria; Toivonen, Tuuli

    2016-07-28

    In this paper, we demonstrate why and how both temporality and multimodality should be integrated in health related studies that include accessibility perspective, in this case healthy food accessibility. We provide evidence regarding the importance of using multimodal spatio-temporal accessibility measures when conducting research in urban contexts and propose a methodological approach for integrating different travel modes and temporality to spatial accessibility analyses. We use the Helsinki metropolitan area (Finland) as our case study region to demonstrate the effects of temporality and modality on the results. Spatial analyses were carried out on 250 m statistical grid squares. We measured travel times between the home location of inhabitants and open grocery stores providing healthy food at 5 p.m., 10 p.m., and 1 a.m. using public transportation and private cars. We applied the so-called door-to-door approach for the travel time measurements to obtain more realistic and comparable results between travel modes. The analyses are based on open access data and publicly available open-source tools, thus similar analyses can be conducted in urban regions worldwide. Our results show that both time and mode of transport have a prominent impact on the outcome of the analyses; thus, understanding the realities of accessibility in a city may be very different according to the setting of the analysis used. In terms of travel time, there is clear variation in the results at different times of the day. In terms of travel mode, our results show that when analyzed in a comparable manner, public transport can be an even faster mode than a private car to access healthy food, especially in central areas of the city where the service network is dense and public transportation system is effective. This study demonstrates that time and transport modes are essential components when modeling health-related accessibility in urban environments. Neglecting them from spatial

  4. Valuing urban open space using the travel-cost method and the implications of measurement error.

    PubMed

    Hanauer, Merlin M; Reid, John

    2017-08-01

    Urbanization has placed pressure on open space within and adjacent to cities. In recent decades, a greater awareness has developed to the fact that individuals derive multiple benefits from urban open space. Given the location, there is often a high opportunity cost to preserving urban open space, thus it is important for both public and private stakeholders to justify such investments. The goals of this study are twofold. First, we use detailed surveys and precise, accessible, mapping methods to demonstrate how travel-cost methods can be applied to the valuation of urban open space. Second, we assess the degree to which typical methods of estimating travel times, and thus travel costs, introduce bias to the estimates of welfare. The site we study is Taylor Mountain Regional Park, a 1100-acre space located immediately adjacent to Santa Rosa, California, which is the largest city (∼170,000 population) in Sonoma County and lies 50 miles north of San Francisco. We estimate that the average per trip access value (consumer surplus) is $13.70. We also demonstrate that typical methods of measuring travel costs significantly understate these welfare measures. Our study provides policy-relevant results and highlights the sensitivity of urban open space travel-cost studies to bias stemming from travel-cost measurement error. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Modeling travel impedance to medical care for children with birth defects using Geographic Information Systems.

    PubMed

    Delmelle, Eric M; Cassell, Cynthia H; Dony, Coline; Radcliff, Elizabeth; Tanner, Jean Paul; Siffel, Csaba; Kirby, Russell S

    2013-10-01

    Children with birth defects may face significant geographic barriers accessing medical care and specialized services. Using a Geographic Information Systems-based approach, one-way travel time and distance to access medical care for children born with spina bifida was estimated. Using 2007 road information from the Florida Department of Transportation, we built a topological network of Florida roads. Live-born Florida infants with spina bifida during 1998 to 2007 were identified by the Florida Birth Defects Registry and linked to hospital discharge records. Maternal residence at delivery and hospitalization locations were identified during the first year of life. Of 668 infants with spina bifida, 8.1% (n = 54) could not be linked to inpatient data, resulting in 614 infants. Of those 614 infants, 99.7% (n = 612) of the maternal residential addresses at delivery were successfully geocoded. Infants with spina bifida living in rural areas in Florida experienced travel times almost twice as high compared with those living in urban areas. When aggregated at county levels, one-way network travel times exhibited statistically significant spatial autocorrelation, indicating that families living in some clusters of counties experienced substantially greater travel times compared with families living in other areas of Florida. This analysis demonstrates the usefulness of linking birth defects registry and hospital discharge data to examine geographic differences in access to medical care. Geographic Information Systems methods are important in evaluating accessibility and geographic barriers to care and could be used among children with special health care needs, including children with birth defects. Copyright © 2013 Wiley Periodicals, Inc.

  6. Spatial-temporal travel pattern mining using massive taxi trajectory data

    NASA Astrophysics Data System (ADS)

    Zheng, Linjiang; Xia, Dong; Zhao, Xin; Tan, Longyou; Li, Hang; Chen, Li; Liu, Weining

    2018-07-01

    Deep understanding of residents' travel patterns would provide helpful insights into the mechanisms of many socioeconomic phenomena. With the rapid development of location-aware computing technologies, researchers have easy access to large quantities of travel data. As an important data source, taxi trajectory data are featured by their high quality, good continuity and wide distribution, making it suitable for travel pattern mining. In this paper, we use taxi trajectory data to study spatial-temporal characterization of urban residents' travel patterns from two aspects: attractive areas and hot paths. Firstly, a framework of trajectory preprocessing, including data cleaning and extracting the taxi passenger pick-up/drop-off points, is presented to reduce the noise and redundancy in raw trajectory data. Then, a grid density based clustering algorithm is proposed to discover travel attractive areas in different periods of a day. On this basis, we put forward a spatial-temporal trajectory clustering method to discover hot paths among travel attractive areas. Compared with previous algorithms, which only consider the spatial constraint between trajectories, temporal constraint is also considered in our method. Through the experiments, we discuss how to determine the optimal parameters of the two clustering algorithms and verify the effectiveness of the algorithms using real data. Furthermore, we analyze spatial-temporal characterization of Chongqing residents' travel pattern.

  7. Optimizing Air Transportation Service to Metroplex Airports. Part 1; Analysis of Historical Data

    NASA Technical Reports Server (NTRS)

    Donohue, George; Hoffman, Karla; Sherry, Lance; Ferguson, John; Kara, Abdul Qadar

    2010-01-01

    The air transportation system is a significant driver of the U.S. economy, providing safe, affordable, and rapid transportation. During the past three decades airspace and airport capacity has not grown in step with demand for air transportation (+4% annual growth), resulting in unreliable service and systemic delays. Estimates of the impact of delays and unreliable air transportation service on the economy range from $32B to $41B per year. This report describes the results of an analysis of airline strategic decision-making with regards to: (1) geographic access, (2) economic access, and (3) airline finances. This analysis evaluated markets-served, scheduled flights, aircraft size, airfares, and profit from 2005-2009. During this period, airlines experienced changes in costs of operation (due to fluctuations in hedged fuel prices), changes in travel demand (due to changes in the economy), and changes in infrastructure capacity (due to the capacity limits at EWR, JFK, and LGA). This analysis captures the impact of the implementation of capacity limits at airports, as well as the effect of increased costs of operation (i.e. hedged fuel prices). The increases in costs of operation serve as a proxy for increased costs per flight that might occur if auctions or congestion pricing are imposed.

  8. Understanding medical travel from a source country perspective: a cross sectional study of the experiences of medical travelers from the Maldives.

    PubMed

    Suzana, Mariyam; Walls, Helen; Smith, Richard; Hanefeld, Johanna

    2018-06-19

    The resolution adopted in 2006 by the World Health Organization on international trade and health urges Member States to understand the implications of international trade and trade agreements for health and to address any challenges arising through policies and regulations. The government of Maldives is an importer of health services (with outgoing medical travelers), through offering a comprehensive universal health care package for its people that includes subsidized treatment abroad for services unavailable in the country. By the end of the first year of the scheme approximately US$11.6 m had been spent by the government of Maldives to treat patients abroad. In this study, affordability, continuity and quality of this care were assessed from the perspective of the medical traveler to provide recommendations for safer and more cost effective medical travel policy. Despite universal health care, a substantial proportion of Maldivian travelers have not accessed the government subsidy, and a third reported not having sufficient funds for the treatment episode abroad. Among the five most visited hospitals in this study, none were JCI accredited at the time of the study period and only three from India had undergone the National Accreditation Board for Hospitals (NABH) in India. Satisfaction with treatment received was high amongst travelers but concern for the continuity of care was very high, and more than a third of the patients had experienced complications arising from the treatment overseas. Source countries can use their bargaining power in the trade of health services to offer a more comprehensive package for medical travelers. Source countries with largely public funded health systems need to ensure that medical travel is truly affordable and universal, with measures for quality control such as the use of accredited foreign hospitals to make it safer and to impose measures that ensure the continuity of care for travelers.

  9. Travel burden and dentist bypass among dentally insured children.

    PubMed

    McKernan, Susan C; Pooley, Mark J; Momany, Elizabeth T; Kuthy, Raymond A

    2016-06-01

    Using administrative data from Iowa Medicaid and a large private dental insurer, we compared distance to the nearest primary care dentist for children ages 6-15 in 2012. Additionally, we examined rates of provider bypass in both populations as an indicator of spatial accessibility to dental care. We calculated measures of travel burden, including distance to the nearest primary care dentist and distance to current primary care dentist. Distance outcomes and rates of bypass, traveling beyond the nearest dentist for care, were compared by insurance type. We found that Medicaid-enrolled children lived farther from the nearest dentist and farther from their current dentist than privately insured children. However, rates of bypass were higher among the privately insured population. These results were consistent among urban and rural residents; additionally, both rural populations demonstrated greater travel distances than urban dwellers. Travel burden was greater among Medicaid-enrolled children. Lower rates of bypass, in conjunction with lower rates of dental utilization in this population, may indicate a distance threshold beyond which dental care becomes unattainable. © 2016 American Association of Public Health Dentistry.

  10. Formal Methods Applications in Air Transportation

    NASA Technical Reports Server (NTRS)

    Farley, Todd

    2009-01-01

    The U.S. air transportation system is the most productive in the world, moving far more people and goods than any other. It is also the safest system in the world, thanks in part to its venerable air traffic control system. But as demand for air travel continues to grow, the air traffic control system s aging infrastructure and labor-intensive procedures are impinging on its ability to keep pace with demand. And that impinges on the growth of our economy. Air traffic control modernization has long held the promise of a more efficient air transportation system. Part of NASA s current mission is to develop advanced automation and operational concepts that will expand the capacity of our national airspace system while still maintaining its excellent record for safety. It is a challenging mission, as efforts to modernize have, for decades, been hamstrung by the inability to assure safety to the satisfaction of system operators, system regulators, and/or the traveling public. In this talk, we ll provide a brief history of air traffic control, focusing on the tension between efficiency and safety assurance, and the promise of formal methods going forward.

  11. 14 CFR 382.117 - Must carriers permit passengers with a disability to travel with service animals?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Must carriers permit passengers with a disability to travel with service animals? 382.117 Section 382.117 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL Services...

  12. 14 CFR 382.117 - Must carriers permit passengers with a disability to travel with service animals?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Must carriers permit passengers with a disability to travel with service animals? 382.117 Section 382.117 Aeronautics and Space OFFICE OF THE... BASIS OF DISABILITY IN AIR TRAVEL Services on Aircraft § 382.117 Must carriers permit passengers with a...

  13. 14 CFR 382.117 - Must carriers permit passengers with a disability to travel with service animals?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Must carriers permit passengers with a disability to travel with service animals? 382.117 Section 382.117 Aeronautics and Space OFFICE OF THE... BASIS OF DISABILITY IN AIR TRAVEL Services on Aircraft § 382.117 Must carriers permit passengers with a...

  14. Travel and transplantation: travel-related diseases in transplant recipients.

    PubMed

    Kotton, Camille N

    2012-12-01

    Travel-related diseases may be seen in transplant recipients after travel, after transplant tourism, and via transmission from blood and organ donors, augmented by recent increases in travel, migration, and globalization. Such infections include tuberculosis, Plasmodium (malaria), Babesia, Trypanosoma cruzi (Chagas disease), Strongyloides, Coccidioides, Histoplasma, Leishmania, Brucella, HTLV, dengue, among numerous others. Review of cohorts of transplant recipients show that they tend to have minimal or suboptimal preparation prior to travel, with limited pretravel vaccination, medications, and education, which poses a greatly increased risk of travel-related infections and complications. The epidemiology of such travel-related infections in transplant recipients, along with methods for prevention, including vaccines, chemoprophylaxis, and education may help SOT recipients avoid travel-related infections, and are discussed in this review. Optimizing the understanding of the risk of tropical, geographically restricted, and other unusual or unexpected, travel-related infections will enhance the safety of vulnerable transplant recipients from potentially life-threatening infections.

  15. Perceptions about the impact of global medical travel on poorer populations in India.

    PubMed

    Gifford, Blair; Park, SinYoung; Anand, Sharmila

    2009-01-01

    There is anecdotal evidence that the increasing focus on global medical travel health services for foreigners in India is likely to exacerbate the different levels of access to health services between India's wealthy and poor populations. However, surveyed physicians (n=177) at three hospitals in New Delhi indicated positive attitudes to global medical travel, especially in regards to global medical travel's effects on poorer populations. Overall, these results appear to be the result of respondents' support of the economic development, new medical technologies, and increased medical training that comes from the health infrastructure investments needed to attract foreign patients.

  16. A comparative analysis of arranging in-flight oxygen aboard commercial air carriers.

    PubMed

    Stoller, J K; Hoisington, E; Auger, G

    1999-04-01

    As air travel has become more commonplace in today's society, so too has air travel by oxygen-using individuals. Because there is little oversight or standardization of in-flight oxygen by the Federal Aviation Administration, individual airlines' policies and practices may vary greatly. On the premise that such variation may cause confusion by prospective air travelers, we undertook the current study to describe individual air carriers' policies and practices and to provide guidance to future air travelers. Data were collected by a series of telephone calls placed by the study investigators to all commercial air carriers listed in the 1997 Cleveland Metropolitan Yellow Pages. The callers were registered respiratory therapists who identified themselves as inexperienced oxygen-requiring travelers wishing to arrange in-flight oxygen for an upcoming trip. Standard questions were asked of each carrier that included the following: Did the carrier have a special "help desk" to assist with oxygen arrangements? What oxygen systems, liter flow options, and interface devices were available? What was the charge for oxygen? How was the charged determined? What documentation from the physician was required? How much notification was required by the airline before the actual flight? In addition to recording these responses, the total amount of time spent on the telephone by the caller was logged along with the number of telephone calls and number of people spoken to in arranging in-flight oxygen. To compare oxygen charges between airlines, we calculated charges based on a "standard trip," which was defined as a nonstop, round-trip lasting 6 h in which the traveler used a flow rate of 2 L/min. Of the 33 commercial air carriers listed in the directory, 11 were US-based carriers and 22 were international-based carriers. Seventy-six percent of the airlines offered in-flight oxygen. For the 25 carriers offering in-flight oxygen, mean phone time required to make the arrangements was 9

  17. 28 CFR 36.403 - Alterations: Path of travel.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... access to an area of a facility that contains a primary function shall be made so as to ensure that, to... function area served by that path of travel. (b) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not limited...

  18. 28 CFR 36.403 - Alterations: Path of travel.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... access to an area of a facility that contains a primary function shall be made so as to ensure that, to... function area served by that path of travel. (b) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not limited...

  19. 28 CFR 36.403 - Alterations: Path of travel.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... access to an area of a facility that contains a primary function shall be made so as to ensure that, to... function area served by that path of travel. (b) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not limited...

  20. 28 CFR 36.403 - Alterations: Path of travel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... access to an area of a facility that contains a primary function shall be made so as to ensure that, to... function area served by that path of travel. (b) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not limited...

  1. A global travelers' electronic health record template standard for personal health records

    PubMed Central

    Detmer, Don E; Shabbir, Syed-Abdul; Nguyen, Phung Anh; Jian, Wen-Shan; Mihalas, George I; Shortliffe, Edward H; Tang, Paul; Haux, Reinhold; Kimura, Michio

    2011-01-01

    Tourism as well as international business travel creates health risks for individuals and populations both in host societies and home countries. One strategy to reduce health-related risks to travelers is to provide travelers and relevant caregivers timely, ongoing access to their own health information. Many websites offer health advice for travelers. For example, the WHO and US Department of State offer up-to-date health information about countries relevant to travel. However, little has been done to assure travelers that their medical information is available at the right place and time when the need might arise. Applications of Information and Communication Technology (ICT) utilizing mobile phones for health management are promising tools both for the delivery of healthcare services and the promotion of personal health. This paper describes the project developed by international informaticians under the umbrella of the International Medical Informatics Association. A template capable of becoming an international standard is proposed. This application is available free to anyone who is interested. Furthermore, its source code is made open. PMID:21849333

  2. A global travelers' electronic health record template standard for personal health records.

    PubMed

    Li, Yu-Chuan; Detmer, Don E; Shabbir, Syed-Abdul; Nguyen, Phung Anh; Jian, Wen-Shan; Mihalas, George I; Shortliffe, Edward H; Tang, Paul; Haux, Reinhold; Kimura, Michio

    2012-01-01

    Tourism as well as international business travel creates health risks for individuals and populations both in host societies and home countries. One strategy to reduce health-related risks to travelers is to provide travelers and relevant caregivers timely, ongoing access to their own health information. Many websites offer health advice for travelers. For example, the WHO and US Department of State offer up-to-date health information about countries relevant to travel. However, little has been done to assure travelers that their medical information is available at the right place and time when the need might arise. Applications of Information and Communication Technology (ICT) utilizing mobile phones for health management are promising tools both for the delivery of healthcare services and the promotion of personal health. This paper describes the project developed by international informaticians under the umbrella of the International Medical Informatics Association. A template capable of becoming an international standard is proposed. This application is available free to anyone who is interested. Furthermore, its source code is made open.

  3. Travel assistant device (TAD) to aid transit riders with special needs.

    DOT National Transportation Integrated Search

    2008-08-01

    The goal of the Americans with Disabilities (ADA) Act is to provide equal opportunity, full participation, and independence to persons with disabilities. The inability to travel, or the lack of knowledge in accessing the available transportation opti...

  4. Stigma and barriers to accessing mental health services perceived by Air Force nursing personnel.

    PubMed

    Hernandez, Stephen H A; Bedrick, Edward J; Parshall, Mark B

    2014-11-01

    We investigated perceptions of stigma and barriers associated with accessing mental health services among active component U.S. Air Force officer and enlisted nursing personnel (N = 211). The Britt and Hoge et al Stigma scale and Hoge et al Barriers to Care scale were administered via an anonymous, online survey. Stigma items pertained to concerns that might affect decisions to seek mental health treatment. Most of the sample agreed with the items "Members of my unit might have less confidence in me" and "My unit leadership might treat me differently." Approximately 20% to 46% agreed with the other four stigma items. Officer nursing personnel were significantly more likely than enlisted to agree that accessing mental health services would be embarrassing, harm their career, or cause leaders to blame them for the problem (p ≤ 0.03 for each comparison). Getting time off from work for treatment and scheduling appointments were perceived as barriers by 41% and 21% of respondents, respectively. We conclude that proportions of Air Force nursing personnel reporting concerns about potential stigmatizing consequences of seeking mental health care are substantial and similar to ranges previously reported by military service members screening positive for mental health problems after deployment. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  5. California air transportation study: A transportation system for the California Corridor of the year 2010

    NASA Technical Reports Server (NTRS)

    1989-01-01

    To define and solve the problems of transportation in the California Corrider in the year 2010, the 1989 California Polytechnic State University Aeronautical Engineering Senior Design class determined future corridor transportation needs and developed a system to meet the requirements. A market study, which included interpreting travel demand and gauging the future of regional and national air travel in and out of the corridor, allowed the goals of the project to be accurately refined. Comprehensive trade-off studies of several proposed transporation systems were conducted to determine which components would form the final proposed system. Preliminary design and further analysis were performed for each resulting component. The proposed system consists of three vehicles and a special hub or mode mixer, the Corridor Access Port (CAP). The vehicles are: (1) an electric powered aircraft to serve secondary airports and the CAP; (2) a high speed magnetic levitation train running through the CAP and the high population density areas of the corridor; and (3) a vertical takeoff and landing tilt rotor aircraft to serve both intercity and intrametropolitan travelers from the CAP and city vertiports. The CAP is a combination and an extension of the hub, mode mixer, and Wayport concepts. The CAP is an integrated part of the system which meets the travel demands in the corridor, and interfaces with interstate and international travel.

  6. Organisational travel plans for improving health.

    PubMed

    Hosking, Jamie; Macmillan, Alexandra; Connor, Jennie; Bullen, Chris; Ameratunga, Shanthi

    2010-03-17

    Dependence on car use has a number of broad health implications, including contributing to physical inactivity, road traffic injury, air pollution and social severance, as well as entrenching lifestyles that require environmentally unsustainable energy use. Travel plans are interventions that aim to reduce single-occupant car use and increase the use of alternatives such as walking, cycling and public transport, with a variety of behavioural and structural components. This review focuses on organisational travel plans for schools, tertiary institutes and workplaces. These plans are closely aligned in their aims and intervention design, having emerged from a shared theoretical base. To assess the effects of organisational travel plans on health, either directly measured, or through changes in travel mode. We searched the following electronic databases; Transport (1988 to June 2008), MEDLINE (1950 to June 2008), EMBASE (1947 to June 2008), CINAHL (1982 to June 2008), ERIC (1966 to June 2008), PSYCINFO (1806 to June 2008), Sociological Abstracts (1952 to June 2008), BUILD (1989 to 2002), Social Sciences Citation Index (1900 to June 2008), Science Citation Index (1900 to June 2008), Arts & Humanities Index (1975 to June 2008), Cochrane Database of Systematic Reviews (to August 2008), CENTRAL (to August 2008), Cochrane Injuries Group Register (to December 2009), C2-RIPE (to July 2008), C2-SPECTR (to July 2008), ProQuest Dissertations & Theses (1861 to June 2008). We also searched the reference lists of relevant articles, conference proceedings and Internet sources. We did not restrict the search by date, language or publication status. We included randomised controlled trials and controlled before-after studies of travel behaviour change programmes conducted in an organisational setting, where the measured outcome was change in travel mode or health. Both positive and negative health effects were included. Two authors independently assessed eligibility, assessed trial

  7. Spatial accessibility to healthcare services in Shenzhen, China: improving the multi-modal two-step floating catchment area method by estimating travel time via online map APIs.

    PubMed

    Tao, Zhuolin; Yao, Zaoxing; Kong, Hui; Duan, Fei; Li, Guicai

    2018-05-09

    Shenzhen has rapidly grown into a megacity in the recent decades. It is a challenging task for the Shenzhen government to provide sufficient healthcare services. The spatial configuration of healthcare services can influence the convenience for the consumers to obtain healthcare services. Spatial accessibility has been widely adopted as a scientific measurement for evaluating the rationality of the spatial configuration of healthcare services. The multi-modal two-step floating catchment area (2SFCA) method is an important advance in the field of healthcare accessibility modelling, which enables the simultaneous assessment of spatial accessibility via multiple transport modes. This study further develops the multi-modal 2SFCA method by introducing online map APIs to improve the estimation of travel time by public transit or by car respectively. As the results show, the distribution of healthcare accessibility by multi-modal 2SFCA shows significant spatial disparity. Moreover, by dividing the multi-modal accessibility into car-mode and transit-mode accessibility, this study discovers that the transit-mode subgroup is disadvantaged in the competition for healthcare services with the car-mode subgroup. The disparity in transit-mode accessibility is the main reason of the uneven pattern of healthcare accessibility in Shenzhen. The findings suggest improving the public transit conditions for accessing healthcare services to reduce the disparity of healthcare accessibility. More healthcare services should be allocated in the eastern and western Shenzhen, especially sub-districts in Dapeng District and western Bao'an District. As these findings cannot be drawn by the traditional single-modal 2SFCA method, the advantage of the multi-modal 2SFCA method is significant to both healthcare studies and healthcare system planning.

  8. Travel health preparation and travel-related morbidity of splenectomised individuals.

    PubMed

    Boeddha, Christien; de Graaf, Wilmar; Overbosch, David; van Genderen, Perry J J

    2012-07-01

    Asplenic or hyposplenic patients are at an increased risk of encapsulated bacterial and intraerythrocytic parasitic infections, which are endemic at many travel destinations. With proper travel health advice and preparation splenectomised individuals could have comparable travel-related morbidity as healthy control subjects. We conducted a prospective case-control study with 21 travel pairs. Each pair consisted of a splenectomised patient (case) and a healthy, non-splenectomised travel companion (control) in order to match for travel destination, duration and potential exposures to travel-related health risks. All participants filled out a questionnaire detailing travel health preparation including vaccination and malaria prophylaxis as well as travel-related morbidity. Cases and controls were comparable for age and gender. Cases received significantly more information about on demand use of antibiotics in case of fever. Immunisation coverage against encapsulated bacteria and adherence to malaria prophylaxis guidelines was suboptimal. There were no significant differences in the occurrence of travel-related ailments nor differences in severity of ailments. The immunisation coverage against encapsulated bacteria and adherence to malaria prophylaxis guidelines was suboptimal in some splenectomised patients and should be improved. Strict adherence to national travel health advice guidelines and specific guidelines for asplenic patients is advisable. However, with regard to travel-related morbidity there are no significant differences in morbidity between splenectomised patients and healthy controls, at least in the setting of short-term travel. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. 25 CFR 700.533 - Restrictions affecting travel and travel expense reimbursement.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 2 2012-04-01 2012-04-01 false Restrictions affecting travel and travel expense... travel and travel expense reimbursement. (a) When an employee is on officially authorized travel his or... in cash or kind for travel expenses from any other source, even when the employee's expenses exceed...

  10. 25 CFR 700.533 - Restrictions affecting travel and travel expense reimbursement.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 2 2014-04-01 2014-04-01 false Restrictions affecting travel and travel expense... travel and travel expense reimbursement. (a) When an employee is on officially authorized travel his or... in cash or kind for travel expenses from any other source, even when the employee's expenses exceed...

  11. 25 CFR 700.533 - Restrictions affecting travel and travel expense reimbursement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Restrictions affecting travel and travel expense... travel and travel expense reimbursement. (a) When an employee is on officially authorized travel his or... in cash or kind for travel expenses from any other source, even when the employee's expenses exceed...

  12. 25 CFR 700.533 - Restrictions affecting travel and travel expense reimbursement.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false Restrictions affecting travel and travel expense... travel and travel expense reimbursement. (a) When an employee is on officially authorized travel his or... in cash or kind for travel expenses from any other source, even when the employee's expenses exceed...

  13. 25 CFR 700.533 - Restrictions affecting travel and travel expense reimbursement.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false Restrictions affecting travel and travel expense... travel and travel expense reimbursement. (a) When an employee is on officially authorized travel his or... in cash or kind for travel expenses from any other source, even when the employee's expenses exceed...

  14. Travelers' Diarrhea and Other Gastrointestinal Symptoms Among Boston-Area International Travelers

    PubMed Central

    Stoney, Rhett J.; Han, Pauline V.; Barnett, Elizabeth D.; Wilson, Mary E.; Jentes, Emily S.; Benoit, Christine M.; MacLeod, William B.; Hamer, Davidson H.; Chen, Lin H.

    2017-01-01

    This prospective cohort study describes travelers' diarrhea (TD) and non-TD gastrointestinal (GI) symptoms among international travelers from the Boston area, the association of TD with traveler characteristics and dietary practices, use of prescribed antidiarrheal medications, and the impact of TD and non-TD GI symptoms on planned activities during and after travel. We included adults who received a pre-travel consultation at three Boston-area travel clinics and who completed a three-part survey: pre-travel, during travel, and post-travel (2–4 weeks after return). TD was defined as self-reported diarrhea with or without nausea/vomiting, abdominal pain, or fever. Demographic and travel characteristics were evaluated by χ2 test for categorical and Wilcoxon rank-sum test for continuous variables. Analysis of dietary practices used logistic generalized estimating equation models or logistic regression models. Of 628 travelers, 208 (33%) experienced TD and 45 (7%) experienced non-TD GI symptoms. Of 208 with TD, 128 (64%), 71 (36%), and 123 (62%) were prescribed ciprofloxacin, azithromycin, and/or loperamide before travel, respectively. Thirty-nine (36%) of 108 took ciprofloxacin, 20 (38%) of 55 took azithromycin, and 28 (28%) of 99 took loperamide during travel. Of 172 with TD during travel, 24% stopped planned activities, and 2% were hospitalized. Of 31 with non-TD GI symptoms during travel, six (13%) stopped planned activities. International travelers continue to experience diarrhea and other GI symptoms, resulting in disruption of planned activities and healthcare visits for some. Although these illnesses resulted in interruption of travel plans, a relatively small proportion took prescribed antibiotics. PMID:28719282

  15. Travelers' Diarrhea and Other Gastrointestinal Symptoms Among Boston-Area International Travelers.

    PubMed

    Stoney, Rhett J; Han, Pauline V; Barnett, Elizabeth D; Wilson, Mary E; Jentes, Emily S; Benoit, Christine M; MacLeod, William B; Hamer, Davidson H; Chen, Lin H

    2017-06-01

    AbstractThis prospective cohort study describes travelers' diarrhea (TD) and non-TD gastrointestinal (GI) symptoms among international travelers from the Boston area, the association of TD with traveler characteristics and dietary practices, use of prescribed antidiarrheal medications, and the impact of TD and non-TD GI symptoms on planned activities during and after travel. We included adults who received a pre-travel consultation at three Boston-area travel clinics and who completed a three-part survey: pre-travel, during travel, and post-travel (2-4 weeks after return). TD was defined as self-reported diarrhea with or without nausea/vomiting, abdominal pain, or fever. Demographic and travel characteristics were evaluated by χ 2 test for categorical and Wilcoxon rank-sum test for continuous variables. Analysis of dietary practices used logistic generalized estimating equation models or logistic regression models. Of 628 travelers, 208 (33%) experienced TD and 45 (7%) experienced non-TD GI symptoms. Of 208 with TD, 128 (64%), 71 (36%), and 123 (62%) were prescribed ciprofloxacin, azithromycin, and/or loperamide before travel, respectively. Thirty-nine (36%) of 108 took ciprofloxacin, 20 (38%) of 55 took azithromycin, and 28 (28%) of 99 took loperamide during travel. Of 172 with TD during travel, 24% stopped planned activities, and 2% were hospitalized. Of 31 with non-TD GI symptoms during travel, six (13%) stopped planned activities. International travelers continue to experience diarrhea and other GI symptoms, resulting in disruption of planned activities and healthcare visits for some. Although these illnesses resulted in interruption of travel plans, a relatively small proportion took prescribed antibiotics.

  16. DefenseLink Special: Travels with Pace, March 2006

    Science.gov Websites

    Us Travels with Pace Chairman of the Joint Chiefs of Staff Marine Gen. Peter Pace U.S. Marine Gen . Peter Pace, chairman of the Joint Chiefs of Staff, speaks to students attending the Turkish War College U.S. Air Force Staff Sgt. D. Myles Cullen Hi-Res Pace Wraps Up Visit to Allied Nations WASHINGTON

  17. Key Considerations for an Economic and Legal Framework Facilitating Medical Travel

    PubMed Central

    Hinrichs-Krapels, Saba; Bussmann, Sarah; Dobyns, Christopher; Kácha, Ondřej; Ratzmann, Nora; Holm Thorvaldsen, Julie; Ruggeri, Kai

    2016-01-01

    Medical travel has the capacity to counter increasing costs of health care by creating new markets and increased revenue for health services, potentially benefiting local populations, economies, and health-care systems. This paper is part of a broad, comprehensive project aimed at developing a global health access policy (GHAP). It presents key issues to consider in terms of ensuring economic viability, sustainability, and limiting risk to the many stakeholders involved in the rapidly expanding industry of medical travel. The noted economic and legal barriers to medical travel are based on a synthesis of themes found in an extensive review of the available literature. Economic considerations, when setting up a GHAP, include a dynamic approach to pricing that is fair to the local population. Legal considerations include the implementation of international quality standards and the protection of the rights of those traveling as well as those of local populations in recipient countries. By taking into account these opportunities, the GHAP will more adequately address existing gaps in the economic and legal regulation of medical travel. PMID:27066467

  18. Key Considerations for an Economic and Legal Framework Facilitating Medical Travel.

    PubMed

    Hinrichs-Krapels, Saba; Bussmann, Sarah; Dobyns, Christopher; Kácha, Ondřej; Ratzmann, Nora; Holm Thorvaldsen, Julie; Ruggeri, Kai

    2016-01-01

    Medical travel has the capacity to counter increasing costs of health care by creating new markets and increased revenue for health services, potentially benefiting local populations, economies, and health-care systems. This paper is part of a broad, comprehensive project aimed at developing a global health access policy (GHAP). It presents key issues to consider in terms of ensuring economic viability, sustainability, and limiting risk to the many stakeholders involved in the rapidly expanding industry of medical travel. The noted economic and legal barriers to medical travel are based on a synthesis of themes found in an extensive review of the available literature. Economic considerations, when setting up a GHAP, include a dynamic approach to pricing that is fair to the local population. Legal considerations include the implementation of international quality standards and the protection of the rights of those traveling as well as those of local populations in recipient countries. By taking into account these opportunities, the GHAP will more adequately address existing gaps in the economic and legal regulation of medical travel.

  19. Vaccination knowledge, attitude and practice among Chinese travelers who visit travel clinics in Preparation for international travel.

    PubMed

    Zhang, Min; Zhang, Jianming; Hao, Yutong; Fan, ZhengXing; Li, Lei; Li, Yiguang; Ju, Wendong; Zhang, Hong; Liu, Wei; Zhang, Mengzhang; Wu, Di; He, Hongtao

    2016-06-01

    Although international travel has become increasingly more common in main land China, few data are available on vaccination knowledge, attitude and practice (KAP) among Chinese travelers. In each of 14 International Travel Healthcare Centers (ITHCs) situated in mainland China 200 volunteers were recruited for a cross-sectional investigation by questionnaire on KAP related to travel vaccinations. For the evaluation the study subjects were grouped by demographic data, past travel experience, travel destination, duration of stay abroad, purpose of travel. Among the 2,800 Chinese travelers who participated in the study, 67.1% were aware of national and travel vaccination recommendations. The knowledge about vaccine preventable diseases was low. The most common sources (73.4%) of information were requirements by destination countries obtained in connection with the visa application, Chinese companies employing workers/laborers for assignments overseas, and foreign schools. The overall acceptance rate of recommended vaccines was 68.7%, but yellow fever was accepted by 99.8% of the participants when recommended. Among 81.1% respondents who recalled to have received vaccinations in the past, only 25.9% of them brought the old vaccination records with them to their ITHC consultations. The results indicate that increased awareness of the importance of pre-travel vaccination is needed among the travellers in order to improve their KAP. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

  20. U.S. school travel, 2009 an assessment of trends.

    PubMed

    McDonald, Noreen C; Brown, Austin L; Marchetti, Lauren M; Pedroso, Margo S

    2011-08-01

    The White House Task Force on Childhood Obesity has set a goal of increasing walking and biking to school by 50% within 5 years. Meeting the goal requires a detailed understanding of the current patterns of school travel. To document nationally representative estimates of the amount of school travel and the modes used to access school in 2009 and compare these levels with 1969, 1995, and 2001. The National Household Travel Survey collected data on the travel patterns of 150,147 households in 2008 and 2009. Analyses, conducted in 2010, documented the time, vehicle miles traveled, and modes used by American students to reach school. A binary logit model assessed the influence of trip, child, and household characteristics on the decision to walk to school. In 2009, 12.7% of K-8 students usually walked or biked to school compared with 47.7% in 1969. Rates of walking and biking to school were higher on the trip home from school in each survey year. During the morning peak period, school travel accounted for 5%-7% of vehicle miles traveled in 2009 and 10%-14% of all private vehicles on the road. There have been sharp increases in driving children to school since 1969 and corresponding decreases in walking to school. This increase is particularly evident in the number of vehicle trips generated by parents dropping children at school and teens driving themselves. The NHTS survey provides a unique opportunity to monitor these trends in the future. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  1. AirData

    EPA Pesticide Factsheets

    The AirData site provides access to yearly summaries of United States air pollution data, taken from EPA's air pollution databases. AirData has information about where air pollution comes from (emissions) and how much pollution is in the air outside our homes and work places (monitoring).

  2. Severe Sunburn After a Hot Air Balloon Ride: A Case Report and Literature Review.

    PubMed

    Ozturk, Sinan; Karagoz, Huseyin

    2015-01-01

    Hot air balloon tours are very popular among travelers worldwide. Preventable burn injuries associated with hot air balloon rides have been reported during crashes into power lines, in propane burner explosions, and following contact with the propane burner tanks. We present a case of severe repeated sunburn, which poses another risk of preventable injury during hot air balloon rides, and briefly discuss the injury epidemiology of hot air balloon rides. © 2015 International Society of Travel Medicine.

  3. 77 FR 5252 - Federal Travel Regulation; GSA E-Gov Travel Service (ETS) Transition to E-Gov Travel Service 2...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-02

    ... Travel Regulation; GSA E-Gov Travel Service (ETS) Transition to E-Gov Travel Service 2 (ETS2) AGENCY... (QMC), at [email protected]gov or (703) 605-2151. SUPPLEMENTARY INFORMATION: The Federal Travel...-GOV TRAVEL SERVICE GSA Bulletin ETS 12-01 TO: Heads of Federal Agencies SUBJECT: GSA E-Gov Travel...

  4. Retrospective review of adverse incidents involving passengers seated in wheeled mobility devices while traveling in large accessible transit vehicles.

    PubMed

    Frost, Karen L; Bertocci, Gina

    2010-04-01

    Characterize wheeled mobility device (WhMD) adverse incidents on large accessible transit vehicles (LATVs) based on vehicle motion, WhMD activity during incident, incident scenario and injury. Retrospective records review. WhMD passengers traveling on LATVs while remaining seated in their. Adverse incidents characterized based on vehicle motion, WhMD activity during incident, and incident scenario. Injury characterized based on outcome, medical attention sought, vehicle activity, WhMD activity and incident scenario. 115 WhMD-related incident reports for years 2000-2005 were analyzed. Most incidents occurred when the LATV was stopped (73.9%), during ingress/egress (42.6%), and at the securement station (33.9%) when the LATV was moving. The combination of WhMD tipping and passenger falling (43.4%) occurred most frequently, and was 1.8 times more likely to occur during ingress/egress than at the securement station. One-third (33.6%) of all incidents resulted in injury, and injuries were equally distributed between ingress/egress (43.6%) and at the securement station (43.6%). WhMD users have a greater chance of incurring injury during ingress/egress than during transit. Research is needed to objectively assess real world transportation experiences of WhMD passengers, and to assess the adequacy of existing federal legislation/guidelines for accessible ramps used in public transportation. Copyright 2009 IPEM. Published by Elsevier Ltd. All rights reserved.

  5. Travelers' Health

    MedlinePlus

    ... Minute Travel Long-Term Travel Mass Gatherings Medical Tourism Mental Health Motion Sickness Natural Disasters Pregnant Travelers Road Safety Senior Citizens Sex Tourism STDs Sun Exposure Swimming and Diving Study Abroad ...

  6. Travelers' Diarrhea

    MedlinePlus

    ... Climates Humanitarian Aid Workers Humanitarian Aid Workers in Ecuador Insurance International Adoption Jet Lag Last-Minute Travel Long-Term Travel Mass Gatherings Medical Tourism Mental Health Motion Sickness Natural Disasters Pregnant Travelers ...

  7. Analysis of Airport Access - A Methods Review and Research Program

    DOT National Transportation Integrated Search

    1971-10-01

    The report points up the differences and similarities between airport access travel and general urban trip making. Models and surveys developed for, or applicable, to airport access planning are reviewed. A research proram is proposed which would gen...

  8. Superconducting magnets for traveling-wave maser application. Technical documentary report, Oct 1960--Mar 1962

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Okwit, S.; Siegel, K.; Smith, J.G.

    1962-09-01

    Results of an investigation to determine the feasibility of incorporating superconducting magnet techniques in the design of traveling-wave maser systems are reported. Several different types of magnet configurations were investigated: isomagnets, Helmholtz coils, modified Helmholtz coils, air-core solenoids, and magnetic end-loaded air-core solenoids. The magnetic end-loaded air-core solenoid was found to be the best configuration for the S-band maser under consideration. This technique yielded relatively large regions of field homogeneity with relatively small aspect ratios (length of solenoid/diameter of solenoid). Several small-scale models of full-length superconducting magnets and foreshortened end-loaded superconducting magnets were constructed using un-annealed niobium wire. Measurements havemore » shown that these magnets were adequate for traveling-wave maser applications that require magnetic fields up to 2,200 G and marginal for magnetic fields up to 2,500 G.« less

  9. Utilizing Traveler Demand Modeling to Predict Future Commercial Flight Schedules in the NAS

    NASA Technical Reports Server (NTRS)

    Viken, Jeff; Dollyhigh, Samuel; Smith, Jeremy; Trani, Antonio; Baik, Hojong; Hinze, Nicholas; Ashiabor, Senanu

    2006-01-01

    The current work incorporates the Transportation Systems Analysis Model (TSAM) to predict the future demand for airline travel. TSAM is a multi-mode, national model that predicts the demand for all long distance travel at a county level based upon population and demographics. The model conducts a mode choice analysis to compute the demand for commercial airline travel based upon the traveler s purpose of the trip, value of time, cost and time of the trip,. The county demand for airline travel is then aggregated (or distributed) to the airport level, and the enplanement demand at commercial airports is modeled. With the growth in flight demand, and utilizing current airline flight schedules, the Fratar algorithm is used to develop future flight schedules in the NAS. The projected flights can then be flown through air transportation simulators to quantify the ability of the NAS to meet future demand. A major strength of the TSAM analysis is that scenario planning can be conducted to quantify capacity requirements at individual airports, based upon different future scenarios. Different demographic scenarios can be analyzed to model the demand sensitivity to them. Also, it is fairly well know, but not well modeled at the airport level, that the demand for travel is highly dependent on the cost of travel, or the fare yield of the airline industry. The FAA projects the fare yield (in constant year dollars) to keep decreasing into the future. The magnitude and/or direction of these projections can be suspect in light of the general lack of airline profits and the large rises in airline fuel cost. Also, changes in travel time and convenience have an influence on the demand for air travel, especially for business travel. Future planners cannot easily conduct sensitivity studies of future demand with the FAA TAF data, nor with the Boeing or Airbus projections. In TSAM many factors can be parameterized and various demand sensitivities can be predicted for future travel. These

  10. Lithium-Air Battery: High Performance Cathodes for Lithium-Air Batteries

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    2010-08-01

    BEEST Project: Researchers at Missouri S&T are developing an affordable lithium-air (Li-Air) battery that could enable an EV to travel up to 350 miles on a single charge. Today’s EVs run on Li-Ion batteries, which are expensive and suffer from low energy density compared with gasoline. This new Li-Air battery could perform as well as gasoline and store 3 times more energy than current Li-Ion batteries. A Li-Air battery uses an air cathode to breathe oxygen into the battery from the surrounding air, like a human lung. The oxygen and lithium react in the battery to produce electricity. Current Li-Airmore » batteries are limited by the rate at which they can draw oxygen from the air. The team is designing a battery using hierarchical electrode structures to enhance air breathing and effective catalysts to accelerate electricity production.« less

  11. Air Traffic Management Research at NASA

    NASA Technical Reports Server (NTRS)

    Farley, Todd

    2012-01-01

    The U.S. air transportation system is the most productive in the world, moving far more people and goods than any other. It is also the safest system in the world, thanks in part to its venerable air traffic control system. But as demand for air travel continues to grow, the air traffic control systems aging infrastructure and labor-intensive procedures are impinging on its ability to keep pace with demand. And that impinges on the growth of our economy. Part of NASA's current mission in aeronautics research is to invent new technologies and procedures for ATC that will enable our national airspace system to accommodate the increasing demand for air transportation well into the next generation while still maintaining its excellent record for safety. It is a challenging mission, as efforts to modernize have, for decades, been hamstrung by the inability to assure safety to the satisfaction of system operators, system regulators, and/or the traveling public. In this talk, we'll provide a brief history of air traffic control, focusing on the tension between efficiency and safety assurance, and we'll highlight some new NASA technologies coming down the pike.

  12. International travel patterns and travel risks for stem cell transplant recipients.

    PubMed

    Mikati, Tarek; Griffin, Kenneth; Lane, Dakotah; Matasar, Matthew; Shah, Monika K

    2015-01-01

    Stem cell transplantation (SCT) is being increasingly utilized for multiple medical illnesses. However, there is limited knowledge about international travel patterns and travel-related illnesses of stem cell transplant recipients (SCTRs). An observational cross-sectional study was conducted among 979 SCTRs at Memorial Sloan Kettering Cancer Center using a previously standardized and validated questionnaire. International travel post SCT, pre-travel health advice, exposure risks, and travel-related illnesses were queried. A total of 516 SCTRs completed the survey (55% response rate); of these, 40% were allogeneic SCTRs. A total of 229 (44.3%) respondents reported international travel outside the United States and Canada post SCT. The international travel incidence was 32% [95% confidence interval CI 28-36] within 2 years after SCT. Using multivariable Cox regression analysis, variables significantly associated with international travel within first 2 years after SCT were history of international travel prior to SCT [hazard ratio (HR) = 5.3, 95% CI 2.3-12.0], autologous SCT (HR = 2.6, 95% CI 1.6-2.8), foreign birth (HR = 2.3, 95% CI 1.5-3.3), and high income (HR = 2.0, 95% CI 1.8-3.7). During their first trip, 64 travelers (28%) had traveled to destinations that may have required vaccination or malaria chemoprophylaxis. Only 56% reported seeking pre-travel health advice. Of those who traveled, 16 travelers (7%) became ill enough to require medical attention during their first trip after SCT. Ill travelers were more likely to have visited high-risk areas (60 vs 26%, p = 0.005), to have had a longer mean trip duration (24 vs 12 days, p = 0.0002), and to have visited friends and relatives (69 vs 21%, p < 0.0001). International travel was common among SCTRs within 2 years after SCT and was mainly to low-risk destinations. Although the overall incidence of travel-related illnesses was low, certain subgroups of travelers were at a

  13. Risk factors and pre-travel healthcare of international travellers attending a Dutch travel clinic: a cross-sectional analysis.

    PubMed

    Wieten, Rosanne W; van der Schalie, Maurice; Visser, Benjamin J; Grobusch, Martin P; van Vugt, Michèle

    2014-01-01

    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. 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. 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. 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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Association Between Travel Distance and Metastatic Disease at Diagnosis Among Patients With Colon Cancer

    PubMed Central

    Massarweh, Nader N.; Chiang, Yi-Ju; Xing, Yan; Chang, George J.; Haynes, Alex B.; You, Y. Nancy; Feig, Barry W.; Cormier, Janice N.

    2014-01-01

    Purpose Health care access and advanced cancer stage are associated with oncologic outcomes for numerous common cancers. However, the impact of patient travel distance to health care on stage at diagnosis has not been well characterized. Methods This study used a historical cohort of patients with colon cancer in the National Cancer Data Base from 2003 through 2010. The primary outcome, stage at diagnosis, was evaluated using hierarchical regression modeling. A secondary outcome was time to receipt of initial therapy that was evaluated using Cox shared frailty modeling. Results Among 296,474 patients with colon cancer (mean age, 68 ± 13.6 years; 47.6% male; 78.5% white), 3.9% traveled ≥ 50 miles to the diagnosing facility. Fewer black patients, patients with higher income, and patients with lower education traveled longer distances (trend test P < .001 for all). Patients traveling ≥ 50 miles were more likely to present with metastatic disease compared with those traveling less than 12.5 miles (odds ratio [OR], 1.18; 95% CI, 1.12 to 1.24) or 12.5 to 49.9 miles (OR, 1.18; 95% CI, 1.12 to 1.24). In sensitivity analyses, the association was robust to alternate methods of modeling travel distance (quintile stratification or continuous). Travel distance ≥ 50 miles was also associated with a higher likelihood of earlier initiation of therapy compared with travel distance of less than 12.5 miles (hazard ratio [HR], 1.10; 95% CI, 1.08 to 1.13) or 12.5 to 49.9 miles (HR, 1.11; 95% CI, 1.08 to 1.13). Conclusion Advanced colon cancer stage at diagnosis is associated with patient travel distance to health care, which may be a barrier to early cancer screening. Health care reform efforts designed to address only insurance coverage may not mitigate disparities based on difficulties accessing cancer care. PMID:24516014

  15. Development and Implementation of the Ebola Traveler Monitoring Program and Clinical Outcomes of Monitored Travelers during October - May 2015, Minnesota.

    PubMed

    DeVries, Aaron; Talley, Pamela; Sweet, Kristin; Kline, Susan; Stinchfield, Patricia; Tosh, Pritish; Danila, Richard

    2016-01-01

    In October 2014, the United States began actively monitoring all persons who had traveled from Guinea, Liberia, and Sierra Leone in the previous 21 days. State public health departments were responsible for monitoring all travelers; Minnesota has the largest Liberian population in the United States. The MDH Ebola Clinical Team (ECT) was established to assess travelers with symptoms of concern for Ebola virus disease (EVD), coordinate access to healthcare at appropriate facilities including Ebola Assessment and Treatment Units (EATU), and provide guidance to clinicians. Minnesota Department of Health (MDH) began receiving traveler information collected by U.S. Customs and Border Control and Centers for Disease Control and Prevention staff on October 21, 2014 via encrypted electronic communication. All travelers returning from Liberia, Sierra Leone, and Guinea during 10/21/14-5/15/15 were monitored by MDH staff in the manner recommended by CDC based on the traveler's risk categorization as "low (but not zero)", "some" and "high" risk. When a traveler reported symptoms or a temperature ≥100.4° F at any time during their 21-day monitoring period, an ECT member would speak to the traveler and perform a clinical assessment by telephone or via video-chat. Based on the assessment the ECT member would recommend 1) continued clinical monitoring while at home with frequent telephone follow-up by the ECT member, 2) outpatient clinical evaluation at an outpatient site agreed upon by all parties, or 3) inpatient clinical evaluation at one of four Minnesota EATUs. ECT members assessed and approved testing for Ebola virus infection at MDH. Traveler data, calls to the ECT and clinical outcomes were logged on a secure server at MDH. During 10/21/14-5/15/15, a total of 783 travelers were monitored; 729 (93%) traveled from Liberia, 30 (4%) Sierra Leone, and 24 (3%) Guinea. The median number monitored per week was 59 (range 45-143). The median age was 35 years; 136 (17%) were aged

  16. Impact of changes to policy for Mexican risk travel on Canadian blood donor deferrals.

    PubMed

    O'Brien, Sheila F; Uzicanin, Samra; Choquet, Karine; Yi, Qi-Long; Fan, Wenli; Goldman, Mindy

    2013-10-01

    Travel to malaria risk areas such as Mexico is a common source of donor deferral in Canada. On February 21st, 2011 the deferrable regions in Mexico were revised to permit donation if donors travelled to the state of Quintana Roo, Mexico, a popular ocean-side resort area. Canadian travel data and malaria deferral rates since 2007 were plotted to examine trends. Deferral records in one centre were accessed from January to April, 2011 to tabulate travel destinations of deferred donors immediately before and after the change. Travel to Mexico and the Caribbean accounts for 63% of general population travel, and travel to Mexico has been increasing (P <0.05). Deferral for short-term malaria risk travel has a strong seasonal trend with peaks in the winter and troughs in the summer. Approximately 36,000 fewer donations were lost following the change, a reduction of 37% from the previous year. Deferrals in one centre increased for Caribbean/Central America after the change (P <0.05) consistent with the seasonal trend, but decreased for Mexico (P <0.05). Deferrals for malaria risk travel are substantial. Careful revision and refinement of risk areas of travel can significantly reduce the burden of deferral.

  17. Travel itinerary uncertainty and the pre-travel consultation--a pilot study.

    PubMed

    Flaherty, Gerard; Md Nor, Muhammad Najmi

    2016-01-01

    Risk assessment relies on the accuracy of the information provided by the traveller. A questionnaire was administered to 83 consecutive travellers attending a travel medicine clinic. The majority of travellers was uncertain about destinations within countries, transportation or type of accommodation. Most travellers were uncertain if they would be visiting malaria regions. The degree of uncertainty about itinerary potentially impacts on the ability of the travel medicine specialist to perform an adequate risk assessment, select appropriate vaccinations and prescribe malaria prophylaxis. This study reveals high levels of traveller uncertainty about their itinerary which may potentially reduce the effectiveness of their pre-travel consultation. © The Author 2016. Published by Oxford University Press on behalf of International society of travel medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Travel with CPAP machines: how frequent and what are the problems?

    PubMed

    Bodington, Richard; Johnson, Owen; Carveth-Johnson, Pippa; Faruqi, Shoaib

    2018-01-01

    Obstructive sleep apnoea syndrome is a common condition for which continuous positive airways pressure (CPAP) is the standard treatment. The condition affects a population of which a substantial proportion will be travelling. We use a questionnaire survey of CPAP users to gain understanding regarding the behaviours, attitudes and problems surrounding travel with CPAP machines during travel and while abroad. All CPAP patients on our database at a UK district general hospital reviewed over a period of 4 years were sent a postal questionnaire. A response rate of 53% was achieved giving data on 588 trips. In the last 2 years, 63.7% of respondents had travelled; reasons for not travelling were CPAP related in only five cases. Travellers took their CPAP machines on 81% of trips. A similar proportion of patients took their CPAP machines regardless of the mode of travel, destination or length of holiday. Problems with checking in the CPAP machine were encountered in 4% of trips, all as part of air travel. Just over a third of patients faced problems either with the power cord, adapter or transport of the CPAP machine. Of those taking overnight flights, half did not sleep and none used their CPAP machines in flight. CPAP usage while away did not differ to usage at home. This is the first report to describe in some detail CPAP machine use and associated problems in travel and while away. The data may aid the targeting of brief interventions in CPAP clinics as well as helping to standardize the process of check-in in order to help travellers with CPAP machines. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  19. Energy conservation and air transportation

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Air transportation demand and passenger energy demand are discussed, in relation to energy conservation. Alternatives to air travel are reviewed, along with airline advertising and ticket pricing. Cargo energy demand and airline systems efficiency are also examined, as well as fuel conservation techniques. Maximum efficiency of passenger aircraft, from B-747 to V/STOL to British Concorde, is compared.

  20. Access management research and awareness program : phase IV final report

    DOT National Transportation Integrated Search

    1999-11-01

    Access management involves balancing the dual roles that roadways must play - through travel and access to property and economic activity. When these roles are not in proper balance, the result is a roadway system that functions sub-optimally. The Io...

  1. Geographic disparities in patient travel for dialysis in the United States.

    PubMed

    Stephens, J Mark; Brotherton, Samuel; Dunning, Stephan C; Emerson, Larry C; Gilbertson, David T; Harrison, David J; Kochevar, John J; McClellan, Ann C; McClellan, William M; Wan, Shaowei; Gitlin, Matthew

    2013-01-01

    To estimate travel distance and time for US hemodialysis patients and to compare travel of rural versus urban patients. Dialysis patient residences were estimated from ZIP code-level patient counts as of February 2011 allocated within the ZIP code proportional to census tract-level population, obtained from the 2010 U.S. Census. Dialysis facility addresses were obtained from Medicare public-use files. Patients were assigned to an "original" and "replacement" facility, assuming patients used the facility closest to home and would select the next closest facility as a replacement, if a replacement facility was required. Driving distances and times were calculated between patient residences and facility locations using GIS software. The mean one-way driving distance to the original facility was 7.9 miles; for rural patients average distances were 2.5 times farther than for urban patients (15.9 vs. 6.2 miles). Mean driving distance to a replacement facility was 10.6 miles, with rural patients traveling on average 4 times farther than urban patients to a replacement facility (28.8 vs. 6.8 miles). Rural patients travel much longer distances for dialysis than urban patients. Accessing alternative facilities, if required, would greatly increase rural patient travel, while having little impact on urban patients. Increased travel could have clinical implications as longer travel is associated with increased mortality and decreased quality of life. © 2013 National Rural Health Association.

  2. Increasing referral of at-risk travelers to travel health clinics: evaluation of a health promotion intervention targeted to travel agents.

    PubMed

    MacDougall, L A; Gyorkos, T W; Leffondré, K; Abrahamowicz, M; Tessier, D; Ward, B J; MacLean, J D

    2001-01-01

    Increases in travel-related illness require new partnerships to ensure travelers are prepared for health risks abroad. The travel agent is one such partner and efforts to encourage travel agents to refer at-risk travelers to travel health clinics may help in reducing travel-attributable morbidity. A health promotion intervention encouraging travel agents to refer at-risk travelers to travel health clinics was evaluated. Information on the knowledge, attitudes, and behaviors of travel agents before and after the intervention was compared using two self-administered questionnaires. The Wilcoxon signed rank test was used to compare the mean difference in overall scores to evaluate the overall impact of the intervention and also subscores for each of the behavioral construct groupings (attitudes, barriers, intent, and subjective norms). Multiple regression techniques were used to evaluate which travel agent characteristics were independently associated with a stronger effect of the intervention. A small improvement in travel agents overall attitudes and beliefs (p =.03) was found, in particular their intention to refer (p =.01). Sixty-five percent of travel agents self-reported an increase in referral behavior; owners or managers of the agency were significantly more likely to do so than other travel agents (OR = 7.25; 95% CI: 1.64 32.06). Older travel agents, those that worked longer hours and those with some past referral experience, had significantly higher post-intervention scores. Travel agents can be willing partners in referral, and agencies should be encouraged to develop specific referral policies. Future research may be directed toward investigating the role of health education in certification curricula, the effectiveness of different types of health promotion interventions, including Internet-facilitated interventions, and the direct impact that such interventions would have on travelers attending travel health clinics.

  3. Headache associated with airplane travel: a rare entity.

    PubMed

    Cherian, Ajith; Mathew, Mini; Iype, Thomas; Sandeep, P; Jabeen, Afshan; Ayyappan, K

    2013-01-01

    Airplane travel headache is rare and has recently been described as a new form of headache associated with a specific situation. Of the 1,208 patients with primary headaches attending a tertiary care neurology hospital, two (0.16%) patients satisfied the criteria for headache related to airplane travel. Both the patients fulfilled the proposed diagnostic criteria for airplane travel headache. This unique headache had a mean duration of 24 minutes, localized to the medial supraorbital region described as having an intense jabbing or stabbing character that occurred exclusively and maximally during aircraft landing or take-off, following which pain intensity subsided . This rare headache felt on aircraft descent is probably due to the squeeze effect on the frontal sinus wall, when air trapped inside it contracts producing a negative pressure leading to mucosal edema, transudation and intense pain. Use of nasal decongestants either alone or in combination with naproxen sodium prior to ascent and descent abated the headache episodes. Awareness about this unique entity is essential to provide proper treatment and avoid patient suffering.

  4. Human travel and traveling bedbugs.

    PubMed

    Delaunay, Pascal

    2012-12-01

    A dramatic increase of reported bedbug (Cimex lectularius and Cimex hemipterus) infestations has been observed worldwide over the past decade. Bedbug infestations have also been detected across a wide range of travel accommodations, regardless of their comfort and hygiene levels. Travelers are increasingly exposed to the risks of bedbug bites, infestation of personal belongings, and subsequent contamination of newly visited accommodations and their homes. We searched Medline publications via the PubMed database. National bedbug recommendations, textbooks, newspapers, and Centers for Disease Control websites were also searched manually. To detect infested sites, avoid or limit bedbug bites, and reduce the risk of contaminating one's belongings and home, bedbug biology and ecology must be understood. A detailed search of their most classic hiding niches is a key to finding adult bedbugs, nymphs, eggs, and feces or traces of blood from crushed bedbugs. Locally, bedbugs move by active displacement to feed (bite) during the night. Bed, mattress, sofa, and/or curtains are the most frequently infested places. If you find bedbugs, change your room or, even better, the hotel. Otherwise, travelers should follow recommendations for avoiding bedbugs and their bites during the night and apply certain simple rules to avoid infesting other sites or their home. Travelers exposed to bedbugs can minimize the risks of bites and infestation of their belongings, and must also do their civic duty to avoid contributing to the subsequent contamination of other hotels and, finally, home. © 2012 International Society of Travel Medicine.

  5. FACILITATING ADVANCED URBAN METEOROLOGY AND AIR QUALITY MODELING CAPABILITIES WITH HIGH RESOLUTION URBAN DATABASE AND ACCESS PORTAL TOOLS

    EPA Science Inventory

    Information of urban morphological features at high resolution is needed to properly model and characterize the meteorological and air quality fields in urban areas. We describe a new project called National Urban Database with Access Portal Tool, (NUDAPT) that addresses this nee...

  6. The influence of travel time on breast cancer characteristics, receipt of primary therapy, and surveillance mammography.

    PubMed

    Onega, Tracy; Cook, Andrea; Kirlin, Beth; Shi, Xun; Alford-Teaster, Jennifer; Tuzzio, Leah; Buist, Diana S M

    2011-08-01

    Travel time has been shown to influence some aspects of cancer characteristics at diagnosis and care for women with breast cancer, but important gaps remain in our understanding of its impact. We examined the influence of travel time to the nearest radiology facility on breast cancer characteristics, treatment, and surveillance for women with early-stage invasive breast cancer. We included 1,012 women with invasive breast cancer (stages I and II) who had access to care within an integrated health care delivery system in western Washington State. The travel times to the nearest radiology facility were calculated for all the U.S. Census blocks within the study area and assigned to women based on residence at diagnosis. We collected cancer characteristics, primary and adjuvant therapies, and surveillance mammography for at least 2.5 years post diagnosis and used multivariable analyses to test the associations of travel time. The majority of women (68.6%) lived within 20 min of the nearest radiology facility, had stage I disease (72.7%), received breast conserving therapy (68.7%), and had annual surveillance mammography the first 2 years after treatment (73.7%). The travel time was not significantly associated with the stage or surveillance mammography after adjusting for covariates. Primary therapy was significantly related to travel time, with greater travel time (>30 min vs. ≤ 10 min) associated with a higher likelihood of mastectomy compared to breast conserving surgery (RR = 1.53; 95% CI, 1.16-2.01). The travel time was not associated with the stage at diagnosis or surveillance mammography receipt. The travel time does seem to influence the type of primary therapy among women with breast cancer, suggesting that women may prefer low frequency services, such as mastectomy, if geographic access to a radiology facility is limited.

  7. The influence of travel time on breast cancer characteristics, receipt of primary therapy, and surveillance mammography

    PubMed Central

    Cook, Andrea; Kirlin, Beth; Shi, Xun; Alford-Teaster, Jennifer; Tuzzio, Leah; Buist, Diana S. M.

    2013-01-01

    Travel time has been shown to influence some aspects of cancer characteristics at diagnosis and care for women with breast cancer, but important gaps remain in our understanding of its impact. We examined the influence of travel time to the nearest radiology facility on breast cancer characteristics, treatment, and surveillance for women with early-stage invasive breast cancer. We included 1,012 women with invasive breast cancer (stages I and II) who had access to care within an integrated health care delivery system in western Washington State. The travel times to the nearest radiology facility were calculated for all the U.S. Census blocks within the study area and assigned to women based on residence at diagnosis. We collected cancer characteristics, primary and adjuvant therapies, and surveillance mammography for at least 2.5 years post diagnosis and used multivariable analyses to test the associations of travel time. The majority of women (68.6%) lived within 20 min of the nearest radiology facility, had stage I disease (72.7%), received breast conserving therapy (68.7%), and had annual surveillance mammography the first 2 years after treatment (73.7%). The travel time was not significantly associated with the stage or surveillance mammography after adjusting for covariates. Primary therapy was significantly related to travel time, with greater travel time (>30 min vs. ≤ 10 min) associated with a higher likelihood of mastectomy compared to breast conserving surgery (RR = 1.53; 95% CI, 1.16–2.01). The travel time was not associated with the stage at diagnosis or surveillance mammography receipt. The travel time does seem to influence the type of primary therapy among women with breast cancer, suggesting that women may prefer low frequency services, such as mastectomy, if geographic access to a radiology facility is limited. PMID:21553117

  8. FLIRT-ing with Zika: A Web Application to Predict the Movement of Infected Travelers Validated Against the Current Zika Virus Epidemic.

    PubMed

    Huff, Andrew; Allen, Toph; Whiting, Karissa; Breit, Nathan; Arnold, Brock

    2016-06-10

     Beginning in 2015, Zika virus rapidly spread throughout the Americas and has been linked to neurological and autoimmune diseases in adults and babies. Developing accurate tools to anticipate Zika spread is one of the first steps to mitigate further spread of the disease. When combined, air traffic data and network simulations can be used to create tools to predict where infectious disease may spread to and aid in the prevention of infectious diseases. Specific goals were to: 1) predict where travelers infected with the Zika Virus would arrive in the U.S.; and, 2) analyze and validate the open access web application's (i.e., FLIRT) predictions using data collected after the prediction was made. FLIRT was built to predict the flow and likely destinations of infected travelers through the air travel network. FLIRT uses a database of flight schedules from over 800 airlines, and can display direct flight traffic and perform passenger simulations between selected airports. FLIRT was used to analyze flights departing from five selected airports in locations where sustained Zika Virus transmission was occurring. FLIRT's predictions were validated against Zika cases arriving in the U.S. from selected airports during the selected time periods.  Kendall's τ and Generalized Linear Models were computed for all permutations of FLIRT and case data to test the accuracy of FLIRT's predictions. FLIRT was found to be predictive of the final destinations of infected travelers in the U.S. from areas with ongoing transmission of Zika in the Americas from 01 February 2016 - 01 to April 2016, and 11 January 2016 to 11 March 2016 time periods. MIA-FLL, JFK-EWR-LGA, and IAH were top ranked at-risk metro areas, and Florida, Texas and New York were top ranked states at-risk for the future time period analyzed (11 March 2016 - 11 June 2016). For the 11 January 2016 to 11 March 2016 time period, the region-aggregated model indicated 7.24 (95% CI 6.85 - 7.62) imported Zika cases per 100

  9. [Foodborne dermatosis after traveling: gnathostomiasis].

    PubMed

    Orduna, Tomás A; Lloveras, Susana C; Echazarreta, Sofía E; Garro, Santiago L; González, Gustavo D; Falcone, Claudia C

    2013-01-01

    We describe a case of a 32-year-old man, resident in Buenos Aires, with dermatologic manifestations compatible with gnathostomiasis. The patient had traveled to Colombia in the month prior to the onset of symptoms. There, he repeatedly ate ceviche (raw fish marinated in lemon juice). He presented with an erythematous migratory panniculitis accompanied by eosinophilia. He underwent skin biopsy of a lesion and pathological diagnosis was "eosinophilic panniculitis". The triad of migratory panniculitis, eosinophilia and consume of raw fish during the trip to Colombia was suggestive of gnathostomiasis. Ivermectin treatment started out with good initial response but subsequent relapse. We performed a new treatment with the same drug with good results and no relapses during three years of follow up. The dermatological disease is common upon return from a trip, and is the third leading cause of morbidity in travelers. It is very important to recognize cutaneous manifestations of disease as many of them are potentially serious and may compromise the patient's life if not promptly diagnosed and treated.

  10. Prevention of Disease in Travel from the Perspective of Iranian Traditional Medicine.

    PubMed

    Motavasselian, Fatemeh; Hashemi, Monireh Seyed; Emtiazy, Majid

    2016-05-01

    Due to the high volume of travel and the spread of various diseases as well as disorders during a trip, one of the major concerns for travelers is the issues related to disease spread, control, and prevention. The approach of philosophers and traditional physicians along with hygiene measures were noted as trip recommendations in their textbooks. Considering negligence in disease prevention and the lack of dedicated and systematic discussion on this topic, this article aims at collecting their experiences as a practical reference point. This qualitative study, review articles in the field of traditional medicine and search in authentic books on traditional medicine. The gathered data were initially analyzed and then categorized. Results were described in several sub-categories, including general recommendation, food and drinking recommendations during travel, prevention of dehydration in warm and cold conditions, poisoned and polluted air recommendations, management of sea passengers, fatigue due to travel, and the prevention of skin diseases. These measures are efficient interventions and cost-effective, which provide guidelines for traveler's health during a trip.

  11. Improving the United States airline industry's capacity to provide safe and dignified services to travelers with disabilities: focus group findings.

    PubMed

    McCarthy, Michael J

    2011-01-01

    As a component of a training development project for intercity air travel providers, we investigated the capacity of the airline industry to meet the needs of travelers with disabilities by exploring: (1) the level of sensitivity among personnel to travelers' needs, (2) training currently provided, (3) areas in which additional training might be beneficial, and (4) organisational/systems-level commitment to dignified assistance to all travelers. Forty-four airline/vendor employees participated in nine focus groups in four US cities. Groups were audio recorded and transcribed. A grounded-theory approach was used to develop a coding system which was then applied to transcripts to identify themes. Factors influencing capacity grouped broadly into four areas: characteristics of the job/system, characteristics of current training, characteristics of providers themselves, and characteristics of travelers. At an interpersonal level, providers were empathetic and desired to provide dignified services. They lacked training and adequate equipment in some cases, however, and organisational commitment varied between companies. Traveler characteristics were also shown to impact service delivery. Results are promising but additional regulatory and organisational policies are needed to ensure quality services. Providers and consumers of intercity air travel services may benefit from the findings and recommendations of this study.

  12. Airport landside operations and air service

    NASA Astrophysics Data System (ADS)

    Mandle, P. B.; Whitlock, E. M.; Lamagna, F.; Mundy, R. A.; Oberhausen, P. J.

    The following areas are discussed: airport curbside planning and design; analysis of New Orleans airport ground transportation system; time series analysis of intercity air travel volume; economic justification of air service to small communities; and general aviation and the airport and airway system (an analysis of cost allocation and recovery).

  13. TRAVEL FORECASTER

    NASA Technical Reports Server (NTRS)

    Mauldin, L. E.

    1994-01-01

    Business travel planning within an organization is often a time-consuming task. Travel Forecaster is a menu-driven, easy-to-use program which plans, forecasts cost, and tracks actual vs. planned cost for business-related travel of a division or branch of an organization and compiles this information into a database to aid the travel planner. The program's ability to handle multiple trip entries makes it a valuable time-saving device. Travel Forecaster takes full advantage of relational data base properties so that information that remains constant, such as per diem rates and airline fares (which are unique for each city), needs entering only once. A typical entry would include selection with the mouse of the traveler's name and destination city from pop-up lists, and typed entries for number of travel days and purpose of the trip. Multiple persons can be selected from the pop-up lists and multiple trips are accommodated by entering the number of days by each appropriate month on the entry form. An estimated travel cost is not required of the user as it is calculated by a Fourth Dimension formula. With this information, the program can produce output of trips by month with subtotal and total cost for either organization or sub-entity of an organization; or produce outputs of trips by month with subtotal and total cost for international-only travel. It will also provide monthly and cumulative formats of planned vs. actual outputs in data or graph form. Travel Forecaster users can do custom queries to search and sort information in the database, and it can create custom reports with the user-friendly report generator. Travel Forecaster 1.1 is a database program for use with Fourth Dimension Runtime 2.1.1. It requires a Macintosh Plus running System 6.0.3 or later, 2Mb of RAM and a hard disk. The standard distribution medium for this package is one 3.5 inch 800K Macintosh format diskette. Travel Forecaster was developed in 1991. Macintosh is a registered trademark of

  14. HIV and travel.

    PubMed

    Schuhwerk, M A; Richens, J; Zuckerman, Jane N

    2006-01-01

    There is a high demand for travel among HIV-positive individual. This demand arises partly from those who have benefited from advances in antiretroviral therapy as well as those with disease progression. The key to a successful and uneventful holiday lies in careful pre-trip planning, yet many patients fail to obtain advice before travelling. Travel advice for HIV patients is becoming increasingly specialized. In addition to advice on common travel-related infectious diseases, HIV-positive travellers are strongly advised to carry information with them and they need specific advice regarding country entry restrictions, HIV inclusive travel insurance, safety of travel vaccinations and highly active antiretroviral therapy-related issues. A wide range of relevant issues for the HIV-positive traveller are discussed in this review and useful websites can be found at the end.

  15. A profile of travelers--an analysis from a large swiss travel clinic.

    PubMed

    Bühler, Silja; Rüegg, Rolanda; Steffen, Robert; Hatz, Christoph; Jaeger, Veronika K

    2014-01-01

    Globally, the Swiss have one of the highest proportions of the population traveling to tropical and subtropical countries. Large travel clinics serve an increasing number of customers with specific pre-travel needs including uncommon destinations and preexisting medical conditions. This study aims to identify health characteristics and travel patterns of travelers seeking advice in the largest Swiss travel clinic so that tailored advice can be delivered. A descriptive analysis was performed on pre-travel visits between July 2010 and August 2012 at the Travel Clinic of the Institute of Social and Preventive Medicine, University of Zurich, Switzerland. A total of 22,584 travelers sought pre-travel advice. Tourism was the main reason for travel (17,875, 81.5%), followed by visiting friends and relatives (VFRs; 1,715, 7.8%), traveling for business (1,223, 5.6%), and "other reasons" (ie, volunteer work, pilgrimage, study abroad, and emigration; 1,112, 5.1%). The main travel destination was Thailand. In the VFR group, the highest proportions of traveling children (258, 15.1%) and of pregnant or breastfeeding women (23, 3.9%) were observed. Mental disorders were more prominent in VFRs (93, 5.4%) and in travel for "other reasons" (63, 5.7%). The latter stayed for the longest periods abroad; 272 (24.9%) stayed longer than 6 months. VFR travelers received the highest percentage of yellow fever vaccinations (523, 30.5%); in contrast, rabies (269, 24.2%) and typhoid vaccinations (279, 25.1%) were given more often to the "other travel reasons" group. New insights into the characteristics of a selected and large population of Swiss international travelers results in improved understanding of the special needs of an increasingly diverse population and, thus, in targeted preventive advice and interventions. © 2014 International Society of Travel Medicine.

  16. Geographic Access Modeling of Emergency Obstetric and Neonatal Care in Kigoma Region, Tanzania: Transportation Schemes and Programmatic Implications.

    PubMed

    Chen, Yi No; Schmitz, Michelle M; Serbanescu, Florina; Dynes, Michelle M; Maro, Godson; Kramer, Michael R

    2017-09-27

    Access to transportation is vital to reducing the travel time to emergency obstetric and neonatal care (EmONC) for managing complications and preventing adverse maternal and neonatal outcomes. This study examines the distribution of travel times to EmONC in Kigoma Region, Tanzania, using various transportation schemes, to estimate the proportion of live births (a proxy indicator of women needing delivery care) with poor geographic access to EmONC services. The 2014 Reproductive Health Survey of Kigoma Region identified 4 primary means of transportation used to travel to health facilities: walking, cycling, motorcycle, and 4-wheeled motor vehicle. A raster-based travel time model was used to map the 2-hour travel time catchment for each mode of transportation. Live birth density distributions were aggregated by travel time catchments, and by administrative council, to estimate the proportion of births with poor access. Of all live births in Kigoma Region, 13% occurred in areas where women can reach EmONC facilities within 2 hours on foot, 33% in areas that can be reached within 2 hours only by motorized vehicles, and 32% where it is impossible to reach EmONC facilities within 2 hours. Over 50% of births in 3 of the 8 administrative councils had poor estimated access. In half the councils, births with poor access could be reduced to no higher than 12% if all female residents had access to motorized vehicles. Significant differences in geographic access to EmONC in Kigoma Region, Tanzania, were observed both by location and by primary transportation type. As most of the population may only have good EmONC access when using mechanized or motorized vehicles, bicycles and motorcycles should be incorporated into the health transportation strategy. Collaboration between private transportation sectors and obstetric service providers could improve access to EmONC services among most populations. In areas where residents may not access EmONC facilities within 2 hours

  17. Geographic Access Modeling of Emergency Obstetric and Neonatal Care in Kigoma Region, Tanzania: Transportation Schemes and Programmatic Implications

    PubMed Central

    Chen, Yi No; Schmitz, Michelle M; Serbanescu, Florina; Dynes, Michelle M; Maro, Godson; Kramer, Michael R

    2017-01-01

    ABSTRACT Background: Access to transportation is vital to reducing the travel time to emergency obstetric and neonatal care (EmONC) for managing complications and preventing adverse maternal and neonatal outcomes. This study examines the distribution of travel times to EmONC in Kigoma Region, Tanzania, using various transportation schemes, to estimate the proportion of live births (a proxy indicator of women needing delivery care) with poor geographic access to EmONC services. Methods: The 2014 Reproductive Health Survey of Kigoma Region identified 4 primary means of transportation used to travel to health facilities: walking, cycling, motorcycle, and 4-wheeled motor vehicle. A raster-based travel time model was used to map the 2-hour travel time catchment for each mode of transportation. Live birth density distributions were aggregated by travel time catchments, and by administrative council, to estimate the proportion of births with poor access. Results: Of all live births in Kigoma Region, 13% occurred in areas where women can reach EmONC facilities within 2 hours on foot, 33% in areas that can be reached within 2 hours only by motorized vehicles, and 32% where it is impossible to reach EmONC facilities within 2 hours. Over 50% of births in 3 of the 8 administrative councils had poor estimated access. In half the councils, births with poor access could be reduced to no higher than 12% if all female residents had access to motorized vehicles. Conclusion: Significant differences in geographic access to EmONC in Kigoma Region, Tanzania, were observed both by location and by primary transportation type. As most of the population may only have good EmONC access when using mechanized or motorized vehicles, bicycles and motorcycles should be incorporated into the health transportation strategy. Collaboration between private transportation sectors and obstetric service providers could improve access to EmONC services among most populations. In areas where residents may

  18. [Travel times of patients to ambulatory care physicians in Germany].

    PubMed

    Schang, Laura; Kopetsch, Thomas; Sundmacher, Leonie

    2017-12-01

    The time needed by patients to get to a doctor's office represents an important indicator of realised access to care. In Germany, findings on travel times are only available from surveys or for some regions. For the first time, this study examines nationwide and physician group-specific travel times in the ambulatory care sector in Germany and describes demographic, supply-side and spatial determinants of variations. Using a full review of patient consultations in the statutory health insurance system from 2009/2010 for 14 physician groups (approximately 518 million cases), case-related travel times by car between patients' places of residence and physician's practices were estimated at the municipal level. Physicians were reached in less than 30 min in 90.8% of cases for primary care physicians and up to 63% of cases for radiologists. Patients between 18 and under 30 years of age travel longer to get to the doctor than other age groups. The average travel time at the county level systematically differs between urban and rural planning areas. In the case of gynecologists, dermatologists and ophthalmologists, the average journey time decreases with increasing physician density at the county level, but remains approximately constant from a recognisable point of inflection. There is no association between primary care physician density and travel time at the district level. Spatial analyses show physician group-specific patterns of regional concentrations with an increased proportion of cases with very long travel times. Patients' travel times are influenced by supply- and demand-side determinants. Interactions between influential determinants should be analysed in depth to examine the extent to which the time travelled is an expression of regional under- or over-supply rather than an expression of patient preferences.

  19. 78 FR 79456 - Government-Wide Travel Advisory Committee (GTAC); Public Advisory Committee Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-30

    ... purpose of the GTAC is to conduct public meetings, submit reports and to make recommendations to existing... vehicles) and sustainability of federal travel. Meeting Access: The meeting is open to the public via...

  20. Travel health: sun protection and skin cancer prevention for travellers.

    PubMed

    Wood, Cate

    The UK population likes to travel to sunny parts of the world, where the risk of sunburn is greater than it is at home. Sunburn and the cultural desire for a tan is one of the risk factors for the increase in skin cancer. The rise in foreign travel has resulted in an increased demand for pre-travel health services, with nurses in primary care acting as the main providers.Within these consultations, the traveller and their travel plans are risk assessed.Travel health consultations give an ideal opportunity to discuss and advise the public regarding sun burn and skin cancer protection. However, there are also other ways to impart safety in the sun message to travellers. Skin protection is a health promoting activity provided as a part of public health provision and all nurses can play a role in prevention.

  1. Accessibility of antiretroviral therapy in Ghana: convenience of access.

    PubMed

    Addo-Atuah, Joyce; Gourley, Dick; Gourley, Greta; White-Means, Shelley I; Womeodu, Robin J; Faris, Richard J; Addo, Nii Akwei

    2012-01-01

    The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, or otherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. • Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA. • Waiting time to receive care was from 4 to 9 h. • While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. • The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. • PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider-patient communication, which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify

  2. Air breathing in the Arctic: influence of temperature, hypoxia, activity and restricted air access on respiratory physiology of the Alaska blackfish Dallia pectoralis

    PubMed Central

    Lefevre, Sjannie; Damsgaard, Christian; Pascale, Desirae R.; Nilsson, Göran E.; Stecyk, Jonathan A. W.

    2014-01-01

    The Alaska blackfish (Dallia pectoralis) is an air-breathing fish native to Alaska and the Bering Sea islands, where it inhabits lakes that are ice-covered in the winter, but enters warm and hypoxic waters in the summer to forage and reproduce. To understand the respiratory physiology of this species under these conditions and the selective pressures that maintain the ability to breathe air, we acclimated fish to 5°C and 15°C and used respirometry to measure: standard oxygen uptake () in normoxia (19.8 kPa PO2) and hypoxia (2.5 kPa), with and without access to air; partitioning of standard in normoxia and hypoxia; maximum and partitioning after exercise; and critical oxygen tension (Pcrit). Additionally, the effects of temperature acclimation on haematocrit, haemoglobin oxygen affinity and gill morphology were assessed. Standard was higher, but air breathing was not increased, at 15°C or after exercise at both temperatures. Fish acclimated to 5°C or 15°C increased air breathing to compensate and fully maintain standard in hypoxia. Fish were able to maintain through aquatic respiration when air was denied in normoxia, but when air was denied in hypoxia, standard was reduced by ∼30–50%. Pcrit was relatively high (5 kPa) and there were no differences in Pcrit, gill morphology, haematocrit or haemoglobin oxygen affinity at the two temperatures. Therefore, Alaska blackfish depends on air breathing in hypoxia and additional mechanisms must thus be utilised to survive hypoxic submergence during the winter, such as hypoxia-induced enhancement in the capacities for carrying and binding blood oxygen, behavioural avoidance of hypoxia and suppression of metabolic rate. PMID:25394628

  3. 0-6767 : evaluation of existing smartphone applications and data needs for travel survey.

    DOT National Transportation Integrated Search

    2014-08-01

    Current and reliable data on traffic movements : play a key role in transportation planning, : modeling, and air quality analysis. Traditional : travel surveys conducted via paper or computer : are costly, time consuming, and labor intensive : for su...

  4. 41 CFR 301-10.136 - What exceptions to the Fly America Act requirements apply when I travel between the United States...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... destination, you must use the U.S. flag air carrier service unless such use would extend your travel time... the U.S. by 2 or more; or (2) Extend your travel time by at least 6 hours or more; or (3) Require a... Fly America Act requirements apply when I travel between the United States and another country? 301-10...

  5. 41 CFR 301-10.136 - What exceptions to the Fly America Act requirements apply when I travel between the United States...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... destination, you must use the U.S. flag air carrier service unless such use would extend your travel time... the U.S. by 2 or more; or (2) Extend your travel time by at least 6 hours or more; or (3) Require a... Fly America Act requirements apply when I travel between the United States and another country? 301-10...

  6. 41 CFR 301-10.136 - What exceptions to the Fly America Act requirements apply when I travel between the United States...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... destination, you must use the U.S. flag air carrier service unless such use would extend your travel time... the U.S. by 2 or more; or (2) Extend your travel time by at least 6 hours or more; or (3) Require a... Fly America Act requirements apply when I travel between the United States and another country? 301-10...

  7. 41 CFR 301-10.136 - What exceptions to the Fly America Act requirements apply when I travel between the United States...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... destination, you must use the U.S. flag air carrier service unless such use would extend your travel time... the U.S. by 2 or more; or (2) Extend your travel time by at least 6 hours or more; or (3) Require a... Fly America Act requirements apply when I travel between the United States and another country? 301-10...

  8. 41 CFR 301-10.136 - What exceptions to the Fly America Act requirements apply when I travel between the United States...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... destination, you must use the U.S. flag air carrier service unless such use would extend your travel time... the U.S. by 2 or more; or (2) Extend your travel time by at least 6 hours or more; or (3) Require a... Fly America Act requirements apply when I travel between the United States and another country? 301-10...

  9. The New England travel market: changes in generational travel patterns

    Treesearch

    Rodney B. Warnick

    1995-01-01

    The purpose of this study was to examine and explore the New England domestic travel market trends, from 1979 through 1991 within the context of generations. The existing travel markets, who travel to New England, are changing by age cohorts and specifically within different generations. The New England changes in generational travel patterns do not reflect national...

  10. Personal and environmental correlates of active travel and physical activity in a deprived urban population

    PubMed Central

    Ogilvie, David; Mitchell, Richard; Mutrie, Nanette; Petticrew, Mark; Platt, Stephen

    2008-01-01

    Background Environmental characteristics may be associated with patterns of physical activity in general or with particular types of physical activity such as active travel (walking or cycling for transport). However, most studies in this field have been conducted in North America and Australia, and hypotheses about putative correlates should be tested in a wider range of sociospatial contexts. We therefore examined the contribution of putative personal and environmental correlates of active travel and overall physical activity in deprived urban neighbourhoods in Glasgow, Scotland as part of the baseline for a longitudinal study of the effects of opening a new urban motorway (freeway). Methods We conducted a postal survey of a random sample of residents (n = 1322), collecting data on socioeconomic status, perceptions of the local environment, travel behaviour, physical activity and general health and wellbeing using a new 14-item neighbourhood rating scale, a travel diary, the short form of the International Physical Activity Questionnaire (IPAQ) and the SF-8. We analysed the correlates of active travel and overall physical activity using multivariate logistic regression, first building models using personal (individual and household) explanatory variables and then adding environmental variables. Results Active travel was associated with being younger, living in owner-occupied accommodation, not having to travel a long distance to work and not having access to a car, whereas overall physical activity was associated with living in social rented accommodation and not being overweight. After adjusting for personal characteristics, neither perceptions of the local environment nor the objective proximity of respondents' homes to motorway or major road infrastructure explained much of the variance in active travel or overall physical activity, although we did identify a significant positive association between active travel and perceived proximity to shops. Conclusion

  11. International travel between global urban centres vulnerable to yellow fever transmission.

    PubMed

    Brent, Shannon E; Watts, Alexander; Cetron, Martin; German, Matthew; Kraemer, Moritz Ug; Bogoch, Isaac I; Brady, Oliver J; Hay, Simon I; Creatore, Maria I; Khan, Kamran

    2018-05-01

    To examine the potential for international travel to spread yellow fever virus to cities around the world. We obtained data on the international flight itineraries of travellers who departed yellow fever-endemic areas of the world in 2016 for cities either where yellow fever was endemic or which were suitable for viral transmission. Using a global ecological model of dengue virus transmission, we predicted the suitability of cities in non-endemic areas for yellow fever transmission. We obtained information on national entry requirements for yellow fever vaccination at travellers' destination cities. In 2016, 45.2 million international air travellers departed from yellow fever-endemic areas of the world. Of 11.7 million travellers with destinations in 472 cities where yellow fever was not endemic but which were suitable for virus transmission, 7.7 million (65.7%) were not required to provide proof of vaccination upon arrival. Brazil, China, India, Mexico, Peru and the United States of America had the highest volumes of travellers arriving from yellow fever-endemic areas and the largest populations living in cities suitable for yellow fever transmission. Each year millions of travellers depart from yellow fever-endemic areas of the world for cities in non-endemic areas that appear suitable for viral transmission without having to provide proof of vaccination. Rapid global changes in human mobility and urbanization make it vital for countries to re-examine their vaccination policies and practices to prevent urban yellow fever epidemics.

  12. Access to destinations : arterial data acquisition and network-wide travel time estimation (phase II).

    DOT National Transportation Integrated Search

    2010-03-01

    The objectives of this project were to (a) produce historic estimates of travel times on Twin-Cities arterials : for 1995 and 2005, and (b) develop an initial architecture and database that could, in the future, produce timely : estimates of arterial...

  13. Breast cancer stage at diagnosis: is travel time important?

    PubMed

    Henry, Kevin A; Boscoe, Francis P; Johnson, Christopher J; Goldberg, Daniel W; Sherman, Recinda; Cockburn, Myles

    2011-12-01

    Recent studies have produced inconsistent results in their examination of the potential association between proximity to healthcare or mammography facilities and breast cancer stage at diagnosis. Using a multistate dataset, we re-examine this issue by investigating whether travel time to a patient's diagnosing facility or nearest mammography facility impacts breast cancer stage at diagnosis. We studied 161,619 women 40 years and older diagnosed with invasive breast cancer from ten state population based cancer registries in the United States. For each woman, we calculated travel time to their diagnosing facility and nearest mammography facility. Logistic multilevel models of late versus early stage were fitted, and odds ratios were calculated for travel times, controlling for age, race/ethnicity, census tract poverty, rural/urban residence, health insurance, and state random effects. Seventy-six percent of women in the study lived less than 20 min from their diagnosing facility, and 93 percent lived less than 20 min from the nearest mammography facility. Late stage at diagnosis was not associated with increasing travel time to diagnosing facility or nearest mammography facility. Diagnosis age under 50, Hispanic and Non-Hispanic Black race/ethnicity, high census tract poverty, and no health insurance were all significantly associated with late stage at diagnosis. Travel time to diagnosing facility or nearest mammography facility was not a determinant of late stage of breast cancer at diagnosis, and better geographic proximity did not assure more favorable stage distributions. Other factors beyond geographic proximity that can affect access should be evaluated more closely, including facility capacity, insurance acceptance, public transportation, and travel costs.

  14. Utilization of travel reimbursement in the Veterans Health Administration.

    PubMed

    Nelson, Richard E; Hicken, Bret; Cai, Beilei; Dahal, Arati; West, Alan; Rupper, Randall

    2014-01-01

    To improve access to care, the Veterans Health Administration (VHA) increased its patient travel reimbursement rate from 11 to 28.5 cents per mile on February 1, 2008, and again to 41.5 cents per mile on November 17, 2008. We identified characteristics of veterans more likely to receive travel reimbursements and evaluated the impact of these increases on utilization of the benefit. We examined the likelihood of receiving any reimbursement, number of reimbursements, and dollar amount of reimbursements for VHA patients before and after both reimbursement rate increases. Because of our data's longitudinal nature, we used multivariable generalized estimating equation models for analysis. Rurality and categorical distance from the nearest VHA facility were examined in separate regressions. Our cohort contained 214,376 veterans. During the study period, the average number of reimbursements per veteran was higher for rural patients compared to urban patients, and for those living 50-75 miles from the nearest VHA facility compared to those living closer. Higher reimbursement rates led to more veterans obtaining reimbursement regardless of urban-rural residence or distance traveled to the nearest VHA facility. However, after the rate increases, urban veterans and veterans living <50 miles from the nearest VHA facility increased their travel reimbursement utilization slightly more than other patients. Our findings suggest an inverted U-shaped relationship between veterans' utilization of the VHA travel reimbursement benefit and travel distance. Both urban and rural veterans responded in roughly equal manner to changes to this benefit. © 2013 National Rural Health Association.

  15. Is the closest facility the one actually used? An assessment of travel time estimation based on mammography facilities.

    PubMed

    Alford-Teaster, Jennifer; Lange, Jane M; Hubbard, Rebecca A; Lee, Christoph I; Haas, Jennifer S; Shi, Xun; Carlos, Heather A; Henderson, Louise; Hill, Deirdre; Tosteson, Anna N A; Onega, Tracy

    2016-02-18

    Characterizing geographic access depends on a broad range of methods available to researchers and the healthcare context to which the method is applied. Globally, travel time is one frequently used measure of geographic access with known limitations associated with data availability. Specifically, due to lack of available utilization data, many travel time studies assume that patients use the closest facility. To examine this assumption, an example using mammography screening data, which is considered a geographically abundant health care service in the United States, is explored. This work makes an important methodological contribution to measuring access--which is a critical component of health care planning and equity almost everywhere. We analyzed one mammogram from each of 646,553 women participating in the US based Breast Cancer Surveillance Consortium for years 2005-2012. We geocoded each record to street level address data in order to calculate travel time to the closest and to the actually used mammography facility. Travel time between the closest and the actual facility used was explored by woman-level and facility characteristics. Only 35% of women in the study population used their closest facility, but nearly three-quarters of women not using their closest facility used a facility within 5 min of the closest facility. Individuals that by-passed the closest facility tended to live in an urban core, within higher income neighborhoods, or in areas where the average travel times to work was longer. Those living in small towns or isolated rural areas had longer closer and actual median drive times. Since the majority of US women accessed a facility within a few minutes of their closest facility this suggests that distance to the closest facility may serve as an adequate proxy for utilization studies of geographically abundant services like mammography in areas where the transportation networks are well established.

  16. Heightening Walking Above its Pedestrian Status : Walking and Travel Behavior in California

    DOT National Transportation Integrated Search

    2016-06-30

    People walk a lotto walk pets, to exercise and recreate, and to access public transit and local shops. Walk trips begin and end almost every journey, even trips made by automobile. Data from the current California Household Travel Survey (CHTS) sh...

  17. Development and Implementation of the Ebola Traveler Monitoring Program and Clinical Outcomes of Monitored Travelers during October – May 2015, Minnesota

    PubMed Central

    DeVries, Aaron; Talley, Pamela; Sweet, Kristin; Kline, Susan; Stinchfield, Patricia; Tosh, Pritish; Danila, Richard

    2016-01-01

    Background In October 2014, the United States began actively monitoring all persons who had traveled from Guinea, Liberia, and Sierra Leone in the previous 21 days. State public health departments were responsible for monitoring all travelers; Minnesota has the largest Liberian population in the United States. The MDH Ebola Clinical Team (ECT) was established to assess travelers with symptoms of concern for Ebola virus disease (EVD), coordinate access to healthcare at appropriate facilities including Ebola Assessment and Treatment Units (EATU), and provide guidance to clinicians. Methods Minnesota Department of Health (MDH) began receiving traveler information collected by U.S. Customs and Border Control and Centers for Disease Control and Prevention staff on October 21, 2014 via encrypted electronic communication. All travelers returning from Liberia, Sierra Leone, and Guinea during 10/21/14–5/15/15 were monitored by MDH staff in the manner recommended by CDC based on the traveler’s risk categorization as “low (but not zero)”, “some” and “high” risk. When a traveler reported symptoms or a temperature ≥100.4° F at any time during their 21-day monitoring period, an ECT member would speak to the traveler and perform a clinical assessment by telephone or via video-chat. Based on the assessment the ECT member would recommend 1) continued clinical monitoring while at home with frequent telephone follow-up by the ECT member, 2) outpatient clinical evaluation at an outpatient site agreed upon by all parties, or 3) inpatient clinical evaluation at one of four Minnesota EATUs. ECT members assessed and approved testing for Ebola virus infection at MDH. Traveler data, calls to the ECT and clinical outcomes were logged on a secure server at MDH. Results During 10/21/14–5/15/15, a total of 783 travelers were monitored; 729 (93%) traveled from Liberia, 30 (4%) Sierra Leone, and 24 (3%) Guinea. The median number monitored per week was 59 (range 45–143). The

  18. Integrating travel behavior with land use regression to estimate dynamic air pollution exposure in Hong Kong.

    PubMed

    Tang, Robert; Tian, Linwei; Thach, Thuan-Quoc; Tsui, Tsz Him; Brauer, Michael; Lee, Martha; Allen, Ryan; Yuchi, Weiran; Lai, Poh-Chin; Wong, Paulina; Barratt, Benjamin

    2018-04-01

    Epidemiological studies typically use subjects' residential address to estimate individuals' air pollution exposure. However, in reality this exposure is rarely static as people move from home to work/study locations and commute during the day. Integrating mobility and time-activity data may reduce errors and biases, thereby improving estimates of health risks. To incorporate land use regression with movement and building infiltration data to estimate time-weighted air pollution exposures stratified by age, sex, and employment status for population subgroups in Hong Kong. A large population-representative survey (N = 89,385) was used to characterize travel behavior, and derive time-activity pattern for each subject. Infiltration factors calculated from indoor/outdoor monitoring campaigns were used to estimate micro-environmental concentrations. We evaluated dynamic and static (residential location-only) exposures in a staged modeling approach to quantify effects of each component. Higher levels of exposures were found for working adults and students due to increased mobility. Compared to subjects aged 65 or older, exposures to PM 2.5 , BC, and NO 2 were 13%, 39% and 14% higher, respectively for subjects aged below 18, and 3%, 18% and 11% higher, respectively for working adults. Exposures of females were approximately 4% lower than those of males. Dynamic exposures were around 20% lower than ambient exposures at residential addresses. The incorporation of infiltration and mobility increased heterogeneity in population exposure and allowed identification of highly exposed groups. The use of ambient concentrations may lead to exposure misclassification which introduces bias, resulting in lower effect estimates than 'true' exposures. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Cost Estimates For Selected California Smart Traveler Operational Tests, Volume 1, Technical Report

    DOT National Transportation Integrated Search

    1993-03-01

    THIS REPORT ALSO COMPARES THE COSTS OF USING "SMART-TRAVELER" APPROACHES WITH THE COSTS OF EXPANDING CONVENTIONAL TRANSIT SERVICES TO REDUCE TRAFFIC CONGESTION, AIR POLLUTION AND MOBILITY PROBLEMS IN SUBURBAN AREAS, WHERE MOST PEOPLE IN U.S. METROPOL...

  20. [The profile of Israeli travelers to developing countries: perspectives of a travel clinic].

    PubMed

    Stienlauf, Shmuel; Meltzer, Eyal; Leshem, Eyal; Rendi-Wagner, Pamela; Schwartz, Eli

    2010-09-01

    The number of Israeli travelers is increasing, including the number of travelers to developing countries. This study aimed to characterize the profile of Israeli travelers to developing countries. Data regarding demographics, travel destinations, trip duration and the purpose of travel were collected on travelers attending the pre-travel clinic at the Sheba Medical Center during a period of 9 years. Between the dates 1/1/1999 and 31/12/2007, 42,771 travelers presented for consultation at the Sheba Medical Center pre-travel clinic. The average age was 30.8 +/- 13.4 years and 54% of the travelers were males. The female proportion increased from 42% in 1999 to 49% in 2006. There was a steady increase in the number of travelers attending our clinic, except in 2003 (coinciding with the SARS epidemic). Post-army backpackers (20-25 year-old age group) were only 43% of the travelers. Children (<18 years), and elderly (>60 years) comprised 4.4% and 4.6% of the travelers, respectively. The favorite destinations were Asia (55%), followed by Latin America (27%) and Africa (13%). The distribution of travel destinations varied significantly during the study period. Of note is the sharp decline in travel to Africa following the terrorist attack in Mombassa, Kenya (November 2002). The median trip duration changed during the study period, from 30 to 45 days, between 1999-2004 and 2005-2007 respectively. The majority (87%) of voyagers traveled for pleasure, 6% went for business, and 7% were representatives of governmental organizations. This study found an increasing diversity in the traveler population (more women, more children and older travelers) and more diversity in travel destinations. Disease outbreaks and terrorist attacks had transient negative impacts on the number of travelers.

  1. The impact of injection anxiety on education of travelers about common travel risks.

    PubMed

    Noble, Lorraine M; Farquharson, Lorna; O'Dwyer, Niamh A; Behrens, Ron H

    2014-01-01

    Despite many travelers receiving at least one vaccination during the pre-travel consultation, little is known about travelers' fear of injections and the impact this may have on educating travelers about health risks associated with their trip. This study aimed to investigate: (1) the prevalence of injection anxiety in travelers attending a pre-travel consultation, (2) whether anxiety due to anticipating a vaccination adversely affects recall of information and advice, and (3) whether clinicians can recognize travelers' anxiety, and how they respond to anxious travelers. Consecutive adult travelers (N = 105) attending one of two inner-city travel clinics completed self-report measures of state anxiety, injection anxiety, and symptoms of needle phobia immediately before and after their pre-travel consultation. Clinicians were also asked to rate travelers' anxiety and report any anxiety management strategies. Standardized information was presented during the consultation and recall of information and advice was assessed immediately post-consultation. Delayed recall (24 hours) was assessed for a subsample (20%) of participants. More than one third of travelers reported feeling nervous or afraid when having an injection (39%). Travelers' state anxiety was related to their psychological and physiological reactions to needles, and reduced significantly post-consultation. Recall of information and advice varied, with failure of recall ranging from 2 to 70% across 15 items, and delayed recall being significantly lower. No relationship was found between recall and anxiety. Clinician-rated anxiety moderately correlated with travelers' self-reported anxiety. A significant proportion of travelers experienced injection anxiety when attending the pre-travel consultation, with some travelers reporting symptoms consistent with criteria for Blood Injection Injury phobia. There were important gaps in recall of information and advice about common travel risks. Although no

  2. Challenges to providing pre-travel care for travellers visiting friends and relatives: an audit of a specialist travel medicine clinic.

    PubMed

    Rowe, Kate; Chaves, Nadia; Leder, Karin

    2017-09-01

    Travellers visiting friends and relatives (VFRs) often have complex pre-travel needs. We identified the characteristics, destinations, vaccinations and pre-travel advice provided to VFRs and compared these with non-VFR travellers. The significant differences we found suggest that future research should focus on improving the uptake of recommended interventions in VFR travellers. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. An open-access microfluidic model for lung-specific functional studies at an air-liquid interface.

    PubMed

    Nalayanda, Divya D; Puleo, Christopher; Fulton, William B; Sharpe, Leilani M; Wang, Tza-Huei; Abdullah, Fizan

    2009-10-01

    In an effort to improve the physiologic relevance of existing in vitro models for alveolar cells, we present a microfluidic platform which provides an air-interface in a dynamic system combining microfluidic and suspended membrane culture systems. Such a system provides the ability to manipulate multiple parameters on a single platform along with ease in cell seeding and manipulation. The current study presents a comparison of the efficacy of the hybrid system with conventional platforms using assays analyzing the maintenance of function and integrity of A549 alveolar epithelial cell monolayer cultures. The hybrid system incorporates bio-mimetic nourishment on the basal side of the epithelial cells along with an open system on the apical side of the cells exposed to air allowing for easy access for assays.

  4. [Immunization for children travelling to the tropics: neglected vaccines].

    PubMed

    Imbert, P; Guérin, N; Sorge, F

    2008-06-01

    Each year hundreds of thousands of children leave France to travel to developing countries where they are exposed to infectious agents that can be prevented by vaccination. During the child's pre-travel check-up, practitioners should check that all mandatory immunizations are up-to-date and provide advice on relevant vaccines in function of the epidemiological situation at the chosen destination. However various factors hinder full compliance with this approach and some vaccines are underused. Underused vaccines are referred to as neglected vaccines. In the French vaccination schedule three vaccinations can be considered as neglected. The first is the hepatitis B vaccine that has a low coverage level in France due to strong reluctance to its use despite the fact that the virus is widespread in tropical areas. The second is pneumococcal vaccine that should be administered to all infants less than 2 years of age, especially for travel to areas where pneumonia and meningitis are frequent. The third is BCG vaccine that is now at greater risk of being neglected in child travellers because its use has been downgraded from a general requirement to a recommendation only for children at risk. A serious limitation on the use of travel vaccinations is cost that can lead families to neglect some infectious risk such as hepatitis A that is a major risk for child travellers as well as for their relatives during or after the trip and typhoid fever that is essentially an imported disease. Rabies vaccine is also underused due to its cost and to poor understanding of the risk by many practitioners and families. The purpose of this article is to underline the need to improve information and access to vaccines that are all too often neglected in child travellers.

  5. Travel characteristics and risk-taking attitudes in youths traveling to nonindustrialized countries.

    PubMed

    Han, Pauline; Balaban, Victor; Marano, Cinzia

    2010-01-01

    International travel to developing countries is increasing with rising levels of disposable income; this trend is seen in both adults and children. Risk-taking attitude is fundamental to research on the prevention of risky health behaviors, which can be an indicator of the likelihood of experiencing illness or injury during travel. The aim of this study is to investigate whether risk-taking attitudes of youths are associated with travel characteristics and likelihood of experiencing illness or injury while traveling to nonindustrialized countries. Data were analyzed from the 2008 YouthStyles survey, an annual mail survey gathering demographics and health knowledge, attitudes, and practices of individuals from 9 through 18 years of age. Travelers were defined as respondents who reported traveling in the last 12 months to a destination other than the United States, Canada, Europe, Japan, Australia, or New Zealand. Risk-taking attitude was measured by using a four-item Brief Sensation-Seeking Scale. All p values ≤ 0.05 were considered significant. Of 1,704 respondents, 131 (7.7%) traveled in the last 12 months. Females and those with higher household income were more likely to travel (odds ratio = 1.6,1.1). Of those who traveled, 16.7% reported seeking pretravel medical care, with most visiting a family doctor for that care (84.0%). However, one-fifth of respondents reported illness and injury during travel; of these, 83.3% traveled with their parents. Males and older youths had higher mean sensation-seeking scores. Further, travelers had a higher mean sensation-seeking score than nontravelers. Those who did not seek pretravel medical care also had higher mean sensation-seeking scores (p = 0.1, not significant). Our results show an association between risk-taking attitudes and youth travel behavior. However, adult supervision during travel and parental directives prior to travel should be taken into consideration. Communication messages should emphasize the

  6. Air breathing in the Arctic: influence of temperature, hypoxia, activity and restricted air access on respiratory physiology of the Alaska blackfish Dallia pectoralis.

    PubMed

    Lefevre, Sjannie; Damsgaard, Christian; Pascale, Desirae R; Nilsson, Göran E; Stecyk, Jonathan A W

    2014-12-15

    The Alaska blackfish (Dallia pectoralis) is an air-breathing fish native to Alaska and the Bering Sea islands, where it inhabits lakes that are ice-covered in the winter, but enters warm and hypoxic waters in the summer to forage and reproduce. To understand the respiratory physiology of this species under these conditions and the selective pressures that maintain the ability to breathe air, we acclimated fish to 5°C and 15°C and used respirometry to measure: standard oxygen uptake (Ṁ(O₂)) in normoxia (19.8 kPa P(O₂)) and hypoxia (2.5 kPa), with and without access to air; partitioning of standard Ṁ(O₂) in normoxia and hypoxia; maximum Ṁ(O₂) and partitioning after exercise; and critical oxygen tension (P(crit)). Additionally, the effects of temperature acclimation on haematocrit, haemoglobin oxygen affinity and gill morphology were assessed. Standard Ṁ(O₂) was higher, but air breathing was not increased, at 15°C or after exercise at both temperatures. Fish acclimated to 5°C or 15°C increased air breathing to compensate and fully maintain standard Ṁ(O₂) in hypoxia. Fish were able to maintain Ṁ(O₂) through aquatic respiration when air was denied in normoxia, but when air was denied in hypoxia, standard Ṁ(O₂) was reduced by ∼30-50%. P(crit) was relatively high (5 kPa) and there were no differences in P(crit), gill morphology, haematocrit or haemoglobin oxygen affinity at the two temperatures. Therefore, Alaska blackfish depends on air breathing in hypoxia and additional mechanisms must thus be utilised to survive hypoxic submergence during the winter, such as hypoxia-induced enhancement in the capacities for carrying and binding blood oxygen, behavioural avoidance of hypoxia and suppression of metabolic rate. © 2014. Published by The Company of Biologists Ltd.

  7. Mechanism of travelling-wave transport of particles

    NASA Astrophysics Data System (ADS)

    Kawamoto, Hiroyuki; Seki, Kyogo; Kuromiya, Naoyuki

    2006-03-01

    Numerical and experimental investigations have been carried out on transport of particles in an electrostatic travelling field. A three-dimensional hard-sphere model of the distinct element method was developed to simulate the dynamics of particles. Forces applied to particles in the model were the Coulomb force, the dielectrophoresis force on polarized dipole particles in a non-uniform field, the image force, gravity and the air drag. Friction and repulsion between particle-particle and particle-conveyer were included in the model to replace initial conditions after mechanical contacts. Two kinds of experiments were performed to confirm the model. One was the measurement of charge of particles that is indispensable to determine the Coulomb force. Charge distribution was measured from the locus of free-fallen particles in a parallel electrostatic field. The averaged charge of the bulk particle was confirmed by measurement with a Faraday cage. The other experiment was measurements of the differential dynamics of particles on a conveyer consisting of parallel electrodes to which a four-phase travelling electrostatic wave was applied. Calculated results agreed with measurements, and the following characteristics were clarified. (1) The Coulomb force is the predominant force to drive particles compared with the other kinds of forces, (2) the direction of particle transport did not always coincide with that of the travelling wave but changed partially. It depended on the frequency of the travelling wave, the particle diameter and the electric field, (3) although some particles overtook the travelling wave at a very low frequency, the motion of particles was almost synchronized with the wave at the low frequency and (4) the transport of some particles was delayed to the wave at medium frequency; the majority of particles were transported backwards at high frequency and particles were not transported but only vibrated at very high frequency.

  8. Bioethics and transnational medical travel: India,"medical tourism," and the globalisation of healthcare.

    PubMed

    Runnels, Vivien; Turner, Leigh

    2011-01-01

    Health-related travel, also referred to as "medical tourism" is historically well-known. Its emerging contemporary form suggests the development of a form of globalised for-profit healthcare. Medical tourism to India, the focus of a recent conference in Canada, provides an example of the globalisation of healthcare. By positioning itself as a low-cost, high-tech, fast-access and high-quality healthcare destination country, India offers healthcare to medical travellers who are frustrated with waiting lists and the limited availability of some procedures in Canada. Although patients have the right to travel and seek care at international medical facilities, there are a number of dimensions of medical tourism that are disturbing. The diversion of public investments in healthcare to the private sector, in order to serve medical travellers, perversely transfers public resources to international patients at a time when the Indian public healthcare system fails to provide primary healthcare to its own citizens. Further, little is known about patient safety and quality care in transnational medical travel. Countries that are departure points as well as destination countries need to carefully explore the ethical, social, cultural, and economic consequences of the growing phenomenon of for-profit international medical travel.

  9. Rotorcraft air transportation

    NASA Technical Reports Server (NTRS)

    Gilbert, G. A.

    1983-01-01

    Intermodal relationships and the particular ways in which they affect public transportation applications of rotorcraft are addressed. Some aspects of integrated services and general comparisons with other transportation modes are reviewed. Two potential application scenarios are discussed: down-to-downtown rotorcraft service and urban public transport rotorcraft service. It is concluded that to integrate well with ground access modes community rotorcraft service should be limited stop service with published schedules, and operate on a few specific routes between a few specific destinations. For downtown-to-downtown service, time savings favorable to rotorcraft are benefits that reflect its more direct access, relatively higher line-haul travel speeds, and less circuitous travel. For the scenario of public transport within urban areas, first, improving cruise speeds has a limited potential due to allowing for a ""station spacing'' effect. Secondly, public acceptance of higher acceleration/deceleration rates may be just as effective as a technological innovation as achieving higher cruise speeds.

  10. Pre-travel health preparation for malaria prevention among Hong Kong travellers.

    PubMed

    Hung, Kevin K C; Lin, Agatha K Y; Cheng, Calvin K Y; Chan, Emily Y Y; Graham, Colin A

    2015-03-01

    Malaria remains a significant cause of travel-related mortality and morbidity. Asians are known to have higher risks because they are less careful in pre-travel health preparations. This study reports on a cohort of travellers to malaria-prone regions examined in a previous study, which explored general levels of pre-travel health preparation. To describe the preparations taken by travellers at Hong Kong International Airport going to destinations with significant malaria risks according to the WHO. A cross-sectional survey was conducted by personal interviews at the boarding gates of flights in April 2013. The flights were chosen from those to malaria-prone regions (type I or above) from the 2012 WHO International Travel and Health Country List. 403 respondents (75.6% Chinese ethnicity) were travelling to malaria-prone regions. 95.3% were travelling to developing countries including China, Thailand, Malaysia and India. 55.1% of respondents had taken at least one mosquito prevention measure and 8.9% of respondents had malaria chemoprophylaxis. Stepwise multivariate logistic regression analysis showed that female gender (OR=2.21, 95% CI 1.23 to 3.97), residence outside Hong Kong (OR=2.71, 95% CI 1.46 to 5.04) and travel including rural areas (OR=5.67, 95% CI 3.11 to 10.34) were predictors of optimum pre-travel health preparations. Underestimation of malaria risks was a major barrier to adequate pre-travel health preparations. Targeted health education and information about risk is necessary to improve levels of travel health preparedness. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. An estimation of vehicle kilometer traveled and on-road emissions using the traffic volume and travel speed on road links in Incheon City.

    PubMed

    Jung, Sungwoon; Kim, Jounghwa; Kim, Jeongsoo; Hong, Dahee; Park, Dongjoo

    2017-04-01

    The objective of this study is to estimate the vehicle kilometer traveled (VKT) and on-road emissions using the traffic volume in urban. We estimated two VKT; one is based on registered vehicles and the other is based on traffic volumes. VKT for registered vehicles was 2.11 times greater than that of the applied traffic volumes because each VKT estimation method is different. Therefore, we had to define the inner VKT is moved VKT inner in urban to compare two values. Also, we focused on freight modes because these are discharged much air pollutant emissions. From analysis results, we found middle and large trucks registered in other regions traveled to target city in order to carry freight, target city has included many industrial and logistics areas. Freight is transferred through the harbors, large logistics centers, or via locations before being moved to the final destination. During this process, most freight is moved by middle and large trucks, and trailers rather than small trucks for freight import and export. Therefore, these trucks from other areas are inflow more than registered vehicles. Most emissions from diesel trucks had been overestimated in comparison to VKT from applied traffic volumes in target city. From these findings, VKT is essential based on traffic volume and travel speed on road links in order to estimate accurately the emissions of diesel trucks in target city. Our findings support the estimation of the effect of on-road emissions on urban air quality in Korea. Copyright © 2016. Published by Elsevier B.V.

  12. Web-based GIS: the vector-borne disease airline importation risk (VBD-AIR) tool

    PubMed Central

    2012-01-01

    Background Over the past century, the size and complexity of the air travel network has increased dramatically. Nowadays, there are 29.6 million scheduled flights per year and around 2.7 billion passengers are transported annually. The rapid expansion of the network increasingly connects regions of endemic vector-borne disease with the rest of the world, resulting in challenges to health systems worldwide in terms of vector-borne pathogen importation and disease vector invasion events. Here we describe the development of a user-friendly Web-based GIS tool: the Vector-Borne Disease Airline Importation Risk Tool (VBD-AIR), to help better define the roles of airports and airlines in the transmission and spread of vector-borne diseases. Methods Spatial datasets on modeled global disease and vector distributions, as well as climatic and air network traffic data were assembled. These were combined to derive relative risk metrics via air travel for imported infections, imported vectors and onward transmission, and incorporated into a three-tier server architecture in a Model-View-Controller framework with distributed GIS components. A user-friendly web-portal was built that enables dynamic querying of the spatial databases to provide relevant information. Results The VBD-AIR tool constructed enables the user to explore the interrelationships among modeled global distributions of vector-borne infectious diseases (malaria. dengue, yellow fever and chikungunya) and international air service routes to quantify seasonally changing risks of vector and vector-borne disease importation and spread by air travel, forming an evidence base to help plan mitigation strategies. The VBD-AIR tool is available at http://www.vbd-air.com. Conclusions VBD-AIR supports a data flow that generates analytical results from disparate but complementary datasets into an organized cartographical presentation on a web map for the assessment of vector-borne disease movements on the air travel network

  13. Web-based GIS: the vector-borne disease airline importation risk (VBD-AIR) tool.

    PubMed

    Huang, Zhuojie; Das, Anirrudha; Qiu, Youliang; Tatem, Andrew J

    2012-08-14

    Over the past century, the size and complexity of the air travel network has increased dramatically. Nowadays, there are 29.6 million scheduled flights per year and around 2.7 billion passengers are transported annually. The rapid expansion of the network increasingly connects regions of endemic vector-borne disease with the rest of the world, resulting in challenges to health systems worldwide in terms of vector-borne pathogen importation and disease vector invasion events. Here we describe the development of a user-friendly Web-based GIS tool: the Vector-Borne Disease Airline Importation Risk Tool (VBD-AIR), to help better define the roles of airports and airlines in the transmission and spread of vector-borne diseases. Spatial datasets on modeled global disease and vector distributions, as well as climatic and air network traffic data were assembled. These were combined to derive relative risk metrics via air travel for imported infections, imported vectors and onward transmission, and incorporated into a three-tier server architecture in a Model-View-Controller framework with distributed GIS components. A user-friendly web-portal was built that enables dynamic querying of the spatial databases to provide relevant information. The VBD-AIR tool constructed enables the user to explore the interrelationships among modeled global distributions of vector-borne infectious diseases (malaria. dengue, yellow fever and chikungunya) and international air service routes to quantify seasonally changing risks of vector and vector-borne disease importation and spread by air travel, forming an evidence base to help plan mitigation strategies. The VBD-AIR tool is available at http://www.vbd-air.com. VBD-AIR supports a data flow that generates analytical results from disparate but complementary datasets into an organized cartographical presentation on a web map for the assessment of vector-borne disease movements on the air travel network. The framework built provides a flexible

  14. Fellow travellers: Working memory and mental time travel in rodents.

    PubMed

    Dere, Ekrem; Dere, Dorothea; de Souza Silva, Maria Angelica; Huston, Joseph P; Zlomuzica, Armin

    2017-03-19

    The impairment of mental time travel is a severe cognitive symptom in patients with brain lesions and a number of neuropsychiatric disorders. Whether animals are also able to mentally travel in time both forward and backward is still a matter of debate. In this regard, we have proposed a continuum of mental time travel abilities across different animal species, with humans being the species with the ability to perform most sophisticated forms of mental time travel. In this review and perspective article, we delineate a novel approach to understand the evolution, characteristics and function of human and animal mental time travel. Furthermore, we propose a novel approach to measure mental time travel in rodents in a comprehensive manner using a test battery composed of well-validated and easy applicable tests. Copyright © 2017. Published by Elsevier B.V.

  15. Schistosomiasis in Scottish travellers: public health importance of laboratory testing and the need for enhanced surveillance.

    PubMed

    Alexander, Claire L; Cottom, Laura; Smith, Kitty; Perrow, Kali; Coyne, Michael; Jones, Brian L

    2018-03-01

    Imported schistosomiasis is of significant public health importance and is likely to be underestimated since infection is often asymptomatic. We describe data from travellers residing in Scotland which includes a subset of group travellers from one of the largest Health Boards in Scotland. Clotted bloods were obtained during the period 2001-15 from a total of 8163 Scottish travellers. This included seven groups comprising of 182 travellers. Sera were examined for the presence of Schistosome species antibody at the Scottish Parasite Diagnostic and Reference Laboratory (SPDRL). Of all, 25% (n = 1623) tested positive with 40% (n = 651) of those patients aged between 20 and 24 years. Although 62% (n = 1006) of those who tested positive reported travel to Africa, important information on the specific region visited was lacking in almost one-third of samples received. Overall, 62 (34%) of group travellers tested positive and 95% (n = 59) reporting travel to Africa. Globalization, affordable air travel and improved awareness, are likely to contribute towards the increasing number of imported schistosomiasis cases. Therefore, enhanced surveillance capturing detailed travel history and fresh water exposures will improve risk stratification, pre-travel advice and optimize testing and treatment regimes for this increasingly important parasitic disease.

  16. The normalisation of substance abuse among young travellers in Ireland: implications for practice.

    PubMed

    Van Hout, Marie Claire; Connor, Sean

    2008-01-01

    This report presents the findings of an exploratory study aimed at assessing the nature and extent of drug use amongst a group of young Travellers (aged twelve to eighteen years) in the South Eastern Region of Ireland. The results are intended to inform the Irish policy debate by providing data on patterns of youth drug use, drug-related risk behaviours, the impact of drug use on the Traveller community and issues regarding access to services. The young Travellers exhibited similar trends to "settled" adolescents with regard to drug use trends and attitudes but reported poor levels of health awareness and knowledge of drug services. The social exclusion of young Travellers puts them at risk of problematic drug use due to issues of poor literacy levels, family crisis, discrimination, poor knowledge of service provision relating to drug education and treatment, and the location of halting sites in areas of high drug usage.

  17. Headache Attributed to Airplane Travel: A Review of Literature.

    PubMed

    Nierenburg, Hida; Jackfert, Katelin

    2018-06-14

    Headaches due to airplane travel are rare but documented in the literature. We aim to provide a review of diagnostic criteria and treatment for this condition. Several cases of this syndrome have been reported since it was first described in 2004. Airplane headache is classified as unilateral, stabbing, orbito-frontal pain, lasting under 30 min, and occurs during ascent or descent of a plane. Patients with this condition can develop anxiety and fear of flying given the intensity and severity of the pain. The pathophysiology of this syndrome is unknown, but theories include suspected barotrauma given changes in barometric pressure during ascent and descent. There are no randomized controlled trials regarding treatment, but case reports suggest headache prevention with pre-treatment with naproxen, decongestants, and triptans prior to air travel. Some non-pharmacological therapies reported include Valsalva maneuvers, chewing, relaxation techniques, and pressure at the pain area. As more cases of headache attributed to airplane travel are reported, epidemiological data can be obtained to further understand the incidence and prevalence of this condition, which can lead to improved treatment options for patients.

  18. Wilderness Recreation Demand: A Comparison of Travel Cost and On-Site Cost Models

    Treesearch

    J.M. Bowker; A. Askew; L. Seymour; J.P. Zhu; D. English; C.M. Starbuck

    2009-01-01

    This study used travel cost and on-site day cost models, coupled with the Forest Service’s National Visitor Use Monitoring data, to examine the demand for and value of recreation access to designated Wilderness.

  19. The Concept of Travel Medicine and the Actual Situation of Travel-Related Illnesses.

    PubMed

    Tunalı, Varol; Turgay, Nevin

    2017-06-01

    Travel medicine defines all diseases and medical situations that are related to travel. Travel medicine comprises infectious diseases, traumas, altitude sickness, sun burns, embolisms, jet lag, and many more travel-related situations. With the increasing possibility and ease of travel, the number of people who have travelled internationally has exceeded 1.13 billion in 2014, and the revenues of international travel have exceeded 1.25 trillion dollars. With every passing day, international travels are shifting toward the developing countries and to more exotic regions of the world, and travelers tend to be more adventurous and daring, thereby increasing risky behaviors during travels. Traveling plays an important role in transmitting infections such as Zika virus infection, Ebola, avian flu, severe acute respiratory syndrome, Chikungunya, and dengue fever and is the principal reason for the epidemics of these types of infections on a global scale. With this background, we suggest that travel medicine is an important but "neglected" medical discipline as the discipline of Parasitology itself like most parasitic diseases.

  20. A method for the determination of potentially profitable service patterns for commuter air carriers

    NASA Technical Reports Server (NTRS)

    Ransone, R. K.; Kuhlthau, A. R.; Deptula, D. A.

    1975-01-01

    A methodology for estimating market conception was developed as a part of the short-haul air transportation program. It is based upon an analysis of actual documents which provide a record of known travel history. Applying this methodology a forecast was made of the demand for an air feeder service between Charlottesville, Virginia and Dulles International Airport. Local business travel vouchers and local travel agent records were selected to provide the documentation. The market was determined to be profitable for an 8-passenger Cessna 402B aircraft flying a 2-hour daily service pattern designed to mesh to the best extent possible with the connecting schedules at Dulles. The Charlottesville - Dulles air feeder service market conception forecast and its methodology are documented.