Sample records for additional travel costs

  1. Program Tracks Cost Of Travel

    NASA Technical Reports Server (NTRS)

    Mauldin, Lemuel E., III

    1993-01-01

    Travel Forecaster is menu-driven, easy-to-use computer program that plans, forecasts cost, and tracks actual vs. planned cost of business-related travel of division or branch of organization and compiles information into data base to aid travel planner. Ability of program to handle multiple trip entries makes it valuable time-saving device.

  2. Construction of road network vulnerability evaluation index based on general travel cost

    NASA Astrophysics Data System (ADS)

    Leng, Jun-qiang; Zhai, Jing; Li, Qian-wen; Zhao, Lin

    2018-03-01

    With the development of China's economy and the continuous improvement of her urban road network, the vulnerability of the urban road network has attracted increasing attention. Based on general travel cost, this work constructs the vulnerability evaluation index for the urban road network, and evaluates the vulnerability of the urban road network from the perspective of user generalised travel cost. Firstly, the generalised travel cost model is constructed based on vehicle cost, travel time, and traveller comfort. Then, the network efficiency index is selected as an evaluation index of vulnerability: the network efficiency index is composed of the traffic volume and the generalised travel cost, which are obtained from the equilibrium state of the network. In addition, the research analyses the influence of traffic capacity decrease, road section attribute value, and location of road section, on vulnerability. Finally, the vulnerability index is used to analyse the local area network of Harbin and verify its applicability.

  3. 48 CFR 731.205-46 - Travel costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Travel costs. 731.205-46 Section 731.205-46 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL....205-46 Travel costs. It is USAID policy to require prior written approval of international travel by...

  4. 48 CFR 731.205-46 - Travel costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Section 731.205-46 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 731.205-46 Travel costs. It is USAID policy to require prior written approval of international travel by...

  5. Self-monitoring induced savings on type 2 diabetes patients' travel and healthcare costs.

    PubMed

    Leminen, Aapeli; Tykkyläinen, Markku; Laatikainen, Tiina

    2018-07-01

    Type 2 diabetes (T2DM) is a major health concern in most regions. In addition to direct healthcare costs, diabetes causes many indirect costs that are often ignored in economic analyses. Patients' travel and time costs associated with the follow-up of T2DM patients have not been previously calculated systematically over an entire healthcare district. The aim of the study was to develop a georeferenced cost model that could be used to measure healthcare accessibility and patient travel and time costs in a sparsely populated healthcare district in Finland. Additionally, the model was used to test whether savings in the total costs of follow-up of T2DM patients are achieved by increasing self-monitoring and implementing electronic feedback practices between healthcare staff and patients. Patient data for this study was obtained from the regional electronic patient database Mediatri. A georeferenced cost model of linear equations was developed with ESRI ArcGIS 10.3 software and ModelBuilder tool. The Model utilizes OD Cost Matrix method of network analysis to calculate optimal routes for primary-care follow-up visits. In the study region of North Karelia, the average annual total costs of T2DM follow-up screening of HbA1c (9070 patients) conforming to the national clinical guidelines are 280 EUR/297 USD per patient. Combined travel and time costs are 21 percent of the total costs. Implementing self-monitoring for a half of the follow-up still within the guidelines, the average annual total costs of HbA1c screening could be reduced by 57 percent from 280 EUR/297 USD to 121 EUR/129 USD per patient. Travel costs related to HbA1c screening of T2DM patients constitute a substantial cost item, the consideration of which in healthcare planning would enable the societal cost-efficiency of T2DM care to be improved. Even more savings in both travel costs and healthcare costs of T2DM can be achieved by utilizing more self-monitoring and electronic feedback practices. Additionally

  6. Use of travel cost models in planning: A case study

    Treesearch

    Allan Marsinko; William T. Zawacki; J. Michael Bowker

    2002-01-01

    This article examines the use of the travel cost, method in tourism-related decision making in the area of nonconsumptive wildlife-associated recreation. A travel cost model of nonconsumptive wildlife-associated recreation, developed by Zawacki, Maninko, and Bowker, is used as a case study for this analysis. The travel cost model estimates the demand for the activity...

  7. A cost comparison of travel models and behavioural telemedicine for rural, Native American populations in New Mexico.

    PubMed

    Horn, Brady P; Barragan, Gary N; Fore, Chis; Bonham, Caroline A

    2016-01-01

    The purpose of this study was to model the cost of delivering behavioural health services to rural Native American populations using telecommunications and compare these costs with the travel costs associated with providing equivalent care. Behavioural telehealth costs were modelled using equipment, transmission, administrative and IT costs from an established telecommunications centre. Two types of travel models were estimated: a patient travel model and a physician travel model. These costs were modelled using the New Mexico resource geographic information system program (RGIS) and ArcGIS software and unit costs (e.g. fuel prices, vehicle depreciation, lodging, physician wages, and patient wages) that were obtained from the literature and US government agencies. The average per-patient cost of providing behavioural healthcare via telehealth was US$138.34, and the average per-patient travel cost was US$169.76 for physicians and US$333.52 for patients. Sensitivity analysis found these results to be rather robust to changes in imputed parameters and preliminary evidence of economies of scale was found. Besides the obvious benefits of increased access to healthcare and reduced health disparities, providing behavioural telehealth for rural Native American populations was estimated to be less costly than modelled equivalent care provided by travelling. Additionally, as administrative and coordination costs are a major component of telehealth costs, as programmes grow to serve more patients, the relative costs of these initial infrastructure as well as overall per-patient costs should decrease. © The Author(s) 2015.

  8. Sensitivity of whitewater rafting consumers surplus to pecuniary travel cost specifications

    Treesearch

    Donald B.K. English; J. Michael Bowker

    1996-01-01

    Considerable research has examined how different ways of accounting for onsite and travel time affect surplus estimates from travel cost models. However, little has been done regarding different definitions of out-of-pocket costs. Estimates of per trip consumer surplus are developed for a zonal travel cost model for outfitted rafting on the Chattooga River. Nine price...

  9. Cost-effectiveness analysis of malaria chemoprophylaxis for travellers to West-Africa

    PubMed Central

    2010-01-01

    Background The importation of malaria to non-endemic countries remains a major cause of travel-related morbidity and a leading cause of travel-related hospitalizations. Currently they are three priority medications for malaria prophylaxis to West Africa: mefloquine, atovaquone/proguanil and doxycycline. We investigate the cost effectiveness of a partial reimbursement of the cheapest effective malaria chemoprophylaxis (mefloquine) for travellers to high risk areas of malaria transmission compared with the current situation of no reimbursement. Methods This study is a cost-effectiveness analysis based on malaria cases imported from West Africa to Switzerland from the perspective of the Swiss health system. We used a decision tree model and made a literature research on the components of travel related malaria. The main outcome measure was the cost effectiveness of malaria chemoprophylaxis reimbursement based on malaria and deaths averted. Results Using a program where travellers would be reimbursed for 80% of the cost of the cheapest malaria chemoprophylaxis is dominant (i.e. cost saving and more effective than the current situation) using the assumption that currently 68.7% of travellers to West Africa use malaria chemoprophylaxis. If the current usage of malaria chemoprophylaxis would be higher, 82.4%, the incremental cost per malaria case averted is € 2'302. The incremental cost of malaria death averted is € 191'833. The most important factors influencing the model were: the proportion of travellers using malaria chemoprophylaxis, the probability of contracting malaria without malaria chemoprophylaxis, the cost of the mefloquine regimen, the decrease in the number of travellers without malaria chemoprophylaxis in the reimbursement strategy. Conclusions This study suggests that a reimbursement of 80% of the cost of the cheapest effective malaria chemoprophylaxis (mefloquine) for travellers from Switzerland to West Africa is highly effective in terms of malaria

  10. Time and travel costs incurred by women attending antenatal tests: A costing study.

    PubMed

    Verhoef, Talitha I; Daley, Rebecca; Vallejo-Torres, Laura; Chitty, Lyn S; Morris, Stephen

    2016-09-01

    to estimate the costs to women, their friends and family for different antenatal tests in the Down's syndrome (DS) screening pathway. questionnaire-based costing study. eight maternity clinics across the UK. pregnant women (n=574) attending an appointment for DS screening, NIPT or invasive testing between December 2013 and September 2014. using data collected from the questionnaires we calculated the total costs to women by multiplying the time spent at the hospital and travelling to and from it by the opportunity costs of the women and accompanying person and adding travel and childcare costs. Assumptions about the value of opportunity costs were tested in one-way sensitivity analyses. The main outcome measure was the mean cost to the women and friends/family for each test (DS screening, NIPT, and invasive testing). mean costs to women and their family/friend were £33.96 per visit, of which £22.47 were time costs, £9.15 were travel costs and £2.34 were childcare costs. Costs were lowest for NIPT (£22), £32 for DS screening (£44 if combined with NIPT), and highest for invasive testing (£60). Sensitivity analysis revealed that variations around the value of leisure time opportunity costs had the largest influence on the results. there are considerable costs to women, their friends and family when attending different tests in the DS screening pathway. when assessing the cost-effectiveness of changes to this pathway, costs to women should be considered. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Effects of travel cost and participation in recreational activities on national forest visits

    Treesearch

    Seong-Hoon Cho; J.M. Bowker; Donald B.K. English; Roland K. Roberts; Taeyoung Kim

    2014-01-01

    In the face of higher travel costs due to rising gasoline prices and scarce budget resources,we explored differences in the impacts of travel costs on recreational demand for visitors participating in various recreational activities. Five individual travel cost models were estimated, one for each of 5 national forests (i.e., Allegheny, Coconino, Mount Baker-Snoqualmie...

  12. Cost risk benefit analysis to support chemoprophylaxis policy for travellers to malaria endemic countries.

    PubMed

    Massad, Eduardo; Behrens, Ben C; Coutinho, Francisco A B; Behrens, Ronald H

    2011-05-17

    In a number of malaria endemic regions, tourists and travellers face a declining risk of travel associated malaria, in part due to successful malaria control. Many millions of visitors to these regions are recommended, via national and international policy, to use chemoprophylaxis which has a well recognized morbidity profile. To evaluate whether current malaria chemo-prophylactic policy for travellers is cost effective when adjusted for endemic transmission risk and duration of exposure. a framework, based on partial cost-benefit analysis was used. Using a three component model combining a probability component, a cost component and a malaria risk component, the study estimated health costs avoided through use of chemoprophylaxis and costs of disease prevention (including adverse events and pre-travel advice for visits to five popular high and low malaria endemic regions) and malaria transmission risk using imported malaria cases and numbers of travellers to malarious countries. By calculating the minimal threshold malaria risk below which the economic costs of chemoprophylaxis are greater than the avoided health costs we were able to identify the point at which chemoprophylaxis would be economically rational. The threshold incidence at which malaria chemoprophylaxis policy becomes cost effective for UK travellers is an accumulated risk of 1.13% assuming a given set of cost parameters. The period a travellers need to remain exposed to achieve this accumulated risk varied from 30 to more than 365 days, depending on the regions intensity of malaria transmission. The cost-benefit analysis identified that chemoprophylaxis use was not a cost-effective policy for travellers to Thailand or the Amazon region of Brazil, but was cost-effective for travel to West Africa and for those staying longer than 45 days in India and Indonesia.

  13. 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.

  14. 41 CFR 301-70.505 - May any travel costs be reimbursed if the employee travels to an alternate location for medical...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (if any) of actual costs of travel from the point of interruption to the alternate location and return... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false May any travel costs be reimbursed if the employee travels to an alternate location for medical treatment? 301-70.505 Section 301-70...

  15. 41 CFR 301-70.506 - How do we define actual cost and constructive cost when an employee interrupts a travel...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... appropriate en route travel time. [FTR Amdt. 70, 63 FR 15971, Apr. 1, 1998. Redesignated by FTR Amdt. 108, 67... cost and constructive cost when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70.506 Section 301-70.506 Public Contracts and Property Management Federal Travel...

  16. 41 CFR 301-70.506 - How do we define actual cost and constructive cost when an employee interrupts a travel...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... appropriate en route travel time. [FTR Amdt. 70, 63 FR 15971, Apr. 1, 1998. Redesignated by FTR Amdt. 108, 67... cost and constructive cost when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70.506 Section 301-70.506 Public Contracts and Property Management Federal Travel...

  17. 41 CFR 301-70.506 - How do we define actual cost and constructive cost when an employee interrupts a travel...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... appropriate en route travel time. [FTR Amdt. 70, 63 FR 15971, Apr. 1, 1998. Redesignated by FTR Amdt. 108, 67... cost and constructive cost when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70.506 Section 301-70.506 Public Contracts and Property Management Federal Travel...

  18. 41 CFR 301-70.506 - How do we define actual cost and constructive cost when an employee interrupts a travel...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... appropriate en route travel time. [FTR Amdt. 70, 63 FR 15971, Apr. 1, 1998. Redesignated by FTR Amdt. 108, 67... cost and constructive cost when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70.506 Section 301-70.506 Public Contracts and Property Management Federal Travel...

  19. 41 CFR 301-70.506 - How do we define actual cost and constructive cost when an employee interrupts a travel...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... appropriate en route travel time. [FTR Amdt. 70, 63 FR 15971, Apr. 1, 1998. Redesignated by FTR Amdt. 108, 67... cost and constructive cost when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70.506 Section 301-70.506 Public Contracts and Property Management Federal Travel...

  20. 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.

  1. 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

  2. An examination of sources of sensitivity of consumer surplus estimates in travel cost models.

    PubMed

    Blaine, Thomas W; Lichtkoppler, Frank R; Bader, Timothy J; Hartman, Travis J; Lucente, Joseph E

    2015-03-15

    We examine sensitivity of estimates of recreation demand using the Travel Cost Method (TCM) to four factors. Three of the four have been routinely and widely discussed in the TCM literature: a) Poisson verses negative binomial regression; b) application of Englin correction to account for endogenous stratification; c) truncation of the data set to eliminate outliers. A fourth issue we address has not been widely modeled: the potential effect on recreation demand of the interaction between income and travel cost. We provide a straightforward comparison of all four factors, analyzing the impact of each on regression parameters and consumer surplus estimates. Truncation has a modest effect on estimates obtained from the Poisson models but a radical effect on the estimates obtained by way of the negative binomial. Inclusion of an income-travel cost interaction term generally produces a more conservative but not a statistically significantly different estimate of consumer surplus in both Poisson and negative binomial models. It also generates broader confidence intervals. Application of truncation, the Englin correction and the income-travel cost interaction produced the most conservative estimates of consumer surplus and eliminated the statistical difference between the Poisson and the negative binomial. Use of the income-travel cost interaction term reveals that for visitors who face relatively low travel costs, the relationship between income and travel demand is negative, while it is positive for those who face high travel costs. This provides an explanation of the ambiguities on the findings regarding the role of income widely observed in the TCM literature. Our results suggest that policies that reduce access to publicly owned resources inordinately impact local low income recreationists and are contrary to environmental justice. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Age-Related Employment Costs at the Travelers Companies in 1981.

    ERIC Educational Resources Information Center

    Billings, A. E., Jr.

    1983-01-01

    The Travelers Companies studied its work force in 1981 and discovered that some employment costs, such as health insurance claims, increase as employees age, while other costs, such as those associated with turnover, decrease. (SK)

  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. 41 CFR 301-70.802 - Must we ensure that travel on Government aircraft is the most cost-effective alternative?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) Consider the cost of non-productive or lost work time while in travel status and certain other costs when... travel on Government aircraft is the most cost-effective alternative? 301-70.802 Section 301-70.802 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL...

  6. 41 CFR 301-70.802 - Must we ensure that travel on Government aircraft is the most cost-effective alternative?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Consider the cost of non-productive or lost work time while in travel status and certain other costs when... travel on Government aircraft is the most cost-effective alternative? 301-70.802 Section 301-70.802 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL...

  7. 41 CFR 301-70.802 - Must we ensure that travel on Government aircraft is the most cost-effective alternative?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) Consider the cost of non-productive or lost work time while in travel status and certain other costs when... travel on Government aircraft is the most cost-effective alternative? 301-70.802 Section 301-70.802 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL...

  8. 41 CFR 301-70.802 - Must we ensure that travel on Government aircraft is the most cost-effective alternative?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Consider the cost of non-productive or lost work time while in travel status and certain other costs when... travel on Government aircraft is the most cost-effective alternative? 301-70.802 Section 301-70.802 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL...

  9. 41 CFR 301-70.802 - Must we ensure that travel on Government aircraft is the most cost-effective alternative?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) Consider the cost of non-productive or lost work time while in travel status and certain other costs when... travel on Government aircraft is the most cost-effective alternative? 301-70.802 Section 301-70.802 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL...

  10. Cost-benefit of WC/rBS oral cholera vaccine for vaccination against ETEC-caused travelers' diarrhea.

    PubMed

    Lundkvist, Jonas; Steffen, Robert; Jönsson, Bengt

    2009-01-01

    The most common infectious health problem encountered by travelers to countries in the developing region is travelers' diarrhea (TD), with enterotoxigenic Escherichia coli (ETEC) being the most common pathogen isolated. Although mild in most cases, the disease still leads to the loss of a significant part of a vacation or business trip. There is currently a lack of knowledge about the costs in relation to the benefits of vaccination against TD caused by ETEC, and the purposes of this study were to estimate and develop a cost-benefit analysis of vaccination using whole-cell/recombinant-B-subunit oral cholera vaccine. The consequences of the vaccination were identified and quantified in monetary terms. The cost-benefits for leisure and business travelers were assessed separately. The value of the travel was separated into the cost of the trip and of lost leisure time/business opportunities. A person with TD was in base case estimated to lose on average 3.5 days of a 7-day leisure trip and 2.5 days of a 4-day business trip. Results are presented for a Canadian traveler to endemic areas in year 2007 in US$. The average cost of a TD event was estimated at $1,460 and $1,996 for leisure and business travelers, respectively. The net value of the vaccination, however, varied with the risk of the disease. Through extensive literature searches, an updated ETEC map illustrating the proportion of ETEC-caused TD was created. The analysis indicated that vaccination would be considered cost-effective at incidence rates of ETEC-caused TD above about 13 and 9% for leisure and business travelers, respectively. It is, however, important to keep in mind that it is the value of the travel for the individual traveler that will decide if the vaccination provides good value for money.

  11. A multinational investigation of time and traveling costs in attending anticoagulation clinics.

    PubMed

    Jowett, Sue; Bryan, Stirling; Mahé, Isabelle; Brieger, David; Carlsson, Jonas; Kartman, Bernt; Nevinson, Mark

    2008-01-01

    Anticoagulation is used in patients with atrial fibrillation to reduce the risk of ischemic stroke. The therapy requires regular monitoring and, frequently, dose adjustment. This study aimed to determine the time and traveling costs that patients incur to themselves and society in attending anticoagulation clinics. A subset of patients from 105 primary and secondary care clinics allocated to the warfarin arm of SPORTIF III (patients from Australia, France, Portugal, Spain, Sweden, and the UK) completed a questionnaire. Patients indicated the type of transport used for clinic visits, and estimated traveling expenses. Patients were also asked to estimate total traveling and clinic attendance time, and to confirm whether they were currently employed and whether they had to give up time from work to attend the clinic. Time cost of companions was also taken into consideration. Cost per visit was calculated (euro, 2003 prices). Questionnaires for a total of 381 patients were analyzed, with the majority of patients from Sweden (n = 130) and the UK (n = 101). Mean cost to patients varied widely between countries, ranging from euro6.9 (France) to euro20.5 (Portugal) per visit. For most countries, time costs (value of lost working and leisure time) were the main driver of costs. Mean time cost to society ranged from euro5.6 (France) to euro31.7 (Portugal) per visit. Patients incur considerable costs when visiting anticoagulation clinics, and these costs vary by country. The results suggest the importance of taking a broad economic perspective when considering the cost-effectiveness of warfarin.

  12. The cost-constrained traveling salesman problem

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

    Sokkappa, P.R.

    1990-10-01

    The Cost-Constrained Traveling Salesman Problem (CCTSP) is a variant of the well-known Traveling Salesman Problem (TSP). In the TSP, the goal is to find a tour of a given set of cities such that the total cost of the tour is minimized. In the CCTSP, each city is given a value, and a fixed cost-constraint is specified. The objective is to find a subtour of the cities that achieves maximum value without exceeding the cost-constraint. Thus, unlike the TSP, the CCTSP requires both selection and sequencing. As a consequence, most results for the TSP cannot be extended to the CCTSP.more » We show that the CCTSP is NP-hard and that no K-approximation algorithm or fully polynomial approximation scheme exists, unless P = NP. We also show that several special cases are polynomially solvable. Algorithms for the CCTSP, which outperform previous methods, are developed in three areas: upper bounding methods, exact algorithms, and heuristics. We found that a bounding strategy based on the knapsack problem performs better, both in speed and in the quality of the bounds, than methods based on the assignment problem. Likewise, we found that a branch-and-bound approach using the knapsack bound was superior to a method based on a common branch-and-bound method for the TSP. In our study of heuristic algorithms, we found that, when selecting modes for inclusion in the subtour, it is important to consider the neighborhood'' of the nodes. A node with low value that brings the subtour near many other nodes may be more desirable than an isolated node of high value. We found two types of repetition to be desirable: repetitions based on randomization in the subtour buildings process, and repetitions encouraging the inclusion of different subsets of the nodes. By varying the number and type of repetitions, we can adjust the computation time required by our method to obtain algorithms that outperform previous methods.« less

  13. Decreasing patient cost and travel time through pediatric rheumatology telemedicine visits.

    PubMed

    Kessler, Elizabeth A; Sherman, Ashley K; Becker, Mara L

    2016-09-20

    There is a critical shortage of pediatric rheumatologists in the US. Substantial travel to clinics can impose time and monetary burdens on families. The aim of this study was to evaluate the cost of in-person pediatric rheumatology visits for families and determine if telemedicine clinics resulted in time and cost savings. Factors associated with interest in telemedicine were also explored. Surveys were offered to parents and guardians of patients in Pediatric Rheumatology follow-up clinics in Kansas City, Missouri, the primary site of in-person care, and at a telemedicine outreach site 160 miles away, in Joplin, Missouri. Survey questions were asked about non-medical, out-of-pocket costs associated with the appointment and interest in a telemedicine clinic. At the primary Kansas City clinic, the median distance traveled one-way was 40 miles [IQR = 18-80]. In the Joplin sample, the median distance traveled to the telemedicine clinic was 60 miles [IQR = 20-85] compared to 175 miles [IQR = 160-200] for the same cohort of patients when seen in Kansas City (p < 0.001). When the Joplin cohort was seen via telemedicine they missed less time from work and school (p = 0.028, p = 0.003, respectively) and a smaller percentage spent money on food compared to when they had traveled to Kansas City (p < 0.001). There was no statistical difference between the Joplin cohort when they had traveled to Kansas City and the Kansas City cohort in terms of miles driven to clinic, time missed from work and school, and percentage of subjects who spent money on food. Traditional in-person visits can result in a financial toll on families, which can be ameliorated by the use of telemedicine. Telemedicine leveled the economic burden of clinic visits so that when the Joplin cohort was seen via telemedicine, they experienced costs similar to the Kansas City cohort.

  14. Impact of a University-Based Outpatient Telemedicine Program on Time Savings, Travel Costs, and Environmental Pollutants.

    PubMed

    Dullet, Navjit W; Geraghty, Estella M; Kaufman, Taylor; Kissee, Jamie L; King, Jesse; Dharmar, Madan; Smith, Anthony C; Marcin, James P

    2017-04-01

    The objective of this study was to estimate travel-related and environmental savings resulting from the use of telemedicine for outpatient specialty consultations with a university telemedicine program. The study was designed to retrospectively analyze the telemedicine consultation database at the University of California Davis Health System (UCDHS) between July 1996 and December 2013. Travel distances and travel times were calculated between the patient home, the telemedicine clinic, and the UCDHS in-person clinic. Travel cost savings and environmental impact were calculated by determining differences in mileage reimbursement rate and emissions between those incurred in attending telemedicine appointments and those that would have been incurred if a visit to the hub site had been necessary. There were 19,246 consultations identified among 11,281 unique patients. Telemedicine visits resulted in a total travel distance savings of 5,345,602 miles, a total travel time savings of 4,708,891 minutes or 8.96 years, and a total direct travel cost savings of $2,882,056. The mean per-consultation round-trip distance savings were 278 miles, average travel time savings were 245 minutes, and average cost savings were $156. Telemedicine consultations resulted in a total emissions savings of 1969 metric tons of CO 2 , 50 metric tons of CO, 3.7 metric tons of NO x , and 5.5 metric tons of volatile organic compounds. This study demonstrates the positive impact of a health system's outpatient telemedicine program on patient travel time, patient travel costs, and environmental pollutants. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  15. 77 FR 67366 - Federal Acquisition Regulation; Information Collection; Travel Costs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-09

    ... DEPARTMENT OF DEFENSE GENERAL SERVICES ADMINISTRATION NATIONAL AERONAUTICS AND SPACE...; Information Collection; Travel Costs AGENCY: Department of Defense (DOD), General Services Administration (GSA), and National Aeronautics and Space Administration (NASA). ACTION: Notice of request for comments...

  16. 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.

  17. Modeling spatial segregation and travel cost influences on utilitarian walking: Towards policy intervention

    PubMed Central

    Yang, Yong; Auchincloss, Amy H.; Rodriguez, Daniel A.; Brown, Daniel G.; Riolo, Rick; Diez-Roux, Ana V.

    2015-01-01

    We develop an agent-based model of utilitarian walking and use the model to explore spatial and socioeconomic factors affecting adult utilitarian walking and how travel costs as well as various educational interventions aimed at changing attitudes can alter the prevalence of walking and income differentials in walking. The model is validated against US national data. We contrast realistic and extreme parameter values in our model and test effects of changing these parameters across various segregation and pricing scenarios while allowing for interactions between travel choice and place and for behavioral feedbacks. Results suggest that in addition to income differences in the perceived cost of time, the concentration of mixed land use (differential density of residences and businesses) are important determinants of income differences in walking (high income walk less), whereas safety from crime and income segregation on their own do not have large influences on income differences in walking. We also show the difficulty in altering walking behaviors for higher income groups who are insensitive to price and how adding to the cost of driving could increase the income differential in walking particularly in the context of segregation by income and land use. We show that strategies to decrease positive attitudes towards driving can interact synergistically with shifting cost structures to favor walking in increasing the percent of walking trips. Agent-based models, with their ability to capture dynamic processes and incorporate empirical data, are powerful tools to explore the influence on health behavior from multiple factors and test policy interventions. PMID:25733776

  18. Evidence on global medical travel.

    PubMed

    Ruggeri, Kai; Záliš, Ladislav; Meurice, Christopher R; Hilton, Ian; Ly, Terry-Lisa; Zupan, Zorana; Hinrichs, Saba

    2015-11-01

    The potential benefits of travelling across national borders to obtain medical treatment include improved care, decreased costs and reduced waiting times. However, medical travel involves additional risks, compared to obtaining treatment domestically. We review the publicly-available evidence on medical travel. We suggest that medical travel needs to be understood in terms of its potential risks and benefits so that it can be evaluated against alternatives by patients who are seeking care. We propose three domains -quality standards, informed decision-making, economic and legal protection - in which better evidence could support the development of medical travel policies.

  19. Evidence on global medical travel

    PubMed Central

    Záliš, Ladislav; Meurice, Christopher R; Hilton, Ian; Ly, Terry-Lisa; Zupan, Zorana; Hinrichs, Saba

    2015-01-01

    Abstract The potential benefits of travelling across national borders to obtain medical treatment include improved care, decreased costs and reduced waiting times. However, medical travel involves additional risks, compared to obtaining treatment domestically. We review the publicly-available evidence on medical travel. We suggest that medical travel needs to be understood in terms of its potential risks and benefits so that it can be evaluated against alternatives by patients who are seeking care. We propose three domains –quality standards, informed decision-making, economic and legal protection – in which better evidence could support the development of medical travel policies. PMID:26549906

  20. 25 CFR 39.703 - What ground transportation costs are covered for students traveling by commercial transportation?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... for Funds § 39.703 What ground transportation costs are covered for students traveling by commercial... 25 Indians 1 2010-04-01 2010-04-01 false What ground transportation costs are covered for students traveling by commercial transportation? 39.703 Section 39.703 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT...

  1. A cost-effectiveness comparison of the use of antimicrobial agents for treatment or prophylaxis of travelers' diarrhea.

    PubMed

    Reves, R R; Johnson, P C; Ericsson, C D; DuPont, H L

    1988-11-01

    We conducted a decision analysis to compare the cost-effectiveness of antimicrobial agents used for treatment with their use for prophylaxis of travelers' diarrhea. Estimates of the likelihood and the cost of various outcomes were obtained from a panel of experts using the Delphi group opinion technique. Treatment with sulfamethoxazole-trimethoprim for three days was compared with daily prophylaxis with sulfamethoxazole-trimethoprim or doxycycline. The cost-effectiveness of prophylaxis with either agent (75% to 83%) was greater than that of treatment (38%). Treatment would become more cost-effective than prophylaxis when the cumulative risk of acquiring travelers' diarrhea was less than 0.05 episodes per person per week or if the effectiveness of prophylaxis fell below 35% for doxycycline and 46% for sulfamethoxazole-trimethoprim. The most important contributor to the mean cost of travelers' diarrhea in this analysis was the cost associated with a day of incapacitation due to illness. On the basis of the results of this decision analysis, we conclude that prophylaxis of travelers' diarrhea is an option that should be considered for individual situations and recommend further studies of its cost-effectiveness.

  2. 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...

  3. 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.

  4. Travel costs associated with flood closures of state highways near Centralia/Chehalis, Washington.

    DOT National Transportation Integrated Search

    2014-09-01

    This report discusses the travel costs associated with the closure of roads in the greater : Centralia/Chehalis, Washington region due to 100-year flood conditions starting on the Chehalis River. The costs : were computed for roadway closures on I-5,...

  5. An analysis of travel costs on transport of load and nest building in golden hamster.

    PubMed

    Guerra, Rogerio F.; Ades, Cesar

    2002-03-28

    We investigated the effects of travel costs on transporting nest material and nest-building activity in golden hamsters. Nest-deprived animals were submitted to run alleys 30, 90 and 180 cm long to access a source containing paper strips as nest material (Experiment 1) or were submitted to the same travel costs in 24-h experimental sessions (Experiment 2). We noted that increased travel costs were related to a decreased number of trips to the source, larger amounts (cm(2)) of nest material transported per trip (although total loads also decreased in longer alleys), longer intervals between trips, and increased time spent at the source and in nest building activity. Foraging efficiency (i.e. size of load divided by the time spent at the source) decreased as a function of travel costs, and animals transported their loads in two fundamental ways: in 30-cm alleys, they simply used their mouth to pull the paper strips, but in 90- or 180-cm alleys they transported the loads in their cheek pouches. The animals were faster when returning to the home-cage and their running speed (cm/s) increased as a function of the length of the alley, showing that animals are under different environmental pressures when searching for resources and subsequently running back with the load to the nest. Both male and female subjects were sensitive to travel costs, but males engaged in nest building activity more promptly and exhibited higher mean performances in most measures. We conclude that nest material is a good reinforcer, and our major results are in accordance with the predictions of microeconomic and optimal foraging theories.

  6. Variable population exposure and distributed travel speeds in least-cost tsunami evacuation modelling

    NASA Astrophysics Data System (ADS)

    Fraser, S. A.; Wood, N. J.; Johnston, D. M.; Leonard, G. S.; Greening, P. D.; Rossetto, T.

    2014-11-01

    Evacuation of the population from a tsunami hazard zone is vital to reduce life-loss due to inundation. Geospatial least-cost distance modelling provides one approach to assessing tsunami evacuation potential. Previous models have generally used two static exposure scenarios and fixed travel speeds to represent population movement. Some analyses have assumed immediate departure or a common evacuation departure time for all exposed population. Here, a method is proposed to incorporate time-variable exposure, distributed travel speeds, and uncertain evacuation departure time into an existing anisotropic least-cost path distance framework. The method is demonstrated for hypothetical local-source tsunami evacuation in Napier City, Hawke's Bay, New Zealand. There is significant diurnal variation in pedestrian evacuation potential at the suburb level, although the total number of people unable to evacuate is stable across all scenarios. Whilst some fixed travel speeds approximate a distributed speed approach, others may overestimate evacuation potential. The impact of evacuation departure time is a significant contributor to total evacuation time. This method improves least-cost modelling of evacuation dynamics for evacuation planning, casualty modelling, and development of emergency response training scenarios. However, it requires detailed exposure data, which may preclude its use in many situations.

  7. Variable population exposure and distributed travel speeds in least-cost tsunami evacuation modelling

    NASA Astrophysics Data System (ADS)

    Fraser, S. A.; Wood, N. J.; Johnston, D. M.; Leonard, G. S.; Greening, P. D.; Rossetto, T.

    2014-06-01

    Evacuation of the population from a tsunami hazard zone is vital to reduce life-loss due to inundation. Geospatial least-cost distance modelling provides one approach to assessing tsunami evacuation potential. Previous models have generally used two static exposure scenarios and fixed travel speeds to represent population movement. Some analyses have assumed immediate evacuation departure time or assumed a common departure time for all exposed population. In this paper, a method is proposed to incorporate time-variable exposure, distributed travel speeds, and uncertain evacuation departure time into an existing anisotropic least-cost path distance framework. The model is demonstrated for a case study of local-source tsunami evacuation in Napier City, Hawke's Bay, New Zealand. There is significant diurnal variation in pedestrian evacuation potential at the suburb-level, although the total number of people unable to evacuate is stable across all scenarios. Whilst some fixed travel speeds can approximate a distributed speed approach, others may overestimate evacuation potential. The impact of evacuation departure time is a significant contributor to total evacuation time. This method improves least-cost modelling of evacuation dynamics for evacuation planning, casualty modelling, and development of emergency response training scenarios.

  8. Variable population exposure and distributed travel speeds in least-cost tsunami evacuation modelling

    USGS Publications Warehouse

    Fraser, Stuart A.; Wood, Nathan J.; Johnston, David A.; Leonard, Graham S.; Greening, Paul D.; Rossetto, Tiziana

    2014-01-01

    Evacuation of the population from a tsunami hazard zone is vital to reduce life-loss due to inundation. Geospatial least-cost distance modelling provides one approach to assessing tsunami evacuation potential. Previous models have generally used two static exposure scenarios and fixed travel speeds to represent population movement. Some analyses have assumed immediate departure or a common evacuation departure time for all exposed population. Here, a method is proposed to incorporate time-variable exposure, distributed travel speeds, and uncertain evacuation departure time into an existing anisotropic least-cost path distance framework. The method is demonstrated for hypothetical local-source tsunami evacuation in Napier City, Hawke's Bay, New Zealand. There is significant diurnal variation in pedestrian evacuation potential at the suburb level, although the total number of people unable to evacuate is stable across all scenarios. Whilst some fixed travel speeds approximate a distributed speed approach, others may overestimate evacuation potential. The impact of evacuation departure time is a significant contributor to total evacuation time. This method improves least-cost modelling of evacuation dynamics for evacuation planning, casualty modelling, and development of emergency response training scenarios. However, it requires detailed exposure data, which may preclude its use in many situations.

  9. 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

  10. 78 FR 31550 - Federal Acquisition Regulation; Submission for OMB Review; Travel Costs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-24

    ... DEPARTMENT OF DEFENSE GENERAL SERVICES ADMINISTRATION NATIONAL AERONAUTICS AND SPACE...; Submission for OMB Review; Travel Costs AGENCIES: Department of Defense (DOD), General Services Administration (GSA), and National Aeronautics and Space Administration (NASA). ACTION: Notice of request for...

  11. Cost effective solar hot water system for econo-travel motor hotel located at Hampton, VA

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

    Not Available

    1978-11-01

    This paper gives the final report of a cost effective solar hot water heating system installed on the Econo-Travel Motor Hotel at 2708 Mercury Boulevard, Hampton, Virginia. The description of the system along with the final cost breakdown, performance data and payback time are given. The payback time for the installed system will be approximately four (4) years instead of the 6.65 years estimated for the proposal. The additional savings is due to the reduction in the peak demand charge since the electric hot water heaters are not required to operate at the same time each morning as the dryersmore » used for the laundry. As called for in the proposal to DOE, the success of the system will be determined by the reduction in the utility cost and reduced use of our fossil fuels. The results shown in the hotel's monthly electricity bills indicate that this goal has been accomplished.« less

  12. How much does it cost to care for survivors of colorectal cancer? Caregiver's time, travel and out-of-pocket costs.

    PubMed

    Hanly, Paul; Céilleachair, Alan Ó; Skally, Mairead; O'Leary, Eamonn; Kapur, Kanika; Fitzpatrick, Patricia; Staines, Anthony; Sharp, Linda

    2013-09-01

    Cancer treatment is increasingly delivered in an outpatient setting. This may entail a considerable economic burden for family members and friends who support patients/survivors. We estimated financial and time costs associated with informal care for colorectal cancer. Two hundred twenty-eight carers of colorectal cancer survivors diagnosed on October 2007-September 2009 were sent a questionnaire. Informal care costs included hospital- and domestic-based foregone caregiver time, travel expenses and out-of-pocket (OOP) costs during two phases: diagnosis and treatment and ongoing care (previous 30 days). Multiple regression was used to determine cost predictors. One hundred fifty-four completed questionnaires were received (response rate = 68%). In the diagnosis and treatment phase, weekly informal care costs per person were: hospital-based costs, incurred by 99% of carers, mean = €393 (interquartile range (IQR), €131-€541); domestic-based time costs, incurred by 85%, mean = €609 (IQR, €170-€976); and domestic-based OOP costs, incurred by 68%, mean = €69 (IQR, €0-€110). Ongoing costs included domestic-based time costs incurred by 66% (mean = €66; IQR, €0-€594) and domestic-based OOP costs incurred by 52% (mean = €52; IQR, €0-€64). The approximate average first year informal care cost was €29,842, of which 85 % was time costs, 13% OOP costs and 2% travel costs. Significant cost predictors included carer age, disease stage, and survivor age. Informal caregiving associated with colorectal cancer entails considerable time and OOP costs. This burden is largely unrecognised by policymakers, service providers and society in general. These types of studies may facilitate health decision-makers in better assessing the consequences of changes in cancer care organisation and delivery.

  13. Cost effective solar hot water system for Econo-Travel Motor Hotel located at Richmond, Virginia. Final report

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

    Not Available

    1979-09-01

    The final report is presented of a cost effective solar hot water heating system installed on the Econo-Travel Motor Hotel at 5408 Williamsburg Road, Richmond, Virginia. The description of the system is given along with the final cost breakdown, expected performance data and expected payback time for the installed system is estimated to be approximately five (5) years instead of the 6.65 years estimated for the proposal. The additional savings is due to the reduction in the peak demand charge since the electric hot water heaters are not required to operate at the same time each morning as the dryersmore » used for the laundry. The success of the system will be determined by the reduction in the utility cost and reduced use of our fossil fuels. The results shown in the hotel's monthly electricity bills indicate that this goal has been accomplished.« less

  14. Surveillance of Travellers: An Additional Tool for Tracking Antimalarial Drug Resistance in Endemic Countries

    PubMed Central

    Gharbi, Myriam; Flegg, Jennifer A.; Pradines, Bruno; Berenger, Ako; Ndiaye, Magatte; Djimdé, Abdoulaye A.; Roper, Cally; Hubert, Véronique; Kendjo, Eric; Venkatesan, Meera; Brasseur, Philippe; Gaye, Oumar; Offianan, André T.; Penali, Louis; Le Bras, Jacques; Guérin, Philippe J.; Study, Members of the French National Reference Center for Imported Malaria

    2013-01-01

    Introduction There are growing concerns about the emergence of resistance to artemisinin-based combination therapies (ACTs). Since the widespread adoption of ACTs, there has been a decrease in the systematic surveillance of antimalarial drug resistance in many malaria-endemic countries. The aim of this work was to test whether data on travellers returning from Africa with malaria could serve as an additional surveillance system of local information sources for the emergence of drug resistance in endemic-countries. Methodology Data were collected from travellers with symptomatic Plasmodium falciparum malaria returning from Senegal (n = 1,993), Mali (n = 2,372), Cote d’Ivoire (n = 4,778) or Cameroon (n = 3,272) and recorded in the French Malaria Reference Centre during the period 1996–2011. Temporal trends of the proportion of parasite isolates that carried the mutant genotype, pfcrt 76T, a marker of resistance to chloroquine (CQ) and pfdhfr 108N, a marker of resistance to pyrimethamine, were compared for travellers and within-country surveys that were identified through a literature review in PubMed. The in vitro response to CQ was also compared between these two groups for parasites from Senegal. Results The trends in the proportion of parasites that carried pfcrt 76T, and pfdhfr 108N, were compared for parasites from travellers and patients within-country using the slopes of the curves over time; no significant differences in the trends were found for any of the 4 countries. These results were supported by in vitro analysis of parasites from the field in Senegal and travellers returning to France, where the trends were also not significantly different. Conclusion The results have not shown different trends in resistance between parasites derived from travellers or from parasites within-country. This work highlights the value of an international database of drug responses in travellers as an additional tool to assess the emergence of drug

  15. Surveillance of travellers: an additional tool for tracking antimalarial drug resistance in endemic countries.

    PubMed

    Gharbi, Myriam; Flegg, Jennifer A; Pradines, Bruno; Berenger, Ako; Ndiaye, Magatte; Djimdé, Abdoulaye A; Roper, Cally; Hubert, Véronique; Kendjo, Eric; Venkatesan, Meera; Brasseur, Philippe; Gaye, Oumar; Offianan, André T; Penali, Louis; Le Bras, Jacques; Guérin, Philippe J

    2013-01-01

    There are growing concerns about the emergence of resistance to artemisinin-based combination therapies (ACTs). Since the widespread adoption of ACTs, there has been a decrease in the systematic surveillance of antimalarial drug resistance in many malaria-endemic countries. The aim of this work was to test whether data on travellers returning from Africa with malaria could serve as an additional surveillance system of local information sources for the emergence of drug resistance in endemic-countries. Data were collected from travellers with symptomatic Plasmodium falciparum malaria returning from Senegal (n = 1,993), Mali (n = 2,372), Cote d'Ivoire (n = 4,778) or Cameroon (n = 3,272) and recorded in the French Malaria Reference Centre during the period 1996-2011. Temporal trends of the proportion of parasite isolates that carried the mutant genotype, pfcrt 76T, a marker of resistance to chloroquine (CQ) and pfdhfr 108N, a marker of resistance to pyrimethamine, were compared for travellers and within-country surveys that were identified through a literature review in PubMed. The in vitro response to CQ was also compared between these two groups for parasites from Senegal. The trends in the proportion of parasites that carried pfcrt 76T, and pfdhfr 108N, were compared for parasites from travellers and patients within-country using the slopes of the curves over time; no significant differences in the trends were found for any of the 4 countries. These results were supported by in vitro analysis of parasites from the field in Senegal and travellers returning to France, where the trends were also not significantly different. The results have not shown different trends in resistance between parasites derived from travellers or from parasites within-country. This work highlights the value of an international database of drug responses in travellers as an additional tool to assess the emergence of drug resistance in endemic areas where information is limited.

  16. 511, America's traveler information number. Deployment assistance report #1, Business models and cost considerations

    DOT National Transportation Integrated Search

    2002-01-01

    Business models and cost recovery are the critical factors for determining the sustainability of the traveler information service, and 511. In March 2001 the Policy Committee directed the 511 Working Group to investigate plausible business models and...

  17. 48 CFR 352.216-70 - Additional cost principles.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Additional cost principles... Additional cost principles. As prescribed in 316.307(j), the Contracting Officer shall insert the following clause: Additional Cost Principles (January 2006) (a) Bid and proposal (B & P) costs. (1) B & P costs are...

  18. Cost effective solar hot water system for Econo-Travel Motor Hotel, Chesapeake, Virginia. Final report

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

    Not Available

    1978-12-01

    The final report of a cost effective solar hot water heating system installed on the Econo-Travel Motor Hotel at 4725 W. Military Highway, Chesapeake, Virginia, is presented. The description of the system along with the final breakdown performance data and payback time are given. The payback time for the installed system will be approximately four (4) years instead of the 6.65 years estimated for the proposal. The additional savings is due to the reduction in the peak demand charge since the electric hot water heaters are not required to operate at the same time each morning as the dryers usedmore » for the laundry. As called for in the proposal to DOE, the success of the system will be determined by the reduction in the utility cost and reduced use of our fossil fuels. The results shown in the hotel's monthly electricity bills indicate that this goal has been accomplished.« less

  19. Clinical pharmacy travel medicine services: a new frontier.

    PubMed

    Jackson, Adam B; Humphries, Tammy L; Nelson, Kent M; Helling, Dennis K

    2004-12-01

    Travel to remote destinations has increased dramatically in recent years. The Clinical Pharmacy International Travel Clinic (CPITC) was established in 1991 in the Kaiser Permanente Colorado Region to provide pre-travel advice to members to decrease their risk of travel-related diseases. The CPITC is unique from other travel medicine clinics because it is a pharmacist-run telepharmacy service. The team includes an infectious diseases physician, an infectious diseases clinical pharmacy specialist, 4 clinical pharmacists, and a pharmacy technician. The clinical pharmacists provide consultations via telephone. Both patient- and trip-related information are gathered to assess the traveler's health risks. Recommendations are provided regarding food- and water-borne diseases, insect-borne diseases, sexually transmitted diseases, and diseases related to animal bites. Additionally, detailed information is provided on vaccines that may be needed to protect travelers against various diseases. The travel consult is documented electronically. A copy of the consult, along with a booklet that provides travel information, is mailed to the patient. Success of the CPITC is demonstrated in several ways. The clinic initially served Kaiser Permanente members in the Colorado Region. The service has expanded and now also provides travel consults to Kaiser Permanente members in the Northwest and Ohio Regions. Patient satisfaction is high, and significant cost-savings have been realized secondary to avoiding the use of unnecessary vaccinations and medications. The CPITC allows resources to be leveraged and provides one center where individuals trained in travel medicine provide information to members, thus improving efficiency and decreasing cost.

  20. A travel cost analysis of nonconsumptive wildlife-associated recreation in the United States

    Treesearch

    William T. Zawacki; Allan Marsinko; J. Michael Bowker

    2000-01-01

    Increased emphasis on sustainable resource management in forestry has effectuated a demand for various nontimber values. Nonconsumptive wildlife recreation is an important nontimber service produced on forest and rangeland. Travel cost models and data from the 1991 National Survey of Fishing, Hunting and Wildlife-Associated Recreation are used to estimate the demand...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. German travelers' preferences for travel vaccines assessed by a discrete choice experiment.

    PubMed

    Poulos, Christine; Curran, Desmond; Anastassopoulou, Anastassia; De Moerlooze, Laurence

    2018-02-08

    Many travelers to regions with endemic infectious diseases do not follow health authorities' recommendations regarding vaccination against vaccine-preventable infectious diseases, before traveling. The determinants of individual travelers' decisions to vaccinate before traveling are largely unknown. This study aimed to provide this information using a discrete choice experiment (DCE) administered to four types of German travelers: (1) business travelers; (2) travelers visiting friends and relatives (VFR); (3) leisure travelers; and (4) backpackers. A DCE survey was developed, pretested and administered online. It included a series of choice questions in which respondents chose between two hypothetical vaccines, each characterized by four disease attributes with varying levels describing the of risk, health impact, curability and transmissibility of the disease they would prevent (described with four disease attributes with varying levels of risk, health impact, curability and transmissibility), and varying levels of four vaccine attributes (duration of protection, number of doses required, time required for vaccination, and vaccine cost). A random-parameters logit model was used to estimate the importance weights each traveler type placed on the various attribute levels. These weights were used to calculate mean monetary equivalents (MMEs) of changes in each attribute (holding all others constant) and of hypothetical disease-vaccine combinations. All traveler types' choices indicated that they attached the greatest importance to the risk and health impact of disease and to the vaccine cost whereas the other disease and vaccine attributes were less important for their decisions about travel vaccines. An option of not choosing any of the vaccine-pairs presented was rarely selected indicating that travelers' generally prefer to be vaccinated rather than not. The MMEs of changes in vaccine attributes indicated a very high variability between the individual travelers

  7. Do British travel agents provide adequate health advice for travellers?

    PubMed Central

    Lawlor, D A; Burke, J; Bouskill, E; Conn, G; Edwards, P; Gillespie, D

    2000-01-01

    Travel-related illness is a burden for primary care, with more than two million travellers consulting a general practitioner each year. The annual cost of travel-related illness in the United Kingdom is 11 million Pounds. Travel agents are in a unique position to influence this burden as the most common and most serious problems are preventable with simple advice and/or immunisation. This study, using covert researchers, suggests this potential is not being fully utilised. PMID:10954940

  8. Cost effective solar hot water system for Econo-Travel Motor Hotel located at Woodbrdge, VA. Final report

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

    Not Available

    1978-11-01

    The final report of a cost effective solar hot water heating system installed on the Econo-Travel Motor Hotel at 13317 Gordon Boulevard, Woodbridge, Virginia is given. The description of the system along with the final breakdown, performance data and payback time are given. The payback time for the installed system will be approximately four (4) years instead of the 7.2 years estimated for the proposal. The additional savings is due to the reduction in the peak demand charge since the electric hot water heaters are not required to operate at the same time each morning as the dryers used formore » the laundry. As called for in the proposal to DOE, the success of the system will be determined by the reduction in the utility cost and reduced use of our fossil fuels. The results shown in the hotel's monthly electricity bills indicate that this goal has been accomplished.« less

  9. A travel clinic in your office: grow your practice and protect international travelers.

    PubMed

    Kirsch, Michael

    2009-01-01

    Medical practices today face economic challenges from declining reimbursements and rising overhead costs. Physicians need to develop new income sources to invigorate their practices and remain viable. Travel medicine-advising and immunizing international travelers-is a rapidly growing specialty in the United States that generates substantial cash reimbursements and professional satisfaction. Travel Clinics of America, a physician-operated company, specializes in helping physicians to incorporate travel medicine into their existing practices.

  10. Cost effective solar hot water system for Econo-Travel Motor Hotel located at Bluefield, West Virginia. Final report

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

    Not Available

    1979-07-01

    The final report of a cost effective solar hot water heating system installed on the Econo-Travel Motor Hotel at 3400 Cumberland Road, Bluefield, West Virginia. The description of the system along with the final breakdown performance data and payback time are given. The payback time for the installed system will be approximately five (5) years instead of the 7.73 years estimated for the proposal. The additional savings is due to the reduction in the peak demand charge since the electric hot water heaters are not required to operate at the same time each morning as the dryers used for themore » laundry. The success of the system will be determined by the reduction in the utility cost and reduced use of our fossil fuels. The results shown in the hotel's monthly electricity bills indicate that this goal has been accomplished.« less

  11. The impact of the use of intraoperative radiotherapy on costs, travel time and distance for women with breast cancer in the Mexico City Metropolitan Area.

    PubMed

    Bargallo-Rocha, Juan Enrique; Soto-Perez-de-Celis, Enrique; Picó-Guzmán, Francisco Javier; Quintero-Rodríguez, Carlos Eduardo; Almog, David; Santiago-Concha, Gabriel; Flores-Balcazar, Christian Haydee; Corona, Jaime; Vazquez-Romo, Rafael; Villarreal-Garza, Cynthia; Mohar, Alejandro

    2017-11-01

    The low availability and poor access to external beam radiotherapy (EBRT) in developing countries makes it hard for women with breast cancer to receive breast conservation. We studied the effect of providing intraoperative radiotherapy (IORT) on the travel time, distance, and costs of in the Mexico City Metropolitan Area (MCMA). Sixty-nine patients treated between January 2013 and September 2014 were analyzed. Travel distance and transit time was calculated using Google Maps. The time and distance patients living in the MCMA treated with IORT would have spent if they had received EBRT was calculated. Cost analysis for each modality was performed. 71% (n = 49) lived in the MCMA. Sixteen (33%) received additional EBRT and 33 (66%) received IORT only. Mean driving distance and transit time of those 33 women was 132.6 km (SD 25.7) and 66 min (SD 32.9). Patients from the MCMA receiving IORT alone avoided 990 visits, 43 700 km and 65 400 min in transit. IORT led to a 12% reduction in costs per patient. By reducing costs and time needed for patients to receive radiotherapy, IORT could potentially enhance access to breast conservation in resource-limited developing countries. © 2017 Wiley Periodicals, Inc.

  12. 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

  13. 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...

  14. Repatriation of human remains following death in international travellers.

    PubMed

    Connolly, Ruairi; Prendiville, Richard; Cusack, Denis; Flaherty, Gerard

    2017-03-01

    Death during international travel and the repatriation of human remains to one's home country is a distressing and expensive process. Much organization is required involving close liaison between various agencies. A review of the literature was conducted using the PubMed database. Search terms included: 'repatriation of remains', 'death', 'abroad', 'tourism', 'travel', 'travellers', 'travelling' and 'repatriation'. Additional articles were obtained from grey literature sources and reference lists. The local national embassy, travel insurance broker and tour operator are important sources of information to facilitate the repatriation of the deceased traveller. Formal identification of the deceased's remains is required and a funeral director must be appointed. Following this, the coroner in the country or jurisdiction receiving the repatriated remains will require a number of documents prior to providing clearance for burial. Costs involved in repatriating remains must be borne by the family of the deceased although travel insurance may help defray some of the costs. If the death is secondary to an infectious disease, cremation at the site of death is preferred. No standardized procedure is in place to deal with the remains of a migrant's body at present and these remains are often not repatriated to their country of origin. Repatriation of human remains is a difficult task which is emotionally challenging for the bereaving family and friends. As a travel medicine practitioner, it is prudent to discuss all eventualities, including the risk of death, during the pre-travel consultation. Awareness of the procedures involved in this process may ease the burden on the grieving family at a difficult time. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

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

    PubMed

    Turner, Leigh

    2012-06-15

    -border health services available in the United States and intranational travel to clinics in Canada. In contrast to medical tourism companies, they do not market holiday tours in addition to medical care. Two companies occupy a narrow market niche and promote testing for CCSVI and "Liberation therapy" for multiple sclerosis. Three additional companies offer bariatric surgery and cosmetic surgery at facilities in Mexico. Four businesses offer health insurance products intended to cover the cost of obtaining privately financed health care in the U.S. These businesses also help their clients arrange treatment beyond Canada's borders. Finally, one medical travel company based in Canada markets health services primarily to U.S. citizens. This article uses content analysis of websites of Canadian companies marketing medical travel to provide insight into Canada's medical travel industry. The article reveals a complex marketplace with different types of companies taking distinct approaches to marketing medical travel.

  16. 41 CFR 102-76.75 - What costs are included in the costs of alterations to provide an accessible path of travel to an...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... primary function for facilities subject to the standards in § 102-76.65(a)? 102-76.75 Section 102-76.75... altered area containing a primary function for facilities subject to the standards in § 102-76.65(a)? For... of travel to an altered area containing a primary function include the costs associated with— (a...

  17. 41 CFR 102-76.75 - What costs are included in the costs of alterations to provide an accessible path of travel to an...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... primary function for facilities subject to the standards in § 102-76.65(a)? 102-76.75 Section 102-76.75... altered area containing a primary function for facilities subject to the standards in § 102-76.65(a)? For... of travel to an altered area containing a primary function include the costs associated with— (a...

  18. 41 CFR 102-76.75 - What costs are included in the costs of alterations to provide an accessible path of travel to an...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... primary function for facilities subject to the standards in § 102-76.65(a)? 102-76.75 Section 102-76.75... altered area containing a primary function for facilities subject to the standards in § 102-76.65(a)? For... of travel to an altered area containing a primary function include the costs associated with— (a...

  19. 41 CFR 102-76.75 - What costs are included in the costs of alterations to provide an accessible path of travel to an...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... primary function for facilities subject to the standards in § 102-76.65(a)? 102-76.75 Section 102-76.75... altered area containing a primary function for facilities subject to the standards in § 102-76.65(a)? For... of travel to an altered area containing a primary function include the costs associated with— (a...

  20. 41 CFR 102-76.75 - What costs are included in the costs of alterations to provide an accessible path of travel to an...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... primary function for facilities subject to the standards in § 102-76.65(a)? 102-76.75 Section 102-76.75... altered area containing a primary function for facilities subject to the standards in § 102-76.65(a)? For... of travel to an altered area containing a primary function include the costs associated with— (a...

  1. 10 CFR 719.43 - What is the treatment of travel costs?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...-46, as appropriate, to be reimbursable. (b) Travel time may be allowed at a full hourly rate for the... remaining travel time shall be reimbursed at 50 percent of the full hourly rate, except that in no event will travel time spent working for other clients be allowable. Also, for long distance travel that...

  2. A Novel Collaboration to Reduce the Travel-Related Cost of Residency Interviewing.

    PubMed

    Shappell, Eric; Fant, Abra; Schnapp, Benjamin; Craig, Jill P; Ahn, James; Babcock, Christine; Gisondi, Michael A

    2017-04-01

    Interviewing for residency is a complicated and often expensive endeavor. Literature has estimated interview costs of $4,000 to $15,000 per applicant, mostly attributable to travel and lodging. The authors sought to reduce these costs and improve the applicant interview experience by coordinating interview dates between two residency programs in Chicago, Illinois. Two emergency medicine residency programs scheduled contiguous interview dates for the 2015-2016 interview season. We used a survey to assess applicant experiences interviewing in Chicago and attitudes regarding coordinated scheduling. Data on utilization of coordinated dates were obtained from interview scheduling software. The target group for this intervention consisted of applicants from medical schools outside Illinois who completed interviews at both programs. Of the 158 applicants invited to both programs, 84 (53%) responded to the survey. Scheduling data were available for all applicants. The total estimated cost savings for target applicants coordinating interview dates was $13,950. The majority of target applicants reported that this intervention increased the ease of scheduling (84%), made them less likely to cancel the interview (82%), and saved them money (71%). Coordinated scheduling of interview dates was associated with significant estimated cost savings and was reviewed favorably by applicants across all measures of experience. Expanding use of this practice geographically and across specialties may further reduce the cost of interviewing for applicants.

  3. The travel cost method and the economic value of leisure time

    USGS Publications Warehouse

    Douglas, Aaron J.; Johnson, Richard L.

    2004-01-01

    Recent estimates of high values for tourist related recreation USA amenity values indicate that allocation of basic water and terrestrial resources to recreation activities should be given precedence over conventional market oriented activities that often degrade or even extirpate the resource. We discuss at length the travel cost method (TCM), a survey based technique that quantifies the non-market benefits of trips to recreation sites. The TCM has been cast in the role of an ‘umpire’ in recent resource allocation debates. Understanding the key role of the TCM in the debate will aid tourist agency officials throughout the world. This article is a U.S. Government work and is in the public domain in the U.S.A.

  4. 75 FR 63184 - Temporary Duty (TDY) Travel Allowances

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-14

    ... agency travel programs, save money on travel costs, better protect the environment, and conserve natural... these strategies into their travel management policies, procedures, and activities related to official...

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

    PubMed Central

    2012-01-01

    businesses market regional, cross-border health services available in the United States and intranational travel to clinics in Canada. In contrast to medical tourism companies, they do not market holiday tours in addition to medical care. Two companies occupy a narrow market niche and promote testing for CCSVI and “Liberation therapy” for multiple sclerosis. Three additional companies offer bariatric surgery and cosmetic surgery at facilities in Mexico. Four businesses offer health insurance products intended to cover the cost of obtaining privately financed health care in the U.S. These businesses also help their clients arrange treatment beyond Canada’s borders. Finally, one medical travel company based in Canada markets health services primarily to U.S. citizens. Conclusions This article uses content analysis of websites of Canadian companies marketing medical travel to provide insight into Canada’s medical travel industry. The article reveals a complex marketplace with different types of companies taking distinct approaches to marketing medical travel. PMID:22703873

  6. Future Trends in Business Travel Decision Making

    NASA Technical Reports Server (NTRS)

    Mason, Keith J.

    2002-01-01

    This research surveys twenty large companies and their travellers to identify and evaluate the effects of pressures on the business travel market in the future. The influence of the following areas on the decision making process are addressed: (1) Corporate travel policies and increasing professionalism in corporate purchasing; (2) The development of global strategic airline alliances; (3) The emergence of low cost airlines on short haul markets; and (4) The development of internet based booking tools and travel agency IT. The survey shows differences in views between travel managers, and travellers with regard to corporate travel policies. While travel managers see policy rules, travellers interpret these as guidelines, indicating travel managers will need to take further actions to exercise true control of travel budgets. The data shows that companies are more likely to prescribe a class of airline ticket, than the choice of airline itself. Corporate hierarchical bias in travel policies is still common both for short and particularly long haul flying. Other findings show that while travel managers believe that their companies are likely to sign global deals with strategic airline groups within a five year period in a bid to consolidating spending, they also believe that nearly a third of short haul flying will be taken with low cost carriers, indicating further penetration in this business travel market by these carriers. The paper also provides other predictions about the business travel market, based on the survey findings.

  7. 48 CFR 2452.251-70 - Contractor employee travel.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Contractor employee travel... 2452.251-70 Contractor employee travel. As prescribed in 2451.7001, insert the following clause in all cost-reimbursement solicitations and contracts involving travel: Contractor Employee Travel (OCT 1999...

  8. Economics of Malaria Prevention in US Travelers to West Africa

    PubMed Central

    Adachi, Kenji; Coleman, Margaret S.; Khan, Nomana; Jentes, Emily S.; Arguin, Paul; Rao, Sowmya R.; LaRocque, Regina C.; Sotir, Mark J.; Brunette, Gary; Ryan, Edward T.; Meltzer, Martin I.

    2014-01-01

    Background. Pretravel health consultations help international travelers manage travel-related illness risks through education, vaccination, and medication. This study evaluated costs and benefits of that portion of the health consultation associated with malaria prevention provided to US travelers bound for West Africa. Methods. The estimated change in disease risk and associated costs and benefits resulting from traveler adherence to malaria chemoprophylaxis were calculated from 2 perspectives: the healthcare payer's and the traveler's. We used data from the Global TravEpiNet network of US travel clinics that collect de-identified pretravel data for international travelers. Disease risk and chemoprophylaxis effectiveness were estimated from published medical reports. Direct medical costs were obtained from the Nationwide Inpatient Sample and published literature. Results. We analyzed 1029 records from January 2009 to January 2011. Assuming full adherence to chemoprophylaxis regimens, consultations saved healthcare payers a per-traveler average of $14 (9-day trip) to $372 (30-day trip). For travelers, consultations resulted in a range of net cost of $20 (9-day trip) to a net savings of $32 (30-day trip). Differences were mostly driven by risk of malaria in the destination country. Conclusions. Our model suggests that healthcare payers save money for short- and longer-term trips, and that travelers save money for longer trips when travelers adhere to malaria recommendations and prophylactic regimens in West Africa. This is a potential incentive to healthcare payers to offer consistent pretravel preventive care to travelers. This financial benefit complements the medical benefit of reducing the risk of malaria. PMID:24014735

  9. Costs, Benefits, and Adoption of Additive Manufacturing: A Supply Chain Perspective.

    PubMed

    Thomas, Douglas

    2016-07-01

    There are three primary aspects to the economics of additive manufacturing: measuring the value of goods produced, measuring the costs and benefits of using the technology, and estimating the adoption and diffusion of the technology. This paper provides an updated estimate of the value of goods produced. It then reviews the literature on additive manufacturing costs and identifies those instances in the literature where this technology is cost effective. The paper then goes on to propose an approach for examining and understanding the societal costs and benefits of this technology both from a monetary viewpoint and a resource consumption viewpoint. The final section discusses the trends in the adoption of additive manufacturing. Globally, there is an estimated $667 million in value added produced using additive manufacturing, which equates to 0.01 % of total global manufacturing value added. US value added is estimated as $241 million. Current research on additive manufacturing costs reveals that it is cost effective for manufacturing small batches with continued centralized production; however, with increased automation distributed production may become cost effective. Due to the complexities of measuring additive manufacturing costs and data limitations, current studies are limited in their scope. Many of the current studies examine the production of single parts and those that examine assemblies tend not to examine supply chain effects such as inventory and transportation costs along with decreased risk to supply disruption. The additive manufacturing system and the material costs constitute a significant portion of an additive manufactured product; however, these costs are declining over time. The current trends in costs and benefits have resulted in this technology representing 0.02 % of the relevant manufacturing industries in the US; however, as the costs of additive manufacturing systems decrease, this technology may become widely adopted and change the

  10. Travellers' diarrhoea.

    PubMed

    Ericsson, Charles D

    2003-02-01

    Risk of travellers' diarrhoea is about 7% in developed countries and 20-50% in the developing world. Options for prevention include education and chemoprophylaxis. Vaccination is a promising but incomplete option. Achieving behaviour modification of food and water choices among tourists is difficult. Bismuth subsalicylate (BSS)-containing compounds are about 62% effective in the prevention of travellers' diarrhoea. Antibiotics are about 84% effective in preventing travellers' diarrhoea. Routine prophylaxis of travellers' diarrhoea, especially with antibiotics, should be discouraged. Oral rehydration is generally important in the treatment of diarrhoea, but travellers' diarrhoea is only infrequently dehydrating in adults. The addition of oral rehydration solutions confers no additional benefit to loperamide in the treatment of travellers' diarrhoea in adults. Presently, the most active of the antibiotics routinely available for treatment are members of the fluoroquinolone group. Antibiotics that are not absorbed such as aztreonam and a rifampicin-like agent, rifaximin, are both effective. The latter might become a therapy of choice once it is routinely available, due to predictably less adverse reactions with a non-absorbed antibiotic. Preliminary results with azithromycin look very promising. Less severe disease can be treated with a variety of non-antibiotic agents (e.g. BSS-containing compounds, loperamide and a calmodulin inhibitor, zaldaride). The combination of an antibiotic and loperamide is superior to treatment with either agent alone in a several studies and is arguably the treatment of choice for distressing travellers' diarrhoea.

  11. Degradable transportation network with the addition of electric vehicles: Network equilibrium analysis.

    PubMed

    Zhang, Rui; Yao, Enjian; Yang, Yang

    2017-01-01

    Introducing electric vehicles (EVs) into urban transportation network brings higher requirement on travel time reliability and charging reliability. Specifically, it is believed that travel time reliability is a key factor influencing travelers' route choice. Meanwhile, due to the limited cruising range, EV drivers need to better learn about the required energy for the whole trip to make decisions about whether charging or not and where to charge (i.e., charging reliability). Since EV energy consumption is highly related to travel speed, network uncertainty affects travel time and charging demand estimation significantly. Considering the network uncertainty resulted from link degradation, which influences the distribution of travel demand on transportation network and the energy demand on power network, this paper aims to develop a reliability-based network equilibrium framework for accommodating degradable road conditions with the addition of EVs. First, based on the link travel time distribution, the mean and variance of route travel time and monetary expenses related to energy consumption are deduced, respectively. And the charging time distribution of EVs with charging demand is also estimated. Then, a nested structure is considered to deal with the difference of route choice behavior derived by the different uncertainty degrees between the routes with and without degradable links. Given the expected generalized travel cost and a psychological safety margin, a traffic assignment model with the addition of EVs is formulated. Subsequently, a heuristic solution algorithm is developed to solve the proposed model. Finally, the effects of travelers' risk attitude, network degradation degree, and EV penetration rate on network performance are illustrated through an example network. The numerical results show that the difference of travelers' risk attitudes does have impact on the route choice, and the widespread adoption of EVs can cut down the total system travel

  12. 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.

  13. 48 CFR 752.7002 - Travel and transportation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Travel and transportation... Travel and transportation. For use in cost reimbursement contracts performed in whole or in part overseas. Travel and Transportation (JAN 1990) (a) General. The Contractor will be reimbursed for reasonable...

  14. Quantifying recreation use values from removing dams and restoring free-flowing rivers: A contingent behavior travel cost demand model for the Lower Snake River

    NASA Astrophysics Data System (ADS)

    Loomis, John

    2002-06-01

    A travel cost demand model that uses intended trips if dams are removed and the river restored is presented as a tool for evaluating the potential recreation benefits in this counterfactual but increasingly policy relevant analysis of dam removal. The model is applied to the Lower Snake River in Washington using data from mail surveys of households in the Pacific Northwest region. Five years after dam removal, about 1.5 million visitor days are estimated, with this number growing to 2.5 million annually during years 20-100. Using the travel cost method model estimate of the value of river recreation, if the four dams are removed and the 225 km river is restored, the annualized benefits at a 6.875% discount rate would be $310 million. This gain in river recreation exceeds the loss of reservoir recreation but is about $60 million less than the total costs of the dam removal alternative. The analysis suggests this extension of the standard travel cost method may be suitable for evaluating the gain in river recreation associated with restoration of river systems from dam removal or associated with dam relicensing conditions.

  15. PRT Impact Study - Operational Phase : Volume 1. Travel Analysis.

    DOT National Transportation Integrated Search

    1979-03-01

    Part of a three-volume work, this report describes the analysis performed on travel data collected for the Pre-PRT Impact Study. The data analyzed consist of travel behavior, travel patterns, model utilization and travel costs of various modes of tra...

  16. Measuring the Social Recreation Per-Day Net Benefit of the Wildlife Amenities of a National Park: A Count-Data Travel-Cost Approach

    NASA Astrophysics Data System (ADS)

    Mendes, Isabel; Proença, Isabel

    2011-11-01

    In this article, we apply count-data travel-cost methods to a truncated sample of visitors to estimate the Peneda-Gerês National Park (PGNP) average consumer surplus (CS) for each day of visit. The measurement of recreation demand is highly specific because it is calculated by number of days of stay per visit. We therefore propose the application of altered truncated count-data models or truncated count-data models on grouped data to estimate a single, on-site individual recreation demand function, with the price (cost) of each recreation day per trip equal to out-of-pocket and time travel plus out-of-pocket and on-site time costs. We further check the sensitivity of coefficient estimations to alternative models and analyse the welfare measure precision by using the delta and simulation methods by Creel and Loomis. With simulated limits, CS is estimated to be €194 (range €116 to €448). This information is of use in the quest to improve government policy and PNPG management and conservation as well as promote nature-based tourism. To our knowledge, this is the first attempt to measure the average recreation net benefits of each day of stay generated by a national park by using truncated altered and truncated grouped count-data travel-cost models based on observing the individual number of days of stay.

  17. Measuring the social recreation per-day net benefit of the wildlife amenities of a national park: a count-data travel-cost approach.

    PubMed

    Mendes, Isabel; Proença, Isabel

    2011-11-01

    In this article, we apply count-data travel-cost methods to a truncated sample of visitors to estimate the Peneda-Gerês National Park (PGNP) average consumer surplus (CS) for each day of visit. The measurement of recreation demand is highly specific because it is calculated by number of days of stay per visit. We therefore propose the application of altered truncated count-data models or truncated count-data models on grouped data to estimate a single, on-site individual recreation demand function, with the price (cost) of each recreation day per trip equal to out-of-pocket and time travel plus out-of-pocket and on-site time costs. We further check the sensitivity of coefficient estimations to alternative models and analyse the welfare measure precision by using the delta and simulation methods by Creel and Loomis. With simulated limits, CS is estimated to be 194 (range 116 to 448). This information is of use in the quest to improve government policy and PNPG management and conservation as well as promote nature-based tourism. To our knowledge, this is the first attempt to measure the average recreation net benefits of each day of stay generated by a national park by using truncated altered and truncated grouped count-data travel-cost models based on observing the individual number of days of stay.

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. Travel immunization update for older adults.

    PubMed

    Spain, Margaret P; Edlund, Barbara J

    2010-04-01

    Older Americans are among the most widely traveled group in our society. Recent trends point to more international travel, more travel to Third World countries, and more travel by older adults with significant health problems. Regardless of the reason for travel, older adults need to plan for healthy travel. Primary care providers need to inquire at routine visits if patients have plans for international travel. If travel to other countries or regions is being considered, patients must be advised of the importance of early travel preparation. To begin with, older adults should be up to date on all routine immunizations. Those planning on international travel may need additional required and/or recommended immunizations, depending on the individual's health status, travel itinerary, length of stay, and health risks associated with destination sites. Primary care providers should be knowledgeable about travel medicine resources in the community to make referrals for travelers requiring additional immunizations and health information. Copyright 2010, SLACK Incorporated.

  4. Interstellar Travel. (Latest citations from the Aerospace Database)

    NASA Technical Reports Server (NTRS)

    1996-01-01

    The bibliography contains citations concerning travel between the stars. Topics include cost considerations, hyperspace navigation, exploration, and propulsion systems for vehicles to be used in interstellar travel. Human factor issues and social aspects of interstellar travel are also discussed.

  5. Costs, Benefits, and Adoption of Additive Manufacturing: A Supply Chain Perspective

    PubMed Central

    Thomas, Douglas

    2017-01-01

    There are three primary aspects to the economics of additive manufacturing: measuring the value of goods produced, measuring the costs and benefits of using the technology, and estimating the adoption and diffusion of the technology. This paper provides an updated estimate of the value of goods produced. It then reviews the literature on additive manufacturing costs and identifies those instances in the literature where this technology is cost effective. The paper then goes on to propose an approach for examining and understanding the societal costs and benefits of this technology both from a monetary viewpoint and a resource consumption viewpoint. The final section discusses the trends in the adoption of additive manufacturing. Globally, there is an estimated $667 million in value added produced using additive manufacturing, which equates to 0.01 % of total global manufacturing value added. US value added is estimated as $241 million. Current research on additive manufacturing costs reveals that it is cost effective for manufacturing small batches with continued centralized production; however, with increased automation distributed production may become cost effective. Due to the complexities of measuring additive manufacturing costs and data limitations, current studies are limited in their scope. Many of the current studies examine the production of single parts and those that examine assemblies tend not to examine supply chain effects such as inventory and transportation costs along with decreased risk to supply disruption. The additive manufacturing system and the material costs constitute a significant portion of an additive manufactured product; however, these costs are declining over time. The current trends in costs and benefits have resulted in this technology representing 0.02 % of the relevant manufacturing industries in the US; however, as the costs of additive manufacturing systems decrease, this technology may become widely adopted and change the

  6. A Low Cost Traveling Wave Tube for Wireless Communications

    NASA Technical Reports Server (NTRS)

    Vancil, Bernard Kenneth; Wintucky, Edwin G.; Williams, W. D. (Technical Monitor)

    2002-01-01

    Demand for high data rate wireless communications is pushing up amplifier power, bandwidth and frequency requirements. Some systems are using vacuum electron devices again because solid-state power amplifiers are not able to efficiently meet the new requirements. The traveling wave tube is the VED of choice because of its excellent broadband capability as well as high power efficiency and frequency. But TWTs are very expensive on a per watt basis below about 200 watts of output power. We propose a new traveling wave tube that utilizes cathode ray tube construction technology and electrostatic focusing. We believe the tube can be built in quantity for under $1,000 each. We discuss several traveling wave tube slow wave circuits that lend themselves to the new construction. We will present modeling results and data on prototype devices.

  7. 47 CFR 25.111 - Additional information and ITU cost recovery.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Additional information and ITU cost recovery....111 Additional information and ITU cost recovery. (a) The Commission may request from any party at any time additional information concerning any application, or any other submission or pleading regarding...

  8. Suburb-to-suburb intercity travel: Energy, time and dollar expenditures

    NASA Technical Reports Server (NTRS)

    Fels, M. F.

    1976-01-01

    The effect of adding suburb to terminal and terminal to suburb travel is examined. The energy consumed in entire trips was estimated. The total energy costs are compared with total travel times, and dollar costs to the traveler. Trips between origins in seven suburbs of Newark, New Jersey and destinations in two Washington, D. C. suburbs are analyzed.

  9. 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.

  10. An evaluation of the effect of level of service and cost on demand for intercity bus travel : final report.

    DOT National Transportation Integrated Search

    1980-01-01

    This report describes an evaluation of the effect on intercity bus ridership of changes in frequency of service and cost. The study was based on a comparison of travel between 19 selected cities in Virginia served by air, bus, or rail. These modes we...

  11. A study of the additional costs of dispensing workers' compensation prescriptions.

    PubMed

    Schafermeyer, Kenneth W

    2007-03-01

    Although there is a significant amount of additional work involved in dispensing workers' compensation prescriptions, these costs have not been quantified. A study of the additional costs to dispense a workers' compensation prescription is needed to measure actual costs and to help determine the reasonableness of reimbursement for prescriptions dispensed under workers' compensation programs. The purpose of this study was to determine the minimum additional time and costs required to dispense workers' compensation prescriptions in Texas. A convenience sample of 30 store-level pharmacy staff members involved in submitting and processing prescription claims for the Texas Mutual workers' compensation program were interviewed by telephone. Data collected to determine the additional costs of dispensing a workers' compensation prescription included (1) the amount of additional time and personnel costs required to dispense and process an average workers' compensation prescription claim, (2) the difference in time required for a new versus a refilled prescription, (3) overhead costs for processing workers' compensation prescription claims by experienced experts at a central processing facility, (4) carrying costs for workers' compensation accounts receivable, and (5) bad debts due to uncollectible workers' compensation claims. The median of the sample pharmacies' additional costs for dispensing a workers' compensation prescription was estimated to be at least $9.86 greater than for a cash prescription. This study shows that the estimated costs for workers' compensation prescriptions were significantly higher than for cash prescriptions. These costs are probably much more than most employers, workers' compensation payers, and pharmacy managers would expect. It is recommended that pharmacy managers should estimate their own costs and compare these costs to actual reimbursement when considering the reasonableness of workers' compensation prescriptions and whether to accept

  12. A Cost Benefit Analysis of an Active Travel Intervention with Health and Carbon Emission Reduction Benefits.

    PubMed

    Chapman, Ralph; Keall, Michael; Howden-Chapman, Philippa; Grams, Mark; Witten, Karen; Randal, Edward; Woodward, Alistair

    2018-05-11

    Active travel (walking and cycling) is beneficial for people’s health and has many co-benefits, such as reducing motor vehicle congestion and pollution in urban areas. There have been few robust evaluations of active travel, and very few studies have valued health and emissions outcomes. The ACTIVE before-and-after quasi-experimental study estimated the net benefits of health and other outcomes from New Zealand’s Model Communities Programme using an empirical analysis comparing two intervention cities with two control cities. The Programme funded investment in cycle paths, other walking and cycling facilities, cycle parking, ‘shared spaces’, media campaigns and events, such as ‘Share the Road’, and cycle-skills training. Using the modified Integrated Transport and Health Impacts Model, the Programme’s net economic benefits were estimated from the changes in use of active travel modes. Annual benefits for health in the intervention cities were estimated at 34.4 disability-adjusted life years (DALYs) and two lives saved due to reductions in cardiac disease, diabetes, cancer, and respiratory disease. Reductions in transport-related carbon emissions were also estimated and valued. Using a discount rate of 3.5%, the estimated benefit/cost ratio was 11:1 and was robust to sensitivity testing. It is concluded that when concerted investment is made in active travel in a city, there is likely to be a measurable, positive return on investment.

  13. A Cost Benefit Analysis of an Active Travel Intervention with Health and Carbon Emission Reduction Benefits

    PubMed Central

    Grams, Mark; Witten, Karen; Woodward, Alistair

    2018-01-01

    Active travel (walking and cycling) is beneficial for people’s health and has many co-benefits, such as reducing motor vehicle congestion and pollution in urban areas. There have been few robust evaluations of active travel, and very few studies have valued health and emissions outcomes. The ACTIVE before-and-after quasi-experimental study estimated the net benefits of health and other outcomes from New Zealand’s Model Communities Programme using an empirical analysis comparing two intervention cities with two control cities. The Programme funded investment in cycle paths, other walking and cycling facilities, cycle parking, ‘shared spaces’, media campaigns and events, such as ‘Share the Road’, and cycle-skills training. Using the modified Integrated Transport and Health Impacts Model, the Programme’s net economic benefits were estimated from the changes in use of active travel modes. Annual benefits for health in the intervention cities were estimated at 34.4 disability-adjusted life years (DALYs) and two lives saved due to reductions in cardiac disease, diabetes, cancer, and respiratory disease. Reductions in transport-related carbon emissions were also estimated and valued. Using a discount rate of 3.5%, the estimated benefit/cost ratio was 11:1 and was robust to sensitivity testing. It is concluded that when concerted investment is made in active travel in a city, there is likely to be a measurable, positive return on investment. PMID:29751618

  14. 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.

  15. PRT Impact Study Pre-PRT Phase : Volume 1. Travel Analysis.

    DOT National Transportation Integrated Search

    1976-03-01

    Part of a three-volume work, this report describes the analysis performed on travel data collected for the Pre-PRT Impact Study. The data analyzed consist of travel behavior, travel patterns, model utilization and travel costs of various modes of tra...

  16. 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

  17. ACM CCS 2013-2015 Student Travel Support

    DTIC Science & Technology

    2016-10-29

    ACM CCS 2013-2015 Student Travel Support Under the ARO funded effort titled “ACM CCS 2013-2015 Student Travel Support,” from 2013 to 2015, George...Mason University awarded 10 students travel awards every year. These grants enabled the students to offset the cost to attend the ACM Conference on...AGENCY NAME(S) AND ADDRESS (ES) U.S. Army Research Office P.O. Box 12211 Research Triangle Park, NC 27709-2211 travel grant, acm ccs REPORT

  18. 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.

  19. Degradable transportation network with the addition of electric vehicles: Network equilibrium analysis

    PubMed Central

    Zhang, Rui; Yao, Enjian; Yang, Yang

    2017-01-01

    Introducing electric vehicles (EVs) into urban transportation network brings higher requirement on travel time reliability and charging reliability. Specifically, it is believed that travel time reliability is a key factor influencing travelers’ route choice. Meanwhile, due to the limited cruising range, EV drivers need to better learn about the required energy for the whole trip to make decisions about whether charging or not and where to charge (i.e., charging reliability). Since EV energy consumption is highly related to travel speed, network uncertainty affects travel time and charging demand estimation significantly. Considering the network uncertainty resulted from link degradation, which influences the distribution of travel demand on transportation network and the energy demand on power network, this paper aims to develop a reliability-based network equilibrium framework for accommodating degradable road conditions with the addition of EVs. First, based on the link travel time distribution, the mean and variance of route travel time and monetary expenses related to energy consumption are deduced, respectively. And the charging time distribution of EVs with charging demand is also estimated. Then, a nested structure is considered to deal with the difference of route choice behavior derived by the different uncertainty degrees between the routes with and without degradable links. Given the expected generalized travel cost and a psychological safety margin, a traffic assignment model with the addition of EVs is formulated. Subsequently, a heuristic solution algorithm is developed to solve the proposed model. Finally, the effects of travelers’ risk attitude, network degradation degree, and EV penetration rate on network performance are illustrated through an example network. The numerical results show that the difference of travelers’ risk attitudes does have impact on the route choice, and the widespread adoption of EVs can cut down the total system

  20. Inspection of the Secretary of Energy`s foreign travel

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

    NONE

    1996-10-07

    On December 9, 1995, the Secretary of Energy requested that the Department`s Inspector General (IG) conduct a thorough examination of all Secretarial foreign travel from 1993 to December 1995 to include the purpose of each trip, the activities of each Federal participant in each trip, the funding of each trip, and claims for reimbursements for expenses by Federal trip participants. The Secretary also requested that the review include an assessment of travel authorization, voucher, traveler reimbursement, and auditing systems employed by the Department to identify steps that could be taken to reduce errors and improve accounting oversight. Additionally, the Secretarymore » requested that the Inspector General conduct a thorough examination of the establishment and filling of the Department`s Ombudsman position. The Office of Inspector General (OIG) initiated a review into these matters and assigned primary responsibility for the review to the Office of Inspections. The purpose of this inspection was to conduct a thorough examination of the 16 Secretarial foreign trips from June 1993 to December 1995. This report focuses on the four trade missions because of their extent and cost. We examined a number of Departmental management systems and processes involved in planning and executing the 16 foreign trips. To determine the actual cost of the 16 trips, it was necessary to determine who participated in the trips and to identify the individual travel costs. We were required to perform extensive reviews of records and conduct a large number of interviews because the Department could not provide any specific documents that could accurately account for who actually participated on the 16 trips. Having identified who participated, it was then necessary to examine key aspects of the Department`s management systems. Our report contains 31 recommendations for corrective action.« less

  1. Benchmarking DoD Use of Additive Manufacturing and Quantifying Costs

    DTIC Science & Technology

    2017-03-01

    46 VI. Cost Benefit ...developing a cost model. The US Army Logistics Innovation Agency published a study called “Additive Manufacturing Cost - Benefit Analysis”. This...to over fifteen thousand dollars on GSA Advantage. Desktop printers do not require extensive support equipment. 47    VI. Cost Benefit

  2. 7 CFR 52.50 - Travel and other expenses.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... and other expenses. Charges may be made to cover the cost of travel time incurred in connection with... hour. This includes time spent waiting for transportation as well as time spent traveling, but not to exceed eight hours of travel time for any one person for any one day: And provided further, that if...

  3. 7 CFR 52.50 - Travel and other expenses.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and other expenses. Charges may be made to cover the cost of travel time incurred in connection with... hour. This includes time spent waiting for transportation as well as time spent traveling, but not to exceed eight hours of travel time for any one person for any one day: And provided further, that if...

  4. 7 CFR 52.50 - Travel and other expenses.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... and other expenses. Charges may be made to cover the cost of travel time incurred in connection with... hour. This includes time spent waiting for transportation as well as time spent traveling, but not to exceed eight hours of travel time for any one person for any one day: And provided further, that if...

  5. Comparing Value of Urban Green Space Using Contingent Valuation and Travel Cost Methods

    NASA Astrophysics Data System (ADS)

    Chintantya, Dea; Maryono

    2018-02-01

    Green urban open space are an important element of the city. They gives multiple benefits for social life, human health, biodiversity, air quality, carbon sequestration, and water management. Travel Cost Method (TCM) and Contingent Valuation Method (CVM) are the most frequently used method in various studies that assess environmental good and services in monetary term for valuing urban green space. Both of those method are determined the value of urban green space through willingness to pay (WTP) for ecosystem benefit and collected data through direct interview and questionnaire. Findings of this study showed the weaknesses and strengths of both methods for valuing urban green space and provided factors influencing the probability of user's willingness to pay in each method.

  6. 38 CFR 21.9585 - Travel expenses.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Counseling § 21.9585 Travel expenses. VA will not pay for any costs of travel to and from the place of counseling regardless of whether the individual requests educational and vocational counseling or whether the counseling is required. (Authority: 38 U.S.C...

  7. 38 CFR 21.9585 - Travel expenses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Counseling § 21.9585 Travel expenses. VA will not pay for any costs of travel to and from the place of counseling regardless of whether the individual requests educational and vocational counseling or whether the counseling is required. (Authority: 38 U.S.C...

  8. 38 CFR 21.9585 - Travel expenses.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Counseling § 21.9585 Travel expenses. VA will not pay for any costs of travel to and from the place of counseling regardless of whether the individual requests educational and vocational counseling or whether the counseling is required. (Authority: 38 U.S.C...

  9. 38 CFR 21.9585 - Travel expenses.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Counseling § 21.9585 Travel expenses. VA will not pay for any costs of travel to and from the place of counseling regardless of whether the individual requests educational and vocational counseling or whether the counseling is required. (Authority: 38 U.S.C...

  10. 48 CFR 2052.215-77 - Travel approvals and reimbursement.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Travel approvals and....215-77 Travel approvals and reimbursement. As prescribed at 2015.209-70(d), the contracting officer shall insert the following clause in cost reimbursement solicitations and contracts which require travel...

  11. 48 CFR 2052.215-77 - Travel approvals and reimbursement.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Travel approvals and....215-77 Travel approvals and reimbursement. As prescribed at 2015.209-70(d), the contracting officer shall insert the following clause in cost reimbursement solicitations and contracts which require travel...

  12. 48 CFR 2052.215-77 - Travel approvals and reimbursement.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Travel approvals and....215-77 Travel approvals and reimbursement. As prescribed at 2015.209-70(d), the contracting officer shall insert the following clause in cost reimbursement solicitations and contracts which require travel...

  13. 48 CFR 2052.215-77 - Travel approvals and reimbursement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Travel approvals and....215-77 Travel approvals and reimbursement. As prescribed at 2015.209-70(d), the contracting officer shall insert the following clause in cost reimbursement solicitations and contracts which require travel...

  14. 48 CFR 2052.215-77 - Travel approvals and reimbursement.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Travel approvals and....215-77 Travel approvals and reimbursement. As prescribed at 2015.209-70(d), the contracting officer shall insert the following clause in cost reimbursement solicitations and contracts which require travel...

  15. Measuring and modeling travel well-being in a dynamic context.

    DOT National Transportation Integrated Search

    2013-03-01

    Travel behavior models typically assume that people base their travel choices on time and cost : considerations and do not account sufficiently for qualitative factors that affect the choice. Travel : choices are however more likely to be motivated b...

  16. Convective instabilities in traveling fronts of addition polymerization

    NASA Technical Reports Server (NTRS)

    Pojman, John A.; Jones, Chris E.; Khan, Akhtar M.

    1993-01-01

    An autocatalytic reaction in an unstirred vessel can support a constant velocity wavefront resulting from the coupling of diffusion to the chemical reaction. A flare front is a common example in which heat is the autocatalytic species that diffuses into unreacted regions stimulating a reaction that produces more heat. Traveling fronts were studied in synthetic polymerization reactions under high pressure by workers in the former USSR. More recently, propagating fronts of methacrylic acid polymerization were studied under ambient conditions, both with video techniques and by NMR.

  17. Additive Manufacturing of Low Cost Upper Stage Propulsion Components

    NASA Technical Reports Server (NTRS)

    Protz, Christopher; Bowman, Randy; Cooper, Ken; Fikes, John; Taminger, Karen; Wright, Belinda

    2014-01-01

    NASA is currently developing Additive Manufacturing (AM) technologies and design tools aimed at reducing the costs and manufacturing time of regeneratively cooled rocket engine components. These Low Cost Upper Stage Propulsion (LCUSP) tasks are funded through NASA's Game Changing Development Program in the Space Technology Mission Directorate. The LCUSP project will develop a copper alloy additive manufacturing design process and develop and optimize the Electron Beam Freeform Fabrication (EBF3) manufacturing process to direct deposit a nickel alloy structural jacket and manifolds onto an SLM manufactured GRCop chamber and Ni-alloy nozzle. In order to develop these processes, the project will characterize both the microstructural and mechanical properties of the SLMproduced GRCop-84, and will explore and document novel design techniques specific to AM combustion devices components. These manufacturing technologies will be used to build a 25K-class regenerative chamber and nozzle (to be used with tested DMLS injectors) that will be tested individually and as a system in hot fire tests to demonstrate the applicability of the technologies. These tasks are expected to bring costs and manufacturing time down as spacecraft propulsion systems typically comprise more than 70% of the total vehicle cost and account for a significant portion of the development schedule. Additionally, high pressure/high temperature combustion chambers and nozzles must be regeneratively cooled to survive their operating environment, causing their design to be time consuming and costly to build. LCUSP presents an opportunity to develop and demonstrate a process that can infuse these technologies into industry, build competition, and drive down costs of future engines.

  18. 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

  19. 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.

  20. WHAMII - An enumeration and insertion procedure with binomial bounds for the stochastic time-constrained traveling salesman problem

    NASA Technical Reports Server (NTRS)

    Dahl, Roy W.; Keating, Karen; Salamone, Daryl J.; Levy, Laurence; Nag, Barindra; Sanborn, Joan A.

    1987-01-01

    This paper presents an algorithm (WHAMII) designed to solve the Artificial Intelligence Design Challenge at the 1987 AIAA Guidance, Navigation and Control Conference. The problem under consideration is a stochastic generalization of the traveling salesman problem in which travel costs can incur a penalty with a given probability. The variability in travel costs leads to a probability constraint with respect to violating the budget allocation. Given the small size of the problem (eleven cities), an approach is considered that combines partial tour enumeration with a heuristic city insertion procedure. For computational efficiency during both the enumeration and insertion procedures, precalculated binomial probabilities are used to determine an upper bound on the actual probability of violating the budget constraint for each tour. The actual probability is calculated for the final best tour, and additional insertions are attempted until the actual probability exceeds the bound.

  1. Who Visits a National Park and What do They Get Out of It?: A Joint Visitor Cluster Analysis and Travel Cost Model for Yellowstone National Park

    NASA Astrophysics Data System (ADS)

    Benson, Charles; Watson, Philip; Taylor, Garth; Cook, Philip; Hollenhorst, Steve

    2013-10-01

    Yellowstone National Park visitor data were obtained from a survey collected for the National Park Service by the Park Studies Unit at the University of Idaho. Travel cost models have been conducted for national parks in the United States; however, this study builds on these studies and investigates how benefits vary by types of visitors who participate in different activities while at the park. Visitor clusters were developed based on activities in which a visitor participated while at the park. The clusters were analyzed and then incorporated into a travel cost model to determine the economic value (consumer surplus) that the different visitor groups received from visiting the park. The model was estimated using a zero-truncated negative binomial regression corrected for endogenous stratification. The travel cost price variable was estimated using both 1/3 and 1/4 the wage rate to test for sensitivity to opportunity cost specification. The average benefit across all visitor cluster groups was estimated at between 235 and 276 per person per trip. However, per trip benefits varied substantially across clusters; from 90 to 103 for the "value picnickers," to 185-263 for the "backcountry enthusiasts," 189-278 for the "do it all adventurists," 204-303 for the "windshield tourists," and 323-714 for the "creature comfort" cluster group.

  2. Modeling the costs and benefits of temporary recommendations for poliovirus exporting countries to vaccinate international travelers.

    PubMed

    Duintjer Tebbens, Radboud J; Thompson, Kimberly M

    2017-07-05

    Recognizing that infectious agents readily cross international borders, the International Health Regulations Emergency Committee issues Temporary Recommendations (TRs) that include vaccination of travelers from countries affected by public health emergencies, including serotype 1 wild polioviruses (WPV1s). This analysis estimates the costs and benefits of TRs implemented by countries with reported WPV1 during 2014-2016 while accounting for numerous uncertainties. We estimate the TR costs based on programmatic data and prior economic analyses and TR benefits by simulating potential WPV1 outbreaks in the absence of the TRs using the rate and extent of WPV1 importation outbreaks per reported WPV1 case during 2004-2013 and the number of reported WPV1 cases that occurred in countries with active TRs. The benefits of TRs outweigh the costs in 77% of model iterations, resulting in expected incremental net economic benefits of $210 million. Inclusion of indirect costs increases the costs by 13%, the expected savings from prevented outbreaks by 4%, and the expected incremental net benefits by 3%. Despite the considerable costs of implementing TRs, this study provides health and economic justification for these investments in the context of managing a disease in advanced stages of its global eradication. Copyright © 2017 The Auhors. Published by Elsevier Ltd.. All rights reserved.

  3. Travel time data collection for measurement of advanced traveler information systems accuracy

    DOT National Transportation Integrated Search

    2003-06-01

    The objective of this white paper is to recommend an approach to measuring ATIS travel time accuracy so that ITS planners might have the data they need to make cost effective decisions regarding deployment of surveillance technologies to support ATIS...

  4. Wildfire effects on hiking and biking demand in New Mexico: a travel cost study.

    PubMed

    Hesseln, Hayley; Loomis, John B; González-Cabán, Armando; Alexander, Susan

    2003-12-01

    We use a travel cost model to test the effects of wild and prescribed fire on visitation by hikers and mountain bikers in New Mexico. Our results indicate that net benefits for mountain bikers is $150 per trip and that they take an average of 6.2 trips per year. Hikers take 2.8 trips per year with individual net benefits per trip of $130. Both hikers' and mountain bikers' demand functions react adversely to prescribed burning. Net benefits for both groups fall as areas recover from prescribed burns. Because both visitation and annual recreation benefits decrease to these two types of visitors, this gives rise to multiple use costs associated with prescribed burning. With respect to wildfire, hikers and mountain bikers both exhibit decreased visitation as areas recover from wildfires, however, only hikers indicate an increase in per trip net benefits. Bikers' demand effectively drops to zero. These results differ from previous findings in the literature and have implications for efficient implementation of the National Fire Plan and whether prescribed burning is a cost effective tool for multiple use management of National Forests. Specifically, that fire and recreation managers cannot expect recreation users to react similarly to fire across recreation activities, or different geographic regions. What is cost effective in one region may not be so in another.

  5. 48 CFR 752.7014 - Notice of changes in travel regulations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... travel regulations. 752.7014 Section 752.7014 Federal Acquisition Regulations System AGENCY FOR... Clauses 752.7014 Notice of changes in travel regulations. The following clause is for use in cost-reimbursement contracts involving work overseas. Notice of Changes in Travel Regulations (JAN 1990) (a) Changes...

  6. 9 CFR 354.106 - Travel expenses and other charges.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Travel expenses and other charges. 354.106 Section 354.106 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... § 354.106 Travel expenses and other charges. Charges are to be made to cover the cost of travel and...

  7. 20 CFR 404.278 - Additional cost-of-living increase.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Section 404.278 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.278...) Measuring period for the additional increase—(1) Beginning. To compute the additional increase, we begin...

  8. Estimating the Economic Value of Ice Climbing in Hyalite Canyon: An Application of Travel Cost Count Data Models that Account for Excess Zeros*

    PubMed Central

    Anderson, D. Mark

    2009-01-01

    Recently, the sport of ice climbing has seen a drastic increase in popularity. This paper uses the travel cost method to estimate the demand for ice climbing in Hyalite Canyon, Montana, one of the premier ice climbing venues in North America. Access to Hyalite and other ice climbing destinations have been put at risk due to liability issues, public land management agendas, and winter road conditions. To this point, there has been no analysis on the economic benefits of ice climbing. In addition to the novel outdoor recreation application, this study applies econometric methods designed to deal with “excess zeros” in the data. Depending upon model specification, per person per trip values are estimated to be in the range of $76 to $135. PMID:20044202

  9. Refusal of recommended travel-related vaccines among U.S. international travellers in Global TravEpiNet.

    PubMed

    Lammert, Sara M; Rao, Sowmya R; Jentes, Emily S; Fairley, Jessica K; Erskine, Stefanie; Walker, Allison T; Hagmann, Stefan H; Sotir, Mark J; Ryan, Edward T; LaRocque, Regina C

    2016-07-01

    International travellers are at risk of travel-related, vaccine-preventable diseases. More data are needed on the proportion of travellers who refuse vaccines during a pre-travel health consultation and their reasons for refusing vaccines. We analyzed data on travellers seen for a pre-travel health consultation from July 2012 through June 2014 in the Global TravEpiNet (GTEN) consortium. Providers were required to indicate one of three reasons for a traveller refusing a recommended vaccine: (1) cost concerns, (2) safety concerns or (3) not concerned with the illness. We calculated refusal rates among travellers eligible for each vaccine based on CDC recommendations current at the time of travel. We used multivariable logistic regression models to examine the effect of individual variables on the likelihood of accepting all recommended vaccines. Of 24 478 travellers, 23 768 (97%) were eligible for at least one vaccine. Travellers were most frequently eligible for typhoid (N = 20 092), hepatitis A (N = 12 990) and influenza vaccines (N = 10 539). Of 23 768 eligible travellers, 6573 (25%) refused one or more recommended vaccine(s). Of those eligible, more than one-third refused the following vaccines: meningococcal: 2232 (44%) of 5029; rabies: 1155 (44%) of 2650; Japanese encephalitis: 761 (41%) of 1846; and influenza: 3527 (33%) of 10 539. The most common reason for declining vaccines was that the traveller was not concerned about the illness. In multivariable analysis, travellers visiting friends and relatives (VFR) in low or medium human development countries were less likely to accept all recommended vaccines, compared with non-VFR travellers (OR = 0.74 (0.59-0.95)). Travellers who sought pre-travel health care refused recommended vaccines at varying rates. A lack of concern about the associated illness was the most commonly cited reason for all refused vaccines. Our data suggest more effective education about disease risk is needed for

  10. Effectiveness of pre-travel consultation in the prevention of travel-related diseases: a retrospective cohort study.

    PubMed

    Tafuri, Silvio; Guerra, Rocco; Gallone, Maria Serena; Cappelli, Maria Giovanna; Lanotte, Serafina; Quarto, Michele; Germinario, Cinzia

    2014-01-01

    This study aims to evaluate the effectiveness of pre-travel counselling carried out in Travel Clinics. This is a retrospective cohort. Three hundred international travellers were enrolled; 150 people were from users of Bari Travel Clinic, 150 were users of a travel agency. Enrolled subjects were interviewed using a questionnaire. The average age of the enrolled subjects was 37.5 ± 13.9, without statistically significant differences between the two groups. 86% of cases and 19.3% of the controls reported the use of anti-malaria prophylaxis (p < 0.0001). Vaccination against cholera was given to 62% of cases and 7.3% of the controls (p < 0.001). Travel Clinic users, 6% reported diarrhoea and these figures were 27% in the control group (p < 0.0001). The proportion of those interviewed who reported fever (3.7) or insomnia (1.3) did not differ between the two groups. Mosquito bites were reported by 8% of cases and 20% of the controls (p = 0.003). Three cases of malaria were reported among the controls but no cases were detected among the cases (chi-square = 3.03; p = 0.08). Our study demonstrated the effectiveness of pre-travel counselling; in the future, new studies must investigate the cost-effectiveness of pre-travel prevention measures.

  11. Refusal of recommended travel-related vaccines among U.S. international travellers in Global TravEpiNet

    PubMed Central

    Lammert, Sara M.; Rao, Sowmya R.; Jentes, Emily S.; Fairley, Jessica K.; Erskine, Stefanie; Walker, Allison T.; Hagmann, Stefan H.; Sotir, Mark J.; Ryan, Edward T.

    2017-01-01

    Background: International travellers are at risk of travel-related, vaccine-preventable diseases. More data are needed on the proportion of travellers who refuse vaccines during a pre-travel health consultation and their reasons for refusing vaccines. Methods: We analyzed data on travellers seen for a pre-travel health consultation from July 2012 through June 2014 in the Global TravEpiNet (GTEN) consortium. Providers were required to indicate one of three reasons for a traveller refusing a recommended vaccine: (1) cost concerns, (2) safety concerns or (3) not concerned with the illness. We calculated refusal rates among travellers eligible for each vaccine based on CDC recommendations current at the time of travel. We used multivariable logistic regression models to examine the effect of individual variables on the likelihood of accepting all recommended vaccines. Results: Of 24 478 travellers, 23 768 (97%) were eligible for at least one vaccine. Travellers were most frequently eligible for typhoid (N = 20 092), hepatitis A (N = 12 990) and influenza vaccines (N = 10 539). Of 23 768 eligible travellers, 6573 (25%) refused one or more recommended vaccine(s). Of those eligible, more than one-third refused the following vaccines: meningococcal: 2232 (44%) of 5029; rabies: 1155 (44%) of 2650; Japanese encephalitis: 761 (41%) of 1846; and influenza: 3527 (33%) of 10 539. The most common reason for declining vaccines was that the traveller was not concerned about the illness. In multivariable analysis, travellers visiting friends and relatives (VFR) in low or medium human development countries were less likely to accept all recommended vaccines, compared with non-VFR travellers (OR = 0.74 (0.59–0.95)). Conclusions: Travellers who sought pre-travel health care refused recommended vaccines at varying rates. A lack of concern about the associated illness was the most commonly cited reason for all refused vaccines. Our data suggest more effective

  12. Travellers and influenza: risks and prevention.

    PubMed

    Goeijenbier, M; van Genderen, P; Ward, B J; Wilder-Smith, A; Steffen, R; Osterhaus, A D M E

    2017-01-01

    Influenza viruses are among the major causes of serious human respiratory tract infection worldwide. In line with the high disease burden attributable to influenza, these viruses play an important, but often neglected, role in travel medicine. Guidelines and recommendations regarding prevention and management of influenza in travellers are scarce. Of special interest for travel medicine are risk populations and also circumstances that facilitate influenza virus transmission and spread, like travel by airplane or cruise ship and mass gatherings. We conducted a PUBMED/MEDLINE search for a combination of the MeSH terms Influenza virus, travel, mass gathering, large scale events and cruise ship. In addition we gathered guidelines and recommendations from selected countries and regarding influenza prevention and management in travellers. By reviewing these search results in the light of published knowledge in the fields of influenza prevention and management, we present best practice advice for the prevention and management of influenza in travel medicine. Seasonal influenza is among the most prevalent infectious diseases in travellers. Known host-associated risk factors include extremes of age and being immune-compromised, while the most relevant environmental factors are associated with holiday cruises and mass gatherings. Pre-travel advice should address influenza and its prevention for travellers, whenever appropriate on the basis of the epidemiological situation concerned. Preventative measures should be strongly recommended for travellers at high-risk for developing complications. In addition, seasonal influenza vaccination should be considered for any traveller wishing to reduce the risk of incapacitation, particularly cruise ship crew and passengers, as well as those participating in mass gatherings. Besides advice concerning preventive measures and vaccination, advice on the use of antivirals may be considered for some travellers. © International Society of

  13. Cybermediation in the Tourism and Travel Industries

    NASA Astrophysics Data System (ADS)

    Killion, Les

    Travel and tourism are second only to pornography in adopting Internet-based technologies to intermediate between those supplying the total travel experience, and those seeking to satisfy leisure needs by engaging in tourism. From Thomas Cook in the 1800s, traditional ‘travel trade networks’ have provided the components of the travel experience: transport, accommodation and attractions. However, the Internet has encouraged customer self-service, and on-going debate regarding the future of traditional travel trade intermediaries. The intermediation debate suggests the emergence of ‘hybrid’ intermediation systems combining customer self-service with face-to-face customer contacts characteristic of traditional travel agents. A focus group investigation identified profiles and motives of customers using the Internet to make holiday arrangements. Potential cost savings are a primary motivation for customer self-service. Using the Internet for travel and tourism is becoming commonplace among older travellers as well as younger people. In gathering information before making holiday decisions, potential tourists also engage in a Web 2.0 environment where family and friends, not established intermediaries, provide reliable and authentic information via their individual blogs.

  14. Airline travel since 9/11

    DOT National Transportation Integrated Search

    2005-12-01

    Airline capacity (expressed in available seats) has : increased more slowly than the increase in airline passenger : travel. : Low-cost carriers represent a growing portion of the : domestic aviation market. This change has been accompanied :...

  15. 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.

  16. Cost-effectiveness of additional catheter-directed thrombolysis for deep vein thrombosis.

    PubMed

    Enden, T; Resch, S; White, C; Wik, H S; Kløw, N E; Sandset, P M

    2013-06-01

    Additional treatment with catheter-directed thrombolysis (CDT) has recently been shown to reduce post-thrombotic syndrome (PTS). To estimate the cost effectiveness of additional CDT compared with standard treatment alone. Using a Markov decision model, we compared the two treatment strategies in patients with a high proximal deep vein thrombosis (DVT) and a low risk of bleeding. The model captured the development of PTS, recurrent venous thromboembolism and treatment-related adverse events within a lifetime horizon and the perspective of a third-party payer. Uncertainty was assessed with one-way and probabilistic sensitivity analyzes. Model inputs from the CaVenT study included PTS development, major bleeding from CDT and utilities for post DVT states including PTS. The remaining clinical inputs were obtained from the literature. Costs obtained from the CaVenT study, hospital accounts and the literature are expressed in US dollars ($); effects in quality adjusted life years (QALY). In base case analyzes, additional CDT accumulated 32.31 QALYs compared with 31.68 QALYs after standard treatment alone. Direct medical costs were $64,709 for additional CDT and $51,866 for standard treatment. The incremental cost-effectiveness ratio (ICER) was $20,429/QALY gained. One-way sensitivity analysis showed model sensitivity to the clinical efficacy of both strategies, but the ICER remained < $55,000/QALY over the full range of all parameters. The probability that CDT is cost effective was 82% at a willingness to pay threshold of $50,000/QALY gained. Additional CDT is likely to be a cost-effective alternative to the standard treatment for patients with a high proximal DVT and a low risk of bleeding. © 2013 International Society on Thrombosis and Haemostasis.

  17. Cost-effectiveness of additional catheter-directed thrombolysis for deep vein thrombosis

    PubMed Central

    ENDEN, T.; RESCH, S.; WHITE, C.; WIK, H. S.; KLØW, N. E.; SANDSET, P. M.

    2013-01-01

    Summary Background Additional treatment with catheter-directed thrombolysis (CDT) has recently been shown to reduce post-thrombotic syndrome (PTS). Objectives To estimate the cost effectiveness of additional CDT compared with standard treatment alone. Methods Using a Markov decision model, we compared the two treatment strategies in patients with a high proximal deep vein thrombosis (DVT) and a low risk of bleeding. The model captured the development of PTS, recurrent venous thromboembolism and treatment-related adverse events within a lifetime horizon and the perspective of a third-party payer. Uncertainty was assessed with one-way and probabilistic sensitivity analyzes. Model inputs from the CaVenT study included PTS development, major bleeding from CDT and utilities for post DVT states including PTS. The remaining clinical inputs were obtained from the literature. Costs obtained from the CaVenT study, hospital accounts and the literature are expressed in US dollars ($); effects in quality adjusted life years (QALY). Results In base case analyzes, additional CDT accumulated 32.31 QALYs compared with 31.68 QALYs after standard treatment alone. Direct medical costs were $64 709 for additional CDT and $51 866 for standard treatment. The incremental cost-effectiveness ratio (ICER) was $20 429/QALY gained. One-way sensitivity analysis showed model sensitivity to the clinical efficacy of both strategies, but the ICER remained < $55 000/QALY over the full range of all parameters. The probability that CDT is cost effective was 82% at a willingness to pay threshold of $50 000/QALY gained. Conclusions Additional CDT is likely to be a cost-effective alternative to the standard treatment for patients with a high proximal DVT and a low risk of bleeding. PMID:23452204

  18. Paediatric palliative care by video consultation at home: a cost minimisation analysis.

    PubMed

    Bradford, Natalie K; Armfield, Nigel R; Young, Jeanine; Smith, Anthony C

    2014-07-28

    In the vast state of Queensland, Australia, access to specialist paediatric services are only available in the capital city of Brisbane, and are limited in regional and remote locations. During home-based palliative care, it is not always desirable or practical to move a patient to attend appointments, and so access to care may be even further limited. To address these problems, at the Royal Children's Hospital (RCH) in Brisbane, a Home Telehealth Program (HTP) has been successfully established to provide palliative care consultations to families throughout Queensland. A cost minimisation analysis was undertaken to compare the actual costs of the HTP consultations, with the estimated potential costs associated with face-to face-consultations occurring by either i) hospital based consultations in the outpatients department at the RCH, or ii) home visits from the Paediatric Palliative Care Service. The analysis was undertaken from the perspective of the Children's Health Service. The analysis was based on data from 95 home video consultations which occurred over a two year period, and included costs associated with projected: clinician time and travel; costs reimbursed to families for travel through the Patients Travel Subsidy (PTS) scheme; hospital outpatient clinic costs, project co-ordination and equipment and infrastructure costs. The mean costs per consultation were calculated for each approach. Air travel (n = 24) significantly affected the results. The mean cost of the HTP intervention was $294 and required no travel. The estimated mean cost per consultation in the hospital outpatient department was $748. The mean cost of home visits per consultation was $1214. Video consultation in the home is the most economical method of providing a consultation. The largest costs avoided to the health service are those associated with clinician time required for travel and the PTS scheme. While face-to-face consultations are the gold standard of care, for families located

  19. Assessing cost-effectiveness in obesity: active transport program for primary school children--TravelSMART Schools Curriculum program.

    PubMed

    Moodie, Marj; Haby, Michelle M; Swinburn, Boyd; Carter, Robert

    2011-05-01

    To assess from a societal perspective the cost-effectiveness of a school program to increase active transport in 10- to 11-year-old Australian children as an obesity prevention measure. The TravelSMART Schools Curriculum program was modeled nationally for 2001 in terms of its impact on Body Mass Index (BMI) and Disability-Adjusted Life Years (DALYs) measured against current practice. Cost offsets and DALY benefits were modeled until the eligible cohort reached age 100 or died. The intervention was qualitatively assessed against second stage filter criteria ('equity,' 'strength of evidence,' 'acceptability to stakeholders,' 'feasibility of implementation,' 'sustainability,' and 'side-effects') given their potential impact on funding decisions. The modeled intervention reached 267,700 children and cost $AUD13.3M (95% uncertainty interval [UI] $6.9M; $22.8M) per year. It resulted in an incremental saving of 890 (95%UI -540; 2,900) BMI units, which translated to 95 (95% UI -40; 230) DALYs and a net cost per DALY saved of $AUD117,000 (95% UI dominated; $1.06M). The intervention was not cost-effective as an obesity prevention measure under base-run modeling assumptions. The attribution of some costs to nonobesity objectives would be justified given the program's multiple benefits. Cost-effectiveness would be further improved by considering the wider school community impacts.

  20. Patriot Express Program Could Be More Cost-Effective for Overseas Permanent Change of Station and Temporary Duty Travel

    DTIC Science & Technology

    2015-07-06

    Department of Defense F r a u d , W a s t e & A b u s e Results in Brief Patriot Express Program Could Be More Cost-Effective for Overseas...availability for passengers traveling overseas. July 6, 2015 As a result , DoD did not maximize its return on investment in the Patriot Express Program and...comments from the Commander, Naval Supply Systems Command, partially addressed Recommendation 3.b. As a result of management comments, we redirected

  1. Solving standard traveling salesman problem and multiple traveling salesman problem by using branch-and-bound

    NASA Astrophysics Data System (ADS)

    Saad, Shakila; Wan Jaafar, Wan Nurhadani; Jamil, Siti Jasmida

    2013-04-01

    The standard Traveling Salesman Problem (TSP) is the classical Traveling Salesman Problem (TSP) while Multiple Traveling Salesman Problem (MTSP) is an extension of TSP when more than one salesman is involved. The objective of MTSP is to find the least costly route that the traveling salesman problem can take if he wishes to visit exactly once each of a list of n cities and then return back to the home city. There are a few methods that can be used to solve MTSP. The objective of this research is to implement an exact method called Branch-and-Bound (B&B) algorithm. Briefly, the idea of B&B algorithm is to start with the associated Assignment Problem (AP). A branching strategy will be applied to the TSP and MTSP which is Breadth-first-Search (BFS). 11 nodes of cities are implemented for both problem and the solutions to the problem are presented.

  2. Valuing river characteristics using combined site choice and participation travel cost models.

    PubMed

    Johnstone, C; Markandya, A

    2006-08-01

    This paper presents new welfare measures for marginal changes in river quality in selected English rivers. The river quality indicators used include chemical, biological and habitat-level attributes. Economic values for recreational use of three types of river-upland, lowland and chalk-are presented. A survey of anglers was carried out and using these data, two travel cost models were estimated, one to predict the numbers of trips and the other to predict angling site choice. These models were then linked to estimate the welfare associated with marginal changes in river quality using the participation levels as estimated in the trip prediction model. The model results showed that higher flow rates, biological quality and nutrient pollution levels affect site choice and influence the likelihood of a fishing trip. Consumer surplus values per trip for a 10% change in river attributes range from pound 0.04 to pound 3.93 ( pound 2001) depending on the attribute.

  3. Travellers and influenza: risks and prevention

    PubMed Central

    van Genderen, P.; Ward, B. J.; Wilder-Smith, A.; Steffen, R.; Osterhaus, A. D. M. E.

    2017-01-01

    Background: Influenza viruses are among the major causes of serious human respiratory tract infection worldwide. In line with the high disease burden attributable to influenza, these viruses play an important, but often neglected, role in travel medicine. Guidelines and recommendations regarding prevention and management of influenza in travellers are scarce. Of special interest for travel medicine are risk populations and also circumstances that facilitate influenza virus transmission and spread, like travel by airplane or cruise ship and mass gatherings. Methods: We conducted a PUBMED/MEDLINE search for a combination of the MeSH terms Influenza virus, travel, mass gathering, large scale events and cruise ship. In addition we gathered guidelines and recommendations from selected countries and regarding influenza prevention and management in travellers. By reviewing these search results in the light of published knowledge in the fields of influenza prevention and management, we present best practice advice for the prevention and management of influenza in travel medicine. Results: Seasonal influenza is among the most prevalent infectious diseases in travellers. Known host-associated risk factors include extremes of age and being immune-compromised, while the most relevant environmental factors are associated with holiday cruises and mass gatherings. Conclusions: Pre-travel advice should address influenza and its prevention for travellers, whenever appropriate on the basis of the epidemiological situation concerned. Preventative measures should be strongly recommended for travellers at high-risk for developing complications. In addition, seasonal influenza vaccination should be considered for any traveller wishing to reduce the risk of incapacitation, particularly cruise ship crew and passengers, as well as those participating in mass gatherings. Besides advice concerning preventive measures and vaccination, advice on the use of antivirals may be considered for some

  4. 41 CFR 301-10.261 - When may I use a Government aircraft for travel?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... or lost work time while in travel status and certain other costs should be considered when comparing... Government aircraft for travel? 301-10.261 Section 301-10.261 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES ALLOWABLE TRAVEL EXPENSES 10...

  5. 41 CFR 301-10.261 - When may I use a Government aircraft for travel?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... or lost work time while in travel status and certain other costs should be considered when comparing... Government aircraft for travel? 301-10.261 Section 301-10.261 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES ALLOWABLE TRAVEL EXPENSES 10...

  6. 41 CFR 301-10.261 - When may I use a Government aircraft for travel?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... or lost work time while in travel status and certain other costs should be considered when comparing... Government aircraft for travel? 301-10.261 Section 301-10.261 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES ALLOWABLE TRAVEL EXPENSES 10...

  7. 41 CFR 301-10.261 - When may I use a Government aircraft for travel?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... or lost work time while in travel status and certain other costs should be considered when comparing... Government aircraft for travel? 301-10.261 Section 301-10.261 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES ALLOWABLE TRAVEL EXPENSES 10...

  8. 41 CFR 301-10.261 - When may I use a Government aircraft for travel?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... or lost work time while in travel status and certain other costs should be considered when comparing... Government aircraft for travel? 301-10.261 Section 301-10.261 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES ALLOWABLE TRAVEL EXPENSES 10...

  9. Estimating the economic value of ice climbing in Hyalite Canyon: An application of travel cost count data models that account for excess zeros.

    PubMed

    Anderson, D Mark

    2010-01-01

    Recently, the sport of ice climbing has seen a dramatic increase in popularity. This paper uses the travel cost method to estimate the demand for ice climbing in Hyalite Canyon, Montana, one of the premier ice climbing venues in North America. Access to Hyalite and other ice climbing destinations have been put at risk due to liability issues, public land management agendas, and winter road conditions. To this point, there has been no analysis on the economic benefits of ice climbing. In addition to the novel outdoor recreation application, this study applies econometric methods designed to deal with "excess zeros" in the data. Depending upon model specification, per person per trip values are estimated to be in the range of $76 to $135. Copyright 2009 Elsevier Ltd. All rights reserved.

  10. Testing the convergent validity of the contingent valuation and travel cost methods in valuing the benefits of health care.

    PubMed

    Clarke, Philip M

    2002-03-01

    In this study, the convergent validity of the contingent valuation method (CVM) and travel cost method (TCM) is tested by comparing estimates of the willingness to pay (WTP) for improving access to mammographic screening in rural areas of Australia. It is based on a telephone survey of 458 women in 19 towns, in which they were asked about their recent screening behaviour and their WTP to have a mobile screening unit visit their nearest town. After eliminating missing data and other non-usable responses the contingent valuation experiment and travel cost model were based on information from 372 and 319 women, respectively. Estimates of the maximum WTP for the use of mobile screening units were derived using both methods and compared. The highest mean WTP estimated using the TCM was $83.10 (95% C.I. $99.06-$68.53), which is significantly less than the estimate of $148.09 ($131.13-$166.60) using the CVM. This could be due to the CVM estimates also reflecting non-use values such as altruism, or a range of potential biases that are known to affect both methods. Further tests of validity are required in order to gain a greater understanding of the relationship between these two methods of estimating WTP. Copyright 2001 John Wiley & Sons, Ltd.

  11. Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons

    PubMed Central

    Ostermann, Julia K.; Reinhold, Thomas; Witt, Claudia M.

    2015-01-01

    Objectives The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group) with the costs for those receiving usual care (control group). Methods Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome) and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs) across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache). Results Data from 44,550 patients (67.3% females) were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14–7,414.29]) than in the control group (EUR 5,857.56 [5,650.98–6,064.13]; p<0.0001) with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48–3,809.53] vs. control EUR 3,092.84 [2,981.31–3,204.37]) and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90–1,102.59] vs. control EUR 867.87 [853.52–882.21]). Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant. Conclusion Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system. PMID:26230412

  12. 2017 National Household Travel Survey - California Add-On |

    Science.gov Websites

    Transportation Secure Data Center | NREL 7 National Household Travel Survey - California Add-On 2017 National Household Travel Survey - California Add-On The California add-on survey supplements the 2017 National Household Travel Survey (NHTS) with additional household samples and detailed travel

  13. 50 CFR 260.79 - Travel and other expenses.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... based on an hourly rate, an additional hourly charge may be made for travel time including time spent waiting for transportation as well as time spent traveling, but not to exceed 8 hours of travel time for... charge may be made for travel time outside the employee's official work hours. ...

  14. 50 CFR 260.79 - Travel and other expenses.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... based on an hourly rate, an additional hourly charge may be made for travel time including time spent waiting for transportation as well as time spent traveling, but not to exceed 8 hours of travel time for... charge may be made for travel time outside the employee's official work hours. ...

  15. 50 CFR 260.79 - Travel and other expenses.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... based on an hourly rate, an additional hourly charge may be made for travel time including time spent waiting for transportation as well as time spent traveling, but not to exceed 8 hours of travel time for... charge may be made for travel time outside the employee's official work hours. ...

  16. 50 CFR 260.79 - Travel and other expenses.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... based on an hourly rate, an additional hourly charge may be made for travel time including time spent waiting for transportation as well as time spent traveling, but not to exceed 8 hours of travel time for... charge may be made for travel time outside the employee's official work hours. ...

  17. 50 CFR 260.79 - Travel and other expenses.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... based on an hourly rate, an additional hourly charge may be made for travel time including time spent waiting for transportation as well as time spent traveling, but not to exceed 8 hours of travel time for... charge may be made for travel time outside the employee's official work hours. ...

  18. What proportion of international travellers acquire a travel-related illness? A review of the literature.

    PubMed

    Angelo, Kristina M; Kozarsky, Phyllis E; Ryan, Edward T; Chen, Lin H; Sotir, Mark J

    2017-09-01

    As international travel increases, travellers may be at increased risk of acquiring infectious diseases not endemic in their home countries. Many journal articles and reference books related to travel medicine cite that between 22-64% of international travellers become ill during or after travel; however, this information is minimal, outdated and limited by poor generalizability. We aim to provide a current and more accurate estimate of the proportion of international travellers who acquire a travel-related illness. We identified studies via PubMed or travel medicine experts, published between January 1, 1976-December 31, 2016 that included the number of international travellers acquiring a travel-related illness. We excluded studies that focused on a single disease or did not determine a rate based on the total number of travellers. We abstracted information on traveller demographics, trip specifics, study enrollment and follow-up and number of ill travellers and their illnesses. Of 743 studies, nine met the inclusion criteria. The data sources were from North America (four studies) and Europe (five studies). Most travellers were tourists, the most frequent destination regions were Asia and Africa, and the median trip duration ranged from 8-21 days. Six studies enrolled participants at the travellers' pre-travel consultation. All studies collected data through either extraction from the medical record, weekly diaries, or pre- and post-travel questionnaires. Data collection timeframes varied by study. Between 6-87% of travellers became ill across all studies. Four studies provided the best estimate: between 43-79% of travellers who frequently visited developing nations (e.g. India, Tanzania, and Kenya) became ill; travellers most frequently reported diarrhoea. This is the most comprehensive assessment available on the proportion of international travellers that develop a travel-related illness. Additional cohort studies would provide needed data to more precisely

  19. 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.

  20. Additively Manufactured Low Cost Upper Stage Combustion Chamber

    NASA Technical Reports Server (NTRS)

    Protz, Christopher; Cooper, Ken; Ellis, David; Fikes, John; Jones, Zachary; Kim, Tony; Medina, Cory; Taminger, Karen; Willingham, Derek

    2016-01-01

    Over the past two years NASA's Low Cost Upper Stage Propulsion (LCUSP) project has developed Additive Manufacturing (AM) technologies and design tools aimed at reducing the costs and manufacturing time of regeneratively cooled rocket engine components. High pressure/high temperature combustion chambers and nozzles must be regeneratively cooled to survive their operating environment, causing their design fabrication to be costly and time consuming due to the number of individual steps and different processes required. Under LCUSP, AM technologies in Sintered Laser Melting (SLM) GRCop-84 and Electron Beam Freeform Fabrication (EBF3) Inconel 625 have been significantly advanced, allowing the team to successfully fabricate a 25k-class regenerative chamber. Estimates of the costs and schedule of future builds indicate cost reductions and significant schedule reductions will be enabled by this technology. Characterization of the microstructural and mechanical properties of the SLM-produced GRCop-84, EBF3 Inconel 625 and the interface layer between the two has been performed and indicates the properties will meet the design requirements. The LCUSP chamber is to be tested with a previously demonstrated SLM injector in order to advance the Technology Readiness Level (TRL) and demonstrate the capability of the application of these processes. NASA is advancing these technologies to reduce cost and schedule for future engine applications and commercial needs.

  1. [Traveler's thrombosis].

    PubMed

    Riedel, M; Bohanes, V

    2002-08-01

    It is pathophysiologically conceivable that prolonged sitting in a tight space (e.g., in airplane or other transport vehicle) may lead to leg vein thrombosis. The association between the incidence of venous thromboembolism and long travel has not been sufficiently documented but seems probable. However, this association is only weak and the incidence of symptomatic thromboembolism much lower than the impression given by the recent publicity. In a healthy person, the risk of suffering a clinically relevant leg vein thrombosis solely because of a flight is extreme low. In persons with risk factors for venous thromboembolism, the flight represents an additional, as yet not quantifiable risk. This risk increases with the duration of the travel. The most important cause of thrombosis during long journeys seems to be venostasis due to relative immobilization. It is not clear whether flight travel represents a higher risk of thrombosis compared to other transport vehicles with comparable duration and immobilization. Until more exact information becomes available, it seems reasonable to recommend simple isometric and isotonic leg exercises during long travel. More aggressive measures must be considered for persons with risk factors for thromboembolism, but these measures should be individualized.

  2. [Psychiatric patient: the most vulnerable traveller].

    PubMed

    Felkai, Péter; Kurimay, Tamás; Fülöp, Emoke

    2011-01-23

    Authors analyse questions of medical evacuation of the psychotic patient from abroad to homeland. This task can be considered the most difficult problem for the attending physician and the escorting medical team as well. The main challenge is to recognise the psychotic patient in a foreign country with a different health-care system and to overcome the language barrier and the different cultural background. The second issue is to prepare the patients - who are usually in a poor condition - for the medical evacuation by commercial aircraft. Another important issue is to take the patient through the strict security control. All of these (partially unsolved) problems make the mentally ill patient defenceless. Although the repatriation of a mentally ill patient is vital and urgent, travel insurance policy mostly excludes to cover the cost of treatment and repatriation. The high cost of treatment and repatriation of the patient should be paid by the patient or the family, who are often in the position of insolvency. In this paper authors present the history of a patient and give a brief review on travel-related mental disorders, the epidemiology of mental alterations during travel as well as the problems of appropriate evacuation. Authors conclude that there is a need for a better approach of the airport authorities and insurance decision makers to the mentally ill patient travelling abroad.

  3. Monitoring distances travelled by horses using GPS tracking collars.

    PubMed

    Hampson, B A; Morton, J M; Mills, P C; Trotter, M G; Lamb, D W; Pollitt, C C

    2010-05-01

    The aims of this work were to (1) develop a low-cost equine movement tracking collar based on readily available components, (2) conduct preliminary studies assessing the effects of both paddock size and internal fence design on the movements of domestic horses, with and without foals at foot, and (3) describe distances moved by mares and their foals. Additional monitoring of free-ranging feral horses was conducted to allow preliminary comparisons with the movement of confined domestic horses. A lightweight global positioning system (GPS) data logger modified from a personal/vehicle tracker and mounted on a collar was used to monitor the movement of domestic horses in a range of paddock sizes and internal fence designs for 6.5-day periods. In the paddocks used (0.8-16 ha), groups of domestic horses exhibited a logarithmic response in mean daily distance travelled as a function of increasing paddock size, tending asymptotically towards approximately 7.5 km/day. The distance moved by newborn foals was similar to their dams, with total distance travelled also dependent on paddock size. Without altering available paddock area, paddock design, with the exception of a spiral design, did not significantly affect mean daily distance travelled. Feral horses (17.9 km/day) travelled substantially greater mean daily distances than domestic horses (7.2 km/day in 16-ha paddock), even when allowing for larger paddock size. Horses kept in stables or small yards and paddocks are quite sedentary in comparison with their feral relatives. For a given paddock area, most designs did not significantly affect mean daily distance travelled.

  4. Travelers' health problems and behavior: prospective study with post-travel follow-up.

    PubMed

    Vilkman, Katri; Pakkanen, Sari H; Lääveri, Tinja; Siikamäki, Heli; Kantele, Anu

    2016-07-13

    The annual number of international tourist arrivals has recently exceeded one billion, yet surprisingly few studies have characterized travelers' behavior, illness, and risk factors in a prospective setting. Particularly scarce are surveys of data spanning travel, return, and follow-up of the same cohort. This study examines behavior and illness among travelers while abroad, after return home, and at follow-up. Patterns of behavior connected to type of travel and illness are characterized so as to identify risk factors and provide background data for pre-travel advice. Volunteers to this prospective cohort study were recruited at visits to a travel clinic prior to departure. Data on the subjects' health and behavior were collected by questionnaires before and after journeys and over a three-week follow-up. In addition, the subjects were asked to fill in health diaries while traveling. The final study population consisted of 460 subjects, 79 % of whom reported illness during travel or on arrival: 69 % had travelers' diarrhea (TD), 17 % skin problems, 17 % fever, 12 % vomiting, 8 % respiratory tract infection, 4 % urinary tract infection, 2 % ear infection, 4 % gastrointestinal complaints other than TD or vomiting, and 4 % other symptoms. Of all subjects, 10 % consulted a doctor and 0.7 % were hospitalized; 18 % took antimicrobials, with TD as the most common indication (64 %). Ongoing symptoms were reported by 25 % of all travelers upon return home. During the three-week follow-up (return rate 51 %), 32 % of respondents developed new-onset symptoms, 20 % visited a doctor and 1.7 % were hospitalized. Factors predisposing to health problems were identified by multivariable analysis: certain regions (Southern Asia, South-Eastern Asia, and Eastern Africa), female gender, young age, and long travel duration. Despite proper preventive measures like vaccinations, malaria prophylaxis, and travel advice, the majority of our subjects fell ill during or

  5. 75 FR 59094 - Federal Travel Regulation; Miscellaneous Amendments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ... references in a number of sections, by providing additional guidance for determining distance measurements... to carry senior Federal officials and non-Federal travelers. DATES: Effective Date: This final rule... concerning when travel on Government aircraft is not reported; adds additional guidance for determining...

  6. Fuzzy Hungarian Method for Solving Intuitionistic Fuzzy Travelling Salesman Problem

    NASA Astrophysics Data System (ADS)

    Prabakaran, K.; Ganesan, K.

    2018-04-01

    The travelling salesman problem is to identify the shortest route that the salesman journey all the places and return the starting place with minimum cost. We develop a fuzzy version of Hungarian algorithm for the solution of intuitionistic fuzzy travelling salesman problem using triangular intuitionistic fuzzy numbers without changing them to classical travelling salesman problem. The purposed method is easy to empathize and to implement for finding solution of intuitionistic travelling salesman problem happening in real life situations. To illustrate the proposed method numerical example are provided.

  7. 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

  8. How low an effect of a preventive measure against diarrhoea are travellers willing to pay for?: A survey of Norwegian travellers.

    PubMed

    Hasle, Gunnar; Heier, Lise

    Traveller's diarrhoea (TD) is the most common infectious problem for travellers, and we lack effective ways of preventing it, apart from antibiotic prophylaxis. This study aims to quantify the risk reduction of a hypothetic TD vaccine Norwegian travellers are willing to pay for. 1204 clients at Reiseklinikken responded to a questionnaire asking what level of effectiveness would be required of a hypothetical vaccine against TD costing US$65. 18.7% of the respondents would buy the vaccine even if it was only 20% effective. Among respondents older than 50 years, the proportion was 28.8%. Our findings should encourage the development of vaccines and other preventive measures against travellers' diarrhoea. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. 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.

  10. Pre-travel preparation and outcome of HIV-infected travellers from a UK clinic.

    PubMed

    Cathcart, S; Boyle, J; Sabin, C; Johnson, M; Zuckerman, J N

    2003-05-01

    Objectives. To review the pre-travel preparations and travel health outcomes of HIV-infected individuals. Methods. A prospective questionnaire-based study among English speaking adults with HIV infection attending an outpatient clinic from July to November 2000. Results. Baseline and follow-up questionnaire data were available for 34 individuals whose median CD4 count was 451 cells/mm(3). Eleven of these (32%) had sought travel advice before departure. Eight (23.5%) had been vaccinated or were planning vaccination against at least one condition and 17 (50%) listed travel-specific medications they planned to take with them. Those who were travelling to Africa were more likely to be vaccinated than those who were not travelling to Africa (3/4 vs 5/30, respectively, P=0.03). Those travelling to Europe were less likely to be vaccinated than those who were not (1/16 vs 7/18, P=0.04). The median duration of travel was 14 days (1-180). Fifteen subjects (44%) became ill while abroad. Those who became ill abroad were more likely to have visited Asia (P=0.003) and less likely to have visited the Americas (P=0.02) than those who did not become ill abroad. In addition, they tended to have stayed abroad for longer periods (P=0.07) and had visited more countries (P=0.04) than those who did not become ill abroad. Sixteen individuals (47%) reported illness on their return to the UK. Conclusions. HIV-infected travellers have an increased susceptibility to opportunistic and other travel-related infections and the need for appropriate advice, vaccination and prophylactic therapy is important. Health care provision in this field is in need of uniform guidelines to coordinate travel health management for this particular high risk group.

  11. [Vaccinations and malaria prophylaxis for international travelers].

    PubMed

    Alberer, Martin; Löscher, Thomas

    2015-05-01

    The prevention of infectious diseases by vaccination and by counselling about malaria prophylaxis is a central aspect of travel medicine. Besides mandatory vaccinations required for entry to certain countries various vaccinations may be indicated depending on destination and type of travel as well as on individual risks of the traveler. In addition, pre-travel counselling should always include a check-up of standard vaccinations. Protection against mosquito bites is the basis of malaria prophylaxis. The addition of chemoprophylaxis is warranted in high risk areas. When regular chemoprophylaxis is not applied it is recommended to carry an appropriate antimalarial drug which can be used for emergency stand-by treatment in case of unexplained fever and when medical attention is not available within 24 hours. Travelers should realize that self-treatment is a first-aid measure and that they should still seek medical advice as soon as possible. © Georg Thieme Verlag KG Stuttgart · New York.

  12. 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

  13. Cost-effectiveness of additional blood screening tests in the Netherlands.

    PubMed

    Borkent-Raven, Barbara A; Janssen, Mart P; van der Poel, Cees L; Bonsel, Gouke J; van Hout, Ben A

    2012-03-01

    During the past decade, blood screening tests such as triplex nucleic acid amplification testing (NAT) and human T-cell lymphotropic virus type I or I (HTLV-I/II) antibody testing were added to existing serologic testing for hepatitis B virus (HBV), human immunodeficiency virus (HIV), and hepatitis C virus (HCV). In some low-prevalence regions these additional tests yielded disputable benefits that can be valuated by cost-effectiveness analyses (CEAs). CEAs are used to support decision making on implementation of medical technology. We present CEAs of selected additional screening tests that are not uniformly implemented in the EU. Cost-effectiveness was analyzed of: 1) HBV, HCV, and HIV triplex NAT in addition to serologic testing; 2) HTLV-I/II antibody test for all donors, for first-time donors only, and for pediatric recipients only; and 3) hepatitis A virus (HAV) for all donations. Disease progression of the studied viral infections was described in five Markov models. In the Netherlands, the incremental cost-effectiveness ratio (ICER) of triplex NAT is €5.20 million per quality-adjusted life-year (QALY) for testing minipools of six donation samples and €4.65 million/QALY for individual donation testing. The ICER for anti-HTLV-I/II is €45.2 million/QALY if testing all donations, €2.23 million/QALY if testing new donors only, and €27.0 million/QALY if testing blood products for pediatric patients only. The ICER of HAV NAT is €18.6 million/QALY. The resulting ICERs are very high, especially when compared to other health care interventions. Nevertheless, these screening tests are implemented in the Netherlands and elsewhere. Policy makers should reflect more explicit on the acceptability of costs and effects whenever additional blood screening tests are implemented. © 2011 American Association of Blood Banks.

  14. 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.

  15. 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.

  16. Cuba: U.S. Restrictions on Travel and Remittances

    DTIC Science & Technology

    2008-07-30

    Estrella de Cuba, from booking travel to Cuba. The agency reportedly was one of the largest licensed travel agencies, booking some 300 to 500 passengers...Cuba.20 In addition to La Estrella de Cuba, OFAC suspended the service activities of several other companies in 2006, including Baby Envios Travel

  17. Cuba: U.S. Restrictions on Travel and Remittances

    DTIC Science & Technology

    2008-09-28

    travel agency, La Estrella de Cuba, from booking travel to Cuba. The agency reportedly was one of the largest licensed travel agencies, booking some...that do business with Cuba.20 In addition to La Estrella de Cuba, OFAC suspended the service activities of several other companies in 2006, including

  18. Seattle wide-area information for travelers (SWIFT) : deployment cost study

    DOT National Transportation Integrated Search

    1998-10-19

    The Seattle Wide-area Information For Travelers (SWIFT) project was a highly successful Intelligent Transportation System (ITS) Field Operational Test (FOT) that was conducted over a four-year period from 1993 to 1997. The purpose of the project was ...

  19. Empirical analysis of domestic medical travel for elective cardiovascular procedures.

    PubMed

    Langley, Jacob D; Johnson, Tricia J; Hohmann, Samuel F; Meurer, Steve J; Garman, Andy N

    2013-10-01

    To investigate whether domestic medical travel (DMT; traveling outside of one's home region but within the United States for medical care) and surgeon volume affect clinical outcomes and costs for patients undergoing elective cardiovascular procedures. Retrospective, cross-sectional analysis of patient discharge data from US academic medical centers. Patients were classified as medical travelers if they received elective, nonemergent care more than 250 miles from home. High-volume surgeons (HVSs) were those above the 75th percentile compared with other study surgeons in the annual number of cardiovascular surgeries performed. Multivariable regression models were fit to test the relationships among complications, mortality, length of stay (LOS), cost, DMT status, and surgeon volume, controlling for sociodemographic and clinical factors. Patients who traveled to HVSs were more likely to be male, white, have lower severity of illness, and have health insurance through an indemnity plan or preferred provider organization with coverage outside of the patient's home region. Patients who traveled to HVSs had shorter LOS and fewer complications than those who received care from local, low-volume surgeons. There was no significant difference in mortality between travelers and nontravelers. Patients who travelled to HVSs for elective cardiovascular procedures had outcomes similar to or better than those of patients who received care locally from low-volume surgeons. We found no increase in complications or LOS, despite potentially complex logistical arrangements required by travelers. More work is needed to evaluate the potential of DMT to improve the value of care provided for selected procedures.

  20. 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.

  1. 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.

  2. Synthesis of traveler choice research: improving modeling accuracy for better transportation decisionmaking.

    DOT National Transportation Integrated Search

    2013-08-01

    "Over the last 50 years, advances in the fields of travel behavior research and travel demand forecasting have been : immense, driven by the increasing costs of infrastructure and spatial limitations in areas of high population density : together wit...

  3. Interstellar Travel without 'Magic'

    NASA Astrophysics Data System (ADS)

    Woodcock, G.

    The possibility of interstellar space travel has become a popular subject. Distances of light years are an entirely new realm for human space travel. New means of propulsion are needed. Speculation about propulsion has included "magic", space warps, faster-than-light travel, known physics such as antimatter for which no practical implementation is known and also physics for which current research offers at least a hint of implementation, i.e. fusion. Performance estimates are presented for the latter and used to create vehicle concepts. Fusion propulsion will mean travel times of hundreds of years, so we adopt the "space colony" concepts of O'Neill as a ship design that could support a small civilization indefinitely; this provides the technical means. Economic reasoning is presented, arguing that development and production of "space colony" habitats for relief of Earth's population, with addition of fusion engines, will lead to vessels that can go interstellar. Scenarios are presented and a speculative estimate of a timetable is given.

  4. 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.

  5. International Launch Vehicle Selection for Interplanetary Travel

    NASA Technical Reports Server (NTRS)

    Ferrone, Kristine; Nguyen, Lori T.

    2010-01-01

    In developing a mission strategy for interplanetary travel, the first step is to consider launch capabilities which provide the basis for fundamental parameters of the mission. This investigation focuses on the numerous launch vehicles of various characteristics available and in development internationally with respect to upmass, launch site, payload shroud size, fuel type, cost, and launch frequency. This presentation will describe launch vehicles available and in development worldwide, then carefully detail a selection process for choosing appropriate vehicles for interplanetary missions focusing on international collaboration, risk management, and minimization of cost. The vehicles that fit the established criteria will be discussed in detail with emphasis on the specifications and limitations related to interplanetary travel. The final menu of options will include recommendations for overall mission design and strategy.

  6. 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.

  7. 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.

  8. Effectiveness and economic analysis of the whole cell/recombinant B subunit (WC/rbs) inactivated oral cholera vaccine in the prevention of traveller's diarrhoea.

    PubMed

    López-Gigosos, Rosa; Garcia-Fortea, Pedro; Calvo, Maria J; Reina, Emilia; Diez-Diaz, Rosa; Plaza, Elena

    2009-05-16

    Nowadays there is a debate about the indication of the oral whole-cell/recombinant B-subunit cholera vaccine (WC/rBS) in traveller's diarrhoea. However, a cost-benefit analysis based on real data has not been published. A cost-effectiveness and cost-benefit study of the oral cholera vaccine (WC/rBS), Dukoral for the prevention of traveller's diarrhoea (TD) was performed in subjects travelling to cholera risk areas. The effectiveness of WC/rBS vaccine in the prevention of TD was analyzed in 362 travellers attending two International Vaccination Centres in Spain between May and September 2005. The overall vaccine efficacy against TD was 42,6%. Direct healthcare-related costs as well as indirect costs (lost vacation days) subsequent to the disease were considered. Preventive vaccination against TD resulted in a mean saving of 79.26 euro per traveller. According to the cost-benefit analysis performed, the recommendation for WC/rBS vaccination in subjects travelling to zones at risk of TD is beneficial for the traveller, regardless of trip duration and visited continent.

  9. Challenges and solutions for applying the travel cost demand model to geographically remote visitor destinations: A case study of bear viewing at Katmai National Park and Preserve

    USGS Publications Warehouse

    Richardson, Leslie; Huber, Christopher; Loomis, John

    2017-01-01

    Remote and unique destinations present difficulties when attempting to construct traditional travel cost models to value recreation demand. The biggest limitation comes from the lack of variation in the dependent variable, defined as the number of trips taken over a set time frame. There are various approaches that can be used for overcoming limitations of the traditional travel cost model in the context of remote destinations. This study applies an adaptation of the standard model to estimate recreation benefits of bear viewing at Katmai National Park and Preserve in Alaska, which represents a once-in-a-lifetime experience for many visitors. Results demonstrate that visitors to this park’s Brooks Camp area are willing to pay an average of US$287 per day of bear viewing. Implications of these findings for valuing recreation at other remote destinations are discussed.

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

    PubMed

    Aung, A K; Trubiano, J A; Spelman, D W

    2015-01-01

    International travellers with immunocompromising conditions such as human immunodeficiency virus (HIV) infection, solid organ transplantation (SOT) and haematopoietic stem cell transplantation (HSCT) are at a significant risk of travel-related illnesses from both communicable and non-communicable diseases, depending on the intensity of underlying immune dysfunction, travel destinations and activities. In addition, the choice of travel vaccinations, timing and protective antibody responses are also highly dependent on the underlying conditions and thus pose significant challenges to the health-care providers who are involved in pre-travel risk assessment. This review article provides a framework of understanding and approach to aforementioned groups of immunocompromised travellers regarding pre-travel risk assessment and management; in particular travel vaccinations, infectious and non-infectious disease risks and provision of condition-specific advice; to reduce travel-related mortality and morbidity. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Cuba: U.S. Restrictions on Travel and Remittances

    DTIC Science & Technology

    2006-08-30

    Estrella de Cuba, from booking travel to Cuba. The agency reportedly was one of the largest licensed travel agencies, booking some 300 to 500...office. In January 2006, OFAC suspended a South Florida travel agency, La Estrella de Cuba, from booking travel to Cuba. The agency reportedly was one...conducting on-site audits at agencies that do business with Cuba and expects to complete 25 audits in 2006.14 In addition to La Estrella de Cuba, OFAC

  12. 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.

  13. 42 CFR 413.355 - Additional payment: QIO photocopy and mailing costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospective Payment for Skilled Nursing Facilities § 413.355 Additional payment: QIO photocopy and mailing costs. An additional payment is made to a skilled nursing facility in accordance with § 476.78 of this...

  14. 42 CFR 413.355 - Additional payment: QIO photocopy and mailing costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospective Payment for Skilled Nursing Facilities § 413.355 Additional payment: QIO photocopy and mailing costs. An additional payment is made to a skilled nursing facility in accordance with § 476.78 of this...

  15. 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.

  16. Reduction of travellers' diarrhoea by WC/rBS oral cholera vaccine in young, high-risk travellers.

    PubMed

    Torrell, Josep Ma Ramon; Aumatell, Cristina Masuet; Ramos, Sergi Morchon; Mestre, Laura Gavaldà; Salas, Carme Micheo

    2009-06-19

    A bidirectional cohort study investigates whether pre-travel vaccination with whole cell/recombinant B subunit inactivated, killed oral cholera vaccine reduces the incidence of diarrhoea in young adult travellers to high-risk areas. Risk of travellers' diarrhoea was assessed according to destination and reason for travel in high-risk travellers of a travel clinic in Barcelona, Spain. Those at high-risk between January and December 2005 were advised on water/food safety and hygiene. High-risk travellers between January and December 2006 were additionally vaccinated with WC/rBS oral cholera vaccine. Data regarding diarrhoea were gathered by structured telephone interview or e-mailed questionnaire following the travellers' return. The incidence of diarrhoea in the group vaccinated with WC/rBS oral cholera vaccine (n=321) was 17.4%, compared with 39.7% in the non-vaccinated group (n=337) (adjusted risk ratio 0.40). The first episode was significantly shorter in the vaccinated group (mean 2.3 days) than in the non-vaccinated group (mean 3.8 days) (p<0.001). The protective effect of the WC/rBS oral cholera vaccine was 57% in the young, high-risk travellers. Vaccination with the WC/rBS oral cholera vaccine as well as food safety and hygiene advice could offer effective means of reducing the risk of diarrhoea while abroad.

  17. Modal shifts in short-haul passenger travel and the consequent energy impacts. [Intercity travel under 500 miles

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

    Not Available

    1980-03-01

    A study was performed to evaluate the impacts of strategies to effect modal shifts in short-haul passenger travel (defined herein as intercity travel under 500 miles) from energy-intensive modes to those modes that are less energy-intensive. A series of individual strategies, ranging from incentives to the less energy-intensive modes (bus, rail) to penalties to the more energy-intensive modes (auto, air) was examined to determine energy saved and policy implications relative to strategy implementation. The most effective of the individual strategies were then combined in all permutations, and the analysis was repeated. As part of the analytical process, effects of factorsmore » other than energy (user cost and time, emissions, government subsidy, and travel fatailities) were examined in a benefit/cost analysis. Finally, energy savings, benefit/cost impacts, implementation considerations, and policy implications were evaluated to arrive at conclusions as to the effectiveness of the more-influential strategies and to the overall effectiveness of induced modal shifts. The principal conclusion of the study is that the maximum 1980 energy saving that might be realized by modal shifts, discounting the concurrent effects of demand suppression and improvement of mode efficiency, is approximately 83 x 10/sup 12/ Btu (46,500 bbl gasoline per day), 3.8% of the total projected 1980 energy consumption in the short-haul transportation sector and 0.23% of the total US petroleum use. It was also concluded that strategies to achieve these small savings by modal shifts would result in significant economic, social, and business disruptions.« less

  18. 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)

  19. Incremental Costs and Cost Effectiveness of Intensive Treatment in Individuals with Type 2 Diabetes Detected by Screening in the ADDITION-UK Trial: An Update with Empirical Trial-Based Cost Data.

    PubMed

    Laxy, Michael; Wilson, Edward C F; Boothby, Clare E; Griffin, Simon J

    2017-12-01

    There is uncertainty about the cost effectiveness of early intensive treatment versus routine care in individuals with type 2 diabetes detected by screening. To derive a trial-informed estimate of the incremental costs of intensive treatment as delivered in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care-Europe (ADDITION) trial and to revisit the long-term cost-effectiveness analysis from the perspective of the UK National Health Service. We analyzed the electronic primary care records of a subsample of the ADDITION-Cambridge trial cohort (n = 173). Unit costs of used primary care services were taken from the published literature. Incremental annual costs of intensive treatment versus routine care in years 1 to 5 after diagnosis were calculated using multilevel generalized linear models. We revisited the long-term cost-utility analyses for the ADDITION-UK trial cohort and reported results for ADDITION-Cambridge using the UK Prospective Diabetes Study Outcomes Model and the trial-informed cost estimates according to a previously developed evaluation framework. Incremental annual costs of intensive treatment over years 1 to 5 averaged £29.10 (standard error = £33.00) for consultations with general practitioners and nurses and £54.60 (standard error = £28.50) for metabolic and cardioprotective medication. For ADDITION-UK, over the 10-, 20-, and 30-year time horizon, adjusted incremental quality-adjusted life-years (QALYs) were 0.014, 0.043, and 0.048, and adjusted incremental costs were £1,021, £1,217, and £1,311, resulting in incremental cost-effectiveness ratios of £71,232/QALY, £28,444/QALY, and £27,549/QALY, respectively. Respective incremental cost-effectiveness ratios for ADDITION-Cambridge were slightly higher. The incremental costs of intensive treatment as delivered in the ADDITION-Cambridge trial were lower than expected. Given UK willingness-to-pay thresholds in patients with screen

  20. 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

  1. Using probabilistic terrorism risk modeling for regulatory benefit-cost analysis: application to the Western hemisphere travel initiative in the land environment.

    PubMed

    Willis, Henry H; LaTourrette, Tom

    2008-04-01

    This article presents a framework for using probabilistic terrorism risk modeling in regulatory analysis. We demonstrate the framework with an example application involving a regulation under consideration, the Western Hemisphere Travel Initiative for the Land Environment, (WHTI-L). First, we estimate annualized loss from terrorist attacks with the Risk Management Solutions (RMS) Probabilistic Terrorism Model. We then estimate the critical risk reduction, which is the risk-reducing effectiveness of WHTI-L needed for its benefit, in terms of reduced terrorism loss in the United States, to exceed its cost. Our analysis indicates that the critical risk reduction depends strongly not only on uncertainties in the terrorism risk level, but also on uncertainty in the cost of regulation and how casualties are monetized. For a terrorism risk level based on the RMS standard risk estimate, the baseline regulatory cost estimate for WHTI-L, and a range of casualty cost estimates based on the willingness-to-pay approach, our estimate for the expected annualized loss from terrorism ranges from $2.7 billion to $5.2 billion. For this range in annualized loss, the critical risk reduction for WHTI-L ranges from 7% to 13%. Basing results on a lower risk level that results in halving the annualized terrorism loss would double the critical risk reduction (14-26%), and basing the results on a higher risk level that results in a doubling of the annualized terrorism loss would cut the critical risk reduction in half (3.5-6.6%). Ideally, decisions about terrorism security regulations and policies would be informed by true benefit-cost analyses in which the estimated benefits are compared to costs. Such analyses for terrorism security efforts face substantial impediments stemming from the great uncertainty in the terrorist threat and the very low recurrence interval for large attacks. Several approaches can be used to estimate how a terrorism security program or regulation reduces the

  2. Low Cost Injection Mold Creation via Hybrid Additive and Conventional Manufacturing

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

    Dehoff, Ryan R.; Watkins, Thomas R.; List, III, Frederick Alyious

    2015-12-01

    The purpose of the proposed project between Cummins and ORNL is to significantly reduce the cost of the tooling (machining and materials) required to create injection molds to make plastic components. Presently, the high cost of this tooling forces the design decision to make cast aluminum parts because Cummins typical production volumes are too low to allow injection molded plastic parts to be cost effective with the amortized cost of the injection molding tooling. In addition to reducing the weight of components, polymer injection molding allows the opportunity for the alternative cooling methods, via nitrogen gas. Nitrogen gas cooling offersmore » an environmentally and economically attractive cooling option, if the mold can be manufactured economically. In this project, a current injection molding design was optimized for cooling using nitrogen gas. The various components of the injection mold tooling were fabricated using the Renishaw powder bed laser additive manufacturing technology. Subsequent machining was performed on the as deposited components to form a working assembly. The injection mold is scheduled to be tested in a projection setting at a commercial vendor selected by Cummins.« less

  3. [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.

  4. The economic burden of overseas medical treatment: a cross sectional study of Maldivian medical travelers.

    PubMed

    Suzana, Mariyam; Mills, Anne; Tangcharoensathien, Viroj; Chongsuvivatwong, Virasakdi

    2015-09-26

    Access to tertiary care is a problem common to many small states, especially island ones. Although medical treatment overseas (MTO) may result in cost savings to high income countries, it can be a relatively high cost for low and middle income source countries. The purpose of this study was to estimate the costs of overseas medical treatment incurred by the households of medical travelers from Maldives and assess the burden of medical treatment overseas on the government and on households. A survey was conducted of inbound Maldivian medical travelers who traveled during the period June - December 2013. Participants were stratified by the source of funds used for treatment abroad. Three hundred and forty four government-subsidized and 471 privately funded Maldivians were interviewed. Self-reported data on the utilization and expenses incurred during the last visit abroad, including both expenses covered by the government and borne by the household, were collected using a researcher administered structured questionnaire. The median per capita total cost of a medical travel episode amounted to $1,470. Forty eight percent of the cost was spent on travel. Twenty six percent was spent on direct medical costs, which were markedly higher among patients subsidized by the government than self-funded patients (p = <0.001). The two highest areas of spending for public funds were neoplasms and diseases of the circulatory system in contrast to diseases of the musculoskeletal system and nervous system for privately funded patients. Medical treatment overseas imposed a considerable burden on households as 43% of the households of medical travelers suffered from catastrophic health spending. Annually, an estimated $68.9 million was spent to obtain treatment for Maldivians in overseas health facilities ($204 per capita), representing 4.8% of the country's GDP. Overseas medical treatment represents a substantial economic burden to the Maldives in terms of lost consumer spending

  5. 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.

  6. 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

  7. Patients with mental problems - the most defenseless travellers.

    PubMed

    Felkai, Peter; Kurimay, Tamas

    2017-09-01

    Severe mental illness occurring abroad is a difficult situation for patients, their families, and for the local medical community. Patients with mental problem are doublely stigmatized due to their mental illness and because they are foreigners in an unfamiliar country. The appropriate treatment is often delayed, while patients are often dealt with in a manner that violates their human rights. Moreover, repatriation - which is vital in this case - is often delayed due to the lack of international protocols for the transportation and treatment of mentally ill travelers. Authors analyzed several factors related to acute mental health problems during travel: the etiology of symptoms, the appropriate treatment possibilities abroad, and medical evacuation and repatriation of the psychotic patient. The article presents a brief review of travel-related mental disorders, the epidemiology of mental health issues faced by travelers, and the significance of pre-travel advice for these patients. The first problem is to recognize (and redress) the particular challenges faced by a psychotic patient in a strange country. The second challenge is to prepare the patients, often in a poor psychiatric state, for medical evacuation by commercial aircraft. Another important question is the best way to take the patient through customs and security control. All of these, as yet unresolved, issues can make the mental patient virtually defenseless. Although timely repatriation of a mentally ill patient is vital and urgent, most travel insurance policies exclude treatment and repatriation costs incurred due to acute mental illness. The high cost of treatment and repatriation must be paid by the patient or their family, which could lead to severe financial strain or insolvency. Changing the approaches taken by the local mental health care community, police, airport security, and insurance companies remain a challenge for psychiatrists. © International Society of Travel Medicine, 2017

  8. PET-CT in oncological patients: analysis of informal care costs in cost-benefit assessment.

    PubMed

    Orlacchio, Antonio; Ciarrapico, Anna Micaela; Schillaci, Orazio; Chegai, Fabrizio; Tosti, Daniela; D'Alba, Fabrizio; Guazzaroni, Manlio; Simonetti, Giovanni

    2014-04-01

    The authors analysed the impact of nonmedical costs (travel, loss of productivity) in an economic analysis of PET-CT (positron-emission tomography-computed tomography) performed with standard contrast-enhanced CT protocols (CECT). From October to November 2009, a total of 100 patients referred to our institute were administered a questionnaire to evaluate the nonmedical costs of PET-CT. In addition, the medical costs (equipment maintenance and depreciation, consumables and staff) related to PET-CT performed with CECT and PET-CT with low-dose nonenhanced CT and separate CECT were also estimated. The medical costs were 919.3 euro for PET-CT with separate CECT, and 801.3 euro for PET-CT with CECT. Therefore, savings of approximately 13% are possible. Moreover, savings in nonmedical costs can be achieved by reducing the number of hospital visits required by patients undergoing diagnostic imaging. Nonmedical costs heavily affect patients' finances as well as having an indirect impact on national health expenditure. Our results show that PET-CT performed with standard dose CECT in a single session provides benefits in terms of both medical and nonmedical costs.

  9. 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

  10. 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.

  11. Preparing for International Travel and Global Medical Care.

    PubMed

    Mahadevan, Swaminatha V; Strehlow, Matthew C

    2017-05-01

    Thorough pretravel preparation and medical consultation can mitigate avoidable health and safety risks. A comprehensive pretravel medical consultation should include an individualized risk assessment, immunization review, and discussion of arthropod protective measures, malaria prophylaxis, traveler's diarrhea, and injury prevention. Travel with children and jet lag reduction require additional planning and prevention strategies; travel and evacuation insurance may prove essential when traveling to less resourced countries. Consideration should also be given to other high-risk travel scenarios, including the provision of health care overseas, adventure and extreme sports, water environments and diving, high altitude, and terrorism/unstable political situations. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Morbidity among Israeli paediatric travellers.

    PubMed

    Rabinowicz, Shira; Schwartz, Eli

    2017-09-01

    International travel, particularly to developing countries, is becoming increasingly common among the Israeli population, including an increase in the number of travelling children. Since children are a distinct travellers' population, data about their post-travel morbidity are needed. A retrospective study which examined all children (0-19 years old) who presented to our centre after international travel from 1999 to 2015. About 314 children were seen. The mean age was 10 years (SD ± 5.8). Most of the patients (80.6%) were tourists, and the rest were expatriates. The main destinations visited were South-Asia (46.5%), Sub-Saharan Africa (33.4%), Latin-America (7%) and Europe (6.4%). Overall, the most common diagnoses were gastrointestinal (GI) (mainly chronic) disorders (30.6%), followed by febrile diseases (26.4%), among which 18.1% of patients were diagnosed with dengue fever and 12% with malaria. Dermatologic conditions accounted for 25.2%. Additional diagnoses were schistosomiasis (6.4%) and neuropsychiatric symptoms (2.2%). A substantial part, 10.8%, had eosinophilia, either symptomatic or asymptomatic. Travellers to Asia, compared to travellers to Africa, presented more commonly with GI illness (OR 2.02, 95% confidence interval 1.13-3.61), and dermatologic conditions (OR 1.94, 95% confidence interval 1.05-3.61). Morbidity was associated with a variety of transmission modes, such as food-borne illnesses (30.9%), bite and sting wounds (10.2%), mosquito-borne infections (8%), freshwater contact (6.7%) and tick-borne infections (2.2%). The main conditions seen in paediatric returning travellers were GI, febrile and dermatologic illnesses, some may be rare in their country of origin. Targeting care for the suspected pathogens based on updated knowledge of epidemiology and thorough travel history is essential. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  13. [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

  14. Travel Pattern and Prescription Analysis at a Single Travel Clinic Specialized for Yellow Fever Vaccination in South Korea.

    PubMed

    Chin, Bum Sik; Kim, Jae Yoon; Gianella, Sara; Lee, Myunghee

    2016-03-01

    Travel-related risks for infectious diseases vary depending on travel patterns such as purpose, destination, and duration. In this study, we describe the patterns of travel and prescription of vaccines as well as malaria prophylaxis medication (MPM) at a travel clinic in South Korea to identify the gaps to fill for the optimization of pre-travel consultation. A cohort of travel clinic visitors in 2011 was constructed and early one-third of the visitors of each month were reviewed. During the study period, 10,009 visited the travel clinic and a retrospective chart review was performed for 3,332 cases for analysis of travel patterns and prescriptions. People receiving yellow fever vaccine (YFV) (n = 2,933) were traveling more frequently for business and tourism and less frequently for providing non-medical service or research/education compared to the 399 people who did not receive the YFV. Overall, most people were traveling to Eastern Africa, South America, and Western Africa, while South-Eastern Asia was the most common destination for the non-YFV group. Besides YFV, the typhoid vaccine was the most commonly prescribed (54.2%), while hepatitis A presented the highest coverage (74.7%) considering the natural immunity, prior and current vaccination history. Additionally, 402 (82.5%) individuals received a prescription for MPM among the 487 individuals travelling to areas with high-risk of malaria infection. Age over 55 was independently associated with receiving MPM prescription, while purpose of providing service and travel duration over 10 days were associated with no MPM prescription, despite travelling to high-risk areas. Eastern Africa and South America were common travel destinations among the visitors to a travel clinic for YFV, and most of them were travelling for tourism and business. For the individuals who are traveling to areas with high-risk for malaria, more proactive approach might be required in case of younger age travelers, longer duration, and

  15. Travel Pattern and Prescription Analysis at a Single Travel Clinic Specialized for Yellow Fever Vaccination in South Korea

    PubMed Central

    Gianella, Sara

    2016-01-01

    Background Travel-related risks for infectious diseases vary depending on travel patterns such as purpose, destination, and duration. In this study, we describe the patterns of travel and prescription of vaccines as well as malaria prophylaxis medication (MPM) at a travel clinic in South Korea to identify the gaps to fill for the optimization of pre-travel consultation. Materials and Methods A cohort of travel clinic visitors in 2011 was constructed and early one-third of the visitors of each month were reviewed. During the study period, 10,009 visited the travel clinic and a retrospective chart review was performed for 3,332 cases for analysis of travel patterns and prescriptions. Results People receiving yellow fever vaccine (YFV) (n = 2,933) were traveling more frequently for business and tourism and less frequently for providing non-medical service or research/education compared to the 399 people who did not receive the YFV. Overall, most people were traveling to Eastern Africa, South America, and Western Africa, while South-Eastern Asia was the most common destination for the non-YFV group. Besides YFV, the typhoid vaccine was the most commonly prescribed (54.2%), while hepatitis A presented the highest coverage (74.7%) considering the natural immunity, prior and current vaccination history. Additionally, 402 (82.5%) individuals received a prescription for MPM among the 487 individuals travelling to areas with high-risk of malaria infection. Age over 55 was independently associated with receiving MPM prescription, while purpose of providing service and travel duration over 10 days were associated with no MPM prescription, despite travelling to high-risk areas. Conclusion Eastern Africa and South America were common travel destinations among the visitors to a travel clinic for YFV, and most of them were travelling for tourism and business. For the individuals who are traveling to areas with high-risk for malaria, more proactive approach might be required in

  16. 7 CFR 1710.253 - Engineering and cost studies-addition of generation capacity.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 11 2014-01-01 2014-01-01 false Engineering and cost studies-addition of generation... TO ELECTRIC LOANS AND GUARANTEES Construction Work Plans and Related Studies § 1710.253 Engineering... engineering and cost studies as specified by RUS. The studies shall cover a period from the beginning of the...

  17. 7 CFR 1710.253 - Engineering and cost studies-addition of generation capacity.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 11 2012-01-01 2012-01-01 false Engineering and cost studies-addition of generation... TO ELECTRIC LOANS AND GUARANTEES Construction Work Plans and Related Studies § 1710.253 Engineering... engineering and cost studies as specified by RUS. The studies shall cover a period from the beginning of the...

  18. 7 CFR 1710.253 - Engineering and cost studies-addition of generation capacity.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Engineering and cost studies-addition of generation... TO ELECTRIC LOANS AND GUARANTEES Construction Work Plans and Related Studies § 1710.253 Engineering... engineering and cost studies as specified by RUS. The studies shall cover a period from the beginning of the...

  19. 7 CFR 1710.253 - Engineering and cost studies-addition of generation capacity.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 11 2013-01-01 2013-01-01 false Engineering and cost studies-addition of generation... TO ELECTRIC LOANS AND GUARANTEES Construction Work Plans and Related Studies § 1710.253 Engineering... engineering and cost studies as specified by RUS. The studies shall cover a period from the beginning of the...

  20. 7 CFR 1710.253 - Engineering and cost studies-addition of generation capacity.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 11 2011-01-01 2011-01-01 false Engineering and cost studies-addition of generation... TO ELECTRIC LOANS AND GUARANTEES Construction Work Plans and Related Studies § 1710.253 Engineering... engineering and cost studies as specified by RUS. The studies shall cover a period from the beginning of the...

  1. 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.

  2. SideRack: A Cost-Effective Addition to Commercial Zebrafish Housing Systems

    PubMed Central

    Burg, Leonard; Gill, Ryan; Balciuniene, Jorune

    2014-01-01

    Abstract Commercially available aquatic housing systems provide excellent and relatively trouble-free hardware for rearing and housing juvenile as well as adult zebrafish. However, the cost of such systems is quite high and potentially prohibitive for smaller educational and research institutions. The need for tank space prompted us to experiment with various additions to our existing Aquaneering system. We also noted that high water exchange rates typical in commercial systems are suboptimal for quick growth of juvenile fish. We devised a housing system we call “SideRack,” which contains 20 large tanks with air supply and slow water circulation. It enables cost-effective expansion of existing fish facility, with a key additional benefit of increased growth and maturation rates of juvenile fish. PMID:24611601

  3. 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.

  4. Bluetooth-based travel time/speed measuring systems development.

    DOT National Transportation Integrated Search

    2010-06-01

    Agencies in the Houston region have traditionally used toll tag readers to provide travel times on : freeways and High Occupancy Vehicle (HOV) lanes, but these systems require large amounts of costly and : physically invasive infrastructure. Bluetoot...

  5. International travellers from New Jersey: piloting a travel health module in the 2011 Behavioral Risk Factor Surveillance System survey.

    PubMed

    Stoney, Rhett J; Kozarsky, Phyllis; Bostick, Roberd M; Sotir, Mark J

    2016-01-01

    In 2011, the Centers for Disease Control and Prevention and the New Jersey Department of Health used the New Jersey Behavioral Risk Factor Survey (NJBRFS), a state component of the national Behavioral Risk Factor Surveillance System (BRFSS) to pilot a travel health module designed to collect population-based data on New Jersey residents travelling internationally. Our objective was to use this population-based travel health information to serve as a baseline to evaluate trends in US international travellers. A representative sample of New Jersey residents was identified through a random-digit-dialing method and administered the travel health module, which asked five questions: travel outside of USA during the previous year; destination; purpose; if a healthcare provider was visited before travel and any travel-related illness. Additional health variables from the larger NJBRFS were considered and included in bivariate analyses and multiple logistic regression; weights were assigned to variables to account for survey design complexity. Of 4029 participants, 841 (21%) travelled internationally. Top destinations included Mexico (10%), Canada (9%), Dominican Republic (6%), Bahamas (5%) and Italy (5%). Variables positively associated with travel included foreign birth, ≥$75 000 annual household income, college education and no children living in the household. One hundred fifty (18%) of 821 travellers with known destinations went to high-risk countries; 40% were visiting friends and relatives and only 30% sought pre-travel healthcare. Forty-eight (6%) of 837 responding travellers reported travel-related illness; 44% visited high-risk countries. Approximately one in five NJBRFS respondents travelled internationally during the previous year, a sizeable proportion to high-risk destinations. Few reported becoming ill as a result of travel but almost one-half of those ill had travelled to high-risk destinations. Population-based surveillance data on travellers can help

  6. 48 CFR 752.7002 - Travel and transportation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    .... 752.7002 Section 752.7002 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts of USAID Contract Clauses 752.7002 Travel and transportation. For use in cost reimbursement contracts performed in whole or in part overseas...

  7. Neurologic Aspects of Infections in International Travelers

    PubMed Central

    Han, May H.; Zunt, Joseph R.

    2009-01-01

    Background As international travel for business and pleasure becomes part of contemporary lifestyle, the clinician today is confronted with an increasing number of travelers returning ill with unfamiliar syndromes. The physician will encounter a myriad of patients with exotic infections, emerging infectious diseases, or resurgent Old-World infections. Review Summary This review article will discuss salient points of important infectious diseases associated with overseas travel, provide a syndromic approach to the traveler who returns with neurologic manifestations, and list resources for additional diagnostic, therapeutic, and preventive information. Conclusions As many of infections acquired in other countries can directly or indirectly affect the nervous system, the care of the ill traveler often falls into the hands of neurologists. The contemporary neurologist should therefore be knowledgeable of the clinical manifestations, potential complications, and appropriate management of region-specific infections. PMID:15631642

  8. International travellers from New Jersey: piloting a travel health module in the 2011 Behavioral Risk Factor Surveillance System survey†

    PubMed Central

    Stoney, Rhett J.; Kozarsky, Phyllis; Bostick, Roberd M.; Sotir, Mark J.

    2016-01-01

    Background In 2011, the Centers for Disease Control and Prevention and the New Jersey Department of Health used the New Jersey Behavioral Risk Factor Survey (NJBRFS), a state component of the national Behavioral Risk Factor Surveillance System (BRFSS) to pilot a travel health module designed to collect population-based data on New Jersey residents travelling internationally. Our objective was to use this population-based travel health information to serve as a baseline to evaluate trends in US international travellers. Methods A representative sample of New Jersey residents was identified through a random-digit-dialing method and administered the travel health module, which asked five questions: travel outside of USA during the previous year; destination; purpose; if a healthcare provider was visited before travel and any travel-related illness. Additional health variables from the larger NJBRFS were considered and included in bivariate analyses and multiple logistic regression; weights were assigned to variables to account for survey design complexity. Results Of 4029 participants, 841 (21%) travelled internationally. Top destinations included Mexico (10%), Canada (9%), Dominican Republic (6%), Bahamas (5%) and Italy (5%). Variables positively associated with travel included foreign birth, ≥$75 000 annual household income, college education and no children living in the household. One hundred fifty (18%) of 821 travellers with known destinations went to high-risk countries; 40% were visiting friends and relatives and only 30% sought pre-travel healthcare. Forty-eight (6%) of 837 responding travellers reported travel-related illness; 44% visited high-risk countries. Conclusions Approximately one in five NJBRFS respondents travelled internationally during the previous year, a sizeable proportion to high-risk destinations. Few reported becoming ill as a result of travel but almost one-half of those ill had travelled to high-risk destinations. Population

  9. Cost Effectiveness in Evaluation Technical Assistance: Different Aspects of Measuring Cost and Outcomes.

    ERIC Educational Resources Information Center

    Estes, Gary D.

    The paper focuses on the Title I Evaluation Technical Assistance Centers to illustrate issues of measuring costs and deciding on outcome criteria before promoting "cost-effective" approaches. Effects are illustrated for varying resource allocations among personnel, travel, materials, and phone costs as a function of emphasizing…

  10. 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.

  11. Risk and burden associated with the acquisition of viral hepatitis A and B in the corporate traveler.

    PubMed

    Bunn, William B

    2008-08-01

    As the number of international business travelers continues to grow, so does the list of destinations, many of which are endemic for both hepatitis A and B. Generally, travelers are unaware of the risks of acquiring viral hepatitis when traveling; many are unsure of modes of transmission and do not seek pretravel advice or do not follow the recommendations of travel health professionals. Infected employees can result in increased health care costs and reduced productivity in the workplace. Safe and efficacious monovalent vaccines and a combined hepatitis A and B vaccine are available. Successful corporate health and immunization programs can prevent hepatitis A and B when employees are abroad on business. This article examines the distribution, risks, costs, burden, and prevention of hepatitis A and B in the international business traveler.

  12. 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.

  13. 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.

  14. 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.

  15. 41 CFR 301-53.2 - What may I do with promotional benefits or materials I receive from a travel service provider?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What may I do with promotional benefits or materials I receive from a travel service provider? 301-53.2 Section 301-53.2 Public... obtained under the same conditions as those offered to the general public and at no additional cost to the...

  16. 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

  17. A shift from motorised travel to active transport: What are the potential health gains for an Australian city?

    PubMed Central

    Knibbs, Luke D.; Ware, Robert S.; Heesch, Kristiann C.; Tainio, Marko; Woodcock, James; Veerman, J. Lennert

    2017-01-01

    Introduction An alarmingly high proportion of the Australian adult population does not meet national physical activity guidelines (57%). This is concerning because physical inactivity is a risk factor for several chronic diseases. In recent years, an increasing emphasis has been placed on the potential for transport and urban planning to contribute to increased physical activity via greater uptake of active transport (walking, cycling and public transport). In this study, we aimed to estimate the potential health gains and savings in health care costs of an Australian city achieving its stated travel targets for the use of active transport. Methods Additional active transport time was estimated for the hypothetical scenario of Brisbane (1.1 million population 2013) in Australia achieving specified travel targets. A multi-state life table model was used to estimate the number of health-adjusted life years, life-years, changes in the burden of diseases and injuries, and the health care costs associated with changes in physical activity, fine particle (<2.5 μm; PM2.5) exposure, and road trauma attributable to a shift from motorised travel to active transport. Sensitivity analyses were conducted to test alternative modelling assumptions. Results Over the life course of the Brisbane adult population in 2013 (860,000 persons), 33,000 health-adjusted life years could be gained if the travel targets were achieved by 2026. This was mainly due to lower risks of physical inactivity-related diseases, with life course reductions in prevalence and mortality risk in the range of 1.5%-6.0%. Prevalence and mortality of respiratory diseases increased slightly (≥0.27%) due to increased exposure of larger numbers of cyclists and pedestrians to fine particles. The burden of road trauma increased by 30% for mortality and 7% for years lived with disability. We calculated substantial net savings ($AU183 million, 2013 values) in health care costs. Conclusion In cities, such as Brisbane

  18. A shift from motorised travel to active transport: What are the potential health gains for an Australian city?

    PubMed

    Zapata-Diomedi, Belen; Knibbs, Luke D; Ware, Robert S; Heesch, Kristiann C; Tainio, Marko; Woodcock, James; Veerman, J Lennert

    2017-01-01

    An alarmingly high proportion of the Australian adult population does not meet national physical activity guidelines (57%). This is concerning because physical inactivity is a risk factor for several chronic diseases. In recent years, an increasing emphasis has been placed on the potential for transport and urban planning to contribute to increased physical activity via greater uptake of active transport (walking, cycling and public transport). In this study, we aimed to estimate the potential health gains and savings in health care costs of an Australian city achieving its stated travel targets for the use of active transport. Additional active transport time was estimated for the hypothetical scenario of Brisbane (1.1 million population 2013) in Australia achieving specified travel targets. A multi-state life table model was used to estimate the number of health-adjusted life years, life-years, changes in the burden of diseases and injuries, and the health care costs associated with changes in physical activity, fine particle (<2.5 μm; PM2.5) exposure, and road trauma attributable to a shift from motorised travel to active transport. Sensitivity analyses were conducted to test alternative modelling assumptions. Over the life course of the Brisbane adult population in 2013 (860,000 persons), 33,000 health-adjusted life years could be gained if the travel targets were achieved by 2026. This was mainly due to lower risks of physical inactivity-related diseases, with life course reductions in prevalence and mortality risk in the range of 1.5%-6.0%. Prevalence and mortality of respiratory diseases increased slightly (≥0.27%) due to increased exposure of larger numbers of cyclists and pedestrians to fine particles. The burden of road trauma increased by 30% for mortality and 7% for years lived with disability. We calculated substantial net savings ($AU183 million, 2013 values) in health care costs. In cities, such as Brisbane, where over 80% of trips are made by

  19. 78 FR 20393 - Cost Recovery for Permit Processing, Administration, and Enforcement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-04

    ... by the general public.'' This charge is designed ``to recover the full cost to the Federal Government... general public. In keeping with Federal cost recovery policy, we are only proposing fees for those... based on the employees' salaries and benefits. The cost of travel includes travel associated with field...

  20. 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.

  1. 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.

  2. Medical insurance claims associated with international business travel.

    PubMed

    Liese, B; Mundt, K A; Dell, L D; Nagy, L; Demure, B

    1997-07-01

    Preliminary investigations of whether 10,884 staff and consultants of the World Bank experience disease due to work related travel. Medical insurance claims filed by 4738 travellers during 1993 were compared with claims of non-travellers. Specific diagnoses obtained from claims were analysed overall (one or more v no missions) and by frequency of international mission (1, 2-3, or > or = 4). Standardised rate of claims ratios (SSRs) for each diagnostic category were obtained by dividing the age adjusted rate of claims for travellers by the age adjusted rate of claims for non-travellers, and were calculated for men and women travellers separately. Overall, rates of insurance claims were 80% higher for men and 18% higher for women travellers than their non-travelling counterparts. Several associations with frequency of travel were found. SRRs for infectious disease were 1.28, 1.54, and 1.97 among men who had completed one, two or three, and four or more missions, and 1.16, 1.28, and 1.61, respectively, among women. The greatest excess related to travel was found for psychological disorders. For men SRRs were 2.11, 3.13, and 3.06 and for women, SRRs were 1.47, 1.96, and 2.59. International business travel may pose health risks beyond exposure to infectious diseases. Because travellers file medical claims at a greater rate than non-travellers, and for many categories of disease, the rate of claims increases with frequency of travel. The reasons for higher rates of claims among travellers are not well understood. Additional research on psychosocial factors, health practices, time zones crossed, and temporal relation between travel and onset of disease is planned.

  3. Travelling abroad with cystic fibrosis: Assessment of risks and healthcare requirements.

    PubMed

    Miller, Rachel; Blanch, Laura; Lenaghan, Sarah; Anderson, Alan; Doe, Simon; Bourke, Stephen J

    2017-04-01

    There is limited information on the risks and healthcare requirements of patients with cystic fibrosis (CF) undertaking travel abroad. Of 100 patients (mean age 24.7 years, mean FEV 1 57.3 %predicted) attending a UK adult CF Centre, 96% had travelled abroad but 14% now limited travel on medical advice. They travelled frequently and widely, often undertaking adventurous activities on holidays, but because of the costs involved, 18% travelled without travel insurance and 23% with insurance which did not cover CF. Of those who had ever had an illness abroad 10% had a CF-related illness (7 chest infection, 2 dehydration, 1 pancreatitis) and 12% a non-CF-related illness (4 sunburn, 3 gastroenteritis, 3 ear infection, 1 fall, 1 gastro-oesophageal reflux). There is a wide range of disease severity and assessment of the medical risks and the travel insurance premium to be charged should be based on the individual's health status rather than generically on the basis of a diagnosis of CF. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Update on traveler's diarrhea.

    PubMed

    Strum, W B

    1988-07-01

    Traveler's diarrhea affects a substantial number of travelers to high-risk areas of the world. The key to controlling this troublesome disease is prevention. The most important preventive measures depend on educating patients to consume only safe foods and pure water. Physicians cannot overemphasize the importance of avoiding high-risk foods and of boiling water if a safe water supply is not available. Prophylactic medications are a secondary consideration and should be prescribed with discretion. In most cases, diarrhea is mild and self-limited, requiring only fluid and electrolyte replacement and perhaps an antidiarrheal agent. In moderate to severe cases, the addition of an antimicrobial agent may be of benefit. Until an efficacious polyvalent vaccine is developed, caution and common sense, together with discretionary dietary and hygienic practices, are the best defenses against traveler's diarrhea. The ultimate solution is greatly improved sanitation and personal hygiene, especially in high-risk countries. However, only dreamers will consider waiting for this transformation to occur.

  5. 5 CFR 734.503 - Allocation and reimbursement of costs associated with political activities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... employee covered under this subpart must apportion the costs of mixed travel based on the time spent on political activities and the time spent performing official duties. Prorating the cost of travel involves..., receptions, rallies, and similar activities. Time spent in actual travel, private study, or rest and...

  6. Why Do Long-Distance Travelers Have Improved Pancreatectomy Outcomes?

    PubMed

    Jindal, Manila; Zheng, Chaoyi; Quadri, Humair S; Ihemelandu, Chukwuemeka U; Hong, Young K; Smith, Andrew K; Dudeja, Vikas; Shara, Nawar M; Johnson, Lynt B; Al-Refaie, Waddah B

    2017-08-01

    Centralization of complex surgical care has led patients to travel longer distances. Emerging evidence suggested a negative association between increased travel distance and mortality after pancreatectomy. However, the reason for this association remains largely unknown. We sought to unravel the relationships among travel distance, receiving pancreatectomy at high-volume hospitals, delayed surgery, and operative outcomes. We identified 44,476 patients who underwent pancreatectomy for neoplasms between 2004 and 2013 at the reporting facility from the National Cancer Database. Multivariable analyses were performed to examine the independent relationships between increments in travel distance mortality (30-day and long-term survival) after adjusting for patient demographics, comorbidity, cancer stage, and time trend. We then examined how additional adjustment of procedure volume affected this relationship overall and among rural patients. Median travel distance to undergo pancreatectomy increased from 16.5 to 18.7 miles (p for trend < 0.001). Although longer travel distance was associated with delayed pancreatectomy, it was also related to higher odds of receiving pancreatectomy at a high-volume hospital and lower postoperative mortality. In multivariable analysis, difference in mortality among patients with varying travel distance was attenuated by adjustment for procedure volume. However, longest travel distance was still associated with a 77% lower 30-day mortality rate than shortest travel among rural patients, even when accounting for procedure volume. Our large national study found that the beneficial effect of longer travel distance on mortality after pancreatectomy is mainly attributable to increase in procedure volume. However, it can have additional benefits on rural patients that are not explained by volume. Distance can represent a surrogate for rural populations. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights

  7. Cuba: U.S. Restrictions on Travel and Remittances

    DTIC Science & Technology

    2007-02-27

    forwarded to the OFAC-Miami office. In January 2006, OFAC suspended a South Florida travel agency, La Estrella de Cuba, from booking travel to Cuba...Department spokesman, OFAC had plans to conduct 25 on- site audits in 2006 at agencies that do business with Cuba.15 In addition to La Estrella de Cuba

  8. Cuba: U.S. Restrictions on Travel and Remittances

    DTIC Science & Technology

    2009-03-31

    office. In January 2006, OFAC suspended a South Florida travel agency, La Estrella de Cuba, from booking travel to Cuba. The agency reportedly was one...plans to conduct 25 on-site audits in 2006 at agencies that do business with Cuba.22 In addition to La Estrella de Cuba, OFAC suspended the service

  9. 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.

  10. 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

  11. 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.

  12. 41 CFR 301-70.701 - Who has the authority to grant exemptions to mandatory use of Government contractor-issued travel...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... through a travel charge card is impractical or imposes unreasonable burdens or costs on Federal employees... grant exemptions to mandatory use of Government contractor-issued travel charge card for official travel? 301-70.701 Section 301-70.701 Public Contracts and Property Management Federal Travel Regulation...

  13. Medical insurance claims associated with international business travel.

    PubMed Central

    Liese, B; Mundt, K A; Dell, L D; Nagy, L; Demure, B

    1997-01-01

    OBJECTIVES: Preliminary investigations of whether 10,884 staff and consultants of the World Bank experience disease due to work related travel. Medical insurance claims filed by 4738 travellers during 1993 were compared with claims of non-travellers. METHODS: Specific diagnoses obtained from claims were analysed overall (one or more v no missions) and by frequency of international mission (1, 2-3, or > or = 4). Standardised rate of claims ratios (SSRs) for each diagnostic category were obtained by dividing the age adjusted rate of claims for travellers by the age adjusted rate of claims for non-travellers, and were calculated for men and women travellers separately. RESULTS: Overall, rates of insurance claims were 80% higher for men and 18% higher for women travellers than their non-travelling counterparts. Several associations with frequency of travel were found. SRRs for infectious disease were 1.28, 1.54, and 1.97 among men who had completed one, two or three, and four or more missions, and 1.16, 1.28, and 1.61, respectively, among women. The greatest excess related to travel was found for psychological disorders. For men SRRs were 2.11, 3.13, and 3.06 and for women, SRRs were 1.47, 1.96, and 2.59. CONCLUSIONS: International business travel may pose health risks beyond exposure to infectious diseases. Because travellers file medical claims at a greater rate than non-travellers, and for many categories of disease, the rate of claims increases with frequency of travel. The reasons for higher rates of claims among travellers are not well understood. Additional research on psychosocial factors, health practices, time zones crossed, and temporal relation between travel and onset of disease is planned. PMID:9282127

  14. 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.

  15. 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.

  16. 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

  17. Review: Malaria Chemoprophylaxis for Travelers to Latin America

    PubMed Central

    Steinhardt, Laura C.; Magill, Alan J.; Arguin, Paul M.

    2011-01-01

    Because of recent declining malaria transmission in Latin America, some authorities have recommended against chemoprophylaxis for most travelers to this region. However, the predominant parasite species in Latin America, Plasmodium vivax, can form hypnozoites sequestered in the liver, causing malaria relapses. Additionally, new evidence shows the potential severity of vivax infections, warranting continued consideration of prophylaxis for travel to Latin America. Individualized travel risk assessments are recommended and should consider travel locations, type, length, and season, as well as probability of itinerary changes. Travel recommendations might include no precautions, mosquito avoidance only, or mosquito avoidance and chemoprophylaxis. There are a range of good options for chemoprophylaxis in Latin America, including atovaquone-proguanil, doxycycline, mefloquine, and—in selected areas—chloroquine. Primaquine should be strongly considered for nonpregnant, G6PD-nondeficient patients traveling to vivax-endemic areas of Latin America, and it has the added benefit of being the only drug to protect against malaria relapses. PMID:22144437

  18. 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.

  19. 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.

  20. Cost and Time Effectiveness Analysis of a Telemedicine Service in Bangladesh.

    PubMed

    Sorwar, Golam; Rahamn, Md Mustafizur; Uddin, Ramiz; Hoque, Md Rakibul

    2016-01-01

    Telemedicine has great potential to overcome geographical barriers to providing access to equal health care services, particularly for people living in remote and rural areas in developing countries like Bangladesh. A number of telemedicine systems have been implemented in Bangladesh. However, no significant studies have been conducted to determine either their cost effectiveness or efficiency in reducing travel time required by patients. In addition, very few studies have analyzed the attitude and level of satisfaction of telemedicine service recipients in Bangladesh. The aim of this study was to analyze the cost and time effectiveness of a telemedicine service, implemented through locally developed PC based diagnostic equipment and software in Bangladesh, compared to conventional means of providing those services. The study revealed that the introduced telemedicine service reduced cost and travel time on average by 56% and 94% respectively compared to its counterpart conventional approach. The study also revealed that majority of users were highly satisfied with the newly introduced telemedicine service. Therefore, the introduced telemedicine service can be considered as a low cost and time efficient health service solution to improve health care facilities in the remote rural areas in Bangladesh.

  1. Quantifying incident-induced travel delays on freeways using traffic sensor data : phase II

    DOT National Transportation Integrated Search

    2010-12-01

    Traffic incidents cause approximately 50 percent of freeway congestion in metropolitan areas, resulting in extra travel time and fuel cost. Quantifying incident-induced delay (IID) will help people better understand the real costs of incidents, maxim...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. Cuba: U.S. Restrictions on Travel and Remittances

    DTIC Science & Technology

    2009-01-21

    forwarded to the OFAC-Miami office. In January 2006, OFAC suspended a South Florida travel agency, La Estrella de Cuba, from booking travel to Cuba. The...Department spokesman, OFAC had plans to conduct 25 on-site audits in 2006 at agencies that do business with Cuba.22 In addition to La Estrella de Cuba

  8. 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

  9. 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.

  10. Injecting risk behavior among traveling young injection drug users: travel partner and city characteristics.

    PubMed

    Montgomery, Martha E; Fatch, Robin S; Evans, Jennifer L; Yu, Michelle; Davidson, Peter J; Page, Kimberly; Hahn, Judith A

    2013-06-01

    Young injection drug users (IDUs), a highly mobile population, engage in high levels of injecting risk behavior, yet little is understood about how such risk behavior may vary by the characteristics of the cities to which they travel, including the existence of a syringe exchange program (SEP), as well as travel partner characteristics. In 2004-2005, we conducted a 6-month prospective study to investigate the risk behavior of 89 young IDUs as they traveled, with detailed information gathered about 350 city visits. In multivariable analyses, travel to larger urban cities with a population of 500,000-1,000,000 was significantly associated with injecting drugs (adjusted odds ratio (AOR) = 3.71; 95 % confidence interval (CI), 1.56-8.82), ancillary equipment sharing (AES; AOR = 7.05; 95 % CI, 2.25-22.06) and receptive needle sharing (RNS; AOR = 5.73; 95 % CI, 1.11-27.95), as compared with visits to smaller cities with populations below 50,000. Region of the country, and the existence of a SEP within the city visited, were not independently associated with injecting drugs, AES, or RNS during city visits. Traveling with more than one injecting partner was associated with injecting drugs during city visits (AOR = 2.77; 95 % CI, 1.46-5.27), when compared with traveling alone. Additionally, both non-daily and daily/almost daily alcohol use during city visits were associated with AES (AOR = 3.37; 95 % CI, 1.42-7.68; AOR = 3.03; 95 % CI, 1.32-6.97, respectively) as compared with no alcohol consumption. Traveling young IDUs are more likely to inject when traveling with other IDUs and to engage in higher risk injection behavior when they are in large cities. Risk behavior occurring in city visits, including equipment sharing and alcohol consumption, suggests further need for focused interventions to reduce risk for viral infection among this population.

  11. 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.

  12. 7 CFR 62.300 - Fees and other costs for service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .... Fees for QSVP services shall be based on the time required to provide service calculated to the nearest quarter hour period, including, but not limited to, official assessment time, travel time, and time... costs. Applicants are responsible for paying actual travel costs incurred to provide QSVP services...

  13. 7 CFR 62.300 - Fees and other costs for service.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... Fees for QSVP services shall be based on the time required to provide service calculated to the nearest quarter hour period, including, but not limited to, official assessment time, travel time, and time... costs. Applicants are responsible for paying actual travel costs incurred to provide QSVP services...

  14. 7 CFR 62.300 - Fees and other costs for service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... Fees for QSVP services shall be based on the time required to provide service calculated to the nearest quarter hour period, including, but not limited to, official assessment time, travel time, and time... costs. Applicants are responsible for paying actual travel costs incurred to provide QSVP services...

  15. 7 CFR 62.300 - Fees and other costs for service.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... Fees for QSVP services shall be based on the time required to provide service calculated to the nearest quarter hour period, including, but not limited to, official assessment time, travel time, and time... costs. Applicants are responsible for paying actual travel costs incurred to provide QSVP services...

  16. 7 CFR 62.300 - Fees and other costs for service.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... Fees for QSVP services shall be based on the time required to provide service calculated to the nearest quarter hour period, including, but not limited to, official assessment time, travel time, and time... costs. Applicants are responsible for paying actual travel costs incurred to provide QSVP services...

  17. 16 CFR 1105.11 - Compensable costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... services, and attorneys that are incurred by participants; (c) Transportation costs; (d) Travel-related costs such as lodging, meals, tipping, telephone calls; and (e) All other reasonable costs incurred... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Compensable costs. 1105.11 Section 1105.11...

  18. 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...

  19. 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.

  20. 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 ...

  1. 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 ...

  2. 'No cost of echolocation for flying bats' revisited.

    PubMed

    Voigt, Christian C; Lewanzik, Daniel

    2012-08-01

    Echolocation is energetically costly for resting bats, but previous experiments suggested echolocation to come at no costs for flying bats. Yet, previous studies did not investigate the relationship between echolocation, flight speed, aerial manoeuvres and metabolism. We re-evaluated the 'no-cost' hypothesis, by quantifying the echolocation pulse rate, the number of aerial manoeuvres (landings and U-turns), and the costs of transport in the 5-g insectivorous bat Rhogeessa io (Vespertilionidae). On average, bats (n = 15) travelled at 1.76 ± 0.36 m s⁻¹ and performed 11.2 ± 6.1 U-turns and 2.8 ± 2.9 ground landings when flying in an octagonal flight cage. Bats made more U-turns with decreasing wing loading (body weight divided by wing area). At flight, bats emitted 19.7 ± 2.7 echolocation pulses s⁻¹ (range 15.3-25.8 pulses s⁻¹), and metabolic rate averaged 2.84 ± 0.95 ml CO₂ min⁻¹, which was more than 16 times higher than at rest. Bats did not echolocate while not engaged in flight. Costs of transport were not related to the rate of echolocation pulse emission or the number of U-turns, but increased with increasing number of landings; probably as a consequence of slower travel speed when staying briefly on ground. Metabolic power of flight was lower than predicted for R. io under the assumption that energetic costs of echolocation call production is additive to the aerodynamic costs of flight. Results of our experiment are consistent with the notion that echolocation does not add large energetic costs to the aerodynamic power requirements of flight in bats.

  3. Quinolone resistance mutations in the faecal microbiota of Swedish travellers to India.

    PubMed

    Johnning, Anna; Kristiansson, Erik; Angelin, Martin; Marathe, Nachiket; Shouche, Yogesh S; Johansson, Anders; Larsson, D G Joakim

    2015-10-24

    International travel contributes to the spread of antibiotic resistant bacteria over the world. Most studies addressing travel-related changes in the faecal flora have focused on specific mobile resistance genes, or depended on culturing of individual bacterial isolates. Antibiotic resistance can, however, also spread via travellers colonized by bacteria carrying chromosomal antibiotic resistance mutations, but this has received little attention so far. Here we aimed at exploring the abundance of chromosomal quinolone resistance mutations in Escherichia communities residing in the gut of Swedish travellers, and to determine potential changes after visiting India. Sweden is a country with a comparably low degree of quinolone use and quinolone resistance, whereas the opposite is true for India. Massively parallel amplicon sequencing targeting the quinolone-resistance determining region of gyrA and parC was applied to total DNA extracted from faecal samples. Paired samples were collected from 12 Swedish medical students before and after a 4-15 week visit to India. Twelve Indian residents were included for additional comparisons. Methods known resistance mutations were common in Swedes before travel as well as in Indians, with a trend for all mutations to be more common in the Indian sub group. There was a significant increase in the abundance of the most common amino acid substitution in GyrA (S83L, from 44 to 72%, p=0.036) in the samples collected after return to Sweden. No other substitution, including others commonly associated with quinolone resistance (D87N in GyrA, S80I in ParC) changed significantly. The number of distinct genotypes encoded in each traveller was significantly reduced after their visit to India for both GyrA (p=0.0020) and ParC (p=0.0051), indicating a reduced genetic diversity, similar to that found in the Indians. International travel can alter the composition of the Escherichia communities in the faecal flora, favouring bacteria carrying

  4. 29 CFR 25.7 - Fees; cost; expenses; decisions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... limited to per diem, travel expenses and services on a time-worked basis. (e) Upon request, the Secretary... ORDER 10988 § 25.7 Fees; cost; expenses; decisions. (a) Arbitrator's fees, per diem and travel expenses.... Travel and per diem should be paid at the maximum rate payable to Government employees under the...

  5. 29 CFR 25.7 - Fees; cost; expenses; decisions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... limited to per diem, travel expenses and services on a time-worked basis. (e) Upon request, the Secretary... ORDER 10988 § 25.7 Fees; cost; expenses; decisions. (a) Arbitrator's fees, per diem and travel expenses.... Travel and per diem should be paid at the maximum rate payable to Government employees under the...

  6. 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

  7. 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.

  8. Why do medical tourists travel to where they do? The role of networks in determining medical travel.

    PubMed

    Hanefeld, J; Lunt, N; Smith, R; Horsfall, D

    2015-01-01

    Evidence on medical tourism, including patient motivation, is increasing. Existing studies have focused on identifying push and pull factors across different types of treatment, for example cosmetic or bariatric surgery, or on groups, such as diaspora patients returning 'home' for treatment. Less attention has been on why individuals travel to specific locations or providers and on how this decision is made. The paper focused on the role of networks, defined as linkages - formal and informal - between individual providers, patients and facilitators to explain why and where patients travel. Findings are based on a recently completed, two year research project, which examined the effects of medical tourism on the UK NHS. Research included in-depth interviews with 77 returning medical tourists and over sixty managers, medical travel facilitators, clinicians and providers of medical tourism in recipient countries to understand the medical tourism industry. Interviews were conducted between 2011 and 2012, recorded and transcribed, or documented through note taking. Authors undertook a thematic analysis of interviews to identify treatment pathways by patients, and professional linkages between clinicians and facilitators to understand choice of treatment destination. The results highlight that across a large sample of patients travelling for a variety of conditions from dental treatment, cosmetic and bariatric surgery, through to specialist care the role of networks is critical to understand choice of treatment, provider and destination. While distance, costs, expertise and availability of treatment all were factors influencing patients' decision to travel, choice of destination and provider was largely the result of informal networks, including web fora, personal recommendations and support groups. Where patients were referred by UK clinicians or facilitators these followed informal networks. In conclusion, investigating medical travel through focus on networks of

  9. Direct and indirect costs incurred by Australian living kidney donors.

    PubMed

    Barnieh, Lianne; Kanellis, John; McDonald, Stephen; Arnold, Jennifer; Sontrop, Jessica M; Cuerden, Meaghan; Klarenbach, Scott; Garg, Amit X; Boudville, Neil

    2017-12-07

    To describe the direct and indirect costs incurred by Australian living kidney donors. We studied 55 living kidney donors from 3 centres in Perth, Australia and 1 centre in Melbourne, Australia (2010-2014); 49 donors provided information on expenses incurred during the donor evaluation period and up to 3 months after donation. We used a micro-costing approach to measure and value the units of resources consumed. Expenses were grouped as direct costs (ground and air travel, accommodation, and prescription medications) and indirect costs (lost wages and lost productivity). We standardized costs to the year 2016 in Australian dollars. The most common direct costs were for ground travel (100%), parking (76%), and post-donation pain medications or antibiotics (73%). The highest direct costs were for air travel (median $1,986 [3 donors]) and ground travel (median $459 [49 donors]). Donors also reported lost wages (median $9,891 [37 donors]). The inability to perform household activities or care for dependants were reported by 32 (65%) and 23 (47%) donors. Total direct costs averaged $1,682 per donor (median $806 among 49 donors). Total indirect costs averaged $7,249 per donor (median $7,273 among 49 donors). Total direct and indirect costs averaged $8,932 per donor (median $7,963 among 49 donors). Many Australian living kidney donors incur substantial costs during the donation process. Our findings inform the continued development of policies and programs designed to minimize costs incurred by living kidney donors. This article is protected by copyright. All rights reserved.

  10. 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.

  11. Superconducting traveling wave accelerators

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

    Farkas, Z.D.

    1984-11-01

    This note considers the applicability of superconductivity to traveling wave accelerators. Unlike CW operation of a superconducting standing wave or circulating wave accelerator section, which requires improvement factors (superconductor conductivity divided by copper conductivity) of about 10/sup 6/ in order to be of practical use, a SUperconducting TRaveling wave Accelerator, SUTRA, operating in the pulsed mode requires improvement factors as low as about 10/sup 3/, which are attainable with niobium or lead at 4.2K, the temperature of liquid helium at atmospheric pressure. Changing from a copper traveling wave accelerator to SUTRA achieves the following. (1) For a given gradient SUTRAmore » reduces the peak and average power requirements typically by a factor of 2. (2) SUTRA reduces the peak power still further because it enables us to increase the filling time and thus trade pulse width for gradient. (3) SUTRA makes possible a reasonably long section at higher frequencies. (4) SUTRA makes possible recirculation without additional rf average power. 8 references, 6 figures, 1 table.« less

  12. Post-infectious sequelae of travelers' diarrhea.

    PubMed

    Connor, Bradley A; Riddle, Mark S

    2013-01-01

    Travelers' diarrhea (TD) has generally been considered a self-limited disorder which resolves more quickly with expeditious and appropriate antibiotic therapy given bacteria are the most frequently identified cause. However, epidemiological, clinical, and basic science evidence identifying a number of chronic health conditions related to these infections has recently emerged which challenges this current paradigm. These include serious and potentially disabling enteric and extra-intestinal long-term complications. Among these are rheumatologic, neurologic, gastrointestinal, renal, and endocrine disorders. This review aims to examine and summarize the current literature pertaining to three of these post-infectious disorders: reactive arthritis, Guillain-Barré syndrome, and post-infectious irritable bowel syndrome and the relationship of these conditions to diarrhea associated with travel as well as to diarrhea associated with gastroenteritis which may not be specifically travel related but relevant by shared microbial pathogens. It is hoped this review will allow clinicians who see travelers to be aware of these post-infectious sequelae thus adding to our body of knowledge in travel medicine. Data for this article were identified by searches of PubMed and MEDLINE, and references from relevant articles using search terms "travelers' diarrhea" "reactive arthritis" "Guillain-Barré syndrome" "Post-Infectious Irritable Bowel Syndrome." Abstracts were included when related to previously published work. A review of the published literature reveals that potential consequences of travelers' diarrhea may extend beyond the acute illness and these post-infectious complications may be more common than currently recognized. In addition since TD is such a common occurrence it would be helpful to be able to identify those who might be at greater risk of post-infectious sequelae in order to target more aggressive prophylactic or therapeutic approaches to such individuals. It is

  13. 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.

  14. 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.

  15. Cost savings from a telemedicine model of care in northern Queensland, Australia.

    PubMed

    Thaker, Darshit A; Monypenny, Richard; Olver, Ian; Sabesan, Sabe

    2013-09-16

    To conduct a cost analysis of a telemedicine model for cancer care (teleoncology) in northern Queensland, Australia, compared with the usual model of care from the perspective of the Townsville and other participating hospital and health services. Retrospective cost-savings analysis; and a one-way sensitivity analysis performed to test the robustness of findings in net savings. Records of all patients managed by means of teleoncology at the Townsville Cancer Centre (TCC) and its six rural satellite centres in northern Queensland, Australia between 1 March 2007 and 30 November 2011. Costs for set-up and staffing to manage the service, and savings from avoidance of travel expenses for specialist oncologists, patients and their escorts, and for aeromedical retrievals. There were 605 teleoncology consultations with 147 patients over 56 months, at a total cost of $442 276. The cost for project establishment was $36 000, equipment/maintenance was $143 271, and staff was $261 520. The estimated travel expense avoided was $762 394; this figure included the costs of travel for patients and escorts of $658 760, aeromedical retrievals of $52 400 and travel for specialists of $47 634, as well as an estimate of accommodation costs for a proportion of patients of $3600. This resulted in a net saving of $320 118. Costs would have to increase by 72% to negate the savings. The teleoncology model of care at the TCC resulted in net savings, mainly due to avoidance of travel costs. Such savings could be redirected to enhancing rural resources and service capabilities. This teleoncology model is applicable to geographically distant areas requiring lengthy travel.

  16. 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.

  17. 48 CFR 1842.7002 - Travel outside of the United States.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Travel outside of the... AND SPACE ADMINISTRATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Additional NASA Contract Clauses 1842.7002 Travel outside of the United States. The contracting officer shall...

  18. 48 CFR 1842.7002 - Travel outside of the United States.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Travel outside of the... AND SPACE ADMINISTRATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Additional NASA Contract Clauses 1842.7002 Travel outside of the United States. The contracting officer shall...

  19. 48 CFR 1842.7002 - Travel outside of the United States.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Travel outside of the... AND SPACE ADMINISTRATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Additional NASA Contract Clauses 1842.7002 Travel outside of the United States. The contracting officer shall...

  20. 48 CFR 1842.7002 - Travel outside of the United States.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Travel outside of the... AND SPACE ADMINISTRATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Additional NASA Contract Clauses 1842.7002 Travel outside of the United States. The contracting officer shall...

  1. 48 CFR 1842.7002 - Travel outside of the United States.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Travel outside of the... AND SPACE ADMINISTRATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Additional NASA Contract Clauses 1842.7002 Travel outside of the United States. The contracting officer shall...

  2. Clinical Characteristics and Etiology of Travelers' Diarrhea among Korean Travelers Visiting South-East Asia

    PubMed Central

    Ahn, Ji Yong; Chang, Kyu-Jin; You, Myung Hwan; Chai, Jin Sung; Kang, Young A; Kim, Seong-Han; Jeoung, Hyesook; Cheon, Doosung; Jeoung, Ahyong; Choi, Eun Suk

    2011-01-01

    The morbidity of travelers' diarrhea (TD) is still high. This study examined the incidence of common pathogens and characteristics of TD among Korean travelers who visited South-East Asian countries. We performed a prospective study involving 479 Korean travelers with diarrheal disease from February 2009 to April 2009 and stool samples were examined and questionnaire surveys were done after arrival. Enterotoxigenic Escherichia coli (ETEC) was found in 36.0% of TD cases, as were the following: Enteroaggregative Escherichia coli (EAEC) in 27.0%, Vibrio parahaemolyticus in 13.1%, and Norovirus in 11.5%. The detected rate of classic TD was higher in men (P = 0.007), in patients who had a shorter duration trip (P = 0.023) and in patients who drank more than 1 liter of water per day (P = 0.037). Positive stool culture rates were higher in men (P = 0.005), in hospitalized patients (P = 0.013). and in those who consumed impure water or raw foods (P = 0.033). A higher severity of disease corresponded to a significantly higher culture positivity rate (P = 0.029). We should consider the possibility of other pathogens in addition to ETEC in patients with TD who visit South-East Asia. Travelers need to educate about risk factors associated with TD. PMID:21286009

  3. Clinical characteristics and etiology of travelers' diarrhea among Korean travelers visiting South-East Asia.

    PubMed

    Ahn, Ji Yong; Chung, Jin-Won; Chang, Kyu-Jin; You, Myung Hwan; Chai, Jin Sung; Kang, Young A; Kim, Seong-Han; Jeoung, Hyesook; Cheon, Doosung; Jeoung, Ahyong; Choi, Eun Suk

    2011-02-01

    The morbidity of travelers' diarrhea (TD) is still high. This study examined the incidence of common pathogens and characteristics of TD among Korean travelers who visited South-East Asian countries. We performed a prospective study involving 479 Korean travelers with diarrheal disease from February 2009 to April 2009 and stool samples were examined and questionnaire surveys were done after arrival. Enterotoxigenic Escherichia coli (ETEC) was found in 36.0% of TD cases, as were the following: Enteroaggregative Escherichia coli (EAEC) in 27.0%, Vibrio parahaemolyticus in 13.1%, and Norovirus in 11.5%. The detected rate of classic TD was higher in men (P = 0.007), in patients who had a shorter duration trip (P = 0.023) and in patients who drank more than 1 liter of water per day (P = 0.037). Positive stool culture rates were higher in men (P = 0.005), in hospitalized patients (P = 0.013). and in those who consumed impure water or raw foods (P = 0.033). A higher severity of disease corresponded to a significantly higher culture positivity rate (P = 0.029). We should consider the possibility of other pathogens in addition to ETEC in patients with TD who visit South-East Asia. Travelers need to educate about risk factors associated with TD.

  4. 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.

  5. A quantum heuristic algorithm for the traveling salesman problem

    NASA Astrophysics Data System (ADS)

    Bang, Jeongho; Ryu, Junghee; Lee, Changhyoup; Yoo, Seokwon; Lim, James; Lee, Jinhyoung

    2012-12-01

    We propose a quantum heuristic algorithm to solve the traveling salesman problem by generalizing the Grover search. Sufficient conditions are derived to greatly enhance the probability of finding the tours with the cheapest costs reaching almost to unity. These conditions are characterized by the statistical properties of tour costs and are shown to be automatically satisfied in the large-number limit of cities. In particular for a continuous distribution of the tours along the cost, we show that the quantum heuristic algorithm exhibits a quadratic speedup compared to its classical heuristic algorithm.

  6. 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

  7. Application of travel time information for traffic management : technical summary.

    DOT National Transportation Integrated Search

    2012-01-01

    Using conventional methods, it is extremely costly to measure detailed traffic characteristics in high quality spatial or temporal resolution. For analyzing travel characteristics on roadways, the floating car method, developed in the 1920s, has hist...

  8. The severe acute respiratory syndrome: impact on travel and tourism.

    PubMed

    Wilder-Smith, Annelies

    2006-03-01

    SARS and travel are intricately interlinked. Travelers belonged to those primarily affected in the early stages of the outbreak, travelers became vectors of the disease, and finally, travel and tourism themselves became the victims. The outbreak of SARS created international anxiety because of its novelty, its ease of transmission in certain settings, and the speed of its spread through jet travel, combined with extensive media coverage. The psychological impacts of SARS, coupled with travel restrictions imposed by various national and international authorities, have diminished international travel in 2003, far beyond the limitations to truly SARS hit areas. Governments and press, especially in non SARS affected areas, have been slow to strike the right balance between timely and frequent risk communication and placing risk in the proper context. Screening at airport entry points is costly, has a low yield and is not sufficient in itself. The low yield in detecting SARS is most likely due to a combination of factors, such as travel advisories which resulted in reduced travel to and from SARS affected areas, implementation of effective pre-departure screening at airports in SARS-hit countries, and a rapid decline in new cases at the time when screening was finally introduced. Rather than investing in airport screening measures to detect rare infectious diseases, investments should be used to strengthen screening and infection control capacities at points of entry into the healthcare system. If SARS reoccurs, the subsequent outbreak will be smaller and more easily contained if the lessons learnt from the recent epidemic are applied. Lessons learnt during the outbreak in relation to international travel will be discussed.

  9. Cosmocultural Evolution: Cosmic Motivation for Interstellar Travel?

    NASA Astrophysics Data System (ADS)

    Lupisella, M.

    Motivations for interstellar travel can vary widely from practical survival motivations to wider-ranging moral obligations to future generations. But it may also be fruitful to explore what, if any, "cosmic" relevance there may be regarding interstellar travel. Cosmocultural evolution can be defined as the coevolution of cosmos and culture, with cultural evolution playing an important and perhaps critical role in the overall evolution of the universe. Strong versions of cosmocultural evolution might suggest that cultural evolution may have unlimited potential as a cosmic force. In such a worldview, the advancement of cultural beings throughout the universe could have significant cosmic relevance, perhaps providing additional motivation for interstellar travel. This paper will explore some potential philosophical and policy implications for interstellar travel of a cosmocultural evolutionary perspective and other related concepts, including some from a recent NASA book, Cosmos and Culture: Cultural Evolution in a Cosmic Context.

  10. 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.

  11. 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.

  12. Traveling-Wave Maser for 32 GHz

    NASA Technical Reports Server (NTRS)

    Shell, James; Clauss, Robert

    2009-01-01

    The figure depicts a traveling-wave ruby maser that has been designed (though not yet implemented in hardware) to serve as a low-noise amplifier for reception of weak radio signals in the frequency band of 31.8 to 32.3 GHz. The design offers significant improvements over previous designs of 32-GHz traveling-wave masers. In addition, relative to prior designs of 32-GHz amplifiers based on high-electron-mobility transistors, this design affords higher immunity to radio-frequency interference and lower equivalent input noise temperature. In addition to the basic frequency-band and low-noise requirements, the initial design problem included a requirement for capability of operation in a closed-cycle helium refrigerator at a temperature .4 K and a requirement that the design be mechanically simplified, relative to prior designs, in order to minimize the cost of fabrication and assembly. Previous attempts to build 32- GHz traveling-wave masers involved the use of metallic slow-wave structures comprising coupled transverse electromagnetic (TEM)-mode resonators that were subject to very tight tolerances and, hence, were expensive to fabricate and assemble. Impedance matching for coupling signals into and out of these earlier masers was very difficult. A key feature of the design is a slow-wave structure, the metallic portions of which would be mechanically relatively simple in that, unlike in prior slow-wave structures, there would be no internal metal steps, irises, or posts. The metallic portions of the slow-wave structure would consist only of two rectangular metal waveguide arms. The arms would contain sections filled with the active material (ruby) alternating with evanescent-wave sections. This structure would be transparent in both the signal-frequency band (the aforementioned range of 31.8 to 32.3 GHz) and the pump-frequency band (65.75 to 66.75 GHz), and would impose large slowing factors in both frequency bands. Resonant ferrite isolators would be placed in the

  13. NASA's attack on costs

    NASA Technical Reports Server (NTRS)

    Low, George M.

    1994-01-01

    This article's concern is regarding the high costs of space travel and the need to minimize or reduce these costs in order to effectively provide the continuation of the space programs and space exploration needs of the future. Discussed is the possibility and need to optimize payloads in order to lower the costs associated with them. Design phase principles and implementation phase points are discussed.

  14. 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...

  15. 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.

  16. Dual traveling wave rotary ultrasonic motor with single active vibrator

    NASA Astrophysics Data System (ADS)

    An, Dawei; Yang, Ming; Zhuang, Xiaoqi; Yang, Tianyue; Meng, Fan; Dong, Zhaopeng

    2017-04-01

    Traveling wave rotary ultrasonic motor with double vibrators can improve the output performance effectively. However, the rotor has to be energized through a slip ring, which increases the complexity and reduces the reliability. Inheriting the concept of two traveling waves propagating in the stator and rotor, a dual traveling wave rotary ultrasonic motor energized only in the stator is proposed. By analyzing the oscillatory differential equation and the contact particles motion, a traveling wave is found in the rotor and the drive mechanism of dual traveling wave is studied. With the resonant rotor adopted, the consistent eigenfrequencies are calculated by finite element method and verified by an impedance analyzer. The performance experiment presents that the dual traveling wave rotary ultrasonic motor is superior to the motor with single traveling wave. The no-load speed is 60 rpm and the stalling torque is 0.85 Nm. Additionally, compared with a reported motor with double vibrators, the proposed motor presents the better output performance and the simpler design.

  17. Government regulation and public opposition create high additional costs for field trials with GM crops in Switzerland.

    PubMed

    Bernauer, Thomas; Tribaldos, Theresa; Luginbühl, Carolin; Winzeler, Michael

    2011-12-01

    Field trials with GM crops are not only plant science experiments. They are also social experiments concerning the implications of government imposed regulatory constraints and public opposition for scientific activity. We assess these implications by estimating additional costs due to government regulation and public opposition in a recent set of field trials in Switzerland. We find that for every Euro spent on research, an additional 78 cents were spent on security, an additional 31 cents on biosafety, and an additional 17 cents on government regulatory supervision. Hence the total additional spending due to government regulation and public opposition was around 1.26 Euros for every Euro spent on the research per se. These estimates are conservative; they do not include additional costs that are hard to monetize (e.g. stakeholder information and dialogue activities, involvement of various government agencies). We conclude that further field experiments with GM crops in Switzerland are unlikely unless protected sites are set up to reduce these additional costs.

  18. Cost estimates for selected California smart traveler operation tests. Volume 1, technical report

    DOT National Transportation Integrated Search

    1993-03-01

    The original "California Smart Traveler" report describes how telephone-based information systems can be used to develop new types of public transportation services (e.g. single-trip carpools) and to integrate these new services with conventional tra...

  19. Comparison of geographic methods to assess travel patterns of persons diagnosed with HIV in Philadelphia: how close is close enough?

    PubMed

    Eberhart, Michael G; Share, Amanda M; Shpaner, Mark; Brady, Kathleen A

    2015-02-01

    Travel distance to medical care has been assessed using a variety of geographic methods. Network analyses are less common, but may generate more accurate estimates of travel costs. We compared straight-line distances and driving distance, as well as average drive time and travel time on a public transit network for 1789 persons diagnosed with HIV between 2010 and 2012 to identify differences overall, and by distinct geographic areas of Philadelphia. Paired t-tests were used to assess differences across methods, and analysis of variance was used to assess between-group differences. Driving distances were significantly longer than straight-line distances (p<0.001) and transit times were significantly longer than driving times (p<0.001). Persons living in the northeast section of the city traveled greater distances, and at greater cost of time and effort, than persons in all other areas of the city (p<0.001). Persons living in the northwest section of the city traveled farther and longer than all other areas except the northeast (p<0.0001). Network analyses that include public transit will likely produce a more realistic estimate of the travel costs, and may improve models to predict medical care outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  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. 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

  3. The systemic lupus erythematosus travel burden survey: baseline data among a South Carolina cohort.

    PubMed

    Williams, Edith M; Ortiz, Kasim; Zhang, Jiajia; Zhou, Jie; Kamen, Diane

    2016-04-29

    Many studies on the impact of systemic lupus erythematosus or lupus have identified patient travel costs as being problematic. We administered a survey that examined the impact of self-rated travel burden on lupus patients. The systemic lupus erythematosus travel burden survey included 41 patients enrolled in the systemic lupus erythematosus database project at the Medical University of South Carolina. Most participants reported that travel caused medications to be discontinued or appointments to be missed. In unadjusted logistic regressions of the relationship between these outcomes and medical travel burden, both distance to rheumatologists and time to lupus medical care were significant. Our findings suggest that more research is needed to examine the influence of travel burden among this population, but data from this report could help to inform physicians, academic researchers, and other health professionals in South Carolina and other areas with significant rural populations on how travel burden may impact patients receiving care for lupus and provide an opportunity for the development of interventions aimed at assisting lupus patients with management of stressors related to travel burden.

  4. Freeway travel time estimation using existing fixed traffic sensors : phase 2.

    DOT National Transportation Integrated Search

    2015-03-01

    Travel time, one of the most important freeway performance metrics, can be easily estimated using the : data collected from fixed traffic sensors, avoiding the need to install additional travel time data collectors. : This project is aimed at fully u...

  5. Acceptability, Feasibility, and Cost of Telemedicine for Nonacute Headaches: A Randomized Study Comparing Video and Traditional Consultations.

    PubMed

    Müller, Kai Ivar; Alstadhaug, Karl Bjørnar; Bekkelund, Svein Ivar

    2016-05-30

    practices were not statistically different between the two randomized groups. In addition, telemedicine consultations were shorter than traditional visits (38.8 vs 43.7 min, P<.001). The travel cost per rural individual (292/402, 73%) was €249, and estimated lost income was €234 per visit. The travel cost in the urban area (110/402, 27%) was €6, and estimated lost income was €117 per visit. The median traveling distance for rural patients was 526 km (range 1892 km), and the median traveling time was 7.8 hours (range 27.3 hours). Rural patients had a longer waiting time than urban patients (64 vs 47 days, P=.001), and fewer women were referred from rural areas (P=.04). Rural women reported higher pain scores than urban women (P=.005). Our study shows that telemedicine is an accepted, feasible, time-saving, and cost-saving alternative to traditional specialist consultations for nonacute headaches. Clinicaltrials.gov NCT02270177; http://clinicaltrials.gov/ct2/show/NCT02270177 (Archived by WebCite at http://www.webcitation.org/6hmoHGo9Q).

  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. 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.

  8. 24 CFR 570.206 - Program administrative costs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....204, since those costs are eligible as part of such activities. (a) General management, oversight and coordination. Reasonable costs of overall program management, coordination, monitoring, and evaluation. Such.... (2) Travel costs incurred for official business in carrying out the program; (3) Administrative...

  9. International students' image of rural Pennsylvania as a travel destination

    Treesearch

    Po-Ju Chen; Deborah L. Kerstetter

    1998-01-01

    The purpose of this study was to examine the image international students at Penn State have of rural travel destinations in the state of Pennsylvania. In addition, this study investigated whether destination image differed depending upon travel behavior and socio-demographic variables. Four distinct image dimensions, "tourism infrastructure," "...

  10. Closing the gap in travel medicine: reframing research questions for a new era.

    PubMed

    Chen, Lin H; Leder, Karin; Wilson, Mary E

    2017-07-01

    Travel medicine needs are changing. New patterns of travel, including greater travel by individuals from emerging economies with different values in costs, risks and benefits, must be considered. This review aims to (1) highlight selected studies that have been published that address previously identified gaps in knowledge; (2) propose possible ways to consider questions regarding travel medicine practice for travelers from emerging economies, underscoring priorities for research focusing on these important populations; (3) highlight potential deficiencies in relevance of current international guidelines as they pertain to travelers from emerging economies; (4) frame research questions for travelers from emerging economies and (5) consider roles for ISTM in closing the gap. We reviewed past travel medicine research priorities published in 2010 to identify publications that responded to some research questions posed. We also reviewed CDC and WHO recommendations and assessed their applicability to travelers from emerging economies. Recent publications have responded to some research questions, but gaps remain and new questions have emerged. Re-framing of several key research questions is needed for travelers from emerging economies. A new challenge looms for traditional travel medicine fields to identify and attend to knowledge and guideline gaps, particularly to rethink questions regarding travel medicine to make them relevant for travelers from emerging economies. The International Society of Travel Medicine is well positioned to assist emerging economies assess their resources and needs, formulate research priorities and tailor the development of travel medicine into a framework aligned to their requirements. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  11. 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

  12. 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

  13. 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.

  14. 48 CFR 3452.216-70 - Additional cost principles.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... practice is to treat these costs by some other method, they may be accepted if they are found to be reasonable and equitable. Bid and proposal costs do not include independent research and development costs or pre-award costs. (b) Independent research and development costs. Independent research and development...

  15. Traveling salesman problem with a center.

    PubMed

    Lipowski, Adam; Lipowska, Dorota

    2005-06-01

    We study a traveling salesman problem where the path is optimized with a cost function that includes its length L as well as a certain measure C of its distance from the geometrical center of the graph. Using simulated annealing (SA) we show that such a problem has a transition point that separates two phases differing in the scaling behavior of L and C, in efficiency of SA, and in the shape of minimal paths.

  16. 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.

  17. 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.

  18. Energetically optimal travel across terrain: visualizations and a new metric of geographic distance with anthropological applications

    NASA Astrophysics Data System (ADS)

    Wood, Brian M.; Wood, Zoë J.

    2006-01-01

    We present a visualization and computation tool for modeling the caloric cost of pedestrian travel across three dimensional terrains. This tool is being used in ongoing archaeological research that analyzes how costs of locomotion affect the spatial distribution of trails and artifacts across archaeological landscapes. Throughout human history, traveling by foot has been the most common form of transportation, and therefore analyses of pedestrian travel costs are important for understanding prehistoric patterns of resource acquisition, migration, trade, and political interaction. Traditionally, archaeologists have measured geographic proximity based on "as the crow flies" distance. We propose new methods for terrain visualization and analysis based on measuring paths of least caloric expense, calculated using well established metabolic equations. Our approach provides a human centered metric of geographic closeness, and overcomes significant limitations of available Geographic Information System (GIS) software. We demonstrate such path computations and visualizations applied to archaeological research questions. Our system includes tools to visualize: energetic cost surfaces, comparisons of the elevation profiles of shortest paths versus least cost paths, and the display of paths of least caloric effort on Digital Elevation Models (DEMs). These analysis tools can be applied to calculate and visualize 1) likely locations of prehistoric trails and 2) expected ratios of raw material types to be recovered at archaeological sites.

  19. 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

  20. 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.

  1. The cost of an additional disability-free life year for older Americans: 1992-2005.

    PubMed

    Cai, Liming

    2013-02-01

    To estimate the cost of an additional disability-free life year for older Americans in 1992-2005. This study used 1992-2005 Medicare Current Beneficiary Survey, a longitudinal survey of Medicare beneficiaries with a rotating panel design. This analysis used multistate life table model to estimate probabilities of transition among a discrete set of health states (nondisabled, disabled, and dead) for two panels of older Americans in 1992 and 2002. Health spending incurred between annual health interviews was estimated by a generalized linear mixed model. Health status, including death, was simulated for each member of the panel using these transition probabilities; the associated health spending was cross-walked to the simulated health changes. Disability-free life expectancy (DFLE) increased significantly more than life expectancy during the study period. Assuming that 50 percent of the gains in DFLE between 1992 and 2005 were attributable to increases in spending, the average discounted cost per additional disability-free life year was $71,000. There were small differences between gender and racial/ethnic groups. The cost of an additional disability-free life year was substantially below previous estimates based on mortality trends alone. © Health Research and Educational Trust.

  2. Serious altitude illness in travelers who visited a pre-travel clinic.

    PubMed

    Croughs, Mieke; Van Gompel, Alfons; Rameckers, Sarah; Van den Ende, Jef

    2014-01-01

    Few data are available on the incidence and predictors of serious altitude illness in travelers who visit pre-travel clinics. Travel health consultants advise on measures to be taken in case of serious altitude illness but it is not clear if travelers adhere to these recommendations. Visitors to six travel clinics who planned to travel to an altitude of ≥3,000 m were asked to complete a diary from the first day at 2,000 m until 3 days after reaching the maximum sleeping altitude. Serious altitude illness was defined as having symptoms of serious acute mountain sickness (AMS score ≥ 6) and/or cerebral edema and/or pulmonary edema. The incidence of serious altitude illness in the 401 included participants of whom 90% reached ≥4,000 m, was 35%; 23% had symptoms of serious AMS, 25% symptoms of cerebral edema, and 13% symptoms of pulmonary edema. Independent predictors were young age, the occurrence of dark urine, travel in South America or Africa, and lack of acclimatization between 1,000 and 2,500 m. Acetazolamide was brought along by 77% of the responders of whom 41% took at least one dose. Of those with serious altitude illness, 57% had taken at least one dose of acetazolamide, 20% descended below 2,500 m on the same day or the next, and 11% consulted a physician. Serious altitude illness was a very frequent problem in travelers who visited pre-travel clinics. Young age, dark urine, travel in South America or Africa, and lack of acclimatization nights at moderate altitude were independent predictors. Furthermore, we found that seriously ill travelers seldom followed the advice to descend and to visit a physician. © 2014 International Society of Travel Medicine.

  3. 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.

  4. 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

  5. 25 CFR 171.555 - What additional costs will I incur if I am granted a Payment Plan?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What additional costs will I incur if I am granted a... AND WATER IRRIGATION OPERATION AND MAINTENANCE Financial Matters: Assessments, Billing, and Collections § 171.555 What additional costs will I incur if I am granted a Payment Plan? You will incur the...

  6. 25 CFR 171.555 - What additional costs will I incur if I am granted a Payment Plan?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What additional costs will I incur if I am granted a... AND WATER IRRIGATION OPERATION AND MAINTENANCE Financial Matters: Assessments, Billing, and Collections § 171.555 What additional costs will I incur if I am granted a Payment Plan? You will incur the...

  7. Cost Benefit Studies. Final Report.

    ERIC Educational Resources Information Center

    Weiner, Arthur; Marson, Arthur A.

    This document applies Dr. Mehar Aurora's method for conducting cost benefit studies to the Food Manufacturing Technology-Dairy and the Food Manufacturing Technology-Canning and Freezing programs offered by the Moraine Park Technical Institute. Costs to individual students enrolled in the programs include tuition, fees, housing, travel, books,…

  8. 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

  9. Travelers' Health: Scabies

    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 ...

  10. Travelers' Health: Diphtheria

    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 ...

  11. International Travelers' Sociodemographic, Health, and Travel Characteristics: An Italian Study.

    PubMed

    Troiano, Gianmarco; Mercone, Astrid; Bagnoli, Alessandra; Nante, Nicola

    Approximately the 8% of travelers requires medical care, with the diagnosis of a vaccine-preventable disease. The aim of our study was to analyze the socio-demographic, health and travel characteristics of the Italian international travelers. We conducted a cross sectional study from January 2015 to June 2016, at the Travel Medicine Clinic of Siena, asking the doctor to interview patients who attended the Clinic, recording socio-demographic and travel information, malaria prophylaxis, vaccinations. The data were organized in a database and processed by software Stata®. We collected 419 questionnaires. Patients chose 71 countries for their travels; the favorite destinations were: India (6.31%), Thailand (6.31%), and Brazil (5.10%). The mean length of stay was 36.17 days. Italians, students, and freelancers tended to stay abroad for a longer time (mean: 36.4 days, 59.87 days and 64.16 days respectively). 33.17% of our sample used drugs for malaria chemoprophylaxis: 71.9% of them used Atovaquone/Proguanil (Malarone®), 26.6% used Mefloquine (Lariam®), 1.5% other drugs. The vaccinations that travelers mostly got in our study were to prevent hepatitis A (n = 264), the typhoid fever (n = 187), the Tetanus + Diphtheria + Pertussis (n = 165), the Yellow fever (n = 118) and the cholera (n = 78). Twenty-eight (6.68%) refused some recommended vaccinations. The vaccines mostly refused were for Typhoid fever (n = 20), hepatitis a (n = 9), and cholera (n = 9). Our results demonstrated that Italian international travelers are at-risk because of their poor vaccinations adherence. This implies that pre-travel counseling is fundamental to increase the knowledge of the risks and the compliance of future travelers. Copyright © 2016 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  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. 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.

  14. Travelers' Health: Rabies

    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 ...

  15. Travelers' Health: Poliomyelitis

    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 ...

  16. Travelers' Health: Rubella

    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 ...

  17. Travelers' Health: Cryptosporidiosis

    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 ...

  18. Happiness in motion: emotions, well-being, and active school travel.

    PubMed

    Ramanathan, Subha; O'Brien, Catherine; Faulkner, Guy; Stone, Michelle

    2014-08-01

    A pan-Canadian School Travel Planning intervention promoted active school travel (AST). A novel component was exploring emotion, well-being, and travel mode framed by the concept of "sustainable happiness." Relationships between travel mode and emotions, parent perceptions of their child's travel mode on well-being, and factors related to parent perceptions were examined. Questionnaires were administered to families (N = 5423) from 76 elementary schools. Explanatory variables were demographics (age and sex), school travel measures (mode, distance, accompaniment by an adult, safety, and barriers), and emotions (parent and child). Outcomes examined parent perceived benefits of travel mode on dimensions of well-being (physical, emotional, community, and environmental). Descriptive statistics, chi-square tests and hierarchical regression were used. Parents and children who used AST reported more positive emotions versus passive travelers. Parents of active travelers reported stronger connections to dimensions of well-being. AST had the strongest association with parents' perceptions of their child's well-being, and positive emotions (parent and child) were also significantly related to well-being on the trip to school. As an additional potential benefit of AST, interventions should raise awareness of the positive emotional experiences for children and their parents. Future research should experimentally examine if AST causes these emotional benefits. © 2014, American School Health Association.

  19. 41 CFR 301-74.2 - What costs should be considered when planning a conference?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... transportation; and (i) Employees' time at the conference and on en route travel. ... Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 74... associated with the conference. Some examples of such costs are: (a) Authorized travel and per diem expenses...

  20. 41 CFR 301-74.2 - What costs should be considered when planning a conference?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... transportation; and (i) Employees' time at the conference and on en route travel. ... Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 74... associated with the conference. Some examples of such costs are: (a) Authorized travel and per diem expenses...

  1. 41 CFR 301-74.2 - What costs should be considered when planning a conference?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... transportation; and (i) Employees' time at the conference and on en route travel. ... Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 74... associated with the conference. Some examples of such costs are: (a) Authorized travel and per diem expenses...

  2. 41 CFR 301-74.2 - What costs should be considered when planning a conference?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... transportation; and (i) Employees' time at the conference and on en route travel. ... Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 74... associated with the conference. Some examples of such costs are: (a) Authorized travel and per diem expenses...

  3. 41 CFR 301-74.2 - What costs should be considered when planning a conference?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... transportation; and (i) Employees' time at the conference and on en route travel. ... Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 74... associated with the conference. Some examples of such costs are: (a) Authorized travel and per diem expenses...

  4. 2 CFR 200.444 - General costs of government.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false General costs of government. 200.444 Section... Cost § 200.444 General costs of government. (a) For states, local governments, and Indian Tribes, the general costs of government are unallowable (except as provided in § 200.474 Travel costs). Unallowable...

  5. On the road and away from home: a systematic review of the travel experiences of cancer patients and their families.

    PubMed

    Vindrola-Padros, Cecilia; Brage, Eugenia; Chambers, Pinkie

    2018-05-23

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

  6. 40 CFR 30.27 - Allowable costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER...-Profit Organizations.” The allowability of costs incurred by institutions of higher education is... include transportation and subsistence costs for travel performed; recipients will pay these in accordance...

  7. A prospective study to determine the costs incurred by families of children newly diagnosed with cancer in Ontario.

    PubMed

    Tsimicalis, Argerie; Stevens, Bonnie; Ungar, Wendy J; McKeever, Patricia; Greenberg, Mark; Agha, Mohammad; Guerriere, Denise; Barr, Ronald; Naqvi, Ahmed; Moineddin, Rahim

    2012-10-01

    A diagnosis of cancer in childhood places a considerable economic burden on families, although costs are not well described. The objectives of this study were to identify and determine independent predictors of the direct and time costs incurred by such families. A prospective, cost-of-illness study was conducted in families of children newly diagnosed with cancer. Parents recorded the resources consumed and costs incurred during 1 week per month for three consecutive months beginning the fourth week following diagnosis and listed any additional costs incurred since then. Descriptive and multiple regression analyses were performed to describe families' costs (expressed in 2007 Canadian dollars) and to determine direct and time cost predictors. In total, 28 fathers and 71 mothers participated. The median total direct and time costs in 3 months were $CAD3503 and $CAD23 130, respectively, per family. The largest component of direct costs was travel and of time costs was time allocated previously for unpaid activities. There were no statistically significant predictors of direct costs. Six per cent of the variance for time costs was explained by language spoken at home. Families of children with cancer are confronted with a wide range of direct and time costs, the largest being travel and time allocated previously for unpaid activities. Copyright © 2011 John Wiley & Sons, Ltd.

  8. High Power RF Testing of A 3-Cell Superconducting Traveling Wave Accelerating Structure

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

    Kanareykin, Alex; Kostin, Romna; Avrakhov, Pavel

    Euclid Techlabs has completed the Phase II SBIR project, entitled “High Power RF Testing of a 3-Cell Superconducting Traveling Wave Accelerating Structure” under Grant #DE-SC0006300. In this final technical report, we summarize the major achievements of Phase I of the project and review the details of Phase II of the project. The accelerating gradient in a superconducting structure is limited mainly by quenching, i.e., by the maximum surface RF magnetic field. Various techniques have been developed to increase the gradient. A traveling wave accelerating SC structure with a feedback waveguide was suggested to allow an increased transit time factor andmore » ultimately, a maximum gradient that is 22%-24% higher than in the best of the time standing wave SRF cavity solution. The proposed structure has an additional benefit in that it can be fabricated much longer than the standing wave ones that are limited by the field flatness factor. Taken together, all of these factors will result in a significant overall length and, correspondingly cost reduction of the SRF based linear collider ILC or SRF technology based FELs. In Phase I of this project, a 3-cell L-band SC traveling wave cavity was designed. Cavity shape, surface field ratios, inter-cell coupling coefficients, accelerating field flatness have been reviewed with the analysis of tuning issues. Moreover, the technological aspects of SC traveling wave accelerating structure fabrication have been studied. As the next step in the project, the Phase II experimental program included engineering design, manufacturing, surface processing and high gradient testing. Euclid Techlabs, LLC contracted AES, Inc. to manufacture two niobium cavities. Euclid Techlabs cold tested traveling wave regime in the cavity, and the results showed very good agreement with mathematical model specially developed for superconducting traveling wave cavity performance analysis. Traveling wave regime was adjusted by amplitude and phase

  9. Cost Per Additional Responder Associated With Ixekizumab and Etanercept in the Treatment of Moderate-to-Severe Psoriasis.

    PubMed

    Feldman, Steven R; Foster, Shonda A; Zhu, Baojin; Burge, Russel; Al Sawah, Sarah; Goldblum, Orin M

    2017-12-01

    BACKGROUND: Newer psoriasis treatments can achieve greater levels of efficacy than older systemic therapies; however, current psoriasis costs are substantial. We sought to estimate costs per additional responder associated with ixekizumab and etanercept, versus placebo, using efficacy data from phase 3 clinical trials (UNCOVER-2 and UNCOVER-3). METHODS: In UNCOVER-2/UNCOVER-3, patients received subcutaneous placebo, etanercept 50 mg twice weekly (BIW), or ixekizumab one 80 mg injection every 2 weeks (Q2W) after a 160-mg starting dose. Twelve-week induction-phase Psoriasis Area and Severity Index (PASI) 75, PASI 90, and PASI 100 response rates for ixekizumab, etanercept, and placebo were obtained from pooled data from the overall and United States (US) subgroup intention-to-treat (ITT) populations, and used to calculate numbers needed to treat (NNTs) to achieve one additional PASI 75, PASI 90, or PASI 100 response for ixekizumab Q2W and etanercept BIW versus placebo. Twelve-week drug costs per patient were calculated based on the UNCOVER-2/UNCOVER-3 dosing schedule and wholesale acquisition costs. Mean costs per additional responder for PASI 75, PASI 90, and PASI 100 for each treatment versus placebo were calculated for pooled UN-COVER-2/UNCOVER-3 overall and US subgroup ITT populations. RESULTS: Pooled overall ITT population: costs per additional PASI 75, PASI 90, or PASI 100 responder were US $37,540, US $46,299, or US $80,710 for ixekizumab Q2W and US $57,533, US $120,720, or US $404,695 for etanercept BIW, respectively. US subgroup ITT population: costs per additional PASI 75, PASI 90, or PASI 100 responder were US $38,165, US $49,740, or US $93,536 for ixekizumab Q2W and US $69,580, US $140,881, or US $631,875 for etanercept BIW, respectively. CONCLUSIONS: Twelve-week costs per additional responder were lower for ixekizumab Q2W than for etanercept BIW across all levels of clearance (PASI 75, PASI 90, and PASI 100) in the pooled UNCOVER-2/UNCOVER-3 overall and

  10. Dengue vaccines: Are they safe for travelers?

    PubMed

    Halstead, Scott B; Aguiar, Maira

    2016-01-01

    The four dengue viruses (DENV) circulate among nearly one-half of the world's population in tropical and semitropical countries imposing a huge morbidity burden on travelers. Sanofipasteur has developed a tetravalent live-attenuated vaccine, Dengvaxia, recently approved by the World Health Organization and licensed in four dengue-endemic countries. An additional two dengue vaccines, developed by the National Institute of Allergy and Infectious Diseases (NIAID), USA and Takeda, are entering phase III testing. Dengvaxia is composed of four yellow fever 17D-DENV chimeras, the NIAID vaccine contains three mutagenized DENV and one DENV2/4 chimera while the Takeda vaccine contains an attenuated DENV 2 and three DENV 2-DENV chimeras. Which of these vaccines might be useful in protecting travelers against dengue infections and disease? Dengvaxia requires three doses administered over the course of one year but in addition has safety signals suggesting that susceptible individuals should not be vaccinated. The NIAID vaccine is promising as a travel vaccine as a single dose fully protected susceptible adults against live dengue 2 virus challenge. The protective efficacy and safety of the Takeda vaccine remain to be demonstrated. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Antibiotic resistance in travellers' diarrhoeal disease, an external perspective.

    PubMed

    Hitch, Geeta; Fleming, Naomi

    2018-05-01

    There are many recommendations on the use of antibiotics for prophylaxis and treatment of travellers' diarrhoea (TD). As pharmacists with a special interest in antimicrobial stewardship, we examine and offer our perspective on advice that is recommended to travellers in terms of prevention, treatment and management of TD with a focus on antibiotic use and resistance. Publications on TD were identified through PubMed, Google Scholar and Cochrane Library databases searches using search terms 'travellers diarrhoea', 'travellers diarrhoea', 'travellers' diarrhoea' 'guidelines', 'expert opinion', 'expert reviews', 'South Asia' and 'South East Asia' (S and SE Asia), 'antibiotics', 'resistance genes', 'travel advice', 'pharmacists', 'guidelines', 'prevention' and 'treatment'. References of articles were also screened for additional relevant studies. Whilst most guidelines and expert reviews were in agreement with the restricted use of antibiotics unless there was a clinical need, the literature review identified gaps in research into behaviours of travellers regarding non-compliance with the pre-travel advice provided and the need for in depth training and education for all healthcare professionals in providing 'tailored' advice for travellers going to high-risk destinations. Travellers should be made aware of the problems of antimicrobial resistance in their destination and home countries and offered alternative forms of prophylaxis for TD. Strategies for prevention of TD, other than the use of antibiotics, also need to be emphasized. All healthcare professionals involved in giving advice about TD should be familiar with the epidemiology of the condition as this will inform responsible behaviours, risk assessment and management strategies in different geographical areas.

  12. Trends and characteristics among HIV-infected and diabetic travelers seeking pre-travel advice.

    PubMed

    Elfrink, Floor; van den Hoek, Anneke; Sonder, Gerard J B

    2014-01-01

    The number of individuals with a chronic disease increases. Better treatment options have improved chronic patients' quality of life, likely increasing their motivation for travel. This may have resulted in a change in the number of HIV-infected travelers and/or travelers with Diabetes Mellitus (DM) visiting our travel clinic. We retrospectively analyzed the database of the travel clinic of the Public Health Service Amsterdam, between January 2001 and December 2011 and examined the records for patients with these conditions. Of the 25,000 travelers who consult our clinic annually, the proportion of travelers with HIV or DM has increased significantly. A total of 564 HIV-infected travelers visited our clinic. The mean age was 41 years, 86% were male, 43% visited a yellow fever endemic country and 46.5% had a CD4 count <500 cells/mm(3). Travelers with low CD4 counts traveled significantly more often to visit friends or relatives. A total of 3704 diabetics visited our clinic. The mean age was 55 years, 52% were male, 27% visited a yellow fever endemic country and 36% were insulin-dependent. Insulin-dependent diabetics traveled more often for work than non-insulin-dependent diabetics. Adequately trained and qualified travel health professionals and up-to-date guidelines for travelers with chronic diseases are of increasing importance. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Seroepidemiology of dengue in travellers: a paired sera analysis.

    PubMed

    Leder, Karin; Mutsch, Margot; Schlagenhauf, Patricia; Luxemburger, Christine; Torresi, Joseph

    2013-01-01

    Dengue is a frequent cause of fever in travellers. The true extent is unknown as many infections are asymptomatic or undiagnosed. We used paired sera, with pre- and post-travel specimens from Swiss travellers to tropical destinations, to evaluate the seroepidemiology of travel-related dengue. Post-travel specimens were tested for the presence of IgG and IgM antibodies to dengue antigen serotypes (1, 2, 3 and 4) using an indirect enzyme-linked immunosorbent assay (ELISA). All post-travel sera that screened as positive for dengue IgG or IgM antibodies were re-tested with the corresponding pre-travel sera as paired assays in order to detect seroconversion. There were 285 travellers with specimens available for analysis. Two hundred and fifty seven of the 285 individuals (90.2%) had negative dengue serology post-travel. Of the remaining 28 cases, 25 were dengue IgG positive and 3 had equivocal results. This corresponds to IgG seropositivity in 8.9%. Eighteen of these 25 individuals had a pre-travel specimen available for testing, of which 15 were positive for IgG consistent with possible past exposure. Three of the 18 had negative serology pre-travel, indicating possible recent infection. This corresponds to an attack rate of possible dengue of 1.1% and an incidence rate of 6.7 per 1000 person-months (95% CI 0-60.0). Two of these three individuals had received yellow fever vaccine for their trip, raising the potential of cross-reactivity. The confirmed dengue attack rate therefore was 0.23% with a corresponding incidence rate of 2.2 per 1000 person-months (95% CI-0-33.1). Seroepidemiology provides additional evidence of an appreciable risk of acute dengue infection among travellers to tropical destinations. Copyright © 2013. Published by Elsevier Ltd.

  14. 45 CFR 1301.32 - Limitations on costs of development and administration of a Head Start program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Limitations on costs of development and... administrative staff functions such as the costs allocated to fringe benefits, travel, per diem, transportation... staff functions, such as the allocable costs of fringe benefits, travel, per diem and transportation...

  15. Australian senior adventure travellers to Peru: Maximising older tourists' travel health experience.

    PubMed

    Bauer, Irmgard

    2012-03-01

    Financially comfortable, with ample spare time and much better health, older people travel more than ever and to more adventurous destinations. Taking Australian senior adventure travellers to Peru as an example, travel health preparations need to take into account the phenomenon 'senior traveller', the destination with its attractions and challenges, and age-related changes and restrictions. The need for routine travel health advice, vaccinations and prophylaxis remains unchanged. However, more emphasis should be placed on locality-specific issues so that age-appropriate advice and preparations maximize the chances for a safe and memorable travel experience. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Staying Healthy While You Travel (For Parents)

    MedlinePlus

    ... ear discomfort , travel (or motion) sickness, and diarrhea . Jet Lag When you fly across time zones, it ... for longer than usual. In addition to tiredness, jet lag can also cause an upset stomach and ...

  17. Cost of post-stroke outpatient care in Malaysia.

    PubMed

    Akhavan Hejazi, Seyed Majid; Mazlan, Mazlina; Abdullah, Saini Jeffery Freddy; Engkasan, Julia Patrick

    2015-02-01

    This study aimed to investigate the direct cost of outpatient care for patients with stroke, as well as the relationship between the aforementioned cost and the sociodemographic and stroke characteristics of the patients. This was a cross-sectional study involving patients with first-ever stroke who were attending outpatient stroke rehabilitation, and their family members. Participants were interviewed using a structured questionnaire designed to obtain information regarding the cost of outpatient care. Stroke severity was measured using the National Institute of Health Stroke Scale. This study comprised 49 patients (28 men, 21 women) with a mean age of 60.2 (range 35-80) years. The mean total cost incurred was USD 547.10 (range USD 53.50-4,591.60), of which 36.6% was spent on attendant care, 25.5% on medical aids, 15.1% on travel expenses, 14.1% on medical fees and 8.5% on out-of-pocket expenses. Stroke severity, age > 70 years and haemorrhagic stroke were associated with increased cost. The mean cost of attending outpatient therapy per patient was USD 17.50 per session (range USD 6.60-30.60), with travelling expenses (41.8%) forming the bulk of the cost, followed by medical fees (38.1%) and out-of-pocket expenses (10.9%). Multiple regression analysis showed that stroke severity was the main determinant of post-stroke outpatient care cost (p < 0.001). Post-stroke outpatient care costs are significantly influenced by stroke severity. The cost of attendant care was the main cost incurred during the first three months after hospital discharge, while travelling expenses was the main cost incurred when attending outpatient stroke rehabilitation therapy.

  18. Travel agents and the prevention of health problems among travelers in Québec.

    PubMed

    Provost, Sylvie; Gaulin, Colette; Piquet-Gauthier, Blandine; Emmanuelli, Julien; Venne, Sylvie; Dion, Réjean; Grenier, Jean-Luc; Dessau, Jean-Claude; Dubuc, Martine

    2002-01-01

    Among the factors influencing travelers to seek preventive health advice before departure, the travel agent's recommendation plays an important role. The objective of our study was to document the practices and needs of travel agents in Québec (Canada) in relation to the prevention of health problems among travelers. In June 2000, a cross-sectional descriptive survey was carried out among travel agents from all travel agencies in Québec. One agent per agency was asked to answer our questions. Data were collected using a 32-item telephone questionnaire. Altogether, 708 travel agents from the 948 agencies contacted answered our questionnaire (participation rate: 75%). Most respondents (81%) believed that the travel agent has a role to play in the prevention of health problems among travelers, especially to recommend that travelers consult a travel clinic before departure. Although over 80% of the agents interviewed mentioned recommending a visit to a travel clinic before an organized tour to Thailand or a backpacking trip in Mexico, less than half said they make the same recommendation for a stay in a seaside resort in Mexico. The majority of respondents were acquainted with the services offered in travel health clinics, and these clinics were the source of travel health information most often mentioned by travel agents. However, nearly 60% of the agents questioned had never personally consulted a travel clinic. When asked about the best way to receive information about travelers' health, more than 40% of respondents favoured receiving information newsletters from public health departments regularly whereas 28% preferred the Internet. Despite the limits of this study, our results should help the public health network better target its interventions aimed to inform travel agents on prevention of health problems among travelers.

  19. 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.

  20. Lewis Online Travel System: Preparer's/Traveler's Manual, Release 1.0

    NASA Technical Reports Server (NTRS)

    Seese, Michael

    1992-01-01

    The Lewis Online Travel System (LOTS) is a menu-driven interactive application that automates nearly all of the functions associated with government travel. The purpose of this manual is to provide LOTS users with concise instructions for using the computerized application. As such, it will not go into the details of travel regulations.

  1. 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.

  2. Traveling with breathing problems

    MedlinePlus

    ... obstructive lung disease - travel; Chronic bronchitis - travel; Emphysema - travel ... you: Are short of breath most of the time Get short of breath ... doctor if you plan to travel in a place at a high altitude (such ...

  3. Acceptability, Feasibility, and Cost of Telemedicine for Nonacute Headaches: A Randomized Study Comparing Video and Traditional Consultations

    PubMed Central

    Alstadhaug, Karl Bjørnar; Bekkelund, Svein Ivar

    2016-01-01

    the investigation, advice, and prescription practices were not statistically different between the two randomized groups. In addition, telemedicine consultations were shorter than traditional visits (38.8 vs 43.7 min, P<.001). The travel cost per rural individual (292/402, 73%) was €249, and estimated lost income was €234 per visit. The travel cost in the urban area (110/402, 27%) was €6, and estimated lost income was €117 per visit. The median traveling distance for rural patients was 526 km (range 1892 km), and the median traveling time was 7.8 hours (range 27.3 hours). Rural patients had a longer waiting time than urban patients (64 vs 47 days, P=.001), and fewer women were referred from rural areas (P=.04). Rural women reported higher pain scores than urban women (P=.005). Conclusion Our study shows that telemedicine is an accepted, feasible, time-saving, and cost-saving alternative to traditional specialist consultations for nonacute headaches. Trial Registration Clinicaltrials.gov NCT02270177; http://clinicaltrials.gov/ct2/show/NCT02270177 (Archived by WebCite at http://www.webcitation.org/6hmoHGo9Q) PMID:27241876

  4. Traveling Theta Waves in the Human Hippocampus

    PubMed Central

    Zhang, Honghui

    2015-01-01

    The hippocampal theta oscillation is strongly correlated with behaviors such as memory and spatial navigation, but we do not understand its specific functional role. One hint of theta's function came from the discovery in rodents that theta oscillations are traveling waves that allow parts of the hippocampus to simultaneously exhibit separate oscillatory phases. Because hippocampal theta oscillations in humans have different properties compared with rodents, we examined these signals directly using multielectrode recordings from neurosurgical patients. Our findings confirm that human hippocampal theta oscillations are traveling waves, but also show that these oscillations appear at a broader range of frequencies compared with rodents. Human traveling waves showed a distinctive pattern of spatial propagation such that there is a consistent phase spread across the hippocampus regardless of the oscillations' frequency. This suggests that traveling theta oscillations are important functionally in humans because they coordinate phase coding throughout the hippocampus in a consistent manner. SIGNIFICANCE STATEMENT We show for the first time in humans that hippocampal theta oscillations are traveling waves, moving along the length of the hippocampus in a posterior–anterior direction. The existence of these traveling theta waves is important for understanding hippocampal neural coding because they cause neurons at separate positions in the hippocampus to experience different theta phases simultaneously. The theta phase that a neuron measures is a key factor in how that cell represents behavioral information. Therefore, the existence of traveling theta waves indicates that, to fully understand how a hippocampal neuron represents information, it is vital to also account for that cell's location in addition to conventional measures of neural activity. PMID:26354915

  5. Season and Weather Effects on Travel-Related Mood and Travel Satisfaction.

    PubMed

    Ettema, Dick; Friman, Margareta; Olsson, Lars E; Gärling, Tommy

    2017-01-01

    This study examines the effects of season and weather on mood (valence and activation) and travel satisfaction (measured by the Satisfaction with Travel Scale). Analyses are presented of 562 time-sampled morning commutes to work made by 363 randomly sampled people in three different Swedish cities asking them to use smartphones to report their mood in their home before and directly after the commutes. These reports as well as satisfaction with the commute obtained in summer and winter are linked to weather data and analyzed by means of fixed-effects regression analyses. The results reveal main effects of weather (temperature and precipitation) on mood and travel satisfaction (temperature, sunshine, precipitation, and wind speed). The effects of weather on mood and travel satisfaction differ depending on travel mode. Temperature leads to a more positive mood, wind leads to higher activation for public transport users, and sunshine leads to a more negative mood for cyclists and pedestrians. Sunshine and higher temperatures make travel more relaxed although not for cycling and walking, and rain and snow lead to a higher cognitive assessed quality of travel.

  6. Immunizations for foreign travel.

    PubMed Central

    Hill, D. R.

    1992-01-01

    One of the most important aspects of preparing travelers for destinations throughout the world is providing them with immunizations. Before administering any vaccines, however, a careful health and immunization history and travel itinerary should be obtained in order to determine vaccine indications and contraindications. There are three categories of immunizations for foreign travel. The first category includes immunizations which are routinely recommended whether or not the individual is traveling. Many travelers are due for primary vaccination or boosting against tetanus-diphtheria, measles-mumps-rubella, pneumococcal pneumonia, and influenza, for example, and the pre-travel visit is an ideal time to administer these. The second category are immunizations which might be required by a country as a condition for entry; these are yellow fever and cholera. The final category contains immunizations which are recommended because there is a risk of acquiring a particular disease during travel. Typhoid fever, meningococcal disease, rabies, and hepatitis are some examples. Travelers who are pregnant or who are infected with the human immunodeficiency virus require special consideration. Provision of appropriate immunizations for foreign travel is an important aspect of preventing illness in travelers. PMID:1337807

  7. The quantified self during travel: mapping health in a prospective cohort of travellers.

    PubMed

    Farnham, Andrea; Furrer, Reinhard; Blanke, Ulf; Stone, Emily; Hatz, Christoph; Puhan, Milo A

    2017-09-01

    Travel medicine research has remained relatively unchanged in the face of rapid expansion of international travel and is unlikely to meet health challenges beyond infectious diseases. Our aim was to identify the range of health outcomes during travel using real-time monitoring and daily reporting of health behaviours and outcomes and identify traveller subgroups who may benefit from more targeted advice before and during travel. We recruited a prospective cohort of travellers ≥ 18 years and planning travel to Thailand for <5 weeks from the travel clinics in Zurich and Basel (Switzerland). Participants answered demographic, clinical and risk behaviour questionnaires pre-travel and a daily health questionnaire each day during travel using a smartphone application. Environmental and location data were collected passively by GPS. Classification trees were used to identify predictors of health behaviour and outcomes during travel. Non-infectious disease events were relatively common, with 22.7% (17 out of 75 travellers) experiencing an accident, 40.0% ( n  = 30) a wound or cut and 14.7% ( n  = 11) a bite or lick from an animal. Mental health associated events were widely reported, with 80.0% ( n  = 60) reporting lethargy, 34.7% ( n  = 26) anxiety and 34.7% ( n  = 26) feeling tense or irritable. Classification trees identified age, trip length, previous travel experience and having experienced a sports injury in the past year as the most important discriminatory variables for health threats. Our study offers a revolutionary look at an almost real-time timeline of health events and behaviours during travel using mHealth technology. Non-infectious disease related health issues were common in this cohort, despite being largely unaddressed in traditional travel medicine research and suggest a substantial potential for improving evidence-based travel medicine advice. © International Society of Travel Medicine, 2017. Published by Oxford

  8. Medical tourism: a cost or benefit to the NHS?

    PubMed

    Hanefeld, Johanna; Horsfall, Daniel; Lunt, Neil; Smith, Richard

    2013-01-01

    'Medical Tourism' - the phenomenon of people travelling abroad to access medical treatment - has received increasing attention in academic and popular media. This paper reports findings from a study examining effect of inbound and outbound medical tourism on the UK NHS, by estimating volume of medical tourism and associated costs and benefits. A mixed methods study it includes analysis of the UK International Passenger Survey (IPS); interviews with 77 returning UK medical tourists, 63 policymakers, NHS managers and medical tourism industry actors policymakers, and a review of published literature. These informed costing of three types of treatments for which patients commonly travel abroad: fertility treatment, cosmetic and bariatric surgery. Costing of inbound tourism relied on data obtained through 28 Freedom-of-Information requests to NHS Foundation Trusts. Findings demonstrate that contrary to some popular media reports, far from being a net importer of patients, the UK is now a clear net exporter of medical travellers. In 2010, an estimated 63,000 UK residents travelled for treatment, while around 52,000 patients sought treatment in the UK. Inbound medical tourists treated as private patients within NHS facilities may be especially profitable when compared to UK private patients, yielding close to a quarter of revenue from only 7% of volume in the data examined. Costs arise where patients travel abroad and return with complications. Analysis also indicates possible savings especially in future health care and social costs averted. These are likely to be specific to procedures and conditions treated. UK medical tourism is a growing phenomenon that presents risks and opportunities to the NHS. To fully understand its implications and guide policy on issues such as NHS global activities and patient safety will require investment in further research and monitoring. Results point to likely impact of medical tourism in other universal public health systems.

  9. Medical Tourism: A Cost or Benefit to the NHS?

    PubMed Central

    Hanefeld, Johanna; Horsfall, Daniel; Lunt, Neil; Smith, Richard

    2013-01-01

    ‘Medical Tourism’ – the phenomenon of people travelling abroad to access medical treatment - has received increasing attention in academic and popular media. This paper reports findings from a study examining effect of inbound and outbound medical tourism on the UK NHS, by estimating volume of medical tourism and associated costs and benefits. A mixed methods study it includes analysis of the UK International Passenger Survey (IPS); interviews with 77 returning UK medical tourists, 63 policymakers, NHS managers and medical tourism industry actors policymakers, and a review of published literature. These informed costing of three types of treatments for which patients commonly travel abroad: fertility treatment, cosmetic and bariatric surgery. Costing of inbound tourism relied on data obtained through 28 Freedom-of-Information requests to NHS Foundation Trusts. Findings demonstrate that contrary to some popular media reports, far from being a net importer of patients, the UK is now a clear net exporter of medical travellers. In 2010, an estimated 63,000 UK residents travelled for treatment, while around 52,000 patients sought treatment in the UK. Inbound medical tourists treated as private patients within NHS facilities may be especially profitable when compared to UK private patients, yielding close to a quarter of revenue from only 7% of volume in the data examined. Costs arise where patients travel abroad and return with complications. Analysis also indicates possible savings especially in future health care and social costs averted. These are likely to be specific to procedures and conditions treated. UK medical tourism is a growing phenomenon that presents risks and opportunities to the NHS. To fully understand its implications and guide policy on issues such as NHS global activities and patient safety will require investment in further research and monitoring. Results point to likely impact of medical tourism in other universal public health systems

  10. Sexually Transmitted Diseases and Travel: From Boudoir to Bordello.

    PubMed

    Avery, Ann K; Zenilman, Jonathan M

    2015-10-01

    Travel has historically been an important risk factor for acquisition of sexually transmitted infections (STIs). Travel is often associated with a sense of adventure, periods of loneliness, and exploration away from one's home environment-which often form a milieu in which sexual activity can occur with new partners. Survey data clearly demonstrate that out-of-country travel is associated with recruitment of new sex partners and increased STI risk. Pretravel counseling to prevent STI risk is variable, and there is little evidence that it modifies risk behavior. Some travel occurs specifically for sexual purposes, such as the sexual tourism junkets to Southeast Asian destinations which became popular during the 1980s or the more recent rise in the popularity of circuit parties for men who have sex with men. Some travel situations pose particularly high risks. For example, military deployments and assignments to work camps such as those for oil extraction occur in the context of large groups of individuals of reproductive age, often predominantly males, exposed to high levels of stress in unfamiliar environments. Additionally, over the past decade, the Internet has dramatically changed the ability to identify sexual partners while traveling.

  11. [Evaluation of pre-travel prevention and morbidity in child travelers].

    PubMed

    Brigot-Rotenberg, D; Quinet, B; Moulin, F; Aurel, M; Carbajal, R; De Suremain, N

    2016-04-01

    International travel is growing, but few data exist on prevention for children traveling. The aim of this study was to describe a population of children traveling from France to countries outside Europe and to evaluate the quality of prevention and healthcare services provided for these travelers. We conducted a retrospective epidemiological study in three pediatric emergency departments in Paris from August to October 2009 and 2012. Data were collected retrospectively from anonymous questionnaires proposed to families consulting emergency services, irrespective of their reason, who had recently traveled (in the year preceding travel outside the European Union). Of the 166 children included, who for the most part had traveled to visit relatives and friends in Sub-Saharan Africa and North Africa, 76% of their families were from the destination countries, 78% had received prevention counseling, mostly with their doctor. They had been vaccinated against yellow fever, but the hepatitis A vaccine was neglected. The preventive measures had been difficult to achieve in practice. During travel, 54% of children had health problems (39% diarrhea, 29% vomiting, 31% fever) prompting medical care in 28%, 5% were admitted to a hospital, and 4% had return to France earlier than planned. In epidemic areas, 13% of children had malaria. There is poor counseling on basic prevention (hygiene, diarrhea, malaria, immunization). Time constraints in pediatricians and competing priorities could explain this problem. The challenge for healthcare providers to reduce these pathologies is to provide services of sufficient quality and clarity. All medical stakeholders have an important role to play. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Aging and space travel

    NASA Technical Reports Server (NTRS)

    Mohler, S. R.

    1982-01-01

    The matter of aging and its relation to space vehicle crewmembers undertaking prolonged space missions is addressed. The capabilities of the older space traveler to recover from bone demineralization and muscle atrophy are discussed. Certain advantages of the older person are noted, for example, a greater tolerance of monotony and repetitious activities. Additional parameters are delineated including the cardiovascular system, the reproductive system, ionizing radiation, performance, and group dynamics.

  13. Electronic Travel Aids for Blind Persons.

    ERIC Educational Resources Information Center

    Hill, Everett W.; Bradfield, Anna L.

    1984-01-01

    The article describes application for visually impaired persons of widely used Electronic Travel Aids--the Lindsay Russell Pathsounder, the Mowat Sensor, the Sonicguide, and the C-5 Laser Cane. In addition, a research review provides insight into the issues affecting future use of the devices. (Author/CL)

  14. Student Travel: Policies - Regulations - Exhibits.

    ERIC Educational Resources Information Center

    Trujillo, Lorenzo A.; And Others

    The Jefferson County (Colorado) Public Schools' regulations and policies concerning student travel covers these forms of travel: student activity travel, extended student travel, district sponsored student travel, district authorized student travel, student exchange, and bonus learning trips. Issues and items addressed include: (1) authorization…

  15. Pre-travel care for immunocompromised and chronically ill travellers: A retrospective study.

    PubMed

    van Aalst, Mariëlle; Verhoeven, Roos; Omar, Freshta; Stijnis, Cornelis; van Vugt, Michèle; de Bree, Godelieve J; Goorhuis, Abraham; Grobusch, Martin P

    2017-09-01

    Immunocompromised and chronically ill travellers (ICCITs) are susceptible to travel related diseases. In ICCITs, pre-travel care regarding vaccinations and prophylactics is complex. We evaluated the protection level by preventive measures in ICCITs by analysing rates of vaccination protection, antibody titres, and the prescription of standby antibiotics. We analysed, and reported according to STROBE guidelines, pre-travel care data for ICCITs visiting the medical pre-travel clinic at the Academic Medical Centre, The Netherlands from 2011 to 2016. We analysed 2104 visits of 1826 ICCITs. Mean age was 46.6 years and mean travel duration 34.5 days. ICCITs on immunosuppressive treatment (29.7%), HIV (17.2%) or diabetes mellitus (10.2%) comprised the largest groups. Most frequently visited countries were Suriname, Indonesia, and Ghana. Most vaccination rates were >90%. Of travellers in high need of hepatitis A and B protection, 56.6 and 75.7%, underwent titre assessments, respectively. Of ICCITs with a respective indication, 50.6% received a prescription for standby antibiotics. Vaccination rates in our study population were overall comparable to those of healthy travellers studied previously in our centre. However, regarding antibody titre assessments and prescription of standby antibiotics, this study demonstrates that uniform pre-travel guidelines for ICCITs are highly needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Travel and vaccination patterns: a report from a travel medicine clinic in northern Sweden.

    PubMed

    Angelin, Martin; Evengård, Birgitta; Palmgren, Helena

    2011-09-01

    The Travel Medicine Clinic in Umeå is one of Sweden's largest public providers of vaccination and counselling prior to international travel. During the study period it was the only travel medicine clinic in Umeå. This study describes the demography of the visitors to the clinic and travel destinations and durations, as well as vaccinations administered. This was a retrospective study for the period January 2005 to April 2008 based on pre-travel consultation questionnaires and on vaccine expenditure data. A 10% sample of 16,735 first visits prior to international travel was consecutively selected according to the chronology of the visits. Data on 1698 travellers were included in the study. Thailand was the most common destination among visitors, accounting for one third of all destinations. Medical problems affecting pre-travel health planning were rare. Four out of 5 visitors (79%) received only 1 vaccination, mainly for hepatitis A. Travellers to Thailand more often sought travel health advice compared to travellers to Turkey, despite the fact that the 2 destinations were almost equally distributed among travellers from Umeå. We found differences between men and women in money spent on vaccines and in particular in vaccination against Japanese encephalitis. To assess the optimal vaccination level at a travel medicine clinic is difficult. Decisions are affected by general recommendations and the risk perception of the travel medicine practitioner, as well as the risk perception of the traveller. The sex difference found in this study might be due to gender differences in risk perception and should be further investigated.

  17. Travel during Pregnancy

    MedlinePlus

    ... are 36 weeks pregnant. When is the best time to travel during pregnancy? The best time to travel is the middle of your pregnancy—between week ... Sitting or not moving for long periods of time, such as during long-distance travel, can increase the risk of DVT. Pregnancy further ...

  18. 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.

  19. Bayesian Travel Time Inversion adopting Gaussian Process Regression

    NASA Astrophysics Data System (ADS)

    Mauerberger, S.; Holschneider, M.

    2017-12-01

    A major application in seismology is the determination of seismic velocity models. Travel time measurements are putting an integral constraint on the velocity between source and receiver. We provide insight into travel time inversion from a correlation-based Bayesian point of view. Therefore, the concept of Gaussian process regression is adopted to estimate a velocity model. The non-linear travel time integral is approximated by a 1st order Taylor expansion. A heuristic covariance describes correlations amongst observations and a priori model. That approach enables us to assess a proxy of the Bayesian posterior distribution at ordinary computational costs. No multi dimensional numeric integration nor excessive sampling is necessary. Instead of stacking the data, we suggest to progressively build the posterior distribution. Incorporating only a single evidence at a time accounts for the deficit of linearization. As a result, the most probable model is given by the posterior mean whereas uncertainties are described by the posterior covariance.As a proof of concept, a synthetic purely 1d model is addressed. Therefore a single source accompanied by multiple receivers is considered on top of a model comprising a discontinuity. We consider travel times of both phases - direct and reflected wave - corrupted by noise. Left and right of the interface are assumed independent where the squared exponential kernel serves as covariance.

  20. Season and Weather Effects on Travel-Related Mood and Travel Satisfaction

    PubMed Central

    Ettema, Dick; Friman, Margareta; Olsson, Lars E.; Gärling, Tommy

    2017-01-01

    This study examines the effects of season and weather on mood (valence and activation) and travel satisfaction (measured by the Satisfaction with Travel Scale). Analyses are presented of 562 time-sampled morning commutes to work made by 363 randomly sampled people in three different Swedish cities asking them to use smartphones to report their mood in their home before and directly after the commutes. These reports as well as satisfaction with the commute obtained in summer and winter are linked to weather data and analyzed by means of fixed-effects regression analyses. The results reveal main effects of weather (temperature and precipitation) on mood and travel satisfaction (temperature, sunshine, precipitation, and wind speed). The effects of weather on mood and travel satisfaction differ depending on travel mode. Temperature leads to a more positive mood, wind leads to higher activation for public transport users, and sunshine leads to a more negative mood for cyclists and pedestrians. Sunshine and higher temperatures make travel more relaxed although not for cycling and walking, and rain and snow lead to a higher cognitive assessed quality of travel. PMID:28220100

  1. 41 CFR Appendix C to Chapter 301 - Standard Data Elements for Federal Travel [Traveler Identification

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... for Federal Travel [Traveler Identification] C Appendix C to Chapter 301 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES Ch. 301, App. C Appendix C to Chapter 301—Standard Data Elements for Federal Travel [Traveler Identification] Group name Data...

  2. Extended-spectrum β-lactamase-producing Enterobacteriaceae colonisation in long-term overseas business travellers.

    PubMed

    Mizuno, Yasutaka; Miura, Yuri; Yamaguchi, Tetsuo; Matsumoto, Tetsuya

    International travel is considered a risk for colonisation with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE). To our knowledge, no studies to date have focused on ESBL-PE colonisation among long-term business travellers. Therefore this study aimed to clarify the characteristics associated with ESBL-PE colonisation in Japanese long-term business travellers. Japanese business travellers planning to stay abroad for ≥6 months were enrolled. Of the 192 travellers, 135 provided only post-travel stool samples and 57 provided both pre- and post-travel stool samples. Additionally, microbiological analyses of ESBL-PE strains, including susceptibility tests and polymerase chain reaction amplification of CTX-M genes and their sequencing were performed. A post-travel survey showed that of the 55 travellers (40.7%) who tested positive for ESBL-PE after travel, the highest proportion was travellers returning from East and Central Asia. CTX-M gene analyses showed that CTX-M-15 was the most frequently observed (55.0%). A pre- and post-travel survey showed that of the 22 travellers (44.9%) acquired ESBL-PE during their travel, with acquisition most frequently observed in travellers returning from South Asia. Risk-based evaluations of ESBL-PE colonisation should be performed not only for regular tourists but also for long-term business travellers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Health risks, travel preparation, and illness among public health professionals during international travel.

    PubMed

    Balaban, Victor; Warnock, Eli; Ramana Dhara, V; Jean-Louis, Lee Ann; Sotir, Mark J; Kozarsky, Phyllis

    2014-01-01

    Few data currently exist on health risks faced by public health professionals (PHP) during international travel. We conducted pre- and post-travel health surveys to assess knowledge, attitudes, and practices (KAP), and illnesses among PHP international travelers. Anonymous surveys were completed by PHP from a large American public health agency who sought a pre-travel medical consult from September 1, 2009, to September 30, 2010. Surveys were completed by 122 participants; travelers went to 163 countries. Of the 122 respondents, 97 (80%) reported at least one planned health risk activity (visiting rural areas, handling animals, contact with blood or body fluids, visiting malarious areas), and 50 (41%) reported exposure to unanticipated health risks. Of the 62 travelers who visited malarious areas, 14 (23%) reported inconsistent or no use of malaria prophylaxis. Illness during travel was reported by 33 (27%) respondents. Most of the PHP travelers in our study reported at least one planned health risk activity, and almost half reported exposure to unanticipated health risks, and one-quarter of travelers to malarious areas reported inconsistent or no use of malaria chemoprophylaxis. Our findings highlight that communication and education outreach for PHP to prevent travel-associated illnesses can be improved. Published by Elsevier Ltd.

  4. 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.

  5. Pre-Travel Health Preparation of Pediatric International Travelers: Analysis From the Global TravEpiNet Consortium.

    PubMed

    Hagmann, Stefan; LaRocque, Regina C; Rao, Sowmya R; Jentes, Emily S; Sotir, Mark J; Brunette, Gary; Ryan, Edward T

    2013-12-01

    Children frequently travel internationally. Health-related data on such children are limited. We sought to investigate the demographics, health characteristics, and preventive interventions of outbound US international pediatric travelers. We analyzed data from 32 099 travelers presenting for pre-travel healthcare at the Global TravEpiNet (GTEN), a national consortium of 19 travel clinics, from January 1, 2009 to June 6, 2012. A total of 3332 (10%) of all GTEN travelers were children (<18 years of age). These children traveled mostly for leisure (36%) or to visit friends or relatives (VFR) (36%). Most popular destination regions were Africa (41%), Southeast Asia (16%), Central America (16%), and the Caribbean (16%). Compared with children traveling for leisure, VFR children were more likely to present <14 days before departure for pre-travel consultation (44% vs 28%), intended to travel for 28 days or longer (70% vs 22%), and to travel to Africa (62% vs 32%). Nearly half of the pediatric travelers (46%) received at least 1 routine vaccine, and most (83%) received at least 1 travel-related vaccine. Parents or guardians of one third of the children (30%) refused at least 1 recommended travel-related vaccine. Most pediatric travelers visiting a malaria-endemic country (72%) received a prescription for malaria chemoprophylaxis. Ten percent of travelers seeking pre-travel healthcare at GTEN sites are children. VFR-travel, pre-travel consultation close to time of departure, and refusal of recommended vaccines may place children at risk for travel-associated illness. Strategies to engage pediatric travelers in timely, pre-travel care and improve acceptance of pre-travel healthcare interventions are needed. © The Author 2013. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  6. Do travel clinic visitors read information on sexual risk abroad in travel health brochures?

    PubMed Central

    Croughs, Mieke; de Gouw, Annemarie; Remmen, Roy; Van den Ende, Jef

    2016-01-01

    Background: A substantial proportion of travel clinic visitors have sexual encounters while abroad. Hence, guidelines on travel health recommend discussing sexual risk in a pre-travel consultation. However, previous studies showed that it often is not discussed. Although travel clinic visitors usually do receive written information on sexual risk abroad, few data are available on whether this information is read. Therefore, this prospective cohort study in travel clinic visitors was performed. Methods: Travel clinic visitors were invited to complete a questionnaire after return from their journey. Results: A total of 130 travellers (55%) responded. Half of them recorded they read the information on sexual risk. Male gender (OR 9.94 95% CI 3.12 – 31.63) and ‘travelling with others’ (OR 2.7 95% CI 1.29 – 5.78) were significant independent predictors of reading the information on sexual risk. High risk travellers, i.e. those travelling without a steady partner, were less likely to have read it. Although websites and apps were mentioned as better methods of providing information, none of the participants visited the websites on sexual behaviour and sexually transmitted infections recommended in the travel health brochure. Conclusion: Only half of travel clinic visitors read information on sexual risk in the health brochure received in the clinic and none of them visited the related websites mentioned in the brochure. Further research to identify the most effective way to inform travellers about sexual risk is needed. PMID:28989499

  7. Do travel clinic visitors read information on sexual risk abroad in travel health brochures?

    PubMed

    Croughs, Mieke; de Gouw, Annemarie; Remmen, Roy; Van den Ende, Jef

    2017-01-01

    A substantial proportion of travel clinic visitors have sexual encounters while abroad. Hence, guidelines on travel health recommend discussing sexual risk in a pre-travel consultation. However, previous studies showed that it often is not discussed. Although travel clinic visitors usually do receive written information on sexual risk abroad, few data are available on whether this information is read. Therefore, this prospective cohort study in travel clinic visitors was performed. Travel clinic visitors were invited to complete a questionnaire after return from their journey. A total of 130 travellers (55%) responded. Half of them recorded they read the information on sexual risk. Male gender (OR 9.94 95% CI 3.12 - 31.63) and 'travelling with others' (OR 2.7 95% CI 1.29 - 5.78) were significant independent predictors of reading the information on sexual risk. High risk travellers, i.e. those travelling without a steady partner, were less likely to have read it. Although websites and apps were mentioned as better methods of providing information, none of the participants visited the websites on sexual behaviour and sexually transmitted infections recommended in the travel health brochure. Only half of travel clinic visitors read information on sexual risk in the health brochure received in the clinic and none of them visited the related websites mentioned in the brochure. Further research to identify the most effective way to inform travellers about sexual risk is needed.

  8. Travelling Fronts and Entire Solutionsof the Fisher-KPP Equation in N

    NASA Astrophysics Data System (ADS)

    Hamel, François; Nadirashvili, Nikolaï

    This paper is devoted to time-global solutions of the Fisher-KPP equation in N: where f is a C2 concave function on [0,1] such that f(0)=f(1)=0 and f>0 on (0,1). It is well known that this equation admits a finite-dimensional manifold of planar travelling-fronts solutions. By considering the mixing of any density of travelling fronts, we prove the existence of an infinite-dimensional manifold of solutions. In particular, there are infinite-dimensional manifolds of (nonplanar) travelling fronts and radial solutions. Furthermore, up to an additional assumption, a given solution u can be represented in terms of such a mixing of travelling fronts.

  9. Improving health sector travel.

    PubMed

    Hurdle, David; Davis, Adrian

    2004-10-01

    Preventing ill health and obesity and building more physical activity into our daily lives have never been so high on the agenda, and the way we travel can help. Many workplaces and schools are drawing up travel plans, with the aims usually to minimise car use and encourage healthier and more environmentally friendly travel. The Transport White Paper of 1998 advocated travel plans and singled out hospitals for action. Travel plans continue to be a focus within the latest Transport White Paper, launched in July 2004. This article covers various prompts to the health sector to implement travel plans. It addresses issues and concerns facing NHS Trusts, the practical things Trusts can do, and the increasing amount of good practice available. Finally, it demonstrates that travel plans can work, and are working, in the health sector.

  10. 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.

  11. 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.

  12. Childhood and Travel Literature.

    ERIC Educational Resources Information Center

    Espey, David

    If children are not present in most travel literature--precisely because the genre has most typically been the domain of solitary male travelers who are escaping domestic obligation, routine, the familiar, and the family--they nevertheless are an integral part of the genre. The traveler is in many ways a child, an innocent abroad. Traveler writers…

  13. Elasticity of Vehicle Miles of Travel to Changes in the Price of Gasoline and the Cost of Driving in Texas

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

    Wenzel, Tom P.; Fujita, K. Sydny

    This report examines the sensitivity of annual vehicle miles of travel (VMT) of light-duty vehicles to the price of gasoline, commonly referred to as the elasticity of demand for VMT to the price of gasoline; the fuel-economy-related rebound effect is generally assumed to be of the same magnitude as the VMT elasticity of gas price or driving cost. We use detailed odometer readings from over 30 million vehicles in four urban areas of Texas, over a six-year period. We account for economic conditions over this period, as well as vehicle age. Following the literature we include fixed effects by vehiclemore » make and individual vehicle, as well as the effect of adding an instrument to predict monthly gasoline price independent of any influences of demand for gasoline on its price.« less

  14. 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

  15. Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel.

    PubMed

    Hagmann, Stefan H F; Han, Pauline V; Stauffer, William M; Miller, Andy O; Connor, Bradley A; Hale, DeVon C; Coyle, Christina M; Cahill, John D; Marano, Cinzia; Esposito, Douglas H; Kozarsky, Phyllis E

    2014-12-01

    US residents make 60 million international trips annually. Family practice providers need to be aware of travel-associated diseases affecting this growing mobile population. To describe demographics, travel characteristics and clinical diagnoses of US residents who present ill after international travel. Descriptive analysis of travel-associated morbidity and mortality among US travellers seeking care at 1 of the 22 US practices and clinics participating in the GeoSentinel Global Surveillance Network from January 2000 to December 2012. Of the 9624 ill US travellers included in the analysis, 3656 (38%) were tourist travellers, 2379 (25%) missionary/volunteer/research/aid workers (MVRA), 1580 (16%) travellers visiting friends and relatives (VFRs), 1394 (15%) business travellers and 593 (6%) student travellers. Median (interquartile range) travel duration was 20 days (10-60 days). Pre-travel advice was sought by 45%. Hospitalization was required by 7%. Compared with other groups of travellers, ill MVRA travellers returned from longer trips (median duration 61 days), while VFR travellers disproportionately required higher rates of inpatient care (24%) and less frequently had received pre-travel medical advice (20%). Illnesses of the gastrointestinal tract were the most common (58%), followed by systemic febrile illnesses (18%) and dermatologic disorders (17%). Three deaths were reported. Diagnoses varied according to the purpose of travel and region of exposure. Returning ill US international travellers present with a broad spectrum of travel-associated diseases. Destination and reason for travel may help primary health care providers to generate an accurate differential diagnosis for the most common disorders and for those that may be life-threatening. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel

    PubMed Central

    Hagmann, Stefan H F; Han, Pauline V; Stauffer, William M; Miller, Andy O; Connor, Bradley A; Hale, DeVon C; Coyle, Christina M; Cahill, John D; Marano, Cinzia; Esposito, Douglas H; Kozarsky, Phyllis E

    2015-01-01

    Background US residents make 60 million international trips annually. Family practice providers need to be aware of travel-associated diseases affecting this growing mobile population. Objective To describe demographics, travel characteristics and clinical diagnoses of US residents who present ill after international travel. Methods Descriptive analysis of travel-associated morbidity and mortality among US travellers seeking care at 1 of the 22 US practices and clinics participating in the GeoSentinel Global Surveillance Network from January 2000 to December 2012. Results Of the 9624 ill US travellers included in the analysis, 3656 (38%) were tourist travellers, 2379 (25%) missionary/volunteer/research/aid workers (MVRA), 1580 (16%) travellers visiting friends and relatives (VFRs), 1394 (15%) business travellers and 593 (6%) student travellers. Median (interquartile range) travel duration was 20 days (10–60 days). Pre-travel advice was sought by 45%. Hospitalization was required by 7%. Compared with other groups of travellers, ill MVRA travellers returned from longer trips (median duration 61 days), while VFR travellers disproportionately required higher rates of inpatient care (24%) and less frequently had received pre-travel medical advice (20%). Illnesses of the gastrointestinal tract were the most common (58%), followed by systemic febrile illnesses (18%) and dermatologic disorders (17%). Three deaths were reported. Diagnoses varied according to the purpose of travel and region of exposure. Conclusions Returning ill US international travellers present with a broad spectrum of travel-associated diseases. Destination and reason for travel may help primary health care providers to generate an accurate differential diagnosis for the most common disorders and for those that may be life-threatening. PMID:25261506

  17. Combating Terrorism: Additional Steps Needed to Enhance Foreign Partners’ Capacity to Prevent Terrorist Travel

    DTIC Science & Technology

    2011-06-01

    identified enhancing the capacity of partner nations as one of two pillars supporting that strategy. The attempted attack on a Detroit-bound airliner on...not have reciprocal relationships to share such information or other travel-related information, such as airline passenger lists, with other...Bureau of European and Eurasian Affairs • Negotiations to share Passenger Name Records data to prescreen airline passengers against terrorist

  18. Hospital Rating Systems and Implications For Patient Travel to Better-rated Hospitals.

    PubMed

    Subramanian, Arun; Adler, Joel T; Shah, Nilay D; Hyder, Joseph A

    2017-03-01

    Publicly reported hospital ratings aim to encourage transparency, spur quality improvement, and empower patient choice. Travel burdens may limit patient choice, particularly for older adults (aged 65 years and more) who receive most medical care. For 3 major hospital ratings systems, we estimated travel burden as the additional 1-way travel distance to receive care at a better-rated hospital.Distances were estimated from publicly available data from the US Census, US News Top Hospitals, Society of Thoracic Surgeons composite rating for coronary artery bypass grafting (STS-CABG), and Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS).Hospitals were rated for HCAHPS (n = 4656), STS-CABG (n = 470), and US News Top Hospitals (n = 15). Older adults were commonly located within 25 miles of their closest HCAHPS hospital (89.6%), but less commonly for STS-CABG (62.9%). To receive care at a better-rated hospital, travel distances commonly exceeded 25 miles: HCAHPS (39.2%), STS-CABG (62.7%), and US News Top Hospital (85.2%). Additional 1-way travel distances exceeded 25 miles commonly: HCAHPS (23.7%), STS-CABG (36.7%), US News Top Hospitals (81.8%).Significant travel burden is common for older adults seeking "better" care and is an important limitation of current hospital ratings for empowering patient choice.

  19. Patient costs associated with accessing HIV/AIDS care in Malawi

    PubMed Central

    Pinto, Andrew D; van Lettow, Monique; Rachlis, Beth; Chan, Adrienne K; Sodhi, Sumeet K

    2013-01-01

    Introduction The decentralization of HIV services has been shown to improve equity in access to care for the rural poor of sub-Saharan Africa. This study aims to contribute to our understanding of the impact of decentralization on costs borne by patients. Such information is valuable for economic evaluations of anti-retroviral therapy programmes that take a societal perspective. We compared costs reported by patients who received care in an urban centralized programme to those in the same district who received care through rural decentralized care (DC). Methods A cross-sectional survey on patient characteristics and costs associated with accessing HIV care was conducted, in May 2010, on 120 patients in centralized care (CC) at a tertiary referral hospital and 120 patients in DC at five rural health centres in Zomba District, Malawi. Differences in costs borne by each group were compared using χ2 and t-tests, and a regression model was developed to adjust for confounders, using bootstrapping to address skewed cost data. Results There was no significant difference between the groups with respect to sex and age. However, there were significant differences in socio-economic status, with higher educational attainment (p<0.001), personal income (p=0.007) and household income per person (p=0.005) in CC. Travel times were similar (p=0.65), as was time waiting at the clinic (p=0.63) and total time spent seeking care (p=0.65). There was a significant difference in travel-related expenses (p<0.001) related to the type of travel participants noted that they used. In CC, 60% of participants reported using a mini-bus to reach the clinic; in DC only 4% reported using a mini-bus, and the remainder reported travelling on foot or by bicycle. There were no significant differences between the groups in the amount of lost income reported or other out-of-pocket costs. Approximately 91 Malawi Kwacha (95% confidence intervals: 1–182 MKW) or US$0.59 represents the adjusted difference in

  20. Simple cost analysis of a rural dental training facility in Australia.

    PubMed

    Lalloo, Ratilal; Massey, Ward

    2013-06-01

    Student clinical placements away from the university dental school clinics are an integral component of dental training programs. In 2009, the School of Dentistry and Oral Health, Griffith University, commenced a clinical placement in a remote rural community in Australia. This paper presents a simple cost analysis of the project from mid-2008 to mid-2011. All expenditures of the project are audited by the Financial and Planning Services unit of the university. The budget was divided into capital and operational costs, and the latter were further subdivided into salary and non-salary costs, and these were further analysed for the various types of expenditures incurred. The value of the treatments provided and income generated is also presented. Remote rural placements have additional (to the usual university dental clinic) costs in terms of salary incentives, travel, accommodation and subsistence support. However, the benefits of the placement to both the students and the local community might outweigh the additional costs of the placement. Because of high costs of rural student clinical placements, the financial support of partners, including the local Shire Council, state/territory and Commonwealth governments, is crucial in the establishment and ongoing sustainability of rural dental student clinical placements. © 2013 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  1. The New England travel market: generational travel patterns, 1979 to 1996

    Treesearch

    Rod Warnick

    2002-01-01

    Generations of travelers who select New England as a primary destination are examined over time from the years of 1979 through 1996 and the analysis serves to update an earlier review of generational travel patterns of the region (Warnick, 1994). Changes in travel patterns are noted by overall adjusted annual change rates by demographic and geographic regions of...

  2. Interviews With Patients Who Traveled From Macedonia/Kosovo, The Netherlands, and Sweden for Paid Kidney Transplantations.

    PubMed

    van Balen, L J; Ambagtsheer, Frederike; Ivanovski, N; Weimar, W

    2016-12-01

    Patients travel worldwide for paid kidney transplants. Although transplantations abroad are not always illegal, they are commonly perceived to be illegal and unethical involving risks. We aimed to describe the motivations and experiences of patients who traveled abroad for paid kidney transplantations and to examine how these transplantations were facilitated. We interviewed 22 patients who traveled from Macedonia/Kosovo, the Netherlands, and Sweden for paid kidney transplantations between years 2000 and 2009. Patients traveled because of inadequate transplant activity in their domestic countries and dialysis-related complaints. However, 6 patients underwent preemptive transplantations. Cultural factors such as patients' affinity with destination countries, feelings of being discriminated against by the health-care system, and family ties also help explain why patients travel abroad. Seven of the 22 patients went to their country of origin. They were able to organize their transplantations by arranging help from family and friends abroad who provided contacts of caregivers there and who helped cover the costs of their transplants. The costs varied from €5000 to €45 000 (US$6800-US$61 200). Seven patients paid the hospital, 5 paid their doctor, 4 paid a broker, and 6 paid their donors. Research should include interviews with brokers, transplant professionals, and other facilitators to achieve a full picture of illegally performed transplantations.

  3. Health preparations and travel-related morbidity of kidney transplant recipients traveling to developing countries.

    PubMed

    Roukens, A H E; van Dissel, J T; de Fijter, J W; Visser, L G

    2007-01-01

    A cross-sectional, descriptive study was conducted among Dutch kidney transplant recipients to investigate travel health knowledge, attitudes and practices while staying abroad. A total of 290 individuals visiting the nephrology outpatient clinic completed the questionnaires. Thirty four percent of the responders had traveled outside Western Europe (WE) and Northern America (NA); 22% of these travelers did not seek pre-travel health advice. Transplant physicians were most frequently consulted for pre-travel advice (53%). Of the responders traveling outside WE and NA 29% were ill during their most recent journey. Diabetic transplant recipients were at the highest risk. Four of seventeen ill recipients (24%) were hospitalized, reflecting the high morbidity of travel-related disease in this patient group. Our data show that there is need for improvement of pre-travel healthcare, and suggest an important role for transplant physicians in providing adequate counseling.

  4. Travelers' Health: Pregnant Travelers

    MedlinePlus

    ... Most experts recommend a slower ascent with adequate time for acclimatization. No studies or case reports show harm to a fetus if the mother travels briefly to high altitudes during pregnancy. However, it ...

  5. A telegeriatric service in a small rural hospital: A case study and cost analysis.

    PubMed

    Versleijen, Marloes; Martin-Khan, Melinda G; Whitty, Jennifer A; Smith, Anthony C; Gray, Leonard C

    2015-12-01

    Small hospitals in rural areas usually have an insufficient caseload of frail old people to justify the regular presence of a geriatrician. This study examined the costs of providing a telegeriatric service by videoconference in a rural hospital, compared to the costs of a visiting geriatrician that travels to undertake in-person consultations. A cost analysis was undertaken to compare the costs of the telegeriatric service model with the costs of a visiting geriatrician service model. A recently established telegeriatric service at Warwick Hospital was used as a case study. In the base case model (assuming four patients per round and a round-trip travel distance of 312 kilometres), an estimated AUD$131 per patient consultation can be saved in favour of the telegeriatric service model. Key drivers of costs are the number of patients per round and the travel distance and time in the visiting geriatrician model. At a workload of four patients per round, it is less expensive to conduct a telegeriatric service than a visiting geriatrician service when the round-trip travel time exceeds 76 minutes. Even under quite conservative assumptions, a telegeriatric service offers an economically feasible approach to the delivery of specialist geriatric assessment in rural and remote settings. © The Author(s) 2015.

  6. Travelers' Health: Hepatitis C

    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 ...

  7. Travelers' Health: Motion Sickness

    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 ...

  8. 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.

  9. Travelers' Health: Hepatitis B

    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 ...

  10. Travelers' Health: Meningococcal Disease

    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 ...

  11. Travelers' Health: HIV Infection

    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 ...

  12. Travelers' Health: Leishmaniasis, Visceral

    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 ...

  13. Travelers' Health: Hepatitis A

    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 ...

  14. Travelers' Health: Varicella (Chickenpox)

    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 ...

  15. Travelers' Health: Japanese Encephalitis

    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 ...

  16. Travelers' Health: Leishmaniasis, Cutaneous

    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 ...

  17. 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...

  18. Health Behavior of International Travelers to Calcutta: Identifying the Need for a Travelers' Clinic.

    PubMed

    Chatterjee

    1994-12-01

    With the growing rates of travel and, potentially therefore, of travel-related illness in India, this study was conducted to establish both the need of a travelers' clinic in Calcutta and a profile of the group or groups at risk of illness best served by such facilities. A total of 452 visitors, half business and package holiday travelers (group A) and half younger, low-budget tourists with less pretravel advice (group B), were compared. Through a questionnaire, their health, pretravel advice and prophylaxis, use of first aid, safe water use, posttravel treatment, and opinion concerning the need for a travelers' clinic were determined. Group A travelers stayed in deluxe hotels with more pretravel advice (90% compared to 72% in group B), were taking antimalarial agents (82% compared to 61% in group B), remained healthy (72% compared to 58% in group B), consumed safe water (87% compared to 47% in group B), and were more likely to seek posttravel treatment (75% compared to 60% in group B). The group B travelers, consequently, felt an increasing need for a travelers' clinic (92% compared to 82% in group A). Given the complexities of travel in India, there is a palpable need for appropriate medical attention to travelers, especially among the young, budget tourists, which is best provided at a travelers' clinic.

  19. 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.

  20. The Cost of an Additional Disability-Free Life Year for Older Americans: 1992–2005

    PubMed Central

    Cai, Liming

    2013-01-01

    Objective To estimate the cost of an additional disability-free life year for older Americans in 1992–2005. Data Source This study used 1992–2005 Medicare Current Beneficiary Survey, a longitudinal survey of Medicare beneficiaries with a rotating panel design. Study Design This analysis used multistate life table model to estimate probabilities of transition among a discrete set of health states (nondisabled, disabled, and dead) for two panels of older Americans in 1992 and 2002. Health spending incurred between annual health interviews was estimated by a generalized linear mixed model. Health status, including death, was simulated for each member of the panel using these transition probabilities; the associated health spending was cross-walked to the simulated health changes. Principal Findings Disability-free life expectancy (DFLE) increased significantly more than life expectancy during the study period. Assuming that 50 percent of the gains in DFLE between 1992 and 2005 were attributable to increases in spending, the average discounted cost per additional disability-free life year was $71,000. There were small differences between gender and racial/ethnic groups. Conclusions The cost of an additional disability-free life year was substantially below previous estimates based on mortality trends alone. PMID:22670874

  1. Impact of medical travel on imports and exports of medical services.

    PubMed

    Johnson, Tricia J; Garman, Andrew N

    2010-12-01

    Medical travel is travel outside of an individual's home region or country in pursuit of medical care that is more accessible, of higher quality and/or of lower cost. This paper estimates the inflows of foreign residents seeking medical care in the U.S. and outflows of U.S. residents seeking care abroad. Using data from the U.S. Bureau of Economic Analysis, U.S. International Trade Administration and a survey of domestic health care providers, we estimate the lower and upper bounds for the number of medical travelers into and out of the U.S. and the value of these services. We estimate that between 43,000 and 103,000 foreigners came into the U.S. for medical care, and between 50,000 and 121,000 U.S. residents traveled abroad for care in 2007. Despite a net loss in the number of medical travelers flowing out of the U.S. for care, the trade surplus for medical travel could be as high as $1 billion. While a slight net outflow of patients leaving the U.S. for medical care may exist, the resulting impact on exports is still positive for the U.S., due to a higher average spending per patient coming to the U.S. New mechanisms are needed to track the balance of mobility and trade for medical care on a regular basis. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  2. Traveling with Food Allergies

    MedlinePlus

    ... to know Tips for Traveling with Food Allergies Restaurants and Travel All-Inclusive Resorts See All Resources ... risk of exposure to allergens on the flight. Restaurants and Travel Watch these webinars for expert advice ...

  3. Travel medicine and HIV infection.

    PubMed

    Igreja, Ricardo

    2008-09-01

    The number of HIV-infected persons who travel is increasing. This increase arises from those who have benefited from advances in antiretroviral therapy. The key to successful travel is careful pre-trip planning although many patients do not obtain advice before travelling. Travel advice for HIV patients is becoming increasingly specialized, and includes travel vaccination and highly active antiretroviral therapy-related issues. A closer collaboration between HIV and travel health clinics could provide better care for HIV-infected individuals.

  4. Pre-travel health advice-seeking behavior among US international travelers departing from Boston Logan International Airport.

    PubMed

    LaRocque, Regina C; Rao, Sowmya R; Tsibris, Athe; Lawton, Thomas; Barry, M Anita; Marano, Nina; Brunette, Gary; Yanni, Emad; Ryan, Edward T

    2010-01-01

    Globally mobile populations are at higher risk of acquiring geographically restricted infections and may play a role in the international spread of infectious diseases. Despite this, data about sources of health information used by international travelers are limited. We surveyed 1,254 travelers embarking from Boston Logan International Airport regarding sources of health information. We focused our analysis on travelers to low or low-middle income (LLMI) countries, as defined by the World Bank 2009 World Development Report. A total of 476 survey respondents were traveling to LLMI countries. Compared with travelers to upper-middle or high income (UMHI) countries, travelers to LLMI countries were younger, more likely to be foreign-born, and more frequently reported visiting family as the purpose of their trip. Prior to their trips, 46% of these travelers did not pursue health information of any type. In a multivariate analysis, being foreign-born, traveling alone, traveling for less than 14 days, and traveling for vacation each predicted a higher odds of not pursuing health information among travelers to LLMI countries. The most commonly cited reason for not pursuing health information was a lack of concern about health problems related to the trip. Among travelers to LLMI countries who did pursue health information, the internet was the most common source, followed by primary care practitioners. Less than a third of travelers to LLMI countries who sought health information visited a travel medicine specialist. In our study, 46% of travelers to LLMI countries did not seek health advice prior to their trip, largely due to a lack of concern about health issues related to travel. Among travelers who sought medical advice, the internet and primary care providers were the most common sources of information. These results suggest the need for health outreach and education programs targeted at travelers and primary care practitioners. © 2010 International Society of

  5. Intelligent transportation systems for traveler information : deployment benefits and lessons learned

    DOT National Transportation Integrated Search

    2007-01-01

    In the 10 most congested areas of the country, each rush hour traveler pays an annual "congestion tax" of $850 to $1,600 in lost time and fuel and spends a total of almost 8 work days each year stuck in traffic. To address this costly problem, the U....

  6. Aggregate Auto Travel Forecasting : State of the Art and Suggestions for Future Research

    DOT National Transportation Integrated Search

    1976-12-01

    The report reviews existing forecasting models of auto vehicle miles of travel (VMT), and presents evidence that such models incorrectly omit time cost and spatial form variables. The omission of these variables biases parameter estimates in existing...

  7. Direct and indirect costs of asthma in Canada, 1990.

    PubMed Central

    Krahn, M D; Berka, C; Langlois, P; Detsky, A S

    1996-01-01

    OBJECTIVE: To calculate the direct and indirect costs of asthma in Canada. DESIGN: Cost-of-illness study. SETTING: Canada. PATIENTS: All Canadians receiving inpatient or outpatient care for asthma in 1990. OUTCOME MEASURES: Direct costs incurred by inpatient care, emergency services, physician and nursing services, ambulance use, drugs and devices, outpatient diagnostic tests, research and education. Indirect costs from productivity loss due to absence from work, inability to to perform housekeeping activities, need to care for children with asthma who were absent from school, time spent travelling and waiting for medical care, and premature death from asthma. All costs are in 1990 Canadian dollars. RESULTS: Depending on assumptions, the total cost of asthma was estimated to be between $504 million and $648 million. Direct costs were $306 million. The single largest component of direct costs was the cost of drugs ($124 million). The largest component of indirect costs was illness-related disability ($76 million). CONCLUSIONS: Annual costs of treating asthma are comparable to the individual cost of infectious diseases, hematological diseases, congenital defects, perinatal illnesses, home care and ambulance services. Asthma costs may increase in the future, given current morbidity and mortality trends. Further evaluation of the effectiveness and cost-effectiveness of available asthma interventions in addition to aggregate cost data are required to determine whether resource allocation for the treatment of asthma can be improved. PMID:8634960

  8. A comparison of exposure to risk factors for giardiasis in non-travellers, domestic travellers and international travellers in a Canadian community, 2006-2012.

    PubMed

    Swirski, A L; Pearl, D L; Peregrine, A S; Pintar, K

    2016-04-01

    The purpose of this study is to determine how demographic and exposure factors related to giardiasis vary between travel and endemic cases. Exposure and demographic data were gathered by public health inspectors from giardiasis cases reported from the Region of Waterloo from 2006 to 2012. Logistic regression models were fit to assess differences in exposure to risk factors for giardiasis between international travel-related cases and Canadian acquired cases while controlling for age and sex. Multinomial regression models were also fit to assess the differences in risk profiles between international and domestic travel-related cases and endemic cases. Travel-related cases (both international and domestic) were more likely to go camping or kayaking, and consume untreated water compared to endemic cases. Domestic travel-related cases were more likely to visit a petting zoo or farm compared to endemic cases, and were more likely to swim in freshwater compared to endemic cases and international travel-related cases. International travellers were more likely to swim in an ocean compared to both domestic travel-related and endemic cases. These findings demonstrate that travel-related and endemic cases have different risk exposure profiles which should be considered for appropriately targeting health promotion campaigns.

  9. Summary travel characteristics : Hawaii

    DOT National Transportation Integrated Search

    1997-10-01

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  10. Summary travel characteristics : Massachusetts

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  11. Summary travel characteristics : Arkansas

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  12. Summary travel characteristics : Virgina

    DOT National Transportation Integrated Search

    1997-09-30

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  13. Summary travel characteristics : Florida

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  14. Summary travel characteristics : Kansas

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  15. Summary travel characteristics : California

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  16. Summary travel characteristics : Texas

    DOT National Transportation Integrated Search

    1997-09-30

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  17. Summary travel characteristics : Illinois

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  18. Summary travel characteristics : Montana

    DOT National Transportation Integrated Search

    1997-09-30

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  19. Summary travel characteristics : Kentucky

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  20. Summary travel characteristics : Wisconsin

    DOT National Transportation Integrated Search

    1997-10-01

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  1. Summary travel characteristics : Maryland

    DOT National Transportation Integrated Search

    1997-09-19

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  2. Summary travel characteristics : Nevada

    DOT National Transportation Integrated Search

    1997-09-30

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  3. Summary travel characteristics : Iowa

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  4. Summary travel characteristics : Washington

    DOT National Transportation Integrated Search

    1997-10-01

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  5. Summary travel characteristics : Alabama

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  6. Summary travel characteristics : Nebraska

    DOT National Transportation Integrated Search

    1997-09-30

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  7. Summary travel characteristics : Oregon

    DOT National Transportation Integrated Search

    1997-10-01

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  8. Summary travel characteristics : Maine

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  9. Summary travel characteristics : Utah

    DOT National Transportation Integrated Search

    1997-09-30

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  10. Summary travel characteristics : Michigan

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  11. Summary travel characteristics : Missouri

    DOT National Transportation Integrated Search

    1997-09-30

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  12. Summary travel characteristics : Colorado

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  13. Summary travel characteristics : Alaska

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  14. Summary travel characteristics : Oklahoma

    DOT National Transportation Integrated Search

    1997-09-30

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  15. Summary travel characteristics : Indiana

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  16. Summary travel characteristics : Idaho

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  17. Summary travel characteristics : Tennessee

    DOT National Transportation Integrated Search

    1997-09-30

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  18. Summary travel characteristics : Georgia

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  19. Summary travel characteristics : Delaware

    DOT National Transportation Integrated Search

    1997-09-29

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...

  20. Summary travel characteristics : Ohio

    DOT National Transportation Integrated Search

    1997-09-30

    The Summary Travel Characteristics publication series contains summary tables of travel statistics for census regions and divisions, States, and metropolitan areas. The tables in this report provide an overview of the findings of the American Travel ...