The importance of different forms of prevention in travel medicine

The Asia-Pacific region is becoming an increasingly popular destination for holidaymakers and business travelers.Despite the seductive tourist attractions and the growing financial importance of the region,infectious diseases have unfortunately repeatedly caused major epidemics in the region.The area includes various geographical situations from high mountains to the subtropical and monsoon forests,dry deserts and seashore.The travel medicine specialist’s task is to decrease the various risk of travel to the region.Infectious diseases,extreme temperatures and marine hazards could be almost entirely prevented by primary prevention forms of travel medicine such as vaccination,chemoprophylaxis and pretravel advice.There are some high-risk groups(e.g.,elderly people,backpackers,families with children,adventure travelers) among the growing number of tourists.Obviously,the increased numbers of such travelers result in a rising incidence of travelrelated illnesses and accidents.For those groups,primary prevention sometimes is not enough. The pretravel medical check up,specialists’ consultations and treatment,as forms of secondary prevention,are also essential in travel medicine.Patients who suffer from serious illnesses or who have accidents must often be repatriated."State-of-the-art repatriation",as a special form of tertiary prevention of travel medicine will play an important role in the future and is direcdy related to effective travel insurance,which could help in providing good medical care to the patients even far from their home.The levels,methods and importance of prevention in travel medicine are discussed in this article.

旅游保险发展与旅游收入增长的相关性分析——以海南省为例

运用spss和eviews统计软件,通过建立计量经济模型对海南省2003～2010年的保险业、旅游业相关经济数据进行回归分析,结果显示,海南省旅游保险发展与旅游收入增长之间存在显著的正相关关系。基于此,提出综合运用政府和市场两方面力量,启动旅游业与保险业双方的合力,建立"旅保合作"的工作机制,建立评价指标体系,对旅游相关企业和保险公司进行评估,构建旅游保险客户数据库等促进旅游保险与旅游业互动发展的策略。

Factors Affecting Disease Risk Perception and Self-Management Behaviors among Japanese Long-Term Overseas Volunteers

Introduction: Many overseas volunteers have worked in low and middle-income countries. However traveling abroad and staying in an unfamiliar environment with inadequate medical infrastructure exposes volunteers to a wide range of health risks. The aim of this study was to clarify the relationships among disease knowledge and symptoms, disease risk perception, and self-management skills. Methods: This was a questionnaire survey of 189 Japanese who were preparing to volunteer abroad. A factor analysis was conducted on 13 items (six general risk events and seven major diseases) of risk perception. Correlation analysis was performed between the identified risk perception factors and disease knowledge and symptoms. Risk perception scores by factors from the seven disease items were compared between the Self-management Score (SMS) group and disease knowledge and risk of symptoms group, using T-tests. St. Luke’s International University Ethics Committee (19-A092) approved this study. Results: Many participants expected to suffer from digestive diseases (69.3%) and dermatitis (55%) in the field. On the other hand, few expected high risk of malaria (26.5%) or dengue fever (36%). Factor analysis yielded robust factor loadings creating a “Dread” and an “Unknown” factor accounting for 62.2% of total variance. Strong correlation was not found between SMS and disease risk perception. A weak negative correlation was observed in dengue fever, digestive disorders, and dermatitis (r = −0.20 to −0.25, p < 0.001) on the “Unknown” factor. A high SMS score was associated with a lower “Unknown” factor score for malaria, diarrhea, dermatitis, and dental disorders. In addition, higher disease knowledge was significantly associated with higher “Dread” factor score for dental disorders. Conclusions: Self-management skills and disease knowledge will enable higher risk awareness of common diseases and high lethality diseases.

TOD residents' attitudes toward walking to transit station: a case study of transit-oriented developments(TODs) in Bangkok,Thailand

The study aims to analyze the attitude toward walking to the stations of residents living within 1 km of transit stations, or they are called transit-oriented development(TOD) residents. They are highly expected to walk to transit station and use rail in their daily travel. In this research, 249 respondents are asked 10 questions on attitudes of walking to station. The analysis was conducted in two stages: factor analysis and structural equation model. As the current access mode of respondents,walkers are more likely to be low-income households.People using motorized mode are mostly from middle-to high-income, households the largest group of respondents.For walking acceptance, high-income group accepts distance and time shorter than other incomes. Low-income households can accept the longer walking distance but shorter time. Middle-income households are more likely to walk in shorter distance than lower-income households,but they tend to accept longer walking time than others.As for the analysis results, the feeling of walking among all respondents significantly influences the walking acceptance. The benefit of walking significantly influences walking acceptance only among middle-income households. The walking attitudes on convenience, safety, a sense of freedom, healthiness, and environmental friendliness highly affect respondents' acceptable walking distance and time in TODs.

Countries at risk of importation of chikungunya virus cases from Southern Thailand: A modeling study

Southern Thailand has been experiencing a large chikungunya virus(CHIKV)outbreak since October 2018.Given the magnitude and duration of the outbreak and its location in a popular tourist destination,we sought to determine international case exportation risk and identify countries at greatest risk of receiving travel-associated imported CHIKV cases.We used a probabilistic model to estimate the expected number of exported cases from Southern Thailand between October 2018 and April 2019.The model incorporated data on CHIKV natural history,infection rates in Southern Thailand,average length of stay for tourists,and international outbound air passenger numbers from the outbreak area.For countries highly connected to Southern Thailand by air travel,we ran 1000 simulations to estimate the expected number of imported cases.We also identified destination countries with conditions suitable for autochthonous CHIKV transmission.Over the outbreak period,we estimated that an average of 125(95%credible interval(CrI):102e149)cases would be exported from Southern Thailand to international destinations via air travel.China was projected to receive the most cases(43,95%CrI:30e56),followed by Singapore(7,95%CrI:2e12)and Malaysia(5,95%CrI:1e10).Twenty-three countries were projected to receive at least one imported case,and 64%of these countries had one or more regions that could potentially support autochthonous CHIKV transmission.The overall risk of international exportation of CHIKV cases associated with the outbreak is Southern Thailand is high.Our model projections are consistent with recent reports of CHIKV in travelers returning from the region.Countries should be alert to the possibility of CHIKV infection in returning travelers,particularly in regions where autochthonous transmission is possible.

旅游景点间细粒度语义交互作用挖掘及模式分析:以云南省为例

研究旅游景点语义交互及交互作用模式,对根据游客需求优化旅游格局有重要意义。现有语义交互挖掘方法忽略了文本中包含人感知信息的上下文词汇;此外,缺少以景点交互为单位分析交互作用模式的研究。为此,本文提出了一个景点间细粒度语义交互作用挖掘和模式分析框架。首先抽取文本中景点交互的语境;然后利用TF-IDF关键词抽取和语义网络分析方法,从讨论焦点和语义结构角度挖掘景点间细粒度的语义交互作用;最后结合Spearman秩相关系数、Graph Kernel图相似度度量方法和网络分析方法,分析语义交互作用模式。以云南省2018年游记数据进行实例分析,结果表明:①利用本文提出的框架可以挖掘和分析各个景点间细粒度的语义交互作用,辅助有关部门结合游客意见提升旅游体验;可以分析语义交互作用模式,发现优化旅游格局的关键路线片段;②苍山-洱海应着重提升自然风光体验;而大理古城-洱海应考虑改善游客对品牌旅游资源关注不足的问题;③云南省单核心集聚型、单核心辐射型、多区域合作型景点语义交互模式共存,呈现出点轴渐进扩散特征。可利用中介中心性较高且跨区域的景点交互,推动其他2种模式向多区域合作型转化,推进全域旅游战略实施。本文研究可为旅游路线推荐以及平衡旅游格局提供参考。