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Background Early diagnosis is key to reducing the morbi-mortality associated with P. falciparum malaria among international travellers. However, access to microbiological tests can be challenging for some healthcare settings. Artificial Intelligence could improve the management of febrile travellers. Methods Data from a multicentric prospective study of febrile travellers were obtained to build a machine-learning model to predict malaria cases among travellers presenting with fever. Demographic characteristics, clinical and laboratory variables were leveraged as features. Eleven machine-learning classification models were evaluated by 50-fold cross-validation in a Training set. Then, the model with the best performance, defined by the Area Under the Curve (AUC), was chosen for parameter optimization and evaluation in the Test set. Finally, a reduced model was elaborated with those features that contributed most to the model. Results Out of 11 machine-learning models, XGBoost presented the best performance (mean AUC of 0.98 and a mean F1 score of 0.78). A reduced model (MALrisk) was developed using only six features: Africa as a travel destination, platelet count, rash, respiratory symptoms, hyperbilirubinemia and chemoprophylaxis intake. MALrisk predicted malaria cases with 100% (95%CI 96–100) sensitivity and 72% (95%CI 68–75) specificity. Conclusions The MALrisk can aid in the timely identification of malaria in non-endemic settings, allowing the initiation of empiric antimalarials and reinforcing the need for urgent transfer in healthcare facilities with no access to malaria diagnostic tests. This resource could be easily scalable to a digital application and could reduce the morbidity associated with late diagnosis. [ABSTRACT FROM AUTHOR]

Background: Exclusive breastfeeding is vital for the optimal development of infants, yet the practice of using infant formula has become increasingly prevalent. While many studies globally investigate factors affecting breastfeeding, there is a scarcity of research focusing on marginalized groups, particularly the Roma community. This study seeks to compare the breastfeeding rates of Roma and non-Roma mothers upon discharge from a maternity hospital in Greece. It also examines factors contributing to the decline in breastfeeding among Roma women, with particular emphasis on the role of midwifery support. The aim of this study is to promote the development of supportive policies and programs for breastfeeding among Roma mothers. Methods: A cross-sectional study was conducted from September 2019 to January 2022, involving 248 infants born at ≥37 weeks of gestation and their mothers, who were of Greek nationality. Both Roma and non-Roma participants received consistent, high-quality care from the same midwife researcher, who personally attended to them. All participants initiated breastfeeding immediately after their newborns' births and practiced rooming-in by keeping their babies in the room with them during their hospital stay. Data were collected through questionnaires to determine the rates of exclusive breastfeeding among the two groups. Results: The study found that a smaller proportion of Roma mothers exclusively breastfed their infants compared to non-Roma mothers, despite receiving similar levels of support from healthcare professionals. Conclusions: The provision of midwifery support did not significantly enhance exclusive breastfeeding rates among Roma mothers. This suggests the need for more comprehensive and multi-faceted interventions. Further research is required to confirm these findings and to design effective programs aimed at increasing exclusive breastfeeding rates, thereby improving health outcomes for Roma children and mothers. [ABSTRACT FROM AUTHOR]

Copyright of Revista 180 is the property of Revista 180 and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A substantial proportion of global travel occurs between low- and middle-income countries (LMICs) for the purposes of migration, medical tourism, trade and employment, and this is likely to accelerate due to climate-change-related migration. Traveller studies based in LMICs are needed to better monitor the global spread of antibiotic resistance.

The research analyses the tourism situation in Extremadura (Spain) in recent years to assess whether the COVID-19 pandemic has been an opportunity to revitalise these destinations. An analysis was carried out at the municipal level using contextual variables and tourism indicators obtained from surveys of the National Institute of Statistics. The data were processed and compared using Geographic Information Systems, allowing for a spatial and temporal assessment. The results provide a detailed overview of the current state of tourism in the municipalities of Extremadura, determining whether pre-pandemic levels of activity have been recovered and identifying the municipalities with significant improvements in their tourism potential during the period studied.

AbstractIncreasing but unknown numbers of women are adopting itinerant lifestyles on the road, in the pursuit of ambitions and aspirations that extend beyond the conventional role of women as they age. Using data from a study that aimed to describe women who travel without men, either alone or with other women, across Australia in self-contained accommodation, this paper illustrates the richness and diversity of these lives through the narratives of four women. The study from which these data were taken was informed by an ethnographic approach. A montage has been used to present four narratives that together illustrate dominant themes that emerged from the analysis. Initially 29 women, travelling either alone or with other women in mobile accommodation across Australia, were interviewed using audio-visual media or telephones between March 2020-March 2022. From the thematic analysis of these interviews, four participants’ narratives were chosen to represent the main themes derived from the analysis while at the same time retaining the women’s individual perspectives and voices. The four narratives included in this montage paper exemplify four key themes: the adventure of exploring Australia; experiencing the new and unknown; developing self-knowledge and self-confidence; and taking control of one’s life. The women’s stories demonstrate commonality as well as diversity, of a chosen lifestyle beyond the conventional view of women as homemakers, and redefining the conventional view of ageing as one of decline and deterioration. These narratives demonstrate older women living lives that provide new and different pathways to personal growth, independence and self-confidence. [ABSTRACT FROM AUTHOR]

Summary: This article reports on the findings from a national evaluation of a specialist, Irish, social work service for Traveller families and communities. It begins with an historical overview of the service which was established in the 1960s but which has evolved and developed over the past few decades at a time of changing patterns of Traveller lives and social and economic conditions. It was also a period when the role of social work was changing, most notably with the introduction of state regulation of the profession. The article then critically analyses national and international literature on the role of social workers with Travellers. It then describes the mixed research method used to evaluate the service. Findings: The findings highlight various, sometimes competing perspectives on the social work role, drawn from administrative data, a survey of social workers interviews with social workers and Traveller representatives. These include views about how the social work role was viewed by social workers and Traveller representatives, informed by theories on anti-oppressive practice, systems approaches and forms of advocacy. Applications: The article concludes with a discussion of ways in which the lessons learned from the evaluation can be used to further develop the social work service in ways that can enhance the lives of Travellers, through forms of continuous professional development and the created of a national policy and practice framework. [ABSTRACT FROM AUTHOR]

This article aims to situate Traveller evictions within discussions on local authorities and their role in realising human rights. It focuses on the scenario where local authorities choose to merely tolerate rather than regularise Travellers' housing situation, leading to forced evictions without culturally appropriate alternative accommodation. Through a case study in a Belgian city, three aspects will be examined. First, the local authority's position will be evaluated against the case law of the European Court of Human Rights. Second, the article will analyse the involved actors' human rights engagement. Based on these findings, a third aspect will be to briefly explore three strategies to improve local authorities' human rights performance in this context: to further develop their position within human rights law and strengthen their engagement with the supranational level; to hold local authorities accountable in terms of human rights law at the domestic level; and to integrate a human rights framework into local authorities' daily decision-making processes. It will be argued that these strategies show different strengths and weaknesses, highlighting the importance of cooperation between multiple levels and actors. Taken together, they hold the potential to reinforce each other and promote processes and outcomes truly benefitting human rights implementation. [ABSTRACT FROM AUTHOR]

This article analyses Helon Habila's Travellers (2019), focusing on its depiction of African migrants in Europe as strangers, as defined by Sara Ahmed in Strange Encounters (2000): those who, in spite of their proximity, are recognized as not belonging or out of place. Following Ahmed, this essay deals with the relation between space and migrant experience in Habila's novel, in which the configuration of cities such as Berlin and London and of Europe as a whole is presented as characterized by the enforcement of boundaries and spaces of belonging (Ahmed, 2000), so that the African stranger emerges as an undesirable, threatening, foreign element to be feared and expelled. On the other hand, such a logic of defensiveness, homogeneity, and exclusion is partly challenged and undermined in Travellers by acts of resistance carried out by both African and European characters and by acts of domestic hospitality. These acts suggest the disruption of frontiers and borders, and their corresponding sealed and homogeneous spaces (Ahmed, 2000), together with the necessity of exercising hospitality at a collective and political level. As opposed to the configuration of Europe as Fortress Europe, in which identity and community are defined in terms of affiliation to roots, homeland, or race, in Travellers we find thus an appeal to what Jacques Derrida has called the "democracy to come", a political, always deferred space of unconditional hospitality that opens up to the foreigner and the stranger. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is twofold. The first objective is to identify the factors that affect Gen Z tourists' M-payment behaviour. Next, this study investigates the inter-relationship between Gen Z tourist's perception of M-payment benefits, adoption behaviour, usage risk and future usage intention. Design/methodology/approach: The sample comprised Malaysian Gen Z individuals (n = 326) who had experience using M-payment methods while travelling outbound. Given the complex nature of the model and the goal to predict and explain relationships within Gen Z's M-payment usage, partial-least square-structural equation modelling was used to assess the study framework and test the proposed relationships. Findings: This study reveals significant influences on Gen Z tourists' behavioural intentions towards M-payment usage. Perceived benefits, performance expectancy, social influence and perceived trust positively impact behavioural intentions, while effort expectancy exhibits no significant effect. Furthermore, perceived trust is strongly influenced by perceived security, which also positively influences behavioural intentions. A mediated relationship is evident as trust mediating the effect of perceived security on behavioural intentions. Research limitations/implications: This study's findings contribute to understanding the intricate relationships influencing Gen Z's M-payment behaviour and underscore trust's pivotal role in mediating the security–behavioural intention relationship. Originality/value: This study is among the first to consider Mental Accounting Theory and the Unified Theory of Acceptance and Use of Technology as crucial underpinning theories in comprehending the intricate relationships that influence Gen Z travellers' perceptions and behaviours concerning M-payment systems. [ABSTRACT FROM AUTHOR]

Background High-speed global travel, increased trade, world population growth, migration, urbanization and climate change have favoured the emergence and spread of pathogens. We aimed to analyse the evolution of imported infections in Spain during 2012–2022 and the potential impact of some of the abovementioned factors on differential morbidity patterns. Methods In this retrospective study (January 2012 to December 2022), we analysed data collected by the +Redivi network across 25 health centres. The network's standardised database records new cases of imported infections, including patient demographics, travel history, pre-travel advice and diagnostic information. To assess outcome rates over time and potential interactions, we constructed penalized weighted models to reduce the bias related to a low event rate and used weighted logistic regression for morbidity outcomes. Results We recorded 25 632 episodes, comprising 13 913 migrants, 4047 visiting friends and relatives (VFR) immigrants, 392 VFR travellers and 7280 travellers. Most immigrants came from South America (48.3%), Sub-Saharan Africa (28.5%), North Africa (6.6%), South Central Asia (5.4%) and Central America/Caribbean (5.3%). The most common regions visited by travellers were Sub-Saharan Africa (33.5%), South America (24.5%), Central America/Caribbean (13.5%), Southeast Asia (12%) and South Central Asia (10%). The proportion of diagnoses of malaria, strongyloidiasis and unspecified self-limiting febrile syndrome < 3 weeks remained unchanged during the study period. An increased frequency of diagnosis was reported for schistosomiasis, blastocystosis, giardiasis, dengue, diarrhoea, new cases of HIV, latent and pulmonary tuberculosis, whereas a decrease was reported for syphilis, chikungunya fever, Chagas disease and eosinophilia. We detected interactions between time and sex or type of participant across the different diagnoses. Conclusions Our study underscores the importance of epidemiological data in understanding infectious diseases dynamics among travellers and migrants, emphasizing how demographic shifts, migration trends and healthcare policies affect disease profiles. Comprehensive data play an essential role in enhancing public health policies and travel advice. [ABSTRACT FROM AUTHOR]

Helon Habila's Travellers was written as a response to the refugee crisis in 2015, and it narrates loosely connected stories of African asylum seekers precariously travelling in Southern and Western European countries seeking shelter. This article discusses the novel's representation of Europeans and migrants acting together by drawing from Jacques Rancière's theorization of dissensus as a tool to challenge existing political hierarchies by creating new solidarities against present orders. I maintain that the novel manages to problematize the mainstream media images of immigration issues, as well as other such narrative tropes that reinforce the understanding of immigrants as Europe's others. I argue that the novel instead exposes facets of structural violence in fortress Europe as it violently suppresses immigrant voices. Along these lines, the novel is further discussed as a representative of critical art or dissensual art that not only exposes contemporary exclusionary politics, but also advances a new affective politics by actively demonstrating more democratic ways of including people without a political voice. It can thus help to reconfigure which political questions are included in public deliberations in the future and provoke new, more democratic ways of seeing immigration issues. [ABSTRACT FROM AUTHOR]

Objective: The objective of the research was to explore rural and remote pharmacists' experiences of encountering grey nomads with diabetes. Design: A qualitative Interpretive Description design was used to explore and capture the experiences of rural and remote pharmacists interacting with grey nomads who had diabetes. Data from the interviews were analysed thematically. Setting: The Pharmacy Guild of Australia was approached and through their membership rural and remote pharmacists were invited to participate in the research. Participants: Nine rural and remote pharmacists who had encounters and provided services to grey nomads with diabetes responded to be interviewed. Results: The analysed findings established four major themes including: the influence of rural and remote locations on services; common problems encountered by the pharmacists; preparation for travel by grey nomads with diabetes; and pharmacists' preparedness to support grey nomads with diabetes. Conclusion: The findings of this study identified that pharmacists needed remuneration for services provided to grey nomads with diabetes. Also, further development of the My Health record and telehealth to include pharmacists would be advantageous for grey nomads who have diabetes. Pharmacists stated there was a need for further education and a continuing professional development module specifically designed for pharmacists on diabetes self‐management that moved beyond medications. A pre‐travel checklist for grey nomads with diabetes travelling in rural and remote Australia would benefit all stakeholders through better preparation of travellers with diabetes to self‐manage, thereby reducing the demand for health services including pharmacies. [ABSTRACT FROM AUTHOR]

This study explores issues related to the work of customs and border crossings by travellers from the territories of the Russian Empire. The article analyses travel notes, diaries, memoirs, and correspondence of several Ukrainian and Russian travellers who journeyed through European countries during the 19th century. The research primarily focuses on the narratives of Ukrainian and Russian travellers, including O. Bodyansky, H. Halahan, A. Glagolev, P. Kovalevsky, I. Sreznevsky, and others. It was found that travellers paid the most attention to crossing the Russian-Austrian border and, accordingly, to Russian and Austrian customs, there were several reasons for this: first, the main overland transport routes to France, Britain, and the German lands passed through Austro-Hungarian territories. Second, the first experience of crossing the border was associated with Russian and Austrian customs. However, travellers considered the work of British, Belgian, and French customs to be the most professional. The study identifies a typical list of prohibitions on the import or export of certain goods, such as tobacco, tea, printed materials (including books, sheet music, and newspapers, especially during the rise of revolutionary movements in Europe), and others. The letters of third parties, not belonging to the travellers, were also subject to inspection. Due to certain reasons defined by the specifics of Russian imperial internal policy and censorship bans, travellers resorted to smuggling printed materials. Illegal activities during border crossings in European countries were associated with ignorance of local laws, significant customs sizes (according to subjective considerations), and the lack of information about the presence of prohibited goods in rented transport. The study also reveals that rumors about customs officials’ bribery and horrific inspections were mostly unfounded. However, travellers did document numerous instances where officials violated the law and exceeded their official powers. [ABSTRACT FROM AUTHOR]

Research shows that UK Travellers¹ struggle to combine traditional values with mainstream education, leading to many dropping out of school before gaining qualifications. While there is an appetite for continuing home-schooling, Traveller parents struggle with this. Lincolnshire Traveller Initiative (LTI) offers Traveller children a structured home-schooling method that is sensitive to their cultural needs. Through 31 qualitative interviews with Traveller parents and children who have engaged with LTI, we explore their educational experiences prior to LTI, and the impact that such initiatives have on their educational outlooks. We found that while all the children struggled with mainstream schooling, the educational model offered by LTI - a model which was supported by LTI's collaborative partners - helped Travellers to obtain qualifications and explore the possibility of developing their career paths or attending higher education. This paper has implications for educational practitioners hoping to engage with the Traveller community in the future. Firstly, it underlines the importance of building a trusted connection with the community, as relationships and cultural sensitivity are key. Secondly, it highlights the necessity of offering flexible and adaptable lessons that provide the knowledge necessary for obtaining key qualifications, while still supporting and providing the skills deemed essential in the Traveller community. [ABSTRACT FROM AUTHOR]

Cultural events and festivals play a key role in shaping the world's cultural tourism landscape. This article examines the multifaceted impact of cultural events and festivals on cultural tourism in economic, social, cultural and environmental dimensions. A comprehensive review of existing literature and case studies highlights the important contribution of cultural events and festivals to the tourism industry and local communities. Cultural events and festivals have become important drivers of cultural tourism, offering unique experiences that attract tourists while shaping the identity and vitality of local communities. This article examines the multifaceted impact of cultural events and festivals on both cultural tourism and local communities, focusing on economic, social, cultural and environmental dimensions. Through extensive literature and case studies, this study highlights the various ways in which cultural events and festivals contribute to tourism development and community well-being, addressing the challenges and opportunities of sustainable management. [ABSTRACT FROM AUTHOR]

Research on Traveller education in Ireland is limited. Internationally, studies on the education of the Traveller, Roma or Gypsy community tend to focus on educational participation and exclusion, discrimination, identity and belonging with little focus on the representation of Traveller student across different types of schools and educational settings. This chapter examines the distribution of Traveller students across mainstream and alternative education settings in Ireland, and how this distribution varies across different types of schools and centres. Using data from the Growing Up in Ireland principal survey and survey data from Irish alternative education providers (The National Youthreach Programme), it explores the concentration of Travellers in mainstream provision, in designated disadvantaged schools (Delivering Equality of Opportunity in Schools [DEIS]) compared to non-DEIS schools, and alternative education in Ireland. Findings show a higher representation of Traveller students in schools designated disadvantaged compared to non-disadvantaged settings and greater numbers of Traveller students in large primary and, to a lesser extent, secondary schools. The findings for alternative education show that Traveller young people make up 15% of learners which is higher than their representation in the general population or the school system. There is marked regional variation with higher representation of Travellers in alternative education settings in the West of Ireland compared to other regions. With increasing policy emphasis on inclusive education and the need to increase retention of students from Traveller backgrounds, it is perhaps an opportune time to explore the distribution of Traveller students across different school and alternative educational contexts so that educational supports can be targeted more effectively. [ABSTRACT FROM AUTHOR]

This article extends Fullilove’s research about root shock and displacement by describing two community spatial justice projects led by Irish Travellers (also known as Mincéirs), an indigenous ethnic minority historically oppressed due to their distinctive nomadic culture who continue to experience systemic discrimination. Traveller-led genealogy and community mapping projects extend understandings of displacement, not from located urban neighbourhoods, but from familiar circuits including places. The article describes how younger generations, having inherited the negative effects of this ‘route shock’, engaged older generations to document, visit, and map Traveller places and mazeways, and in so doing, share stories with younger generations and a wider public that acknowledges Traveller contributions to Irish society. [ABSTRACT FROM AUTHOR]

This paper illustrates the place of root shock in the colonial and postcolonial history of Ireland and situates this series of Irish papers inspired by Mindy Fullilove’s seminal book. It explains why the practice of eviction has such a traumatic resonance within Irish society. This trauma was laid bare in the responses to a 2023 artwork by Spicebag that connected modern eviction with its historical precedents. In this paper the elements of Spicebag’s work are given their historical context with an account of dispossession and plantation, famine and exile, urban poverty, and neoliberal privatization of land and housing. In each case, a new form of root shock was added to the earlier legacies producing chronic place-based trauma. [ABSTRACT FROM AUTHOR]

The main objective of this research is to identify how individuals belonging to the Mapuche people were integrated into domestic service in the province of Concepción during the first half of the 19th century. This investigation takes into account the circumstances surrounding this labor integration, with a particular focus on the masterservant relationship that facilitated their inclusion in testamentary legacies. On the review of more than 450 wills that were legalized in the various notary offices of Concepción between 1823 and 1861, a dozen cases were identified where it is expressly stated that the servant legatee was of Mapuche origin, and that the inheritance was bequeathed to them "for services". The analysis of these wills, from a qualitative perspective, allows us to understand a series of common practices for the time, such as the use of Mapuche servants by the elites of Concepción, the change of Mapuche surnames for a "Chileanized" one, the transfer of surnames to servants when they had been raised by their masters, the bequest of various elements as remuneration for services and their insertion into a monetarized system, among others. The notarial sources will be complemented with the use of autobiographical accounts of travelers who were in Chile, such as Eduard Poeppig, Mary Graham or Edmund Reuel Smith, texts in which they give an account of how relations between Mapuche and Chileans functioned in the Frontier zone. [ABSTRACT FROM AUTHOR]

In Late Antiquity, travellers suffered countless difficulties when setting out on a journey. The roads were full of problems and in this scenario numerous clerics crossed the Iberian Peninsula and France either to attend the councils to discuss different aspects of dogma or to reach new monastic centers, all after the Council of Nicaea. Thanks to the detailed accounts of the hagiographies, we can give shape to the relationship between man and God in critical situations during a journey. [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background When malaria is suspected in case of fever after travel in endemic areas, the current recommendation is to repeat the malaria test at 24-hour intervals, with up to two additional tests, as long as the test result is negative. A retrospective analysis was conducted to investigate the appropriateness of this recommendation by determining the proportion of tests with negative result at first and subsequently with a positive one at second or third attempt. Methods A retrospective study was conducted at the Centre for Primary Care and Public Health, Lausanne, covering a period of 15 years. All patients tested once for malaria were included. Testing included microscopy thick and thin films as well as malaria rapid diagnostic test used in combination. The main outcome measure was the proportion of patients with a first negative test result, subsequently positive on second or third test over the total patients with suspected malaria assessed. Demographic, travel, clinical, and laboratory variables were collected from patients' records to identify potential predictors of an initially negative and then positive test result. Results Four thousand nine hundred seventy-two patients were included. Of those, 4557 (91.7%) had definitive negative test results, and 415 (8.3%) had a positive result on the first test [332/415 (80%) Plasmodium falciparum , 40/415 (9.6%) P. vivax , 21/415 (5.1%) P. ovale , 12/415 (2.9%) P. vivax / ovale , 9/415 (2.2%) P. malariae and 1/415 (0.2%) P. knowlesi ], and 3/4972 (0.06%) had a positive result on the second test after a first negative result, 1/4972(0.02%) had a positive test result after 2 negative results, all with P. falciparum. One of the four patients that were positive after their initial negative test was pregnant. The very small number of patients with an initially negative test result and secondarily positive did not allow for risk factor analysis. Conclusions The current recommendation of serial malaria testing is not supported by the present study, a fortiori for those who do not present with a strong clinical or laboratory predictor of malaria. [ABSTRACT FROM AUTHOR]

Abstract Background The Lihir Islands of Papua New Guinea host a mining operation that has resulted in a mine-impacted zone (MIZ) with reduced malaria transmission and a substantial influx of mine employees, informal cross-country traders, returning locals, and visitors. Prevalence of malaria parasites was assessed in travellers arriving on the Lihir Group of Islands to evaluate the risk of parasite importation. Methods In 2018, a cross-sectional study at the airport and main wharf was conducted, targeting asymptomatic travellers who had been away from Lihir for at least 12 days. Microscopy, rapid diagnostic tests (RDTs), and quantitative PCR (qPCR) were used to determine Plasmodium parasite prevalence, employing logistic regression models to identify factors associated with qPCR positivity. Results 398 travellers arriving by plane and 402 arriving by boat were included. Both cohorts were significantly different. Mean age among travellers arriving by plane was 40.1 years (SD ± 10.1), 93% were male and 96% were employed at the mine. In contrast, among travellers arriving by boat, the mean age was 31.7 years (SD ± 14.0), 68% were male and 36% were employed at the mine. The prevalence of malaria infection among travellers arriving by plane was 1% by RDT and microscopy, and increased to 5% by qPCR. In contrast, those arriving by boat showed a prevalence of 8% by RDT and microscopy, and 17% by qPCR. Risk factors for infection were arriving by boat (OR 4.2; 95%CI 2.45,7.21), arriving from nearby provinces with high malaria incidence (OR 5.02; 95%CI 1.80, 14.01), and having been away from Lihir for 91 days or more (OR 4.15; 95%CI 2.58, 6.66). Being mine worker staying at the mine accommodation was related with less infection risk (OR 0.24; 95% CI 0.14, 0.43); while Lihirian residents returning from a trip, VFRs, or people with trading unrelated to mining had higher risks (p = 0.0066). Conclusions Travellers arriving by boat faced increased risk of malaria infection than those arriving by plane. This subpopulation poses an import risk to the MIZ and the rest of Lihir Islands. Screening of high-risk groups at wharfs, and collaboration with nearby Islands, could sustain reduced transmission and facilitate malaria elimination strategies.

While more than 4.3 million people in the UK live with a diagnosis of diabetes, a further 2.4 million people are at high risk of developing type 2 diabetes. Diabetes prevalence in Travelling communities is unclear, partly owing to the way that practices record ethnicity. This population faces many challenges, including social isolation and discrimination from wider society, and a range of barriers to healthcare access. This article outlines an outreach pilot project in Essex designed to improve access to diabetes services and screening for these communities. The pilot was successful in conducting 14 diabetes healthcare checks in one day, and was able to refer other health concerns onward for review. Although there is much work still required to improve inclusion for Travellers in diabetes care, the project represents a positive starting point. [ABSTRACT FROM AUTHOR]

The article investigates the records of travellers from Dnieper Ukraine about their visits to Paris in the 19th — early 20th centuries with the aim of reconstructing the image of the French capital. The study is based on travel notes compiled at various times by military personnel, scholars, and individuals involved in the arts. The travelogues are characterized by the subjectivity of descriptions, absence of clear structure, and irregular presentation of data. The author deliberately investigated travel notes created over different decades by individuals from diverse social strata, including M. Bashkirtseva, K. Halahan (senior), O. Krasnokutsky, H. Lukomsky, M. Luchytska, M. Rigelman, K. Skalkovsky, and others. The result of the research is an attempt to form a comprehensive and relatively objective image of the city, emphasizing the changes that occurred over the century. In the course of the investigation, it was established that the attention of travellers from Dnieper Ukraine, who visited Paris, was focused on several aspects related to urban space, including landscape descriptions, the atmosphere of Paris, architectural landmarks, and social phenomena that were less common or entirely absent in the Russian Empire. The transmission of their own romantic fascination with the city was also highlighted in the travelogues. However, there were occasional attempts at scholarly investigations that drew on geographical, historical, ethnographic, and statistical information borrowed by the authors of travel notes from surveys conducted by predecessors, materials from the French press, official publications of government institutions, and local authorities. The images of Paris created by various wanderers from Dnieper Ukraine had a subjective and emotional character. Nevertheless, they allow identifying the main trends in the development of urban space during the specified period and characterizing both external changes and shifts in the social environment that took place over the century. [ABSTRACT FROM AUTHOR]

Background Artemisinin-based combination therapies (ACTs) are recommended as first-line treatment against uncomplicated Plasmodium falciparum infection. Mutations in the PfKelch13 (PF3D7_1343700) gene led to resistance to artemisinin in Southeast Asia. Mutations in the Pfcoronin (PF3D7_1251200) gene confer reduced artemisinin susceptibility in vitro to an African Plasmodium strain, but their role in clinical resistance has not been established. Methods We conducted a retrospective observational study of Israeli travellers returning from sub-Saharan Africa with P. falciparum malaria, including patients with artemether–lumefantrine (AL) failure. Blood samples from all malaria-positive patients are delivered to the national Parasitology Reference Laboratory along with personal information. Confirmation of malaria, species identification and comparative parasite load analysis were performed using real-time PCR. DNA extractions from stored leftover samples were analysed for the presence of mutations in Pfkelch13 and Pfcoronin. Age, weight, initial parasitaemia level and Pfcoronin status were compared in patients who failed treatment vs responders. Results During 2009–2020, 338 patients had P. falciparum malaria acquired in Africa. Of those, 15 (24–69 years old, 14 males) failed treatment with AL. Four were still parasitemic at the end of treatment, and 11 had malaria recrudescence. Treatment failure rates were 0% during 2009–2012, 9.1% during 2013–2016 and 17.4% during 2017–2020. In all patients, the Pfkelch13 propeller domain had a wild-type sequence. We did find the P76S mutation in the propeller domain of Pfcoronin in 4/15 (28.6%) of the treatment-failure cases compared to only 3/56 (5.5%) in the successfully treated patients (P  = 0.027). Conclusion AL treatment failure emergence was not associated with mutations in Pfkelch13. However, P76S mutation in the Pfcoronin gene was more frequently present in the treatment-failure group and merits further investigation. The increase of malaria incidence in sub-Saharan-Africa partly attributed to the COVID-19 pandemic might also reflect a wider spread of ACT resistance. [ABSTRACT FROM AUTHOR]

Halal tourism is being developed to enhance Islamic law-based destinations' social, cultural, and destination values. However, the determinants influencing the antecedents of tourist loyalty to halal tourism have yet to be studied extensively. This study aims to analyze the role of antecedents of traveller loyalty in halal tourism in Yogyakarta. SEM-based quantitative research was used for its analysis. The study involved 200 participants, with the main criteria being that they had visited tourist destinations in Yogyakarta. The participants were selected by purposive sampling and then given an online questionnaire containing statements according to the research variables. All data were analyzed with SEM-AMOS. The findings show that the halal tourism experience, value perception, and satisfaction influence traveller loyalty. In contrast, traveller satisfaction is influenced by the halal tourism experience and value perception. Hence, the better the management of halal tourism in Yogyakarta, the more it contributes to increasing traveller satisfaction, which has implications for traveller loyalty. This research provides perspectives and technical and theoretical implications for entrepreneurs, governments, and managers of halal tourism destinations to increase socialization activities and intensify the concept of halal tourism, which has been proven to have a positive and significant effect on satisfaction and loyalty.

This article presents a study on the types of travelers and the research conducted on them in the field of travel medicine. The study found that there were differences between the proportion of publications and the volume of travelers in certain groups. For example, while tourists made up the highest volume of travelers, there were relatively fewer research studies conducted on this group. On the other hand, business travelers accounted for a smaller volume of travel but had a higher proportion of research publications. The study also highlighted a gap in research on vulnerable travelers, despite their higher risk of morbidity and mortality. The authors emphasize the need for more research to guide healthcare interventions for different types of travelers. [Extracted from the article]

Background The Lihir Islands of Papua New Guinea host a mining operation that has resulted in a mine-impacted zone (MIZ) with reduced malaria transmission and a substantial infux of mine employees, informal cross-country trad‑ ers, returning locals, and visitors. Prevalence of malaria parasites was assessed in travellers arriving on the Lihir Group of Islands to evaluate the risk of parasite importation. Methods In 2018, a cross-sectional study at the airport and main wharf was conducted, targeting asymptomatic travellers who had been away from Lihir for at least 12 days. Microscopy, rapid diagnostic tests (RDTs), and quantitative PCR (qPCR) were used to determine Plasmodium parasite prevalence, employing logistic regression models to identify factors associated with qPCR positivity. Results 398 travellers arriving by plane and 402 arriving by boat were included. Both cohorts were signifcantly difer‑ ent. Mean age among travellers arriving by plane was 40.1 years (SD±10.1), 93% were male and 96% were employed at the mine. In contrast, among travellers arriving by boat, the mean age was 31.7 years (SD±14.0), 68% were male and 36% were employed at the mine. The prevalence of malaria infection among travellers arriving by plane was 1% by RDT and microscopy, and increased to 5% by qPCR. In contrast, those arriving by boat showed a prevalence of 8% by RDT and microscopy, and 17% by qPCR. Risk factors for infection were arriving by boat (OR 4.2; 95%CI 2.45,7.21), arriving from nearby provinces with high malaria incidence (OR 5.02; 95%CI 1.80, 14.01), and having been away from Lihir for 91 days or more (OR 4.15; 95%CI 2.58, 6.66). Being mine worker staying at the mine accommodation was related with less infection risk (OR 0.24; 95% CI 0.14, 0.43); while Lihirian residents returning from a trip, VFRs, or people with trading unrelated to mining had higher risks (p=0.0066). Conclusions Travellers arriving by boat faced increased risk of malaria infection than those arriving by plane. This subpopulation poses an import risk to the MIZ and the rest of Lihir Islands. Screening of high-risk groups at wharfs, and collaboration with nearby Islands, could sustain reduced transmission and facilitate malaria elimination strategies. [ABSTRACT FROM AUTHOR]

Background Dengue fever (DF), caused by the dengue virus (DENV), is the most common arboviral disease in travellers worldwide. It is hypothesized that compared with primary DF, secondary DF may result in antibody-dependent enhancement of the immune response, resulting in more severe disease. We aimed to compare clinical and laboratory parameters in travellers with primary and secondary DF to determine whether secondary DF is associated with markers of severe disease. Methods We conducted a retrospective cohort study, which included all patients diagnosed with DF at the Central Virology Laboratory of the Israeli Ministry of Health during 2008–19. Clinical, laboratory and virological data were extracted from laboratory and patient records. A diagnosis of DENV infection was based on a positive nonstructural protein 1 (NS1) test, polymerase chain reaction or serology testing for immunoglobulin M (IgM) and immunoglobulin G (IgG). Primary and secondary infections were classified based on travel history, NS1 result and IgM/IgG ratio. Severe DF was defined according to WHO classification. Results We identified 245 DF cases: 210 (86%) primary and 35 (14%) secondary. Whilst fever duration was significantly longer in secondary compared with primary infections (6.4 vs 5.3 days, P  = 0.027), mean Aspartate aminotransferase levels were significantly higher in primary compared with secondary cases (146 vs 65 U/L, P  < 0.001), and no other clinical or laboratory parameter differed significantly between the groups. Of note, only four patients had severe DF, all had primary infections and none died. Conclusions In a cohort of returning travellers with DF, secondary infection, compared with primary infection, was not associated with a consistent trend towards greater severity of the clinical and laboratory markers examined in this study. [ABSTRACT FROM AUTHOR]

Background International travellers frequently acquire infectious diseases whilst travelling, yet relatively little is known about the impact and economic burden of these illnesses on travellers. We conducted a prospective exploratory costing study on adult returning travellers with falciparum malaria, dengue, chikungunya or Zika virus. Methods Patients were recruited in eight Travel and Tropical Medicine clinics between June 2016 and March 2020 upon travellers' first contact with the health system in their country of residence. The patients were presented with a structured 52-question self-administered questionnaire after full recovery to collect information on patients' healthcare utilization and out-of-pocket costs both in the destination and home country, and about income and other financial losses due to the illness. Results A total of 134 patients participated in the study (malaria, 66; dengue, 51; chikungunya, 8; Zika virus, 9; all fully recovered; median age 40; range 18–72 years). Prior to travelling, 42% of patients reported procuring medical evacuation insurance. Across the four illnesses, only 7% of patients were hospitalized abroad compared with 61% at home. Similarly, 15% sought ambulatory services whilst abroad compared with 61% at home. The average direct out-of-pocket hospitalization cost in the destination country (USD $2236; range: $108–$5160) was higher than the direct out-of-pocket ambulatory cost in the destination country (USD $327; range: $0–$1560), the direct out-of-pocket hospitalization cost at home (USD $35; range: $0–$120) and the direct out-of-pocket ambulatory costs at home (US$45; range: $0–$192). Respondents with dengue or malaria lost a median of USD $570 (Interquartile range [IQR] 240–1140) and USD $240 (IQR 0–600), respectively, due to their illness, whilst those with chikungunya and Zika virus lost a median of USD $2400 (IQR 1200–3600) and USD $1500 (IQR 510–2625), respectively. Conclusion Travellers often incur significant costs due to travel-acquired diseases. Further research into the economic impact of these diseases on travellers should be conducted. [ABSTRACT FROM AUTHOR]

Dieser Artikel behandelt die Wissensproduktion über nichtsesshafte Bevölkerungsgruppen wie Nachtmänner, Roma und Reisende in Dänemark zwischen 1800 und 1950. Hierbei wird die These eines dahingehenden dänischen Sonderweges vertreten, nicht nur im Vergleich zu Deutschland, sondern auch zu den skandinavischen Nachbarn. Dieser äußerte sich in einem unterentwickelten Interesse von Wissenschaft und Staat für entsprechende Gruppen und mündete in einer Ablehnung eugenischer Zwangsmaßnahmen. Die Analyse dieses Sonderweges erfolgt anhand von Schlüsseltexten aus drei Perioden: einer nationalromantischen ab ca. 1800, einer durch den dänischen Gypsy Lorist Johan Miskow geprägten zu Beginn des 20. Jahrhunderts und einer eugenischen ab 1938. Ein besonderes Interesse gilt hierbei Kontinuitäten und Brüchen in Narrativen von Reinheit vs. Vermischung. // This article analyses knowledge production about itinerant groups such as Nightmen, Roma and Travellers in Denmark between 1800 and 1950. It puts forward the thesis of a Danish Sonderweg in this regard, not only compared with Germany, but also the Scandinavian neighbours. This Sonderweg was characterized by an underdeveloped interest of science and state authorities for respective groups and culminated into a rejection of forced eugenic measures. The analysis is based on key texts from three periods: a national romantic one from approximately 1800 onwards, one shaped by the Danish Gypsy Lorist Johan Miskow at the beginning of the 20th century, and one eugenic from 1938. Special interest is given to continuities and fractions in narratives of purity vs. mixture.

Background: Since Strongyloides can persist in its host for decades, and cause life threatening infections data on prevalence, the burden and risk factors for infection is crucial in migrant populations. Methods: In this observational retrospective cohort study, we describe the epidemiological, clinical, and microbiological characteristics of imported strongyloidiasis diagnosed at the Karolinska University Hospital, Stockholm, Sweden, during 2010–2021. Results: We identified 98 individuals with strongyloidiasis, 89 (90.8%) born in endemic and 9 (9.2%) in non-endemic countries. Sub-Saharan Africa was the most common origin among the group born in endemic countries (62, 69.7%), (p

Background: Prompt administration of post-exposure prophylaxis (PEP) is crucial to prevent a fatal rabies infection after an animal associated injury (AAI), preferably within 24 h. PEP, especially in case of a type III injury for which rabies immune globulin (RIG) is needed, is difficult to obtain abroad. This, along with the fear of potentially having contracted a lethal disease, might be an important source for anxiety and distress. We investigated the occurrence and extent of self-reported anxiety and distress at different timepoints among Dutch travellers after encountering an AAI, and the involved factors. Methods: A retrospective quantitative observational study was conducted including insured Dutch travellers who actively contacted Eurocross Assistance after encountering an AAI abroad. An online questionnaire was designed to measure anxiety and distress levels, using the HADS (Hospital Anxiety and Depression Scale) and distress thermometer at three time points: departure from home (T1), post-AAI (T2), and treatment administration (T3). Statistical analyses included T-tests, Chi-square tests, and ANCOVA analyses. Results: We showed a significant increase in mean anxiety and distress scores at T2, and a significant decrease at T3. Women were more often anxious and distressed. Between T1 and T2, PrEP, and being aware of the risks were positively associated with anxiety levels, and PrEP and WHO region Africa with distress levels. Between T2 and T3, anxiety levels remained higher for monkey-induced injury, thoracic injuries, and WHO region Southeast Asia. PEP-delay between 24–48 h resulted in decreased distress levels at this time period, while type II injury elevated distress levels. Conclusions: This study showed significant anxiety and distress levels after an AAI among the vast majority of travellers, which is detrimental to their health-related quality of life (HR-QOL). This highlights the importance of proper pre-travel information. In the context of rabies prevention, these results suggest that pre-travel advice and policy makers should also take aspects of HR-QOL into consideration. [ABSTRACT FROM AUTHOR]

Purpose of Review: Recent changes in Japanese encephalitis (JE) distribution, including its emergence in mainland Australia, call for a review of the epidemiology, diagnosis, treatment and prevention of this important disease. Recent Findings: Climate change, urbanisation and changes in vector ecology have driven changes in JE epidemiology including expansion to new areas. Residents of and travellers to endemic areas face potential exposure risks. Surveillance gaps and diagnostic challenges lead to under-appreciation of the true disease burden. Treatment is supportive, but modern vaccines are safe and efficacious. Summary: The recent emergence of JE in south-eastern Australia highlights its changing epidemiology and the threat this disease poses to other areas with largely naive human populations and with competent mosquito vectors and vertebrate hosts. Awareness of disease features and diagnostic approaches is critical to case detection in travellers and endemic populations, and preventive measures including vaccination should be advised for those with exposure risk. [ABSTRACT FROM AUTHOR]

Arab-Persian historical and geographical works represent one large data set, on the basis of which science builds a historical picture of the countries that were in the Middle Ages in the circle of Arab culture influence. The Arab-Persian geographical literature has preserved a lot of information about the history and ethnography of many countries of the world, collected from merchants, travellers, scientists and other personalities. The information of Arab and Persian authors about Khwarazm is the most important historical source. Khwarazm is rightfully considered as one of the cultural centres of the ancient and medieval East. Various aspects of the socio-economic life of the region are covered in a number of works by Arab and Persian scientists. According to the Arab and Persian sources of the 10th century, the author studies the history of Khwarazm. The heyday of the Arab-Persian classical geographical literature falls on the 9th – 10th centuries. The authors give very accurate descriptions of Khorezm towns and villages, the distances between them, trade routes, various types of handicraft production, exported and imported goods, etc.

Individuals were asked to play an active role in infection control in the COVID-19 pandemic. Yet while government messages emphasised taking responsibility for the public good (e.g. to protect the National Health Service), they appeared to overlook social, economic and political factors affecting the ways that people were able to respond.We co-produced participatory qualitative research with members of Gypsy and Traveller communities in England between October 2021 and February 2022 to explore how they had responded to COVID-19, its containment (test, trace, isolate) and the contextual factors affecting COVID-19 risks and responses within the communities.Gypsies and Travellers reported experiencing poor treatment from health services, police harassment, surveillance, and constrained living conditions. For these communities, claiming the right to health in an emergency required them to rely on community networks and resources.They organised collective actions to contain COVID-19 in the face of this ongoing marginalisation, such as using free government COVID-19 tests to support self-designed protective measures including community-facilitated testing and community-led contact tracing. This helped keep families and others safe while minimising engagement with formal institutions.In future emergencies, communities must be given better material, political and technical support to help them to design and implement effective community-led solutions, particularly where government institutions are untrusted or untrustworthy.