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Health Advice (health + advice)

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Medical Sciences	100%

Selected Abstracts

Factors Influencing Standard Pretravel Health Advice,A Study in Belgium

JOURNAL OF TRAVEL MEDICINE, Issue 5 2007
Kristina Van De Winkel MD
Background Travelers with risk factors, medical conditions such as immunosuppression, medication intake, pregnancy, or elderly age, need adaptation or reinforcement of pretravel health advice. The literature provides little data on the frequency of these risk groups in the travel population. This study intended to investigate whether risk factors influencing standard travel advice are common in the population attending our travel clinic. Methods A prospective survey was carried out over a 2-month period in 2004 at the travel clinic of the Institute for Tropical Medicine in Antwerp, Belgium. A list of risk factors focused on the following three important advice categories: malaria prophylaxis, yellow fever vaccination, and travelers' diarrhea or other enteric infections. We counted how frequently a risk factor was observed for each advice category (potential influence) and, after considering the travel characteristics, how often a real adaptation of advice was necessary (actual influence). Results Of 2,227 travelers, 276 were found to have a possible influencing factor (12.4%). The potential influence was 10.9% (243/2,227) for malaria prophylaxis advice, 6.1% (136/2,227) for yellow fever vaccination, and 1.9% (43/2,227) for travelers' diarrhea advice. The actual influence was lower 8% (184/2,227), 5% (109/2,227), and 1.2% (27/2,227), respectively. The main interfering factors were as follows: for influence on malaria advice, age ,60 years (44%) and neuropsychiatric disorders (15.6%); for yellow fever vaccination, age ,60 years (63.2%) and immunosuppression (10.3%); and for influence on travelers' diarrhea advice, decreased gastric acidity (44.2%) and immunosuppression (32.6%). Conclusion Travelers with risk factors are not infrequently seen at our travel clinic. Some groups are more prominently present and could be the focus of travel group,specific instructions. The study suggests that being informed about risk groups is essential for advising travelers. [source]

Resources Used by General Practitioners for Advising Travelers from New Zealand

JOURNAL OF TRAVEL MEDICINE, Issue 2 2000
Peter A. Leggat
Background: The risks of the destination and any specific requirements for travel health advice may be obtained from a variety of resources. This study was designed to investigate the usefulness of various resources available in New Zealand for providing travel health advice and the extent to which GPs used these resources in providing travel health advice. Methods: Four hundred GPs (400/2830) were randomly selected from the register of the New Zealand Medical Council and sent self-administered questionnaires. Two reminders were sent. Results: Three hundred and thirty-two (332/400, 83%) GPs responded. The usefulness of various resources was reported, including Health Advice for Overseas Travellers (277/289, 96%), New Ethicals (256/278, 92%), New Zealand Public Health Report (79/164, 48%), International Travel and Health (41/144, 28%), computerized databases (6/122, 5%), journals (14/130, 11%), and other resources (44/139, 32%). Health Advice for Overseas Travellers was regarded as significantly more useful than International Travel and Health (x2= 4,68, df = 1, p < .05). Only 23% (70/309) of respondents indicated that they always used these resources in their practice of travel medicine. Fifty percent (154/309) of respondents indicated that they usually used these resources, while 27% (83/309) of respondents indicated that they used these resources sometimes. Only 1% (2/309) of GPs did not use resources at all for their practice of travel medicine. Conclusion: The most useful resource was Health Advice for Overseas Travellers, which outlines the New Zealand recommendations for medical practitioners providing travel health advice. It may be useful for GPs to gain access to and training in association with a greater range of specialist resources to use in conjunction with the provision of travel health advice. These might include international guidelines, journals, and access to computerized databases and the internet. With the recent introduction of a widely accessible computerized database in New Zealand, follow-up studies could be instituted to determine if GPs' use of computerized databases becomes more widespread and whether access to and use of these computerized databases influences the provision of travel health advice by GPs. Further studies are needed to examine the appropriateness of the advice provided by the various resources used by GPs in New Zealand. [source]

Personalized nutrition for the prevention of cardiovascular disease: a future perspective

JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2008
J. A. Lovegrove
Abstract Cardiovascular disease (CVD) is responsible for significant morbidity and mortality in the Western and developing world. This multi-factorial disease is influenced by many environmental and genetic factors. At present, public health advice involves prescribed population-based recommendations, which have been largely unsuccessful in reducing CVD risk. This is, in part, due to individual variability in response to dietary manipulations, that arises from nutrient,gene interactions (defined by the term ,nutrigenetics'). The shift towards personalized nutritional advice is a very attractive proposition, where, in principle, an individual can be given dietary advice specifically tailored to their genotype. However, the evidence-base for the impact of interactions between nutrients and fixed genetic variants on biomarkers of CVD risk is still very limited. This paper reviews the evidence for interactions between dietary fat and two common polymorphisms in the apolipoprotein E and peroxisome proliferator-activated receptor-, genes. Although an increased understanding of how these and other genes influence response to nutrients should facilitate the progression of personalized nutrition, the ethical issues surrounding its routine use need careful consideration. [source]

Factors Influencing Standard Pretravel Health Advice,A Study in Belgium

Knowledge and Behavior of Tourists to Manu National Park, Peru, in Relation to Leishmaniasis

JOURNAL OF TRAVEL MEDICINE, Issue 4 2002
Irmgard L. Bauer
Background: Tourists have been infected with Leishmania braziliensis and the lack of appropriate travel information on the disease has been documented. The aim of this study was to describe the knowledge and behavior of tourists booked on a trip to Manu National Park in Peru in relation to leishmaniasis and its prevention. Methods: The clients of two tour operators in Cusco, Peru, represented the experimental and control group. The experimental group completed a questionnaire after the tour briefing the night before the trip and received the information leaflet. A second questionnaire was completed just before returning from the park. The clients in the control group did not receive the leaflet. Results: Three hundred and seventy-three questionnaire pairs were collected (173 experimental, 200 control). Only 24 (6%) of all participants claimed to have heard of leishmaniasis. Of the 92.5% of tourists who read the leaflet, 156 (97.5%) found it informative, although 50 (32.5%) wanted more information. It was suggested that the leaflet should be distributed by tour operators (56.9%), general practitioners/family doctors (49%), and travel agents (47.1%). There was no significant difference in the use of preventive measures between the groups. One-third of the experimental group claimed to have paid more attention to protection due to the information given in the leaflet. Conclusions: There is generally a lack of knowledge on leishmaniasis with a great feeling of need for more and detailed information. Correct and complete information on leishmaniasis should be included in the health advice for travelers to endemic areas. [source]

Travel Agents and the Prevention of Health Problems among Travelers in Québec

JOURNAL OF TRAVEL MEDICINE, Issue 1 2002
Sylvie Provost
Background: 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. Methods: 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. Results: 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. Conclusion: 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. [source]

Problems and Risks of Unsolicited E-mails in Patient-Physician Encounters in Travel Medicine Settings

JOURNAL OF TRAVEL MEDICINE, Issue 3 2001
Andreas Sing
Background: International travel and use of modern information technology are expressions of modern life style. Seeking on-line travel health advice via E-mail for preventive (teleprevention) or diagnostic reasons may become increasingly popular among patients with financial resources and Internet access. This study was undertaken to compare the behavior of travel clinic or tropical medicine physicians and other providers of travel-related medical information services toward unsolicited E-mails from fictitious patients in pretravel and post-travel scenarios. We also wanted to test the potential of E-mail advice for preventive medicine (teleprevention), and to find out how the "Good Samaritan Law" is observed. Methods: Two different E-mails were posted to E-mail addresses of 171 physicians (members of travel health and/or tropical medicine societies) and services offering advice on travel health issues identified by an AltaVista search. These E-mails, from two different fictitious travelers, were asking for advice regarding malaria prophylaxis in a pretravel scenario and describing symptoms suggesting acute malaria. Results: Of the contacted addresses 43.3% and 49.7% respectively, replied to the pre- and post-travel E-mail. Of those suggesting antimalarial chemoprophylaxis in the pretravel scenario, 13.2% proposed inadequate regimens, and at least 3.5% of the post-travel replies were inappropriate. The "Good Samaritan Law" was observed by a significant number of physicians. Conclusions: Both patients and physicians have to be aware of the limitations of E-mail communication. Guidelines protecting physicians against legal and ethical consequences of this new communication technology are urgently needed. [source]

Resources Used by General Practitioners for Advising Travelers from New Zealand

Health Risk Behavior of Rural Low-Income Expectant Fathers

PUBLIC HEALTH NURSING, Issue 4 2006
Kevin D. Everett
ABSTRACT Objectives: To assess expectant fathers' health risk behaviors and attitudes about pregnancy-related health issues. Pregnancy may be viewed as a teachable moment: a time when women are receptive to health advice and take action to improve their health and the health of their babies. Pregnancy may also be a teachable moment for expectant fathers, although men's behaviors are rarely considered as part of prenatal care or in associated research. Design: Cross-sectional prevalence study. Sample: Rural low-income expectant fathers (N=138) whose pregnant partners had enrolled in a Medicaid managed care health plan. Measurement: A telephone survey measuring five health risk behaviors, sociodemographic variables, and pregnancy- and behavior change-related attitudes. Results: Analyses found the following: 49.3% smoked cigarettes; 30.4% engaged in hazardous drinking in the past month; 27.5% had very low physical activity levels; 94.9% had at-risk fruit/vegetable intake; and 42% had weight-related health risk (25.4% met body mass index [BMI] criteria for obesity). Further, 47.9% of the men engaged in three or more of five assessed health risk behaviors. Conclusions: This sample of expectant fathers engages in high rates of health risk behaviors. Failure to address the health risk behavior of men during prenatal care represents a missed opportunity to improve paternal, maternal, and family health. [source]

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

CLINICAL TRANSPLANTATION, Issue 4 2007
A.H.E. Roukens
Abstract:, 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. [source]

Expatriates in High,UV Index and Tropical Countries: Sun Exposure and Protection Behavior in 9,416 French Adults

JOURNAL OF TRAVEL MEDICINE, Issue 2 2007
Khaled Ezzedine MD
Background Overexposure to sunlight during long stays in tropical countries can reveal short- and long-term harmful effects on the skin of Caucasian residents, especially for fair-skinned subjects. The aim of this study was to describe sun exposure and sun protection behaviors during lifetime among French adults who declared having experienced at least one expatriation period in tropical or high,sun index areas for a duration of more than three consecutive months. Methods A self-reported questionnaire on sun exposure behavior was addressed two times, in 1997 and 2001, to the 12,741 French adult volunteers enrolled in the SU.VI.MAX cohort. A total of 8,084 subjects answered to the first survey and 1,332 additional responders answered to the second. Among the 9,416 individuals, 1,594 (652 women and 942 men) corresponded to expatriates and the remaining 7,822 to nonexpatriates (4,972 women and 2,850 men). A descriptive analysis of sun exposure and sun protection behaviors during lifetime of expatriates and nonexpatriates was performed by gender. Results Among women, 39% of expatriates belonged to the 50 to 60 class of age at inclusion, versus 33% in nonexpatriates (72 and 55% in men, respectively). In women, expatriates declared more frequently having during lifetime exposed voluntarily their skin to the sun, practiced tanning between 11 a.m. and 4 p.m., less gradually exposed their skin, experienced intensive sun exposure, and exposed their skin during nautical sports and practiced naturism. In men, expatriates declared more frequently having experienced intensive sun exposure and exposed their skin during outdoor occupations and during nautical and mountain sports. Conclusions Although expatriates are aware of travel health advices concerning the countries where they planned to stay, they are usually poorly informed about sun exposure risk factors. Such individuals who planned to expatriate in countries with a high ultraviolet index should benefit from a visit to a travel clinic including specific health care information for risk related to sun exposure, ie, skin cancers and photoaging. [source]