فهرست مطالب

Travel Medicine and Global Health - Volume:8 Issue: 1, 2020
  • Volume:8 Issue: 1, 2020
  • تاریخ انتشار: 1398/12/27
  • تعداد عناوین: 7
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  • Maryam Gholami, Ali Mohammad Keshtvarz Hesam Abadi *, Shima Miladi, Marjan Gholami Pages 1-12
    Introduction

    Planning in the field of medical tourism is of particular importance. The main objective of this research was to identify and analyze the factors affecting the growth of medical tourism in Iran. It could be a small step toward promoting entrepreneurship and increasing non-oil revenues in the country.

    Methods

    Studies published in the Persian and English language during the years 2006-2019 in Science Direct, ProQuest, Springer, Medline, Scopus, Ovid, and SID databases were reviewed, and the findings were then compared.

    Results

    A total of 75 articles out of 2631 unique publications were included in this study. Most articles reported studies performed for all patients, including the whole country (Iran) (n=22, 30%), Shiraz only (n=11, 15%), Tehran only (n=11, 15%), Mashhad only (n=6, 8%), Isfahan only (n=5, 6%), and Ardabil only (n=4, 5%).

    Conclusion

    Given the history of Iranian hospitals in attracting foreign patients and the analysis of their status, there are many limitations in achieving a proper standing in the medical tourism industry. Strategies offered by various managers and authorities in tourism can lead to increased attraction of medical tourists to public and private hospitals in Shiraz, relying on the capabilities and potential of Shiraz and its health sectors, including climate and nature, cultural and historical attractions, renowned practitioners, advanced equipment, facilities, and methods, and thereby generating more foreign exchange earnings and employment.

    Keywords: Medical tourism, Hospitals, Growth, Development, Iran
  • Yusuke Oshita *, Koki Tsuchiya, Koji Ishikawa, Kodai Hirabayashi, Tetsuya Nemoto Pages 13-17
    Introduction

    Reports indicate that 22%–64% of travelers experience some illness when in a foreign country. To date, no prior study has reported the use of ambulances by travelers or the epidemiology of travel-related injury.

    Methods

    In this retrospective study, we aimed to describe ambulance use by international travelers, including the rates of travel-related injury and illness. To do so, ambulance dispatch data from January 1, 2010 to December 31, 2018 was used.

    Results

    Overall, of the 43 201 cases of ambulance use during the study period, 524 (1.2%) were international travelers. Ambulance use by international travelers increased from 0.35% in 2010 (15/4311) to 2.54% in 2018 (125/4913), an average annual increase of 0.27%. Of the international travelers, 392 (74.8%) had minor complaints, 110 cases (21.0%) had moderate complaints, 280 (53.4%) had internal disease, and 223 cases (42.6%) had suffered trauma. Regarding location, 253 (48.3%) were from a hotel/lodge, 83 (15.8%) were from a road/parking, and 30 (5.7%) were in the forest/mountain.

    Conclusion

    Most international travelers use ambulances for minor complaints, typically internal disease or trauma, and approximately half access the service from a hotel or lodge.

    Keywords: Ambulance, Travel Medicine, Emergency, Trauma, Injury, Japan
  • Inam Danish Khan * Pages 18-21
    Introduction
    Extreme-altitudes (5500 m/18045 ft and higher) pose environmental, psychophysiological, infrastructural, logistic, and ergonomic challenges that question explorer’s adaptability and mission-efficiency due to isolation, monotony, intimidating environment and terse health conditions. The assessment of an explorer’s comprehensive adaptability in extreme-altitudes is of paramount importance in ensuring mission-preparedness. Knowledge, attitude, and practices (KAP) of explorers staying on extreme-altitudes was assessed through personal interview technique.
    Methods
    125 healthy, acclimatized, mountain-trained explorers staying above 4570 m/15 000 ft in winter-season for at least 30 days on extreme-altitudes were assessed by a single cross-sectional study through personal interviews on KAP related to extreme-altitude and cold-adaptation.
    Results
    Mean duration of stay on extreme-altitude was 55.7 days. All explorers knew about difficulties and health-problems at extreme-altitude. All explorers felt that mountain-training and acclimatization were beneficial. 92% felt that mission tenure of 90 days on the extreme-altitude was adequate. 92.8% felt they were adequately trained for the extreme-altitude; however, only 52% felt confident about health-training. 66.4% did preventive rewarming of extremities. 66.4% regularly smoked/chewed tobacco. 57.6% had sleep problems and 64% had altered appetite. 26.4% felt difficulties related to living conditions, infrastructure, and logistics.
    Conclusion
    Explorers at extreme-altitude exhibited adequate knowledge and performed activities with progressive attitude and healthy practices. Explorers endured altered psychophysiology at extreme-altitude and regarded the utility of training and acclimatization programs. Knowledge-practice gap existed towards tobacco consumption. There was a felt need for the improvement of living conditions, infrastructure, logistics, and health-related training.
    Keywords: health knowledge, attitudes, Practice, Psychophysiology
  • Bader Alhendi *, Saleh Al Saifi, Aliaa Khaja Pages 22-30
    Introduction

    The State of Kuwait spends large sums of governmental funds on sending patients abroad to receive medical treatment. This study aimed to explain the rationale behind receiving primary medical care overseas, given the expense and inconvenience, from the perspective of Kuwaiti patients whose applications were approved.

    Methods

    The survey was designed based on recommendations from an expert panel of physicians working in Kuwait and aimed to give insight into outbound medical services as perceived by the Kuwaiti population. Using Google Forms, the survey was sent electronically to 1067 patients who received treatment abroad sponsored by the government in the year 2018, and 590 responses were returned. The study itself explored reasons for seeking treatment abroad, finances, preferred countries, and whether there were touristic reasons behind such practice. Data was analyzed using SPSS version 26.

    Results

    Overall, males (52.3%) and females (47.7%) were equally represented in the study sample. The mean age for the study sample was 41±13.4 years. Approximately 45.3% of the respondents were married and had children. Of the remaining respondents, 21.9% were married with no children and 23.8% were single without children. All respondents received medical treatment abroad, and 52.3% of the married respondents and 47.7% of the single respondents stated that they received treatment once and more than once, respectively.

    Conclusion

    Most Kuwaiti citizens do not have faith in the Kuwaiti medical system. Therefore, heavy investments are needed to send patients abroad.

    Keywords: Treatment Abroad, Medical tourism, Economic burden, Kuwait Healthcare
  • Sailendra Thapa *, Pratigya Kayastha, Durga Mishra Pages 31-36
    Introduction

    The prevalence of type 2 diabetes has been escalating worldwide, including low- and middle-income countries such as Nepal. Early detection of individuals at risk is of the utmost importance to prevent the escalating condition. This study used a simple, cost-effective screening tool known as the Indian Diabetes Risk Score (IDRS) in order to assess the proportion of risk groups and factors associated with it among the residents of Banepa municipality, a semi-urban area of central Nepal.

    Methods

    A community-based cross-sectional study was conducted among 245 adults of Banepa municipality. Face to face interviews were conducted to collect the information through a pretested, semi-structured questionnaire. IDRS was used to identify the risk group for developing type 2 diabetes. Data were entered in Microsoft Excel 2010 and exported to SPSS v.11.5 for further analysis.

    Results

    The proportion of people with high risk, moderate risk and low risk was 31%, 51.4% and 17.6%, respectively for developing type 2 diabetes. The analysis showed age (P < 0.01), education (P = 0.05), marital status (P = 0.01), body mass index (BMI) (P < 0.01), waist circumference (P < 0.01), physical activities (P < 0.01) and family history of diabetes (P < 0.04) were significantly associated with risk of type 2 diabetes.

    Conclusion

    Nearly one-third of the study participants were in high-risk group and half of them were at moderate risk. This increasing trend of risk requires an urgent application of preventive measures through lifestyle modification.

    Keywords: Indian Diabetes Risk Score_Type 2 diabetes mellitus_Nepal
  • Shervin Assari * Pages 37-43
    Introduction
    Although income is among the major social determinants of mental health of middle-aged and older individuals, socially marginalized groups gain less health from their income and other socioeconomic status (SES) resources compared to socially privileged groups. This pattern is called marginalization-related diminished returns (MDRs). Most of the existing knowledge on MDRs, however, has been derived from studies that have defined marginalization based on race, ethnicity, or sexual orientation. As a result, very limited information exists on whether similar MDRs can be observed for middle-aged and older immigrants or not. Building on the MDRs framework, this study compared a national sample of immigrants and non-immigrants for the effects of income on the mental well-being of middle-aged and older adults in the United States.
    Methods
    This is a cross-sectional study. The 2015 National Health Interview Survey (NHIS) enrolled 14 149 middle-aged and older individuals who were either immigrants (n=1977; 14.0%) or non-immigrants (n=12 166; 86.0%). The independent variable (IV) was income that was treated as a continuous variable. The dependent variable was mental well-being, also treated as a continuous variable. Age, gender, race, ethnicity, education, marital status, employment, self-rated health, obesity, and region were confounders. Immigration (nativity status) was the moderator. Logistic regression was applied for data analysis.
    Results
    High income was associated with higher odds of good mental well-being in middle-aged and older adults. However, immigration showed a significant statistical interaction with income, which was suggestive of a smaller protective effect of high income on mental well-being for immigrant than non-immigrant middle-aged and older adults.
    Conclusion
    In line with MDRs, the association between income and mental well-being is weaker for immigrant than non-immigrant middle-aged and older adults. There is a need to help high income immigrants secure health outcomes similar to those of non-immigrants. Such changes may require bold and innovative economic, public, and social policies that help immigrants more effectively translate their income and socioeconomic resources into tangible outcomes such as mental well-being.
    Keywords: Population Groups, Immigrants, Socioeconomic status, income, Elderly, Psychological factors