The effects www.selleckchem.com/products/PD-0332991.html of a change of location were investigated for the day

prior to CoR (CoR−1), the CoR (CoR0, eg, travel day), and the first day at the new location (CoR+1). The fifth day after the change of residence (CoR+5) was used as a post-CoR reference value. Perceived travel strain was measured with a 4-point worded scale [“travel strain was very (4), rather (3), hardly (2), not at all (1) strenuous”]. To test for the adequacy of the given sample size, a statistical power calculation was conducted using the power calculator provided by our University, imputing the baseline and average response values. The statistical power of the three significant variables was 0.26/0.36/0.90 (systolic BP/diastolic BP/sleep), indicating a small power for detecting differences in BP, but a large power for detecting differences in sleep. To test for the feasibility of using a parametrical statistical approach, the normal distribution of all four dependent variables (diastolic BP, systolic BP, quality of sleep, and mood) during pre-travel baseline and on the four single days around the CoR was controlled for visually on the basis of histograms. All distributions were found to be adequate. To analyze the effect

of the CoR, a multivariate analysis of variance for repeated measures was Wortmannin calculated for the five time points BL, CoR−1, CoR0, CoR+1, and CoR+5, thereby comparing each of the days CoR−1 to CoR+5 with the baseline value Niclosamide (BL) using so-called “simple contrasts.” Thus, four contrasts were calculated for every variable. The statistical significance of these comparisons (p values) is displayed in Table 2. All four outcome variables were analyzed simultaneously in the multivariate approach, thus following the suggestions of Drummond to use one global statistical test.[38] Also, this approach controlled for the multiple comparisons calculated. To test for possible differences between morning and evening

BP readings, average morning and evening BP responses (average of CoR−1, CoR0, CoR+1 − BL) were compared using t-tests for paired samples. To test the association of the responses to the CoR with variables describing the study participants, their medical condition and travel, the correlation of the response values (average of CoR−1, CoR0, CoR+1 − BL) of BP, sleep, and mood with these variables was calculated. Also, the inter-correlation of the average responses of the four outcome variables to the CoR was determined. To test the validity of the scales used, their correlation with standardized scales, clinical BP readings, or other external variables was calculated. All analyses were conducted using SPSS 15.0. The results illustrated in Figure 1 are based on means and confidence intervals.

9 A number of factors—including foreign birth, traveling alone, traveling for less than 14 days, and traveling for vacation—independently predicted a lower likelihood of pursuing health information prior to departure. Most commonly, travelers reported a lack of concern about health issues as the primary reason that they did not pursue health information prior to their trip. These findings underscore that efforts are needed to heighten the awareness of the risk associated with travel to LLMI countries. Among travelers to LLMI countries who sought health advice prior to departure, we found the internet to be the most common source of information.

However, only a small proportion (11%) of all travelers to LLMI countries visited the CDC Travelers’ Health website. Primary care practitioners Selleck Ceritinib were another common source of health information among travelers to LLMI countries, and VFR travelers were particularly likely to have pursued health information from a primary care practitioner. Less than a third of travelers to LLMI countries who pursued health information visited a travel medicine 5-FU nmr specialist, and among VFR travelers,

this number was only 3%. Boston Logan International Airport is one of the United States’ largest airports in terms of passenger volume and flight movements,10 and travelers departing from Boston Logan International Airport are likely similar to those departing from other major hubs in the United States. Nevertheless, an important limitation of our study was its restriction to a single US airport. Due to the travel patterns from Boston Logan International Phloretin Airport, few survey respondents were directly traveling to Southeast Asia or sub-Saharan Africa. Furthermore, although our survey was conducted over more than 7 months, the sample size for any given destination was small and precluded any analysis

by geographic destination or country of birth. Survey data from other points of departure in the United States would be useful for gathering information on a broader range of travelers and for identifying any characteristics unique to travelers to specific destinations. Our results suggest a number of interventions that might be productive in improving the health knowledge of travelers to LLMI countries. In particular, we found the internet to be a key source of health information for travelers to LLMI countries. Given this finding, focusing education interventions at the time of online ticket purchase or through popular websites for travelers might be productive. Linking directly from such sites to the CDC Travelers’ Health website may be a useful tactic, as many survey respondents did not use this resource. Providing web-based material in languages other than English may be useful for targeting foreign-born travelers.