Malaria: une espèce en voie de disparition [Malaria: an endangered species?].

The implementation at scale of preventive measures and the use of effective treatments in populations living in endemic areas has led to a drastic reduction of the burden of malaria in all continents. The considerable investment of international agencies to support local governments in the fight against malaria allows hoping to achieve the millennium goals for malaria and child mortality in several countries. Malaria elimination, and even eradication becomes a realistic objective, especially so because a vaccine may be soon available to complement the armamentarium. For travelers, the tendency will be to reduce the number of countries where chemoprophylaxis or stand-by treatment is recommended and to insist on the rigorous use of measures to prevent mosquito bites such as repellents and insecticide-impregnated bednets.

Iowa Department of Transportation Strategic Plan, January 2003 Through December 2006, June 2004

To provide safe and modern transportation systems and services to individuals who travel in Iowa, the Iowa Department of Transportation has identified three broad-based and far-reaching strategic goals: accessibility, responsiveness and accountability. These goals are outlined in this plan, which is aligned with the Accountable Government Act. In addition, the plan specifically addresses strategic needs to serve our customers, and to respond to trends of a growing population and the ever changing need to enhance and expand Iowa's transportation systems. This plan is a living document, and therefore, will be updated periodically.

Iowa Department of Transportation Strategic Plan Revised, January 2003 Through December 2006, June 2004

To provide safe and modern transportation systems and services to individuals who travel in Iowa, the Iowa Department of Transportation has identified three broad-based and far-reaching strategic goals: accessibility, responsiveness and accountability. These goals are outlined in this plan, which is aligned with the Accountable Government Act. In addition, the plan specifically addresses strategic needs to serve our customers, and to respond to trends of a growing population and the ever changing need to enhance and expand Iowa's transportation systems. This plan is a living document, and therefore, will be updated periodically.

Experiències catalanes, angleses i irlandeses en el millorament de l’accès a l’habitatge

El Grup de Recerca d´Accés a l´Habitatge de la Universitat Rovira i Virgili ha portat a terme durant l´any 2011 una sèrie d´activitats gràcies a l´ajuda concedida per la convocatòria de l´AGAUR PBR-DGR 2010, que ha donat suport al Grup tant de forma directa (per exemple, en viatges i dietes) com indirecta (gràcies a l´ajuda prestada per la Sra. Helaine Cristina Madeira Santos, becària de suport al Grup de Recerca, que ha portat a terme tasques de coordinació i investigació). Així, el Grup ha portat a terme tasques d´investigació (per exemple, la signatura d´un Conveni amb l’Agència de l’Habitatge de Catalunya amb la finalitat de portar a terme en el termini de 3 anys l’elaboració d´un marc legislatiu sobre les tinences intermitges en el Dret català); tasques de formació (gràcies a la participació en Congressos i Jornades); esta coordinant una xarxa sobre grups d´habitatge (per exemple, mitjançant un Congrés internacional sobre habitatge celebrat a Granada); ha publicat llibres i articles científics (per exemple, la publicació dels treballs presentats en les III Jornades Internacionals de Housing de 2010); i finalment cal destacar que l´activitat del Grup ha tingut un gran impacte en els mitjans de comunicació. Tot aquest treball ha permès al Grup arribar a unes conclusions sobre el status quo de l´habitatge a Espanya, per exemple les mancances del mercat d´habitatge en propietat i en lloguer i els aspectes que cal reformar quant al règim tributari i processal d´aquestes formes de tinença immobiliària. La principal conclusió, però, és la necessitat de regular noves formes d´entendre la tinença de la terra tot seguint els models ja presents en altres països europeus (principalment, Anglaterra i Irlanda), com la propietat compartida i la propietat temporal, figures en les quals està aprofundint actualment el Grup de recerca.

Feasibility and clinical outcomes when using practice guidelines for evaluation of fever in returning travelers and migrants : a validation study.

BACKGROUND: Practice guidelines for examining febrile patients presenting upon returning from the tropics were developed to assist primary care physicians in decision making. Because of the low level of evidence available in this field, there was a need to validate them and assess their feasibility in the context they have been designed for. OBJECTIVES: The objectives of the study were to (1) evaluate physicians' adherence to recommendations; (2) investigate reasons for non-adherence; and (3) ensure good clinical outcome of patients, the ultimate goal being to improve the quality of the guidelines, in particular to tailor them for the needs of the target audience and population. METHODS: Physicians consulting the guidelines on the Internet (www.fevertravel.ch) were invited to participate in the study. Navigation through the decision chart was automatically recorded, including diagnostic tests performed, initial and final diagnoses, and clinical outcomes. The reasons for non-adherence were investigated and qualitative feedback was collected. RESULTS: A total of 539 physician/patient pairs were included in this study. Full adherence to guidelines was observed in 29% of the cases. Figure-specific adherence rate was 54.8%. The main reasons for non-adherence were as follows: no repetition of malaria tests (111/352) and no presumptive antibiotic treatment for febrile diarrhea (64/153) or abdominal pain without leukocytosis (46/101). Overall, 20% of diversions from guidelines were considered reasonable because there was an alternative presumptive diagnosis or the symptoms were mild, which means that the corrected adherence rate per case was 40.6% and corrected adherence per figure was 61.7%. No death was recorded and all complications could be attributed to the underlying illness rather than to adherence to guidelines. CONCLUSIONS: These guidelines proved to be feasible, useful, and leading to good clinical outcomes. Almost one third of physicians strictly adhered to the guidelines. Other physicians used the guidelines not to forget specific diagnoses but finally diverged from the proposed attitudes. These diversions should be scrutinized for further refinement of the guidelines to better fit to physician and patient needs.

The Traveler January 2005

Tourism, Travel, Unity Day, Group Tours, Vision Iowa

Evaluation of Different Methods to Calculate Heavy-Truck VMT, Final Report, December 2004

Reliable estimates of heavy-truck volumes are important in a number of transportation applications. Estimates of truck volumes are necessary for pavement design and pavement management. Truck volumes are important in traffic safety. The number of trucks on the road also influences roadway capacity and traffic operations. Additionally, heavy vehicles pollute at higher rates than passenger vehicles. Consequently, reliable estimates of heavy-truck vehicle miles traveled (VMT) are important in creating accurate inventories of on-road emissions. This research evaluated three different methods to calculate heavy-truck annual average daily traffic (AADT) which can subsequently be used to estimate vehicle miles traveled (VMT). Traffic data from continuous count stations provided by the Iowa DOT were used to estimate AADT for two different truck groups (single-unit and multi-unit) using the three methods. The first method developed monthly and daily expansion factors for each truck group. The second and third methods created general expansion factors for all vehicles. Accuracy of the three methods was compared using n-fold cross-validation. In n-fold cross-validation, data are split into n partitions, and data from the nth partition are used to validate the remaining data. A comparison of the accuracy of the three methods was made using the estimates of prediction error obtained from cross-validation. The prediction error was determined by averaging the squared error between the estimated AADT and the actual AADT. Overall, the prediction error was the lowest for the method that developed expansion factors separately for the different truck groups for both single- and multi-unit trucks. This indicates that use of expansion factors specific to heavy trucks results in better estimates of AADT, and, subsequently, VMT, than using aggregate expansion factors and applying a percentage of trucks. Monthly, daily, and weekly traffic patterns were also evaluated. Significant variation exists in the temporal and seasonal patterns of heavy trucks as compared to passenger vehicles. This suggests that the use of aggregate expansion factors fails to adequately describe truck travel patterns.

An Investigation of User Costs and Benefits of Winter Road Closures, June 2005

This project explores the user costs and benefits of winter road closures. Severe winter weather makes travel unsafe and dramatically increases crash rates. When conditions become unsafe due to winter weather, road closures should allow users to avoid crash costs and eliminate costs associated with rescuing stranded motorists. Therefore, the benefits of road closures are the avoided safety costs. The costs of road closures are the delays that are imposed on motorists and motor carriers who would have made the trip had the road not been closed. This project investigated the costs and benefits of road closures and found that evaluating the benefits and costs is not as simple as it appears. To better understand the costs and benefits of road closures, the project investigates the literature, conducts interviews with shippers and motor carriers, and conducts case studies of road closures to determine what actually occurred on roadways during closures. The project also estimates a statistical model that relates weather severity to crash rates. Although, the statistical model is intended to illustrate the possibility to quantitatively relate measurable and predictable weather conditions to the safety performance of a roadway. In the future, weather conditions such as snow fall intensity, visibility, etc., can be used to make objective measures of the safety performance of a roadway rather than relying on subjective evaluations of field staff. The review of the literature and the interviews clearly illustrate that not all delays (increased travel time) are valued the same. Expected delays (routine delays) are valued at the generalized costs (value of the driver’s time, fuel, insurance, wear and tear on the vehicle, etc.), but unexpected delays are valued much higher because they result in interruption of synchronous activities at the trip’s destination. To reduce the costs of delays resulting from road closures, public agencies should communicate as early as possible the likelihood of a road closure.

Le corps à l'ouvrage : les représentations du corps dans les récits de voyage d'Ella Maillart, d'Annemarie Schwarzenbach, de Nicolas Bouvier et de Lorenzo Pestelli

Dans les années trente, Ella Maillart et Annemarie Schwarzenbach quittent la Suisse pour l'Afghanistan. Deux décennies plus tard, L. Pestelli et N. Bouvier s'embarquent à leur tour sur les routes d'Orient. Filles et fils de grands industriels, d'universitaires ou de diplomates, ces quatre écrivains-voyageurs mettent un point d'honneur à s'éloigner d'une conception bourgeoise du voyage en présentant leur départ comme un moyen de se définir dans l'ailleurs, c'est-à-dire en dehors de leur héritage social, familial, national et occidental. L'Orient leur semble le lieu des possibles. Or, malgré leur désir de table rase, ils s'aperçoivent vite que, quoi qu'ils fassent, leur corps porte les stigmates de l'Occident. Ils vont donc tenter de le modifier. Si le but du voyage n'est pas de faire totalement disparaître le corps, ce n'est qu'en le risquant, en l'offrant au monde, pour le meilleur et souvent pour le pire, que les voyageurs croient pouvoir goûter aux délices du dehors. Mais ce bonheur charnel, physique, sensuel voire érotique, comment le dire ? Et quelle langue adopter pour rendre compte de sa présence physique au monde ? La réunion de ces quatre auteurs d'époques, de genres et de plumes différents, nous permet d'observer l'évolution des représentations du corps dans le récit de voyage au vingtième siècle tout en questionnant nos habitudes de lecture. Quelle représentation attendons-nous du corps dans un récit de voyage ? Celui-ci est-il vraiment le lieu privilégié pour remettre le corps à l'ouvrage ? The Boby at work. Body representations ìn the narratives of Eila Maillart, Annemarie Schwarzenbach, Nicolas Bouvier and Lorenzo Pestelli. In the 1930s, Ella Maillart and Annemarie Schwarzenbach left Switzerland for Afghanistan. Two decades later, Lorenzo Pestelli and Nicolas Bouvier set out on the routes to the East. Daughters and sons of prominent industrialists, academics or diplomats, these four writer-travellers made a point of straying away from the bourgeois conception of travel by presenting their departure as a way of defining the self away from social, family, national and Western inheritance. The East appears to them as the location of many possibilities. Yet, in spite of their desire for a clean slate, they soon realise that, no matter what they do, their body carries the stigma of the West. They will thus try to modify it. If the aim of their travelling is not to make the body disappear completely, it is only by putting it at risk and by offering it to the world, for better and often for worse, that the travellers believe they can taste the delights from the outside. But how to put in words this carnal, physical, sensual and even erotic pleasure? And what language can be chosen to account for one's presence in the world? Working jointly on four writers, from different eras, genres and styles, helps us to observe the evolution of the representations of the body in travel literature in the 20`h century and at the same time it questions our reading habits. What representations of the body do we expect in travel literature? Is travel literature really the privileged location to put the body back to work?

Health Care and Public Transit; Your Ticket to Health Care Access, 2005

Transportation is an important health care issue. The majority of the population here in Iowa have ready access and typically use private automobiles to access health care and other community services. There is also a significant segment of the population that either does not have access to a personal automobile or is not currently capable of driving. This can potentially limit their access to health care, but it has greater health implications because it can also limit access to nutrition and other community services, as well as involvement in social activities. For people unable to drive themselves, the alternatives generally include reliance on family, friends, volunteer groups, and public transit. Many choose transit because it gives them a degree of independence. Public transit is often used to supplement other options even when they are available. It becomes critical in circumstances where the other options don’t exist. In many cases there may be no family available or they may not always be able to get off work when travel needs arise during the workday. Friends may be in similar circumstances and volunteer groups may be either unavailable or overwhelmed. The fact that many patients depend on public transit to get to and from health care appointments makes it beneficial for health care professionals to get to know more about public transit and how it operates here in Iowa.

The Lincoln Highway Association’s “Object Lesson:” The Seedling Mile in Linn County Iowa,

The Seedling Mile in Linn County, Iowa, was part of the Lincoln Highway Association’s so-called “object lesson” program that sought to graphically demonstrate, in the paving of selected one-mile demonstration sections, the benefits of concrete paving to improving road travel across the nation. Constructed in 1918-19, this Seedling Mile became much more than an object lesson and served as something of a battleground between two municipalities—Marion and Cedar Rapids—in their struggle over the county seat and their place on the Lincoln Highway. The Seedling Mile eventually became part of a continuously paved section of the Lincoln Highway between Chicago and Cedar Rapids, with the whole of the Lincoln Highway in Iowa paved in some fashion by the 1930s. In 2002, Linn County reconstructed Mt. Vernon Road from the City of Mt. Vernon to the west end of the Seedling Mile impacting the historic road section. An agreement between concerned government agencies resulted in this publication in partial mitigation of the impact to this historic road section under the guidelines of the National Historic Preservation Act.

Volatile transport during the crystallization of anatectic melts: Oxygen, boron and hydrogen stable isotope study on the metamorphic complex of Naxos, Greece

Crystallization of anatectic melts in high-temperature metamorphic terrains releases volatile-rich magmas that can be transported into adjacent lithologies. This study addresses the variations in the oxygen, boron and hydrogen isotopic composition of aplite-pegmatite dikes that formed during the crystallization of anatectic melts in regional high-temperature metamorphism on the island of Naxos, Greece, and propagated upward into the overlying sequences of metamorphic schist. The transport distance of these dikes was increased through a significant horizontal component of travel that was imposed by contemporaneous low-angle extensional shearing. Laser fluorination oxygen isotope analyses of quartz, tourmaline, garnet, and biotite mineral separates from the aplite-pegmatite dikes show a progressive rise in delta(18)O values with increasing distance from the core. Oxygen isotope fractionations among quartz, tourmaline, and garnet show temperature variations from > 700degreesC down to similar to400degreesC. This range is considered to reflect isotopic fractionation beginning with crystallization at high temperatures in water-undersaturated conditions and then evolving through lower temperature crystallization and retrograde sub-solidus exchange. Two processes are examined for the cause of the progressive increase in delta(18)O values: (1) heterogeneous delta(18)O sources and (2) fluid-rock exchange between the aplite/pegmatite magmas and their host rock. Although the former process cannot be ruled out, there is as yet no evidence in the exposed sequences on Naxos for the presence of a suitable high delta(18)O magma source. In contrast, a tendency for the delta(18)O of quartz in the aplite/pegmatite dikes to approach that of the quartz in the metamorphic rock suggests that fluid-rock exchange with the host rock may potentially be an important process. Advection of fluid into the magma is examined based on Darcian fluid flow into an initially water-undersaturated buoyantly propagating aplitic dike magma. It is shown that such advective flow could only account for part of the O-18-enrichment, unless it were amplified by repeated injection of magma pulses, fluid recycling, and deformation-assisted post-crystallization exchange. The mechanism is, however, adequate to account for hydrogen isotope equilibration between dike and host rock. In contrast, variations in the delta(11)B values of tourmalines suggest that B-11/B-10 fractionation during crystallization and/or magma degassing was the major control of boron geochemistry rather than fluid-rock interaction and that the boron isotopic system was decoupled from that of oxygen. Copyright (C) 2003 Elsevier Ltd.

Troubles digestifs associés aux protozoaires et aux helmintes: prise en charge par le médecin de famille [Gastrointestinal complaints associated to helminth and protozoan: management by the general practitioner].

Protozoan and helminthes are frequently associated with persistent digestive complaints, not only in returning travelers from the tropics, but also in industrialized countries. The symptoms are often more vague than those associated to bacterial or viral infections and diarrhea is not always a key feature of the clinical presentation. Three stool examinations and a full blood cells count looking for eosinophilia is the comer stone of the investigations looking for digestive parasites. This article reviews the epidemiology, clinical presentation, diagnostic and management of digestive protozoans and helminthes.