How do people make rich inferences from such sparse data? Recent research has explored this inferential ability by investigating probabilistic reasoning in infancy. For example, 8- and 11-month-old infants can make inferences from samples to populations and vice versa (Denison & Xu, 2010a; Xu & Denison, 2009; Xu & Garcia, 2008a). The current experiment investigates the developmental origins of this probabilistic inference mechanism with 4.5- and 6-month-old infants. Infants were shown 2 large boxes, 1 containing a ratio of 4 pink to 1 yellow balls, the other containing the opposite ratio. The experimenter sampled from, for example, the mostly pink box and removed a sample of either 4 pink and 1 yellow balls or 4 yellow and 1 pink balls on alternating trials. Six-month-olds but not 4.5-month-olds looked longer at the 4 yellow and 1 pink sample (the improbable outcome) than at the 4 pink and 1 yellow sample (the probable outcome).
Searches of the literature or Internet using the term "medical tourism" produce two sets of articles: travel for the purpose of delivering health care or travel for the purpose of seeking health care. The first usage primarily appears in the medical literature and is beyond the scope of this article, which focuses on travel to seek health care. Still, there are some aspects these two topics have in common: both are affected by ease and speed of international travel and communication associated with globalization, and both raise questions about continuity of care as well as issues related to cultural, language, and legal differences; both also raise questions about ethics. This article describes some of the motivating factors, contributing elements, and challenges in elucidating trends, as well as implications for clinicians who provide pretravel advice and those who care for ill returning travelers.
Among ill returned travelers to Schistosoma-endemic areas reported to the GeoSentinel Surveillance Network over a decade 410 schistosomiasis diagnoses were identified: 102 Schistosoma mansoni, 88 S. haematobium, 7 S. japonicum, and 213 Schistosoma unknown human species. A total of 83% were acquired in Africa. Unlike previous large case series, individuals born in endemic areas were excluded. Controlling for age and sex, those traveling for missionary or volunteer work, or as expatriates were more likely to be diagnosed with schistosomiasis. Sixty-three percent of those with schistosomiasis presented within six months of travel. Those seen early more often presented with fever and respiratory symptoms compared with those who presented later. One-third of patients with schistosomiasis were asymptomatic at diagnosis. Half of those examined for schistosomiasis were diagnosed with infection. Screening for schistosomiasis should be encouraged for all potentially exposed travelers and especially for missionaries, volunteers, and expatriates.
Similar to previous studies, VFR status was associated with pretravel health practices that leave travelers at risk for important infectious diseases. This association differed by ethnicity, which may also be an important marker of nonadherence to pretravel health recommendations. These findings have important implications for identifying at-risk travelers and properly targeting prevention messages.
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