Methods: Coroners' files for the 25 years between 1993 and 2017 were interrogated. All cases of death on or at the cliffs were examined, and demographic data were extracted, including date of death, gender, age, nationality, whether the victims were alone at the cliffs prior to their death, whether the fall was witnessed, prevailing weather conditions, post-mortem examinations, toxicology reports and inquest verdicts.
Results: Overall, 66 deaths occurred on or at the base of the Cliffs of Moher during the period 1993 through August 2017. In total, 18 (27.3%) of the victims were international visitors to Ireland, including 11 males (61.1%). The mean age of travellers (n = 17) was 34.2 years. Victims were nationals of 12 different countries, with 13 being European nationals. Most deaths occurred in summer (n = 7) or spring (n = 6), with eight deaths (44%) reported at weekends. In total, 15 victims (83.3%) had walked along the cliff path alone. A jump or fall from the cliffs was witnessed in only two cases (11.1%). Post-mortem examinations revealed multiple traumatic injuries consistent with a fall from a height. Four cases had evidence of alcohol intoxication. Suicide or open verdicts were returned in 50% (n = 9) of the cases.
Conclusions: Travelling alone to the site, purchasing one-way tickets, or depositing belongings on the clifftop support the possibility of suicidal intent, while being intoxicated could be a co-factor in suicidal jumps or support the possibility of an accidental fall. This knowledge could help to identify travellers at the greatest risk of death at cliffs.
METHODS: Semi-structured interviews were conducted with severely obese patients attending a regional, structured, multidisciplinary lifestyle modification programme. Coding and thematic analysis of the transcripts were completed by three independent researchers. A thematic analysis was performed based on examination of the transcribed interviews. Demographic and clinical data such as gender, age and body mass index were also recorded.
RESULTS: Twelve patients (six males), with a mean age of 54 ± 5.98 years and a mean body mass index of 46.2 ± 8.2 kg/m2, agreed to semi-structured interviews (14-52-minute duration). The principal themes emerging from the interviews included obese air traveller embarrassment, physical discomfort on commercial flights, perceived weight bias, challenges in accessing hotel rooms, heat intolerance in warm climates, restricted leisure travel activities and medical co-morbidities. Most of the interviewees perceived a health benefit to travel but regarded obesity as a significant barrier to international travel.
CONCLUSION: These findings highlight the limitations experienced by obese travellers when engaging in international travel. Our results may inform the pre-travel health advice given to obese travellers. They might also serve to raise awareness among operators within the travel industry of the difficulties travellers with severe obesity face.
Methods: Records of travellers aged 60 years and older attending the Tropical Medical Bureau clinic in Galway, Ireland between 2014 and 2018 were examined. Descriptive and inferential.analysis of data was performed.
Results: A total of 337 older travellers sought pre-travel health advice during the study period. The mean age of the cohort was 65.42 (±10) years. Most of the travellers (n = 267, 80%) had at least one travelling companion. Nearly half of older travellers (n = 155, 46.8%) were travelling with a single companion. Tourism was the main reason for travel for the majority (n = 260, 77.6%), followed by visiting friends and relatives (VFR) (n = 23, 6.9%) travellers. The mean interval remaining before the planned trip was 4.36 (±2) weeks, and the mean duration of travel was 3.16 (±1) weeks. The most popular single country of destination was India with 33 (9.8%) visitors, and South East Asia was the most popular region with 132 (39.2%) older travellers. The majority of travellers (n = 267, 79.2%) had a documented pre-existing medical condition. The most commonly reported medical conditions were hypertension (n = 26, 7.7%), dyslipidaemia (n = 18, 5.3%), diabetes mellitus (n = 12, 3.5%), insect bite sensitivity (n = 11, 3.3%), and hypothyroidism (n = 9, 2.6%). Antihypertensive agents (n = 32, 9.4%) and statins (n = 24, 7.1%) were the most frequently used medications. Typhoid (n = 112, 33.2%) and hepatitis A (n = 84, 24.9%) were the most common vaccinations administered to older travellers at the clinic.
Conclusions: This study provides an insight into the demographics, travel characteristics, and medical profile of elderly travellers seeking advice at a large travel clinic in Ireland. A wide range of travel destinations, diseases and medication use was reported among this group of travellers, which may enable travel medicine physicians to provide more tailored advice and to more appropriately counsel older travellers.
METHODS: The PubMed database was accessed to source relevant literature, using combinations of pertinent search terms. Only articles published in the English language were selected. Reference lists of published articles were also examined for relevant articles.
RESULTS: With regard to preferred destinations, South/Central America and the Caribbean were more likely to receive tourists looking for casual sex. Longer duration of travel, travelling alone or with friends, alcohol or drug use, being younger and being single were factors associated with higher levels of casual sex overseas. The majority of literature retrieved on sex workers focused on risk behaviours, sexually transmitted infections (STI), mobility of sex workers and how these factors affected their lives. Sex tourists require better access to effective methods of preventing HIV, such as pre-exposure prophylaxis, and better education on HIV prevention. Drugs and alcohol play a major role as risk factors for and cofactors in casual sexual behaviour while abroad.
CONCLUSIONS: Travellers need to be informed of the increased risks of STI before travel. They should be aware of the local prevalence of STIs and the risks associated with their sexual practices when they travel, including engaging with commercial sex workers, having unprotected sexual intercourse and becoming victims of sexual violence.