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Fulltext MUSLIM TRAVELLERS’ PERCEPTION ON QUALITY OF SERVICE BY UMRAH AND HAJJ TRAVEL AGENCIES IN MALAYSIA

AINATUN NABIHAH MOHD SHUKRI, AZIZUL YADI YAAKOP, KALSITINOOR SET

UMT Journal of Undergraduate Research, 2019;1(1):18-23.
MyJurnal

Millions of Muslims from all over the world perform Umrah and Hajj every year. There were 250,000 pilgrims from Malaysia in 2017, and the number is expected to grow by 20 percent in 2018. This projected increase will create a huge demand for Umrah and Hajj travel agencies’ services in Malaysia. At present, there are 328 Umrah and Hajj travel agencies registered under Malaysia’s Ministry of Tourism and Culture (MOTAC). However, the supposedly bright outlook maybe marred by undesirable consequences. Along with the increase in the number of Umrah and Hajj travel agencies, there also tends to be an increase in fraud Umrah packages offered by fake agents in Malaysia. Such incidents will cause sadness and anger in the victims and other involved parties. Umrah package fraud involving fake agents in Malaysia has attracted the attention of many including the public, the government, the private sector, even the media. Nevertheless, studies on correlation between Muslim travellers’ perception of the quality of service by Umrah travel agencies and their decision to purchase the Umrah package are scarce in Malaysia. Hence, this study investigated Muslim travellers’ perception of Umrah and Hajj travel agencies’ service quality and its influence on their decision to purchase the Umrah package, in an attempt to discover why some Muslim travellers fell into fake agents’ trap in Malaysia. A total of 319 Muslim respondents completed the questionnaire on service quality perception, specifically service quality elements and loyalty. The data obtained was examined using SPSS version 25 for descriptive and regression analysis. Umrah and Hajj travel agencies as well as relevant government agencies could use the findings of the study to assist with formulating plans and policies to improve the quality of service by Umrah and Hajj industry players and awareness among Muslim travellers on the importance of being able to identify bogus agencies. The limitations, implications andsuggestions for future research are also discussed.

Matched MeSH terms: Travel
Practices, barriers and facilitators to the delivery of pretravel health services by community pharmacists: A scoping review using the theoretical domains framework

Abdul Kadir N, Wahab MSA, Mohd Suhaimi A, Othman N

Res Social Adm Pharm, 2023 Nov;19(11):1412-1423.
PMID: 37612154 DOI: 10.1016/j.sapharm.2023.08.004

BACKGROUND: The involvement of community pharmacists (CPs) in the provision of pretravel health services is increasing due to the increase in international travelers, the increased risk of travel-related diseases, and the expansion of pharmacists' scope of practice in some countries. In order to improve the quality and effectiveness of pretravel health care provided by CPs, a greater understanding of the practices, barriers, and facilitators is required.
OBJECTIVE: This scoping review aimed to identify and describe existing studies on pretravel health services provided by CPs, and the barriers, and facilitators.
METHODS: The PubMed, Science Direct, Scopus, and Web of Science databases were searched for pertinent studies from their inception to February 2023. A manual search was also conducted of prominent travel medicine journals, Google Scholar, and the reference lists of the included studies. Potential barriers and facilitators were mapped to the 14 domains of the Theoretical Domains Framework (TDF).
RESULTS: There were twelve studies included in the review. Pretravel health advice was the most prevalent form of pretravel health services. Within ten domains of the TDF, various factors that either facilitate or impede the provision of pretravel health services by CPs were identified.
CONCLUSION: The provision of pretravel health services by CPs may be affected by a number of practitioner and organizational factors. The provision of pretravel health services can be facilitated by informational resources, training and education in travel medicine, and collaboration amongst healthcare providers.

Matched MeSH terms: Travel*
Fulltext Transport, Mobility and the Wellbeing of Older Adults: An Exploration of Private Chauffeuring and Companionship Services in Malaysia

Abdul Latiff AR, Mohd S

Int J Environ Res Public Health, 2023 Feb 03;20(3).
PMID: 36768086 DOI: 10.3390/ijerph20032720

As physical abilities and health decline with age, older adults tend to lose their driving abilities, which affects their mobility. As mobility is important to older adults' wellbeing, there is a need to explore alternative modes of transportation to increase their ability to actively participate in society. Hence, this paper aims to understand the characteristics of private chauffeuring and companionship services for older adults, and to assess their possible effects on older adults' wellbeing. We gathered the views of transport operators, government agencies, and city councils that offer private chauffeuring and companionship services for older adults. We frame the model of private chauffeuring and companionship services as alternative mobility for older adults and outline a conceptual framework for its possible effects on their wellbeing. The underlying mobility characteristics were availability, accessibility, safety, and affordability-all of which influence wellbeing. The study found that the private chauffeuring and companionship model for older adults includes an additional model of government-to-consumer services in addition to the existing peer-to-peer and business-to-consumer services. While the services are available, the services provided are not standardized, with different operators offering different services and prices, and limiting certain geographical areas. Transport operators perceived that the services they offer promote older adults' physical and mental health, improve their social participation in the community, and empower them in making their travel decisions. The findings of the paper provide insights for policy makers for future planning of alternative transportation for older adults to enhance their mobility.

Matched MeSH terms: Travel*
Fulltext First molecular documented case of a rarely reported parasite: Plasmodium knowlesi infection in Denmark in a traveller returning from Malaysian Borneo

Aftab H, Kemp M, Stensvold CR, Nielsen HV, Jakobsen MM, Porskrog A, et al.

Travel Med Infect Dis, 2023;53:102580.
PMID: 37088361 DOI: 10.1016/j.tmaid.2023.102580

Plasmodium knowlesi has been reported as an emerging infection throughout the Southeast Asian region, especially in the Malaysian state of Sabah, where it accounts for the majority of the malaria cases reported. This is in contrast to Europe, where imported P. knowlesi is a rarely reported infection. We present a case of P. knowlesi infection in a Danish woman returning from a short trip to Malaysian Borneo. Microscopy of blood smears revealed 0.8% infected erythrocytes, but due to the atypical morphological presentation, a conclusive species identification was made by molecular methods. Plasmodium knowlesi is a potentially fatal infection and taking the increasing travel activity into consideration after the coronavirus disease 2019 (COVID-19) pandemic, P. knowlesi should be a differential diagnosis in patients with travel-associated illness returning from highly endemic Southeast Asian areas.

Matched MeSH terms: Travel
Enteric Fever in a Tertiary Paediatric Hospital: A Retrospective Six-Year Review

Ahmad Hatib NA, Chong CY, Thoon KC, Tee NW, Krishnamoorthy SS, Tan NW

Ann Acad Med Singap, 2016 Jul;45(7):297-302.
PMID: 27523510

INTRODUCTION: Enteric fever is a multisystemic infection which largely affects children. This study aimed to analyse the epidemiology, clinical presentation, treatment and outcome of paediatric enteric fever in Singapore.
MATERIALS AND METHODS: A retrospective review of children diagnosed with enteric fever in a tertiary paediatric hospital in Singapore was conducted from January 2006 to January 2012. Patients with positive blood cultures for Salmonella typhi or paratyphi were identified from the microbiology laboratory information system. Data was extracted from their case records.
RESULTS: Of 50 enteric fever cases, 86% were due to Salmonella typhi, with 16.3% being multidrug resistant (MDR) strains. Sixty-two percent of S. typhi isolates were of decreased ciprofloxacin susceptibility (DCS). Five cases were both MDR and DCS. The remaining 14% were Salmonella paratyphi A. There were only 3 indigenous cases. Ninety-four percent had travelled to typhoid-endemic countries, 70.2% to the Indian subcontinent and the rest to Indonesia and Malaysia. All patients infected with MDR strains had travelled to the Indian subcontinent. Anaemia was a significant finding in children with typhoid, as compared to paratyphoid fever (P = 0.04). Although all children were previously well, 14% suffered severe complications including shock, pericardial effusion and enterocolitis. None had typhoid vaccination prior to their travel to developing countries.
CONCLUSION: Enteric fever is largely an imported disease in Singapore and has contributed to significant morbidity in children. The use of typhoid vaccine, as well as education on food and water hygiene to children travelling to developing countries, needs to be emphasised.

Matched MeSH terms: Travel
Emergence of Klebsiella pneumoniae producing dual carbapenemases (NDM-1 and OXA-232) and 16S rRNA methylase (armA) isolated from a Malaysian patient returning from India

Al-Marzooq F, Ngeow YF, Tay ST

Int J Antimicrob Agents, 2015 Apr;45(4):445-6.
PMID: 25631676 DOI: 10.1016/j.ijantimicag.2014.12.013
Matched MeSH terms: Travel*
[Not Available]

Al-Zergani F, Ronit A, Theilgaard ZP, Ronayne A, Nielsen HV, Porskrog A

Ugeskr Laeger, 2023 Oct 02;185(40).
PMID: 37873999

Scrub typhus is caused by the mite-borne bacterium Orientia tsutsugamushi. Imported cases have been suspected in Denmark but no diagnostic method has yet been available to confirm the diagnosis. This is a case report of a 38-year-old male admitted to hospital with high fever, severe malaise and headache after returning from Malaysia. Scrub typhus was suspected and the patient recovered after one week of doxycycline treatment. The pathogen was identified by use of microbiome 16S/18S rRNA next-generation sequencing on ethylenediamine tetraacetic acid (EDTA) blood, which in the future may serve an important role in the investigation of travel-associated infections.

Matched MeSH terms: Travel
Changes in the prevalence of influenza-like illness and influenza vaccine uptake among Hajj pilgrims: A 10-year retrospective analysis of data

Alfelali M, Barasheed O, Tashani M, Azeem MI, El Bashir H, Memish ZA, et al.

Vaccine, 2015 May 21;33(22):2562-9.
PMID: 25887084 DOI: 10.1016/j.vaccine.2015.04.006

Influenza is an important health hazard among Hajj pilgrims. For the last ten years, pilgrims are being recommended to take influenza vaccine before attending Hajj. Vaccination coverage has increased in recent years, but whether there has been any change in the prevalence of influenza-like illness (ILI) is not known. In this analysis, we examined the changes in the rate of ILI against seasonal influenza vaccine uptake among Hajj pilgrims over the last decade.

Matched MeSH terms: Travel
Cutaneous larva migrans--a traveller's disease

Allen CP

N Z Med J, 1990 Jul 25;103(894):345.
PMID: 2374665

A New Zealander who had travelled to Malaysia presented with cutaneous larva migrans. Treatment with mebendazole was successful.

Matched MeSH terms: Travel*
Fulltext Compliance of the Gulf Cooperation Council airlines with COVID-19 mitigation measures

Alshahrani NZ, Alshahrani SM, Alshahrani AM, Leggat PA, Rashid H

J Travel Med, 2021 02 23;28(2).
PMID: 33146380 DOI: 10.1093/jtm/taaa205
Matched MeSH terms: Air Travel/legislation & jurisprudence*
Fulltext Overview of Japanese encephalitis disease and its prevention. Focus on IC51 vaccine (IXIARO®)

Amicizia D, Zangrillo F, Lai PL, Iovine M, Panatto D

J Prev Med Hyg, 2018 Mar;59(1):E99-E107.
PMID: 29938245 DOI: 10.15167/2421-4248/jpmh2018.59.1.962

Japanese encephalitis (JE) is a vector-borne disease caused by the Japanese encephalitis virus (JEV). JEV is transmitted by mosquitoes to a wide range of vertebrate hosts, including birds and mammals. Domestic animals, especially pigs, are generally implicated as reservoirs of the virus, while humans are not part of the natural transmission cycle and cannot pass the virus to other hosts. Although JEV infection is very common in endemic areas (many countries in Asia), less than 1% of people affected develop clinical disease, and severe disease affects about 1 case per 250 JEV infections. Although rare, severe disease can be devastating; among the 30,000-50,000 global cases per year, approximately 20-30% of patients die and 30-50% of survivors develop significant neurological sequelae. JE is a significant public health problem for residents in endemic areas and may constitute a substantial risk for travelers to these areas. The epidemiology of JE and its risk to travelers have changed, and continue to evolve. The rapid economic growth of Asian countries has led to a surge in both inbound and outbound travel, making Asia the second most-visited region in the world after Europe, with 279 million international travelers in 2015. The top destination is China, followed by Thailand, Hong Kong, Malaysia and Japan, and the number of travelers is forecast to reach 535 million by 2030 (+ 4.9% per year). Because of the lack of treatment and the infeasibility of eliminating the vector, vaccination is recognized as the most efficacious means of preventing JE. The IC51 vaccine (IXIARO®) is a purified, inactivated, whole virus vaccine against JE. It is safe, well tolerated, efficacious and can be administered to children, adults and the elderly. The vaccination schedule involves administering 2 doses four weeks apart. For adults, a rapid schedule (0-7 days) is available, which could greatly enhance the feasibility of its use. Healthcare workers should inform both short- and long-term travelers of the risk of JE in each period of the year and recommend vaccination. Indeed, it has been shown that short-term travelers are also at risk, not only in rural environments, but also in cities and coastal towns, especially in tourist localities where excursions to country areas are organized.

Matched MeSH terms: Travel Medicine
Plasmodium knowlesi: the emerging zoonotic malaria parasite

Antinori S, Galimberti L, Milazzo L, Corbellino M

Acta Trop, 2013 Feb;125(2):191-201.
PMID: 23088834 DOI: 10.1016/j.actatropica.2012.10.008

Plasmodium knowlesi was initially identified in the 30s as a natural Plasmodium of Macaca fascicularis monkey also capable of experimentally infecting humans. It gained a relative notoriety in the mid-30s as an alternative to Plasmodium vivax in the treatment of the general paralysis of the insane (neurosyphilis). In 1965 the first natural human infection was described in a US military surveyor coming back from the Pahang jungle of the Malaysian peninsula. P. knowlesi was again brought to the attention of the medical community when in 2004, Balbir Singh and his co-workers reported that about 58% of malaria cases observed in the Kapit district of the Malaysian Borneo were actually caused by P. knowlesi. In the following years several reports showed that P. knowlesi is much more widespread than initially thought with cases reported across Southeast Asia. This infection should also be considered in the differential diagnosis of any febrile travellers coming back from a recent travel to forested areas of Southeast Asia. P. knowlesi can cause severe malaria with a rate of 6-9% and with a case fatality rate of 3%. Respiratory distress, acute renal failure, shock and hyperbilirubinemia are the most frequently observed complications of severe P. knowlesi malaria. Chloroquine is considered the treatment of choice of uncomplicated malaria caused by P. knowlesi.

Matched MeSH terms: Travel
Fulltext Trend Analysis of Travel Medicine Topics Presented at an International Tropical Medicine Conference

Asawapaithulsert P, Flaherty GT, Piyaphanee W

Am J Trop Med Hyg, 2022 Aug 17;107(2):492-494.
PMID: 35895400 DOI: 10.4269/ajtmh.22-0177

Prior to the COVID-19 pandemic, there was a rapid increase in international travel. Travel medicine is a branch of preventive medicine focusing on risk assessment pre-travel, during travel and post-travel with the aim of promoting health and preventing adverse health outcomes. Travel medicine specialists inform travelers about potential health risks and mitigate infectious disease risks such as travelers' diarrhea, yellow fever, and malaria. Travel medicine topics were popular in the American Society of Tropical Medicine and Hygiene conferences between 2016 and 2020, and now comprise approximately 2% of all presentations. Most topics related to the post-travel assessment (50%), followed by diseases contracted during travel (26%), and pre-travel assessment and consultation (24%). Our analysis of the 10 sub-domains of travel medicine issues found that malaria (26%) and immunization (12%) were represented to the greatest extent. We anticipate that both travel and tropical medicine fields will regain their popularity after recovery from the pandemic.

Matched MeSH terms: Travel; Travel Medicine
Fulltext The tobacco industry's accounts of refining indirect tobacco advertising in Malaysia

Assunta M, Chapman S

Tob Control, 2004 Dec;13 Suppl 2:ii63-70.
PMID: 15564223 DOI: 10.1136/tc.2004.008987

OBJECTIVE: To explore tobacco industry accounts of its use of indirect tobacco advertising and trademark diversification (TMD) in Malaysia, a nation with a reputation for having an abundance of such advertising.
METHODS: Systematic keyword and opportunistic website searches of formerly private tobacco industry internal documents made available through the Master Settlement Agreement.
RESULTS: 132 documents relevant to the topic were reviewed. TMD efforts were created to advertise cigarettes after advertising restrictions on direct advertising were imposed in 1982. To build public credibility the tobacco companies set up small companies and projected them as entities independent of tobacco. Each brand selected an activity or event such as music, travel, fashion, and sports that best suited its image. RJ Reynolds sponsored music events to advertise its Salem brand while Philip Morris used Marlboro World of Sports since advertising restrictions prevented the use of the Marlboro man in broadcast media. Despite a ban on tobacco advertisements in the mass media, tobacco companies were the top advertisers in the country throughout the 1980s and 1990s. The media's dependence on advertising revenue and support from the ruling elite played a part in delaying efforts to ban indirect advertising.
CONCLUSION: Advertising is crucial for the tobacco industry. When faced with an advertising ban they created ways to circumvent it, such as TMDs.

Matched MeSH terms: Travel
Fulltext Infected aneurysm after returning from Southeast Asia: think Burkholderia pseudomallei!

Auvens C, Neuwirth C, Piroth L, Blot M

BMJ Case Rep, 2019 May 22;12(5).
PMID: 31122956 DOI: 10.1136/bcr-2018-228856

Melioidosis is a protean disease which is endemic to Southeast Asia and northern Australia. Here, we report a case of infected aortic aneurysm due to Burkholderia pseudomallei in an immunocompetent man 6 months after a trip to northern Malaysia. This patient initially received inappropriate surgical and antibiotic treatment, leading to a peri-prosthetic aortic infection with lumbar spondylitis and contiguous psoas muscle abscess. This case highlights the difficulty of diagnosing melioidosis given its diverse clinical manifestations and the limits of routine microbiological methods to identify B. pseudomallei Melioidosis should be considered a possible diagnosis in individuals with unexplained fever subsequent to travel in an endemic area.

Matched MeSH terms: Travel*
Fulltext A cross-sectional study of the prevalence, density, and risk factors associated with malaria transmission in urban communities of Ibadan, Southwestern Nigeria

Awosolu OB, Yahaya ZS, Farah Haziqah MT, Simon-Oke IA, Fakunle C

Heliyon, 2021 Jan;7(1):e05975.
PMID: 33521357 DOI: 10.1016/j.heliyon.2021.e05975

Background: Malaria is a severe global public health challenge that causes significant morbidity and mortality worldwide, particularly in sub-Saharan Africa. This study was designed to determine the prevalence, parasite density, and risk factors associated with malaria infection transmission among residents of two urban communities of Ibadan, southwestern Nigeria.
Materials and methods: A cross-sectional hospital-based study was carried out on 300 participants. Blood samples were obtained. Thick and thin blood films were prepared and viewed using the standard parasitological technique of microscopy. Moreover, data on sociodemographic and environmental variables were obtained using a pre-tested standard questionnaire.
Results: Of the 300 participants examined, a total of 165 (55.0%) were found positive for Plasmodium falciparum with a mean (S.D) parasite density of 1814.70 (1829.117) parasite/μL of blood. The prevalence and parasite density of malaria infection vary significantly (P < 0.05) with age group. Children <5 years old were more likely to have malaria infection and high parasite densities than adults (p < 0.05). Similarly, in relation to gender, males significantly (P < 0.05) had a higher prevalence (60.2%) and mean (S.D) parasite density of malaria infection [2157.73 (1659.570) parasite/μL of blood] compared to females. Additionally, those without formal education had the highest prevalence (73.0%) and mean (S.D) parasite density of infection [2626.96 (2442.195) parasite/μL of blood]. The bivariate logistic regression analysis shows that age group 6-10 (Crude Odds Ratio, COR 0.066, 95% CI: 0.007-0.635), presence of streams/rivers (COR 0.225, 95% CI: 0.103-0.492), distance from streams/rivers within ≤1 km (COR 0.283, 95% CI: 0.122-0.654) and travel to rural area (COR 4.689, 95% CI: 2.430-9.049) were the significant risk factors.
Conclusions: Malaria infection is prevalent in the study area and was greatly influenced by traveling activities from the rural areas to urban centers and vice versa. Multifaceted and integrated control strategy should be adopted. Health education on mosquito prevention and chemoprophylaxis before and during travel to rural areas are essential.

Matched MeSH terms: Travel
Fulltext Economic impacts of Wuhan 2019-nCoV on China and the world

Ayittey FK, Ayittey MK, Chiwero NB, Kamasah JS, Dzuvor C

J Med Virol, 2020 05;92(5):473-475.
PMID: 32048740 DOI: 10.1002/jmv.25706
Matched MeSH terms: Travel/economics
Fulltext Modelling the Effect of Vaccination Program and Inter-state Travel in the Spread of COVID-19 in Malaysia

Aziz MHN, Safaruddin ADA, Hamzah NA, Supadi SS, Yuhao Z, Aziz MA

Acta Biotheor, 2022 Nov 17;71(1):2.
PMID: 36394646 DOI: 10.1007/s10441-022-09453-3

A modified version of the SEIR model with the effects of vaccination and inter-state movement is proposed to simulate the spread of COVID-19 in Malaysia. A mathematical analysis of the proposed model was performed to derive the basic reproduction number. To enhance the model's forecasting capabilities, the model parameters were estimated using the Nelder-Mead simplex method by fitting the model outputs to the observed data. Our results showed a good fit between the model outputs and available data, where the model was then able to perform short-term predictions. In line with the rapid vaccination program, our model predicted that the COVID-19 cases in the country would decrease by the end of August. Furthermore, our findings indicated that relaxing travel restrictions from a highly vaccinated region to a low vaccinated region would result in an epidemic outbreak.

Matched MeSH terms: Travel
Immigrant Health Study. 9. The chest radiographic changes in an immigrant population - a pilot study. [Abstract]

Basri JJA

JUMMEC, 1998;3:64-64.

With the increasing ease of travel and the passage of peoples between counkies there is a need to ensure that the recipient country is not burdened by the need for care of ilniiiigrant with health problems as well as the increased risk posed to the local population froni exposure to conun~unicabled isease. To assess the chest radiographs of a selected group of inun~igrantsto ascertain the presence of abnormalities especially the presence of tuberculosis. A total of 250 imniigrants were prospectively evaluated by a PA chest radiograph. The chest radiograph was evaluated by two radiologists for the presence of abnormalities of the heart, lungs, mediastinum and bony rib cage. There were 112 Indonesians, 133 Bangladeshis, one Myanmar, three Pakistanis and one others. Males made-up 222 while there were 28 females. The chest radiograph was diagnostic in all cases. There were 13 cases with enlarged hearts but with no evidence of heart failure. There was only a single inlmigrant who had evidence of active TB though there were 6 others who had evidence of old disease. There was evidence of other infections in five. With regard to the mediastinuni there was a single case with enlarged hila probably secondary to increased cardiac output. There were 21 patients with scoliosis of the spine and two with abnormaIities of the ribs. Even though there was a single case with evidence of TB from this pilot study, from unreported data from the UMMC, there were 15,16 and 23 immigrants treated for TB for 1994,1995 and 1996 respectively. This was mainly seen in the Indonesians followed by the Bangladeshis and Myanmar. We attribute this discrepancy to the biased salnpie in this study where probably only the healthy were seen while those who were not well did not want to participate in this study. In addition, this may also be due to the small sample used in this study. We feel that screening of the immigrants out in the field may be able to detect cases of active TB. As for the large hearts we feel that in the absence of any cardiac symptoms and other radiological changes these are probably due to the increased workload on the heart from physical activities. This is a recognised presentation. The changes in the mediastinum and bony rib cage are probably not very significant.

Matched MeSH terms: Travel
Calculating carbon emissions from personal travelling: insights from a top-down analysis of key calculators

Bekaroo G, Roopowa D, Zakari A, Niemeier D

Environ Sci Pollut Res Int, 2021 Feb;28(7):8853-8872.
PMID: 33078355 DOI: 10.1007/s11356-020-11179-z

Personal travelling unfavourably contributes to the emissions of greenhouse gases, which adversely causes long-term damage to the climate. In order to reduce the associated negative impacts of such activities on the environment, there is a wide consensus that enhancements and innovations in the efficiency of vehicles will not be enough, but behavioural changes are needed. For this, individuals should be able to measure their travel-related carbon emissions, and such emissions could be determined by using personal carbon footprint calculators, which proliferated during the previous decade. However, various research questions related to such calculators are yet to be answered in published literature. As such, this paper investigates how key transport-based calculators account for emissions from personal transport-related activities following a top-down analysis. In this endeavour, ten such calculators are investigated through a set of formulated research questions to analyse their scope, calculation approach used, transparency, consistency of results, communication methods utilized and platform differences. Results revealed that the calculators have varying granularity, have limited transparency, provide significantly inconsistent results in some cases and are not fully engaging end users. Based on limitations identified, recommendations have been proposed through a taxonomy to guide policy-makers towards improving such tools.

Matched MeSH terms: Travel

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