A5103049670- Reproductive tract infections research
- Adolescent Sexual and Reproductive Health
- Cervical Cancer and HPV Research
- Urinary Tract Infections Management
- Occupational Health and Performance
- Respiratory viral infections research
- Public Health Policies and Education
- HIV, Drug Use, Sexual Risk
- Palliative Care and End-of-Life Issues
- Viral gastroenteritis research and epidemiology
- Virology and Viral Diseases
- Urological Disorders and Treatments
- Sex work and related issues
- Pleural and Pulmonary Diseases
- Suicide and Self-Harm Studies
- Patient Dignity and Privacy
- Viral Infections and Outbreaks Research
- Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Injury Epidemiology and Prevention
- Streptococcal Infections and Treatments
- Antimicrobial Resistance in Staphylococcus
- Bacterial Identification and Susceptibility Testing
- Disaster Response and Management
- Syphilis Diagnosis and Treatment
- Occupational and environmental lung diseases
Defense Health Agency
2024
U.S. Army Center for Health Promotion and Preventive Medicine
2005-2022
Uniformed Services University of the Health Sciences
2021-2022
Oak Ridge Associated Universities
2022
North Bristol NHS Trust
2011-2018
Defense Center for Public Health - Aberdeen
2011-2017
National Health Service
2016
Naval Health Research Center
2016
Southmead Hospital
2015-2016
United States Army Medical Command
2011-2014
The use of prophylactic radiotherapy to prevent procedure-tract metastases (PTMs) in malignant pleural mesothelioma remains controversial, and clinical practice varies worldwide. We aimed compare with deferred (given only when a PTM developed) suitably powered trial.We did multicentre, open-label, phase 3, randomised controlled trial 22 UK hospitals patients histocytologically proven who had undergone large-bore interventions the 35 days prior recruitment. Eligible were (1:1), using...
To evaluate noise-induced hearing injury (NIHI) and blast-related comorbidities among U.S. Army soldiers in an effort to understand the morbidity burden future health service requirements for wounded war fighters returning from Central Command Area of Responsibility, predominantly Iraq Afghanistan deployments.Inpatient outpatient records with diagnosed NIHI or (e.g., significant threshold shift [STS], loss, tinnitus, sensorineural eardrum perforations, mild traumatic brain injury,...
Palliative care is underused in non-malignant respiratory diseases, including interstitial lung diseases (ILDs). We investigated current practices around palliative and supportive explored the impact of a decision aid tool.This was single centre study UK ILD centre. Retrospective analysis hospice referrals patients with idiopathic pulmonary fibrosis (IPF) under Bristol (BILD) service were used to identify unmet needs. Using quality improvement methodology, we on clinician behaviours for...
The 1999 cessation of vaccination against adenovirus types 4 and 7 among US Army trainees resulted in reemergence acute respiratory disease (ARD) outbreaks. 2011 implementation a replacement vaccine led to dramatic sustained decreases ARD cases, supporting continuation this population at high risk for ARD.
Purpose: U.S. Army soldiers face unique noise exposures in the current deployed setting. The effects of these deployment-related have not previously been documented. Method: In an attempt to initiate this process, medical evaluations performed at military audiology clinics from April 2003 through March 2004 were reviewed compare noise-induced hearing loss injury (NIHLI) outcomes among whose diagnoses classified as postdeployment-related versus non-postdeployment-related. Sentinel NIHLI...
To assess the burden of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in a high-risk population, monthly incidence laboratory-confirmed MRSA service members/trainees stationed at Fort Benning, Georgia, USA without hospitalization or surgery documented 30 days prior to infection was calculated for calendar years 2002-2007. Clinical management and antibiotic susceptibility patterns were also evaluated. By 2007, approximately 67% S. strains MRSA, 82% these...
To review reported chlamydia infection trends in the U.S. military and identify reasons for differences.Defense Medical Surveillance System 2000-2008 reports nondeployed, active duty members were studied. Incidence, rate ratios, confidence intervals generated. Age- gender-specific rates compared with US national rates. Screening reporting policies procedures reviewed.Overall incidence was 922 cases per 100,000 person-years, considerable service variability (392-1,431 person-years Navy Army,...
Introduction Patients with progressive idiopathic fibrotic interstitial lung disease (ILD), such as those pulmonary fibrosis (IPF), can have an aggressive course, a median survival of only 3–5 years from diagnosis. The palliative care needs these patients are often unmet. There calls for new models care, whereby the patient’s usual respiratory clinician remains central to integration principles and practices into their management, but optimal model service delivery has yet be determined....
Background: Patients with advanced life-limiting diseases have high information needs concerning prognosis yet discussions between patients and healthcare professionals are either avoided or inaccurate due to over-optimism. Available prognostic models problematic. Literature indicates that hospital specialist palliative care frequently asked prognosticate, although their experience of prognostication is unknown. Identifying this will support the development training for professionals. Aim:...
Background: Increasing numbers of Staphylococcus aureus infections demonstrate antibiotic resistance. Military populations experiencing crowding are at increased risk community-acquired methicillin-resistant S. (CA-MRSA) infection. High prevalence CA-MRSA infection among Army personnel was previously documented Fort Benning, GA from 2002 to 2007. Purpose: To ascertain recent trends Benning regarding susceptibility, rates, and treatment regimens personnel. Methods: Incident cases active duty...
Iquitos Peru, a densely populated port city housing both large military base and booming tourist industry, provides thriving market for commercial sex and, consequently, sexually transmitted disease (STD). The purpose of this study was to characterize the prevalence gonococcal chlamydial infections among workers (CSWs) correlate those findings with social/behavioral characteristics.One hundred CSWs, recruited through street brothel outreach, were administered questionnaires. Urine specimens...
Introduction Patients with malignant pleural mesothelioma (MPM) may develop painful ‘procedure tract metastasis’ (PTM) at the site of previous interventions. Prophylactic radiotherapy has been used to minimise this complication; however, three small randomised trials have shown conflicting results regarding its effectiveness. The surgical and large bore procedures in trial (SMART Trial) is a suitably powered, multicentre, controlled trial, designed evaluate efficacy prophylactic within 42...
Abstract Background In 2017, a mumps outbreak occurred in US military barracks. Serum collected at service entry was used to compare pre-exposure with presumptive vaccine-induced antibody levels from persons who developed (cases) and potentially exposed did not develop (non-cases). Sufficient information determine of exposure during the available. Methods Pre-outbreak serum samples Department Defense Repository were available 254 members. Twelve clinical symptoms had post-outbreak collected....
Summary: Although human immunodeficiency virus (HIV) rates are increasing rapidly in Asia, a full understanding of the extent other sexually transmitted diseases (STDs) many these areas is lacking. There have been anecdotes rising STDs Mongolia, country thus far relatively unaffected by HIV. To further STDs, prevalence study was conducted STD clinic Ulaanbaatar, capital and largest city Mongolia. Among 260 patients, gonorrhoea, chlamydia syphilis 31.1%, 8.1% 8.6% respectively for males...
Urogenital and rectal specimens collected from the "IWantTheKit" Internet-based sexually transmitted infection screening program were evaluated for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis. Of 881 paired submitted August 2013 to December 2016, 15.0% (n = 132) tested positive 1 or more infections, of which 50.8% 67) identified exclusively through testing.
Sexually transmitted diseases, in particular Chlamydia trachomatis and Neisseria gonorrhoeae, are ranked as the top 2 most commonly notified disease US Army. Although surveillance programs place to capture event data, no routine STD program captures laboratory test information.To evaluate testing practices/methodologies Army laboratories 2007, a questionnaire was distributed all 38 laboratories. The results of survey were compared across installations civilian public health laboratories.Of...
Abstract Introduction Chlamydia pneumoniae (Cp) is a bacterium that causes pneumonia and other respiratory diseases. Fever may be present early but absent by time of presentation to clinic. Increases in X-ray-confirmed (XCP) laboratory-confirmed Cp infections were observed new soldiers training at Fort Leonard Wood (FLW), Missouri, 2014. These findings prompted site assistance visit from the U.S. Army Public Health Command, Aberdeen Proving Ground, Maryland, with review available data...
A 2005 assessment of noise-induced hearing injury (NIHI) among Army audiology clinic patients seen between April 2003 and March 2004 found elevated rates NIHI soldiers returning from deployment. Because study limitations, it was not possible to extrapolate the findings entire soldier population in relation deployment status. We performed this determine patterns incidence as a function status accuracy completeness provider use NIHI-related ICD-9CM codes. These refinements were made with goal...