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A M Croft

Publications and source records attributed to A M Croft.

29 records · Page 2Linked to original sources
PubMed1999

Handsearching the Journal of the Royal Naval Medical Service for Trials.

As part of the Cochrane Collaboration's international research endeavour, the authors carried out a handsearch of the Journal of the Royal Naval Medical Service from 1948 to 1998, searching for randomised controlled trials (RCTs) and controlled clinical trials (CCTs). Five trials were identified, of which three were RCTs and two were CCTs. The first trial was published in 1960. The identified trials were in the fields of dentistry (two trials), gastroenterology, occupational medicine and orthopaedic surgery. Of the five trials, only two had been located previously through a rigorous interrogation of Medline. The three newly identified trials were reported to the UK Cochrane Centre, and details of these three trials were entered into Medline for use by clinicians and investigators in the future.

Controlled Clinical Trials as Topic↗
PubMed1998

Outpatient waiting times: indicators of hospital performance?

We monitored outpatient waiting times at UK military hospitals over an 18-month period (September 1996-March 1998). The highest mean waiting times for Consultant appointment were in urology (19 weeks) and orthopaedics (18 weeks). The lowest mean waiting times were in psychiatry (3 weeks), ENT surgery (5 weeks) and rheumatology (6 weeks). Waiting times for surgical specialties were around 50% higher than for medical specialties. The inter-hospital variability in waiting times was 260%. Military waiting list initiatives were introduced in 4 key specialties, but the majority of these initiatives only had a temporary impact in reducing outpatient waiting times. Waiting times reflect the accessibility of a hospital's services, and are a crude but easily measured indicator of one aspect of patient care. With a military population base, outpatient waiting times should be reduced to the lowest practicable level. The keys to achieving a long-term reduction in waiting times are proper staffing levels and the efficient management of clinics.

Ambulatory Care↗
PubMed1997

An outbreak of rubella in British troops in Bosnia.

An outbreak of rubella in April 1996 involved four male British soldiers deployed to Bosnia-Herzegovina. All were helicopter ground crew who were members of the same unit and who periodically travelled to and worked at forward air refuelling stations in Bosnia. There was a potential for spread of the infection to adjacent British units, to troops of other nations in the peacekeeping force, and also to the local civilian population. The British force included 620 female personnel, some of whom may have been non-immune to rubella. One pregnant British servicewoman was repatriated to UK for her own protection. There was a potential health risk, including the possibility of congenital rubella syndrome, in the non-immune wives and partners of deployed male personnel, as a result of contact during the mid-tour home leave of the husbands or partners. The outbreak was monitored through a medical surveillance system known as ARRC 97, and was contained by prompt and rigorous control measures. This outbreak shows the importance of effective surveillance and of good microbiology laboratory support during military operations. The role of immunization against rubella during future military deployments is discussed.

Adult↗
PubMed1997

Health data from Operation Resolute (Bosnia). Part 1: Primary care data.

This paper describes routine sickness events occurring during Weeks 1-19 of Operation Resolute (Bosnia). The period covered is 20 December 1995 to 28 April 1996. Primary care data were collected and analysed through an HQ ARRC epidemiological surveillance system which encompassed all British personnel in theatre. There was a total of 17,054 primary care consultations in the British force, which at its peak in late January numbered 10,832 personnel. 11,472 of these consultations were due to disease (67% of the total) and 5568 to non-battle injury (32% of the total). The observed rate of sickness due to disease was close to the predicted rate, which was 1.35% of the force per day. The observed rate of sickness due to non-battle injury was between 6 and 10 times higher than the predicted rate of 0.05% of the force per day. There were only 14 primary care consultations due to battle injury.

Bosnia and Herzegovina↗
PubMed1997

Sports injuries in British troops deployed on Operation Resolute (Bosnia)

This study presents epidemiological data on sports injuries in deployed British troops in Bosnia, during the first five months of Operation Resolute. A retrospective analysis was carried out of sports injuries seen in one practice in the divisional rear area during April 1996. They account for a significant morbidity in deployed troops and are a major cause of manpower wastage and of medical repatriations. The continuous monitoring of sports injury should be a central part of the epidemiological surveillance of deployed troops. Their occurrence during operations can be minimised by judicious restrictions on those sports, such as football, which are known to have an adverse injury profile.

Athletic Injuries↗
PubMed1997

Medical repatriations from Operation Resolute (Bosnia).

Operation Resolute is a peace enforcement mission in Bosnia-Herzegovina, which commenced on 20 December 1995. During Weeks 1-26 of the operation a total of 405 British personnel were repatriated on medical grounds, out of a mean force size of 9,299. We analysed these repatriations by clinical category and according to final destination. In addition we carried out a focused analysis of the 87 medical repatriations which occurred during May 1996. 77.5% of all the repatriations in the first 6 months of Operation Resolute were for surgical conditions, and 22.5% were medical. Eighty two per cent of British soldiers were repatriated to UK, and 18% to Germany. The mean weekly repatriation rate during this 6-month period was 1.7 per 1,000 force strength. Orthopaedic conditions were by far the greatest single cause of repatriation. During the month of May there was a total of 87 repatriations, of which 12 were due to disease. These showed no consistent pattern. Seventy five of the May repatriations were due to injury and of these 29% were caused by sport, 5% by road traffic accidents, 4% were eye injuries and one was due to burns; other occupational injuries accounted for a further 27% of the total. Twenty out of the 87 personnel repatriated in May had pre-existing medical conditions, but only 35% of these had been reviewed by their medical officer prior to deployment. Medical officers should be more diligent in carrying out pre-deployment fitness screening. The routine medical surveillance of deployed troops should be targeted towards occupational causes of injury, since these are preventable and account for terminal manpower losses.

Bosnia and Herzegovina↗
PubMed1997

Skin disease in British troops in the Bosnian winter.

During the winter of 1995-1996, there took place a major deployment of North Atlantic Treaty Organization peacekeeping forces to Bosnia. Epidemiological surveillance of British troops through the ARRC-97 program has provided detailed information about their dermatological health. Skin disease was responsible for 12.7% of primary care consultations. Dry skin prove a common problem for troops. We recommend that emollients be placed on general issue during winter deployments to the Balkans. Dermatology should be included in pre-Bosnia training for all medical personnel.

Adult↗
PubMed1995

The employability of pregnant and breastfeeding servicewomen.

The Army Medical Services are responsible for promoting health in the military workplace. A survey of the potential health risks in the workplace to British Army servicewomen who are pregnant, or who breastfeed, was carried out. It was found that there was a total of 30 major workplace hazards to pregnant or breastfeeding servicewomen, and that medical guidance in this area was lacking. A Medline literature search on these hazards, was compiled, and an overview of the nature and extent of the military problem, together with a brief policy recommendation applying to each hazard. Guidelines based on these recommendations were distributed to primary care and obstetric unit medical officers in all three Armed Services. It is intended that the guidelines will assist Service doctors in giving informed advice on the avoidance of military occupational risks to pregnancy and to lactation.

Breast Feeding↗
PubMedDate not supplied

Side effects of mefloquine prophylaxis for malaria: an independent randomized controlled trial.

A prospective randomized double-'blind' trial was undertaken during a military exercise in East Africa to determine whether there was a significant difference in the incidence of side effects experienced by soldiers taking mefloquine 250 mg weekly compared with those taking chloroquine 300 mg weekly and proguanil 200 mg daily as chemoprophylaxis for malaria. Subject to their informed voluntary consent, male soldiers who were not aviators were included in the study. Identical questionnaires were completed voluntarily at the end of 2 and 8 weeks. Symptoms were classified by nature into-'all', 'neuropsychological', 'enteric' and 'other', and by severity into 'severe' and 'very severe'. The proportions of respondents experiencing side effects were compared to seek statistically significant differences between the chemoprophylactic groups. Questionnaire 1 was completed after 2 weeks by 183 of 317 subjects (58%) randomly assigned mefloquine and by 176 of 307 subjects (57%) randomly assigned chloroquine-proguanil. The incidence of putative side effects was not significantly different between the groups (71/183 vs. 70/176), odds ratio 0.96 (95% confidence interval [CI] 0.63 to 1.47). Questionnaire 2 was completed after 8 weeks by 145 of 317 subjects (46%) randomly assigned mefloquine and by 142 of 307 subjects (46%) randomly assigned chloroquine-proguanil. The incidence of putative side effects was still not significantly different between the groups (95/145 vs. 103/142), odds ratio 0.72 (95% CI 0.43 to 1.19). None of the subjects developed a serious neuropsychological reaction. Among respondents, 12.8% and 38% admitted lack of full compliance at 2 and 8 weeks, respectively. Exclusion of these subjects during a secondary analysis did not affect the results. None of the subjects developed malaria in the 12 months following return to the UK. Subject to the limitations of a response rate that was smaller than desired and the fact that the study was conducted in fit male military personnel, these results support evidence which indicates that mefloquine is no more toxic than chloroquine-proguanil.

Africa, Eastern↗