Publications by authors named "Fletcher T"

Clinical practice guidelines indicate treatments for specific anxiety diagnoses. Misdiagnosing specific anxiety disorders as unspecified anxiety may prevent patients from receiving appropriate care. Provider knowledge and attitudes may influence diagnostic practices.

View Article and Find Full Text PDF

A key lesson from the west Africa (2014-16) Ebola disease epidemic was that outbreak responses fail when they respond to patients through a narrow clinical lens without considering the broader community and social context of care. Here, in the second of two Series papers on the modern landscape of Ebola disease, we review progress made in the last decade to improve patient-centred care. Although the biosafety imperatives of treating Ebola disease remain, recent advances show how to mitigate these so that patients are cared for in a safe and dignified manner that encourages early treatment-seeking behaviour and provides support after the return of patients to their communities.

View Article and Find Full Text PDF

Background: Crimean-Congo Haemorrhagic Fever (CCHF) is a viral haemorrhagic fever with a case fatality rate of 5-25% that has been prioritised for research and development by the World Health Organisation. There are no CCHF rapid diagnostic tests (RDTs) commercially available. We describe the development and evaluation of an antigen-targeting lateral flow immunoassay RDT for CCHF.

View Article and Find Full Text PDF

Background: Perfluoroalkyl substances (PFAS) have been associated with impaired antibody levels after childhood vaccinations and immunosuppressive effects in animals. However, the in vivo effects of PFAS on antigen specific human T cell responses have not been investigated in adults. In Ronneby, Sweden, the drinking water of one of the water works was previously highly contaminated with primarily perfluorohexane sulfonic acid (PFHxS) and perfluorooctane sulfonic acid (PFOS).

View Article and Find Full Text PDF
Article Synopsis
  • The protocol outlines a Cochrane Review aimed at evaluating the effectiveness of vaccines for preventing Ebola virus disease.
  • The primary focus is on individuals who have been directly exposed or may have been exposed to the Ebola virus.
  • The review will analyze existing studies to determine how well these vaccines perform in preventing the disease in those at risk.
View Article and Find Full Text PDF

The use of low-cost sensors, with open-source code, facilitates greater spatial resolution and flexibility of environmental monitoring, thus generating more information and overcoming limitations of traditional commercial sensors. Measurement of water turbidity using submerged sensors can be problematic in that rapid biofouling requires frequent site visits to remove, clean, calibrate and replace the sensor. We therefore designed an automated system using low-cost commercially-available sensors that pumps water from the stream, samples it for turbidity and purges remaining water, leaving the turbidity sensor dry between measurements, thus greatly reducing the biofouling problem and minimizing operation costs.

View Article and Find Full Text PDF
Article Synopsis
  • - Human threadworm is a globally distributed parasite affecting over 600 million people, with serious implications for immunosuppressed individuals, yet its prevalence among Fijian migrants in the UK is largely unknown.
  • - A study involving 250 Fijian migrants in the UK revealed a significant rate of gastrointestinal parasites (GIPs), with 35.1% testing positive for threadworm and 6.8% for hookworms, based on comprehensive diagnostic methods.
  • - Findings emphasized the need for specialized parasitological testing, particularly multiplex real-time PCR (rtPCR), which proved more effective than traditional microscopy in diagnosing infections among chronic cases in this population.
View Article and Find Full Text PDF

Crimean-Congo haemorrhagic fever (CCHF) is a widely distributed and potentially fatal tick-borne viral disease with no licensed specific treatments or vaccines. In 2019, WHO published an advanced draft of a research and development roadmap for CCHF that prioritised the development and deployment of the medical countermeasures most needed by CCHF-affected countries. This Personal View presents updated CCHF research and development priorities and is the product of broad consultation with a working group of 20 leading experts in 2023-24.

View Article and Find Full Text PDF

This study presents the process of design and development of a low-cost turbidimeter for monitoring water quality, facilitating rigorous spatial-temporal variability analysis within large-scale hydrological systems. We propose a low-cost optical turbidimeter, modifying the existent SEN0189 turbidity sensor, Arduino boards, and additional sensors for temperature compensation. We compared a low-cost system with high-tech sensors, modifying the original low-cost SEN0189 probe for enhanced environmental performance.

View Article and Find Full Text PDF

Introduction: Several cross-sectional studies have linked perfluoroalkyl substances (PFAS) to prevalence of menopause. These findings might be influenced by reverse causation mechanism, making longitudinal studies more suitable. However, existing longitudinal studies are limited and present conflicting results.

View Article and Find Full Text PDF
Article Synopsis
  • Travel to resource-limited areas can increase the risk of infections from multi-drug resistant bacteria like ESBL-PE and CRE, which lead to serious health issues.
  • A study examined the prevalence of these bacteria in British service personnel by analyzing 239 fecal samples and discovered a 16.7% presence of ESBL-PE, but no CRE cases were found.
  • While the rate of ESBL-PE in service personnel is similar to that in civilian populations in England, different genetic variations of the bacteria were observed, highlighting the need for ongoing monitoring to track infection risks.
View Article and Find Full Text PDF

Background: We evaluated the results of examining a single faecal sample for gastrointestinal parasites (GIP) using a combination of traditional methods with multiplex qPCR for helminths and protozoa, compared to a reference standard of examining three faecal samples from each person using traditional diagnostic methods alone.

Methods: Three faecal samples were collected at weekly intervals from 596 healthy Nepalese men. Each sample underwent formalin-ethyl acetate (FEA) concentration and light microscopy, and charcoal culture.

View Article and Find Full Text PDF
Article Synopsis
  • The authors, both occupational therapists from different racial backgrounds, reflect on their personal and cultural experiences during the COVID-19 pandemic and civil unrest through auto-ethnography.
  • Their collaboration focuses on promoting emotional and spiritual wellness, addressing healthcare disparities while supporting their local African American community.
  • They created a handwoven kente-style liturgical stole ministry to uplift African American pastors, helping them cope with challenges in worship and community during difficult times.
View Article and Find Full Text PDF

Unlabelled: Clinical trials of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) therapeutics often include virological secondary endpoints to compare viral clearance and viral load reduction between treatment and placebo arms. This is typically achieved using quantitative reverse-transcriptase PCR (RT-qPCR), which cannot differentiate replicant competent virus from non-viable virus or free RNA, limiting its utility as an endpoint. Culture-based methods for SARS-CoV-2 exist; however, these are often insensitive and poorly standardized for use as clinical trial endpoints.

View Article and Find Full Text PDF

Owing to its specialised methodology, palaeoecology is often regarded as a separate field from ecology, even though it is essential for understanding long-term ecological processes that have shaped the ecosystems that ecologists study and manage. Despite advances in ecological modelling, sample dating, and proxy-based reconstructions facilitating direct comparison of palaeoecological data with neo-ecological data, most of the scientific knowledge derived from palaeoecological studies remains siloed. We surveyed a group of palaeo-researchers with experience in crossing the divide between palaeoecology and neo-ecology, to develop Ten Simple Rules for publishing your palaeoecological research in non-palaeo journals.

View Article and Find Full Text PDF

DDX17 is an RNA helicase shown to be involved in critical processes during the early phases of neuronal differentiation. Globally, we compiled a case-series of 11 patients with neurodevelopmental phenotypes harbouring de novo monoallelic variants in DDX17. All 11 patients in our case series had a neurodevelopmental phenotype, whereby intellectual disability, delayed speech and language, and motor delay predominated.

View Article and Find Full Text PDF

The volume of stormwater generated by streetscapes in cities is a primary driver of urban stream degradation. Large infiltration trenches can be integrated into streetscapes to potentially retain large volumes of runoff and increase growth rates of nearby trees. To test this, a field study was conducted where three structural soil infiltration trenches receiving runoff (12 m long, 0.

View Article and Find Full Text PDF

Introduction: Epidemiological studies highlight the presence of associations between per- and polyfluoroalkyl substances (PFAS) exposure with liver damage. In 2013, PFAS contamination was discovered in Veneto (Italy), leading to the implementation of a Surveillance Program (SP). Our objective is to investigate the association between PFAS exposure and biomarkers of liver function using single-pollutant and mixture approaches, while exploring the sex-specific differences and the mediating role of obesity in the association.

View Article and Find Full Text PDF

Crimean-Congo hemorrhagic fever (CCHF) is a major emerging infectious disease threat, and children are reported to have a milder disease course compared with adults, in contrast to other viral hemorrhagic fevers. The aim of this study was to compare adult and pediatric patients with CCHF to improve understanding of pathogenesis and the natural history of the disease. A retrospective analysis of all children and adults admitted with confirmed CCHF between 2011 and 2020.

View Article and Find Full Text PDF

Up to 33% of American adults will experience a diagnosable anxiety disorder in their lifetime. Approximately one-third of anxiety diagnoses assigned by mental health providers in outpatient settings are unspecified. The tendency of many providers to use an unspecified anxiety diagnosis may negatively impact the provision of evidence-based treatments for specific anxiety disorders.

View Article and Find Full Text PDF

Introduction: Perfluoroalkyl substances (PFAS) are widely used, ubiquitous and highly persistent man-made chemicals. Previous cross-sectional studies have consistently linked PFAS exposure to alterations in lipid profiles. However, longitudinal investigations are preferred to mitigate issues related to reverse causation and confounding.

View Article and Find Full Text PDF

African American veterans who use tobacco use evidence-based tobacco-cessation treatment less than other racial/ethnic groups, contributing to higher tobacco-related treatment burden for them. This study aimed to assess barriers and facilitators African American patients face before engaging in Veterans Health Administration behavioral tobacco-cessation treatment services, as an initial step to identify new implementation strategies. African American veterans (N = 30) who use tobacco at a large Veterans Affairs Medical Center completed interviews about perceived barriers and facilitators to behavioral treatment, views on telehealth, and suggested care improvements.

View Article and Find Full Text PDF

Introduction: Long-term contamination of tap water and groundwater by perfluoroalkyl and polyfluoroalkyl substances (PFASs) has been documented in the Veneto region of northern Italy. This study aimed to assess the exposure of individuals residing in the contaminated area and to test several toxicokinetic (TK) models of varying complexities to identify an efficient method for predicting perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) concentrations in human serum using observed data.The ultimate goal is to provide public health officials with guidance on selecting the appropriate TK model for specific contexts, a reliable and rapid tool to support human bio-monitoring (HBM) studies.

View Article and Find Full Text PDF

Per- and polyfluoroalkyl substances (PFASs) are a class of synthetic organic chemicals of global concern. A group of 36 scientists and regulators from 18 countries held a hybrid workshop in 2022 in Zürich, Switzerland. The workshop, a sequel to a previous Zürich workshop held in 2017, deliberated on progress in the last five years and discussed further needs for cooperative scientific research and regulatory action on PFASs.

View Article and Find Full Text PDF