Implementation of a multidisciplinary program for active duty personnel seeking care for low back pain in a U.S. Navy Medical Center: a feasibility study.

The aim of the pilot study was to evaluate a multidisciplinary program for nonspecific low back pain (NSLBP) at a major U.S. Navy base. In this single blinded randomized clinical trial, subjects were drawn from a larger, prospective cohort of active duty service members seeking care for NSLBP pain at a U.S. Navy Branch Medical Clinic. Outcome measures included return to work, self-reported pain, function, and psychological distress. Subjects were randomly allocated to one of two study arms: a multidisciplinary reconditioning program or the current standard of care for low back pain. The intervention lasted 4 weeks with a 12-week follow-up. Thirty-three subjects were enrolled. Subjects allocated to multidisciplinary care reported significantly lower perceived disability (p = 0.014) and less pain than those allocated to usual care at the end of the intervention period. All subjects returned to their usual duty following the conclusion of the intervention. The implementation of the intervention program was successful. Subjects in the multidisciplinary program showed a clinically significant improvement in the perception of disability compared to the usual care group. This is an important finding since perception of disability is associated with long-term functional outcome.

Socio-demographic and behavioral correlates of herpes simplex virus type 1 and 2 infections and co-infections among adults in the USA.

OBJECTIVES: Although herpes simplex virus (HSV)-1 and HSV-2 may co-exist and interact, some epidemiologic features including geographical distribution, secular trends, route of transmission, and established risk factors may distinguish these HSV sub-types. With recent data indicating a link between genital herpes and either strain, a re-evaluation of risk factors for HSV-1/HSV-2 infection and co-infection is needed. METHODS: We used the 1999-2004 National Health and Nutrition Examination Study (NHANES) data and logistic regression modeling to identify socio-demographic and behavioral risk factors that can independently predict HSV-1/HSV-2 infection and co-infection. RESULTS: Approximately 48% were positive for HSV-1 alone, 7% were positive for HSV-2 alone and 12% were co-infected with HSV-1 and HSV-2. History of genital herpes was found in individuals infected with either or both HSV sub-types. Whereas age, sex, race, and level of education independently predicted all three outcomes, lifetime sexual activity as well as use of tobacco products and recreational drugs mainly correlated with HSV-2 infection and HSV-1/HSV-2 co-infection. Lifetime use of alcohol was not consistently associated with HSV-1/HSV-2 infection and co-infection. CONCLUSIONS: Sexual activity played an important role for HSV-2 and was potentially important for HSV-1, with implications for healthcare practice and vaccine development.

Gender and age disparities in the prevalence of Chlamydia infection among sexually active adults in the United States.

BACKGROUND: Chlamydia trachomatis (CT) causes a costly and potentially recurrent bacterial infection that accounts for a considerable proportion of sexually transmitted infections (STIs) in the United States. Disparities by gender and age group in CT prevalence have been reported previously. The current study evaluates demographic, socioeconomic, and behavioral risk and protective factors that may account for gender/age disparities in CT infections among sexually active young adults in the United States. METHODS: Secondary analyses were performing using the 1999-2006 National Health and Nutrition Examination Survey (NHANES) data. RESULTS: A total sample of 5611 adults, 20-39 years of age, who participated in the 1999-2006 NHANES, reported lifetime sexual experience, and had valid laboratory-based CT status, was analyzed. CT prevalence did not differ significantly by gender and was estimated to be 1.6%. It was slightly higher for people <25 years vs. those ≥25 years of age; age disparities were reduced after controlling for demographic, socioeconomic, and behavioral characteristics. Among those <25 years, non-Hispanic blacks had a higher odds of CT infection compared with other groups. Among those ≥25 years of age, not having had unprotected sex in the past month reduced the odds for CT infection, whereas non-Hispanic black race and never married status increased the odds for CT infection. CONCLUSIONS: Among sexually active adults, no gender disparities were observed in CT prevalence. Age group disparities were partly explained by personal characteristics associated with risk of STIs.