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Read GJM, McLean S, Thompson J, Stanton NA, Baber C, Carden T, Salmon PM. Managing the risks associated with technological disruption in the road transport system: a control structure modelling approach. Ergonomics 2024; 67:498-514. [PMID: 37381733 DOI: 10.1080/00140139.2023.2226850] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 06/11/2023] [Indexed: 06/30/2023]
Abstract
Road transport is experiencing disruptive change from new first-of-a-kind technologies. While such technologies offer safety and operational benefits, they also pose new risks. It is critical to proactively identify risks during the design, development and testing of new technologies. The Systems Theoretic Accident Model and Processes (STAMP) method analyses the dynamic structure in place to manage safety risks. This study applied STAMP to develop a control structure model for emerging technologies in the Australian road transport system and identified control gaps. The control structure shows the actors responsible for managing risks associated with first-of-a-kind technologies and the existing control and feedback mechanisms. Gaps identified related to controls (e.g. legislation) and feedback mechanisms (e.g. monitoring for behavioural adaptation). The study provides an example of how STAMP can be used to identify control structure gaps requiring attention to support the safe introduction of new technologies.
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Affiliation(s)
- G J M Read
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Maroochydore, Australia
- School of Health, University of the Sunshine Coast, Maroochydore, Australia
| | - S McLean
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Maroochydore, Australia
| | - J Thompson
- Transport, Health and Urban Design Research Hub, University of Melbourne, Melbourne, Australia
- University Department of Rural Health, School of Medicine, University of Melbourne, Melbourne, Australia
| | - N A Stanton
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Maroochydore, Australia
- Transportation Research Group, University of Southampton, Southampton, UK
| | - C Baber
- School of Computer Science, University of Birmingham, Birmingham, UK
| | - T Carden
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Maroochydore, Australia
| | - P M Salmon
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Maroochydore, Australia
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Chiel LE, Stevens EL, Bishay LC, Collins MS, Rama JA, Edgar L, McLean S, Haynes I, Muzumdar H, Weiss P, Boyer D, Giles BL. Pediatric Pulmonary Milestones 2.0: Development, Lessons Learned, and Future Directions. ATS Sch 2024; 5:19-31. [PMID: 38628297 PMCID: PMC11019770 DOI: 10.34197/ats-scholar.2023-0075ps] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/05/2023] [Indexed: 04/19/2024] Open
Abstract
Pediatric pulmonology fellowship training programs are required by the Accreditation Council for Graduate Medical Education to report Pediatric Subspecialty Milestones biannually to track fellow progress. However, several issues, such as lack of subspecialty-specific context and ambiguous language, have raised concerns about their validity and applicability to use for fellow assessment and curriculum development. In this Perspective, we briefly share the process of the Pediatric Pulmonology Milestones 2.0 Work Group in creating new specialty-specific Milestones and tailoring information on the Harmonized Milestones to pediatric pulmonologists, with the goal of improving the Milestones' utility for stakeholders, including pulmonology fellows, faculty, program directors, and accrediting bodies. In addition, we created a supplemental guide to better link the Milestones to pulmonary-specific scenarios to create a shared mental model between stakeholders and remove a potential detriment to validity. Through the process, a number of guiding principles were clarified, including: 1) every Milestone should be able to be assessed independently, without overlap with other Milestones; 2) there should be clear developmental progression from one Milestone to the next; 3) Milestones should be based on the unique skills expected of pediatric pulmonologists; and 4) health equity should be a core component to highlight as a top priority to all stakeholders. In this Perspective, we describe these principles that guided formulation of the Pediatric Pulmonary Milestones to help familiarize the pediatric pulmonary community with the new Milestones. In addition, we share lessons learned and challenges in our process to inform other specialties that may soon participate in this process.
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Affiliation(s)
- Laura E. Chiel
- Division of Pulmonary Medicine, Department
of Pediatrics, Boston Children’s Hospital, Harvard Medical School,
Boston, Massachusetts
| | - Erica L. Stevens
- Division of Pulmonology, Allergy, and
Immunology, Department of Pediatrics, Norton Children’s Hospital,
University of Louisville School of Medicine, Louisville, Kentucky
| | - Lara C. Bishay
- Division of Pulmonology and Sleep
Medicine, Department of Pediatrics, Children’s Hospital Los Angeles, Keck
School of Medicine of University of Southern California, Los Angeles,
California
| | - Melanie S. Collins
- Division of Pediatric Pulmonary Medicine,
Department of Pediatrics, Connecticut Children’s Hospital, University of
Connecticut School of Medicine, Harford, Connecticut
| | - Jennifer A. Rama
- Division of Pediatric Pulmonology,
Department of Pediatrics, Texas Children’s Hospital, Baylor College of
Medicine, Houston, Texas
| | - Laura Edgar
- Department of Research, Milestones
Development, and Evaluation, Accreditation Council for Graduate Medical
Education, Chicago, Illinois
| | - Sydney McLean
- Department of Research, Milestones
Development, and Evaluation, Accreditation Council for Graduate Medical
Education, Chicago, Illinois
| | - Ida Haynes
- Department of Research, Milestones
Development, and Evaluation, Accreditation Council for Graduate Medical
Education, Chicago, Illinois
| | - Hiren Muzumdar
- Division of Pulmonology, Department of
Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of
Pittsburgh, Pittsburgh, Pennsylvania
| | - Pnina Weiss
- Division of Pulmonary, Allergy,
Immunology, and Sleep Medicine, Department of Pediatrics, Yale Medicine, New
Haven, Connecticut
| | - Debra Boyer
- Division of Pulmonary and Sleep Medicine,
Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State
University College of Medicine, Columbus, Ohio; and
| | - B. Louise Giles
- Division of Pediatric Pulmonology,
Department of Pediatrics, Comer Children’s Hospital, University of
Chicago School of Medicine, Chicago, Illinois
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McLean S, King BJ, Thompson J, Carden T, Stanton NA, Baber C, Read GJM, Salmon PM. Forecasting emergent risks in advanced AI systems: an analysis of a future road transport management system. Ergonomics 2023; 66:1750-1767. [PMID: 38009364 DOI: 10.1080/00140139.2023.2286907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/19/2023] [Indexed: 11/28/2023]
Abstract
Artificial Intelligence (AI) is being increasingly implemented within road transport systems worldwide. Next generation of AI, Artificial General Intelligence (AGI) is imminent, and is anticipated to be more powerful than current AI. AGI systems will have a broad range of abilities and be able to perform multiple cognitive tasks akin to humans that will likely produce many expected benefits, but also potential risks. This study applied the EAST Broken Links approach to forecast the functioning of an AGI system tasked with managing a road transport system and identify potential risks. In total, 363 risks were identified that could have adverse impacts on the stated goals of safety, efficiency, environmental sustainability, and economic performance of the road system. Further, risks beyond the stated goals were identified; removal from human control, mismanaging public relations, and self-preservation. A diverse set of systemic controls will be required when designing, implementing, and operating future advanced technologies.Practitioner summary: This study demonstrated the utility of HFE methods for formally considering risks associated with the design, implementation, and operation of future technologies. This study has implications for AGI research, design, and development to ensure safe and ethical AGI implementation.
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Affiliation(s)
- S McLean
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Australia
| | - B J King
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Australia
| | - J Thompson
- Transport, Health and Urban Design (THUD) Research Lab, Melbourne School of Design, The University of Melbourne, Melbourne, Australia
| | - T Carden
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Australia
| | - N A Stanton
- Transportation Research Group, University of Southampton, Southampton, UK
| | - C Baber
- School of Computer Science, University of Birmingham, Birmingham, UK
| | - G J M Read
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Australia
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia
| | - P M Salmon
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Australia
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McLean S, Naughton M, Kerhervé H, Salmon PM. From Anti-doping-I to Anti-doping-II: Toward a paradigm shift for doping prevention in sport. International Journal of Drug Policy 2023; 115:104019. [PMID: 37028132 DOI: 10.1016/j.drugpo.2023.104019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/23/2023] [Accepted: 03/25/2023] [Indexed: 04/08/2023]
Abstract
Doping remains an intractable issue in sport and occurs in a complex and dynamic environment comprising interactions between individual, situational, and environmental factors. Anti-doping efforts have previously predominantly focused on athlete behaviours and sophisticated detection methods, however, doping issues remain. As such, there is merit in exploring an alternative approach. The aim of this study was to apply a systems thinking approach to model the current anti-doping system for four football codes in Australia, using the Systems Theoretic Accident Model and Processes (STAMP). The STAMP control structure was developed and validated by eighteen subject matter experts across a five-phase validation process. Within the developed model, education was identified as a prominent approach anti-doping authorities use to combat doping. Further, the model suggests that a majority of existing controls are reactive, and hence that there is potential to employ leading indicators to proactively prevent doping and that new incident reporting systems could be developed to capture such information. It is our contention that anti-doping research and practice should consider a shift away from the current reactive and reductionist approach of detection and enforcement to a proactive and systemic approach focused on leading indicators. This will provide anti-doping agencies a new lens to look at doping in sport.
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McReynolds CB, Haynes I, McLean S, Edgar L. Milestones Next Steps: Results of a Feedback Questionnaire. J Grad Med Educ 2023; 15:268-271. [PMID: 37139215 PMCID: PMC10150813 DOI: 10.4300/jgme-d-23-00113.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Affiliation(s)
- Clifton B. McReynolds
- Clifton B. McReynolds, PhD, is Milestones Program Evaluation and Research Associate, Accreditation Council for Graduate Medical Education (ACGME)
| | - Ida Haynes
- Ida Haynes, MSHC, is Milestones Project Specialist, ACGME
| | - Sydney McLean
- Sydney McLean, MHA, is Milestones Project Manager, ACGME
| | - Laura Edgar
- Laura Edgar, EdD, is Vice President, Milestones Development, ACGME
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Thomas HR, Braunstein SE, Golden DW, Du KL, Weiner AA, Bridges K, Vijayakumar S, McLean S, Edgar L, Fields EC. Milestones 2.0: Refining the Competency-Based Assessment of Radiation Oncology Medical Residents. Int J Radiat Oncol Biol Phys 2023; 115:12-18. [PMID: 36526379 DOI: 10.1016/j.ijrobp.2022.07.1838] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Horatio R Thomas
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Steve E Braunstein
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois
| | - Kevin L Du
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut
| | - Ashley A Weiner
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina
| | | | - Srinivasan Vijayakumar
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Sydney McLean
- Accreditation Council for Graduate Medical Education (ACGME), Chicago, Illinois
| | - Laura Edgar
- Accreditation Council for Graduate Medical Education (ACGME), Chicago, Illinois
| | - Emma C Fields
- Department of Radiation Oncology, Virginia Commonwealth University Health System, Massey Cancer Center, Richmond, Virginia.
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Liebowitz JE, Torralba KD, Kolfenbach J, Marston B, Dua AB, O'Rourke KS, McKown K, Battistone MJ, Valeriano-Marcet J, Edgar L, McLean S, Gouze KR, Bolster MB. Rheumatology Milestones 2.0: A Roadmap for Competency-Based Medical Training of Rheumatology Fellows in the 21st Century. Arthritis Care Res (Hoboken) 2022; 74:675-685. [PMID: 33181000 DOI: 10.1002/acr.24507] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/08/2020] [Accepted: 11/05/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Since 2014, rheumatology fellows have been assessed not only based on their ability to provide patient care and possession of medical knowledge but also on their skill in serving as patient advocates, navigators of health systems, and members of a health care team. Such assessments have been carried out through the use of competency-based milestones from the Accreditation Council of Graduate Medical Education (ACGME). However, a needs assessment has demonstrated interest in more context validity and subspecialty relevance since the development of the ACGME internal medicine (IM) subspecialty reporting milestones. The ACGME thus created a milestones working group, and the present study was undertaken to develop Rheumatology Milestones 2.0 as well as a supplemental guide to assist with implementation. METHODS The working group, consisting of 7 rheumatology program directors, 2 division directors, a community practice rheumatologist, a rheumatology fellow in training, and a public member who is a rheumatology patient, was overseen by the ACGME vice president for milestones development and met through three 12-hour, in-person meetings to compose the rheumatology specialty milestones and supplemental guide within the ACGME Milestones 2.0 project. RESULTS Informed by the needs assessment data and stakeholders, the working group revised and adapted the ACGME IM subspecialty reporting milestones to create a rheumatology-specific set of milestones and a supplemental guide for their implementation. CONCLUSION The Rheumatology Milestones 2.0 provides a specialty-specific, competency-based evaluation tool that can be used by program directors, clinical competency committees, and others to assess the competencies of rheumatology fellows during training and help measure readiness for independent practice.
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Affiliation(s)
| | | | | | | | - Anisha B Dua
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Kevin McKown
- University of Wisconsin School of Medicine and Public Health, Madison
| | - Michael J Battistone
- University of Utah Health Sciences Center and George E. Whalen Veterans Affairs Health Sciences Center, Salt Lake City
| | | | - Laura Edgar
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Sydney McLean
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Karen R Gouze
- Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Marcy B Bolster
- Harvard Medical School and Massachusetts General Hospital, Boston
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8
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Laucirica D, Schofield C, McLean S, Margaroli C, Agudelo-Romero P, Stick S, Tirouvanziam R, Kicic A, Garratt L. 348: Pseudomonas aeruginosa infection modulates primary granule exocytosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01772-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Huglin J, Whelan L, McLean S, Greer K, Mitchell D, Downie S, Farlie MK. Exploring utilisation of the allied health assistant workforce in the Victorian health, aged care and disability sectors. BMC Health Serv Res 2021; 21:1144. [PMID: 34686210 PMCID: PMC8540135 DOI: 10.1186/s12913-021-07171-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/08/2021] [Indexed: 11/28/2022] Open
Abstract
Background Allied health assistants (AHAs) support allied health professionals (AHPs) to meet workforce demands in modern healthcare systems. Previous studies have indicated that AHAs may be underutilised in some contexts. This study aims to identify factors contributing to the effective utilisation of AHAs across health, aged care and disability sectors and possible pathway elements that may optimise AHA careers in Victoria. Methods Using an interpretive description approach data collection included a workforce survey and semi structured interviews (individual and group). Data analysis included descriptive statistics, independent t-tests and thematic analysis. Participants included allied health assistants, allied health professionals and allied health leaders in the health, aged care or disability sectors; educators, managers or student of allied health assistance training; and consumers of Victorian health, disability or aged care services. Results The literature scan identified numerous potential barriers to and enablers of AHA workforce utilisation. A total of 727 participants completed the survey consisting of AHAs (n = 284), AHPs & allied health leaders (n = 443). Thirteen group and 25 individual interviews were conducted with a total of 119 participants. Thematic analysis of the interview data identified four interrelated factors (system, training, individual and workplace) in pre-employment training and workplace environments. These factors were reported to contribute to effective utilisation of the AHA workforce across health, aged care and disability sectors. Study findings were also used to create a conceptual diagram of potential AHA career pathway elements. Conclusion This study identified pre-employment and workplace factors which may contribute to the optimal utilisation of the AHA workforce across Victorian health, aged care and disability sectors. Further study is needed to investigate the transferability of these findings to national and global contexts, and testing of the conceptual model. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07171-z.
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Affiliation(s)
- J Huglin
- Allied Health Workforce Innovation, Strategy, Education & Research (WISER) Unit, Monash Health, 400 Warrigal Road, Cheltenham, VIC, 3192, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, VIC, 3168, Australia
| | - L Whelan
- Allied Health Workforce Innovation, Strategy, Education & Research (WISER) Unit, Monash Health, 400 Warrigal Road, Cheltenham, VIC, 3192, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, VIC, 3168, Australia
| | - S McLean
- Allied Health Workforce Innovation, Strategy, Education & Research (WISER) Unit, Monash Health, 400 Warrigal Road, Cheltenham, VIC, 3192, Australia
| | - K Greer
- Allied Health Workforce Innovation, Strategy, Education & Research (WISER) Unit, Monash Health, 400 Warrigal Road, Cheltenham, VIC, 3192, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, VIC, 3168, Australia
| | - D Mitchell
- Allied Health Workforce Innovation, Strategy, Education & Research (WISER) Unit, Monash Health, 400 Warrigal Road, Cheltenham, VIC, 3192, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, VIC, 3168, Australia
| | - S Downie
- Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, VIC, 3168, Australia.,Department of Health, Victoria State Government, Lonsdale Street, Melbourne, VIC, 3000, Australia
| | - M K Farlie
- Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, VIC, 3168, Australia.
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McLean S, Yoshida EM, Sirpal S, Chandok N. A national paucity of hepatologists: An unprecedented opportunity for interdisciplinary collaboration. Can Liver J 2021; 4:343-345. [PMID: 35989888 PMCID: PMC9235121 DOI: 10.3138/canlivj-2021-0921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 12/01/2023]
Affiliation(s)
- Sydney McLean
- Division of Gastroenterology, Department of Medicine, William Osler Health System, Brampton, Ontario, Canada
| | - Eric M Yoshida
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sanjeev Sirpal
- Department of Emergency Medicine, University of Montréal, Montréal, Québec, Canada
| | - Natasha Chandok
- Division of Gastroenterology, Department of Medicine, William Osler Health System, Brampton, Ontario, Canada
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DeLomba W, Bernstein M, Basso K, Suárez E, McLean S, Beaudoin F. 231 The Tolerability and Effectiveness of Duloxetine for the Prevention of Persistent Musculoskeletal Pain After Trauma and Injury: A Pilot Three-Group Randomized Controlled Trial. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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AURORA Study Group, Beaudoin F, An X, Li Q, House S, Musey P, Hendry P, Jones C, Lewandowski C, Storrow A, McLean S. 207 Associations Between Alcohol Use and Adverse Posttraumatic Neuropsychiatric Sequelae in the Early Aftermath of Trauma. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Nayar R, Anderson S, Dyhdalo KS, Edgar L, Hatlak K, Henderson-Jackson E, McLean S, Rosenbaum MW, Rosenblum F, Naritoku WY. ACGME Milestones 2.0: why and what's new for cytopathology? J Am Soc Cytopathol 2021; 10:485-494. [PMID: 34167909 DOI: 10.1016/j.jasc.2021.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Primary stakeholders in the Accreditation Council for Graduate Medical Education (ACGME) Milestones Project are: ACGME, Residency Programs, Residents, Fellowship Programs, Fellows, and Certification Boards. The intent of the Milestones is to describe the educational and professional developmental trajectory of a trainee from the first stages of their postgraduate education through the completion of their clinical training. The Milestones 2.0 project includes changes made based on experience with Milestones 1.0. METHODS The ACGME solicited volunteers to participate in the development of subspecialty Milestones 2.0. The workgroup was charged with reviewing/making any additions to the four "Harmonized Milestones", developing subspecialty specific milestones for the Patient Care and Medical Knowledge competencies, and creating a supplemental guide. The Milestones were finalized following review of input from an open comment period. RESULTS The Cytopathology Milestones 2.0 will go into effect July 2021. They include additional subcompetencies in the 4 harmonized competency areas and cytopathology-specific edits to the patient care and medical knowledge subcompetencies. Although the number of subcompetencies has increased from 18 to 21, within each subcompetency, the number of milestone trajectories has decreased. Additionally, within each subcompetency, the wording has been streamlined. A supplemental guide was created and Milestones 1.0 were compared to 2.0; however, curriculum mapping has been left to programs to develop. CONCLUSIONS The ultimate goal of the Cytopathology Milestones 2.0 is to provide better real-time documentation of the progress of cytopathology fellows. The expected outcome is to produce highly competent cytopathologists, improving the care they provide, regardless of the program at which they trained.
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Affiliation(s)
- Ritu Nayar
- Department of Pathology, Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital, Chicago, Illinois
| | - Scott Anderson
- Department of Pathology, University of Vermont Medical Center, Vermont
| | - Kathryn S Dyhdalo
- Department of Pathology, Cleveland Clinic Lerner College of Medicine, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Laura Edgar
- ACGME Vice President for Milestones Development, Chicago, Illinois
| | - Kate Hatlak
- ACGME Executive Director, Pathology Review Committee, Chicago, Illinois
| | - Evita Henderson-Jackson
- Department of Pathology, University of South Florida Morsani College of Medicine, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | | | - Matthew W Rosenbaum
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Frida Rosenblum
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Wesley Y Naritoku
- Department of Clinical Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California
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14
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Affiliation(s)
- Sydney McLean
- Sydney McLean, MHA, is Milestones Project Manager, Accreditation Council for Graduate Medical Education (ACGME)
| | - Laura Edgar
- Laura Edgar, EdD, CAE, is Vice President, Milestones Development, ACGME
| | - Braden Harsy
- Braden Harsy, MA, is Milestones Project Administrator, ACGME
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16
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Clark JL, Perez-Brumer AG, Reisner SL, Salazar X, McLean S, Huerta L, Silva-Santisteban A, Moriarty KM, Mimiaga MJ, Sanchez J, Mayer KH, Lama JR. Social Network Organization, Structure, and Patterns of Influence Within a Community of Transgender Women in Lima, Peru: Implications for Biomedical HIV Prevention. AIDS Behav 2020; 24:233-245. [PMID: 30989553 PMCID: PMC6801001 DOI: 10.1007/s10461-019-02506-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Understanding social network structures can contribute to the introduction of new HIV prevention strategies with socially marginalized populations like transgender women (TW). We conducted 20 semi-structured interviews and four focus groups (n = 32) with TW from selected social networks in Lima, Peru between May and July, 2015. Participants described layers of social influence from diverse actors in their social networks. The majority identified a close relative as their primary social support, with whom they confided secrets but avoided issues of transgender identity, sexuality, and sex work. Participants described close circles of TW friends with whom they shared information about gender identity, body modification, and sexual partners, but avoided issues like HIV. Community leadership included political leaders (who advocated for transgender rights) as well as social leaders (who introduced TW to hormone therapy, body modification, and commercial sex). Detailed analysis of TW social networks can contribute to implementation and acceptability of new HIV prevention technologies.
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Affiliation(s)
- J L Clark
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Leconte Avenue, CHS 37-121, Los Angeles, CA, 90095, USA.
| | - A G Perez-Brumer
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - S L Reisner
- Department of Pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - X Salazar
- Instituto de Estudios de Sexualidad y Derechos Humanos, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - S McLean
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - L Huerta
- Asociacion Civil Impacta Salud y Educacion, Lima, Peru
| | - A Silva-Santisteban
- Instituto de Estudios de Sexualidad y Derechos Humanos, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - K M Moriarty
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Leconte Avenue, CHS 37-121, Los Angeles, CA, 90095, USA
- Brown University Alpert School of Medicine, Providence, RI, USA
| | - M J Mimiaga
- Center for Health Equity Research, Brown University, Providence, RI, USA
- Departments of Behavioral and Social Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Brown University Alpert School of Medicine, Providence, RI, USA
| | - J Sanchez
- Asociacion Civil Impacta Salud y Educacion, Lima, Peru
- CITBM, Universidad Nacional Mayor San Marcos, Lima, Peru
- Department of Global Health, University of Washington School of Medicine, Seattle, WA, USA
| | - K H Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - J R Lama
- Asociacion Civil Impacta Salud y Educacion, Lima, Peru
- Department of Global Health, University of Washington School of Medicine, Seattle, WA, USA
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Herres J, Beaudoin F, Chang B, Datner E, Rabinowitz A, McGrath M, Peacock F, House S, Musey P, Hendry P, McLean S. 373 Determining Patterns of Postconcussive Symptoms in Adults Presenting to the Emergency Department After Motor Vehicle Collision Across Age Groups. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Blount J, Pan Y, Mauck M, Datner E, Kurz M, Hendry P, Lewandowski C, Pearson C, McLean S, Linnstaedt S. (208) 17b-Estradiol as a Predictor and Potential Mediator of Chronic Musculoskeletal Pain Development in Women following Trauma Exposure. The Journal of Pain 2019. [DOI: 10.1016/j.jpain.2019.01.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Alreni A, McLean S, Harrop D, Kilner K. Measuring upper limb disability in patients with neck pain: evaluation of the reliability of the single arm military press test. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Proudfoot JM, Murrey MW, McLean S, Greenland EL, Barden AE, Croft KD, Galano JM, Durand T, Mori TA, Pixley FJ. F 2-isoprostanes affect macrophage migration and CSF-1 signalling. Free Radic Biol Med 2018; 126:142-152. [PMID: 30096434 DOI: 10.1016/j.freeradbiomed.2018.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 12/29/2022]
Abstract
F2-isoprostanes (F2-IsoP) are formed in vivo via free radical peroxidation of arachidonic acid. Enhanced oxidative stress is implicated in the development of atherosclerosis in humans and F2-IsoP have been detected in atherosclerotic plaque. Colony stimulating factor-1 (CSF-1) is essential to macrophage survival, proliferation and differentiation and has been detected in human atherosclerotic plaques. Accumulation of macrophages within the vascular wall is an important component of atherosclerosis but little is known about the effect of F2-IsoP on the migration of these cells. Our aim was to examine the effect of free and lipid-bound 15-F2t-isoprostane (15-F2t-IsoP) on macrophage migration and investigate the signalling pathways involved. Mouse macrophages (cell line BAC1.2F5) were pre-incubated with 15-F2t-IsoP (free, bound to cholesterol or monoacylglycerol or within oxidized phospholipid) and cell migration was assessed using chemotaxis towards CSF-1 in Boyden chambers. Migration was also measured using the wound healing assay with primary mouse bone marrow derived macrophages. We showed that 15-F2t-IsoP dose-dependently inhibited BAC1.2F5 macrophage spreading and adhesion but stimulated their migration towards CSF-1, with maximum effect at 10 µM. Analysis of CSF-1 stimulated signalling pathways in BAC1.2F5 macrophages showed that phosphorylation of Akt, a key mediator of cell migration, and one of its regulators, the mTORC2 component, Rictor, was significantly decreased. In contrast, phosphorylation of the adhesion kinases, FAK and Pyk2, and the adhesion scaffold protein, paxillin, was enhanced after treatment with 15-F2t-IsoP. Mouse bone marrow macrophages were transfected with FAK or Pyk2 small interfering RNA (siRNA) to examine the role of FAK and Pyk2 in 15-F2t-IsoP signalling. Pyk2 silencing inhibited 15-F2t-IsoP-induced reduction in cell area and phospho-paxillin adhesion numbers. The size distribution of adhesions in the presence of 15-F2t-IsoP was also affected by Pyk2 silencing and there was a trend for Pyk2 silencing to reduce 15-F2t-IsoP-stimulated macrophage migration. These results demonstrate that 15-F2t-IsoP affects macrophage adhesions and migration, which are integral components of macrophage involvement in atherosclerosis.
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Affiliation(s)
- J M Proudfoot
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Medical Research Foundation, GPO Box X2213, Perth, Western Australia 6847, Australia.
| | - M W Murrey
- School of Biomedical Sciences, University of Western Australia, The Queen Elizabeth II Medical Centre, Nedlands, Western Australia 6009, Australia.
| | - S McLean
- School of Biomedical Sciences, University of Western Australia, The Queen Elizabeth II Medical Centre, Nedlands, Western Australia 6009, Australia.
| | - E L Greenland
- School of Biomedical Sciences, University of Western Australia, The Queen Elizabeth II Medical Centre, Nedlands, Western Australia 6009, Australia.
| | - A E Barden
- Medical School, University of Western Australia, Royal Perth Hospital Medical Research Foundation, GPO Box X2213, Perth, Western Australia 6847, Australia.
| | - K D Croft
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Medical Research Foundation, GPO Box X2213, Perth, Western Australia 6847, Australia.
| | - J-M Galano
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, University Montpellier, ENSCM, Faculté de Pharmacie, 15 Av. Ch. Flahault, BP 14491, F-34093 Montpellier Cedex 05, France.
| | - T Durand
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, University Montpellier, ENSCM, Faculté de Pharmacie, 15 Av. Ch. Flahault, BP 14491, F-34093 Montpellier Cedex 05, France.
| | - T A Mori
- Medical School, University of Western Australia, Royal Perth Hospital Medical Research Foundation, GPO Box X2213, Perth, Western Australia 6847, Australia.
| | - F J Pixley
- School of Biomedical Sciences, University of Western Australia, The Queen Elizabeth II Medical Centre, Nedlands, Western Australia 6009, Australia.
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Daines L, McLean S, Buelo A, Lewis S, Sheikh A, Pinnock H. Clinical prediction models to support the diagnosis of asthma in primary care: a systematic review protocol. NPJ Prim Care Respir Med 2018; 28:15. [PMID: 29777106 PMCID: PMC5959853 DOI: 10.1038/s41533-018-0086-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/26/2018] [Accepted: 04/26/2018] [Indexed: 02/01/2023] Open
Abstract
Substantial over-diagnosis and under-diagnosis of asthma in adults and children has recently been reported. As asthma is mostly diagnosed in non-specialist settings, a clinical prediction model (CPM) to aid the diagnosis of asthma in primary care may help improve diagnostic accuracy. We aim to systematically identify, describe, compare, and synthesise existing CPMs designed to support the diagnosis of asthma in children and adults presenting with symptoms suggestive of the disease, in primary care settings or equivalent populations. We will systematically search Medline, Embase and CINAHL from 1 January 1990 to present. Any CPM derived for use in a primary care population will be included. Equivalent populations in countries without a developed primary care service will also be included. The probability of asthma diagnosis will be the primary outcome. We will include CPMs designed for use in clinical practice to aid the diagnostic decision making of a healthcare professional during the assessment of an individual with symptoms suggestive of asthma. We will include derivation studies, and external model validation studies. Two reviewers will independently screen titles/abstracts and full texts for eligibility and extract data from included papers. The CHARMS checklist (or PROBAST if available) will be used to assess risk of bias within each study. Results will be summarised by narrative synthesis with meta-analyses completed if possible. This systematic review will provide comprehensive information about existing CPMs for the diagnosis of asthma in primary care and will inform the development of a future diagnostic model.
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Affiliation(s)
- L Daines
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Scotland.
| | - S McLean
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Scotland
| | - A Buelo
- Scottish Collaboration for Public Health Research and Policy, The University of Edinburgh, Edinburgh, Scotland
| | - S Lewis
- Edinburgh Clinical Trials Unit, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Scotland
| | - A Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Scotland
| | - H Pinnock
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Scotland
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Keen C, McLean S, Fowler-Davis S. The snowball effect: developing research capacity from small funding grants. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Alreni A, McLean S, Harrop D, Kilner K. Outcome measures utilisation in managing non-specific neck pain: a national survey of current physiotherapy practice in the UK. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Khoury S, Parisien M, Wang QP, Neely G, Bortsov A, McLean S, Sofer T, Louie T, Kaunisto M, Kalso E, Belfer I, Slade G, Smith S, Fillingim R, Ohrbach R, Greenspan J, Maixner W, Diatchenko L. Genome wide association study of sleep quality identifies a new association with loci near MPP6. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fox A, Bonacci J, McLean S, Saunders N. Exploring individual adaptations to an anterior cruciate ligament injury prevention program. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.01.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Jones L, Borstov A, Fillingim R, Peak D, Kurz M, Hendry P, Rathlev N, Swor R, Domeier R, Damiron K, Pearson C, Kaushik S, Feldman J, McLean S. (100) African Americans experience a greater burden of acute pain after motor vehicle collision than European Americans. The Journal of Pain 2016. [DOI: 10.1016/j.jpain.2016.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fox A, Davidson S, McGinnis R, Cain S, Saunders N, McLean S. Exploring the use of wireless inertial measurement units for biomechanical analysis of side-step cutting manoeuvres. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Enock L, Saad M, McLean S. Is telephone triage an effective and feasible form of treatment within physiotherapy outpatient settings? A systematic review. International Journal of Therapy and Rehabilitation 2014. [DOI: 10.12968/ijtr.2014.21.sup7.s2b] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Bortsov A, Miller W, Soward A, Swor R, Peak D, Jones J, Rathlev N, Lee D, Domeier R, Hendry P, McLean S. (145) Derivation of an emergency department-based clinical prediction tool to identify individuals at increased risk of chronic musculoskeletal pain development after motor vehicle collision. The Journal of Pain 2014. [DOI: 10.1016/j.jpain.2014.01.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McLean S, Foley WJ, Davies NW, Brandon S, Duo L, Blackman AJ. Metabolic fate of dietary terpenes fromEucalyptus radiata in common ringtail possum (Pseudocheirus peregrinus). J Chem Ecol 2013; 19:1625-43. [PMID: 24249230 DOI: 10.1007/bf00982297] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/1992] [Accepted: 03/16/1993] [Indexed: 10/25/2022]
Abstract
Arboreal marsupials consume terpenes in quantities that are toxic to other mammals, indicating that they possess special detoxification mechanisms. The metabolic fate of dietary terpenes was studied in the common ringtail possum (Pseudocheirus peregrinus). Three animals were fedEucalyptus radiata leaf for 10 days. Leaf consumption increased over three days to an average steady state of about 10-15 mmol total terpenes per day. GCMS analysis identified six urinary terpene metabolites, which were dicarboxylic acids, hydroxyacids, or lactones. Another nine metabolites could only be shown to be terpene-derived but of unknown structure. The amounts excreted were estimated by GC-FID, using response factors based on carbon content. Total 24-hr excretion of terpene-derived metabolites increased to 6.2-7.6 mmol on days 5-10, while glucuronic acid excretion remained constant at about 1.5 mmol. No other conjugates of terpene metabolites were found. The strategy used by the possum to detoxify dietary terpenes seems to be to polyoxygenate the molecules forming highly polar, acidic metabolites that can be readily excreted. Conjugation is minimal, perhaps to conserve carbohydrate and amino acids.
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Affiliation(s)
- S McLean
- School of Pharmacy, University of Tasmania, PO Box 252 C, Hobart, Tasmania, Australia
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Potts A, Sinka K, Love J, Gordon R, McLean S, Malcolm W, Ross D, Donaghy M. High uptake of HPV immunisation in Scotland--perspectives on maximising uptake. ACTA ACUST UNITED AC 2013; 18. [PMID: 24094062 DOI: 10.2807/1560-7917.es2013.18.39.20593] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In September 2008, Scotland introduced a national human papillomavirus (HPV) immunisation programme with bivalent HPV vaccine, to prevent cervical cancer. This school-based programme routinely vaccinates girls aged between 12 and 13 years. A catch-up campaign, running over three years, also began at this time, offering vaccination to all girls aged 13 years to under 18 years old. The HPV immunisation campaign presented challenges due to this vaccine being targeted to girls in school and older girls who had left school. Following a long and comprehensive planning process, this campaign was successfully implemented across Scotland, delivering high vaccine uptake of 91.4% for three doses of vaccine in the first year (September 2008 to August 2009) for the routine cohort and 90.1% in the second year (September 2009 to August 2010) for the routine cohort. We describe the planning process, challenges and implementation strategies employed to achieve this high uptake.
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Affiliation(s)
- A Potts
- Health Protection Scotland (HPS), NHS National Services Scotland, Glasgow, United Kingdom
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McLean S, Hoffman JE. Attention restores awareness of changing colors in moving objects. J Vis 2013. [DOI: 10.1167/13.9.1281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
To examine the extent to which hotel patrons drink in excess of current health recommendations, and to identify risk factors for excessive drinking, hotel patrons were invited to participate in a survey of social drinking, which included a free breath test. Patrons were approached at 15 min. intervals, and 1000 subjects were studied. Amongst this group of hotel patrons interviewed, 1 in 2 had consumed alcohol in excess of the daily limit recommended by the National Health & Medical Research Council. One in 10 intending drivers had a BAC over the legal limit. Excessive drinking and drink driving appear to be prevalent amongst hotel patrons, and hotels should be targets for interventions designed to reduce these problems. For example, the National Guidelines for the Responsible Serving of Alcohol should be more widely practised.
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Affiliation(s)
- S McLean
- School of Pharmacy, University of Tasmania, PO Box 252C, Hobart Tasmania, 7001, Australia
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McLean S, Wells S, Postell E, Doran M, Hoffman J. Do the two cerebral hemispheres act as independent tracking mechanisms? J Vis 2012. [DOI: 10.1167/12.9.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Grimwood S, Lu Y, Schmidt AW, Vanase-Frawley MA, Sawant-Basak A, Miller E, McLean S, Freeman J, Wong S, McLaughlin JP, Verhoest PR. Pharmacological characterization of 2-methyl-N-((2'-(pyrrolidin-1-ylsulfonyl)biphenyl-4-yl)methyl)propan-1-amine (PF-04455242), a high-affinity antagonist selective for κ-opioid receptors. J Pharmacol Exp Ther 2011; 339:555-66. [PMID: 21821697 DOI: 10.1124/jpet.111.185108] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
2-Methyl-N-((2'-(pyrrolidin-1-ylsulfonyl)biphenyl-4-yl)methyl)propan-1-amine (PF-04455242) is a novel κ-opioid receptor (KOR) antagonist with high affinity for human (3 nM), rat (21 nM), and mouse (22 nM) KOR, a ∼ 20-fold reduced affinity for human μ-opioid receptors (MORs; K(i) = 64 nM), and negligible affinity for δ-opioid receptors (K(i) > 4 μM). PF-04455242 also showed selectivity for KORs in vivo. In rats, PF-04455242 blocked KOR and MOR agonist-induced analgesia with ID(50) values of 1.5 and 9.8 mg/kg, respectively, and inhibited ex vivo [(3)H](2-(benzofuran-4-yl)-N-methyl-N-((5S,7R,8R)-7-(pyrrolidin-1-yl)-1-oxaspiro[4.5]decan-8-yl)acetamide ([(3)H]CI977) and [(3)H](2S)-2-[[2-[[(2R)-2-[[(2S)-2-amino-3-(4-hydroxyphenyl) propanoyl]amino]propanoyl]amino]acetyl]-methylamino]-N-(2-hydroxyethyl)-3-phenylpropanamide ([(3)H]DAMGO) binding to KOR and MOR receptors with ID(50) values of 2.0 and 8.6 mg/kg, respectively. An in vivo binding assay was developed using (-)-4-[(3)H]methoxycarbonyl-2-[(1-pyrrolidinylmethyl]-1-[(3,4-dichlorophenyl)acetyl]-piperidine ([(3)H]PF-04767135), a tritiated version of the KOR positron emission tomography ligand (-)-4-[(11)C]methoxycarbonyl-2-[(1-pyrrolidinylmethyl]-1-[(3,4-dichlorophenyl)acetyl]-piperidine ([(11)C]GR103545) in which PF-04455242 had an ID(50) of 5.2 mg/kg. PF-04455242 demonstrated antidepressant-like efficacy (mouse forced-swim test), attenuated the behavioral effects of stress (mouse social defeat stress assay), and showed therapeutic potential in treating reinstatement of extinguished cocaine-seeking behavior (mouse conditioned place preference). KOR agonist-induced plasma prolactin was investigated as a translatable mechanism biomarker. Spiradoline (0.32 mg/kg) significantly increased rat plasma prolactin levels from 1.9 ± 0.4 to 41.9 ± 4.9 ng/ml. PF-04455242 dose-dependently reduced the elevation of spiradoline-induced plasma prolactin with an ID(50) of 2.3 ± 0.1 mg/kg, which aligned well with the ED(50) values obtained from the rat in vivo binding and efficacy assays. These data provide further evidence that KOR antagonists have potential for the treatment of depression and addiction disorders.
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Affiliation(s)
- S Grimwood
- Neuroscience Research Unit, Pfizer Inc., Groton, CT 06340, USA.
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Tubaro M, Danchin N, Goldstein P, Filippatos G, Hasin Y, Heras M, Jansky P, Norekval TM, Swahn E, Thygesen K, Vrints C, Zahger D, Arntz HR, Bellou A, de La Coussaye JE, de Luca L, Huber K, Lambert Y, Lettino M, Lindahl B, McLean S, Nibbe L, Peacock WF, Price S, Quinn T, Spaulding C, Tatu-Chitoiu G, van de Werf F. Pre-hospital treatment of STEMI patients. A scientific statement of the Working Group Acute Cardiac Care of the European Society of Cardiology. ACTA ACUST UNITED AC 2011; 13:56-67. [DOI: 10.3109/17482941.2011.581292] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Platts-Mills T, Brown L, Bortsov A, Edwards L, McLean S. Oligoanalgesia in older adults presenting to US emergency departments after motor vehicle collision. The Journal of Pain 2011. [DOI: 10.1016/j.jpain.2011.02.100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fox KAA, Mclean S. . Heart 2010; 96:1860-1860. [DOI: 10.1136/hrt.2010.207738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Fox KAA, Mclean S. . Heart 2010; 96:1859-1859. [DOI: 10.1136/hrt.2010.207159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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McLean S, Wild S, Connor P, Flapan AD. Treating ST elevation myocardial infarction by primary percutaneous coronary intervention, in-hospital thrombolysis and prehospital thrombolysis. An observational study of timelines and outcomes in 625 patients. Emerg Med J 2010; 28:230-6. [PMID: 20595712 DOI: 10.1136/emj.2009.086066] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To describe the effects of implementing of a percutaneous coronary intervention (PPCI) service and compare the distribution of reperfusion therapies 12 months pre and post introduction of PPCI. DESIGN Observational study with data collected 12 months pre and post-availability of Primary PCI as routine treatment. SETTING Lothian region in South-East Scotland. Patients 625 Patients who received reperfusion treatment between December 2005 and November 2007. RESULTS PHT was given to 96/328 patients (29%) prior to availability of PPCI as routine treatment. Following routine availability, PPCI was delivered to 248/297 patients who received reperfusion treatment (84%). Median diagnosis-to-PCI balloon inflation time and hospital door-to-balloon time were 84 and 54 min, respectively. Patients received PPCI balloon inflation within 90 min of diagnosis in 60% of cases. PPCI-related delay was 74 min compared with prehospital thrombolysis (PHT). PHT (152 min) and PPCI (166 min) had shorter symptom onset-to-assessment of reperfusion times than in-hospital thrombolysis (IHT) (226 min). CONCLUSIONS More than two-thirds of the total-ischaemic-time in (ST-segment elevation myocardial infarction) STEMI occurs before the patient reaches hospital, with less than one-third being accounted for by door-to-needle (IHT) or door-to-balloon (PPCI) time. The magnitude of difference in the time between symptom onset-and-assessment of reperfusion treatment efficacy is short and should be considered, particularly in patients treated with thrombolysis in hospitals without cath-lab facilities. Optimal reperfusion treatment including a combination of PHT, IHT and PPCI, as recommended in international guidelines, is feasible in the UK although the balance between the use of different treatments will differ between urban and rural areas.
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Affiliation(s)
- S McLean
- The Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK.
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Kim A, McLean S, Swearingen A. Two-Stage Basilic Vein Transposition—A New Approach for Pediatric Dialysis Access. J Vasc Surg 2010. [DOI: 10.1016/j.jvs.2010.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Maciocia PM, Cruden N, McLean S, Flapan AD, Newby DE. 044 Effect of smoking status on angiographic outcomes and 12 month mortality following primary percutaneous coronary intervention for acute myocardial infarction:. Heart 2010. [DOI: 10.1136/hrt.2010.195958.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Davis S, McLean S. Smoking habits and beliefs, and attitudes to cigarette advertisements, amongst grade 6 children. Community Health Stud 2010; 11:35s-40s. [PMID: 3581785 DOI: 10.1111/j.1753-6405.1987.tb00511.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abstract
This study reports on an intervention programme to promote responsible drinking in hotels. The licensees of eight hotels agreed to participate in a trial of measures designed to assist patrons to avoid drink-driving, and seven other hotels were used as controls. The interventions acceptable to licensees comprised commercial-quality promotional material with the theme "0.05 Know Your Limits", and a breath analysis machine and poster on its use. Patrons leaving the hotels on Thursday, Friday and Saturday nights were interviewed and breath-tested. Although the intervention material had been seen by one-third of patrons in the intervention hotels, there was no significant difference between them and control hotel patrons in either median BAC or the proportion who were going to drive with BAC over the legal limit. There was poor compliance by hotels with the intervention procedures, indicating that a major impediment to the implementation and evaluation of programmes to promote responsible drinking is a lack of motivation by many licensees, despite support by some licensees and the Australian Hotels Association.
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Affiliation(s)
- S McLean
- School of Pharmacy, University of Tasmania, PO Box 252C, Hobart, 7001, Australia
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Abstract
Drink drivers arrested in Tasmania are routinely asked by police where they had last been drinking, and these data were examined for 716 drivers arrested in Southern Tasmania during a 4-month period in 1992. Nearly half (43%) of arrested drink drivers cited individual hotels as the place where they had last been drinking. This enabled a citation score to be assigned to each of the 82 hotels in metropolitan Hobart. The distribution of citation scores was highly skewed, with eight hotels accounting for 45% of hotel citations, and two accounting for 20%. The hotels' citation scores were compared in relation to the rank order of their licence fees, since better measures of patronage proved unobtainable. Some hotels with small total alcohol sales did appear to have an unexpectedly large number of citations, suggesting less than responsible serving practices. Hoteliers' comments were sought on the interpretation of citation scores, and incorporated into a discussion of the limitations of the data in determining the extent of individual hotel responsibility for drink drivers. Important questions remaining include (1) what is the validity of citations made by drink drivers at the time of arrest; (2) what appropriate and quantifiable denominator can be used to adjust the number of citations to the level of patronage; and (3) what level of citations is too high and requires action?
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Affiliation(s)
- L J Wood
- Department of Geography and Environmental Studies, University of Tasmania, Hobart, Australia
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