Publications by authors named "Regan L"

Context: A career in medicine is a journey of countless opportunities, challenges and choices. Determining the "right" decision for any given career choice ultimately must come from within; thus, a clear understanding of a physician's core professional identity is critical. Existing conceptualizations of professional identity within medicine focus primarily on medical training; however, it is clear that professional identity evolves throughout one's career.

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Introduction: Coronavirus 2019 (COVID-19) accelerated the need for virtual learning including telesimulation. Many emergency medicine (EM) programs halted in-person simulation and trialed telesimulation, but specifics on its utilization and plans for future use are unknown. Telesimulation has been defined as "a process by which telecommunication and simulation resources are utilized to provide education, training, and/or assessment to learners at an off-site location.

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Background: Pregnancy offers an opportunity to provide equitable access to contraception information and provision, and professional bodies advocate provision of contraception in the immediate postpartum period. This study examines the contribution of pre-registration midwifery education in preparing student midwives for this aspect of their role.

Method: A qualitative study using semi-structured interviews.

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Background And Aims: The Scottish Highlands face unique prehospital care challenges due to population dispersity, mountainous terrain, seasonal weather, and higher trauma burden compared to the nearest Major Trauma Centres (MTCs) as highlighted by the Scottish Trauma Audit Group (STAG). Primary road/air transfer from scene to nearest designated MTC averages 1-5 hours, making prompt and informed utilisation of prehospital and in-hospital resources within the Highlands critical - comparative to other UK metropolitan regions where the trauma population majority lay within 20-45 minute transfer windows. This paper reviews the Highland pre-hospital immediate care and trauma (PICT) Team's trauma response through a retrospective review of PICT patient report forms (PRFs).

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In protein design, the ultimate test of success is that the designs function as desired. Here, we discuss the utility of cell free protein synthesis (CFPS) as a rapid, convenient and versatile method to screen for activity. We champion the use of CFPS in screening potential designs.

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Background: To address health inequities, emergency physicians must understand the structural underpinnings of health disparities, including social determinants of health (SDoH), and must critically reflect on the integration of SDoH into clinical practice. SDoH education should include reflective knowledge acquisition, while incorporating systemic sociohistorical forces and individual factors, such as bias, which propagate inequities but are rarely emphasized in graduate medical education (GME). The health humanities (HH), an inclusive transdisciplinary field combining arts, humanities, and social justice, may represent a novel unexplored approach toward incorporating SDoH in GME.

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Objectives: The Master Adaptive Learner (MAL) model postulates that learners develop adaptive expertise through cycles of self-regulated learning. Despite a robust theoretical basis, the actual observable behaviors of MALs are not well characterized. We sought to define behaviors that characterize MALs within emergency medicine (EM) training.

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The UK is usually viewed as having liberal abortion regulations, providing good access to abortion care within a publicly funded health service. However, the underlying laws are authoritarian, dating from an era when public executions drew large crowds and 67 years before women were able to vote. Abortion is only legal when two doctors certify it meets the permitted grounds, and the penalty for self-managed abortion is up to life imprisonment for both the woman and any accomplice.

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Fluorescence microscopy enables specific visualization of proteins in living cells and has played an important role in our understanding of the protein subcellular location and function. Some proteins, however, show altered localization or function when labeled using direct fusions to fluorescent proteins, making them difficult to study in live cells. Additionally, the resolution of fluorescence microscopy is limited to ∼200 nm, which is 2 orders of magnitude larger than the size of most proteins.

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Objective: Dispersed population, mountainous topography, and extreme weather present logistical challenges for the emergency services providing care to the resident population and tourists visiting the Scottish Highlands. Debate over the value of air ambulances has left uncertainty over when they benefit patients and when their use may inadvertently prolong transfer times in rural settings. The primary objective of this study was to find a provisional threshold at which air ambulances are likely to improve time from injury to arrival at the emergency department for this rural patient cohort using motorcycle road traffic collisions as a single trauma etiology.

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Protein engineering allows for the programming of specific building blocks to form functional and novel materials with customisable physical properties suitable for tailored engineering applications. We have successfully designed and programmed engineered proteins to form covalent molecular networks with defined physical characteristics. Our hydrogel design incorporates the SpyTag (ST) peptide and SpyCatcher (SC) protein that spontaneously form covalent crosslinks upon mixing.

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Article Synopsis
  • Recurrent miscarriage is defined as having three or more first-trimester losses, but clinicians can investigate after two if they suspect underlying issues.
  • Women experiencing recurrent miscarriage should be tested for certain blood clotting disorders and offered assessments like 3D ultrasounds for uterine anomalies.
  • Routine testing for certain inherited conditions is not recommended, and lifestyle changes like maintaining a healthy BMI, quitting smoking, and limiting alcohol and caffeine intake are advised.
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We present and analyze video-microscopy-based single-particle-tracking measurements of the budding yeast (Saccharomyces cerevisiae) membrane protein, Pma1, fluorescently labeled either by direct fusion to the switchable fluorescent protein, mEos3.2, or by a novel, light-touch, labeling scheme, in which a 5 amino acid tag is directly fused to the C-terminus of Pma1, which then binds mEos3.2.

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Objectives: Health technology assessment (HTA) is an established mechanism for explicit priority setting to support universal health coverage. However, full HTA requires significant time, data, and capacity for each intervention, which limits the number of decisions it can inform. Another approach systematically adapts full HTA methods by leveraging HTA evidence from other settings.

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Biomaterials for tissue regeneration must mimic the biophysical properties of the native physiological environment. A protein engineering approach allows the generation of protein hydrogels with specific and customised biophysical properties designed to suit a particular physiological environment. Herein, repetitive engineered proteins were successfully designed to form covalent molecular networks with defined physical characteristics able to sustain cell phenotype.

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Objective: To develop core outcome sets (COS) for miscarriage management and prevention.

Design: Modified Delphi survey combined with a consensus development meeting.

Setting: International.

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Background: Routine expertise is the efficient use of mastered skills at a high level of competency in familiar situations.

Problem: Novel case variation and continuous scientific advances preclude reliance on routine expertise alone.

Solution: Medical training programs must prepare learners to solve unfamiliar problems by cultivating adaptive expertise.

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Residency and fellowship program directors profoundly impact trainees, institutions, and patient safety. Yet, there is concern for rapid attrition in the role. The average program director tenure is only 4-7 years, and that timeline is likely a result of burnout or opportunities for career advancement.

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Introduction: Despite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies.

Methods: We screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies.

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Article Synopsis
  • The period before and during pregnancy is key for tackling malnutrition, which can help prevent noncommunicable diseases in mothers and their infants.
  • The FIGO Nutrition Checklist is a tool that helps identify dietary needs, body mass index, diet quality, and micronutrient intake for better health outcomes.
  • This review aims to provide nutritional recommendations for healthcare providers implementing the checklist, sharing global dietary guidelines and insights for addressing nutritional deficiencies in women, benefiting both mothers and their children for generations.
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Gestational diabetes (GDM) impacts approximately 17 million pregnancies worldwide. Women with a history of GDM have an 8-10-fold higher risk of developing type 2 diabetes and a 2-fold higher risk of developing cardiovascular disease (CVD) compared with women without prior GDM. Although it is possible to prevent and/or delay progression of GDM to type 2 diabetes, this is not widely undertaken.

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Obesity is a chronic, progressive, relapsing, and treatable multifactorial, neurobehavioral disease. According to the World Health Organization, obesity affects 15% of women and has long-term effects on women's health. The focus of care in patients with obesity should be on optimizing health outcomes rather than on weight loss.

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