Dr Grant Research Articles

ECR Spotlight – Sulayman Lyons

ECR Spotlight is a series of interviews with early-career authors from a selection of papers published in Journal of Experimental Biology and aims to promote not only the diversity of early-career researchers (ECRs) working in experimental biology but also the huge variety of animals and physiological systems that are essential for the ‘comparative’ approach. Sulayman Lyons is an author on ‘ Highland deer mice support increased thermogenesis in response to chronic cold hypoxia by shifting uptake of circulating fatty acids from muscles to brown adipose tissue’, published in JEB. Sulayman conducted the research described in this article while a PhD student in Dr Grant McClelland's lab at McMaster University, Hamilton, Canada. He is now a Postdoctoral Fellow in the lab of Dr Jacqueline Beaudry at University of Toronto, Canada, investigating how animals can partition metabolic substrates to fuel metabolism.

Editorial introductions

Editorial introductions

Editorial introductions

Editorial introductions

Sientra High-Strength Cohesive Textured Round Implant Technique: Roundtable Discussion

: A panel of board-certified plastic surgeons chaired by Dr Grant Stevens convened to discuss their respective experiences with the Sientra High-Strength Cohesive (HSC) Textured Round silicone gel breast implants. The authors have implanted a combined total of approximately 2100 patients. Surgical pearls, complication avoidance, and practice integration tips are among the topics reviewed. The surgeons also present challenging cases and describe how the HSC textured implants helped them achieve a successful outcome. 5 Therapeutic.

Behavioural Addictions as a Way to Classify Behaviours

AbbreviationsCB compulsive buyingCBT cognitive-behavioural therapyCSB compulsive sexual behaviourDSM Diagnostic and Statistical Manual of Mental DisordersPG pathological gamblingThe concept of behavioural addiction as a way to classify behaviours that mirror the symptoms and consequences of classic alcohol and drug addictions has become of great interest to researchers and clinicians.' This is, in part, due to ongoing discussions regarding the creation of a category for behavioural addictions within the general class of substance use disorders in DSM-5, scheduled for release in May 2013.2 To date, PG is the only proposed member of the category, but it signals the recognition by the scientific community of what the National Institute on Drug Abuse considers relatively pure models of addiction because the presence of an exogenous substance does not contaminate their processes.3What defines a behavioural addiction? The simplest definition is that these are disorders whose overt symptoms are behaviourally expressed, and are viewed-at least initially-as pleasurable (for example, gambling, sex, shopping, and Internet use), and have attained an irresistible quality, such as the substance addictions. The boundaries of this emerging category are relatively fluid, appearing to expand or contract depending on an expert's own particular views. Some investigators choose to include impulse control disorders, currently listed in DSM-IV-TR (for example, PG, kleptomania, and pyromania) as members of the behavioural addiction category, but have also included disorders not currently recognized in the DSM system (for example, CB, Internet addiction, and CSB).3·4 In this edition of The Canadian Journal of Psychiatry, both Dr Jon ? Grant and colleagues5 and Dr Robert F Leeman and Dr Marc ? Potenza6 write about the behavioural addictions, yet appear to disagree about its members. For example, Dr Grant and colleagues5 include pyromania and binge eating disorder, but Dr Leeman and Dr Potenza6 do not. Conversely, Dr Leeman and Dr Potenza6 include video game playing, but Dr Grant and colleagues5 do not. This perfectly illustrates how, even among those actively writing on the topic, there remains disagreement of its breadth. And while classification should rest on research evidence, the data we have are imperfect and subject to varying interpretation.While controversy remains about the optimal categorization of the behavioural addictions, research evidence supports the linkage between these disorders and substance addictions, strengthening the rationale to include both behavioural and substance addictions in the same general class. One of the benefits from recognizing this category is that improved classification could enable a more accurate description of endophenotype and biological markers that characterize these conditions. More precise classification could lead to specific treatments.Scientists and others writing about behavioural addictions have described common elements that link them with substance addiction. A growing body of phenomenological, genetic, and neurobiological evidence supports a relation among proposed behavioural addictions to the substance addictions.4·7 As outlined in this issue by Dr Grant and colleagues5 and Dr Leeman and Dr Potenza,6 they share common core clinical features. For example, both involve the performance of repetitive or compulsive behaviours, despite negative consequences; diminished control over the behaviours; craving prior to engaging in the behaviour, and experiencing a pleasurable response while engaged in the behaviour.4 Further, they appear to share features of tolerance, withdrawal, repeated attempts to cut back, and impairment in multiple life domains.4·8·9 Phenomenological data also suggest a relation between the behavioural and substance addictions. They often begin in the late teens or early twenties, and while several of the behavioural addictions, such as CB and kleptomania, are more common in women,10· other behaviourally expressed addictions appear to have a male preponderance (for example, PG and CSB), similar to that seen in substance addictions. …

Should Cosmetic Surgery Be Limited to Selected Specialties?

Although name calling has become a national pastime (as you saw if you were paying attention to the recent national election), there ought to be no room for ad hominem attacks in professional discourse. Yet recently, Plastic Surgery Practice ran an article by Dr Grant Stevens discussing his opinion of “core” cosmetic surgery providers, 1 which claimed that only a limited number of specialists are qualiÞ ed to perform cosmetic surgery, an argument that has often been made within the plastic surgery community. 2 Although Dr Stevens has made many contributions to cosmetic surgery, the statements and opinions within the article are not the product of rational investigation. Instead, they are simply aimed at limiting who should do cosmetic surgery based solely on speciÞ c limited specialties. There is no question that all surgeons owe the public safe treatment with predictable outcomes, but so many variables affect this that a physician’s original specialty training cannot be the exclusive determinant. No specialty “owns” the face or body, and no specialty owns cosmetic surgery. The word “core” has taken on a new meaning in the discussion of cosmetic surgery qualiÞ cations. All of a sudden, a group of selfappointed (if not self-anointed) leaders in several specialties, most visibly plastic surgery, are making the argument, and even trying to legislate their own specialists as the only ones qualiÞ ed for cosmetic surgery procedures. These specialties are trying to convince each other (and those who will listen) that they hold the keys to the cosmetic universe.

Editorial introductions

Editorial introductions

Differences in vitamin D status likely explain racial disparities in breast cancer mortality rates in the southeast

The recent article in Cancer by Adams and colleagues1 found that after diagnosis of breast cancer, African American women had significantly higher breast cancer–specific and all-cause mortality rates than did European American women, and this effect persisted after consideration of commonly accepted risk factors. One factor not considered was vitamin D status. Solar ultraviolet B (UVB) irradiance is the most important source of vitamin D for most North Americans. Solar UVB dose has been found to be inversely correlated with breast cancer mortality rates in ecological studies for both African American and European American women.2 Vitamin D has also been found to be associated with survival rates after diagnosis of breast cancer. In a study in Canada with an 11.6-year follow-up period after breast cancer diagnosis, women with deficient vitamin D levels had an increased risk of distant recurrence and death compared with those who had sufficient levels.3 In detail, women with serum 25-hydroxyvitamin D (25(OH)D) levels <20 ng/mL, compared with those who had levels >30 ng/mL, had a multivariate adjusted hazard ratio of 1.71 (95% confidence interval, 1.02-2.86) for distant recurrence, and of 1.60 (95% confidence interval, 0.96-2.64) for death.3 There is also evidence from observational studies that serum 25(OH)D level affects breast cancer incidence rates.4 The relative risk versus 25(OH)D level outlined in that study4 might be used to estimate the breast cancer disparity in the United States. It was found that in the 2001 to 2004 period, mean serum 25(OH)D levels was 15 ng/mL in African American women and 26 ng/mL in European American women.5 These levels indicate a 46% higher breast cancer incidence rate for African Americans based on the relationship in the results of Grant.4 Because it is likely that vitamin D competes with more risk-modifying factors in cancer incidence than in cancer mortality rates (vitamin D reduces tumor angiogenesis and metastasis), the disparity for mortality rates might be higher. Therefore, future studies on racial disparities in breast cancer mortality should include serum 25(OH)D levels at the time of diagnosis, as well as, if necessary, vitamin D supplementation to reach and maintain serum 25(OH)D levels between 30 and 40 ng/mL. Dr Grant receives funding from the UV Foundation (McLean, Virginia), Bio-Tech Pharmacal (Fayetteville, Arkansas), the Vitamin D Council (San Luis Obispo, California), and the Vitamin D Society (Canada). The other authors make no disclosures. William B. Grant PhD*, Luca Mascitelli MD , Mark R. Goldstein MD , * Sunlight, Nutrition, and Health Research Center (SUNARC), San Francisco, California, Comando Brigata Alpina “Julia”, Medical Service, Udine, Italy, 1845 Veterans Park Drive, Suite 110, Naples, Florida.

Yellow fever vaccination in travellers of advanced age

AbstractEBM specialist Dr Grant Dex compares the risk of giving a yellow fever vaccine to an over 60 year old with that of the patient travelling to a high‐risk area unvaccinated. Copyright © 2009 Wiley Interface Ltd

Browsing issues

Browsing issues

The utility of site‐based datasets and regional ecosystem mapping for biodiversity conservation in the Southeast Queensland Bioregion: Past, present, future

The utility of site-based datasets and regional ecosystem mapping for biodiversity conservation in the Southeast Queensland Bioregion: Past, present, future. Ben E. Lawson. School of Natural and Rural Systems Management (NRSM) & School of Geography, Planning and Architecture (GPA), The University of Queensland, Brisbane 4072, Australia. Email: b.lawson@uq.edu.au. Key words: conservation, ecosystem mapping, regional ecosystems, site-based data. Ecosystem mapping and site-based datasets are core components of conservation planning and management schemes. In Queensland, regional ecosystem mapping is used for landscape-level planning, underpinned by site-based data. This doctoral research assesses their utility as surrogates for biodiversity patterns with a view to future needs. The research is supervised by Dr Grant Wardell-Johnson, Associate Professor Bob Beeton (NRSM) and Dr David Pullar (GPA) from the University of Queensland. The ecologically diverse Southeast Queensland (SEQ) Bioregion is the focus of this research. Issues and limitations in the two datasets, which underpin this research, were the first component examined. Regional ecosystem mapping showed a decrease in the number of heterogeneous polygons (i.e. a polygon with multiple ecosystems assigned) across successive versions. Polygon heterogeneity levels were positively correlated with endangered ecosystems and lower polygon accuracy, and strongly related to particular regional ecosystem and geomorphology types (see Lawson 2006). Retrospective analysis of the Queensland Herbarium's site-based floristic dataset, ‘CORVEG’, showed improved data quality and completeness in the past decade as a consequence of more explicit sampling protocols, although missing information continues to limit data utility (see Lawson in press). Case studies were used to explore the application of regional ecosystem mapping in varied circumstances. The first case study examined SEQ sand islands where high levels of map unit homogeneity relative to adjacent mainland areas were observed. Analysis showed that mapping effectively portrayed ecological patterns and that homogeneity existed across various map scales and map authors across the islands, suggesting that high polygon homogeneity were ecological, not cartographic, phenomena (see Lawson & Wardell-Johnson in press). The second case study came from Toohey Forest in southern SEQ, an area mapped as a single regional ecosystem type at 1:100 000 scale despite its recognized biotic and abiotic diversity. Fine-scale mapping approaches were explored to assess the representation of floristic patterns, indicating that ongoing reduction in regional ecosystem mapping scale and incorporation of fine-scale geomorphic mapping were vital to improve the representation of floristic diversity. Core components of the research which are yet to be completed will elucidate species richness and dissimilarity patterns within and between map units and reveal the ecosystem types that are (and aren't) well portrayed by the mapped patterns, the reasons for this, and measures to improve representation. Queensland's regional ecosystem mapping program shows continued improvement in the representation of biodiversity patterns, with some areas more effectively portrayed than others. The use of heterogeneous polygons to identify ecosystems otherwise unrecognizable at particular map scales is simultaneously a major advantage and disadvantage to representing biodiversity patterns. Opportunities are available to focus limited resources on particular geomorphological and regional ecosystem types, and for alternate methods of representing geographically restricted ecosystems. Greater consideration of current and future uses of site-based floristic data is necessary. For example, hierarchical datasets serving multiple biodiversity objectives should be considered. These issues are directly relevant to the mapping of biodiversity condition.

Epidermal Growth Factor Receptor Signaling Regulates Bax and Bcl-w Expression and Apoptotic Responses During Intestinal Adaptation in Mice

Normal intestinal adaptation to massive small-bowel resection requires intact epidermal growth factor receptor signaling and consists of increased enterocyte proliferation and apoptosis. Although emphasis has been placed on understanding the regulation of proliferation, few studies have evaluated the mechanism and contribution of apoptosis to the adaptation response. We sought to test the hypothesis that epidermal growth factor receptor signaling regulates specific Bcl-2 family members (Bax and Bcl-w) to direct apoptosis and adaptation after massive small-bowel resection. Laser capture microdissection microscopy permitted measurement of Bax and Bcl-w messenger RNA expression in crypt and villus enterocytes in control conditions and under epidermal growth factor receptor-inhibited (waved-2 mice) or stimulated (epidermal growth factor transgenic mice) conditions after a 50% small-bowel resection or sham operation. Resection-induced adaptation was then studied in Bax-null and Bcl-w-null mice under control circumstances and after epidermal growth factor receptor stimulation. When compared with Bcl-w, the most significant expression changes were observed with Bax and took place within crypt enterocytes. Epidermal growth factor receptor stimulation resulted in a decreased ratio of Bax to Bcl-w expression and decreased rates of apoptosis. Bax-null mice had no apoptosis response to small-bowel resection and displayed an amplified adaptation response to the administration of epidermal growth factor. Bcl-w-null mice had poor survival and impaired adaptation to small-bowel resection, an effect that was rescued by crossbreeding these mice with epidermal growth factor transgenic mice. The crypt expression of Bax and Bcl-w is influenced by epidermal growth factor receptor signaling and is key for the regulation of apoptosis. Epidermal growth factor receptor stimulation, coupled with apoptosis inhibition, may provide a novel strategy to amplify adaptation responses in patients after massive intestinal loss.

A List of Essays on Scottish History in Books Published during the Years 1999–2000

DR ALEXANDER GRANT is Reader in Medieval British History at the University of Lancaster. In compiling this supplement to the ‘List of Articles’, he attempts to take account of the considerable number of essays on Scottish history which are pub- lished in books rather than periodicals. It is, unfortunately, much more difficult to survey books, and the list is therefore unlikely to be exhaustive. Nevertheless, it is hoped to make it as full as possible, and for that reason all those who contribute, or have contributed, essays on Scottish history to books are asked to send the details to Dr Grant. Items listed here were mostly published in 2000, but some from 1999 and earlier which have come to notice since the previous lists were compiled have also been included.

Bullying: It's not just a school problem

Bullying: It's not just a school problem

A List of Essays on Scottish History in Books Published during the Years 1998–1999

DR ALEXANDER GRANT is Reader in Medieval British History at the University of Lancaster. In compiling this supplement to the ‘List of Articles’, he attempts to take account of the considerable number of essays on Scottish history which are pub- lished in books rather than periodicals. It is, unfortunately, much more difficult to survey books, and the list is therefore unlikely to be exhaustive. Nevertheless, it is hoped to make it as full as possible, and for that reason all those who contribute, or have contributed, essays on Scottish history to books are asked to send the details to Dr Grant. Items listed here were mostly published in 2000, but some from 1999 and earlier which have come to notice since the previous lists were compiled have also been included.

A List of Essays on Scottish History in Books Published during the Years 1997–1998

DR ALEXANDER GRANT is Reader in Medieval British History at the University of Lancaster. In compiling this supplement to the ‘List of Articles’, he attempts to take account of the considerable number of essays on Scottish history which are pub- lished in books rather than periodicals. It is, unfortunately, much more difficult to survey books, and the list is therefore unlikely to be exhaustive. Nevertheless, it is hoped to make it as full as possible, and for that reason all those who contribute, or have contributed, essays on Scottish history to books are asked to send the details to Dr Grant. Items listed here were mostly published in 2000, but some from 1999 and earlier which have come to notice since the previous lists were compiled have also been included.

Documentation for the Sake of Documentation?

HomeCirculationVol. 100, No. 13Documentation for the Sake of Documentation? Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBDocumentation for the Sake of Documentation? David Grant David GrantDavid Grant San Pedro Medical Clinic San Antonio, Tex Search for more papers by this author Originally published28 Sep 1999https://doi.org/10.1161/01.CIR.100.13.1461Circulation. 1999;100:1461To the Editor:In their recent study, Frolkis and colleagues1 attempt to determine by chart review how often patients with acute myocardial infarction are counseled to quit smoking and encouraged to exercise. They acknowledge that if no such counseling nor encouragement is documented in the chart, the study assumes none was done.Certainly a patient hospitalized with an acute infarction is unusually likely to be amenable to the idea of quitting smoking and ought to be so encouraged. But many patients are still not interested in quitting. In those cases, most doctors probably do not document a fruitless attempt at counseling in the chart. Why commemorate a waste of breath with a waste of ink? Frolkis and colleagues suggest doing the documentation if only to placate chart reviewers and defense lawyers.Physician time and patience are finite resources. Suggesting that a patient quit smoking and getting the brush-off from that patient is a bit trying. Having in addition to write in a chart, “Counseled patient to quit smoking, but compliance doubtful,” is considerably more trying on a doctor’s patience. Furthermore, a cursory comment about smoking and lifestyle changes, made mainly to justify a chart entry that “covers” the doctor, is very unlikely to leave a patient with any useful motivation.The idea that “If it’s not documented in the chart, it wasn’t done,” speaks volumes about anyone who subscribes to it. References 1 Frolkis JP, Zyzanski SJ, Schwartz JM, Suhan PS. Physician noncompliance with the 1993 National Cholesterol Education Program (NCEP-ATPII) guidelines. Circulation.1998; 98:851–855.CrossrefMedlineGoogle ScholarcirculationahaCirculationCirculationCirculation0009-73221524-4539Lippincott Williams & WilkinsResponseFrolkis Joseph P., MD, PhD, Suhan Pamela, RN, Schwartz Jonathan, MD, and Zyzanski Stephen J., PhD28091999We were pleased that Dr Grant acknowledges the importance of counseling high-risk patients to quit smoking cigarettes but were puzzled by the intensity of his objection to documenting such an effort. The use of cigarettes represents the largest preventable cause of mortality and health-related expenditure in the United States, accounting for ≈400 000 deaths yearly.R1R2 The data are clear that even brief interventions by physicians and other healthcare professionals can significantly increase quit rates and that the documentation of current tobacco use is a key element of any successful cessation program.R3 Interventions targeted to hospitalized patients have reported major impact, presumably because patients may be more receptive to suggestions regarding lifestyle change in the setting of an acute event or procedure.R4 Unfortunately, many patients report that their caregivers have never urged them to quit smoking.R5In addition, as we report, there is good evidence that what is recorded in the hospital record is an accurate reflection of actual physician behavior, so the conclusion that “most doctors probably do not document a fruitless attempt at counseling in the chart” must be viewed with caution. Moreover, we are not encouraging documentation “to placate chart reviewers and defense lawyers,” as Dr Grant states; we are merely reporting the reality of the ways chart notes can be used.Less clear is what Dr Grant finds so different about documenting advice to discontinue cigarette use from the many other suggestions physicians offer and routinely record in the hospital or office chart. Advising patients to lose weight, increase exercise, reduce alcohol consumption, wear seat belts, practice safe sex, or get yearly mammograms, as well as documenting such advice, provides key information for our own future use or for those colleagues who may encounter our patients at another time or in another setting. Because most patients who eventually quit cigarettes successfully have tried and failed previously, noting one’s effort to help patients with this complicated and sometimes painful process can provide both patient and physician with a useful marker of their joint progress. We are not advocates of defensive medicine or creating unnecessary paperwork. Our concern is that physicians underutilize their considerable influence in helping patients adopt the healthier lifestyles that could decrease the burden of heart disease. Previous Back to top Next FiguresReferencesRelatedDetailsCited By Conroy M, Majchrzak N, Silverman C, Chang Y, Regan S, Schneider L and Rigotti N (2005) Measuring provider adherence to tobacco treatment guidelines: A comparison of electronic medical record review, patient survey, and provider survey, Nicotine & Tobacco Research, 10.1080/14622200500078089, 7:2, (35-43), Online publication date: 1-Apr-2005. September 28, 1999Vol 100, Issue 13 Advertisement Article InformationMetrics Copyright © 1999 by American Heart Associationhttps://doi.org/10.1161/01.CIR.100.13.1461 Originally publishedSeptember 28, 1999 PDF download Advertisement

GPs to produce a strategy for the future Academic staff seek prime minister's help over funding Calman proposals will affect hospital manpower Tobacco companies curb advertising NHS chairmen will have charters Correction

# GPs to produce a strategy for the future {#article-title-2} The General Medical Services Committee will begin to discuss its strategy for the future of general practice at its September meeting. This will be the first stage of the GMSC's response to the government's document Primary Care: The Future (15 June, p 1500). Dr Ian Bogle, who was re-elected unopposed as chairman but said that it would be the last year that he stood, said last week that he and the negotiators planned a weekend meeting to draft the strategy. This would be wide-ranging and cover a definition of core services, contractual options, recruitment, workload, and funding. Welcoming the move Dr Tony Stanton, secretary of the inner London local medical committees, said that the committee needed to debate all the issues urgently. General practitioners' wish to recruit more doctors and reduce list sizes might not be achievable. He did not believe that they wanted to see the hospital service depleted further to pay for additional primary care services. The GMSC has set up a task group to examine how it conducts its business. Dr John Ball will chair the group, and its other members are Dr Lawrence Buckman, Dr John Canning, Dr Grant Kelly, and Dr Fay Wilson. Dr Ball, a former chairman of the GMSC, told the committee that there was a wealth of talent on the committee that was never tapped and he wondered whether concentrating so much work and responsibility on a few people was the right way …

Dr Grantly Dick-Read.

Dr Grantly Dick-Read.

Propaganda and the role of the state in inter-war Britain

This is a study of government publicity activities in Britain between the wars. Mariel Grant focuses on the development of public relations bureaux and information services in Whitehall. She shows how during the inter-war period publicity came to be regarded as a legitimate and necessary task of democractic government, and that although government departments pursued propaganda activities with different motives and divergent persepectives, they adopted a similar approach to both the tool and their audience. Dr Grant explores a variety of differnt issues and campaigns, including the Post Office's attempts to make the public `telephone conscious', the Ministry of Health's sex education efforts, the multi-departmental and protracted `Drink More Milk' campaign. She shows how the experiences and developments of the 1920s and 1930s contributed to the decision in 1939 to establish the propaganda ministry designed to manage wartime publicity and shape public opinion. The book offers valuable insights into the nature of propaganda and its management, and contributes to our understanding of the changing role of the state in modern British society.