Journal of the Royal Society of Medicine最新文献

{"title":"Low muscle mass and the risk of long COVID.","authors":"Farrah Jawad, Ali S Jawad","doi":"10.1177/01410768251326488","DOIUrl":"https://doi.org/10.1177/01410768251326488","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"1410768251326488"},"PeriodicalIF":8.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotics for common infections in primary care before, during and after the COVID-19 pandemic: cohort study of extent of prescribing based on risks of infection-related hospital admissions.","authors":"Ali Fahmi, Ya-Ting Yang, Xiaomin Zhong, Alexander Pate, Anita Sharma, Simon Watts, Darren M Ashcroft, Ben Goldacre, Brian MacKenna, Jon Massey, Amir Mehrkar, Seb Bacon, Brian McMillan, Paul Dark, Kieran Hand, Victoria Palin, Tjeerd Pieter van Staa","doi":"10.1177/01410768251328997","DOIUrl":"10.1177/01410768251328997","url":null,"abstract":"<p><p>ObjectivesAntibiotics are effective in treating bacterial infections, but they carry the risks of antimicrobial resistance and effectiveness loss. This study aimed to assess whether antibiotics for common infections are prescribed in a risk-based manner and how this changed during the COVID-19 pandemic.DesignCohort study of common infections and antibiotic prescribing.SettingWith the approval of NHS England, we accessed pseudonymised patient-level electronic health records of primary care data from The Phoenix Partnership through OpenSAFELY.ParticipantsWe included adults registered at general practices in England with a record of common infection, including lower respiratory tract infection (LRTI), upper respiratory tract infections (URTI) and lower urinary tract infection (UTI), from January 2019 to March 2023. Patients with a record of COVID-19 were excluded.Main outcome measuresPatient-specific risks of infection-related hospital admission were estimated for each infection using risk prediction scores for patients who were not prescribed an antibiotic. The infection cohorts were then grouped into risk deciles, and probabilities of being prescribed an antibiotic were assessed.ResultsWe found 15,719,750 diagnoses of common infections. Of them, 450,215 (2.86%) were hospitalised in the 30 days after the diagnosis and 10,429,060 (66.34%) were prescribed an antibiotic. There were substantial differences in observed rates of hospital admissions between the lowest and highest risk deciles (25-fold difference in URTI). The probability of being prescribed an antibiotic for LRTI or UTI was unrelated to hospital admission risk, and that for URTI was weakly related to hospital admission risk. During the COVID-19 pandemic, the level of risk-based antibiotic prescribing reduced.ConclusionsThere is a need to better target antibiotics in primary care to patients with worse prognosis and strengthen treatment guidelines in personalisation of prescribing.</p>","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"1410768251328997"},"PeriodicalIF":8.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Legal principles of shared decision-making for healthcare: what are we required to do?","authors":"Abeezar I Sarela, Jose Miola, Kathy Oliver, James Badenoch, Peter Selby","doi":"10.1177/01410768251324817","DOIUrl":"10.1177/01410768251324817","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"1410768251324817"},"PeriodicalIF":8.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key SARS-CoV-2 testing strategies implemented in the UK: rationale and impact.","authors":"Tom Fowler, Chris Kenny, Sarah Tunkel, Andrew Dodgson, Jeanette Hall, Peter Marks, Paul Klapper, Malur Sudhanva, Raghavendran Kulasegaran-Shylini, Zareen Thorlu-Bangura, Obaghe Edeghere, Catherine Falconer, Robert Jenkins, Edward Blandford, Ian Hall, Iain Buchan, W John Edmunds, Tim Peto, Susan Hopkins","doi":"10.1177/01410768251322225","DOIUrl":"https://doi.org/10.1177/01410768251322225","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"1410768251322225"},"PeriodicalIF":8.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why do doctors make poor decisions? Spotlighting 'noise' as an under-recognised source of error in clinical practice.","authors":"Isaac Ks Ng, Daniel J Morgan, Tow Keang Lim","doi":"10.1177/01410768251324822","DOIUrl":"10.1177/01410768251324822","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"1410768251324822"},"PeriodicalIF":8.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of malaria and neglected tropical diseases in children and adolescents, 1990-2019: a population-based, cross-sectional study.","authors":"Jinxin Zheng, Daoqi Zhang, Shunxian Zhang, Muxin Chen, Zhaoyu Guo, Shiyang Guan, Yushu Liu, Robert Bergquist, Shizhu Li, Xiaonong Zhou, Xinyu Feng","doi":"10.1177/01410768251321572","DOIUrl":"10.1177/01410768251321572","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate the global burden of malaria and neglected tropical diseases (NTDs) in children and adolescents aged 0-19 years and to analyse trends to inform public health and policy decisions.</p><p><strong>Design: </strong>Population-based, cross-sectional study.</p><p><strong>Setting: </strong>Global analysis across 204 countries and territories.</p><p><strong>Participants: </strong>Children and adolescents aged 0-19 years with malaria and NTDs, stratified by age, gender and location from 1990 to 2019.</p><p><strong>Main outcome measures: </strong>Yearly incidence, prevalence, and disability-adjusted life years (DALYs) for malaria and NTDs, age-standardised incidence rates (ASIRs) and age-standardised DALY rates (ASDRs).</p><p><strong>Results: </strong>The global burden of malaria and NTDs among children and adolescents aged 0-19 years remains substantial. In 2019, 195.6 million cases of malaria and NTDs were recorded globally, resulting in 43.9 million (95% Uncertainty Interval (UI): 25.0-70.4 million) DALYs. The incidence rate increased until 2005 and then declined. Sub-Saharan Africa had the highest ASDR, while high-income regions had the lowest. Significant ASDR reductions occurred in Andean Latin America and South Asia. The burden was highest in low-Socio-Demographic Index (SDI) regions, with malaria accounting for over 93% of DALYs among children under five. Females had slightly higher incidence rates, while DALYs were evenly distributed between genders. There was an inverse association observed between SDI and ASDRs.</p><p><strong>Conclusions: </strong>Malaria and NTDs continue to disproportionately affect children and adolescents in low-SDI regions, especially sub-Saharan Africa. Sustaining gains while accelerating control efforts is the key to successful control progress and ambiguous elimination goals for both malaria and NTDs.</p>","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"1410768251321572"},"PeriodicalIF":8.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The urgent responsibility to confront psychiatric abuses and defend ethical principles in a turbulent world.","authors":"Alexander J Smith, Robert van Voren, Dinesh Bhugra, Anna Buadze, Michael Liebrenz","doi":"10.1177/01410768251320168","DOIUrl":"10.1177/01410768251320168","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"1410768251320168"},"PeriodicalIF":8.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planning for end of life in the past and present: historical, legal and clinical perspectives on ReSPECT.","authors":"James David van Oppen, Sarah Gunn, Timothy John Coats, Nataly Papadopoulou, Michaela Senkova, Sarah Tarlow, Elizabeth Wicks","doi":"10.1177/01410768251317843","DOIUrl":"10.1177/01410768251317843","url":null,"abstract":"<p><p>The ReSPECT ('Recommended Summary Plan for Emergency Care and Treatment') process was developed in the UK to guide and document conversations and decision-making with patients and their relatives around intervention during critical deterioration. This includes advising whether resuscitation should be attempted when a person dies. Current medical preparation for death is qualitatively different to social behaviours by people in the past and presents some controversies when considering the legal status of death-related decisions. In this article, we discuss our interdisciplinary perspectives as archaeological, historical, legal, medical and clinical psychologist academics following a historico-medico-legal appraisal of the ReSPECT process as situated in the current UK legal and cultural landscape. We review controversies and conundrums, and contextualise and contrast the current position to preparing for death and dying in the past.</p>","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"1410768251317843"},"PeriodicalIF":8.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compassion fatigue: result or cause of burnout? And do doctors get it?","authors":"Dinesh Bhugra","doi":"10.1177/01410768251320166","DOIUrl":"10.1177/01410768251320166","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"1410768251320166"},"PeriodicalIF":8.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout: its meaning and how to deal with it?","authors":"Dinesh Bhugra","doi":"10.1177/01410768251320167","DOIUrl":"10.1177/01410768251320167","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"1410768251320167"},"PeriodicalIF":8.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}