Journal of the Royal College of Physicians of Edinburgh最新文献

{"title":"Teaching forensic medicine in eighteenth-century Scotland.","authors":"Daisy Cunynghame","doi":"10.1177/14782715251367542","DOIUrl":"https://doi.org/10.1177/14782715251367542","url":null,"abstract":"<p><p>Analysing the handwritten notes recorded by students who attended the classes of Andrew Duncan, Professor of the Institutions of Medicine at the University of Edinburgh, the article uncovers the contents of Britain's first forensic medicine lecture series. It explores not only aspects of forensic medicine distinctive to the late eighteenth century but also uncovers elements of forensic teaching which were distinctly Scottish and distinctly related to the background, connections and experiences of the courses' creator. The article uncovers the methodology for examining a crime scene which the notes describe, as well as the investigative techniques used in the examination of alleged cases of abortion, rape and murder. Finally, the article reflects on the role physicians were expected to play in the identification of fictitious diseases - diseases, allegedly, falsified to elicit charity, avoid military conscription or to avoid work.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251367542"},"PeriodicalIF":0.9,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and preliminary validation of a cognitive-physical frailty index in an older adult cohort: The NEDICES study.","authors":"Carlos Felipe Rengifo Rodas, Félix Bermejo-Pareja, Jesús López-Arrieta, Julián Benito-León","doi":"10.1177/14782715251369601","DOIUrl":"https://doi.org/10.1177/14782715251369601","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a multidimensional syndrome characterised by reduced physiological reserve and increased vulnerability to adverse health outcomes. While traditional frailty models focus primarily on physical decline, emerging evidence supports the integration of cognitive domains for a more comprehensive assessment.</p><p><strong>Objective: </strong>To develop and preliminarily validate a cognitive-physical frailty index using data from a large, prospective population-based cohort of older adults in central Spain.</p><p><strong>Methods: </strong>We constructed a frailty index based on 12 variables spanning physical, cognitive, subjective, and functional domains. These were selected from the Neurological Disorders in Central Spain (NEDICES) study using criteria based on feasibility, clinical relevance, and prior evidence of mortality prediction. Frailty distributions and transitions were analysed between two time points (1994-1995 and 1997-1998), and mortality risk was assessed using Cox proportional hazards models.</p><p><strong>Results: </strong>Among the 5,278 participants, the frailty distribution shifted to the right over the 3-year follow-up period, reflecting an increasing vulnerability.. The frailty index demonstrated a strong association with all-cause mortality (hazard ratio = 28.05; 95% CI: 16.37-48.06). Quartile-based stratification illustrated clearly within-sample progression. The index showed high goodness-of-fit under a gamma distribution, supporting its internal coherence.</p><p><strong>Conclusion: </strong>This brief, multidimensional frailty index offers a feasible tool for capturing early cognitive and physical decline and predicting short-term mortality in ageing populations. Although preliminary, these findings underscore the value of integrating cognitive indicators into frailty assessment. Future validation in other cohorts and with long-term data is warranted.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251369601"},"PeriodicalIF":0.9,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical appraisal of an original research article.","authors":"Sham Santhanam, Vinod Ravindran, Chris Wincup","doi":"10.1177/14782715251369964","DOIUrl":"https://doi.org/10.1177/14782715251369964","url":null,"abstract":"<p><p>Critical appraisal of evidence involves carefully evaluating a study's validity, reliability, applicability and generalisability. It is essential for all clinicians and those involved in academic publishing. A manuscript must adhere to two sets of standards. First, reporting guidelines ensure uniformity, transparency and clarity. Then, critical appraisal tools or criteria assess the study's methodological robustness. The manuscript may undergo a preliminary screening before we initiate the critical appraisal process. The foremost criterion is evaluating the journal's quality, assessing the study topic, design and sample size, and checking if the study objectives and outcome measures have been clearly stated. An original study is typically presented in the standard 'IMRaD' format, with each section addressing a specific set of questions. The primary purpose of the 'Introduction' section is to justify the study's objective. The 'Methods' section is crucial to the manuscript. It aids in assessing the validity of the research, describes the critical parameters in a study protocol and ensures the study's replicability. The main components covered in the 'Methods' section include the study question, design, population, sample size, outcome measures, statistical analysis and details of ethics approval. The 'Results' section should discuss the study's findings, which are outlined in the objectives. The 'Discussion' section covers the implications of the study, which should be balanced, and the interpretation in this section should align with the reported results. The validity of a study is nothing but its closeness to the truth, that is, the extent to which the results are accurate and free from bias. Hence, minimising this chance of bias in a study makes it more valid. Internal validity generally reflects a study's methodological robustness, and external validity reflects the generalisability or applicability. In this era of evidence-based medicine, critical appraisal becomes necessary as people always discuss practising it in their daily clinical practice.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251369964"},"PeriodicalIF":0.9,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Realigning history: The Toronto Four insulin discovery team.","authors":"Kenneth McHardy","doi":"10.1177/14782715251369614","DOIUrl":"https://doi.org/10.1177/14782715251369614","url":null,"abstract":"<p><p>This article relates to the discovery and deployment of the world's first clinically useful insulin in Toronto more than 100 years ago. It addresses the propagation of a false account of how this breakthrough was achieved and the controversy that ensued leading to a diminution of the contribution of the Scottish academic leader of the discovery team. It describes how, despite the advent - some 60 years later - of a meticulously compiled and definitive history of what really happened in Toronto, the traditional account has proved resistant to correction. It concludes with a description of a spectacular memorial project in Aberdeen restoring the reputation of Professor JJR Macleod, and going on to respectfully reunite 'the Toronto Four'.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251369614"},"PeriodicalIF":0.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Primum non nocere' - The old lie?","authors":"Tim Cassidy","doi":"10.1177/14782715251374900","DOIUrl":"https://doi.org/10.1177/14782715251374900","url":null,"abstract":"<p><p>Harm occurs in 10% of hospitalised patients. After 20 years of patient safety implantation plans using a Safety 1 paradigm, developed from high-risk industries, there has been no significant change, except in certain niche areas. Hospital medicine has changed over the last two decades; we now work in an intractable system. The Safety 2 paradigm looks at how things go right (90% of times) so often. Clinicians are able to adjust their work to conditions (work as done) and adapt to changing conditions. Therefore, the way forward, is a combination of these two paradigms. It is still the case that some of these adverse events are relatively simple or can be treated as relatively simple without serious consequences. Using a Safety 1 paradigm will therefore be appropriate. But there is a growing number of cases where this approach will not work. In these instances, it is necessary to adopt a Safety 2 view.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251374900"},"PeriodicalIF":0.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dealing with manuscript rejections in academic medicine: It takes two hands to clap.","authors":"Isaac Ks Ng, Wilson Gw Goh","doi":"10.1177/14782715251372412","DOIUrl":"https://doi.org/10.1177/14782715251372412","url":null,"abstract":"<p><p>Academic publishing is increasingly prevalent in clinical training and practice, as part of the burgeoning field of academic medicine, where physicians are expected not only to perform their conventional clinical duties and responsibilities, but also increasingly have to engage in various forms of scholarly activities to contribute to evidence-based practice, as part of their key performance indicators. However, for physicians who are not trained as academics or scientists, the learning curve for scholarly endeavours can be steep and fraught with setbacks and rejections. Therefore, in this editorial article, we offer our perspectives as residents-in-training on the roles of both clinician-authors and journal editorial/peer review teams in facilitating healthy cognitive-emotional processing of unfavourable manuscript decisions in academic medicine.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251372412"},"PeriodicalIF":0.9,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical lead in medicine and co-lead at Medical School: Reflections from transitioning through the RCP Chief Registrar programme within the NHS.","authors":"Sushuma Kalidindi","doi":"10.1177/14782715251372408","DOIUrl":"https://doi.org/10.1177/14782715251372408","url":null,"abstract":"<p><p>The Royal College of Physicians flagship chief registrar programme, an initiative launched nearly a decade ago was an innovative leadership and management programme for medical registrars which has now been rolled out to other specialties as well. The role has evolved over time and explores the broader aspects of the ways of workings in the UK National Health Service, the progression and impact for individuals, teams and organisations across the wider health economy both from the perspective of acute care as well as treating long-term conditions. A personal reflection on connecting the experiential learning attained from being a chief registrar and transitioning through this unique and distinctive programme towards embedding into the Consultant Physician job that encompasses broadening horizons into non-clinical managerial domains such as Clinical Lead from a service line perspective as well as academic Co-lead to widen the landscape of undergraduate medical school placements is illustrated in this article.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251372408"},"PeriodicalIF":0.9,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reframing failure; redefining success.","authors":"Clare Bostock","doi":"10.1177/14782715251368571","DOIUrl":"https://doi.org/10.1177/14782715251368571","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251368571"},"PeriodicalIF":0.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The People's Dispensary.","authors":"","doi":"10.1177/14782715251369558","DOIUrl":"https://doi.org/10.1177/14782715251369558","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251369558"},"PeriodicalIF":0.9,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation demystified and reimagined-using simulation to transform clinical practices.","authors":"Craig Brown, David Savage","doi":"10.1177/14782715251365452","DOIUrl":"https://doi.org/10.1177/14782715251365452","url":null,"abstract":"<p><p>Simulation has traditionally been used for paedagogical purposes. More recently, simulation has been advocated for use in transformational ways - leveraging simulation to test and improve clinical systems and service delivery. This article presents a narrative account of transformational simulation in stroke care. We describe three simulation-based initiatives: a review of simulation on door-to-needle times, development of a telethrombolysis protocol and implementation of a thrombectomy pathway. This article demonstrates how simulation can be used to transform healthcare. Our examples have focussed on stroke presentations; however, the 'seven I's model' outlines how simulation can be used to identify, improve and innovate across the care spectrum.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251365452"},"PeriodicalIF":0.9,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}