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This JAMA Patient Page describes syphilis infection, risks of congenital syphilis during pregnancy, and pros and cons of screening for syphilis during pregnancy.
Introduction
Mental health problems are important causes of disability and economic costs worldwide. Randomised clinical trials examining the treatment of mental health disorders measure heterogeneous outcomes, causing difficulties in data synthesis, interpretation and translation into clinical practice. The aim of the Patient Important Outcomes in Psychiatry (PIO-Psych) Initiative is to develop an overarching, transdiagnostic research-based and consensus-based core outcome set for adult mental health disorders.
Methods and analysis
The development of the PIO-Psych transdiagnostic core outcome set will include three phases: (1) a systematic scoping review of the literature to develop the initial list of outcomes for the Delphi study; (2) a Delphi study in three rounds including people with lived experience of mental health disorders and their relatives, clinicians, researchers and others (administrators, mental healthcare policymakers, philosophers); (3) a hybrid consensus meeting to agree on the final overarching, transdiagnostic core outcome set and corresponding time points of assessment of each outcome.
Ethics and dissemination
Ethical approval is not applicable to this study according to the Research Ethics Committee of the Capital Region of Denmark, as it is not an interventional study. All data will be reported anonymously, and it will not be possible to identify study participants. Results will be disseminated via stakeholder and research networks and peer-reviewed publications.
Trial registration details
The PIO-Psych Initiative was pre-registered with COMET (Core Outcome Measures for Effectiveness Trials) on 17 May 2024 (https://www.comet-initiative.org/Studies/Details/3125).
Circulation, Volume 151, Issue 23, Page e1047-e1048, June 10, 2025.
Circulation, Volume 151, Issue 23, Page e1049-e1050, June 10, 2025.
5.000 euro ciascuno per progetti innovativi in farmacologia
Objectives
The COVID-19 pandemic induced significant changes in access policies to general practice (GP) in most countries. This study aimed to compare and discuss changes in the diagnostic patterns and GP procedures before and during the pandemic.
Design and setting
A register study including data from 11 Danish GP clinics.
Participants
Enlisted patients from GP followed 1 year before (February 2019 to January 2020; n=48 650) and 1 year during (April 2020 to March 2021; n=47 207) the COVID-19 pandemic.
Outcome measures
Diagnostic patterns, consultation type (face-to-face, email and phone), contact persons (GP or GP staff) and patient characteristics.
Results
The average number of contacts with GP increased from 6.3 contacts per year per patient before the pandemic to 8.3 annual contacts during the pandemic (p
Objective
This review aimed to map the concept of patient safety culture in emergency departments (EDs), describe the availability of evidence related to patient safety culture as assessed by healthcare workers, identify the key focus areas of existing studies and pinpoint gaps in the current literature.
Design
A scoping review followed a comprehensive methodological process that included five steps based on the framework developed by Arksey and O’Malley and updated by Peters et al.
Eligibility criteria
Studies encompassing original research and all pertinent published and grey literature within the last 15 years (2010–2024) that aligned with the population (healthcare workers), concept (patient safety culture) and context (emergency department) framework for this study were included.
Data sources
PubMed, CINAHL (EBSCOhost), WOS, Embase, MEDLINE (Ovid), and KISS databases were searched for original studies published between 2010 and 2024 that aligned with the topic of this study.
Data extraction and synthesis
Two researchers independently extracted data from 28 eligible articles using a predetermined data extraction tool. A third researcher reviewed the data to ensure accuracy.
Results
A total of 28 articles were included in the review. The findings indicated an increase in research on patient safety culture in emergency departments since 2021. However, no eligible studies have assessed it within North America. Teamwork within units was the most positively perceived dimension, whereas the reporting of patient safety incidents was the least positively perceived dimension.
Conclusions
Although research on patient safety culture in eergency departments has increased, the findings remain limited in their generalisability due to a lack of diverse methodologies. Qualitative studies are needed to deepen the understanding of patient safety culture in multifaceted contexts. This review contributes to the academic field by bringing us closer to developing tailored interventions that can foster a positive patient safety culture in emergency departments.
Protocol registration
The protocol for this scoping review was registered in the Open Science Framework (https://osf.io/9f7qc).
Objectives
To investigate the change in anticholinergic burden over a 5 year period in relation to the health characteristics of older adults.
Study design
Using data from the MultiCare Cohort Study (2008–2013), a prospective observational cohort study based on patient data from 158 general practices
Setting
Primary care in Germany.
Participants
3189 multimorbid adults aged 65 to 85 years
Primary and secondary outcome measures
The primary outcome was the change in the anticholinergic burden score (ACB) over a 5 year period. The ACB was defined as the dependent variable and was calculated by including all anticholinergic drugs prescribed to participants during the study period. Independent variables included age, sex, education (according to CASMIN), depressiveness (GDS), cognitive function (LDST), quality of life (EQ5D-3L) and the number of diseases weighted by severity. We performed multilevel mixed-effects multivariable linear regression analyses.
Results
A total of 7068 observations were analysed during three follow-ups. The mean age of the participants was 74.4±5.2 years and 59.3% were female. The mean ACB score was 1.5±1.7 at baseline and did not change significantly over time. In contrast, a higher severity-weighted number of diseases (coefficient: 0.08, 95% CI: 0.05/0.10, p
This JAMA Patient Page describes causes, risk factors, evaluation and treatment, and bystander instructions for cardiac arrest in apparently healthy young adults.
This case series uses artificial intelligence and natural language processing to analyze a large dataset of patient messages to inform patient-centered research, counseling, and quality improvement initiatives in cancer care.
This Viewpoint discusses the unintended consequences of the 21st Century Cures Act for patients and clinicians.
A woman in her 40s with a medical history of complex regional pain syndrome presented to the dermatology department for evaluation of a pruritic recurrent rash on her right anterior thigh. What is your diagnosis?
Coordinato del San Raffaele, finanziato da associazioni pazienti
Introduction
The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) may be as high as 38% in the adult population with potential serious complications, multiple comorbidities and a high socioeconomic burden. However, there is a general lack of awareness and knowledge about MASLD and its progressive stages (metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis). Therefore, MASLD is still far underdiagnosed. The ‘Global Research Initiative for Patient Screening on MASH’ (GRIPonMASH) consortium focuses on this unmet public health need. GRIPonMASH will help (primary) healthcare providers to implement a patient care pathway, as recommended by multiple scientific societies, to identify patients at risk of severe MASLD and to raise awareness. Furthermore, GRIPonMASH will contribute to a better understanding of the pathophysiology of MASLD and improved identification of diagnostic and prognostic markers to detect individuals at risk.
Methods
This is a prospective multicentre observational study in which 10 000 high-risk patients (type 2 diabetes mellitus, obesity, metabolic syndrome or hypertension) will be screened in 10 European countries using at least two non-invasive tests (Fibrosis-4 index and FibroScan). Blood samples and liver biopsy material will be collected and biobanked, and multiomics analyses will be conducted.
Ethics and dissemination
The study will be conducted in compliance with this protocol and applicable national and international regulatory requirements. The study initiation package is submitted at the local level. The study protocol has been approved by local medical ethical committees in all 10 participating countries. Results will be made public and published in scientific, peer-reviewed, international journals and at international conferences.
Registration details
NCT05651724, registration date: 15 Dec 2022.
Stroke, Ahead of Print. BACKGROUND:Treatment burden is the workload of health care for people with long-term conditions and the impact on wellbeing. A validated measure of treatment burden for use as an outcome measure in stroke trials is needed. We adapted a patient-reported measure of treatment burden in multimorbidity, Patient Experience With Treatment and Self-Management (PETS), version 2.0, to create a stroke-specific measure, PETS-stroke, and examined its psychometric properties.METHODS:We conducted an observational cohort study. Stroke and transient ischemic attack survivors were recruited between February 2022 to June 2023 from 10 hospitals in the United Kingdom and through the Scottish Health Research Register. Participants completed the PETS-stroke questionnaire along with 3 other patient-reported measures (the Stroke Southampton Self-Management Questionnaire, the Satisfaction With Stroke Care Measure, and the Shortened Stroke Impact Scale). We performed confirmatory factor analysis to test the factor structure of the PETS-stroke. We assessed Spearman rank correlations between PETS-stroke and other patient-reported measures to determine convergent validity. An intraclass correlation coefficient was performed to assess test-retest reliability. Proportions of missing data along with feedback from qualitative interviews were used to determine feasibility. T-tests were conducted to examine variations in PETS-stroke scores based on multimorbidity and socioeconomic factors.RESULTS:Three hundred eighty-one participants were included (mean age, 68.2 [SD, 11.2] years; female, 43.3%). The best fit was achieved with a 9-factor structure, and internal consistency was good (Omega values, 0.729–0.921). The factor loadings for the individual indicator items across 8 of the 9 domains were moderate to strong. All domains of PETS-stroke showed moderate to strong correlations with at least one other patient-reported measure. Test-retest reliability was good for all domains (intraclass correlation coefficient >0.7). Qualitative feedback on feasibility was positive: participants found the questionnaire to be easy and quick to complete, and missing data were within acceptable limits for 7 domains. PETS-stroke scores significantly differed based on multimorbidity in 3 domains and in 8 domains based on socioeconomic status.CONCLUSIONS:Psychometric performance suggests that PETS-stroke is a valid and feasible measure of treatment burden after stroke.
Objectives
Aggression and violence against physicians in hospitals is acknowledged to be an issue, and patients (and their relatives/friends) have been identified as the most prevalent source. The aim of this study is to investigate the impact of patient aggression and violence against physicians on the team and organisational levels.
Design
This is a qualitative interview study based on semistructured, in-depth individual interviews. Interview transcripts were coded and analysed in Atlas.ti.
Setting
Interviews were conducted in Chinese hospitals.
Participants
This study involved 29 diverse participants, including physicians, hospital team leaders and hospital board members, working in two secondary hospitals and two tertiary hospitals in China.
Results
This study found that, at the team level, aggression and violence by patients (and their relatives/friends) can affect team climate, team communication, team beliefs and team resources. At the organisational level, such aggression and violence can have negative financial impacts (ie, involving compensation and additional costs) and societal impacts (ie, image and reputational damage, and public distrust). Although peer support and leaders’ support were identified as important sources for physicians to deal with violent incidents, these sources were not used to their full potential.
Conclusions
Recovering a team climate after a violent incident and providing diverse forms of support, especially proactive support from leaders and peers, represent two important approaches to cope with the negative impact of patient (and their relatives/friends) aggression and violence against physicians on both team and organisational levels.
