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28 results

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  • Introduction of point-of-care blood testing in early intervention in psychosis services: effects on physical health screening

  • Monty Lyman, Jack B. Fanshawe, Joshua Brewin, Thomas R. Fanshawe, Philip J. Turner, Margaret Glogowska, Ian Smith, Sarah Amani, Gail Hayward, Belinda Lennox
  • Journal:
    The British Journal of Psychiatry , FirstView
    Published online by Cambridge University Press:
    11 April 2025, pp. 1-6
  • Background

    There is a significant mortality gap between the general population and people with psychosis. Completion rates of regular physical health assessments for cardiovascular risk in this group are suboptimal. Point-of-care testing (POCT) for diabetes and hyperlipidaemia – providing an immediate result from a finger-prick – could improve these rates.

    Aims

    To evaluate the impact on patient–clinician encounters and on physical health check completion rates of implementing POCT for cardiovascular risk markers in early intervention in psychosis (EIP) services in South East England.

    Method

    A mixed-methods, real-world evaluation study was performed, with 40 POCT machines introduced across EIP teams in all eight mental health trusts in South East England from March to May 2021. Clinician training and support was provided. Numbers of completed physical health checks, HbA1c and lipid panel blood tests completed 6 and 12 months before and 6 months after introduction of POCT were collected for individual patients. Data were compared with those from the South West region, which acted as a control. Clinician questionnaires were administered at 2 and 8 months, capturing device usability and impacts on patient interactions.

    Results

    Post-POCT, South East England saw significant increases in HbA1c testing (odds ratio 2.02, 95% CI 1.17–3.49), lipid testing (odds ratio 2.38, 95% CI 1.43–3.97) and total completed health checks (odds ratio 3.61, 95% CI 1.94–7.94). These increases were not seen in the South West. Questionnaires revealed improved patient engagement, clinician empowerment and patients’ preference for POCT over traditional blood tests.

    Conclusions

    POCT is associated with improvements in the completion and quality of physical health checks, and thus could be a tool to enhance holistic care for individuals with psychosis.

  • Point-of-Care Blood Testing in Severe Mental Illness: A Mixed-Methods Evaluation

  • Monty Lyman, Jack Fanshawe, Josh Brewin, Thomas Fanshawe, Philip Turner
  • Journal:
    BJPsych Open / Volume 10 / Issue S1 / June 2024
    Published online by Cambridge University Press:
    01 August 2024, pp. S58-S59
    • Article
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  • Aims

    There is a significant mortality gap between the general population and people with SMI. This is especially prominent in those with psychotic disorders, underpinned by an increased risk of cardiometabolic disease. Identifying patients at risk early in their psychotic disorder is of key importance to reduce this mortality gap. Despite the recognised importance of regular physical health assessments in this group, completion rates are suboptimal. Point-of-care testing (POCT) to screen for diabetes and hyperlipidaemia, providing a result from a fingerprick sample in under 10 minutes presents a potential solution to enhance delivery of physical health checks and improve health outcomes in a proactive manner.

    We introduced POCT across EIP teams in Southeast of England and evaluated the impact on physical health check completion rates and the quality of clinician-patient interactions in EIP teams.

    Methods

    A stepped wedge study was performed, introducing Abbot Afinion-2 machines across 30 EIP teams in all eight Mental Health Trusts in South East England (2021–2022). Numbers of completed physical health checks, and HBA1C and lipids blood tests completed in six months before and six months after introduction of POCT were collected from individual patients. Data were compared with those from the South West, which acted as a control region. Data were analysed from National Clinical Audit of Psychosis (NCAP) over comparable date range (2021–2022) to corroborate the findings. Clinician questionnaires were administered at three timepoints (after training, two-months, and eight-months), capturing training experiences, device usability and impacts on patient interactions.

    Results

    In Southeast England, the rate and quality of physical health checks increased after introduction of POCT HbA1c testing OR 2.02 (95% CI 1.17 to 3.49), lipids 2.38 (1.43 to 3.97), and total completed health checks 3.61 (1.94 to 7.94). These increases were not seen in the Southwest region that did not introduce the machines. A post-hoc review of national audit data also showed a greater improvement of health checks in the intervention group compared with the comparator group over an overlapping timescale. Findings from the questionnaires evidenced improved patient engagement, clinician empowerment and the preference of POCT over traditional blood tests in this setting.

    Conclusion

    POCT is associated with improvements in the rate and quality of physical health checks, and this study emphasizes the potential of POCT in reducing health inequalities and enhancing holistic care for individuals living with severe mental illness.

  • Whitman’s Undemocratic Vistas: Mortal Anxiety, National Glory, White Supremacy

  • JACK TURNER
  • Journal:
    American Political Science Review / Volume 117 / Issue 2 / May 2023
    Published online by Cambridge University Press:
    27 July 2022, pp. 705-718
    Print publication:
    May 2023
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  • Walt Whitman’s Democratic Vistas (1871) has become a touchstone of democratic theory. Commentators of unusual ideological range uphold the book as politically exemplary. This article demonstrates that recent theoretical celebrations of Democratic Vistas are sanitized and incomplete. I expose the antidemocratic side of Democratic Vistas by analyzing (1) its philosophy of death and (2) its politics of race. Whitman framed his immortalist response to death within an imperialist historical teleology. That teleology entailed violations of Native sovereignty, the political inequality of Black Americans, and the projection of both Black and Native peoples’ evolutionary extinction. Democratic Vistas emerges from this analysis as both necropolitical and white supremacist. If, as Richard Rorty argues, Vistas models a salutary form of reformist “national pride,” then it also illustrates the dangerous susceptibility of such pride to moral innocence and self-deceit.

  • Delivery of Immunomodulatory Microparticles in a Murine Model of Rotator Cuff Tear

  • Jack R. Krieger, Mary Caitlin P. Sok, Thomas C. Turner, Edward A. Botchwey
  • Journal:
    MRS Advances / Volume 3 / Issue 50 / 2018
    Published online by Cambridge University Press:
    28 June 2018, pp. 2981-2989
    Print publication:
    2018
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  • Full thickness rotator cuff tears (RCT) and the associated muscle degeneration that results due to this injury presents a significant clinical burden. The prevention or recovery from this degeneration requires the synchronized behavior of many cells that participate in regeneration. Strategies that tune the inflammatory cascade that is initiated after injury serves as a powerful way to influence tissue repair. Here, we use the local, sustained delivery of the immunomodulatory small molecule FTY720 to examine whether the recruitment of pro-regenerative myeloid cells affects the healing outcome. We find that PLGA microparticles have an atrophic effect on the muscle that is ameliorated with the release of FTY720. However, the inability of FTY720 delivery to induce pro-regenerative monocyte and macrophage recruitment and our findings demonstrating enrichment of CD4+ T cells suggest that effects of this small molecule are context dependent and that the underlying mechanisms behind this RCT associated muscle degeneration require further studies.

  • Parasitic nematodes of the genus Syphacia Seurat, 1916 infecting Muridae in the British Isles, and the peculiar case of Syphacia frederici

  • ALEX STEWART, ANN LOWE, LESLEY SMALES, ANNA BAJER, JAN BRADLEY, DOROTA DWUŻNIK, FRITS FRANSSEN, JACK GRIFFITH, PETER STUART, CYAN TURNER, GRZEGORZ ZALEŚNY, JERZY M. BEHNKE
  • Journal:
    Parasitology / Volume 145 / Issue 3 / March 2018
    Published online by Cambridge University Press:
    23 August 2017, pp. 269-280

  • Syphacia stroma (von Linstow, 1884) Morgan, 1932 and Syphacia frederici Roman, 1945 are oxyurid nematodes that parasitize two murid rodents, Apodemus sylvaticus and Apodemus flavicollis, on the European mainland. Only S. stroma has been recorded previously in Apodemus spp. from the British Isles. Despite the paucity of earlier reports, we identified S. frederici in four disparate British sites, two in Nottinghamshire, one each in Berkshire and Anglesey, Wales. Identification was based on their site in the host (caecum and not small intestine), on key morphological criteria that differentiate this species from S. stroma (in particular the tail of female worms) and by sequencing two genetic loci (cytochrome C oxidase 1 gene and a section of ribosomal DNA). Sequences derived from both genetic loci of putative British S. frederici isolates formed a tight clade with sequences from continental worms known to be S. frederici, clearly distinguishing these isolates from S. stroma which formed a tight clade of its own, distinct from clades representative of Syphacia obvelata from Mus and S. muris from Rattus. The data in this paper therefore constitute the first record of S. frederici from British wood mice, and confirm the status of this species as distinct from both S. obvelata and S. stroma.

Religion and the State

  • Introduction States, Consumption and Managing Religions

  • Edited by Jack Barbalet, Adam Possamai, Bryan Turner
  • Book:
    Religion and the State
    Published by:
    Anthem Press
    Published online:
    05 May 2012
    Print publication:
    15 December 2011, pp 1-22

  • Summary

    When sociologists refer to the contemporary crisis of multiculturalism, they are typically talking about how modern states, especially liberal democratic states, respond to the rise of “public religions.” These religious conflicts and uncertainties about appropriate state responses to them have produced a general retreat from multiculturalism – at least in Europe (Joppke, 2004). More specifically, the contemporary problem of politics and religion has been increasingly orchestrated around the global revival of Islam and the emergence of a global Muslim community. However, the particular issues surrounding Muslim minorities in non-Muslim secular societies can be seen as simply one instance of the more general issue of state and religion relationships in modern complex societies. There is growing awareness about the limitations of the Westphalian solution to religious conflicts and hence political theory is undertaking a serious reconsideration of liberalism as the philosophical basis of political strategies to manage conflicting cultural, religious and ethnic interests. In the modern global world where state boundaries have been contested, there is a need to rethink how the competing claims of secular and religious citizens can be articulated and respected within public discourse (Habermas, 2008).

    This question – how to manage the public expression of religion in multicultural and therefore multifaith societies – is not simply an issue for conventional liberal societies, because religious revivalism and community conflict raise political issues across a wide spectrum of modern societies.

  • Chapter 13 - Public Religions and the State: A Comparative Perspective

  • from Part III - Concluding Comments
  • Edited by Jack Barbalet, Adam Possamai, Bryan Turner
  • Book:
    Religion and the State
    Published by:
    Anthem Press
    Published online:
    05 May 2012
    Print publication:
    15 December 2011, pp 277-282

  • Summary

    The preceding chapters highlight a number of aspects of religion which depart from, fundamentally modify and recontextualize the received wisdom about religion, especially as it has been understood through the prism of classical sociology. Each of the distinct sources of the classical perspective outlines an understanding of religion that – while contrasting with other understandings – has been taken with the others to represent the various facets of religion in the modern world. And yet none of these facets of religion is today found in forms projected by the sociological luminaries.

    Émile Durkheim famously characterized religion in terms of a distinction he believed inherent in all religions, namely that between the sacred and the profane. The sacred, Durkheim held, was a symbolic form of the enduring and defining values of the society itself in which the religion in question resides. But the coherence of a more or less societally wide normative consensus that Durkheim assumes in making this claim is in fact not to be found in modern societies. This is largely because the populations of modern societies are not unitary in terms of their origins and historical memory, either through geographic mobility that accompanies modern occupational careers or through international migration, which has been a major demographic factor throughout the twentieth century and promises to continue in the present. Associated with these trends, the idea of the sacred – which requires a traditional understanding of received meaning supported by ritual practices – has given way if not to a scientific to at least a mundane utilitarian and therefore market set of values.

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