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12 results

  • 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.

  • Governing from the Centre: the 1977 French Local Elections

  • Jack Hayward, Vincent Wright
  • Journal:
    Government and Opposition / Volume 12 / Issue 4 / 01 October 1977
    Published online by Cambridge University Press:
    28 March 2014, pp. 433-454

  • FRANCE IS A COUNTRY IN WHICH PAST POLITICAL BATTLES ARE IN the forefront of the minds of those who are engaged in contemporary conflicts. The March 1977 elections in the 36,383 communes of metropolitan France could evoke memories of 1877 and 1947. The thirtieth anniversary of the Gaullist landslide of 1947 was directly concerned with local elections as such, while 1877 recalled the defeat of President MacMahon's attempt to impose his choice of government a century ago, which finally settled the struggle between Left and Right over the regime of the Third Republic. Anticipation that the regime established by General de Gaulle would be put to the searching test of a clash between the President and a Left-wing Assembly majority converted in some people's minds the March 1977 local clections into a prologue to this decisive national confrontation.

  • National Aptitudes for Planning in Britain, France, and Italy

  • Jack Hayward
  • Journal:
    Government and Opposition / Volume 9 / Issue 4 / 01 October 1974
    Published online by Cambridge University Press:
    28 March 2014, pp. 397-410

  • THE COMPARATIVE STUDY OF NATIONAL ECONOMIC PLANNING WAS fashionable in the 1960s at a time when the French model had become extremely popular in Western Europe. However, analyses of planning experience were then generally inhibited by a preoccupation with descriptions of the formal planning procedures rather than with any serious attempt to assess anything but the economic consequences of planning. (Andrew Shonfield's classic study of Modern Capitalism was a conspicuous exception to this criticism.) Attention was focused on plans as official documents rather than upon a set of planning practices that might be only remotely related to any formal statement of public policy. Planning was viewed too much from the forecasting end rather than the implementation end and the rationality of objectives became more of a preoccupation than the practical problems of translating them into reality. A normative model of efficient decision-making was all too often assumed to be readily transposable because of a wholly unrealistic notion of the ways in which organizations work.

  • 10 - Bonapartist and Gaullist Heroic Leadership: Comparing Crisis Appeals to an Impersonated People

  • Edited by Peter Baehr, Lingnan University, Hong Kong, Melvin Richter, City University of New York
  • Book:
    Dictatorship in History and Theory
    Published online:
    05 January 2013
    Print publication:
    16 February 2004, pp 221-240

  • Summary

    Attempts to simplify by dichotomizing the complexity of French political traditions, either in an attempt to achieve intellectual clarity or from a polemical urge to promote guilt or virtue by repulsion and association, have been numerous since the French Revolution. There have been more historically sensitive efforts to respect the variety within each component of the left/right duality. In particular, Réne Rémond's distinction between three French rights - ultra-racist legitimist, Orléanist, liberal and Bonapartist nationalist - had much to commend it when first formulated in 1954. However, in later editions he sought to force Gaullism into this tripartite straightjacket while warning that “Historical rapprochements are normally only the most subtle form of anachronism.” A presupposition of this chapter's deliberate use of hindsight to see nineteenth-century Bonapartism through the twentieth-century phenomenon of Gaullism is that it allows us to offer a retrospective corrective to ill-considered attributions of either ignominious or glorious ancestry.

    While acknowledging that the Bonapartist nationalist right incorporated minority left-wing elements, Rémond argued that dependence upon its predominantly right-wing support pushed it rightward under Napoleon, Louis Napoleon, Boulanger, and de Gaulle. He was prepared to accept that in theory Bonapartism “lent itself to many interpretations. Political Janus, its ambiguity allowed within limits some scope for adaptation. In 1849 it could, almost equally and with equal likelihood, have given birth to a left-wing or right-wing Bonapartism.”