Paul Jon Greenwood and David Edward Shiers
The purpose of this paper is to improve the quality of monitoring of risk factors that predict the likelihood of people with severe mental illness (SMI) developing cardiovascular…
Abstract
Purpose
The purpose of this paper is to improve the quality of monitoring of risk factors that predict the likelihood of people with severe mental illness (SMI) developing cardiovascular disease (CVD), diabetes and obesity, major contributors to poor physical health and risk of premature mortality.
Design/methodology/approach
The first phase of the AQuA “Don’t just screen-intervene” initiative supported five specialised community-based Early Intervention for Psychosis services in North West England to assess the effectiveness of monitoring of cardiometabolic risk in their patients using standards derived from the Lester Positive Cardiometabolic Health Resource, a nationally acknowledged framework for people with psychosis receiving antipsychotic medication. The initial findings formed the basis for a quality improvement programme which ran from November 2012 until May 2013.
Findings
By the end of a six month quality improvement programme the likelihood of a patient receiving a comprehensive cardiometabolic risk screening (evidenced by recorded measurement of body mass index or waist circumference, blood pressure, blood glucose and lipid profile, assessment of smoking status and enquiry of relevant family history) had increased from 10 to between 63 and 80 per cent.
Research limitations/implications
Cardiometabolic risk monitoring from the onset of psychosis and its treatment can be improved utilising quality improvement methodology in real-world specialist mental health services. Earlier identification and treatment of risk factors that predict higher rates of obesity, diabetes and SMI may help people with SMI avoid life-restricting and life-shortening physical disorders.
Practical implications
Given the National Audit of Schizophrenia findings of inadequate screening in those with established SMI alongside evidence that CVD risk can emerge early in the course of psychosis, a group of early intervention in psychosis services in North West England decided to examine this aspect of their routine clinical practice. This service evaluation describes the effectiveness of a quality improvement programme based on the Lester Positive Cardiometabolic Health Resource (referred to as Lester resource henceforth) to improve the effectiveness of monitoring of risk factors that predict the likelihood of people experiencing psychosis and schizophrenia developing CVD diabetes and obesity.
Social implications
A combination of social disadvantage and unhealthy lifestyles, adverse cardiometabolic impacts of antipsychotic medication and inequitable access to physical healthcare combine to put people with SMI at particular risk from CVD, the single biggest cause of premature death, and much more common than suicide (Brown et al., 2010). Despite higher rates of potentially modifiable CVD risk factors (De Hert et al., 2009) people with SMI appear to be missing out on opportunities to actively prevent conditions like CVD and diabetes compared to the general population.
Originality/value
People with SMI such as schizophrenia die 15-20 years earlier on average than the general population. Around 20 per cent of premature deaths can be explained by suicide and injury, but the remainder arise from a variety of natural causes such as CVD, chronic obstructive pulmonary disorder and certain cancers and infections (Nordentoft et al., 2013). The authors worked with five mental health trusts in the North West of England covering a sample of over 500 cases within early intervention services.
Details
Keywords
Tom Schultheiss, Lorraine Hartline, Jean Mandeberg, Pam Petrich and Sue Stern
The following classified, annotated list of titles is intended to provide reference librarians with a current checklist of new reference books, and is designed to supplement the…
Abstract
The following classified, annotated list of titles is intended to provide reference librarians with a current checklist of new reference books, and is designed to supplement the RSR review column, “Recent Reference Books,” by Frances Neel Cheney. “Reference Books in Print” includes all additional books received prior to the inclusion deadline established for this issue. Appearance in this column does not preclude a later review in RSR. Publishers are urged to send a copy of all new reference books directly to RSR as soon as published, for immediate listing in “Reference Books in Print.” Reference books with imprints older than two years will not be included (with the exception of current reprints or older books newly acquired for distribution by another publisher). The column shall also occasionally include library science or other library related publications of other than a reference character.
It's been three years since my previous survey in RSR. Superb reference books in pop music have been appearing so frequently that I've been having trouble keeping up. Let's hope…
Abstract
It's been three years since my previous survey in RSR. Superb reference books in pop music have been appearing so frequently that I've been having trouble keeping up. Let's hope “next year's” survey will only be 12 months in the making and not 36.
Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Tenn. 37203. Mrs. Cheney does not sell the books listed here. They are…
Abstract
Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Tenn. 37203. Mrs. Cheney does not sell the books listed here. They are available through normal trade sources. Mrs. Cheney, being a member of the editorial board of Pierian Press, will not review Pierian Press reference books in this column. Descriptions of Pierian Press reference books will be included elsewhere in this publication.
In this paper, I compare Theodore Schatzki’s practice theory, the existential phenomenology of Martin Heidegger upon whom Schatzki drew in its formation, and my own theory of…
Abstract
In this paper, I compare Theodore Schatzki’s practice theory, the existential phenomenology of Martin Heidegger upon whom Schatzki drew in its formation, and my own theory of institutional logics which I have sought to develop as a religious sociology of institution. I examine how Schatzki and I both differently locate our thinking at the level of practice. In this essay I also explore the possibility of appropriating Heidegger’s religious ontology of worldhood, which Schatzki rejects, in that project. My institutional logical position is an atheological religious one, poly-onto-teleological. Institutional logics are grounded in ultimate goods which are praiseworthy “objects” of striving and practice, signifieds to which elements of an institutional logic have a non-arbitrary relation, sources of and references for practical norms about how one should have, make, do or be that good, and a basis of knowing the world of practice as ordered around such goods. Institutional logics are constellations co-constituted by substances, not fields animated by values, interests or powers.
Because we are speaking against “values,” people are horrified at a philosophy that ostensibly dares to despise humanity’s best qualities. For what is more “logical” than that a thinking that denies values must necessarily pronounce everything valueless? Martin Heidegger, “Letter on Humanism” (2008a, p. 249).
Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18;…
Abstract
Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.
Index by subjects, compiled by K.G.B. Bakewell covering the following journals: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management…
Abstract
Index by subjects, compiled by K.G.B. Bakewell covering the following journals: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.
Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18;…
Abstract
Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.
Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18;…
Abstract
Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.
Jo-Ellen Pozner, Mary Kate Stimmler and Paul M. Hirsch
One of the lessons learned from the recent financial-sector crisis is that institutions may sometimes sow the seeds of their own destruction. We offer a two-tiered analysis of how…
Abstract
One of the lessons learned from the recent financial-sector crisis is that institutions may sometimes sow the seeds of their own destruction. We offer a two-tiered analysis of how the diffusion of innovative practices – in this case, issuing and securitizing subprime mortgages – can lead to an unanticipated breakdown of established institutions. At the institutional level, we demonstrate that the lack of effective external regulatory presence, the emergence of new norms through the introduction of a new institutional logic, and intense mimetic and competitive pressures may lead organizational actors to exploit a suboptimal innovation. At the organizational level, we argue that over-embeddedness of central actors within relatively closed networks and superstitious learning processes can exacerbate the biases to which decision makers are susceptible, leading to the institutionalization of a suboptimal organizational practice. These two parallel sets of processes led to severe consequences at the institutional level, which we label “terminal isomorphism.” We end by discussing consequences for institutional theory, future research directions, and recommendations for policy makers.