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Page 1 of 24

  • 23 - Office, and Appointment to Office, in Early Christian Circles

  • from Part V - Contested Beliefs
  • Edited by Bruce W. Longenecker, Baylor University, Texas, David E. Wilhite, Baylor University, Texas
  • Book: The Cambridge History of Ancient Christianity
  • Published online: 23 August 2023
  • Print publication: 24 August 2023, pp 536-558

  • Summary

    In an earlier essay on the interplay between charisma and office, I listed the questions I had left unanswered:

    the origin of bishops, deacons, and presbyters, the precise extent and scope of their duties (as part of which we should pose the, as much unasked as unanswered, question of how bishops and/or presbyters come to have the exclusive right of presidency at the Eucharist), the fate of the teacher in the second century, and the manner in which, despite the opposition of such figures as Clement, Hermas and Ignatius, the episcopate takes on an intellectual role in the second century.1

    Although this list is not exhaustive, as new questions arise, this provides a starting point for an examination of questions related to office, and appointment to office, in early Christian communities, that had yet to receive satisfactory treatment.

  • Pathways to care for psychosis in Malawi

  • Demoubly Kokota, Robert C. Stewart, Chiwoza Bandawe, Genesis Chorwe-Sungani, Olive Liwimbi, Charles Masulani Mwale, Kazione Kulisewa, Michael Udedi, Saulos Gondwe, Anthony Sefasi, Richard Banda, Thandiwe Mkandawire, Stephen M. Lawrie
  • Journal: BJPsych International , FirstView
  • Published online by Cambridge University Press: 31 July 2023, pp. 1-5
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  • People with psychosis in Malawi have very limited access to timely assessment and evidence-based care, leading to a long duration of untreated psychosis and persistent disability. Most people with psychosis in the country consult traditional or religious healers. Stigmatising attitudes are common and services have limited capacity, particularly in rural areas. This paper, focusing on pathways to care for psychosis in Malawi, is based on the Wellcome Trust Psychosis Flagship Report on the Landscape of Mental Health Services for Psychosis in Malawi. Its purpose is to inform Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE), a longitudinal study that aims to build on existing services to develop sustainable psychosis detection systems and management pathways to promote recovery.

  • A marginal structural model to estimate the effect of antidepressant medication treatment on major cardiovascular events among people with post-traumatic stress disorder

  • Kwanghyun Kim, Sunghyuk Kang, Chung Mo Nam, Robert Stewart, Alexander C. Tsai, Sun Jae Jung
  • Journal: Psychological Medicine , First View
  • Published online by Cambridge University Press: 24 July 2023, pp. 1-10
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  • Background

    Previous evidence on antidepressant medication and cardiovascular disease (CVD) among patients with posttraumatic stress disorder (PTSD) has been inconclusive. We estimated the association between antidepressant medication and CVD by applying a marginal structural model.

    Methods

    We analyzed medical utilization records of 27 170 people with PTSD without prior major cardiovascular events in the Korean National Health Insurance Database (NHID). PTSD and CVD were defined in accordance with the recorded ICD-10 diagnostic codes. We acquired information on antidepressant use from the NHID and categorized them by medication type. A composite major adverse cardiovascular events (MACE) outcome was defined as coronary artery disease with revascularization, ischaemic stroke, and/or haemorrhagic stroke. We used inverse probability of treatment weighting to estimate the parameters of a marginal structural discrete-time survival analysis regression model, comparing the resulting estimates to those derived from traditional time-fixed and time-varying Cox proportional hazards regression. We calculated cumulative daily defined doses to test for a dose–response relationship.

    Results

    People exposed to antidepressants showed a higher hazard of MACE [hazard ratio (HR) 1.34, 95% confidence interval (CI) 1.18–1.53]. The estimated effects were strongest for selective serotonin reuptake inhibitors (HR 1.24, 95% CI 1.08–1.44) and TCAs (HR 1.33, 95% CI 1.13–1.56). Exposure to serotonin-norepinephrine reuptake inhibitors did not appear to increase the risk of MACE. People exposed to higher doses of antidepressants showed higher risk of MACE.

    Conclusions

    In a national cohort of people with PTSD, exposure to antidepressant medications increased the risk of MACE in a dose–response fashion.

  • Increased violence and aggression levels during the SARS-Cov-2 pandemic; data from three London acute psychiatric inpatient facilities.

  • S. Bonaccorso, O. Ajnakina, A. Ricciardi, S. Ouabbou, J. Wilson, C. Theleritis, M. Badhan, A. Metastasio, N. Stewart, M. Barczyck, F. Johansson, T. Tharmaraja, F. Schifano
  • Journal: European Psychiatry / Volume 66 / Issue S1 / March 2023
  • Published online by Cambridge University Press: 19 July 2023, p. S908
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  • Introduction

    The COVID-19 pandemic has significantly impacted mental health services, with the literature reporting an increase in the incidence of psychiatric admissions.

    Objectives

    The aim of this study was to assess the impact of the pandemic on clinical presentations, characteristics of admission and incidents occurring in three acute inpatient mental health facilities in the UK.

    Methods

    This was a retrospective study comparing data from the first and third UK lockdown to the five years prior to the pandemic. Data was acquired from electronic clinical records and addressed two acute psychiatric inpatient wards and one psychiatric intensive care unit. Key outcomes of comparison were clinical presentations, number of admissions, length of hospital stay, number of incidents and characteristics of incidents.

    Results

    Compared to the previous 5 years, a higher number of incidents characterized by violence and aggression were reported during the first (56.8% vs 44.3%, x2=16.56, df=1, p<0.001) and third lockdown (100.0% vs 86.2%, x2=36.40, df=1, p<0.001). An increase in non-psychotic disorders was observed in the first lockdown (20.0% vs 13.1%, x2=4.76, df=1, p=0.029), whilst increased first episode psychosis (19.7% vs 11.3%, x2=8.1, df=1, p=0.004) and schizophrenia spectrum disorders (74.4% vs 57.2%, x2= 7.6, df=1, p=0.006) were diagnosed during the third lockdown. There were no significant changes in the diagnosis of mood disorders in both lockdowns compared to previously. The median length of inpatient stay significantly reduced during the first lockdown (28 days vs 36 days, x2= 7.66, df=1, p=0.006).

    Conclusions

    Increased inpatient incidents may be explained by the impact of the pandemic on staffing levels and resources, combined with increased emotional distress amongst patients in the face of uncertainty. The pandemic may have increased substance misuse potentially linked with the increased incidence of first episode psychosis.

    Disclosure of Interest

    S. Bonaccorso: None Declared, O. Ajnakina: None Declared, A. Ricciardi: None Declared, S. Ouabbou: None Declared, J. Wilson: None Declared, C. Theleritis: None Declared, M. Badhan: None Declared, A. Metastasio: None Declared, N. Stewart: None Declared, M. Barczyck: None Declared, F. Johansson: None Declared, T. Tharmaraja: None Declared, F. Schifano Speakers bureau of: Prof. Fabrizio Schifano is a member of the European Medical Agency

  • White kidney bean extract as a nutraceutical: effects on gut microbiota, alpha-amylase inhibition, and user experiences

  • David Houghton, Oliver M. Shannon, Peter I. Chater, Matthew D. Wilcox, Jeffrey P. Pearson, Kyle Stanforth, Cara Jordan, Leah Avery, Alasdair P. Blain, Abraham Joel, Ruth Jeffers, Ruth Nolan, Andrew Nelson, Christopher J. Stewart, Fiona C. Malcomson
  • Journal: Gut Microbiome / Volume 4 / 2023
  • Published online by Cambridge University Press: 01 June 2023, e8
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  • White kidney bean extract (WKBE) is a nutraceutical often advocated as an anti-obesity agent. The main proposed mechanism for these effects is alpha-amylase inhibition, thereby slowing carbohydrate digestion and absorption. Thus, it is possible that WKBE could impact the gut microbiota and modulate gut health. We investigated the effects of supplementing 20 healthy adults with WKBE for 1 week in a randomised, placebo-controlled crossover trial on the composition of the gut microbiota, gastrointestinal (GI) inflammation (faecal calprotectin), GI symptoms, and stool habits. We conducted in vitro experiments and used a gut model system to explore potential inhibition of alpha-amylase. We gained qualitative insight into participant experiences of using WKBE via focus groups. WKBE supplementation decreased the relative abundance of Bacteroidetes and increased that of Firmicutes, however, there were no significant differences in post-intervention gut microbiota measurements between the WKBE and control. There were no significant effects on GI inflammation or symptoms related to constipation, or stool consistency or frequency. Our in vitro and gut model system analyses showed no effects of WKBE on alpha-amylase activity. Our findings suggest that WKBE may modulate the gut microbiota in healthy adults, however, the underlying mechanism is unlikely due to active site inhibition of alpha-amylase.

  • 1 - Welcome to Brexit Britain

  • from Part I - The Short Term
  • Paul Whiteley, University of Essex, Harold D. Clarke, University of Texas, Dallas, Matthew Goodwin, University of Kent, Canterbury, Marianne C. Stewart, University of Texas, Dallas
  • Book: Brexit Britain
  • Published online: 25 April 2023
  • Print publication: 04 May 2023, pp 3-23
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  • Summary

    In June 2016 the UK shocked the world by voting to leave the European Union. In our previous book (Brexit: Why Britain Voted to Leave the European Union) we told the story of what happened in the referendum and why it produced a leave vote. This book is a sequel to the earlier one and examines what happened after the decision was made looking at events up to the point that the UK formally left the EU in January 2020. This was a period of unprecedented political and electoral turmoil in British politics which for a period looked like it could shatter the party system. It encompassed three elections and three different Prime Ministers and unprecedented volatility in both Parliamentary and electoral politics. The book maps out the twists and turns of the Brexit process, both at the level of the political elites and among the mass public. It then goes on to examine the long-run antecedents of this momentous decision, using data that goes back more than fifty years. Finally, it speculates about the economic and poltical consequences of Brexit for the future, while taking into account the Covid Pandemic which itself added to the turmoil in British politics.

  • Postscript

  • Paul Whiteley, University of Essex, Harold D. Clarke, University of Texas, Dallas, Matthew Goodwin, University of Kent, Canterbury, Marianne C. Stewart, University of Texas, Dallas
  • Book: Brexit Britain
  • Published online: 25 April 2023
  • Print publication: 04 May 2023, pp 309-316

  • Summary

    In June 2016 the UK shocked the world by voting to leave the European Union. In our previous book (Brexit: Why Britain Voted to Leave the European Union) we told the story of what happened in the referendum and why it produced a leave vote. This book is a sequel to the earlier one and examines what happened after the decision was made looking at events up to the point that the UK formally left the EU in January 2020. This was a period of unprecedented political and electoral turmoil in British politics which for a period looked like it could shatter the party system. It encompassed three elections and three different Prime Ministers and unprecedented volatility in both Parliamentary and electoral politics. The book maps out the twists and turns of the Brexit process, both at the level of the political elites and among the mass public. It then goes on to examine the long-run antecedents of this momentous decision, using data that goes back more than fifty years. Finally, it speculates about the economic and poltical consequences of Brexit for the future, while taking into account the Covid Pandemic which itself added to the turmoil in British politics.

Page 1 of 24