Chichester Hospital

ABSTRACTAny claim for the ecclesiological integrity of Anglicanism seems, at the moment, tenuous. The divisions within the Anglican Communion over the issues of human sexuality and gender do not seem easily healed, despite the efforts of the current archbishop of Canterbury, Justin Welby, and his predecessor, Rowan Williams. Despite the proud assertions of Anglican apologists down the ages that the Church was positioned, following the Elizabethan ‘settlement’ of 1588, with moderation and good sense as a via media between Rome and Geneva, this new five-volume history of Anglicanism reveals a church that has been in conflict from its very origins. In seeking to be a church for the whole of England, it was naturally constituted of competing theological and ecclesiological visions, influenced by continental reformations, that could never be entirely congruent – divisions which, at certain junctions since the break with Rome almost 500 years ago, have been the source of significant aggravation and tribalism. Those politico-theological tensions, the History underlines, were exported across Britain’s expanding empire, spawning vibrant new networks and associations that only served further to disrupt the fragile unity of the Church of England after the confessional state was dismantled by the British parliament in 1828–1832. Despite the enormous vibrancy engendered by this conflict of traditions, now stretched across a global Communion and influenced as much by post-colonialism and globalisation as older theological traditions, the final two volumes pose challenging questions for any who would seek to speak meaningfully of a single entity called the ‘Anglican Church’. This article suggests that the greatest threat to contemporary Anglicanism, however, lies in a postmodern retreat from the ecumenical task as truth becomes ever more contextualised, driven by a desire for peaceful cohabitation rather than institutional coherence. These volumes might suggest, rather, that Anglicanism’s hope (and its gift to the wider Church) is to be found precisely in its conflicted quest for truth and unity in faithful response to Scripture, tradition and reason.

This retrospective analysis of prospectively collected abdominal aortic aneurysm (AAA) screening data aimed to identify predictors of AAA-related events (surgery or death) with a view to better targeting of screening. For the interval 1984-2007, data for 1649 subjects with an AAA were collected prospectively as part of the Chichester AAA screening programme. This included serial aortic size measurements, blood pressure, risk factors for arterial disease and concurrent medications. AAA growth rates were adjusted for risk factor confounders using flexible hierarchical modelling. AAA growth distribution was analysed using Silverman's test of multimodality. Some 1231 subjects met the inclusion criteria of having more than one scan and a surveillance interval of over 3 months. AAA growth showed a bimodal pattern with nearly 50 per cent of all aneurysms never progressing to surgery or rupture. Adjusted annual AAA growth rates of at least 2 mm significantly predicted AAA-related events. This analysis identified a bimodal growth pattern for AAA, with a significant association between annual AAA growth rate of at least 2 mm and AAA-related events.

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