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Patients in forensic psychiatric care (FPC) are commonly treated with a wide range of psychotropic medications. There is, however, a lack of understanding regarding how pharmacological treatment and psychotropic polypharmacy are used throughout care.
Method
This register-based cohort study included patients admitted to FPC in Sweden between 2009 and 2020. We estimated the prevalence of the use of major psychotropic medication, as well as psychotropic polypharmacy, at admission and discharge. We also examined the change in antipsychotic use after admission.
Results
In total, 1962 patients were included. Antipsychotics were the most used psychotropic medication class, with 86.2% (95%CI: 84.5–87.8) of patients receiving at least one typical or atypical antipsychotic at admission. Changes in the antipsychotic regime were more common at the beginning of FPC, compared to later time points. Within the subgroup of patients discharged during the study period (n = 561), there was a reduction in the use of typical antipsychotics (admission: 34.9%; discharge: 26.6%) and hypnotics and sedatives (admission: 37.4%; discharge: 28.1%). Other major medication classes remained relatively stable. The prevalence of psychiatric polypharmacy at admission was 70.6% (95%CI: 68.5–72.7) and remained similar during care.
Conclusions
Our study documented a high prevalence of antipsychotic use and psychotropic polypharmacy through FPC. Further, a high level of off-label antipsychotic use and antipsychotic polypharmacy was observed. Stronger evidence regarding the effectiveness and safety of these treatment strategies is needed.
How does the deployment and withdrawal of UN peacekeepers affect local economic development in civil war countries? This study provides a large-N subnational analysis across UN peacekeeping operations that assesses their impact on the local economy both during deployment and after their withdrawal. We expect a positive association between UN peacekeeping and economic development. Besides providing a sizeable cash injection into the economy, peacekeepers can safeguard both the resumption of everyday economic exchanges at the grassroots level and the influx of aid and development projects. To test this, we combine subnational data on peacekeeping deployments with high-resolution data on nightlight emissions. Results from two-way fixed effects models, using matching, show that a more sizable peacekeeping presence can help boost economic activity in their area of operation. Importantly, we identify a slow but positive economic development in areas of deployment after peacekeepers withdraw, which is confirmed in a DiD estimation approach.
With high-speed turbulent combustion applications, we here mean airbreathing engine systems capable of powering aircraft at supersonic and low hypersonic flight speeds between 3 < Ma < 8. Such aircraft are most likely to be designed differently compared to today’s aircraft, being centered around a common engine duct embracing different engine systems activated at different flight speeds. For takeoff and landing, conventional turbojet engines will likely be used, whereas for cruise conditions, a dual-mode ramjet engine, capable of transi-tioning between pure ramjet and scramjet modes is preferred. Such engines do not yet exist, but experimental and computational research is currently generating data and information, paving the way toward further understanding of the aerothermodynamics. This will generate the basis for more advanced experiments that, together with high-fidelity simulations, can lead toward the realization of hypersonic flight vehicles. Here, coarse-grained reacting large eddy simulation and hybrid Reynolds-averaged Navier–Stokes or LES, together with small comprehensive reaction mechanisms, conjugate heat transfer, and thermal radiation modeling, play an important role. In this chapter, the necessary modeling steps and methods, as well as chemical reaction mechanisms, are scrutinized, and results from a few selected cases are presented to illustrate the key physical processes as well as the accuracy of present LES-based prediction methods and the remaining challenges.
In this chapter, we investigate how a couple where one of the spouses is diagnosed with dementia handle challenges in narrations of past shared events that arise when the spouse with dementia has limited access to these events. Partners of people diagnosed with dementia recurrently have to take into consideration that their spouse may not remember details in stories they tell, even though the person with dementia is a main participant in the events being retold. The design of such stories is complex as the interactants must keep track of both the content of the story and manage the potential sensitivity of telling a story that should already be known to both spouses. We show how the spouse without dementia (re)organizes the participation framework in resourceful ways and delicately deals with her spouse’s limited memory using a variety of face-saving practices. The analyses highlight how issues related to knowledge and dementia can benefit from using an interactional and distributed perspective. While access and rights to knowledge is usually divided between participants depending on the knowledge domain and the participants’ relation to the topic, in the case of a dementia disease a more flexible approach towards such divisions could be advantageous.
In a questionnaire, participants judged the increase in SARS-CoV-2 virus exposure when moving closer to an infected person. Earlier studies have shown that the actual increase in virus exposure is underestimated and the present study replicated and extended these studies. The primary purpose was to investigate to what extent questionnaire judgments about hypothetical situations can predict judgments and actual behavior in real physical space. Participants responded to a questionnaire and the same participants also took part in a parallel study that was conducted in a room with a mannequin representing a virus infected person. The earlier reported bias in the perception of exposure as a function of distance to a virus source was replicated in the questionnaire and the physical laboratory study. A linear function connected median exposure judgments at the same distances from a virus source in the questionnaire and in the laboratory, R2 = 0.99. When asked to move to a distance that would give a prescribed exposure level, a linear function described the relationship between questionnaire distance judgments and moves to distances in the physical space, R2 = 0.95. We concluded that questionnaire data about perceived virus exposures are reliable indicators of real behavior. For health reasons, the significant underestimations of the steep increase of virus exposure during an approach to a virus source need to be stressed in communications to policy makers, the public, professionals working close to clients, nursing staff, and other care providers.
New Religious Movements have arisen not only in the present but have also developed in the past. While they differ in ideology and practice, they generally seem to live in high tension with mainstream society, especially when it comes to child-rearing. This Element examines several aspects of children growing up in new religions. It relies upon literature from different groups concerning child upbringing, the function of children in the groups considering the religious ideologies, and parental perspectives and parental styles. It also utilizes accounts from young adults growing up in these groups, both those who chose to stay and who chose to leave their groups as adults. A range of topics, such as socialization, education, health care, and relations to surrounding society are explored. In addition, this Element considers issues of physical and emotional abuse, state interventions, and the impact of second- and third generations of children in new religions.
The proliferation of digital technologies is changing the face of markets and society. This on-going market digitalization represents an opportunity for Market Studies – a field that has long considered the role of technologies in markets. Careful inquiry into market digitalization allows for continued agnostic and descriptive research, but also prompts us to consider the human outcomes of market arrangements. This chapter explores how the digitalization of markets affects human relationships and experiences. Basing our argument on a review of contemporary scholarship on market digitalization, we suggest that digitalization reconfigures both visibility and participation in markets. This typology actualizes how everyday human market interaction is changing, exemplified through the figures of the consumer, the influencer, and the activist. We find that Market Studies is in a strong position to address technologies as it already considers several roles in markets: as market devices, objects of exchange, as well as market infrastructures. We propose that Market Studies should continue to explore differences in market arrangements, as well as the significant variability among the people interacting in digitalizing markets.
The ethical treatment of human remains after excavation is a core debate in archaeology. This project explores the treatment of human remains in some European museums with an aim to support open discussion of complex ethical issues among research and heritage professionals involved in the care of human remains.
How did Hitler's personal religious beliefs help to shape the development of National Socialism? Through close analysis of primary sources, Mikael Nilsson argues that Hitler's admiration of Jesus was central in both his public and private life, playing a key role throughout his entire political career. Christianity in Hitler's Ideology reexamines the roots of National Socialism, exploring how antisemitic forms of Christian nationalism de-Judaized Jesus and rendered him as an Aryan. In turn, the study analyses how Hitler's religious and ideological teachers such as Völkisch-Christian writers Houston Stewart Chamberlain and Dietrich Eckart weaponised these ideas. Nilsson challenges the established understanding that Hitler only used religion as a tool of propaganda. Instead, it is argued that religious faith and deeply held convictions were at the core of National Socialism, its racism, the Second World War, and the Holocaust.
Here, I deal with the issue of Hitler’s belief in Jesus’ divinity and show that, in contrast to what modern scholarship has thus far claimed about this question, Hitler did indeed refer to Jesus as divine on many occasions throughout his life. He even spoke of Jesus as the Son of God. I argue that Hitler’s views cannot be explained away by claiming that his words were simply clever propaganda intended to draw Christians into the NSDAP. The particularities of Hitler’s religious views and his interpretation of Jesus were simply too odd for them to act effectively as a propaganda tool designed to gain the sympathies of mainstream Christians. This chapter builds on an article that was published in the Journal of Religious History in June 2021.
The conclusion that Hitler was genuinely inspired by Jesus in his antisemitic struggle against the Jews thus cannot be avoided. Hitler viewed Jesus as the original Aryan warrior who had begun an apocalyptic battle against the Jews, but who had been killed before he had had a chance to finish the job. Historians must start taking Hitler’s (and the other leading Nazis’) religious beliefs seriously if we wish to fully understand how Hitler and his followers could be so morally convinced that what they were doing was the right thing – indeed, the “good” thing – to do. It adds significantly to our understanding not only of how Hitler could sway so many Germans to do what he wanted, but also of how the Nazis’ ultimate crime – the Holocaust – was possible to undertake in one of Europe’s most “civilized” and culturally and economically developed nations. Hitler thought he was following in the footsteps of Jesus – an alleged Aryan warrior who had dedicated his life to fighting the Jews – and that the National Socialists had a duty to finish what he was convinced Jesus had started: the eradication of theof the Jewish people from the face of the earth.
In this chapter, I cover the religious and ideological background development of how the character of Jesus came to be remade a Jew into an Aryan. I show the complicity of many leading Christian theologians in this development through their willingness to adapt to racist ideas and to integrate these into the Christian faith, thereby laying the foundation for what became National Socialist Christianity, most clearly embodied in the form of the splinter group in the German Protestant church known as German Christians (Deutsche Christen). This chapter is crucial in order for the reader to be able to understand how Hitler’s interpretation of Jesus could ever have come about and been accepted. It was not Hitler who created the idea of Jesus as an Aryan warrior attacking the Jews; Hitler only integrated an already existing and established idea into his own worldview.
In the last empirical chapter, I show the many ways in which Hitler’s belief in Jesus as an Aryan warrior turned Jesus into a moral/ethical, religious, and ideological role model for the Nazis. Hitler’s selective interpretation of Jesus’ life and mission meant that the latter was seen as an Aryan hero and combatant against the Jews. The story of how Jesus had cleared the Temple grounds of moneylenders was one of Hitler’s favorite images and one that he constantly brought up as an example for every Nazi to follow. The National Socialists were considered to be the true heirs and followers of Christ; but while the Jews had prevented Jesus from fulfilling his divine mission by killing him, the Nazis would indeed succeed in destroying the Jews and thus completing Jesus’ divine mission on earth. The chapter stresses the important point that Hitler believed his genocidal war on the Jewish people to be a mission sanctioned and proscribed by God.