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Demonic Assault, Providence, and the Search for Salvation in Early Modern Reformed English Protestant Theology
- Brendan C. Walsh
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- Journal:
- Church History / Volume 91 / Issue 4 / December 2022
- Published online by Cambridge University Press:
- 03 May 2023, pp. 753-779
- Print publication:
- December 2022
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- Article
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During the late sixteenth and early seventeenth centuries—the height of European demonological interest—England experienced a series of demonic possession cases that gained substantial attention from the clergy and laypeople alike. Reported across sensationalist pamphlets and learned demonological treatises, these cases were presented as extraordinary tokens of God's providence intended to be interpreted and responded to by those involved. English Calvinists during this period were largely interested in demonic possession for three primary reasons: what providential meaning this spiritual affliction offered, what action God was compelling them to carry out, and, more importantly, what profit they could gain in fulfilling their godly duties. The profit cited by these Calvinists was a glimpse into their predestined fate. This article argues that demonic affliction was fashioned as an emblematic phenomenon by English Calvinist communities with dispossession (exorcism) cast as a definitive form of spiritual warfare designed to provide comfort for the faithful and guide them toward a blessed conclusion. In this context, possession functioned as a providential catalyst: a call to carry out dispossession that, once fulfilled, brought the entire act to completion. Examining four possession textual accounts in detail, with a particular focus on the exploits of the controversial Puritan exorcist John Darrell, this article examines the intellectual construction of spirit possession and exorcism within an aligned Calvinist providential and eschatological framework. These cases exemplify many of the prevailing interpretations of spirit possession in the early modern English context and illustrate how this affliction offered individuals a potential salve to the vexed nature of Calvinist predestination.
A Geographic Simulation Model for the Treatment of Trauma Patients in Disasters
- Brendan G. Carr, Lauren Walsh, Justin C. Williams, John P. Pryor, Charles C. Branas
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- Journal:
- Prehospital and Disaster Medicine / Volume 31 / Issue 4 / August 2016
- Published online by Cambridge University Press:
- 25 May 2016, pp. 413-421
- Print publication:
- August 2016
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Background
Though the US civilian trauma care system plays a critical role in disaster response, there is currently no systems-based strategy that enables hospital emergency management and local and regional emergency planners to quantify, and potentially prepare for, surges in trauma care demand that accompany mass-casualty disasters.
ObjectiveA proof-of-concept model that estimates the geographic distributions of patients, trauma center resource usage, and mortality rates for varying disaster sizes, in and around the 25 largest US cities, is presented. The model was designed to be scalable, and its inputs can be modified depending on the planning assumptions of different locales and for different types of mass-casualty events.
MethodsTo demonstrate the model’s potential application to real-life planning scenarios, sample disaster responses for 25 major US cities were investigated using a hybrid of geographic information systems and dynamic simulation-optimization. In each city, a simulated, fast-onset disaster epicenter, such as might occur with a bombing, was located randomly within one mile of its population center. Patients then were assigned and transported, in simulation, via the new model to Level 1, 2, and 3 trauma centers, in and around each city, over a 48-hour period for disaster scenario sizes of 100, 500, 5000, and 10,000 casualties.
ResultsAcross all 25 cities, total mean mortality rates ranged from 26.3% in the smallest disaster scenario to 41.9% in the largest. Out-of-hospital mortality rates increased (from 21.3% to 38.5%) while in-hospital mortality rates decreased (from 5.0% to 3.4%) as disaster scenario sizes increased. The mean number of trauma centers involved ranged from 3.0 in the smallest disaster scenario to 63.4 in the largest. Cities that were less geographically isolated with more concentrated trauma centers in their surrounding regions had lower total and out-of-hospital mortality rates. The nine US cities listed as being the most likely targets of terrorist attacks involved, on average, more trauma centers and had lower mortality rates compared with the remaining 16 cities.
ConclusionsThe disaster response simulation model discussed here may offer insights to emergency planners and health systems in more realistically planning for mass-casualty events. Longer wait and transport times needed to distribute high numbers of patients to distant trauma centers in fast-onset disasters may create predictable increases in mortality and trauma center resource consumption. The results of the modeled scenarios indicate the need for a systems-based approach to trauma care management during disasters, since the local trauma center network was often too small to provide adequate care for the projected patient surge. Simulation of out-of-hospital resources that might be called upon during disasters, as well as guidance in the appropriate execution of mutual aid agreements and prevention of over-response, could be of value to preparedness planners and emergency response leaders. Study assumptions and limitations are discussed.
,Carr BG ,Walsh L ,Williams JC ,Pryor JP .Branas CC A Geographic Simulation Model for the Treatment of Trauma Patients in Disasters . Prehosp Disaster Med.2016 ;31 (4 ):413 –421 .