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This Element offers a theoretically informed examination of the manner in which religion, especially alternative and emergent religious and spiritual movements, is managed by law and legal mechanisms in the authoritarian theocracy of Iran. It highlights how these phenomena have been affected by the intersection of law, politics, and Shiʿi theology in recent Iranian history. The growing interest of Iranian citizens in new religious movements and spiritual currents, fostered by the cultural diffusion of Western writings and ideas, is described. The development of religious diversity in Iran and a corresponding loss of commitment toward some Islamic doctrines and practices are of considerable concern to both the Iranian religious and political establishments. This has led to social control efforts over any religious and spiritual movement differing from the regime's view of Islam. Those efforts, supported in large part by Western anticult ideas, culminated in the passage of a piece of stringent legislation in 2021. The Element closes with applications of theorizing from the sociology of law and of religion.
Troublesome events are common in human groups, and humans respond to perceived dangerous situations by creating narratives that both give a name to the events and serve as one means of exercising control. We argue that conspiracy narratives are a distinctive type of danger narrative but also one that varies with the degree of alleged danger. These narratives are most likely to develop during periods of extreme social and cultural dislocation. QAnon is one in a succession of conspiracy narratives through American history, such as witchcraft narrative in 1692 Salem and the 1980s Satanic cult narrative, in which satanic figures are alleged to have invaded the everyday world with catastrophic results. It is a particularly important case as it can be analyzed in real time and it has reached an advanced level of narrative development. We identify core characteristics of advanced conspiracy narratives as revelatory framing, mythic themes, insurgent media network, and narrative radicalization. Narrative radicalization is particularly important as it involves blaming specific actors and attributing intentionality to their actions, which constitutes a bridge from narrative interpretation to social intervention.
This chapter examines research about recruitment to political and new religious movements from the 1960s, 70s, and 80s, contrasting those results with the meager research base on participants in QAnon, noting similarities and differences. The major finding from the earlier research was that young people participated of their own volition as an expression of their human agency. They were not “brainwashed”. This key finding is generally applicable to QAnon participants, although QAnon devotees are typically older and often were recruited through social media and the internet. Social psychological theories such as “foot-in-the-door” and what happens when prophecies fail are applied to QAnon recruitment as well. The chapter ends with suggestions for research needed to fully understand QAnon recruitment.
Prior trials suggest that intravenous racemic ketamine is a highly effective for treatment-resistant depression (TRD), but phase 3 trials of racemic ketamine are needed.
Aims
To assess the acute efficacy and safety of a 4-week course of subcutaneous racemic ketamine in participants with TRD. Trial registration: ACTRN12616001096448 at www.anzctr.org.au.
Method
This phase 3, double-blind, randomised, active-controlled multicentre trial was conducted at seven mood disorders centres in Australia and New Zealand. Participants received twice-weekly subcutaneous racemic ketamine or midazolam for 4 weeks. Initially, the trial tested fixed-dose ketamine 0.5 mg/kg versus midazolam 0.025 mg/kg (cohort 1). Dosing was revised, after a Data Safety Monitoring Board recommendation, to flexible-dose ketamine 0.5–0.9 mg/kg or midazolam 0.025–0.045 mg/kg, with response-guided dosing increments (cohort 2). The primary outcome was remission (Montgomery-Åsberg Rating Scale for Depression score ≤10) at the end of week 4.
Results
The final analysis (those who received at least one treatment) comprised 68 in cohort 1 (fixed-dose), 106 in cohort 2 (flexible-dose). Ketamine was more efficacious than midazolam in cohort 2 (remission rate 19.6% v. 2.0%; OR = 12.1, 95% CI 2.1–69.2, P = 0.005), but not different in cohort 1 (remission rate 6.3% v. 8.8%; OR = 1.3, 95% CI 0.2–8.2, P = 0.76). Ketamine was well tolerated. Acute adverse effects (psychotomimetic, blood pressure increases) resolved within 2 h.
Conclusions
Adequately dosed subcutaneous racemic ketamine was efficacious and safe in treating TRD over a 4-week treatment period. The subcutaneous route is practical and feasible.
Edited by
Ben Kiernan, Yale University, Connecticut,T. M. Lemos, Huron University College, University of Western Ontario,Tristan S. Taylor, University of New England, Australia
General editor
Ben Kiernan, Yale University, Connecticut
This chapter explores the related questions of whether or not genocide is found in sources from ancient Mesopotamia and whether ancient Mesopotamian empires carried out genocidal violence. The chapter focuses on the three most relevant sets of sources from Mesopotamia: evidence from the 23rd century BCE related to the violent reprisals of two kings of Akkad, Rimuš and Naram-Sin, against the “rebellious” cities of Sumer and Elam; the Sumerian “city laments” dating to a few centuries later; and first-millennium BCE Neo-Assyrian royal inscriptions. This examination demonstrates that, while mass violence is hardly rare in accounts of Mesopotamian history, finding evidence for genocide is not a straightforward task. Whether or not the Mesopotamians practiced genocide hinges on how one defines that term, and whether the targeted destruction of cities constitutes a type of genocide. In addition to an exploration of urbicide as genocide, the chapter considers how Mesopotamian accounts of mass violence contributed to accounts and practices of violence, including genocidal violence, elsewhere in ancient West Asia in later periods.
The impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health is still being unravelled. It is important to identify which individuals are at greatest risk of worsening symptoms. This study aimed to examine changes in depression, anxiety and post-traumatic stress disorder (PTSD) symptoms using prospective and retrospective symptom change assessments, and to find and examine the effect of key risk factors.
Method
Online questionnaires were administered to 34 465 individuals (aged 16 years or above) in April/May 2020 in the UK, recruited from existing cohorts or via social media. Around one-third (n = 12 718) of included participants had prior diagnoses of depression or anxiety and had completed pre-pandemic mental health assessments (between September 2018 and February 2020), allowing prospective investigation of symptom change.
Results
Prospective symptom analyses showed small decreases in depression (PHQ-9: −0.43 points) and anxiety [generalised anxiety disorder scale – 7 items (GAD)-7: −0.33 points] and increases in PTSD (PCL-6: 0.22 points). Conversely, retrospective symptom analyses demonstrated significant large increases (PHQ-9: 2.40; GAD-7 = 1.97), with 55% reported worsening mental health since the beginning of the pandemic on a global change rating. Across both prospective and retrospective measures of symptom change, worsening depression, anxiety and PTSD symptoms were associated with prior mental health diagnoses, female gender, young age and unemployed/student status.
Conclusions
We highlight the effect of prior mental health diagnoses on worsening mental health during the pandemic and confirm previously reported sociodemographic risk factors. Discrepancies between prospective and retrospective measures of changes in mental health may be related to recall bias-related underestimation of prior symptom severity.
Current dam discharge patterns in Noxon Rapids Reservoir reduce concentration and exposure times (CET) of herbicides used for aquatic plant management. Herbicide applications during periods of low dam discharge may increase herbicide CETs and improve efficacy. Applications of rhodamine WT dye were monitored under peak (736 to 765 m3 s−1) and minimum (1.4 to 2.8 m3 s−1) dam discharge patterns to quantify water-exchange processes. Whole-plot dye half-life under minimal discharge was 33 h, a 15-fold increase compared with the dye treatment during peak discharge. Triclopyr concentrations measured during minimum discharge within the treated plot ranged from 214 ± 25 to 1,243 ± 36 µg L−1 from 0 to 48 h after treatment (HAT), respectively. Endothall concentrations measured during minimum discharge in the same plot ranged from 164 ± 78 to 2,195 ± 1,043 µg L−1 from 0 to 48 HAT, respectively. Eurasian watermilfoil (Myriophyllum spicatum L.) occurrence in the treatment plot was 66%, 8%, and 14% during pretreatment, 5 wk after treatment (WAT), and 52 WAT, respectively. Myriophyllum spicatum occurrence in the nontreated plot was 68%, 71%, and 83% during pretreatment, 5 WAT, and 52 WAT, respectively. Curlyleaf pondweed (Potamogeton crispus L.) occurrence in the treatment plot was 29%, 0%, and 97% during pretreatment, 5 WAT, and 52 WAT, respectively. Potamogeton crispus increased from 24% to 83% at 0 WAT to 52 WAT, respectively, in the nontreated plot. Native species richness declined from 3.3 species per point to 2.1 in the treatment plot in the year of treatment but returned to pretreatment numbers by 52 WAT. Native species richness did not change during the study in the nontreated reference plot. Herbicide applications during periods of low flow can increase CETs and improve control, whereas applications during times of high-water flow would shorten CETs and could result in reduced treatment efficacy.
Background: A subset of patients experience poor outcomes following anterior cervical discectomy and fusion (ACDF). Our study aimed to identify postoperative trajectories of disability, neck/arm pain and determine baseline measures that predict subgroup membership. Methods: Patients with cervical spondylotic radiculopathy undergoing ACDF are presented. Prognostic factors comprised demographic, health and surgery-related variables. Study outcomes were trajectories of neck disability index scores, numeric rating scales for neck/arm pain modeled with latent-class growth analysis. Associations were explored using robust Poisson models and reported with risk ratios and 95% confidence intervals. Results: Patients (N = 352; mean (SD) age = 50.9(9.5) years, 43.8% female) identified trajectories for disability (excellent=45.3%,fair=39.2%,poor=15.5%),arm pain (excellent=24.5%,good=52.0%,poor=23.5%),and neck pain (excellent=13.7%,good=63.1%,poor=23.2%). Greater physical and mental health-related quality of life were associated with a reduced risk of poor outcome(per SD,0.40[0.30,0.53]-0.80[0.65,0.99]), while higher risk for depression (per SD, 1.36[1.12,1.65]-2.26[1.84,2.78]), longer wait time(per 90 days, 1.31[1.05,1.63]-1.64[1.20,2.24]), and longer procedure time (per 30 min,1.07[1.03,1.10]-1.08[1.05,1.12]) were associated with an increased risk of poor outcome for all outcomes. Poor disability was increased with self-reported depression(3.03[1.76,5.21]), greater neck-to-arm pain ratio (2.63 [1.28 to 5.40]), ASA score > 2(2.26[1.33,3.83]), and preoperative opiates (2.05[1.18,3.56]), while preoperative physiotherapy (0.51[0.30, 0.88]), spinal injections (0.48[0.23 to 0.98]), and regular exercise (0.44 [0.24, 0.79]) decreased risk. Receiving compensation and smoking were associated with poor outcome for neck pain. Remaining candidate prognostic factors were not associated with clinical outcome. Conclusions: Perioperative factors were shown to decrease risk of poor outcomes for pain and disability two years following ACDF.
Reinforcement learning has previously been applied to the problem of controlling a perched landing manoeuvre for a custom sweep-wing aircraft. Previous work showed that the use of domain randomisation to train with atmospheric disturbances improved the real-world performance of the controllers, leading to increased reward. This paper builds on the previous project, investigating enhancements and modifications to the learning process to further improve performance, and reduce final state error. These changes include modifying the observation by adding information about the airspeed to the standard aircraft state vector, employing further domain randomisation of the simulator, optimising the underlying RL algorithm and network structure, and changing to a continuous action space. Simulated investigations identified hyperparameter optimisation as achieving the most significant increase in reward performance. Several test cases were explored to identify the best combination of enhancements. Flight testing was performed, comparing a baseline model against some of the best performing test cases from simulation. Generally, test cases that performed better than the baseline in simulation also performed better in the real world. However, flight tests also identified limitations with the current numerical model. For some models, the chosen policy performs well in simulation yet stalls prematurely in reality, a problem known as the reality gap.
Primary care providers (PCPs) are expected to help patients with obesity to lose weight through behavior change counseling and patient-centered use of available weight management resources. Yet, many PCPs face knowledge gaps and clinical time constraints that hinder their ability to successfully support patients’ weight loss. Fortunately, a small and growing number of physicians are now certified in obesity medicine through the American Board of Obesity Medicine (ABOM) and can provide personalized and effective obesity treatment to individual patients. Little is known, however, about how to extend the expertise of ABOM-certified physicians to support PCPs and their many patients with obesity.
Aim:
To develop and pilot test an innovative care model – the Weight Navigation Program (WNP) – to integrate ABOM-certified physicians into primary care settings and to enhance the delivery of personalized, effective obesity care.
Methods:
Quality improvement program with an embedded, 12-month, single-arm pilot study. Patients with obesity and ≥1 weight-related co-morbidity may be referred to the WNP by PCPs. All patients seen within the WNP during the first 12 months of clinical operations will be compared to a matched cohort of patients from another primary care site. We will recruit a subset of WNP patients (n = 30) to participate in a remote weight monitoring pilot program, which will include surveys at 0, 6, and 12 months, qualitative interviews at 0 and 6 months, and use of an electronic health record (EHR)-based text messaging program for remote weight monitoring.
Discussion:
Obesity is a complex chronic condition that requires evidence-based, personalized, and longitudinal care. To deliver such care in general practice, the WNP leverages the expertise of ABOM-certified physicians, health system and community weight management resources, and EHR-based population health management tools. The WNP is an innovative model with the potential to be implemented, scaled, and sustained in diverse primary care settings.
Media coverage of non-suicidal self-injury (NSSI) ranges from providing helpful education to displaying graphic images. We offer the first research-informed, consensus-based guidelines for the responsible reporting and depicting of NSSI in the media, while also advising on ideas for dissemination and collaboration between media professionals and healthcare experts.
Using as a starting point the work of internationally-renowned Australian scholar Sam Ricketson, whose contributions to intellectual property (IP) law and practice have been extensive and richly diverse, this volume examines topical and fundamental issues from across IP law. With authors from the US, UK, Europe, Asia, Australia and New Zealand, the book is structured in four parts, which move across IP regimes, jurisdictions, disciplines and professions, addressing issues that include what exactly is protected by IP regimes; regime differences, overlaps and transplants; copyright authorship and artificial intelligence; internationalization of IP through public and private international law; IP intersections with historical and empirical research, human rights, privacy, personality and cultural identity; IP scholars and universities, and the influence of treatises and textbooks. This work should be read by anyone interested in understanding the central issues in the evolving field of IP law.
Gene × environment (G × E) interactions in eating pathology have been increasingly investigated, however studies have been limited by sample size due to the difficulty of obtaining genetic data.
Objective
To synthesize existing G × E research in the eating disorders (ED) field and provide a clear picture of the current state of knowledge with analyses of larger samples.
Method
Complete data from seven studies investigating community (n = 1750, 64.5% female) and clinical (n = 426, 100% female) populations, identified via systematic review, were included. Data were combined to perform five analyses: 5-HTTLPR × Traumatic Life Events (0–17 events) to predict ED status (n = 909), 5-HTTLPR × Sexual and Physical Abuse (n = 1097) to predict bulimic symptoms, 5-HTLPR × Depression to predict bulimic symptoms (n = 1256), and 5-HTTLPR × Impulsivity to predict disordered eating (n = 1149).
Results
The low function (s) allele of 5-HTTLPR interacted with number of traumatic life events (P < .01) and sexual and physical abuse (P < .05) to predict increased likelihood of an ED in females but not males (Fig. 1). No other G × E interactions were significant, possibly due to the medium to low compatibility between datasets (Fig. 1).
Conclusion
Early promising results suggest that increased knowledge of G × E interactions could be achieved if studies increased uniformity of measuring ED and environmental variables, allowing for continued collaboration to overcome the restrictions of obtaining genetic samples.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Given the common view that pre-exercise nutrition/breakfast is important for performance, the present study investigated whether breakfast influences resistance exercise performance via a physiological or psychological effect. Twenty-two resistance-trained, breakfast-consuming men completed three experimental trials, consuming water-only (WAT), or semi-solid breakfasts containing 0 g/kg (PLA) or 1·5 g/kg (CHO) maltodextrin. PLA and CHO meals contained xanthan gum and low-energy flavouring (approximately 122 kJ), and subjects were told both ‘contained energy’. At 2 h post-meal, subjects completed four sets of back squat and bench press to failure at 90 % ten repetition maximum. Blood samples were taken pre-meal, 45 min and 105 min post-meal to measure serum/plasma glucose, insulin, ghrelin, glucagon-like peptide-1 and peptide tyrosine-tyrosine concentrations. Subjective hunger/fullness was also measured. Total back squat repetitions were greater in CHO (44 (sd 10) repetitions) and PLA (43 (sd 10) repetitions) than WAT (38 (sd 10) repetitions; P < 0·001). Total bench press repetitions were similar between trials (WAT 37 (sd 7) repetitions; CHO 39 (sd 7) repetitions; PLA 38 (sd 7) repetitions; P = 0·130). Performance was similar between CHO and PLA trials. Hunger was suppressed and fullness increased similarly in PLA and CHO, relative to WAT (P < 0·001). During CHO, plasma glucose was elevated at 45 min (P < 0·05), whilst serum insulin was elevated (P < 0·05) and plasma ghrelin suppressed at 45 and 105 min (P < 0·05). These results suggest that breakfast/pre-exercise nutrition enhances resistance exercise performance via a psychological effect, although a potential mediating role of hunger cannot be discounted.
This collection of essays, by leading scholars and practitioners from a range of countries, pays homage to a pre-eminent figure in the field of intellectual property: Sam Ricketson. Inspired by the breadth of Ricketson’s work, the contributions explore issues from a perspective that looks across the field – in particular, across the regimes, jurisdictions, disciplines and professions of IP. Topics explored across the regimes include the nature of IP subject matter, overlaps in protection, historical connections between copyright and patents and the transplantation of civil law moral rights to common law copyright. In across jurisdictions, chapters address, inter alia, the application of private international law to cross-border IP disputes, the Berne Convention and AI-authored works, how countries might exit the Berne Convention and dispute settlement under TRIPS. The intersection of copyright and privacy laws, the relationship between privacy, personality and trade mark laws, the teaching of IP and human rights and the conduct of empirical and historical research in IP are among the matters considered across disciplines. Contributions across professions include the participation of scholars in IP policy making, the IP textbook in legal practice, and the role of expert evidence in IP litigation.