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This article considers the existence of a distinctive form of fundamentalism in the northern-Irish province of Ulster. It does so by examining the Protestant minorities that grew significantly in the decades after the Ulster revival of 1859. These evangelical others are important because their members were more likely to have fundamentalist tendencies than those who belonged to the main Protestant churches. The existing scholarship on fundamentalism in Northern Ireland focuses on Ian Paisley (1926–2014), who was a life-long adversary of Irish republican separatism and a self-identified fundamentalist. Yet, the focus on Paisley draws attention away from the potential origin of fundamentalism in the early twentieth century that is associated with religious revival in the early 1920s and the heresy trial of a “modernist” Presbyterian professor in 1927. George Marsden's classic study defined fundamentalism as an American phenomenon, yet, with Paisley and developments in the 1920s in mind, he noted that “Ulster appears to be an exception.”1 To what extent was that true? Was there a constituency of potential fundamentalists in the north of Ireland in the early twentieth century? If there was, did the social and political circumstances of the region and period produce a distinctive Ulster variety of fundamentalism?
This article explores the religious response of one neglected writer to the evolutionary philosophy of Herbert Spencer. William Todd Martin was a minister of the Presbyterian Church in Ireland and in 1887 published The Evolution Hypothesis: A Criticism of the New Cosmic Philosophy. The work demonstrates the essentially contested nature of “evolution” and “creation” by showing how a self-confessed creationist could affirm an evolutionary understanding of the natural world and species transformation. Martin's approach reflected a transatlantic Presbyterian worldview that saw the harmony of science and religion on the basis of Calvinism, Baconianism and Scottish Common Sense philosophy. Martin's critique is also relevant to issues that continue to animate philosophers of science and religion, including the connections between mind and matter, morality and consciousness in a Darwinian framework, and the relationship between subjective conscious experience and evolutionary physicalism. Martin was able to anticipate these debates because his critique was essentially philosophical and theological rather than biological and biblicist.
The American evangelist Dwight L. Moody visited Ulster on three occasions – 1874, 1883 and 1892 – and his modern, respectable version of revivalism offered a welcome alternative to the ambiguous legacy of the 1859 Ulster revival. Moody stimulated an outpouring of interdenominational activism and may have contributed to a fundamentalist impulse amongst Evangelicals. His legacy in Ulster, as elsewhere, was to energise Evangelicals but at the expense of weakening the ability, perhaps even the desire, of church members to adhere to denominational principles. In that sense, both so-called ‘fundamentalists’ and ‘modernists’ in Northern Ireland in the 1920s were Moody's heirs.
Cognitive behavior therapy (CBT) is effective for most patients with a social anxiety disorder (SAD) but a substantial proportion fails to remit. Experimental and clinical research suggests that enhancing CBT using imagery-based techniques could improve outcomes. It was hypothesized that imagery-enhanced CBT (IE-CBT) would be superior to verbally-based CBT (VB-CBT) on pre-registered outcomes.
Methods
A randomized controlled trial of IE-CBT v. VB-CBT for social anxiety was completed in a community mental health clinic setting. Participants were randomized to IE (n = 53) or VB (n = 54) CBT, with 1-month (primary end point) and 6-month follow-up assessments. Participants completed 12, 2-hour, weekly sessions of IE-CBT or VB-CBT plus 1-month follow-up.
Results
Intention to treat analyses showed very large within-treatment effect sizes on the social interaction anxiety at all time points (ds = 2.09–2.62), with no between-treatment differences on this outcome or clinician-rated severity [1-month OR = 1.45 (0.45, 4.62), p = 0.53; 6-month OR = 1.31 (0.42, 4.08), p = 0.65], SAD remission (1-month: IE = 61.04%, VB = 55.09%, p = 0.59); 6-month: IE = 58.73%, VB = 61.89%, p = 0.77), or secondary outcomes. Three adverse events were noted (substance abuse, n = 1 in IE-CBT; temporary increase in suicide risk, n = 1 in each condition, with one being withdrawn at 1-month follow-up).
Conclusions
Group IE-CBT and VB-CBT were safe and there were no significant differences in outcomes. Both treatments were associated with very large within-group effect sizes and the majority of patients remitted following treatment.
Simulation plays an integral role in the Canadian healthcare system with applications in quality improvement, systems development, and medical education. High-quality, simulation-based research will ensure its effective use. This study sought to summarize simulation-based research activity and its facilitators and barriers, as well as establish priorities for simulation-based research in Canadian emergency medicine (EM).
Methods
Simulation-leads from Canadian departments or divisions of EM associated with a general FRCP-EM training program surveyed and documented active EM simulation-based research at their institutions and identified the perceived facilitators and barriers. Priorities for simulation-based research were generated by simulation-leads via a second survey; these were grouped into themes and finally endorsed by consensus during an in-person meeting of simulation leads. Priority themes were also reviewed by senior simulation educators.
Results
Twenty simulation-leads representing all 14 invited institutions participated in the study between February and May, 2018. Sixty-two active, simulation-based research projects were identified (median per institution = 4.5, IQR 4), as well as six common facilitators and five barriers. Forty-nine priorities for simulation-based research were reported and summarized into eight themes: simulation in competency-based medical education, simulation for inter-professional learning, simulation for summative assessment, simulation for continuing professional development, national curricular development, best practices in simulation-based education, simulation-based education outcomes, and simulation as an investigative methodology.
Conclusion
This study summarized simulation-based research activity in EM in Canada, identified its perceived facilitators and barriers, and built national consensus on priority research themes. This represents the first step in the development of a simulation-based research agenda specific to Canadian EM.
For this study, we adapted the Montgomery Borgatta Caregiver Burden Scale, used widely in the United States, to the Saudi Arabian context. To produce an Arabic, culturally sensitive version of the scale, we conducted semi-structured interviews with 20 Saudi family caregivers. The Arabic version of the scale was tested, and participants were asked to comment on the appropriateness of items for the construct of “caregiver burden” using the repertory grid technique and laddering procedure – two constructivist methods derived from personal construct theory. From interview findings, we examined the content of the items and the caregiver burden construct itself. Our findings suggest that the use of constructivist methods to refine constructs and quantitative instruments is highly informative. This strategy is feasible even when little is known about the investigated constructs in the target culture and further elucidates our understanding of cross-cultural variations or invariance of different versions of the scale.
Identifying clinical features that predict conversion to bipolar disorder (BD) in those at high familial risk (HR) would assist in identifying a more focused population for early intervention.
Method
In total 287 participants aged 12–30 (163 HR with a first-degree relative with BD and 124 controls (CONs)) were followed annually for a median of 5 years. We used the baseline presence of DSM-IV depressive, anxiety, behavioural and substance use disorders, as well as a constellation of specific depressive symptoms (as identified by the Probabilistic Approach to Bipolar Depression) to predict the subsequent development of hypo/manic episodes.
Results
At baseline, HR participants were significantly more likely to report ⩾4 Probabilistic features (40.4%) when depressed than CONs (6.7%; p < .05). Nineteen HR subjects later developed either threshold (n = 8; 4.9%) or subthreshold (n = 11; 6.7%) hypo/mania. The presence of ⩾4 Probabilistic features was associated with a seven-fold increase in the risk of ‘conversion’ to threshold BD (hazard ratio = 6.9, p < .05) above and beyond the fourteen-fold increase in risk related to major depressive episodes (MDEs) per se (hazard ratio = 13.9, p < .05). Individual depressive features predicting conversion were psychomotor retardation and ⩾5 MDEs. Behavioural disorders only predicted conversion to subthreshold BD (hazard ratio = 5.23, p < .01), while anxiety and substance disorders did not predict either threshold or subthreshold hypo/mania.
Conclusions
This study suggests that specific depressive characteristics substantially increase the risk of young people at familial risk of BD going on to develop future hypo/manic episodes and may identify a more targeted HR population for the development of early intervention programs.
from
PART I
-
Geography, Occupations and Social Classes
By
Andrew R. Holmes, Lecturer in Modern Irish History, Queen's University Belfast,
Eugenio F. Biagini, Professor of Modern and Contemporary History in the University of Cambridge and a Fellow of Sidney Sussex College Cambridge
The Protestants of Ireland are a complex community, made so by social, denominational, political, economic and geographical factors. Since the early seventeenth century, there have been tensions between, on the one hand, Church of Ireland Protestants in the south, the self-styled natural leaders of Ireland with their ties to the land and the state, and, on the other, Presbyterian-dominated Ulster with its tenant farmers, industrial character and often cantankerous disposition. Of course, this simplistic dichotomy obscures social and economic divisions within both communities and the numerically small but dynamic subculture of Protestant churches and sects that have contributed much to the development of the island. Given its often bewildering variety, historians have struggled to describe the complexity of this group.
Confessional State, Enlightenment and Rebellion, 1740–1800
Ireland in the 1740s, according to S. J. Connolly, was an ancien régime society in which religious inequalities were inseparable from social hierarchy and landownership. The dominance of the members of the established episcopal Church of Ireland was predicated on the rights of landed property, not the rights of numbers. The religious allegiance of the Irish population had been determined in the previous century by population movements rather than conversion. Three-quarters to four-fifths of the population were Catholic and though various Protestants were at certain times compelled to make common cause, Irish religious divisions were not simply binary – tensions between Protestants were as important and contributed to the remarkable events of 1798 when Presbyterian rebels in Ulster joined with Catholic insurgents in the south to overthrow in part the political, social and economic ascendancy of episcopal Protestants. The confessional divisions expressed during the Williamite wars had largely subsided by the 1740s. The Age of Reason had cooled somewhat the religious temperature of the previous century, though it was the ‘good behaviour’ of Irish Catholics during the Jacobite risings of 1715 and 1745 that is perhaps more important. The penal laws played their part, but those against Catholic religious practice quickly entered abeyance whereas those concerned with landownership were rigorously enforced.
The continental margin of southern South Africa exhibits an array of emergent marginal marine sediments permitting the reconstruction of long-term eustatic sea-level changes. We report a suite of optical luminescence ages and supplementary amino acid racemization data, which provide paleosea-level index points for three sites on this coastline. Deposits in the Swartvlei and Groot Brak estuaries display tidal inlet facies overlain by shoreface or eolian facies. Contemporary facies relations suggest a probable high stand 6.0-8.5 m above modern sea level (amsl). At Cape Agulhas, evidence of a past sea-level high stand comprises a gravel beach (ca. 3.8 m amsl) and an overlying sandy shoreface facies (up to 7.5 m amsl). OSL ages between 138±7 ka and 118±7 ka confirm a last interglacial age for all marginal marine facies. The high stand was followed by a sea-level regression that was associated with the accumulation of eolian dunes dating to between 122±7 ka and 113±6 ka. These data provide the first rigorous numerical age constraints for last interglacial sea-level fluctuations in this region, revealing the timing and elevation of the last interglacial high stand to broadly mirror a number of other far-field locations.
One of the most important developments in nineteenth-century Ireland was the so-called transformation of Presbyterians in Ulster from United Irish rebels in 1798 to loyalists in 1885. According to W. E. H. Lecky, ‘the defection of the Presbyterians from the movement of which they were the main originators, and the great and enduring change which took place in their sentiments …are facts of the deepest importance in Irish history and deserve very careful and detailed examination’. It is often stated that this process was facilitated by the rise of evangelicalism, which forged Protestant unity between Presbyterians and their erstwhile enemy the Church of Ireland on the basis of conversionist religion and anti-Catholicism. The key individual in this movement was Henry Cooke, the dominant figure in nineteenth-century Presbyterianism who gained fame as the champion of Trinitarian orthodoxy within the Synod of Ulster in the late 1820s. The connection between conservative evangelical religion and conservative politics was asserted by his principal Arian adversary, Henry Montgomery, who was proud that his two brothers were United Irishmen, though he strongly objected to armed rebellion. Writing in 1847, Montgomery claimed that the natural Presbyterian love of civil and religious liberty had been repudiated by Cooke and the ‘miserable, priest-led Calvinist Presbyterians’ of the lower orders who now swelled the ranks of the Orange Order. Many modern historians have followed the same line of interpretation. For instance, K.A. Miller has referred to ‘the hegemony of Rev. Henry Cooke and others who led their people into the Unionist alliance with Anglican proprietors, evangelicalism, and the Orange Order’.
Yet the relationship between Presbyterian evangelicalism, politics, and loyalty was complex and contingent. Three points are worth emphasising. First, care must be taken when describing the connection between political affiliation and religious outlook. This essay demonstrates that there were a number of possible relationships between religion and politics that depended upon particular circumstances. For instance, Presbyterians may have been at the forefront of radical politics in the 1790s, but the clear majority were opposed to the rebellion and supported reform through lawful means. Furthermore, though Cooke was a Peelite Conservative, he, along with the overwhelming majority of Presbyterian ministers, was not an Orangeman and nor was ‘Conservative’ necessarily a synonym for ‘Orange’ in the nineteenth century. Second, the majority of Presbyterian ministers disagreed with Cooke’s conflation of evangelicalism and conservative politics.