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This chapter explores the Custody of the Holy Land as a legal, spiritual and cultural product of the Holy Land. It explores its roots in Catholic spirituality and pilgrimage, the Holy Land as a shared religious landscape, and the influence of Islamic law/Ottoman governance.
The year 1700, which marks the end of this investigation, did usher in some notable changes in the life of the Custody. The death of the last Spanish Habsburg monarch in November saw the throne transfer to the Bourbon line, signaling the coming end to an imperial rivalry that had raged in the Custody as well as other global arenas for over a century. While France would remain an important ally of the Custody at the Ottoman Porte for several decades more, its influence in the Mediterranean was declining by the end of the century, especially once the forces of Revolution began tearing at the foundations of the monarchy. The Franciscan brothers arguably faced a more serious challenge to their administration of the pilgrimage from the new enlightenment culture emerging in Europe at this time, which embraced among other things a certain skepticism about the Catholic Church and its doctrine including belief in divine immanence. Still, while perhaps much more muted in tone than in the previous century, pilgrimage treatises produced after 1700 make it clear that Reformation debates over the efficacy of the pilgrimage continued to haunt the Custody. And there were other signs as well that many of the conflicts that beset the venerable pilgrimage institution by 1517 were still testing the administration of the friars. Internal sources show, in particular, that differences over nation and reformed identity remained sources of tension within the Holy Land family. The competition with the Greek Orthodox over altars also reignited in 1701, leading to several more decades of episodic conflict. Indeed, by the end of the eighteenth century, the Greek Orthodox would succeed in asserting their claims to precedence in the Holy Places. And yet, for the brothers of the Holy Land, there were some welcome signs of continuity as well. As in times past, Catholic pilgrims arrived each year in the Holy Land to visit its many sacred sites. Alms continued to flow into Jerusalem from all corners of an increasingly global Catholic tradition in support of the ministry of the Custody and Franciscan jurisdiction persisted. Despite the many challenges the friars faced to their jurisdiction after 1517 from other Christians – including other Catholics and even fellow Franciscans –they continued to exercise control over the Custody after 1700, and the Order of Friars Minor remains in charge to this day.
Chatper 5 examines the growing influence of the papal Congregation of the Propaganda Fide in the administration of the Custody after 1622. It argues that its intervention reflects the importance given to the Holy Land as both a frontier, and spiritual center, of an increasingly global Catholic tradition.
This final chapter explores competition between Franciscan reform traditions over jurisdiction in the Custody to understand the Holy Land's importance as a Franciscan sacred landscape, and custodial administration as a manifestation of Franciscan authority and legitimacy.
Chapter 2 investigates growing competition between the Franciscan (Latin) and Greek Orthodox community over the legal and material possession of altars to understand these as vessels of political and spiritual legitimacy.
Chatper 3 studies a unique pilgrimage society known as the Order of the Holy Sepulcher as a window into the the Holy Land as a source of spiritual and political legitimacy for Catholics in the wake of the Reformation.
A shared biblical past has long imbued the Holy Land with special authority as well as a mythic character that has made the region not only a revered spiritual home for Muslims, Christians, and Jews but also a source of a living sacred history that continues to inform present-day realities and religious identities. This book explores the Early Modern Holy Land (1517–1700) as a critical place in which many early modern Catholics sought spiritual and political legitimacy during a period of profound and disruptive change. The Ottoman conquest of the region, the division of the Western Church, Catholic reform, the integration of the Mediterranean into global trading networks, and the emergence of new imperial rivalries transformed the Custody of the Holy Land (Custodia Terrae Sanctae), the venerable Catholic institution that had overseen Western pilgrimage since 1342, into a site of intense intra-Christian conflict by 1517. This contestation thrusts into relief the Holy Land’s importance both a frontier and sacred center of an embattled Catholic tradition, and in consequence, as a critical site of Catholic renewal and reinvention.
A shared biblical past has long imbued the Holy Land with special authority as well as a mythic character that has made the region not only the spiritual home for Muslims, Christians, and Jews, but also a source of a living sacred history that informs contemporary realities and religious identities. This book explores the Holy Land as a critical site in which early modern Catholics sought spiritual and political legitimacy during a period of profound and disruptive change. The Ottoman conquest of the region, the division of the Western Church, Catholic reform, the integration of the Mediterranean into global trading networks, and the emergence of new imperial rivalries transformed the Custody of the Holy Land, the venerable Catholic institution that had overseen Western pilgrimage since 1342, into a site of intense intra-Christian conflict by 1517. This contestation underscored the Holy Land's importance as a frontier and center of an embattled Catholic tradition.
Recently, artificial intelligence-powered devices have been put forward as potentially powerful tools for the improvement of mental healthcare. An important question is how these devices impact the physician-patient interaction.
Aifred is an artificial intelligence-powered clinical decision support system (CDSS) for the treatment of major depression. Here, we explore the use of a simulation centre environment in evaluating the usability of Aifred, particularly its impact on the physician–patient interaction.
Twenty psychiatry and family medicine attending staff and residents were recruited to complete a 2.5-h study at a clinical interaction simulation centre with standardised patients. Each physician had the option of using the CDSS to inform their treatment choice in three 10-min clinical scenarios with standardised patients portraying mild, moderate and severe episodes of major depression. Feasibility and acceptability data were collected through self-report questionnaires, scenario observations, interviews and standardised patient feedback.
All 20 participants completed the study. Initial results indicate that the tool was acceptable to clinicians and feasible for use during clinical encounters. Clinicians indicated a willingness to use the tool in real clinical practice, a significant degree of trust in the system's predictions to assist with treatment selection, and reported that the tool helped increase patient understanding of and trust in treatment. The simulation environment allowed for the evaluation of the tool's impact on the physician–patient interaction.
The simulation centre allowed for direct observations of clinician use and impact of the tool on the clinician–patient interaction before clinical studies. It may therefore offer a useful and important environment in the early testing of new technological tools. The present results will inform further tool development and clinician training materials.
The use of an electronic hand hygiene monitoring system (EHHMS) decreased due to the coronavirus disease 2019 (COVID-19) pandemic. We analyzed dispenser use, hand hygiene (HH) badge use, and HH compliance to determine the effect of COVID-19 on EHHMS use and HH compliance. HH product shortages and other pandemic-induced challenges influenced EHHMS use.
We aimed to investigate the heterogeneity of seasonal suicide patterns among multiple geographically, demographically and socioeconomically diverse populations.
Weekly time-series data of suicide counts for 354 communities in 12 countries during 1986–2016 were analysed. Two-stage analysis was performed. In the first stage, a generalised linear model, including cyclic splines, was used to estimate seasonal patterns of suicide for each community. In the second stage, the community-specific seasonal patterns were combined for each country using meta-regression. In addition, the community-specific seasonal patterns were regressed onto community-level socioeconomic, demographic and environmental indicators using meta-regression.
We observed seasonal patterns in suicide, with the counts peaking in spring and declining to a trough in winter in most of the countries. However, the shape of seasonal patterns varied among countries from bimodal to unimodal seasonality. The amplitude of seasonal patterns (i.e. the peak/trough relative risk) also varied from 1.47 (95% confidence interval [CI]: 1.33–1.62) to 1.05 (95% CI: 1.01–1.1) among 12 countries. The subgroup difference in the seasonal pattern also varied over countries. In some countries, larger amplitude was shown for females and for the elderly population (≥65 years of age) than for males and for younger people, respectively. The subperiod difference also varied; some countries showed increasing seasonality while others showed a decrease or little change. Finally, the amplitude was larger for communities with colder climates, higher proportions of elderly people and lower unemployment rates (p-values < 0.05).
Despite the common features of a spring peak and a winter trough, seasonal suicide patterns were largely heterogeneous in shape, amplitude, subgroup differences and temporal changes among different populations, as influenced by climate, demographic and socioeconomic conditions. Our findings may help elucidate the underlying mechanisms of seasonal suicide patterns and aid in improving the design of population-specific suicide prevention programmes based on these patterns.
Silver nitrate cautery and bipolar electrocautery are commonly used in the treatment of epistaxis. Currently, there are no recommendations on optimum contact times or power for nasal cautery. ENT consultant practice in the UK has not previously been evaluated.
This study examined the burn depth associated with silver nitrate (75 per cent concentration) cautery and bipolar electrocautery on porcine septum samples, using varying contact times and power. ENT consultants completed a survey evaluating their practice.
Results and conclusion
ENT consultant practice of nasal cautery was shown to vary widely. Silver nitrate cautery with a contact time of less than 30 seconds does not cause a full thickness burn. The findings lend some support to bilateral cauterisation with silver nitrate. Bipolar electrocautery should be set at lower than 10 W and with a contact time of less than 4 seconds to reduce the risk of complications associated with a full thickness burn.