Political Thought and Practice in the Ottoman Empire (Halcyon Days in Crete IX Symposium, Rethymno, 9-11 January 2015)

Conference presentatio

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Conceptualizing Inter-religious Relations in the Ottoman Empire: The Early Modern Centuries

This article presents the points of view from which interreligious relations in the Ottoman world have been approached in academic historiography, the frames of interpretation and concepts that have been used, and the critical reassessments and revisions that are currently underway. Conceptions about the position of the non-Muslims and the nature and forms of interreligious relations in the Ottoman Empire have changed perceptively over the last half century. The mosaic world of subjugated nations and self-governed religious communities (millets) that lived parallel and distinct lives gave its place, in the last two decades of the twentieth century, to the plural society of extensive interreligious interaction at individual or communal level. In tandem came the shift from an emphasis on the oppression of the non-Muslims to that on toleration. We are now in a new phase of revision which focuses on the forms, extent and limits of toleration and intercommunal interaction, and pays close attention to change over time

Interfaith Marriage in the Early Modern Ottoman Empire: Legal and Social Aspects

Marriage in the Ottoman Empire was regulated by religious law, sultanic decrees, and local custom. In the multiethnic and multireligious realm of the sultans, men and women were expected to marry within their own religious community, according to the latter’s rites and in conformance with its rules, observances, and traditions. This social expectation, however, did not preclude interfaith marriages as long as the latter were sanctioned by the religious authorities concerned or were concluded in a way permissible under Ottoman law, namely with an Islamic marriage contract registered at a kadi court. The most common kinds of interfaith marriage were unions of Muslim men with non-Muslim women and of European foreigners with local Christians. We know about such unions from a variety of sources and some aspects of the issue have already drawn the attention of historians. This article focuses on the early modern period and is concerned with the legal underpinnings that allowed interfaith marriages, the judicial practice concerning them and the stance of the Orthodox Church towards women married outside the faith. The article presents the preliminary results of an ongoing research based on Ottoman, Greek and European sources that investigates the power of the Orthodox Church to implement canon law and its prohibitions, which also includes the prohibition to marry a non-Orthodox person

Ali Yaycioglu, Partners of the Empire: The Crisis of the Ottoman Order in the Age of Revolutions

Review of Ali Yaycioglu. Partners of the Empire: The Crisis of the Ottoman Order in the Age of Revolutions. Stanford: Stanford University Press, 2016. 347 pp