The survival of witchcraft prosecutions and witch belief in South West Scotland

During the era of the Scottish witch-hunts, Dumfries and Galloway was one of the last regions to initiate witch prosecutions, but it was also one of the most reluctant to completely surrender all belief in witches until a comparatively late date. In the late seventeeth and early eighteenth centuries south-west Scotland, better known for the persecution of covenanters, took the practice of witchcraft and charming very seriously indeed, and for perhaps longer than other parts of Scotland, though the area has received surprisingly little scholarly investigation. The trial evidence is not incompatible with that found elsewhere though there is less demonic content. Accusations of witchcraft in this region were mostly concerned with the troubles of everyday life, agricultural problems, family tensions and disagreements between neighbours. From 1670 to about 1740, the very decades that were giving birth to the Scottish Enlightenment, learned interest in the supernatural was actually on the increase and the topic received an unprecedented level of questioning, investigation, and scrutiny. Ironically, the ‘superstitions’ that both church and state had been attempting to eradicate for some two hundred years were now being used to defend religion against the growing threat of atheism. The zeal of the ministers does seem to have contributed to the endurance of witch beliefs in the South West, as elsewhere. Against this backdrop, the survival of witch belief and the continued prosecution of witches in southwest Scotland is examined, thus contributing to our understanding of the individualistic nature of witch persecution and the various dynamics at play within the Scottish witch-hunting experience

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo