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Investigations at the Native American site complex of Stark Farms in Mississippi, USA, have yielded numerous examples of metal artifacts of European origin. Our study suggests that they derive from contact between the AD 1540–1541 winter encampment of the Spanish Hernando de Soto expedition and the local Indigenous polity. The artifacts display a wide range of modifications, uses, and depositional contexts congruent with hybrid practices. We argue that the early colonial setting of Stark Farms requires a different perspective on cultural mixing than is often applied in studies of European colonialism. This is highlighted by the strongly improvisational nature of the modification of the metal objects, embodying a political climate in which European incursions were precarious and in which hybridity and power were heterogeneous and fluid.
For people in mental health crisis, acute day units (ADUs) provide daily structured sessions and peer support in non-residential settings, often as an addition or alternative to crisis resolution teams (CRTs). There is little recent evidence about outcomes for those using ADUs, particularly compared with those receiving CRT care alone.
We aimed to investigate readmission rates, satisfaction and well-being outcomes for people using ADUs and CRTs.
We conducted a cohort study comparing readmission to acute mental healthcare during a 6-month period for ADU and CRT participants. Secondary outcomes included satisfaction (Client Satisfaction Questionnaire), well-being (Short Warwick–Edinburgh Mental Well-being Scale) and depression (Center for Epidemiologic Studies Depression Scale).
We recruited 744 participants (ADU: n = 431, 58%; CRT: n = 312, 42%) across four National Health Service trusts/health regions. There was no statistically significant overall difference in readmissions: 21% of ADU participants and 23% of CRT participants were readmitted over 6 months (adjusted hazard ratio 0.78, 95% CI 0.54–1.14). However, readmission results varied substantially by setting. At follow-up, ADU participants had significantly higher Client Satisfaction Questionnaire scores (2.5, 95% CI 1.4–3.5, P < 0.001) and well-being scores (1.3, 95% CI 0.4–2.1, P = 0.004), and lower depression scores (−1.7, 95% CI −2.7 to −0.8, P < 0.001), than CRT participants.
Patients who accessed ADUs demonstrated better outcomes for satisfaction, well-being and depression, and no significant differences in risk of readmission, compared with those who only used CRTs. Given the positive outcomes for patients, and the fact that ADUs are inconsistently provided in the National Health Service, their value and place in the acute care pathway needs further consideration and research.
Built around two visits to Westminster Abbey, this short coda compares early eighteenth-century attitudes to theatrical transitions to William Hazlitt's and Charles Lamb's writing about actors. Both Lamb and Hazlitt emerge as hostile to what I have called the art of transition, as they each denigrate the performance of a character in favour of the study of that figure’s psychological constitution.
This chapter reveals the elaboration of a set of critical priorities, transition prime among them, crystallised by Aaron Hill in the 1730s. Offering what he claimed to be a purified version of pantomime’s techniques for arresting attention, Hill wrote of how actors could become a ‘true FAUSTUS’ for the theatres through transition, creating iconic and dynamic moments of suspension during which they could shift mind and body from one passion to another. Hill’s emphases continue into the time of David Garrick, whose transitions into ‘pensively preparatory attitudes’ were praised as intellectual achievements and blamed as pantomimical tricks. Ultimately, pauses and the transitions that occurred upon them became moments when an actor could be described as asserting their artistic autonomy and the focal point of critical attention. The realisation of Hill’s dreams — a theatre where sophisticated emotion replaced slapstick motion as the key source of spectacle — soon, however, risked becoming a Faustian pact, for an insight into the transitions of a play seemed to demand as much private attention to the page as public engagement with the stage.
King Lear was considered as David Garrick’s most significant part. I argue that this judgement depends on the extent to which this play (following Nahum Tate’s and Garrick’s alterations of Shakespeare’s text) offered a remarkable sequence of contrasting emotions through the performance of madness. The representation of Lear’s insanity required a mastery of the art of transition, yet Garrick’s practice of such an art was not without its challenges. While his critics explored the aesthetic, sociological, and psychological questions of how to perform a king’s madness, performance editions and promptbook markings reveal Garrick’s own efforts to render the part’s transitions with everything from innovative make-up to minute textual editing. Such transitions, and those of Edgar’s pretend madness, ultimately performed an essential function, moderating and so maintaining spectators’ emotional engagement in the Tate-Garrick tragedy. Such moderation is alien to Shakespeare’s play of 1608, and, while the eighteenth-century Lear can tell us much about a celebrated performance in Georgian London, it thus also serves as a critical standpoint for re-evaluating the structures of Jacobean tragedy.
This chapter begins by demonstrating that an attention to transition was a key element in some prominent literary critical writing of the later eighteenth century. I then argue that, within such writing, the understanding of transition evolves from that explored in my earlier chapters. Borrowing a term that Elizabeth Montagu, William Richardson, and their contemporaries make frequent use of, one might call this evolution a shift from dramatic transition to ‘dramatic character’. Montagu does this as she argues for the moral impact of Shakespeare’s incessantly enthralling dramatic characters, and Richardson when he claims that Shakespeare’s dramatic characters are such perfect imitations of life that their passions and transitions might serve as the subjects of philosophical enquiry into human nature. I use Maurice Morgann’s Essay on the Dramatic Character of Falstaff (1777) and David Hume's Treatise of Human Nature (1740) to illuminate the tensions inherent in such a critical standpoint, as efforts to explain moments of spectacular dramatic transition in terms of a character's stable identity risk minimising the spectacle that invited such explanation in the first place.
This chapter considers David Garrick's performance of odes in order to demonstrate both how eighteenth-century attention to transition crossed twenty-first-century modal boundaries and how the recovery of this approach might help us understand anew a form of public poetry that brought together star performers and musical accompaniment. Focusing jointly on two works of 1769, Garrick’s delivery of his Ode to Shakespeare and Daniel Webb’s Observations on the Correspondences between Poetry and Music, I show how transition, as a technique for emphasising the passions through contrast and comparison, aligns the dramatic and lyric modes. This is especially true of the Shakespeare ode, which positions the Elizabethan playwright as both Britain’s national dramatist and Britain’s national poet, a figure who is simultaneously lyric and dramatic through his mastery of the passions. Indeed, Garrick, who incorporated references to his own performances of Macbeth, Hamlet, and Lear into his ode, also might be seen to make the same claim for himself as the pre-eminent interpreter of Shakespeare.
Francis Gentleman recorded that David Garrick’s performance of Thomas Otway's Jaffeir ‘beggars description, by an amazing variety of transitions, tones and picturesque attitudes’. I use Gentleman's commentary to introduce here the concept of transition with respect to three things: theatrical practice, theories of the passions, and the eighteenth-century understanding of the mind in wonder. My argument throughout is that the identification of transitions leads to simultaneous recognition of the iconic and dynamic qualities of an object.
This chapter traces the fortunes of Aaron Hill’s English translation (1735) of Voltaire’s tragedy Zaïre (1732), from its first performance under Hill’s direction outside the patent theatres to David Garrick’s reworking of it at Drury Lane. I show that Zara’s scepticism of established religion and her father’s deathbed proselytising are used by Hill to produce what his friend John Dennis called an ‘enthusiastic’ passion and suggest that Voltaire’s work appealed to Hill for its handling of religious material capable of producing extreme sequences of sublime emotions. At the same time, Hill’s Zara is also an exposition of what Hill described as ‘dramatic passions’. Those who read, saw, or performed Zara could witness the outward marks of many passions and trace on stage and on the page their performance through transition to the very instant. Such opportunities made the play perfect for what Hill called an ‘Experiment’ on English tastes and acting. When Garrick came to revive this experiment in the 1750s, its passions become the property of Garrick himself, as he rewrote sections of the play to favour his character of Lusignan.
Surgical repair of Tetralogy of Fallot has excellent outcomes, with over 90% of patients alive at 30 years. The ideal time for surgical repair is between 3 and 11 months of age. However, the symptomatic neonate with Tetralogy of Fallot may require earlier intervention: either a palliative intervention (right ventricular outflow tract stent, ductal stent, balloon pulmonary valvuloplasty, or Blalock-Taussig shunt) followed by a surgical repair later on, or a complete surgical repair in the neonatal period. Indications for palliation include prematurity, complex anatomy, small pulmonary artery size, and comorbidities. Given that outcomes after right ventricular outflow tract stent palliation are particularly promising – there is low mortality and morbidity, and consistently increased oxygen saturations and increased pulmonary artery z-scores – it is now considered the first-line palliative option. Disadvantages of right ventricular outflow tract stenting include increased cardiopulmonary bypass time at later repair and the stent preventing pulmonary valve preservation. However, neonatal surgical repair is associated with increased short-term complications and hospital length of stay compared to staged repair. Both staged repair and primary repair appear to have similar long-term mortality and morbidity, but more evidence is needed assessing long-term outcomes for right ventricular outflow tract stent palliation patients.
Great art is about emotion. In the eighteenth century, and especially for the English stage, critics developed a sensitivity to both the passions of a performance and what they called the transitions between those passions. It was these pivotal transitions, scripted by authors and executed by actors, that could make King Lear beautiful, Hamlet terrifying, Archer hilarious and Zara electrifying. James Harriman-Smith recovers a lost way of appreciating theatre as a set of transitions that produce simultaneously iconic and dynamic spectacles; fascinating moments when anything seems possible. Offering fresh readings and interpretations of Shakespearean and eighteenth-century tragedy, historical acting theory and early character criticism, this volume demonstrates how a concern with transition binds drama to everything, from lyric poetry and Newtonian science, to fine art and sceptical enquiry into the nature of the self.
Among 353 healthcare personnel in a longitudinal cohort in four hospitals in Atlanta, GA (May-June 2020), 23 (6.5%) had SARS-CoV-2 antibodies. Spending >50% of a typical shift at bedside (OR 3.4, 95% CI: 1.2–10.5) and Black race (OR 8.4, 95% CI: 2.7–27.4) were associated with SARS-CoV-2 seropositivity.