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To develop an international template to support patient submissions in Health Technology Assessments (HTAs). This was to be based on the experience and feedback from the implementation and use of the Scottish Medicines Consortium's (SMC) Summary Information for Patient Groups (SIP).
To gather feedback on the SMC experience, web-based surveys were conducted with pharmaceutical companies and patient groups familiar with the SMC SIP. Semistructured interviews with representatives from HTA bodies were undertaken, along with patient group discussions with those less familiar with the SIP, to explore issues around the approach. These qualitative data informed the development of an international SIP template.
Survey data indicated that 82 percent (18 of 22 respondents) of pharmaceutical company representatives felt that the SIP was worthwhile; 88 percent (15/17) of patient group respondents found the SIP helpful. Both groups highlighted the need for additional support and guidance around plain language summaries. Further suggestions included provision of a glossary of terms and cost-effectiveness information. Patient group interviews supported the survey findings and led to the development of a new template. HTA bodies raised potential challenges around buy-in, timing, and bias connected to the SIP approach.
The international SIP template is another approach to support deliberative processes in HTA. Although challenges remain around writing summaries for lay audiences, along with feasibility considerations for HTA bodies, the SIP approach should support more meaningful patient involvement in HTAs.
This essay explores the symbolism and material contexts of a number of knightly figures who play the harp in twelfth-century Insular texts. Tristan is perhaps the best known of the harpers, and Horn is close at his heels, followed by the more problematic Hereward. The texts in which these figures appear differ significantly in form, and they find striking parallels in other twelfth-century works, including chronicles and saints’ lives. Both Horn and Tristan either harp or refer to their harping in the course of their narratives and this particular attribute of the hero, reinforced by the stories of historic harpers who appear in other contemporary texts, emphasizes an aspect of the characters’ heroism that somehow sets them apart and becomes integral to their identities; in the case of Tristan, the iconography of the hero harping serves to identify him outside his literary context, as would a saint's emblem. The hero is presented with a material attribute that goes beyond those of his contemporaries and that both elevates and enhances him. The symbolism and significance of harping define certain aspects of this nexus of characters whose identities are bound to one another through the instrument they play and with which one of them is portrayed in visual art. These images evoke diverse literary and material contexts and reflect the varied nature of the Insular sources on which Anglo-Norman authors drew: the stories examined here look both to Anglo-Saxon and Celtic traditions, as well as to Biblical imagery.
Tristan harps in several different contexts in the early texts in which he appears. Three of these contexts were emblematic enough to have been preserved in a series of thirteenth-century floor tiles discovered at Chertsey Abbey in the nineteenth century. As Melissa Furrow has recently argued, the tiles would not serve to tell the story of Tristan, but rather to remind viewers of what they knew already.
Materiality and the material are important in medieval romance. The essays here focus both on the physical forms of romance texts (manuscripts, verse form, illustrations and visual portryals), and on how romances themselves inhabit and reflect on the material culture of the Middle Ages. Specific themes discussed include social, historical, and physical space; bodies and gender politics; and romance illustrations in manuscripts, and in other media. Nicholas Perkins is University Lecturer and Tutor in medieval English, University of Oxford. Contributors: Siobhain Bly Calkin, Nancy Mason Bradbury, Aisling Byrne, Anna Caughey, Neil Cartlidge, Mark Cruse, Morgan Dickson, Rosalind Field, Elliott Kendall, Megan Leitch, Henrike Manuwald, Ad Putter, Raluca Radulescu, Robert Rouse,