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The end of the First World War and the relaxation of restrictions on travel that were in place during it produced a sense of release, among other emotions. Paul Fussell employs an aptly exuberant simile when he refers to the many writers who were ‘propelled on their post-war travels as if by a wartime spring tightly compressed’. Besides those that will be discussed in this chapter, Fussell’s list of several members of the ‘British Literary Diaspora’ who travelled or went to live in exile around the globe includes Norman Douglas, Lawrence Durrell, V. S. Pritchett, and Robert Graves. The propulsion that Fussell describes is evident in D. H. Lawrence’s statement in his Sea and Sardinia (1921): ‘Comes over one an absolute necessity to move.’ This urge to mobility is often accompanied by an energetic sense of inquiry.
This article considers the opportunities available to, and the constraints to be negotiated by, female litigants at the court of Star Chamber during the reigns of the early Tudor kings. Star Chamber was a prerogative court and grew in popularity following the transformation and clarification of its judicial functions under Thomas Wolsey in the early sixteenth century. While it has suffered losses to its records, around five thousand cases still survive from the early Tudor period, including nearly one thousand cases involving female litigants. Unlike those in other Westminster courts, such as Common Pleas, Chancery, or the Court of Requests, Star Chamber cases have yet to be fully examined for what they can tell us about women's access to justice and their experience of legal process. This article begins by surveying the number of cases involving female litigants, showing that far more women came to the court as plaintiffs than as defendants. The numbers were significant—in line with Chancery—but still show women as a minority. Drawing on a wide range of examples, the paper explores the major factors determining, and limiting, women's active roles as litigants, taking into consideration cultural expectations, legal practice (including the operation of coverture), and, where detected, individual decision-making.
‘Border’ has two principal meanings. The first denotes an edge, margin, limit or boundary; the second a frontier between two states. These two senses create an ambiguity, for the first definition suggests the outer reaches and the second a way across to another place. On the one hand, then, there is the implication of getting as far as one can go; on the other, of coming to a line that separates and joins, thus offering the opportunity for further travel in a different region. The concept of the border thereby introduces to travel writing a tension as it points to both the circumscription and the possibilities of travel. The idea of crossing also implies transformation, another important feature of many travel narratives. As Bill Aitken (2002 , 4) puts it: ‘To the traveller borderlands always intrigue with their potential for cultural initiation quite apart from the magic of being on the threshold of the new that all frontier situations involve.’
The Oxford English Dictionary (OED) traces ‘border’ to the late fourteenth century, to the Middle English and Old French bordure and earlier Old French bordeüre, thence back to the late Latin bordatura, meaning ‘edging’. The medieval usage recorded by the OED does not relate specifically to a line between countries. The earliest quotation showing that sense is from the late sixteenth century. Between these two dates the first usage of borders to signify territories is from around 1425. In both their literal and symbolic senses, borders are central to journey accounts. Most obviously, borders refer to the limits around nations. They both define territories and place them in relation to one another, but the physical movement of travellers from one site to another is often metaphoric, also. Travel literature is frequently populated with the representation of borders between the known and the unknown, the civilized and the savage, the domestic and the wild, the land and the sea, the cultivated and the desert. In addition, there are borders between the past and the present which give travel texts their (often problematic) temporal texture. For example, Peter Matthiessen exclaims of the journey recounted in The Snow Leopard that ‘[w] e walked 250 miles over the Himalaya up to the Tibetan plateau. It was like walking into the Middle Ages – just amazing’ (Shapiro 2004, 356).
Bringing together original contributions from scholars around the world, this volume traces the history of travel writing from antiquity to the Internet age. It examines travel texts of several national or linguistic traditions, introducing readers to the global contexts of the genre. From wilderness to the urban, from Nigeria to the polar regions, from mountains to rivers and the desert, this book explores some of the key places and physical features represented in travel writing. Chapters also consider the employment in travel writing of the diary, the letter, visual images, maps and poetry, as well as the relationship of travel writing to fiction, science, translation and tourism. Gender-based and ecocritical approaches are among those surveyed. Together, the thirty-seven chapters here underline the richness and complexity of this genre.
The OPTIMA mood disorders service is a newly established specialist programme for people with bipolar disorder requiring frequent admissions. This audit compared data on hospital admissions and home treatment team (HTT) spells in patients before entry to and after discharge from the core programme. We included patients admitted between April 2015 and March 2017 who were subsequently discharged. Basic demographic data and numbers of admissions and HTT spells three years before and after discharge were collected and analysed.
Thirty patients who completed the programme were included in the analyses. The median monthly rate of hospital admissions after OPTIMA was significantly reduced compared with the rate prior to the programme. HTT utilisation was numerically reduced, but this difference was not statistically significant.
These results highlight the effectiveness and importance of individually tailored, specialist care for patients with bipolar disorder following discharge from hospital.
Depression is considered to have the highest disability burden of all conditions. Although treatment-resistant depression (TRD) is a key contributor to that burden, there is little understanding of the best treatment approaches for it and specifically the effectiveness of available augmentation approaches.
We conducted a systematic review and meta-analysis to search and quantify the evidence of psychological and pharmacological augmentation interventions for TRD.
Participants with TRD (defined as insufficient response to at least two antidepressants) were randomised to at least one augmentation treatment in the trial. Pre-post analysis assessed treatment effectiveness, providing an effect size (ES) independent of comparator interventions.
Of 28 trials, 3 investigated psychological treatments and 25 examined pharmacological interventions. Pre-post analyses demonstrated N-methyl-d-aspartate-targeting drugs to have the highest ES (ES = 1.48, 95% CI 1.25–1.71). Other than aripiprazole (four studies, ES = 1.33, 95% CI 1.23–1.44) and lithium (three studies, ES = 1.00, 95% CI 0.81–1.20), treatments were each investigated in less than three studies. Overall, pharmacological (ES = 1.19, 95% CI 1.08–1.30) and psychological (ES = 1.43, 95% CI 0.50–2.36) therapies yielded higher ESs than pill placebo (ES = 0.78, 95% CI 0.66–0.91) and psychological control (ES = 0.94, 95% CI 0.36–1.52).
Despite being used widely in clinical practice, the evidence for augmentation treatments in TRD is sparse. Although pre-post meta-analyses are limited by the absence of direct comparison, this work finds promising evidence across treatment modalities.
Declaration of interest
In the past 3 years, A.H.Y. received honoraria for speaking from AstraZeneca, Lundbeck, Eli Lilly and Sunovion; honoraria for consulting from Allergan, Livanova and Lundbeck, Sunovion and Janssen; and research grant support from Janssen. In the past 3 years, A.J.C. received honoraria for speaking from AstraZeneca and Lundbeck; honoraria for consulting with Allergan, Janssen, Livanova, Lundbeck and Sandoz; support for conference attendance from Janssen; and research grant support from Lundbeck. B.B. has recently been (soon to be) on the speakers/advisory board for Hexal, Lilly, Lundbeck, Mundipharma, Pfizer, and Servier. No other conflicts of interest.