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A drama critic who was dispatched to review a ‘farcical comedy’ in the year 1895 could barely conceal his annoyance – he had seen it all before. ‘Our farcical comedies’, he wrote, ‘are all modeled on much the same lines, we are beginning to perceive, and novelty in their plot is becoming a rare quality’. By that time, characters in farcical comedy were no longer throwing bacon and chops across the stage or discovering infants under meat platters, as their predecessors had done in popular one-act farces like John Maddison Morton's Box and Cox (1859) and W. E. Suter's The Lost Child (1863). The slapstick comedy of earlier farces had given way for the most part to laughter more verbal and less crudely physical, framed in narratives of love, marriage, and romantic and sexual intrigue, often inspired by adaptations from the French. Bernard Shaw, although contemptuous of what he called ‘the farcical comedy outbreak’ of the 1890s and the ‘galvanic’ laughter that he attributed to it (OTN II: 118, 124), was hardly immune to the attractions of farce in his own play writing. He introduced many of the generic markers of farcical comedy in his plays, most notably in The Philanderer and especially You Never Can Tell, but would continue to disparage the genre on the whole as a disgrace to humanity.
But we should not accept too uncritically Shaw's assessment of contemporary farce as mechanical and inhuman. Not only does this sweeping indictment of farcical comedy leave little room for appreciating the disarming fun of plays like Clo Graves's all-too-soon-forgotten A Mother of Three (1896), Brandon Thomas's Charley's Aunt (1892), and W. S. Gilbert's Engaged (1877), it also produced Shaw's oddly skewed critique of the most notable play of its kind in the 1890s, or perhaps any period, Oscar Wilde's The Importance of Being Earnest (1895). In his review of Wilde's play, Shaw confessed that he was amused by Earnest and laughed as much as anybody in the audience – but it was a ‘miserable mechanical laughter’, he added, provoked by a formulaic farce that cancelled any sense of ‘reality’ and ‘humanity’. All in all, Earnest offered only ‘stock mechanical fun … for instance, the lies, the deceptions, the cross purposes, the sham mourning, the christening of the two grown-up men, the muffin-eating, and so forth’.
Objectives: The aim of this study was to estimate the cost-effectiveness of nebulized magnesium sulphate (MgSO4) in acute asthma in children from the perspective of the UK National Health Service and personal social services.
Methods: An economic evaluation was conducted based on evidence from a randomized placebo controlled multi-center trial of nebulized MgSO4 in severe acute asthma in children. Participants comprised 508 children aged 2–16 years presenting to an emergency department or a children's assessment unit with severe acute asthma across thirty hospitals in the United Kingdom. Children were randomly allocated to receive nebulized salbutamol and ipratropium bromide mixed with either 2.5 ml of isotonic MgSO4 or 2.5 ml of isotonic saline on three occasions at 20-min intervals. Cost-effectiveness outcomes were constructed around the Yung Asthma Severity Score (ASS) after 60 min of treatment; whilst cost-utility outcomes were constructed around the quality-adjusted life-year (QALY) metric. The nonparametric bootstrap method was used to present cost-effectiveness acceptability curves at alternative cost-effectiveness thresholds for either: (i) a unit reduction in ASS; or (ii) an additional QALY.
Results: MgSO4 had a 75.1 percent probability of being cost-effective at a GBP 1,000 (EUR 1,148) per unit decrement in ASS threshold, an 88.0 percent probability of being more effective (in terms of reducing the ASS) and a 36.6 percent probability of being less costly. MgSO4 also had a 67.6 percent probability of being cost-effective at a GBP 20,000 (EUR 22,957) per QALY gained threshold, an 8.5 percent probability of being more effective (in terms of generating increased QALYs) and a 69.1 percent probability of being less costly. Sensitivity analyses showed that the results of the economic evaluation were particularly sensitive to the methods used for QALY estimation.
Conclusions: The probability of cost-effectiveness of nebulized isotonic MgSO4, given as an adjuvant to standard treatment of severe acute asthma in children, is less than 70 percent across accepted cost-effectiveness thresholds for an additional QALY.
Oscar Wilde was a courageous individualist whose path-breaking life and work were shaped in the crucible of his time and place, deeply marked by the controversies of his era. This collection of concise and illuminating articles reveals the complex relationship between Wilde's work and ideas, and contemporary contexts including Victorian feminism, aestheticism and socialism. Chapters investigate how Wilde's writing was both a resistance to and quotation of Victorian master narratives and genre codes. From performance history to film and operatic adaptations, the ongoing influence and reception of Wilde's story and work is explored, proposing not one but many Oscar Wildes. To approach the meaning of Wilde as an artist and historical figure, the book emphasises not only his ability to imagine new worlds, but also his bond to the turbulent cultural and historical landscape around him - the context within which his life and art took shape.
The theatre was uniquely alluring to women of the Victorian period. Itwas one of few professions accessible to women, holding out the prospect of a career that would be active, disciplined and — at least for a lucky few — remunerative. Life in the theatre also gave women a voice, for on stage they could speak while others sat waiting in suspense for their next word — including men, who in most other settings compelled women to silence. This control over audiences, over men in particular, often proved intoxicating to Victorian actresses. On the other side of the footlights, stunned Victorian men often became infatuated with women of the stage even as, paradoxically, they felt imperilled by them.
This fascination with the stage could be experienced powerfully and enviously by women who had no connection with the theatre at all. Florence Nightingale, for example, expresses it in Cassandra when she calls the opportunity of being a professional the supreme attraction of the life of an actress, much more than the opportunity to achieve fame or wealth. Amateurism was the fate of most women, however talented, singing or drawing ‘as an amusement (a pass-time as it is called)’, denying themselves a vocation to sacrifice their lives to the needs of a husband and children. But the actress was different:
in the morning she studies, in the evening she embodies those studies: she has the means of testing and correcting them by practice, and of resuming her studies in the morning, to improve the weak parts, remedy the failures, and in the evening try the corrections again.