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This chapter analyses cross-dressing in Restoration Shakespeare – in the main, female characters dressed in male attire – exploring the key question of how this theatrical device was influenced by the advent of the professional actress on the English stage. The approach is twofold. Firstly, the chapter examines the use of cross-dressing in specific Restoration-era adaptations of Shakespeare. One of the earliest of these, Dryden and Davenant’s The Tempest (1667), provides additional opportunities for transvestite performance as the play’s new male role of Hippolito was performed as a travesty part by an actress (either Mary Davis or Jane Long) and the female part of Sycorax (also added to the play by the adapters) was likely played by a man. Furthermore, it explores how other adapters treated the cross-dressing already inherent in the Shakespearean texts they chose to rewrite, considering, for example, George Granville’s The Jew of Venice (1701) and Charles Burnaby’s Love Betrayed (1703), a version of Twelfth Night. Secondly, the chapter investigates the Restoration performance history of Shakespearean ‘originals’ that feature transvestism, including Twelfth Night and The Merry Wives of Windsor. The chapter nuances our understanding of gender in Restoration Shakespeare through a detailed consideration of cross-dressing.
For patients with bifascicular block and syncope of unknown origin, different American Heart Association guidelines give Class 2A recommendations for two treatments: the implantable loop recorder (ILR) and empiric pacemaker insertion (PM). Equipoise reflected in guidelines may contribute to uncertainty in management and inefficient resource use. The objective of this analysis is to determine the cost-effectiveness of ILR compared to PM in the management of older adults (age>50 years) with bifascicular block and syncope over two years, from the perspective of a Canadian publicly funded health care system, in the Syncope: Pacing or Recording In ThE Later Years (SPRITELY) trial.
Methods:
Resource utilization data was collected throughout the trial, and unit costs were assigned (2017 Canadian dollars). Utility was measured at baseline and annually with the EQ-5D-3L. Quality adjusted life years (QALYs) were calculated as area-under-the-curve, and adjusted for baseline imbalances in utility. Confidence intervals for the incremental cost effectiveness ratio were generated with non-parametric bootstrapping.
Results:
Mean cost in participants randomized to PM was CAD 9,759 (USD 7,400), compared to CAD 13,453 (USD 10,200) in participants randomized to ILR. The ILR strategy resulted in 0.020 QALYs more than the PM strategy. The incremental cost effectiveness ratio was CAD 186,553 (95% CI: −831,950–1,191,816) (USD 141,900, 95% CI: −632,740–906,440) per additional QALY. In 1,000 bootstrapped replicates, the cost of the ILR strategy was always greater than that of the PM strategy. At the threshold of CAD 50,000 (USD 38,000) per additional QALY, the probability that the ILR strategy is the cost effective option is 0.504.
Conclusions:
ILR costs were greater than PM costs, with little difference in QALY outcomes over two-years. Findings are generalizable to patients similar to SPRITELY participants, from the perspective of the Canadian health care system. However, practice pattern variation and payment systems inhibit generalizability to other countries. Future analysis will explore cost and QALY outcomes in countries that participated in the SPRITELY trial.
Fiona Ritchie analyses the significant role played by women in the construction of Shakespeare's reputation which took place in the eighteenth century. The period's perception of Shakespeare as unlearned allowed many women to identify with him and in doing so they seized an opportunity to enter public life by writing about and performing his works. Actresses (such as Hannah Pritchard, Kitty Clive, Susannah Cibber, Dorothy Jordan and Sarah Siddons), female playgoers (including the Shakespeare Ladies Club) and women critics (like Charlotte Lennox, Elizabeth Montagu, Elizabeth Griffith and Elizabeth Inchbald), had a profound effect on Shakespeare's reception. Interdisciplinary in approach and employing a broad range of sources, this book's analysis of criticism, performance and audience response shows that in constructing Shakespeare's significance for themselves and for society, women were instrumental in the establishment of Shakespeare at the forefront of English literature, theatre, culture and society in the eighteenth century and beyond.