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Racial disparities in healthcare have been well documented in the United States. We hypothesise that there will be a racial variance in different clinical variables in single-ventricle patients through stages of palliation.
Materials and Methods:
Retrospective single-centre study stratified all single-ventricle patients who reached stage 2 palliation by race: Black and White. Other races were excluded. Demographic and clinical characteristics were compared, alongside follow-up survival data. Primary outcomes were progression to Fontan and overall survival.
Results:
Among 526 patients, 325 (61.8%) were White, and 201 (38.2%) were Black. Median age at stage 2 palliation was 150 days for White and 165 for Black patients (p = 0.005), with similar weights. Black patients exhibited higher median cardiopulmonary bypass times (87 vs. 74 minutes, p = 0.001) and a greater frequency of genetic syndromes (30.1% vs. 22.1%, p = 0.044). No significant differences were observed in outcomes between groups from stage 2 to stage 3, pre-stage 3 cardiac catheterisation variables, or perioperative outcomes. Multivariable regression analysis identified hypoplastic pulmonary arteries as the risk factor for mortality after stage 2. Survival analysis showed no difference in survival by race; however, occurrence of combined cardiovascular event was significantly higher in Black race.
Conclusions:
Significant racial disparities exist among single-ventricle patients regarding the timing of stage 2 palliation, cardiopulmonary bypass duration, and frequency of genetic syndromes. Black race was a risk factor for sub-optimal long-term outcome, although perioperative mortality was similar. These race-related factors warrant further studies to improve our understanding of the impact of race on outcomes.
The first chapter defines what was meant by ’caricature’ in Britain between the late seventeenth century and the early nineteenth century. I explain how the varied usage of ’caricature’ captured the richness of caricatúra’s connotations and etymology in Italian, discussing Giuseppe Baretti’s Italian–English Dictionary, Annibale Carracci’s ’perverse realism’ and the history of ritratti carichi and caricature drawing in Britain. I establish the full scope of carticature’s significance for literature and letters in the Romantic period, extricating the history of literature’s ’caricature’ from the ’golden age of caricature’ associated with the single-sheet satirical print genre. Extracts from the novels of Mary Brunton and Maria Edgeworth illustrate the literary sphere’s view of satirical prints, while quotations from books newspapers and periodicals exemplify the use and debate of ’caricature’ as a term in social and political critique as well as in criticism of literature and the arts.
The third chapter suggests that The Spectator’s characters set important precedents of diversion, originality and realism for the caricature talk that constituted realist character in the critical recognition and writing of the Romantic novel. The second part of the chapter shows how anti-caricature rhetoric became conventionalised in late eighteenth-century essays that sought to explain and promote the appeal of Addison and Steele’s character ’Sir Roger De Coverley’.
This is the first of three chapters showing how caricature talk co-operates with characterisation techniques in genre-defining novels of the Romantic period. I give an account of anti-caricature rhetoric in the critical reception of Jane Austen’s novels, from contemporaneous reviews and responses to the twentieth century. I describe Austen’s particular moral concept of caricature as an effect of self-indulgence, first examining instances of the word ’caricature’ in Northanger Abbey and Sense and Sensibility, then close-reading depictions of fat bodies in Persuasion and Sanditon, as instances of literary realism’s ’explained caricatures’.
The fifth chapter explores how concepts of caricature interacted with historical romance in the critical reception and writing of Walter Scott’s characters. I explore Scott’s association of pictorial caricature with accuracy, particularity and referentiality, looking in particular at The Heart of Mid-Lothian and Guy Mannering, and suggesting the implications of John Kay’s caricatures for Scott’s ’compendious realism’. Scott’s defences of historical ’caricature’ – in his essay on Tobias Smollett and in the Magnum Opus edition of The Monastery – are a counterpoint to the anti-caricature rhetoric used to disparage his novels. Returning to the realist device of the ’explained caricature’, I differentiate national caricatures of the Scots and Jewish ’body-corporate’ in Rob Roy, The Heart of Mid-Lothian and Ivanhoe.
The second chapter explores how literary writing in the Romantic period denies and decries caricature. I describe a ’caricature talk’, dominated by anti-caricature rhetoric, that seeks to establish the quality, verisimilitude and representational justice of textual characterisations; and I explore how caricature talk constitutes formal realism in the literary criticism of the Romantic period. The second part of the chapter positions imaginative literary caricature in relation to anxiety about prospographic and personal caricature describing real people, providing essential context for Chapter 3’s discussion of character originality and realism.
The sixth and final chapter considers horror writing’s appropriation of flesh-caricature from writing descriptive of the human body, dismantling character’s place in formal realism. I explore the grotesquing of the disproportioned body in Mary Shelley’s Frankenstein and her short story ’Transformation’, and in Walter Scott’s dwarf characters, where the aesthetic type of the ’gigantic dwarf’ gives rise to a mode of writing I call ’horrid realism’. The second part of the chapter grounds horrid realism in eighteenth-century texts that imagine the literalisation of caricatúra, such as Thomas Browne’s depiction of the Hippocratic face, and the effects of swaddling bands and foundation garments as pictured by John Locke, Jean-Jacques Rousseau, William Buchan, William Cadogan, Mary Wollstonecraft, William Godwin and J. P. Malcolm.
What does the caricature talk of the Romantic period have to do with literary criticism’s persistent notion of ‘caricature’ as a technique or style of characterisation in an author’s work? Does caricature have a formal existence, a set of stylistic markers, which can be identified in fictive characters across literary works?
What was caricature to novelists in the Romantic period? Why does Jane Austen call Mr Dashwood's wife 'a strong caricature of himself'? Why does Mary Shelley describe the body of Frankenstein's creature as 'in proportion', but then 'distorted in its proportions' – and does caricature have anything to do with it? This book answers those questions, shifting our understanding of 'caricature' as a literary-critical term in the decades when 'the English novel' was first defined and canonised as a distinct literary entity. Novels incorporated caricature talk and anti-caricature rhetoric to tell readers what different realisms purported to show them. Recovering the period's concept of caricature, Caricature and Realism in the Romantic Novel sheds light on formal realism's self-reflexivity about the 'caricature' of artifice, exaggeration and imagination. This title is part of the Flip it Open Programme and may also be available Open Access. Check our website Cambridge Core for details.
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