Early Encounters Research Articles

EFL Prospective Teachers’ Competency in Phonological Awareness: Impact on Teaching English Reading

Deficits in EFL teachers’ proficiency have surfaced recently as one of the possible factors contributing to children’s reading problems at their early encounters with literacy. Phonological awareness (PA) has dominated specialists’ interests well-timed with escalating reports containing more provoking evidence connecting children's reading disability with deficiencies in PA. This paper aims at investigating the impact of perceived proficiency, GPA, and gender of prospective teachers on shaping their future reading instruction detectable by prospective teachers' PA beliefs, awareness and knowledge. Towards this end, a four-section survey was administered to 158 pre-service EFL teachers. Results confirmed significant differences related to knowledge and beliefs at the expense of awareness.

In Pursuit of “queer-friendly” Healthcare: An Interview Study of How Queer Individuals Select Care Providers

ABSTRACTLGBQ+ individuals experience worse health outcomes than do other individuals. Some communication research finds that LGBQ+ individuals report receiving poor care during the mid- to post-health care, but this research assumes that LGBQ+ individuals have already received care. Little research has examined the pre- to early encounter experience of LGBQ+ individuals. This study presents exploratory research into how LGBQ+ individuals seek “queer-friendly” health care during pre- and early encounter experiences. Using an interview methodology, we report the facilitators and barriers to seeking queer-friendly care reported by LGBQ+ individuals. We offer implications for how health care providers and systems can better promote queer-friendly healthcare.

Lamas, Empresses and Tea: Early Twentieth-Century Sino-British Encounters in Eastern Tibet

ABSTRACTAt the turn of the twentieth century, the Tibetan plateau was a zone of intense imperial contact—and competition—between British India and Qing China. Even before the 1904 Younghusband Expedition to Lhasa, Indian rupees had become the primary currency of commercial exchange across the plateau, and British explorers had gathered detailed knowledge of both the presumed natural resource bounty of eastern Tibet and the lucrative border tea trade traversing it. This article explores models manifested by these interactions between British and Qing officials, merchants and explorers in the Kham region of ethnographic Tibet and the role empires played in the nineteenth- and early twentieth-century global spread of Euro-American norms. Although Sichuan officials directly engaged with administering Kham shared a common perception of Khampa society with their British counterparts, they also recognised the encroachment of Indian rupees and British explorers as challenges to Qing authority, if not a prologue to territorial expansion paralleling the contemporaneous scramble for concessions in coastal China. Beginning with the establishment of the Zongli Yamen in 1861, close Sino-British interaction along two tracks, British ‘lessons’ in statecraft and diplomacy in the imperial capital Beijing and commercial and political actions in the imperial borderland of Kham, provided models for Qing assertion of exclusive authority on the plateau. Two globalising norms inflected in these British models—territoriality and sovereignty—fostered transformative policies in the borderland during the first decade of the twentieth century. Implemented by Sichuan officials, these policies sought to undermine Lhasa's local challenge to Chinese authority via monasteries, thereby legitimising appeal to international law to repel regional challenges from both British India and Russia. This article analyses in depth two examples of these policies in action: a silver coin modelled on the Empress Victoria Indian rupee and a monopoly tea company partly modelled on British Indian tea firms and the Indian Tea Association. Both contributed to weakening the political, social and economic power projected into Kham by British India and Lhasa. The adaptation of these models in Qing policies fostered by the late nineteenth- and early twentieth-century Sino-British encounter in Kham reveals the conduits through which Euro-American norms of authority were shared, and demonstrates their power to transform relations in the interstices of global power, where empires met empires and states met states.

Athletic Training Student Core Competency Implementation During Patient Encounters.

Health care research evidence suggests that early patient encounters (PEs), as well as the purposeful implementation of professional core competencies (CCs), for athletic training students (ATSs) may be beneficial to their ability to provide care. However, no investigators have related facets of the clinical education experience with CC implementation as a form of summative assessment of the clinical experience. To determine the relationship between the frequency and length of PEs, as well as the student's role and clinical site during PEs, and the students' perceived CC implementation during these encounters. Cross-sectional study. Professional athletic training program, National Collegiate Athletic Association Division I institution. We purposefully recruited 1 athletic training program that used E*Value software; 40 participants (31 females, 9 males) enrolled in the professional phase (12 first year, 14 second year, 14 third year) participated. Participants viewed a 20-minute recorded CC educational module followed by educational handouts, which were also posted online for reference throughout the semester. The E*Value software was used to track PEs, including the type of encounter (ie, actual patient, practice encounter, didactic practice scenario), the type of site where the encounter occurred (university, high school), and the participant's role (observed, assisted, performed), as well as responses to an added block of questions indicating which, if any, of the CCs were implemented during the PE. Variables per patient were PE length (minutes), participant role, site at which the encounter occurred, and whether any of the 6 CCs were implemented ( yes/ no). Variables per participant were average encounter length (minutes), encounter frequency, modal role, clinical site assignment, and the number of times each CC was implemented. Separate 1-way analyses of variance were used to examine the relationships between role or clinical site and implementation of total number of CCs. Multiple linear regressions were used to determine how the average length and frequency of PEs were related to the average and total number of implemented CCs. Binary logistic regression models indicated how the length of each encounter, role of the participant, and type of clinical site related to the implementation of each CC. The roles of participants during PEs were related to their ability to implement the total number of CCs ( F = 103.48, P < .001). Those who observed were likely to implement fewer total CCs than those who assisted (M diff = -0.29, P < .001); those who assisted were likely to implement more total CCs than those who performed (M diff = 0.32, P < .001). Frequency of encounters was the only significant variable in the model examining all independent variables with CC implementation ( b4,32 = 3.34, t = 9.46, P < .001). The role of the student, namely assisting during PEs, and the volume of PEs should be considered priorities for students to promote greater CC implementation.

Reflections on Disciplines and Fields, Problems, Policies, and Life

Following a cursory review of early childhood influences, I discuss growing up during World War II and the subsequent experiences that led me to sociology and criminology. Early encounters with ideas, realities, and people—far too many to acknowledge properly—are noted briefly. I close with observations concerning a few issues of special significance and my experiences with them.

‘Great is Darwin and Bergson his poet’: Julian Huxley's other evolutionary synthesis

SUMMARYIn 1912, Julian Huxley published his first book The Individual in the Animal Kingdom which he dedicated to the then world-famous French philosopher Henri Bergson. Historians have generally adopted one of two attitudes towards Huxley's early encounter with Bergson. They either dismiss it entirely as unimportant or minimize it, deeming it a youthful indiscretion preceding Huxley's full conversion to Fisherian Darwinism. Close biographical study and archive materials demonstrate, however, that neither position is tenable. The study of the Bergsonian elements in play in Julian Huxley's early works fed into Huxley's first ideas about progress in evolution and even his celebrated theories of bird courtship. Furthermore, the view that Huxley rejected Bergson in his later years needs to be revised. Although Huxley ended up claiming that Bergson's theory of evolution had no explanatory power, he never repudiated the descriptive power of Bergson's controversial notion of the élan vital. Even into the Modern Synthesis period, Huxley represented his own synthesis as drawing decisively on Bergson's philosophy.

Housing a Heretic: Johannes Oecolampadius (1482–1531) and the ‘Pre-History’ of the Servetus Affair

ABSTRACTAlthough many scholars have written about Calvin's treatment of Michael Servetus, very few have explored Servetus's earliest encounters with other Protestant Reformers. By utilizing letters, prefaces and other writings in the sixteenth century, this study aims to develop a portrait of the multiple ways in which the Basel Reformer, Johannes Oecolampadius, influenced Servetus and ultimately, the outcome of his trial. Perhaps most notably in the background of the Servetus affair, Oecolampadius allowed Servetus to live in his house for 10 months prior to the publication of his first antitrinitarian book. The correspondence between the two of them, and the correspondence between Oecolampadius and other Reformers in 1530–1531, enables us to fill out the picture of Servetus's early ideas and reactions to them. The descriptions of events more than 20 years later in Geneva likewise aid our understanding of Servetus's trial and the ways Oecolampadius's legacy and reputation affected it.

Apart from the Mainstream: James Castle

Apart from the Mainstream:James Castle Karen Wilkin (bio) What compels someone to make art? The question remains fascinating and perplexing. We can invoke the simplest—and possibly truest—explanation and say that it's a fundamental characteristic of what makes us human, citing Paleolithic cave art to prove the point, but in the 1950s, the French art historian and critic (and archaeologist, resistance fighter, politician, and novelist) André Malraux suggested a more precise answer. "What makes the artist," he maintained, "is that in his youth he was more deeply moved by his visual experience of works of art than by that of the things they represent—and perhaps of Nature as a whole." The notion seems plausible, perhaps because of its similarity to the notion of "imprinting," the phenomenon described by animal behaviour specialists about the same time that Malraux published his once widely read book; researchers found that newly hatched goslings, for example, regard the first thing they see as their mother and will follow whatever or whoever it is, whether avian, human, or anything else. Since art is often about other art as much as it as about appearances, the natural world, or emotions, whether the connection takes the form of refutation, questioning, or expanding the ideas posited by the "other art," Malraux's theory that the desire to make art is itself generated by existing art appears credible: a sensitive young person is "imprinted" at a formative age by a painting or a sculpture, so that, like goslings following a surrogate parent, the future painter or sculptor remains more impressed by the work of art than by real experience. Yet Malraux's seemingly persuasive formulation is wholly inadequate when we try to apply it to those remarkable men and women [End Page 277] who are driven to paint or draw or to make sculpture without having had any crucial, early encounters with significant works of art—or with any works of art at all. The history of recent modernism is full of examples. The sculptor David Smith to name only one, grew up in the Midwest before the start of the World War I. He recalled that although he was interested in an illustrated Bible, as a child, and received praise for modelling a lion in clay, he had never seen any art in Decatur, Indiana, where he spent his boyhood, or in Paulding, Ohio, where his family moved when he was 15, "other than some very, very dark picture with sheep in it in the public library." But Smith knew that he wanted to be an artist. And there are many other examples, most notably the histories of self-taught vernacular artists such as James Castle (1899–1977). Castle is an enigma. Born profoundly deaf in rural Idaho, he spent his entire life on the family farm. Since he was not sent to a special school for the deaf until the age of 10—much too late, according to experts in teaching the hearing-impaired—he never acquired speech or learned to read. As far as anyone knows, the closest thing to "art" that he experienced in his silent world came from newspaper and magazine illustrations, mail order catalogues, cartoons and advertisements, even the decorations on commercial packaging—his parents ran the local post office, at one point—yet image-making was his sole, lifelong preoccupation and his main means of communication. Castle spent all of his time making art. Exempt from farm chores (he is said to have refused to participate), he retreated to his "studio," first an unused chicken coop, later a trailer, devoting himself to drawing haunting, poetic landscapes and interiors notable for their convincing perspective and sensitivity to tonality, to making constructions of animals, stylized people, and objects, and to creating hand-drawn "books" and "photo albums," adopting, first out of necessity and later by choice, scavenged paper and home-brewed mediums. Most mysterious are his hand-drawn "books," "photo albums," and word pieces, [End Page 278] with their inexplicable letters and "messages." Another mystery is the difference between Castle's moody, naturalistic farmyards and interiors and his rigid, frontal renditions of people. It's usually impossible to decide whether he...

Central Banks and Gold: How Tokyo, London, and New York Shaped the Modern World by Simon James Bytheway and Mark Metzler

Reviewed by: Central Banks and Gold: How Tokyo, London, and New York Shaped the Modern World by Simon James Bytheway and Mark Metzler Michael Schiltz (bio) Central Banks and Gold: How Tokyo, London, and New York Shaped the Modern World. By Simon James Bytheway and Mark Metzler. Cornell University Press, Ithaca NY, 2016. xviii, 240 pages. $39.95. Since the beginning of the twenty-first century, Japan has constantly been in the spotlight of economic and financial historians. This may have to do with the particular relevance of Japan's financial travails in recent history. As is well known, the bursting of the country's proverbial bubble economy heralded a "lost decade" (some would argue two lost decades). In hindsight, it turned out to be a highly delineated experience of the predicament that struck most of the developed world in the aftermath of the crisis of 2007–8. Not only was "quantitative easing," the preferred medicine for stress relief practiced by central bankers, remarkably similar to Japan's postbubble strategy, but, as Japan's policymakers had learned earlier, Western economies have responded very slowly, if at all, to their medicine. According to some, maintaining adequate aggregate demand is a worldwide problem and will persist for some time. Scholars such as Lawrence Summers and Robert Gordon refer to this phenomenon as "secular stagnation" (as opposed to a cyclical, or short-term, stagnation). Very low, and even negative, interest rates may be around for a long time, and this without causing out-of-control [End Page 492] inflation—an assumption that not only upsets long-established economic theory but, eventually, may also invalidate a host of conceptual instruments guiding central bankers when trying to understand and forecast inflation.1 The significance of Japan's early encounter with protracted economic stagnation has not been lost on Simon Bytheway and Mark Metzler, but they also identify a pattern. As they emphatically note in the introduction to Central Banks and Gold, Japanese markets have been the de facto leading indicator for economic turbulence in the history of modern finance capitalism. This has held true for the largely Great Britain–led gold standard period before 1914, the turbulent interwar years, and the postwar, (obviously) U.S.-led dollar standard period. In their own words: "Every truly major international crisis of the era—1907, 1920, 1929—appeared first in Tokyo, having an onset some three to six months earlier than in New York and London." This book can legitimately be read as an attempt to dissect and unravel the networks and protocols behind Japan's particular position. On the one hand, Japan is located at the periphery of the world's monetary geography, as the country's frequent exclusion from the London-New York axis makes abundantly clear. On the other hand, it has turned out to be at the very center of a host of policy debates and developing crises. If anything, Bytheway and Metzler's meticulously researched argument takes aim at this paradox. Key to explaining the latter, they argue, is the persistently secretive nature of tightly knit networks of central bankers that existed from the late nineteenth century onward and that must be held accountable for many systemic events in the world economic order throughout the twentieth century (and into the twenty-first century). Their story is at once a very personal one, for instance, highlighting the oddities of these powerful men and their often withdrawn lives. At the same time, the authors attempt to describe these networks as a profoundly structural element in central bank policymaking. In their view, personal relationships functioned as powerful tools for mobilizing power and commitment to self-proclaimed policy expertise and for defining the latter as unpolluted by political preference. The book starts by showing how Tokyo-London cooperation started long before World War I, in the aftermath of the Sino-Japanese War, something that may still be surprising to some readers. The roots of cooperation are found in the setting up of Japan's gold standard, particularly in the way Japan was to receive the Chinese war indemnity (1895). In a contentious move, the indemnity was kept in a non-interest-bearing account at the Bank [End...

Reverse Ethnography and the Recovery of Indigenous Anthropological Ancestors

Reverse Ethnography and the Recovery of Indigenous Anthropological Ancestors Richard Handler Margaret M. Bruchac, Savage Kin: Indigenous Informants and American Anthropologists. Tucson: University of Arizona Press, 2018. 280 pp. They've got a lot of stuff there, but they don't know much about it. Staff member at a Kwagiulth tribal center, referring to the University of British Columbia Anthropology Museum (as quoted in Clifford 1997:122) Margaret M. Bruchac begins Savage Kin with a meditation on the naming, or re-naming, practices of settler societies that allowed anthropologists and other authorities to assert control over knowledge about indigenous peoples on the North American continent. If those peoples' ethnonyms could be replaced by generic terms like "savage," "primitive," and "Indian," then it made sense, from the anthropologists' perspective, to treat such people as objects of knowledge but not as subjects capable of producing their own knowledge about the world and about themselves. Their "myths" became anthropologists' facts—social facts about savages, not historical facts about a collective past or cosmological facts about the world. And yet, to "collect" such facts, and the artifacts through [End Page 1119] which they were represented, anthropologists had to work with their "savage kin," their Indigenous interlocutors, who had their own reasons for translating knowledge about their worlds into terms anthropologists could understand. In Savage Kin, Bruchac, who is an Assistant Professor of Anthropology and Coordinator of Native American and Indigenous Studies at the University of Pennsylvania, dissects the social and historical processes through which Americanist anthropologists constructed their scientific authority. They did this by collecting Indigenous artifacts and knowledge, and then working to control the stories the collected materials could be used to tell about Indigenous peoples in museums and publications. Savage Kin is a brilliant first step in reversing that process, as Bruchac works backward from museum objects and the archival documentation associated with them to recover some of the hitherto lost stories of how those objects were detached from Indigenous cultural contexts and drafted into service in a quite different context. The book that has resulted from such a research procedure is both a collection of fascinating tales about anthropological ancestors and a theoretical and methodological treatise that is challenging in the best sense of the word: it demands that we rethink our assumptions. Chapters 2–6 of this 8-chapter book trace new histories of North Americanist anthropologists and their savage kin—anthropologist-collectors and the Indigenous "informants" and "assistants" who were far more central to the work of knowledge-creation than such terms suggest. These chapters are bracketed by introductory chapters and a conclusion in which Bruchac describes a research program she calls reverse ethnography (19). When she began looking for "materials that might document Indigenous commentary" on "early anthropological encounters" (177), she did not know what to expect; but, to her surprise, she discovered a wealth of documents—letters, field notes, and publications. Yet, those documents had been hidden through an organized disorderliness she calls cataloging erasures (177). Most white collectors, anthropologists, and museum curators considered collected objects to be theirs (either the property of the institution for which they worked or their personal private property), just as they considered the work of collection and research to be theirs. Their Indigenous collaborators—especially those who were women—were written out of the record. [End Page 1120] To maintain such fictions, white collectors treated much of the documentation relevant to museum objects so cavalierly that something like Bruchac's reverse ethnography is necessary to restore the record. Documents were "detached" (sometimes willfully) from objects (17) and "scattered" (177) among multiple museums, archives, and caches of personal papers. Documents were also detached from their creators in the sense that the writings of Indigenous collaborators were absorbed into the archives of white anthropologists and then "concealed by indexing processes that identified them as works by their non-Native collaborators" (177). For example, in Bruchac's chapter on Franz Boas (1858–1942) and George Hunt (1854–1933), we learn not only how Boas relied on Hunt—who by now is well-known in the history of anthropology—but how Hunt relied on the women of his household, who have been historically invisible. In...

Undead Uprising: Haiti, Horror, and the Zombie Complex by John Cussans

Reviewed by: Undead Uprising: Haiti, Horror, and the Zombie Complex by John Cussans Lucy Swanson Undead Uprising: Haiti, Horror, and the Zombie Complex. By John Cussans. London: Strange Attractor, 2017. ISBN 978-1907222474. 404 pp. $26.95 paperback. Zombies and "Voodoo" have long served as a shorthand in Anglo-American popular culture for the supposedly barbaric nature of Haiti and Haitians. In Undead Uprising: Haiti, Horror and the Zombie Complex, John Cussans charts this discursive and thematic network of (pseudo-) ethnographic, journalistic, and cinematic representations of Haiti that has served to dehumanize and demonize the nation since at least the events that began the Haitian Revolution in 1791. Cussans approaches the subject of the zombie and Vodou as a scholar of visual culture with a background in cultural history. He seeks to demystify the portrayal of the nation in films and other cultural products by contextualizing their creation in relation to contemporaneous sociohistorical events that shaped Haitian relations with international powers (primarily the United States and France). Through this examination, Cussans elaborates a theory of the "Zombie Complex" mentioned in his title. He states that it "refers to a range of ethical, psychological, and political thought-problems clustered around the central figure of the living-corpse which, though ostensibly fictional, stubbornly reminds us of the horribly actual limits (or lack of limits) of humanity, the individual and the human" (iv). Through this nexus of ontological questions, he links the "apocalyptic flesh-eating zombie" (100) that emerged with George Romero's 1968 film Night of the Living Dead to the Haitian folkloric living dead figure, typically a passive victim controlled by a zombi master. This research dovetails with Kaiama Glover's recent article "'Flesh like One's Own': Benign Denials of Legitimate Complaint" (Public Culture, 2017), which explores how the cannibal zombie can be related to the abject way Haiti is portrayed in US news media. In the introduction to Undead Uprising, Cussans narrates his interest in the subjects of the book. He cites an early encounter with what he calls "Voodoo-horror" in a Hollywood B-movie, and describes a connection with his doctoral work on imitative behavior in the British "Video Nasty" controversy in the 1980s and in the work of French philosopher Georges Bataille.1 These references reflect the author's methodology, which includes critical analysis of sensationalistic popular culture read through the lens of philosophy and cultural history. Cussans examines the role of mimetic behavior as it relates to the zombie complex, offering a very interesting account of references to the purported role of Mesmerism in the Haitian [End Page 165] Revolution. He examines how the practice—a precursor to hypnotism—arrived in colonial Saint-Domingue, and how it came to be viewed as playing a decisive role in the 1791 revolts inaugurating the revolution. Given his personal and professional background, Cussans identifies himself as "an armchair historian" (vi) of Haiti, yet his work is thoroughly researched and maintains a highly critical eye toward the exoticizing and othering way in which Haitian Vodou is presented in Western media and popular narratives, even those with purported journalistic or objective value. He makes extensive reference to critical work within the field of Haitian studies, which anchors his discourse and helps it to serve as a corrective to the exploitative works he analyzes. Undead Uprising is divided into two parts, each containing four chapters. The first examines the folkloric Haitian zombi, while the other tracks the evolution of the figure into a violent flesh-hungry monster through the vehicle of Romero's Night of the Living Dead. The transition between the two major parts of the book is illustrated by a graph labeled "Axis of Living Death" (220), which offers a visual interpretation of the transformation of the zombie myth. The largely chronological organization allows the reader to better understand the changing but enduring significance of Vodou to representations of Haiti globally. In the first chapter, the author studies William Seabrook's 1929 travelogue The Magic Island, which introduced the zombie to North American audiences. In addition to interrogating the zombie's role as justification for the US Occupation of Haiti, the chapter elaborates on Bataille's significance to the...

Reading Performance, Reading Gender: Early Encounters with Beaumont and Fletcher’s &lt;i&gt;The Scornful Lady&lt;/i&gt; in Print

This essay investigates Francis Beaumont’s seventeenth-century afterlife through material evidence left by early readers. Taking his immensely popular collaboration with John Fletcher, The Scornful Lady, as a test case, it traces patterns of shared interest and attention in different readers’ engagements with the play in quarto. Considering commonplacing habits, readers’ marks, and preparations for performance from a printed text, the article emphasizes fluidity between page- and stage-based engagements with drama in the seventeenth century. It also argues for the perhaps surprising receptiveness of Beaumont and Fletcher’s drama to readers’ reflections on and interrogations of gendered expectations, particularly regarding public female decorum.

Envisioning Islam: Syriac Christians and the Early Muslim World

Envisioning Islam: Syriac Christians and the Early Muslim World

GBS and the USA: The Beginnings of the Beginning

ABSTRACT The beginning of Shaw's serious engagement with America and Americans is normally associated with Richard Mansfield's production of Arms and the Man at New York's Herald Square Theatre on 17 September 1894. While it is true, as one of Mansfield's biographers put it, that prior to Mansfield's Arms and the Man Shaw was merely “a small speck on the horizon” for most Americans, a reexamination of several secondary sources and new evidence from previously unexplored manuscript sources reveal that Shaw's interest in America had started to take shape long before 1894. This article argues that Shaw's early encounters with American social and political values laid the foundation for his subsequent and frequent condemnations of American society.

Medical student reflections on geriatrics: Moral distress, empathy, ethics and end of life

ABSTRACTMedical students’ early clinical encounters may influence their perceptions of geriatrics. This study examines reflective essays written by 3rd-year medical students on required clinical rotations. Using content analysis, the authors analyzed the essays’ thematic content. The authors then used chi-squared analysis to compare themes with geriatric patients (age 60+) to themes with other age groups. One hundred twenty out of 802 essays described a geriatric patient. The most common geriatric themes were (1) death and dying, (2) decision making, (3) meaningful physician–patient interactions, (4) quality of care, and (5) professional development. Geriatric essays were more likely to discuss death/dying and risk–benefit themes and less likely to discuss abuse. Geriatric essays were more likely to describe students’ moral distress. Geriatric essays with moral distress were more likely to include empathy themes compared to geriatric essays without moral distress. Geriatric patients may pose unique ethical challenges for early clinical students.

Implications for the future of palliative care for pancreatic cancer: A retrospective institutional study.

153 Background: Five year overall survival rate for localized and metastatic pancreatic adenocarcinoma (PAC) is discouraging at 31.5% and 2.7%, respectively. Evidence supports that early palliative care (PC) involvement leads to better quality of life and prolongs OS. Referral to PC is often delayed as it is perceived as an alternative rather than adjunctive care. We conducted a retrospective study to identify different variables that affect PC consultation among patients (pts) with PAC admitted to the hospital and to study the impact of health care utilizations on OS. Methods: A retrospective medical record review of pts with PAC diagnosed/treated at SUNY Upstate University hospital was conducted (2011-2015). Variables like age, sex, race, stage at diagnosis, insurance status, performance status (PS), frequency of hospital admissions, nights spent, procedure visits, blood products used, and time variable to PC referral from diagnosis were collected. OS was calculated using Kaplan Meier analysis. Results: We identified 325 pts with diagnosis of PAC. 86.72% pts had one or more hospital admissions during course of their illness and of these, 15.85% saw PC during initial inpatient admission. 36.23% saw PC later in the course of their illness and 13.96% pts were offered palliative care in first outpatient visit. Median time interval to see palliative care was 75 days (d) from diagnosis, with 25% pts seeing PC 304d from diagnosis. Variables that had significant impact on early palliative care encounter (0-30d) were age &gt; 70, stage IV at diagnosis, PS of 4, medicare insurance, offered PC in first visit (p&lt; 0.001). OS was not statistically significant between groups who had ≥ 1 vs 0 blood products given, &lt; 3 vs ≥ 3 hospital admissions, ≤ 13 vs &gt; 13 nights spent, ≥ 1 vs 0 procedures done, ≤ 3 vs &gt; 3 consults service seen. Median OS for pts with time interval to see PC 0-30d vs &gt; 120d was 33d and 510d respectively with adjusted hazard ratio of 6.252 (95% CI 3.462-11.29). Conclusions: We demonstrated that PC is underutilized with only minority of pts benefiting from it during their cancer treatment. OS was poor in group evaluated by palliative care early than late which could be due to patients with advanced disease and poor PS being referred early.

Václav Havel by Kieran Williams (review)

SEER, 95, 4, OCTOBER 2017 790 rewarding participation. Despite these mechanisms, which reduced historywriting to the mere accomplishment of sophisticated propaganda in a scholarly form in a general context of de-professionalization of the discipline, educated historians participated, alongside Party activists and veterans untrained in history, in the struggle for resources, positions and privilege’ (pp. 337–38). That said, Romanian historiography under Ceaușescu was not entirely subservient to the dictates of the Party. One has only to read the contributions of respected historians in Revue Roumaine d’Histoire and Revista de Istorie to find support for such a view. UCL SSEES and Georgetown University, Dennis Deletant Washington D.C. Williams, Kieran. Václav Havel. Critical Lives. Reaktion Books, London, 2016. 237 pp. Illustrations. Notes. Select bibliography. Index. £11.99 (paperback). Williams’s biography of Václav Havel is less a conventional narrative of his life and influence, though it does touch on all the key moments, than a search for the deeper forces which gave rise to his thought and actions. Williams sees Havel as a figure who was always consumed by a poetic instinct to unsettle and disturb, to continually force others to step outside of their ordinary routines. The analysis relies on Williams’s deep immersion in Havel’s writing — not just the standard essays and plays but also his earliest poetry, multiple drafts of all his works, and the writings of his main influences. Though its informational density may be overwhelming to casual readers or those not familiar with the history of the region, it will be that much more rewarding to students of Havel’s art, philosophy and politics, especially ones not fluent in Czech, who will find much needed context and a number of original interpretations. Williams begins with the fact that biography was a problem for Havel. As the son of a wealthy and well-known family, he was the object of envy and some isolation in his youth. This same background then made him a class enemy for the Communists and limited his formal education. His dissident activities, however, also became the source of his moral authority. And by the end of his life he was an icon, whose reputation was so great that it became an impediment to communication. Much of the interest in the work comes from Williams’s excavation of the roots of Havel’s thought in family traditions — a preference for harmony and the moral improvement of public life — rivalries with an older generation that included Milan Kundera and the screenwriter Jaroslav Dietl, and early encounters with philosophy. He finds the main key to Havel’s thought in the REVIEWS 791 work of the Czech thinker Josef Šafařík who argued that each individual was morally bound to avouch a personal truth. The effect of Havel’s personality on his politics and art are a constant underlying theme in the text. These character traits include his desire to embrace life in all its forms, his optimism and ability to see the good in even forced experiences like the army and prison (which Williams cleverly terms ‘a sabbatical from the nerve-wracking life of dissent’), and his inclination to legalistic thinking (an inspiration for the strategy of Charta 77). Two more intellectual habits of mind were his belief that small actions could have wideranging consequences and his constant worry about how consumerism and technology estrange people from real being. Along the way Williams takes issue with some misconceptions about Havel’s political thought. He argues that Havel was not opposed to political parties as some have contended and in fact thought them essential both in 1968 and after the revolution. He similarly says that Havel was not against economic reforms and instead believed that the architect of the Czech reforms, Václav Klaus, was creating a ‘big-state conservatism’. The problem in both cases may have been that Havel’s arguments were too subtle and nuanced for easy consumption, a tendency he parodied in the title of his memoir (its Czech title is Please Be Brief, a request he often received from journalists). An interesting question about Havel is the extent to which he is a distinctively Czech thinker...

The Hangover: The Lasting Impact of Early Conflict on the Duration of Bargaining Relationships

Although studies have shown that employer opposition negatively affects the likelihood of success at the certification and first-contract stages, there is little to no indication of what the long-term impact of such opposition might be for relationships that successfully conclude a first agreement. Using survival analysis on nearly three decades of data from Ontario, this article investigates whether relationships that experience early conflict encounter a “hangover”—a heightened likelihood of dissolution—that extends into the representation phase of the process, meaning beyond the settlement of the first agreement. Using unfair labor practice charges and first contract arbitration applications as proxies for conflict, the author finds evidence of a hangover for relationships that exhibit a turbulent start. Further, findings suggest that relationships that experience this early conflict also have a higher likelihood of dissolution throughout the entire relationship.

Personal professional identity formation through interprofessional learning and early patient encounter during preclinical years.

Personal professional identity formation through interprofessional learning and early patient encounter during preclinical years.

IL-1β As Mediator of Resolution That Reprograms Human Peripheral Monocytes toward a Suppressive Phenotype.

During infection pathogen-associated molecular patterns activate immune cells to initiate a cascade of reactions leading to inflammation and the activation of the adaptive immune response culminating in the elimination of foreign pathogens. However, shortly after activation of the host defense machinery, a return to homeostasis is preferred to prevent inflammation-induced tissue damage. This switch from the initial immunogenic to the subsequent tolerogenic phase after clearance of the infection can be mediated through highly plastic peripheral monocytes. Our studies reveal that an early encounter with toll-like receptor 7/8-ligand R848 mediates a strong pro-inflammatory monocytic phenotype that primes its own reprogramming toward an immunosuppressive one. Previously, we showed that these R848-treated antigen-presenting cells (APCs) fail to activate allogeneic T cells and induce regulatory T cells (Tregs) through signal transducer and activator of transcription 3 (STAT3)-dependent PD-L1. Here, we further demonstrate that R848-treated APCs suppress CD3/CD28-mediated and dendritic cell-mediated T cell activation and that adenosine and indoleamine 2,3-dioxygenase/kynurenin pathways are involved in tolerance induction. Reprogramming of monocytes after R848 stimulation requires the pro-inflammatory cytokine IL-1β and a boosted IL-6 release. The subsequent autocrine prolonged activation of STAT3 induces direct upregulation of tolerogenic factors which finally downregulate proliferation of activated T cells and mediate Tregs. Thereby our study suggests that inflammatory cytokines, such as IL-1β and IL-6, should be considered as mediators of resolution of inflammation.