Parallel Themes Research Articles

Abstract C073: Enhancing cancer care: Insights from the CAFÉ Trial on Financial Navigation and program improvements

Abstract Purpose: Cancer-related financial hardship is prevalent and associated with poor health outcomes. CAFÉ is a multi-site randomized control trial (RCT) testing a financial navigation intervention to reduce financial hardship for people newly diagnosed with cancer. Methods: The CAFÉ trial randomized participants to usual care or one of two intervention arms. Participants randomized to the intervention arms received either brief (one proactive outreach) or extended (three proactive outreaches) contact from a navigator to assess for financial concerns. Navigation services lasted for 6 months. At the final outreach call, we asked participants to provide feedback on areas of program improvement. We also conducted two rounds of interviews (early and later intervention) with the CAFÉ financial navigators to explore lessons learned regarding implementing the program. Data was summarized using a content analysis approach. Results: Among 201 participants (102 extended; 99 brief) that offered feedback at the final outreach call, 64% (129) were satisfied with the navigation program and did not feel changes were warranted. Suggested improvements included: improving the timeliness and usefulness of resources offered (18%; 37); offering earlier and more frequent/ongoing outreach from the navigators (14%; 28); receiving more active support from the navigators in accessing or processing information and resources (13%; 27); and increasing the scope of the navigator role to aid in complicated billing or insurance questions (9%; 19). Improving timeliness/usefulness of resources offered and frequency of outreach was noted slightly more often by participants in the brief arm (36%) than those in the extended arm (29%). Financial navigators (n=4) reported parallel themes for improvement including: expanding the navigator’s scope to help with billing, insurance, and cost questions; tailoring resources offered to the participant’s specific needs; and reaching out to participants closer to their cancer diagnosis. Navigators identified additional improvements including: having sufficient staffing and time to fulfill navigator functions; creating a simple and integrated documentation/tracking tool within the organization’s electronic health record; and translating important resources and instructions, like financial assistance applications, into Spanish. Conclusion: The overall satisfaction with the CAFÉ program underscores its potential to positively impact the well-being of individuals newly diagnosed with cancer. However, patients and navigators alike underscored important areas of improvement that health care systems may want to consider for future implementation: timeliness and length of the outreach, personalization of offered resources, and expansion of navigator role. Navigators also noted opportunities for improving data tracking and staffing. Future analyses will determine the effectiveness of the CAFÉ program on financial, health and healthcare outcomes. Citation Format: Jennifer L. Schneider, Blake Locher, Jennifer S. Rivelli, Deborah A. King, Lisa Shulman, Amanda F. Petrik, Nora B. Henrikson, Matthew P. Banegas. Enhancing cancer care: Insights from the CAFÉ Trial on Financial Navigation and program improvements [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C073.

30 Years of Advancing the Field of Education Abroad: Reflections and New Directions for Frontiers

We used several reflection processes to assess where we are currently as a field and journal and to chart our future directions. First, after a SWOT analysis, the Editorial Board divided itself into three working groups, reflecting on the focus, organization, and quality of our work. Each made recommendations and brought them back for discussion with the full Board. Also, we invited a group of Visiting Distinguished Editorial Fellows to join us as action editors for a number of submissions whose review process had been complicated by the pandemic and editorial transition, and to come together for a reflective conversation on what they noticed and would like to see more of based on their long histories in the field. There were many parallel themes between this conversation and those of the Editorial Board working groups, which led us to plan several changes for our journal. Our consensus is that moving forward, we would like to support more robust engagement with the existing literature, rigorous methodologies, critical interdisciplinary thought pieces, and clearly articulated relevance to practice.

From Temporal Existence to Eternal Quest: Upanishadic Themes in Yeats’s “Sailing to Byzantium”

The main objective of this article is to unveil the core themes of Upanishads in W. B. Yeats’s poem “Sailing to Byzantium”. Upanishads, the foundational texts of Vedic philosophy, propound the nature of gross reality, self and its relation with the eternal reality. These concepts find their reflections and intersections in “Sailing to Byzantium”. Both of them also propel the limitations of this gross world and the bliss of transcending the confinements of metempsychosis. Besides, they project that beyond the realm of ephemeral mask lies the effulgence of the cosmic consciousness which can be only radiated by realizing the dichotomy between soul and body. To expound these insights, they both underpin the parallel themes, symbols, images, and allegories. Likewise, the propagation of spiritual evolution to ignite the light within beyond the temporal existence is the Upanishadic motif that recurs in Yeats’s poem. By delving into these core themes, this study contributes a fresh revisiting and explores how the ideas, images and philosophy transcend geographical boundaries and diverse cultures. In its essence, this study involves a qualitative study to research by implementing the subtlety and interpretive analysis of the selected verses from the Upanishad and “Sailing to Byzantium”.

The Portrayal of Spring in English and Arabic Poetry: A Comparative Stylistic Study of Selected Poems

This comparative study highlights many romantic affinities in some poems by modern and classic English and Arabic poets. These romantic poets represent spring similarly as a source of pleasure, peace, and comfort. They see spring as their place of sharing compassion, love, and happiness. The study is mainly based on the Parallelism theory of the American School of Comparative Literature which focuses on the parallel themes, linguistic devices, and images of different authors whose social, historical, traditional, and linguistic aspects are different (Bressler, 2011, p. 42). It also adopts the New Criticism’s methodology of analyzing poetic metaphors, symbols, structures, and similes. Their romantic compositions connect spring spiritually, aesthetically, and invisibly with these poets’ souls. They glorify and adopt spring and its influence on them as a symbol of pleasure and comfort.

Athletic Trainers' Experiences With and Perceptions of Salary Negotiation Decision-Making During the Hiring Process.

Appropriate salaries for athletic trainers (ATs) have been a contentious topic for decades. Although professional advocacy efforts to increase ATs' salaries have gained traction, little is known about ATs' experiences with negotiation during the hiring process. To explore the reasons, influences, and factors influencing ATs' negotiation decisions. Qualitative study. Individual video interviews. Twenty-eight ATs who participated in a previous study and indicated a willingness to participate in the qualitative follow-up were interviewed (17 women, 10 men, 1 nonbinary individual; age = 37.8 ± 8.9 years, athletic training experience = 15.1 ± 8.3 years). Of the 28 participants, 18 did negotiate, whereas 10 did not. An individual video conference interview was conducted with each participant. After transcription, data were analyzed into themes and categories following the consensual qualitative research tradition. To ensure trustworthiness of the findings, we confirmed accuracy through member checks, triangulated the data using multianalyst research teams, and confirmed representativeness by including an external auditor. Four parallel themes emerged during data analysis: factors for determining salary negotiation, reasons for negotiating/not negotiating, negotiation influencers/deterrents, and experiences with negotiation/impact of not negotiating. Negotiators used a variety of data sources to support their requests, and their decisions were motivated by their own known value, the area's cost of living, and their current financial or employment situations. Negotiators relied on previous experiences to guide negotiations and provided successes and regrets from their negotiation experience. Nonnegotiators also used a variety of data types but were deterred by fear of not knowing how to negotiate, of losing the offer, or of offending those involved. Nonnegotiators highlighted a lack of confidence in their ability to negotiate and provided the financial consequences and personal regrets from not negotiating. More training, education, and publicly available data are needed to assist ATs in future negotiation attempts.

From the Arctic to the Tropics: A Thematic Analysis of Teacher Candidates’ Reflections of Two Cross-Cultural Programs

This study describes how one university prepares culturally responsive teacher candidates through Alaska and Thailand cross-cultural summer study trips. The study addressed the impact of the Alaska and Thailand cross-cultural experiences on teacher candidates as described in their reflective writings. The reflections addressed their socialization and depth of understanding and appreciation of children and adults from another culture. The authors looked for parallel themes that emerged as characteristics of both experiences.

Compulsory Heterosexuality in Indonesia: A Literary Exploration of the Work of Ayu Utami

The fall of Suharto from the presidency in the Reformation of 1998 created space for greater freedom of expression, including for women, in the world’s largest Muslim-majority nation, Indonesia. Ayu Utami is an Indonesian writer whose first novel, Saman, was published at the time of the Indonesian Reformation to critical and commercial acclaim. Other women writers followed her lead, expressing their work on women and sexuality. Through her writing, Utami challenges a patriarchal culture which continues to marginalise women. This paper focuses on the two of Utami’s literary works, Si Parasit Lajang: Seks, Sketsa dan Cerita (The Single Parasite: Sex, Sketches and Stories) (2003) and Pengakuan Eks Parasit Lajang (Confessions of a Former Single Parasite) (2013). These two books have parallel themes, representing Utami’s challenges to dominant discourses on women and marriage. In the first book, Utami shows that women face discrimination if they remain single. Her political stance to remain unmarried is a way to show that women can choose alternative ways of life, rather than submit to the valorised option: to get married. Utami’s shift of position, as elaborated in the second book through the story of her autobiographical character A, who is a Catholic, has to do with a developing tendency of the Islamic conservatism in Indonesia to silence the expression of minority groups, including minority religious communities. This paper argues that to understand Utami’s shift in position on marriage, we must understand the ways in which her position as a member of a minority and, sometimes endangered, religious community shapes her position.

Toward Inummarik (well-balanced humans): an investigation of the role of land-based learning programs in public education

ABSTRACT As a reaction to imposed education systems, traditional land-based education can be viewed as a source of resistance against a capitalist settler state, and most importantly, for the maintenance of Indigenous autonomy and sovereignty. However, formal k-12 learning environments are dominated by values systems and orientations to environmental education that potentially undermine Indigenous land-based education values and approaches. Within Canada, though there is a growing body of literature outlining the advantages of land-based learning for academic success and student well-being in public schools, funding models and policy restrictions have been slower to change and can impede implementation. With this article we hope to add to the growing body of evidence, supporting land-based learning as a legitimate pedagogy in public education. We approach this through a cross-case analysis of the results of two separate research projects and identifying the parallel themes, which emerged: youth resilience, Inuit autonomy, and authenticity in learning. Although our results focus on the development of individuals, within our conclusion we extend the argument toward systemic changes needed in Canadian public education not only as an act of decolonization but in supporting the development of Innumarik.

Nanomedicine approaches for treatment of hematologic and oncologic malignancies.

Cancer is a leading cause of death worldwide. Nowadays, the therapies are inadequate and spur demand for improved technologies. Rapid growth in nanotechnology and novel nanomedicine products represents an opportunity to achieve sophisticated targeting strategies and multi-functionality. Nanomedicine is increasingly used to develop new cancer diagnosis and treatment methods since this technology can modulate the biodistribution and the target site accumulation of chemotherapeutic drugs, thereby reducing their toxicity. Cancer nanotechnology and cancer immunotherapy are two parallel themes that have emerged over the last few decades while searching for a cure for cancer. Immunotherapy is revolutionizing cancer treatment, as it can achieve unprecedented responses in advanced-stage patients, including complete cures and long-term survival. A deeper understanding of the human immune system allows the establishment of combination regimens in which immunotherapy is combined with other treatment modalities (as in the case of the nanodrug Ferumoxytol). Furthermore, the combination of gene therapy approaches with nanotechnology that aims to silence or express cancer-relevant genes via one-time treatment is gradually progressing from bench to bedside. The most common example includes lipid-based nanoparticles that target VEGF-Α and KRAS pathways. This review focuses on nanoparticle-based platforms utilized in recent advances aiming to increase the efficacy of currently available cancer therapies. The insights provided and the evidence obtained in this paper indicate a bright future ahead for immuno-oncology applications of engineering nanomedicines.

Facilitators, barriers and considerations for the implementation of healthcare innovation: A qualitative rapid systematic review.

Family caregiving scholars recommend that health providers receive competency-based education to partner with and support family caregivers to care and to maintain their own health. While it may be relatively easy to develop competency-based education for healthcare providers, ensuring widespread uptake and spread and scale of healthcare education is critical to ensuring consistent person-centered support for all family caregivers (FCGs) throughout the care trajectory. The development of novel healthcare innovations requires implementation strategies for uptake and spread, with implementation involving the use of strategies to integrate a novel innovation into healthcare. Research suggests that there are many factors involved in successful implementation and a synthesis of potential factors is warranted. The purpose of this review is to provide an in-depth examination of facilitators, barriers and considerations for implementation of a novel healthcare innovation that will be used to develop an implementation plan for spread and scale of our competency-based education for health providers to learn about person-centered care for FCGs. A systematic review of published and grey literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA [Moher etal.,2015]) guidelines. The systematic review involved searching four databases for original research articles that described barriers, facilitators and/or other considerations when implementing innovations. Twenty-eight articles were included in the qualitative thematic analyses and described three areas of implementation research: barriers, facilitators and recommendations. There were major and parallel themes that emerged under facilitators and barriers. There were a wide variety of strategies that were identified as recommendations. The findings were synthesised into five considerations for implementation: Research and information sharing, intentional implementation planning, organisational underpinnings, creating the clinical context and facilitative training. This review provides an integrative overview of identified facilitators, barriers and recommendations for implementation that may aid in developing implementation strategies that can be tailored to the local context or innovation being implemented.

The Tripolar Great Game in the IOR Competition, Cooperation or Acute Confrontation

The domination of the seas has remained a prerequisite for acquisition of power in inter-state relations. The Indian Ocean Region (IOR) has long been considered a backwater to major power rivalry and global geopolitics. Despite being the smallest of the world’s oceans, the commercial and economic importance of Indian Ocean is never being questioned. IOR hosts major sea routes connecting four continents, Asia, Africa, Europe, and America, and has gained significant geostrategic importance because of rising Chinese naval power and a refocus on sea lanes as an arena of both competition and cooperation. It facilitates maritime trade in the region, transports more than half of the world's seaborne oil and hosts twenty-three of the world's top 100 container ports. However, it is often seen through a highly securitized lens. Three major powers which account for nearly half of global economy in the Indian Ocean arena, India, China, and United States, are vying for influence. China’s large and growing economic investment is reshaping the region, forcing both US and India to adapt. It has the maritime silk road which is half of the Belt and Road Initiative. United States reacted to it with the Indo-Pacific and Asia-Pivot strategy, and India through its Look-East policy. Pakistan, being one of the major trade corridors in IOR, possesses the golden chair. The paper is an attempt to investigate the tripolar great game amongst Beijing, Washington and New Delhi and examines whether the thrust is regional cooperation, competition, or acute confrontation. (Baqai, 2021, February 12) The parallel themes of twenty-first century regionalism and a crisscross of geopolitics and geoeconomics will also be factored in.

Are Cost-of-Care Conversations Best Practice? A Qualitative Study of Oncologists' Attitudes and Practice.

Patients' desire for cost conversations exceeds the incidence of such conversations, and many oncologists report avoiding cost conversations despite reporting willingness to have them. Our objective was to examine oncologists' attitudes toward cost conversations and how those attitudes affect practice. An experienced investigator conducted individual interviews with oncologists practicing in Kentucky. Participants were asked about their attitude toward and experience with cost conversations and their advice for discussing cost with patients. Interview transcripts were analyzed by a four-member team using qualitative descriptive analysis to identify themes. Participants were 32 MDs (male = 68.8%) age 31-77 years who were board-certified in medical oncology (53.1%), surgical oncology (25.0%), or radiation oncology (21.9%). We categorized participants into two groups: (1) those who viewed cost conversations as best practice and reported pursuing such conversations (37.5%) and (2) those who viewed cost conversations as not best practice and reported avoiding them (62.5%). Our analysis revealed three parallel themes for each category: Cost conversation attitudes and practice were based on (1) making good treatment decisions, (2) being a good clinician, and (3) having a good relationship with patients. Not all oncologists view cost conversations as best practice. To improve cost conversation attitudes and practice, cost conversations can be framed as a strategic tool that-when used well-fosters optimal decision making, professionalism, and the therapeutic relationship.

Simultaneous Events, Parallel Themes, Spatial Oppositions: A Comparative Content Analysis of Traditional Dance

This paper focuses on the smallest units and micro-structures of traditional dance. I propose a new approach that ventures beyond the identification of simple syntagmatic relations derived from the temporal succession of movements: a former practice of dance analyses that relied on theories borrowed from linguistics and music. The following discussion, based on the analysis of movement content as spatial change, demonstrates the existence of independent but simultaneous movement events in dance: each event possesses an expressive potential and the capacity for performance as a single rhythmical unit. Identifying events creates the possibility of separating parallel running, autonomous movement themes. Amongst the examined structures, an exceptional one, here termed contrakinesis, emerges, which represents spatial opposition as a recurring, characteristic phenomenon in East Central European traditional dance. The theory of simultaneous events and parallel themes reveals that concepts of expression in traditional dance can be comprehensively recognized only through a content-oriented exploration relying on movement analysis: an approach derived from investigating the dance itself.

Family Reunification Decision-Making in Dutch Family Foster Care: A Dual Perspective Approach

BackgroundAn important responsibility of the child welfare system, is taking decisions on the reunification of children with their birth parents after the children have lived in foster families. We currently lack evidence-based knowledge to guide the reunification decision-making process.ObjectiveThe present study uses concept mapping as an exploratory method, to identify themes that seem to be used by two groups of professionals in their judgement and decision making on reunification.MethodFirst, we consulted 78 foster care workers and studied 172 legal cases to examine criteria important for reunification. Next, unique criteria were grouped and rated by 35 foster care workers and also by 12 family judges separately. The data was analysed with multidimensional scaling and cluster analysis which resulted in a concept map for each group of professionals.ResultsBoth foster care workers and family judges suggested the following themes in the reunification decision-making process: (a) birth parents’ functioning and parenting abilities, (b) birth parents’ acceptance of support, and (c) the child’s functioning, developmental needs and wishes. Besides parallel themes, both foster care workers and family judges also seem to consider unique themes.ConclusionsThe suggested similarities and differences between the two groups of professionals possibly reflect different professional frameworks. The foster care workers’ considerations seem to have an orientation towards permanency planning while the family judges’ considerations seem to be linked to the legal framework. Gaining insight in the perspective of different groups of professionals involved in the process of reunification, is a small but important step towards reaching consensus through discussion in order to achieve the optimal implementation of the decisions considered in the best interest of children’s future.

Concept Paper; Juvenile LWOP and the Death Penalty; Handbook on Sentencing Policies and Practices in the 21st Century (Vol. 4), Cassia Spohn and Pauline K. Brennan

The Handbook on Sentencing Policies and Practices in the 21st Century is the fourth in a series of publications by the American Society of Criminology’s Division on Corrections and Sentencing. The book is a compendium of research on related issues with both direct and subtle nexuses. A major contribution of the book is its interdisciplinary approach analyzing sentencing and plea bargaining from both a focal-concerns perspective and legal perspectives — including in capital cases. Although this review provides an overview of the entire informative treatise, it primarily focuses on Chapters 6, 11, and 12 because these three chapters, all of which focus on juveniles either facing life sentences or the death penalty, deeply explore the problems attendant to sentencing disparities. These chapters illustrate how the punishment pendulum swung from rehabilitation to retribution and back, as illustrated by the U.S. Supreme Court’s jurisprudence concerning juvenile offenders. Another insight is the parallel themes of the “liberation hypothesis” discussed in the book’s analysis of sentencing guidelines and the death penalty: jurors and judges consider extra-legal factors as the opportunity for subjective discretion increases. The book illustrates that sentencing is a collaborative process involving legislators, prosecutors, corrections officials, judges and juries, and that plea bargaining plays a central role in the process.

Verzet en rechten

AbstractResistance and Rights. Comparing Arendt, Foucault, and YoungThe question if rights can be used in addressing gender-based oppression is at the center of recent debates in feminist theory. On the one hand, post-structuralist critiques have argued that differentiated rights, aimed at redressing injustices, reify the identity of oppressed groups (). On the other hand, proponents of differentiated rights have argued that these should be understood social-phenomenologically, as enabling social agents to counteract their oppression (Young 2011; ). This paper argues in favor for the latter position while taking seriously the concern with regard to social identity articulated by the former. I do so by comparing Hannah Arendt and Michel Foucault on the relation between resistance and rights. Starting from the observation that Arendt and Foucault agree on the need for a new law that can curtail the destructive dynamics of late-modernity, I argue that their account of resistance ascribes great importance to rights. Discussing the two authors in turn, I focus on two parallel themes. Firstly, confronted with the fight against anti-Semitic persecution (Arendt) and the struggle against governmental techniques (Foucault), they invoke rights against the near-total domination by late-modern states. Secondly, reflecting on how freedom practices require relationships with others in which one can develop one’s individual uniqueness, they hint towards rights that consolidate these relationships, of which friendship is the paradigmatic example. In conclusion, I return to the feminist debate on differential rights to show how Young’s model of communicative democracy is influenced by and is an instance of the relational rights that can be found in Arendt and Foucault.

Regulation of Unfair Terms in Consumer Contracts--An American Perspective

In the typical merchant-consumer transaction, standard terms are of course the norm. Consumer transactions are documented by contracts of adhesion where most, if not all, of the terms are drafted by the merchant and are not negotiable. Even if they were negotiable, the vast majority of consumers will either not be aware of this possibility or, quite reasonably, will conclude that they cannot bargain effectively over terms either because they do not understand their legal import or they cannot envision alternatives that would better serve their interests. Sometimes those standard terms are so one-sided in favor of the merchant that they inflict unfair hardship on the unknowing consumer. In the United States, there is no omnibus law on unfair contract terms that applies uniformly throughout the country. Regulation of unfair terms is addressed piecemeal, with limited protection in certain sectors at the federal level and most of the regulatory norms imposed by the individual states. Those norms can take statutory or common law form, and while they can vary widely from state to state, there are some parallel themes.

Civil War Monuments and the Militarization of America by Thomas J. Brown

Reviewed by: Civil War Monuments and the Militarization of America by Thomas J. Brown William B. Lees Civil War Monuments and the Militarization of America. Thomas J. Brown. Chapel Hill: Univ. of North Carolina Press, 2019. ISBN 978-1-4696-5374-7. 384 pp., paper, $29.95. In a thorough and well-researched book, Thomas J. Brown seeks "to reframe a rich recent literature on Civil War Memory" (9). Growth of this literature has paralleled increased interest in heritage-related memory studies and a growing pushback to Confederate symbolism, racism, and violent hate crimes. Much of this literature has focused on Southern monuments espousing in word and symbol the Lost Cause narrative or "useful history" of the Civil War. This history negated Southern defeat, extolled values supported by the Confederacy, and supported resurrection of the antebellum social contract between former master and former slave in a Jim Crow world. Brown's goal, clearly established in his introduction, is not to refute the existing literature but to make a very compelling argument that Civil War monuments, irrespective of their location in the former Confederacy or the loyal Northern states, also mirror or in fact had a role in the militarization of the United States. In chapter 1, Brown considers emergence of the soldier monument in post–Civil War America after a decade or so of commemoration by stark and impersonal forms (such as the obelisk) generally placed in cemetery or square to acknowledge human loss in the absence of the body itself. An essential part of this chapter, though, is a review of the nation's earlier, post-Colonial rejection of honoring great leaders and military heroes, and the military state in general, that was not seen to befit the new republican form of government. He argues successfully that the rejection of the aristocratic model in our new nation is reflected on the antebellum landscape by a general lack of monuments to the common soldier or military leaders. Prior to the Civil War, the standing army was small, and concepts of citizenship, manhood, and [End Page 430] leadership were vested in civilian, and usually agrarian, pursuits. The huge losses of the war, however, with so many soldiers buried on distant and usually unknown fields, inspired a substitute in the form of an obelisk or stone, which soon was supplanted by a sculpture of a nameless common soldier. Chapter 2 discusses how these sculpted portraits of soldiers on perpetual picket duty remained nameless but evolve to represent the soldier as a model of citizenship; a mantle previously held by the likes of the farmer or blacksmith. Chapters 3 and 4 consider the broadening of the post–Civil War monumental landscape to include parallel themes of leadership and victory. Leadership monuments, which extolled the virtues and importance of Union and Confederate officers such as Lee and Grant and political leaders such as Lincoln and Davis, became more and more commonplace as the veterans, now in places of political and economic prominence, vied for a lasting place in the story of our nation's greatest conflict. Monuments extolling victory through grand arches and other forms long familiar throughout Europe were understandably more common in the north, but commemoration of victory (of perhaps a different sort) was no less sought out in the South—and to some degree, it was achieved there. In chapter 5, Brown presents a useful discussion of the conflation of Civil War commemoration with that of World War I, which often receives little attention in most studies of monuments of the former. Brown concludes his book with an epilogue focusing on a new iconoclasm resulting from increasing opposition to existing Confederate monuments starting in the Jim Crow era but escalating rapidly with racially charged events of the current century. This resulted in "the most important season of American iconoclasm since the destruction of the equestrian statue of George III in 1776" (283). Anyone interested in Civil War monuments as memory, especially those who think they have this figured out, need to read this impressive book. Brown's volume is at times tedious, and it dives deep into the art history aspects of monuments, but this is itself an oft-neglected value...

When the Hurlyburly's Done / When the Battle's Lost and Won: Service, Suffering, and Survival of Civil War and Great War Veterans

When the Hurlyburly's Done / When the Battle's Lost and WonService, Suffering, and Survival of Civil War and Great War Veterans Ian Isherwood (bio) Marching in the Gettysburg Liberty Parade in May 1918 was a drum corps consisting entirely of Civil War veterans.1 As local citizens demonstrated their patriotism—notably with the Kaiser hanging in effigy—the old soldiers helped keep the pace for two thousand citizens who turned out to vigorously support the Great War. It was no doubt a moving moment, the nation's largest veteran demographic encouraging and supporting the next generation of soldiers to fight for cause and country in a very different war waged on a very different continent. Though fifty years separated the trenches of Petersburg from those of the western front, for one moment, the men who fought in the nation's bloodiest war marched alongside doughboys who were training, on a battlefield of that war, to fight in France.2 It is common to see the two conflicts as though existing in separate historical worlds. One is distinctly nineteenth century in its conduct and in its soldiers' experiences. The other is decidedly more modern; it was fought with bolt-action rifles, high explosives, and during it, new technologies like tanks, airplanes, and gas came into their own as weapons of war. To see the Civil War and Great War as similar invites obvious criticism. But soldiers who fought in each could identify common characteristics of their experiences. Soldiers of both wars knew the deep bonds of service forged through fire that carried over into the uncertain postwar world; both knew the burden of survival and living with mental or physical reminders of their service; and they both knew what it was like to survive, memorialize old comrades, and guard the memory of their war generation for decades afterward. When the doughboys came back from France, they shared spaces of memory—Memorial Day parades and Armistice Day observances—with veterans who understood what it was like to come home from a major war. [End Page 109] In both the United States and Great Britain scholars of the Civil War and the First World War have increased their attention to veterans' history, and, despite the major differences between the two conflicts, historians approach these subjects using similar language and methods.3 This essay considers comparatively this literature according to three tropes common in the historiography of both wars: service, suffering, and survival. First, scholars in each field have focused on how veterans created a sense of group identity—defined here as a war generation—based on the shared experience of military service.4 Veterans organized, lobbied, wrote, and sought care from one another and within their communities. Second, scholars are particularly interested in the concept of suffering, a subject that has grown in influence due to a wider discussion of veterans and mental health. Both war generations returned men and women who lived through traumatic events, and historians of the Civil War and the First World War have built a substantial literature around the psychology of traumatic experiences, one that has fostered significant debate. The last concept for analysis is the notion of survival. In both cases, by surviving and participating in memorialization, veterans were important to the legacy of their wars. Veterans served as agents of memory for decades; they reflected on and wrote about their experiences, erected monuments to lost comrades, and participated in social rituals acknowledging their status within society. Through their service, suffering, and survival, veterans became powerful reminders of their wars; they helped frame how later scholars interpreted both the Civil War and First World War as it was—and as it has been—experienced and remembered. Though there are general similarities in veteran experiences in the modern period, it is important to acknowledge that the concept of the "universal veteran" is inherently problematic.5 Each conflict is obviously distinct, and every society has its own culturally constructed ways of understanding war. Yet, the way historians write about veterans across the two fields reflects parallel themes, indicating researchers' practical impulse to use similar methodologies and tools to conceptualize veterans across time and space. While veterans' experiences...

Impact of a Self-contained Clinical Learning Space on a Physical Therapist Assistant Education Program

Background and Purpose. Immersion within practice areas or clinical education (CE) experiences are required to be both integrated within the curriculum (ie, integrated clinical education [ICE] experiences) and at the end of the curriculum (ie, terminal clinical education [TCE] experiences) for an accredited physical therapist assistant (PTA) education program. In addition, programs must meet accreditation requirements for ICE and TCE within specified clock hour (520–720) and program length limitations (five semesters). The purpose of this article was to describe one program's model for providing integrated PTA CE in a self-contained learning space and to describe the outcomes achieved in the first 2 years of operation. Method/Model Description and Evaluation. Planning, administrative approval, community fund-raising, and institutional capital budget allocation commitments took 6 years before the Nate Waters Physical Therapy Clinic (NWPTC) at Tulsa Community College, Tulsa, OK, opened in August 2014. The clinic design is based on a learning spaces framework providing students an actual clinic setting to learn and practice skills. The learning space allows students to gain clinical confidence in a comfortable, supportive learning environment, in which time restraints, high productivity requirements, and reimbursement restrictions are eliminated or minimized for the novice student. A mixed-method program evaluation assessed the 2-year performance of the self-contained clinic with two quantitative and three qualitative assessments. Outcomes. Implementation of the self-contained clinic allowed for a curriculum reduction of clinical hours from 680 to 560. The clinic generated an average of 65 visits each month with a range of 41–124 visits. No significant difference was found on the PTA students' midterm scores from the final TCE's Clinical Performance Instrument (PTA CPI, Version 1998) for the 2015 and 2016 cohorts compared with two preclinic cohorts (2013 and 2014), despite 22% less clinical time for the studied cohorts. Qualitative interviews of faculty and students showed three parallel themes and two related themes. Parallel themes in both groups included teaching in context, confidence, and communication, whereas related themes included faculty absence of concerns or complaints and student fear of failure. Students also identified an enhanced PT/PTA role formation as a benefit of the clinic. Discussion and Conclusion. Student experiences in the NWPTC are aligned to support integration of learning in the classroom. Faculty supervision in the clinic reinforces the concepts taught in didactic courses. As a self-funded, self-contained teaching clinic, NWPTC allowed faculty control on curriculum alignment and scheduling, thus allowing for a reduction in required clinical contact hours with no indication of decreased student outcomes. While CE in PTA education programs continues to be predominantly outsourced, a self-contained ICE clinic can be of value to PTA programs.