So-called Real World Research Articles

Strategies following failure of CAR-T-cell therapy in non-Hodgkin lymphoma.

Several CD19 CAR-T-cell drugs are approved for safety and efficacy in advanced B-cell cancers with encouraging results. However, primary refractory and relapse are common. We critically analyze long-term data on efficacy of CD19 CAR-T-cell therapies in B-cell non-Hodgkin lymphomas from clinical trials with those of so-called real world data. We identify co-variates associated with efficacy, discuss mechanisms of relapse, summarize the data on the results of post-failure therapy including allotransplants, monoclonal and bi-specific antibodies, antibody-drug conjugates, immune checkpoint-inhibitors and repeat infusions of CAR-T-cells. We conclude, save for allotransplants, there are few data strongly supporting any of these interventions. Most trial are with few heterogeneously-treated subjects with diverse interventions and brief follow-up. Interventions need to be tailored to the cause(s) of CAR-T-cell failure. Prestly, there is not a convincingly safe and effective therapy of people failing initial CAR-T-cell therapy of B-cell non-Hodgkin lymphoma.

A Practice for Surrender

An experiment of conceptual self-surveillance in the form of a video essay, A Practice for Surrender looks at the topic of digital sleep data collection with a conspiratorial gaze. It seems that the once mystical and private refuge of sleep has become compromised by capitalist strategies of "quantific(a)tion". As self-trackers transform to workers in their sleep, the digital subject is redefined by contours of data drawn around a regular absence. While criticising the artificiality of measuring sleep, however, it could be asked in counterpoint: what marks the so-called real world beyond the confines of this stage set?

Improved implementation of medical tests-barriers and opportunities.

Applying the concept of a value proposition to medical testing is just one of the many ways to identify and monitor the value of tests. A key part of this concept focusses on processes that should take place after a test is introduced into routine local practice, namely test implementation. Thisprocess requires identification of the clinical pathway, the stakeholders and the benefits or disbenefits that accrue to those stakeholders. There are various barriers and challenges to test implementation. Implementation requires the process of clinical audit which involves measurement of outcomes external to the laboratory but this is not widely performed in laboratory medicine. A second key challenge is that implementation requires liaison with stakeholders outside of the laboratory including clinicians and other healthcare professional such as finance managers. Many laboratories are remote from clinical care and other stakeholders making such liaison difficult. The implementation process is based on data which again will be primarily on processes outside of the laboratory. However the recent enthusiasm for so-called real world data and new data mining techniques may represent opportunities that will facilitate better test implementation. A final barrier is that a range of new tools not currently in the education curriculum of the laboratory professional is required for implementation such as those of preparing a business case to support the introduction of a test and health economic analysis. Theprofessional bodies in laboratory medicine could assist with education in these areas.

Rethinking authentic assessment: work, well-being, and society

This article seeks a deeper understanding of the concept of authentic assessment which ensures it does not become another educational buzzword, slowly diminishing in real meaning. I consider the origins of the term in the US schooling sector, and how it has developed over time, and in different countries, to today focus in higher education largely on real world tasks. There is, however, I argue, a common conflation of real world with the world of work. Little of this literature actually engages with the rich philosophical debates on authenticity, and in this article, I suggest that this deeper understanding of authenticity can enable us to build on existing work on authentic assessment to develop a more holistic and richer concept that will be more beneficial to individual students and to the larger society of which they are part. I argue that we should move from thinking in terms of either the so-called real world, or the world of work, to focus our justification for authentic assessment on its social value (which encompasses but is not limited to its economic value). To achieve this aim, I suggest we move from simply focusing on the authentic task to considering why that task matters? This then enables a shift from the student in isolation to the student as a member of society. Senses of achievement can become richer, thus enhancing the students’ sense of self, self-worth, and well-being.

“The Time of That Other Interpretation”: Gesture, Symptom, and Rilke’sThe Notebooks of Malte Laurids Brigge

“The Time of That Other Interpretation”: Gesture, Symptom, and Rilke’s<i>The Notebooks of Malte Laurids Brigge</i>

Systems Failure: The Uses of Disorder in English Literature. Andrew Franta. Baltimore: Johns Hopkins University Press, 2019. Pp. x+215.

It is this standpoint, necessarily distinct from any particular character’s experience, that both establishes the novel’s critical posture and accounts for Franta’s interest in the impersonal dimensions of literary realism. If Systems Failure emphasizes what is external to—and larger than—the modern individual taken singly, it does so in order to show how literary systems interact with extraliterary systems in ways that are not simply mimetic. One of the overarching claims of Franta’s study is that much of the realist novel’s power (critical and otherwise) derives from its lack of correspondence with the so-called real world it is supposed to represent. Indeed, novels often succeed at doing what social and political systems cannot do: assembling their component parts within a comprehensible aesthetic order. Versions of this claim appear throughout the book, beginning with the opening chapter on Johnson’s biography of Richard Savage. Franta explains that Johnson in effect fictionalizes his subject’s life by fixing it within a discursive framework necessarily devoid of either genuine opacity or contingency—the stuff of real life. The subsequent chapter on Sterne develops this point further by showing how the biographer’s dilemma could be converted into the ordering principle of fiction: “Rather than novels about disorder, Tristram Shandy and A Sentimental Journey are about the collision between the impossibility of ordering the world and the impossibility of not ordering the novel” (43). The novel is not so much a systems failure as it is a system that feeds on failure; as Franta shows, it is capable of doing its job very well.

All evidence is real world evidence.

Randomized controlled trials are criticized for the difficulty of translating the results obtained to healthcare and clinical practice. The populations of patients enrolled in the studies are supposed to be too different from the patients encountered daily by the health professionals. The solution of these problems should come from the so-called real world evidence: data generated by the patients, from diseases registries, from electronic medical records or, in perspective, from big data. However, all evidence is real world evidence - whether RCT or observational or any other source. In a sense the more real you want to be one the more is the risk of bias. The answer to the problems of clinical research can only come from the careful evaluation of the evidence, assessing how reliably the evidence support all the factors that can determine a recommendation or a decision. These factors include the importance of a health problem, the balance between health benefits and risks, the values that people attach to outcomes, resource use, equity, acceptability and feasibility. Ideally, the evidence should be exposed transparently in a GRADE framework evidence to decision (EtD).

Reasons for disparity in statin adherence rates between clinical trials and real-world observations: a review

With statins, the reported rate of adverse events differs widely between randomized clinical trials (RCTs) and observations in clinical practice, the rates being 1-2% in RCTs vs. 10-20% in the so-called real world. One possible explanation is the claim that RCTs mostly use a run-in period with a statin. This would exclude intolerant patients from remaining in the trial and therefore favour a bias towards lower rates of intolerance. We here review data from RCTs with more than 1000 participants with and without a run-in period, which were included in the Cholesterol Treatment Trialists Collaboration. Two major conclusions arise: (i) the majority of RCTs did not have a test dose of a statin in the run-in phase. (ii) A test dose in the run-in phase was not associated with a significantly improved adherence rate within that trial when compared to trials without a test dose. Taken together, the RCTs of statins reviewed here do not suggest a bias towards an artificially higher adherence rate because of a run-in period with a test dose of the statin. Other possible explanations for the apparent disparity between RCTs and real-world observations are also included in this review albeit mostly not supported by scientific data.

Collaborative Learning with Sustainability-driven Projects: A Summary of the EPS@ISEP Programme

This paper describes the collaborative learning environment, aligned with the United Nations Millennium Development Goals, provided by the European Project Semester (EPS). EPS is a one semester capstone project programme offered by eighteen European engineering schools as part of their student ex-change programme portfolio. In this international programme, students are organized in teams, grouping individuals from diverse academic backgrounds and nationalities. The teams, after choosing a project proposal, become fully responsible for the conduction of their projects. By default, project proposals refer to open multidisciplinary real problems. The purpose of the project is to expose students to problems of a greater dimension and complexity than those faced throughout the degree programme as well as to put them in con-tact with the so-called real world, in opposition to the academic world. EPS provides an integrated framework for undertaking capstone projects, which is focused on multicultural and multidisciplinary teamwork, communication, problem-solving, creativity, leadership, entrepreneurship, ethical reasoning and global contextual analysis. Specifically, the design and development of sustainable systems for growing food allow students not only to reach the described objectives, but to foster sustainable development practices. As a re-sult, we recommend the adoption of this category of projects within EPS for the benefit of engineering students and of the society as a whole.

Medeia escrava: sobre amada de Toni Morrison

The essay proposes a lecture of Toni Morrison’s novel Beloved, keeping the focus on the evident resemblance that exists between the story written by the contemporary author and the classical myth of Medea, and highlighting the distinctions of each one. The comparison between the two protagonists has already been drawn, more than once, and it is not the first time that a novel, whose protagonist is a woman who has killed her own offspring is compared to the mythical Greek personage. Women’s appeal to the horrible infanticide as a reaction to a tragic situation has been recurrent throughout history and throughout stories. And it is in the dialectic between reality and fiction that it is possible to notice the first big different among the two narratives. While Medea is a mythical character, Sethe – the character created by Toni Morrison – is a fiction based on a real person, on Margaret Garner, who has really killed her daughter, and because of this gesture became an important and almost mythical personage in the struggle of North American abolitionists. The second difference to be highlighted lies in the motivation of the act around which the story revolves: Self-love, in one case; maternal love in another. The third and last major outstanding distinction is directly linked to the first, that is, to the dialectic between fiction and reality. For coming from a story that really happened, the character of Toni Morrison has to face the reaction to her murderous act in the so-called real world, serve sentence in jail and suffer for it in her life. The deus ex-machina solution is reserved for mythical heroines. If there is a god able to save Sethe, it is a quite phenomenal one and goes by the name of Eros.

Monitoring Chronic Myeloid Leukemia in the Real World: Gaps and Opportunities.

In clinical trials, in which treatment algorithms and monitoring schedules are tightly prescribed by research protocols, outcomes for patients with chronic myeloid leukemia (CML) have been excellent, with > 90% 5-year survival rates. However, outside of clinical trials in the so-called real world, monitoring schedules are more variable, with< 40% of patients undergoing quantitative polymerase chain reaction (qPCR) molecular testing 3 to 4 times during the first year after diagnosis as recommended by National Comprehensive Cancer Network/European Leukemia Net (NCCN/ELN) evidence-based guidelines. Results from chart reviews, claims-based databases, and observational databases suggest that carefully monitored patients with CML are more likely to be adherent to medications, incur fewer hospitalizations, experience lower overall treatment costs, and have better progression-free survival and overall survival compared with patients who are not monitored. Regular monitoring provides valuable early information on treatment responses that physicians can use to modify treatment. Unfortunately, physician-perceived resource barriers, lack of familiarity, and lack of agreement have restricted monitoring guideline adoptions. Multifaceted approaches to encourage appropriate monitoring are needed to improve clinical outcomes and reduce costs in the real world.

Out-of-hospital cardiac arrest: manual or mechanical CPR?

The appropriate role for mechanical chest compression devices in pre-hospital care has been debated in recent years.1 The quality of manual cardiopulmonary resuscitation (CPR) during out-of-hospital cardiac arrest is often less than optimum, and affects survival.2 Mechanical compression devices are an attractive alternative: they never get tired, give consistent chest compressions, and allow CPR to continue during transfer of the patient. Results from two studies3,4 of implementation of mechanical CPR devices in the so-called real world showed higher rates of return of spontaneous circulation and survival to discharge with mechanical CPR than with manual CPR.

La création d’un nouvel espace social: Internet et la documentalité / Internet comme documentalité

The opposition between “in real life” an “in virtual life” is often used of, in order to distinguish between two parts of the world. We are supposed to live a virtual life on the Internet, behind the lightened screen of our computer, while we are supposed to live a real life in the real world. I claim that the Internet is not a virtual world, and that it is a part of the actual world for there are causal links between the Internet and the so-called real world. According to David Lewis, worlds that are causally linked to each other cannot be different worlds. The only way to conceive of the Internet as a part of the actual world is to adopt Maurizio Ferraris’ hypothesis about documentality because, under such a hypothesis, what one writes has a causal power.

Treating COPD in the Real World

Evidence-basedmedicine is central tomodernmedical practice and relies on the availability of data from appropriately conducted randomized clinical trials (RCTs). These studies establish whether treatment is effective and, when an active comparator group is included in the trial,whether the new therapy is better than currently used treatment. In some conditions such as chronic obstructive pulmonary disease (COPD) for which no single surrogate end point predicts response to treatment, multiple trials of varying duration are neededtoconvincephysiciansandregulators thatdrugtherapy is beneficial. Themainstays of COPDmanagement, including inhaled long-acting antimuscarinic agents or long-acting β-agonists (LABAs) alone or combined with inhaled corticosteroids (ICSs),havebeenshown inRCTs to improve lung function and quality of life and reduce exacerbation frequency.1-3 Patients included in these trials are selectedonthebasisofhaving stable COPD without serious diseases that would lead to prematuredeath, and these studies are then incorporated into treatment guidelines that direct clinical practice.4 AlthoughRCTsprovideevidence thatadrugworks inaspecificpatientpopulation,whathappenswhen treatment isused in the general patient population seen in daily practice remains uncertain. Evidence from RCTs may be biased due to premature study withdrawal, which limits the ability of investigators to answer important supplementary questions about the effects of treatment on the natural history of the disease.5 Large clinical trials can identify unanticipated new adverse effects such as pneumonia with ICS use,6 although whether the newevents have the same clinical importance as non–steroid-associated pneumonia is less clear.7,8 More importantly, theprofile ofpatients included inRCTsdiffers in age and comorbidity from that of many patients with COPD who are seenbyphysicians inmost settings.Hence, it is important to establishwhether outcomes seen in clinical treatment trials apply in the so-called real world of clinical practice. Large administrative health care databases, statistical methods needed to interrogate these complex data sets, and, in somecountries likeCanada, comprehensivehealthcareprovision that reduces confounding due to socioeconomic treatment choices all provide the opportunity to study the effect ofclinicians’prescribingchoices. In this issueofJAMA,Gershon and colleagues9 report the results of an investigation of the comparative efficacy of using a LABA alone or together with an ICS in elderly patients with COPD living in Ontario. The authors identified patient records for 38 266 individuals who met their database-validated diagnosis of COPD and had received a newprescription for a LABAor a LABA-ICS combination.Approximately 1 in 10patients receivedaLABAasamonotherapy, possibly reflecting the influence of guidelines and pharmaceuticalpromotionontreatmentchoices.Patientswere matched for confounding variables using a propensitymatching protocol, and the resulting 3160 LABA and 8712 LABA-ICS users were followed up for as long as 5 years, with theprincipal outcomebeing riskofdeathorhospitalization for COPD. The matched patients were older (mean age, 77 years) and had more comorbid diseases (median, 7) than is usual in RCT populations. Approximately 30% had been hospitalized in the previous 6 months and 28% had a diagnosis of asthma recordedat some timepreviously.Approximately 25%hadnot undergone spirometry to confirm theCOPDdiagnosis, but the demographic characteristics of this subgroup and its subsequent outcomes were similar to the group as a whole. Median life expectancy in these older patients was approximately 2.5 years, leading to an annual mortality rate almost3 timeshigher thanwasseen in theTORCHstudy, theonly RCT to studymortality with ICS-LABA therapy as its primary endpoint.1 In the studybyGershonet al,9 amongpatients prescribed ICS-LABAdrugs, the relative risk of death or hospitalization was approximately 8% less than among those treated withLABAsalone.This is similar to the6.8%reduction in relative riskofdeathreportedwith thesedrugs in theTORCHstudy, although that difference in the latter study was not statistically significant. This resultmay reflect the greater number of deaths reported in the study by Gershon et al compared with the TORCH study (4353 vs 398, respectively) and the use of a combined end point with COPD hospitalizations. As Gershon et al report, the benefit associated with ICS-LABA use was greatest among patients with a prior diagnosisofasthmaandamongpatientswithout thisdiagnosiswho did not receive a long-acting antimuscarinic agent. However, there was no difference between treatments in the incidence of pneumonia. This is in contrast bothwith previousRCTs2,6,7 and with a large database study from Quebec10 that reported adoublingof the incidenceofpneumonia inCOPDpatients receiving ICSs. However, the population in the study by Gershonet alwasdefineddifferently, had adifferent baseline risk profile forpneumonia, andwas followedup for longer than the 60 days reported in the Quebec study. Database studies always raise concerns about why a physician prescribed a particular drug for a specific patient, often leading to important differences between study groups. The size and scope of the report byGershon et al provide some reassurance that this is not themain factor in explaining thedifferences they report. Their diagnostic criterion identified approximately 80%of patients correctly as havingCOPD, and in a series ofmodeled scenarioswith increasing degrees of diagRelated article page 1114 Opinion

Queerness and Children’s Literature: Embracing the Negative

Queerness and Children’s Literature: Embracing the Negative Laura Robinson (bio) Click for larger view View full resolution As I sit down to write this introduction in late summer of 2013, three unrelated media stories keep tugging my attention away from queerness and children’s literature, the special topic for this issue of Bookbird. First, in July 2013, the group Geeks Out called for a boycott of the soon-to-be released film version of Orson Scott Card’s 1985 novel Ender’s Game. Geeks Out is protesting Card’s anti-gay stance, which he articulated in a 1990 interview for the magazine Sunstone. Lest you think this was a while back, the New York Times also points out that Card was on the board of the National Organization for Marriage, which opposes gay marriage, until very recently. Second, the Russian government’s new law against gay propagandizing is rousing the ire of many people internationally and mobilizing a movement to boycott the winter Olympics in Sochi. Third, on 22 July, Dwayne Jones, a [End Page v] transgender sixteen year old, was beaten to death by a mob in Jamaica supposedly because he went to a party dressed as a female.1 While at first glance these stories seem unrelated, each is strangely connected to queerness and children’s literature. First, Geeks Out might do well to consider how the young adult novel Ender’s Game can be read, despite Card’s beliefs spoken elsewhere. As Jennifer Mitchell argues in this issue, this novel, the first of Card’s trilogy, if not the others, “is full of queer potential.” Indeed, the queerness of a novel that has spent 42 weeks on the New York Times bestsellers list (paperback mass market fiction) might have more ideological impact than an organization that attempts to regulate the meaning of marriage. Reading texts queerly can change the world. Second, the BBC News Europe’s coverage of the concern over how Russia’s repressive laws will affect athletes at the Sochi Olympics quotes the interior ministry as saying “that officials would act during the games—as at any other time—to protect children ‘from the propaganda of non-traditional sexual relations’” (BBC News, my emphasis). Many critics have discussed the use of children as a trope to police adult sexuality (see Undoing Gender, Butler and Kincaid). Given the arguments in his book Innocence, Heterosexuality, and the Queerness of Children’s Literature, Tison Pugh might take this further and suggest to the Russian state that the very laws that enforce or fetishize childhood innocence work to produce queerness and, moreover, create such an ignorance “that normative heterosexuality itself becomes corruptive” (166). The marriage of queer theory with children’s literature studies enables us to unpack the devastating irony of Russia’s attempt to police not only sexuality but its representation in so-called propaganda. Third, according to the Ottawa Citizen, Dwayne Jones was kicked out of his home and shamed at age fourteen and then murdered at age sixteen, all because he did not, and perhaps simply could not, abide by the standards of his society. I include Dwayne’s story because he is a child who did not end up having what Judith Butler calls a “livable life.” She discusses the violence that homosexual and trans people experience all over the world: “The negation, through violence, of that body is a vain and violent effort to restore order, to renew the social world on the basis of intelligible gender, and to refuse the challenge to rethink that world as something other than natural or necessary” (Undoing Gender 34). The work we do as literary scholars may sometimes seem far removed from the so-called real world; however, many academics’ insistence on unveiling the constructedness of the social order, on denaturalizing power relations, on challenging the world as it is, whether through history, anthropology, psychology, or children’s literature, can indeed have an impact on real children’s lives, can “open the possibility of both identifying and articulating queer child life” (xxxiii, emphasis in original), to borrow words from Steven Bruhm and Natasha Hurley. This issue on queerness and children’s literature yokes together the political...

Introduction: Austerity and the Alt-Ac

Introduction:Austerity and the Alt-Ac Veronica Austen (bio) and Clint Burnham (bio) This set of papers was developed in two Committee for Professional Concerns (cpc) sessions at the accute 2013 conference at the University of Victoria. Together, they offer an ungainly whole (or two halves that do not make a whole, as Adorno would say): on the one hand, the dire and less-dire job prospects both inside and outside the academy for our graduates; on the other hand, an analysis of how the politics of austerity have shaped that very academy. Marilyn Rose’s contribution helps to set the scene regarding the challenges and opportunities involved in developing professional skills training programs for our graduate students, programs that can promote a broad range of professional skills that will prepare students for possibilities “Beyond Academe.” Elizabeth Hodgson, Tiffany Potter, and Julie Walchli at University of British Columbia, for instance, outline one such strategy: a co-op program for PhD students. April McNeil similarly emphasizes the need to prepare graduate students for multiple possible career paths by arguing for the role career educators can play. Michael Lesiuk’s survey of the alt-ac literature (alt-ac equals alternatives to academic careers) is sobering, with the hopefulness of being drafted like a track star to a football team but also the reality of prospects of living on welfare while holding out for the mythic tenure-stream position. [End Page 1] The vexed question here, then, is the relationship between the abilities of institutions to train graduate students for the job market (a job market that is a dubious metaphor, if not outright myth, as Marc Bousquet argued ten years ago) and the conditions—austerity—under which these institutions now operate. Thus Heather Latimer takes issue with the very concepts of time and futurity that underwrite the ideologies of austerity, arguing that the hope for a good job in the future allows many of us to accept undesirable employment conditions in the present (short-term contracts, no support for research, no job security or benefits). If Latimer is inspired in part by the queer futurity of Lee Edelman’s No Future, Mervyn Nicholson’s critique is similarly positioned, arguing that the metaphor of austerity treats citizens (including students and academics) as children. Finally, Herb Wyile’s linking of austerity to the broader context of neoliberalism reminds us that the Thatcherite slogan “There is No Alternative” (tina) subvents much of university administrations’ Janus-faced protection of and gutting of traditional humanities programs. What our bringing together of these discussions of austerity and the alt-ac speaks to is the Catch-22 that humanities programs are currently facing. To embrace strategies for allowing our graduate students to pursue alt-ac paths may represent a positive step toward dealing realistically with our students’ dwindling chances of securing tenure-stream positions. Supporting our graduate students so that they can have many opportunities after graduation seems logically as if it could be a nicely positive evolution in our thinking about graduate programs. Not only does this shift in thinking suggest a means for promoting our students’ well-being and sense of fulfilment but also it can serve to justify the existence of graduate programs. If we can, by suggesting graduate programs lead to multiple career paths, bridge the assumed distance between academia and the so-called real world, then we may be better able to refute current waves of thought that stereotype academic pursuits as self-interested navel-gazing. In other words, by embracing the alt-ac, we may more firmly establish our relevance. And yet, jumping on the bandwagon of the alt-ac also could threaten to obscure the ever-increasing need to fight against the rhetoric of austerity that threatens the integrity, if not outright destruction, of our undergraduate and graduate programs. We can, and should, better train our graduate students for multiple postgraduation possibilities, but that does not mean that we should abandon the fight to see more possibilities for them within the professoriate. In the midst of an environment whereby budgets are informed by prioritization processes like that at the University of Guelph [End Page 2] where units like food services and residences...

Spaces, Gaps, and Levels

Adopting an aesthetic perspective, as distinct from a strictly narratological one, this article centres on the represented reality of a film that the concept of diegesis in its various formulations posits. In particular, it addresses this reality's experience by viewers, its figurative location, and its relation to other aspects of a narrative film work, as well as the so-called real world. Although concurring with some significant criticisms of the diegetic/nondiegetic framework, it also calls for preserving aspects of what some theorists argue constitutes the semiotic and experiential character of diegesis. Including, for example, the existence of a distinct referential (denotational) level of a film, and the sort of variable gap between what is within and without the world of characters and narrative events (and fluid ‘border crossings’ between the two) that is suggested by Robynn Stilwell. These views are taken up into a different model, a topological one, which entails conceiving both fictional repre...

Standards, Commodification, and Critical Service Learning in Minority Language Communities

The article analyzes the standards and ideological and material impact of community-based service learning programs for minority language students. The author outlines the five content standards of programs including Communication, Cultures, and Communities. The author argues that the Communities standard cannot be met solely within the classroom, as it requires evidence of so-called real world language practice, creating the need for service learning programs. It is also noted that service learning programs for minority language communities are linked to the administrative goal of meeting national standards for language skills. The author also explores the Medical Spanish for Heritage Learners project at the University of Texas-Pan American.

Infinite Hope—and for Us; or, Come on in, the Real World is Fine

Infinite Hope—and for Us; or, Come on in, the Real World is Fine Kel Morin-Parsons (bio) I have never been particularly iconoclastic, as unfashionable as it may be to admit it. While in graduate school during the 1990s, however, I found myself more than once speaking in hushed tones with certain professors on a topic in which I found myself increasingly interested: working outside the academy with a doctorate. Doing so is, of course, not that unusual in itself. What was, and is, unusual is choosing to do so—or at least discovering that a road ending outside the academy is not just a consolation prize. I was, as a graduate student, as focused as any of my colleagues on a tenured teaching position. I did conferences, I lined up a publication, and I worked for and was fortunate enough to get scholarships. I had the world’s most supportive thesis advisor, who was appropriately exacting, and I loved every minute of it. I tried to do everything right. After a particular teaching experience, however—with, I should emphasize, a number of enthusiastic students and wonderful material—I began to realize that the professor’s life was, for various reasons, probably not for me. It had been emphasized to me from the beginning that I had entered a program designed to train scholars for the academy. That, of course, was proper and laudable. But as my own situation changed, I made a number of [End Page 7] discoveries about the abilities and skills nurtured by graduate school and, I would find, valued by the so-called real world—and they were all good. I wanted to explore other options, but I genuinely wasn’t sure what they might be. I had been used to thinking of the skills I was acquiring solely in terms of their application within an academic setting. Then a friend asked me to take on the job of administrator for a small non-profit organization on whose board he sat. He himself held a phd in political economy and had worked both in and out of the academy for two decades; he told me later that he saw clear abilities and inclinations in me for which I didn’t seem to have a context and felt that I just needed a shove to start the process of thinking differently about my training and its application. At the time, however, I was still in graduate school, and while I did take on the job I was slow to think differently—the nature of work meant that I was still dealing largely with people with scholarly backgrounds, and it seemed they just needed someone to sort out certain aspects of communication and organization; it never occurred to me that the ability to do those very things was a skill set in itself and one to which an academic background might have contributed. After having worked at this non-profit for a while, I applied to a placement agency specializing in administrative positions. It was then that I truly began to realize surprising things about my graduate education. A manager at the placement agency, who had contacted me after having seen my (slightly modified academic) cv, made it clear that I possessed tremendously valuable skills—I was “marketable,” in that language of the commercial at which we’re all supposed to wince. As I worked with her and considered my cv, I realized that the graduate programs made demands on us that developed tremendously applicable capacities. As most of us not only took seminar courses but taught or assisted with undergraduate courses, we all had experience in organizing teaching material, developing it and presenting it as lectures, managing people, and managing time. Added to this experience were the skills developed by all graduate students as they learn to conduct research—the gathering and analyzing of information and the transformation of that raw data into coherent pieces of writing. On top of all of this is the fact that those of us trained in literature can, as a rule, write well—something not always a given—and tend to understand the basics of good communication. In a world...

Coming of age in Second Life: an anthropologist explores the virtually human

Millions of people around the world today spend portions of their lives in online virtual worlds. Second Life is one of the largest of these virtual worlds. The residents of Second Life create communities, buy property and build homes, go to concerts, meet in bars, attend weddings and religious services, buy and sell virtual goods and services, find friendship, fall in love--the possibilities are endless, and all encountered through a computer screen. Coming of Age in Second Life is the first book of anthropology to examine this thriving alternate universe. Boellstorff conducted more than two years of fieldwork in Second Life, living among and observing its residents in exactly the same way anthropologists traditionally have done to learn about cultures and social groups in the so-called real world. He conducted his research as the avatar Tom Bukowski, and applied the rigorous methods of anthropology to study many facets of this new frontier of human life, including issues of gender, race, sex, money, conflict and antisocial behavior, the construction of place and time, and the interplay of self and group. Coming of Age in Second Life shows how virtual worlds can change ideas about identity and society. Bringing anthropology into territory never before studied, this book demonstrates that in some ways humans have always been virtual, and that virtual worlds in all their rich complexity build upon a human capacity for culture that is as old as humanity itself.