Summary This article examines stories of men who gelded themselves in early modern England. These events, it argues, were shaped and partly motivated by a culture in which castration was seen as both degrading and potentially empowering. Religious precedents such as that of Origen of Alexandria framed self-gelding as a foolhardy activity, but one which nevertheless indicated an impressive degree of mastery over the body and its urges. Meanwhile, judicial and popular contexts framed castration as a humiliating and emasculating ordeal. Instances of self-gelding in this period are rare but nonetheless illuminating. Relayed in medical texts and popular ballads, such actions typically occurred as a response to emotional distress. In particular, men gelded themselves as a means to express feelings of emasculation within heterosexual relationships, and to dramatically renounce their role in the libidinal economy.
AbstractPurpose/aimAgeism negatively affects health care. This paper presents an extended validation of a novel scale assessing ageism among dental students.Method and materialsA previously pilot‐tested 27‐question scale applied to a larger sample (n = 315) from two U.S. dental schools with Principal Component Analysis used to assess internal structure of the measure. Questions whose deletion increased the overall α loading on >1 factor or those unexpectedly grouped in another factor were thoroughly examined.ResultsThe scale resulted in five statements (grouped in two factors), which explained 63% of the overall variance with a substantially higher reliability value than other solutions (0.76). Two factors highly correlated were grouped together in a single scale. The five statements are "Elderly people do not take good care of their teeth" (0.62), "Elderly patients do not usually comply with dental advice" (0.93), "The Elderly patient does not live long enough to make it worthwhile to invest time and effort in complex dental treatment" (0.81), "The elderly patient does not live long enough to make it worthwhile to invest money in expensive dental treatment" (0.95), and "Dental treatment of elderly patients is too time‐consuming" (0.57).ConclusionsFive items achieved high reliability toward the validity of this scale.
AbstractCommunication assessment of people with profound intellectual and multiple disabilities (PIMD) has seldom been investigated. Here, we explore approaches and decision making in undertaking communication assessments in this group of people. A questionnaire was sent to UK practitioners. The questionnaire elicited information about assessment approaches used and rationales for assessment choices. Fifty‐five speech and language therapists (SLTs) responded. Findings revealed that the Preverbal Communication Schedule, the Affective Communication Assessment and the Checklist of Communication Competence were the most frequently used published assessments. Both published and unpublished assessments were often used. Rationales for assessment choice related to assessment utility, sensitivity to detail and change and their applicability to people with PIMD. Underpinning evidence for assessments was seldom mentioned demonstrating the need for more empirical support for assessments used. Variability in practice and the eclectic use of a range of assessments was evident, underpinned by practice‐focused evidence based on tacit knowledge.
In: CESifo economic studies: a joint initiative of the University of Munich's Center for Economic Studies and the Ifo Institute, Band 64, Heft 4, S. 729-729
Purpose This paper aims to refine conceptual treatment of the social facet in business relationships and reinforce its significance in the industrial marketing and purchasing (IMP) research tradition by integrating the concept of social capital in its original interpretation into the actor-resource-activity (ARA) model.
Design/methodology/approach The paper begins by indicating some typical conceptual challenges associated with application of social capital in IMP. This is followed by a conceptual clarification that explores the origin and the essence of social capital in economic sociology. Finally, the paper proposes integrating social capital in its original interpretation into IMP's ARA model and presents four propositions on how social capital is created in interaction between business actors.
Findings The paper shows how bridging Bourdieu's theory of social capital with the IMP approach may solve the identified conceptual challenges. This paper's main contribution is a cyclical model depicting how social capital is created in business networks. It is integrated into the ARA model and designed specifically for studying the social facet of business relationships.
Research limitations/implications The paper is expected to aid IMP researchers in empirical contexts where the social component in business relationships is particularly prominent. As such, the novel approach presented could be used to further understand how social exchange processes are related to relationship governance, relationship initiation and development.
Originality/value The proposed model shows how social capital is generated through the dynamic interplay in the social facets of actor, activity and resource dimensions, emphasising its creation dynamics. The model integrates insights from the classic works in economic sociology to strengthen the social side of IMP's socioeconomic interface and is intended to be used as a tool for empirical application.
Purpose This study provides us with new knowledge in the form of conceptual framework of the contextual layers of service experience within professional business services. This study aims to answer the following questions: What kinds of contextual layers can be identified influencing service experience? How specific characteristics of professional service context may influence customer experience at these different layers?
Design/methodology/approach The framework is based on extensive literature review considering research in the fields of service and relationship perspectives, likewise professional services.
Findings The framework is based on extensive literature review in the fields of service and relationship perspectives, likewise professional services.
Originality/value Only a limited number of studies seem to address the highly topical context of professional/knowledge-intensive business services and relationships. The authors tie the discussion concerning different contextual layers of service experience to this specific operating context with the aim of identifying their importance and influence in service experience. Related to this context, this study highlights the importance of understanding role of individuals in service experience, rarely emphasized in B2B dyadic setting. The framework also contributes to current discussion regarding service experience and "zooms in" to the context and its detailed levels.
Introduction and Objectives
The accuracy of conclusions based on Electronic Healthcare Record (EHR) research is highly dependent on the correct selection of descriptors (codes) by users. We aimed to evaluate the feasibility and acceptability of filmed vignette monologues as a resource-light method of assessing and comparing how different EHR users record the same clinical scenario.
Methods
Six short monologues of actors portraying patients presenting allergic conditions to their General Practitioners were filmed head-on then electronically distributed for the study; no researcher was present during data collection. The method was assessed by participant uptake, reported ease of completion by participants, compliance with instructions, the receipt of interpretable data by researchers, and participant perceptions of vignette quality, realism and information content.
Results
22 participants completed the study, reporting only minor difficulties. 132 screen prints were returned electronically, enabling analysis of codes, free text and EHR features. Participants assigned a quality rating of 7.7/10 (range 2-10) to the vignettes and rated the extent to which vignettes reflected real-life (86-100%). Between 1 and 2 hours were required to complete the task. Full compliance with instructions varied between participants but was largely successful.
Conclusions
Filmed monologues are a reproducible, standardized method which require few resources, yet allow clear assessment of clinicians' and EHRs systems' impact on documentation. The novel nature of this method necessitates clear instructions so participants can fully complete the study without face to face researcher oversight.
IntroductionIn Brazil, the National Health System (SUS) provides healthcare to the public. The system hasmultiple administrative databases; the major databases record hospital (SIH) and outpatient (SIA)procedures. Epidemiological information is collected for all populations in subsystems, such as mor-tality (SIM), live births (SINASC) and diseases of compulsory declaration (SINAN). Each subsystemhas its own information system, which is able to provide information about consultations, clinicalinformation and medicines dispensed. However, these systems are not linked, thereby preventingindividual-centred analysis.
ObjectiveTo describe the methods and results of parameter setting that are needed to execute the probabilisticdeduplication of large administrative and epidemiological databases in Brazil and to create a NationalHealth Database Centred on the individual.
MethodsThis paper shows the results of a record linkage model to integrate data from SIH, SIA, SIM, andSINAN, which have different formats and attributes between them and over time. These data consistof 1.3 billion records from 2000-2015. Probabilistic and deterministic record linkages were used todeduplicate these data. The Kappa statistic and clerical review were used to ensure the quality ofthe linkage. The graph algorithm and depth-first search were used to generate the identifiers.
ResultsThe deterministic deduplication process resulted in a database with 403,113,527 possible uniqueindividuals. After the probabilistic deduplication process of the former database was performed,159,703,805 unique individuals were identified. This result had an estimated a false positive errorrate of 3.3%, and the false negative error was estimated at 12.3%.
ConclusionsThe National Health Database centred on the individual was generated and will allow researchersto use real-world evidence to conduct clinical, epidemiological, economic and other studies. Thisdatabase represents a significant cohort, spanning 15 years of historical data and preserving patientprivacy. The success of the process described will allow repeating and appending the data for futureyears and enable important studies to promote SUS efficiency and provide better treatments forpatients.
KeywordsData linkage, record linkage, Brazilian health database, SUS deduplication
IntroductionLinked administrative data sets are an emerging tool for studying the health and well-being of the population. Previous papers have described methods for linking Canadian data, although few have specifically focused on children, nor have they described linkage between tax outcomes and a cohort of children who are particularly at risk for poor financial outcomes.
Objective and methodsThis paper describes a probabilistic linkage performed by Statistics Canada linking the Montreal Longitudinal Experimental Study (MLES) and the Quebec Longitudinal Study of Kindergarten Children (QLSKC) survey cohorts and administrative tax data from 1992 through 2012.
ResultsThe number of valid cases in the original cohort file with valid tax records was approximately 84\%. Rates of false positives, false negatives, sensitivity, and specificity of the linkage were all acceptable. Using the linked file, the relationship of childhood behavioural indicators and adult income can be investigated in future studies.
ConclusionsInnovative methods for creating longitudinal datasets on children will assist in examining long-term outcomes associated with early childhood risk and protective factors as well as an evidence base for interventions that promote child well-being and positive outcomes.
