Consolidations: Dickens and Seacole

Discussing Charles Dickens’s American Notes for General Circulation and Bleak House in conjunction with Mary Seacole’s Wonderful Adventures of Mrs Seacole in Many Lands this chapter traces a crucial shift in mid-nineteenth-century literature which consolidates British imperialism via “enlightened” differentiation from the United States and culminates in the more paternalistic rhetoric following the 1857 Sepoy Rebellion. While travelling both authors construct conciliatory images of the English home that do not overtly challenge the sensibilities of the British reading audience. In her travel account, Seacole utilises a confident tone often directly addressing her readers more familiarly than the Black authors before her. Dickens too uses excessive overt narrative comment to promote an idea of a shared sense of indignation at lacking American manners in his travelogue and at the misguided international philanthropy of Mrs Jellyby in Bleak House. Both their consolidating tonalities rest less on complex introspection than on an explicit reassuring British familiarity. However, while Dickens increasingly understands British familial feeling as tied to whiteness, Seacole contests such racialised conceptions of national belonging.

Rejected Online Feedback From a Swiss Physician Rating Website Between 2008 and 2017: Analysis of 2352 Ratings

Background Previous research internationally has only analyzed publicly available feedback on physician rating websites (PRWs). However, it appears that many PRWs are not publishing all the feedback they receive. Analysis of this rejected feedback could provide a better understanding of the types of feedback that are currently not published and whether this is appropriate. Objective The aim of this study was to examine (1) the number of patient feedback rejected from the Swiss PRW Medicosearch, (2) the evaluation tendencies of the rejected patient feedback, and (3) the types of issues raised in the rejected narrative comments. Methods The Swiss PRW Medicosearch provided all the feedback that had been rejected between September 16, 2008, and September 22, 2017. The feedback were analyzed and classified according to a theoretical categorization framework of physician-, staff-, and practice-related issues. Results Between September 16, 2008, and September 22, 2017, Medicosearch rejected a total of 2352 patient feedback. The majority of feedback rejected (1754/2352, 74.6%) had narrative comments in the German language. However, 11.9% (279/2352) of the rejected feedback only provided a quantitative rating with no narrative comment. Overall, 25% (588/2352) of the rejected feedback were positive, 18.7% (440/2352) were neutral, and 56% (1316/2352) were negative. The average rating of the rejected feedback was 2.8 (SD 1.4). In total, 44 subcategories addressing the physician (n=20), staff (n=9), and practice (n=15) were identified. In total, 3804 distinct issues were identified within the 44 subcategories of the categorization framework; 75% (2854/3804) of the issues were related to the physician, 6.4% (242/3804) were related to the staff, and 18.6% (708/3804) were related to the practice. Frequently mentioned issues identified from the rejected feedback included (1) satisfaction with treatment (533/1903, 28%); (2) the overall assessment of the physician (392/1903, 20.6%); (3) recommending the physician (345/1903, 18.1%); (4) the physician’s communication (261/1903, 13.7%); (5) the physician’s caring attitude (220/1903, 11.6%); and (6) the physician’s friendliness (203/1903, 10.6%). Conclusions It is unclear why the majority of the feedback were rejected. This is problematic and raises concerns that online patient feedback are being inappropriately manipulated. If online patient feedback is going to be collected, there needs to be clear policies and practices about how this is handled. It cannot be left to the whims of PRWs, who may have financial incentives to suppress negative feedback, to decide which feedback is or is not published online. Further research is needed to examine how many PRWs are using criteria for determining which feedback is published or not, what those criteria are, and what measures PRWs are using to address the manipulation of online patient feedback.

Rejected Online Feedback From a Swiss Physician Rating Website Between 2008 and 2017: Analysis of 2352 Ratings (Preprint)

BACKGROUND Previous research internationally has only analyzed publicly available feedback on physician rating websites (PRWs). However, it appears that many PRWs are not publishing all the feedback they receive. Analysis of this rejected feedback could provide a better understanding of the types of feedback that are currently not published and whether this is appropriate. OBJECTIVE The aim of this study was to examine (1) the number of patient feedback rejected from the Swiss PRW Medicosearch, (2) the evaluation tendencies of the rejected patient feedback, and (3) the types of issues raised in the rejected narrative comments. METHODS The Swiss PRW Medicosearch provided all the feedback that had been rejected between September 16, 2008, and September 22, 2017. The feedback were analyzed and classified according to a theoretical categorization framework of physician-, staff-, and practice-related issues. RESULTS Between September 16, 2008, and September 22, 2017, Medicosearch rejected a total of 2352 patient feedback. The majority of feedback rejected (1754/2352, 74.6%) had narrative comments in the German language. However, 11.9% (279/2352) of the rejected feedback only provided a quantitative rating with no narrative comment. Overall, 25% (588/2352) of the rejected feedback were positive, 18.7% (440/2352) were neutral, and 56% (1316/2352) were negative. The average rating of the rejected feedback was 2.8 (SD 1.4). In total, 44 subcategories addressing the physician (n=20), staff (n=9), and practice (n=15) were identified. In total, 3804 distinct issues were identified within the 44 subcategories of the categorization framework; 75% (2854/3804) of the issues were related to the physician, 6.4% (242/3804) were related to the staff, and 18.6% (708/3804) were related to the practice. Frequently mentioned issues identified from the rejected feedback included (1) satisfaction with treatment (533/1903, 28%); (2) the overall assessment of the physician (392/1903, 20.6%); (3) recommending the physician (345/1903, 18.1%); (4) the physician’s communication (261/1903, 13.7%); (5) the physician’s caring attitude (220/1903, 11.6%); and (6) the physician’s friendliness (203/1903, 10.6%). CONCLUSIONS It is unclear why the majority of the feedback were rejected. This is problematic and raises concerns that online patient feedback are being inappropriately manipulated. If online patient feedback is going to be collected, there needs to be clear policies and practices about how this is handled. It cannot be left to the whims of PRWs, who may have financial incentives to suppress negative feedback, to decide which feedback is or is not published online. Further research is needed to examine how many PRWs are using criteria for determining which feedback is published or not, what those criteria are, and what measures PRWs are using to address the manipulation of online patient feedback.

Common Data Elements for Muscle Biopsy Reporting

Context There is no current standard among myopathologists for reporting muscle biopsy findings. The National Institute of Neurological Disorders and Stroke has recently launched a common data element (CDE) project to standardize neuromuscular data collected in clinical reports and to facilitate their use in research. Objective To develop a more-uniform, prospective reporting tool for muscle biopsies, incorporating the elements identified by the CDE project, in an effort to improve reporting and educational resources. Design The variation in current biopsy reporting practice was evaluated through a study of 51 muscle biopsy reports from self-reported diagnoses of genetically confirmed or undiagnosed muscle disease from the Congenital Muscle Disease International Registry. Two reviewers independently extracted data from deidentified reports and entered them into the revised CDE format to identify what was missing and whether or not information provided on the revised CDE report (complete/incomplete) could be successfully interpreted by a neuropathologist. Results Analysis of the data highlighted showed (1) inconsistent reporting of key clinical features from referring physicians, and (2) considerable variability in the reporting of pertinent positive and negative histologic findings by pathologists. Conclusions We propose a format for muscle-biopsy reporting that includes the elements in the CDE checklist and a brief narrative comment that interprets the data in support of a final interpretation. Such a format standardizes cataloging of pathologic findings across the spectrum of muscle diseases and serves emerging clinical care and research needs with the expansion of genetic-testing therapeutic trials.

Can Postvention Be Prevention?

Background. There has been recent interest in postvention activities which involve provision of support to family members and others affected by a suicide death. Aims. To review the current status of postvention support, including definitions used and the objectives and effectiveness of support activities for people bereaved by suicide. Methods. Selected controlled studies of support activities and programs are reviewed with narrative comment. Results. Not applicable. Conclusions. Effective postvention support can be viewed as contributing toward suicide prevention among those people who are bereaved by suicide. Further development of support programs is needed.

Nocturnal Intrusions and Divine Interventions on Behalf of Judah. David's Wisdom and Saul's Tragedy in 1 Samuel 26

A literary strand of narratives about Saul in 1 Samuel emerged in a process of rewriting Israelite-Judean history. 1 Sam 26* and a number of other episodes (1 Sam 10:8; 10:17-27; 13:7a-13a; 14:24-46; parts of 1 Sam 9; 1 Sam 16:1-13; 16:14-23; 17*; 1 Sam 28*, 31*; 2 Sam 1*) present the first Israelite king as a figure that was informed by Greek tragic heroism. More specifically, the themes and the formation of the characters in the story of David's nocturnal intrusion in 1 Samuel 26 are set side by side with the post-classical drama Rhesus. 1 Sam 26 is understood as a narrative comment on Saul's destiny in prophetic tradition. Saul's tragic heroism is described with skl “to act foolishly” 1 Sam 26:21b. Also, Qohelet's royal travesty in Eccl 1:12-2:26 alludes to this notion of Saul as a tragic king who acts foolishly (skl). He is contrasted with his glorious opponent David who succeeds (śkl) in all his endeavours.

Social Space in Ancient Theatres

How do modern archeological discoveries mesh with and affect present views of ancient theatrical techniques – specifically, of the interrelationship between performers and audience? Looking especially at the ways in which the audience itself was able to interact through the construction of the areas devoted to its own accommodation and circulation, Leslie du S. Read here blends narrative comment and photographic illustration to create a picture of the essential sociability of ancient theatre spaces – an aspect usually ignored by scholars primarily concerned with dramaturgical techniques. Leslie du S. Read, who is presently Head of the Drama Department at the University of Exeter, has for a number of years been researching both visible and known remains of classical theatres, and writing on the social context of stagecraft. He has at present a collection of over 4,000 slides of some 300 theatres, and is in the final stage of completing a history and guide to ancient theatre sites. All photographs in the present article were also taken by the author.