Using deterministic record linkage to link ambulance and emergency department data : is it possible without patient identifiers?

Routine linkage of emergency ambulance records with those from the emergency department is uncommon in the UK. Our study, known as the Pre-Hospital Emergency Department Data Linking Project (PHED Data), aimed to link records of all patients conveyed by a single emergency ambulance service to thirteen emergency departments in the UK from 2012-2016. We aimed to examine the feasibility and resource requirements of collecting de-identified emergency department patient record data and, using a deterministic matching algorithm, linking it to ambulance service data. We used a learning log to record contacts and activities undertaken by the research team to achieve data linkage. We also conducted semi-structured interviews with information management/governance staff involved in the process. We found that five steps were required for successful data linkage for each hospital trust. The total time taken to achieve linkage was a mean of 65 weeks. A total of 958,057 emergency department records were obtained and, of these, 81% were linked to a corresponding ambulance record. The match rate varied between hospital trusts (50%-94%). Staff expressed strong enthusiasm for data linkage. Barriers to successful linkage were mainly due to inconsistencies between and within acute trusts in the recording of two ambulance event identifiers (CAD and call sign). Further data cleaning was required on emergency department fields before full analysis could be conducted. Ensuring the data was not re-identifiable limited validation of the matching method. We conclude that deterministic record linkage based on the combination of two event identifiers (CAD and call sign) is possible. There is an appetite for data linkage in healthcare organisations but it is a slow process. Developments in standardising the recording of emergency department data are likely to improve the quality of the resultant linked dataset. This would further increase its value for providing evidence to support improvements in health care delivery. Ambulance records are rarely linked to other datasets; this study looks at the feasibility and resource requirement to use deterministic matching to link ambulance and emergency department data for patients conveyed by ambulance to the emergency department.It is possible to link these data, with an average match rate of 81% across 13 emergency departments and one large ambulance trust.All trusts approached provided match-able data and there was an appetite for data linkage; however, it was a long process taking an average of 65 weeks.We conclude that deterministic matching using no patient identifiers can be used in this setting

Consumer acculturation theory: (crossing) conceptual boundaries

Consumer acculturation theorists have developed an insightful body of literature about the ways in which migrants adapt to foreign cultures via consumption. The present paper revisits 14 key studies from this field to highlight its most important contributions, critique its conceptual boundaries, and present cases of conceptual border crossings that indicate an emerging need for a broader conceptualization of the phenomenon. The paper closes by introducing a model that frames consumer acculturation as a complex system of recursive socio-cultural adaptation, and discusses its implications for future research

Consumer ethnicity three decades after: a TCR agenda

Research into consumer ethnicity is a vital discipline that has substantially evolved in the past three decades. This conceptual article critically reviews its immense literature and examines the extent to which it has provided extensive contributions not only for the understanding of ethnicity in the marketplace but also for personal/collective well-being. We identify two gaps accounting for scant transformative contributions. First, today social transformations and conceptual sophistications require a revised vocabulary to provide adequate interpretive lenses. Second, extant work has mostly addressed the subjective level of ethnic identity projects but left untended the meso/macro forces affecting ethnicity (de)construction and personal/collective well-being. Our contribution stems from filling both gaps and providing a theory of ethnicity (de)construction that includes migrants as well as non-migrants

The impact of social media on consumers' acculturation and purchase intentions

YesSocial media has emerged as a significant and effective means of assisting and endorsing activities and communications among peers, consumers and organizations that outdo the restrictions of time and space. While the previous studies acknowledge the role of agents of culture change, it largely remains silent on the role of social media in influencing acculturation outcomes and consumption choices. This study uses self-administered questionnaire to collect data from 514 Turkish-Dutch respondents and examines how their use of social media affects their acculturation and consumption choices. This research makes a significant contribution to consumer acculturation research by showing that social media is a vital means of culture change and a driver of acculturation strategies and consumption choices. This study is the first to investigate the role of social media as an agent of culture change in terms of how it impacts acculturation and consumption. The paper discusses implications for theory development and for practice

Power dynamics in immigrant families in Britain and its effect on consumption

This paper explores how culture is used, through consumption, to empower the disenfranchised. Despite the calibre and scope of current literature pertaining to this theme, current research has not fully investigated how marginalised groups use consumption as a means of empowerment. The study investigates how marginalised groups of female immigrants use consumption to empower themselves in a patriarchal home environment. Using in-depth interviews our research examined acts of resistance through consumption we identify how married women consciously use consumption as a form of resistance against culturally construed roles they no longer identify with

Parental gate-keeping in diasporic Indian families: examining the intersection of culture, gender and consumption

Stories of familial memories, histories and daily life, from sixteen daughters of diasporic Indian families living in Britain, are used to examine how culture, gender and consumption are negotiated within family settings. The differing gate-keeping roles played by parents, children and grandparents within families, in resisting or promoting the negotiation of cultural boundaries, have not been examined before. This provides a crucial opportunity to examine the changing pattern(s) of power, identity and gender roles in ethnic families; the gap in research on gender roles within the family; the family as part of a social system; the cultural embeddedness of family relationships; and the family at a more disaggregated level. These daughters’ stories identified the polarisation of parental positions over a number of key issues, notably language, media and consumption (e.g. food, alcohol, clothing); showed the importance of understanding gender as performance across the family/societal boundaries; and demonstrated the centrality of communities and networks in supporting and restraining different interpretations of culture, consumption and gender by mothers and fathers

Imagined multiple worlds: how South Asian women in Britain use family and friends to navigate the 'border crossings' between household and societal contexts

Our primary goal is to capture glimpses of “the imagined … multiple worlds” of young adult women in post-modern ethnic families, households and society. Drawing on a dialogical model of acculturation and diasporic identity, we show how young South Asian women in Britain use multiple identities across a variety of cultural settings to negotiate and navigate cultural and consumer behavioural borders. Using an ethno-consumerist framework for our research design, we provide a more nuanced understanding of the intersections between ethnicity, identity, self and consumption in families and peer friendship groups. These interactions reflect the individual’s co-existence and identity maintenance in two cultures