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The criticisms relate to: (1) lack of agency, (2) operationalization of regimes, (3) bias towards bottom-up change models, (4) epistemology and explanatory style, (5) methodology, (6) socio-technical landscape as residual category, and (7) flat ontologies versus hierarchical levels.
The objective of the current report was to revisit Lynam's [ 1, 5] operationalization for capturing the fledgling psychopath.
The Patterson et al [ 8] operationalization of integrity largely subsumes the Koenig et al. [ 7] definition of 'ethical responsibility to self and others' and included "honesty to self and others", "willingness to hold others to account", "maintaining confidentiality" and "willingness to challenge unacceptable behaviour".
This approach will result in twelve final models (4 operationalizations of the predictor × 3 main outcomes).
From these dimensions and from existing questionnaires [ 44, 45], operationalizations were made (see Additional files 1 and 2 for the original questionnaire in Dutch and an English translation).
Of the 6 identified attributes, 5 allowed operationalization into concrete levels (i.e., type of analgesic; degree of pain relief with analgesics; type of side-effects; severity of side-effects; and out-of-pocket cost).
Moreover, as summarized in Table 1, the operationalization of psychological outcome and QoL varied greatly as different constructs such as behavior, self esteem or mental health had been evaluated.
Nonetheless, the TTO method has been shown to be prone to several types of biases [ 3], its operationalization may influence results [ 4], and the way in which the answers of respondents usually are interpreted has been argued to be too simplistic (e.g. not accounting for time preferences for health) [ 5].
However, there is an increasing recognition that the last 30 years' operationalization and simplification of psychopathology has not resulted in visible gains in the validity of psychiatric categories [ 1, 20, 43].
Although these system aims were derived from experienced gaps in communication previously identified in cerebral palsy care settings [ 7], an operationalization in broader terms (i.e. system use would improve my job performance/increase my productivity/make it easier to do my job/etcetera [ 14]) might have better addressed the wide range of professionals' outcome expectancies.
Operationalization: (1) Age at the time of divorce.
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