Discuss the Different Components of Michael Porters Essay Example for Free

Discuss the Different Components of Michael Porters Essay National prosperity is created not inherited. It does not grow out of a country’s natural endowments, its labor pool, its inters rates or its currency’s value. A nations competitiveness depends on the capacity of its industry to innovate and upgrade. They benefit from having strong domestic rivals, aggressive home based suppliers and demanding local customers. Innovation is what drives and sustains competitiveness. A firm must avail itself to all dimension of competition, which he categorized into four major components of the â€Å"diamond of national advantage† 1. Factor Conditions: The appropriateness of the nations factors of production to compete successfully in a specific industry. Porters notes that although these factor conditions are very important in the determination of trade, they are not the only source of competitiveness as suggested by the classical, or factor portions, theories trade. Most importantly for Porter, it is the ability of a nation to continually create, upgrade, and deploy its factors ( such as skilled labors) that is important, not the initial endowment. 2. Demand conditions: The degree of health and competition the firm must face in its original home market. Firms that can survive and flourish in highly competitive and demanding local markets are much more likely to gain the competitive edge. Porter notes that if the character of the market, not its size, that is paramount in promoting the continual competitiveness of the firm. And Porter translates Characters as demanding costumers. 3. Related and supporting industries: The competitiveness of all related industries and suppliers to the firm. A firm that is operating within a mass of related firms and industries gains and maintains advantages through close working relationship, proximity to suppliers, and timeliness of product and information flows. The constant and close interaction is successful if it occurs not only in terms of physical proximity but also through the willingness of firms to work at it. 4. Firms strategy, structure and rivalry: The conditions of the home- nation that either hinder or aid in the firms creation and sustaining of international strategy is universally appropriate. It depends on the fit and flexibility of what works for that country at that time. These four points constiture what nations and firms must strive to â€Å"create and sustain through a highly localized process† to ensure their success.

A Sense of Sin Essay Example for Free

A Sense of Sin Essay No one doubts the presence of evil in the world. We experience it in a variety of ways: national and international conflict; domestic and street violence; political and corporate corruption; and a host of manifestations of sexism, clericalism, racism, ageism, and other violations of justice. All such forms of brutality, disorder and discrimination, seem from a theological perspective, are rooted in sin. But do we ever recognize the sin and name it as such? 1 Retrieving a Sense of Sin For some reason, sin seems to have lost its hold on us as a way of accounting for and naming so much of the evil we know. Among the many other reasons, the eclipse of the religious world view through the rise of the secular spirit accounts significantly for the loss of the sense of sin. In fact, in his post-synodal exhortation, Reconciliatio et Penitentia (1984), Pope John Paul II credits â€Å"secularism† above all with contributing to a loss of a sense of sin.2 The secular spirit questions the relevance and meaning of all Christian symbols, and even of religion itself. One effect of this secular spirit on the meaning of sin, for example, has been to reduce sin to some form of psychological or social disorder. The therapeutic perspective which pervades the secular spirit looks on behavior as either healthily adaptive-problem-solving behavior, or as unhealthy, nonadaptive, and problem-creating behavior.3 It does not call the latter sin. For a survey at major attempts in the past twenty years to explore the mystery of sin, see James A. O’Donohue, Toward a Theology of Sin: A Look at the Last Twenty Years,† Church 2 (Spring 1986): 48-54. 2 The other factors of a non-ecclesial nature which John Paul II lists as errors made in evaluating certain findings of the human sciences, deriving systems of ethics from historical relativism, and identifying sin with neurotic guilt. Within the thought and life of the Church, certain trends have also contributed to the loss of the sense of sin. Among these he lists the movement from seeing sin everywhere to not recognizing it anywhere; from an emphasis on fear of external punishment to preaching a love of God that excludes punishment; from correcting erroneous consciences to respecting consciences but excluding the duty to tell the truth. Two other ecclesial factors are the plurality of opinions existing in the church on questions of morality and the deficiencies in the practice of penance. To restore a healthy sense of sin, the pope advocates â€Å"a sound catechetics, illuminated by the biblical theology of the covenant, by an attentive listening and trustful openness to the magisterium of the church, which never ceases to enlighten consciences, and by an ever more careful practice of the sacrament of penance.† See Origins 14 (December 20, 1984): 443-444, quotation at p. 444. 3 The research of the team headed by sociologist Robert Bellah which has produced Habits of the Heart (Berkeley: University of California Press, 1985), a study of the American beliefs and practices which give shape to our character and form our social order, shows that the therapist is the newest character forming American culture. See Chapter Two â€Å"Culture and Character: The Historical Conversation,† pp. 27-51, especially pp. 47-48. 2 Moreover, the secular, therapeutic perspective tends to look on persons more as victims of unconscious or socio-cultural influences than as agents of free actions. Psychiatrists Karl Menninger in Whatever Happened to Sin4 and M. Scott Peck in People of the Lie5 want to make full allowance for those conditions which cause people to do evil. Yet both insist on a strip of responsibility which cannot be negotiated away to these determining influences. While the behavioral sciences provide us with helpful explanations of human behavior, they do not give a full account. Sin is real, and we need a fresh way to get at it and call it what it is. What do we need to grasp in order to retrieve a sense of sin in an adult manner? Contemporary moral theology says a â€Å"sense of responsibility.† Christian theologians find in â€Å"responsibility† the essential theme of Christian faith and the central characteristic of the moral life. A leading Protestant theologian of this century, H. Richard Niebuhr, has done much to give impetus to the â€Å"responsibility† motif in Christian morality. 6 He summarizes the constituents of responsibility by describing the agent’s actions as a response to an action upon him in accordance with his interpretation of the latter action and with his expectation of response to his response; and all of this is in a continuing community of agents. (The Responsible Self, 65) Since God is present to us in and through all that makes up our lives so that we are never not in the presence of God, our responses to all our actions upon us include our response to God. As Niebuhr asserts, â€Å"Responsibility affirms: God is acting in all our actions upon you. So respond to all actions upon you as to respond to his action† (The Responsible Self, 126). If â€Å"being responsible† sums up the quality of character and action marking Christian moral living, sin will mark the failure to be fully responsible. â€Å"Responsibility† as a motif for the moral life has found its way into Catholic moral thinking with the strong support of the biblical renewal in the Catholic Church. Bernard Hà ¤ring, who has been instrumental in renewing Catholic moral thinking, has used this notion of â€Å"responsibility† with great success in reconstructing Catholic moral thought. Along with other Catholic theologians, Hà ¤ring has found in the biblical renewal a fresh theological framework and an orientation for understanding the moral life.7 We turn, then, to the biblical perspective on sin. Menninger, Whatever Happened to Sin? (New York: Hawthorn Books, Inc., 1973). Peck, People of the Lie (New York: Simon and Shuster, 1983). 6 See especially Niebuhr, The Responsible Self (New York: Harper Row, 1963), pp. 61-65. 7 Bernard Hà ¤ring’s writings are vast and wide-ranging. His early three-volume work, The Law of Christ (Westminster: Newman Press, 1961, 1963, 1966), was one of the first major works by a Catholic moral theologian to rethink morality in light of the biblical renewal. His most recent three-volume work, Free and Faithful in Christ (New York: Seabury Press, 1978, 1979, 1981), is an expression of Hà ¤ring’s more mature thought. This work is not a revision of The Law of Christ, but a completely new work. Charles E. Curran, a student of Hà ¤ring, has followed his teacher’s lead in making efforts at renewing moral theology in light of the biblical renewal. Some of Curran’s pertinent articles are â€Å"The Relevancy of the Ethical Teaching of Jesus† and â€Å"Conversion: The Central Message of Jesus† in A New Look at Christian Morality (Notre Dame: Fides Publishers, Inc., 1968), pp. 1-23 and 25-71. Sin: The Biblical Perspective From the Bible we see that Christian morality is primarily a â€Å"vocation.† This means that our life is a response to the word of God spoken to us preeminently in Jesus, but also in and through the people and events of our lives. From the perspective of vocation, wherein God calls and we respond, responsibility replaces obligation as the primary characteristic of the moral life. Also, the relationship that we establish with God in and through our responses to all things becomes the focal point of the moral life. From this point of view, practicing the presence of God becomes essential for Christian responsibility, Christian moral growth, and our awareness of sin. A consistent theme of contemporary theology has been that we cannot have a proper understanding of sin unless we have a proper understanding of the nature and implications of the covenant God has established with us. â€Å"Covenant† and â€Å"heart† are the dominant metaphors of biblical faith for understanding the moral life. They provide the biblical horizon against which to recognize sin. Covenant The two frequently used terms for sin in the Old Testament point to violations of relationships. Hattah is the most common term. Its meaning, â€Å"to miss the mark† or â€Å"to offend,† points to a purposeful action oriented toward an existing relationship. The existence of the relationship makes the offence or failure possible. Pesa, meaning â€Å"rebellion,† is a legal term denoting a deliberate action violating a relationship in community. The New Testament term for sin is hamartia. It connotes a deliberate action rooted in the heart and missing the intended mark. 8 These terms acquire theological significance when used in the context of the covenant which expresses the most personal kind of relationship between God and us. The primary aim of the covenant is that God loves us without our having done anything to attract God’s attention or to win that love. God’s covenant is a bond of completely gratuitous love, pure grace. But God’s initiative of love (grace) does not destroy our freedom. Unlike the Godfather, God makes an offer we can refuse. God’s offer of love awaits our acceptance. Once we accept the offer of love we commit ourselves to living as the covenant requires. The covenant context lifts the notion of sin out of a legalistic framework to set it on a level of a personal relationship with God. In worshipping the golden calf (Ex 32), Israel missed the mark of covenant love, or sinned, not so much because Israel broke one of the laws of the covenant, but because Israel broke the personal bond of love of which the law was an external expression. The law was not to be the final object of Israel’s fidelity. God was. Sin in the Bible is not merely breaking a law. Sin is breaking or weakening the God-given bond of love. The law was an aid to Israel’s fidelity and pointed to the responsibilities of being in relationship to God.

Experienced Stigma in Severe Mental Illness

Experienced Stigma in Severe Mental Illness Exploring experienced stigma in severe mental illness – contributing to validation of a psychometric instrument Luà ­s Pedro Santos de Mendonà §a Table of contents (Jump to) Acknowledgements   Acronyms 1 Introduction 1.1 About stigma 1.1.1 Why to focus on stigma? 1.1.2 Evolution of the concept 1.1.3 Development of stigma 1.1.4 Different concepts of stigma 1.1.5 Correlates and consequences of stigma 1.2 Stigma research 1.2.1 Instruments to measure stigma categories and criteria for psychometric properties 1.2.2 Perceived stigma 1.2.3 Self-Stigma 1.2.4 Experienced stigma 1.2.5 Stigma studies in Portugal 1.3 Consumer experiences of stigma questionnaire (CESQ) 1.3.1 Main research with psychometric data involving CESQ. Acronyms CASS Clinician Assessment of Schizophrenic Syndromes CAT Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment CESQ – Consumer Experiences of Stigma Questionnaire CFA – Confirmatory Factor Analysis CI – Confidence interval CRPD Convention on the Rights of People with Disabilities DISC – Discrimination and Stigma Scale DSSS – Depression Self-stigma Scale EDS – Experiences of Discrimination Scale EFA – Exploratory Factor Analysis FBS Frankfurter Befindlichkeits-Skala GAF Global Assessment of Functioning GAS Global Assessment Scale HIV/AIDS – Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome HSRS Health Sickness Rating Scale HSS – Stigmatisation Scale ICCPR International Covenant on Civil and Political Rights ICD – International Classification of Diseases ISE – The Inventory of Stigmatising Experiences ISMI – Internalised Stigma of Mental Illness KMO – Kaiser-Meyer Olkin statistic M – Mean MIDUS – MacArthur Foundation Midlife Development in the United States MSA – Measures of sampling adequacy MSS – Maristan Stigma Scale NAMI National Aliiance for Mentally Ill PA – Parallel Analysis PAF – Principal Axis Factoring PANSS – Positive and Negative Syndrome Scale PCM – Polychoric correlation matrix PDD – Perceived devaluation and discrimination scale PD-S Paranoid-Depresività ¤ts-Skala QOLI – Quality of Life Interview RES – Rejection Experiences Scale RMSEA Root mean square error of approximation SD – Standard deviation SESQ – Self-esteem and Stigma Questionnaire SFS – Social Functioning Scale SLDS – Satisfaction with Life Domains Scale SRER – Self Reported Experiences of Rejection SS – Stigma Scale SSMIS – Self-stigma of Mental Illness Scale UDHR Universal Declaration of Human Rights WHO – World Health Organization WLSMV Means and Variance adjusted weighted least square 1 Introduction 1.1 About stigma 1.1.1 Why to focus on stigma? Stigma is defined as a sign of disgrace or discredit. Authors agree it is a powerful negative attribute, having its impact on all social relations. Stigma is present everywhere in our society. It affects different characteristics in people, ranging from sexual orientation to HIV/AIDS, several medical disorders, gender, race, unemployment or obesity. However, it is in mental health disorders that stigma has its most devastating impact, although not always obvious. Discrimination, the enactment of stigma, appears closely associated to it. While stigma lies at the base of discrimination, discriminatory practices also promote and reinforce stigma. Discrimination is also about the conditions in which patients live, mental health budgets and the priority which we allow these services to achieve.1 In other words, stigma and discrimination lead to social exclusion – a triad that is a key determinant of mental health. Stigma and discrimination are violations of human rights. Intention and commitment to fight stigma are present in the spirit of legally binding treaties such as the Universal Declaration of Human Rights (UDHR)2 , International Covenant on Civil and Political Rights (ICCPR)3, International Covenant on Economic, Social and Cultural Rights (ICESCR)4 and Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT)5, and are explicitly mentioned on the Convention on the Rights of People with Disabilities (CRPD)6. CRPD actually demands that signatories ‘take all appropriate measures to eliminate discrimination on the basis of disability by any person, organisation or private enterprise’, and to ‘adopt immediate, effective and appropriate measures †¦ to combat stereotypes, prejudices and harmful practices relating to persons with disabilities †¦ in all areas of life’.6 From the part of the World Health Organization, tackling stigma, discrimination and social exclusion is a major concern of the General Assembly, with of the General Assembly, with reflection in the WHO Mental Health Action Plan 2013-20207. At regional level, in European Union, commitment to fighting stigma and discrimination is a consequence of signing treaties like European Convention on Human Rights, European Social Charter, European Convention on the Prevention of Torture and Inhuman or Degrading Treatment or Punishment and, specifically, Recommendation Rec(2004)10, of the Committee of Ministers to member states, concerning the protection of the human rights and dignity of persons with mental disorder. Still at regional level, and in line with WHO Mental Health Action Plan, stigma and discrimination is one of the main action areas of European Mental Health Action Plan.8 At national level, fighting stigma, discrimination and social exclusion is a component of policies, plans and programs worldwide. In a time when quality mechanisms tend to be implemented into healthcare systems, there is also a trend to develop parts of quality standards that have statements on fighting stigma at a local level. NICE quality standards are a good example9. To implement stigma into quality standards is, by itself, a strategy to fight it, by turning each service user in a potential advocate, as Byrne noted1. Therefore, there is the need to foster development of indicators that can be used regarding mental illness stigma. 1.1.2 Evolution of the concept Stigma is a word that has its reminiscences in the Greek civilization. Stigma were body marks that were intentionally applied to individuals- the stigmatized that carried unacceptable moral or individual traits, as compared to standards in that society. Christians absorbed the concept, adding two other meanings to those body marks – to indicate a holy grace or to indicate a sign of deformity/physical disease. Anyway, even in early days of Christianity, stigma implied, from the social point of view, firstly, â€Å"imputing a meaning into something† even if it did not have that meaning, and, secondly, dealing with deviations to a social norm. Goffmann10 was the first author to theorize stigma. To Goffmann, stigma is the result of a gap between perceived attributes and stereotypes. It is a matter of perspective, not reality. it is â€Å"in the eye of the beholder†. Stereotypes are selective perceptions that categorize people, and that exaggerate differences between groups (‘them and us’) in order to obscure differences within groups.11 He defines three types of attributes: Body(physical) – e.g. visible deformities in the body, deformity caused by physical disease Character (personal) – e.g. mental illness, criminal conviction Tribal (Social) – e.g. stigma of one group against another. Goffmann also distinguishes between â€Å"discredited† and discreditable†. Those concepts were further developed by Jones et al.12 , who proposed six dimensions of stigma: Concealability indicates how obvious or detectable the characteristic is to others. Course indicates whether the stigmatizing condition is reversible over time. Irreversible conditions provoke more negative attitudes than others. Disruptiveness indicates the extent to which a mark blocks or diminishes interpersonal interactions. Aesthetics reflects what is attractive or pleasing to ones perceptions. When applied to stigma, it means whether a mark provokes a reaction of disgust. Origin refers to how the condition came into being. Perceived responsibility on the conditions will carry more negative attitude. Peril, refers to feelings of danger or threat induced in others. This can mean physical threat (as in â€Å"contamination†) or simply uneaseness. According to Byrne, stigma is connoted with a few negative attributes. Shame is its first expression, resulting from perception as indulgence or as a weakness, despite centuries of knowledge, media campaigns and â€Å"the decade of the brain†. Blame is also an attitude that appears associated to shame.1 Maintaining secrecy is the maladaptive way some people find to cope with shame, but it can lead to deleterious consequences. 1.1.3 Development of stigma Negative attitudes towards people with mental illness, according to Byrne 1, exist since playschool and extend into early adulthood. This is suggested by several studies: Weiss13 examined a cohort of children of elementary school age and confirmed the prejudices eight years after; Green14 compared attitudes between several studies using the same measures, that ranged over 22 years, and found consistent results indicating community had the same negative attitudes. This objects the common belief that with increased scientific knowledge about mental illness, stigma would tend to disappear. 1.1.4 Different concepts of stigma Stigma concept has evolved in the last fifteen years. Link and Phelan have added discrimination to Jones’ original dimensions.15 Still, in 2001 the same authors present two major challenges for the concept of stigma. The first challenge is that researchers who research stigma do so from their own vantage point, giving priority to their scientific theories and research techniques rather than words and perceptions about people they study, which lead to misunderstanding of the experience of people being stigmatized and to perpetuation of assumptions that are unsubstantiated. The second challenge is about individualization of stigma and the fact that in research it tends to be considered as an attribute or a mark of the individual rather than a designation or tag that others affix to a person. Thus, Link and Phelan propose a definition of stigma based on a convergence a few components: Distinguishing and labelling human differences – oversimplification of salient differences between human beings occurs, with further labelling of individuals. Associating human differences to negative attributes – Labels previously mentioned are associated to negative sterotypes, as previously described by Goffmann. Categories and stereotypes are often â€Å"automatic† and facilitate â€Å"cognitive efficiency†. Separating â€Å"us from them† – Social labels connote a separation between the group that stigmatizes (â€Å"us†) and the group that is being stigmatized (â€Å"them†). For example, some people talk about people who have schizophrenia as being â€Å"schizophrenics†. Status loss and discrimination – stigma leads to loss of status in social hierarchy, and to discrimination, both at individual and at structural levels. Link and Phelan also emphasize that stigma is a matter of power – certain groups in the society have the power to stigmatize. Stigma is also a matter of degree – there is a continuum between its existence and its absence. Corrigan16, has an opposing view, focused on cognitive and behaviour features of mental illness. He proposed a model in which stigma was categorized either as public or self stigma. Public stigma is defined as the reaction that the general population has to people with mental illness. Self stigma is the prejudice which people with mental illness turn against themselves. In each of the categories, stigma is broken down into three elements: stereotypes (cognitive knowledge structures) prejudice (cognitive and emotional consequence of stereotypes) and discrimination (behavioural consequence of prejudice)17 . Thornicroft et al.18, elaborate on this framework, stating that stigma is composed of problems at three levels: Knowledge, Attitudes and Behaviour. Mental health knowledge is also known in the literature as mental health literacy. A study by Jorm et al. in Australia has shown better knowledge was correlated with better recognition of the features of depression, and better compliance with help seeking or medication and/or psychotherapy compliance.19 Nevertheless, by citing contradicting evidence, Thornicroft18 states that â€Å"an increase in knowledge about mental illness does not necessarily improve either attitudes or behaviour towards people with mental illness.† Negative attitudes, also known as prejudice, is the most studied component. According to Thornicroft, it can predict more strongly actual discrimination than do stereotypes. Attitudes have been widely researched. There are studies regarding both public, healthcare practitioners (and medical students) and caregivers. Thornicroft emphasizes the importance of studying actual behaviour, stressing that most of the studies have focused on attitudes towards hypothetical situations, rather than actual stigmatizing and discriminative behaviour. Thornicroft proposes a shift from research focused on stigma to research focused on discrimination.18 1.1.5 Correlates and consequences of stigma Stigma can have profound impact both at individuals with mental illness and their relatives. Rà ¼sch et al.17 list four negative consequences of public stigma: Everyday life discriminations encountered in interpersonal relations and depictions in media Structural discrimination – inequity in the access to opportunities in private and public institutions. Self-stigma (versus empowerment) Fear of stigma as a barrier to use health services. About self-stigma and empowerment, Rà ¼sch et al. comment, firstly, that self-stigma and empowerment are on the same continuum of self-esteem. They also remark that people may have different reactions to public stigma – while some people react with low self-esteem (self-stigmatized), some people might react with anger or indifference. They point out a possible explanation for this resides both within group identification with public stigma and perceived legitimacy of it. They also point the issue of self-disclosure – a person who considers mental illness is a part of his/her identity will more likely reveal his/her condition to others. Secondly, Rà ¼sch et al. comment on the relationship between stigma and service use. People decrease usage of psychiatric services in order to overcome public stigma. This is supported by evidence showing associations of this lack of usage with negative reactions from family members and poorer social status. Lack of usage of psychiatric services is intrinsically linked to decreased treatment compliance and, therefore, poorer prognosis.20,21 Personal stigma has shown to be associated with variables at different domains, in a systematic review and meta-analysis conducted by Livingston and Boyd. In the psychosocial domain, stigma has been negatively associated with hope, self-esteem, empowerment/mastery, self-efficacy, quality of life and social support/integration, both at group and individual levels.22–24 In the psychiatric domain, stigma has been positively associated with symptom severity and negatively with treatment adherence22. There are mixed results regarding association of stigma to diagnosis, illness duration, hospitalizations, insight, treatment setting, functioning and medication side effects, with most of the studies failing to show any statistically significant association. Regarding socio-demographic variables, both gender, age, education, employment, marital status, income and ethnicity have failed to show any consistent results.22 We should note, however, that some studies have shown significant associations, both positive and negative, regarding each of the variables, with stigma. 1.2 Stigma research Wahl et al., in 1999, mention four types of stigma research: Research that involves self-reports from general public. Research using vignettes or profiles of individuals and study participants’ ratings of people described. Analogue behaviour studies,(â€Å"experimental studies†) in which people are led to believe they are dealing with a person with mental illness. They note, however, there was, at the time, few research focused on mental health consumer, and his personal experiences of mental stigma.25 The paradigm changed and nowadays there is a relatively large number of instruments to measure personal experiences of mental stigma. 1.2.1 Instruments to measure stigma categories and criteria for psychometric properties In 2010, Brohan et al. 26, reviewed systematically 75 studies with instruments to measure personal experiences of mental stigma. Quality criteria for health status questionnaires have been thoroughly reviewed by Terwee et al,27 and are briefly described in Table 1. Table 1 Criteria for quality of psychometric instruments26,27 Brohan et al.26 considered instruments to measure personal experiences of stigma in three categories: Perceived stigma Self-Stigma Experienced stigma The found fourteen measures, used in the studies, which are listed in Table 2, and that were, thus, grouped in each of those categories. Instruments used were also assessed as to their psychometric properties, according to criteria by Terwee et al.27 Table 2 Scales assessing stigma experienced by people with experience of mental illness (Adapted from Brohan et al.26) 1.2.2 Perceived stigma Perceived or felt stigma, according to Scambler et al46 original definition, refers principally to the fear of enacted stigma, but also encompasses a feeling of shame associated with the illness. Van Brakel et al47, however, remove the feeling of shame from that definition, considering research about perceived stigma as research in which â€Å"people with a (potentially) stigmatized health condition are interviewed about stigma and discrimination they fear or perceive to be present in the community or society†. Perceived stigma can refer both to what an individual thinks most people would believe towards a certain group of the society or what that individual thinks about him personally as a member of a stigmatized group.48 Components of perceived stigma reported in the literature as measurable variables include stereotype awareness (perception by the individual of how individuals with mental illness are viewed by â€Å"most other people† in the society)16 and personal expectations or fears of encountering stigma. Perceived stigma is addressed in the vast majority (79%) of the studies reported by Brohan et al. Seven measures were used in the literature to measure it: PDD, SSMIS, ISE, HSS, SESQ, DSSS and DISC. PDD26,28 is the most commonly used scale. It totals 12 items its two subscales measure perceived discrimination and perceived devaluation – a way of measuring stereotype awareness. Perceived stigma is also measured in 10 item stereotype awareness subscale in SSMIS30. HSS investigates perceptions of how the person feels they have been personally viewed or treated by the society. In 2 of its items, DISC addresses the expectation of being stigmatized in various aspects of life – a concept called anticipated discrimination. Although in a specific setting and about a specific group, MSS44,45 â€Å"health professionals† subscale measures in our opinion perceived stigma regarding healthcare professionals, so it would fit in perceived stigma category. Regarding psychometric properties, all of the measures above mentioned reported on content validity. PDD, SESQ and DSS did not report whether target population was involved in selecting items in the scale. DSSS and SESQ reported results on internal consistency. However, PDD; SSMIS, ISE and HSS, although have calculations for Cronbach’s alpha, do not have factor analysis. SSMIS and SESQ have measured test retest reliability. MSS has been multiculturally tested, and its content validity was assessed. Cronbach alpha, internal consistency and test-retest reliability have been reported and meet criterion level. 1.2.3 Self-Stigma Self-stigma is considered, by Corrigan, the internalization of the public stigma. For Corrigan et al, there are three components in self stigma: negative belief about the self (e.g., character weakness, incompetence) – cognitive response, agreement with beliefs expressed by the public or the society and negative emotional reaction (e.g., low self-esteem, low self-efficacy) – affective response and behaviour response to prejudice (e.g., failing to pursue work and housing opportunities)16,49 Self-stigma is assessed by ISMI, SSMIS, DSSS, SS and ISE. Alienation, stereotype endorsement and social withdrawal subscales in ISMI, measure self-stigma, which correspond to its affective, cognitive and behavioural dimensions50. SSMIS measures self-stigma through three sub-scales: stereotype agreement; stereotype self-concurrence and self-esteem decrement26,30. SS has a â€Å"disclosure† subscale, which focus on the three dimensions already mentioned26,35. ISE contains one item on social withdrwal36. DSSS addresses self-stigma through two subscales – general self-stigma and secrecy: general self-stigma measures personal stereotype awareness. Secrecy subscale can be comparable to social withdrawal subscale in ISMI and disclosure scale in SS33. MSS44,45 has a 4 item subscale on self-stigma. According to Brohan, all the measures reported on content validity. DSSS did not report on target population involvement in item selection. SSMIS and ISE reported on partial criteria for internal consistency, reporting Cronbach’s alpha calculation but not factor analysis. ISMI; DSSS and SS have full internal consistency analysis. ISMI, SSMIS and SS have been reported to have measured test-retest reliability. 1.2.4 Experienced stigma According to Brohan and van Brakel, experienced stigma is the â€Å"experience of actual discrimination and/or participation restrictions on the part of the person affected†26,47. For the purpose of this definition, measuring experienced stigma can refer to measuring experiencing stigma in general or a report of experiences of stigma in specific situations or areas of life.26 By measuring experienced stigma, one can, thus, assess direct effects of public stigma on the stigmatized individual. Measures of experienced stigma include ISMI, CESQ, SRES, DSSS, SRE, SS, ISE, MIDUS, DISC and EDS. CESQ will b

Working Capital Analysis of Wal-Mart Essay -- Business Management Fina

Working Capital Analysis of Wal-Mart Every business decision is associated in one way or another with the financial condition of the organization. The results of a working capital analysis will assist in the determination of organization ¡Ã‚ ¦s ability to remain in a particular line of business. The primary focus of Team C ¡Ã‚ ¦s analysis of Wal-Mart, Inc is its current and future financial condition. The most imperative areas that are found in the Capital Structure Analysis Report fall into the following categories: Working Capital Management, Valuation and Investment, and Cost of Capital. The company ¡Ã‚ ¦s operational processes within each area can be examined and related financial data reviewed. Once the financial data is collected and calculated potential areas for improvements can be identified and corrective or innovative measures can be implemented. As in all businesses, which include Wal-Mart, it must be considered that there is always room for improvement. Working Capital Management In order to fully understand the company ¡Ã‚ ¦s financial position a financial manager must consider the amount of net working capital available. The net working capital is the difference between current assets and current liabilities. Companies normally have a positive net working capital. The components of working capital change continually within the cycle of operations. (Brealey, 2001) Therefore, an effective manager will monitor the cash conversion periods to determine the length of the production process. The longer the process, the longer the company ¡Ã‚ ¦s money will be tied up in the process. The two elements in the business cycle that normally absorb the most cash are inventory and receivables. The main sources of cash are payables and equity or loans. Speeding up the working capital cycle will generate more cash for the company. www.planware.org This management of working capital will allow the company to maximize its use of existing cash flows as well as leverage additional sources of working capital. Underperforming Company Ratios Although Wal-Mart is performing well overall and remains a leader within the retail industry, the company is not without opportunities for improvement. An analysis of the financial ratios for the company over the last three years as well as an industry comparison has identified areas in which the company could enhance its ... ... 3.03 3.26 3.59 Payout Ratio_______________________.19__________.17__________.23____ Table B Industry Averages_____________________________________________________ Fiscal Year 2001 2002 2003____ Leverage Debt Ratio 1.58 2.2 .53 Times Interest Earned Ratio .75 1.78 2.46 Liquidity Current Ratio 3.1 2.8 2.6 Quick Ratio .6 .5 .4 Net Working Capital .195 .07 .195 Efficiency Asset Turnover Ratio 2.23 2.27 2.2 Average Collection Period 12.6 10.4 8 Inventory Turnover 5.24 5.38 5.73 Profitability Net Profit Margin 3.7 2.8 3.97 Payout Ratio_______________________ 32.4__________34.3________34.6___ Tables are a combination of the following resources: www.walmart.com, www.reuter.com, www.biz.yahoo.com, UOP library resource Dun and Bradstreet industry ratios, and www.bloomberg.com.

Ballad Of Birmingham :: essays research papers

Dudley Randall's Ballad of Birmingham Dudley Randall's Ballad of Birmingham gives a poetic account of the bombing of a Birmingham church in 1963. The poem was written in ballad form to convey the mood of the mother to her daughter. The author also gives a graphic account of what the 1960's were like. Irony played a part also in the ballad showing the church as the warzone and the freedom march as the safer place to be. Writing the poem in ballad form gave a sense of mood to each paragraph. The poem starts out with an eager little girl wanting to march for freedom. The mother explains how treacherous the march could become showing her fear for her daughters life. The mood swings back and forth until finally the mother's fear overcomes the child's desire and the child is sent to church where it will be safe. The tempo seems to pick up in the last couple of paragraphs to emphasize the mothers distraught on hearing the explosion and finding her child's shoe. The poem also focuses on what life was like in the sixties. It tells of black freedom marches in the South how they effected one family. It told of how our peace officers reacted to marches with clubs, hoses, guns, and jail. They were fierce and wild and a black child would be no match for them. The mother refused to let her child march in the wild streets of Birmingham and sent her to the safest place that no harm would become of her daughter. Going to church in the ghetto in Birmingham was probably the safest place a mother could send her child. But this is where the irony takes place. The irony makes the church the warzone and place of destruction while the march was the safest place to be. The child was depicted as combed hair, freshly bathed, with white gloves, and white shoes, which is also ironic. The mother had sent an angel dressed in white to a firestorm from hell called church. The mother was completely sure that her daughter was safe until she

Home Schooling Provides Parents More Control :: Exploratory Essays Research Papers

Home Schooling Provides Parents More Control For most students, school begins with the first bell of the day and ends with the last, but for 228 pupils in the Smallville school district and roughly 1.5 million nationwide, the structure of a typical school day is anything but typical. These are home-schooled students, and their reasons for dropping out of standard educational systems are almost as varied as the hours which they keep. While some families want more time together, others focus on the special needs of children, and still others hope to instill values that they feel are not addressed in public or even private schools. Nearly all seek more control over the education of their children. "With home schooling, you can take your child's learning style and develop curriculum that fits how your child learns best. You're not trying to put a square peg in a round hole," said Sheri Cramer, whose ninth-grade son Jordan recently left public schooling to enroll under a new part-time policy adopted by the Lakota Board of Education last August. Under the policy, home-schooled students can enroll in up to two classes in the district each year and take part in extracurricular activities while maintaining their home-schooled status. "Through the policy, Jordan gets the best of both worlds †¹ he can still take part in school activities, but can work at his own pace and get individual attention also," says Cramer. It is this individualization that draws families to home schooling. "Because of the direct one-on-one interaction, you can tell if material is too boring or too difficult for your child and can make adjustments to that," says West Chester CHEC(Christian Home Education of Cincinnati) support group leader Susan Schechter, who has home schooled her two children for eight years. "I've always felt that I was able to do with home schooling what most teachers would like to do if they had the time and money." While expenses are not always a problem for home schoolers, they receive no financial aid from the government, and come from mostly single-paycheck families so that one parent can teach at home. "The idea is for parents to participate and share the skills they have with others so that we (home schooling families) don't have to hire as many teachers," says Schechter. For the majority of home schoolers, the primary teacher is the parent, though many are involved in home-schooling co-ops for special classes or hire private tutors for difficult subjects.

Clubfoot

Clubfoot is defined as a congenital foot deformity characterized by a kidney shaped foot that turns inward and points down. The forefoot is curved inward, the heel is bent inward, and the ankle is fixed in planter flexion with the toes pointing down. Shortened tendons on the inside of the lower leg, together with abnormally shaped bones that restrict movement outwards cause the foot to turn inwards. A tightened Achilles tendon causes the foot to point downwards. The medical term for clubfoot is talipes equinovarus. It is the most common congenital disorder of the lower extremity. There are several variations, but talipes equinovarus being the most common. Clubfeet occurs in approximately 1 in every 800-1000 babies, being twice as common in boys as girls. One or both feet may be affected. Clubfoot is most common in children who suffer from spina bifida who have an L4 or L5 motor level. Many orthopedic surgeons instead of serial casting suggest early taping and gentle manipulation followed by an application of a well-padded splint. The reason for this is because serial casting can cause skin irritations and breakdown. Another technique manipulation and casting is a treatment that begins shortly after birth. It involves slowly stretching out the tightened muscles and holding the foot in an improved position with a cast. The casts are made of plaster and extend from the toes to either just above the knee, or just below it. Adduction of the foot is usually corrected first, followed by inversion of the hindfoot, and lastly the plantar flexion. The casts are changed frequently, each time repositioning the foot a little closer to normal. For the first two-three weeks, the casts are changed every second to fourth day. Cast changes are then decreased to once every one-two weeks. This treatment continues until the child is three to six months old. This method of treatment is distressing to the infant for only a short period of time. For this reason parents will be taught cast care before leaving the clinic. If the foot is too stiff to allow for adequate correction, then the tight or shortened tendons may need to be lengthened or released. The type of surgery varies according to how much soft tissue is released. During a surgical correction of a mild case of clubfoot, the surgeon must decide which joints require no, minimal, or moderate incision. In mild clubfoot, the mid and posterior subtalar joints requires minimal or no incision. All medial tendons are lengthened, the anterior and midtarsal joints are released, and the heel chord is lengthened. In treating a moderate case of clubfoot, the surgeon releases the anterior subtalar joint, and all medial tendons are lengthened. Lastly when treating the severe clubfoot, all deformities are attempted to be corrected Once an acceptable correction has been achieved by casting it will need to be maintained with a splint. The most common type of splint is the Dennis Brown boot and bar. Initially the splint must be worn twenty four hours a day. As the child learns to walk, the time in the splint is gradually reduced to nighttime use only. This could continue until the child is four or five years old. Physical therapy is also used to treat a child with clubfoot. It includes stretching, splinting, taping, monitoring casts, and teaching the parents how to help and motivate the child to do everyday life activities. To maintain correction, the child should be followed by the orthopedic surgeon until the bones, in the foot have stopped growing. This is necessary because the growing foot may slowly loose correction. If this happens, surgery on the tendons or abnormal bones may be needed with repeat casting. Most children who have been treated for clubfeet develop normally, and participate in any athletic or recreational activity they choose.