Monday, September 30, 2019

Music Appreciation Essay

1.What were the three forms of English madrigals? Describe each type. – Madrigal Proper, in this form, the madrigal was through-composed. It used quite a bit of word-painting, which is the matching of music to the words in the text. There also is The Ballet, which is a piece in which dancers tell a story through their movements and the music. Lastly, there is The Ayre, with is a form of madrigal that is performed in a number of different ways, including with or without accompaniment. 2. What were chorales? Why were they popular? – Easy to sing melodies, often based on traditional folk songs. They were popular because the printing press allowed for the publishing of hymnbooks. 3. What is a consort? – An instrumental ensemble consisting of six instruments: flute or recorder, lute, cittern, violin or treble viola de gamba, bandore, and the bass viola de gamba. 4. Who was Guillaume Dufay? What contributions did he make to Renaissance music? – A Franco-Flemish composer who was born in Brussels, he was a prolific composer and one of the most influential of the fifteenth century. He wrote music in almost every musical form available at the time, including chants, motets, chorales, and Masses. 5. Who was William Byrd? What contributions did he make to Renaissance music? – An Englishman born in 1543; was one composer who created consort music. He is sometimes considered one of the first â€Å"geniuses† of the keyboard and many of his compositions were published in My Ladye Nevells Book and Parenthia. Critical Thinking Questions 1.How did music in the Renaissance differ from medieval music? – Medieval music refers to music written during the Middle Ages, around the time of 500AD – 1400. Most music of this time was monothonic or homorhythmic plainchant. Renaissance music refers to the period from around 1400-1600.The sound became different, in the sense of tone. Notable composers of this period are Orlando Gibbons, John Bull, Thomas Tallis and William Byrd. 2. What were the effects of the printing press on music and composers? – It allowed hymnbook to be published. and this lead the music away from borrowing music of older folk songs. 3. If the Renaissance is thought to represent a rebirth or new birth, how is this reflected in the music of the Renaissance? – The music was changing in good ways, from the medieval times. They were able to move away from borrowing music from old folk songs. 4. What was the role of music during the Renaissance? How was it used in society? – The printing press also initiated the printing of music for commercial purposes. This largely began in Venice, Italy, around 1501, when Ottaviano Petrucci printed the first significant collection of polyphonic music. Music came to occupy a greater position in society during the Renaissance period. One reason for this was the growing number of people who had more time for leisure activities. 5. Many of the songs from ancient times through the Renaissance built on the melodies of previous songs. What were the advantages for composers of using a melody that had already been created? – The advantages that people had from borrowing melodies of previous songs were that they already had a base to their music and only had to come up with words, if they were needed.

Sunday, September 29, 2019

Made for India

While consumers across the world are seeing a growing number of â€Å"Made in India† labels on the goods they buy, Indian shoppers are witnessing a more subtle change. Increasingly, multinational companies are selling products that are not just made in — but that are made for — India. Entire generations of Indian consumers, who once felt grateful simply for being able to experience the same brands as the rest of the world, are now realizing they can ask for products that cater to their wants and needs. And they stand a good chance of getting what they want. â€Å"The willingness of big brands to customize their products was never the issue,† says Harminder Sahni, managing director of Technopak Advisors India, one of the country's largest management consultancies. â€Å"What has changed is that the Indian market has finally reached a critical mass — after the U. S. and China, this is the largest consumer market in the world — that justifies the investment. † That wasn't always the case. Before the Indian economy opened up in the early 1990s, â€Å"imported† goods were a sought-after commodity, their foreignness often being their most desirable attribute. Not surprisingly, then, many multinationals didn't think success would require much effort when their brands finally entered the country after 1991. Things have changed. As Indian consumers became more aware of trends and advancements in technology, they began to demand similar sophistication. More important, they wanted products built to their needs. That meant not just automobiles, household appliances and consumer electronics, but also mobile phones, foods and apparel. â€Å"Earlier, there was a reverence for anything foreign because local products were of terrible quality,† says Abraham Koshy, professor of marketing at the Indian Institute of Management, Ahmedabad (IIMA). â€Å"But as the market developed, the focus started shifting from the product to the brand. Customers started patronizing a brand only if the product suited them. So the need arose for companies to adjust their products to customers' requirements. † It isn't only about holding on to existing customers. If altering a product's design or introducing a variant will help a brand reach out to an additional customer group, most companies would think it worth the investment. â€Å"Brands that establish their relevance with customers do well,† says Shripad Nadkarni, director of MarketGate Consulting, a Mumbai-based marketing and brand consultancy. The increasing use of third-party sourcing helps further the customization cause; companies can simply take on additional local suppliers who will adapt the products for different markets and customer groups. Of course, localization doesn't work for all products. Many high-end luxury goods, for instance, rely on their country-of-origin tag to enhance their brand appeal. A â€Å"Made in India† label on these products would be disastrous, says Technopak's Sahni. Koshy adds that products where the unit consumption is low may not justify huge outlays on customization.

Saturday, September 28, 2019

Reading Is Fundamental Essay

Reading is the foundation that a child’s ability to learn is built on. The fundamentals of all learning are based on reading. Research has proven time and time again that reading to your child, even as early as pregnancy and infancy, helps to spark their curiosity to learn to read. By reading aloud during pregnancy and infancy, the ground work is being laid in the development for a child’s love of reading (Promoting Literacy). To help children develop a love of reading start by having books all around. In the words of Dr. Seuss, â€Å"The more that your read, the more things you will know. The more you learn the more places you will go. † (Dr. Seuss). An early start with teaching the concept of page turning, observing pictures, and sequencing will feed little ones curiosity. You can further spark their imagination and creative thinking skills by sharing a picture book without words. Also, reading at bed time will also help small children learn that reading is a relaxing and comforting activity. As children get older we need to make sure we don’t always make reading feel as if it is a task, but rather enjoyable. The U. S. Department of Education found that, generally the more children read for fun the higher their reading scores are in school (U. S. Department of Education, 2007). The answer to how to help children develop a love of reading mainly lies in how we as adults encourage them. Most of a child’s early learning comes from copying what they see their parents do, so if children do not see their parents read then they are not going to be compelled to read themselves. There are so many ways we can nurture a love of reading with children that in turn will help them develop in so many different ways. We read for so many different reasons and it is important that we convey those differences to our children so they can maximize the benefits they get from their own reading. Without being surrounded by people who read then it will be difficult for a child to make that vital connection between reading and enjoyment, thus hindering the development of a love of reading. Children should know books are not just purely for pleasure, but can also be used for a source of information. Once able to read then a whole world of literature opens up and as long as people write and read what is written then books will continue to provide education, information, and pleasure for all who participate. Works Cited Dr. Seuss. â€Å"I Can Read With My Eyes Wide Shut. † www. goodreads. com. Promoting Literacy. â€Å"Bonding With Your Unborn Baby Through Books. † www. earlymoments. com. U. S. Department of Education, 2007. â€Å"Facts About Children’s Literacy. † www. neg. org.

Friday, September 27, 2019

How did Witte's and Pobedonostsev's visions of Russia and its path Essay

How did Witte's and Pobedonostsev's visions of Russia and its path differ Could either of them have saved autocracy - Essay Example Ivan III wiped out the idea of democracy by annexing territory of both principalities of their kingdom, ensuring that no united political power would be able to oppose their total authoritarian rule. The leader drew a firm support of the Russian Orthodox Church to legitimize an autocratic rule (MacKenzie & Curran, 2001). The people of Russia would therefore feel the effects of this rule in later years during the time of reign of both Alexander III and Nicholas II of between 1880 and 1905. Many Russians suffered due to autocratic rule at these times and later it resulted to the Russian Revolution. During the time of these two rulers, the people of Russia ran to extreme poverty due to existence of famine, lack of education, the people lived under poor working condition in cities, there were limited industries even though society that is more agrarian could be noticed no development could be hastened. Due to autocracy, the Russian empire was deteriorated politically, economically, and socially. There were no industries and most of the people were peasants with high level of illiteracy. Most of the citizens were still under the slavery of wealthy property owners. The government still had no defined legal or constitution as well as parliament thus as a result no elections could be conducted. For efficient and smooth run of the entire vast empire, the Tsar appointed various ministers to help him rule. People were denied freedom of speech thus grievances could not be aired to the Tsar. The first round in the struggle to define a direction of Russia’s development was between the conservative stability proclaimed by Pobedonostsev, which elaborated on maintenance of Russia’s natural institution and massive industrial change driven by Witte that emphasized on the introduction of European institutions (MacKenzie & Curran, 2001). The two men experienced a reversal of their early

Thursday, September 26, 2019

Communication Skills in the Construction Industry Assignment

Communication Skills in the Construction Industry - Assignment Example This paper shall likewise recommend that individual sites be treated as a separate business unit managed by a Project Manager. Site Managers or Project Managers should report directly to the project delivery Director to ensure that accountability and deliverables for each project are monitored more effectively. The changes shall also ensure that reporting lines and administrative responsibilities are delineated and established that will clear any ambiguities amongst the personnel at the construction site. A detailed task list on a per module basis during construction phases will make it possible to report a more accurate construction status. This strategy will also enable the project management group to monitor usage of materials and wastage. The foreman will report materials usage, completion status, and manpower consumption. Being informed of the exact construction status on a more regular basis, client expectation will be easier to manage. Determining the critical path will enable any site manager to determine the exact time for construction materials to be delivered. This will lessen the cost of warehousing and materials storage. Heavy equipment use will also be predictable which will lessen the rental cost and parking cost. As a predicate, the construction operation is normally conducted in this manner—during Fridays, foremen are mandated to report the status of the section they are supposed to complete for the week. On Saturdays, based on the report given by the foremen, a verification team inspects the completion stage or the status of each of the work order. On Sundays, the project leaders compare the completed work orders base on the project plan of the building. Base on the completion status, delivery of materials and heavy equipment rentals for the work order that is scheduled to be completed for the week are then reserved for the following week. If there is some misunderstanding with regards to the expectation and the work orders completed, r evision as well as the new instructions, the architects and engineers are called to provide more detailed instruction on the Monday-morning foreman’s meeting.

Position Paper Essay Example | Topics and Well Written Essays - 1000 words

Position Paper - Essay Example This in a way is a debate of nature vs. nurture. The fact is that some of these differences are strictly biological whereas others can be influenced by the environment children are raised in. People’s mental and emotional performance as adults has a strong connection to their parents perceptions of their genders during their childhood. Although many parents in the contemporary society tend to provide their children with the same kind of upbringing without any distinction on the basis of gender thus educating them alike and offering them same opportunities of play and recreation, yet prejudice ultimately causes them to restrain the physical activity of their daughters unconsciously. The way children and their behavior is perceived by the parents shapes the way they treat their children as well as the experiences children are given. â€Å"Since life leaves footprints on the very structure and function of the brain, these various experiences produce sex differences in adult beha vior and brains—the result not of innate and inborn nature but of nurture† (Begley, 2009). Parents raise their children with definite perceptions that instill in their personalities over time. Daughters are raised with this perception that they would have to leave the home one day to live with their husbands. This perception is inculcated in them that shyness, delicacy, and cleanliness are the expected behaviors and/or traits from them. On the other hand, boys are raised with the perception that they would have to earn and support the family one day and that the expected traits of them include physical strength, aggression, and smartness. Understanding these overt or hidden messages received repeatedly from their parents, children start working toward attaining these goals, thus developing differences across genders over the passage of time. Although parents may influence the mental and emotional performance of their children, they have no control over their physical de velopment. Parents having only daughters in the conservative societies where women are not empowered have a tendency to raise at least one of the daughters as a son. This concept is frequently captured in many movies and newspapers frequently. Even recently, a Saudi woman named Saliha disguised herself as a man with consent of her father in order to be able to become a bus driver and earn some money to assist her family financially, news reported in Al-Sharq Arabic Newspaper. Saliha said, â€Å"I live with my parents and four sisters and our conditions are very difficult†¦ I looked at [my father’s] poor health condition and advanced age and I requested him to allow me to replace him, especially that I was a good driver† (Saliha cited in â€Å"Gender no bar†). Even in such cases, the parents might develop a greater level of comfort between their daughter and men in the society so that their daughter can interact with them without hesitation that typically pe rsists between men and women during interaction, yet they cannot change her biological features. Such characters in the movie are overly dressed in baggy clothes to hide the curves and artificial moustaches are applied on the face. In spite of the obvious link of the physical differences of men and women to biology, biology alone is not responsible for other physical behaviors that are displayed by men and women e.g. their susceptibility to diseases. â€Å"Rarely does biology act alone to determine health inequities. Social

Wednesday, September 25, 2019

Professional Capstone Project Essay Example | Topics and Well Written Essays - 4500 words

Professional Capstone Project - Essay Example To address this issue further clinical trials are essential and preventive health strategies addressing the established causative agents should be implemented. Lung cancer often results from the abnormal growth of the cells lining the passageway of the lungs. They can be dangerous as they can spread and invade other tissues of the body. Because of this it is one of the most common causes of cancer death worldwide. The disease has a very low prognosis, with less than 15% of the diagnosed patients surviving 5 years after diagnosis. The clinical signs and symptoms are often vague and non-specific Radiologic tests such as x-ray and CT scan often provides the usual indication of lung cancer. PET scan has been shown to be important in cancer staging. The role of diagnosis on the staging, treatment and management of lung cancer cannot be overemphasized, thus it is essential to understand the contributions and limitations of each diagnostic procedure. The signs and symptoms of lung cancer are often covert or if not, they mimic other respiratory infections. Radiologic techniques, especially X-ray and CT (computerized axial tomography) scan are the most preferred techniques for initial diagnosis, and yet both offer some advantages and drawbacks. X-ray could not determine small tumors, if detected the patient may be in the late stages thus making treatment more difficult and even impossible. CT scan is more sensitive, having the ability to determine even the smaller tumors and yet lacks the ability to resolve whether the tumor is benign or just an inflammation as a result of respiratory infection. Furthermore, CT scan has not reduced the mortality rate of lung cancer. Furthermore, CAT scans have not decreased the incidence of the disease (Spiro, 2007). Proper screening and diagnosis of any type of cancer is important in the staging and treatment.

Tuesday, September 24, 2019

Should education be regarded as a public good or merit good Essay

Should education be regarded as a public good or merit good - Essay Example It shall promote understanding, tolerance and friendship among all nations, racial or religious groups, and shall further the activities of the United Nations for the maintenance of peace." (art.26 - Universal Declaration of Human Rights) This is a research paper to find out if education falls under public good or merit good. For this purpose it is important to define public good or merit good. A public good in economics can be defined as a good that is non-rival which means consumption of the good by one individual does not reduce the amount of the good available for consumption by others (Varian, 1992). The term public good is often used to refer to goods that are non-excludable which means that it is not possible to exclude individuals from the good's consumption. If we take an example of a sweet, if it is consumed by a person it is not available for another person. Where as fresh air and clean drinking water may be considered a public good as it is not generally possible to prevent people from breathing and drinking it (Wikipedia, 2007a). There are very few absolutely public goods, but common examples include law, parks, street-lighting, defence, traffic light, etc. The theory of public goods was first developed by the economist Paul A. Samuelson. In his classic paper The Pure Theory of Public Expenditure published in the year 1954 he defined a public good as follows: ...[goods] which all enjoy in common in the sense that each individual's consumption of such a good leads to no subtractions from any other individual's consumption of that good... (Samuelson, 387-389) In other words public goods are those products where, for any given output, consumption by additional consumers does not reduce the quantity consumed by existing consumers. Since there is no marginal cost involved in producing the public goods, it is commonly thought that they must be provided free of charge. In other words those who benefit less than the cost of using the public good will not use it which will lead to a loss of welfare. Public goods are mostly non-excludable, which means that if once provided anyone can use them, which when charged will lead to "free-riding". This is the reason that these goods will not be provided by free market. However, the public pays a price through the taxes paid to the government (ieg.ee, N.D.). A merit good is defined as a good that is under-consumed if provided by the market mechanism. The main reason for this is individuals take into consideration how the good benefits them as an individual. They do not consider the benefits that consumption generates for others in society. In pure economic terms, this is because the positive externalities of the good are not internalized by consumers. A merit good is a product that society values and judges that each and every individual should have it regardless of whether an individual wants it or not (Wikipedia, 2007b). Merit goods are products that are generally not distributed by means of the price system, but based on merit or need of the society. These goods can be supplied by free market, but not on the right quantity. They are provided by state as "good for you" (ieg.ee, N.D.). Should education be considered as a public good or a merit good Traditionally, in many parts of the world

Monday, September 23, 2019

Interview with Accident Victim Essay Example | Topics and Well Written Essays - 750 words

Interview with Accident Victim - Essay Example However, there was nitrogen inside the pipe as it had been formerly connected to the oxygen feed mixer. As there was no warning sign indicating it as a confined space or to indicate that the pipe contained nitrogen, the workers had no way to identify its presence. Worsening the situation, nitrogen cannot be detected using human senses as it is both odorless and tasteless. Admittedly, nitrogen is potentially dangerous at high concentrations as it causes asphyxiation. As the workers entered the pipe and as they covered the mouth of the pipe with plastic sheet, they were overcome by nitrogen. When one of their coworkers looked into the pipe through an opening in the plastic sheet, he found both of them lying unconscious. Immediately, the plant emergency response team was informed. They arrived and took both of the workers out of the pipe. They were given cardiopulmonary resuscitation. Thereafter, they were transferred to hospital by ambulance. Both of them were in critical condition and were given oxygen therapy for about a week. Thereafter, he was released and took a week’s rest at home. In total, the person lost about two week’s work. Soon, there was an OSHA visit and the company was fined for the accident. In addition, the company was made to improve its safety standards immediately.  

Sunday, September 22, 2019

Three Kinds of Books to Read Essay Example for Free

Three Kinds of Books to Read Essay Im an avid reader and I have found the most interesting books fall within three categories. The categories are fiction, nonfiction, and poetry. I have read books in all of these categories and although Im not an expert, I will explain the differences of these categories. Nonfiction is probably my favorite category, because while reading these books the reader is reliving something that happened to someone or an event that happened somewhere. These books are based on true facts, being about an event or about an individual persons life, or the life of a family. The reader can get the feeling that they know these people or were there during the event by reading the facts. They can also get to know how someone used to think by reading the thoughts of the people in the book during the events in that persons life. The author takes the story to places and events that actually exist and happened. The reader not only learns about individual people, but also about the differences in time lines, for example what a specific place was like in the 1900s and what it is like in the 2000s. The reader can learn about the difference in ethics between different countries, and about the eating habits in different countries. The reader can learn the difference between how styles have changed from years gone by and now. The reader can also learn how the style in houses has changed and even the differences in what types of plants were planted most commonly years ago and now. These types of stories can give the reader an idea of what it would be like to live in a different time or place. There are many different things that can be learned by reading this type of book, and many subjects that fall under this topic (nonfiction) from autobiographies to the history of a country. Fiction is another very interesting type of book to read. When reading a fiction book, the reader can let their imagination run to the fullest extent possible. The reader can take the writers words and put their own images to the story. Each reader makes the story their own when doing this, two people can read the same story and have two completely different ideas on what the writer had pictured when writing that story. With fiction, the reader knows  when they start reading, that the facts in the book are not real. The story can range anywhere from a thousand years ago to a thousand years in the future. The story can be about witches or warlocks, dragons and demons or about underwater countries. The reader can fly the skies on the back of a fire-breathing dragon, while being chased by a warlock, only to end up fighting with magic to save the world. The writer can take the reader into a love affair between a couple that has everything against them or that is being torn apart by friends and family. The writer can take the reader on a ship across a continent during raging storms, while the occupants hearts are waging their own storms inside the ship. The story can take the reader to worlds that do not exist and still give the impression that they are real and that the reader has just visited that place. With fiction the main idea is that there are no rules on what can be written about, the only thing holding a writer back with this type of book is the writers own imagination. Poetry is probably one of the most interesting and one of the hardest books to read and understand. Many people think that they cannot read and understand poetry. Reading poetry is not like reading a magazine or the newspaper, but it is easy enough to learn how to read and understand the meaning of most poetry. Poetry is the writer sharing a private part of him/herself, giving of the soul to the reader. The individual writer can be using past experience or just the imagination of what they wished could have happened or would happen in the future. Poetry is sometimes the hardest to read because it does come from the soul, it is a bearing of the soul to others, showing the inner most private thoughts and feelings. Reading poetry can make the reader feel the exact emotion that was being felt when the writer put his pen to paper and wrote the poem, or when whatever was being wrote about really happened. Poetry can give a feeling of happiness just by reading it; it can make a person cry, or know that there really is true love in this world of ours. Some poetry can be scary to read when it is about suicide, a suicide attempt, or the abuse of a child. It can also make you look at yourself as a person and what you have done to make the world around you a better place. Poetry can show you the beauty of a place, without you going to that place on your own; it can give you a feeling of calm and peace. Poetry is a wonderful thing to read, it is a sharing of two people  that have never met before. So as you can see, there are different types of books that show you different things in their own ways. You can read about the true-life stories of a person or get to know one of the first presidents. You can ride the skies on a white carpet while fighting evil demons, or you can sit and feel the feelings of a person that wrote about losing a true love. Whatever your tastes in books are they will pretty much fall within one of these categories. Regardless of what you like to read, just read and get everything that you can out of each and every book that comes across your hands.

Saturday, September 21, 2019

Consumer Loyalty in UK Sports Leisure Industry

Consumer Loyalty in UK Sports Leisure Industry The sports leisure industry in UK is booming with possibilities. The consumer spending pattern across the entertainment hubs such as online casinos, outdoor sports and other holiday sports has been growing as a sweeter spot for both consumers as well as service providers (Skills Active, 2009). The core purpose of this study is to analyze through research findings if the consumers are loyal to a type of leisure sport based on socio-economical factors such as income, education and occupation etc. The sport and recreation industry as a whole employs around 621,000 people. This is spread across the public, private and voluntary sectors. (Skills Active, 2009) In such a highly competitive environment, customer loyalty has become an increasingly effective means for securing a firms profitability (Reinartz Kumar, 2002). Consumer loyalty refers to a customers repeated same brand purchase within a given category, based on a favorable attitude toward and preference for the particular brand. Empirical findings have revealed that increased market share and decreasing price sensitivity among customers are particular contributions of customer loyalty to a firms profitability (Chaudhuri Holbrook, 2001). The establishment and maintenance of a loyal customer base should, therefore, be (and in many cases already is) a key objective for service providers, since it promotes a sustainable competitive position in the market place. Customer loyalty rests in particular on the brand, which plays an important role in customer retention. A brand can be described as a cluster of functional and emotional values that promises a unique and welcome experience (de Chernatony et al., 2006, p. 819) for its customers. By creating unique associations and feelings among customers that are directly and exclusively connected to the given, the brand helps service providers differentiate themselves from their competitors. In addition to its differentiation function, the brand serves as a potential relationship partner for the customer. The customer brand relationship can evolve and develop through continuous positive interactions between the customer and the brand (Grà ¶nroos, 2007, p. 331) and provides them with the opportunity to offer their customers benefits that go beyond the core service (cf. Hennig Thurau et al., 2002, p. 234). In such relationships, customers perceive a brand as a legitimate partner in the relationship ( Sweeney Chew, 2000;). Customers construct relationships with brands so that they provide and add meaning and value to their lives (Fournier Yao, 1997). This value is generated by the relational benefits resulting from the relationship with the brand as perceived by the customer (cf. Aaker, 2002, p. 95). Ultimately, the customer decides whether the relationship with a given brand generates value or not. Hence, it is fundamental for the establishment of customer loyalty to understand what potential and existing customers expect from their relationship with the brand. However, since customers personalities and lifestyles differ, as does their evaluation of the relationship with the brand, customer characteristics must also be taken into account. With the objective of fostering customer loyalty, sports leisure service providers in UK introduced loyalty schemes. These so called club memberships, sports complex memberships and other hospitality tie ups through credit card providers etc (Plimmer, 2006). While these programs attract a great number of leisure sports customers, skepticism has been expressed whether such programs in fact lead to true customer loyalty based on a positive attitude toward and preference for the brand. Critics assert that the reason why customers repurchase a service again from the service provider rests alone on the rational and economic benefits the hospitality provider offers (Dowling Uncles, 1997). In the past two decades interest in service quality has strengthened as research has shown how improvements in quality can lead to improved organizational performance and competitiveness (Douglas Connor, 2003). To evaluate how well their companies are meeting customer needs, service managers often use measurements of service quality and customer satisfaction (Dabholkar, 1995). Therefore, service quality and customer satisfaction have received much attention from service marketers and academic researchers (Spreng MacKoy, 1996). In addition, Taylor (1997) has noted that the two constructs (service quality and customer satisfaction) have became very important for marketing theory and practice, since many researchers have indicated their relationship to desirable consumer outcomes (Spreng MacKoy, 1996). The majority of services, including sport services, have helped create more demanding and discerning customers. Increasing expectations of sport services have led managers to become customer focused, which in turn has resulted in the introduction of customer care initiatives in order to improve the quality of service provision (Guest Taylor, 1999). A sport service provider can reduce the detrimental impact of effective factors by first ensuring that its customers are as highly satisfied with its services as possible (Javadein, 2008 Sports Leisure Service Loyalty). Sport organizations are better positioned to reap the positive outcomes associated with having a largely satisfied customer base if they have an understanding of those factors that contribute to their customers satisfaction because meeting customers expectations for key service quality attributes should lead to satisfied customers who, in turn, will remain loyal to the service and recommend it to other potential customers (Javadein, 2008 Sports Leisure Service Loyalty). In summary, sport managers should be interested in understanding what it is about their service that specifically influences their customers behavior. They need know that, what specific aspects of their services influence customers in terms of their satisfaction and their perceptions of service quality, which, in turn, lead to behavioral loyalty. Unfortunately, the work that integrates the role of service loyalty within the context of service marketing variables like service quality and customer satisfaction has received less attention. There have been very limited attempts to investigate the relationship between service quality and loyalty in the context of sport (Javadein, 2008 Sports Leisure Service Loyalty). In this research, it is examined if their exists loyalty amongst the consumers for sports leisure services based on their strata segmentation based on their education, income, occupational status and segregated residence. PROBLEM DISCUSSION Leisure sport seekers can get to indulge in sporting and recreation in schools, offices, and while on vacation and at other times too (Mintel, 2009). Briefly the following avenues for leisure sports can be availed by one and all in UK: Outdoor Sports education Outdoor pursuits Area, club and duty management in a range of venues, including casinos and bingo halls; Online games Adventure tourism Managers of sport and leisure organizations are faced with rising customer expectations of their services. As a result of increasing competition, a greater awareness of consumer rights and improvements in service quality, customer expectations of sport and leisure services are in danger of spiraling out of control. Indeed, the ability to manage customer expectations to ensure that they remain appropriate and realistic is a skill that has become increasingly essential for those who manage the industry. Reference Changing social trends will require more effective and efficient management. The population is getting progressively older, couples are having children later, society is becoming more litigious, there is a trend towards sports, home-based leisure is becoming increasingly important and society is becoming globalised. This will have implications for programming, marketing, image and competitive edge. These changes will all require better management (Mintel, 2009). The concept of customer loyalty in leisure sports industry of UK has been not studied properly. The principles of marginality have not been put to use in trying to understand if there exists customer loyalty in this space based on the number of hours spent in the sports leisure activities, types of activities and other such parameters. And also at this point of time it is unknown if there exists some differences between consumers preferences based on their social class segmentation such as income wise, education wise or occupational status wise etc. Reference OVERALL PURPOSE RESEARCH QUESTIONS Based upon the problem discussion the core purpose of the research is to provide an insight on the customer loyalty in sports leisure industry of UK based on parameters such as social class segmentation, consumer leisure behavior towards such options, types of leisure trips selected and to measure or explain these differences through marginality principles. The following are the key Research Questions that will be addressed in the research work: Q1. Are there any significant differences in the leisure behavior of UK population? Q2. Can such differences be measured using Marginality Principles? Q3. What would be the key recommendations for boosting Customer Loyalty in sports leisure industry of UK? LITERATURE REVIEW In this chapter the research work and related entities are discussed at length viz. pertaining to sports leisure industry as a whole, the social classes in UK and other relevant factors which affect a consumers behavior towards the offered services. A conceptual framework for the research would also be presented in this chapter. ELEMENTS IN SPORTS LEISURE With high levels of investment planned by government and employers, mainly in response to the successful London Olympics bid for 2012, there are more graduate career opportunities in the sport and leisure industry than ever before.  The introduction of the Smoking Ban Law in 2006-2007 has had a big impact on the casino and bingo industry.   While many bingo clubs have suffered from falling revenue, there has been a big increase in the number of players visiting online bingo sites and as a result many new job opportunities now exist in the online gaming industry (Mintel report, 2009).  Ãƒâ€šÃ‚   Types of Leisure Sports There is a growing awareness and understanding of health and fitness activities in the UK. More people than ever are actively taking part in sport and leisure as a hobby and this is also fuelling a growth in the number of available jobs. The major types of sports leisure areas include Health and fitness, Club and duty management, Sales and marketing, Instructing and coaching, Consultancy work based on Group Policy referrals usually with particular sections of the population, e.g. those with diabetes, arthritis, Lifestyle consultancy and nutrition opportunities are increasing as the sector embraces the concept of wellness, Sport development performance, administration and facility management (Lucie Johnston, Sports Leisure January 2010). For those who are employed in sports leisure industry the working hours can be long.   Employees are often required to work shift patterns and weekends. Typical salaries after training range from  £20,000 to  £35,000 (Graduate Recruitm ent Bureau, 2009). Manpower Overview Just over half of the sport and recreation workforce in England is female. It has a higher proportion of young people (16-24) than the workforce across England as a whole (SkillsActive Workforce and Skills Summary 2009). 95% of employees are currently from white ethnic groups, compared to 91% in the whole economy (SkillsActive Workforce and Skills Summary 2009). The sport and recreation industry as a whole employs around 621,000 people. This is spread across the public, private and voluntary sectors. (SkillsActive, 2009) There are a huge number of volunteers working in sport and recreation.   The latest Active People survey estimates that two million people in the UK commit at least one hour a week to volunteering in sport. There are currently just over 140 casinos, employing 14,000 people in the UK. There are 17,000 employees in the bingo club industry and 57,000 in the betting industry. The Gambling Act 2005 permitted online casinos to operate from the UK and consequently there are now over 320 online operators of betting and gambling sites employing almost 8,000 people. (The Gambling Commission Annual Report 2008/2009). There are 3,000 private health clubs and over 2,500 leisure centers in the UK, which together employ over 45,000 staff.   An additional 800 clubs are expected to open over the next few years in this growth in dustry (Skills Active, 2009). CUSTOMER SEGMENTATION In order to define distinct target groups, customers are typically segmented along demographic, psychographic, and/or behavioral dimensions (cf. Peter Olson, 2008, pp. 370; Solomon et al., 2006, p. 9). The sports leisure seekers market is segmented as follows: The upper class in Britain is statistically very small and consists of the peerage, gentry, and landowners. These people were traditionally the wealthiest in the land having inherited money and position. Typically they would speak with Received Pronunciation accent and have been educated at schools. Reference The upper middle class in Britain typically consists of professionals with tertiary education, speaking Received Pronunciation. The higher upper middle class are traditionally educated at more prestigious Public Schools. The lower section of the upper middle class tends to occupy less prestigious public schools. Middle class in Britain typically consists of bourgeois with degrees from the less prestigious universities, or possibly no tertiary education. They would speak in accents which are provincial as well as Estuary English . They would be engaged in owning and running local businesses; working for larger corporations as junior and middle management; teaching, social work an d engineering, accountancy, information technology, nursing and other skilled jobs. Reference Nouveau riche, are people from poorer backgrounds who have made money themselves, primarily in business, middle-class professions, or entertainment. They may retain the mannerisms of their original social group or may imitate the behavior of the traditional upper class by, for instance, sending their children to public school or taking elocution lessons, but often in a way that is seen as gauche by the real upper class and middle classes (satirized as Mr Nouveau Richards by Jilly Cooper). This group is characterized by ostentatious displays of conspicuous consumption. Premier League Footballers are typical of this group. Spiralist Meritocracy as another group was identified by Jilly Cooper in her book Class as people from working class or lower middle class backgrounds who gained an education at grammar school and university and have subsequently obtained professional or managerial jobs wit hin companies or government (Wikipedia, Social Structure of United Kingdom). Mondeo Man group are of people employed in the private sector in a salesman or entry level management position that drives a company car such as a Ford Mondeo. These people would have had limited education and cultural aspirations but are keen to move up in the world .The lower middle class in Britain consists of people in white collar jobs living in less prosperous suburbs. They would typically not have had a university education, at least before the 1980s expansion in higher education. Reference These people would speak in local accents, although relatively mild. Skilled working class in UK represents people who would be in skilled blue collar jobs, traditionally in industry but in recent decades showing entrepreneurial development as the stereotypical white van man, or self employed contractors. Reference Unskilled working class in UK represents people who would work in blue collar jobs with low incomes. They would typically have left school as soon as legally permissible and not value education (Wikipedia, Social Structure of United Kingdom). As per Annual Survey of Hours and Earnings (ASHE), 2007 the socio economic graph as per these roles with the median salary clearly depicts the relationship between occupational and age as variables against the income levels (refer Appendix I). CONSUMER LOYALTY Defining Consumer Loyalty As the comparison of the different definitions of customer loyalty illustrates, two key dimensions exist: a behavioral (cf. Cunningham, 1956) and an attitudinal (cf. Day, 1969) dimension. Both are described below in more detail and an equal consideration of both dimensions is advocated, if true loyalty is to be achieved. Behavioral loyalty refers to the consumers actual behavior of repurchasing specific bran within a given category over time (e.g., Day, 1969; Chaudhuri Holbrook, 2002). Kumar and Shah (2004, p. 318) describe behavioral loyalty as loyalty of a consumer as observed from the customers purchase behavior. This explicitly means that the consumer repeatedly chooses the same brand when he needs a specific product or service. This behavior may be a result of a true preference for the brand. However, repeat purchases of the same brand may also be attributable to mere convenience, habit, or because the barriers to change (i.e. the switching barriers) are too high. While proponents of the one dimensional construct of consumer loyalty argue that attitude is irrelevant in determining loyalty toward a brand and consider the debate on the notion of true loyalty a waste of time (Sharp et al., 2002) opponents claim that behavioral definitions of consumer loyalty are inadequate for explaining how and w hy customers are loyal to a specific brand, and call for an analysis of the individuals dispositional basis for repeated purchase (Dick Basu, 1994, p. 100). Zins (2001, p. 270) further criticizes that the observation of behavioral loyalty alone does not leave room to draw any substantiated conclusions about customers future actions. Only measuring behavioral loyalty actually overestimates the share of true loyalty, since it does not account for those customers who buy a brand simply because no other alternative is available or because a particular brand is offering a special promotion (Day, 1969). Prior research has demonstrated a direct relationship between reasons for liking a particular sport team and loyalty. The current study replicates and extends this line of inquiry by examining the mediating role of attachment, a process by which an individual moves from merely liking a team (attraction) to becoming loyal to a team (allegiance). Data (Collegiate N = 194; Collegiate and Professional N = 402, Favorite Sport Team N = 808) were collected to examine 13 benefits and attributes associated with liking a sport team, 3 attitude formation properties, and allegiance. A three stage test of mediation using MLR revealed that attachment mediated the relationship between allegiance and Vicarious Achievement, Nostalgia, Star Player, Escape, Success, and Peer Group Acceptance. The results indicated that allegiance is the outcome of a developmental process by which an individual places greater symbolic value on, has stronger emotional reactions, and has more functional knowledge in relat ion to attractive benefits and attributes associated with a sport team (Frank Daniel C., 2006 Loyalty, Attachment, Sport Consumers, Attitude Development, Participation). Low attitudinal loyalty combined with low behavioral loyalty indicates an absence of loyalty (cf. Dick Basu, 1994, p. 101). Day (1969, p. 30) categorizes those customers as spuriously loyal who exhibit high repeat purchase behavior, but lack any attachment to the brand and can easily be captured by another brand offering a better deal. Latent loyalty, in contrast, is reflected by high attitudinal loyalty combined with low repeat purchase. True loyalty, firms preferred condition, can be conceptualized as an attitudeà ¢Ã¢â€š ¬Ã‚ based behavioral loyalty toward the given brand (see Kim et al., 2008, pp. 99à ¢Ã¢â€š ¬Ã‚ 100). A direct relationship between customer loyalty and relationship marketing has been proposed by a number of authors. Webster (1994, p. 26) claims that Customer loyalty has meaning only within the context of relationship marketing. Similarly, Aaker (2002, p. 23) proposes that one approach for enhancing consumer loyalty is the development or strengthening of customers relationship with the brand, which constitutes the basic objective of relationship marketing. Relationship marketing thus serves as a concept that contributes to the understanding of the factors that drive customer loyalty. The conceptualization of the loyalty construct has evolved over the years. In todays changing global environment, every organization is searching for innovative ways to achieve competitive advantage, increase customer loyalty, and improve efficiency without sacrificing quality of service (Javalgi Moberg, 1997). Service loyalty, with its final effect on repurchasing by customers, is perhaps one of the most important constructs in service marketing. Indeed, loyal customers that indulge in repeat purchases are the base of any business (Caruana, 2002). Some have tagged customer loyalty as a key source of competitive advantage (Bharadwaj et al., 1993) and a key to firm survival and growth (Reichheld, 1996). However, how loyalty has been conceptualized and measured has varied considerably across studies, resulting in calls for more research into the fundamental meaning of loyalty (Oliver, 1999). Three conceptual viewpoints have been suggested to define customer loyalty: the behavioral perspective, the attitudinal perspective and the composite perspective (Bowen Chen, 2001; Zins, 2001). The behavioral perspective, purchase loyalty, strictly looks at repeat purchase behavior and is based on the customers purchase history. Here, the emphasis is on past -rather than on future actions. Moreover, no other loyal behavioral actions such as price tolerance, word of mouth, or complaint behavior can be interpreted. Concentrating on the behavioral aspect of loyalty could overestimate true loyalty. The attitudinal perspective, in contrast, allows gain in additional understanding of loyal behavior (Zins, 2001). Here, customer loyalty is approached as an attitudinal construct. Attitude denotes the degree to which a consumers tendency towards a service is favorably inclined. This inclination is reflected by activities such as the customers recommending service providers to other consumers or their commitment to repatronize a preferred service provider (Gremler Brown, 1996). Based on a favorable attitude towards a service provider, customers may improve preference loyalty (De Ruyter et al., 1998). Lastly, the composite perspective combines attitudinal and behavioral definitions of loyalty. The composite perspective might be considered as an alternative to affective loyalty since using both attitude and behavior in a loyalty definition disputably increases the predicting power of loyalty (Pritchard Howard, 1997). In the present study loyal are defined those customers who hold favorable attitudes toward an organization, recommend the organization to other consumers and exhibit repurchase behavior Consumer Loyalty in Sports Consumer loyalty is of great value to recreational sport agencies in terms of their effectiveness and success. In recent decades, students in the field of recreation and leisure have paid growing attention to the phenomenon of customer loyalty. This paper reviews how exploration of consumer loyalty began, especially in the field of recreation and leisure. There have been three stages of evolution: the one-dimensional approach, two-dimensional approach, and multidimensional approach. The latter two developed out of critiques of an established approach. The authors find the multidimensional approach to be the most comprehensive, and thus the most promising, perspective for future research on consumer loyalty in the field of recreation and leisure (Tian-Shiang Kuo Evolution of Scholars Approach to Studying Consumer Loyalty in Recreational Sport and Fitness Business). Because it is much cheaper to serve loyal customers and easier to maintain their support, customer loyalty is of great value to organizations (Seybold, 2001). Rosenberg and Czepiel, whom Park and Kim cite (2000), claim that attracting a new customer costs 6 times more than retaining an existing customer. To a great extent, the success of a recreational sport and fitness business depends on how the business manages customers loyalty (Backman Crompton, 1991a, 1991b). As Park and Kim note, consumer loyalty is embodied not only in economic transactions with a business but more broadly in general support for the organization (Park Kim, 2000). Glimpsing the importance of consumer loyalty to sport-related businesses, in recent decades scholars in the field of recreation and leisure have paid growing attention to the phenomenon of customer loyalty (Gahwiler Havitz, 1995; Howard, Edginton, Selin, 1988; Park Kim, 2000). What has been the result of this increased focus? For one thing, a gradual evolution in how researchers approach the phenomenon of customer loyalty has resulted. Three stages can be roughly identified. In the very beginning, most investigators focused on only one dimension of consumer loyalty, either the behavioral or attitudinal dimension. Next, as a result of criticism of this initial research model, models that approached both behavioral and attitudinal dimensions of customer loyalty were developed. Finally, the latest studies of customer loyalty incorporate multiple attitudinal or psychological facets. This has led to a deeper, better-integrated understanding of loyalty. The following describes in more d etail each evolutionary stage of the historical development of customer loyalty research. Behavioral Approaches The majority of early studies of consumer loyalty looked only at its behavioral dimension. A customer was viewed as loyal to a product or service if he or she demonstrated consistent purchase of one brand over time (Backman Crompton, 1991b). According to Prichard and colleagues, one-dimensional behavioral approaches were classified in four groups by Jacoby and Chestnut (Prichard, Howard, Havitz, 1992, pp.156-157). The first group comprises researchers who located loyalty in the customers purchasing sequence, for example George N. Brown. The second group comprises researchers such as Ross M. Cunningham who defined loyalty on the basis of the proportion of the customers purchases that featured the brand in question. Jacoby and Chestnuts third group includes the scholars who applied probability models to analyze consumers purchasing behavior. To this group belongs Ronald E. Frank, who in the early 1960s investigated repeat-purchase probabilities using a simple chance model. The fourth and last of Jacoby and Chestnuts group integrated several behavioral variables for generating definition of customer loyalty (Prichard et al., 1992). Burford, Enis, and Paul (1971), as an example, put forward an index combining three behavioral measures of customer loyalty: proportion of resources spent on brand or store, amount allocated to switching, and the number of alternative brands or stores. While operationalizing such behavioral approaches is easy enough, at the same time they may exhibit fatal weaknesses as theoretical frameworks upon which to hang studies of consumer loyalty. Beginning in the late 1960s, some consumer loyalty researchers began to criticize behavioral approaches to their task (Howard et al., 1988, p. 42). They pointed out, for example, that because the associated measures relied on overt, observable behaviors, behavioral conceptualizations of consumer loyalty were doomed to such error as the classification of particular consumers as loyal in one study and non-loyal in the next (Backman Crompton, 1991b, p. 206). Moreover, failure to identify relations between loyalties measured by different patterns of use brought many researchers to the conclusion that brand loyalty encompassed more than repeat use (Backman Crompton, 1991b, p. 206). Attitudinal Approaches Conceptually, behavioral models could not, Day noted (1969), discriminate between true or intentional loyalty and spurious loyalty (Backman Crompton, 1991b; Prichard et al., 1992). Day (1969) and Jacoby (1971) proposed an attitudinal conceptualization of customer loyalty in order to better understand it. According to Jacoby (as cited in Prichard et al., 1992), a customer who shows brand loyalty by implication repeat[s] purchase based on cognitive, affective, evaluative and predispositional factors: the classical primary components of an attitude (1971, p. 26). Prichard et al. (1992) also briefly review those early researchers who looked at psychological aspects of consumer loyalty as well as behavioral. Guest, Monroe, and Guiltinan; Bennett and Kassarijia; and Jain, Pinson, and Malhotra all made an effort to study consumers attitudes or intentions. Just like approaches focused one-dimensionally on consumer behavior, however, approaches focused one-dimensionally on attitudinal loyalty had limitations. According to Prichard et al., the early studies of the attitudinal components in consumer loyalty, when they were reviewed by loyalty theorists, were often found to lack adequate theoretical conceptualization. A result of this was a multitude of measures that confounded research. Examination of the theoretical and empirical rigor underlying the development of various attitudinal measures raised certain questions about construct validity (Prichard et al., 1992). Overall, then, early definitions of customer loyalty as solely a behavioral construct or solely an attitudinal construct could be accused not only of superficiality but also of insufficiency. In time, a two-dimensional approach would replace these flawed perspectives. Reference Consumer Loyalty in Leisure Leisure activities could be said to be more important than ever before. International comparisons show that the British work long hours, and lengthy commuting times only add to the burden. It is increasingly likely that both partners in a household work full time, and household duties such as food shopping and cleaning must be shared, placing a premium on the time available for more enjoyable activities. Reference There is also the increasing problem of sedentary occupations, with many people spending their working day sitting in front of a computer terminal or talking on the telephone. This produces a demand for active leisure or recreation, but developments in technology mean that there is also an increasing temptation to sit in front of the television or to spend hours on the Internet or playing video games (Research Markets UK Leisure and Recreation Market Review 2002). The Most Popular Leisure Activities The survey, which was carried out on a nationally representative sample of 1,012 adults in August 2002, simply asked people about the leisure activities they considered `enjoyable, either in the evening or at the weekend. Unsurprisingly, the leisure market is dominated by in-home activities, with 92% of people content to spend their evenings or weekends watching television (or, with some more initiative, watching bought or hired videos). Listening to music or the radio at home is another popular choice (80%). Even when they wish to socialize, most people now think first of entertaining friends or family at home (79%), rather than going out. Venues providing entertainment and cultural services have to work harder than ever to persuade people out of their comfortable homes. Most consumers (77%) are content to go out for a meal as their main leisure experience outside the home (Research Ma

Friday, September 20, 2019

The communication quality between doctor and foreign patient

The communication quality between doctor and foreign patient 1. Introduction While traveling is getting easier and migration is taking place frequently, cultural differences and communication problems have emerged as a new problem of today. The most important case communication is inevitable for a non-speaker of the native language is being a patient. Some undesirable outcomes may occur if the patient can not give the correct information. With the recent migrations in the western countries such as Germany, France, USA, Canada, UK, Holland the number of non-speakers of the native language has become noteworthy. In Turkey, there is also an increase in the number of foreign patients with the real estate sales to the foreigners in the places such as Antalya and Bodrum. On the other hand, highly qualified healthcare professionals and competitive pricing increased the share of health tourism in the whole tourism income (http://www.medicaltourisminturkey.org). On the ground of the importance of communication, according to various resources, 80% of the medical mistakes are caused by giving incorrect information [13,8]. Having gained more and more importance recently, foreign patient-doctor communication and the gaps it has, will be evaluated with the view of knowledge management, and finally, the method developed to prevent the incorrect information translation will be introduced. 2. Literature Review Foreign patients do not know the local language and therefore the language of the doctor is analyzed in detail. [1,2,10,14] In the basis of this study, lies the increase in the number of the non-speakers of the language of migrated country. For example in USA, 18% of people older than 5 years speak another language at their home (U.S. Census Bureau 2002: QT-P16, cited in Lee 2003:3). This information takes place in the article of Alexander and friends (2009) that contains interesting data about the non-speakers of native language: â€Å"In Geneva, Switzerland, 43% of the population is foreign born and about 25% of the population speaks a language other than French at home.† 2.1. Culture Edward Tylors definition is cited as the first definition of culture[15]. Tylor(1903/1988) defines as â€Å"culture or civilization, taken in its wide ethnographic sense, is that complex whole which includes knowledge, belief, art, morals, law, custom, and other capabilities and habits acquired by man as a member of society†.As one of the famous authors who has decoded the most about his studies on culture, Hofstede (2005:4) defines culture as â€Å"the collective programming of the mind which distinguishes the members of one group or category of people from another†. According to these definitions, language is critical for both underlined words. â€Å"Capabilities† are built by interpretation of language. â€Å"Collective programming of mind† programming codes are generated by language. We can say that culture is created by language. The effects of culture on health care are similar to those of language. For example in Turkey (strong uncertainty avoidance and collectivist culture) women are willing to be consulted to a woman obstetrician ( H2 hospital Director of Quality Department), in USA (weak uncertainty avoidance and individualist ) there is no such problems. According Collins et al. (2002, cited in Lee 2003:5): â€Å"Effective communication between patient and doctor is critical to good medical outcomes.† So a woman patient form a different culture may affect the medical outcomes. In literature, several paper [2,6] use language and culture interchangeable but in this paper we will use the language as creator of culture. 2.2. Developed Methods To Pass Trough The Language Barrier Information transfer (communication) between a patient and a doctor is generated in two ways. If the patient and the doctor speak the same language and their cultures are close to each other the transfer is established directly. If there are differences in the language and the culture of patient and doctor, a proxy is used. Followings are the proxies developed in the situation if the patients do not know the local language: Going to hospital with a friend or relative who knows local language and using him or her as translator. -In the deep interviews done with medical sector workers, most of the foreigners live in Turkey use this method, but if the friend or relative in the role of translator does not know the local language so much then some problems may emerge. Interpreter establishes the communication between patient and doctor. -This method is specially used in private health care enterprises in Turkey. Because of cost, increasing effects, interpreters are not chosen by patients who have no good economic welfare. In many countries the language requirements of interpreters are not defined, and non-medical professional interpreters are used widely. In the study of Karliner et al.(2007) â€Å"professional interpreters are associated with improved clinical care more than is use of ad hoc interpreters, and professional interpreters appear to increase the quality of clinical care for limited English proficiency(LEP) patients to approach or equal that for patient without language barriers.† Also many studies showed that professional interpreters who do not know the culture of the patient may offend the patient and the patient may lose confidence [3] .- Translation of those who are not medical staff -This type of translation is more common among immigrants. Because of large numbers of Turks living in Germany, it is quite probable to find non-medical staff that knows Turkish in the hospital.- If the medical staff knows foreign language. -The manager of public hospital and the managers of H1 and H2 hospitals said that the most important communication problem of medical sector is medical staffs without foreign language.- In these studies low content rates of the patients can be seen. The most satisfactory method is bilingual staff and the least one is translation of relatives/friends of the patient. 3. Data and Method The aim of this paper is to improve communication quality between doctor and foreign patient. The research question is How can we improve the communication quality between doctor and foreign patient? Yin (1994) defined a case study as â€Å"an empirical inquiry that investigates a contemporary phenomenon within its real-life context, especially when the boundaries between phenomenon and context are not clearly evident.† Kohn(1997) states that â€Å"Yin suggests the methodology may actually be more powerful for explanatory purposes in its ability to answer questions of how and why†. In this paper by the definition of case study methods and the structure of the research question. Semi-structured interviews and observations are used for data collection and case study method is used for analyzing data. 3.1. Selecting Cases In Turkey there are 5 types of hospital. H1 private and multi branch, H2 private unique branch, H3 private, multi branch and foundation supported ,H4 public hospital, H5 university hospital. Cluster sampling method is used because population is heterogeneous. The population is first divided into separate groups of elements which is called as clusters, H1, H2, H3, H4, H5. A sampling from the hospitals in service in different cities, eager to provide data and known as the best in their cluster, is generated. As some hospitals demanded during the negotiations, the clusters they belong to are mentioned instead of their names. Table 3 -Hospital Characteristics in each Cluster Cluster Total Staff (approximately) Total Branch Is there a department for foreign patient? Informant H1 7500 17 Y Hospital Director(M.D), Professor of PhysicalMedicine andRehabilitation H2 450 1 N Director of Quality Department, Head of Nursing Department, Emergency Doctor(M.D), Emergency Nurse, Senior Staff of Public Relation H3 800 4 N Medical Director(M.D), Manager of Human Resources H4 1600 1 N Head of Nursing Department, Emergency Doctor(M.D), Emergency Nurse, H5 More than 10.000 1 N Emergency Doctor1(M.D), Emergency Doctor2(M.D), 3.2. Problems with patients who do not know Turkish In some regions of Turkey, there are people who do not know the native language. We see that usually a relative or a friend of the patient help the communication as a translator (H1 Professor of PhysicalMedicine andRehabilitation). During the deep interviews with H3 Medical Director, he says: â€Å"Citizens from the eastern region of our country, and immigrants from Iraq, Afghanistan, and Africa come to hospital when they are ill, with a relative or a friend of them; and we intervene the patients with the translation of these people.† The process goes on in two ways for the non-citizen patients. If the patient can speak English; as the public relations, nurses or the doctor can, the communication is established with the help of staff. But if the patient speaks a language other than the staff can do, then a translator is required. Hospital Director in H1 hospital stated that: â€Å"The number of our foreign patients that become ill in Turkey is less than the patients that was ill before coming to Turkey. We sent our doctors to other countries and enable them to meet doctors working in clinics and hospitals. In the next step, foreign doctor sends his/her patient to us. Before the patient arrives, we get the tests and diagnosis applied to the patient. We meet the patient at the airport and accommodate the patient according to his/her economic welfare. All the transportation and other needs of the patient are met by our department established for this purpose. Taking into consideration the countries most foreign patients come from, we employ that staffs who know their language. Because the number of foreign patients in H1 hospital is more than other private and public hospitals, many applications were developed in accordance with the needs. For example, if the patient gets lost anywhere in the hospital and shows the card given to him/her to any hospital employee the problem is solved. â€Å"In the frame of JCI accreditation, the patients and employee are not asked to identify themselves according to their room number. For the probability of being lost in the hospital mostly used sentences takes place in Turkish and in the language of the patient. When patient shows his or her need in own language, the Turkish translation takes place under it then the communication is established.† In H2, H3, H4, H5 hospitals, patients usually come after they get ill in Turkey. Quality manager of H2 hospital: â€Å"Our patients usually come us after an illness in Turkey or according to the recommendation of their acquaintance who were satisfied from our service. Among our patients, there is a group which establishes contact with us before they come to examination and shows the previous cure documents, and the other group comes without any plan or foreknowledge.† In 2007 the distribution of the foreign patients came to H2 hospital is as follows: Many demographic features of the patients are: 64% are men and 36% women. 52% paid cash, 26% used assurance and 21% cured for free by the hospital. Foreign patient level in all hospitals is about 1%. If we consider the graphic which Hofstede(2005:191) has drawn according to the cultures of the countries; The patients coming to H2 hospital take place in all four areas. These patients took service in 15 different departments. In communication with these patients, proxies were used. In 2007 H1 hospitals foreign patients came from 69 different countries such as Afghanistan, Argentina, Germany, Angola, Albania, Austria, Azerbaijan, Kazakhstan, Russia, UK, USA, Canada, Finland, Czech Republic, India, Iraq, Iran, Vietnam, Uruguay shortly all quadrants of Hofstedes culture dimentions. In literature LEP (limited English proficiency) concept is used but limited Turkish proficiency, limited Arabic proficiency, limited Chinese proficiency are also problem. When we look at the problems about the culture and language, the cases in USA and Europe countries are common for all countries and should be solved in all countries. In mostly used method, using proxy, the main problem is the transfer of the knowledge. Knowledge changes while transferring from one place to another, so knowledge can not be transferred but translated. For example; in communication with simultaneous translation the question of Turk doctor â€Å"Neyin var?† is translated as â€Å"what is wrong?†or â€Å"obligation† word is used. But the purpose here is to ask â€Å"What seems your chief complaint today?† In the article of Holden et al(2004) which includes usual examples, the following part takes place: â€Å"For example, Japanese speakers of English are influenced by the notions of politeness. Rather than categorically refusing a request, Japanese might say: ‘Ill think about it (which means â€Å"there is no way I am going to do anything about it.; or, often with a great sucking of breath between clenched teeth: ‘Thats very difficult, meaning that something is a sheer impossibility.† 3.3. Specific Situation Patient Name : Y.S. Year : 2008 Age : 48 Nationality : Greece â€Å"The patient comes to Bursa because of the dead of a friend of him. He goes to emergency with stomach ache. He is alone. The patient speaks English and Greek. After he turns to information desk, he is taken to the emergency doctor. The emergency doctor knows only Turkish. A professional interpreter is called. Patient tells the interpreter that when he first comes to the emergency he could not express himself to the hospital employee and he needs immediate cure. In addition, he says that he was depressed even before the therapy and if he didnt have to, he would not come to a Turkish doctor.†(Interpreter, H2 hospital Emergency Doctor(M.D), Emergency Nurse, Senior Staff of Public Relation) As we can understand from these expressions the patient has a negative point of view against Turkey because of the dreary events between Turkey and Greece in the past. This point of view is considered as a code given form the society he lived since his childhood [18] As the patient has to wait despite the emergency, he uses accusatory expressions. He says that â€Å"the doctor in the emergency is young and inexperienced†. That the translator is easy-going and that he mentions the negative behaviors of the patient after the examination has been an important factor in the success of the treatment. â€Å"After the therapy blood test and abdominal USG are demanded. Then gastroenteritis is diagnosed and his prescription was filled.† (Emergency Doctor) â€Å"After making a good bargain, patient lowers the price and pays in cash.†(H2 Director of Quality Department) Because of the proximity of a less individualist society and relatively low prices in Turkey, the patients says that he also has a tooth ache and wants to see the therapy room for teeth. After seeing the room he takes a tooth therapy, as well. 4. Solution In this article we stated that knowledge is translated not transferred. Culler(1982) states that â€Å"every understanding is a misunderstanding.†[4]. If every understanding is a misunderstanding then communication between different cultures using different proxies is a distorted understanding. To establish the communication in mother language gains importance. â€Å"Communication between physicians and patients is fundamental for medical care.†(Joos et al.1996, cited in Lee et al. 2003). The solutions are developed in a way that the patients take less time of the proxies. Physician reads the report in his/her own language both audibly and visually, and may also provide videos and audios in the language of the patient[5,19]. The method developed in the scope of this article is a little more different. Native speaker doctors prepared the questions for diagnosis in their own language as well as the answers to such questions. Until the diagnosis the patient chooses the questions in own language then physician and patient gets the printouts in their own languages. The forgotten point in the developed audio and video based system is, while answering physicians question without the system patient uses own language and physician does not understand. Videos are important in one-way communication as giving information about how the test will be done like as urine test. How can we solve communication problems between foreign patient and doctor? Can XML be a solution? XML is defined by the W3C: â€Å"Extensible Markup Language (XML) is a simple, very flexible text format .Originally designed to meet the challenges of large-scale electronic publishing, XML is also playing an increasingly important role in the exchange of a wide variety of data on the Web and elsewhere† (http://www.w3.org/XML) We can use xml for information transfer from one language to another one. We use transfer because native speaker doctors prepared the questions for diagnosis in their own language as well as the answers to such questions. Foreign patient and doctor use software in their own language, culture and words. Foreign patient and doctor information transfer process can be modeled as below: Both foreign patient and the doctor can see every question in their native language and culture. 4.1. Software This software can support all languages. When we add a new language program XML file is extending. When we add a new language it will be located in this section: en de tr fr new language code I have only migraine data for testing software in Turkish, French, German and English languages. Lets think that our doctor is a Turk and patient is a French native speaker. Doctor select question in his/her native language â€Å"Ã…Å ¸ikayetiniz nedir?† and patient see this question in his native language â€Å"Quest ce quil vous arrive ?†. CultureStr for doctor is â€Å"tr† and for patient is â€Å"fr†. If we add a new language this section will be extend. and . Screen shot: 5. Conclusion Translations done by ad hoc interpreters and professional interpreters who does not know patients culture are equivalent according to the transfer of the knowledge but are not equal. Because of this, these are the translation of knowledge rather than transfer of knowledge. Our solution can be a solution for knowledge transfer problems and limited all language proficiency. What we need is only questions for every complaint, what doctor are asking to their patients. It is not easy but if we do this, a visit to a foreign country will be much safe and a patient will have a chance to chose his/her doctor in which country he/she wishes. Every understanding may be a misunderstanding because what we understand may be different from what is said by others. We understand equivalent of what said by others, not equal. By this project we are trying to extend understanding. As we mentioned before according to varied resources 80% of the medical mistakes are caused by wrong information (wrong information transfer). If we extend enough equivalent it will be nearly equal, at this point medical mistakes will decrease. 6. Acknowledgement We gratefully acknowledge the support of Yalà §Ãƒâ€žÃ‚ ±n Aytek ÃÅ"stà ¼ndaÄÅ ¸, Asst. Prof. Dr. Mehmet Erà §ek, Didem Parlak, Ä °smail Cahit Gà ¶rmez, Asst. Prof. Dr. Melike Ã…Å ¾ahiner, Asst. Prof. Dr. Ã…Å ¾ule ÃÆ'-ncà ¼l, Prof. Dr. Zeynep Gà ¼ven, Dr. Demet Dinà §, Dr. ÃÆ'-mer AydÄ ±n, Dr. ÃÅ"nal Egeli, Senem Kayas, Dr. Suna YÄ ±ldÄ ±rÄ ±m and Onur Uslu. 7. References [1] Alexander B., Perneger TV., Bovier PA., Loutan L., and Stalder H. Improving communication between physicians and patients who speak a foreign landuage. British Journal of General Practice 2003: 53: 541-546 [2] Alexander B. and Hudelson P. Communicating With Foreign Language- Speaking Patients: Is Access to Professional Interpreters Enough? Journal of Travel Medicine 2009: 1-6 [3] Collins KS., Hughes DL., Doty MM., Ives BL., Edwards JN., and Tenney K. Diverse Communities, Common Concerns: Assessing Health Care Quality for Minority Americans. Findings from the Commonwealth Fund 2001 Health Care Quality Survey. New York: Commonwealth Fund. [4] Culler J. On Deconstruction, New York: Cornel University Press 1982. [5] Galvez E and Stronks A (2007) â€Å"Hospitals, Language, and Culture† Joint Commusion International(http://www.jointcommission.org/NR/rdonlyres/E64E5E89-5734-4D1D-BB4D-C4ACD4BF8BD3/0/hlc_paper.pdf Last accessed Agust 2009) [6] Gale DD. Cultural Sensitivity Beyond Ethnicity: A Universal Precautions Model. The Internet Journal of Allied Health Sciences and Practice 2006:4(1):1-5 [7] Holden NJ. and Kortzfleisch HFOV. Why Cross- Cultural Knowledge Transfer is a Form of Translation in More Ways Than You Think. Knowledge and Process Management 2004: 11(2): 127-136 [8] Joint Commition International. http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_25.htm Last accessed: June 2008 [9] Joos SK., Hickam DH., Gordon GH., and Baker LH. 1996. Effects of Physician Communication Intervention on Patient Care Outcomes. Journal of General Internal Medicine 11(3): 147:155 [10] Karliner LS.,JAcops AE, Chen AH and Mutha S. Do Professional Interpreters Improve Clinical Care for Patients with Limited English Profeciency? A Systematic Review of the Literature. Health Service Research 2007: 42(2): 727-754 [11] Kohn LT. Methods in Case Study Analysis( Panel discussion conducted at the 1996 meeting of the Association for Health Services Research) 1997. [12] Lee SM. A Review of Language and Other Communication Barriers in Health Care. Office of Public Health and Science 2003. [13] Packard, C.Finding Links between Healthcare Safety, Communication, and Cultural Norms and Assumptions. Carle Selected Papers 2009 Vol.50 No.2 : 55-58 (http://www.carleconnect.com/CSP/CSP%20Fall_Winter%2007/13.Packard.pdf Last accessed Agust 2009) [14] Perloff RM., Bonder B., Ray GB., and Ray EB. Doctor-Patient Communication, Cultural Competence, and Minority Health. American Behavioral Scientist 2006: 49(6): 835-852 [15] Vatrapu R., and Suthers D. â€Å"Culture and Computers: A Review of the Concept of Culture and Implications for Intercultural Collaborative Online Learning. IWIC 2007: 260-275 [16] Hofstede G. And Hofstede GJ. Cultures and Organizations Software of the Mind. McGraw-Hill. 2005 [17] Yin, R.K.Case Study Research, Design and Methods, 2nd ed. Newbury Park, Sage Publications, 1994. [18] Hostede G.and Hofstede GJ. Cultures and Organizations: Software of the Mind, Second Edition, McGraw-Hill, New York, 2005. [19] http://pgsi.com (Last accessed Agust 2009) 8. Corresponding Author Serkan Tà ¼rkeli, AcÄ ±badem University, Faculty of Health Sciences, Department of Healthcare Management, Istanbul, Maltepe, Turkey,Tel:(0090) 505 488 84 45, Fax:(0090) 216 589 84 85 E-Mail:[emailprotected], Web:www.nasnim.com/serkanturkeli

Thursday, September 19, 2019

Meg Bogins The Women Troubadours Essay -- Meg Bogin Women Troubadours

Meg Bogin's The Women Troubadours What is Bieiris de Romans’ speaker seeking from the woman, Maria, about whom Bieiris writes? More generally, what are female troubadours as a whole seeking from their loves, and their craft? Meg Bogin, in her The Women Troubadours, asserts that â€Å"their poems were addressed to women†¦ to whom they vowed eternal homage and obedience. In exchange for their prostration, the troubadours expected to be ennobled, enriched, or simply made ‘better’† (Bogin, 9). Is the poetry of female troubadours less about the women being addressed and more about the troubadours themselves? By performing a close textual analysis of Bieiris de Romans’ poem to Maria, I hope to elucidate some possible answers to these questions. The poem opens with Bieiris’ speaker addressing her subject as â€Å"Lady Maria.† Rather than merely employing the woman’s first name, or utilizing a possessive phrase such as â€Å"my love† or â€Å"my Maria,† the speaker addresses her as â€Å"lady.† This implies a certain bestowal of respect upon her subject, and is potentially also a means to convey an understanding on the speaker’s part that this Maria has not yet consented to be hers. Next, the speaker proceeds to enumerate copious qualities that she finds pleasing in Maria. She begins by praising Maria’s â€Å"merit and distinction.† By â€Å"distinction† we can safely assume that the speaker refers to a pleasing reputation that Maria has cultivated within society, and possibly also the speaker’s own opinion that Maria is able to be distinguished as superior to other women. The term â€Å"merit,† however, is relatively ambiguous. By â€Å"merit,† the speaker could be indicating one or many qualities, including, but not limited to, virtue, achievement, a... ...g female companion, who will comply with her wishes and desires. Thus, Maria, judging from the qualities attributed to her in the poem, seems a perfect target for Bieiris’ speaker’s affections. Bieiris also appears to have created a speaker who is more concerned with being given the ability to express her desires than with the woman about whom those desires are expressed. Maria seems to be utilized as somewhat of a passive vessel about whom Bieiris can write and express herself in a literary fashion. The desire that Bieiris succeeds in expressing, then, is less one for Maria in particular and more one for composing lyric poetry in general. As a troubadour, Bieiris most likely avidly seeks patronage. Thus Maria is less of a goal to achieve and more a means to a different end: composing poetry for the sake of procuring a reputation, and obtaining financial gain.

Wednesday, September 18, 2019

jimhf Huck and Jim’s Relationship :: Adventures Huckleberry Huck Finn Essays

Huckleberry Finn and Jim’s Relationship Throughout The Adventures of Huckleberry Finn, Mark Twain illustrates the bond formed between Huck, the young white protagonist, and Jim, Huck's black companion. Huck's father Pap, while he was still alive, had beaten Huck repeatedly, kidnapped and scared his son to the extent, that Huck, out of fear, feigns his own death to escape Pap's grasp. While Huck and Jim travel down the river it becomes apparent that Jim is more of a father figure to Huck than his biological father. Pap teaches the virtues of a life not worth living, while Jim gives Huck the proper fatherly support, compassion, and knowledge for Huck to become a man. Although Huck and Jim come from separate racial backgrounds their time together allows them to surpass their ethnic segregation and become true friends, and family. A father's attributes are meant to be examples for which his offspring can base their own lives. Pap attains non-of these attributes. Pap is an ignorant drunkard who attempts to swindle and scam any possible person. He goes so far as to even filch from his-own son. Pap views Huck as someone upon whom he can assert himself. He attempts to drain Huck of all characteristics that would make Huck superior to himself. "You're educated, too, they say; can read and write. You think you're better'n your father, now, don't you, because he can't? I'll take it out of you... Ain't you a sweet-scented dandy, though? A bed; and bed-clothes... and your own father got to sleep with the hogs... I bet I'll take some o' these frills out o' you before I'm done with you."(21-23) Pap is no father to Huck, he berates, kidnaps, and beats his own son with no remorse. The only lessons that Huck learns from Pap are what not to do with his life. He's seen the draw-backs of alcohol, stealing, and other such elicit actions that his father has performed. Pap is a low down dirty scoundrel who wishes nothing but the worst for his-own son. While Pap acts as an anchor on Huck's heel, Jim opens up a new world for Huck, and becomes his companion and a resource of knowledge.

Tuesday, September 17, 2019

Cognitive Behavioral Theory Essay

Cognitive behavioral therapy (CBT) is a short-term, problem-centered therapy that is used to address psychopathology within the individual (Beck, 1995). This model of therapy is used to address issues of depression, anxiety, eating disorders, relational problems, and drug abuse, and can be utilized when working with individuals, as well as within group and family modalities. The core aspects of this therapy include collaboration and participation by the client, a strong alliance between therapist and client, and an initial focus on current problems and functioning (Beck, 1995). The theory of CBT emphasizes the relationship between the individual’s thoughts feelings and behaviors, which is seen as being the underlying cause of psychopathology in individuals. Therefore, this theory asserts that the identification, evaluation, and modification of one’s negative thoughts will lead to an improvement in one’s mood and behaviors (Beck, 1995). It is important to understand the concepts and theory from which CBT is based in order for it to be efficiently implemented in therapeutic work with individuals, groups, or families. While CBT is used to treat psychological disorders, this theory can be examined by looking at the thoughts, feelings, and behaviors of individual’s with an absence of psychopathology. Beck (1979) and Beck (1995) present the cognitive model in order to explain the theory of CBT. The cognitive model demonstrates that the emotions that an individual experiences and the behaviors that they exhibit are a result of their perception of a situation or event (Beck, 1995). When in any given situation, an individual’s immediate thought response is their automatic thought (Beck, 1995). These thoughts are an immediate evaluation of the situation, which in turn directly influence the feeling that a person has about the situation. Automatic thoughts are experienced by everyone and occur in the individual’s mind prior to reasoning. These thoughts occur swiftly and often times the individual may be unaware that they have occurred, being more observant of the emotion that they are feeling in the moment (Beck, 1995). Once an automatic thought occurs within the individual, it triggers a feeling, which in turn triggers the individual’s response, such as a behavior and/or physiological response. For example, after a young child begins to pick up his blocks to be put away, his mother rubs him on the back and gives him praise for his actions. His automatic thought may be, â€Å"I am good when I put away blocks,† triggering a feeling of confidence, an increased level of physical energy, and the behavior of putting away the remaining blocks. Automatic thoughts can be neutral, positive, or negative. We all have our own automatic thoughts as we move through our day-to-day lives and interact with others. In regards to individuals with psychological disorders, the cognitive model looks at how negative thoughts influence the individual’s feelings and behaviors (Beck, 1995). From a CBT lens, it is the negative automatic thoughts that an individual has that perpetuate symptoms of psychological disorders, the occurrence of negative mood, uncomfortable physiological responses, and maladaptive or inappropriate behaviors (Beck, 1995). While we all have moments of experiencing negative automatic thoughts, for those with psychological disorders, and more pervasive difficulties in living, negative thoughts are often experienced in situations that are neutral, producing negative feelings that lead to maladaptive behaviors or responses that would not typically be expected from the neutral situation (Beck, 1995). Aaron Beck presents theory of the cognitive model of how depression is rooted and perpetuated in individuals as a result of the interaction between negative automatic thoughts, feelings, and behavioral response. In this discussion, depression is conceptualized in terms of the cognitive triad, which describes three components of negative thinking of the depressed individual: the individual’s negative view of self, their negative view of the others and the world, and their negative view of the future (Beck, Rush, Shaw, & Emery, 1979). The cognitive triad is maintained via the remaining components of Beck’s cognitive model of depression, the individual’s schemas, or core beliefs, and the utilization of faulty thinking, or cognitive errors (Beck, Rush, Shaw, & Emery, 1979). Cognitive theory asserts that our automatic thoughts are rooted in our core belief system or cognitive schemas. Core beliefs begin to be developed early in life and are based on experiences that the individual has throughout their life. Because these beliefs are so grounded in how the individual views their life, others, and the world, and begin to be cultivated so early in development, they become a fundamental aspect of the individual, who considers them to be absolute truths (Beck, 1995). Core beliefs are deeply rooted in an individual, so much so that the individual may be unaware of the belief and how it influences their thoughts about themselves and the world. Each belief can have varying levels of presence within an individual’s day to day life, with some core beliefs remaining predominately dormant and only being activated in certain situations, while others may be frequently present in an individual’s thoughts (Beck, 1995). It is the individual’s cognitive schemas that allows for the categorization and evaluation of different experiences or situations (Beck, Rush, Shaw, and Emery, 1979). The core belief system maintains the way an individual experiences and thinks about a given situation (Beck, Rush, Shaw, & Emery, 1979). While everyone conceptualizes a given situation in their own way, each individual typically conceptualizes similar situations in a similar way based on their own core beliefs (Beck, Rush, Shaw, and Emery, 1979). Within a set of similar situations, the individual’s core beliefs trigger automatic thoughts, which in turn trigger the individual’s emotional and behavioral response. Over time, the individual’s responses to similar situations become more consistent, thereby causing the development of a routine response to these types of situations. As this consistently occurs, the schema connected to particular type of event is further developed and the individual’s assertion that the belief holds absolute truth is strengthened (Beck, Rush, Shaw, & Emery, 1979). Beck’s theory underlying CBT focuses on the idea that symptoms of depression, as well as those of other psychological disorders, are developed and maintained through to the individual’s negative core beliefs and triggered negative thoughts. In addition to the individual’s negative schemas, Beck’s theory states that the cognitive triad of negative cognitions of self, others, and future is further perpetuated through patterns of faulty thinking (Beck, Rush, Shaw, & Emery, 1979). There are a variety of faulty thinking mechanisms that are used by individual’s to support their automatic thoughts and core beliefs, even in light of contradictory evidence (Beck, Rush, Shaw, & Emery, 1979). This type of thinking can be characterized as labeling, over generalizing, personalization, emotional reasoning, magnification or minimization, and all-or-nothing or impetrative thinking (Beck, 1995). These cognitive errors are often extreme and unrealistic ways in which the individual assesses and draws conclusions regarding their problems, which is then used to further support their negative belief system and automatic thoughts. CBT theory declares that the individual can learn to identify their automatic thoughts, thereby creating an avenue for changing the emotions, behaviors, and psychological responses to various situations. When utilizing CBT with a client, it is necessary for the therapist to conceptualize the individual’s presenting problems from the perspective of the cognitive model (Beck, 1995). This can be done through the work of gathering information regarding the individual’s current problems, diagnosis, and how the problems have been developed and maintained. As this information is collected, the CBT therapist begins to assess and identify the inaccurate and unhelpful thoughts connected to the problems, and the behaviors that are exhibited as a result of this thinking (Beck, 1995). As this is done, the therapist can then begin to guide the individual to identify, examine, and correct or modify the negative automatic thoughts, underlying core beliefs, and faulty thinking mechanisms that have sustained the presenting problems (Beck, 1995).

Monday, September 16, 2019

Example Solution Manual: exploring strategy text & cases

A key danger to highlight is of long lists of forces or influences that are too unwieldy for practical action. So the second question challenges students to assess which of the forces are likely to be of most significance in driving Industry change. Here students should justify their views In terms of the evidence from the past and the likely Impact In the future of any particular Influence. The end-chapter case example on the European brewing Industry also asks students to do a PESTLE analysis. Illustration 2. Scenarios Scenarios help students think long term and very broadly: here the World Economic Forum and its members are looking a decade ahead, and thinking about gee- economics in general as well as just the market in a narrow sense. The question asks about whether companies have more influence over government policy or gee- economics. It then goes on to ask about how companies might influence government. This also obviously touches on issues of corporate social responsibility, pursued in Chapter 4.Companies probably do have more influence on policy coordination, but the Issue Is which governments they should be talking to (the united States, China? ) and whether It Is only governments that matter (United Nations, International Monetary Fund, World Trade Organization? ). They should also consider how they can best Influence governments, Individually or collectively through, for example, the World Economic Forum or the Business Roundtable, the group of Coos of leading American corporations.To some extent, the power is likely to be exercised negatively: through lobbying against and criticism of proposals for financial re-regulation. It is worthwhile also asking about the influence these corporations can have themselves on gee-economic shifts: some Western company headquarters are shifting away from their home-countries, for example, the global headquarters of American civil engineering conglomerate Hallucination moved to Dublin and Swiss/Swedish engineering company ABA moved its global robotics business headquarters to Shanghai. Illustration 2. The Steel Industry The steel Industry provides a fairly easy-to-understand case of rapid structural change, and one led by industry actors. Understanding how the leading companies in other words, a sense that structures are given rather than changeable. The first question particularly invites a comparative analysis using the radar-plot introduced in Exhibit 2. 5. The radar-plot might look roughly like the following, with the mutinous lines indicating rough positions in around 2000 (10 years earlier than the illustration) and the dotted lines indicating positions in 2010.The comparative positions highlight the increasing power of suppliers such as the iron ore producers (negative); the high power of sophisticated buyers, somewhat mitigated by the declining power of the Big Three (mildly positive perhaps); and the beginning of decreased rivalry (positive) as the larger steel companies such as Imi tate try to consolidate the industry. It might be said that the new entry threat has stabilized and even reduced, though continued investment by Chinese players may increase rivalry especially if they turn to overseas markets.Overall, comparing the size of the two radar plots over time suggests only a marginal change in favor of the steel producers. With regard to the second question, the acquisition strategies seem driven by the desire to reduce rivalry by reducing the number of players and even capacity. You might ask students what is necessary to make this work: here you might highlight the importance for reduced rivalry of both simultaneous cuts in capacity investments by, for example, the Chinese and strong barriers to new entry. With Edgar to the third question, success in raising barriers to entry (e. . Through technological change) and in reducing rivalry (through continued consolidation) would make the industry more attractive. Vertical integration strategies into sources o f supply (e. G. Iron ore) would help too. A potential negative is significant progress with substitute materials. This depends on technological progress, hence providing a useful link between the Porter 5 Forces and PESTLE. Illustration 2. 4 Chugging in the Charity Sector The aim of this Illustration of course is to show that industry structure analysis is elevate to not-for-profits as well.Indeed, charities appear ruthlessly competitive – hence the High Street chugging. The first question points to at least three of the Praetorian forces as causing problems: (I) There are low barriers to entry, with ‘constant refreshment' of the industry by new charities; (it) there is strong buying power on the part of local authorities commissioning services; (iii) there is intense rivalry because of the number of competitors and tendency towards overlap and duplication of charitable services.In addition, they face substitutes in the form of coal authorities and other agencies perfor ming services in-house, but at this point the trend in that respect was in their favor. The suppliers of funds – donors – have many alternative charities to give to. The mergers and increasing concentration levels (the largest are growing fastest) imply growing industry consolidation. At the moment, the industry structure might be described as highly competitive, but there may be widespread advantages to it moving towards a more oligopolies situation. Illustration 2. Cycles of Competition The Wisdom' in strategy theory has been that competitiveness is about building up a Eng-term competitive advantage and then defending it against competitors. The idea industry will work its way out over time. It also highlights the potentially destructive nature of competition (at least from the point of view of industry players) and the value of trying to avoid it. Indeed, a key point is that these competitive cycles are not inevitable. Signaling to competitors, and interpreting the signals of others' competitive moves, can help avoid head-on competition.Retaliation (Section 2. 3 under barriers to entry) is a key principle here, as are the basics of game theory (Chapter 3). With regard to question 1, Francesco might have slowed down or rebuffed entirely Deceptiveness's invasion of the French market by retaliating hard against its initial move: even though the youth niche was not so important to Francesco, a determined response there would have signaled the likelihood that attacking the core French market would be so fiercely opposed that it might not be worth Deceptiveness's while even to try.With regard to question 2, Francesco would have been hard-pressed to avoid escalating competition in the business market. However, one possibility might have been for Francesco to focus on a particular selected niche (say the small firms segment). By signaling clearly through advertising or similar that this niche was the extent of their ambitions, Francesco might have enc ouraged Descriptive to concentrate on its best opportunities, leaving the French get on with their specialist in peace.Illustration 2. 6 Key Debate: How Much Does Industry Matter? This debate addresses an enduring source of controversy in strategy research, and allows students to review the importance of the contents of Chapter 2 (particularly the five forces'), at the same time as introducing the more internally focused issues of Chapter 3 that follows. For Porter, industry matters a lot. The aseptic might argue ‘he would say that, wouldn't he'?After all, this is exactly what his training in industrial economics and the standard products of his consulting firm would favor. However, the important thing here is to recognize the extent of the research he (and collaborators such as Anita McGowan) draw upon to make their case. It is worth pointing out to students that strategy theories are more than ‘Just theories': there is solid empirical research involved too. When meetin g a new theory, students should et used to asking: where is the research evidence?What the research seems to suggest is that an industry is not the be-all and end-all, but that choosing an attractive industry is a very good starting point in strategy: industry accounts for about two-fifths of the explained variance in the Porter and McGowan study (leaving aside control variables etc. ). Turning to the precise question, the kinds of industries that influence members' profitability's more than others seem generally to be service industries (explaining the greater industry effects in the Porter and McGowan study than in Runlet's).But to go on from here, industry influences are most likely to be strongest in highly competitive and mature industries. In such industries, sources of firm-specific differentiation are likely to be few, easily imitated and easily competed away, so making it hard to earn above-normal profits. At the same time, standard recipes for competing would have been est ablished, so only the incompetent would perform substantially below the norm (and competition should have eliminated most such incompetents by the industry maturity stage).These conditions would probably prevail in service industries such as hotels, restaurants and retail. Newer industries commodity competitors and suppliers, so allowing persistent variability in profitability. Video Questions Hoicks Hoicks is a specialist insurer in the Lloyd of London insurance market. The company specializes in niche areas such as property and casualty insurance for high net worth individuals and companies, as well as cover against such risks as hacking, kidnapping and satellite damage. The video case is quite complicated, so best viewed after a thorough working through of the chapter material. . The industry is facing more buyer power, with the rise of online price comparison sites. On the other hand, there is a process of consolidation with the rise of ‘consolidators' (companies such as R esolution), who are acquiring weaker companies in order to build position. This is likely in the long term to reduce rivalry. Major failures such as that of the American giant Alga (American Investment Group) are likely to reduce rivalry too. It is clear that general recessionary pressures are also influencing the market at the time of the video, reducing demand and likely to make it more price-sensitive. . Hoicks has a specialist position, aside from companies like Alga or the general insurers that Resolution is trying to buy, and its power in its niche is reinforced by its brand (well known in the United Kingdom). It also has the advantage of having both an underwriting (issue of insurance policies) and investment business, which mean that Hoicks is protected from short-term cycles or crises in one part of the business, probably helping to buffer it from price competition in the short term too. Assignment 2. PESTLE Analysts PESTLE analysis is a useful starting point for environmen tal analysis. Illustration 2. 1 provides a model. A ‘blank of the basic template of illustration 2. 1 can be provided to dents who can then be asked to complete it for the forces at work in a particular industry. The danger is that long lists of forces or influences can be generated by this device. So the second question challenges students to assess which of the forces are likely to be of most significance in driving industry change.Here students should justify their views in terms of the evidence from the past and the likely impact in the future of any particular influence. See the discussion of the PESTLE for the end- chapter case on the European brewing industry for an example. Assignment 2. 2 Building Scenarios Assignment 2. Requires students to focus on change in industry characteristics and competitive forces through the construction of scenarios. Guidelines for the construction of scenarios are given in Section 2. 2. 2 it is recommended that students follow these, buil ding either two or four scenarios for a given industry.The work done in Assignment 2. 1 should provide the bases of identifying the key industry forces or influences which will enable them to do this. Some of the problems of scenario building should be emphasized to students: Students may try to build in too many factors and, therefore, not be able to limit the number of scenarios. They may find difficulty in generating scenarios with a coherent and compatible set of factors. Some may be wary of having to exercise Judgment; and others will confuse Judgment with hunch.Try to encourage a realistic debate that tests out assumptions and students to build scenarios for an industry for which there is a company case (or for their own industry/company if possible) and then to assess the company's strategic position in the light of the different scenarios (e. G. See the notes above on the brewing industry). One of the issues that might surface is the ease or difficulty with which scenarios c an be constructed. It usually emerges that scenarios are much easier to construct where the number of key forces at work in an industry is relatively few.They are less easy to construct if the number of important forces is high because the number of variables the student is trying to handle becomes too great. This, in turn, raises another issue. Scenarios are of particular use in uncertain environments as a means of helping managers to think through possible futures. However, uncertainty may arise for a number of reasons. If uncertainty arises because of the unpredictability of a few forces, then arguably scenarios may be very lawful, but what if uncertainty arises primarily because there are a large number of forces at work: to what extent are scenarios of use in such circumstances?There are a limited number of very important forces at work in the brewing industry: but what of fast-moving hi-tech industries where there are many different forces at work? Assignment 2. 3 Five Competi tive Forces Five forces analysis is an absolutely fundamental technique in strategy. Section 2. 3 should give students the ability to carry out a basic five forces analysis of any industry. They should be encouraged to consider all of the elements of each of the vive forces: so for example, under barriers to entry, scale and experience effects, channels, retaliation and so on.The radar-plot technique of Exhibit 2. 5 should only be used as a summary once the full analysis is complete; the danger is of it being used to short-circuit the analysis. Students should be expected to do more than simply list elements; they should clearly identify the implications (positive or negative) of each. The second question about conclusions for industry attractiveness should underline the importance of drawing out implications, rather than Just listing. Assignment 2. 4 Comparisons between Industries and Over Time This assignment allows students to build on Assignment 2. In order to consider the inves tment implications of differences between industries and change over time. The assignment is a substantial one if relying on students' own research. However, time can be saved if two case studies are used (e. G. Brewing, pharmaceuticals or hi-if, perhaps looking backwards at change over the past three to five years, rather than change in the future). Similarly, students may save time by using the radar-plot technique (Exhibit 2. 5), as in the discussion of Illustration 2. 3. It is important to note the two follow-up questions.Explicitly asking for Justification helps students avoid the superficial analysis which is easy to do with five forces. Asking the question about investment helps students think about concrete implications, again something that five forces analyses often neglect. By looking over time, students will learn to be cautious about investing in industries with declining attractiveness. By comparing industries, students can also consider industry attractiveness in thei r diversification decisions, an issue picked up in Chapter 7.At the same time, it is worth countering attractive are likely to have high barriers to entry, so the costs of entry may outweigh the benefits of entering. An industry that is becoming relatively unattractive may be neglected by competitors, and, if you enjoy a strong competitive advantage in that industry, it may still be a source of profit to you. Assignment 2. 5 Strategic Groups This assignment builds on the notion of strategic groups and strategic space outlined in Section 2. 4. 1 in the text. Figure 2. 8 provides an example of how the exercise could be carried out.This could, for example, be applied to the European brewing industry: Key strategic dimensions might come under either of the scope or resource commitment characteristics in Section 2. 4. 1 – for example, product range or extent of vertical integration. Possible key strategic dimensions in the European brewing industry might include geographical cover age, strength of brands, diversification, size of firm, type of distribution, and so on. Students are encouraged to draw more than one strategic group map if they believe that more than two dimensions are important.It is useful to ask them to consider the extent to which different bases of such maps give rise to similar or different configurations. They might find, for example, that however the maps are drawn up, some companies always tend to end up in the same groups. In other words, some companies may have a very similar set of strategic characteristics along many dimensions. Students are asked to examine the strategic group maps to see if there are any under-populated White spaces' in the industry.For example, in brewing, is there an opportunity for a giant specialist in making ‘own brand' beer for the large retailers? However, students should assess carefully why there are few competitors in any such white spaces. White spaces can often turn out to be dangerous ‘blac k holes' rather than attractive opportunities. Assignment 2. 6 Critical Success Factors and the Strategy Canvas It is very likely that students will concentrate on success factors that are salient to them as consumers – for example, the product ranges of a clothing retailer.Less visible elements, such as ownership by a diversified parent company, may be neglected. However, for a short assignment, this need not matter too much: the essence is comparison in order to identify areas of (potential) competitive advantage. The key insight of a strategy canvas is to encourage competitors to compete where it s relatively easy to secure a significant advantage (Blue Ocean), and not necessarily to compete fiercely over the top-rated success factors if advantage can only be obtained at very considerable cost (Red Ocean).You can introduce less visible, but strategically significant elements after they have done their basic analysis. Integrative Assignment Full Analysis of an Industry or a Sector This assignment would be a demanding research project over a significant part of the course. It is however a very good test of students' ability to apply tools to real data appropriately, as well as developing their research skills. Students will see it as practical and, if allowed a choice of sectors, relevant to their own interests. Good research resources are essential.As well as free web-based resources such as company reports, trade association statistics and some government or supra- access resources such as the business press and Journals available through Businessperson Premier, Fictive or Prosiest, and reports from organizations such as Remuneration, Key Notes and Minute. Your institution's librarian will advise you on what is available to students and how proficient they are likely to be in using such resources. You would also want to guide students on which industries or sectors to choose.Very broad industries – for example, the world airline industry †“ are likely to overwhelm students with data. It might be helpful to encourage focus – for example, the airline industry in India, or similar. Industry focus also reduces the risk of plagiarism. There are many student assignments of a similar nature available for a fee on the web, and it would definitely be wise to avoid allowing students to research the same industries in successive years. Requiring a specific focus on particular homes (e. G. Internationalization) or some less common concepts (e. . The strategy canvas, cycles of competition etc. ) can also reduce plagiarism. Insisting on precisely citing sources for key data and points (through an end-note system or similar) makes simple plagiarism harder too, as well as being good practice. If allowed, students will find very helpful a couple of example assignments from previous years to guide them roughly on what they are supposed to do. A report length limit of around 2000-2500 words would encourage students to focus on what is really important.Requiring an executive summary would also force students to consider what is really important and what are the key implications. Over a two semester course, this assignment could be stage one of a two-part assessment regime; the second semester could have as an assignment asking students to consider implications of the first part for the strategy of a particular company in the original industry or sector. Case Example The European Brewing Industry This case focuses on the key techniques of PESTLE and five forces analysis that are central to this chapter.Full cases such as the pharmaceutical industry can be used evolve students' skills in seeing trends in industry data and drawing conclusions as to the likely impact of those trends on particular companies in an industry. PESTLE Here it would be helpful to ask the students to draw on wider knowledge or research (you may have beer drinkers from many countries in your class). Depending on how extensive students ' additional research and thinking are, a wide-range of issues may be raised. To highlight some for the purposes of illustration: Political: government campaigns against drink driving Economic: the rise of the Asian economiesSocial: rise of beer consumption in southern Europe Technological: few clear in the case, but innovations around products such as ice- cold lager might be raised Environmental: few clear in the case, but packaging issues are likely to be important Legal: few clear in the case, but changes in licensing laws and permitted alcohol limits for driving are relevant. Pestles can often seem somewhat inconclusive, so it is important to pull out key issues and conclusions. The increasing hostility to drinking (under P and L) and the rise of Asian economies and southern Europe (under E & S) seem particularly important trends.One way of drawing some simple conclusions is to assess the overall balance (positive or negative) under each of the PESTLE headings: in the case of t he European brewing There has traditionally been a wide variation of industry structures across Europe. The United Kingdom is fairly competitive. Denmark, Holland, Italy, Belgium and France, on the other hand, have been in near monopoly situations. However, with increasing exports and imports and cross-border acquisitions, national markets are becoming less protected. An interesting issue, then, is at what level to conduct industry structure analysis.If at a European level, the broad issues to consider under each of the five forces are as follows: Buyers: With more than one fifth of beer sold through supermarkets, and increasing resort to ‘own-label', these buyers are increasingly powerful (underline that buyers are not the ultimate consumers). Suppliers: The high concentration of the packagers suggests that these are becoming increasingly powerful. Substitutes: Wine is clearly a dangerous substitute. New entrants: Internationalization through M and increased trade is introduc ing new entrants into previously protected markets: most countries see increasing imports (Table 2).Enhances-Busch and Gabrielle are two obvious new entrants into Europe. Students might be alerted to the potential threat of Toasting and the other Chinese brewers. Although not prominent in the case, there is still the potential of small new brewers entering using micro-breweries or contract brewers (e. G. Cobra). Rivalry: falling demand, international entrants and over-capacity obviously increase the scope for rivalry. However, note that sales values are rising, that innovation and branding can mitigate price-competition, that there has been a history of price-fixing cartels, and that leading players are attempting consolidation through M.It might be useful to ask the students to compare industry concentration ratios in 2000 and 2009: that is, the share accounted for the top three or five players (Table 3). As ever, it is important to draw conclusions. On balance, the European brewin g industry does not seem attractive, and unlikely to become more so until the current round of consolidation is completed and brewers achieve greater leverage against their buyers and suppliers. Impact on Particular Brewing Companies The three companies are chosen to represent different types of ‘player'. A-B Ellen is the largest player, after a succession of spectacular mergers.It is remarkable how the company is withdrawing from fast-growing China and Eastern Europe, however. Greene King is tiny in comparison to A-B Ellen, with Just one key domestic market, the United Kingdom. However, domestic focus and its own pubs may be giving it a strongly defended local position. You might ask whether there are competitors who might be tempted to buy such a company. Tossing Tao is the wild-card here. It is strong in its booming home market, but it is also interested in moving overseas. But would it make Europe a priority region for expansion, or choose another market?