Monday, March 30, 2020
Causes of Chieftaincy Disputes in Africa and How to Deal with Them Essay The constitution of Ghana defines a chief in article 277 as. In the Chapter unless the context otherwise requires, chief means a person, who, hailing from the appropriate family and lineage has been validly nominated ,elected or selected and enstooled, enskinned or installed as a chief or queen mother in accordance with the relevant customary law and usage. Chieftaincy as an important social institution which binds the people together is fraught with numerous disputes. Chieftaincy disputes are the misunderstanding, that occurs between two or more fractions on the enstoolment or enskinment of a chief or the misunderstanding between an incumbent chief and some of his subjects. Some causes of chieftaincy disputes are. When two families are claiming the right to a stool or a skin. In traditions where chieftaincy runs through multiple families there is likely to be a chieftaincy disputes that will arise between the families. This is in tradition where there are multiple royal families to inherit the throne. Its requires that when the chief dies the next family is to inherit the throne and it runs through all the families in the same manner. But in certain cases the ruling family will want to continue ruling instead of allowing other families to rule as customs demand. Disputes arise since the rest of the families think is wrong for only one family to rule all the times. The AshantiÃ¢â¬â¢s rule from these multiple royal families. We will write a custom essay sample on Causes of Chieftaincy Disputes in Africa and How to Deal with Them specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Causes of Chieftaincy Disputes in Africa and How to Deal with Them specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Causes of Chieftaincy Disputes in Africa and How to Deal with Them specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Another cause of chieftaincy disputes is when stool lands leased or sold to companies or individuals for money which goes into the chiefs own pocket. When stool lands are sold or leased the people expect the chief to use these monies for profitably business that will creates jobs and other activities to the town to improve Standard of living. In most cases the chiefs uses the peoples monies for his own gains. Disputes arise when the people notice that their funds are being misused. Wrongful selection of occupant to the stool or skin by kingmakers and queen mother. This cause of chieftaincy disputes arises when a wrongful occupant influences the king makers and queen mothers with monies and other items to persuade them to enstool or enskin him as a chief. The king makers and queen others uses nepotism to select occupant to rule as chiefs which should not to be done in that manner. The constitution requires a chief to be enstooled or enskinned in accordance with the customary laws and usage, so when a wrongful person is enstooled is cause chieftaincy disputes. When an incumbent chief incurs the displeasure of his subjects through embezzlement and misappropriation of the peoples funds. Another cause of chieftaincy disputes is when the incumbent chief embezzles and misappropriates the funds of the peoples . The chief is expected to use monies raised from the celebrations of festivals and other activities for developmental projects like the building of socials amenities e. g. schools, market place etc to improve the standard of living of his people. But in this case most chiefs do not consider these things but turn to embezzle and misuse the peopleÃ¢â¬â¢s funds. When the people also release that the chief is not embarking on developmental projects or use the funds for profitably gains on the people. The people may also rebel against the chief and this may bring about chieftaincy disputes. Chiefs becoming autocratic and takes unilateral decision on issues, may also leads to chieftaincy dispute. The chiefs centralize powers and authority to himself. It purpose is to achieve high productivity in his ruling which should not to be so . The chiefs does not involves his people in decision making processes. The peoples donÃ¢â¬â¢t have a said in any decision taken by the chief and sometimes disagrees with chief and his autocratic nature since there is a saying that Ã¢â¬Ëtwo heads are better than oneÃ¢â¬ . The people will want to be involve in decision making and so may rebel when they are not involved in the decision making process and therefore rebels when conditions becomes intolerable on their side. In controlling these numerous causes of chieftaincy disputes, the following procedures should be followed. Kingmakers and queen mothers should select candidates who are qualified and have the support of the majority of the people. Qualify persons are to be selected by kingmakers and queen mothers to inherit the chief in accordance with the customary laws of the lands. These persons are to go through the necessary arrangements and have the support from the majority of the people in his favour. In this case the people know the occupant and even support him as the ruling chief of their town. Chiefs are to use the peopleÃ¢â¬â¢s funds for developmental projects in the town. chiefs should looks amenities that the people lacks and put them in place. In the cause of doing this the people will corporate well with the chief and ere will be a good relationship between the people and their chiefs. Multiples royal families must allow the chieftaincy to run from one family to another. In doing and putting these practices together chieftaincy disputes will be solved and peace will reign in our country.
Saturday, March 7, 2020
Blakes The Tyger Essay Example Blakes The Tyger Essay Blakes The Tyger Essay Essay Topic: Prometheus Tyger by William Blake is a beautifully written poem that brings forth many philosophical questions about the origin of the animal known as a tiger. It was published as part of his collection Songs of Experience and through close reading of the poem, deeper meaning is uncovered behind the literary piece. The poem consists of six quatrains or what is known as four-line stanzas and contains along with that, two couplets or rhyming lines. Throughout the reading of the poem, the poem has dual layers of meaning behind its initial denotation of the origin of a tiger and more towards the origin of Satan. The questions to whom created it, where he did it, how he did it, and how the creator felt, illustrates the stream of conscious questioning behind the origin of the devil. Tyger! Tyger! burning bright In the forests of the night, What immortal hand or eye Could frame thy fearful symmetry? The poem goes through a basic order of questioning with the core question of hat immortal hand or eye Could frame thy fearful symmetry? This who question seems connotative of the idea of God as the immortal being and Creator of all things. As a tiger is a nocturnal predator of the night, *urning brightalso also brings forth he imagery of fire and contains consonance. Tigers bring forth imagery of brilliantly orange colored fur and black stripes merged together. This also is a colored illustrations of biblical descriptions of Hell itself. fin the forests of the nightdemonstrate operation in the darkness, something Satan does as well. The duality of meaning in the tigers image and biblical allusion to Satan as the central character of the poem start the stream of rhetorical questioning the author has. In what distant deeps or skies Burnt the fire of thine eyes? On what wings dare he aspire? What the hand dare sieze the fire? The second stanza it asks the question of where fin what distant deeps or skies Burnt the fire of thine eyes? The location of where Satan was formed is presented when bringing forth the location *istant deeps or skies,and the line also presents alliteration as well. The idea of did Satan come from the depths of hell, or was he formed above where God is located in heaven is presented within these lines. The last two lines of the quatrain once again acts as allusions to both a biblical and mythological origin. inn what wings dare he aspire? What the hand dare sieze the fire? oint to Prometheus, a Greek mythological being who stole fire from the gods and gave it to humans in order to progress life. Ultimately he faced severe punishment for his actions. Satan himself can be seen as a Prometheus type character as well. He convinced Adam and Eve to eat of the fruit and was punished for his actions as well. Though he did not seize the fire per say, he did push the first banished for having the pride and avarice to overthrow God. Blake shows such brilliance in the fact that the poem can still be taken on a literal meaning, and as a connotative meaning of biblical origin. And what shoulder, what art Could twist the sinews of thy heart? And when thy heart began to beat, What dread hand? what dread feet The third stanza speaks to the power of the Creator who we recognize as God who must be strong to form such a powerful creature as the essential in the construction of things and the beauty of the tiger mandates and artistic mind. ould twist the sinews of thy heartis a very profound line. Dual meaning can be taken within this line as the heart from the spiritual perspective dictates decision making. If God created Satan, did he create the evil within Satans heart and his actions if God as control over all things and Satan is the origin of evil? The second part of the stanza illustrates the power of Satan as the tiger is a powerful creature of dread and strength, so is Satan. As the hand is capable of destroying and creating and feet dictate presence everywhere. This is especially important in the dual meaning, as the tiger itself does not have hands or feet but rather paws. Thus these two lines once again show that Blake is pointing towards a deeper meaning. What the hammer? what the chain? In what furnace was thy brain? What the anvil? what dread grasp Dare its deadly terrors clasp? The fourth stanza illustrates the metaphor of a blacksmith that God is, ammersand ?Ã ±hainsoften being the tool and object blacksmiths create. These questions seem to ask where and how exactly did you create a being like Satan and what were the restraints and form of Satan. Once again repetition of imagery with fire is displayed here as well. Ehat was furnace was thy brainpoint towards the imagery of hell once again but point towards the mind of Satan as well as how did he develop the idea of pride to think he could overthrow God. When the stars threw down their spears, And watered heaven with their tears, Did he smile his work to see? Did he who made the Lamb make thee? This fifth stanza highlights the downfall of Satan and the other angels that plotted to overtake God. This is seen with the first two lines that talk throwing down spearsand %atered heaven with their tears. As Satan was cast out of Gods presence and the realm of heaven with the other angels were saddened. The second two lines question Gods intent of pleasure or emotion in that His creation deviated so far from Jesus, did he create Satan as well. This stanza sticks out because this deviates much rom the dual meaning of the tiger, but highlights once again the connotative direction of Satans creation. Dare frame thy fearful symmetry? The last stanza remains the same, but the last two lines slightly change in that ares now the last lines first word. The qualities of the Oger that presents a duality between beauty, ferocity, and strength of the beast and Satan, The speaker wonders whether why the hand that created Satan created him. A being of evil and power that shines brightly influencing others negatively. Blake does a brilliant Job of showing two meanings behind his poem.
Thursday, February 20, 2020
Project innovation management--Samsung - Essay Example The innovative strategy of this company has come to rely on external scientific expertise as a means of ensuring that only the latest and the most viable ideas are taken into consideration and developed into products. In this way, Samsung has been able to pursue a strategy that is consistent with its innovative goals. Samsung has over the years come to develop an environment which is extremely receptive of the market forces. This environment has been developed in such a way that the company always remains conscious of the swift changes that are taking place in the business environment and instituting changes accordingly (Michell, 2010). The ability to foster change in such a large company has become enshrined in the companyÃ¢â¬â¢s culture through it motto Ã¢â¬Å"Work Hard, Think Hard and Build Trust.Ã¢â¬ The result of SamsungÃ¢â¬â¢s putting into consideration the need for constant change has been that it has had to develop an environment where its employees are receptive to change. The Work Smart part of its motto seems to foster this new type of receptiveness because it suggests to employees that they have to ensure that they are conscious of the business environment and should be ready to make changes accordingly in order to cater for market demand. It further suggests that employees need to constantly be ready for any possible changes that might be implemented in order to increase efficiency. The Think Hard aspect of SamsungÃ¢â¬â¢s motto suggests that innovation has become a part of its corporate culture and it is this that has ensured the companyÃ¢â¬â¢s success in recent years as a leader in the electronics market (Kim, 2011). Not only is innovation among its employees encouraged, but it has also become the basis upon which Samsung has been able to compete with its major rivals in the market, especially Apple. Think Hard suggests that the company has come to put
Tuesday, February 4, 2020
Write a case study about Cadbury company Essay Example | Topics and Well Written Essays - 3000 words
Write a case study about Cadbury company - Essay Example This very high share of the market reinforces why Cadbury company continues to focus heavily on developing new marketing strategies in order to make their chocolate products stand out from competition. In the late 1990s, Cadbury developed an internal mechanism deemed the formal suggestion programme which was designed to receive various stakeholder feedback regarding the viability of Cadbury products and the companyÃ¢â¬â¢s marketing efforts as a means to improve the Cadbury image (Myers, 1999). This tends to reinforce that the company remains strongly focused on marketing and branding strategies in order to differentiate Cadbury products from other competition. Currently, in terms of marketing strategy, Cadbury appears to be focused on differentiating its chocolate products from those of competitors by focusing on both quality and by utilising humour in its contemporary marketing approaches. One of the companyÃ¢â¬â¢s most notable brands, Cadbury Dairy Milk, has utilised television promotion which utilised a drum-banging gorilla in order to link the Cadbury brand with a more flexible, humorous and modern organisation. This ad appears to have achieved significant sales successes for the Dairy Milk brand, prompting the company to allocate a significant cash budget to produce a sequel to this humorous promotion (Dutta, 2008). Says Phil Rumbol, the marketing director of Cadbury, Ã¢â¬Å"We recognised that gorilla had an enigmatic, almost random element to it that audiences had responded to, and had generated masses of debate onlineÃ¢â¬ (Dutta, 2008, p.2). This represents a significant change from previous marketing efforts at the company, which attempted to place the company, in the minds of the consumer audience, as an organisation which is committed to tradition and confectionary excellence as part of a more upscale marketing focus. It seems that today, in order to make the company more appealing to mass markets and modern audiences, some of
Monday, January 27, 2020
Medical Device Regulations in the European Union INTRODUCTION TO MEDICAL DEVICE REGULATIONS IN THE EUROPEAN UNION: A Medical Device under the jurisdiction of the European Union is defined as Ã¢â¬Å"an instrument, apparatus, appliance, material or other article, whether used alone or in combination, together with any software necessary for its proper application, which a) is intended by the manufacturer to be used for human beings for the purpose of i. diagnosis, prevention, monitoring, treatment or alleviation of disease, ii. diagnosis, monitoring, treatment, alleviation of or compensation for an injury or handicap, iii. investigation, replacement or modification of the anatomy or of a physiological process, or iv. control of conception; and b) does not achieve its principal intended action in or on the human body by pharmacological, immunological or metabolic meansÃ¢â¬ .1 The clinical investigation and the subsequent introduction of a medical device in the European market is primarily regulated and governed by the MHRA (Medicines and Healthcare products Regulatory Agency) with the assistance of competent regulatory institutions called the Notified Bodies. Ã¢â¬Å"A Notified Body is a certification organization which the national authority (the Competent Authority) of a Member State designates to carry out one or more of the conformity assessment procedures described in the annexes of the Directives.Ã¢â¬ 3 The MHRA regulates with the help of two sets of medical device regulations viz. the Statutory Instruments 2002 No.618 (Consolidated legislation) and 2003 No.1697. These legislations employ the three device directives issued by the competent authority into the european law. The directives help the manufacture in better understanding of the manufacturing and the requirments for inroduction into the market of the devices. These directives are: Directive 90/385/EEC: Active Implantable Medical Devices directive Directive 93/42/EEC: Medical Devices directive Directive 98/79/EC: In vitro Diagnostic Medical Device directive Directive 90/385/EEC: Active Implantable Medical Devices directive: This directive encompasses medical devices that are active(i.e powered) and implanted(i.e left in the human body). These include pacemakers, implantable defibrillators, implantable infusion pumps, cochlear implants and implantable neuromuscular stimulators etc. Regulations realizing the Directive came entirely into force in the United Kingdom on January 01 1995. Directive 93/42/EEC: Medical Devices directive: This directive covers an extensive array of devices from uncomplicated bandages to orthopaedic implants and high-end radiology apparatus. Regulations realizing the Directive came entirely into force in the United Kingdom on June 13 1998. Directive 98/79/EC: In vitro Diagnostic Medical Device directive: Ã¢â¬Å"This Directive covers any medical device, reagent, reagent product, kit, instrument, apparatus or system which is intended to be used for the invitro examination of substances derived from the human body, such as blood grouping reagents, pregnancy testing and Hepatitis B test kits. Regulations implementing the Directive came into force in the UK on 7th June 2000 with a transitional period until 7th December 2003. There is no clinical investigation system for in-vitro diagnostic medical devices. Performance evaluations of in vitro diagnostic devices that are performed outside the manufacturers premises should be notified to the UK Competent Authority in accordance with the Medical Devices Regulations 2002: Section 44.Ã¢â¬ 2 The rationale backing these directives is to permit easy movement of the medical devices throughout the European Union whilst upholding high standards of device safety and up-to-the-mark quality. Classification of medical devices: Devices are classified purely based on risk associated with their use. Ranging from low risk to high risk, they are Class I, IIa, IIb and III. A classic example of a class III medical device is a cochlear implant, which is both active and implantable and thus comes under the purview of Directive 90/385/EEC: Active Implantable Medical Devices directive. Let us discuss in detail the regulatory requirments specified as per the MHRA to bring an active implantable cochlear implant into the market designated bt the European Union as the EFTA(European Free Trade Area). Ã¢â¬Å"Examples of AIMDs include: implantable cardiac pacemakers implantable defibrillators leads, electrodes, adaptors for 1) and 2) implantable nerve stimulators bladder stimulators sphincter stimulators diaphragm stimulators cochlear implants implantable active drug administration device catheters, sensors for 9) implantable active monitoring devices programmers, software, transmitters.Ã¢â¬ 4 Cochlear Implants: Ã¢â¬Å"Cochlear implants are electronic hearing prostheses that bypass the damaged hearing components by providing electrical stimulation directly to the auditory nerve fibres in the cochlea. The electrical stimulation is interpreted by the brain as sound. Cochlear implants consist of an external microphone, speech processor and transmitter coil, and an internal stimulator (implanted under the skin just behind the ear) attached to a stimulation electrode which passes into the cochlea. A variation of the cochlear implant is the auditory brainstem implant where electrodes are implanted directly into the auditory area of the brainstem. This can be used in patients who do not have a functional auditory nerve.Ã¢â¬ 5 The regulatory process of bringing a cochlear implant in the European market: It is mandated by law that the manufacturer who intends to bring the device into the EFTA abides by the Essential Requirments stated in the Directive 90/385/EEC: Active Implantable Medical Devices directive and demonstrate the compliance of the device with the safety and efficacy standards set forth in the directive. There are essentially two ways to do it viz. Ã¢â¬Å"either a compilation of the relevant scientific literature currently available on the intended purpose of the device and the techniques employed, together with, if appropriate, a written report containing a critical evaluation of the compilation; or the results and conclusions of a specifically designed clinical investigationÃ¢â¬ 2 Product launch on the basis of evaluation and review of scientific literature can be considered as acceptable if equivalence can be scientifically demonstrated with a device existant in the market and routinely used in clinical practice. Equivalence has to be demonstrated w.r.t technology, critical performance, design, principles of operation, biological safety, population involved, conditions of use and clinical purpose. However, unless satisfactory evidence can be collected by means of scientific literature review, the use of a well-planned clinical trial/investigation should be considered as the best way to attest permissible levels of safety and efficacy. In case of scientific review or pre-clinical assessment, the following fees apply: Class I, IIa, or IIb other than implantable or long-term invasive: Ã £3,000 (Re-notification incase of objection by MHRA Ã £2,100). Class IIb implantable or long-term invasive, Class III, and active implantable: Ã £4,100 (Re-notification incase of objection by MHRA Ã £2,700). Applications for a proposed clinical investigation of the medical device should be made by filling the forms PCA1 and PCA2 along with the necessary information required by the clauses in the forms. Applications should be labeled clearly as Ã¢â¬Å"documentation onlyÃ¢â¬ . The use of English language is mandatory. Documentation should be clear and legible and remain so after reproduction. Electronic applications should be discussed with the MHRA. The manufacturer, for scrutiny by the MHRA should make a total of eight full submission copies available. The charges for the scrutiny of applications are laid out in the Medical Devices Regulations 2002: section 56. They are as follows: Ã¢â¬Å"Fees for Group A (low risk) devices are Ã £2,700 (initial application) or Ã £1,800 (resubmission). Increasing to Ã £3,000 and Ã £2,100 on 1st April 2008. Fees for Group B (high-risk) devices are Ã £3,800 (initial application) or Ã £2,400 (resubmission). Increasing to Ã £4,100 and Ã £2,700 on 1 st April 2008.Ã¢â¬ 2 Applications should be forwarded to: Mrs Daniella Smolenska, Medicines Healthcare products Regulatory Agency (MHRA), European and Regulatory Affairs, Market Towers, 1 Nine Elms Lane, London, SW8 5NQ, Tel: 020 7084 3363, Email [emailprotected]. Approval from the MREC (Multi-centre Research Ethics Committee)/LREC (Local Research Ethics Committee) can be obtained along with the notification to the Competent Authority. However, a clinical investigation can begin only after approval has been obtained from the MREC/LREC and the Competent Authority has not raised an objection to the investigation within the 60 days time constraint period; or approval has been obtained from both the authoritative bodies. General Requirements: A well-defined clinical plan whose methodology and ethical considerations conforms to the standards set forth in the Medical Devices Regulations 2002: section 16 and section 29, the Active Implantable Medical Devices Directive, Annexes 6 and 7, and the Medical Devices Directive, Annexes VIII and X. Supplementary standards are set forth in Standard BS EN ISO 14155-1; 2002, Ã¢â¬Å"Clinical Investigation of Medical Devices for Human Subjects-part 1: General RequirementsÃ¢â¬ , and BS EN ISO 14155-2:2002, Ã¢â¬Å"Clinical Investigation of Medical Devices for Human Subjects-part 2: Clinical PlanÃ¢â¬ . The CA should be notified incase of differences in the EU and non-EU protocols and the reasons for the same. Ã¢â¬Å"All applications must contain a statement (Active Implantable Medical Devices Directive: Annex 6,2.2; Medical Devices Directive: Annex VIII, 2.2): that the device in question conforms to the Essential Requirements except with regard to those aspects of the device that are to be investigated and that in respect of those aspects, every precaution has been taken to protect the health and safety of the patient. By signing this statement, the manufacturer is declaring that the device meets all of the relevant Essential Requirements, other than those subject to the investigation. Manufacturers must therefore ensure that at the time a notification is made to the Competent Authority, they have all documentation required to demonstrate conformity with the relevant Essential Requirements available for submission to the Competent Authority when requested.Ã¢â¬ 2 Device information like name, model, materials used and sterilization standards etc must be provided as set forth in the directive. Pertinent information about the clinical investigation plan, investigation parameters and design, data collection and analysis methods etc. should be made available to the CA. It is strongly advised that Class III devices follow a well-designed post-marketing plan under the Medical Devices Vigilance. Extra care should be taken when labeling devices meant for clinical investigations. Ã¢â¬Å"All devices intended for clinical investigation must bear the wording exclusively for clinical investigation (Medical Devices Directive: annex 1, para 13.3(H) and the Active Implantable Medical Devices Directive: annex 1, 14.1).Ã¢â¬ 2 Reporting of adverse incidents: Ã¢â¬Å"A serious adverse incident is one which: led to a death led to a serious deterioration in the health of the patient, user or others and includes: a life threatening illness or injury a permanent impairment to a body structure or function a condition requiring hospitalisation or increased length of existing hospitalisation a condition requiring otherwise unnecessary medical or surgical intervention and which might have led to death or serious deterioration in health had suitable action or intervention not taken place. This includes a malfunction of the device such that it has to be monitored more closely or temporarily or permanently taken out of service led to foetal distress, foetal death or a congenital abnormality or birth defect might have led to any of the aboveÃ¢â¬ 2 All such incidents should be recorded and reported to the CA as set forth in the Regulation 16(10)(a) of the Medical Devices Regulations 2002 (SI 618) and Annex X of the Medical Devices Directive 93/42. Final written report: A report in conjunction with the Medical Devices Directive (Medical Devices Regulations 2002: Section 16(10) and Section 29(9)) should be submitted to the CA for devices undergoing investigation for a CE marking. However, Class III devices need to be highly regulated, before, after and during the clinical investigation. Owing to the high risks associated with their use, some say the risk can be quantified only as social and not scientific. Ã¢â¬Å"Risks, rather than being inherent within these implant devices, may be seen as socially derived, in processes of negotiation and conflict such as those in the case of hip and breast implantsÃ¢â¬ ¦.most recently, in the wake of the controversies surrounding breast implants and the 3M Capital hip, attention has been drawn to the uneven performance of notified bodies in the EU, which approve new products. This has led to the setting up of a new European Notified Bodies Operations Group (NEBOG) and calls by the MDA for all implants to be reclassified as high risk, Class III. A review of the operation of EU EMDD is also about to begin (MDA, 2001b). It thus appears that increased political scrutiny is being focused on this sector.Ã¢â¬ 6 BIBLIOGRAPHY: THE MEDICAL DEVICES REGULATIONS: IMPLICATIONS ON HEALTHCARE AND OTHER RELATED ESTABLISHMENTS, BULLETIN No. 18, COMPETENT AUTHORITY (UK), Amended January 2006 EC MEDICAL DEVICES DIRECTIVES GUIDANCE FOR MANUFACTURERS ON CLINICAL INVESTIGATIONS TO BE CARRIED OUT IN THE UK, COMPETENT AUTHORITY (UK), Updated November 2007 THE NOTIFIED BODY, BULLETIN No. 6, COMPETENT AUTHORITY(UK), Amended January 2006 http://www.mhra.gov.uk/Howweregulate/Devices/ActiveImplantableMedicalDevicesDirective/index.htm, Last Date Accessed: April 08 2008 http://www.mhra.gov.uk/Safetyinformation/Generalsafetyinformationandadvice/Product-specificinformationandadvice/Cochlearimplants/index.htm, Last Date Accessed: April 08 2008 Kent, Julie and Faulkner, Alex (2002) Regulating human implant technologies in Europeunderstanding the new era in medical device regulation, Health, Risk Society, 4:2, 189 209 Medical Device Development: From Prototype to Regulatory Approval, Aaron V. Kaplan, Donald S. Baim, John J. Smith, David A. Feigal, Michael Simons, David Jefferys, Thomas J. Fogarty, Richard E. Kuntz and Martin B. Leon, 2004;109;3068-3072 Circulation, DOI: 10.1161/01.CIR.0000134695.65733.64,Circulation is published by the American Heart Association. 7272 Greenville Avenue, Dallas, TX, 72514, Copyright 2004 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online, ISSN: 1524-4539.
Sunday, January 19, 2020
Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS Underlying Normal Traits within Abnormal Personality Disorders Student University April 11, 2010 Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS Abstract Scholars have argued for decades concerning the fact that there are normal personality traits underlying abnormal personality traits in people who exhibit dysfunctional personalities. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition is the determinative guide on the descriptions of these personality characteristics, and it determined that there were everal models to be considered when looking for a universal clinical definition of abnormal personality. Researchers used either the Big Four, Big Five or other models to describe what an abnormal personality consisted of and how it related to a normal personality as studied. Researchers measured personality differences based on qualitative, quantitative and other key factor diffe rences to determine normal or abnormal functioning personalities. It was difficult to determine one substantive definition, as the traits overlapped from normal to abnormal characteristics noted. Later, the definition of personality dysfunctions included life skills, personal tasks and life goals, and whether the individual was able to function as a member of his society, while meeting the expectations of that society. A personÃ¢â¬â¢s maladaptiveness and evolutionary sense were added as part of the definition of whether the personality was normal or abnormal, and whether a person had the skill to be able to manage personal relationships were considered as well in the general definition of abnormal personality. Today, treatment options are expanded from the traditional therapy treatments to include drug therapies, psychodynamic herapy, day hospital intervention, and dialectical behavior therapy. To date, day hospital interventions have proved very successful on non-schizophrenic patients suffering from abnormal personality traits. Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS Introduction Scholars have argued for decades concerning the fact that there are normal personality traits underlying abnormal personality traits in people who exhibit dysfunctional personalities. Recently, scholars have begun to make an argument that current category systems of personality isorders (PDs) should be substituted by trait dimensional scheme designations in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 2000). Experts are leaning towards using a Big Four model, which are Ã¢â¬Å"essentially maladaptive variants of the Big Five traits of normal personality, minus OpennessÃ¢â¬ (Watson, 1545). In a discussion of this issue by Watson, Clark and Chmielewski, they state that the newly comprised Big Four model excludes odd or eccentric Cluster A PDs, (Watson, 1545) and that their results noted from three studies show a relationship examining the actors of normal and abnormal personalities. Their results established that the Oddity factor was considered more broad than the Cluster A tr aits and more distinct from Openness and other Big Five models, which suggested Ã¢â¬Å"an alternative five factor model of personality pathology (considering only abnormal traits) and an expanded, integrated Big Six taxonomy that subsumes both normal and abnormal personality characteristicsÃ¢â¬ (Watson, 1545). Model Theories The Watson study explains that the Big Four structure was a result of developed hierarchical models that combined general models, like the Big Three and the Big Five models. These former models of personality reviews included multidimensional factors reminiscent of Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS past personality inventories. When the Big Three and Big Five models were formally combined, it was apparent that Ã¢â¬Å"two higher order traitsÃ¢â¬âNeuroticism/Negative Emotionality and Extraversion/Positive EmotionalityÃ¢â¬âare included in both modelsÃ¢â¬ (Watson, 1547). Considering these changes, Watson proposes a Ã¢â¬Å"Big FourÃ¢â¬ theory which does not include Openness, but does include many of the traits of the other theories. Watson reports that their research on the Big Five heory also includes research on a Big Six taxonomy Ã¢â¬Å"that subsumes both normal and abnormal personality dimensions (Watson, 1551). Definitions of Abnormal Personalities Researchers have made recent discoveries that Ã¢â¬Å"abnormal personalities can be modeled as extremes of normal personality variationÃ¢â¬ (OÃ¢â¬â¢Connor & Doyc e, 2001) (Markon, p. 139). Even though researchers agree that it is possible to describe normal and abnormal personalities within the same frameworks, they disagree on the structure of what the framework will encompass. Even abnormal personality traits are seen now as a variant of the extremes that can happen when eviewing normal personalities. One way to make sense of the distinctions between normal and abnormal personalities is to describe personality disorders (PDs) and develop a working definition for them. By defining the traits for PDs, the researcher is able to develop a base for delineating personalities studied. Once normal traits are identified, abnormal traits need to be assessed. This can be done by reviewing the Big Five model of abnormal personalities. This is the juncture that normal and abnormal personalities overlap. Apparently, there are similar modeling structures that can be tilized to describe both normal and abnormal personalities. Some traits are very common R unning Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS between the two models, and others mimic similar personality descriptions. Meta-analytic Investigation Model One cohesive factor that applies to both normal and abnormal personalities is the meta- analytic investigation model. This model was proposed by OÃ¢â¬â¢Connor in 2002, and it stated that there were structural relationships between normal and abnormal personalities (Markon, p. 142). The OÃ¢â¬â¢Connor study in 2002 reviewed 37 personality and psychopathology inventories to etermine if dimensional structure differences existed between clinical and nonclinical respondents (OÃ¢â¬â¢Connor B. P. , 2002). OÃ¢â¬â¢Connor found similarity between normal and abnormal populations reviewed and measured similarities Ã¢â¬Å"both in the number of factors that exist in the data matrices and in the factor patternÃ¢â¬ (OÃ¢â¬â¢Connor B. P. , 2002). The ten abnormal behavior disorders listed by the DSM-IV are listed as: paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, and obsessiveÃ¢â¬âcompulsiveÃ¢â¬ (Livesley & Jang, p. 258). Each of these disorders shows traits, and it is he way that professional clinicians are able to make accurate diagnoses of abnormal personality traits of their patients. This listing of traits by the DSM, showed that the distinction between what was considered normal and what was considered abnormal was often defined by distinguishing the Ã¢â¬Å"qualitative distinction between the twoÃ¢â¬ (Livesley & Jang, p. 258). Unfortunately, in truth researchers have come to find out that there are no true separations between normal and abnormal disorders, and they are hard pressed to find the dividing lines between the two entities. OÃ¢â¬â¢Connor asked whether the distinction can be made using former Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS models, and what exactly was normal or abnormal personality disorder. When the conceptual distinctions between the two were reviewed, there are several models to note. The most noteworthy working model being that there was Ã¢â¬Å"no evidence of discontinuity in the distributions of 100 traits selected to provide a systematic representation of personality disorderÃ¢â¬ (Livesley & Jang, p. 259). In other words, there was no concrete evidence that the researchers would consistently find traits that were exclusively common or descriptive of a specific personality disorder. In fact, personality disorders were measured across normal and control groups. The findings were that there were similarities within the disorder traits and that some equaled normal and others disordered personality traits. In this way, the researchers queried whether disorder traits could be seen in normal personalities. The answer was that there were few solid frameworks to make the decision which would provide a definitive answer to the question. In effect, extreme ends of the traits seemed to be deemed disorders, while extreme variations alone may not have been considered enough to state that a personality disorder actually existed. Quantitative Differences in Normal and Abnormal Personalities Quantitative differences exist between the normal and abnormal personality. The differences often mix up and muddle the personality traits and the disorders apparent within them. With personality disorders, often Ã¢â¬Å"it is difficult to see how an extreme score on dimensions such as conscientiousness, extraversion, or agreeableness is necessarily pathological. Researchers agreed that there were to be other additional factors that needed be present to justify the diagnosis (Livesley & Jang, p. 262). That additional trait is inflexibility and subjective Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS distress (Livesley & Jang, p. 259). The character trait of inflexibility is defined as one where the person has extreme traits, but not necessarily only an extreme position noted on any given trait. For example, a person who is extremely open and gregarious, but then is not able to tone down his personality when necessary would be an example of this trait. Continuing with this example, what would make the person who is considered otherwise outgoing and spontaneous a person who is suffering from a personality disorder? Maladaptive Personalities The answer may come from prior work done by researchers who were determining personality and abnormal personality disorders. Extreme actions alone were not enough to say the person operated outside of Ã¢â¬Å"normalÃ¢â¬ personality parameters. The researchers at the time believed that personality disorders were the result of someone suffering from an abnormal variation of a personality being studied. It was measured in how much the person suffered from the disorder. This is where the theory of maladaptation or dyscontrolled impairment came into play (Widiger & Trull, 1991; Widiger & Sankis, 2000). The reason the researchers sought a generalized definition is that without one, they Ã¢â¬Å"would have to catalogue the various maladaptive manifestations of each traitÃ¢â¬ (Livesley & Jang, p. 263). This was a difficult proposition, since even Ã¢â¬Å"normalÃ¢â¬ people were prone to exhibit maladaptive traits at some time in their lives. Another problem came with the idea of traits as one certain set of behaviors that were noted on subjects clinically or otherwise. Extreme exhibitions of a trait may show some measureable amount of psychopathology, but were not exclusively indicative of being considered classically maladaptive. In this way, the researchers determined Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS that the Ã¢â¬Å"definition of personality disorder needs to incorporate features of disorder that are separate from, although possibly correlated with, extreme trait variationÃ¢â¬ (Livesley & Jang, p. 263). Harmful Dysfunctional Traits in Personalities These descriptions of personality were necessary because there were more than these factors to consider when determining a personality disorder. In fact, personality was considered to be Ã¢â¬Å"a system of interrelated structures and processesÃ¢â¬ (Costa & McCrae, 1994; Mischel, 1999; Vernon, 1964) which included a personÃ¢â¬â¢ dispositional traits, motives, coping mechanisms, and ability to tame impulses are part of the process of determining normal or abnormal indications of personality. In other words, if these traits were considered Ã¢â¬Å"harmful dysfunctions,Ã¢â¬ (Wakefield, 1992; Livesley & Jang, p. 263) they consisted of harmful traits that were underlying natural functions. So, the definition of a personality disorder can be considered a harmful dysfunction in the normally adaptive functions of a personÃ¢â¬â¢s personality system (Livesley & Jang, p. 263) Another issue within the developing studies of personality disorders was that personality functions were considered to be seen as disturbed in individuals who exhibited personality disorders. Researcher Cantor described a personÃ¢â¬â¢s personality as the types of tasks a person sets as personal goals, and they way the person looks at his or her Ã¢â¬Å"self, and life situations, and the strategies used to achieve personal tasksÃ¢â¬ (Livesley & Jang, p. 263). This delineation of personality traits offered a true to form definition of what a personality disorder consisted of for the individual suffering from it. It was considered of a higher order than simply a dysfunction of a personality trait. Here it was described as needing to concentrate on life tasks as the Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS determining factor to determining if an individual had a personality disorder, and was therefore considered abnormal in terms of functioning personality. The researchers assumed that as a person lives his life, he orders his tasks as to what he sets as priorities for completing goals and meeting the needs of his immediate surrounding community and culture. This comes under the order of living in society and meeting the expectations of people who live near the individual, or a way of fitting in within his community. It also had to do with the personÃ¢â¬â¢s mean biology, or biological features characteristic of the individual. In fact, these tasks did vary depending on where the person lived and what the person had do to be able to survive in his culture. These may come under the umbrella of life skills, and they are definitely different considering where a person lived or had grown up. For example, a person who grew up in a small native Alaskan out island would have different life skills that ould a person who grew up and lived in a borough of Manhattan, NY. The two personalities of these individuals might be similar, but their life skills would be developed in obviously different ways. The person living in the native island village would have an understanding of the elements and what is necessary for bare-bones survival in possibly e xtreme conditions. While, the person who grew up in the city would have to understand how to be Ã¢â¬Å"street smartÃ¢â¬ and may need to know how to survive in even a potentially violent atmosphere if the neighborhood suggested those skills were essential to survive on a daily basis. Each individual may otherwise be soft spoken, or be considered similarly warm-hearted or kind. But decidedly, their life skills would separate them and put them a world away from each other in what they knew and needed to depend on to survive in their environment on a daily basis. Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS Universal Tasks Underlying Personality Traits The researchers then understood that there would need to be a set of universal tasks that needed to be identified. These universal tasks were considered of Ã¢â¬Å"evolutionary significanceÃ¢â¬ nd featured four universal challenges as set by Plutchik (1980). These were the four ways a personÃ¢â¬â¢s identity was developed and they included: the solution to the problems of dominance and submissiveness created by hierarchy that is characteristic of primate social hierarchies; development of a sense of territoriality or belongingness; and solution to the problems of temporality, that is, problems of loss and separation. This allowed the researchers studying personality disorders to come to the conclusion that personality disorders prevented an individual from managing the adaptive answers or solutions hat were considered universally applicable to everyone, or a personÃ¢â¬â¢s life tasks. When an individual had a deficit in any of these areas, there was a noted Ã¢â¬Å"harmful dysfunctionÃ¢â¬ and the person was unable to adapt to be able to function in his environment or society. The life tasks then seen as either being fulfilled or being abandoned by the individual, probably because of this identified deficit. Personality disorder was seen as different from other disorders by the fact that these failures Ã¢â¬Å"should be enduring and traceable to adolescence or at least early adulthood and hey should be due to extreme personality variation rather than another pervasive and chronic mental disorder such as a cognitive or schizophrenic disorderÃ¢â¬ (Livesley & Jang, p. 26 4). Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS Evolutionary Sense Within Personality Traits There was talk of the individual not being able to adapt to his environment in an Ã¢â¬Å"evolutionary senseÃ¢â¬ which spoke to whether the person had garnered enough skills for ensuring adaptive social behavior to allow reproduction and survival (Livesley & Jang, p. 264). This was xplained as stating that the adaptive traits would contribute to the person adapting to his environment and society in general, and the person adapting to his family unit would move the person towards being able to rear children and eventually reproduce to pass down his traits to offspring later on. This is the general definition of people who have self confidence in their dealings with others, and are able to live in harmony in stable relationships, while becoming productive members within their society or community. These can be seen to be part of the ancestral or evolutionary needs of ev ery individual, whether the person had an abnormal ersonality or normal personality. The more common description of an abnormal personality comes from what the common person observes when someone has problems dealing within a relationship. Rutter (1987) stated that personality disorders were characterized by Ã¢â¬Å"persistent, pervasive abnormality in social relationships and social functioning generallyÃ¢â¬ (Rutter, p. 454). Also, Tyrer (2001) stated that Ã¢â¬Å"we do not necessarily need to know everything about someone's personality to recognise the elements that make it disorderedÃ¢â¬ (Tyrer, p. 83). Tyrer states quite honestly that psychiatrists iew these descriptive axioms as something to be deferred, and says Ã¢â¬Å"personality disorder and mental retardation are stigmatic terms that psychiatrists like to avoidÃ¢â¬ (Tyrer, p. 83). So the question is, how can one determine the underlying normality within the abnormal Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONA LITY DISORDERS personality? For this the clinician and the layperson need review the DSM-III, considered the premier source of personality disorder classification (American Psychiatric Association, 1980). The DSM classifies what is considered normal and abnormal in terms of personality. The professionals in the field disagree to the proposed stereotyping of this group of classifications, on the basis of the fact that such profiling is considered Ã¢â¬Å"quite inappropriate in such a complicated fieldÃ¢â¬ (Tyrer, p. 84). In fact, it appears that there are burgeoning alternative and substitute classifications being used for determining personality disorders in surveys, trials, studies and private practice. Most people would be surprised to find out that this topic has been heatedly debated over the past two decades. Many people most likely assume that there is one clinical efinition of what is normal, and what is not normal when it comes to personality disorders. The media plays into this, as well as the television and movie plots. The person seen as abnormal is cloaked in symbolic black, speaks in a raspy voice or has otherwise obvious mentally deviant behaviors that even the least sophisticated person in the audience could confidently label as the Ã¢â¬Å"bad guy. Ã¢â¬ Personality Disorders Studied Abroad Even the study of personality disorders abroad have led researchers to agree to disagree in the area of determining how to describe profiles for patients with underlying normal traits within heir abnormal personality profiles. In a study performed by McCrae (2001) in The PeopleÃ¢â¬â¢s Republic of China, 1,909 psychiatric patients were examined to determine the accuracy of the hypotheses determined from the Interpretive Report of the Revised NEO Personality Inventory (McCrae, p. 155). The researchers determined that the PDs were not separate categories that Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS could be determined in a vacuum. They realized that they needed to consider a more comprehensive and forgiving system of personality traits, to be considered an accurate measure f the patientÃ¢â¬â¢s personality issues and concerns. The researchers found that the personality traits of the patients did not fit into the DSM-IV defined traits. They did Ã¢â¬Å"draw on the same five underlying personality traitsÃ¢â¬ (McCrae, p. 171), and were considered redundant, but there were several areas of overlap to be considered conclusive. In fact, over 60% of the patients that were being treated for maladaptive personalities were not meeting the criteria defined in the DSM-IV, as relating to any criteria for a PD (McCrae, p. 171). The maladaptive behaviors, the personÃ¢â¬â¢s habits and personal attitudes were all measured o find a comprehensive scale for measuring the personality traits of the patients. It was determined that the results were insignificant, and concluded that personality profiles were Ã¢â¬Å"modest predictors of categorical PDs, but they are immensely informative about peopleÃ¢â¬ (McCrae, p. 172). Treatment Options for Abnormal Personality Traits But clinicians and psychiatrists are still interested in treating and helping people who exhibit the traits of these personality disorders identified above. They are in disagreement whether there are normal traits that are underlying the abnormal personality traits that deserve to e treated in an effort to offer the patient an opportunity to live a full and productive life. This is a critical option for people who have normal personality traits, but also exhibit the identified borderline abnormal personality traits as well within their psyche. Over a half decade ago, the best treatments were heralded as therapeutic, and they seemed Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS to promise the greatest success overall. But today, there are many alternate treatments available for individuals exhibiting abnormal personality disorders. They include drug therapies, sychodynamic therapy, day hospital intervention, and dialectical behavior therapy (Linehan, 1992, Tyrer, p. 84). Other methods of treatment that carry high success for the patients are the partial hospitalization of patients (Bateman & Fonagy, 1999). Bateman & Fonagy compared the effectiveness of treating patients exhibiting borderline personality disorders with partial hospitalization s a standard psychiatric care. They studied thirty-eight patients with borderline personality disorder and offered them individual and group psychoanalytic psychotherapy, for up to 18 months (Bateman & Fonagy, 1999). The results were that the patients who had been partially hospitalized did exhibit less problems, with Ã¢â¬Å"An improvement in depressive symptoms, a decrease in suicidal and self-mutilatory acts, reduced inpatient days, and better social and interpersonal function began at 6 months and continued until the end of treatment at 18 monthsÃ¢â¬ (Bateman & Fonagy, 1999). Their conclusion was that the partial hospitalization was determined as a far superior type of psychiatric care for those patients exhibiting borderline personality disorder. This treatment option was in opposition with the standard treatment options of the herapies listed above. These results were similar in the study by Piper, (1993) where a day treatment program at the University of Alberta Hospital in Edmonton, Alberta was studied. The patients were referred from the day treatment program and walk-in clinic, and utilized participants with Ã¢â¬Å"chronically disturbed non-schizophrenic patients, who usually have aff ective and personality disordersÃ¢â¬ (Piper, p. 757). The results of the study were that day treatment programs were considered effective for patients with long-term nonschizophrenic disorders. The Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS atients noted significant improvement in Ã¢â¬Å"four of the five areas studiedÃ¢â¬âinterpersonal functioning, symptomatology, life satisfaction, and self-esteemÃ¢â¬âas well as in several of disturbance associated with individual objectives (Piper, p. 762). Reference American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSMÃ¢â¬âIII). Washington, DC: APA. Bateman, A. & Fonagy, P. (1999). Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial. American Journal of Psychiatry, 156, 1563-1569. Retrieved on April 9, 2010 from http://ajp. sychiatryonline. org/cgi/content/full/156/10/1563? ijkey=bb19a5d 116af525fe927da3b0a0c0250f3d61de3 Costa, P. T. , & McCrae, R. R. (1994). Can personality change? In T. F. Heatherton, & J. L. Weinberger (Eds. ), Can personality change? (pp. 21Ã¢â¬â40). Washington, DC: American Psychological Association. Linehan, M. M. (1992) Cognitive Therapy for Borderline Personality Disorder. New York: Guilford Press. Livesley, W. John & Jang, Kerry L.. (2005). Differentiating normal, abnormal, and disordered personality, European Journal of Personality, 19(4), 257-268. Markon, K. E, Krueger, R. F. , & Watson, D. (2005). Delineating the structure of normal and bnormal personality: An integrative hierarchical approach. Journal of Personality and Social Psychology, 88, 139Ã¢â¬â157. EBSCO Database: Academic Search Premier. McCrae, Robert R. , Jian, Yang, et al. (2001). Personality Profiles and the Prediction of Categorical Personality Disorders. Journal of Personality, 69(2), 155-174. Mischel, W. (1999). Personality coherence and dispositions in a CognitiveÃ ¢â¬âAffective Personality System (CAPS) approach. In D. Cervone, & Y. Shoda (Eds. ), The coherence of personality (pp. 37Ã¢â¬â60). New York: Guilford. OÃ¢â¬â¢Connor B. P. (2002). The search for dimensional structure differences between normality and bnormality: A statistical review of published data on personality and psychopathology. Journal of Personality and Social Psychology. 83(4), 962Ã¢â¬â982. Retrieved on April 9, 2010 from http://www. ncbi. nlm. nih. gov/pubmed/12374447 OÃ¢â¬â¢Connor B. P. & Dyce J. A. (2001) Rigid and extreme: A geometric representation of personality disorders in five-factor model space. Journal of Personality and Social Psychology, 81, 1119Ã¢â¬â1130. PubMed Database. Piper, W. E. , Rosie, J. S. , Azim, H. F. A, Joyce A. S. (1993). A randomized trial of psychiatric day treatment for patients with affective and personality disorders. Hosp Community Psychiatry, 44, 757Ã¢â¬â763. Plutchik, R. (1980). A general psychoevolutionary theory of emotion. In R. Plutchik, & H. Kellerman (Eds. ), Emotion: Theory, research, and experience (pp. 3Ã¢â¬â33). San Diego, CA: Academic. Rutter, M. (1987). Temperament, personality and personality disorder. British Journal of Psychiatry, 150, 443Ã¢â¬â458. Tyrer, Peter. (2001). Personality disorder. The British Journal of Psychiatry, 179, 81-84. Retrieved on April 9, 2010 from http://bjp. rcpsych. org/cgi/content/full/179/1/81 Watson, David, Clark, Lee Anna, Chmielewski, Michael. (2008). Structures of Personality and Their Relevance to Psychopathology: II. Further Articulation of a Comprehensive Unified Trait Structure. Journal of Personality, 76(6), 1545-1586. EBSCO Database: Academic Search Premier. Vernon, P. E. (1964). Personality assessment: A critical survey. London: Methuen. Wakefield, J. C. (1992). Disorder as harmful dysfunction: A conceptual critique of DSM-III-RÃ¢â¬â¢s definition of mental disorder. Psychological Review, 99, 232Ã¢â¬â247. Widiger, T. A. , & Sankis, L. M. (2000). Adult psychopathology: Issues and controversies. Annual Review of Psychology, 51, 377Ã¢â¬â404. Widiger, T. A. , & Trull, T. J. (1991). Diagnosis and clinical assessment. Annual Review of
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November 28, 2012 November 28, 2012 Aisling Lynch C09687271 Aisling Lynch C09687271 Stratgic management the value chain concept: literature review and application analysis on IKEA Stratgic management the value chain concept: literature review and application analysis on IKEA Contents * Introduction * Origination * PorterÃ¢â¬â¢s Value Chain Concept * Linking of the Value Chain * Focus on External Sources * The Future Ã¢â¬â Conclusion * Ikea Example * References DeclarationI, the undersigned, declare that this report is entirely my own written work, except where otherwise accredited, and that it has not been submitted for a degree or other award to any other university or institution. Introduction Since the 1980Ã¢â¬â¢s academics have been pointing to a firmÃ¢â¬â¢s own activity pool for analysis, as a way of determining competitive advantage. It was in 1985 that the term Ã¢â¬Å"Value ChainÃ¢â¬ was coined by Michael Porter (Porter 1998) and all its subsidiary headings. I will look at some of the literature surrounding the Value Chain concept to see how it has evolved and changed since its beginning two decades ago.Using this literature I will see what recommendations are cited to carry this concept into the future with an ever more globalized market. Finally an application of this literature will be carried out on Ikea: a global company that has changed with market trends when necessary to stay a top player in its industry. Origination Kippenberger identifies in his research, how the idea of analyzing internal activities as a source of competitive advantage began in the early 1980Ã¢â¬â¢s with McKinseyÃ¢â¬â¢s Business Systems Concept (Kippenberger 1991).Through this concept, firms could look at their own activity pool and performances and compare these to that done of their competitor. This comparison would then act as a source of competitive advantage. Michael Porter took influence from this research and began to fine tune it even further. His creat ion of the Value Chain concept in 1985 (Porter 1998) has been the topic of detailed research by academics in diverse fields: strategic management (Johnson et al. 2005), marketing (Webster 1988), and customer loyalty (Parasuraman 2000) to name a few.The concept was an aid to identify sources of competitive advantage by providing a basis of differentiation (Porter 1998). According to Porters earlier research, differentiation could be created by using one of both of the following strategies: lower relative cost, or some form of differentiation offering (Porter 1998). PorterÃ¢â¬â¢s Value Chain Concept The original concept started with a tool called the Value Chain which when implemented correctly helped to break down all activities that a business took part in, in order to identify and understand the sources of competitive advantage (Porter 1998).Johnson et al. (2005) states that the value chain can be used to understand how a company creates or loses value in its activities. This nee ds to be identified if the company achieves competitive advantage by providing value to their customers. By stripping systems back to Ã¢â¬Ëstrategically relevant activitiesÃ¢â¬â¢ (Porter 1998), cost savers and creators can be identified as well as the activities that house sources of differentiation. If these are carried out more efficiently, better or cheaper than competitors, then competitive advantage is created (Parasuraman 2000).Kippenberger reminds us that in the original concept all of a firmÃ¢â¬â¢s activities can be broken down into two categories (Kippenberger 1991): primary and support. Primary activities are concerned with the physical creation and delivering of the product (Johnson et al. 2005); whilst support are the activities that supply primary ones with purchased inputs, human resources and technology. It also supplies the entire chain with firm infrastructure (Kippenberger 1991). All activities are embedded into a Ã¢â¬Ëstream of activitiesÃ¢â¬â¢ called th e value system (Porter 1998).These Ã¢â¬Ëgeneric description of activitiesÃ¢â¬â¢ should be mapped out in an activity system (Johnson et al. 2005). This disaggregation of discrete activities can isolate the value creating areas from the lacking (Porter 1998). In this way not so important areas can be combined or Ã¢â¬ËclusteredÃ¢â¬â¢ (Johnson et al. 2005). Thus the firm can now see which areas of activities they should be concentrating their resources on; and which they should de-emphasis or outsource (Johnson et al. 2005). Often the categorization of activities relies on judgment (Kippenberger 1991).Linking of the Value Chain This system of mapping out and categorizing activities helps the firm to link its competencies to competitive advantage (Normann 1993). Relating your core competencies back to your resources is a successful way to gain competitive advantage (Lusch 2011); and participation of this is key to good strategy in a business (Normann 1993). Optimizing co-ordinati on between some activities may take place, as well as trade-offs between activities in order to achieve an overall more successful value result (Porter 1998).Once activities have been clustered or isolated depending on their Ã¢â¬Ëhigher order strategic themesÃ¢â¬â¢ (Porter 1998), the links between the different activities need to identified and analyzed in order to spot any potential competitive advantage sources that lie here (Kippenberger 1991). And so to, the notion of relationship and information management in the value chain arises in the different literature. Emphasis needs to be placed on the relationships between all activities within the firm and with external organizations (Walters 2000).Information plays a significant role in good relations as it helps to co-ordinate all activities in the value chain, and implement any sources of competitive advantage found. Walter and Lancaster (2000) relate back to Browns 1997 industry perspective of value whereby concerns raised in the value chain are to do with supply chain management and logistics involvement. In the upper part of the supply chain, inputs are created or provided by suppliers; the company then adds value to these inputs before handing the product or service downstream, finally reaching the end consumer (Porter 1998).Although most of the literature seeÃ¢â¬â¢s the participation of the supply chain and logistic elements as a necessary involvement in the value chain in order to gain competitive advantage; these essentials play different roles in different literatures. Supply chain management has also been seen as the management of the differing relations along the value chain that take place to maximize value creation (Walters 2000). Every value creating activity is facilitated by logistics such as the management of costs that occur within the supply chain. Focus on External SourcesSo far, the value chain and its successful application has revolved around the industrial view. However to modern ize the value chain from its 1980Ã¢â¬â¢s foundations a focus on maximizing value starting from external sources has come to play. Instead of looking at oneÃ¢â¬â¢s own activities within a business and its supply chain and logistical partners to spot sources of competitive advantage, businesses may start value chain analysis by looking at their target customer (Webster 1988),. Taking a customer-centric approach to the value chain means that when analyzing activities one is looking to see if it maximizes value for the customer.Value opportunities are now distinguished by their ability to satisfy customerÃ¢â¬â¢s needs (Walters 2000). High perceived value is a determinant of customer loyalty (Parasuraman 2000). Research has shown that customer loyalty and retention is more profitable than gaining of a new customer pool. Thus it is in a businessÃ¢â¬â¢s best interest to optimize value creation in the minds of their customer. Value should not be solely focused on product quality, as service quality has been found to be a driver of value perception (Parasuraman 2000). This is especially the case where the product offering and service quality overlap e. . a hotel stay. The idea of customersÃ¢â¬â¢ needs and value perceptions being paramount to the company needs to stem from every aspect and level within that company. There needs to be an organizational believe in order to create a customer orientated firm (Webster 1988). This should start at top management and the CEO and then instilled into every aspect of the company. Thus the idea of an information flow and relationship management comes to the forefront again. Value creation is aided by a good fit between relationships and knowledge within a value chain (Normann 1993).This also contributes to good strategy within an organization where by all equally informed members working pro-actively together helps to create value in whatever activity they may be partaking in (Normann 1993). The value proposition (the val ue the customer understands is being offered to them [Walters 2000]) should be communicated to all stakeholders also (Lusch 2011). It needs to have an appeal to the stakeholders so that they can see the potential value for themselves in putting customer needs first (Lusch 2011). Through this aim, the idea of Ã¢â¬Ëcorporate valueÃ¢â¬â¢ is introduced (Walters 2000).Corporate Value is the notion that if a value chain is to be successful it is crucial that the objectives of all stakeholders as well as customers are to be met. Managing the relationships between all relevant parties through the provision of information is pertinent again. This management is facilitated by the supply chain and logistical functions (as discussed earlier) within the value chain. The Future Ã¢â¬â Conclusion A number of themes keep re-emerging from the literature; all of which are noted to be prominent drivers of a successful value chain, thus being a source of competitive advantage.Corporate value and the value chain should become a guide for a companyÃ¢â¬â¢s mission statement. Supply Chain functions facilitate the strategic direction of fulfilling this mission statement. Logistics helps to implement this whole chain by managing operations (Walters 2000). To succeed in value chain management a number of factors need to be considered. Firstly customer value criteria needs to be identified. In this way a company can ensure that when carrying out Value Chain management they co-ordinate all activities and their suppliers so that customer satisfaction and the attempt to meet stakeholders objectives is maximized.This should be carried out continuously so that at no time should there be a more preferable option to ensure value satisfaction (Walters 2000), (Parasuraman 2000). Successful implementation of supply chain management and logistical functions to aid favorable results in the value chain, can only be done so by the management of relationships and information (Normann 1993). Man y relationships take place within the value chain such as relations between employers and employees, the firm with its customers and stakeholders, and the business with its partners in the supply chain (Kippenberger 1991).Relevant information must be passed to each and every individual within the value chain (Walters 2000). Through good relations, companies can spot value creators and sources of differentiation within the vale chain (Porter 1998). Thus successful companies will learn how to re-invent value rather than just create it (Normann 1993). This will provide competitive advantage in todayÃ¢â¬â¢s globalized market where competition is immensely high. The value chain can now also be used as a tool for evaluating new business opportunities (Walters 2000).Globalization has also caused a change in customersÃ¢â¬â¢ needs and value criteria with the onset of increasing competitor choice in most industries. Thus tapping into customerÃ¢â¬â¢s wants and needs must be done on a con tinuing basis (Parasuraman 2000). This market intelligence needs to be communicated to everyone in the value chain in order that the chain be reconfigured to ensure maximum customer satisfaction and value at all times (Webster 1988). Value propositions should be looked at again. This is the way in which a customer understands the value offered to them (Walters 2000).Firms need to mobilize their customer base so that they can create their own value from the companyÃ¢â¬â¢s product offering (Normann 1993). They can use their value proposition as a tool for doing so. IKEA Example Six decades ago Ikea founder Ingvor Kampvad began a Swedish mail order operation selling furniture (Ikea 2012). Today, it is the global leader in home furnishing expanding into new geographic and product markets each year (Ikea 2012). By November 2011 the company had 332 stores in 38 countries worldwide (Collins 2011); 2010 saw them with an increase of 7. 7% in sales growth from the previous year ($23. Billio n) (Collins 2011). But how does their use of the value chain attribute to this success? IkeaÃ¢â¬â¢s business model is simple: the selling of high quality, Scandinavian designed, flat pack furniture. New product lines have been added to their product offering such as the introduction of soft furnishing items e. g. rugs, paintings etc. Profit making amenities are also located within all their stores such as coffee shops and restaurants. What Ikea saves on efficient warehousing (Ikea Distribution 2011) and low cost components, they pass onto their customers in the form of lower prices.Apart from this low cost strategy the company are able to maximize their organizational practices within the value chain in order to provide greater value to their customers in comparison to fellow competitors. By re-inventing their value proposition they have mobilized customers to take their own value from their offering. Customers are doing the jobs that furniture providers once did such as assemblin g of the product. Ikea aims to ensure that this is as seamless a process as possible for the customer by providing good quality, easy to fit components along with safety warnings and instructions.If we go along Porters definition of value (Porter 1998) -value is what consumers are willing to pay for what a firm provides- then we can see from the Ikea example that consumers perceive the ease of assembly and instructions provided as high value for the low cost that they pay. Similarly when entering the store, customers are provided with measuring tapes, pens and paper etc. This allows the consumer to take over the role of the salesperson partially. This is aided by the amount of information provided about each product through their catalogue (also available upon store entry) and on product displays.Again, these additions communicate extra value gained in the consumerÃ¢â¬â¢s mind by shopping at Ikea versus a competitor. Ikea have reinvented the idea of value for their customers. They do not position themselves as a supplier offering finished goods to an end-consumer. Instead they act as a mediator between two sets of producers (Ikea 2012), whereby the end consumer is also a producer as it is he who finalizes and assembles the offering. Suppliers are located in 50 countries around the world (Ikea 2012). They are selectively hosen to provide low cost, good quality wood that also complies with IkeaÃ¢â¬â¢s Ã¢â¬ËIwayÃ¢â¬â¢ programme, whereby all wood must be obtained in a sustainable and traceable manner (Ikea 2012). By managing good relations with their suppliers in the value chain, good quality, low-priced raw materials can be guaranteed, and constantly meet the Ikea standards. Ikea also heightens the value created by their suppliers through their Ã¢â¬ËIkea EngineeringÃ¢â¬â¢ programme (Ikea 2012). Technicians are provided for suppliers to aid in technical assistance.Between their online and in store till sales, ordering and payment of goods is done elect ronically (Ikea 2012). This passing of information between activities makes it easier for their warehouses to analyze shipping patterns and sales globally (Ikea 2012). Stock quantities and deliveries can also be amended with ease. The communicating of information and managing of relations between all retail and supplier units worldwide means that standards are kept the same and are controlled no matter which Ikea location a customer may be in.This means that no matter where the customer enters an Ikea outlet, that the value provided remains constant and high. Thus providing Ikea with the loyalty that earns them their competitive edge in this growing industry. References 1. Collins, L. (2011, October). How Ikea transformed home furnshings: The New Yorker. Retrieved from The New Yorker: http://www. newyorker. com/reporting/2011/10/03/111003fa_fact_collins 2. Grewal, D. P. (2000). The Impact of Technology on the Quality-Value-Loyalty Chain: A Research Agenda. Journal of the Academy of Marketing Science. , 28(1), 168-174. 3. Ikea. (2011).Ikea Distribution. Retrieved from Ikea: http://www. ikea. com/ms/en_US/jobs/business_types/distribution_logistics/index. html 4. Ikea. (2012). Ikea-History. Retrieved from Ikea: http://www. ikea. com/ms/en_IE/about_ikea/the_ikea_way/history/index. html 5. Johnson, G. S. (2005). Exploring Corporate Strategy. Essex: Pearson Education Limited. 6. Kippenberger, T. (1991). The value chain: the original breakthrough. The Antidote, 2(5), 7-10. 7. Lancaster, G. W. (2000). Implementing value strategy through the value chain. Management Decision, 38(3), 160-178. 8. Lusch, R. W. (2011). A Stakeholder-Unifying,