The Long Road to Software Process Improvement: A Chronology of One Company\u27s Efforts

In late November 1996, AA Company (AAC) formed a \u27methodology team\u27 that began looking at ways to improve the company\u27s development environment. Currently (circa February 2000), AAC is following a plan for improvement based on the Capability Maturity Model (CMM). AAC\u27s initial effort to use CMM as a software process improvement (SPI) framework was somewhat flawed and, as a result, AAC has invested more than three years on the process; they still have a long way to go. This paper chronicles the route taken by AAC in their quest to improve software development and highlights some of the triumphs and traps along the way

Disentangling HIV and AIDS Stigma in Ethiopia,Tanzania and Zambia

The International Center for Research on Women (ICRW), in partnership with organizations in Ethiopia, Tanzania, and Zambia, led a study of HIV and AIDS-related stigma and discrimination in these three countries. This project, conducted from April 2001 to September 2003, unraveled the complexities around stigma by investigating the causes, manifestations and consequences of HIV and AIDS-related stigma and discrimination in sub-Saharan Africa. It then uses this analysis to suggest program interventions. Structured text analysis of 730 qualitative transcripts (650 interviews and 80 focus group discussions) and quantitative analysis of 400 survey respondents from rural and urban areas in these countries revealed the following main insights about the causes, context, experience and consequences of stigma: The main causes of stigma relate to incomplete knowledge, fears of death and disease, sexual norms and a lack of recognition of stigma. Insufficient and inaccurate knowledge combines with fears of death and disease to perpetuate beliefs in casual transmission and, thereby, avoidance of those with HIV. The knowledge that HIV can be transmitted sexually combines with an association of HIV with socially “improper” sex, such that people with HIV are stigmatized for their perceived immoral behavior. Finally, people often do not recognize that their words or actions are stigmatizing. Socio-economic status, age and gender all influence the experience of stigma. The poor are blamed less for their infection than the rich, yet they face greater stigma because they have fewer resources to hide an HIV-positive status. Youth are blamed in all three countries for spreading HIV through what is perceived as their highly risky sexual behavior. While both men and women are stigmatized for breaking sexual norms, gender-based power results in women being blamed more easily. At the same time, the consequences of HIV infection, disclosure, stigma and the burden of care are higher for women than for men. People living with HIV and AIDS face physical and social isolation from family, friends, and community; gossip, name-calling and voyeurism; and a loss of rights, decision-making power and access to resources and livelihoods. People with HIV internalize these experiences and consequently feel guilty, ashamed and inferior. They may, as a result, isolate themselves and lose hope. Those associated with people with HIV and AIDS, especially family members, friends and caregivers, face many of these same experiences in the form of secondary stigma. People living with HIV and AIDS and their families develop various strategies to cope with stigma. Decisions around disclosure depend on whether or not disclosing would help to cope (through care) or make the situation worse (through added stigma). Some cope by participating in networks of people with HIV and actively working in the field of HIV or by confronting stigma in their communities. Others look for alternative explanations for HIV besides sexual transmission and seek comfort, often turning to religion to do so. Stigma impedes various programmatic efforts. Testing, disclosure, prevention and care and support for people with HIV are advocated, but are impeded by stigma. Testing and disclosure are recognized as difficult because of stigma, and prevention is hampered because preventive methods such as condom use or discussing safe sex are considered indications of HIV infection or immoral behaviors and are thus stigmatized. Available care and support are accompanied by judgmental attitudes and isolating behavior, which can result in people with HIV delaying care until absolutely necessary. There are also many positive aspects of the way people deal with HIV and stigma. People express good intentions to not stigmatize those with HIV. Many recognize that their limited knowledge has a role in perpetuating stigma and are keen to learn more. Families, religious organizations and communities provide care, empathy and support for people with HIV and AIDS. Finally, people with HIV themselves overcome the stigma they face to challenge stigmatizing social norms. Our study points to five critical elements that programs aiming to tackle stigma need to address: Create greater recognition of stigma and discrimination. Foster in-depth, applied knowledge about all aspects of HIV and AIDS through a participatory and interactive process. Provide safe spaces to discuss the values and beliefs about sex, morality and death that underlie stigma. Find common language to talk about stigma. Ensure a central, contextually-appropriate and ethically-responsible role for people with HIV and AIDS While all individuals and groups have a role in reducing stigma, policymakers and programmers can start with certain key groups that our study suggests are a priority: Families caring for people living with HIV and AIDS: programs can help families both to cope with the burden of care and also to recognize and modify their own stigmatizing behavior. NGOs and other community-based organizations: NGOs can train their own staff to recognize and deal with stigma, incorporate ways to reduce stigma in all activities, and critically examine their communication methods and materials. Religious and faith-based organizations: these can be supportive of people living with HIV and AIDS in their role as religious leaders and can incorporate ways to reduce stigma in their community service activitie

Savings bank depositors in a crisis: Glasgow 1847 and 1857

Savings banks were created as a means to encourage the newly created working class to save for the uncertainties of urban industrial life. This article explores the success of the Savings Bank of Glasgow, and pays particular attention to the response of savers to the financial and commercial crises of 1847 and 1857. The crisis of 1847 was shallower but longer lasting in Glasgow, while that of 1857 was greatly exacerbated by local conditions in the short term, but of little long-term importance to savers. It suggests that, in both crises, some elements of contagion may have been present but that those who panicked in 1857 were systematically different from those who did not

Reducing HIV stigma and gender-based violence: toolkit for health care providers in India

"The overall aim is to prevent the spread of HIV and AIDS by making it easier for people living with HIV to access health services, disclose their status and prevent the spread of HIV to others, while also eliminating some of the barriers that impede the ability of uninfected women to protect themselves from the virus. Using the toolkit, you will be able to plan and organize educational sessions with health care providers to challenge HIV-related stigma and gender-based violence, also referred to as gender violence in this report. The toolkit will help you raise awareness of the causes and consequences of stigma and violence, and promote action and advocacy to combat them.

Patient and carer perceived barriers to early presentation and diagnosis of lung cancer: a systematic review.

BACKGROUND: Lung cancer is typically diagnosed at a late stage. Early presentation and detection of lung cancer symptoms is critical to improving survival but can be clinically complicated and as yet a robust screening method for diagnosis is not available in routine practice. Accordingly, the barriers to help-seeking behaviour and diagnosis need to be considered. This review aimed to document the barriers to early presentation and diagnosis of lung cancer, based on patient and carer perspectives. METHODS: A systematic review of databases was performed for original, English language articles discussing qualitative research on patient perceived barriers to early presentation and diagnosis of lung cancer. Three major databases were searched: Scopus, PubMed and EBSCOhost. References cited in the selected studies were searched for further relevant articles. RESULTS: Fourteen studies met inclusion criteria for review. Barriers were grouped into three categories: healthcare provider and system factors, patient factors and disease factors. CONCLUSIONS: Studies showed that the most frequently reported barriers to early presentation and diagnosis of lung cancer reported by patients and carers related to poor relationships between GPs and patients, a lack of access to services and care for patients, and a lack of awareness of lung cancer symptoms and treatment. Addressing these barriers offers opportunities by which rates of early diagnosis of lung cancer may be improved

Dizygotic twins concordant for truncus arteriosus

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66437/1/j.1399-0004.1991.tb02989.x.pd

Crossing disciplines: do architecture and planning course leaders see value in a Public Health Practitioner in Residence programme?

Highlights• We study a public health residency in a university architecture and planning department.• We assess the benefits of the residency from the perspective of the teaching staff.• The residency was successful at introducing public health issues and concepts to students.• There appeared to be a gap in the staff's understanding of public health concerns