BIOTECHNOLOGY Essay Example | Topics and Well Written Essays - 500 words

BIOTECHNOLOGY - Essay Example In females, angiogenesis also occurs during the monthly reproductive cycle (to rebuild the uterus lining, to mature the egg during ovulation) and during pregnancy (to build the placenta, the circulation between mother and fetus).† Angiogenesis is considered to be a form of tissue engineering since it meets the definition when it is used either synthetically or naturally to repair damage. That definition is, â€Å"Tissue engineering uses synthetic or naturally derived, engineered biomaterials to replace damaged or defective tissues, such as bone, skin, and even organs† (ATP, 2005). Diseases could be treated by turning angiogenesis â€Å"on† in the case of a severe injury or in the case of coronary artery disease. Disease could be treated by turning angiogenesis â€Å"off† in the case of cancer or diabetic blindness (The Angiogenesis Foundation, 2008). b. Compare necrosis and apoptosis. Describe how we could we take advantage of apoptosis in the treatment of disease? What would be the advantage(s) compared to traditional approached? Hint: Think cancer, hepatitis, etc. According to MedicineNet (2008, pg. 1), necrosis is â€Å"The death of living cells or tissues. Necrosis can be due, for example, to ischemia (lack of blood flow).† According to CancerTherapy.net, â€Å"the P53 gene causes the abnormal cells to commit suicide.   This is called aptosis.† The main difference between these two is that necrosis is not planned and that aptosis is programmed by the body. Aptosis is a necessary part of human life and is not a bad thing, whereas necrosis is very negative. Both occur naturally, but may be influenced by external factors. Aptosis may be used to treat diseases such as cancer or hepatitis since it is programmed cell death. It could kill off the diseased and bad cells without harming the good cells. Cancer occurs when abnormal cells in the body begin to grow out of control. It is caused by DNA damage. There are many

Colour Perception in Skin Disease Diagnosis

Colour Perception in Skin Disease Diagnosis Color Perception Dermatologist’s perspective Abstract: Light and color are two important tools for the dermatologist in diagnosing skin diseases. Many articles have focused on the importance of light and illumination but there are only scanty literature about the importance of color perception. The definitions of color, color spaces and their types, assessment of color and its applications, recent advances in human color vision is reviewed. Key words: Color, colorspace, RGB, CIE L*a*b*, Spectrophotometry, Colorimetry Color perception is due to the evoked neural responses in the eye and visual cortex because of light stimulus. Colors differ from each other in wavelength, intensity, and saturation. The importance of color in plants ranges from attracting insects for pollination to production of bright colored fruits for seed dispersal. Color pigments are present in many animal species and has evolutionary importance for searching food, escaping from predators etc. Human skin color is linked with evolution and is changing according to the environment where humans live. Color science has various implications in telemedicine,dentistry,biometrics,anthropology, cosmetics,textiles , artificial intelligence, etc . Color of the human skin, mucosa, nails plays an important part in the social communication ,diagnosis and treatment of dermatological disorders. Dermatologists need to know about the biophysics of skin, eye ,color spaces , illumination sources to understand about perception of color . All visible colors to human eye can be produced by some combination of the three primary colors, either by additive or subtractive processes. Human color perception is most sensitive to light in the yellow-green region of the spectrum. We have three types of cone receptors for the long(L),medium(M),short (S) wavelengths. The balance of neural activity in these three receptors accounts for the millions of color shades. This is utilized by the Bayer array in modern digital cameras. The number of L, M, S color sensitive cones in the human retina differs among people by up to forty times. Human perception of color is controlled much more by the brain than by the eyes. Color vision has distributed processing in the cortex, with a number of brain zones being involved in processing wavelength data and creating color sense . Cone receptors in the human eye lose their color sensitivity with age, but subjective experience of color remains same over the years. The perception of color is flexibl e and relies on biological processes in the brain and eye. Phenotyping based on skin color has been attempted by many researchers the well known one is Fitzpatrick’s I to VI skin types.Though there are some drawbacks in this classification this is useful in a variety of ways treating diseases with phototherapy, in predicting the post inflammatory hyperpigmentation, for making skin colored prostheses , skin grafting etc. Human skin color can also be classified by visual color matching using the Munsell charts. But visual clinical methods of skin color evaluation for diagnostic purposes are so far mostly subjective and inaccurate. Many studies quantitate the skin color based on the spectrophotometry or tricolorimetry measurements which gives the absolute values of the color. The spectral reflectance provides a lot of biological and medical information about skin and mucosa. In case of non availability of these equipments digital cameras and software has been employed to compare and quantitate human color taken under standard conditions. Analysis of color data has to be done by a conceptual tool called color space. Color space aid the process of describing color between people , between software or machines. Color gamut is the area enclosed by a color space in two or three dimensions. Color space is useful to understand the color capabilities of a particular device or digital image and also useful to identify colors in a more intuitive way. There are many color spaces – sRGB, Adobe RGB, L*a*b*, L*u*v*, CMYK etc. Different color spaces are better for different applications. RGB is used in many display devices computer monitor, digital camera or a television, which uses these as its base colors. CMYK is more commonly used in printers. However, no two display devices are equal. A color shade defined by certain value of RGB on one device may look completely different on another device. A device dependent color space is a color space where the color produced depends both the parameters used and on the equipment used for display. Many devices have their own device-dependent RGB color spaces. RGB space can be visualised like a cube with the three axes corresponding to red, green and blue. L*a*b* color space proposed by CIELAB is popular because it is device independent and the L parameter has a good correlation with perceived lightness. It is non linear and intended to mimic the logarithmic responses of the human eye. Any color can be described by a combination of three coordinates, L*, a*,and b* , where L* is the total quantity of light reflected ,a* represents color ranging from red to green , and b* represents color ranging from blue to yellow . L* measures the brightness component of color, and it varies on an achromatic gray scale between a value of 0 (black) to100 (white). The a* and b* coordinates can be converted into hue angle and chroma of color . Hue refers the degree to which a stimulus can be described as similar to or different from stimuli where 0Â ° represents red and 90Â ° represents yellow. Chroma describes the intensity of color, with higher chroma indicating greater intensity. Melanin density and distribution can be assessed by the L* values wheras erythema can be known by the a* values. The color of gluteal region can be taken as the constitutive color whereas the cheek will give details of the facultative color. Skin that is usually exposed to the sun has a more intense red component, presumably because of increased vascularization. Exposed skin also showed lower reflectance (L*) than covered skin, probably because of melanin .Higher L* levels were associated with lighter skin, tendency for sunburn and less tanning . Han K et al (1) observed that the L*a*b* color space to be the most popular system used to measure skin color. The average L*a*b* values for the body parts were 61.74, 9.56 and 17.07, respectively. The site of lightest skin was found to be the medial arm , whereas the darkest was on the forehead . Redness was highest on the cheek and lowest on the medial arm . Skin color was lighter and more yellow in females than in males, whereas redness was higher in males. The factors that significantly influenced L* were sex, work place and sunbathing, factors that influenced a* were sex, work place and smoking; and the factors that influenced b* were sunbathing and age . Ian LWeatherall et al (2) did color measurement in ventral forearm of skin of 99 subjects and expressed the results in terms of color space L*, a*, and b* values. L* values ranged from 59.7 to 73.4.The hue angle ranged from 54.0 to 77.8degrees.The chroma values ranged from 13.2 to 21.6. These color-space parameters are proposed for the unambiguous communication of skin color information that relates directly to visual observations of clinical importance or scientific interest. Yun et al (3) introduced a new technique to measure L*a*b* color coordinates and the melanin and erythema indexes at the same time by analyzing the skin color of normal Asians . While the correlation of the melanin index with the L* value was negative, it was positively correlated with the a* and b* values. While the erythema index showed a weak correlation with the b* value, its correlation was negative with the L* value and positive with the a* value. Change in colorimetric values of bruises over time was significant for all three color parameters (L*a*b*), the most notable changes being the decrease in red (a*) and increase in yellow (b*) starting at 24 h.( 4) Colorimetric skin color values can also be used to study pigmentation capacity, to predict the risk of actinic cancer, in the study of reactions induced by physical and allergic stimuli ,for choosing appropriate sunscreens (5) Comparison using cheaper and novel ideas in this regard is yet to come. Recent advances in Information technology has allowed us to understand color vision and to extract the true color of the skin. REFERENCES 1) Han K, Choi T, Son D et al Skin color of Koreans: statistical evaluation of affecting factors. Skin Research and Technology 2006; 12(3):170-7 2) Ian LWeatherall1 and Bernard DCoombs Skin Color Measurements in Terms of CIELAB Color Space Values . Journal of Investigative Dermatology 1992; 99: 468–473. 3) Yun IS,LEE WJ et al Skin color analysis using a spectrophotometer in Asians. Skin Res Technol. 2010 ;16(3):311-5. 4) Scafide, K. R., et al. Evaluating change in bruise colorimetry and the effect of subject characteristics over time. Forensic Sci Med Pathol 2013; 9(3): 367-376. 5) Andreassi ,Flori L Practical applications of cutaneous colorimetry. Clinics in Dermatology 1995; 13(4):369-73

Danforth?s Witch Hunt, Is It J Essay -- essays research papers

Danforth’s Witch Hunt, Is it Justified? (An Essay on the Crucible) I write in response to your column regarding Judge Danforth’s actions during the witch trials in Salem. Surprisingly, you praised Judge Danforth for his â€Å"impartiality and tact† during this tragic set of trials. You could not be farther from the truth. Judge Danforth abused his judicial power, throughout the trials, to the fullest of his abilities. His abuses range from berating and coercing witness into saying what he wants them go, to blatantly ignoring testimony that refuted the accusers. He presides over his courtroom as if he has divine right. Judges are supposed to find truth, not invent it. When Mary Warren confessed to Danforth that she, along with the other accusers were sporting, he refused to believe her. To think. that he would obviously ignore her is just beyond my comprehension. he did this simply to save face. To listen to Mary and admit the court system had been wrong was not a choice. Because of this and many other miscalculations on Danforth’s part numerous people lost their lives.   Ã‚  Ã‚  Ã‚  Ã‚  In addition to this, Judge Danforth has chose, very biasedly, what to admit as evidence. He used that power whenever he sought fit. When Giles Corey lacks the evidence to prove that Thomas Putnam hath prompted his daughter to falsely cry witchery on George Jacobs, Danforth dismisses the claim. Why you say? The lack of tangible evidence, yet when the young harlots claimed that invisibl...

Development through the Implementation of Physical Activity to Patients Suffering from Mental Illness.

Introduction Efficient delivery of care is the essence of nursing. Being a successful nurse revolves around the capability to deliver care which contributes to the wellbeing of the patients (Barker, 2005). In exploring the efficient delivery of care to patients suffering from mental illness, this paper consists of two parts. Part One outlines the practical and theoretical aspects of my chosen Service Improvement Initiative, and Part Two focuses on my personal development plan. The Service Improvement Initiative outlines a plan that strives to create a healing environment through the use of mental and physical activities, from sports to board games as a means of providing nursing care to patients. Apart from the medical aspect of this initiative, I will also analyze the theoretical aspects of health care to determine the professional role of nurses in providing care and support that aims to contribute to the wellbeing of patients. Additionally, I intend to discuss the importance of harnessing leadership qualities, management and communication skills of nurses in order to provide high-quality patient care. Mental Health and Physical and Mind Activities In the course of my observations in a psychological ward for adolescents aged 10-17 years, I noticed that there are very little, if any, physical activities such as sports (table tennis, basketball, snooker, etc.). However, over the years, an overwhelming wealth of evidence from nursing practice and research has clearly demonstrated the benefits of such activities (Hainsworth, 2006). Researchers have established that physical activity promotes physical health and brings about physiological benefits (Department of Health, 2004b). For example, Benloucif (2004) found that daylight exercises significantly improve neurophysiological performance and sleep quality especially when they emphasize extensive duration rather than intensity. However, not only does physical activity lead to physiological benefits, but it can also generate psychological benefits such as empowerment of patients and reduction of boredom, which in turn improve clinical outcomes (Ainsworth, 2006). Another major benefit of physical activities in hospitals and wards is the creation of a social environment in which patients thrive (Frost, 2010). For example, physical activities allow service users to socialize and engage in light conversations without showing aggression towards each other (Briles, 2005). Over time, patients will learn the importance of effective communication with other people, the purpose of staying at the hospital/ward, as well as the advantages of participating in decision-making and different activities (Wilkes-Whitehall, 2004). This is particularly important for patients who are vulnerable and are in need of re-establishing their social skills in a controlled environment, such as adolescents suffering from mental illness. In fact, research has demonstrated that a warm and supportive social environment is an important factor in the etiology of mental illness, but also in the therapeutic healing process (Cohen, 2004). Physical activity, such as exercise and sports, has also been found to generally improve mental health conditions, such as anxiety, depression and general wellbeing (Schmitz, 2004). According to Strohle (2009), sports and exercise can moderately reduce anxiety and depression in mentally ill persons. Martinsen (2008) has also demonstrated that some activities (e.g. resistance, aerobic) can prevent the risk of depression. Goodwin (2003) reported the low scores of depression among adolescents as a result of engaging in exercise. Drawing on a large sample of 8,098 adolescents and adults from the ages of 15-54, Goodwin (2003) found that individuals who regularly kept themselves physically active were less depressed. Other researchers (Penedo & Dahn, 2005) have further supported the claim that exercise may be associated with therapeutic benefit among individuals with major depressive disorder. Moreover, the majority of cross-sectional studies have showed that an improved cognitive performance is related to physical fitness (Callaghan, 2004). There are implications of these findings. For example, patients who frequently engage in physical activities may become much more open to considering alternative therapies and treatments. Aside from their physiological benefits, those who participated in this exercise-therapy also showed a generally more resilient and healthier psychological state. In fact, it is well-documented that physical activities and exercise are vital in strengthening self-image and self-esteem in all age groups, especially among children and middle-aged adults (Folkins & Sime, 1981). Research has demonstrated that people who participate in physical activity have an improved self-image (Elavsky et al., 2005). As self-image is an important factor in helping patients to be less vulnerable during social re-integration, clinical outcomes are improved. Additionally, Kirkcaldy, Shephard, and Siefen (2002) presented evidence that participating in physical exercises alleviates social withdrawal, low self-esteem, and depression which are the negative symptoms of schizophrenia. Taking the above-mentioned case studies as well as other relevant literature together, it is clear that there is considerable evidence showing that physical activity through exercise and sports is effective in improving the mental and physical conditions of mentally ill service users. These physical activities promote better life quality via boosting self-esteem, reducing anxiety, improving mood, sleep and resilience to stress (Ekeland et al, 2009). However, further research is still needed to identify the effective exercise regimes and feasible delivery modalities for patients with varying illnesses. It is advised that activities that are any way strenuous or too rigorous would not be suitable for mentally-ill patients with cardiovascular conditions. Also, in order to prevent any form of musculoskeletal injuries, the duration and intensity of exercises should be increased gradually. It is therefore clear that a full assessment of patients must be carefully done by the appropriate medical practitioner before such activities are implemented (Richardson, 2005). Prior to outlining the Service Improvement Initiative, I will first outline the theoretical aspects that need to be considered when implementing a new initiative, and how these can be applied in practical terms. Theoretical Aspects In order to implement a service improvement initiative and effectively manage the changes that ensue, a clear understanding of theoretical aspects must take place. In this paper, the theoretical aspects will be drawn from John Kotter’s model and Pender’s Theory of Health Promotion (1996). In the former model, Kotter’s eight distinct phases will be organized into three broad phases: 1) creating a climate for change; 2) engaging and enabling the whole organization; and 3) implementing and sustaining change (Campbell, 2008). In the latter model, an action can directly motivate the behaviour of others through an extensive and rigorous plan of commitment from which the expected benefits will result (Pender, 1996). This author will examine theoretical aspects such as change management; accountability and responsibility, leadership and management skills, and professional/inter-professional collaboration. The first phase will focus on the importance of urgency, the building of guiding teams and getting the vision right. In fact, it is particularly important that a multi-disciplinary team has a sense of urgency in achieving the programme’s aims. The team must possess four main skills as highlighted by Campbell (2008): up-to-date knowledge about the necessary changes, an ability to justify and add credibility to the changes, awareness of any relevant knowledge on the changes and a sense of leadership in carrying out the changes. Moreover, the vision of the team must be summarised into a short-statement that encapsulates the goals of the initiative. Thus, in the case of the service improvement initiative, it is pivotal that the team of nurses and other staff has exposure to the benefits of physical and mental activities. This can be achieved through a day of seminars given by external scholars and practitioners, as well as take-away booklets and handouts that emphasise the need fo r integrating physical activity into healthcare. The second phase involves communicating the proposed changes that will enable action to take place. On the communication of the proposed changes, it is vital that all individuals involved in the initiative are completely knowledgeable about the changes that are being proposed. There must be a constant dialogue among the people involved to ensure that all parties are kept in the loop (Campbell, 2008). In fact, a clear communication strategy is also important for raising sufficient funds for a server improvement initiative. In order to garner both emotional and financial support, it is imperative that the short-term and long-term benefits of a service improvement initiative are communicated. For example, in the case of the service-user initiative for improving physical activity, the importance of improving the patient experience and the overall clinical outcome needs to be emphasised. Finally, the third phase highlights the importance of keeping a momentum when implementing change By creating a drive and motivation amongst employees, it becomes necessary to ensure that change does not become institutionalized but is a forward-looking process (Campbell, 2008). According to Kotter, â€Å"culture change comes last.† In other words, when change has been successfully implemented for a certain period of time, that is when attitudes and opinions change. In light of this, one would expect that it would take a certain amount of time for the service user initiative to become rooted in the culture of the health-care community. Other important theoretical aspects that also need to be discussed include accountability and responsibility. It is important that each member of the multidisciplinary team, in particular the nursing staff, are vigilant in maintaining both accountability and responsibility. In this case, responsibility is equivalent to the duty of care in law. This applies to all nursing tasks, from simple things such as bathing a patient to complex ones such as surgery. There is a certain degree of risk in any nursing task. When practitioners accept responsibility to perform a task, they must ensure that they accomplish it with competence and at least to the accepted standard (Scrivener, 2011). Accountability is commonly defined as â€Å"an inherent confidence as a professional that allows a nurse to take pride in being transparent about the way he or she has carried out their practice† (Caulfield, 2005, p.24). This reflects the positive aspect of accountability and puts focus on the development and demonstration of competence in practice (Scrivener, 2011). The Nursing and Midwifery Council (NMC, 2008) states that all nurses are accountable for their own actions in practice. As the last few years have seen a rise in litigation for nurses (Diamond, 1995), accountability can be a source of anxiety for nurses. It is therefore imperative that nurses follow strict protocols and guidelines, verifying when unsure and being constantly alert to new situations and information. In relation to responsibility and accountability, according to the NMC, nurses must always ensure that they take complete responsibility for their actions, and always act in according to what is agreed with their patients, their families and carers, and in line with the laws of professional health bodies (Scrivener, 2011). Given these guidelines, in my service improvement initiative, I will ensure that the appropriate responsibility is handed to managers and nurses. Whilst the manager will be ultimately accountable and oversee and be the primary point of contact regarding the actions of the nurses and other staff, there will also be others responsible such as administrative staff. It is therefore essential that there are good management and leadership practices in place so that nurses should have to achieve the proper provision of health care. Another important theoretical aspect to consider is the importance of managing in order to achieve the goals of an organization. Thomas and Worley (2009) describe management as a process of coordinating actions and allocating resources to achieve organizational goals. Similarly, Hersey and colleagues (2001) explained that management is a way of working with and through individuals and groups to accomplish organizational goals. The researchers identified management as a special kind of leadership that concentrates on the achievement of organization goals. Koontz and Weihrich (2008) stated that management is the process of organizing and maintaining an environment in which individual working together in groups efficiently accomplishes selected goal or aims. In application to nursing profession, Sullivan and Decker (2011) define management as the abilities to plan, manage, organize and deliver care. It includes the process of discovering a good way of caring for patients. The goals of the service improvement initiative must therefore be clearly structured and outlined to ensure that both individuals and groups can work towards the initiative’s aims which are to improve the quality of patient care. Leadership may be defined as the ability to direct and influence the task or activities of the members of a group in its efforts to achieve certain objectives (Huczynski & Buchanan 2007). These authors further define leadership as the process of influencing the activities of an organized group in its efforts towards creating an environment focused on goal achievement. Mullins (2007) stated that leadership is a relationship through which one person influences the behavior or action of other people. According to Gopee and Galloway (2009), the key elements of leadership are leader’s personal characteristics, interpersonal relationships, team working and being a role model. They also identified four styles of leadership which include autocratic, democratic, laissez-faire and bureaucratic. In the context of nursing, Sullivan and Garland (2010) list many leadership and managerial skills required from a nurse. These skills range from the initiation and implementation of change, criti cal thinking, problem-solving, effective communication, time-management, appropriate delegation, budgeting and allocating resources and understanding power and politics. In the service improvement initiative, it is therefore important for nurses to acquire both leadership and management skills to be able to function effectively (Marquis and Huston, 2009). In fact, Barr and Dowding (2008) explained that management and leadership skills should be integrated in order to provide high-quality care to the patients. Finally, another critical element for a successful implementation of the service improvement initiative is a culture of â€Å"inter-professional collaboration†. The World Health Organization defines inter-professional collaboration as a process in which â€Å"multiple health workers from different professional backgrounds work together with patients, families, carers, and communities to deliver the highest quality of care.† An expert panel of Inter-professional Education Collaborative (2011) defines inter-professional competencies in health care as â€Å"integrated enactment of knowledge, skills, and values/attitudes that define working together across the professions, with other health care workers, and with patients, along with families and communities, as appropriate to improve health outcomes in specific care contexts†. In the context of the service improvement initiative, a panel of inter-professionals will be involved from the first day to actual implementa tion to ensure that the highest quality of care is given to patients. The Service Improvement Initiative To improve the nursing services in the ward, I plan to execute a six-month program involving 10 adolescent patients from the ages of 10-17, from the psychological ward. Patients will be invited to partake in a range of physical activities, such as exercise and sports, as well as mind games. The overall aim of this initiative is to establish whether such activities have any effect on the behavior or wellbeing of patients. A secondary aim of the initiative is to explore various aspects of the delivery of care, taking into consideration the different theoretical aspects of the nursing practice. The budget will be need to be closely decided in liaison with the manager to ensure that there is sufficient funding for purchasing the sport equipment and the personnel for facilitating and monitoring physical activities. Although the programme is to be conducted in a normal hospital setting, funding will also need to be allocated for the services of the experts and all the administrative and logistical aspects of the initiative. Whilst as a nurse, I can initiate the set of activities for patients, I will need to draw on the assistance and expertise of other medical practitioners for the intervention to be successful. It will also be necessary to set up a multidisciplinary team that will aid in the implementation and completion of the initiative. Team members will be psychiatrists, physical therapists, mental health practitioners, and other experts. It is particularly important to draw on the expertise of a Physical Therapist as it is essential to determine the capabilities of mentally ill individuals when it comes to engaging in physical activities. Psychiatrists also play an important role in assessing the clinical outcomes of patients within a certain time-frame. Given previous research on the risks of physical activity for mentally ill patients (Richardson, 2005), careful considerations shall also be made to ensure that the types of physical activity will depend on the psychological condition of the patient and all physical activities will be limited to light exercise and light sports, such as table tennis. The assessment of the clinical outcomes of the service improvement initiative for adolescent patients will take place on a weekly basis. The assessment criteria will be decided by consulting experts and mental health practitioners. The amount of exercise given in the following week will then depend on the clinical results of the patients at the end of the week. This allows a continuous assessment of patient improvement. It is important to note that the proposed initiative may face a number of challenges. These challenges include the specific culture of a workplace in which some staff may oppose the change, funding costs, fear of increase in work load amongst nurses and a subsequent increase in staff anxiety level (Paton and McCalman, 200; Sharma, 2008). Professional Development Plan Introduction In this section, I will focus on one of the aspects of my personal development which I intend to concentrate on within the first six months of registration. In my personal development plan I will explore my strengths, weaknesses, opportunities and threats (SWOT) and write an action plan that is specific, measurable, achievable, realistic and timely (SMART). Using the reflective tools and SWOT analysis (Appendix B), I have identified my strengths, weaknesses, opportunities and threats, One of the main areas of expertise where I see the weakness and where I would like to see improvements in my knowledge and abilities in the management of medications. Being a nurse does not only require clinical skills but also good leadership, management and communication skills that are learned from practice. Action Plan Administration of medicines is a key element of nursing care. Drug administration is one of the major parts of the nurse’s clinical role. Although doctors traditionally take control of prescribing medicines, a registered nurse does have primary responsibility in administering the correct dosage of medicines. Nurses are responsible regarding the preparation of medicine, verifying and checking appropriate medication, monitoring the effectiveness of treatment and in certain cases, reporting any adverse drug reactions. Given research findings that patients do not always receive the correct medication at their drug rounds, nurses must be vigilant in ensuring appropriate medicine management (Andalo, 2006). However, there has been evidence that medicine management has not been given considerable priority by health care services, and that it is commonly excluded from pre-registration training or in practice (Snowden, 2011). The development of competency in medicine management requires an explicit academic component is present. This is particularly important given recent failures such as those highlighted in Francis Report (Wright, 2013). In this report, Robert Francis revealed the failure among nurses and healthcare assistants to feed patients and give them the basic elements of care such as dignity and respect. Initiatives to combat such behaviour in the future included holding nurses personally and criminally accountable, as well as holding hospital boards responsible should they fail to ensure that all patients are receiving high quality care (Wright, 2013). As I am a student who is in the transition period to a staff nurse, I am aware of the changing responsibilities and accountabil ity that are inherent to being a nurse. Personal Development Plan Nagelkerk (2005) highlights the importance of setting and identifying goals that are intrinsic to your personal development, as it allows you to reflect on your practice and also highlight your strengths and weaknesses, which gives you the opportunity to initiate and implement change. With this in mind, I plan to draw on Snowden’s â€Å"clusters on essential skills for medicine management†. This is relevant to the current service improvement initiative as it highlights the need for newly registered nurses to be completely briefed on patient history and able to responsible administer medicines (Snowden, 2011). Moreover, I will draw on the SMART (Specific, Measurable, Achievable, Realistic and Time) bound framework to set a time scale for my action plan. I will also draw on Snowden’s clusters on essential skills for medicine management as it is a parsimonious model that allows me to evaluate educational needs and professional development. During the first month of the programme, I will ensure that I am completely knowledgeable of the commonly administered medicines that the patients are taking, their actions and side effects. I will do this by liaising with doctors and psychiatrists, and also attending weekly ward rounds. Within the second month, I intend to increase my confidence when it comes to managing my medication round effectively using the eight rights checklist: â€Å"right medication†, â€Å"right patient†, â€Å"right dose†, â€Å"right time†, â€Å"right date†, â€Å"right route†, â€Å"right preparation† and â€Å"right documentation† (Morgan, 2000). I will also develop my knowledge of pharmacology such as the interaction of medicines with different systems of the body. In the third and fourth months of training, I will build up my knowledge on the necessary techniques for administering medicine. I will attend a series of sessions on medicine management as well as observe trained professionals. This is in line with research that nurses must constantly build their body of knowledge and develop their professional skills (Burton & Ormrod, 2011). The fifth and sixth months will focus on the application of the knowledge I acquired. This is where safety management, administration and monitoring of drugs come in. I will practice my skills in ordering medication, their storage and disposal of used medication. I intend to keep a reflective diary about all that I learnt from my own experience and experience of colleagues. The support and assistance of an experienced professional is very important and vital for a newly qualified nurse to gain confidence and practice effectively (NMC, 2008). With the right support and guidance from experienced colleagues, I should be able to manage medications safely and effectively. This will greatly enhance my professional confidence. Having clearly identified my goals and assigned a time limit to achieve them will help me to monitor my progress. I will work hard to make sure that my goals are achievable within the clinical setting. Conclusion Over the course of this paper, it has become clear that the responsibilities of a newly registered nurse are vast. The transition from a student to a nurse is not without its challenges and requires continuous training, support and guidance. To ensure that I am progressing in my knowledge of nursing, I will constantly engage in evaluations and assessment of my learning. For example, I will verify my learning in accordance with the standards of the Nursing and Midwifery Council. APPENDIX A Service Improvement Activity Notification Proforma Details of service improvement project/activity: The main aim of the Service Improvement Initiative is to provide physical activity to mentally ill adolescents aged 10-17 years. The initiative will assess the clinical outcomes following the physical activity intervention, as well as the development of nursing skills needed for the efficient and effective delivery of care. Reason for development: Based on my observations in a psychological ward for adolescents aged 10-17 years, there are no opportunities to be involved in activities such as sports (darts, snooker, etc.). These activities are proven to provide multiple benefits to the service users, both in terms of physical fitness and mental health. Time spent on the project/activity: The program will take place over a span of six months. Resources used: There are a number of resources needed for this initiative. Resources include sufficient funding for paying for the services of team members and experts, as well as a range of sporting equipment, such as table tennis tables. Who was involved: A multidisciplinary team consisting of a group of nurses a physical therapist, psychiatrists, mental health practitioners, and other experts will be set up. Future plans: The initiative will be implemented in six (6) months. It is hoped that the program will become successful and beneficial for the service users and the multidisciplinary team. APPENDIX B Strengths  ·Good communication skills,  ·Good team player  ·Positive attitude  ·Good interpersonal skills  ·Motivated and enthusiastic  ·Responsible Weaknesses  ·Assertiveness  ·Medicine management skills  ·Professional boundary issues Opportunities  ·Access to training  ·Learning from other members of inter-professional team.  ·Education, development and research  ·Effective supervision  ·Effective feedbackThreats  ·Lack of time  ·Staff attitude on ward  ·Staff shortage  ·My inexperience APPENDIX C Objective 1. Improve my knowledge of medication management. Where I am now Insufficient knowledge about medication. Goal To become competent in medication management. Action plan Read British National Formulary Check NICE guidelines on medication Work with colleagues on the ward. Administering medication regularly with supervisionTime 2 weeks 1- week 1- week continuouslyEvaluation Self-evaluation and evaluation by experienced professionals 2. Develop good knowledge of NICE guidelines on medication and current government policies on medication.Insufficient knowledge of NICE on medication management.Competency and ability to practice independently.Read through NICE guidelines on medication (internet, Nursing publications) Administering medication regularly with supervision. 2-month.Self- evaluation and evaluation by experienced professionals 3. Attend training on medication. Insufficient knowledge of certain medicinesGood knowledge about drugs, their use, dosages and side effectsAttend training and seminars on medication 4-monthReflects on the experience gained, discuss with mentor 4. Develop confidence in ordering medication, organising its storage and disposal. Inadequate knowledgeAbility to practice with confidenceActively participate in the daily running of the ward 6-monthEvaluation by mentor and reflecting on practice REFERENCES Andalo, D. (2006). Medicines management in English care homes: a grim and chaotic picture. The Pharmaceutical Journal. 276, 198-199. Barker, P., (2005). The tidal model: A guide for mental health professionals. London: Routledge. Barr, J. & Dowding, L. (2008). Leadership and Healthcare. London: SAGE Publications Limited. Beebe, L. H., Tian, L., Morris, N., Goodwin, A., Allen, S. S., & Kuldau J. ( 2005) Effects of exercise on mental and physical health parameters of persons with schizophrenia. Ment Health Nurs, 26, 661-676. Benloucif, S. (2004). Morning or Evening Activity improves neuropsychological performance and subjective sleep quality in older adults. Sleep, 27(8), 1542-1550. Briles, J. (2005). Zapping Conflict Builds Better Teams. Nursing Times, 35(11), 32. Burton, R., & Ormrod, G. (2011) Nursing Times: Transition to Professional Practice. London: Oxford University Press. Callaghan, P. (2004). Exercise: A neglected intervention in mental healthJournal of Psychiatric and Mental Health Nursing, 11(4), 476-483. Campbell, R. J. (2008). Change Management in Health Care. The Health Care Manager, 27(1), 23–39. Caulfield H. (2005). Accountability. Blackwell Publishing, Oxford, 3. Cohen, S. (2004) Social Relationships and Health. American Psychologist, 59(8), 676–684. Daley, A. (2002). Exercise therapy and mental health in clinical populations: Is exercise therapy a worthwhile interventionAdvances in Psychiatric Treatment, 8, 262–270. doi:10.1192/apt.8.4.262 Department of Health (2004). Choosing Health: Making Healthy Choices. Diamond, B. (1995). Legal Aspects of Nursing. Hemel Hempstead: Prentice Hall. Ekeland, E. (2009). Exercise to improve self-esteem in children and young people. Cochrane Database Syst Rev, 1. Elavsky S. et al., (2005). Physical Activity enhances long-term quality of Life in Older adults: Efficacy, Esteem, and Affective Influences. Annals of Behavioral Medicine, 30(2), 138–145. Folkins, C. H, Sime, W E. (1981). Physical fitness training and mental health. American Journal of Psychology, 36, 373-389. Frost, S. (2010). What are the benefits of activities in nursing homesLivestrong Publications. Accessed March 21 2013 from: http://www.livestrong.com/article/151544-what-are-the-benefits-of-activities-in-nursing-homes/ Goodwin, R, D. (2003). Association between physical activity and mental disorders among adults in the United States. Preventive Medicine, 36(6), 698-703. Hainsowrth, T. (2006), The benefits of increasing levels of physical activity. Nursing Times, 102(20), 21. Hersey, P., Blanchard, K. & Johnson, D. (2001). Management of Organisational Behaviour: Utilising Human Resources. 8th ed. Upper Saddle River, NJ: Prentice-Hall. Gopee, N., & Galloway, J., Eds. (2009) Leadership and Management in Healthcare. London: SAGE Publications Limited. Huczynski, A., & Buchanan, D. A. (2010). Organisational behaviour. 7th Ed. Harlow: Prentice Hall. Inter-professional Education Collaborative Expert Panel (2011). Core competencies for inter-professional collaborative practice: Report of an expert panel. Washington, D.C.: Inter-professional Education Collaborative. Kirkcaldy, B. D. et al. (2002). The relationship between physical activity and self-image and problem behavior among adolescents. Social Psychiatry and Psychiatric Epidemiology, 37, 544-550. Koontz, H., & Weihrich, H. (2008). Essentials of Management: An international Perspective. New Delhi: Tata Mcgraw-Hill. Marquis, B., & Huston, C. (2009). Leadership Roles and Management Functions in Nursing: Theory and Application. 6th Ed. Philadelphia: Wolters Kluwer/Lippincott Williams and Wilkins. Martinsen, E. (2008). Physical activity in the prevention and treatment of anxiety and depression, Nord Journal of Psychiatry, 62, 25-29. Morgan, S. (2000). Assessing and Managing Risk: A Practitioner Handbook. Brighton: Pavilion. Mullins, L. (2007). Management and Organisational Behaviour. 8th Ed. Harlow: Pearson Educational Limited. Nagelkerk, J. (2005). Management Principles. In: D. Huber (Ed.) Leadership and Nursing Care Management. 3rd Ed. Maryland Heights: Saunders Elsevier. Chapter 2. Nursing and Midwifery Council (2008). The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives. London: Nursing and Midwifery Council. Paton, R & MacCalman, S. (2008). Change Management: A Guide to Effective Implementation. London; Sage Publication. Pender, N. J. (1996). Health Promotion in Nursing Practice, 3rd ed. Stamford, USA: Appleton & Lange. Penedo, F. & Dahn, J. (2005). Exercise and well-being: a review of mental and physical health benefits associated with physical activity, Current Opinions in Psychiatry, 18(2), 189-193. Richardson, C. et al. (2005). Integrating physical activity into mental health services for persons with serious mental illnesses. Psychiatric Services, 56(3), 324-41. Roussel, L. (2011). Management And Leadership For Nurse Administrators. Burlington: Jones and Bartlett Learning Savard J., Simard S., Ivers, H., et al (2005). Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, Part II: Immunologic effects. Journal of Clinical Oncology, 23, 6097-6106, Schmitz, N., Kruse, J., & Kugler, J. (2004). The Association between Physical Exercises and Health-Related Quality of Life in Subjects with Mental Disorders: Results from a Cross-Sectional Survey. Preventive Medicine 39, 1200–1207. Scrivener, R. et al. (2011). Accountability and responsibility: Principle of Nursing Practice B. Nursing Standard, 25(29), 35-36. Sharma, R. (2008). Change Management: Concepts and Applications. New-Delhi: Tata McGraw Hill Publishing. Smith, S. et al. (2007). A well-being programme in severe mental illness. International Journal of Clinical Practice, 61(12), 1971-1978. Snowden, A. & Barron, D. (2011). Medicines management in mental health. Nursing Standard, 26(3), 35-40. Strohle, A. (2009). ‘Physical activity, exercise, depression and anxiety disorders’, Journal of Neural Transmission, 116, 777–784. Sullivan, E.J. & Decker, P.J. (2011) Effective leadership and management in nursing. Upper Saddle River, N.J.: Pearson Prentice Hall. Sullivan, E. J. & Garland, G. (2010) Practical Leadership and Management in Nursing. Harlow: Pearson Education Limited. Taylor, A.H. & Faulkner, G. (2008). A new academic journal with a specific focus on the relationship between physical activity and mental health. Mental Health and Physical Activity 1(1), 1-8. Tappen, R., Weiss, S., & Whitehead, D. (2004) Essentials of Nursing Leadership and Management. 3rd Ed. Philadelphia: FA Davis Company. Thomas, G., & Worley, C. (2009). Organisation Development and Change. Canada; South-Western. Wilkes-Whitehall, D. (2004). Archives of Women’s Mental Health – Interpersonal psychotherapy for depressed adolescents, 7(4), 251-25.Elizah

Business Strategy and Innovation of Cisco Systems Inc

EXECUTIVE SUMMARY The purpose of the report was to discuss the business strategy of Cisco Systems Inc (Cisco), a company widely considered innovative. The report was to discuss the justification of Cisco’s status of innovative, how the business environment impacted on Cisco and it’s opportunities for innovation, their sources of competitive advantage, strategic options available to Cisco, and evaluate the risks of implementing the strategic change to achieve this optionThis was done by evaluating Cisco’s current strategies, its business environment and markets, applying strategy frameworks in the context of its industry and innovation, and by analysing the risks that could be associated with implementing this change. Cisco innovate in three ways; they build innovation using research and development budgets; they buy innovation, by making strategic acquisitions; and they partner, developing strategic partnerships and ecosystems to aid innovation. Cisco’s ex ternal environment was assessed using PESTEL analysis and applying Porter’s Five Forces framework.It was established that the main key drivers for change were technological and worldwide competition laws. VRIN Frameworks were applied to assess Cisco’s sources of competitive advantage, as well as some of the threats they face in these areas. It would appear that the biggest threat to Cisco in this area is Non-substitutability; Cisco’s competitors are eroding their market share by offering similar products. Two strategic options were discussed; selling their enterprise products directly to the end users and entering the consumer market.It was decided that the more radical of the two was entering the consumer market; and the risks associated with implementing the change, along with advice on how Cisco could manage the strategic change, were discussed. TABLE OF CONTENTS 1. 0 INTRODUCTION5 2. 0 IS CISCO INNOVATIVE? 6 3. 0 CISCO AND THEIR BUSINESS ENVIRONMENT8 3. 1 TH E MACRO ENVIRONMENT8 3. 2 KEY DRIVERS FOR CHANGE8 3. 3 APPLYING PORTER’S FIVE FORCES FRAMEWORK9 3. 3. 1 The Threat of Entry10 3. 3. 2 Threat of Substitutes11 3. 3. 3 Power of Buyers11 3. 3. 4 Power of Suppliers12 3. 3. 5 Competitive Rivals12 4. 0 COMPETITIVE ADVANTAGE13 4. 1 Value14 4. 2 Rarity15 . 3 Inimitability15 4. 4 Non-Substitutability16 4. 5 Cisco’s Organisational Knowledge16 5. 0 STRATEGIC OPTIONS17 6. 0 IMPLEMENTING STRATEGIC CHANGE19 6. 1 Risk20 6. 2 Managing Strategic Change21 7. 0 CONCLUSION22 8. 0 REFERENCES24 9. 0 BIBLIOGRAPHY26 1. 0 INTRODUCTION Cisco Systems Inc (Cisco) was established in 1984 by a husband and wife team who wanted to solve the technical issue of emailing each other, but on different networks, and developed the first multi-protocol router, a device which allowed the different networks to ‘talk’ to each other by translating the different protocol languages (Cisco Systems Inc, 2012).This report will examine Cisco as an innovat ive company, the external factors affecting their ability to innovate, their sources of competitive advantage within the industry and consider some of Cisco’s strategic options, the risks associated with the changes in strategy and how this can be managed. The information has been compiled from information published by Cisco on their website, Exploring Strategy, Ninth Edition (Johnson, Whittington and Scholes, 2011), Academic Journals and published articles. 2. 0 IS CISCO INNOVATIVE?To establish if Cisco is innovative, first we have to define what innovation is. Innovation can be defined as, â€Å"†¦the conversion of a new knowledge into a new product, process or service and the putting of this new product, process or service into actual use. † (Johnson, Whittington and Scholes, 2011, pg 296). Therefore until the product, process or service is brought to the market; it cannot be considered an innovation. In regards to innovation, Cisco has an extensive innovation strategy. They do this using their â€Å"three pillars of innovation: build, buy and partner† (Cisco, 2012.Acquisitions, pg 1. ), The ‘Build’ aspect relates to internal innovation, whereby they develop products and services with Research and Development (R&D). They have 7 major laboratories in locations around the world, and employ around 20,000 engineers (Cisco, 2012). The diversity of basing these facilities all over the world will only help to aid innovation, as the people can use their own cultures and experiences to develop new product and services, thereby helping to develop worldwide solutions to global industry problems. Yearly Cisco invests over $5 Billion on R&D (Cisco, 2012).With regards to their ‘Buy’ aspect of their innovation strategy, Cisco is constantly looking to acquire technologies to improve their current product range. Cisco has acquired over 160 companies up to the end of 2012, and will continue to actively seek out acquisition opportunities to increase their product range (Cisco, 2012). It may be argued that innovation by acquisition is not innovation; however the innovation comes with the integration of these technologies into their existing product ranges and taking new products to market.Cisco also purchase technologies that have yet to be brought to the market, so are more inventions than innovations, and take calculated risks in doing so. Cisco’s approach to innovation is an open one, and they have many strategic partnerships. Cisco is aware that to maximise the potential of their products, they must rely on the products of other vendors. Cisco have created an Ecosystem, to help develop their Cisco Unified Computing System (UCS), a system that Cisco see as the future of the IT network; the collaboration of the network, all managed simultaneously on one platform (Cisco, 2012).By opening up their innovation to these ecosystem partners, it will engage the partners on a positive way and ensure tha t the partner’s complimentary products and services will be fully compatible with the UCS. The ecosystem approach will help speed up innovation, as more people working together to create innovative products or services are more likely to get superior products to market faster (Johnson, Whittington and Scholes, 2011). Cisco has, since inception, been a first-mover in its markets. Cisco’s vision, â€Å"Changing the way we work, live, play and learn† (Cisco, 2012.Corporate Overview Pg 11), shows that they want to lead the market in developing networking technologies. This gives them considerable advantages, allowing them to become market leaders in these areas, and charge a premium for these products. 3. 0 CISCO AND THEIR BUSINESS ENVIRONMENT When we discuss the business environment, we are in fact looking at the environment where the business operates. In this section the external environment will be analysed using PESTEL framework, focusing on some of the key dri vers for change, use Porters Five Forces to analyse the Industry and will look at the opportunities and threats Cisco face. 3. THE MACRO ENVIRONMENT The Macro Environment of a business is concerned with the external factors which affect almost all organisations (Johnson, Whittington and Scholes, 2011). Appendix A shows a PESTEL analysis for Cisco, outlining some of the issues which they face. For the purpose of the report, however, only the important key drivers for change will be discussed. 3. 2 KEY DRIVERS FOR CHANGE Looking at the PESTEL Analysis, there are some that are more relevant to the industry Cisco operate – Technological. Virtualisation technology became one of the most important key drivers for change in the IT industry of recent times.This meant companies like Cisco had to begin to develop systems that would take advantage of this. This has led to huge developments in ‘Cloud’ technologies, where the resources are provided, at a service fee, over the internet. They provide several variations of the ‘x-as-a-service’ model. This is beneficial to cash-conscious companies, who are looking to reduce the expensive CAPEX costs IT infrastructure incurs, passing this responsibility onto the service provider. The rate at which this technology has been released and adopted has fuelled Cisco’s innovation, as they have to innovate to continue to remain competitive.Another key driver for change is the Competition Laws Cisco are faced with, namely the US Antitrust policy, whereby all acquisitions have to be approved by the Department of Justice and the Federal Change Commission, who look at how acquisitions will affect the competition balance. They do not, however look at the innovative developments these acquisitions will create, nor if the benefit of such innovation outweighs the competition problems (Mandel and Carew, 2011). Appendix B shows some of the scenario outcomes of the effects of acquisition laws on the develop ment of technologies in the Cloud market.Scenario building can be useful, however you cannot have just one universal scenario for the company as a whole, there can be an endless chain of scenarios created for every situation that can be thought up. That is why, when looking at scenarios, it is important to identify the key drivers for change. 3. 3 APPLYING PORTER’S FIVE FORCES FRAMEWORK Porter’s Five Forces Framework can help Cisco establish if an industry is an attractive option, identifying five areas in competitive forces; the threat of entry, the threat of substitutes, the power of buyers, the power of suppliers and competitive rivalry (Johnson, Whittington and Scholes, 2011).For the purpose of the report, we will focus this next section on Cisco’s Switching market. 3. 3. 1 The Threat of Entry Cisco must be aware of potential competitors into their markets, and creating sufficient barriers to entry can help. These barriers need to be overcome by new entrants to the market if they wish to compete (Johnson, Whittington and Scholes, 2011). Cisco, as first-movers, has created several barriers to entry; Cisco has greater experience over its rivals and uses its first-mover advantages to secure market share before anyone else tries to compete.Cisco do not manufacture the components of their products, they rely on over 600 companies for this (Cisco, 2012). They could try to secure exclusivity with these suppliers, thereby reducing the new entrant’s ability to buy the same components, making it harder for them to replicate Cisco’s products. In response to competition threats, Cisco could, in theory, enter into price wars with new entrants to the market, they could increase their marketing spend, and out-market the new entrants, as they have the financial means to do so.Overall, the threat of new entrants means Cisco have to remain innovative, to product new products, protected by patents, and creating new industry standards, to ma intain their share of the market. 3. 3. 2 Threat of Substitutes With the emergence of cloud technologies, Cisco was in danger of falling behind and their products substituted with Cloud technologies. However Cisco has developed products to compete in this area, for example their Switching-as-a-Service, giving their customers the option to have their network switching hosted in the cloud.To avoid being substituted, Cisco had to adapt to the emergence of Cloud technologies to remain relevant. Emerging technologies such as this ensure Cisco retains their innovative edge. 3. 3. 3 Power of Buyers Cisco only sells their enterprise products through a network of distributers. This increases the distributers buying power as Cisco are reliant on them. However due to the complexity of the products, there doesn’t appear to be a threat from the buyers in terms of competition, as they are unlikely to find backward vertical integration attractive.Cisco have to remain innovative to maintain the relationships with their buyers, if Cisco are seen to fall behind technology’s advance, then they will become obsolete to the buyers, and they will look to buy other products that are innovative. 3. 3. 4 Power of Suppliers As previously discussed, Cisco relies on over 600 suppliers to provide the components of their products. This gives the suppliers power, as delays in Cisco receiving their products will disrupt their supply chain. 3. 3. 5 Competitive Rivals In the switching market, Cisco currently hold around 69% of the market share Cisco, 2012), and while this is a comfortable position to be in, Cisco must not become complacent. HP is growing in market share year-on-year (Gabra, 2012), offering Cisco real competition in affordable managed switching products. HP also has a strong brand and a large presence in both the business and consumer markets. This makes HP an attractive alternative to the end user, which is a threat to Cisco’s core switching business. Cisco has to continue to develop their products, make them better than the rivals, to ensure they can maintain the market share.Customers need to see that they are getting value for money, so Cisco must do this with that in mind, they have to make the products affordable AND innovative. Cisco is strong in many areas discussed, they are innovative in nature, it is part of their history that they began and continue to innovate. As innovation is part of Cisco’s DNA, this is unlikely to change. They are developing some of the traditionally physical technologies (switching for example) for the cloud market, creating cloud platforms which they can still provide their core products from.Cisco has patent protection on their products, which puts them in a strong position to their competitors. To keep this patent protection relevant they need to continue to invent new designs to bring to market. They do have some weakness; the entry of HP to their core switching market is worth noting. Cisc o have still got a good market share, however HP are slowly eroding this, with gains in market share each year. Cisco will have to tackle this to ensure this erosion does not progress too far. To do this they must continue to produce superior products to HPs, and thereby drives their innovation. 4. COMPETITIVE ADVANTAGE As previously discussed, Cisco currently have over 69% of the market share in their switching market. How does Cisco maintain their competitive advantage? The resource-based view is that, â€Å"†¦competitive advantage and superior performance of an organisation is explained by the distinctiveness of its capabilities. † (Johnson, Whittington and Scholes, 2011 pg 83) This is to say that it is the capabilities of the companies which give it the competitive advantage; the development of new innovative technologies alone will not give a company this competitive advantage (Eng & Luff 2011).Looking at some of Cisco’s resources and competences (Appendix C) we can see that these are wide-ranging, from the obvious of buildings, Computer Equipment and Employees, to the less obvious; strong balance sheet, worldwide R&D and Ecosystems. From here we can establish which of these are threshold resources and capabilities, those which are required to compete in a market (Johnson, Whittington and Scholes, 2011) and the distinctive resources and capabilities, those required to give a company it’s competitive advantage (Johnson, Whittington and Scholes, 2011).These have been illustrated in Appendix D. For the purpose of this report we will focus on the distinctive resources and capabilities, as those are the ones which will secure Cisco’s Competitive Advantage, and apply VRIN Framework to assess Cisco’s basis of these advantages; Value, Rarity, Inimitability and Non-substitutability. 4. 1 Value â€Å"Strategic capabilities are of value when they provide potential competitive advantage in a market at a cost that allows an org anisation to realise acceptable levels of return†¦Ã¢â‚¬  (Johnson, Whittington and Scholes, 2011 pg 90).Cisco does this by taking advantage of opportunities and limits the threats that they are presented with (Johnson, Whittington and Scholes, 2011). Acquisitions allow them to adopt new technology that their rivals cannot. If, for example, they were only to licence technology from these companies, their competitors could also. By buying these companies this allows them exclusive access to the technologies. Cisco’s R&D spending and the acquisition of technologies allow Cisco to produce products, which they protect with patents, that their competitors do not have, putting them ahead of the competition.Cisco spends billions of dollars each year on R&D, however still produce good profits which is acceptable to their shareholders. This shows that the shareholders understand that to achieve and maintain the market share, then spending on this level is acceptable. 4. 2 Rarity â€Å"Rare capabilities†¦are those possessed uniquely by one organisation or by a few others. † (Johnson, Whittington and Scholes, 2011). Cisco currently has over 8000 patents protecting their products, and files around 700 more per year.This gives them long lasting protection from competitors. Cisco employ over 20,000 engineers (Cisco, 2012) and the skills and knowledge of these people is a valuable commodity. Cisco must ensure they try to maintain a high level of staff retention to avoid engineers going to work for competitors. Cisco has a strong brand in the business market, with around 69% of the market share in the switching market alone (Cisco, 2012).Cisco have to ensure that they keep creating new rare capabilities to maintain this competitive advantage and adequately protecting innovations, for example, in the USA design patens last 14 years (United States Patent and Trademark Office, 2003) and 20 years in the UK (Intellectual Property Office, 2011). 4. 3 Inimita bility â€Å"Inimitable capabilities – those that competitors find difficult to imitate or obtain† (Johnson, Whittington and Scholes, 2011 pg 91). Cisco work with their customers to ensure that their needs are met, in turn this leads to co-specialisation (Johnson, Whittington and Scholes, 2011).If Cisco is successful with this, then the customer is more likely to come back to them with future problems for Cisco to solve, and are unlikely to move to a competitor. Cisco’s innovative culture was imbedded into the company right from inception. Cisco has a competitive advantage here as innovation is something they just ‘do’ and have always done. Breeding this into an established company may prove difficult due to a lack of experience, resources and change resistance.Cisco also adapt well to changes in market conditions, and as technology moves forward, so do Cisco; by producing products and services to meet emerging technology. 4. 4 Non-Substitutability Cisco is at risk of substitution by competitors. Patent protection lessens the risk as by the time the patents expire; technology will have advanced so much that the patented technology is already old. This also does not stop companies from copying ideas; you only need to look at the press coverage of Smartphone producers taking each other to court, accusing the other of patent infringement.Cisco has to ensure that the products and services they offer remain ahead of the competition, to get a foothold on the market, to avoid substitution. 4. 5 Cisco’s Organisational Knowledge â€Å"Organisational knowledge is the collective intelligence, specific to an organisation, accumulated through both formal systems and the shared experience of people in that organisation. † (Johnson, Whittington and Scholes, 2011 pg 94) The items discussed in the VRIN framework above can be consolidated into the organisational knowledge of Cisco, and this too creates competitive advantage.The ex plicit knowledge gained by using codified information within the company’s structure and the tacit knowledge gained by experience and expertise combines is difficult to imitate, thereby creating a source of competitive advantage over rivals (Johnson, Whittington and Scholes, 2011). 5. 0 STRATEGIC OPTIONS When assessing Cisco for potential strategic options, the following had to be considered; what markets do Cisco currently operate in, what products and services do they provide and is there any scope within the value chain for vertical integration?Two of the options which came to light were selling their enterprise products directly to the end user and entering the consumer market. Using the â€Å"Ansoff product/market growth matrix† (Johnson, Whittington and Scholes, 2011 pg 232) selling products to the end user would be market penetration, which would involve Cisco increasing their market share with their current product range through vertical integration of the Sale s and Marketing part of the value chain.The reasons behind Cisco taking this approach would be the potential of increased profit margins. By selling through distribution channels and partners, Cisco will come up against bias towards their competitors. As end users often rely on their IT reseller for advice on what they require, if the IT reseller has a preference for a competitor, then Cisco will lose the opportunity, regardless if their product is superior. They will increase their contact with their end users, and this will increase customer visibility and co-specialisation.Marketing direct to the end user will provide a greater visibility of the Cisco brand and could help build their brand awareness. This would also give them an advantage over competitors who do not sell online, and allow them more direct competition with those that do. They would still be able to work with their partners, as the partners would be the ones implementing the equipment, and will maintain their curre nt partner program revenue.There are a few issues that Cisco needs to be aware of if they implement this option; this will be costly. They will have to increase their sales and marketing presence, and they will also have to increase their distribution facilities, as well as create a direct sales channel, especially an online sales platform. They also run the risk of alienating their partners, as they will be in direct competition with them, which could result in partners looking to other options.This however could be combated by working with the partners, using partner deal registration procedures, to ensure that Cisco and their partners do not end up going after the same deals. They could also provide a referral system for new customers to the partners, if they buy direct from Cisco, then Cisco will refer them to a partner to handle the installation and management of the system. It may be that for this to work Cisco would have to withdraw their business from the distributers, essen tially cutting out some of the middle men.With regards to entering the consumer market, Cisco could go into the market selling new products and services (conglomerate diversification) however in this their current portfolio could be included, as they would be new products into the market (Johnson, Whittington and Scholes, 2011). Consumers are looking for ways to combine their work and home technologies, making accessing all of the information they require easier. Therefore entering the consumer market with a mix of both current and new products may be prudent.This would allow them to build a market share on the products they know well. With new products, Cisco’s innovation policy of â€Å"Build, buy and partner† could apply here; they could build new products, for example set-top TV boxes and smart TVs which include their collaboration products (Cisco Jabber and TelePresence); buy innovation, for example if they were to buy a telecoms provider such as TalkTalk, they co uld introduce IP Telephony at home as a standard offering; or they could partner with the producers of these products to integrate Cisco technologies into these products.This would allow Cisco to generate Economies of Scope, as they would be able to use their existing resources in the new market. This may also produce a synergistic effect (Johnson, Whittington and Scholes, 2011) as the increased brand awareness in the consumer market may bring more sales into the business market and vice-versa. 6. 0 IMPLEMENTING STRATEGIC CHANGE In the previous section two possible strategic options were considered; selling their enterprise products direct to the end user and entering the onsumer market. Here the focus will be on the more radical option of entering the consumer market and will look at the risks associated with implementing this change and how this change can be managed. When evaluating strategies, it is important to look at three key areas; Suitability, Acceptability and Feasibility , otherwise known as SAFe. For the purpose of the report we will focus on risk, a key point in assessing the Acceptability of the strategy (Johnson, Whittington and Scholes, 2011). . 1 Risk â€Å"Risk concerns the extent to which the outcomes of a strategy can be predicted† (Johnson, Whittington and Scholes, 2011 pg 371). This can be assessed using different financial and statistical tools to establish the effects of the strategy on the Cisco’s risk level. Sensitivity testing can be used to challenge the different assumptions about a strategy and what the effects the ‘what if’ scenarios will produce (Johnson, Whittington and Scholes, 2011).If Cisco enters the consumer market with assumptions of how much revenue this will generate, and there is an economic downturn, resulting in reduced revenue, what will the effects if this reduced revenue be? Financial Ratios would allow Cisco to look at the financial impact of the strategic option (Johnson, Whittington a nd Scholes, 2011). For example, entering into the consumer market would be of high financial risk due to sunk costs in setting up the new business stream and increased R&D costs, which would have a negative impact on the financial position of Cisco.Break even analysis is another financial tool that can be used to assess risk. This analysis shows the point where revenue will match fixed and variable costs, allowing Cisco to know the level of revenue required to break even (Johnson, Whittington and Scholes, 2011) and assess if it is even viable. 6. 2 Managing Strategic Change Due to the rate that the technology markets change, Cisco should adopt a revolutionary change strategy (Johnson, Whittington and Scholes, 2011) to ensure they take advantage of the opportunities available to them.They must ensure that there is a clear and concise strategic direction communicated throughout the company and to its stakeholders. To do this Cisco may be required to make changes to management, taking in new people to reinforce the changes (Johnson, Whittington and Scholes, 2011), preferably people with a proven track record in the consumer market. Management must also be ready to provide a business case for change (Johnson, Whittington and Scholes, 2011) to outline why the proposed strategy is a good one, and may include some of the risk assessments mentioned above.Some of the decisions made to facilitate the change may seem extreme; changes in management, portfolio changes, increased focus on the consumer market and increased R&D spend, however these can be seen as both symbolic and rational levers for change (Johnson, Whittington and Scholes, 2011). In managing resistance to change, Cisco should adopt a situational leadership style, where they can use different styles in change leadership to adapt to different situations (Johnson, Whittington and Scholes, 2011).This will allow Cisco the flexibility to use different methods to increase stakeholder ‘buy-in’ to the s trategy. Some stakeholders may resist the changes as they may feel they are unnecessary or the timing is wrong, and it is essential that this is controlled to avoid stakeholders just ‘doing what they are told’. Compliance, as opposed to co-operation (or ‘buy-in’) can be detrimental to the success of the strategy, as underneath the surface nothing will have changed. Using this methods to achieve co-operation from stakeholders will keep the strategy focused (Johnson, Whittington and Scholes, 2011).However managers must also be sensitive to the strategy resistance, if there is a large amount of resistance they must assess to see if the resistance is warranted. Managers should be, wherever possible, honest in regards to the progress of the strategy (Johnson, Whittington and Scholes, 2011), from their business case for change, the progress of the change, through to the results achieved by the change. Failure to be honest in this will result in the stakeholders l osing faith in the strategy. 7. 0 CONCLUSIONCisco’s innovation is based around their ‘three pillars of innovation’; ‘Build’, where they spend around $5 Billion per year on R&D; ‘Buy’, they have acquired over 160 companies over the years and actively seek out new acquisition possibilities each year; and ‘Partner’, Cisco has developed strategic partnerships and ecosystems to aid innovation. The innovation culture has been part of Cisco’s strategy since the company was formed in 1984. The business environment Cisco operates in was discussed using PESTEL analysis and applying Porter’s Five Forces Framework.With the PESTEL analysis it was established that most of their Key Drivers for Change came from the Technological area of PESTEL. It was also decided that the legal aspects relating to competition law was also a Key Driver for Change, as it impacts their Acquisition policies. Scenario building was deemed importan t, however Cisco must be aware that not one scenario was sufficient, they must develop scenarios for all of their Key Drivers for Change. Porter’s Five Forces was discussed to show some of the factors which determine if the industry is attractive, and the threats Cisco face within the industry.It was determined that innovation alone does not bring competitive advantages. Cisco’s distinct resources and capabilities were assessed against the VRIN framework to identify the sources of their competitive advantage. The VRIN framework can also be consolidated to form Cisco’s organisational knowledge, which was also identified as another competitive advantage. Two strategic options for Cisco were discussed, selling of their enterprise products direct to the end user, and entering the consumer market. It was decided that the more radical of the two was the entry into the consumer market.The risks associated with implementing this strategy were discussed as was managing t he change. It was concluded that Cisco should adopt a revolutionary change strategy to facilitate the strategy implementation. 8. 0 REFERENCES CISCO SYSTEMS INC, (2012). 2012 Annual Report. [online]. San Jose: Cisco Systems Inc. Available from: http://www. cisco. com/assets/cdc_content_elements/docs/annualreports/ar2012. pdf [Accessed 19 November 2012] CISCO SYSTEMS INC, (2012). Corporate Overview. [online]. San Jose: Cisco Systems Inc. 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