Bio Medicine Essay Example for Free

Bio Medicine Essay Two Cathy Ann Wilson-Bates Western Governors University EVIDENCE-BASED PRACTICE APPLIED NURSING RESEARCH EBP 1 Brenda Luther, PhD, RN January 25, 2012 Task Two Introduction: What I have learned about working with children in a chronic healthcare setting like dialysis is that they are resilient beings with the propensity for rapid changes in their medical condition. Children almost always surprise me in their unique description of symptoms and pain. Depending on their age, they may not be able to describe the symptoms they feel or tell me â€Å"where it hurts†. A simple ear ache may be described as a â€Å"drum in my ear† or may be observed with non verbal cues like tugging on the ear. Acute Otitis Media is seen quite often during the cold and flu season. Recent clinical guidelines suggest waiting twenty four to seventy two hours before beginning antibiotic therapy. Parents of children with symptoms of otitis media are accustomed to receiving a prescription for antibiotics before they leave the medical office. Adults as well are preconditioned for the little white slip of paper from their physician. Waiting twenty four to seventy two hours to evaluate the need for antibiotics will definitely reduce the over-prescription of antibiotics as well as their efficacy. The waiting and watching of several days may seem like an eternity to a parent caring for a sick and crying child. Educating parents during routine visits to the physician office about the risks of over-prescribing antibiotics will help when the physician needs to discuss the possibility of waiting and evaluating before prescribing antibiotics. Providing a list of comfort measures parents can follow may help relieve the anxiety they have in caring for a sick child. Any comfort measure taken to reduce crying is helpful to the parent of a sick child, but mostly to the child. The following table and paragraphs will share the results of how one group of nurses at an outpatient clinic used clinical evidence to manage this situation. Source |Type of Resource |Source appropriate or |Type of Research | | |general information, |inappropriate |primary research evidence, | | |filtered, or unfiltered | |evidence summary, evidence-based | | | | |guideline, or none of these | |American Academy of Pediatrics and American Academy of|Filtered |Appropriate |Evidence-based guideline | |Family Physicians. Clinical practice guideline: | | | | |Diagnosis and management of acute otitis media. | | | |Causative pathogens, antibiotic resistance and |Unfiltered |Appropriate |Evidence-based guideline | |therapeutic considerations in acute otitis media . | | | | |Pediatric Infectious Disease Journal. | | | | |Ear, nose, and Throat, Current pediatric diagnosis and|General |Inappropriate |None of these | |treatment. | | | | |Treatment of acute otitis media in an era of |Filtered |Appropriate |Evidence –based guideline | |increasing microbial resistance. Pediatric Infectious| | | | |Disease Journal | | | | |Results from interviews with parents who have brought |Unfiltered |Appropriate |Primary research evidence | |their children into the clinic for acute otitis media. | | | | | | | | | Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 13 No 5 1451-1465. This article is an evidence-based clinical guideline. It is a systematic review making it a filtered resource which is very appropriate for this situation. The article describes the current, (as of 2004) recommendations for the diagnosis and management of Acute Otitis Media (Subcommittee on Management of Acute Otitis Media, 2004). These guidelines show several different ways to treat acute otitis media depending on the symptoms of the child. It states that sometimes waiting to give antibioti cs is good and sometimes waiting to give antibiotics is not good. This article is appropriate and provides clarity on the topic. Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. This article discusses antibiotic resistance and describes the bacterial pathogens which are responsible for infections causing acute otitis media. This article is appropriate. It contains a comparison of studies performed based on the different types of bacteria which cause acute otitis media. It stresses the importance of identifying the bacteria causing the infection before giving antibiotics so that number one the bacteria can be eradicated and other bacteria will not become resistant (Block, 1997). PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lang. This textbook source contains general information on the ear, nose and throat. There is much more information here regarding basic anatomy and physiology as well as characteristics of the ear nose and throat. The information regarding otitis media is basic and not an appropriate source of research in this situation for three reasons. Number one, the information is very basic, number two, it does not give any up to date information on how to treat this type of infection, and number three there is too much non-relevant information. McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. This article is a review of the known etiologies that may cause acute otitis media. The article gives up to date information on therapeutic approaches when selecting an appropriate antibiotic therapy. We don’t practice â€Å"cookie cutter† medicine. The same prescription is not always right for all patients or all communities where some bacteria’s may be more prevalent than others (McCracken, 1998). This is appropriate information for this group of people or community. media, P. o. (n. d. ). Interviews. (C. nurses, Interviewer) This set of interviews is simply raw data. General information can however provide great insight as to what is happening out in the community. For example, this information might shed light on the fact that if the parents are willing to hold off on antibiotics for example, would they be more likely to follow up and come back into the clinic when asked? The reaction of parents is dependent upon other several basic factors like finances, a belief system and possibly the ability to obtain transportation. Knowing how the community is going to respond to their choice may have a great effect on the decisions they make. When evaluating the findings of these sources cumulatively, one must first determine the causative pathogens infecting patients in this given community with acute otitis media. After pathogen determination we can determine which antibiotics may be most useful in eradicating the given bacteria. Careful selection of antibiotic therapy will reduce the propensity for antibiotic resistance. Watchful waiting may be a good thing from the perspective of increasing microbial resistance however we must always evaluate patients on their individual needs or on a patient by patient case. One size doesn’t always fit all. Patient education is the key to keeping the public informed of current practice. Physicians and Nurses need to be consistent in the lesson plan shared with patients and remain true to our scope of practice. Communication is essential between the physician, nurse and other multidisciplinary team members in order to provide the best care. There are many considerations in assessing if patients are able to withstand the waiting and evaluation period. Low income families are one example of how the waiting and watching method might not work. Parents may have to take time off work to come to clinic with a sick child. They might struggle finding money for the additional return trip to the clinic and may risk losing their job if they take more time off work. Many low income families may have already waited before seeking help thus creating their own watchful waiting period. They also may not be able to afford antibiotics and as a result may not give the full dose if symptoms have subsided. The perception is that they will save the medication for the next time symptoms arise. Confidentiality might be an issue in smaller communities. People tend to be concerned about neighbors and co-workers and some may not care to share their experience with others. This may be an issue for parents who don’t share custody as in the case of divorce. It is a greater issue when parents or partners don’t share the same fundamental values, especially those related to healthcare. Conclusion: Watchful waiting like the nurses in this clinic are looking at may be useful for some of the patients, but not all. Again, a one size fits all philosophy is not always appropriate in healthcare. Tools like algorithms may be helpful in determining the appropriateness for watching and waiting versus immediate action as determined by physical findings and social circumstances like parental adherence for follow up and ability to afford treatment. Whatever course you choose, watchful waiting or immediate antibiotics the best practice remains a plan of care based on the individual needs of our patients. References Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. media, P. o. (n. d. ). Interviews. (C. nurses, Interviewer) PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lang. Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 113 No 5 1451-1465.

Voyages Essay Example for Free

Voyages Essay People dont always reach their goals, the result sometimes ends up being drastically different then what was originally planned. That situation has happened many times in transoceanic expeditions in the Early Modern Era. The following either reached their expected goal or resulted in something different then what was expected to happen. The first is voyages of Ming Admiral Zheng He. Zheng He led seven expeditions to the Indian Ocean. The expeditions established the Ming dynastys Indian Ocean trade links. He went on these seven voyages in serch of precious land and traded goods that he would bring back to his homeland in China. His voyages went smoothly, resulting in new finds of land and new trading goods that would be higly regarded in China where is was rare. Zheng He reached his goal and actually recieved higher than what was expected. The second is the Portuguese exploration of the coast of Africa. The Portuguese were curious about Africa and their goal was to explore the west coast of Africa and find rare treasures to trade and to convert the Africans to christianity. When they arrived on the West African Coast their curiosity dissapated and they soon realized they would enslave the Africans and have human trafficking of them take place from then on. Their goal was short and simple, to convert people to Christianity. Instead of reaching their goal they reached a new goal that was not planned. They expected different but were more than happy with the results that happend.

Clark Beck Obsessive compulsive inventory Test

Clark Beck Obsessive compulsive inventory Test Clack Beck Obsessive compulsive inventory test intent to find out relationship between ones personality disorder and how it affects ones interpersonal relation. This research has two main purposes. First, this study will observe the relation between personality disorder and interpersonal troubles by using information gather from ones self report and group of people who relate to person who has personality disorder. Second, this research will closely look at relationship between personality disorders traits and interpersonal troubles measure across source. Through out this study, we will able to expand our knowledge about personality disorder and gain reliable information about how personality disorder impacts ones interpersonal relationship. Clark Beck Obsessive compulsive inventory Test Mental disorders which include personality disorder are the one of main cause of disability in the USA. About one in four adults ages 18 and over, suffering some kind of mental disorder include personality disorder. (Andrew) This means about 57 million people suffering mental disorder in USA. (Andrew). People who suffering Personality Disorder is always behaved or involve in considerable personal and social disruption. In other word, Personality Disorder person behave abnormally in social life. In order to understand the how personality disorder impact ones interpersonal relationship, we needs to get information from people around him or her. Clack Beck Obsessive compulsive inventory test will find out relationship between ones personality disorder and ones interpersonal impairment. From this observation, we will able to gain reliable information about how personality disorder impacts ones interpersonal relationship. This research has two main purposes. First, this study will observe the relation between personality disorder and interpersonal troubles by using information gather from ones self report and group of people who interact with personality disorder person. (Allan) Second, this research will closely look at relationship between personality disorders traits and interpersonal troubles measure across source. (Allan) In other word, we will compare the personality disorder traits gathering by ones self-report with the interpersonal problems reported by peers and vice versa. (Allan) By comparing personality disorder traits and peers report, we will able to see how ones personality disorder is perceived differently by one-self and others. (Allan) The population of this study is undergraduate students at a large public university. University students ages are between from 18 to 22. 75 percent of student who participates were Caucasian, 9 percent were Asian, 7 percent of African American, and 8 percent of other ethnicities includes Hispanic, Native American. (Allan) Students who participates this study were all first year students who had been living together about five month in same dormitory. Students rates all other peers who lived together by answer questionnaire form which ask, please rate how well you know each person in four point scale from o (Not at all) to 3 (very well). (Allan) The self report and peer report of personality disorder questionnaires consists of 106 items. The self-report and peer report version of questionnaire items are matched; only the wording of questionnaires are changed. (Allan). Each student will nominate every other students of the group. For each questionnaire, individual will recommended students who are best matched with given characteristic in each question. Also, for each questionnaire, each students rating peers, by indicating sometimes, often, or always shows such characteristic. (Allan) After students completed peer report then all students will completed a self report which is same as peer report, only wording is different. Students marked by using four point scale from 0 (never) to 3 (always). The psychometric properties of the obsessive compulsive test have shown that this test is fairly reliable, and valid. The internal reliability of peer score on PIPD items was 0.74 for 393 University students, within values ranging from 0.90 to 0.19. (Allan) Test-retest reliability of this test was 0.71. Interrater reliability is from 0.57 to 0.75. (Allan) Factor analysis of the peer report and the self report shows relatively high correspondence, coefficients ranged from 0.87 to 0.97. (Allan) The obsessive compulsive inventory test has proved as a valid assessment test. This test has a moderate validity for its construction, and content it contains. Its Factor analysis is relatively high which demonstrate that this test successfully measure what it is intend to measure. Variation of self report and peer report, maximum possible variance across sources ranged from only 4 percent to 13 percent. (Allan) This shows that even though self report and peer report measures similar contents but only little variance shared between self report and peer report of personality disorder. We might able to predict that there is significant gap between how one perceived about oneself and peers think of him or her. In other word, person who suffering personality disorder have low recognition of what his or her peers think of him or her. (Allan) The correlation for concurrent validity is 0.25 to 0.30 with criterion measures. These result demonstrate that people who suffering personality disor der are poor at identifying how they perceived by others. (Allan). Canonical variation pairs explained a moderate amount of cumulative variance, 36 percent of self report and 38 percent of peer report. (Allan) Overall, this study result shows that self reported by personality disorder person and interpersonal problems are highly related and explain a moderate amount of the overall variance of one another. (Allan) Clark Beck obsessive compulsive inventory could be benefit in clinical, counseling or research setting. The obsessive compulsive inventory test has been a useful tool to help person who suffering personality disorder to acknowledge that there is exist gap between what one think about oneself and how others think about him or her. (Daniel) This test results could be use as a clinical setting to help improve ones self awareness of his or her personality disorder and how it affect ones interpersonal relation. Because this personality disorder person has low ability to predict ones interpersonal relation, one used to become anti social person or narcissism. (James) By using Clark Becks compulsive inventory in clinical setting, therapist able to explain and diagnose ones personality disorder and help him or her realize current interpersonal problem. The Clack Beck obsessive compulsive inventory has also benefit to use in counseling. Many personality disorder people do not realize ones disability until they loose everyone around them. Many personality disorder people believe their poor interpersonal relationship were not their problem, it is everyones problem, except oneself. (David) They usually think they are normal and all others are abnormal. So, they avoid to get diagnose of therapist or doctor for their personality problem. In order to prevent worsen their problematic relationship, counselor able to use results of obsessive compulsive inventory test to help personality disorder person to acknowledge their personality disorder. (David) It is important to get a therapy or counseling in early. Early prevention of personality disorder will helps to cure ones problem quickly and prevent to become antisocial personality or narcisstic person. (James) Clark Beck Obsessive compulsive inventory test has its strengths. Main purpose of this study is to find out relation between personality disorder and interpersonal relation. (Allan) This study successfully meets its study purpose. This study proves that personality disorder is significantly related to interpersonal impairment. Those who have any kind of personality disorder will struggle with interpersonal relationship. Also, Clark Beck obsessive compulsive inventory test is written clearly and well organized. Researchers are rewording and use simple words for questionnaires, instead of using complicated psychology or technical term, so anyone could easily follow the questions and understand the what researcher intent to meaning. Even though, Clark Beck obsessive compulsive inventory test is well construct and study successfully achieves its research purpose, there are still few weaknesses or limitation which could improve this study in the future. First, this research has only been conducted with university student of the ages 18 and 22 years old. For this reason, results cannot be generalized to people of other age groups. Therefore, if researcher varies the range of age groups then this study will give more reliable and valid results. Second, the sample of student only survey in USA which are in Central America. So, it could not represent student of eastern culture, Africa or other continents which might show different study results since different counties have different culture, or definition of abnormal personality. Therefore, in the future study, it could be improved if sample was gathered all around the world. In summary, Clark Beck Obsessive compulsive inventory test is a test which could applied for any age groups. The main purpose of this test is to diagnoses ones personality disorder and how it affects ones interpersonal relation. (Allan) Mental disorders which include personality disorder are the one of leading cause of disability in the USA. About one in four adults ages 18 and over, suffering some kind of mental disorder include personality disorder. (Andrew) People who suffering Personality Disorder is always behaved or involve in considerable personal and social disruption. In other word, Personality Disorder person behave abnormally in social life. Therefore, Early prevention or interruption is critical for anyone who has personality disorder otherwise, one could become antisocial or narcisstic personality person. Overall, this study is well constructed and measure what it intent to measure and benefit any one who investigate about personality disorder. I can do everything through him who gives me strength (Philippians 4:13). References Allan, C., Eric, T., Thomas, O. (2004). Self and Peer Perspectives on Pathological personality Traits and Interpersonal Problems. Psychology Assessment, 17, 123-131. Mental Measurement Yearbook. Andrew, D., Janet, B. (2007). Personality change and personality disorder: Some initial thought on the application of McAdams triarchic model to the treatment of personality disorder. Psychology, Crime Law, 13, 19-26. Daniel, O., Jakob, S. (2007). Psychometric properties of the obsessive compulsive Inventory revised among Icelandic college students. Scandinavian Journal of Psychology, 48, 127-133. David, M. Pino, A., Rafael, T. Xavier, C. (2004). Personality characteristics in obsessive-compulsive disorder and individuals with subclinical obsessive compulsive problems. British Journal of Clinical Psychology, 43, 387-398. James, O. (2006). Psychopathy and Antisocial personality disorder conundrum. Australian New Zealand Journal of Psychiatry, 40, 519-528. Hi Andy! My name is Jon and I reviewed your paper today. I wanted to give you some direction apart from the comments above. What I have done with the comments above is selected the first instance of a few grammatical errors which showed up frequently in your paper. In each case, I would like for you to apply the same concept that I have given you to other places in your paper where the same error occurs. I know that this will be a large amount of extra work; however, I believe that once you master these things, you will have greatly improved your ability to write and communicate in English. I hope this will help you in these areas. Remember, if you ever have any doubts about your writing, the online writing center has many writing aids that help. You can find the writing aids page here http://www.liberty.edu/index.cfm?PID=12268

Emphysema :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Emphysema is one of several diseases usually labeled collectively as chronic obstructive pulmonary disease (COPD). It’s the most common cause of death from respiratory disease in the United States; approximately 2 million Americans are afflicted with the disease. Emphysema(COPD) appears to be more prevalent in men than women. Postmortem findings reveal few adult lungs without some degree of emphysema. Causes   Ã‚  Ã‚  Ã‚  Ã‚  Emphysema(COPD) may be caused by a genetic deficiency of alpha 1 -antitrypsin (AAN) and by cigarette smoking. Genetically, one in 3,000 newborns are found with the disease, and 1% to 3% of all cases of emphysema are due to AAT deficiency. Cigarette smoking is thought to cause 20% of the cases. Other causative factors are unknown. Complications   Ã‚  Ã‚  Ã‚  Ã‚  In emphysema(COPD), complications may include recurrent respiratory tract infections, cor pulmonale, and respiratory failure. Peptic ulcer disease strikes 20% to 25% of patients with COPD. Additionally, alveolar blebs and bullae may rupture, leading to spontaneous pneumothorax or pneumomediastinum. Assessment findings   Ã‚  Ã‚  Ã‚  Ã‚  The patient history may reveal that the patient is a long-time smoker. The patient may report shortness of breath and a chronic cough. The history may also reveal anorexia with resultant weight loss and a general feeling of malaise.   Ã‚  Ã‚  Ã‚  Ã‚   Inspection may show a barrel-chested patient who breathes through pursed lips and also uses accessory muscles. You may notice peripheral cyanosis, clubbed fingers and toes, and tachypnea.   Ã‚  Ã‚  Ã‚  Ã‚  Palpation may reveal decreased tactile fremitus and decreased chest expansion. Percussion may detect hyper resonance. On auscultation, you may hear decreased breath sounds, crackles and wheezing during inspiration, a prolonged expiratory phase with grunting respirations, and distant heart sounds. Diagnostic tests   Ã‚  Ã‚  Ã‚  Ã‚  Chest X-rays in advanced disease may show a flattened diaphragm, reduced vascular markings at the lung periphery, over aeration of the lungs, a vertical heart, enlarged anteroposterior chest diameter, and large retrosternal air space.   Ã‚  Ã‚  Ã‚  Ã‚   Pulmonary function tests typically indicate increased residual volume and total lung capacity, reduced diffusing capacity, and increased inspiratory flow.   Ã‚  Ã‚  Ã‚  Ã‚  Electrocardiography may reveal tall, eymmetrical P waves in leads II, III and aVf; vertical QRS axis; and signs of right ventricular hypertrophy late in the disease. Red blood cell count usually demonstrates an increased hemoglobin level late in the disease when the patient has persistent severe hypoxia.

Jurassic Park Summary :: essays research papers

Michael Crichton's Jurassic Park Alan Grant and Ellie Sattler were among many people paleontologists that were funded by a wealthy man by the name of John Hammond. The two of them were visited by a man named Morris who was very interested in Hammond. Apparently he had leased an island of the west of Costa Rica. He had some kind of big development going on for the past ten years. He also had been buying large quantities of Amber which seemed useless due to it's low value. And Morris, being from the government, was very suspicious. Shortly after this visit the two dinosaur diggers were called by this man called Hammond. He wanted the two of them to visit him on his island. It was some type of biological preserve that would change the world in science and Hammond needed all the opinions he could get on if it would be safe. He called it, Jurassic Park. Meanwhile there was a young man by the name of Dodgson who worked with a rival company of John Hammond. He knew Hammond was on to something big having to do with dinosaurs. He met up with one of Hammond's employee's named Nedry who was the design of there park's computer system. Dodgson knew that they're company was some how recreating dinosaurs by making embryos. There was just one problem, they're company was ten years behind and would never catch up. Nedry ended up taking the million dollar offer from Dodgson for the embryo's that would change there whole company and update them on ten years of research. When Sattler and Grant arrived at the island they met up with other acquaintances of Hammond. There was the famous mathematician, Ian Malcolm. The big and rather rude man, Dennis Nedry. The intelligent scientist that was behind the whole park, Henry Wu. And the lawyer, Ed Regis. Soon later the rest of the visitors arrived. It was Hammond's grandchildren. And then, it was ready for the tour to begin. The tour consisted of six people. Hammond's grandchildren, Lex and Tim, Malcolm, Dr. Sattler and Dr.Grant, and Ed Regis. On the tour they saw many interesting things. There was real live moving dinosaurs! The walk around tour briefly explained how the scientists did it. First off they had to find amber which was tree sap that hardened a long time ago when the dinosaurs lived. In this amber contained many bugs such as mosquitoes which drank the blood of dinosaurs millions of years ago. This blood was then used to capture the DNA which would recreated an actual embryo that would soon turn into a live growing dinosaur.

Media Corporations Profiting from Violence Essay -- Argumentative Pers

Media Corporations Profit from Violence      Ã‚   Whether it is a body found along the road, a school shooting, or planes flying into the World Trade Center, the images will be replayed over and over on Television ad nausea.. The most horrific acts may eventually be retold in books and movies. Packaging and selling the violence of the moment belongs to television - and television will keep reminding us of it.    The special custom-made armor covered his body from neck to toe. As the black-clad gunman wandered the street, randomly firing a high powered semi-automatic rifle at Los Angeles police, a city sat transfixed to their televisions, hypnotised by the unreal events unfolding outside their doors. When the LAPD realised that the gunman was covered with body armour, a call to aim for the head was shouted across their 2-way radios. The camera was in the perfect position to catch the shot. The black-clad bank robber firing at will suddenly jerked back, a jet of red exploding from his head. His legs buckled underneath him. His hands dropped the gun, but he was dead before they could reach for the massive wound. He never felt himself hit the ground. A few moments later, the television helicopter landed and began interviewing eyewitnesses. One middle-aged woman looked straight into the camera and deadpanned, "Things like this just don't happen in America."    In Amusing Ourselves To Death, Neil Postman states that "...The clearest way to see through a culture is to attend to its tools of conversation." If that is true, then the tool of conversation in America is television. There are more television sets in American homes than there are homes, and those sets are on for an average of six hours per day, with the average p... ...of all becomes the death of the neighbor next door.       Got the bubbleheaded bleach blond comes on at five she can tell you 'bout the plane crash with a gleam in her eye It's interesting when people die give 'em dirty laundry Don Henley             Works Cited 1. Operation Desert Storm: Outright Disinformation Scheme, David Fingrut 2. Amusing Ourselves to Death, Neil Postman, Penguin Books, 1985, pg. 8 3. Electronic Heroin, Jay Hanson 4. This statistic comes from the United Nations radio program Perspective (no. 96/52). The program was a report on the 1996 UN sponsored World Television Forum. 5. Millions of Viewers Tuned In, But Total Never Will be Known, Mike McDaniel, Houston Chronicle, 10/4/95. 6. Felons On The Air: Does GE's Ownership of NBC Violate the Law? , Sam Husseini, EXTRA!, 11/12/94

Netflix Case

Davor Ramesa k0956979 Netflix case Executive summary What is Netflix’s strategy in the on-line movie rental market? What are Netflix’s sources of competitive advantage? Identify the competences key to the success of Netflix’s strategy and explain why. Netflix was a late entrant to the movie rental market and it was a first mover in the on – line movie rental market. Netflix’s strategy in the movie rental market is differentiation from traditional movie rental stores. Instead of attracting customers to a retail location, Netflix offered home delivery of DVDs through the mail. Why only DVDs? In 1998, most available movies were in VHS cassette format but Netflix concentrated on using only DVDs because its marketing strategy was to develop cross promotional programs with the manufacturers and sellers of DVD players, providing a source of content for the customers. Also, there was no competition in that niche market and DVDs were small and light which made them perfect for mail delivery. Netflix had several sources of competitive advantage. For starters, Netflix’s website included a search engine that allowed customers to easily sort through its selection by title, actor, etc. Using these search engine customers could easily and quickly find a movie that they would like instead of looking on shelves of a retail store. Netflix was using the US Postal Service to deliver DVDs directly to a customer’s home. It was more convenient for customers. They used similar pricing to that offered by traditional video stores in the beginning but what gave them the competitive advantage was moving to a subscription prepaid service. And, soon afterwards they offered unlimited rentals to customers because they were targeting another group of customers – ones that wanted the convenience of watching a movie at any time and change them unlimited during a month. Netflix’s engineers developed a proprietary recommendation system. They have done so because mostly the new movies were being rented and they wanted to balance customers demand. How did this system work? Upon signing into a new account for the first time, customers took a survey to identify their favorite movie genres, as well as rate specific movie titles. This survey gave enough data to Netflix’s engineers to build a base and understand better customer’s preferences. Also, Netflix’s size and growth rate generated a positive †network effect† from its large customer – generated rating system. Because it had the largest collection of movie ratings in the world, customers recognized that they were more likely to have their tastes and preferences accurately reflected from Netflix’s site. The key to success in Netflix’s strategy was hiring Ted Sarandos as chief content office to manage content acquisition. He managed (due to his relationships) to negotiate direct revenue – sharing agreements with nearly all the majors studios. So Netflix was able to improve its relationships with its suppliers. The benefit was not just lower acquisition costs but the promotion of lesser known movies. So, customers had the benefit of large variety of movies. Also, using the proprietary recommendation system and the national inventory Netflix was able to replicate almost perfect inventory. This gave them a serious competitive advantage, since retail stores needed three or five times the copies of a movie to satisfy the same customer demand. Assess Netflix’s performance? Use multiple performance measures (strategic and financial). Table below shows (in 000$) Netflix’s performance using 2 financial ratios in year 1998 and 2006. (source : Netflix 2006 10-k) As we can see from the table, in year 1998 Netflix had poor performance. We can see that it was losing 16. 84 thousands of dollars to subscription (sales= revenue of subscription). Net profit margin was not any better a -18. 940$ . We can see that their operating profit margin was 0. 69 thousands of dollars and net profit margin was 0,04 thousand of dollars in 2006. Why was there such a change in profitability? Answer lies in the number of total subscribers which has grown from 107 000 in 1999 to 6 316 000 in 2006. (source: Netflix 2006 10-k). Number of subscribers was constantly growing since 1998 due to good strategy decisions like : proprietary recommendation system , hiring of Ted Sarandos and opening more distribution centers. All of these moves had one purpose: to add value to their product by increasing customer’s satisfaction. How does Netflix’s strategy compare to Blockbuster? Compare and contrast each’s value chain. Factors which determine the value of the product: Price – of the movie Delivery Time – how long do the customers wait for getting the movie Convenience – what actions do the customers have to do to get the movie Other factors(recommendation system, availability of new movies) Late fees Although prices of Netflix and Blockbuster for a single DVD rental are now the same (10$ per movie-source: http://reviews. cnet. com/4520-11445_7-6325775-1. html), Netflix had an additional value because it offered unlimited rental with the same pricing (an example: you pay monthly fee and you can exchange movies, so you can watch several different DVD†s for the price of one). If you want to rent a movie from a Blockbuster retail store, you can do it in a relatively short time (time you need to get to a retail store) as management proclaimed 10 minute drive for 70% of US population. Delivery time for Netflix is their disadvantage in comparison to Blockbuster, it takes a day or two. Convenience – Netflix has the advantage here since you can order movies from the comfort of your home by using the internet. Blockbuster doesn’t have a recommendation system like Netflix. It only has an employee that can recommend movies to a customer. Netflix has advantage here since it can recommend a movie accordingly to the taste of each customer. New movies are available pretty much the same for both companies. Late fees – in 2005. Blockubuster decided to abolish late fees which gave them an advantage over Netflix, increasing customer satisfaction but also gave them significant costs: 60 milion $ marketing + 600 million dollar of revenue loss. What challenges and opportunities does Netflix face? What are the major risks? Major challenge for Netflix’s online DVD rental business is VOD (video on demand). VOD offers additional value to the customer – no waiting period, since it uses streaming technology to provide customers a movie with no waiting period. This is also an opportunity for Netflix since it has the possibility to implement this new technology into its core business but there are several cons of doing so. First issue is that this feature would cannibalize the core business because Netflix would replace stream of positive cash flows with another. Also Netflix found no way to differentiate itself against competitors like MovieLink and Vongo. Another major risks or challenges for Netflix are cable and satellite providers which offer pay-per-view system, providing HD on demand. For now these services had two primary limitations: technology and content availability. Another major challenge is the entry of Blockbuster in the DVD online rental market. As a bigger company Blockbuster has the financial funds to attract more subscribers using heavy marketing. This entry directly enters Netflix’s niche market and now Netflix has to find a way to differentiate. For starters, what would be Netflix’s entry strategy to these new markets? It could ship the DVDs from USA but this option would have serious disadvantages like import tariffs, shipping costs, long delivery time which would lead to customer dissatisfaction and a very small market share with probably losses rather than profits. If Netflix would open a subsidiary in Europe it would not have problems like the latter but it would need investors since financing the whole subsidiary may present a problem for Netflix. Another issue is that Europe, as a difference to the US, is consisted of many small independent countries with their own laws and import tariffs so this could be a problem as well. Another problem is the customers preferences. If Netflix would try to ship movies from the US (which would also present shipping costs) the European customers might not like US movies that much. They might prefer European movies better. Another issue is that Netflix doesn’t have an established relationship with any European movie studio. So they would lose the competitive advantage that they have in the US. Another problem is the language barrier. In many countries like Germany, Italy, or Spain, movies are synchronized into their mother tongue. So customers might not be willing to rent these movies in the English language. Another issue is the competition in Europe which perhaps would be more competent than Netflix since they know better the customers needs, laws, and other issues mentioned already. Netflix as a company started with an emerging technology – DVD, then. Now the new technology is Blu- ray and as the VHS format was replaced by DVD there are good chances that Blu-ray will replace DVD format. Because Blu-ray technology gives a better resolution than a DVD customers might be willing to switch so Netflix should start to fill its inventory with blu-ray discs and maybe like they did in the past with VHS promote and rent only Blu-ray discs. The goal for Netflix’s is to find the best media (low cost, high quality) for watching a movie or even better – no media at all. Netflix’s, as I see it, biggest threat to DVD rental business is online video streaming. Why? With this technology customers have no waiting period and complete convenience. And these are very important factors when customers are making their decision about watching a movie. Decisive competence key for Netflix is the recommendation system and they should use it with online video streaming.