Research on Degenerative Disc Disease Essay Sample free essay sample

Degenerative phonograph record disease or DDD. is in fact the devolution of the Intervertebral phonograph record. which refers to the fibrocartilage that lies between next Vertebrae* in the spinal column and bunchs of chondrocytes** . both being implicative to mend. The chief Cause of the development of Degenerative phonograph record disease is aging: As the organic structure ages. the phonograph record in the spinal column dehydrate or dry out. and lose their ability to move as daze absorbers between the vertebral organic structures. The castanetss and ligaments that make up the spinal column besides become less flexible and thicken. These conditions become more of an issue due to the minimum blood supply to the phonograph record. unlike the musculuss ; so they lack reparative powers. In this procedure. fibro-cartilage replaces the gelatinlike mucoid stuff of the nucleus pulposus. Nucleus pulposus is the jelly-like substance in the center of the spinal phonograph record. Its map is to administer force per unit area in all waies within each phonograph record under compressive tonss. We will write a custom essay sample on Research on Degenerative Disc Disease Essay Sample or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page While this devolution is a normal procedure of aging – It is instead a ‘Condition’ than a ‘disease’ – and for some people does non make any physical issues ; for others can be accompanied by redness. be really painful and therefore impacting their life quality dramatically. This difference is chiefly because some people have nerve terminations that penetrate more profoundly into the outer beds of their phonograph record. bring forthing an country more prone to redness and hurting. Other factors that can lend to the development of redness and hurting. as a consequence of this status. are the life manners and the different works that people do. Presumably. people who undertake heavy physical activities and set more force per unit area on their dorsum. are prone to develop this status in the earlier phases of their lives. and experience hurting as the consequence. Degenerative disc disease can besides take to other upsets such as: †¢ Narrowing of the canal that houses the spinal cord and nervus roots ; known as: ‘Lumbar spinal stenosis’ †¢ Disc stealing frontward ; known as: ‘Spondylolisthesis’ †¢ Disc stealing backwards ; known as: ‘Retrospondylolisthesis’ . Harmonizing to the findings of American Asso ciation of Neurological Surgeons ( AANS ) more than 65 million Americans suffer from lower dorsum hurting yearly. By the age of 50. 85 per centum of this population will demo grounds of disc devolution ; although the huge bulk of them show no symptoms related to the status. ( 2 ) Treatment OptionsThe first measure in the intervention of any chronic or relentless hurting is to have a thorough medical rating to find the cause of the hurting. Any techniques necessary for intervention of the status ; will so be based on the diagnosing and the advice of medical professionals. Degenerative disc disease can frequently be successfully treated with one or a combination of interventions such as Physical Therapy. Chiropractic therapy. Osteopathic or Chiropractic use. or so with the usage of anti-Inflammatory drugs. Spinal injections could besides supply alleviation from the hurting produced. However. if hurting from degenerative phonograph record disease is terrible. traditional non-operative intervention is frequently uneffective. In such instances. a suited surgical operation from a list of surgical interventions available for this status will be used. The marks that indicate the possible demand for surgery include: Weakness or numbness in legs. leg or back pain restricting normal activity. trouble walking or standing. and medicine and physical therapy are uneffective within two to three months of being in usage. Use of Hypnosis Today. the of import function the head plays in chronic hurting is clearly recognized in the medical literature. The International Association for the Study of Pain provinces that: â€Å"pain is ever subjective. and is defined by the individual who experiences it. † It is besides known that hurting is non merely a esthesis. like vision or touch. but instead chronic hurting is strongly influenced by â€Å"the ways in which the encephalon processes the hurting signals. † This of class. refers to the complex physical procedure initiated when the cause of hurting is triggered – in this instance. for illustration when a force per unit area is applied to the phonograph record – the generated signals. taking to the cortical rousing and the associated hormonal and nervous procedures. which is so interpreted as ‘pain’ . Therefore. our encephalon can ‘learn’ to pull off the esthesis of hurting. Using the head. to command chronic hurting thr ough effectual header schemes. may be used entirely or in concurrence with other hurting direction therapies. Hypnosis is used to cut down the hurting perceptual experience in two general ways: Post-hypnotic suggestions ; that cut down hurting when it is felt. and Self-hypnosis. Many characteristics of Hypnosis are employed in the effectual direction of hurting by Hypnotherapy. For illustration. ‘Relaxation of the whole body’ . leads to the easiness of the musculuss and therefore the easiness of the nervousnesss that signal hurting. doing the decrease or sometimes extinction of the signals at the centripetal degree. Relaxation besides helps by cut downing the feelings of fright and anxiousness ; that are common feelings associated with hurting. ‘Visualisation’ is the most used and a really effectual characteristic of hypnosis in hurting direction. For illustration ‘Visual imagination and distraction’ involved in concentrating on mental images of pleasant scenes – portion of the relaxation procedure – and besides making governable images that represent hurting. ‘Dissociation’ is besides normally used in hurting direction Inductions. this could be in the signifier of proposing the topics to ‘mentally divide themselves from the painful organic structure part’ . or ‘imagining the organic structure and head being separate from each other. and therefore the chronic hurting being besides in the distance from the mind’ or similar suggestions. Hypnosis besides facilitates the direct control of hurting through the usage of different techniques. such as: introducing adjustable ‘pain dial’ or ‘pain switch’ that can command the grade and continuance of hurting. proposing the production of ‘Endorphin’ . and bathing the hurting portion of the organic structure in the produced substance. or the usage of other imaginations such as ‘Glove Anaesthesia’ . The grade to which one can digest a specific hurting. depends on two chief features: the site of the hurting. and it s subjective dimensions – i. e. its strength and continuance. The closer the country of hurting gets to the bole of organic structure – organic structure Centre – and the longer and more intense ; the less tolerable it becomes. In the instance with degenerative phonograph record disease. as the location of hurting is within the bole of the organic structure. and therefore it is more profoundly felt ; concentrating merely on relaxation to cut down or extinguish hurting. may non be plenty. In such instances. after the initial relaxation and the deepener processs. the debut of a more specific technique for hurting control. such as â€Å"Glove Anaesthesia† or other hurting commanding techniques largely involved with the usage of ‘imageries’ are used. These techniques are introduced during the Hypnotherapy with the usage of suggestions such as: â€Å" . . Acknowledge and accept hurting. loosen up the musculuss around the painful portion. and imagine rinsing off the uncomfortableness by a streamlined H2O that is running over and through the painful country. and rinsing trouble off from the organic structure. . † Or: â€Å"Imagine come ining into the tunnel of hurting. this tunnel is yo urs. you can have and command it†¦ See the visible radiation at the terminal of the tunnel. that visible radiation is your mark. . it is where you can make and win over your pain†¦ now. get down taking stairss towards that light†¦ every measure you take. will distance you more and more. . from the hurting. and takes you closer and closer. . to being more in control. and accomplishing freedom from the pain†¦Ã¢â‚¬  The pick of utilizing any of such techniques. being made by the Hypnotherapists. will be based on the specific demands of the patient with relevancy to the quality of hurting. and the patient’s personality and features. The flexibleness that hypnosis provides in the intervention of any painful status. is due to the fact that there are no difficult lines between the available hurting alleviation techniques that could be used for each type of hurting. chiefly being: hurting developed from Chronic conditions. hurting from Surgery. or hurt and unwellnesss. Any technique chiefly developed for a specific class ; could besides be used within the different classs ; should the patients’ specific needs trigger such determination being made. Glove Anaesthesia Glove anesthesia is an illustration of the legion hurting alleviation techniques normally used in Hypnosis. and although its chief usage is in surgeries ; due to the grounds stated above. it can besides be used for other painful conditions including the Degenerative Disc Disease. Prior to the intervention. the patient is asked about his pick of hurting alleviation ; i. e. what experiencing – heat. coldness or anything else – could bring forth the esthesis of hurting decrease or riddance for that person. Once this has been established. and while the patient is relaxed and in the deepened province of hypnosis. suggestion of numbness production in one of his custodies is being made – the 1 that can easy near the painful country – This could be either by conceive ofing that manus is being immersed in the hot or cold H2O. a bowl of ice or any substance that can bring forth the hurting alleviation esthesis. Alternatively. this could be replaced by utilizing â₠¬ËœMental anaesthesia’ conceive ofing an injection of blunting anesthetic into the painful country. or even through pure ‘Imagination’ of the addition or decrease of temperature in the chosen manus. Once the esthesis of numbness in that manus has been produced. the topic will be suggested to put the same manus on the painful country. and maintain it at that place until this esthesis is transferred into the mark country. taking to its numbness. and therefore the decrease or riddance of hurting. Because the devolution of phonograph record is a normal aging procedure – as it was discussed supra. it should be regarded as a status instead than a disease – it is usually safe for the hurting produced as a consequence of this status to be wholly outside the range of the patient’s consciousness. and except from some rare instances. where the relevant organic structure parts are being abnormally overloaded or abused. the absence of the feeling of hurting will by and large non take to an addition in the pathological facet of this status. Therefore. with the really good topics. there is no demand to maintain a portion or an country of hurting nowadays. However. in order to avoid a ‘no hurting / hurting present’ state of affairs resulted from the struggle between the cardinal consciousness and the consciousness of the topic. and besides sing that hurting perceptual experience should ever hold a ‘specified time’ for being turned off ; the u sage of ‘temporary block of pain’ would be more good and safe. ( 6 ) Hence proposing to the topic that for illustration: â€Å"For the following three hours. you will non experience any hurting. After that. the hurting will ‘gradually’ return – The importance of Control: The importance of ‘Control’ in hurting perceptual experience is a well-known phenomenon. Common features act uponing hurting susceptibleness are: – Low motive. taking to passiveness and hence decrease or absence of control over clip and energy. – Low self-image. which creates the feeling of exposure and deficiency of control. and – Dependency. such as dependence on others to make day-to-day activities. and the ensuing feeling of holding no control over one’s life. Hypnosis helps patients to experience. understand and behave in certain ways. This. amongst other benefits. will assist patients with the creative activity or addition of control over their state of affairss. and in understanding and positively altering what pain really signifies to them. Throughout the different phases of Hypnotherapy: from the initial audience. where the waking hypnosis and seeding could be developed. through to the existent Induction. where the station hypnotic su ggestions of one or more suited techniques are being made ; and besides through the debut and instruction of Self-Hypnosis ; this procedure of ‘increasing patients’ motive and control’ takes signifier. and therefore the patients go equipped with one of the most of import tools in hurting direction.

Nike Business Strategy Essay Example

Nike Business Strategy Essay Example Nike Business Strategy Essay Nike Business Strategy Essay Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 1 of 29 M-Prize winner This story is one of ten winning entries in the Long-Term Capitalism Challenge, the third and final leg of the Harvard Business Review / McKinsey M Prize for Management Innovation. Story: Nike’s Gameplan for Growth that’s Good for All by Lorrie Vogel General Manager of Considered Design at Nike Inc. Co-Authored by Agata Ramallo Garcia October 17, 2012 at 1:29pm 18 36 0 Comments 2 Ratings: Overall 4 Innovative 4 Detail Summary Innovation is a cornerstone of the Nike brand. Our company was founded by two visionaries, Bill Bowerman and Phil Knight, who set out to reinvent athletic footwear. Over the past decade, our drive to design and produce better, faster, lighter products has evolved into an even more ambitious agenda – to embed long term sustainability into our business. This broader vision calls for new approaches to design, management, partnership and new tools and metrics to support integration and adoption throughout Nike. Many of Nike’s managementexchange. om/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 2 of 29 management innovations for sustainable growth started internally, with the Corporate Responsibility and Considered Design Teams. As internal efforts took hold, the focus expanded externally. Nike is now reinventing its supplier, industry and business re lationships. It is leading industry efforts for systemic change and pursuing an agenda of truly disruptive innovation. Nike Dare to Dream video: http://vimeo. com/11680452 Moonshot(s) Develop holistic performance measures Make direction-setting bottom-up and outside-in Retool management for an open world Context NIKE, Inc. based near Beaverton, Oregon, is the worlds leading designer, marketer and distributor of authentic athletic footwear, apparel, equipment and accessories for a wide variety of sports and fitness activities. Wholly-owned NIKE subsidiaries include Cole Haan, which designs, markets and distributes luxury shoes, handbags, accessories and coats; Converse Inc. , hich designs, markets and distributes athletic footwear, apparel and accessories; Hurley International LLC, which designs, markets and distributes action sports and youth lifestyle footwear, apparel and accessories; and Umbro International Limited, which designs, distributes and licenses athletic and casual footwear, apparel and equipment, primarily for global football (soccer). In 2011, NIKE Inc. earned $20. 9 billion in reve nues. NIKE Brand Footwear revenues in 2011 represented 55% of total NIKE, Inc revenues, followed by NIKE Brand apparel with 26%, and 5% for NIKE Brand equipment. Approximately 36% of NIKE, Inc. revenues were derived in North America, while the remainder are from across the globe. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 3 of 29 managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 4 of 29 After decades of phenomenal growth and becoming one of the world’s top brands (Interbrand 2010), Nike intentionally shifted its strategy to integrate sustainability as a vehicle for growth. We have come a long way, from our association with the discontent of globalization in the late1990s (and subsequently establishing one of the first corporate responsibility (CR) departments), to setting the bar in embedding sustainability into business practice. We no longer view sustainability as option. Rather it is a business imperative, an innovation opportunity and a potential competitive advantage. As CEO Mark Parker notes: â€Å"The age of abundance is over. The definition of business performance is expanding. Innovation is being redefined. Expectations are being redefined. At Nike, we believe the world must innovate faster for growth that is good for all. † Triggers Innovation is our core competency. Starting in 1964, Nike’s founders, Phil Knight and Bill Bowerman, looked for ways to improve upon the Onitsuka Tiger running shoes they were selling. They weren’t just distributors, they collaborated on design ideas. The legacy of innovation in search of better, lighter, faster product performance evolved and deepened over time. It drives every department, process and person in our company – from the product design process, through production, marketing and distribution. Phil and Bill had a vision that sparked and guided their innovation and approach. While the business has evolved and grown exponentially, that single-minded vision continues to feed innovative thinking, design and business practices today. In addition, several significant events in the 1990’s and early 2000’s prompted a shift in Nike’s vision and approach: the labor crises related to sourcing and manufacturing practices; and scenario planning, which surfaced potential vulnerabilities across the business. The company also went through a reorganization to align more closely to consumers. Within this change, the company moved to embed sustianbility across the company with finance and product teams taking a greater role in the process alongside our VP of CR. In the early 1990s, public reaction to labor practices in factories from which we sourced production triggered innovations in how we oversee and manage our supply chain. We took responsibility and developed stringent standards for our manufacturing partnerships the Code of Conduct (CoC). While the CoC became a significant priority for us and our business partners, it was clear that there still was more to be done to oversee and manage our supply chain. We formed the CR committee of the Board. We disclosed our factory locations. We took measures o share information about our expectations and our progress against strict operational guidelines. These moves signaled our seriousness about the issue and our desire to move quickly and find solutions. The action with the greatest impact has been transparency. It has enabled us to better comprehend the problems and shape more approriate solutions.. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/20 13 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 5 of 29 We also recognized that corporate responsibility had to be a part of Nike’s business. We consolidated CR functions under the the newly created VP of CR position, led by Maria Eitel, which brought together our labor and environment strategies. By 2001, we established Nike’s Board of Directors’ CR Committee, set long-term environmental goals, and jointly published worker survey findings with the Global Alliance. These two important management shifts – the installment of an internal governance model and formalization of CR Reporting put us in the position to proactively manage our whole sustainability agenda. Nike was embarking on a journey to understand the true power of transparency, collaboration and governance. In December 2004, Hannah Jones, became our second VP of CR reporting to Mark Parker, who was then co-president of the Nike brand. Mark Parker soon become CEO of NIKE, Inc. In assuming the CEO position, he brought a passion and commitment for sustainability. Concurrent with these management changes, we entered into an internal cultural shift, recognizing that we cannot solve these challenging issues alone. The commitment to transparent, operation-wide sustainability morphed into embedding sustainability as a future business driver for growth. In 2007, Nike conducted (along with SustainAbility, a consulting firm) a scenario planning on global trends such as water, health, and energy, alongside increasing worldwide concern about climate change. This was not just about our sustainability strategy – it was part of our business strategy. We became acutely aware of our dependence on oil for materials and fossil fuel energy. We were vulnerable, as many companies are, to escalating oil prices and looming carbon restrictions from anti-climate change regulation. The waste production, use of materials and water by contract manufacturers also posed major risks. All of these issues were deemed significant and highlighted the areas of our value chain and our business that had the most potential for innovation. It eventually led us to our long-term vision to build a sustainable business and create value for Nike and our stakeholders by decoupling profitable growth from constrained resources. The labor crises, the management shifts and the scenario planning exercise were all pivotal moments. Collectively, they triggered a commitment to drive sustainability into every aspect of Nike’s business. We have a new vision; we’ve redefined goals as in Nike terms, there is no finish line. It requires innovation in our design process, our production, our sourcing, our tools and metrics, and our whole team structure. Fortunately, innovation is in our cultural DNA and provides a strong foundation. Even so, embedding sustainability thinking in our strategy and then educating every person and evolving the process in the company is a challenge that takes time, continual reassessment, and unerring commitment. Early on, we missed some signals and now we have much stronger tools, teams and a culture that is structured to make progress against our bold sustainability goals. It is clear to us that our long -term potential, and the long-term potential of virtually every other major company in the world, will be severely pressured by [these] external factors, Parker contends. Key Innovations Timeline Innovation is at the very heart of our culture at Nike. One of the cornerstones of innovation is a willingness and desire to learn. And, while we have learned much from our past and others have learned much from our experience, we believe the next era in the evolution from an industrial economy toward a sustainable economy will teach greater lessons than learned before. This evolution requires us to innovate faster, more radically, more disruptively inside of Nike and throughout out our whole ecosystem. It is a top to bottom, bottom to top, inside out and outside in innovation. In 2008, we produced a video for our design team. ‘Considered Design’ lays out a vision for the products we strive to produce. On screen, you see a close up of a runner’s shoes, pacing through puddles and mud. It evolves into a poetic series of athletes in action. Considered Design video: youtube. com/watch? v=1WuyE_x8Vs8 managementexchange. om/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 6 of 29 The accompanying voiceover: â€Å"This is not a shoe, it is an ethos, a shoe reborn as a tennis court, or basketball or †¦ a better shoe†¦Why do [products] have a shelf life? What if there was a closed loop cycle? †¦A sho e can’t change the world, but an ethos can. † The video was intended to inspire. It also set forth a mandate and a vision. How could Nike design products that have no shelf life? How can we reuse and reinvent products? How could we work towards a closed loop vision? This vision was the first important step in driving a new era of innovation. Our CEO Mark Parker has a vision to embed sustainability as an ethos, as a a catalyst of innovation to deliver product and services that deliver superior athletic performance and lower enviromental impact and ultimately drive profitable and sustainable growth for the company â€Å"It’s not about a few people making sustainable products,† says Nike Considered GM, Lorrie Vogel. It’s about making sure that every person in the system adopts a different world view, sense of purpose and approach to their job. † In order to embed sustainability and make it central to our ethos, we have made significant organizational changes, developed new tools and performance metrics, and redefined our relationship with suppliers and industry peers. We started with a focus on our own internal capabilities, knowledge and practices our internal innovation phase. Over time, we have expanded our focus to include suppliers and industry peers our external innovation phase. Internal Innovation Phase – Corporate Responsibility and The Considered Group In 2004, Nike’s various sustainability initiatives (including environmental responsibility) had not really worked their way into daily business decisions. CR was perceived as a risk management function not a valuable market opportunity. It was isolated from Nike’s business units as an add-on or layer to the business strategy and not as a core driver. The good news was that business unit managers spoke aspirationally about the potential of effective CR. Our team set the conceptual metric of return on investment squared or â€Å"ROI2† as CR’s new strategic compass, emphasizing that business decisions included both financial and corporate responsibility returns – people, planet and profit. If CR delivered ROI2, it was helping the business succeed and improve its social and environmental footprint. We took a strategic approach to CR that emphasized value creation, collaboration with business units and proactive strategic planning. â€Å"We wanted to show how we could help them deliver returns on investment to our shareholders. The end goal for us had to be that businesses institutionalize CR into the DNA of the company so that CR is a living, breathing approach to how one does business. By organizing CR around ROI2, we hoped it would evolve from being seen as a cost to being an intrinsic part of a healthy business model, complete with profitability and sustainable growth. ROI2 is Nike’s measure of creating an exponential return from integrating corporate responsibility into our business. Take waste, for example. In FY05-06 we carefully documented and measured the amount of waste generated across our entire supply chain. In one year, the cost of waste across footwear alone was estimated at $844 million. Everyone is involved in initiatives to reduce our waste across the supply chain: from designers to chief financial officer to business partners. Less waste is better for margins and better for the environment. By using design to reduce our waste, we’re tapping one of our greatest resources innovation – and fueling other insights and successes. This provided the backdrop to our evolution and to the targets we set over the course of the next five years. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2 %80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 7 of 29 â€Å"Under our CEO’s guidance and influence, the team began exploring where best to start integrating this strategy into Nike’s ecosystem. We focused on our product creation process and honed in on product design as a key intervention point. Due to its position at the beginning of the supply chain, the design function offered great opportunity to design out environmental issues. We wanted to help Nike â€Å"design the future as opposed to retrofit the past. † According to one of my colleagues the choice to work with designers was natural: â€Å"The designer’s job is to design the future. It’s natural that they would be huge champions of sustainability and they thrive on daunting, new problems. Also, because design is situated at the beginning of the supply chain, the design function is an opportune intervention point. In late 2005, the Considered Design ethos was formally embedded within our business strategy, with a focus on high-performing, aesthetically pleasing greener products. The Considered Group is a think tank, tool box, internal consultancy, competitive catalyst, and an antenna to the outside world. It serves as the hub of the Considered design ethos – consider the choices, consider the impacts. Their mandate is to provide inspiration, education, and the tools to drive sustainability best practices deep into Nike’s product creation units and processes. The team’s objectives include helping Nike assess the entire product lifecycle. The whole structure of Considered Design is thoughtfully designed to cultivate innovation. Instead of commanding and controlling how the business units implement sustainability, the team places responsibility for sustainability in the hands of designers. The team is a centralized hub with reach into key Nike functions. The hub’s spokes are product creation units, to which Considered disseminates knowledge, tools, and support. The team has both environmental and product creation expertise and collaborates closely with the related product engines. Considered’s GM, Lorrie Vogel, explained the organizing philosophy: â€Å"If you don’t know how to translate environmental knowledge into products and processes, you’ll always be outside of the product creation engine. † The Considered team was surprised by how difficult it was to create usable metrics for the product teams. They developed a holistic, predictive way to score products at different intervals throughout the development process. After 18 months of extensive work on developing the right metrics for the tools, the Considered Index was introduced in September 2007. The Index provided predictive metrics that would work uniformly across Nike’s varied footwear line. It evaluated a product’s bill of materials (BOM), a roster of all materials specifications for a shoe’s components, using Nike’s Materials Assessment Tool, an abbreviated life cycle analysis for raw materials. The Index scored environmentally preferred materials (EPMs) on multiple criteria including toxic hazard, energy and water usage, recycled content, recyclability, and other supply chain responsibility issues. As a learning and motivation tool for Nike’s product teams, the Index included a â€Å"Change Agent† category. Teams could win points for up to three new significant footprint-reducing product or process ideas. Lesser awards were also given to teams that adopted other teams’ recent innovations. The Index was carefully calibrated to reward only those products that performed above Nike’s historical averages, with Bronze representing baseline sustainability and Silver and Gold both qualifying as â€Å"Considered†; the distinction was purely internal. The Considered team planned to toughen the Index’s scoring over time. As one manager noted, â€Å"The intention is that we just keep raising the bar. As we do, business units will have to improve. † The Considered team trained product teams how to use the Index. It built a network of Considered â€Å"super-users† who served as internal category experts on Considered questions and provided feedback to the Considered team. Through super-users, Considered would provide updates on noteworthy examples of inspirational implementation and innovation. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 8 of 29 The Index ran on an intranet calculator. Product teams could self-score their products in a minute by entering their product’s BOM number and clicking checkboxes for design and process options. While teams scored their product at the end of the development process to receive an official Considered rating, many product teams used the Index at interim product gates. The very fact that the information and scoring was public was motivating. It cultivated peer competition and energized the pace of adoption and innovation. From the beginning, the team had visible CEO level support. As Vogel explained, â€Å"CEO Mark Parker believes that sustainability is the future of Nike. He also wanted to see the scores up on the wall so that we could really track and learn from the process. † Since Nike began setting targets years ago, we have learned the greatest opportunity to drive change is in the areas where we have the most impact. Materials create Nike’s greatest environmental impact. Nike also controls the design and became the area of focus to roll out the Considered Design ethos in 2009. This same methodology and rigor has been applied to design sustainability into the way we source and manufacture our products. Nike’s effort to drive further innovation throughout the company and integrate sustainability into the very core of our efforts is multifaceted. We have scripted a new vision. We changed the organizational structure and introduced a whole new department. We provided training and leveraged technology. And, we encouraged healthy competition and celebrated successes. Even the best strategy comes to nothing without the commitment, people and processes to make it happen. Continuing to integrate sustainability into our business, rather than layering it on top of how NIKE, Inc. nd our brands currently operate, will increase and accelerate progress, drive scale and the proliferation of sustainable innovation, and enable broad employee engagement. At Nike, dedication to and accountability for sustainability begins at the top. In 2001, we formed a Corporate Responsibility (CR) Committee as part of our Board of Directors committee structure. The CR Committee has oversight of environmenta l impact and sustainability issues, labor practices and corporate responsibility issues in major business decisions. In FY06, we created a management framework to ensure executive accountability for corporate responsibility across the company. The Vice President for Sustainable Business Innovation (SBI) reports directly to President and CEO Mark Parker, and co-manages dedicated teams with business and functional executives to develop and review policies with Board oversight, approve investments and evaluate and refine our approach and direction. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 9 of 29 managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 10 of 29 The SBI team acts as a catalyst for sustainability companywide. Made up of about 130 people, the team leads sustainability strategy development; provides content expertise and consulting to teams companywide; collaborates with sustainability specialists in other parts of the organization; drives ustainability integration; leads engagement with stakeholders; works to mitigate risk and facilitate compliance; and reports on our progress to scale the impact of sustainable innovation beyond Nike. Our new executive-level Committee for Sustainable Innovation also steers our efforts specific to innovation. In 2011, we launched an executive-level Committee for Sustainable Innovation. Th is group is chaired by our CEO and oversees our innovation pipeline and portfolio. It helps to fully capitalize on opportunities by accelerating adoption and bringing these activities to scale. Ultimately, the greatest measure of our success can be found in the finer detail of Nike’s culture. The very vocabulary of Nike designers has changed. We now hear team members say ‘ that’s an inconsiderate design’ in commenting on a product that does not meet the new criteria. External Innovation Phase – Materials Sustainability Index, GreenXchange, Sustainable Apparel Coalition As Nike advanced through a company-wide adoption of the Considered ethos, it became clear that for true, holistic change, we needed to focus beyond our own internal operations. To drive adoption and scale at an industry level, to ultimately change the marketplace for the better, Nike recognized the potential benefit in sharing knowledge, information and tools with suppliers, peers and other stakeholders. Four key initiatives show what we are doing to cultivate innovation outside the business: the Nike Material Sustainability Index (MSI), the GreenXchange, the Sustainable Apparel Coalition, and the DyeCoo waterless dying strategic partnership. Nike Material Sustainability Index (MSI) managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 1/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 11 of 29 The materials in just our NIKE Brand footwear and apparel products come from 900 different material vendors (i. e. , supplier companies). We do not source directly with these vendors; they are independent companies that sell materials to our contract finished-goods manufacturers based on our design specifications. To drive sustainability improvements in materials, we focus on the part of the value chain over which we have the most control: product design. Decisions made in the product design phase determine the majority of a product’s environmental impacts. Nike teams design products with very detailed material specifications, and by providing those teams with the information they need to choose better materials from better vendors, we can improve the sustainability of our products. We are now working to take the Considered Indexes to the next level. We have been on a multi-year journey to refine the footwear and apparel Considered Indexes based on feedback from product creation teams. In addition, we have significantly upgraded the materials rating tool embedded in the Indexes and are calling the new tool the Nike Materials Sustainability Index (Nike MSI). The Nike MSI is embedded in the Indexes that our designers and developers use to assess potential products, and it plays a pivotal role in product design. One major improvement in the Nike MSI is that it rates material vendors in addition to materials themselves, providing strong incentives for the vendors to become more environmentally sustainable. We score material vendors on criteria such as whether they are complying with the Restricted Substance List (RSL) testing requirements and the Nike Water Program requirements; if they take part in materials certification processes, such as the Global Recycle Standard; and whether they have ISO 14001 certification or operate out of certified â€Å"green† buildings. Rating higher on these types of criteria will increase a vendor’s overall Nike MSI score. The Nike MSI does more than rate our material vendors, however. It also scores materials according to (among other things) the chemicals required to make or process them. These scores enable our Nike product-creation teams to make more sustainable, less-toxic choices during product design. It also assigns sustainability scores to materials based on multiple criteria, including how much water is required to produce them and the water stewardship of vendors that process them. The Nike MSI creates a strong incentive for material vendors to enroll in the Nike Water Program and reduce their water-related impacts by recycling process water or implementing innovative low- or no-water coloring processes – as these activities help to increase their MSI scores. Water-efficient materials from water-efficient vendors receive more points on the MSI, and, therefore, stand a better chance of being selected by our product creation teams than other similar materials. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 12 of 29 managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 13 of 29 managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 14 of 29 Materials are a substantial cost, so identifying long-term access to affordable materials that meet our environmental standards is key to our ongoing success and our ability to decouple materials from scarce resources. GreenXchange Over the past ten years of working on sustainability, we have come to understand the value of collaboration and shared knowledge. Without it, companies replicate efforts, reinvent wheels and often only make incremental progress. Nike worked with the collaboration nonprofit, Creative Commons which also believe in the power of open innovation. Nike and Creative Commons share a vision of creating a digital platform that promotes the creation, sharing and adoption of technologies that can potentially solve important global or industry-wide challenges. GreenXchange, a web-based marketplace we founded with several other companies, was born in conversation leading up to the World Economic Forum in Davos in 2009, and launched in 2010. By using a set of standardized, free, legal tools, patent owners can make portions of their intellectual property portfolio available under a set of terms between the current choices of all rights reserved and no rights reserved. With GreenXchange patent licensing tools, patent owners open up a wide swath of technologies for research, development and innovative commercial uses. Patent users receive the rights they need to innovate, and patent owners receive credit for their works as well as the option to receive annual licensing payments. GreenXchange builds on a culture to create common spaces for innovative reuse, as well as standardization efforts for biological materials and scientific data. It also bridges some key gaps in the way that green technologies are developed and utilized. Many active RD companies create green technologies that are not core to their business: they may represent good practices shareable across a large set of companies sometimes even including competitors but lack the business infrastructure to make those patents available for wider use. GreenXchange was our first foray into open innovation with other businesses, set up to allow organizations to collaborate and share intellectual property. We have gained significant insights from this collaboration which continue to inform our strategy to bring sustainability innovations to scale. The very concept of GreenXchange is a management innovation. Instead of taking a proprietary, short term approach to developing and controlling important information and sources, we have done the opposite. Nike continues to urge its peers to collaborate, and is leading the way through its own commitments. Sustainable Apparel Coalition Complementing our work to improve factory conditions, Nike is exploring ways to evaluate and communicate the environmental and social performance of individual products. We are doing this in cooperation with the Sustainable Apparel Coalition (SAC), a group of which we were founding partners. The SAC is an industry-wide group of leading apparel and footwear brands, retailers, manufacturers, NGOs, academic experts and the U. S. Environmental Protection Agency, working to reduce the environmental and social impacts of apparel and footwear products around the world. ttp://www. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 15 of 29 The SAC believes a common approach for measuring and evaluating sustainability performance is essential for driving a â€Å"race to the top† in the apparel supply chain. Apparel retailers and brands can compare the performance of products and upstream supply-chain partners, and those partners will have a single standard for measuring and reporting performance to their downstream customers. Eventually, this approach can provide a foundation for reporting to consumers on the environmental and social footprint of the products they purchase. Through multi-stakeholder engagement, the Coalition seeks to lead the industry toward a shared vision of sustainability built upon a common approach for measuring and evaluating apparel and footwear product sustainability performance that will spotlight priorities for action and opportunities for technological innovation. The Sustainable Apparel Coalition’s vision and purpose are based on a set of hared beliefs: The environmental and social challenges around the global apparel supply system affect the entire industry. These challenges reflect systemic issues which no individual company can solve on their own. Pre-competitive collaboration can accelerate improvement in environmental and social performance for the industry as a whole and reduce cost for individual companies. This collaboration enables individual companies to f ocus more resources on product and process innovation. Credible, practical, and universal standards and tools for defining and measuring environmental and social performance support the individual interests of all stakeholders. DyeCoo waterless dying strategic partnership Nike recently entered into a strategic partnership with DyeCoo Textile Systems B. V. , a Netherlands-based company that has developed and built the first commercially available waterless textile dyeing machines. By using recycled carbon dioxide, DyeCoo’s technology eliminates the use of water in the textile dyeing process. With no water consumption or auxiliary chemical use, a reduction in energy use, elimination of drying and improving the process, the technology can enhance the quality of the dyed fabric and potentially revolutionize textile manufacturing. Our VP of Merchandising and Product, Eric Sprunk further explains, Waterless dyeing is a significant step in our journey to serve both the athlete and the planet, and this partnership reinforces Nike’s long-term strategy and deep commitment to innovation and sustainability. We believe this technology has the potential to revolutionize textile manufacturing, and we want to collaborate with progressive dye houses, textile manufacturers and consumer apparel brands to scale this technology and push it throughout the industry. Postlude In earlier years, we were about innovating solely to deliver optimal performance to our athletes, and strong financial returns to our stakeholders. We also had to react to risks and constraints in our ecosystem. Organizationally, the initial charge resided with the Vice President of the Corporate Responsibility Group. Over time, we made further changes to support, iterate and integrate the leadership vision thoughout the company. It meant an evolution in our approach. Now, our long-term vision is to deliver growth that is good for all – our athletes, our consumers, our investors, our suppliers, our partners, and the world in which we operate. We are using sustainability to redefine business performance and look to show the industry how we can embed sustainability into our approaches to product and manufacturing, and solve challenges in business and sustainability for the world. To enable adoption, our innovation strategy focuses on utilizing better processes, making better choices and bringing those choices to scale. We develop certain tools, such as the Considered Index, to drive our internal integration. We set targets that align to and support our strategy and have expanded our focus to our supply chain and industry peers. We work to optimize and improve our impact, and, at the same time, we innovate with a focus on changing the future. managementexchange. om/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 16 of 29 Timeline 1964 Blue Ribbon Sports founded by runners and revolutionaries Bill Bowerman and Phil Knight -as a distrbutor for the Onitsuka Tiger footwear brand (now ACIS) 1971 Swoosh logo designed for $35. The Nike swoosh the spirit of the winged goddess who inspired the most courageous and chivalrous warriors at the dawn o f civilization Year-end revenues reach $1million. 972 BRS founds Nike late 1970s Nike establishes headquarters in Beaverton, Oregon, expansion internationally. 1985 Sock Racer championed Bowerman’s minimalist values with a breathable four-way-stretch upper, instead of layers of fabric, reducing weight and using less materials. 1988 Launch of ‘Just Do It† campaign and the reputation for unique and inspiring ads. Revenues exceed $1. 2 billion managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2 %80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 17 of 29 990 Niketown stores launched; Labor practices questions 1992 Nike’s first Code of Conduct published to guide practices in contract factories 1993 Nike launched its Reuse-A-Shoe program, allowing consumers to drop off any brand of worn out athletic shoes. Nike grinded the shoes and used the recycled material and manufac turing scrap in new sports surfaces. Since its launch, Nike has recycled more than 25 million pairs of athletic shoes. 1995 Nike began the journey of phasing out volatile organic compounds (VOCs) or petroleum-derived solvents (PDS) from its footwear production, reducing the use of VOCs 90% in just over five years to 2001. Nike also started to manufacture its shoeboxes with 100% recycled cardboard. 1997 Nike committed to fully phasing out SF6, a global warming gas used in Air-Sole cushioning units. In 2006, Nike completed the phase out of all F-gases in Nike-branded footwear. Nike began to blend organic cotton into a range of t-shirts. 2000 Nike Woven started the conversation about using less adhesives and less waste while maintaining comfort, performance and breathability. The Standoff Singlet worn in Sydney was the first time Nike used 75% recycled polyester in a performance product. 001 CR Committee of Board established. Nike also established its first comprehensive list of restricted substances (RSL) to guide suppliers in the production of safe and legally compliant product. The RSLs were based on the most stringent worldwide legislation and also included substances that Nike had voluntarily decided to restrict. 2004 Hannah Jones assumes role as VP, Corporate Responsibility. That year, Nike also de veloped an environmentally preferred rubber that contained 96% fewer toxins by weight than the original formulations. Also, Nike’s first retail introduction of apparel, the Men’s Fitness recycled polyester track suit, was made from 100% recycled polyester in a range of men’s fitness jackets and pants. 2005 Considered Design was formed as an ethos of the company to create products that address environmental impact by reducing waste, increasing the use of environmentally preferred materials and eliminating toxics. Nike introduced the Considered Boot, using a single shoelace woven between the leather parts of the upper, minimizing adhesives and allowing for easier disassembly. 006 Mark Parker becomes CEO 2007 Considered Index introduced. Also, the Nike Long Ball Slip-On was a unique performance-based shoe constructed without the use of solvents to hold it together. 2008 Nike launched the AIR JORDAN XX3, incorporating sustainability without sacrificing performance. That same year, the Air Pegasus 25, one of Nike’s most iconic running shoes, was designed to maximize efficiency . 2010 GreenXchange launched and some of the world’s leading football (soccer) players wore the most environmentally friendly and technologically advanced jerseys on the pitch. ttp://www. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 18 of 29 Also, Nike’s EADT software application enabled designers to make the most sustainable choices right at the start of the product creation process, in real time. The tool was created based on Nike’s internal Considered Index, tested and utilized since 2006, and released to the industry to support transparency and collaboration. 2011 Sustainable Apparel Coalition launched. Also, using a new fabric that’s both thick and soft, the women’s Nike Legend Pant was made from recycled polyester, material made from recycled plastic water bottles. The Nike Legacy GS Boardshort brought performance and innovation to the next level for the competitive surfer, while also lowering environmental impact. 2012 Implementation of Nike Materials Sustainability Index began. And, NIKE, Inc. announced a strategic partnership with DyeCoo Textile Systems B. V. , developer and builder of the first commercially available waterless textile dyeing machine. The technology eliminates the use of water in the textile dyeing process. Challenges Solutions Challenges and Fixes Nike has faced a number of challeges in its efforts to integrate sustainability within product design and innovate a redefined future but it has led to us iterating, innovating and finding new ways to operate more efficiently, effectively and creatively: Uneven adoption of the Index and new vision. Even though corporate leadership held all categories accountable for achieving Considered targets, there was considerable variation in how quickly different groups have integrated the Considered Index and how well they operationalized the tool. Some businesses have faced greater challenges. Some businesses had a more entrenched resistance. Since then, Nike has integrated sustainability principles into its innovation processes, governance and portfolios to generate innovation that delivers products and services that combine performance, innovation and sustainability. Additionally, Nike has set a vision for what changes are needed in innovation, with its people and culture and in the way it works in two areas– in product and in manufacturing – that build on past achievements and on processes established to drive change. ttp://www. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 19 of 29 managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eX change Page 20 of 29 Perfromance risks in the adoption of new materials. There were a number of performance and aesthetic risks that Nike footwear faced in using EPMs such as synthetic leather. There was a potential performance risk, for example, that using recycled content could degrade physical properties like material durability, threatening Nike’s strict quality standards. One of the product creation directors in footwear described that with some EPM synthetic leather alternatives, the options weren’t very attractive: â€Å"Leathers look boardy and dry, and the textiles aren’t very interesting. † Today, rising input costs mean the need for innovation and technology has never been greater. Through innovative design, science, technology and process changes, our long term vision is to progressively design out waste, eliminate hazardous chemicals and non-renewable energy consumption. Innovation also allows us to design in new materials and new approaches to products. This vision has been built on years of assessing trends and materiality for Nike and the changes that are impacting our business, our value chain, our consumers and the world. In 2007, we undertook an assessment with SustainAbility some meta trends that have only become more relevant as we’ve shaped and defined our strategy. These meta trends highlight the areas of our value chain and our business that have the most potential for innovation. We use these filters in our work, our assessment of opportunity and the way we approach reporting. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 21 of 29 managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 22 of 29 ttp://www. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 23 of 29 managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for A ll | Management Innovation eXchange Page 24 of 29 Added complexity. In most cases, Considered made the design process more complex. While designers liked to iteratively find the right design, Considered required thinking about pattern efficiency much earlier in the process. It required more planning, often took longer, and it was often harder to find designs that both looked â€Å"cool† and were efficient. â€Å"On most product decisions, it’s not lower in cost, better in performance, and more sustainable,† explained one category product director. â€Å"If it was that easy, that’d be great! So usually on every component of a shoe, there are tough decisions to be made. † A designer within the Cleated category noted, â€Å"We try to make designs look cool first, then run it by other filters like cost and Considered. We design in response to a lot of constraints, like price and performance requirements, and goals like cool looks and feel. More constraints makes the process harder and, maybe, slower. † Different from then, sustainable innovation is now increasingly at the core of the business. To hedge against the complexity, we needed to focus on identifying disruptive solutions in order to manage environmental impact and business risk. So, what does this mean in terms of the sustainability of our products? The truth is, it’s a challenge to figure out how to measure that. Rather than working toward a certain percentage of, say, recycled content in a finished product, we have worked to improve our base materials, and we are now creating systems that allow us to better assess the impacts of the resulting products. That said, we do already have some ways to measure our success. For example, over the past five years we have achieved a 19 percent reduction in waste related to the production of footwear uppers. Considered Design contributed to that gain, along with manufacturing process optimization and other best practices. That’s the same as not producing 15 million pairs of shoe uppers over that time period. Our use of Environmentally Preferred Materials (EPMs) – ones that have lower environmental impacts throughout their lifecycles in terms of chemistry, water, energy use and waste – provides another strong indicator of our progress. We also learned that addressing symptoms doesn’t embed change so it focuses in on the earliest stages of the product life cycle. Time Given the extremely fast pace of product development in response to consumer trends and ongoing organizational change efforts, product creation employees didn’t have a lot of time for implementing Considered. We now recognize that ntegration is an imperative to address process changes so we redefined reporting structures, design and sourcing processes and created materials to help us better achieve superior products with lower environmental impact. Higher Costs The potential additional costs for developing greener footwear was another challenge facing Considered. Alongside the increasing cost of pe troleum, adding EPMs made Considered design potentially even more expensive. Large product category teams had some success negotiating price reductions based on volume, but smaller categories struggled to overcome margin pressures. Because Nike is a growth copany, sustainability, today, becomes increasingly important to our growth strategy. As we have learned over the years, sustainability is not just a strategy for growth, but a competitive advantage. Supply Chain Partners Some contract manufacturers have been highly responsive to category requests for help implementing Considered, but others, either because of their size, prior capital investments in less-efficient machinery, management focus, or lack of technical capacity, were not able to nimbly and successfully execute the Considered design requirements. Because we now know that early intervention is key, educating factories on why a stable, competitive, well compensated workforce makes good business sense. Nike focuses on training, incentivizing and holding contract manufacturers accountable to its Nike standards and continues to raise the bar with each iteration of the Indexes. Nike’s new rating system, managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 25 of 29 the Manufacturing Index, looks comprehensively at a contract manufacturer’s total performance and includes a deeper look at how a factory approaches sustainability. This Index elevates labor and environmental performance alongside traditional supply chain measures of quality, cost and on-time delivery. Consumers Considered faced several challenges with consumers. For one, many consumers were skeptical that a running shoe made from EPMs would in fact perform as well as a shoe that was not. For example, one focus group initially was very receptive to a Considered running shoe, but after being told it was unusually â€Å"green† started viewing it as a lower performance product. Today, Nike is meeting consumer demands through performance, innovation and sustainability which drive superior product. The Flyknit technology is a good example of where performance meets sustainability. Nike Flyknit, which uses precisely engineered yarn and fabric variations to create a featherweight, formfitting and virtually seamless upper. It’s a new way to knit the multiple pieces of a shoe upper out of what is essentially a single thread. It’s great for the athlete because it is lighter and offers a more custom fit. It’s good for the planet because it drastically reduces waste from the upper production process. And shareholders stand to benefit from the reduced cost of production and potential for increased margins over time as the the innovation grows to full scale. It’s a nascent technology that holds tremendous opportunity. Nike FlyKnit video: http://nikeinc. com/news/nike-flyknit Marketing Nike had not yet figured how to market performance, aesthetics and sustainability in one complete package. There was internal debate as to whether Considered should become its own brand within Nike, or simply a new dimension of the Nike brand. Ultimately, Nike decided that there would be no compromise to performance, no green line of products and that sustainability should not be a constraint but an innovation challenge for designers. Benefits Metrics We know where we’ve been, and we know where we want to go. And we know that there is substantial work ahead. We continue to set the bar higher for ourselves and our business. We have evaluated our business model and our impacts across our value chain, have assessed the coming scenarios and challenges, taken account of our progress against past performance, and worked across our business to set targets embedded deeply into the way we operate. Many of the sustainability issues we seek to solve are still ndergoing innovation. Others are firmly in place and moving forward with needed changes. We deliver on our vision in two ways: Make today better by taking account of our impacts, driving efficiency and optimization Design the future by unleashing innovation, embedding sustainability into our approaches to product and manufacturing, and solving challenges in business and sustainability for the world Accelerated innovation. Our sustainability vision both inspire d and drove us to reinvent our creative process. It accelerated and strengthened innovation as a core competency. managementexchange. com/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 26 of 29 Abillity to attract the best talent. Our success in pioneering sustainability in a holistic way, and to continue to deliver â€Å"the cool factor† and superior performance means we can attract the very best designers, engineers, strategists and marketers. Brand value and goodwill. After our CR challenges in the late 90s we have not only worked hard to regain the trust and respect of customers and industry peers, we have set forth a strategy to lead. We are proud to be a respected brand, design company, innovator and among those recognized as a leader in sustainability. Reduced costs of sustainable sourcing. By sharing best practices and providing open access to our tools and sourcing information, we are driving industry peers to adopt similar processes, materieals and metrics. This means we have the volumes to drive down the costs of what has been a more sustainable, but more costly source. Lessons Lead with a vision. Every person in the organization must understand and embrace a very specific idea of what the future beholds. Provide a specific example that illustrates the vision and engenders passion and a sense of purpose. As Lorrie Vogel says of the Considered Change video: â€Å" We created a concrete vision of what we wanted to be and we got that in front of every person in the company. † Secure Executive level support. To fully integrate changes throughout an organzation, it must be very apparent that the initiative has CEO level support – not just through words, and verbal endorsements, but through the actions and interactions that CEO has inside and outside the company. Set clear targets and metrics to measure success and track progress. Even if the initial measures are imperfect, its important to start to have some means of tracking progress and reinforce the learning. â€Å"If you don’t measure it, it doesn’t happen,† says Lorrie Vogel. managementexchange. om/story/nike%E2%80%99s-gameplan-growth-that%E2%80%99s-good-all 21/02/2013 Nike’s Gameplan for Growth that’s Good for All | Management Innovation eXchange Page 27 of 29 Provide the tools to facilitate the adoption process Very few individuals and organzations take to change easily. It’s human to be comfortable with what is known and to resist change that challenges the status quo. It is critic al to provide the education, training and toolsets to engage people more easily and affect change. We embedded our training and tools within the existing system, leveraging existing processes as much as possible. We provide our product creation teams with extensive training in how to use the Considered Indexes and on the importance of focusing on the sustainability of materials. The teams are given scoring targets for each season of products they design. In the current version of the Considered Indexes, materials make up 35 percent of the score for footwear and 60 percent of the score for apparel, so it’s clear to the design teams that focusing on materials is an effective way to meet their goals. While the Considered Indexes have been sed primarily by the NIKE Brand, our Affiliate brands have also begun introducing and using them to evaluate their product designs and have committed to adopt the indexes by the end of FY15. For example, Hurley International scored selected apparel designs in FY11. The designers and team members did not need to learn a new system in order to get the information they needed. Celebrate and reward success. The creation of incentives is another critical aspe ct of driving change. It is very important to incentive the right behaviors to make sure we achieve the change we want to see. Nike assigned innovation points to drive competition, and managed these through a living index, a forum that was pubic and enabled team members to gauge their success. It also fed a healthy competition between teams and efforts. Collaborate with others. Engage outisde experts to help formulate a vision and maintain an objective peer review. As Lorrie Vogel shares: â€Å"We engaged Natural Step to help develop our ‘North Star’. It is in the spirit of transparency and collaboration that we share our journey and hope that the the definition of business performance is expanding. We will constantly need to deliver innovations that evolve our approach at Nike and share our lessons with the industry to affect the positive change. We hope the world innovates faster than expectations. We cannot achieve our bold goals for sustainability simply by delivering incremental improvements. Sustainability will be the catalyst in transforming business economies and markets, and we will continue to evolve our business to ensure we are able to grow profitably, and to lead. Credits Nike 2011 Sustainable Business Performance Summary: www. nikeresponsibility. om MIT Case Study: Nike Considered: Getting Traction on Sustainability by Rebecca Henderson, Richard M. Locke, Christopher Lyddy, Cate Reavis: https://mitsloan. mit. edu/MSTIR/sustainability/NikeConsidered/Documents/08. 077. Nike%20Considered. Getting%20Traction%20on%20Sustainability. Locke. Henderson. pdf Considered Design video: youtube. com/watch? v=1WuyE_x8Vs8 Nike FlyKnit video: http://nikeinc. com/news/nike-flyknit FY10-11 Sustainable Business Performance Summary: www. nikeresponsibility. com Nike Dare to Dream video: http://vimeo. com/11680452

Ou are expected to select a company in one of the selected sectors Essay

Ou are expected to select a company in one of the selected sectors defined by the International Standard Industrial Classifica - Essay Example The company appeared on the public listings of Dubai Financial Market in 2005 under ARMX trade shares. Currently, Aramex Inc. employs more than twelve thousand workers across sixty countries with strong world-wide network (Aramex Inc, 2011). Service delivery enterprises are normally anchored on key assumption that management, information and communication technology are important aspects and ingredients which are very crucial for success to be realized. However, all employees are required to embrace the use of information technology since it forms crucial part of a qualified member within any supply chain. This ensures efficient monitoring and delivery of intended goods and services to consumers (Kotler and Keller, 2007). Service deliveries ensure that all members of the society are reached with the intended product or services at the right time. Such companies usually operate on a designed conceptual model taking into account economic, social and political forces that determine reso urce allocation and management within companies from every region. The leadership structure is another important aspect of the supply chain (Mentzer et al, 2001). Critical Analysis of Operations Transformation Process for Products/Services Supply chain of Aramex Inc can be described as the core of the company’s organization’s operational efficiency. ... Aramex Inc. combines use of technology in delivering internationally standardized services that avails comprehensive solutions to requirements within supply chain and logistics. The company enjoys the services of its largest logistics and transportation networks in the world hence providing cost-effective services within the supply chain (Aramex Inc, 2011). Aramex Inc. Partner with Zubair Corporation (Z-Corp) headquartered in Oman for the purposes of offering businesses with integrated services such as warehousing and distribution through every means including sea, air and ground transportation. Z-Corp also offers such services as freight forwarding and customs brokerage to wide range of industries such as telecommunications, military and Information Technology related companies. Aramex Inc. also acquired Berco Express (Pty) Ltd to assist in logistics and transportation issues within South Africa and other regions. The company has significant share of South Africa’s freight an d logistics market and has over fifteen operating branches within South Africa (Aramex Inc, 2011). Aramex’s transportation network covers wide region from Middle-East to United Kingdom through to Caribbean countries. Such land networks are utilized by trucks fitted with Modern GPS-tracking system and also advanced technology involving scheduled services and strategic locations for their various terminal offices (Aramex Inc, 2011). This creates a cost-effective service preferred by most companies as compared to shipping services. The company is involved in receiving shipments from defined points taking charge of all clearance procedures to the delivery points of the products. Aramex Inc is capable of providing different modes of transportation depending on customer requirements. Such means

Chemistry central journal Essay Example | Topics and Well Written Essays - 1250 words

Chemistry central journal - Essay Example A prediction was made successfully five out of seven times (Schmuker, de Bruyne, Hà ¤hnel, and Schneider, 2007) on an odorant’s activity. Presently the field is not error proof. Although the study of ORNs and SARs between odorant and activated receptor has grown in recent years, much is left to learn. This study could only predict tested: models by recording in vivo receptor neuron responses to a new set of odorants and successfully predicted the responses of five out of seven receptor neurons. Correlation coefficients ranged from 0.66 to 0.85, demonstrating the applicability of our approach for the analysis of olfactory receptor activation data. (Schmuker, de Bruyne, Hà ¤hnel, and Schneider, 2007) ORNs to 47 ORNs in response to stimulation with odorant molecules† (Schmuker, de Bruyne, Hà ¤hnel, and Schneider, 2007). The responses of the Drosophila ORNs to forty-seven odorants were measured by electophysiological in vivo recordings from de Bruyne, Foster, and Carlson 2001 study â€Å"Odor coding in the Drosophila antenna.† In this 2001 study, the activity in a given compound was classified as â€Å"active’, ‘inactive’, or ‘uncertain’, depending on the spike rate it elicits in the ORN† (de Bruyne, Foster, and Carlson, 2001). The ‘uncertain’ data was not used when training the ANNs for specific ORNs for this study. Then Schmuker, de Bruyne, Hà ¤hnel, and Schneider (2007): trained 30,000 ANN models per ORN, selected those with the highest predictive power, and used them to predict ORN responses to 21 compounds, which were subsequently tested in vivo (in the following referred to as "test data"). We also assayed ten compounds that had already been tested in the previous study. The MATLAB Neural Network Toolbox was used for ANN modeling, employing backpropagation training with a gradient descent algorithm as implemented in MATLABs traingdx function. (Hertz, Palmer, and Krogh, 1991) A well-trained, well-generalizing model will have a high

Running the business from the palm of your hand Essay

Running the business from the palm of your hand - Essay Example In this context the mobile digital platform is gaining significance nowadays. Now people are using their mobile as a means not only to call, chat or message, but to carry out their business functions as well since mobile is one thing they always carry with them. With the introduction of Mobile OS like iPhone OS, Android, Windows OS people are developing apps which caters to everyday needs right from their home to business. Hence application making companies like GP Apps, IndiaNIC, Grapple, SourceBits etc are coming out with apps which cater to everyday business needs. Mobile application is software developed to serve a specific need of individuals, business organization etc. Business Functions are basically operations that need to be carried out by an organization. Like for a Software company the key operations are writing codes, testing, maintenance etc. For a Bank it is accepting deposits, giving loans etc. In TCHO Chocolate, which creates unique flavors of chocolate uses iPhone applications that helps his business process function smoothly. It enables the owner Timothy Childs to remotely control the Flavor Machine, control the time, temperatures, and turn on and off whenever he needs. Through the app Childs can remotely view several video cameras and thus know the status of the factory. General Electric Mobile has their own Mobile center of excellence which develops apps which caters to their business needs. For GE’s Sales and marketing personnel it acts as a great boon as they can share business information and presentation with their colleagues and customers. They also use Transformer Monitoring app which manages their gas turbine inventory and electric transformers in the whole world. Along with it their PDS Movement planner helps monitor railway tracks and diagnose the locomotives. In Dow Corning, the employees use a Roambi Visualizer app which helps them to view the business data including sales figures, their trends and projections in real time basis and analyze them. Their Analytics App for iPhone monitors the Web site traffic along with the online sales for their XIAMETER brand. Using these executives monitors globally what contents are useful for them. Sunbelt Rentals uses Mobile SalesPro app which integrates several databases and systems for the sal es team. Hence this helps the sales team to stay up breast with the latest information on rental rates and availability of equipment. Answer 2 Operational efficiency is the ratio between the input that a business needs and the output which a business delivers. Inputs can be people, money or time. Outputs are new customers, money, innovation, speed, customer loyalty etc. (Kenneth, 2010, p.81). There are several reasons as to why a business should invest in information systems. 1. Operational excellence: Information helps managers to achieve higher levels of productivity and efficiency in business operations. For example Wal-Mart uses a RetailLink system, which links their suppliers to all Wal-Mart's stores. When a customer purchases an item, the supplier knows that he has to ship a

Benefits of Postnatal Debriefing

Benefits of Postnatal Debriefing 215133 POSTNATAL DEBRIEFING STILL VALUED BY WOMEN Introduction Providing debriefing for women in the postnatal period is believed by many midwives to help women to adjust to their childbirth experiences, and to help reduce postnatal psychological morbidity. The evidence base is equivocal in relation to the efficacy of these kinds of interventions, which are typically delivered by midwives in clinical practice. This essay will review several pieces of research relating to postnatal debriefing associated with the psychological distress and potential post traumatic stress disorder associated with childbirth. It will look at the quality of evidence available and discuss some of the parameters of the arguments surrounding the provision of postnatal debriefing, listening and counselling services. It will also make recommendations for practice in relation to this kind of provision, and in relation to future research. Discussion Lavender and Walkinshaw (1998) carried out a randomised trial of a postnatal ‘debriefing’ service provided by midwives, to see what effect it had on psychological morbidity after childbirth. The authors comprise one midwife and one obstetrician, and the midwife has a postgraduate degree, suggestive that they have the skills to carry out and report on such a study. Using a randomised trial design is aimed at filling an apparent gap in the research at the time of the study, in relation to this area of practice (Lavender and Walkinshaw, 1998). This study was carried out â€Å"in a regional teaching hospital in northwest England, and used a sample of â€Å"one hundred and twenty postnatal primigravidas†, who were â€Å"allocated by sealed envelopes to receive the debriefing intervention (n 4 56) or not (n 4 58).† (Lavender and Walkinshaw, 1998 p 215). The study involved the collection of baseline intrapartum and demographic information in order to assess a wid e variety of variables in the study (Lavender and Walkinshaw, 1998). The intervention is described as follows: â€Å" Women randomised to the intervention participated in an interactive interview in which they spent as much time as necessary discussing their labour, asking questions, and exploring their feelings. One research midwife, who had received no formal training in counselling, conducted the interviews, which lasted between 30 and 120 minutes, the duration being guided by the needs of the respondent. Hospital notes were available throughout the interview so that direct questions could be answered. No interview schedule was defined, since the interviews were respondent led.† (Lavender and Walkinshaw, 1998) This approach raises several points. To being with, it is positive that there is such transparency in explaining the intervention, even if the intervention is brief, because it allows the reader to understand the nature, it aids replication, and it demonstrates the lack of specialist knowledge required to perform the intervention. Secondly, it shows that a research midwife, who was not a counsellor, was carrying out the intervention. And thirdly, it demonstrates a woman-focused, midwifery-oriented approach, in that the interviews were respondent led and the length was not limited. Such an approach reflects midwifery philosophies which makes the article useful for midwifery practice. Lavender and Walkinshaw (1998) used an established data collection instrument, the Hospital Anxiety and Depression (HAD) scale, which was administered by postal questionnaire 3 weeks after delivery. Using an established data collection instrument adds strength to the study, but there is a small amount of unreliability about postal questionnaires, because there is never any guarantee that they are filled out by the person they are sent to. Using the pre-tested scale allowed the authors to compare the proportion of women in each group with anxiety and depression scores of more than 10 points, using odds ratios and 95% confidence intervals, both of which are acceptable statistical applications for these data. The 95% response rate ensured a good sample size (Lavender and Walkinsahw, 1998), although the study would have had even more statistical significance if it could have been carried out across more than one site. The benefits of this intervention were established by the study, but the authors raise some concerns, including concern at the high levels of morbidity detected, and question whether using the chosen scale was appropriate for measu ring psychological morbidity after childbirth (normal or abnormal) (Lavender and Walkinshaw, 1998). This study is limited now by its age, and by being superceded by more recent studies. Kershaw et al (2005) carried out a prospective randomised controlled trail with two arms, which compared debriefing methods after birth which were aimed at reducing fear of future childbirth. As can be seen, this studied a more specific intervention, in relation to a very specific outcome, rather than measuring psychological morbidity per se. This would make it more applicable to specific aspects of practice. This study was also carried out in one site, and the authors provide details of the hospital site, which this author would question due to the issue of confidentiality. Kershaw et al (2005) focused on mothers whose first birth was an operative delivery, and gained ethical approval. More details about the ethics of this study would have enhanced its quality. Kershaw et al (2005) provide their inclusion and exclusion criteria, but do not discuss controlling for other variables. They also use a pre-established measurement tool to assess the fear of childbirth experienced by the stu dy participants (Kershaw et al, 2005). They do subsequently present demographic information, and they use a range of suitable statistical tests, explaining the significance of these, which makes it easier for the novice reader to begin to assess the quality of the data analysis. This again was a debriefing intervention carried out by midwives in the postnatal period (Kershaw et al, 2005). However, unlike the previous study, this one differed because the debriefing was held on two separate occasions, and sessions were held at home (Kershaw et al, 2005). Another significant element of this study was that the midwives involved received training in critical incident stress debriefing (Kershaw et al, 2005). The authors justify their study as follows: â€Å" In this study fear of childbirth and post-traumatic stress were measured rather than maternal depression and general health. It was decided not to measure maternal depression as research has suggested this is frequently associated with factors not related to childbirth. Women were allowed sufficient time to debrief, sessions lasted up to an hour and a half.† (Kershaw et al, 1508). This shows some strengths, including a focus on specific psychological features, rather than on general health and depression, which can be difficult to assess. Although the authors state women were allowed sufficient time for the session, this study does not reflect the kind of midwifery philosophy that the Lavender and Walkinshaw (1998) study did. The findings from this study do not support the use of this particular intervention in this particular population. â€Å"The findings of this study demonstrated in the short term no significant difference in the WDEQ fear of childbirth scores and IES emotional distress scores. These findings show community-led debriefing is not proven to be of any value in reducing women’s fear of childbirth following an operative delivery.† (Kershaw et al, 2005 p 1508). However, this study may not be the last word on this kind of intervention, and there are limitations, including the focus only on women who had operative deliveries, focusing on one site, and in the intervention itself. Maybe the nature of the intervention, and the training provided for midwives, was limited. The authors agree that a longer-term evaluation might show different results (Kershaw et al, 2005). It might be that the data collection tool was inappropriate, as with the previous study. However, this study, as with the previous one, does establish the usefulness and facility of midwives providing postnatal support of this kind. Kershaw et al (2005) show that midwives identified those women who would be needing debriefing, but this author would argue that midwives are not experts in mental health, and limiting debriefing to those identified by midwives as at higher risk might miss important cases. Reading between the lines of this study seems to imply that this intervention is valued by midwives and by patients, despite the findings of the statistical analysis. Small et al (2000) carried out a randomised controlled trial of midwife led debriefing to reduce maternal depression after operative childbirth, again, focusing on women who are viewed as potentially at higher risk of mental health morbidity postnatally. This study was carried out in a large maternity teaching hospital in Melbourne, Australia, unlike the previous two studies, which were carried out in the UK. Small et al (2000) had a sample of 1041 women who had given birth by either caesarean section (n = 624) , by assisted vaginal delivery using forceps (n = 353) or vacuum extraction (n = 64), and these women were randomised to the intervention group or the control group (Small et al, 2000). The sample size was statistically calculated for significance, which is a strength of the study. The methodology is clear and the randomisation process described. The intervention â€Å"provided women with an opportunity to discuss their labour, birth, and post ­delivery events and expe riences† (Small et al, 2000 p 1044). Although there is a woman-centred focus in this study, only 1 hour maximum was allowed for the discussion, which this author would suggest is a severe limitation of this intervention in relation to woman-centred debriefing. The midwives were not trained but described as experienced and skilled. The main outcome measures were â€Å"maternal depression (score >13 on the Edinburgh postnatal depression scale) and overall health status (comparison of mean scores on SF ­36 subscales) measured by postal questionnaire at six months postpartum† (Small et al, 2000 p 1044). Again, established scales are being used to lend strength to the study. Small et al (2000) found that â€Å"more women allocated to debriefing scored as depressed six months after birth than women allocated to usual postpartum care (81 (17%) v 65 (14%)), although this difference was not significant (odds ratio = 1.24, 95% confidence interval 0.87 to 1.77)† and â€Å"they were also more likely to report that depression had been a problem for them since the birth, but the difference was not significant (123 (28%) v 94 (22%); odds ratio = 1.37, 1.00 to 1.86).† (p 1043). According to this study, the authors demonstrated that midwife led debriefing following operative births was not only not effective in reducing maternal morbidity (in particular, psychological morbidity), at the six month point after delivery, but that it may have been a contributing factor to emotional health issues for certain women (Small et al, 2000). This author would suggest that it might be the nature of the intervention that is the issue here, because it was provided in hospital, soon after birth, and may not have been particularly woman-centred. Cultural differences between Australian women and UK women cannot be ruled out; neither can cultural differences in models of care and practice. Priest et al (2003) carried out a randomised single-blind controlled trial, stratified for parity and delivery mode, to test whether critical incident stress debriefing after childbirth reduces the incidence of postnatal psychological disorders, also in Australia, in two maternity hospitals. They had a large enough sample size, consisting of 1745 women who delivered healthy term infants between a specificed time period, with 75 allocated to the intervention group and 870 to control group (Priest et al, 2003). Again, the study design is transparent, and the randomisation process clear. As with the previous study by Small et al (2000), the intervention was carried out soon after delivery, but this intervention consisted of an individual, standardised debriefing session based on the principles of critical incident stress debriefing. The intervention is described briefly, and it is stated that the midwives were trained in the intervention (Priest et al, 2003). However, the intervention i tself and the training is not really described in great detail, which affects replication of the study. The intervention is based on theories which are not specifically developed for childbirth trauma, but that have been adapted, and this may be a weakness. As with the other studies, recognised outcome measures are used. Priest et al (2003) found that â€Å"there were no significant differences between control and intervention groups in scores on Impact of Events or Edinburgh Postnatal Depression Scales at 2, 6 or 12 months postpartum, or in proportions of women who met diagnostic criteria for a stress disorder (intervention, 0.6% v control, 0.8%; P = 0.58) or major or minor depression (intervention, 17.8% v control, 18.2%; relative risk [95% CI], 0.99 [0.87–1.11]) during the postpartum year. Nor were there differences in median time to onset of depression (intervention, 6 [interquartile range, 4–9] weeks v control, 4 [3–8] weeks; P = 0.84), or duration of depression (intervention, 24 [12–46] weeks v control, 22 [10–52] weeks; P=0.98).† (p 544). This leads to the conclusion that this single session of midwife led, specific debriefing was ineffective as a means of prevention of postnatal psychological disorders (Priest et al, 2003). While the authors conclude that the intervention had no ill effects (Priest et al, 2003), this author finds these findings significant in their lack of support for the intervention, and would suggest, again, that it may be the nature of the intervention that is leading to these kinds of results. Gamble et al (2005) carried out a randomised controlled trial to assess the effectiveness of a counselling intervention after a traumatic childbirth, based on a midwife-led brief counselling intervention for women deemed at risk of developing symptoms of psychological symptoms postnatally. This was a smaller study group, with only 50 in the intervention group and 53 in the control group, and the intervention was also provided as face to face counselling within 72 hours of birth, as with the previous study, but also had a telephone counselling session at between four and six weeks postnatally (Gamble et al, 2005). The allocation/randomisation process is described, but the midwife was not blind to the randomisation, which may represent a potential source of bias. Established data collection scales were used as with all the previous studies: â€Å"Edinburgh Postnatal Depression Scale (EPDS) , Depression Anxiety and Stress Scale-21 (DASS-21) , and Maternity Social Support Scale (MSSS)â €  (Gamble et al, 2005 p 13). Gamble et al (2005) measured the following outcome measures: posttraumatic stress symptoms, depression, self-blame, and confidence about a future pregnancy. Gamble et al (2005) provide great detail about the underpinnings of the therapeutic intervention, and there is a midwifery/woman-centred focus to the intervention (and, by association, to the study). Gamble et al (2005) found their intervention to be effective in reducing symptoms of trauma, depression, stress, and feelings of self-blame. All of these studies fall within the scope of good standards of evidence for practice, but find marked differences between studies in relation to efficacy and non-efficacy of interventions. There may be a number of reasons for this. Only one study suggests potential negative effects of this kind of intervention, but this was not conclusive and warranted further investigation. However, the literature around this subject does seem to predominantly suggest that such interventions are useful for women following birth. Axe (2000) suggests that women can use such support to help them cope with the difference between their expectations and experiences of birth. Robinson (1999) argues for the increasing occurrence of post traumatic stress disorder following traumatic childbirth, and suggests that this is under-diagnosed and represents a significant maternal morbidity which needs addressing, a suggestion also found by Ayers and Pickering (2001). Creedy et al (2000) state that â€Å"posttraum atic stress disorder after childbirth is a poorly recognized phenomenon,† and that â€Å"women who experienced both a high level of obstetric intervention and dissatisfaction with their intrapartum care were more likely to develop trauma symptoms than women who received a high level of obstetric intervention or women who perceived their care to be inadequate† (p 104). Therefore, the focus on debriefing may not be the only way forward to improve psychological morbidity – there may be a need for research to explore ways of reducing the trauma that occurs in the first place. Czarnocka and Slade (2000) suggest that there may be opportunities for prevention of post traumatic stress and psychological morbidity after birth, through providing care in labour that enhances perceptions of control and support. One study demonstrates that negative experiences of interactions with maternity staff can contribute to psychological morbidity (Wijma et al, 1997). Kenardy (2000) suggests that it is the nature of the debriefing that may be ineffective in those studies that have found such results. Gamble et al (2002) also suggest that the kind and timing of the debriefing warrants further investigation. Hagan et al (1996) did not find any reduction in psychological morbidity following this kind of intervention. Alexander (1999) suggests that some of the problems may be linked to the lack of clarity and understanding that exists about these processes, which are neither necessarily formal psychological counselling nor a simple sharing session. Yet there does seem to be some indication that these kinds of supportive therapies are found to be useful by women and by midwives. Westley (1997) describes providing women with the opportunity to talk about their birth experiences, and have their questions answered, as useful, a finding supported by Smith et al (1996), Phillips (2003), Inglis (2002), Dennett (2003), Charles (1994), Charles and Curtis (1994), Baxter et al (2003), and Allott (1996). Certainly, a range of literature established post-traumatic stress disorder as a potential and/or real psychological morbidity for women having had a baby (Ayers and Pickering, 2001; Creedy et al, 2000; Laing, 2001; Menage, 1996; Robinson, 1999; Ballard et al, 1995; Crompton, 1996). Psychological debriefing interventions may be effective in preventing or managing post traumatic stress disorder in a range of situations (Rose et al, 2004), but there would seem to be some dangers inherent in some of the interventions found in the literature ( Kenardy, 2000; Madden, 2002). Conclusion It would appear from the randomised controlled trials analysed here that while some evidence supports postnatal debriefing as a means of reducing psychological morbidity, significant evidence shows no correlation between postnatal interventions of this kind and improved emotional health outcomes. However, anecdotal evidence and other literature suggests that midwives and women find some benefit from opportunities to talk about their childbirth experiences. Some of these simply allow women an opportunity to talk and to ask questions about what happened to them. This leads to the conclusion that such interventions require much more research, preferably research which includes detailed, qualitative evaluations of interventions, and interventions which are specifically designed for this client group. However, this author would also recommend that such interventions be provided, as they are not proven to do harm in the majority of studies, and represent a woman-centred approach to good mi dwifery care. References Alexander J (1998) Confusing debriefing and defusing postnatally: the need for clarity of terms, purpose and value. Midwifery 14: 122-124. Allott H (1996) Picking up the pieces: the post-delivery stress clinic. British Journal of Midwifery 4(10): 534-536. Axe S (2000) Labour debriefing is crucial for good psychological care. British Journal of Midwifery 8(10): 626-631. Ayers S, Pickering A D (2001) Do women get post-traumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth 28(2): 111-118. Ballard C G, Stanley A K, Brockington I F (1995) Post-traumatic stress disorder (PTSD) after childbirth. The British Journal of Psychiatry 166: 525-528. Baxter J, McCrae A, Dorey-Irani A (2003) Talking with women after birth. British Journal of Midwifery 11(5): 304-309. Charles J L (1994) Birth afterthoughts: a listening and information service. British Journal of Midwifery 2(7): 331-334. Charles J, Curtis L (1994) Birth afterthoughts. Midwives Chronicle 107(1278): 266-268. Creedy D K, Shochet I M, Horsfall J (2000) Childbirth and the development of acute trauma symptoms: incidence and contributing factors. Birth 27(2): 104-111. Crompton J (1996) Post-traumatic stress disorder and childbirth. British Journal of Midwifery 4(6): 290-294. Czarnocka J, Slade P (2000) Prevalence and predictors of post-traumatic stress symptoms following childbirth. British Journal of Clinical Psychology 39: 35-51. Dennett S (2003) Talking about the birth with a midwife. British Journal of Midwifery 11(1): 24-27. Gamble J A, Creedy D K, Webster J, Moyle (2002) A review of the literature on debriefing or non-directive counselling to prevent postpartum emotional distress. Midwifery 18: 72-79. Inglis S (2002) Accessing a debriefing service following birth. British Journal of Midwifery 10(6): 368-371. Kenardy J (2000) The current status of psychological debriefing. It may do more harm than good. British Medical Journal 321:1032-1033. Laing K G (2001) Post-traumatic stress disorder: myth or reality? British Journal of Midwifery 9(7): 447-451. Lavender T, Walkinshaw S A (1998) Can midwives reduce postpartum psychological morbidity? A randomized trial. Birth 25(4): Dec 215-219. Madden I (2002) Midwifery debriefing – in whose best interest? British Journal of Midwifery 10(10): 631-634. Menage J (1993) Post-traumatic stress disorder in women who have undergone obstetric and/ or gynaecological procedures. A consecutive study of 30 cases of PTSD. Journal of Reproductive and Infant Psychology 11: 221-228. Menage J (1996) Post-traumatic stress disorder following obstetric/ gynaecological procedures. British Journal of Midwifery 4(10): 532-533. Page L (1996) Positive care in childbirth. British Journal of Midwifery 4(10): 530-531. Phillips S (2003) Debriefing following traumatic childbirth. British Journal of Midwifery 11(12): 725-730. Robinson J (1999) When delivery is torture – postnatal PTSD. British Journal of Midwifery 7(11): 684. Robinson J (1998) Dangers of debriefing. British Journal of Midwifery 6(4): 251. Rose S, Bisson J, Wessely S (2004) Psychological debriefing for preventing post-traumatic stress disorder (PTSD) (Cochrane Review). In: The Cochrane Library, Issue 1. Chichester: John Wiley Sons. Small R, Lumley J, Donohue L, Potter A, Waldenstrà ¶m U (2000) Randomised controlled trial of midwife led debriefing to reduce maternal depression after operative childbirth. British Medical Journal 321:1043-1047. Smith J A, Mitchell S (1996) Debriefing after childbirth: a tool for effective risk management. British Journal of Midwifery 4(11): 581-586. Wessely S, Rose S, Bisson J (1999) A systematic review of brief psychological interventions (â€Å"debriefing†) for the treatment of immediate trauma-related symptoms and the treatment of post traumatic stress disorder. In: Cochrane Collaboration. Cochrane library. Issue 4. Oxford: Update Software. Westley W (1997) ‘Time to talk’ listening service. Midwives 110(1309): 30-31. Wijma K, Soderquist M A, Wijma B (1997) Post traumatic stress disorder after childbirth: a cross-sectional study. Journal of Anxiety Disorders 11: 587-597.