Psychological Analysis of Terrorism and Terrorists

Psychological Analysis of Terrorism and Terrorists Bakhtawar Mushtaque ZAHRA BARKAT â€Å"Terrorism in Pakistan: why people are involved in terrorist activities a psychological approach† â€Å"Everyone worried about stopping terrorism, well there is really an easy way: stop participating in it.†, (Noam Chomsky). A person scarifies his life to claim a few more lives, is an extreme sorrowful situation of terror act. Terrorists are the ones who cause terrorism. It is not very simple to define terrorism but literature says â€Å"terrorism is an unlawful act, mass violence directed particularly at civilians, resulting in widespread fear. Such violence is often motivated by social, religious, or psychological ideals and intended to induce societal and national changes†, (Taylor and Fancies 2014). I am interested in this topic because I want to know the reasons which impact on the psyche of individual that insists people to opt for terrorist activities. Else, the relation between the causes of terrorist acts with psychological construction. The most importantly, I want to structure some strategies through which we can overcome this situation. The point to ponder is what thing had such an impact on one’s psychology that persuaded him to be completely hypnotized in a way that he does not think even once before doing that? This is a fundamental question that revolves in our minds whenever we hear any news about such activities. Terrorism is recorded as a major violence in Pakistan in recent years. According to (Taylor and Francis 2014), â€Å"There were 13,721 incidents in Pakistan from 2001 to 2013. From 2001 to 2005, there have been 523 terrorist incidents in Pakistan but from 2007 to November 2013, the total number of incidents has risen to 13,198.† â€Å"Pakistan is both an ally in the war on terror, and in some sense, a battleground in the war on terror†.(Stephen Hadley) With the feeling of disappointment we have encountered a very high rate of terrorism in Pakistan. The number of terror acts (suicide bombings) between 2001 and 2007 stood at 15 only, but from 2007 to 2013, Pakistan jumped to 1,404 t errorist attacks. It is deliberately increasing day by day and the data shows the highest rate anywhere in the world. Terrorism have three main perspective such as macro sociological, psychosocial and psychological. In this paper we will discuss third approach which has been a major problem in Pakistan recent years. This approach mainly include the teaching of religious extremism and wrong social practices which impact on individual’s psyche. There are many social problems but we will focus on few of them including poverty, illiteracy, injustice and unemployment. These are highly prevalent in Pakistan; developing a disease of making psychological errors between right and wrong and encourages a feeling of jealousy and ignorance. . Identifying the causes would be a major help in providing the remedies for these unwanted acts. What ISLAM teaches us about peace and humanity? The religion of Islam advocates peace and mutual agreement and admonishes aggression. â€Å" Don’t aggress; GOD dislikes the aggressors†. (Quran 5:87) One of the main themes elaborated in Quran is peace, unless there is injustice that cannot be resolved by all the peaceful means available. According to Tellis 2014, â€Å"Peace have direct link with psychological construction, if there will be no peace around, effect will be the astounding violent activities which ultimately leads psychological disturbances like anxiety and depression.†. Violent behaviors may be terrorism, target killing and so on. In reality, love and compassion is the real antidote for every act of terrorism. Religious causes: A famous analyst Richardson proposed behavioral model in 2011 he states that â€Å"In operant conditioning we repeat the behavior when we get positive reinforcement. With this concept the religiously defined reward in eternal life and military outcome of the suicide bombings could be some factors positively reinforcing the behavior†. The conspiracy by some of our ancestors provoking a fake concept of allowance in religion to practice such extreme activities has resulted to mass destruction in today’s world. These practices have lived their lives for many years and passed to every generation. The true image of Islam is also breached and presented as a religion of extremists. A feel of hatred has risen in the world against Islam and the Pakistanis. This has resulted to seek for revenge and vengeance against the world in one’s psychology. According to Yousafzai 2007 â€Å"One of the motive in religiously motivated terrorist is â€Å"revenge† and it paired wi th the sense of altruism as many of them always had relative who has been killed or abused in the holy war†. Violence has strong religious endorsement and approval in Pakistan. In one of the psychoanalytical theory of violence namely drive theory it is written that to understand the cause of terror act, it is necessary to know about the frustration_agression fold. This fold is complex due to psychological disturbances like rage and hopelessness. Through the religious teachings this fold get stronger by scholars and they think that there is no other way to get success in religion. (Bajoria 2011) Teachings of these practices are still carried out in rural areas and areas where lack of sense and knowledge is found. These practices are usually conducted in the local religious schools and involve developing psychology in a student to charge against those who neglect or argue in any law they imply. One research conducted in 2010 by Patric Hadin proved that in Pakistan 70% of terrori sts are being prepared in schools. He states that â€Å"It is very easy to set the mind (brain wash) of school going students and build their psychology according to once own desire.† In one of the Pakistani drama â€Å"KHUDA ZAMEEN SE GAYA NAHI† I saw that youngsters were taught by the scholars that this is JAHAD and this is the sacrifice on the name of GOD. In Pakistan, religious factor have a great support of MEDIA which are making changes in psychology of youngsters because they are more towards media. One of the case study was conducted in Pakistan where it has been observed that independent media played a role in spreading these acts in Pakistan. Study shows one institution where the teachings was conducted and influenced the suicide bombers through mass media. Result shows that 80% Pakistanis were grabbed through this strategy†. (Sarhandi 2011) These heinous acts create a fear and instability in the society and mostly people surrender. The feel of this pow er changes to extremism leads psychological disorder which mainly include aggression. In addition, their minds are modified and are persuaded in a way that encourages these activities, so called JIHAD, will grant them a fruitful reward in their Hereafter. To explain the religion terrorism within a psychodynamic framework, we need to focused on the trait of NARCISSIM which produce a sense of self damage. Terrorist’s intellectual will show the grandiose view inside the GOD. (Randy Borum 2004) This view will make him a victim. Moreover, The mind setting (brain wash) is the common finding among the majority of the terrorist in Pakistan. In one of the swat operation against terrorism in Pakistan in 2009, many of the adolescents who were to be FUTURE SUCIDE BOMBERs in Pakistan were psychologically educated. Before inducting them in the community for such activities, they prepared them wholly in almost 6 weeks and they do work to change their psychology through different stages in M adrassa. This religious fanaticism for the love of martyrdom and its reward is a major cause of the terrorist attacks like suicide bombings in Pakistan. Social issues: For a common man, our social environment is full of injustice, illiteracy, insecurity, poverty and unemployment. Till today, these issues are at peak in Pakistan which also insists people to opt for activities like terrorism. This is also known as emotional terrorism because terrorist think of their children and families emotionally. They think to give them quality of life by providing money to them and they don’t think about thousands of innocent lives victimized due to their act. This seems to be all due to unemployment and poverty. Taylor and Francis 2014 states that this act of thinking end up the people in psychological problems which mainly include depression and anxiety. A study conducted on 1,031 terrorist incidents in the northwestern province of Khyber Pakhtunkhwa found that 80% of the perpetrators were unemployed and were motivated by changes in psychology. (Assad Nizami Tariq Hassan 2014). Furthermore, Pakistan is listed in one of the strongest developing countries; struggling to improve the rate of literacy. It has always remained a big problem and a major cause of terrorism in Pakistan too. People are not enough educated, particularly in rural areas. They do not have eligible sense of right or wrong. Taylor and Francis 2014 also witnessed in their study that â€Å"7 out of 10 terrorist are from rural areas and are under privileged and stalking of illiteracy†. Such people easily become a victim of anti-social ideas. They apply what they are taught without any remorse or guilt of the results. According to Jeff Vencatramen 2007, â€Å"scientific psychology reveal that poverty and illiteracy produce suffering and frustration and this breads aggression against others that translate in terrorism.† Moreover, injustice and inequality play the role of a catalyst while in the execution of the plans of the terrorists. Social injustice and unfairness burden other instabilities and inequalities that ultimately lead violence. According to Jeff Vencatramen 2007, â€Å"personality traits are not irrelevant to terrorism. Political oppression of inequality lead many negative personality traits in individual like impulsivity and obnoxious.† Although terrorist do willingly these acts, they know their bond with family and relations are going to be over. This leads to anxiety, stress and many other problems. These problems grab their actual perception, awareness and judgment. According to Horgon 2008, â€Å"Terrorist’s psyche view their own actions as rational and purposeful, driven in response to their own perception of social, religious, and other realities. They see their own selves as good and victims as bad. These are some main factors which are accountable for terrorism. There are many other factors which are responsible for terrorist activities. For instance, in tuberculosis the main cause is mycobacterium tuberculosis but there are many other factors which cause the disease. According to Jeff Victoroff 2006, â€Å"Many of the individual terrorist across the Pakistan have mainly no more causes oppressed than religious and social like poverty, illiteracy and so on and it is claim that this escort to the psyc hological distress.† Now this is the time to take a step forward and think how to eradicate this problem. Attempts are still way in Pakistan. Scenarios are going to be complex and may worsen the situations. In the very low level, we can give knowledge to the adolescents in school and colleges which are at high risk. According to Testas 2014, â€Å"we should educate our young generation and teach them the consequences of terrorist activities. This education carry two aspects. First, to build the safe psyche of young generation so they can make the best decision for themselves and the second is to reduce the illiteracy which ultimately bring the positive influence.† At the state level our political leaders should take step ahead. They should eliminate injustice, poverty and other social instability to prevent population from these activities which are taking lives from irreproachable families. According to Newman 2014, â€Å"Our common goal to eradicate terrorist activities should be to reduce the poverty and promote social justice, to bring the marginalized into the mainstream of the psychological health, economy and society.† With the contribution of political leaders, these acts can be eradicated at the community, national and international level. Definitely, we hope that our initiatives will make some positive changes in our country. Conclusion: Definitely, terrorists have some major psychological distress which push them further towards those terrorist activities. With the religious perspective, mind setting was seen in most of the Pakistani terrorists. There were social issues like poverty, injustice and many more which were highly common in Pakistani terrorist. These both major causes lead many psychological problems like aggression, anxiety and distress. Killing or delivering punishment on the grounds is not going to solve the issue but would promote such unwanted activities. State needs to review the impact of terrorism in the past decade and develop a policy to combat terrorism socially and psychologically. It is also a responsibility of a common man, towards humanity and our country, not to be ignorant. The ignorance may lead to a fine destruction of our society. Our youth will suffer. And when youth suffers, the future suffers. References: Bhatti,J.A., Mehmood,A., Shahid,M., Bhatti,S.A., Akhtar,U., Razzak,J.A. (2011). Epidemiological patterns of suicide terrorism in the civilian Pakistani population. International Journal of Injury Control and Safety Promotion, 8(3), 206-211. doi:10.1080/17457300.2011.555558 Newman,E. (2006). Exploring the ?Root Causes? of Terrorism. Studies in Conflict Terrorism, 29, 749-772. doi:10.1080/10576100600704069 Nizami,A.Z., Rana,M.H., Hassan,T.M., Minhas,F.A. (2014). Terrorism in Pakistan: a behavioral sciences perspective. Behavioral Sciences and the Law, 32, 335-346. doi:10.1002/bsl.2118 Testas,A. (2010). DETERMINANTS OF TERRORISM IN THE MUSLIM WORLD: AN EMPIRICAL CROSS-SECTIONAL ANALYSIS. Terrorism and Political Violence, 16(2). doi:10.1080=09546550490482504 Venkatraman a,A. (2007). Religious Basis for Islamic Terrorism: The Quran and Its Interpretations. Studies in Conflict Terrorism, 30, 229-248. doi:10.1080/10576100600781612 Tellis,A.J. (2014). Pakistans Record on Terrorism: Conflicted Goals, Compromised Performance. The Washington Quarterly. Retrieved from doi.org/10.1162/wash.2008.31.2.7 Bajoria,J. (2011, May 13). Retrieved from http://www.cfr.org/pakistan/pakistans-new-generation-terrorists/p15422 Borum,R. (2004). Psychology of Terrorism. The University of South Florida. Khan,A.M., Sarhandi,I., Hussain,J., Iqbal,S., Taj,R. (2011). Impact of Terrorism on Mental Health. Pakistan Institute of Medical Sciences,, 18(1), 46_49. Yousafzai,A.W., Siddiqui,M.N. (2007). Psychological perspective of suicide bombing. journal of Pakistan psychiatric society, 4(2), 121. La corte,L.D. (2007). Explaining Terrorism: A Psychosocial Approach. perspectives on terrorism, 1(2).

023 Understand Child and Young Person development Essay

Age range Explain the sequence and rate of development 0-3 months When born, babies show innate reflexes, such as swallowing and sucking, rooting reflex, grasp reflex, startle reflex, walking and standing reflex; in the first month babies become less curled up and the startle reflex is starting to fade; toward the end of the third month babies start lifting and turning their heads. 3-6 months When lying on front babies can lift their arms and legs balancing on their tummies; they can reach and grab a toy and they can pass it from one hand to another; they can also roll from their backs to front; around sixth month babies are becoming able to sit with support (e. g. high chair). 6-9 months Babies can sit without support; they are beginning to crawl or find other ways of being mobile (bottom-shuffling); starting to use fingers to feed. 9-12 months Babies are becoming very mobile, fast crawling, standing up by the furniture, some babies walk along the furniture using their hands to hold on; developing abilities to handle objects and putting them into containers; babies able to feed themselves with fingers. 1-2 years At the beginning of this period babies are beginning to walk and around 18 months they are becoming more and more skilful on their feet, moving faster; toddlers around this age begin to sit and push with their legs to move on the sit-and-ride toys. Towards their second year children walk confidently, they can run and climb; towards the end of the second year some children are becoming ready to start potty training. 2-4 years In the third year children start potty training; they become able to push with feet or peddle a tricycle; children can walk upstairs alternating their feet; towards the end of the this period children are skilful enough to feed and dress themselves; they are able to do threading, pouring and they can use scissors. 4-7 years Physical development less rapid, however skills are becoming more refined and movements more coordinated. Ability to kick and control ball; development of fine motor skills essential for handwriting. 7-12 years Good coordination of small and large movements; growing physical skilfulness means task can be done quicker, more accurately and more confidently; neater drawing and writing; accurate cutting. Between 9 and 12 children gain even better coordination and speed in fine and gross motor skills. Around 11th year the bodies of some girls are starting to change (growing breasts) and some might start their periods. 12-16 years Gradual body changes in both girls and boys (girls physically mature quicker [around 15/ 16] than boys [around 17/18]. Fast body changes may affect spatial awareness which can become occasionally poor as a result. 16-19 years The maturing of the body is finishing with the full development of sexual organs; the body is taking a distinctive female or male shape. 023 Table 2: Intellectual and cognitive development Age range Explain the sequence and rate of development 0-3 months Quite early on babies are able to recognise the smell of their mother and her voice; later they become familiar with voices of important others and they can be calmed when they hear them; they are interested in faces. In their 3rd month babies start to differentiate between day and night (settled routine); babies become interested in mobiles and other objects around them. 3-6 months Babies are becoming interested in what is happening around them, turning their head in the direction of interest; objects are being explored by hands and mouth. 6-9 months Developing fine motor skills allow babies for a better exploration of objects by handling and touching with fingers; around 8 or 9 months babies understand object permanence (objects continue to exists even when out of sight). 9-12 months Babies are more aware of what is happening around them, they are starting to understand routines through signals (bib = food) 1-2 years Children enjoy pop-up and posting toys and in their 2nd year they are starting to have a go at simple jigsaw puzzles and building bricks. 2-4 years Children pretend play with miniature world; they more interested in books, mark making and painting. In their fourth year children are able to concentrate and focus longer on activities which which caught their interest. 4-7 years Children begin to do some simple counting and calculations, recognizing letters is followed by gradual decoding of simple words and later by reading. 7-12 years Reading and writing is becoming easier, children start reading silently to themselves. Play becomes more organized and follows rules. Development of thinking and reasoning is demonstrated through independent problem solving. 12-16 years Further development of reasoning and problem solving; children are gradually starting to understand more abstract concepts. 16-19 years Cognitive abilities are becoming further refined, leading to high level skills in young people. 023 Table 3: Communication development Age range Explain the sequence and rate of development 0-3 months To start with babies express their hunger, tiredness or other discontent through crying; around 5th/6th week babies start to coo when content; in the third month babies start smiling and reciprocate smiles. 3-6 months Babies starting to understand a little of what is being said and they are starting to give some communication signals themselves (e. g. raised arms when they want to be picked up). 6-9 months Babies become quite vocal, babbling with a differentiated tuneful string of sounds. They are also starting to understand various important key words connected with their routines (e. g. ?dinner? ). 9-12 months Babies clearly show they understand more of what is being said around them/ to them. Babbling is still main way of communication. 1-2 years First meaningful sounds/ words are beginning to emerge around 13 months, and at the end of 2nd year children might have a vocabulary of about 200 words. 2-4 years Language is becoming a powerful means of communication. From connecting two words first children are beginning gradually to build up sentences and their talking is becoming understandable even to those who are not in regular contact with the child. Even though there might be the odd mistake in the sentence structure, the language toward the end of this period is becoming fluent and children ask questions and generally enjoy expressing themselves through language. 4-7 years Children are becoming involved with written language – they are starting to learn to read and write. 7-12 years Reading and writing becomes easier now; at the beginning of this period children enjoy telling jokes to others; apart from chatting, children are beginning to be able to form a simple argument and be persuasive, they are becoming increasingly able to negotiate with others. Their writing shows more grammatical awareness as well as own imagination. 12-16 years Reading and writing skills are becoming very good and children are becoming increasingly skilful in negotiating and persuasion of others (peers and adults). 16-19 years Communication with peers is becoming very important; differentiation between formal and informal language and its use in real life is becoming more and more important; young people use different means to communicate (via phones, mobile messaging, emails, facebook, etc. ). 023 Table 4: Social, emotional and behavioural development Age range Explain the sequence and rate of development 0-3 months First social contacts are being established mainly during feeding; at the end of the first month babies start to show first smiles which then gradually become response to familiar faces. 3-6 months Babies smile and squeal with delight when playing with familiar others. 6-9 months Babies try to stay close to their primary carers and around 8 months babies may become distressed when their primary carer leaves. 9-12 months Babies are fixed on their carers and do not want to be with strangers. 1-2 years Children start notice other children around them and they show some interest in them and later start parallel play. They also start show some frustrations and tantrums as they gradually discover some boundaries. 2-4 years Children play alongside others and may start copying their actions. Around the third year children become more aware of others and their needs which also reflects in their play which is gradually starting to be more and more cooperative. Children enjoy being praised by adults. 4-7 years Developing language is helping children to form better relationships and children begin to show some preferences in friendships. 7-12 years Friendships are becoming more stable and more important and may influence decision making (if my friend is doing something I might be more likely doing it also). Gender specific play is becoming more apparent. Children start to compare themselves to others. Children enjoy being given some responsibilities. 12-16 years Friends and friendships are very important and gradually opinions from friends might feel more important that those of parents/ carers. This leads to exploration and challenge of the boundaries of relationships as well as learning to deal with disagreements, arguments, etc. There are anxieties coming from pressures from school. 16-19 years Young people enjoy being with their friends, they are finding discovering their own identity and sense of belonging to a group/ groups of specific characteristics which defines for them who they are (religious groups, sport group, goth, etc. ) 023 Table 5: Moral development Age range Explain the sequence and rate of development 0-3 months 3-6 months 6-9 months 9-12 months Children might start paying attention to â€Å"no† and might stop their behaviour for a moment. 1-2 years Children are beginning to understand â€Å"no† and they start using it themselves. 2-4 years At the beginning of this phase still no understanding what is right or wrong but children understand when they are said â€Å"No†. Later they become able to follow some simple rules. Around 4 years children are becoming thoughtful at times but most of the times will decide what to do on the basis of adult approval. 4-7 years Children are beginning to understand rules; they try to understand them, follow them and may attempt to create their own rules where no rules are given (made-up game with friends). 7-12 years Children share their knowledge of rules with others and will readily point out if someone breaks the rules. Later they are becoming more aware of behaviour consequences and they are generally becoming more thoughtful. 12-16 years Children are beginning to be aware of a bigger picture – rules of communities and societies and they are beginning to understand the need for that. 16-19 years There is a interest in moral issues, finding out that right and wrong is not always black and white. Questioning and testing of rules. A2 Answer the following questions. 1. What is the difference between ‘sequence’ of development and ‘rate’ of development? 2. Why is the difference important? (Ref 1. 2) Q1. What is the difference between a sequence of development and rate of development? Sequence of development is the order in which development occurs, e. g. children are able to sit before they learn to crawl. The order of the sequences in development are always the same (even though there might be some individual differences: babies always learn to move about before standing up and walking, but some babies bottom-shuffle instead of crawling). Rate, on the other hand, is the speed in which individuals go through the stages/ sequences of development. Most children learn to walk when they are about 12 months old. However, some babies might be ready to walk when they are 10 months old and others when they are 15 months old. Individuals might also be developing with different rate in different areas, e. g. some children might be developing quickly physically, but their speech might be delayed. These individual differences are results of genetic predispositions and other biological influences as well as environmental stimulation. Q2. Why is the difference important? Knowing the sequences of development in different areas is important for practitioners to be able to plan accordingly and therefore to support the development in individuals. The rate of the development is important in terms of recognizing any atypical development and recommending/ searching any additional interventions when needed. TASK B Complete table; Research and report B1 Complete a table as shown on the following page, identifying the different personal and external factors that influence children and young people’s development. (Ref 2. 1, 2. 2) B2 Produce a report to demonstrate your knowledge and understanding of differing theories of development. This report should identify how these theories have influenced current practice and include the following: Cognitive (e. g. Piaget) Psychoanalytic (e. g. Freud) Humanist (e. g. Maslow) Social learning (e. g. Bandura) Operant conditioning (e. g. Skinner) Behaviourist (e. g. Watson) Social pedagogy. Over the years there have been many theories trying to explain certain aspects of development, behaviour, learning, etc. In the following text we will look at the most influential theories which are being used by practitioners in better understanding as well as day to day work with children and young people. After a brief description of how an individual theory was founded, we will discuss the key points for work at nurseries. Theory of cognitive development (Constructivist approach) Theory of cognitive development is connected with the name of Jean Piaget (1896-1980) who through work on intelligence tests started to notice how children at same stages make very similar mistakes in their tasks and problem solving approaches. Piaget then closely observed his own children, capturing their development in details and later using these observations to create a theory of cognitive development. Piaget considered children as active learners who create ? schemas? (believes) about the world based on their experiences. This is how they make sense about what is happening around them. However, a child? s schemas are going to be challanged time to time by new and unexpected experiences and as a result existing schema will have to adapted to fit these in (e. g. touching something hot will alter the notion that everything is safe to touch and child will learn that certain objects can hurt when being touched). Piaget? s theory influenced the practice by having a ? child-centred? approach. In our setting, for example, we make regular observations on what our children are interested in and what they like to play/ do. After careful evaluations and identifications of possible next steps of development we plan activities which as well as reflecting children? s interest also further challenge them to encourage the development. Psychoanalytic theory of personality Sigmund Freud (1856-1939) suggested that every personality has got three parts to it – id, ego and superego. We all are born with id, which is the part of our personality that is driven by our desires and reflects in pleasure-seeking behaviour. Id is selfish and passionate and it is purely after satisfying its needs, known as ? gratification?. However, through social contact and learning babies/children gradually learn to be aware of the outside world and eventually of needs of others. They will be developing ego, which is able to plan the actions so the needs of the individual can still be met but in more socially desired way, e. g. ability to wait for once turn when the food is being served at pre-school settings. This is called ? differed gratification?. Later, as a result of further parenting and learning about social and cultural values, the superego is developed. Superego could be described as an internalised parent as the child is starting to be aware of what is good and what is bad without external reminder – e. g. I must not hit because it hurts. If the behaviour trespasses the imperatives of the superego, the individual will feel guilt as they are now aware that their behaviour was bad (this is referred as ? conscience? ). Apart from judging conscience, superego has got a notion of an ego-ideal to which it will strive. When ego demonstrates good behaviour the ego-ideal part of superego will reward this, e. g. feeling good after doing something for someone else even when external praise is not present. Even though Freud has been criticised for basing his description and explanations of development on sexual motives, some of his theoretical concepts are now widely accepted (e. g. the concept of unconscious mind – id and most of superego). One could say that orientation on children? s needs might be partly inspired by Freud? s ideas about the dynamics of id, ego and superego. Too strong superego and suppressed unconscious id will lead to many problems in adult life, where individual tries to live mainly by what is required by the outside world rather than allowing themselves to follow own desires. In early years healthy development of ego can be supported by putting the child and their needs in the centre of our attention; activities and work with children is individualized and child-led, yet still well planned and safe. For example, in our setting we might notice that a particular child enjoys opening and closing doors, gates, etc. Instead of completely discouraging him from doing that we might identify situations when it might be appropriate for him/her to do so and explain the necessary things around it in a child-friendly way (e. g. : When everybody has got their shoes on, you can open the door, Henry. , We will keep the gate closed now, because we are going to play in the yard now. , Mind your fingers when closing the door – you could close them in and that would really hurt. , etc. ). If we say ? no? to children it is good to make sure that the child knows about the reasons behind our decisions (even though they might find it hard initially anyway, they are more likely to come round and understand it in their own time). Humanistic theory of motivation and personality – Abraham Maslow (1908-1970) Maslow studied motivation in people and came up with what is now known as Hierarchy of Needs. Maslow divided the needs into five categories (physiological, safety, love/belonging, esteem, self-actualisation) and put them in hierarchical order from the most essential and basic needs to higher-order needs. Maslow argues that it is necessary to fulfil the needs from from the bottom of the hierarchy first to be able to meet the needs of higher order. Only when all the other lower needs are met, an individual can focus on fulfilling the highest needs of self-actualisation, such as creativity, problem solving, morality, etc. In our practice we are aware, that when a child is for example overtired and hungry (the most basic physiological needs), there is no space to try to fit in other things, e. g. ?wait for your turn? , ? say please? ,†¦. (which would be working on their higher order needs, such as love/belonging (friendship) or esteem (respect for others, respect by others). This child at that stage needs to be fed and put to sleep as soon as possible and other input has to wait until the child is again able to tune to it/ receive it. Social cognitive theory Social cognitive theory has its roots in behaviouristic approach. However, Albert Bandura (born 1925), even though accepting learning by conditioning, argued that lots of learning happens through social observations (? observational learning? ). Observational learning is when children copy what other children or adults do; in comparison to conditioning, observational learning happens spontaneously and often without the need for reinforcement. Cognitive abilities seem to play an important role in observational learning as children need to be capable to notice the activity itself as well as remember it accurately. As staff we need to be mindful in the way we act and interact in front of children as they are likely to copy our behaviour. In accordance with the social cognitive theory we try to set good examples to the children in our settings by showing good manners and being courteous to them as well as to one another. Behaviourist approach to learning – operant conditioning Operant conditioning is based on classical conditioning (I. P. Pavlov; J. B. Watson), which teaches that certain behaviour/ reaction can be connected with a stimulus through conditioning, e. g. fear of cats after a bad experience with a cat. F. B. Skinner (1904-1990) however took this a bit further and through experiments mainly with pigeons and rats showed that learning can be strengthen by reinforcements, such as positive reinforcement (praise, sticker, attention, etc. ), negative reinforcement (this is removing something which is negative from the situation so it no longer poses a ? threat? or causes negative emotions and the whole experience becomes more positive, e. g. child does want to play with a toy because it is scared of the noises it makes – by switching the sound off, the child is able to explore the toy) and punishers (negative consequence which is likely to prevent individuals to repeat their behaviour – e. g. touching hot iron). Skinner researched most effective ways to retain the learnt behaviour and he found out that even though continuous positive reinforcement is good at the beginning of the learning, later unpredictable positive reinforcement keeps the learnt behaviour in place for longer period of time. This is because even though the reward comes frequently, we are not sure when it is going to come next and therefore we keep doing the behaviour. At our setting we might be using operant conditioning for example when we are helping a child to potty train. First every sitting on the potty, regardless of results will be rewarded. When the child gets into the habit of sitting on the potty, then only successful potty session will be rewarded with a sticker (however praise for trying when unsuccessful remains). When starting to do regularly this stickers might gradually become praise and sticker will be awarded if the child successfully asks for potty when they need it. Behaviourist approach to learning – Classical conditioning J. B. Watson (1878 – 1958) followed I. P. Pavlov? s work on classical conditioning with animals (dogs salivating when food arrived became then salivating even at the mere sight of the bowl; Pavlov took this further by conditioning completely unrelated food stimulus, such as bell or light, which after regular presence at the mealtimes would later on its own initiate the salivating response in dogs). Watson showed that classical conditioning is possible in humans as well (famous Little Albert experiment, where a baby was conditioned to have fear of rats). Classical conditioning is not really used in practice as a active way of teaching, however its theory can be used for observational purposes (e. g. recognising when sucking thumb signals hunger etc. ). Social pedagogy Social pedagogy is a discipline which brings together theory and practice in order to assure the best and holistic way of supporting children in their development and education. The overall aim of social pedagogy is to give children and young people the best possible chances for their future lives. In accordance with social pedagogy the Early Years Foundation Stage Framework (EYFS) has been devised to capture the development in early years and to help professionals to monitor, plan and support effectively individual development. For better and focused understanding the development has been divided into seven areas, out of which three are recognised as prime areas (Personal, Social and Emotional Development; Communication and Language; Physical Development) and four are described as specific areas of development (Literacy; Mathematics; Understanding the World; Expressive Arts and Design). The support the professionals can provide is differentiated into helpful advice in positive relationship and suggestions for enabling environments. In EYFS we can see influence of Piaget? s work in enabling environments where the focus is predominantly on individual? s own experience. We can also strongly identify the theory of ? zone of proximal development? by Vygotsky (cognitive development) in EYFS as we can easily identify where children are in their development, what is the next developmental stage for them and how we can support this next step. 023 Personal and external factors influencing development B3 Personal Factors: Give ONE explanation of a positive influence on the development of children and young people Health status: given by genetic predispositions as well as environmental factors, such as diet, pollution, stress, etc. If obesity is genetically passed on in the family than healthy diet together with developing positive attitude towards regular exercise will help the child to maintain a good health. Disability: Physical impairment, such as missing or underdeveloped limb Wheel chair together with barrier free environment (e. g. lifts, ramps, low sinks, etc. ) will help to support independence of an individual. Sensory impairment: visual impairments, hearing impairments, death-blindness, When working with individuals with visual impairment, we can use the other senses to compensate and provide necessary stimulation which helps the development, e. g. using special toys/ learning material which uses touch and sound as a mean of gaining information. However, if there is some vision left (which usually there is), the environment can be adjusted by using contrast colours, non-reflective material, good lighting, etc. Learning difficulties: Dyslexia, dyspraxia, dysgraphia, dysortographia, ADHD, ADD Children with ADHD benefit from having a regular routine. Activities needs to be short and well planned with simple and easy to follow instructions. Hands-on activities with regular physical exercise and lots of praise are essential. External Factors: Poverty and deprivation: poor diet, inadequate housing, lack of education, lack of access to play and leisure, low aspirations and expectations Good education can help the individual to break from the poverty and secure them a better brighter future. Family environment/background: neglecting parents, abusive parents, parents with alcohol or other drug-taking problems, ill parents who are not able to provide adequate environment for their children, etc. Parents who are ill and no longer able to fully provide for their children could be provided with carers who would help with the overall smooth running of the household, caring for needs of the disabled parent and the needs of the children, while keeping the family itself together. Personal choices: from certain age children/ young people make some decisions for themselves which can have effect on their development, e. g. taking drugs, changing their diet, etc. To help to prevent drug-taking it is important to support the development of a positive self-image and healthy self-esteem; education and raising awareness of dangers of drug-abuse is also a helpful preventative measure. Looked after/care status: children in residential care, in foster families, in their own family but having care status (they are the responsibility of local authorities). If children are being fostered it is beneficial if siblings can stay together. Education: Educational system, through family itself, through other groups (religious groups, sport groups, hobbies and interests, etc. ) Finding out strengths of an individual (which do not have to necessarily academic) and building upon those to build a healthy self-esteem and recognition of self-worth – this can help to compe with other weaker areas in a positive way. 023 Task C Report Produce a short report in the form of an induction pack for new staff at a setting, covering the following. a. Give two examples of assessment methods that could be used to monitor a child/young person’s development. (Ref 3. 1) b. Give three examples of why sometimes child/young person’s development does not follow the expected pattern. (Ref 3. 2) c. Give one explanation of how disability can impact and affect development. (Ref 3. 3) d. Give three examples of different types of intervention that could promote positive outcomes for the child/young person, where development is not following the expected pattern. (Ref 3. 4) a. In our setting we use several assessment methods to monitor our children? s development. The most used one is a short free description on sticky labels – these capture a specific short observation in a specific area of development (e. g. Physical Development); the date and the identified area/ areas get recorded on the label. This method of recording information is useful for gathering evidence of the progress of development in specific areas and building a developmental profile of an individual child. We also use specific observation sheets, on which we capture a more detailed and complex observation. In the next section on the sheet the observation is evaluated and areas of the development are identified (often more than one). In the last section we identify the next steps for the child and how we can help the child to achieve that. We have two types of observation sheets in our settings following this format – one is purely written observation, the other one is a photo observation sheet. This method of recording and evaluation allows us not only to add to the developmental profile of each child but also to plan effectively to further support the child? s development. b. There are many possible reason why at times the development might not follow the expected pattern. Apart from the most obvious ones, such as disabilities and special learning needs, the development can get affected by external factors, such as environmental reasons, cultural reasons, social reasons; and specific individual reasons, such as emotional reasons, physical reasons and communication difficulties. Environmental reasons: Among environmental reasons which may affect child? s development is for example where and in what conditions a child lives and what type of school they attend. Social reasons: There might be big differences between children in terms of wealth of their families, family status and family structure (big family with strong bonds in comparison to divorced parents with negative mutual relationship), education of parents as well as their ability to tune themselves to the needs of their children – all of these will affect the way children will be developing. Communication skills: Slower developing communication skills have got potential to negatively influence the development in other areas. The inability to effectively express themselves may result in frustrations in children and aggressive behaviour as well as consequently lower literacy skills. Similar effects can be observed in children whose families? language is not the dominant language of the country. If the dominant language is not fully acquired the child may significantly struggle once at school. c. Disability can affect more than one area of development as children can become frustrated and their self-esteem can be lowered. The attitudes of low expectations and stereotyping by others will also have a secondary negative impact on a child? s development. d. There are several ways how difficulties in development can be recognised, monitored and positively supported. Educational establishments will have appointed SENCO, a person who is responsible for identification and organising further support for children with special needs. If appropriate Educational psychologist will be contacted to make a full assessment and recommendations in how to support individuals in education (behavioural problems and learning difficulties). Suggested interventions may be discussed with parents and with learning support assistants and individual educational plan might be written up and followed. If there are any issues with speech and communication, Speech and language therapist will be consulted – the outcomes of the assessment will lead to a specific plan of action, often involving regular contact in which special exercises will be explained, practised and taught to children and their parents/carers/other professionals for them to be able to support the children outside the sessions. If a child? s physical development is affected, physiotherapist can provide help with special exercises and massages to aid the physical development, maximize the range of movement and develop the appropriate movement control. Task D Report Produce a report which explains the following: a. Why is early identification of speech, language or communication delay important for a child/young person’s well-being? (Ref 4. 1) b. What are the potential risks for the child/young person’s well-being if any speech, language or communication delay is not identified early? (Ref 4. 1) c. Analyse the importance of early identification of the potential risks of late recognition to speech, language and communication delays and disorders. (Ref 4. 1) d. Who might be involved in a multi-agency team to support a child/young person’s speech, language and communication development? (Ref 4. 2) e. How, when and why would a multi-agency approach be applied? (Ref 4. 3) f. Give four different examples of play opportunities and describe how you would put them into practice to support the development of a child/young person’s speech, language and communication. (Ref 4. 3) a. Early identification of the language and communication difficulties is important as it can support the development to prevent further (secondary) impact on other areas. Also, as the brains in young children have not finished their development, the earlier we can intervene, the better prospects of success we have. b. Problems in language and communication can have a negative effect on other areas of development, such as cognitive and social development. Children with language and communication difficulties are more likely to struggle at school in learning to read and write, which can have further negative impact not only on other subjects but more importantly on their self-esteem. Children with such problems can become gradually isolated. c. Early identification of the potential risks of late recognition to speech, language and communication delays and disorders is very important in terms of putting the most appropriate interventions in place to support the development and benefit the children? s needs. Well timed and well tailored intervention has got the potential to optimize the development and to minimize potential negative impact for other areas of development. d. In the multi-agency team to support the child with speech, language and communication there will be the child? s GP or a health visitor, who will make a referral to a speech and language specialist. If there is a suspicion that the communication difficulties are connected with learning difficulties Educational Psychologist will be consulted. When it is decided on the type of intervention needed, the parents, the educational setting professionals and the rest of the team should work together in order to implement the chosen intervention in order to meet the needs of the child. e. Multi-agency approach is used when parents and/ or other professionals (such as GP, early years settings, etc. ) have recognised that a child is in need of additional help to aid the development. Different professionals are involved in the assessment of the needs (e. g. GP to assess potential hearing or other impairments) and speech and language therapist devises the best possible individual support. Multi-agency approach brings together different fields of expertise to assure the best possible outcome for the child. f. There are many informal opportunities how children? s communication and language development can be supported. These might often be more effective than formal exercises as they naturally meet the child in they world of play, making it more motivating and fun. Nursery rhymes and songs – Children enjoy joining in nursery rhymes and songs. These are short and memorable and their rhythmical pattern make them perfect little exercises for developing language, pronunciation and fluency (good practice when dealing with stutter). Books are perfect for developing passive and active vocabulary, understanding meaning of words and learning correct sentence structure informally. Books are a wonderful way to spark children? s imagination as well as teaching them to express themselves about the world around them by providing the relevant vocabulary. Pictures in books make it possible for children from the earliest age to actively engage with the story as well as to engage in a dialogue with another person. Dressing up and role play again helps the child in an informal way to engage in talking and communication with others whilst enjoying the imaginative play. Puppets are a fantastic way how to involve children in communication through play. Children are fascinated by puppets and enjoy adults taking active part in their play, which again allows for an opportunity to develop language and communication in a fun way. 023 Task E Complete table Complete the table on the next page, showing how the different types of transitions can affect children and young people’s development and evaluate how having positive relationships during this period of transition would be of benefit. Additional Guidance Different types are: a. Emotional, affected by personal experience, e. g. bereavement, entering/leaving care. b. Physical, e. g. moving to a new educational establishment, a new home/locality, from one activity to another. c. Physiological e. g. puberty, long-term medical conditions. d. Intellectual, e. g. moving from pre-school to primary, to post-primary. (Ref 5. 1, 5. 2) Give ONE specific example of a transition Give ONE possible effect on children and young people’s development Evaluate the benefit of a positive relationship during this period of transition ~ provide ONE example Emotional: Bereavement Depression which may affect sleep pattern, children may become lethargic and less interested in engaging in any activities which may affect they social, emotional and cognitive development Positive relationship with open communication and listening skills allows for a child to ask difficult questions and share their worries and sadness, to talk over difficult memories and anxieties about the future. This may help with overcoming the past and the sadness. Physical: Moving home Moving home may effect the children social development as they may lose previous friends and find themselves unable to fit in new friendship groups. Some children might start having food issues, such as overeating to deal with anxieties. This can affect their emotional, social and physical development. Positive relation can provide a helping hand with dealing with the new situation while supporting the self-esteem and encouraging the confidence in a young person. Positive relationship can also act as model of skills of how to establish a new relationship. Physiological: Gaining a physical disability – e. g. lost limb Withdrawal – children may become very solitary, unable and unwilling to join in with their peers, which can affect their physical, emotional, social as well as cognitive development. Positive relationship will communicate acceptance and healthy support in dealing with a life-changing situation; this should help in dealing with difficulties as they come Intellectual: Moving from pre-school to primary school Lack of concentration and motivation as the child might feel overwhelmed by new routines and new demands which they might find very difficult – this may affect their natural cognitive development and they might regress into safer younger stage of development. Positive relationship will allow for a child to feel safe, valued and as achieving (in their own pace) by identifying the appropriate approach of working with the child with the sensitivity to their specific needs and pace of development.

EMI and the CT Scanner Essay

In early 1972 there was considerable disagreement among top management at EMI Ltd, the UKbased music, electronics, and leisure company. The subject of the controversy was the CT scanner, a new medical diagnostic imaging device that had been developed by the group’s Central Research Laboratory (CRL). At issue was the decision to enter this new business, thereby launching a diversification move that many felt was necessary if the company was to continue to prosper. Complicating the problem was the fact that this revolutionary new product would not only take EMI into the fast-changing and highly competitive medical equipment business, but would also require the company to establish operations in North America, a market in which it had no prior experience. In March 1972 EMI’s board was considering an investment proposal for  £6 million to build CT scanner manufacturing facilities in the United Kingdom. Development of the CT Scanner company background and history EMI Ltd traces its origins back to 1898, when the Gramophone Company was founded to import records and gramophones from the United States. It soon established its own manufacturing and recording capabilities, and after a 1931 merger with its major rival, the Columbia Gramophone Company, emerged as the Electric and Musical Industries, Ltd. EMI Ltd quickly earned a reputation as an aggressive technological innovator, developing the automatic record changer, stereophonic records, magnetic recording tape, and the pioneer commercial television system adopted by the BBC in 1937. Beginning in 1939, EMI’s R&D capabilities were redirected by the war effort toward the development of fuses, airborne radar, and other sophisticated  electronic devices. The company emerged from the war with an electronics business, largely geared to defenserelated products, as well as its traditional entertainment businesses. The transition to peacetime was particularly difficult for the electronics division, and its poor performance led to attempts to pursue new industrial and consumer applications. EMI did some exciting pioneering work, and for a while held hopes of being Britain’s leading computer company. Market leadership in major electronics applications remained elusive, however, while the music business boomed. The 1955 acquisition of Capitol Records in the United States, and the subsequent success of the Beatles and other recording groups under contract to EMI, put the company in a very strong financial position as it entered the 1970s. In 1970 the company h ad earned  £21 million before tax on sales of  £215 million, and although extraordinary losses halved those profits in 1971, the company was optimistic for a return to previous profit levels in 1972 (see exhibits 10.1 to 10.3 for EMI’s financial performance). Around that time, a change in top management signaled a change in corporate strategy. John Read, an accountant by training and previously sales director for Ford of Great Britain, was appointed chief executive officer after only four years in the company. Read recognized the risky, even fickle, nature of the music business, which accounted for two-thirds of EMI’s sales and profits. In an effort to change the company’s strategic balance, he began to divert some of its substantial cash flow into numerous acquisitions and internal developments. To encourage internal innovation, Read established a research fund that was to be used to finance innovative developments outside the company’s immediate interests. Among the first projects financed was one proposed by Godfrey Hounsfield, a research scientist in EMI’s Central Research Laboratories (CRL). Hounsfield’s proposal opened up an opportunity for the company to diversify in the fast-growing medical electronics field. ct scanning: the concept In simple terms, Hounsfield’s research proposal was to study the possibility of creating a threedimensional image of an object by taking multiple X-ray measurements of the object from different angles, then using a computer to reconstruct a picture from the data contained in hundreds of overlapping and  intersecting X-ray slices. The concept became known as computerized tomography (CT). Although computerized tomography represented a conceptual breakthrough, the technologies it harnessed were quite well known and understood. Essentially, it linked X-ray, data processing, and cathode ray tube display technologies in a complex and precise manner. The real development challenge consisted of integrating the mechanical, electronic, and radiographic components into an accurate, reliable, and sensitive system. Figure 10.1 provides a schematic representation of the EMI scanner, illustrating the linkage of the three technologies, as well as the patient handling table and X-ray gantry. Progress was rapid, and clinical trials of the CT scanner were under way by late 1970. To capture the image of multiple slices of the brain, the scanner went through a translate-rotate sequence, as illustrated in figure 10.2. The X-ray source and detector, located on opposite sides of the patient’s head, were mounted on a gantry. After each scan, or â€Å"translation,† had generated an X-ray image comprising 160 data points, the gantry would rotate 1 ° and another scan would be made. This procedure would continue through 180 translations and rotations, storing a total of almost 30,000 data points. Since the detected intensity of an X-ray varies with the material through which it passes, the data could be reconstructed by the computer into a threedimensional image of the object that distinguished bone, tissue, water, fat, and so on. At about the time of the CT clinical trials, John Powell, formerly managing director of Texas Instrument’s English subsidiary, joined EMI as technical director. He soon became convinced that the poor profitability of the nonmilitary electronics business was due to the diffusion of the company’s 2,500-person R&D capability over too many diverse small-volume lines. In his words, â€Å"EMI was devoted to too many products and dedicated to too few.† Because the CT scanner project built on the company’s substantial and well-established electronics capability, Powell believed it gave EMI an important opportunity t o enter an exciting new field. He felt that this was exactly the type of effort in which the company should be prepared to invest several million  pounds. Diagnostic Imaging Industry During the first half of the twentieth century, diagnostic information about internal organs and functions was provided almost exclusively by conventional X-ray examination, but in the 1960s hostemostel.com and 1970s, several new imaging techniques emerged. When the CT scanner was announced, three other important technologies existed: X-ray, nuclear, and ultrasound. EMI management believed its CT scanner would displace existing diagnostic imaging equipment in only a few applications, specifically head and brain imaging. x-ray In 1895 Wilhelm Roentgen discovered that rays generated by a cathode ray tube could penetrate solid objects and create an image on film. Over the next 40 to 50 years, X-ray equipment was installed in almost every healthcare facility in the world. Despite its several limitations (primarily due to the fact that detail was obscured when three-dimensional features were superimposed on a two-dimensional image), X-rays were universally used. In 1966 a Surgeon General’s report estimated that between one-third and one-half of all crucial medical decisions in the United States depended on interpretation of X-ray films. That country alone had more than 80,000 X-ray installations in operation, performing almost 150 million procedures in 1970. The X-ray market was dominated by five major global companies. Siemens of West Germany was estimated to have 22 percent of the world market, N.V. Philips of the Netherlands had 18 percent, and Compagnie Generale de Radiologie (CGE), subsidiary of th e French giant Thomson Brandt, held 16 percent. Although General Electric had an estimated 30 percent of the large US market, its weak position abroad gave it only 15 percent of the world market. The fifth largest company was Picker, with 20 percent of the US market, but less than 12 percent worldwide. The size of the US market for X-ray equipment was estimated at $350 million  in 1972, with an additional $350 million in X-ray supplies. The United States was thought to represent 35– 40% of the world market. Despite the maturity of the product, the X-ray market was growing by almost 10% annually in dollar terms during the early 1970s. A conventional X-ray system represented a major capital expenditure for a hospital, with the average system costing more than $100,000 in 1973. In the mid-1960s a nuclear diagnostic imaging procedure was developed. Radioisotopes with a short radioactive life were projected into the body, detected and monitored on a screen, then recorded on film or stored on a tape. Still in an early stage of development, this technology was used to complement or, in some instances, replace a conventional X-ray diagnosis. Both static and dynamic images could be obtained. Following the pioneering development of this field by Nuclear-Chicago, which sold the first nuclear gamma camera in 1962, several other small competitors had entered the field, notably Ohio Nuclear. By the late 1960s larger companies such as Picker were getting involved, and in 1971 GE’s Medical Systems Division announced plans to enter the nuclear medicine field. As new competitors, large and small, entered the market, competition became more aggressive. The average nuclear camera and data processing system sold for about $75,000. By 1973, shipments of nuclear imaging equipment into the US market were estimated to be over $50 million. Ultrasound had been used in medical diagnosis since the 1950s, and the technology advanced significantly in the early 1970s, permitting better-defined images. The technique involves transmitting sonic waves and picking up the echoes, which when converted to electric energy  could create images. Air and bone often provide an acoustic barrier, limiting the use of this technique. But because the patient was not exposed  to radiation, it was widely used as a diagnostic tool in obstetrics and gynecology. In 1973 the ultrasound market was very small, and only a few small companies were reported in the field. Picker, however, was rumored to be doing research in the area. The cost of the equipment was expected to be less than half that of a nuclear camera and support system, and perhaps a third to a quarter that of an X-ray machine. Because of its size, sophistication, progressiveness, and access to funds, the US medical market clearly represented the major opportunity for a new device such as the CT scanner. EMI management was uncertain about the sales potential for their new product, however. As of 1972, there were around 7,000 hospitals in the United States, ranging from tiny rural hospitals with fewer than 10 beds to giant teaching institutions with 1,000 beds or more (see table 10.1). Since the price of the EMI Scanner was expected to be around $400,000, only the largest and financially strongest short-term institutions would be able to afford one. But the company was encouraged by the enthusiasm of the physicians who had seen and worked with the scanner. In the opinion of one leading American neurologist, at least 170 machines would be required by major US hospitals. Indeed, he speculated, the time might come when a neurologist would feel ethically compelled to order a CT scan before making a diagnosis. During the 1960s the radiology departments in many hospitals were recognized as important money-making operations. Increasingly, radiologists were able to commission equipment manufacturers to build specially designed (often esoteric) X-ray systems and applications. As their budgets expanded, the size of the US X-ray market grew from $50 million in 1958 to $350 million in 1972. Of the 15,000 radiologists in the United States, 60 percent were primarily based in offices and 40 percent in hospitals. Little penetration of private clinics was foreseen for the CT scanner. Apart from these broad statistics, EMI had little ability to forecast the potential of the US market for scanners. EMI’s Investment Decision conflicting management views By late 1971 it was clear that the clinical trials were successful and EMI management had to decide whether to make the investment required to develop the CT scanner business. One group of senior managers felt that direct EMI participation was undesirable for three reasons. First, EMI lacked medical product experience. In the early 1970s EMI offered only two very small medical products, a patient-monitoring device and an infrared thermography device, which together represented less than 0.5 percent of the company’s sales. Second, they argued that the manufacturing process would be quite different from EMI’s experience. Most of its electronics work had been in the job shop mode required in producing small numbers of highly specialized defense products on cost-plus government contracts. In scanner production, most of the components were purchased from subcontractors and had to be integrated into a functioning system. Finally, many believed that without a working knowledge of the North American market, where most of the demand for scanners was expected to be, EMI might find it very difficult to build an effective operation from scratch. Among the strongest opponents of EMI’s self-development of this new business was one of the scanner’s earliest sponsors, Dr Broadway, head of the Central Research Laboratory. He emphasized that EMI’s potential competitors in the field had considerably greater technical capabilities and resources. As the major proponent, John Powell needed convincing market information to counter the critics. In early 1972 he asked some of the senior managers how many scanners they thought the company would sell in its first 12 months. Their first estimate was five. Powell told them to think again. They came back with a figure of 12, and were again sent back to reconsider. Finally, with an estimate of 50, Powell felt he could go to bat for the  £6 million  investment, since at this sales level he could project handsome profits from year one. He then prepared an argument that justified the scanner’s fit with EMI’s overall objectives, and outlined a basic strategy for the business. Powell argued that self-development of the CT scanner represented just the sort of vehicle EMI had been seeking to provide some focus to its development effort. By definition, diversification away from existing product-market areas would move the company into somewhat unfamiliar territory, but he firmly believed that the financial and strategic payoffs would be huge. The product offered access to global markets and an entry into the lucrative medical equipment field. He felt the company’s objective should be to achieve a substantial share of the world medical electronics business not only in diagnostic imaging, but also through the extension of its technologies into computerized patient planning and radiation therapy. Powell claimed that the expertise developed by Hounsfield and his team, coupled with protection from patents, would give EMI three or four years, and maybe many more, to establish a solid market position. He argued that investments should be made quickly and boldly to maximize the market share of the EMI scanner before competitors entered. Other options, such as licensing, would impede the development of the scanner. If the licensees were the major Xray equipment suppliers, they might not promote the scanner aggressively since it would cannibalize their sales of X-ray equipment and consumables. Smaller companies would lack EMI’s sense of commitment and urgency. Besides, licensing would not provide EMI with the major strategic diversification it was seeking. It would be, in Powell’s words, â€Å"selling our birthright.† the proposed strategy Because the CT scanner incorporated a complex integration of some technologies in which EMI had only limited expertise, Powell proposed that the manufacturing strategy should rely heavily on outside sources of those components rather than trying to develop the expertise internally. This approach would not only minimize risk, but would also make it possible to implement a manufacturing program rapidly. He proposed the concept of developing various â€Å"centers of excellence† both inside and outside the company, making each responsible for the continued superiority of the subsystem it manufactured. For example, within the EMI UK organization a unit called SE Labs, which manufactured instruments and displays, would become the center of excellence for the scanner’s viewing console and display control. Pantak, an EMI unit with a capability in X-ray tube assembly, would become the center of excellence for the X-ray generation and detection subsystem. An outside vendor with which the company had worked in developing the scanner would be the center of excellence for data processing. Finally, a newly created division would be responsible for coordinating these subsystem manufacturers, integrating the various components, and assembling the final scanner at a company facility in the town of Hayes, not far from the CRL site. Powell emphasized that the low initial investment was possible because most of the components and subsystems were purchased from contractors and vendors. Even internal centers of excellence such as SE Labs and Pantak assembled their subsystems from purchased components. Overall, outside vendors accounted for 75–80 percent of the scanner’s manufacturing cost. Although Powell felt his arrangement greatly reduced EMI’s risk, the  £6 hostemostel.com million investment was a substantial one for the company, representing about half the funds available for capital investment over the coming year. (See exhibit 10.2 for a balance sheet and exhibit 10.3 for a projected funds flow.) The technology strategy was to keep CRL as the company’s center of excellence for design and software expertise, and to use the substantial profits Powell was projecting from even the earliest sales to maintain technological leadership position. Powell would personally head up a team to develop a marketing strategy. Clearly, the United States had to be the main focus of EMI’s marketing activity. Its neuroradiologists were regarded as world leaders and tended to welcome technological innovation. Furthermore, its  institutions were more commercial in their outlook than those in other countries and tended to have more available funds. Powell planned to set up a US sales subsidiary as soon as possible, recruiting sales and service personnel familiar with the North American healthcare market. Given the interest shown to date in the EMI scanner, he did not think there would be much difficulty in gaining the attention and interest of the medical community. Getting the $400,0 00 orders, however, would be more of a challenge. In simple terms, Powell’s sales strategy was to get machines into a few prestigious reference hospitals, then build from that base. the decision In March 1972 EMI’s chief executive, John Read, considered Powell’s proposal in preparation for a board meeting. Was this the diversification opportunity he had been hoping for? What were the risks? Could they be managed? How? If he decided to back the proposal, what kind of an implementation program would be necessary to ensure its eventual success? CASE B The year 1977 looked like it would be a very good one for EMI Medical Inc., a North American subsidiary of EMI Ltd. EMI’s CT scanner had met with enormous success in the American market. In the three years since the scanner’s introduction, EMI medical electronics sales had grown to  £42 million. Although this represented only 6 percent of total sales, this new business contributed pretax profits of  £12.5 million, almost 20 percent of the corporate total (exhibit 10.4). EMI Medical Inc. was thought to be responsible for about 80 percent of total scanner volume. And with an order backlog of more than 300 units, the future seemed rosy. Despite this formidable success, senior management in both the subsidiary and the parent company were concerned about several developments. First, this fast-growth field had attracted more than a dozen new entrants in the past two years, and technological advances were occurring rapidly. At the same time, the growing political debate ov er hospital cost containment often focused on $500,000 CT scanners as an example of questionable hospital spending. Finally, EMI was beginning to feel some internal organizational strains. Entry Decision  product launch Following months of debate among EMI’s top management, the decision to go ahead with the EMI Scanner project was assured when John Read, the company CEO, gave his support to Dr Powell’s proposal. In April 1972 a formal press announcement was greeted by a response that could only be described as overwhelming. EMI was flooded with inquiries from the medical and financial communities, and from most of the large diagnostic imaging companies wanting to license the technology, enter into joint ventures, or at least distribute the product. The response was that the company had decided to enter the business directly itself. Immediately action was implemented to put Dr Powell’s manufacturing strategy into operation. Manufacturing facilities were developed and supply contracts drawn up with the objective of beginning shipments within 12 months. In May, Godfrey Hounsfield, the brilliant EMI scientist who had developed the scanner, was dispatched to the US accompanied by a leading English neurologist. The American specialists with whom they spoke confirmed that the scanner had great medical importance. Interest was running high in the medical community. In December, EMI mounted a display at the annual meeting of the Radiological Society of North America (RSNA). The exhibit was the highlight of the show, and boosted management’s confidence to establish a US sales company to penetrate the American medical market. us market entry In June 1973, with an impressive pile of sales leads and inquiries, a small sales office was established in Reston, Virginia, home of the newly appointed US sales branch manager, Mr Gus Pyber. Earlier that month the first North American head scanner had been installed at the prestigious Mayo Clinic, with a second machine promised to the Massachusetts General Hospital for trials. Interest was high, and the new sales force had little difficulty getting into the offices of leading radiologists and neurologists. By the end of the year, however, Mr Pyber had been fired in a dispute over appropriate expense levels, and James Gallagher, a former marketing manager with a major drug company, was hired to replace him. One of Gallagher’s first steps was to convince the company that the Chicago area was a far better location for the US office. It allowed better servicing of a national market, was a major center for medical electronics companies, and had more convenient linkages with London. This last point was important since all major strategic and policy decisions were being made directly by Dr Powell in London. During 1974, Gallagher concentrated on recruiting and developing his three-man sales force and two-man service organization. The cost of maintaining each salesman on the road was estimated at $50,000, while a serviceman’s salary and expenses at that time were around $35,000 annually. The production rate for the scanner was running at a rate of only three or four machines a month, and Gallagher saw little point in developing a huge sales force to sell a product for which supply was limited, and interest seemingly boundless. In this seller’s market the company developed some policies that were new to the industry. Most notably, they required that the customer deposit one-third of the purchase price with the order to guarantee a place in the production schedule. Sales leads and enquiries were followed up when the sales force could get to them, and the general attitude of the company seemed to have somewhat of a â€Å"take it or leave it† tone. It was in this period that EMI developed a reputation for arrogance in some parts of the medical profession. Nonetheless, by June 1974 the company had delivered 35 scanners at $390,000 each, and had another 60 orders in hand. Developing Challenges competitive challenge Toward the end of 1974, the first competitive scanners were announced. Unlike the EMI scanner, the new machines were designed to scan the body rather than the head. The Acta- Scanner had been developed at Georgetown University’s Medical Center and was manufactured by a small Maryland company called Digital Information Sciences  Corporation (DISCO). Technologically, it offered little advance over the EMI scanner except for one important feature. Its gantry design would accommodate a body rather than a head. While specifications on scan time and image composition were identical to those of the EMI scanner, the $298,000 price tag gave the Acta-Scanner a big advantage, particularly with smaller hospitals and private practitioners. The DeltaScan offered by Ohio Nuclear (ON) represented an even more formidable challenge. This head and body scanner had 256 ∞ 256 pixels compared with EMI’s 160 ∞ 160, and promised a 21/2-minute scan rather than the 41/2-minute scan time offered by EMI. ON offered these superior features on a unit priced $5,000 below the EMI scanner at $385,000. Many managers at EMI were surprised by the speed with which these products had appeared, barely two years after the EMI scanner was exhibited at the RSNA meeting in Chicago, and 18 months after the first machine was installed in the Mayo Clinic. The source of the challenge was also interesting. DISCO was a tiny private company, and ON contributed about 20 percent of its parent Technicare’s 1974 sales of $50 million. To some, the biggest surprise was how closely these competitive machines resembled EMI’s own scanner. The complex wall of patents had not provided a very enduring defense. ON tackled the issue directly in its 1975 annual report. After announcing that $882,200 had been spent in Technicare’s R&D Center to develop DeltaScan, the report stated: Patents have not played a significant role in the development of Ohio Nuclear’s product line, and it is not believed that the validity or invalidity of any patents known to exist is material to its current market position. However, the technologies on which its products are based are sufficiently complex and application of patent law sufficiently indefinite that this belief is not free from all doubt. The challenge represented by these new competitive products caused EMI to speed up the announcement of the body scanner Dr Hounsfield had been working on. The new CT 5000 model incorporated a second-generation technology in which multiple beams of radiation were shot at multiple detectors, rather  than the single pencil beam and the single detector of the original scanner (see exhibit 10.5). This technique allowed the gantry to rotate 10 ° rather than l ° after each translation, cutting scan time from 41/2 minutes to 20 seconds. In addition, the multiple-beam emission also permitted a finer image resolution by increasing the number of pixels from 160 ∞ 160 to 320 ∞ 320. Priced over $500,000, the CT 5000 received a standing ovation when Hounsfield demonstrated it at the radiological meetings held in Bermuda in May 1975. Despite EMI’s reassertion of its leadership position, aggressive competitive activity continued. In March 1975, Pfizer Inc., the $1.5 billion drug giant, announced it had acquired the manufacturing and marketing rights for the Acta-Scanner. EMI was then operating at an annual production rate of 150 units, and ON had announced plans to double capacity to 12 units per month by early 1976. Pfizer’s capacity plans were unknown. The most dramatic competitive revelation came at the annual RSNA meeting in December 1975, when six new competitors displayed CT scanners. Although none of the newcomers offered immediate delivery, all were booking orders with delivery dates up to 12 months out on the basis of their spec sheets and prototype or mock-up equipment exhibits. Some of the new entrants (Syntex, Artronix, and Neuroscan) were smaller companies, but others (General Electric, Picker, and Varian) were major medical electronics competitors. Perhaps most impressive was the General Electric CT/T scanner, which took the infant technology into its third generation (see exhibit 10.6). By using a 30 °-wide pulsed fan X-ray beam, the GE scanner could avoid the time-consuming â€Å"translate-rotate† sequence of the firstand second-generation scanners. A single continuous 360 ° sweep could be completed in 4.8 seconds, and the resulting image was reconstructed by the computer in a 320 ∞ 320 pixel matrix on a cathode ray tube. The unit was priced at $615,000. Clinical trials were scheduled for January, and shipment of production units was being quoted for mid-1976. The arrival of GE on the horizon signaled the beginning of a new competitive game. With a 300-person sales force and a service network of 1,200, GE clearly had marketing muscle. They had reputedly spent $15 million developing their third-generation scanner, and were continuing to spend at a rate of $5 million annually to keep ahead technologically. During 1975, one industry source estimated, about 150 new scanners were installed in the US, and more than twice as many orders entered. (Orders were firm, since most were secured with hefty front-end deposits.) Overall, orders were split fairly evenly between brain and body scanners. EMI was thought to have accounted for more than 50 percent of orders taken in 1975, ON for almost 30 percent. Market size and growth Accurate assessments of market size, growth rate, and competitors’ shares were difficult to obtain. The following represents a sample of the widely varying forecasts made in late 1975: †¢ Wall Street was clearly enamored with the industry prospects (Technicare’s stock price rose from 5 to 22 in six months) and analysts were predicting an annual market potential of $500 million to $1 billion by 1980. †¢ Frost and Sullivan, however, saw a US market of only $120 million by 1980, with ten years of cumulative sales only reaching $1 billion by 1984 (2,500  units at $400,000). †¢ Some leading radiologists suggested that CT scanners could be standard equipment in all short-term hospitals with 200 beds or more by 1985. †¢ Technicare’s president, Mr R. T. Grimm, forecast a worldwide market of over $700 million by 1980, of which $400 million would be in the US. †¢ Despite the technical limitations of its first-generation product, Pfizer said it expected to sell more than 1,500 units of its Acta-Scanner over the next five years. Within EMI, market forecasts had changed considerably. By late 1975, the estimate of the US market had been boosted to 350 units a year, of which EMI hoped to retain a 50 percent share. Management was acutely aware of the difficulty of forecasting in such a turbulent environment, however. international expansion New competitors also challenged EMI’s positions in markets outside the US. Siemens, the $7 billion West German company, became ON’s international distributor. The distribution agreement appeared to be one of short-term convenience for both parties, since Siemens acknowledged that it was developing its own CT scanner. Philips, too, had announced its intention to enter the field. Internationally, EMI had maintained its basic strategy of going direct to the national market rather than working through local partners or distributors. Although all European sales had originally been handled out of the UK office, it quickly became evident that local servicing staffs were required in most countries. Soon separate subsidiaries were established in most continental European countries, typically with a couple of salesmen, and three or four servicemen. Elsewhere in the world, salesmen were often attached to EMI’s existing music organization in that country (e.g., in South Africa, Australia, and Latin America). In Japan, however, EMI signed a distribution agreement with Toshiba which, in October 1975, submitted the largest single order to date: a request for 33 scanners. EMI in 1976: Strategy and Challenges emi’s situation in 1976 By 1976 the CT scanner business was evolving rapidly, but, as the results indicated, EMI had done extremely well financially (exhibit 10.5). In reviewing developments since the US market entry, the following was clear: †¢ While smaller competitors had challenged EMI somewhat earlier than might have been expected, none of the big diagnostic imaging companies had brought its scanner to market, even four years after the original EMI scanner announcement. †¢ While technology was evolving rapidly, the expertise of Hounsfield and his CRL group, and the aggressive reinvestment of much of the early profits in R&D, gave EMI a strong technological position. †¢ While market size and growth were highly uncertain, the potential was unquestionably much larger than EMI had forecast in their early plans. †¢ In all, EMI was well established, with a strong and growing sales volume and a good technical reputation. The company was unquestionably the industry leader. Nonetheless, in the light of all the developments, the strategic tasks facing EMI in 1976 differed considerably from those of earlier years. The following paragraphs outline the most important challenges and problems facing the company in this period. strategic priorities EMI’s first sales priority was to protect its existing highly visible and prestigious customer base from competitors. When its second-generation scanner was introduced in mid-1975, EMI promised to upgrade without charge the first-generation equipment already purchased by its established customers. Although each of these 120 upgrades was estimated to cost EMI $60,000 in components and installation costs, the US sales organization felt that the expense was essential to maintain the confidence and good faith of this important core group of customers. To maintain its leadership image, the US company also expanded its service organization substantially. Beginning in early 1976, new regional and district sales and service offices were opened with the objective of providing customers with the best service  in the industry. A typical annual service contract cost the hospital $40,000 per scanner. By year’s end, the company boasted 20 service centers with 150 service engineers – a ratio that represented one serviceman for every two or three machines installed. The sales force by this time had grown to 20, and was much more customer oriented. Another important task was to improve delivery performance. The interval between order and promised delivery had been lengthening; at the same time, promised delivery dates were often missed. By late 1975, it was not unusual for a 6-month promise to convert into a 12- or 15month actual delivery time. Fortunately for EMI, all CT manufacturers were in backorder and were offering extended delivery dates. However, EMI’s poor performance in meeting promised dates was hurting its reputation. The company responded by substantially expanding its production facilities. By mid-1976 there were six manufacturing locations in the UK, yet because of continuing problems with component suppliers, combined capacity for head and body scanners was estimated at less than 20 units a month. Organizational and personnel issues As the US sales organization became increasingly frustrated, they began urging top management to manufacture scanners in North America. Believing that the product had reached the necessary level of maturity, Dr Powell judged that the time was ripe to establish a US plant to handle at least final assembly and test operations. A Northbrook, Illinois site was chosen. Powell had become EMI’s managing director and was more determined than ever to make the new medical electronics business a success. A capable manager was desperately needed to head the business, particularly in view of the rapid developments in the critical North American market. Consequently, Powell was delighted when Normand Provost, who had been his boss at Texas Instruments, contacted him at the Bermuda radiological meeting in March 1975. He was hired with the hope that he could build a stronger, more integrated US company. With the Northbrook plant scheduled to begin operations by mid-1976, Normand Provost began hiring skilled production personnel. A Northbrook product development center was also a vision of Provost’s to allow EMI to draw on US technical expertise and experience in  solid state electronics and data processing, and the company began seeking people with strong technological and scientific backgrounds. Having hired Provost, Dr Powell made several important organizational changes aimed at facilitating the medical electronics business’s growth and development. In the UK, he announced the creation of a separate medical electronics group. This allowed the separate operating companies, EMI Medical Ltd (previously known as the X-Ray Systems Division), Pantak (EMI) Ltd, SE Labs (EMI) Lt., and EMI Meterflow Ltd, to be grouped together under a single group executive, John Willsher. (See exhibit 10.6.) At last, a more integrated scanner business seemed to be emerging organizationally. The US sales subsidiary was folded into a new company, EMI Medical Inc., but continued to operate as a separate entity. The intention was to develop this company as an integrated diversified medical electronics operation. Jim Gallagher, the general manager of the US operations, was fired and Bob Hagglund became president of EMI Medical Inc. While Gallagher had been an effective salesman, Powell thought the company needed a more rounded general manager in its next phase of expansion. Hagglund, previously executive vice president of G.D. Searle’s diagnostic business, seemed to have the broader background and outlook required to manage a larger integrated operation. He reported through Provost back to Dr Powell in the UK. While Provost’s initial assignment was to establish the new manufacturing and research facilities in the US, it was widely assumed within EMI that he was being groomed to take responsibility for the company’s medical electronics businesses worldwid e. However, in April 1976, while visiting London to discuss progress, Provost died of a heart attack. As a result, the US and UK organizations reported separately to Dr Powell. product diversification Since EMI wished to use the scanner as a means to become a major force in medical electronics, Powell argued that some bold external moves were needed to protect the company’s leadership position. In March 1976, EMI acquired for $2 million ( £1.1 million) SHM Nuclear Corporation, a California-based company that had developed linear accelerators for cancer therapy and  computerized radiotherapy planning systems. Although the SHM product line needed substantial further development, the hope was that linking such systems to the CT scanner would permit a synchronized location and treatment of cancer. Six months later EMI paid  £6.5 million to acquire an additional 60 percent of Nuclear Enterprises Ltd, an Edinburgh-based supplier of ultrasound equipment. In the 1976 annual report, Sir John Read, now EMI’s chairman, reaffirmed his support for Dr Powell’s strategy: We have every reason to believe that this new grouping of scientific and technological resources will prove of national benefit in securing a growing share of worldwide markets for high-technology products†¦ Future Prospects At the close of 1976, EMI’s medical electronics business was exceeding all expectations. In just three years, sales of electronics products had risen from  £84 million to  £207 million; a large part of this increase was due to the scanner. Even more impressive, profits of the electronics line had risen from  £5.2 million in 1972/73 to  £26.4 million in 1975/76, jumping from 16 to 40 percent of the corporate total. Rather than dwindling, interest in scanners seemed to be increasing. Although the company had sold around 450 scanners over the past three years (over 300 in the US alone), its order backlog was estimated to be 300 units. At the December 1976 RSNA meeting, 120 of the 280 papers presented were related to CT scanning. As he reviewed the medical electronics business he had built, Dr Powell was generally pleased with the way in which the company had met the challenges of being a pioneer in a new industry segment. However, there were several developments that he felt would need considerable attention over the next few years. First, Powell felt that competitive activity would continue to present a challenge; second, some changes in the US regulatory environment concerned him; and finally, he was aware that the recent organization changes had created some strains. competitive problems By the end of 1976, EMI had delivered 450 of the 650-odd scanners installed worldwide, yet its market share had dropped to 56 percent in 1975/76 (198 of 352 scanners sold that June-to-June period were EMI’s). The company gained some consolation from the fact that despite their premium pricing strategy and their delivery problems, they had conceded less than half the total market to the combined competitive field. They also felt some sense of security in the 300 orders they held awaiting delivery. Nonetheless, Sir John Read was clearly concerned: [We are well aware of the developing competition. Our research program is being fully sustained to ensure our continued leadership†¦ In mid-1976, the company announced its intention â€Å"to protect its inventions and assert its patent strength,† and subsequently filed suit against Ohio Nuclear claiming patent infringement. However, at the same time, EMI issued a statement proclaiming that â€Å"it was the company’s wish to make its pioneering scanner patents available to all under suitable licensing arrangements.† At the annual RSNA meeting in December 1976, sixteen competitors exhibited scanners. The year’s new entrants (including CGR, the French X-ray giant; Hitachi from Japan; and G.D. Searle, the US drug and hospital equipment company) were not yet making deliveries, however. The industry’s potential production capacity was now estimated to be over 900 units annually. GE’s much-publicized entry was already six months behind their announced delivery date, but it was strongly rumored that production shipments of GE’s third-generation scanner were about to begin. EMI Medical Inc. awaited that event with some trepidation. (A summary of major competitors and their situations as of 1976 is presented in table 10.2.) Regulatory problems By mid-1976 there were indications that government might try to exert a tighter control over hospital spending in general, and purchase of CT scanners in particular. The rapidly escalating cost of healthcare had been a political issue for years, and the National Health Planning and Resources Development Act of 1974 required states to control the development of costly  or unnecessary health services through a mechanism known as the Certificate of Need (CON) procedure. If they wished to qualify for Medicare or Medicaid reimbursements, healthcare facilities were required to submit documentation to their state’s department of health to justify major capital expenditures (typically in excess of $100,000). Before 1976, the CON procedures had generally been merely an administrative impediment to the process of selling a scanner, delaying but not preventing the authorization of funds. However, by 1976, the cost of medical care represented 8 percent of the gross national product and Jimmy Carter made control of the â€Å"skyrocketing costs of healthcare† a major campaign issue. One of the most frequently cited examples of waste was the proliferation of CT scanners. It was argued that this $500,000 device had become a symbol of prestige and sophistication in the medical community, so that every institution wanted its own scanner, even if a neighboring facility had one that was grossly underutilized. In response to heightened public awareness of the issue, five states declared a moratorium on the purchase of new scanners, including California, which had accounted for over 20 percent of total US scanner placements to date. In November, Jimmy Carter was elected president. organizational problems Perhaps most troublesome to Dr Powell were the organizational problems. Tensions within the EMI organization had been developing for some time, centering on the issues of manufacturing and product design. Managers in the US company felt that they had little control over manufacturing schedules and little input into product design, despite the fact that they were responsible for 80 percent of corporate scanner sales. In their view, the company’s current market position was being eroded by the worsening manufacturing delivery performance from the UK, while its longer-term prospects were threatened by the competitive challenges to EMI’s technological leadership. Although the Northbrook plant had been completed in late 1976, US managers were still not satisfied they had the necessary control over production. Arguing that the quality of subassemblies and components shipped from the UK was deteriorating and delivery promises were becoming even more unreliable,  they began investigating alternate supply sources in the US. UK-based manufacturing managers felt that much of the responsibility for backlogs lay with the product engineers and the sales organizations. Their unreliable sales forecasts and constantly changing design specifications had severely disrupted production schedules. The worst bottlenecks involved outside suppliers and subcontractors that were unable to gear up and down overnight. Complete systems could be held up for weeks or months awaiting a single simple component. As the Northbrook plant became increasingly independent, US managers sensed that the UK plants felt less responsibility for them. In tight supply situations they felt there was a tendency to ship to European or other export customers first. Some US managers also believed that components were increasingly shipped from UK plants without the same rigid final checks they normally received. The assumption was that the US could do their own QC checking, it was asserted. Both these assertions were strongly denied by the English group. Nonetheless, Bob Hagglund soon began urging Dr Powell to let EMI Medical Inc. become a more independent manufacturing operation rather than simply a final assembly plant for UK components. This prospect disturbed John Willsher, managing director of EMI Medical Ltd,  who argued that dividing manufacturing operations could mean duplicating overhead and spreading existing expertise too thin. Others felt that the â€Å"bootleg development† of alternate supply sources showed a disrespect for the â€Å"center of excellence† concept, and could easily compromise the ability of Pantak (X-ray technology) and SE Labs (displays) to remain at the forefront of technology. Product development issues also created some organizational tension. The US sales organization knew that GE’s impressive new third-generation â€Å"fan beam† scanner would soon be ready for delivery, and found customers hesitant to commit to EMI’s new CT 5005 until the GE product came out. For months telexes had been flowing from Northbrook to EMI’s Central Research Laboratories asking if drastic reductions in scan time might be possible to meet the GE threat. Meanwhile, scientists at CRL felt that US CT competition was developing into a specifications war based on the wrong issue, scan time. Shorter elapsed times meant less image blurring, but in the trade-off between scan time and picture resolution, EMI engineers had preferred to concentrate on better-quality images. They felt that the 20-second scan offered by EMI scanners made practical sense since a patient could typically hold his breath that long while being diagnosed. CRL staff were exploring some entirely new imaging concepts and hoped to have a completely new scanning technology ready to market in three or four years. Dr Hounsfield had conducted experiments with the fan beam concept in the early 1970s and was skeptical of its ability to produce good-quality images. To use sodium iodide detectors similar to those in existing scanners would be cost prohibitive in the large numbers necessary to pick up a broad scan; to use other materials such as xenon gas would lead to quality and stability problems, in Hounsfield’s view. Since GE and others offering third-generation equipment had not yet delivered commercial machines, he felt little incentive to redirect his staff to these areas already researched and rejected. There were many other demands on the time and attention of Hounsfield and his staff, all of which seemed important for the company. They were in constant demand by technicians to deal with major problems that arose that nobody else could solve. Sales people wanted him to talk to their largest and most prestigious customers, since a visit by Dr Hounsfield could often swing an important sale. They were also involved in internal training on all new products. The scientific community wanted them to present papers and give lectures. And increasingly, Dr Hounsfield found himself in a public relations role as he accepted honors from all over the globe. The impact was to greatly enhance EMI’s reputation and to reinforce its image as the leader in the field. When it appeared that CRL was unwilling or unable to make the product changes  the US organization felt it needed, Hagglund made the bold proposal that the newly established research laboratories in Northbrook take responsibility for developing a three- to five-second-scan â€Å"fan beam†-type scanner. Dr Powell agreed to study the suggestion, but was finding it difficult to evaluate the relative merits of the US subsidiary’s views and the CRL scientists’ opinions. By year’s end, Dr Powell had still been unable to find anybody to take charge of the worldwide medical electronics business. By default, the main decision-making forum became the Medical Group Review Committee (MGRC), a group of key line and staff managers which met, monthly at first, to help establish and review strategic decisions. Among the issues discussed by this committee were the manufacturing and product development decisions that had produced tensions between the US and UK managers. P owell had hoped that the MGRC would help build communications and consensus among his managers, but it soon became evident that this goal was unrealistic. In the words of one manager close to the events: The problem was there was no mutual respect between managers with similar responsibilities. Medical Ltd was resentful of Medical Inc.’s push for greater independence, and were not going to go out of their way to help the Americans succeed. As the business grew larger and more complex, Dr Powell’s ability to act both as corporate CEO and head of the worldwide medical business diminished. Increasingly, he was forced to rely on the MGRC to address operating problems as well as strategic issues. The coordination problem became so complex that, by early 1977, there were four subcommittees of the MGRC, each with representatives of the US and UK organizations, and each meeting monthly on one side of the Atlantic or the other. Committees included Manufacturing and Operations, Product Planning and Resources, Marketing and Sales Programs, and Service and Spares. powell’s problems As the new year opened, Dr Powell reviewed EMI’s medical electronics business. How well was it positioned? Where were the major threats and opportunities? What were the key issues he should deal with in 1977? Which should he tackle first, and how? These were the issues he turned over in his  mind as he prepared to note down his plans for 1977. Assistant Professor Christopher A. Bartlett prepared this case as a basis for class discussion rather than to illustrate either effective or ineffective handling of an administrative situation. Information was obtained from public sources and third parties. Although employees of the subject company discussed with the researcher events referred to in the case, they did not participate in the preparation of the document. The analysis, conclusions, and opinions stated do not necessarily represent those of the company, its employees or agents, or employees or agents of its subsidiaries. Thorn EMI PLC, on its own behalf and on behalf of all or any of its present or former subsidiaries, disclaims any responsibility for the matters included or referred to in the study.