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The Case of Baby Joe

Chronic Infections in an Infant

By Kristen L.W. Walton

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This interrupted case study follows the declining health of an infant who suffers from recurrent infections and finally is diagnosed with severe combined immunodeficiency (SCID). The case was developed for use in an undergraduate upper-level immunology course to supplement discussion of B and T cell development and the generation of antibody diversity. It could also be modified for use in a genetics class, with emphasis on the molecular aspects of RAG-mediated recombination and inheritance patterns of the disease, or a pathophysiology class, with emphasis on the physiology underlying the symptoms.

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• Assess the likelihood of genetic versus environmental causes of a medical condition in an infant.
• Analyze a data set and use the analysis to predict the most likely stage(s) of immune cell development that are disrupted.
• Determine how alterations in various immune cells could explain observed symptoms.
• Explain the role of RAG enzymes in B cell and T cell development.
• Predict possible treatment options for immunodeficiency caused by genetic mutations in RAG enzymes.

Immunology; immune system; antibody diversity; B cell; T cell; T cell receptor; TCR; recombination activating gene enzyme; RAG; immunodeficiency; somatic recombination recessive allele; severe combined immunodeficiency; SCID; infection

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Undergraduate lower division, Undergraduate upper division

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Trader Joe’s – Case Solution

Trader Joe's ranked among the most successful grocery stores in the United States in 2013. According to experts, the company had the highest sales per square foot compared to any other major player in the market in the same industry. However, in 2013, the company faced several risks as bigger chains (e.g. Wal-Mart and Tesco) started to open small-format stores, which resembled Trader Joe's approach. Furthermore, some analysts started to question whether the company was losing its authenticity and "quirky cool" as the company has seen massive expansion across the nation. What should the company do to ensure further growth?

​David L. Ager, Michael A. Roberto Harvard Business School ( 714419-PDF-ENG ) Sep 7, 2013 (Revision: Dec 9, 2013)

Case questions answered:

Case study questions answered in the first solution:

• Identify multiple innovative efforts of Trader Joe’s over its 50+ year history.
• Considering the uniqueness of Trader Joe’s to its peers, what has made Trader Joe’s unique?
• How do they continue to compete against the larger chains?
• How do they manage to outperform their peers?

Case study questions answered in the second solution:

• What’s the key issue/problem/opportunity in this case?
• Which of the generic competitive strategies do you think Whole Foods, Kroger, and Trader Joe’s were using at the time of the case? Explain why. Don’t be afraid to use value chain logic to support your answer.

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Trader Joe's Case Answers

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1. Identify multiple innovative efforts of Trader Joe’s over its 50+ year history.

Trader Joe’s innovative efforts over its 50+ year history include:

Smaller-footprint neighborhood grocery stores (less than 15,000 square feet) that stock unusual and interesting foods and drinks sourced from around the world that might be new to customers and those from around the corner. (Typical grocery stores are 40,000 to 50,000 square feet).

The company carries about 4,000 stock-keeping units per location, as compared with as many as 50,000 units that are generally carried by most grocery stores. Instead of a wide selection of fresh meats and produce, the store features a wide collection of frozen foods. It also tends to sell its fruit by the piece rather than by the pound.

The company offers 80% or more low-priced private-label products. It includes its now-famous Charles Shaw Winery private label wines that cater to its intelligent, educated, sophisticated, and interesting customer base. These are the urbanites, Volvo-driving professors, college students, and Trader Joe’s groupies who are health-conscious, love to travel, like trying new things, and are interested in finding a great bargain.

The company maintains its uniqueness and low prices by avoiding the following trends and purchasing directly from manufacturers rather than working through distributors and wholesalers. It also stays away from trade shows that feature products that every other retailer sees. Unlike other grocery stores, suppliers are paid promptly and allowed to place their products on the shelves without incurring a charge.

The company requires vendors to maintain complete secrecy about their relationship with the retailer to keep rivals and customers from knowing where it sources its private label products. The suppliers provide Trader Joe’s with a much lower-cost version of their branded products that might be sold at other retailers.

Low investments in technology. There are no self-checkout lanes or flat-screen TVs at checkout counters. Trader Joe’s prefers a customer-friendly environment where customers actually talk with employees.

Marketing primarily through a customer newsletter produced in-house, Fearless Flyer. The company provides information to its customers. These include various products and new product additions, quirky, employee-handwritten in-store signage, and occasional short radio advertisements that it produces itself, instead of the traditional television commercials requiring professional actors or cutout coupons in the Sunday newspaper. There are no Facebook pages, Twitter accounts, or loyalty programs. Customers can return products with no questions asked.

Hiring reliable staff and paying them wages that are more than what is received at rival grocery stores. The company contributes 15.4% of employees’ pay to retirement accounts. Some health care benefits are even offered to part-time employees. New “crewmembers” receive ten days of indoctrinating training about the company’s seven core values.

2. Consider the uniqueness of Trader Joe’s to its peers. What has made Trader Joe’s unique?

From its marketing strategies to its huge array of private label offerings, Trader Joe’s is unique in almost every aspect of its operation and on several levels compared to its peers.

Trader Joe’s carries a large variety of products from around the world, yet only a very few brand-name products.

Store managers are discouraged from making announcements to crewmembers over the intercom system. Instead, a bell system to communicate key messages is used.

Crewmembers restock shelves during normal opening hours to allow customers to talk with and ask questions. Crewmembers walk customers directly to the products they are trying to locate rather than direct them to an aisle.

Crewmembers are friendly. They are people who are well-looked-after with great benefits, paid well, and often hang out with each other after work hours.

Trader Joe’s has created a…

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The Case of Joe

The Case of Joe: Ethical End of Life Decisions

“Give me something. I want to die.”

“Joe” is a 62-year-old building contractor who has been in an ICU for the past 10 weeks. He had gone to his community hospital for bypass surgery (CABG) and aortic valve repair (AVR), and things didn’t go well post-op. His sternal wound became infected with Methicillin-resistant Staphylococcus Aureus (MRSA). Sepsis led to acute hypoxic respiratory failure, a tracheotomy, profound hearing loss, and then acute renal failure ameliorated somewhat by hemodialysis.

The complexity and severity of Joe’s post-operative condition has resulted in transfer to our larger tertiary facility for the past 6 weeks. He now has been weaned off the vent to a few hours of room air, but the care team is not as optimistic as Joe’s family remains. Per chart notes, he is not improving sufficiently to warrant hope for recovery. The best that can be hoped for now, says his critical care physician, is discharge to a long-term acute care hospital (L-TACH). The prognosis does not include any likelihood of return to baseline, or to home. The situation is dire, and Joe seems to “get it.”

On the Saturday of Joe’s tenth week in ICU, he mouths a message to his nurse, and then to the physician who is summoned, and then to an ethics consultant also. “Stop everything. Give me something. I want to die.”

Joe repeats his request with family at the bedside. In later conversation with the ethics consultant, they express frustration with Joe for wanting to “quit.” “That’s not Joe. He’s stubborn. Never quits. He’s been through worse than this, and then went back to work. He must be depressed or not thinking clearly now.”

Is he depressed and not thinking clearly? Psychiatry is consulted to assess Joe’s decisional capacity. He has been informed already that, “We can’t give you something to die. That’s not legal, not in this state.” Although that answer seems to frustrate Joe, he continues to ask that “everything stop.”

No more aggressive treatment. Stop the antibiotics. No more vent. “I want to die.” Joe is deemed to have decisional capacity, per Psych. Ethics thinks so too. The wife, a sister, and two adult children–one of them a nurse in our facility–claim otherwise. “You don’t know Joe. This isn’t him. He isn’t thinking clearly. He’s actually getting better. He can breathe off the vent. His color is much better compared to a week ago. Can you at least not pull the plug for a few days, maybe a week, to give this a chance?” What now should be done for Joe – and his family?

Written by: Tarris Rosell, PhD, DMin

More From Forbes

4 case studies of businesses that scaled to greatness.

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Joe Camberato is the CEO and Founder of National Business Capital , a leading FinTech marketplace offering streamlined small business loans.

Have you ever wondered why some companies succeed in unimaginable ways while others fade into obscurity? The best way to understand how to scale a company is to look at how the most successful companies have done it. Let’s look at four companies that started out small and become global players in their industries.

Amazon is one of the best-known companies in the world, so it’s easy to forget that founder Jeff Bezos started the company out of his garage . In 1994, Bezos financed Amazon, which began as an online bookseller, with $10,000 of his own money.

Amazon experienced many losses during its early days, but its revenue quickly grew from $4.2 million to $8.5 million in 1996. The company went public in 1997, and the following year, it expanded beyond books.

One of its biggest game changers came in 2005 when the company launched Amazon Prime, its subscription service. There are 180 million Prime members in the U.S. alone.

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Amazon’s continued commitment to innovation has led it to be one of the world’s most successful companies. Amazon provides its customers with almost unparalleled convenience.

Under Armour

In 1996, Under Armour was founded with the idea of creating a T-shirt that wicks sweat away more efficiently and keeps athletes dry. The company started small , with founder Kevin Plank selling T-shirts out of the trunk of his car and to his former teammates on the University of Maryland’s football team.

Under Armour made several iterations of its original prototype, and the T-shirt was a huge success. The company began growing organically. Plank wanted to increase the company’s growth, so in 1999, he decided to take out an ESPN ad for $25,000 . It was a risky move at the time, and employees agreed to go without pay for a couple of weeks so the company could afford the ad. However, the risk paid off, and Under Armour generated $1 million in sales the next year and dramatically increased its brand recognition.

Under Armour’s initial funding came from Plank , but the company went public in 2005 . Under Armour began to diversify and release new products, but it never lost focus on its central mission—improving the performance and comfort of all athletes.

In 2007, Brian Chesky and Joe Gebbia couldn’t afford the rent for their San Francisco apartment, so they decided to rent out their loft space to earn some extra money. They didn’t want to post an ad on Craigslist , so they decided to create their own rental site.

In 2009, they were accepted into Y Combinator and received $20,000 in funding . Airbnb later received another $600,000 in funding in a seed round, despite receiving a lot of early resistance. By 2014, Airbnb had more than 550,000 properties listed worldwide and 10 million guests.

One of its keys to success is its focus on the user experience. By allowing people to rent out their homes, the company gives the average person a way to earn an additional stream of income.

In 1997, Netflix was started as a DVD rental service to help customers avoid getting hit with late fees. Customers selected the movies and TV shows they wanted online and could then have them delivered to their homes.

In 1999 , founder Reed Hastings introduced a subscription-based model. Once customers were locked into a monthly subscription, they were more likely to rent more movies. In 2000, Netflix released its Unlimited Movie Rental program, which allowed customers to rent an unlimited number of movies each month for a monthly subscription of $19.95.

In 2007, Netflix launched its online streaming service, and that was the first year the company surpassed $1 billion in revenue. The company later began entering into content licensing deals with television studios and, in 2011, started producing its own original programming.

Netflix has been a success because the company is flexible and able to adapt quickly to changes in the marketplace. And Netflix’s founders were able to see the long-term vision for what the company could become, unlike companies like Blockbuster.

Tips On Scaling Your Business

Scaling a business is the ultimate goal for most entrepreneurs, but how can you make it happen? First, it’s important to understand the difference between growth vs. scaling. Growing businesses focus on getting bigger and acquiring more customers and more team members. In comparison, scaling focuses on efficiency. Scalable companies can serve more customers without significantly more effort.

It’s near-impossible to scale a company by yourself, so you should ensure you have the right team in place. This isn’t just about bringing on more employees. It’s about finding those few, highly specialized employees who can help you move the company forward.

Research from McKinsey found that the highest performers are 800 times more productive than average employees in the same role. Focus on finding and keeping the right staff of people who believe in the company’s mission.

My company started with me. I worked as hard as I could and made some great progress in the beginning, but a business can only reach a certain level with only one person. It started with one hire, then two, then three. Before long, I was surrounded by amazingly talented people, and the business started to grow beyond what I was able to achieve on my own.

You also need to focus on understanding your customers and maintaining quality customer service. As companies start to scale, maintaining a high level of customer service becomes increasingly difficult. Ensure you’re meeting your customers’ needs by creating standard operating procedures, automating what you can and investing in 24/7 live chat.

Scaling your business requires investing in technology and systems, which aren’t cheap. Even if you don’t need the funds yet, start identifying potential banks or online lenders where you can access a loan or ongoing line of credit. Finding the right financing opportunities allows you to build the infrastructure necessary to scale.

Forbes Finance Council is an invitation-only organization for executives in successful accounting, financial planning and wealth management firms. Do I qualify?

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The Case Of Baby Joe Answers Case Solution & Analysis

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TRADER JOE’s CASE STUDY ANALYSIS Harvard Case Solution & Analysis

Home >> Harvard Case Study Analysis Solutions >> TRADER JOE’s CASE STUDY ANALYSIS

TRADER JOE’s CASE STUDY ANALYSIS Case Solution

Challenges face by supermarkets:.

The traditional supermarkets have to face many challenges due to which they have to operate with a very thin profit margin.

The first challenge they are facing is to provide the product at a price that will accept by the buyer. For this reason, they have to sell their products at discounts, and in addition to this; they also need to adopt several sales promotion activities. They have to achieve high economies of scale to prove them in front of buyers.

The entry barriers are too high, therefore they have to stay put in this competitive industry through continuous struggle. It is also hard to find a supplier who provides them the products at a reasonable margin because the numbers of supermarkets are rapidly growing and the suppliers of the products are not very much increasing in numbers. For this reason, most of the supermarkets try to purchase directly from the manufacturer.

The customers are becoming more sophisticated due to their changing needs and supermarkets have to face the challenge of keeping their research work up to date.

The numbers of players in the markets are increasing year by year and supermarkets are facing the challenge of “hard to find a differentiating strategy” that will make them unique from others.

Technology also plays a pivotal role in the development of supermarkets. As their profits are very thin, so, they need a solution to demonstrate quick payback through increased sales/profit or the cost of operations. The faster checkout systems improved security through the use of CCTV cameras and developing an innovative customer relationship management system will provide up-to-date information about their customer’s needs. The technological changes require huge investment, so, that their system remains up to date and free from the fear of getting obsolete.

This technological improvement will also help them to maintain or increase their return on investment. Currently, these technological changes are available in very future supermarkets.

Financial Analysis

The following table shows various financial ratios for different supermarkets.

  Whole Foods:

It has very low sales as compared to the other competitors; it can be assumed that this competitor has adopted a focus strategy with the cost focus also. The profit margin of this competitor as compared to the other big competitors is greater, which is 3%. The operational is high as compared to the other competitors which are 30% their return on equity is also low as compared to the others but is at a satisfactory level. However, their ROA shows great results as compared to the others. Their risk level is also low as their debtequity ratio is at an optimal level.

This firm is operating its strategy successfully creating value for shareholders and for the customers also and earning a positive return on their investment.

Kroger’s gross margin as compared to others is low, which is 21%. This is due to the increased manufacturing cost because they may be failing to find a good supplier or maybe they are not using lean management techniques. Their operating cost percentage as compared to the others is low, which indicates that Kroger maybe they are not emphasizing more on their research, advertisement & marketing which may increase their cost but also their revenue.

The debt equity ratio is too high because they are heavily relying on debts as a result; their return on assets is also low, which is 1%. This may find them self-difficult to pay the interest payments in the coming future. They are exposed to greater risk due to the abnormal debt equity ratio. The firm is not operating the way it should despite an increased number of sales, which may be a cost leadership strategy that it is failing to provide value to its shareholders.

Its gross margin as compared to its operating expense margin is quite similar which indicates that despite earning high there operational cost has sunk their profits and reduced their overall effectiveness. The risk is too high as also it also heavily relies on the debts, which results in an increased interest cost and lower down their return on assets. It is utilizing its assets appropriately as their turnover indicates a value of 2.89 however as compared to others like Kroger and Supervalu is low.

They are operating successfully, but the capital structure strategy has restricted their growth.

This competitor is not operating well by any means. They are highly risky as their debts are showing enormous levels. Their net profit margin due to the greater interest expense is negative. The required rate of return will also be much higher and this also indicates as their ROE is negative that it is not operating as per their adopted generic strategy.

Conclusion:

The analysis of Trader Joe’s competitive position has provided an understanding of the unique advantages Trader Joe’s presently has in a competitive industry.  It also highlights the threats that the company is facing. The successful strategy for the supermarket industry is to exactly do what others are not doing. Since the company's starting almost 50 years ago, Trader Joe’s has since then developed a huge following, as they continue to grow and open stores nationwide.

Question 1:

What is your assessment of the current competitive position of Trader Joe’s?

Trader Joe's is one of the most successful traders and grocers in the country. The current competitive position of Trader Joe’s is very strong in my opinion, even after the underlying threats to the company . The competitive advantages of Trader Joe’s are strong enough to maintain the company’s position strong in the growing supermarket industry. According to the case study, the company has a unique competitive advantage but there are numerous threats to this advantage.

The aforementioned company has targeted individuals from a higher or educated class. Educated people are usually capable of purchasing items and are not dependent on anyone. So targeting this class was a smart move from the company. This company is known to offer goods and materials that are not available in ay supermarket . Trader Joe’s has a less working investment in the store’s inventory, which proves to be very fruitful for the company. The company only appoints experienced and quality employees to be a part of their team. Quality and unique products at reasonable prices are the unique selling point of Trader Joe’s. The company is also very secretive of their suppliers and the product suppliers' name are kept private.As long as the company stays loyal to its individuality and kept selling items that are not easy to find and takes good care of the needs of its customers, it will continue to be successful and grow.Despite all these competitive advantages the company’s position still seems to be lacking behind.........................

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• Category: Xbox Games Showcase

Perfect Dark: Answering the Big Questions from its Incredible First Gameplay Trailer

Today, at Xbox Games Showcase, we got our first look at gameplay from Perfect Dark , a reboot of the classic secret agent series. The fascinating new trailer gave us hints to secret agent Joanna Dark’s mission, showed us her descent into the game’s near-future Cairo setting, and then gave us a tantalising glimpse of the all-new secret agent-inspired gameplay.

Of course, when you’re given a look at such a highly anticipated game, you’re always going to want to ask more questions – and thankfully I was able to go straight to the source to get more details from members of the development team. The Initiative is co-developing Perfect Dark with Crystal Dynamics and other partners that make up Team Perfect Dark. Let’s take a deeper look and answer some of those burning questions.

What Kind of Game Is This?

Perfect Dark is a first-person secret agent thriller in a near-future world. With the blessing of the original Perfect Dark studio, Rare (not to mention some of the leads from the original titles), Team Perfect Dark has pulled inspiration from elements of the first two games, but crafted an entirely new story and universe around them for this reboot.

For previous fans and new players alike, the new game offers a fresh take on the secret agent experience, and is a great opportunity to jump into the world and character. Though fans will have moments that resonate with the history and memories of the original games, no prior knowledge is needed in this new experience.

At the widest level, Perfect Dark will be a single-player experience, with a set of missions – but with choices offered in how you complete those missions. Looking at the trailer, it’s clear that traversal and gadgets are a huge part of this – we see new parkour abilities used throughout, both for movement and combat. The developers tell me that the focus was on creating an intuitive movement system, which will let players find interesting ways to tackle their objectives. Add to that a combat system that allows for both melee and gunplay, stealth mechanics, and liberal use of gadgets, and Perfect Dark is a game that will present players with an objective, but let them figure out how they want to achieve it.

Team Perfect Dark doesn’t want this to feel like any one genre – it takes in elements of first-person shooters, immersive sims, and stealth-action, but blends them into a seamless whole. The goal is to offer a true secret agent fantasy – and letting players use their various tools and abilities in the way they want is key to this.

Who is Joanna Dark?

In this reboot, Joanna (voiced by Alix Wilton Regan with Elissa Bibaud lending visual likeness) is an agent for dataDyne, with a deep personal connection to what’s happening to her world. In this case, the title Perfect Dark is more aspirational – this Joanna won’t be perfect, but she’s striving to be. She’ll make mistakes in this journey, and learn from those experiences. Learning who this Joanna is proves to be just as compelling as the story itself.

Where Is the Game Set?

Perfect Dark ’s near-future world has been impacted by what’s known as “The Cascade,” in which the planet has suffered from a series of environmental disasters, rendering entire regions inhospitable to human life. In the wake of the disaster, a hypercorporation known as Core Mantis steps in to create a solution known as The GEN Network, and deploys it in Cairo – restoring ecological balance and creating a freshly walled city, insulated from the hostile environment outside to become a center for technological innovation.

In its wake, other hypercorporations step in to continue that regeneration – but, as you might expect, not all is as it seems, and their motives may be less altruistic than they appear. It is key that the setting communicates a hopeful future, seeing a world with both destruction and restoration, the bleakness of the past countered with a sense of promise.

It’s into Cairo that Joanna enters. The setting was chosen to offer a counterpoint to other secret agent stories, and media at large – ancient Egypt and modern Egypt have been seen by many, but a near-future take on the country is truly something new. Cairo itself allows for a balance of deeply old and startlingly new that suits the speculative fiction at the heart of Perfect Dark .

What’s Joanna’s Mission in the Trailer?

Joanna is being sent into Cairo to find and apprehend Daniel Carrington, and we see her enter a district called Garden City (and an area of Cairo in real life, too). In Perfect Dark , this is a more affluent and cosmopolitan area of the city, and Core Mantis has selected it to be revitalized by its new eco-technological processes.

We see Joanna find a hideout used by Carrington, who infiltrates Joanna’s AR system and begins to expose more information, and even more questions around the bigger mysteries in Cairo. Joanna will need to learn who can be trusted, and who might be working against her own goals, and Carrington’s role will be a major part of that.

What Can We Use Gadgets For?

Gadgets are a pillar of the secret agent genre. In the trailer, we get a tease of Joanna using a gadget to analyse NPC voices and create vocal “deepfakes” to trick security systems or impersonate other characters, as well as create distractions.

Gadgets can be used for misdirection and manipulation, but we also see that Joanna can use a tool to scan an NPC and learn details about them – it wouldn’t be a secret agent story without some fieldwork, and the developers tell me that parsing the world, around you will be a key part of understanding how to tackle your objectives.

How Does Combat Work?

With this first look at combat, it’s clear this is another aspect of player choice. In the trailer we see lethal and non-lethal weaponry, close-quarters combat, abilities that allow you to take down multiple enemies at once, and more. We can also go loud or go quiet, offering a risk-reward for both methods. Team Perfect Dark wants to create a “symphony” of mechanics, merging traversal, close-quarters-combat, gunplay, unlockable abilities, environmental elements, and gadgets into a unified experience for players.

Find out more about Perfect Dark here .